--- a
+++ b/datasets/labelled_data/SYMPTOM/all.conll
@@ -0,0 +1,28491 @@
+
+
+The O
+patient O
+has O
+been O
+diagnosed O
+with O
+glaucoma O
+, O
+specifically O
+primary O
+open O
+angle O
+glaucoma O
+POAG O
+. O
+Their O
+intraocular O
+pressure O
+measures O
+at O
+48 O
+mmHg O
+, O
+indicating O
+elevated B-SYMPTOM
+pressure I-SYMPTOM
+within I-SYMPTOM
+the I-SYMPTOM
+eye I-SYMPTOM
+. O
+The O
+patient O
+exhibits O
+advanced O
+glaucomatous O
+field O
+damage O
+in O
+their O
+visual O
+field O
+, O
+and O
+their O
+visual O
+acuity O
+is O
+recorded O
+at O
+20 O
+150 O
+. O
+Notably O
+, O
+the O
+patient O
+has O
+undergone O
+prior O
+cataract O
+surgery O
+. O
+However O
+, O
+they O
+have O
+not O
+had O
+LASIK O
+surgery O
+. O
+In O
+addition O
+to O
+glaucoma O
+, O
+the O
+patient O
+also O
+presents O
+with O
+comorbid O
+ocular O
+diseases O
+, O
+including O
+diabetic O
+retinopathy O
+. O
+
+Patient O
+presents O
+with O
+uveitic O
+glaucoma O
+as O
+the O
+definitive O
+diagnosis O
+. O
+Intraocular O
+pressure O
+measures O
+at O
+28 O
+mmHg O
+. O
+Visual O
+field O
+assessment O
+indicates O
+early B-SYMPTOM
+field I-SYMPTOM
+damage I-SYMPTOM
+. O
+Visual O
+acuity O
+is O
+measured O
+at O
+20 O
+30 O
+. O
+No O
+prior O
+history O
+of O
+cataract O
+surgery O
+or O
+LASIK O
+surgery O
+. O
+Notably O
+, O
+patient O
+also O
+presents O
+with O
+comorbid O
+ocular O
+disease O
+, O
+specifically O
+macular O
+edema O
+. O
+
+The O
+individual O
+, O
+aged O
+39 O
+, O
+has O
+been O
+definitively O
+diagnosed O
+with O
+anxiety O
+. O
+They O
+are O
+proficient O
+in O
+English O
+and O
+have O
+reported O
+experiencing O
+significant O
+anxiety B-SYMPTOM
+symptoms I-SYMPTOM
+. O
+Their O
+SSASI O
+score O
+is O
+6 O
+, O
+HAM O
+A O
+score O
+is O
+20 O
+, O
+PHQ O
+9 O
+score O
+is O
+7 O
+, O
+and O
+HAM O
+D O
+score O
+is O
+23 O
+, O
+indicating O
+varying O
+levels O
+of O
+anxiety O
+and O
+depressive B-SYMPTOM
+symptoms I-SYMPTOM
+. O
+They O
+have O
+also O
+expressed O
+experiencing O
+suicidal O
+ideation O
+. O
+There O
+is O
+no O
+history O
+of O
+dementia O
+. O
+Additional O
+assessment O
+using O
+the O
+GAD O
+7 O
+and O
+Beck O
+Depression O
+Inventory O
+is O
+ongoing O
+to O
+further O
+understand O
+their O
+condition O
+. O
+
+
+
+
+
+
+
+
+
+
+
+
+
+
+
+
+The O
+patient O
+'s O
+definitive O
+diagnosis O
+is O
+confirmed O
+through O
+PCR O
+testing O
+. O
+They O
+have O
+shown O
+symptoms O
+such O
+as O
+fever B-SYMPTOM
+, O
+muscle B-SYMPTOM
+pain I-SYMPTOM
+, O
+and O
+shortness B-SYMPTOM
+of I-SYMPTOM
+breath I-SYMPTOM
+. O
+The O
+patient O
+was O
+hospitalized O
+for O
+5 O
+days O
+, O
+with O
+2 O
+of O
+those O
+days O
+requiring O
+ventilation O
+. O
+Their O
+vaccination O
+status O
+indicates O
+they O
+have O
+received O
+1 O
+shot O
+of O
+an O
+mRNA O
+vaccine O
+. O
+The O
+patient O
+'s O
+oxygen O
+saturation O
+level O
+is O
+at O
+95 O
+. O
+They O
+have O
+a O
+history O
+of O
+asthma O
+, O
+a O
+comorbid O
+respiratory O
+disease O
+. O
+
+The O
+patient O
+has O
+been O
+diagnosed O
+with O
+COVID O
+19 O
+. O
+The O
+definitive O
+diagnosis O
+was O
+confirmed O
+through O
+PCR O
+testing O
+. O
+The O
+patient O
+exhibited O
+symptoms O
+including O
+fever B-SYMPTOM
+, O
+headache B-SYMPTOM
+, O
+and O
+body B-SYMPTOM
+pains I-SYMPTOM
+. O
+Due O
+to O
+the O
+severity O
+of O
+the O
+condition O
+, O
+the O
+patient O
+required O
+hospitalization O
+and O
+ventilation O
+support O
+. O
+At O
+the O
+time O
+of O
+assessment O
+, O
+the O
+patient O
+'s O
+oxygen O
+saturation O
+level O
+was O
+96 O
+. O
+The O
+patient O
+had O
+not O
+received O
+any O
+vaccination O
+against O
+COVID O
+19 O
+prior O
+to O
+this O
+illness O
+. O
+Additionally O
+, O
+the O
+patient O
+had O
+a O
+history O
+of O
+bronchiectasis O
+, O
+a O
+comorbid O
+respiratory O
+disease O
+. O
+
+The O
+patient O
+has O
+received O
+a O
+definitive O
+diagnosis O
+of O
+COVID O
+19 O
+through O
+a O
+PCR O
+test O
+. O
+Their O
+reported O
+symptoms O
+include O
+fever B-SYMPTOM
+and O
+muscle B-SYMPTOM
+pain I-SYMPTOM
+. O
+They O
+have O
+not O
+required O
+hospitalization O
+or O
+ventilation O
+for O
+their O
+condition O
+. O
+The O
+patient O
+'s O
+vaccination O
+status O
+indicates O
+that O
+they O
+have O
+received O
+a O
+2 O
+shot O
+COVID O
+19 O
+vaccine O
+series O
+along O
+with O
+a O
+booster O
+dose O
+. O
+Their O
+oxygen O
+saturation O
+level O
+is O
+at O
+97 O
+. O
+There O
+are O
+no O
+comorbid O
+respiratory O
+diseases O
+reported O
+in O
+their O
+medical O
+history O
+. O
+
+The O
+patient O
+'s O
+definitive O
+diagnosis O
+of O
+COVID O
+19 O
+is O
+based O
+solely O
+on O
+a O
+positive O
+result O
+from O
+a O
+rapid O
+test O
+. O
+Their O
+reported O
+symptoms O
+include O
+headache B-SYMPTOM
+and O
+fatigue B-SYMPTOM
+. O
+They O
+have O
+not O
+required O
+hospitalization O
+or O
+ventilation O
+support O
+. O
+The O
+patient O
+is O
+unvaccinated O
+against O
+COVID O
+19 O
+. O
+Their O
+oxygen O
+saturation O
+level O
+is O
+at O
+98 O
+. O
+They O
+have O
+a O
+history O
+of O
+asthma O
+as O
+a O
+comorbid O
+respiratory O
+disease O
+. O
+
+The O
+individual O
+under O
+consideration O
+has O
+not O
+received O
+a O
+definitive O
+diagnosis O
+for O
+COVID O
+19 O
+. O
+They O
+have O
+experienced O
+symptoms O
+such O
+as O
+headache B-SYMPTOM
+but O
+have O
+not O
+required O
+hospitalization O
+or O
+ventilation O
+. O
+Their O
+vaccination O
+status O
+indicates O
+that O
+they O
+are O
+unvaccinated O
+. O
+Information O
+regarding O
+their O
+oxygen O
+saturation O
+is O
+not O
+provided O
+. O
+Additionally O
+, O
+there O
+are O
+no O
+reported O
+comorbid O
+respiratory O
+diseases O
+in O
+this O
+case O
+. O
+
+
+The O
+patient O
+'s O
+definitive O
+diagnosis O
+is O
+rheumatoid O
+arthritis O
+. O
+Currently O
+, O
+there O
+is O
+no O
+active O
+DMARD O
+treatment O
+, O
+but O
+there O
+was O
+prior O
+treatment O
+with O
+hydroxychloroquine O
+. O
+Prednisone O
+is O
+being O
+used O
+along O
+with O
+other O
+RA O
+medications O
+. O
+The O
+patient O
+has O
+3 O
+swollen O
+and O
+2 O
+tender B-SYMPTOM
+joints I-SYMPTOM
+. O
+There O
+is O
+no O
+history O
+of O
+tuberculosis O
+. O
+The O
+DAS O
+28 O
+CRP O
+score O
+is O
+4 O
+. O
+Comorbidities O
+are O
+absent O
+. O
+
+The O
+patient O
+has O
+a O
+definitive O
+diagnosis O
+of O
+rheumatoid O
+arthritis O
+. O
+They O
+are O
+currently O
+undergoing O
+active O
+anti O
+TNF O
+therapy O
+as O
+their O
+DMARD O
+treatment O
+. O
+Prior O
+to O
+this O
+, O
+they O
+were O
+treated O
+with O
+methotrexate O
+. O
+Naproxen O
+is O
+being O
+used O
+as O
+another O
+medication O
+for O
+their O
+rheumatoid O
+arthritis O
+. O
+The O
+patient O
+has O
+5 O
+swollen B-SYMPTOM
+joints I-SYMPTOM
+and O
+2 O
+tender B-SYMPTOM
+joints I-SYMPTOM
+. O
+They O
+have O
+a O
+history O
+of O
+past O
+tuberculosis O
+. O
+There O
+are O
+no O
+comorbidities O
+reported O
+for O
+the O
+patient O
+. O
+
+The O
+patient O
+has O
+a O
+definitive O
+diagnosis O
+of O
+rheumatoid O
+arthritis O
+and O
+is O
+currently O
+undergoing O
+active O
+treatment O
+with O
+hydroxychloroquine O
+, O
+without O
+prior O
+DMARD O
+treatment O
+. O
+Additionally O
+, O
+the O
+patient O
+is O
+taking O
+ibuprofen O
+for O
+their O
+condition O
+. O
+They O
+are O
+experiencing O
+symptoms O
+in O
+6 O
+tender B-SYMPTOM
+joints I-SYMPTOM
+and O
+have O
+a O
+DAS O
+28 O
+CRP O
+score O
+of O
+5 O
+. O
+5 O
+. O
+The O
+patient O
+has O
+comorbid O
+diabetes O
+but O
+no O
+history O
+of O
+tuberculosis O
+. O
+
+
+
+
+
+
+
+
+
+
+
+
+An O
+elderly O
+female O
+with O
+past O
+medical O
+history O
+of O
+hypertension O
+, O
+severe O
+aortic O
+stenosis O
+, O
+hyperlipidemia O
+, O
+and O
+right O
+hip O
+arthroplasty O
+. O
+Presents O
+after O
+feeling O
+a O
+snap O
+of O
+her O
+right O
+leg O
+and O
+falling O
+to O
+the O
+ground O
+. O
+No O
+head B-SYMPTOM
+trauma I-SYMPTOM
+or O
+loss B-SYMPTOM
+of I-SYMPTOM
+consciousness I-SYMPTOM
+. O
+
+78 O
+M O
+transferred O
+to O
+nursing O
+home O
+for O
+rehab O
+after O
+CABG O
+. O
+Reportedly O
+readmitted O
+with O
+a O
+small O
+NQWMI O
+. O
+Yesterday O
+, O
+he O
+was O
+noted O
+to O
+have O
+a O
+melanotic B-SYMPTOM
+stool I-SYMPTOM
+and O
+then O
+today O
+he O
+had O
+approximately O
+9 O
+loose O
+BM O
+w O
+some O
+melena O
+and O
+some O
+frank O
+blood O
+just O
+prior O
+to O
+transfer O
+, O
+unclear O
+quantity O
+. O
+
+A O
+75F O
+with O
+a O
+PMHx O
+significant O
+for O
+severe O
+PVD O
+, O
+CAD O
+, O
+DM O
+, O
+and O
+CKD O
+presented O
+after O
+being O
+found O
+down O
+unresponsive O
+at O
+home O
+. O
+She O
+was O
+found O
+to O
+be O
+hypoglycemic O
+to O
+29 O
+with O
+hypotension O
+and O
+bradycardia O
+. O
+Her O
+hypotension O
+and O
+confusion B-SYMPTOM
+improved O
+with O
+hydration O
+. O
+She O
+had O
+a O
+positive O
+UA O
+which O
+eventually O
+grew O
+klebsiella O
+. O
+She O
+had O
+temp O
+96 O
+. O
+3 O
+, O
+respiratory O
+rate O
+22 O
+, O
+BP O
+102 O
+26 O
+, O
+a O
+leukocytosis O
+to O
+18 O
+and O
+a O
+creatinine O
+of O
+6 O
+baseline O
+2 O
+. O
+Pt O
+has O
+blood O
+cultures O
+positive O
+for O
+group O
+A O
+streptococcus O
+. O
+On O
+the O
+day O
+of O
+transfer O
+her O
+blood O
+pressure O
+dropped O
+to O
+the O
+60s O
+. O
+She O
+was O
+anuric B-SYMPTOM
+throughout O
+the O
+day O
+. O
+She O
+received O
+80mg O
+IV O
+solumedrol O
+this O
+morning O
+in O
+the O
+setting O
+of O
+low O
+BPs O
+and O
+rare O
+eos O
+in O
+urine O
+. O
+On O
+arrival O
+to O
+the O
+MICU O
+pt O
+was O
+awake O
+but O
+drowsy B-SYMPTOM
+. O
+On O
+ROS O
+, O
+pt O
+denies O
+pain B-SYMPTOM
+, O
+lightheadedness B-SYMPTOM
+, O
+headache B-SYMPTOM
+, O
+neck B-SYMPTOM
+pain I-SYMPTOM
+, O
+sore B-SYMPTOM
+throat I-SYMPTOM
+, O
+recent O
+illness O
+or O
+sick O
+contacts O
+, O
+cough B-SYMPTOM
+, O
+shortness B-SYMPTOM
+of I-SYMPTOM
+breath I-SYMPTOM
+, O
+chest B-SYMPTOM
+discomfort I-SYMPTOM
+, O
+heartburn B-SYMPTOM
+, O
+abd I-SYMPTOM
+pain I-SYMPTOM
+, O
+n O
+v O
+, O
+diarrhea O
+, O
+constipation B-SYMPTOM
+, O
+dysuria B-SYMPTOM
+. O
+Is O
+a O
+poor O
+historian O
+regarding O
+how O
+long O
+she O
+has O
+had O
+a O
+rash O
+on O
+her O
+legs O
+. O
+
+An O
+87 O
+yo O
+woman O
+with O
+h O
+o O
+osteoporosis O
+, O
+multiple O
+recent O
+falls O
+, O
+CAD O
+, O
+who O
+presents O
+from O
+nursing O
+home O
+with O
+C2 B-SYMPTOM
+fracture I-SYMPTOM
+. O
+The O
+patient O
+was O
+in O
+her O
+usual O
+state O
+of O
+health O
+at O
+her O
+nursing O
+home O
+until O
+yesterday O
+morning O
+when O
+she O
+sustained O
+a O
+fall O
+when O
+trying O
+to O
+get O
+up O
+to O
+go O
+to O
+the O
+bathroom O
+. O
+The O
+fall O
+was O
+not O
+witnessed O
+, O
+but O
+the O
+patient O
+reportedly O
+did O
+not O
+lose O
+consciousness O
+. O
+The O
+patient O
+complained O
+of O
+neck O
+and O
+rib O
+pain B-SYMPTOM
+. O
+She O
+was O
+taken O
+to O
+OSH O
+, O
+where O
+she O
+was O
+found O
+to O
+have O
+a O
+comminuted O
+fracture B-SYMPTOM
+of I-SYMPTOM
+C2 I-SYMPTOM
+. O
+In O
+the O
+ED O
+, O
+the O
+patient O
+'s O
+VS O
+were O
+T O
+99 O
+. O
+1 O
+, O
+BP O
+106 O
+42 O
+, O
+P O
+101 O
+, O
+R O
+24 O
+. O
+She O
+had O
+an O
+ECG O
+which O
+showed O
+sinus O
+tachycardia O
+and O
+ST O
+depressions O
+in O
+V3 O
+and O
+V4 O
+. O
+CT O
+head O
+was O
+negative O
+for O
+ICH O
+. O
+
+An O
+82 O
+man O
+with O
+chronic O
+obstructive O
+pulmonary O
+disease O
+, O
+status O
+post O
+bioprosthetic O
+atrial O
+valve O
+replacement O
+for O
+atrial O
+stenosis O
+, O
+atrial O
+fibrillation O
+with O
+cardioversion O
+, O
+right O
+nephrectomy O
+for O
+renal O
+cell O
+carcinoma O
+, O
+colon O
+cancer O
+status O
+post O
+colectomy O
+, O
+presents O
+with O
+9 O
+day O
+history O
+of O
+productive O
+cough B-SYMPTOM
+, O
+fever B-SYMPTOM
+and O
+dyspnea B-SYMPTOM
+. O
+
+A O
+94 O
+year O
+old O
+female O
+with O
+hx O
+recent O
+PE O
+DVT O
+, O
+atrial O
+fibrillation O
+, O
+CAD O
+presents O
+with O
+fever B-SYMPTOM
+and O
+abdominal B-SYMPTOM
+pain I-SYMPTOM
+. O
+Earlier O
+, O
+she O
+presented O
+with O
+back B-SYMPTOM
+pain I-SYMPTOM
+and O
+shortness B-SYMPTOM
+of I-SYMPTOM
+breath I-SYMPTOM
+. O
+She O
+was O
+found O
+to O
+have O
+bilateral O
+PE O
+'s O
+and O
+new O
+afib O
+and O
+started O
+on O
+coumadin O
+. O
+Her O
+HCT O
+dropped O
+slightly O
+, O
+requiring O
+blood O
+transfusion O
+, O
+with O
+guaic B-SYMPTOM
+positive I-SYMPTOM
+stools I-SYMPTOM
+. O
+She O
+was O
+discharged O
+and O
+returned O
+with O
+abdominal B-SYMPTOM
+cramping I-SYMPTOM
+and O
+black B-SYMPTOM
+stools I-SYMPTOM
+. O
+EGD O
+showed O
+a O
+small O
+gastric B-SYMPTOM
+and I-SYMPTOM
+duodenal I-SYMPTOM
+ulcer I-SYMPTOM
+healing O
+, O
+esophageal B-SYMPTOM
+stricture I-SYMPTOM
+, O
+no O
+active O
+bleeding B-SYMPTOM
+. O
+She O
+also O
+had O
+an O
+abdominal O
+CT O
+demonstrating O
+a O
+distended O
+gallbladder O
+with O
+gallstones O
+and O
+biliary O
+obstruction O
+with O
+several O
+CBD O
+stones O
+. O
+
+This O
+is O
+a O
+41 O
+year O
+old O
+male O
+patient O
+with O
+medical O
+history O
+of O
+alcohol O
+abuse O
+, O
+cholelithiasis O
+, O
+hypertension O
+, O
+obesity O
+who O
+presented O
+to O
+his O
+local O
+hospital O
+with O
+hematemasis O
+. O
+On O
+Friday O
+evening O
+he O
+had O
+several O
+episodes O
+of O
+vomiting B-SYMPTOM
+of O
+bright O
+and O
+dark O
+red O
+material O
+. O
+In O
+the O
+emergency O
+department O
+, O
+initial O
+vs O
+were O
+T O
+98 O
+. O
+6 O
+P66 O
+BP145 O
+89 O
+R16 O
+O2 O
+sat O
+98 O
+RA O
+. O
+He O
+was O
+started O
+on O
+a O
+protonix O
+gtt O
+and O
+octreotide O
+gtt O
+given O
+his O
+elevated B-SYMPTOM
+liver I-SYMPTOM
+function I-SYMPTOM
+tests O
+. O
+Lab O
+tests O
+show O
+elevated B-SYMPTOM
+lipase I-SYMPTOM
+, O
+pancytopenia O
+and O
+coagulopathy O
+. O
+He O
+had O
+a O
+right O
+upper O
+abdominal O
+quadrant O
+ultrasound O
+which O
+demonstrated O
+gallstones B-SYMPTOM
+and O
+sludge B-SYMPTOM
+and O
+ascites B-SYMPTOM
+. O
+As O
+such O
+given O
+new O
+ascites B-SYMPTOM
+and O
+abdominal B-SYMPTOM
+pain I-SYMPTOM
+he O
+was O
+given O
+levofloxacin O
+750mg O
+IV O
+and O
+flagyl O
+500mg O
+IV O
+reportedly O
+for O
+spontaneous O
+bacterial O
+peritonitis O
+prophylaxis O
+. O
+On O
+the O
+floor O
+, O
+he O
+reports O
+that O
+he O
+had O
+two O
+episodes O
+of O
+vomiting B-SYMPTOM
+of O
+dark O
+red O
+emesis O
+. O
+Per O
+his O
+nurse O
+it O
+was O
+about O
+75ml O
+and O
+was O
+gastrocult B-SYMPTOM
+positive I-SYMPTOM
+. O
+He O
+has O
+right O
+upper O
+abdominal O
+quadrant O
+pain B-SYMPTOM
+radiating O
+to O
+his O
+back O
+. O
+He O
+also O
+reports O
+slow O
+increase O
+in O
+abdominal O
+girth O
+with O
+more O
+acute O
+distention O
+and O
+lower O
+extremity O
+swelling B-SYMPTOM
+over O
+the O
+two O
+days O
+prior O
+to O
+admission O
+. O
+The O
+patient O
+denies O
+fever B-SYMPTOM
+, O
+chills B-SYMPTOM
+, O
+night B-SYMPTOM
+sweats I-SYMPTOM
+, O
+headache B-SYMPTOM
+, O
+sinus B-SYMPTOM
+tenderness I-SYMPTOM
+, O
+rhinorrhea B-SYMPTOM
+or O
+congestion B-SYMPTOM
+. O
+Denied O
+cough B-SYMPTOM
+, O
+shortness B-SYMPTOM
+of I-SYMPTOM
+breath I-SYMPTOM
+. O
+He O
+also O
+denied O
+chest B-SYMPTOM
+pain I-SYMPTOM
+or O
+tightness B-SYMPTOM
+. O
+
+A O
+G2P0010 O
+26 O
+yo O
+F O
+, O
+now O
+estimated O
+to O
+10 O
+weeks O
+pregnant O
+, O
+with O
+4yr O
+hx O
+of O
+IDDM O
+. O
+Last O
+menstrual O
+period O
+is O
+not O
+known O
+but O
+was O
+sometime O
+three O
+months O
+ago O
+. O
+Five O
+days O
+ago O
+, O
+the O
+patient O
+began O
+feeling O
+achy B-SYMPTOM
+and O
+congested B-SYMPTOM
+. O
+She O
+had O
+received O
+a O
+flu O
+shot O
+about O
+1 O
+week O
+prior O
+. O
+She O
+continued O
+to O
+feel O
+poorly O
+and O
+developed O
+hyperemesis O
+. O
+She O
+was O
+seen O
+in O
+the O
+ED O
+but O
+not O
+admitted O
+, O
+where O
+she O
+was O
+given O
+IVF O
+, O
+Reglan O
+and O
+Tylenol O
+and O
+she O
+was O
+found O
+to O
+have O
+a O
+positive O
+pregnancy O
+test O
+. O
+Today O
+, O
+she O
+returned O
+to O
+the O
+ED O
+with O
+worsening O
+of O
+symptoms O
+. O
+She O
+was O
+admitted O
+to O
+the O
+OB O
+service O
+and O
+given O
+IVF O
+and O
+Reglan O
+. O
+Of O
+note O
+, O
+her O
+labwork O
+demonstrates O
+a O
+blood O
+glucose O
+of O
+160 O
+, O
+bicarbonate O
+of O
+11 O
+, O
+beta O
+hCG O
+of O
+3373 O
+and O
+ketones B-SYMPTOM
+in I-SYMPTOM
+her I-SYMPTOM
+urine I-SYMPTOM
+. O
+Her O
+family O
+noted O
+that O
+she O
+was O
+breathing O
+rapidly O
+and O
+was O
+quite O
+somnolent B-SYMPTOM
+. O
+She O
+appears O
+to O
+be O
+in O
+respiratory B-SYMPTOM
+distress I-SYMPTOM
+. O
+
+This O
+is O
+a O
+24 O
+and O
+2 O
+7 O
+weeks O
+, O
+678 O
+gm O
+male O
+, O
+born O
+to O
+a O
+34 O
+year O
+old O
+G2 O
+, O
+P0 O
+to O
+3 O
+woman O
+. O
+Prenatal O
+screens O
+were O
+O O
+positive O
+, O
+antibody O
+negative O
+, O
+hepatitis O
+B O
+surface O
+antigen O
+negative O
+, O
+RPR O
+nonreactive O
+, O
+rubella O
+immune O
+, O
+and O
+GBS O
+unknown O
+. O
+This O
+was O
+an O
+IVF O
+pregnancy O
+, O
+notable O
+for O
+bleeding B-SYMPTOM
+in O
+the O
+first O
+trimester O
+. O
+The O
+mother O
+presented O
+to O
+the O
+Hospital O
+on O
+the O
+morning O
+of O
+delivery O
+with O
+premature O
+rupture B-SYMPTOM
+of I-SYMPTOM
+membranes I-SYMPTOM
+. O
+Betamethasone O
+was O
+given O
+approximately O
+18 O
+hours O
+prior O
+to O
+delivery O
+. O
+The O
+mother O
+was O
+also O
+started O
+on O
+ampicillin O
+, O
+gentamycin O
+, O
+and O
+magnesium O
+sulfate O
+. O
+Mother O
+'s O
+labor O
+progressed O
+despite O
+magnesium O
+and O
+she O
+developed O
+fever B-SYMPTOM
+and O
+chills B-SYMPTOM
+. O
+Maximum O
+temperature O
+was O
+101 O
+. O
+2 O
+degrees O
+. O
+Because O
+of O
+progressive O
+labor O
+and O
+concerns O
+for O
+chorioamnionitis O
+, O
+the O
+decision O
+was O
+made O
+to O
+deliver O
+the O
+infants O
+. O
+Delivery O
+was O
+by O
+cesarean O
+section O
+. O
+The O
+infant O
+was O
+intubated O
+in O
+the O
+Delivery O
+Room O
+and O
+Apgars O
+were O
+5 O
+at O
+one O
+and O
+8 O
+at O
+five O
+minutes O
+. O
+Examination O
+was O
+notable O
+for O
+an O
+extreme O
+pre O
+term O
+infant O
+, O
+intubated O
+. O
+Weight O
+was O
+678 O
+gm O
+. O
+Chest O
+x O
+ray O
+shows O
+respiratory O
+immaturity O
+and O
+diffuse O
+bilateral O
+opacities O
+within O
+the O
+lungs O
+, O
+left O
+greater O
+than O
+right O
+, O
+with O
+increased O
+lung O
+volumes O
+. O
+
+A O
+55y O
+o O
+F O
+with O
+sarcoidosis O
+, O
+COPD O
+, O
+idiopathic O
+cardiomyopathy O
+with O
+EF O
+40 O
+and O
+diastolic O
+dysfunction O
+, O
+varices O
+s O
+p O
+TIPS O
+and O
+hypothyroidism O
+presenting O
+today O
+with O
+confusion B-SYMPTOM
+. O
+She O
+was O
+brought O
+to O
+the O
+ED O
+by O
+her O
+husband O
+for O
+evaluation O
+after O
+he O
+noted O
+worsening O
+asterixis O
+. O
+While O
+in O
+the O
+waiting O
+room O
+the O
+pt O
+became O
+more O
+combative B-SYMPTOM
+and O
+then O
+unresponsive B-SYMPTOM
+. O
+In O
+the O
+ED O
+VS O
+Temp O
+97 O
+. O
+9F O
+, O
+HR O
+115 O
+, O
+BP O
+122 O
+80 O
+, O
+R O
+18 O
+, O
+O2 O
+sat O
+98 O
+2L O
+NC O
+. O
+She O
+was O
+unresponsive B-SYMPTOM
+but O
+able O
+to O
+protect O
+her O
+airway O
+and O
+so O
+not O
+intubated O
+. O
+She O
+vomited B-SYMPTOM
+x1 O
+and O
+received O
+Zofran O
+as O
+well O
+as O
+1 O
+. O
+5 O
+L O
+NS O
+. O
+Labs O
+were O
+significant O
+for O
+K O
+5 O
+. O
+5 O
+, O
+BUN O
+46 O
+, O
+Cr O
+2 O
+. O
+2 O
+up O
+from O
+baseline O
+of O
+0 O
+. O
+8 O
+, O
+and O
+ammonia O
+of O
+280 O
+. O
+Stool O
+was O
+Guaiac O
+negative O
+. O
+A O
+urinalysis O
+and O
+CXR O
+were O
+done O
+and O
+are O
+pending O
+, O
+and O
+a O
+FAST O
+revealed O
+hepatosplenomegaly O
+but O
+no O
+intraperitoneal B-SYMPTOM
+fluid I-SYMPTOM
+. O
+
+A O
+80yo O
+male O
+with O
+dementia O
+and O
+past O
+history O
+of O
+CABG O
+, O
+two O
+caths O
+this O
+year O
+patent O
+LIMA O
+, O
+totally O
+occluded O
+SVG O
+to O
+RPDA O
+, O
+SVG O
+to O
+OM2 O
+, O
+s O
+p O
+BMS O
+to O
+LCX O
+, O
+presents O
+with O
+increasing O
+chest B-SYMPTOM
+pain I-SYMPTOM
+and O
+nausea B-SYMPTOM
+over O
+the O
+past O
+few O
+days O
+. O
+The O
+patient O
+has O
+history O
+of O
+repeated O
+episodes O
+of O
+recurrent O
+chest B-SYMPTOM
+pain I-SYMPTOM
+with O
+relief O
+with O
+morphine O
+. O
+Pt O
+is O
+on O
+ASA O
+, O
+Statins O
+, O
+Imdur O
+, O
+and O
+Heparin O
+. O
+Last O
+month O
+s O
+cath O
+showed O
+patent O
+BMS O
+in O
+LCX O
+and O
+no O
+new O
+lesions B-SYMPTOM
+. O
+According O
+to O
+the O
+family O
+, O
+the O
+patient O
+has O
+increasing O
+episodes O
+of O
+chest B-SYMPTOM
+pain I-SYMPTOM
+with O
+minimal O
+exertion O
+in O
+the O
+last O
+two O
+weeks O
+. O
+
+66 O
+yo O
+female O
+pedestrian O
+struck O
+by O
+auto O
+. O
+Unconscious B-SYMPTOM
+and O
+unresponsive B-SYMPTOM
+at O
+scene O
+. O
+Multiple O
+fractures O
+and O
+complication O
+secondary O
+to O
+the O
+primary O
+injury O
+. O
+S B-SYMPTOM
+p I-SYMPTOM
+embolization I-SYMPTOM
+of I-SYMPTOM
+the I-SYMPTOM
+avulsed I-SYMPTOM
+second I-SYMPTOM
+branch I-SYMPTOM
+of I-SYMPTOM
+brachial I-SYMPTOM
+artery I-SYMPTOM
+, O
+complicated O
+by O
+exp B-SYMPTOM
+lap I-SYMPTOM
+secondary O
+to O
+suspicion O
+of O
+abdominal O
+compartment O
+syndrome O
+. O
+Not O
+much O
+of O
+the O
+response O
+after O
+weaning O
+the O
+sedation O
+with O
+CT O
+of O
+the O
+head O
+showing O
+extensive O
+interparenchymal O
+hemorrhages O
+throughout O
+. O
+
+A O
+43 O
+year O
+old O
+woman O
+with O
+history O
+of O
+transverse O
+myelitis O
+leading O
+to O
+paraplegia O
+, O
+depression O
+, O
+frequent O
+pressure O
+ulcers O
+, O
+presenting O
+with O
+chills B-SYMPTOM
+and O
+reporting O
+she O
+felt O
+" O
+as O
+if O
+dying O
+" O
+. O
+Upon O
+presentation O
+, O
+she O
+denied O
+any O
+shortness B-SYMPTOM
+of I-SYMPTOM
+breath I-SYMPTOM
+, O
+nausea B-SYMPTOM
+, O
+vomiting B-SYMPTOM
+, O
+but O
+did O
+report O
+diarrhea B-SYMPTOM
+with O
+two O
+loose O
+bowel O
+movements O
+per O
+day O
+. O
+Patient O
+reported O
+that O
+she O
+had O
+a O
+fallout O
+with O
+her O
+VNA O
+and O
+has O
+not O
+had O
+any O
+professional O
+wound O
+care O
+. O
+Patient O
+is O
+agitated B-SYMPTOM
+, O
+with O
+rigors O
+, O
+complaining O
+of O
+feeling O
+cold B-SYMPTOM
+and O
+back B-SYMPTOM
+pain I-SYMPTOM
+. O
+Patient O
+rolled O
+and O
+found O
+to O
+have O
+a O
+stage O
+IV O
+decubitus O
+ulcer O
+on O
+coccyx O
+and O
+buttocks O
+, O
+heels O
+. O
+Admission O
+labs O
+significant O
+for O
+thrombocytosis O
+, O
+elevated B-SYMPTOM
+lactate I-SYMPTOM
+, O
+and O
+prolonged B-SYMPTOM
+PT I-SYMPTOM
+. O
+
+A O
+52 O
+year O
+old O
+woman O
+with O
+chronic O
+obstructive O
+pulmonary O
+disease O
+and O
+breast O
+cancer O
+who O
+presented O
+to O
+an O
+outside O
+hospital O
+with O
+shortness B-SYMPTOM
+of I-SYMPTOM
+breath I-SYMPTOM
+and O
+back B-SYMPTOM
+pain I-SYMPTOM
+for O
+several O
+weeks O
+. O
+Had O
+been O
+seen O
+by O
+primary O
+care O
+provider O
+for O
+the O
+back B-SYMPTOM
+pain I-SYMPTOM
+and O
+treated O
+with O
+pain O
+medications O
+. O
+Subsequently O
+developed O
+rash B-SYMPTOM
+that O
+was O
+thought O
+to O
+be O
+zoster O
+. O
+In O
+the O
+last O
+few O
+days O
+, O
+oxygen O
+requirement O
+increased O
+and O
+she O
+had O
+cough B-SYMPTOM
+, O
+fevers B-SYMPTOM
+and O
+sore B-SYMPTOM
+throat I-SYMPTOM
+. O
+Noted O
+oxygen O
+saturation O
+of O
+79 O
+with O
+ambulation O
+at O
+home O
+. O
+At O
+outside O
+hospital O
+she O
+was O
+diagnosed O
+with O
+" O
+multi O
+focal O
+pneumonia O
+. O
+" O
+In O
+the O
+process O
+of O
+obtaining O
+a O
+computerized O
+tomography O
+scan O
+, O
+contrast O
+infiltrated O
+her O
+arm O
+with O
+skin O
+blistering B-SYMPTOM
+and O
+swelling B-SYMPTOM
+. O
+She O
+was O
+treated O
+with O
+ceftriaxone O
+and O
+transferred O
+to O
+current O
+hospital O
+. O
+
+A O
+67 O
+y O
+. O
+o O
+. O
+M O
+with O
+end O
+stage O
+COPD O
+on O
+home O
+oxygen O
+, O
+tracheobronchomalacia O
+s O
+p O
+Y O
+stent O
+, O
+h O
+o O
+RUL O
+resection O
+for O
+squamous O
+cell O
+carcinoma O
+with O
+Cyberknife O
+treatment O
+. O
+Patient O
+had O
+Y O
+stent O
+placed O
+complicated O
+by O
+cough B-SYMPTOM
+and O
+copious O
+secretions O
+requiring O
+multiple O
+therapeutic O
+aspirations O
+. O
+Last O
+bronchoscopy O
+was O
+at O
+OSH O
+, O
+where O
+patient O
+had O
+copious O
+secretions O
+that O
+were O
+aspirated O
+. O
+Pt O
+reports O
+compliance O
+with O
+Mucomyst O
+nebs O
+and O
+Mucinex O
+. O
+Patient O
+reports O
+decreaed B-SYMPTOM
+appetitie I-SYMPTOM
+, O
+50 O
+lb O
+wt O
+loss O
+in O
+6 O
+months O
+. O
+Decreased B-SYMPTOM
+activity I-SYMPTOM
+tolerance I-SYMPTOM
+. O
+Smokes O
+5 O
+cig O
+day O
+. O
+PET O
+scan O
+revealed O
+FDG O
+avid O
+soft O
+tissue O
+mass O
+adjacent O
+to O
+lung O
+resection O
+site O
+with O
+some O
+FDG O
+avid O
+nodes O
+concerning O
+for O
+recurrence O
+. O
+On O
+arrival O
+, O
+vitals O
+were O
+T98 O
+. O
+6 O
+HR86 O
+BP106 O
+78 O
+O289 O
+. O
+Pt O
+denied O
+chest B-SYMPTOM
+pain I-SYMPTOM
+, O
+palpitations B-SYMPTOM
+, O
+trauma B-SYMPTOM
+, O
+F B-SYMPTOM
+C I-SYMPTOM
+, O
+N B-SYMPTOM
+V I-SYMPTOM
+D I-SYMPTOM
+. O
+Pt O
+. O
+presents O
+with O
+worsening O
+SOB B-SYMPTOM
+with O
+R O
+shoulder O
+pain B-SYMPTOM
+and O
+weakness B-SYMPTOM
+. O
+
+A O
+90 O
+year O
+old O
+woman O
+who O
+was O
+recently O
+hospitalized O
+for O
+legionella O
+PNA O
+, O
+and O
+has O
+been O
+continuing O
+her O
+recovery O
+at O
+home O
+with O
+her O
+son O
+. O
+She O
+had O
+been O
+doing O
+fairly O
+well O
+for O
+the O
+last O
+few O
+days O
+except O
+for O
+some O
+waxing O
+and O
+waning O
+confusion B-SYMPTOM
+, O
+and O
+perhaps O
+intermittent O
+dysarthria B-SYMPTOM
+. O
+The O
+son O
+was O
+getting O
+ready O
+for O
+work O
+at O
+1 O
+15am O
+today O
+, O
+as O
+per O
+his O
+usual O
+routine O
+. O
+He O
+looked O
+in O
+on O
+the O
+patient O
+at O
+that O
+time O
+; O
+she O
+appeared O
+to O
+be O
+sleeping O
+comfortably O
+in O
+bed O
+, O
+on O
+her O
+back O
+. O
+Soon O
+thereafter O
+, O
+he O
+heard O
+her O
+walking O
+to O
+the O
+bathroom O
+. O
+At O
+1 O
+40am O
+, O
+he O
+heard O
+a O
+loud O
+crash O
+coming O
+from O
+the O
+bathroom O
+. O
+He O
+found O
+the O
+patient O
+on O
+the O
+floor O
+of O
+the O
+bathroom O
+, O
+making O
+non O
+verbal O
+utterances O
+and O
+with O
+minimal O
+movement O
+of O
+the O
+right O
+side O
+. O
+
+This O
+is O
+a O
+76 O
+year O
+old O
+female O
+with O
+personal O
+history O
+of O
+diastolic O
+congestive O
+heart O
+failure O
+, O
+atrial O
+fibrillation O
+on O
+Coumadin O
+, O
+presenting O
+with O
+low B-SYMPTOM
+hematocrit I-SYMPTOM
+and O
+shortness B-SYMPTOM
+of I-SYMPTOM
+breath I-SYMPTOM
+. O
+Her O
+hematocrit O
+dropped O
+from O
+28 O
+to O
+16 O
+. O
+9 O
+over O
+the O
+past O
+6 O
+weeks O
+with O
+progressive O
+shortness B-SYMPTOM
+of I-SYMPTOM
+breath I-SYMPTOM
+, O
+worse O
+with O
+exertion O
+over O
+the O
+past O
+two O
+weeks O
+. O
+She O
+reports O
+orthopnea O
+. O
+She O
+denies O
+fevers B-SYMPTOM
+, O
+chills B-SYMPTOM
+, O
+chest B-SYMPTOM
+pain I-SYMPTOM
+, O
+palpitaitons B-SYMPTOM
+, O
+cough B-SYMPTOM
+, O
+abdominal B-SYMPTOM
+pain I-SYMPTOM
+, O
+constipation B-SYMPTOM
+or O
+diahrrea B-SYMPTOM
+, O
+melena B-SYMPTOM
+, O
+blood B-SYMPTOM
+in O
+her O
+stool O
+, O
+dysuria B-SYMPTOM
+or O
+rash B-SYMPTOM
+. O
+Her O
+electrocardiogram O
+present O
+no O
+significant O
+change O
+from O
+previous O
+. O
+Her O
+Guaiac O
+was O
+reported O
+as O
+being O
+positive O
+. O
+
+A O
+40 O
+year O
+old O
+woman O
+with O
+a O
+history O
+of O
+alcoholism O
+complicated O
+by O
+Delirium O
+Tremens O
+and O
+seizures O
+2 O
+years O
+ago O
+, O
+polysubstance O
+abuse O
+ncluding O
+IV O
+heroin O
+, O
+cocaine O
+, O
+crack O
+last O
+use O
+2 O
+years O
+ago O
+, O
+heroin O
+inhalation O
+last O
+use O
+2 O
+days O
+ago O
+, O
+hep O
+C O
+, O
+presents O
+for O
+voluntary O
+admission O
+for O
+detox O
+. O
+The O
+patient O
+would O
+like O
+to O
+undergo O
+detoxification O
+so O
+she O
+can O
+take O
+care O
+of O
+her O
+children O
+. O
+She O
+also O
+complains O
+of O
+abdominal B-SYMPTOM
+pain I-SYMPTOM
+in O
+lower O
+quadrants O
+, O
+radiating O
+to O
+the O
+back O
+since O
+yesterday O
+. O
+She O
+says O
+the O
+pain B-SYMPTOM
+has O
+worsened O
+since O
+yesterday O
+and O
+is O
+not O
+related O
+to O
+food O
+intake O
+. O
+She O
+also O
+complains O
+of O
+nausea B-SYMPTOM
+, O
+vomitting B-SYMPTOM
+bilious O
+but O
+nonbloody O
+, O
+and O
+diarrhea B-SYMPTOM
+no O
+black O
+or O
+red O
+stools O
+. O
+She O
+stopped O
+her O
+methadone O
+1 O
+week O
+ago O
+in O
+an O
+effort O
+to O
+quit O
+drug O
+abuse O
+. O
+She O
+reports O
+dyspnea B-SYMPTOM
+on O
+exertion O
+, O
+orthopnea B-SYMPTOM
+. O
+Also O
+describes O
+weight B-SYMPTOM
+gain I-SYMPTOM
+. O
+Labs O
+are O
+significant O
+for O
+elevated B-SYMPTOM
+lipase I-SYMPTOM
+. O
+
+78 O
+year O
+old O
+female O
+with O
+PMHx O
+HTN O
+, O
+dCHF O
+, O
+Diabetes O
+, O
+CKD O
+, O
+Atrial O
+fibrillation O
+on O
+coumadin O
+, O
+ischemic O
+stroke O
+, O
+admitted O
+after O
+presenting O
+to O
+cardiology O
+clinic O
+today O
+with O
+confusion B-SYMPTOM
+and O
+Somnolence B-SYMPTOM
+. O
+Of O
+note O
+, O
+she O
+was O
+recently O
+discharged O
+after O
+presyncope O
+falls O
+. O
+At O
+that O
+time O
+, O
+lasix O
+was O
+stopped O
+and O
+atenolol O
+was O
+switched O
+to O
+metoprolol O
+as O
+there O
+was O
+concern O
+that O
+blunting O
+of O
+tachycardia O
+could O
+be O
+contributing O
+to O
+falls O
+. O
+She O
+was O
+discharged O
+to O
+rehab O
+previously O
+living O
+at O
+home O
+. O
+Per O
+report O
+from O
+the O
+ER O
+, O
+patient O
+has O
+had O
+confusion B-SYMPTOM
+at O
+home O
+for O
+3 O
+weeks O
+, O
+though O
+no O
+family O
+accompanies O
+her O
+to O
+corroborate O
+this O
+story O
+, O
+and O
+patient O
+denies O
+this O
+. O
+The O
+patient O
+is O
+not O
+sure O
+why O
+she O
+is O
+in O
+the O
+hospital O
+. O
+She O
+saw O
+her O
+cardiologist O
+today O
+, O
+who O
+referred O
+her O
+to O
+the O
+ER O
+after O
+she O
+appeared O
+to O
+be O
+dehydrated B-SYMPTOM
+, O
+somnolent B-SYMPTOM
+, O
+and O
+confused B-SYMPTOM
+. O
+The O
+patient O
+denies O
+headache B-SYMPTOM
+, O
+blurry B-SYMPTOM
+vision I-SYMPTOM
+, O
+numbness B-SYMPTOM
+, O
+tingling B-SYMPTOM
+or O
+weakness B-SYMPTOM
+. O
+No O
+CP B-SYMPTOM
+. O
+SOB B-SYMPTOM
+, O
+worsening O
+DOE B-SYMPTOM
+. O
+No O
+nausea B-SYMPTOM
+, O
+vomiting B-SYMPTOM
+. O
+
+A O
+87 O
+year O
+old O
+female O
+NH O
+resident O
+with O
+a O
+history O
+of O
+chronic O
+atrial O
+fibrillation O
+, O
+hypertension O
+and O
+hypothyroidism O
+who O
+presents O
+wit O
+abdominal B-SYMPTOM
+pain I-SYMPTOM
+. O
+She O
+had O
+been O
+in O
+her O
+usual O
+state O
+of O
+health O
+until O
+5 O
+days O
+ago O
+when O
+she O
+suddenly O
+began O
+to O
+have O
+abdominal B-SYMPTOM
+pain I-SYMPTOM
+. O
+Her O
+abdominal B-SYMPTOM
+pain I-SYMPTOM
+was O
+initially O
+intermittent O
+lasting O
+for O
+a O
+few O
+hours O
+at O
+at O
+time O
+. O
+No O
+clear O
+correlation O
+with O
+food O
+. O
+Yesterday O
+, O
+she O
+noticed O
+that O
+her O
+pain B-SYMPTOM
+was O
+much O
+more O
+severe O
+and O
+more O
+localized O
+to O
+the O
+right O
+. O
+This O
+was O
+accompanied O
+by O
+nausea B-SYMPTOM
+and O
+vomitting B-SYMPTOM
+. O
+She O
+vomitted O
+twice O
+, O
+with O
+clear O
+liquid O
+emesis O
+and O
+was O
+sent O
+to O
+a O
+hospital O
+. O
+At O
+the O
+hospital O
+, O
+she O
+was O
+noted O
+to O
+have O
+elevated B-SYMPTOM
+amylase I-SYMPTOM
+lipase I-SYMPTOM
+to O
+538 O
+and O
+516 O
+with O
+elevated O
+bili O
+to O
+4 O
+. O
+1 O
+and O
+AST O
+ALT O
+to O
+198 O
+115 O
+and O
+was O
+given O
+ciprofloxacin O
+, O
+flagyl O
+and O
+500cc O
+NS O
+and O
+was O
+transferred O
+to O
+the O
+emergency O
+department O
+. O
+At O
+the O
+emergency O
+department O
+her O
+vital O
+signs O
+were O
+TM O
+97 O
+. O
+9 O
+HR O
+83 O
+BP O
+157 O
+92 O
+RR O
+18 O
+sat O
+97 O
+RA O
+. O
+
+94M O
+with O
+CAD O
+s O
+p O
+4v O
+CABG O
+, O
+CHF O
+, O
+CRI O
+presented O
+with O
+vfib O
+arrest O
+. O
+Initial O
+labs O
+significant O
+for O
+K O
+2 O
+. O
+7 O
+. O
+EKG O
+showed O
+sinus B-SYMPTOM
+rhythm I-SYMPTOM
+, O
+HR O
+80 O
+with O
+LAD B-SYMPTOM
+, O
+prolonged B-SYMPTOM
+PR I-SYMPTOM
+, O
+TD O
+0 O
+. O
+5 O
+to O
+1mm O
+in O
+V4 O
+V6 O
+. O
+Echo O
+showed O
+Mildly O
+depressed B-SYMPTOM
+global I-SYMPTOM
+left I-SYMPTOM
+ventricular I-SYMPTOM
+function I-SYMPTOM
+, O
+mild O
+to O
+moderate O
+aortic B-SYMPTOM
+regurgitation I-SYMPTOM
+and O
+mild O
+mitral B-SYMPTOM
+regurgitation I-SYMPTOM
+. O
+
+A O
+63 O
+yo O
+man O
+with O
+h O
+o O
+biphenotypic O
+ALL O
+, O
+now O
+Day O
+32 O
+from O
+allogeneic O
+SCT O
+, O
+who O
+presents O
+with O
+one O
+week O
+of O
+worsening O
+SOB B-SYMPTOM
+and O
+two O
+days O
+of O
+a O
+clear O
+productive O
+cough B-SYMPTOM
+. O
+The O
+patient O
+states O
+his O
+SOB B-SYMPTOM
+occured O
+when O
+lying O
+flat O
+, O
+but O
+not O
+with O
+activity O
+. O
+Also O
+admitted O
+to O
+chest B-SYMPTOM
+pressure I-SYMPTOM
+which O
+would O
+come O
+and O
+go O
+in O
+his O
+left O
+chest O
+no O
+related O
+to O
+the O
+SOB B-SYMPTOM
+. O
+Sleeps O
+with O
+3 O
+pillows O
+no O
+change O
+from O
+baseline O
+, O
+denies O
+PND B-SYMPTOM
+; O
+admits O
+to O
+a O
+slight O
+increase O
+in O
+lower O
+extremity O
+edema O
+. O
+Admits O
+to O
+low O
+grade O
+fevers B-SYMPTOM
+to O
+the O
+99 O
+'s O
+and O
+crampy O
+abdominal B-SYMPTOM
+pain I-SYMPTOM
+. O
+Denies O
+chills B-SYMPTOM
+, O
+night B-SYMPTOM
+sweats I-SYMPTOM
+, O
+vomiting B-SYMPTOM
+, O
+or O
+diarrhea B-SYMPTOM
+. O
+Patient O
+also O
+has O
+a O
+history O
+of O
+CMV O
+infection O
+, O
+aspergillus O
+and O
+Leggionare O
+'s O
+disease O
+and O
+is O
+on O
+posaconazole O
+. O
+His O
+CXR O
+showed O
+an O
+opacification B-SYMPTOM
+of O
+the O
+left O
+basilar O
+lobe O
+and O
+also O
+right O
+upper O
+lobe O
+concerning O
+for O
+pneumonia O
+as O
+well O
+as O
+a O
+small O
+loculated O
+right O
+pleural O
+effusion B-SYMPTOM
+. O
+
+85M O
+dementia O
+, O
+colon O
+cancer O
+and O
+recent O
+colectomy O
+with O
+primary O
+reanastomosis O
+p O
+w O
+melena O
+. O
+HCT O
+30 O
+to O
+23 O
+but O
+hemodynamically O
+stable O
+. O
+NGL O
+negative O
+. O
+Exam O
+notable O
+for O
+Tm O
+99 O
+BP O
+128 O
+50 O
+HR O
+70 O
+RR O
+16 O
+with O
+sat O
+100 O
+on O
+RA O
+. O
+WD O
+man O
+, O
+NAD O
+. O
+Chest O
+clear O
+, O
+JVP O
+8cm O
+. O
+RR O
+s1s2 O
+. O
+Soft B-SYMPTOM
+abdomen I-SYMPTOM
+, O
+well O
+healed O
+surgical O
+scar O
+. O
+No O
+edema B-SYMPTOM
+or O
+cord B-SYMPTOM
+. O
+Labs O
+notable O
+for O
+WBC O
+7K O
+, O
+HCT O
+24 O
+, O
+K O
+4 O
+. O
+0 O
+, O
+Cr O
+0 O
+. O
+7 O
+. O
+
+51 O
+year O
+old O
+man O
+with O
+multiple O
+sclerosis O
+, O
+quadriparesis O
+, O
+hypertension O
+, O
+restrictive O
+lung O
+disease O
+, O
+chronic O
+constipation O
+and O
+small O
+bowel O
+obstruction O
+after O
+ileostomy O
+, O
+multiple O
+urinary O
+tract O
+infections O
+also O
+after O
+placement O
+of O
+suprapubic O
+tube O
+, O
+presents O
+with O
+small O
+bowel O
+obstruction O
+and O
+urinary O
+tract O
+infection O
+. O
+Admitted O
+today O
+as O
+his O
+home O
+health O
+aide O
+noticed O
+his O
+urine O
+output O
+was O
+low O
+, O
+75cc O
+overnight O
+when O
+he O
+usually O
+has O
+about O
+1 O
+liter O
+overnight O
+. O
+Over O
+the O
+past O
+two O
+weeks O
+he O
+has O
+had O
+mild O
+earaches B-SYMPTOM
+, O
+a O
+sorethroat B-SYMPTOM
+as O
+well O
+as O
+some O
+rhinorrhea B-SYMPTOM
+. O
+He O
+denies O
+any O
+abdominal B-SYMPTOM
+pain I-SYMPTOM
+, O
+has O
+not O
+sujectively O
+noticed O
+any O
+change O
+in O
+abdominal O
+distention O
+. O
+In O
+the O
+Emergency O
+Department O
+, O
+he O
+was O
+noted O
+to O
+be O
+severely O
+dehydrated B-SYMPTOM
+on O
+exam O
+, O
+and O
+creatinine O
+level O
+was O
+1 O
+. O
+4 O
+up O
+from O
+0 O
+. O
+6 O
+. O
+
+The O
+patient O
+is O
+a O
+79 O
+yoF O
+w O
+a O
+h O
+o O
+CAD O
+s O
+p O
+RCA O
+stenting O
+, O
+diastolic O
+CHF O
+, O
+1 O
+MR O
+, O
+HTN O
+, O
+Hyperlipidemia O
+, O
+previous O
+smoking O
+history O
+, O
+and O
+atrial O
+fibrillation O
+who O
+presents O
+for O
+direct O
+admission O
+from O
+home O
+for O
+progressive O
+shortness B-SYMPTOM
+of I-SYMPTOM
+breath I-SYMPTOM
+. O
+According O
+to O
+Pt O
+, O
+her O
+primary O
+complaint O
+is O
+not O
+shortness B-SYMPTOM
+of I-SYMPTOM
+breath I-SYMPTOM
+, O
+but O
+cough B-SYMPTOM
+X O
+1 O
+week O
+which O
+has O
+been O
+rarely O
+productive O
+of O
+white O
+sputum O
+. O
+She O
+denies O
+associated O
+fevers B-SYMPTOM
+, O
+chills B-SYMPTOM
+, O
+nausea B-SYMPTOM
+, O
+vomiting B-SYMPTOM
+, O
+pleuritic B-SYMPTOM
+pain I-SYMPTOM
+, O
+weight B-SYMPTOM
+gain I-SYMPTOM
+, O
+or O
+dietary B-SYMPTOM
+indiscretion I-SYMPTOM
+. O
+She O
+also O
+reports O
+a O
+sore B-SYMPTOM
+throat I-SYMPTOM
+over O
+the O
+past O
+3 O
+days O
+. O
+She O
+recently O
+underwent O
+thoracentesis O
+for O
+a O
+moderate O
+size O
+pleueral O
+effusion O
+. O
+Cytology O
+of O
+the O
+effusion O
+was O
+negative O
+for O
+malignant O
+cells O
+. O
+Pt O
+denies O
+recent O
+palpitations B-SYMPTOM
+, O
+and O
+reports O
+that O
+she O
+has O
+been O
+compliant O
+with O
+all O
+medications O
+. O
+She O
+admits O
+to O
+recent O
+fatigue B-SYMPTOM
+and O
+2 O
+pillow O
+orthopnea O
+which O
+has O
+been O
+present O
+for O
+months O
+. O
+Current O
+etiology O
+considerations O
+include O
+CHF O
+vs O
+intrinsic O
+pulmonary O
+disease O
+infiltrative O
+vs O
+embolic O
+disease O
+. O
+In O
+order O
+to O
+optimize O
+cardic O
+function O
+with O
+atrial O
+kick O
+, O
+pt O
+underwent O
+cardioversion O
+and O
+became O
+hypotensive B-SYMPTOM
+with O
+a O
+junctional O
+rhythm O
+requiring O
+intubation O
+. O
+She O
+was O
+placed O
+on O
+dobutamine O
+. O
+Off O
+of O
+dobutamine O
+, O
+cardiac O
+monitoring O
+demonstrated O
+a O
+long O
+QTc O
+of O
+700 O
+and O
+an O
+atrial O
+escape O
+rhythm O
+. O
+
+A O
+64 O
+yo O
+female O
+with O
+with O
+history O
+of O
+atrial O
+fibrillation O
+, O
+Chronic O
+Obstructive O
+Pulmonary O
+Disease O
+, O
+hypertension O
+, O
+hyperlipidemia O
+, O
+repair O
+of O
+an O
+atrial O
+septum O
+defect O
+which O
+was O
+complicated O
+by O
+sternal O
+wound O
+infection O
+and O
+post O
+operative O
+atrial O
+fibrillation O
+treated O
+with O
+amiodarone O
+, O
+was O
+initially O
+admitted O
+through O
+the O
+Emergency O
+Department O
+with O
+shortness B-SYMPTOM
+of I-SYMPTOM
+breath I-SYMPTOM
+and O
+back B-SYMPTOM
+pain I-SYMPTOM
+, O
+and O
+was O
+noted O
+to O
+have O
+atrial O
+fibrillation O
+with O
+rapid O
+ventricular O
+response O
+. O
+A O
+computed O
+tomography O
+angiography O
+demonstrated O
+diffuse O
+left O
+anterior O
+descending O
+artery O
+and O
+post O
+obstructive O
+pneumonia O
+concerning O
+for O
+malignancy O
+. O
+For O
+her O
+atrial O
+fibrillation O
+, O
+she O
+was O
+started O
+on O
+diltiazem O
+. O
+For O
+the O
+pneumonia O
+, O
+she O
+was O
+treated O
+with O
+antibiotics O
+. O
+She O
+was O
+then O
+transferred O
+to O
+the O
+floor O
+later O
+that O
+same O
+night O
+on O
+metoprolol O
+50 O
+mg O
+tid O
+. O
+While O
+on O
+the O
+floor O
+, O
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+had O
+a O
+bronchoscopy O
+performed O
+which O
+showed O
+external O
+compression O
+of O
+her O
+left O
+mainstem O
+bronchus O
+, O
+and O
+she O
+had O
+a O
+biopsy O
+via O
+fine O
+needle O
+aspiration O
+, O
+which O
+showed O
+large O
+cell O
+carcinoma O
+. O
+She O
+denies O
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+pain I-SYMPTOM
+, O
+shortness B-SYMPTOM
+of I-SYMPTOM
+breath I-SYMPTOM
+and O
+tachypnea B-SYMPTOM
+. O
+She O
+does O
+note O
+some O
+diaphoresis B-SYMPTOM
+and O
+occasional O
+palpitations B-SYMPTOM
+. O
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+This O
+84 O
+year O
+old O
+man O
+with O
+a O
+history O
+of O
+coronary O
+artery O
+disease O
+presents O
+with O
+2 O
+days O
+of O
+melena O
+and O
+black O
+colored O
+emesis B-SYMPTOM
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+Stools O
+becoming O
+less O
+dark O
+, O
+but O
+he O
+had O
+increased O
+lethargy B-SYMPTOM
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+presented O
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+emergency O
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+today O
+. O
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+blood O
+pressure O
+recorded O
+in O
+the O
+60s O
+, O
+but O
+all O
+in O
+110 O
+120s O
+after O
+that O
+. O
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+the O
+ED O
+, O
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+gastric O
+lavage O
+with O
+coffee O
+ground O
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+that O
+cleared O
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+he O
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+mild O
+ST O
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+V5 O
+that O
+resolved O
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+is O
+on O
+ASPIRIN O
+81 O
+mg O
+Tablet O
+by O
+mouth O
+daily O
+. O
+
+A O
+96 O
+y O
+o O
+female O
+found O
+unresponsive B-SYMPTOM
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+at O
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+. O
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+in O
+dining O
+room O
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+Unresponsive B-SYMPTOM
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+1 O
+min O
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+. O
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+fall O
+but O
+with O
+some O
+c O
+o O
+HA B-SYMPTOM
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+some O
+neck O
+shoulder O
+discomfort B-SYMPTOM
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+showed O
+9mm O
+L O
+parietal O
+SDH O
+. O
+C O
+spine O
+negative O
+. O
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+CT O
+head O
+w O
+o O
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+measuring O
+1 O
+. O
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+cm O
+maximal O
+dimensions O
+with O
+leftward O
+subfalcine O
+herniation O
+of O
+8 O
+mm O
+, O
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+herniation O
+with O
+obliteration O
+of O
+the O
+left O
+suprasellar O
+cistern O
+, O
+and O
+uncal O
+herniation O
+. O
+No O
+fx O
+, O
+destructive O
+infiltrative O
+lesion O
+involving O
+the O
+skull O
+base O
+. O
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+85 O
+y O
+o O
+F O
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+PMHx O
+of O
+HTN O
+, O
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+, O
+h O
+o O
+breast O
+CA O
+and O
+3cm O
+renal O
+pelvis O
+transitional O
+cell O
+tumor O
+who O
+presented O
+for O
+nephrectomy O
+. O
+Her O
+post O
+op O
+course O
+was O
+complicated O
+by O
+agitation B-SYMPTOM
+thought O
+due O
+to O
+narcotics O
+. O
+Today O
+, O
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+was O
+restarted O
+on O
+her O
+home O
+meds O
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+on O
+telemetry O
+, O
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+noted O
+to O
+be O
+bradycardic B-SYMPTOM
+to O
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+. O
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+triggered O
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+HR O
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+40 O
+during O
+which O
+she O
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+asymptomatic O
+. O
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+given O
+1L O
+IVF O
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+her O
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+back O
+up O
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+baseline O
+. O
+However O
+, O
+there O
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+a O
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+hour O
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+when O
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+sat O
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+in O
+the O
+30s O
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+associated O
+hypotension B-SYMPTOM
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+episode O
+occurred O
+with O
+position O
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+and O
+again O
+, O
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+junctional O
+rhythm O
+in O
+30s O
+. O
+
+This O
+is O
+a O
+54 O
+year O
+old O
+male O
+patient O
+with O
+an O
+idiopathic O
+pulmonary O
+fibrosis O
+, O
+who O
+called O
+today O
+with O
+worsening O
+dyspnea O
+for O
+3 O
+days O
+. O
+He O
+had O
+been O
+in O
+unusual O
+state O
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+good O
+health O
+at O
+baseline O
+respiratory O
+status O
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+4L O
+nasal O
+canula O
+at O
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+and O
+6L O
+with O
+exertion O
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+3 O
+days O
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+admission O
+, O
+he O
+hugged O
+his O
+cousin O
+who O
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+rats O
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+and O
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+the O
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+came O
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+acutely O
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+, O
+fevers B-SYMPTOM
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+chills B-SYMPTOM
+, O
+rhinorrhea B-SYMPTOM
+. O
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+receive O
+flu O
+and O
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+vaccines O
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+a O
+recent O
+admission O
+last O
+month O
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+dyspnea B-SYMPTOM
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+computed O
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+revealed O
+increased O
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+lower O
+lobes O
+superimposed O
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+started O
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+outpatient O
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+lung O
+disease O
+. O
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+was O
+discharged O
+on O
+2 O
+3L O
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+canula O
+. O
+He O
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+represented O
+to O
+the O
+emergency O
+department O
+for O
+spontaneous O
+pneumomediastinum O
+of O
+unclear O
+etiology O
+. O
+On O
+day O
+of O
+current O
+admission O
+, O
+the O
+patient O
+called O
+his O
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+complaining O
+of O
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+of I-SYMPTOM
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+since O
+Saturday O
+. O
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+pulmonary O
+rehab O
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+desaturated O
+to O
+the O
+70s O
+on O
+6L O
+with O
+minimal O
+exertion O
+, O
+and O
+he O
+is O
+currently O
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+4L O
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+canula O
+at O
+rest O
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+sick O
+contacts O
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+. O
+He O
+was O
+asked O
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+vs O
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+98 O
+. O
+3 O
+, O
+96 O
+, O
+144 O
+97 O
+, O
+24 O
+, O
+97 O
+6L O
+NC O
+. O
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+78 O
+M O
+w O
+pmh O
+of O
+CABG O
+in O
+early O
+Month O
+only O
+3 O
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+Hospital6 O
+4406 O
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+nursing O
+home O
+for O
+rehab O
+on O
+12 O
+8 O
+after O
+several O
+falls O
+out O
+of O
+bed O
+. O
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+then O
+readmitted O
+to O
+Hospital6 O
+1749 O
+on O
+3120 O
+12 O
+11 O
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+developing O
+acute O
+pulmonary O
+edema O
+CHF O
+unresponsiveness O
+? O
+. O
+There O
+was O
+a O
+question O
+whether O
+he O
+had O
+a O
+small O
+MI O
+; O
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+a O
+small O
+NQWMI O
+. O
+He O
+improved O
+with O
+diuresis B-SYMPTOM
+and O
+was O
+not O
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+. O
+Yesterday O
+, O
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+a O
+melanotic B-SYMPTOM
+stool I-SYMPTOM
+earlier O
+this O
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+and O
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+approximately O
+9 O
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+w O
+some O
+melena O
+and O
+some O
+frank O
+blood O
+just O
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+, O
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+quantity O
+. O
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+Ms O
+Known O
+patient O
+lastname O
+241 O
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+Age O
+over O
+90 O
+2398 O
+year O
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+woman O
+with O
+past O
+medical O
+history O
+significant O
+for O
+hypertension O
+, O
+severe O
+aortic O
+stenosis O
+, O
+hyperlipidemia O
+, O
+arthroplasty O
+. O
+. O
+Per O
+the O
+patient O
+, O
+she O
+was O
+standing O
+and O
+felt O
+a O
+snap O
+of O
+her O
+right O
+leg O
+and O
+fell O
+to O
+the O
+ground O
+. O
+No O
+head B-SYMPTOM
+trauma I-SYMPTOM
+or O
+LOC B-SYMPTOM
+. O
+She O
+was O
+evaluated O
+by O
+orthopedics O
+and O
+transferred O
+to O
+medicine O
+for O
+optimization O
+of O
+her O
+cardiac O
+status O
+. O
+Review O
+of O
+systems O
+Ear O
+, O
+Nose O
+, O
+Throat O
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+mouth I-SYMPTOM
+Cardiovascular O
+Edema O
+, O
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+Respiratory O
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+Data O
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+3294 O
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+10 O
+33 O
+PM O
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+Hemodynamic O
+monitoring O
+Fluid O
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+. O
+5 O
+C O
+99 O
+. O
+5 O
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+37 O
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+5 O
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+99 O
+. O
+5 O
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+93 O
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+70 O
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+54 O
+70 O
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+54 O
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+mmHg O
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+24 O
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+24 O
+insp O
+min O
+SpO2 O
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+Heart O
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+ST O
+Sinus O
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+. O
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+appears O
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+adequate O
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+prn O
+morphine O
+. O
+Given O
+her O
+tight O
+valvular O
+stenosis O
+, O
+she O
+is O
+high O
+risk O
+for O
+general O
+anesthesia O
+. O
+would O
+start O
+standing O
+tylenol O
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+q8 O
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+morphine O
+IV O
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+for O
+breakthrough O
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+am O
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+optimization O
+of O
+her O
+cardiac O
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+, O
+and O
+improvement O
+in O
+renal O
+function O
+. O
+CAD O
+No O
+clear O
+documentation O
+, O
+however O
+given O
+age O
+calcific O
+atherosclerosis O
+is O
+highly O
+likely O
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+Hold O
+beta O
+blocker O
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+hold O
+aspirin O
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+. O
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+FIBRILLATION O
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+to O
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+score O
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+If O
+unstable O
+, O
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+use O
+esmolol O
+first O
+, O
+cardiovert O
+last O
+option O
+. O
+. O
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+on O
+floor O
+. O
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+essential O
+for O
+preventing O
+flash O
+pulmonary O
+edema O
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+setting O
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+continue O
+metoprolol O
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+monitor O
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+consider O
+adding O
+another O
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+Last O
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+5mg O
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+BP O
+sustains O
+above O
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+. O
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+PO O
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+GI O
+Low O
+sodium O
+diet O
+, O
+replete O
+lytes O
+PRN O
+. O
+CODE O
+Confirmed O
+DNR O
+DNI O
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+Pt O
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+75F O
+with O
+a O
+PMHx O
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+, O
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+, O
+DM O
+, O
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+presented O
+to O
+Hospital1 O
+Location O
+un O
+1375 O
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+6 O
+25 O
+after O
+being O
+found O
+down O
+unresponsive O
+at O
+home O
+. O
+She O
+was O
+found O
+to O
+be O
+hypoglycemic B-SYMPTOM
+to O
+29 O
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+hypotension B-SYMPTOM
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+. O
+Her O
+hypotension B-SYMPTOM
+and O
+confusion B-SYMPTOM
+improved O
+with O
+hydration O
+. O
+She O
+had O
+a O
+positive O
+UA O
+which O
+eventually O
+grew O
+klebsiella O
+, O
+treated O
+initially O
+with O
+levofloxacin O
+. O
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+a O
+leukocytosis O
+to O
+18 O
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+a O
+creatinine O
+of O
+6 O
+up O
+from O
+presumed O
+prior O
+baseline O
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+2 O
+. O
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+morning O
+of O
+transfer O
+, O
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+blood O
+cultures O
+result O
+3 O
+3 O
+bottles O
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+for O
+GAS O
+, O
+her O
+antibiotics O
+were O
+switched O
+to O
+vancomycin O
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+was O
+then O
+changed O
+to O
+ceftriaxone O
+. O
+Her O
+blood O
+pressure O
+dropped O
+to O
+the O
+60s O
+. O
+She O
+was O
+given O
+a O
+bolus O
+of O
+bicarb O
+and O
+transfered O
+to O
+their O
+ICU O
+. O
+After O
+an O
+additional O
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+500cc O
+she O
+was O
+started O
+on O
+levophed O
+. O
+She O
+was O
+anuric B-SYMPTOM
+throughout O
+the O
+day O
+. O
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+midline O
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+side O
+. O
+She O
+received O
+80mg O
+IV O
+solumedrol O
+this O
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+in O
+the O
+setting O
+of O
+low O
+BPs O
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+rare O
+eos O
+in O
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+. O
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+arrival O
+to O
+the O
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+pt O
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+awake O
+but O
+drowsy B-SYMPTOM
+. O
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+was O
+receiving O
+levophed O
+throughout O
+her O
+transfer O
+. O
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+VS O
+96 O
+. O
+3 O
+68 O
+102 O
+26 O
+22 O
+97 O
+2L O
+NC O
+on O
+0 O
+. O
+04mcg O
+kg O
+min O
+levophed O
+. O
+On O
+ROS O
+, O
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+denies O
+pain B-SYMPTOM
+, O
+lightheadedness B-SYMPTOM
+, O
+headache B-SYMPTOM
+, O
+neck B-SYMPTOM
+pain I-SYMPTOM
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+throat I-SYMPTOM
+, O
+recent O
+illness O
+or O
+sick O
+contacts O
+, O
+cough B-SYMPTOM
+, O
+shortness B-SYMPTOM
+of I-SYMPTOM
+breath I-SYMPTOM
+, O
+chest B-SYMPTOM
+discomfort I-SYMPTOM
+, O
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+abdomen O
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+tissue O
+mass O
+or O
+calcifications O
+. O
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+free O
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+. O
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+imaged O
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+Mr O
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+Name13 O
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+OM2 O
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+morphine O
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+continued O
+on O
+ASA O
+, O
+Plavix O
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+Statin O
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+BBker O
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+Heparin O
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+on O
+his O
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+A O
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+ambulation O
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+131 O
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+nonbloody O
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+, O
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+heroin O
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+. O
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+sick O
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+Name2 O
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+. O
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+. O
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+3 O
+, O
+96 O
+, O
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+, O
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+, O
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+85 O
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+, O
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+, O
+h O
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+CA O
+and O
+3cm O
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+cell O
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+for O
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+2575 O
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+. O
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+course O
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+complicated O
+by O
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+to O
+narcotics O
+. O
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+, O
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+on O
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+. O
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+40 O
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+asymptomatic O
+. O
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+1L O
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+and O
+her O
+HR O
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+trended O
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+. O
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+, O
+there O
+was O
+a O
+second O
+event O
+an O
+hour O
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+and O
+became O
+bradycardic O
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+25 O
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+25 O
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+Colace O
+100mg O
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+, O
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+, O
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+, O
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+, O
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+, O
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+
+
+An O
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+, O
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+, O
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+, O
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+A O
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+hypotension B-SYMPTOM
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+bradycardia O
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+. O
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+the O
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+. O
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+throughout O
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+, O
+awake O
+but O
+drowsy O
+. O
+This O
+morning O
+she O
+had O
+temp O
+96 O
+. O
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+, O
+respiratory O
+rate O
+22 O
+, O
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+26 O
+. O
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+An O
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+distended O
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+obstruction O
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+CBD O
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+. O
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+
+A O
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+medical O
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+, O
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+ascites O
+, O
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+and O
+coagulopathy O
+. O
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+
+
+66 O
+yo O
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+pedestrian O
+struck O
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+auto O
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+Unconscious B-SYMPTOM
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+scene O
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+head O
+CT O
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+extensive O
+interparenchymal B-SYMPTOM
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+. O
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+80 O
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+. O
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+transverse O
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+leading O
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+, O
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+stage O
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+ulcers O
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+coccyx O
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+, O
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+. O
+Admission O
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+thrombocytosis O
+, O
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+, O
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+A O
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+cancer O
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+67 O
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+. O
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+end O
+stage O
+COPD O
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+home O
+oxygen O
+, O
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+, O
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+p O
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+resection O
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+carcinoma O
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+stent O
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+complicated O
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+lb O
+wt O
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+scan O
+revealed O
+some O
+FDG O
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+A O
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+this O
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+, O
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+non O
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+76 O
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+, O
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+A O
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+seizures B-SYMPTOM
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+. O
+
+78 O
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+HTN O
+, O
+dCHF O
+, O
+Diabetes O
+, O
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+, O
+Atrial O
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+on O
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+, O
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+stroke O
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+after O
+presenting O
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+confusion B-SYMPTOM
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+somnolence B-SYMPTOM
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+recently O
+discharged O
+after O
+presyncope O
+falls O
+. O
+Patient O
+has O
+had O
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+at O
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+. O
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+patient O
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+, O
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+vision I-SYMPTOM
+, O
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+A O
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+reports O
+several O
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+. O
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+, O
+transaminitis O
+, O
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+lipase O
+. O
+
+
+A O
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+old O
+male O
+with O
+biphenotypic O
+ALL O
+, O
+Day O
+32 O
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+BMT O
+, O
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+o O
+CMV O
+infection O
+, O
+aspergillus O
+and O
+Leggionare O
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+disease O
+, O
+presents O
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+acute O
+onset O
+of O
+hypoxia O
+accompanied O
+by O
+fever B-SYMPTOM
+and O
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+days O
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+productive B-SYMPTOM
+cough I-SYMPTOM
+. O
+His O
+CXR O
+showed O
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+opacification O
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+the O
+left O
+basilar O
+lobe O
+and O
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+. O
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+
+
+An O
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+, O
+Chronic O
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+Disease O
+, O
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+, O
+hyperlipidemia O
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+of I-SYMPTOM
+breath I-SYMPTOM
+and O
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+. O
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+A O
+79 O
+year O
+old O
+female O
+wit O
+history O
+of O
+CAD O
+, O
+diastolic O
+CHF O
+, O
+HTN O
+, O
+Hyperlipidemia O
+, O
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+smoking O
+history O
+, O
+and O
+atrial O
+fibrillation O
+who O
+presents O
+for O
+direct O
+admission O
+from O
+home O
+for O
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+shortness B-SYMPTOM
+of I-SYMPTOM
+breath I-SYMPTOM
+. O
+Patient O
+denies O
+recent O
+palpitations B-SYMPTOM
+, O
+and O
+reports O
+that O
+she O
+has O
+been O
+compliant O
+with O
+all O
+medications O
+. O
+She O
+admits O
+to O
+recent O
+fatigue B-SYMPTOM
+and O
+2 O
+pillow O
+orthopnea O
+which O
+has O
+been O
+present O
+for O
+months O
+. O
+Patient O
+underwent O
+cardioversion O
+and O
+became O
+hypotensive B-SYMPTOM
+with O
+a O
+junctional O
+rhythm O
+requiring O
+intubation O
+. O
+She O
+was O
+placed O
+on O
+dobutamine O
+. O
+Off O
+of O
+dobutamine O
+, O
+cardiac O
+monitoring O
+demonstrated O
+a O
+long O
+QTc O
+and O
+an O
+atrial O
+escape O
+rhythm O
+. O
+
+A O
+96 O
+y O
+o O
+female O
+found O
+unresponsive B-SYMPTOM
+on O
+ground O
+at O
+nursing O
+home O
+pressents O
+with O
+headache B-SYMPTOM
+, O
+herniation B-SYMPTOM
+, O
+and O
+some O
+neck O
+shoulder O
+discomfort O
+. O
+CT O
+head O
+shows O
+acute O
+left O
+subdural O
+hematoma O
+. O
+
+
+This O
+is O
+a O
+54 O
+year O
+old O
+male O
+patient O
+with O
+an O
+idiopathic O
+pulmonary O
+fibrosis O
+presenting O
+an O
+acute B-SYMPTOM
+dyspnea I-SYMPTOM
+on O
+exertion O
+, O
+secondary O
+to O
+superimposed O
+pneumonia O
+on O
+patient O
+with O
+no O
+pulmonary O
+reserve O
+. O
+Appears O
+he O
+has O
+been O
+experiencing O
+worsening O
+dyspnea B-SYMPTOM
+with O
+increased O
+O2 O
+requirement O
+for O
+the O
+last O
+several O
+weeks O
+. O
+
+An O
+85 O
+year O
+old O
+woman O
+on O
+verapamil O
+presents O
+with O
+junctional O
+heart O
+rhythm O
+in O
+30s O
+with O
+associated O
+hypotension B-SYMPTOM
+. O
+
+A O
+47 O
+year O
+old O
+man O
+comes O
+to O
+the O
+clinic O
+for O
+the O
+follow O
+up O
+of O
+his O
+neuromuscular O
+disease O
+. O
+He O
+experienced O
+gradual O
+, O
+progressive O
+weakness B-SYMPTOM
+of O
+the O
+left O
+upper O
+extremity O
+over O
+the O
+last O
+year O
+. O
+Over O
+the O
+last O
+few O
+months O
+, O
+he O
+has O
+also O
+noticed O
+weakness B-SYMPTOM
+in O
+the O
+right O
+upper O
+extremity O
+. O
+BP O
+is O
+120 O
+75 O
+, O
+PR O
+is O
+80 O
+and O
+temperature O
+is O
+37 O
+C O
+. O
+Reflexes O
+are O
+brisk O
+in O
+the O
+upper O
+extremities O
+, O
+and O
+the O
+plantar O
+responses O
+are O
+extensor O
+. O
+Mild O
+gait O
+ataxia O
+is O
+present O
+. O
+The O
+patient O
+is O
+under O
+treatment O
+of O
+Riluzole O
+50 O
+mg O
+BID O
+with O
+the O
+diagnosis O
+of O
+ALS O
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+rheumatologic O
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+2 O
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+both O
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+h O
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+A O
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+few O
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+known O
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+went O
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+New O
+Hampshire O
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+Lyme O
+disease O
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+A O
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+spending O
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+legs O
+; O
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+into O
+his O
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+not O
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+. O
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+spinal O
+MRI O
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+digits O
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+A O
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+A O
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+A O
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+. O
+Medical O
+history O
+is O
+significant O
+for O
+appendectomy O
+and O
+several O
+complicated O
+UTIs O
+. O
+She O
+has O
+multiple O
+male O
+partners O
+, O
+and O
+she O
+is O
+inconsistent O
+with O
+using O
+barrier O
+contraceptives O
+. O
+Vital O
+signs O
+are O
+normal O
+. O
+Serum O
+β O
+hCG O
+level O
+is O
+1800 O
+mIU O
+mL O
+, O
+and O
+a O
+repeat O
+level O
+after O
+2 O
+days O
+shows O
+an O
+abnormal O
+rise O
+to O
+2100 O
+mIU O
+mL O
+. O
+Pelvic O
+ultrasound O
+reveals O
+a O
+thin O
+endometrium O
+with O
+no O
+gestational O
+sac O
+in O
+the O
+uterus O
+. O
+
+A O
+51 O
+year O
+old O
+man O
+comes O
+to O
+the O
+office O
+complaining O
+of O
+fatigue O
+and O
+some O
+sexual O
+problems O
+including O
+lack B-SYMPTOM
+of I-SYMPTOM
+libido I-SYMPTOM
+. O
+The O
+patient O
+doesn O
+' O
+t O
+smoke O
+or O
+use O
+any O
+illicit O
+drug O
+. O
+Blood O
+pressure O
+is O
+120 O
+80 O
+mm O
+Hg O
+and O
+pulse O
+is O
+70 O
+min O
+. O
+Oxygen O
+saturation O
+is O
+99 O
+on O
+room O
+air O
+. O
+BMI O
+is O
+24 O
+kg O
+m2 O
+. O
+Skin O
+examination O
+shows O
+increased O
+pigmentation O
+. O
+Genotype O
+testing O
+is O
+consistent O
+with O
+homozygosity O
+for O
+the O
+C282Y O
+mutation O
+. O
+Laboratory O
+study O
+shows O
+transferrin O
+saturation O
+of O
+55 O
+and O
+serum O
+ferritin O
+of O
+550 O
+μg O
+L O
+. O
+He O
+is O
+diagnosed O
+as O
+a O
+case O
+of O
+hemochromatosis O
+. O
+
+A O
+61 O
+year O
+old O
+man O
+comes O
+to O
+the O
+clinic O
+due O
+to O
+nonproductive B-SYMPTOM
+cough I-SYMPTOM
+and O
+progressive B-SYMPTOM
+dyspnea I-SYMPTOM
+. O
+The O
+patient O
+'s O
+medical O
+conditions O
+include O
+hypertension O
+, O
+hypercholesteremia O
+and O
+peptic O
+ulcer O
+disease O
+. O
+He O
+smokes O
+2 O
+packs O
+of O
+cigarettes O
+daily O
+for O
+the O
+past O
+30 O
+years O
+. O
+On O
+examination O
+, O
+there O
+are O
+decreased B-SYMPTOM
+breath I-SYMPTOM
+sounds I-SYMPTOM
+and O
+percussive B-SYMPTOM
+dullness I-SYMPTOM
+at O
+the O
+base O
+of O
+the O
+left O
+lung O
+. O
+Other O
+vital O
+signs O
+are O
+normal O
+. O
+Abdomen O
+is O
+soft O
+without O
+tenderness O
+. O
+CT O
+scan O
+shows O
+a O
+left O
+sided O
+pleural O
+effusion O
+and O
+nodular O
+thickening O
+of O
+the O
+pleura O
+. O
+The O
+plural O
+fluid O
+was O
+bloody O
+on O
+thoracentesis O
+. O
+Biopsy O
+shows O
+proliferation O
+of O
+epithelioid O
+type O
+cells O
+with O
+very O
+long O
+microvilli O
+. O
+
+A O
+7 O
+month O
+old O
+boy O
+is O
+brought O
+to O
+emergency O
+by O
+his O
+parents O
+due O
+to O
+irritability B-SYMPTOM
+and O
+inability B-SYMPTOM
+to I-SYMPTOM
+defecate I-SYMPTOM
+for O
+the O
+past O
+3 O
+days O
+. O
+The O
+patient O
+has O
+had O
+constipation B-SYMPTOM
+and O
+discomfort B-SYMPTOM
+with O
+bowel O
+movements O
+since O
+birth O
+. O
+His O
+symptoms O
+worsened O
+after O
+eating O
+semi O
+solid O
+foods O
+. O
+Vital O
+signs O
+are O
+normal O
+. O
+Abdominal O
+examination O
+shows O
+distension O
+and O
+tenderness O
+to O
+palpation O
+with O
+presence O
+of O
+bowel O
+sounds O
+. O
+Xray O
+with O
+barium O
+shows O
+a O
+narrow O
+rectum O
+and O
+rectosigmoid O
+area O
+. O
+The O
+rest O
+of O
+the O
+colon O
+proximal O
+to O
+this O
+segment O
+is O
+dilated O
+. O
+Digital O
+rectal O
+exam O
+revealed O
+burst O
+of O
+feces O
+out O
+of O
+the O
+anus O
+. O
+The O
+biopsy O
+showed O
+absence O
+of O
+submucosal O
+ganglia O
+in O
+the O
+last O
+segment O
+of O
+the O
+large O
+intestine O
+. O
+
+
+A O
+47 O
+year O
+old O
+man O
+comes O
+to O
+the O
+office O
+for O
+routine O
+checkup O
+. O
+He O
+is O
+complaining O
+of O
+chronic B-SYMPTOM
+cough I-SYMPTOM
+and O
+occasional O
+but O
+progressive O
+dyspnea B-SYMPTOM
+. O
+Other O
+medical O
+conditions O
+include O
+hypertension O
+and O
+osteoarthritis O
+. O
+The O
+patient O
+smokes O
+a O
+pack O
+of O
+cigarettes O
+daily O
+and O
+does O
+not O
+use O
+alcohol O
+or O
+illicit O
+drugs O
+. O
+He O
+used O
+to O
+be O
+a O
+construction O
+worker O
+. O
+On O
+examination O
+, O
+there O
+are O
+decreased B-SYMPTOM
+breath I-SYMPTOM
+sounds I-SYMPTOM
+and O
+percussive B-SYMPTOM
+dullness I-SYMPTOM
+at O
+the O
+base O
+of O
+both O
+lungs O
+. O
+Chest O
+CT O
+scan O
+reveals O
+a O
+mild O
+bilateral O
+pleural O
+effusion O
+and O
+diffuse O
+thickening O
+of O
+the O
+pleura O
+. O
+The O
+patient O
+'s O
+documents O
+show O
+chronic O
+exposure O
+to O
+asbestosis O
+. O
+The O
+specimen O
+of O
+the O
+lungs O
+reveled O
+pulmonary O
+fibrosis O
+that O
+is O
+most O
+predominant O
+in O
+the O
+lower O
+lobes O
+, O
+characterized O
+by O
+the O
+presence O
+of O
+asbestos O
+bodies O
+golden O
+brown O
+beaded O
+rods O
+with O
+translucent O
+centers O
+. O
+
+
+A O
+39 O
+year O
+old O
+woman O
+comes O
+to O
+the O
+clinic O
+complaining O
+of O
+arthralgias O
+and O
+nodules O
+on O
+her O
+legs O
+. O
+She O
+has O
+no O
+fever B-SYMPTOM
+or O
+other O
+skin B-SYMPTOM
+rashes I-SYMPTOM
+. O
+The O
+prior O
+medical O
+condition O
+is O
+unremarkable O
+, O
+and O
+she O
+takes O
+no O
+medications O
+. O
+On O
+physical O
+examination O
+, O
+there O
+is O
+moderate O
+hepatomegaly O
+. O
+The O
+lesions B-SYMPTOM
+on O
+her O
+legs O
+are O
+tender O
+and O
+present O
+predominantly O
+on O
+the O
+anterior O
+surface O
+of O
+the O
+lower O
+extremities O
+. O
+She O
+doesn O
+' O
+t O
+smoke O
+and O
+drinks O
+alcohol O
+occasionally O
+. O
+The O
+patient O
+has O
+2 O
+male O
+sexual O
+partners O
+. O
+Vital O
+signs O
+are O
+normal O
+. O
+Chest O
+x O
+ray O
+demonstrates O
+enlarged O
+hilar O
+lymph O
+nodes O
+, O
+and O
+laboratory O
+testing O
+reveals O
+an O
+elevated B-SYMPTOM
+ACE I-SYMPTOM
+level I-SYMPTOM
+. O
+Biopsy O
+of O
+the O
+skin O
+lesion O
+shows O
+noncaseating O
+granulomas O
+that O
+stain O
+negative O
+for O
+fungi O
+acid O
+fast O
+bacilli O
+. O
+
+A O
+2 O
+year O
+old O
+boy O
+is O
+brought O
+to O
+the O
+office O
+by O
+his O
+parents O
+due O
+to O
+a O
+rash B-SYMPTOM
+that O
+started O
+1 O
+week O
+ago O
+. O
+A O
+similar O
+red O
+, O
+itchy O
+rash B-SYMPTOM
+on O
+the O
+cheeks O
+, O
+trunk O
+, O
+and O
+arms O
+has O
+occurred O
+intermittently O
+since O
+infancy O
+. O
+The O
+patient O
+has O
+had O
+a O
+few O
+upper O
+respiratory O
+infections O
+but O
+no O
+major O
+illnesses O
+. O
+Vaccinations O
+are O
+up O
+to O
+date O
+, O
+and O
+he O
+takes O
+no O
+medications O
+. O
+He O
+is O
+on O
+a O
+balanced O
+diet O
+, O
+and O
+he O
+is O
+healthy O
+in O
+appearance O
+. O
+Vital O
+signs O
+and O
+milestone O
+examination O
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+findings O
+are O
+observed O
+on O
+the O
+cheeks O
+and O
+proximal O
+upper O
+extremities O
+. O
+The O
+diaper O
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+clear O
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+no O
+mucosal B-SYMPTOM
+lesions I-SYMPTOM
+are O
+present O
+. O
+
+A O
+7 O
+year O
+old O
+girl O
+is O
+brought O
+to O
+the O
+emergency O
+department O
+by O
+her O
+parents O
+for O
+generalized O
+rash B-SYMPTOM
+. O
+The O
+mother O
+reports O
+that O
+she O
+was O
+playing O
+outside O
+wearing O
+a O
+skirt O
+and O
+felt O
+a O
+sharp O
+pain B-SYMPTOM
+in O
+her O
+arm O
+while O
+seating O
+on O
+a O
+mat O
+, O
+plying O
+with O
+her O
+doll O
+. O
+Her O
+mother O
+suspects O
+that O
+something O
+had O
+stung O
+her O
+. O
+The O
+patient O
+'s O
+blood O
+pressure O
+is O
+75 O
+55 O
+mm O
+Hg O
+and O
+her O
+heart O
+rate O
+is O
+122 O
+min O
+. O
+Physical O
+examination O
+shows O
+erythematous O
+, O
+raised O
+plaques B-SYMPTOM
+over O
+the O
+trunk O
+, O
+extremities O
+, O
+and O
+face O
+. O
+Lung O
+auscultation O
+reveals O
+bilateral B-SYMPTOM
+expiratory I-SYMPTOM
+wheezes I-SYMPTOM
+. O
+
+
+A O
+66 O
+year O
+old O
+woman O
+comes O
+to O
+the O
+office O
+due O
+to O
+joint B-SYMPTOM
+pain I-SYMPTOM
+in O
+the O
+hands O
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+morning I-SYMPTOM
+stiffness I-SYMPTOM
+that O
+lasts O
+less O
+than O
+15 O
+minutes O
+. O
+The O
+pain B-SYMPTOM
+is O
+moderately O
+severe O
+and O
+worsens O
+with O
+daily O
+activity O
+. O
+The O
+patient O
+used O
+Tylenol O
+with O
+minimal O
+relief O
+. O
+Past O
+medical O
+history O
+is O
+notable O
+for O
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+and O
+hypercholesteremia O
+. O
+Physical O
+examination O
+shows O
+firm O
+nodules O
+over O
+the O
+distal O
+interphalangeal O
+joints O
+, O
+bilaterally O
+. O
+The O
+patient O
+has O
+pain O
+in O
+her O
+knees O
+as O
+well O
+. O
+The O
+knees O
+are O
+stiff O
+in O
+the O
+morning O
+for O
+less O
+than O
+30 O
+minutes O
+and O
+become O
+worse O
+with O
+climbing O
+stairs O
+. O
+She O
+has O
+some O
+sensation O
+of O
+bone O
+friction O
+during O
+activity O
+. O
+X O
+ray O
+shows O
+narrowing O
+of O
+the O
+joint O
+space O
+, O
+subchondral O
+bone O
+sclerosis O
+and O
+osteophyte O
+formation O
+along O
+the O
+joints O
+. O
+
+A O
+23 O
+year O
+old O
+man O
+comes O
+to O
+the O
+emergency O
+department O
+following O
+an O
+episode O
+of O
+syncope O
+. O
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+was O
+working O
+out O
+when O
+he O
+felt O
+dizzy O
+and O
+passed O
+out O
+without O
+head B-SYMPTOM
+injury I-SYMPTOM
+. O
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+has O
+had O
+3 O
+other O
+episodes O
+of O
+light B-SYMPTOM
+headedness I-SYMPTOM
+over O
+the O
+last O
+year O
+, O
+all O
+happening O
+during O
+physical O
+activity O
+. O
+He O
+never O
+had O
+this O
+experience O
+while O
+resting O
+. O
+He O
+has O
+no O
+other O
+medical O
+conditions O
+. O
+The O
+patient O
+does O
+not O
+use O
+tobacco O
+, O
+alcohol O
+, O
+or O
+illicit O
+drugs O
+. O
+His O
+father O
+died O
+suddenly O
+at O
+age O
+35 O
+. O
+Vital O
+signs O
+are O
+within O
+normal O
+limits O
+. O
+On O
+physical O
+examination O
+, O
+the O
+patient O
+has O
+a O
+harsh O
+systolic O
+murmur O
+. O
+The O
+lungs O
+are O
+clear O
+with O
+no O
+peripheral O
+edema O
+. O
+Echocardiography O
+shows O
+asymmetric O
+interventricular O
+septal O
+hypertrophy O
+. O
+
+
+A O
+19 O
+year O
+old O
+girl O
+comes O
+to O
+the O
+clinic O
+due O
+to O
+a O
+left B-SYMPTOM
+wrist I-SYMPTOM
+mass I-SYMPTOM
+. O
+She O
+noticed O
+swelling B-SYMPTOM
+on O
+the O
+top O
+of O
+her O
+wrist O
+about O
+4 O
+months O
+ago O
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+came O
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+the O
+clinic O
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+to O
+cosmetic O
+concerns O
+. O
+Examination O
+shows O
+a O
+nontender O
+, O
+rounded O
+mass O
+on O
+the O
+dorsal O
+wrist O
+that O
+transilluminates O
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+a O
+penlight O
+. O
+Vital O
+signs O
+are O
+normal O
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+The O
+patient O
+needs O
+to O
+type O
+on O
+her O
+computer O
+almost O
+all O
+day O
+. O
+She O
+is O
+left O
+handed O
+. O
+She O
+does O
+not O
+smoke O
+or O
+use O
+illicit O
+drugs O
+. O
+She O
+is O
+in O
+sexual O
+relationship O
+with O
+two O
+male O
+partners O
+and O
+uses O
+condoms O
+. O
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+A O
+63 O
+year O
+old O
+man O
+comes O
+to O
+the O
+clinic O
+for O
+recent O
+unintentional B-SYMPTOM
+weight I-SYMPTOM
+loss I-SYMPTOM
+. O
+The O
+patient O
+also O
+has O
+epigastric B-SYMPTOM
+discomfort I-SYMPTOM
+after O
+meals O
+. O
+He O
+has O
+no O
+known O
+medical O
+problems O
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+takes O
+no O
+medications O
+. O
+His O
+blood O
+pressure O
+is O
+130 O
+75 O
+and O
+pulse O
+rate O
+is O
+88 O
+min O
+. O
+He O
+is O
+not O
+febrile B-SYMPTOM
+. O
+Upper O
+endoscopy O
+shows O
+a O
+lesion B-SYMPTOM
+in O
+the O
+stomach O
+that O
+shows O
+typical O
+features O
+of O
+diffuse O
+type O
+adenocarcinoma O
+presenting O
+with O
+signet O
+ring O
+cells O
+that O
+do O
+not O
+form O
+glands O
+. O
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+A O
+39 O
+year O
+old O
+man O
+comes O
+to O
+the O
+emergency O
+department O
+with O
+an O
+acute O
+onset O
+of O
+severe O
+left O
+toe O
+pain B-SYMPTOM
+. O
+The O
+toe O
+is O
+red O
+and O
+exhibits O
+swelling O
+. O
+The O
+patient O
+is O
+not O
+febrile B-SYMPTOM
+, O
+and O
+does O
+not O
+remember O
+any O
+recent O
+trauma O
+. O
+Medical O
+history O
+is O
+not O
+significant O
+except O
+for O
+the O
+similar O
+attacks O
+and O
+the O
+diagnosis O
+of O
+gouty O
+arthritis O
+. O
+His O
+medication O
+history O
+includes O
+Allopurinol O
+to O
+prevent O
+gouty O
+attacks O
+. O
+His O
+father O
+has O
+the O
+same O
+medical O
+condition O
+. O
+However O
+, O
+his O
+older O
+brother O
+who O
+is O
+41 O
+years O
+old O
+is O
+healthy O
+with O
+no O
+history O
+of O
+gouty O
+arthritis O
+. O
+Physical O
+examination O
+shows O
+a O
+swollen O
+, O
+tender O
+first O
+metatarsophalangeal B-SYMPTOM
+joint I-SYMPTOM
+. O
+Aspiration O
+of O
+the O
+joint O
+showed O
+high B-SYMPTOM
+leukocyte I-SYMPTOM
+count I-SYMPTOM
+, O
+negative O
+Gram O
+stain O
+, O
+and O
+numerous O
+needle O
+shaped O
+crystals O
+, O
+which O
+is O
+compatible O
+with O
+gouty O
+arthritis O
+. O
+
+An O
+8 O
+year O
+old O
+boy O
+is O
+brought O
+to O
+the O
+clinic O
+by O
+his O
+parents O
+because O
+of O
+weakness B-SYMPTOM
+and O
+difficulty B-SYMPTOM
+of I-SYMPTOM
+standing I-SYMPTOM
+up I-SYMPTOM
+from O
+a O
+sitting O
+position O
+. O
+The O
+mother O
+is O
+healthy O
+but O
+had O
+a O
+brother O
+who O
+died O
+in O
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+extremity I-SYMPTOM
+weakness I-SYMPTOM
+and O
+urinary B-SYMPTOM
+retention I-SYMPTOM
+. O
+Patient O
+initially O
+presented O
+with O
+RLE B-SYMPTOM
+weakness I-SYMPTOM
+where O
+his O
+right O
+knee O
+gave O
+out O
+with O
+difficulty O
+walking O
+and O
+right O
+anterior O
+thigh B-SYMPTOM
+numbness I-SYMPTOM
+. O
+MRI O
+showed O
+a O
+spinal B-SYMPTOM
+cord I-SYMPTOM
+conus I-SYMPTOM
+mass I-SYMPTOM
+which O
+was O
+biopsied O
+and O
+found O
+to O
+be O
+anaplastic O
+astrocytoma O
+. O
+Therapy O
+included O
+field O
+radiation O
+t10 O
+l1 O
+followed O
+by O
+11 O
+cycles O
+of O
+temozolomide O
+7 O
+days O
+on O
+and O
+7 O
+days O
+off O
+. O
+This O
+was O
+followed O
+by O
+CPT O
+11 O
+Weekly O
+x4 O
+with O
+Avastin O
+Q2 O
+weeks O
+2 O
+weeks O
+rest O
+and O
+repeat O
+cycle O
+. O
+
+48 O
+M O
+with O
+a O
+h O
+o O
+HTN O
+hyperlipidemia O
+, O
+bicuspid O
+aortic O
+valve O
+, O
+and O
+tobacco O
+abuse O
+who O
+presented O
+to O
+his O
+cardiologist O
+on O
+2148 O
+10 O
+1 O
+with O
+progressive O
+SOB B-SYMPTOM
+and O
+LE O
+edema O
+. O
+TTE O
+revealed O
+severe O
+aortic O
+stenosis O
+with O
+worsening B-SYMPTOM
+LV I-SYMPTOM
+function I-SYMPTOM
+. O
+EF O
+was O
+25 O
+. O
+RV O
+pressure O
+was O
+41 O
+and O
+had O
+biatrial O
+enlargement O
+. O
+Noted O
+to O
+have O
+2 O
+aortic O
+insufficiency O
+with O
+mild O
+MR O
+. O
+He O
+was O
+sent O
+home O
+from O
+cardiology O
+clinic O
+with O
+Lasix O
+and O
+BB O
+which O
+he O
+did O
+not O
+tolerate O
+, O
+continued O
+to O
+have O
+worsening B-SYMPTOM
+SOB I-SYMPTOM
+and O
+LE O
+edema O
+and O
+finally O
+presented O
+here O
+for O
+evaluation O
+. O
+During O
+this O
+admission O
+repeat O
+echo O
+confirmed O
+critical O
+aortic O
+stenosis O
+showing O
+left B-SYMPTOM
+ventricular I-SYMPTOM
+hypertrophy I-SYMPTOM
+with O
+cavity O
+dilation O
+and O
+severe O
+global O
+hypokinesis B-SYMPTOM
+, O
+severe O
+aortic O
+valve O
+stenosis O
+with O
+underlying O
+bicuspid O
+aortic O
+valve O
+, O
+dilated O
+ascending O
+aorta O
+, O
+mild O
+pulmonary O
+artery O
+systolic O
+hypertension O
+. O
+The O
+patient O
+underwent O
+a O
+preop O
+workup O
+for O
+valvular O
+replacement O
+with O
+preop O
+chest O
+CT O
+scan O
+and O
+carotid O
+US O
+showing O
+moderate O
+heterogeneous O
+plaque B-SYMPTOM
+with O
+bilateral O
+1 O
+39 O
+ICA O
+stenosis O
+. O
+He O
+also O
+underwent O
+a O
+cardiac O
+cath O
+with O
+right O
+heart O
+cath O
+to O
+evaluate O
+his O
+pulm O
+art O
+pressures O
+which O
+showed O
+no O
+angiographically O
+apparent O
+flow O
+limiting O
+coronary O
+artery O
+disease O
+. O
+
+A O
+32 O
+yo O
+woman O
+who O
+presents O
+following O
+a O
+severe O
+' O
+exploding O
+' O
+headache B-SYMPTOM
+. O
+She O
+and O
+her O
+husband O
+report O
+that O
+yesterday O
+she O
+was O
+in O
+the O
+kitchen O
+and O
+stood O
+up O
+and O
+hit O
+her O
+head O
+on O
+the O
+corner O
+of O
+a O
+cabinet O
+. O
+The O
+next O
+morning O
+she O
+developed O
+a O
+sudden O
+' O
+exploding O
+' O
+headache B-SYMPTOM
+. O
+She O
+came O
+to O
+the O
+hospital O
+where O
+head O
+CT O
+showed O
+a O
+significant O
+amount O
+of O
+blood O
+in O
+her O
+right O
+ventricle O
+. O
+NSGY O
+evaluated O
+her O
+for O
+spontaneous O
+intraventricular O
+hemorrhage O
+with O
+a O
+concern O
+for O
+an O
+underlying O
+vascular O
+malformation O
+. O
+Cerebral O
+angiogram O
+was O
+done O
+which O
+showed O
+abnormal O
+vasculature O
+with O
+a O
+draining O
+vein O
+from O
+L O
+temporal O
+lobe O
+penetrating O
+deep O
+white O
+matter O
+consistent O
+with O
+AVM O
+. O
+The O
+patient O
+did O
+continue O
+to O
+have O
+a O
+headaches B-SYMPTOM
+but O
+they O
+were O
+improving O
+with O
+pain O
+medication O
+. O
+The O
+patient O
+refused O
+PT O
+evaluation O
+but O
+was O
+ambulating O
+independently O
+without O
+difficulty O
+. O
+She O
+was O
+discharged O
+to O
+home O
+with O
+her O
+husband O
+on O
+2155 O
+12 O
+6 O
+. O
+
+This O
+is O
+a O
+44 O
+year O
+old O
+female O
+with O
+PMH O
+of O
+PCOS O
+, O
+Obesity O
+, O
+HTN O
+who O
+presented O
+with O
+symptoms O
+of O
+cholecystitis O
+and O
+was O
+found O
+incidentally O
+to O
+have O
+a O
+large O
+pericardial O
+effusion O
+. O
+A O
+pericardiocentesis O
+was O
+performed O
+and O
+the O
+fluid O
+analysis O
+was O
+consistent O
+with O
+Burkitt O
+'s O
+lymphoma O
+. O
+Pericardial O
+fluid O
+was O
+kappa O
+light O
+chain O
+restricted O
+CD10 O
+positive O
+monotypic O
+B O
+cells O
+expressing O
+FMC O
+7 O
+, O
+CD19 O
+, O
+CD20 O
+, O
+and O
+myc O
+rearrangement O
+consistent O
+with O
+Burkitt O
+'s O
+Lymphoma O
+. O
+A O
+subsequent O
+lumbar O
+puncture O
+and O
+bone O
+marrow O
+biopsy O
+were O
+negative O
+for O
+any O
+involvement O
+which O
+made O
+this O
+a O
+primary O
+cardiac O
+lymphoma O
+. O
+A O
+cardiac O
+MRI O
+showed O
+a O
+mass O
+that O
+was O
+3cm O
+x O
+1cm O
+on O
+the O
+lateral O
+wall O
+of O
+the O
+right O
+atrium O
+adjacent O
+to O
+the O
+AV O
+junction O
+. O
+Past O
+Medical O
+History O
+1 O
+. O
+Rare O
+migraines B-SYMPTOM
+2 O
+. O
+HTN O
+3 O
+. O
+Obesity O
+4 O
+. O
+PCOS O
+infertility O
+5 O
+. O
+Viral O
+encephalitis O
+meningitis O
+ICH O
+seizure O
+stroke O
+2137 O
+from O
+severe O
+sinus O
+infxn O
+, O
+caused O
+mild O
+non O
+focal O
+residual O
+deficits O
+6 O
+. O
+CSF O
+leak O
+w O
+meningitis O
+s O
+p O
+lumbar O
+drain O
+placement O
+7 O
+. O
+R O
+LE O
+DVT O
+s O
+p O
+IVC O
+filter O
+placement O
+8 O
+. O
+Knee O
+surgery O
+
+74M O
+hx O
+of O
+CAD O
+s O
+p O
+CABG O
+, O
+EF O
+60 O
+prior O
+CVA O
+no O
+residual O
+deficits O
+, O
+HTN O
+, O
+HL O
+, O
+DMII O
+, O
+Moderate O
+to O
+Severe O
+PVD O
+was O
+referred O
+to O
+cardiology O
+for O
+evaluation O
+of O
+PVD O
+, O
+and O
+on O
+examination O
+patient O
+was O
+found O
+to O
+have O
+carotid O
+bruits O
+. O
+Upon O
+further O
+review O
+of O
+symptoms O
+the O
+pt O
+reports O
+Occasional O
+dizziness O
+, O
+no O
+prior O
+syncope O
+occasional O
+HA O
+, O
+Denies O
+CP O
+SOB O
+. O
+No O
+sensory O
+or O
+motor B-SYMPTOM
+defects I-SYMPTOM
+. O
+He O
+recalls O
+that O
+he O
+might O
+have O
+had O
+a O
+stroke O
+10 O
+15 O
+years O
+ago O
+without O
+any O
+residual O
+deficit O
+. O
+Prior O
+to O
+CABG O
+he O
+only O
+had O
+diaphoresis O
+. O
+Further O
+review O
+of O
+systems O
+is O
+notable O
+for O
+absence O
+of O
+chest B-SYMPTOM
+pain I-SYMPTOM
+, O
+dyspnea B-SYMPTOM
+on I-SYMPTOM
+exertion I-SYMPTOM
+, O
+paroxysmal B-SYMPTOM
+nocturnal I-SYMPTOM
+dyspnea I-SYMPTOM
+, O
+orthopnea O
+, O
+palpitations O
+, O
+syncope O
+or O
+presyncope O
+. O
+He O
+underwent O
+Carotid O
+U O
+S O
+that O
+showed O
+significant O
+bilateral O
+carotid O
+stenosis O
+, O
+L O
+R O
+. O
+Angiography O
+revealed O
+an O
+80 O
+stenosis O
+of O
+the O
+R O
+ICA O
+and O
+a O
+90 O
+L O
+ICA O
+stenosis O
+. O
+Cerebral O
+angiography O
+further O
+revealed O
+patent O
+right O
+ACA O
+and O
+MCA O
+and O
+patent O
+left O
+ACA O
+and O
+left O
+MCA O
+. O
+Past O
+Medical O
+History O
+CAD O
+s O
+p O
+CABG O
+in O
+2154 O
+Hospital1 O
+112 O
+Prior O
+CVA O
+Bilateral O
+carotid O
+artery O
+disease O
+Anemia O
+PVD O
+Hypertension O
+Diabetes O
+c O
+b O
+retinopathy O
+and O
+peripheral O
+neuropathy O
+Cataracts O
+s O
+p O
+surgery O
+Thyroid O
+nodule O
+Colon O
+polyps O
+s O
+p O
+resection O
+Intermittent O
+Lower B-SYMPTOM
+back I-SYMPTOM
+pain I-SYMPTOM
+Proteinuria O
+s O
+p O
+right O
+elbow O
+fracture O
+as O
+a O
+child O
+Arthritis O
+
+Patient O
+is O
+a O
+55yo O
+woman O
+with O
+h O
+o O
+ESRD O
+on O
+HD O
+and O
+peritoneal O
+dialysis O
+who O
+presented O
+with O
+watery O
+, O
+non O
+bloody O
+diarrhea B-SYMPTOM
+and O
+weakness B-SYMPTOM
+. O
+She O
+has O
+a O
+history O
+of O
+2 O
+prior O
+C O
+diff O
+infections O
+, O
+the O
+most O
+recent O
+just O
+1 O
+month O
+ago O
+. O
+Recent O
+antibx O
+use O
+in O
+the O
+last O
+month O
+on O
+prior O
+admission O
+. O
+Was O
+also O
+txd O
+for O
+Cdiff O
+at O
+that O
+time O
+for O
+14 O
+d O
+. O
+course O
+with O
+po O
+vanco O
+. O
+Pt O
+was O
+initially O
+admitted O
+to O
+the O
+ICU O
+and O
+was O
+septic O
+on O
+pressors O
+levophed O
+until O
+the O
+morning O
+of O
+8 O
+26 O
+with O
+leukocytosis O
+but O
+no O
+fever B-SYMPTOM
+. O
+C O
+diff O
+assay O
+positive O
+on O
+admission O
+, O
+and O
+pt O
+had O
+leukocytosis O
+consistent O
+with O
+C O
+diff O
+. O
+Patient O
+was O
+placed O
+on O
+Vanco O
+po O
+, O
+Flagyl O
+IV O
+and O
+Flagyl O
+po O
+initially O
+, O
+and O
+when O
+patient O
+improved O
+she O
+was O
+transitioned O
+to O
+Vanco O
+oral O
+and O
+Flagyl O
+oral O
+on O
+8 O
+29 O
+. O
+Patient O
+was O
+treated O
+with O
+Vanco O
+for O
+an O
+extended O
+course O
+of O
+6 O
+weeks O
+given O
+her O
+recurrent O
+C O
+diff O
+. O
+Pt O
+was O
+also O
+encouraged O
+to O
+take O
+probiotics O
+and O
+to O
+bleach O
+her O
+home O
+when O
+she O
+was O
+discharged O
+. O
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+60 O
+yo O
+M O
+with O
+Hep O
+C O
+cirrhosis O
+, O
+grade O
+II O
+esophageal O
+varices O
+, O
+recent O
+admission O
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+UGIB B-SYMPTOM
+2 O
+9 O
+NSAID O
+gastritis O
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+referred O
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+admission O
+throught O
+the O
+ED O
+by O
+hepatology O
+clinic O
+for O
+new O
+slurred B-SYMPTOM
+speech I-SYMPTOM
+and O
+tangential O
+thought O
+process O
+. O
+Patient O
+also O
+describes O
+new O
+imbalance O
+leading O
+to O
+a O
+fall O
+during O
+which O
+he O
+may O
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+hit O
+his O
+head O
+on O
+. O
+Per O
+last O
+liver O
+clinic O
+note O
+has O
+been O
+off O
+ETOH O
+for O
+a O
+year O
+corroborated O
+with O
+pt O
+, O
+utox O
+was O
+negative O
+for O
+alocohol O
+. O
+CT O
+was O
+within O
+normal O
+limits O
+, O
+and O
+neuro O
+evaluation O
+determined O
+this O
+was O
+not O
+ischemic O
+infart O
+. O
+Patient O
+was O
+given O
+a O
+presumptive O
+diagnosis O
+of O
+hepatic O
+encephalopathy O
+and O
+started O
+on O
+lactulose O
+. O
+Liver O
+function O
+tests O
+showed O
+a O
+striking O
+increase O
+in O
+his O
+total O
+and O
+direct O
+bilirubin O
+since O
+last O
+visit O
+. O
+Another O
+worrisome O
+feature O
+was O
+the O
+increase O
+in O
+the O
+patient O
+'s O
+AFP O
+. O
+This O
+could O
+be O
+progression O
+of O
+cirrhosis O
+as O
+he O
+failed O
+interferon O
+twice O
+. O
+He O
+is O
+to O
+follow O
+up O
+as O
+an O
+outpatient O
+to O
+work O
+this O
+up O
+. O
+Past O
+Medical O
+History O
+HCV O
+Cirrhosis O
+tx O
+with O
+interferon O
+x2 O
+with O
+no O
+response O
+Portal O
+Gastropathy O
+Grade O
+II O
+Esophageal O
+varices O
+HTN O
+Recent O
+admission O
+4 O
+2150 O
+UGIB O
+2 O
+9 O
+non O
+steroidal O
+induced O
+gastritis O
+
+This O
+is O
+a O
+57 O
+year O
+old O
+gentleman O
+with O
+CLL O
+and O
+large O
+cell O
+transformation O
+. O
+He O
+presented O
+with O
+his O
+disease O
+back O
+in O
+10 O
+2119 O
+with O
+an O
+elevated B-SYMPTOM
+white I-SYMPTOM
+count I-SYMPTOM
+and O
+LDH O
+. O
+He O
+was O
+without O
+any O
+splenomegaly O
+or O
+any O
+cytopenias O
+at O
+that O
+time O
+. O
+He O
+did O
+have O
+some O
+bulky O
+lymphadenopathy O
+. O
+He O
+then O
+completed O
+four O
+cycles O
+of O
+FCR O
+therapy O
+, O
+which O
+he O
+completed O
+back O
+in O
+09 O
+2119 O
+. O
+He O
+had O
+an O
+excellent O
+response O
+to O
+therapy O
+and O
+was O
+monitored O
+off O
+treatment O
+for O
+approximately O
+two O
+years O
+. O
+He O
+then O
+presented O
+in O
+7 O
+2122 O
+with O
+a O
+rising O
+white O
+count O
+, O
+approximately O
+50 O
+lymphocytes O
+, O
+and O
+a O
+mildly B-SYMPTOM
+elevated I-SYMPTOM
+LDH I-SYMPTOM
+. O
+He O
+also O
+had O
+some O
+mild O
+worsening O
+palpable O
+lymphadenopathy O
+. O
+He O
+then O
+received O
+four O
+cycles O
+of O
+PCR O
+, O
+but O
+did O
+not O
+have O
+much O
+in O
+the O
+way O
+of O
+response O
+and O
+his O
+treatment O
+regimen O
+was O
+switched O
+to O
+R O
+CVP O
+of O
+which O
+he O
+received O
+two O
+cycles O
+. O
+He O
+did O
+again O
+not O
+have O
+a O
+significant O
+response O
+, O
+though O
+continued O
+to O
+have O
+an O
+excellent O
+performance O
+status O
+, O
+and O
+he O
+was O
+ultimately O
+switched O
+to O
+Campath O
+therapy O
+. O
+He O
+did O
+have O
+resolution O
+of O
+his O
+lymphocytosis O
+, O
+and O
+his O
+white O
+count O
+has O
+come O
+down O
+nicely O
+, O
+but O
+did O
+not O
+have O
+much O
+in O
+the O
+way O
+of O
+response O
+in O
+terms O
+of O
+reducing O
+his O
+bulky O
+lymphadenopathy O
+. O
+He O
+then O
+eventually O
+had O
+developed O
+an O
+enlarging O
+left O
+cervical O
+node O
+which O
+was O
+biopsied O
+and O
+was O
+found O
+to O
+have O
+Richter O
+'s O
+transformation O
+. O
+
+41 O
+year O
+old O
+man O
+with O
+history O
+of O
+severe O
+intellectual O
+disability O
+, O
+CHF O
+, O
+epilepsy O
+presenting O
+with O
+facial O
+twitching O
+on O
+the O
+right O
+and O
+generalized O
+shaking B-SYMPTOM
+in O
+at O
+his O
+NH O
+which O
+required O
+20 O
+mg O
+valium O
+to O
+cease O
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+, O
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+seizure O
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+Dilantin O
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+lasix O
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+night O
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+sleep O
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+vanc O
+meropenem O
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+leaking O
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+not O
+concerned O
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+u O
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+pt O
+next O
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+Recurrent O
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+Klebsiella O
+Pseudomonas O
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+Marginal O
+Zone O
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+orbit O
+Dx O
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+03 O
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+R O
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+6 O
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+Hypertension O
+Partial O
+Bowel O
+obstruction O
+s O
+p O
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+C O
+Cryoglobulinemia O
+SLE O
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+x O
+7 O
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+6 O
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+6 O
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+disease O
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+2 O
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+3 O
+17 O
+7 O
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+u O
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+90 O
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+mitral O
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+Microcytic O
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+64yo O
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+p O
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+hemodialysis O
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+30mg O
+, O
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+. O
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+prednisone O
+, O
+followed O
+by O
+VAD O
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+cell O
+transplant O
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+myeloma O
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+due O
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+worsening O
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+kidney O
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+. O
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+This O
+is O
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+78 O
+year O
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+h O
+o O
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+multiple O
+urological O
+procedures O
+, O
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+prostatectomy O
+. O
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+noted O
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+impossible O
+for O
+staff O
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+pass O
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+, O
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+leaked O
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+good O
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+void O
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+scans O
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+. O
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+65 O
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+HLD O
+, O
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+, O
+ventricular O
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+cardiac O
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+. O
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+report O
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+read O
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+yesterday O
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+seconds O
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+39 O
+shortly O
+thereafter O
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+his O
+symptoms O
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+Overnight O
+, O
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+patient O
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+monomorphic O
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+to O
+be O
+unresponsive O
+. O
+CPR O
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+initiated O
+, O
+unclear O
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+patient O
+had O
+a O
+pulse O
+. O
+Within O
+one O
+minute O
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+sinus O
+rhythm O
+. O
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+patient O
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+not O
+report O
+any O
+symptoms O
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+be O
+transferred O
+to O
+the O
+CCU O
+for O
+catheterization O
+and O
+EPS O
+. O
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+hands I-SYMPTOM
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+Na O
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+4 O
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+, O
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+drop I-SYMPTOM
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+loss B-SYMPTOM
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+consciousness I-SYMPTOM
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+medical O
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+significant O
+for O
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+, O
+hyperlipidemia O
+and O
+hypothyroidism O
+. O
+He O
+smokes O
+cigarette O
+1 O
+pack O
+per O
+day O
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+40 O
+years O
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+alcohol O
+consumption O
+of O
+5 O
+to O
+6 O
+beers O
+per O
+week O
+. O
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+is O
+not O
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+about O
+his O
+family O
+history O
+. O
+He O
+is O
+using O
+Levothyroxine O
+, O
+Atorvastatin O
+and O
+HTCZ O
+. O
+His O
+vital O
+signs O
+were O
+stable O
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+the O
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+Left B-SYMPTOM
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+in O
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+Health O
+Stroke O
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+of O
+head O
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+no O
+acute O
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+findings O
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+recombinant O
+tissue O
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+statin O
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+unit O
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+reach O
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+ideal O
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+hair O
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+axillary O
+. O
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+3 O
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+FBS O
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+75 O
+in O
+the O
+latest O
+lab O
+study O
+. O
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+A O
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+an O
+international O
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+few O
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+camp O
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+movements I-SYMPTOM
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+watery O
+and O
+white O
+but O
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+patient O
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+no O
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+Blood O
+pressure O
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+62 O
+lying O
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+drops O
+to O
+75 O
+40 O
+standing O
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+ill I-SYMPTOM
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+dry O
+mucosa O
+. O
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+in O
+dark O
+field O
+microscopy O
+of O
+a O
+fresh O
+stool O
+specimen O
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+lab O
+study O
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+bellow O
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+137 O
+meq O
+L O
+Potassium O
+2 O
+meq O
+L O
+Chloride O
+94meq O
+L O
+CO2 O
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+Fecal O
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+Fecal O
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+blood O
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+A O
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+to O
+the O
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+loss I-SYMPTOM
+and O
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+4 O
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+Chest O
+computed O
+topography O
+showed O
+bilateral O
+multiple O
+infiltrates O
+in O
+the O
+upper O
+lobes O
+and O
+thickened O
+bronchial O
+walls O
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+is O
+a O
+documented O
+positive O
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+in O
+his O
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+giant O
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+for O
+him O
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+He O
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+treating O
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+and O
+cyclophosphamides O
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+His O
+Birmingham O
+Vasculitis O
+Activity O
+Score O
+BVAS O
+is O
+above O
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+the O
+beginning O
+of O
+his O
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+performed O
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+, O
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+177 O
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+elevated O
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+dominant O
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+scan O
+showed O
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+acute O
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+free O
+fluid O
+in O
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+phlegmon O
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+no O
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+emergent O
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+appendectomy O
+under O
+general O
+anesthesia O
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+A O
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+old O
+boy O
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+of I-SYMPTOM
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+past O
+3 O
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+a O
+salad O
+at O
+a O
+restaurant O
+prior O
+to O
+his O
+diarrhea B-SYMPTOM
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+results O
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+Hemoglobin O
+9 O
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+g O
+dL O
+Platelet O
+110 O
+, O
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+nitrogen O
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+in O
+stools O
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+the O
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+flu O
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+contraception O
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+30 O
+minutes O
+a O
+day O
+at O
+least O
+5 O
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+tonsillectomy O
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+The O
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+a O
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+both O
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+worm O
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+The O
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+the O
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+vision I-SYMPTOM
+lost O
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+1 O
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+visited O
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+PCP O
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+underwent O
+brain O
+MRI O
+which O
+revealed O
+a O
+single O
+plaque B-SYMPTOM
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+the O
+brainstem O
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+After O
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+second O
+MRI O
+revealed O
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+the O
+left O
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+Remitting O
+Multiple O
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+section O
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+child O
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+any O
+sexual O
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+smokes O
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+per O
+day O
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+drinks O
+alcohol O
+occasionally O
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+as O
+an O
+editor O
+in O
+a O
+publisher O
+company O
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+happy O
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+can O
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+The O
+patient O
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+60 O
+year O
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+man O
+complaining O
+of O
+frequent O
+headaches B-SYMPTOM
+, O
+generalized O
+bone B-SYMPTOM
+pain I-SYMPTOM
+and O
+difficulty B-SYMPTOM
+chewing I-SYMPTOM
+that O
+started O
+6 O
+years O
+ago O
+and O
+is O
+worsening O
+. O
+Examination O
+shows O
+bilateral B-SYMPTOM
+swellings I-SYMPTOM
+around O
+the O
+molars O
+. O
+The O
+swellings B-SYMPTOM
+have O
+increased O
+since O
+his O
+last O
+examination O
+. O
+Several O
+extraoral B-SYMPTOM
+lesions I-SYMPTOM
+are O
+detected O
+in O
+the O
+head O
+and O
+face O
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+are O
+non O
+tender O
+and O
+attached O
+to O
+the O
+underlying O
+bone O
+. O
+Further O
+evaluation O
+shows O
+increased O
+uptake O
+of O
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+The O
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+candidate O
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+first O
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+FEV1 O
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+60 O
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+. O
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+non O
+significant O
+. O
+His O
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+history O
+is O
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+uncle O
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+used O
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+be O
+treated O
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+combination O
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+inhaled O
+corticosteroids O
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+Zafirlukast O
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+A O
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+dizziness B-SYMPTOM
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+radioactive O
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