Datasets:

JaimeML

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snomed-entity-challenge

like 1

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Brief Hospital Course: The patient presented to the emergency department and was evaluated by the orthopedic surgery team. The patient was found to have right ankle open fracture dislocation and was admitted to the orthopedic surgery service. The patient was taken to the operating room on ___ for R ankle I&D and ORIF, which the patient tolerated well (for full details please see the separately dictated operative report). The patient was taken from the OR to the PACU in stable condition and after recovery from anesthesia was transferred to the floor. The patient was initially given IV fluids and IV pain medications, and progressed to a regular diet and oral medications by POD#1. The patient was given perioperative antibiotics and anticoagulation per routine. The patients home medications were continued throughout this hospitalization. The patient worked with ___ who determined that discharge to home was appropriate. The ___ hospital course was otherwise unremarkable. At the time of discharge the patient was afebrile with stable vital signs that were within normal limits, pain was well controlled with oral medications, incisions were clean/dry/intact, and the patient was voiding/moving bowels spontaneously. The patient is NWB in the right lower extremity, and will be discharged on lovenox for DVT prophylaxis. The patient will follow up in two weeks per routine. A thorough discussion was had with the patient regarding the diagnosis and expected post-discharge course, and all questions were answered prior to discharge. ###RESPONSE: evaluated by the orthopedic surgery team {Orthopedic assessment}, right ankle {Structure of right ankle}, open fracture {Open fracture}, dislocation {Dislocation}, admitted to the orthopedic surgery service {Admission by orthopedic surgeon}, R ankle {Structure of right ankle}, I&D {Incision AND drainage}, ORIF {Open reduction of fracture with internal fixation}, operative {Surgical procedure}, PACU {Postanesthesia care}, stable condition {Patient's condition stable}, anesthesia {Absence of sensation}, given IV fluids {Administration of intravenous fluids}, IV {Intravenous therapy}, pain medications {Administration of analgesic}, regular diet {Normal diet}, oral medications {Administration of drug or medicament via oral route}, antibiotics {Antibiotic therapy}, anticoagulation {Anticoagulant therapy}, unremarkable {No abnormality detected}, stable vital signs {Normal vital signs}, pain {Pain}, oral medications {Administration of drug or medicament via oral route}, incisions {Incision}, voiding {Normal micturition}, moving bowels {Finding of defecation}, right lower extremity {Structure of right lower limb}, DVT {Deep venous thrombosis}, prophylaxis {Preventive procedure}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Medications on Admission: none Discharge Medications: 1. Acetaminophen 1000 mg PO Q8H 2. Docusate Sodium 100 mg PO BID 3. Enoxaparin Sodium 40 mg SC QHS Start: Today - ___, First Dose: Next Routine Administration Time RX *enoxaparin 40 mg/0.4 mL 1 syringe at bedtime Disp #*14 Syringe Refills:*0 4. OxycoDONE (Immediate Release) ___ mg PO Q4H:PRN pain RX *oxycodone 5 mg ___ tablet(s) by mouth q3hrs Disp #*80 Tablet Refills:*0 ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Discharge Disposition: Home Discharge Diagnosis: R ankle fracture dislocation Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). ###RESPONSE: R ankle {Structure of right ankle}, fracture {Open fracture}, dislocation {Dislocation}, Mental Status {Neurological mental status determination}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, Ambulatory - requires assistance or aid {Finding of walking aid use}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Discharge Instructions: MEDICATIONS: - Please take all medications as prescribed by your physicians at discharge. - Continue all home medications unless specifically instructed to stop by your surgeon. - Do not drink alcohol, drive a motor vehicle, or operate machinery while taking narcotic pain relievers. - Narcotic pain relievers can cause constipation, so you should drink eight 8oz glasses of water daily and take a stool softener (colace) to prevent this side effect. ANTICOAGULATION: - Please take lovenox 40mg daily for 2 weeks WOUND CARE: - No baths or swimming for at least 4 weeks. - Any stitches or staples that need to be removed will be taken out at your 2-week follow up appointment. - No dressing is needed if wound continues to be non-draining. - Splint must be left on until follow up appointment unless otherwise instructed - Do NOT get splint wet ACTIVITY AND WEIGHT BEARING: NWB R ankle Danger Signs: Please call your PCP or surgeon's office and/or return to the emergency department if you experience any of the following: - Increasing pain that is not controlled with pain medications - Increasing redness, swelling, drainage, or other concerning changes in your incision - Persistent or increasing numbness, tingling, or loss of sensation - Fever > 101.4 - Shaking chills - Chest pain - Shortness of breath - Nausea or vomiting with an inability to keep food, liquid, medications down - Any other medical concerns ###RESPONSE: Do not drink alcohol {Education about alcohol consumption}, pain relievers {Administration of analgesic}, pain relievers {Administration of analgesic}, constipation {Constipation}, take a stool softener {Administration of laxative}, dressing {Application of dressing}, wound {Wound}, draining {Wound discharge}, Splint {Application of splint}, R ankle {Structure of right ankle}, PCP {Primary care management}, pain {Pain}, pain medications {Administration of analgesic}, redness {Redness of skin over lesion}, swelling {Swelling}, drainage {Discharge}, incision {Incision}, numbness, tingling {Numbness and tingling sensation of skin}, loss of sensation {Numbness}, Fever {Fever}, chills {Chill}, Chest pain {Chest pain}, Shortness of breath {Dyspnea}, Nausea {Nausea}, vomiting {Vomiting}, liquid {Liquid}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Followup Instructions: ___ ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Name: ___ Unit No: ___ Admission Date: ___ Discharge Date: ___ Date of Birth: ___ Sex: M Service: MEDICINE ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Allergies: No Known Allergies / Adverse Drug Reactions Attending: ___. Chief Complaint: Dyspnea and hemoptysis Major Surgical or Invasive Procedure: intubation - ___ arterial line placement - ___ cardiac catheterization - ___ ###RESPONSE: No Known Allergies {Allergic disposition}, Adverse Drug Reactions {Propensity to adverse reactions to drug}, Dyspnea {Dyspnea}, hemoptysis {Hemoptysis}, intubation {Intubation}, arterial line placement {Insertion of catheter into artery}, cardiac catheterization {Cardiac catheterization}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: History of Present Illness: Mr. ___ is an ___ year old man with COPD, CAD, CHF and Afib who presented to ___ complaining of dyspnea and hemoptysis. Patient reports productive cough with yellow sputum for the past 3 weeks that was treated with azithromycin by his primary care doctor one week ago. Patient also c/o hemoptysis for the past ___ days, which he described as "big globs" of blood. Patient also endorses fever and chills at home. At ___, initial VS were 98.1 140 132/67 24 76% RA that improved to 95% on NRB. Labs revelaed WBC 13.1 91.6%N and INR 8.0. CXR revealed RUL consolidation c/f PNA, and he received CTX 1g IV, Vitamin K and was transfered to ___ for further care. At ___ initail VS were 99.0 120 111/70 24 94% 15L NRB. Labs revealed lactate 2.9, WBC 13 92.5%N, HCT 40.7, Cr 2.2, proBNP 4254, TropT 0.28. ABG 7.43, 28, 81. Patient received 2 units FFP, 40mg IV lasix, 10mg IV diltiazem, 30mg PO diltiazem, 500mg IV azithromycin and 1g IV vancomycin. The patient was then admitted to the MICU. On arrival to the MICU, the patient happeard was dyspnic with oxygen saturation of 90% on NRB and was placed on non-invasive ventillation with improvement to 100% oxygen saturation. Review of systems: (+) Per HPI (-) Denies fever, chills, night sweats, recent weight loss or gain. Denies headache, sinus tenderness, rhinorrhea or congestion. Denies shortness of breath, cough, dyspnea or wheezing. Denies chest pain, chest pressure, palpitations. Denies constipation, abdominal pain, diarrhea, dark or bloody stools. Denies dysuria, frequency, or urgency. Denies arthralgias or myalgias. Denies rashes or skin changes. ###RESPONSE: COPD {Chronic obstructive lung disease}, CAD {Coronary arteriosclerosis}, CHF {Congestive heart failure}, Afib {Atrial fibrillation}, dyspnea {Dyspnea}, hemoptysis {Hemoptysis}, productive cough {Productive cough}, yellow sputum {Yellow sputum}, hemoptysis {Hemoptysis}, fever {Fever}, chills {Chill}, RA {Breathing room air}, improved {Patient's condition improved}, NRB {Oxygen administration by mask}, CXR {Plain chest X-ray}, RUL {Structure of upper lobe of right lung}, consolidation {Consolidation}, PNA {Pneumonia}, NRB {Oxygen administration by mask}, lasix {Diuretic therapy}, dyspnic {Dyspnea}, NRB {Oxygen administration by mask}, non-invasive ventillation {Non-invasive ventilation}, fever {Fever}, chills {Chill}, night sweats {Night sweats}, recent weight loss {Recent weight loss}, gain {Recent weight gain}, headache {Headache}, sinus {Nasal sinus structure}, tenderness {Tenderness}, rhinorrhea {Nasal discharge}, congestion {Nasal congestion}, shortness of breath {Dyspnea}, cough {Cough}, dyspnea {Dyspnea}, wheezing {Wheezing}, chest pain {Chest pain}, chest pressure {Tight chest}, palpitations {Palpitations}, constipation {Constipation}, abdominal pain {Abdominal pain}, diarrhea {Diarrhea}, dark {Dark stools}, bloody stools {Hematochezia}, dysuria {Dysuria}, frequency {Increased frequency of urination}, urgency {Urgent desire to urinate}, arthralgias {Joint pain}, myalgias {Muscle pain}, rashes {Eruption of skin}, skin changes {Skin appearance abnormal}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Past Medical History: - Atrial fibrillation and systolic CHF. EF of 35% to 40% - CAD s/p CABG (2 vessel, LIMA to LAD, rSVG to OM) in ___ - Rheumatic heart disease s/p bioprosthetic AVR in ___ - Mitral valve prolapse - Bioprosthetic AVR ___ (bovine) - AAA 3.9 cm in ___ follow at ___ - Hypertension - High cholesterol - Restrictive lung disease - Asthma - Polymyalgia rheumatica, on 10mg prednisone daily - History of cholecystectomy - Hemorrhoids - Chronic renal insufficiency, baseline creatinine 1.6 to 1.9 - Cataract surgery, left - Anemia - Seasonal allergy - Chronic anal fissure ###RESPONSE: Atrial fibrillation {Atrial fibrillation}, systolic CHF {Chronic systolic heart failure}, CAD {Coronary arteriosclerosis}, CABG {Coronary artery bypass grafting}, LIMA {Structure of left internal thoracic artery}, LAD {Structure of anterior descending branch of left coronary artery}, OM {Structure of obtuse marginal branch of circumflex branch of left coronary artery}, Rheumatic heart disease {Rheumatic heart disease}, bioprosthetic AVR {Repair of aortic valve with tissue graft}, Mitral valve prolapse {Mitral valve prolapse}, Bioprosthetic AVR {Repair of aortic valve with tissue graft}, AAA {Abdominal aortic aneurysm}, Hypertension {Hypertensive disorder, systemic arterial}, High cholesterol {Hypercholesterolemia}, Restrictive lung disease {Restrictive lung disease}, Asthma {Asthma}, Polymyalgia rheumatica {Polymyalgia rheumatica}, cholecystectomy {Cholecystectomy}, Hemorrhoids {Hemorrhoids}, Chronic renal insufficiency {Chronic renal insufficiency}, Cataract surgery, left {Surgery of cataract of left eye}, Anemia {Anemia}, Seasonal allergy {Seasonal allergy}, Chronic anal fissure {Chronic anal fissure}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Social History: ___ ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Family History: Pt is adopted, so unknown. ###RESPONSE: adopted {Adopted}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Physical Exam: Admission ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Physical Exam: General: Tachypnic, oriented, mild respiratory distress HEENT: Sclera anicteric, MMM, oropharynx clear, EOMI, PERRL Neck: supple, JVP elevated to 16cm H2O, no LAD CV: tachycardic irrgeular rhythm, no rubs, gallops Lungs: Rales in RUL and ___ bases, no wheezes, Abdomen: soft, non-distended, bowel sounds present, no organomegaly, no tenderness to palpation, no rebound or guarding GU: foley in place Ext: Warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema Neuro: CNII-XII intact, MAEW ###RESPONSE: Physical Exam {Physical examination procedure}, General {General examination of patient}, Tachypnic {Tachypnea}, oriented {Orientated}, distress {Distress}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, MMM {Moist oral mucosa}, oropharynx clear {Pharynx normal}, EOMI {Normal ocular motility}, PERRL {Pupils equal and reacting to light}, Neck {Physical examination procedure}, supple {Normal movement of neck}, JVP {Finding of jugular venous pressure}, LAD {Lymphadenopathy}, CV {Cardiovascular physical examination}, tachycardic {Tachycardia}, irrgeular rhythm {Irregular heart beat}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, Lungs {Examination of respiratory system}, Rales {Respiratory crackles}, RUL {Structure of upper lobe of right lung}, bases {Structure of base of lung}, wheezes {Wheezing}, Abdomen {Examination of abdomen}, soft {Abdomen soft}, non-distended {Normal abdominal contour}, bowel sounds present {Normal bowel sounds}, organomegaly {Abdominal organomegaly}, tenderness {Tenderness}, palpation {Palpation}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, GU {Examination of genitourinary system}, foley in place {Urinary catheter in situ}, Ext {Examination of limb}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, 2+ pulses {Peripheral pulses normal}, clubbing {Clubbing}, cyanosis {Cyanosis}, edema {Edema}, Neuro {Neurological examination}, CNII {Optic nerve structure}, XII intact {Intact hypoglossal nerve}, MAEW {Does move all four limbs}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Pertinent Results: Admission Labs: ___ 10:50AM BLOOD WBC-13.0*# RBC-4.32* Hgb-12.6* Hct-40.7 MCV-94 MCH-29.2 MCHC-31.0 RDW-14.0 Plt ___ ___ 10:50AM BLOOD Neuts-92.5* Lymphs-4.0* Monos-3.0 Eos-0.4 Baso-0.2 ___ 10:50AM BLOOD ___ PTT-33.8 ___ ___ 10:50AM BLOOD Glucose-157* UreaN-69* Creat-2.2* Na-135 K-4.9 Cl-99 HCO3-21* AnGap-20 ___ 10:50AM BLOOD Calcium-8.7 Phos-3.4 Mg-1.6 ___ 11:05AM BLOOD Lactate-2.9* Cardiac Labs: ___ 10:50AM BLOOD CK-MB-8 cTropnT-0.29* proBNP-4254* ___ 10:50AM BLOOD cTropnT-0.28* ___ 10:50AM BLOOD CK(CPK)-283 ___ 10:13PM BLOOD CK-MB-4 cTropnT-0.37* ___ 10:13PM BLOOD CK(CPK)-215 ___ 05:35AM BLOOD CK-MB-4 cTropnT-0.24* ___ 05:35AM BLOOD CK(CPK)-169 ___ 01:24PM BLOOD CK-MB-5 cTropnT-0.18* ___ 01:24PM BLOOD CK(CPK)-138 Interim Labs: ___ 05:35AM BLOOD Cortsol-30.1* Microbiology: ___ BLOOD CULTURE Blood Culture, Routine-PENDING ___ BLOOD CULTURE Blood Culture, Routine-PENDING ___ URINE URINE CULTURE-FINAL ___ SPUTUM GRAM STAIN-FINAL; RESPIRATORY CULTURE-FINAL {YEAST} ___ MRSA SCREEN MRSA SCREEN-FINAL ___ URINE Legionella Urinary Antigen -FINAL ___ URINE URINE CULTURE-FINAL ___ BLOOD CULTURE Blood Culture, Routine-FINAL ___ BLOOD CULTURE Blood Culture, Routine-FINAL . Imaging: CXR ___ Possible asymmetric right greater than left, pulmonary edema; superimposed infectious process not excluded. Given history of hemoptysis, underlying pulmonary hemorrhage is not excluded. Small right pleural effusion. CXR ___ Status post median sternotomy for CABG with overall stable cardiac and mediastinal contours. Prosthetic aortic valve. There is interval worsening of bilateral airspace and interstitial process which may reflect pulmonary edema, worsening pneumonia, or a progressing hypersensitivity reaction. Pulmonary hemorrhage could also have this appearance. Clinical correlation is advised. No pneumothorax. No acute pulmonary abnormality appreciated. TTE ___ The left atrium is mildly dilated. There is mild symmetric left ventricular hypertrophy with normal cavity size. Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. Overall left ventricular systolic function is borderline low (LVEF 50%). A bioprosthetic aortic valve prosthesis is well seated, with normal leaflet/disc motion and transvalvular gradients. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Mild to moderate (___) mitral regurgitation is seen. The estimated pulmonary artery systolic pressure is normal. There is no pericardial effusion. IMPRESSION: Mild symmetric left ventricular hypertrophy with borderline low left ventricular systolic function. Well-seated bioprosthetic aortic valve with normal transvalvular gradients. Mild to moderate mitral regurgitation. Compared with the prior study (images reviewed) of ___, the left ventricular function appears less vigorous. The gradients across the bioprosthetic aortic valve are normal. CXR ___ FINDINGS: As compared to the previous radiograph, there are unchanged bilateral airspace opacities and a small right pleural effusion. The opacities and the effusion have not changed in the interval. Moderate cardiomegaly, status post CABG with subsequent position of the surgical material. No other relevant findings. CXR ___ IMPRESSION: Slight improvement in diffuse pulmonary opacities, suggesting decrease in edema, with probable superimposed pneumonia. CT Chest ___ FINDINGS: There is mild, apical-predominant centrilobular and paraseptal emphysema. Diffuse ground-glass opacities are present throughout both lungs, involving all lobes and extending to the pleural surfaces. Early fibrosis with mild honeycombing at the lung bases. Mild diffuse peribronchial wall thickening, but no interstitial thickening. No pleural effusions. Heart is normal in size, without pericardial effusion. Changes of coronary artery bypass grafting, with mediastinal clips. Note is made of a prosthetic aortic valve and discarded right atrial/ventricular pacemaker leads. Diffuse calcific atherosclerosis is present in the thoracic aorta. Prominent mediastinal nodes measure up to 12 mm in short axis in the superior right paratracheal region, 10 mm in the inferior right paratracheal region, and 13 mm in the subcarinal region. Changes of median sternotomy, with multiple chronically fractured and malpositioned sternal wires. No sternal fluid collections or osseous abnormalities. Examination is not tailored for subdiaphragmatic evaluation, but reveals a nasogastric tube in appropriate position. Gastric diverticulum arises from the greater curvature. Cholecystectomy changes. Accesorry splenule is present. Multiple colonic diverticula, without acute inflammation. IMPRESSION: Diffuse ground-glass pulmonary opacities and early fibrosis. Given patient history, this may represent acute-on-chronic organizing pneumonia, acute interstitial pneumonitis, less likely fibrosis with superimposed infection. . Right Heart Cardiac Catheterization ___ Cardiac Output Results PhaseFick C.O. (l/min)Fick C.I.(l/min/m2) 4.39 2.25 Hemodynamic Measurements (mmHg) Baseline SiteSysDiasEndMeanA WaveV WaveHR RA ___ RV ___ ___ ___ ___ ___ Radiology Summary Total Cine Runs Fluoro Time (minutes)0.90 Effective Equivalent Dose Index (mGy) 12.43 Findings ESTIMATED blood loss: <10 cc Hemodynamics (see above): Assessment & Recommendations 1.Mild pulmonary hypertension 2.Mildly elevated filling pressures. 3.Preserved Cardiac Output. 4.No indication for selective pulmonary vasodilators. . ___ CXR REPORT: Status post sternotomy. NG tube courses throughout the mediastinum to its expected location in the stomach. The ET tube is in good position, lying about 4 cm above the carina. There is a right-sided internal jugular line in unchanged position. There is symmetrical blunting of both costophrenic sulci. Generalized increased lung markings consistent most with fluid overload are grossly unchanged. More confluent abnormalities in the left lung base in particular are also unchanged. I note also CT from ___ suggesting this and in fact very little fluid overload, so presumptively the changes represent the ongoing alveolitis-type changes identified on that radiograph. . ___ CXR FINDINGS: Bilateral diffuse lung opacities are presisting. On concurrent review with prior chest CT dated ___, these opacities represent a combination of ground-glass opacities and consolidation and bibasilar fibrosis, unchanged since ___, but improved since ___. All these changes are more on the right side and may represent continuing alveolitis. As appreciated on recent chest CT, there was no component of pulmonary edema then nor in today's radiograph. Mild widening of the mediastinum is from increased mediastinal fat in conjunction with multiple lymph nodes as appreciated on the chest CT. There is evidence of prior median sternotomy and sternal sutures are intact. Effusions, if any, are small bilaterally and unchanged. There is no pneumothorax. Heart size is normal. Hilar contours are unremarkable. Aorta has a mild tortuous course and demonstrates mild-to-moderate and severe atherosclerotic calcification. ###RESPONSE: WBC {White blood cell count}, RBC {Red blood cell count}, Hgb {Measurement of total hemoglobin concentration}, Hct {Hematocrit determination}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, Neuts {Neutrophil count}, Lymphs {Lymphocyte count}, Monos {Monocyte count}, Eos {Eosinophil count}, PTT {Partial thromboplastin time, activated}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, Cl {Chloride measurement, blood}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, cTropnT {Troponin T cardiac measurement}, proBNP {N-terminal pro-brain natriuretic peptide measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, CXR {Plain chest X-ray}, pulmonary edema {Pulmonary edema}, infectious process {Infectious disease}, hemoptysis {Hemoptysis}, pulmonary hemorrhage {Pulmonary hemorrhage}, pleural effusion {Pleural effusion}, CXR {Plain chest X-ray}, Status post {Postoperative state}, median sternotomy {Median sternotomy}, CABG {Coronary artery bypass grafting}, cardiac {Heart structure}, mediastinal {Mediastinal structure}, aortic valve {Aortic valve structure}, pulmonary edema {Pulmonary edema}, pneumonia {Pneumonia}, hypersensitivity reaction {Hypersensitivity reaction}, Pulmonary hemorrhage {Pulmonary hemorrhage}, pneumothorax {Pneumothorax}, TTE {Transthoracic echocardiography}, left atrium {Left atrial structure}, dilated {Dilatation}, mild symmetric left ventricular hypertrophy {Mild left ventricular hypertrophy}, aortic valve {Aortic valve structure}, aortic regurgitation {Aortic valve regurgitation}, mitral valve leaflets are mildly thickened {Thickened mitral leaflet}, Mild {Mild mitral valve regurgitation}, moderate (___) mitral regurgitation {Moderate mitral valve regurgitation}, pulmonary artery {Pulmonary artery structure}, pericardial effusion {Pericardial effusion}, Mild symmetric left ventricular hypertrophy {Mild left ventricular hypertrophy}, aortic valve {Aortic valve structure}, Mild {Mild mitral valve regurgitation}, moderate mitral regurgitation {Moderate mitral valve regurgitation}, left ventricular {Left cardiac ventricular structure}, aortic valve {Aortic valve structure}, CXR {Plain chest X-ray}, opacities {Abnormally opaque structure}, pleural effusion {Pleural effusion}, opacities {Abnormally opaque structure}, effusion {Effusion}, cardiomegaly {Cardiomegaly}, status post {Postoperative state}, CABG {Coronary artery bypass grafting}, CXR {Plain chest X-ray}, opacities {Abnormally opaque structure}, edema {Edema}, pneumonia {Pneumonia}, CT Chest {Computed tomography of chest}, centrilobular {Centriacinar emphysema}, paraseptal emphysema {Paraseptal emphysema}, ground-glass opacities {Ground glass lung opacity}, both lungs {Both lungs}, pleural surfaces {Pleural membrane structure}, fibrosis {Fibrosis}, honeycombing {Honeycomb appearance}, lung bases {Structure of base of lung}, thickening {Increased thickness}, thickening {Increased thickness}, pleural effusions {Pleural effusion}, Heart {Heart structure}, normal in size {Normal size}, pericardial effusion {Pericardial effusion}, coronary artery bypass grafting {Coronary artery bypass grafting}, aortic valve {Aortic valve structure}, right atrial {Right atrial structure}, ventricular {Cardiac ventricular structure}, atherosclerosis {Atherosclerosis}, thoracic aorta {Thoracic aorta structure}, mediastinal nodes {Mediastinal lymph node structure}, median sternotomy {Median sternotomy}, fractured {Fracture of bone}, sternal {Structure of sternal region}, osseous {Bone structure}, nasogastric tube in appropriate position {Nasogastric tube in situ}, Gastric diverticulum {Gastric diverticulum}, greater curvature {Structure of greater curvature of stomach}, Cholecystectomy {Cholecystectomy}, Accesorry splenule {Accessory spleen}, colonic diverticula {Diverticulosis of colon}, acute inflammation {Acute inflammation}, Diffuse {Diffuse pain}, ground-glass pulmonary opacities {Ground glass lung opacity}, fibrosis {Fibrosis}, chronic organizing pneumonia {Chronic pneumonia}, acute interstitial pneumonitis {Primary atypical interstitial pneumonia}, fibrosis {Fibrosis}, superimposed infection {Superimposed infection}, Right Heart Cardiac Catheterization {Catheterization of right heart}, Hemodynamic Measurements {Hemodynamic measurements}, blood loss {Hemorrhage}, Mild pulmonary hypertension {Mild pulmonary hypertension}, Preserved Cardiac Output {Normal cardiac output}, CXR {Plain chest X-ray}, Status post {Postoperative state}, sternotomy {Sternotomy}, mediastinum {Mediastinal structure}, stomach {Stomach structure}, carina {Structure of carina of trachea}, costophrenic sulci {Structure of costophrenic angle}, lung {Lung structure}, fluid overload {Hypervolemia}, left lung base {Structure of base of left lung}, fluid overload {Hypervolemia}, radiograph {Plain radiography}, CXR {Plain chest X-ray}, lung {Lung structure}, opacities {Abnormally opaque structure}, chest CT {Computed tomography of chest}, opacities {Abnormally opaque structure}, ground-glass opacities {Ground glass lung opacity}, consolidation {Consolidation}, bibasilar {Structure of base of lung}, fibrosis {Fibrosis}, improved {Patient's condition improved}, right side {Right lung structure}, chest CT {Computed tomography of chest}, pulmonary edema {Pulmonary edema}, radiograph {Plain radiography}, mediastinum {Mediastinal structure}, mediastinal {Mediastinal structure}, fat {Structure of adipose tissue}, lymph nodes {Structure of lymph node}, chest CT {Computed tomography of chest}, median sternotomy {Median sternotomy}, sternal {Structure of sternal region}, pneumothorax {Pneumothorax}, Heart {Heart structure}, size is normal {Normal size}, unremarkable {No abnormality detected}, Aorta {Aortic structure}, atherosclerotic {Atherosclerosis}, calcification {Pathologic calcification, calcified structure}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Brief Hospital Course: ___ with COPD, CAD, CHF and Afib presenting with cough, dyspnea and hemoptysis admitted with PNA and pulmonary edema. # Dyspnea and Sepsis: Patient likely had bacterial pneumonia that followed a viral URI several weeks ago. On admission, felt to have pulmonary edema and pneumonia, treated for both with ceftriaxone/azithromycin and diuresis. After 7L diuresis, patient had no improvement. On ___ he was noted to have increasing respiratory distress and was electively intubated. Following intubation he became hypotensive and required pressor support during ___ and ___. Cardiac Catheterization showed wedge of 14 with V wave of 80. CT Chest revealed ground-glass opacities consistent with acute-on-chronic organizing pneumonia or acute interstitial pneumonitis. Was treated with high dose steroids with apparent initial improvement and was extubated. His mental status was very altered after extubation requiring olanazpine with mild effect. He had a respiratory decompensation after several days of extubation requiring reintubation. Abx were broadened to vanco/zosyn and he was started on solumedrol 1gm IV for 3 days for concern for undertreated COP, as his infectious work-up to date had not been revealing and his extensive work-up for cardiac causes of his dyspnea and respiratory failure was negative. As such, given the lack of an alternative diagnosis and the suspicion that COP may be the cause of his respiratory failure, aggressive glucocorticoid treatment was pursued in an effort to give him every chance to survive his acute illness. After three days of treatment with pulse-dose Solumedrol, however, there was no meaningful improvement in his respiratory status and his overall clinical status was progressively worsening with progressive acute renal failure, falling platelets, and worsening mental status (decreasing responsiveness despite holding sedative.) To objectively assess his pulmonary response to steroids, we obtained a repeat CT scan after completing three days of pulse dose steroids which did not show improvement. Given this, and given overall status of resp failure, renal failure, altered mental status - several meetings were held with the patient's son ___ (the patient's HCP) and decision was made to move to ___. Terminally extubated and passed away on ___ with son at bedside. . # AMS - ICU delirium compounded by high steroid dose. Managed with olanzapine with mild effect. His mental status deteriorated to the point that he was essentially non-responsive, including several absent brinstem reflexed (no corneal reflex, no cough, no gag, minimal pupillary response) prior to his being transitioned to ___ care. . # Anuric renal failure - Patient was noted to have increasing Creatinine after reintubation that was concerning for ATN due to an episode of hypotension and hypoperfusion. His creatinine continued to rise and he developed anuric renal failure over the last day of his ICU stay. . # Afib w/ RVR: Patient had a HR in the 140s at ___ and received 10mg IV and 30mg PO diltiazem at ___ ED. His HR was controlled to 100-120 by arrival to the ICU. His home metoprolol was initially resumed, stopped ___ given hypotension. Digoxin was started ___ for rhythm control. ###RESPONSE: COPD {Chronic obstructive lung disease}, CAD {Coronary arteriosclerosis}, CHF {Congestive heart failure}, Afib {Atrial fibrillation}, cough {Cough}, dyspnea {Dyspnea}, hemoptysis {Hemoptysis}, PNA {Pneumonia}, pulmonary edema {Pulmonary edema}, Dyspnea {Dyspnea}, Sepsis {Sepsis}, bacterial pneumonia {Bacterial pneumonia}, viral URI {Viral upper respiratory tract infection}, pulmonary edema {Pulmonary edema}, pneumonia {Pneumonia}, diuresis {Diuresis}, diuresis {Diuresis}, respiratory distress {Respiratory distress}, intubated {Intubation}, intubation {Intubation}, hypotensive {Low blood pressure}, pressor support {Vasopressor therapy}, Cardiac Catheterization {Cardiac catheterization}, CT Chest {Computed tomography of chest}, ground-glass opacities {Ground glass lung opacity}, pneumonia {Pneumonia}, acute interstitial pneumonitis {Primary atypical interstitial pneumonia}, extubated {Removal of endotracheal tube}, mental status was very altered {Altered mental status}, extubation {Removal of endotracheal tube}, extubation {Removal of endotracheal tube}, cardiac {Heart disease}, dyspnea {Dyspnea}, respiratory failure {Respiratory failure}, respiratory failure {Respiratory failure}, acute renal failure {Acute kidney injury}, falling platelets {Platelet count below reference range}, worsening mental status {Altered mental status}, steroids {Steroid therapy}, CT scan {Computed tomography}, resp failure {Respiratory failure}, renal failure {Renal failure syndrome}, altered mental status {Altered mental status}, extubated {Removal of endotracheal tube}, AMS {Altered mental status}, delirium {Delirium}, mental status deteriorated {Altered mental status}, no corneal reflex {Corneal reflex absent}, cough {Cough}, gag {Gagging}, Anuric {Anuria}, renal failure {Renal failure syndrome}, ATN {Acute tubular necrosis}, hypotension {Low blood pressure}, anuric {Anuria}, renal failure {Renal failure syndrome}, Afib w/ RVR {Atrial fibrillation with rapid ventricular response}, hypotension {Low blood pressure}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Medications on Admission: Aspirin 81 mg daily Omeprazole 20 mg daily Saline Nasal spray daily Warfarin 2.5 mg daily Lasix 20 mg daily Metoprolol Succinate 50 mg daily Pravastatin 80 mg daily Ropinirole 0.5 mg BID Fluticasone 110 mcg/Actuation 2 Puff BID Fluticsone 50 mcg nasal spray Prednisone 10 mg daily Discharge Medications: Patient expired ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Discharge Disposition: Expired Discharge Diagnosis: Hypoxic respiratory failure Anuric renal failure Atrial fibrillation with RVR Delirium Discharge Condition: Patient expired after having been transitioned to CMO after progressive multiorgan system failure prompted discussion with his family and HCP. ###RESPONSE: Hypoxic {Hypoxia}, respiratory failure {Respiratory failure}, Anuric {Anuria}, renal failure {Renal failure syndrome}, Atrial fibrillation with RVR {Atrial fibrillation with rapid ventricular response}, Delirium {Delirium}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Discharge Instructions: Patient expired. ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Followup Instructions: ___ ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Name: ___ Unit No: ___ Admission Date: ___ Discharge Date: ___ Date of Birth: ___ Sex: M Service: MEDICINE ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Allergies: No Known Allergies / Adverse Drug Reactions Attending: ___. Chief Complaint: Hyperglycemia/altered mental status/cough Major Surgical or Invasive Procedure: There were no major surgical or invasive procedures during hospitalization. ###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, Hyperglycemia {Hyperglycemia}, altered mental status {Altered mental status}, cough {Cough}, surgical {Surgical procedure}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: History of Present Illness: ___ with history of dementia, hypertention, diabetes presenting with lethargy, cough for one week, noted to have a pneumonia on a chest x-ray at ___ yesterday. Patient was started on azithromycin for this by basilar pneumonia. Patient is in a memory unit. At this unit, they do have access to rehabilitation. Patient normally uses a walker. Because of the weakness for the past one week, the patient has been using a wheelchair. Patient's thought his medical care in ___, and never establish primary care in ___, the doctor at his facility has been continuing medications from his doctor in ___. Daughter concerned that the patient is not receiving adequate attention at facility. Doctor at facility concerned that glucose 367 today. Low 200s here. Patient denies complete ROS. A&Ox1. Patient sent to ___ for further evaluation. -In the ED, initial vitals were: T 98.7 HR 80 BP 136/91 RR 18 SpO2 97% RA -Exam notable for: bibasilar crackles, otherwise normal exam -Labs notable for WBC 9.0, Cr 0.8, lactate 2.7 -CXR was notable LLL opacity concerning for PNA -Received: 1 L IV NS, Levofloxacin 750 mg IV, Olanzapine 10 mg PO total, and his home medications (Metformin, Memantine, Aspirin, Glipizide, Lisinopril -Transfer VS were: T 102.4 HR 102 BP 128/75 RR 23 SpO2 95% RA -On arrival to the floor, the patient unable to engage in ROS evaluation. Patient appeared to be sleeping comfortably. He was continued on IV abx, his home medications, and started on insulin sliding scale. On arrival to the floor, patient was sleeping comfortably, not responsive to voice and unable to participate in ROS. Family members were in the room who reports the patient has been complaining of cough and more lethargic compared to baseline mental status. The patient was given 1 L IV fluids, continued on IV abx, started on insulin sliding scale, but otherwise continued on his home medications. ###RESPONSE: dementia {Dementia}, hypertention {Hypertensive disorder, systemic arterial}, diabetes {Diabetes mellitus}, lethargy {Lethargy}, cough {Cough}, pneumonia {Pneumonia}, chest x-ray {Plain chest X-ray}, basilar pneumonia {Basal pneumonia}, rehabilitation {Rehabilitation therapy}, weakness {Asthenia}, evaluation {Evaluation procedure}, RA {Breathing room air}, bibasilar {Structure of base of lung}, crackles {Respiratory crackles}, CXR {Plain chest X-ray}, LLL {Structure of lower lobe of left lung}, opacity {Abnormally opaque structure}, PNA {Pneumonia}, IV {Intravenous therapy}, IV {Intravenous therapy}, RA {Breathing room air}, evaluation {Evaluation procedure}, sleeping {Asleep}, IV abx {Intravenous antibiotic therapy}, sleeping {Asleep}, cough {Cough}, lethargic {Lethargy}, baseline {Baseline state}, mental status {Mental state finding}, IV {Intravenous therapy}, IV abx {Intravenous antibiotic therapy}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Past Medical History: -Hypertension -Hyperlipidemia -Dementia -Type II Diabetes Mellitus -___: hospitalized at ___ due to hyperglycemia secondary to underlying pneumonia. ###RESPONSE: Hypertension {Hypertensive disorder, systemic arterial}, Hyperlipidemia {Hyperlipidemia}, Dementia {Dementia}, Type II Diabetes Mellitus {Diabetes mellitus type 2}, hyperglycemia {Hyperglycemia}, pneumonia {Pneumonia}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Social History: ___ ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Family History: Father had CAD and died of MI. Mother had stomach cancer ###RESPONSE: CAD {Coronary arteriosclerosis}, died {Dead}, MI {Myocardial infarction}, stomach cancer {Malignant tumor of stomach}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Physical Exam: ADMISSION PHYSICAL EXAM ===================== VS T 98.3 BP 153/84 HR 95 RR 20 SpO2 98 RA General: Sleeping comfortably, snoring, does not respond to voice HEENT: Sclerae anicteric, MMM, oropharynx clear, EOMI, PERRL, neck supple, JVP not elevated, no LAD CV: RRR, normal S1 + S2, no murmurs, rubs, gallops Lungs: L basilar inspiratory crackles, no wheezing or rhonci Abdomen: Soft, non-tender, non-distended, bowel sounds present, no organomegaly, no rebound or guarding GU: Foley in place Ext: Warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema Neuro: CNII-XII intact, ___ strength upper/lower extremities, grossly normal sensation, 2+ reflexes bilaterally, gait deferred. DISCHARGE PHYSICAL EXAM ====================== Vitals: 98.4 122/75 82 18 94RA General: Awake, alert and oriented x 1 (to person) HEENT: Sclerae anicteric, MMM, neck supple, JVP not elevated. CV: RRR, normal S1 + S2, no murmurs. Lungs: Clear to auscultation Abdomen: Soft, non-tender, non-distended, bowel sounds present, no rebound or guarding. Ext: Warm, well perfused, no lower extremity edema. ###RESPONSE: PHYSICAL EXAM {Physical examination procedure}, VS {Vital signs finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, RA {Breathing room air}, General {General examination of patient}, Sleeping {Asleep}, snoring {Snoring}, respond to voice {Responds to voice}, HEENT {Physical examination procedure}, Sclerae anicteric {White sclera}, MMM {Moist oral mucosa}, oropharynx clear {Pharynx normal}, EOMI {Normal ocular motility}, PERRL {Pupils equal and reacting to light}, supple {Normal movement of neck}, JVP not elevated {Normal jugular venous pressure}, LAD {Lymphadenopathy}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, normal S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, murmurs {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, Lungs {Examination of respiratory system}, L basilar {Structure of base of left lung}, crackles {Respiratory crackles}, wheezing {Wheezing}, rhonci {Wheeze - rhonchi}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, tender {Abdominal tenderness}, distended {Swollen abdomen}, bowel sounds present {Normal bowel sounds}, organomegaly {Abdominal organomegaly}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, GU {Examination of genitourinary system}, Ext {Examination of limb}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, 2+ pulses {Peripheral pulses normal}, clubbing {Clubbing}, cyanosis {Cyanosis}, edema {Edema}, Neuro {Neurological examination}, CNII {Optic nerve structure}, XII intact {Intact hypoglossal nerve}, upper {Upper limb structure}, lower extremities {Lower limb structure}, normal sensation {Normal sensation}, 2+ reflexes {Normal reflex}, gait {Finding of gait}, PHYSICAL EXAM {Physical examination procedure}, Vitals {Vital signs finding}, RA {Breathing room air}, General {General examination of patient}, Awake {Awake}, alert {Mentally alert}, oriented {Orientated}, HEENT {Physical examination procedure}, Sclerae anicteric {White sclera}, MMM {Moist oral mucosa}, neck {Neck structure}, supple {Normal movement of neck}, JVP not elevated {Normal jugular venous pressure}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, normal S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, murmurs {Murmur}, Lungs {Examination of respiratory system}, Clear to auscultation {Normal breath sounds}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, tender {Abdominal tenderness}, distended {Swollen abdomen}, bowel sounds present {Normal bowel sounds}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, Ext {Examination of limb}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, edema {Edema}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Pertinent Results: ADMISSION LABS ============= ___ 08:02PM BLOOD WBC-7.3 RBC-3.87* Hgb-12.8* Hct-37.4* MCV-97 MCH-33.1* MCHC-34.2 RDW-13.2 RDWSD-46.6* Plt ___ ___ 08:02PM BLOOD Neuts-63.4 Lymphs-16.3* Monos-15.0* Eos-4.1 Baso-0.7 Im ___ AbsNeut-4.64 AbsLymp-1.19* AbsMono-1.10* AbsEos-0.30 AbsBaso-0.05 ___ 08:02PM BLOOD Glucose-203* UreaN-17 Creat-0.8 Na-134 K-4.2 Cl-94* HCO3-28 AnGap-16 ___ 09:00PM BLOOD Calcium-9.3 Phos-3.7 Mg-1.6 DISCHARGE LABS ============= ___ 06:45AM BLOOD WBC-5.6 RBC-3.99* Hgb-12.7* Hct-38.5* MCV-97 MCH-31.8 MCHC-33.0 RDW-13.1 RDWSD-46.5* Plt ___ ___ 06:45AM BLOOD Glucose-288* UreaN-15 Creat-0.8 Na-142 K-4.5 Cl-101 HCO3-22 AnGap-24* ___ 06:45AM BLOOD Calcium-9.0 Phos-2.9 Mg-1.8 HEMOGLOBIN A1C ============== ___ 09:15AM BLOOD %HbA1c-8.0* eAG-183* URINE STUDIES ============ ___ 11:03PM URINE Color-Straw Appear-Clear Sp ___ ___ 11:03PM URINE Blood-NEG Nitrite-NEG Protein-TR Glucose-150 Ketone-NEG Bilirub-NEG Urobiln-2* pH-6.0 Leuks-NEG ___ 11:03PM URINE RBC-1 WBC-1 Bacteri-FEW Yeast-NONE Epi-0 MICROBIOLOGY ============ ___: BLOOD CULTURE X 2: PENDING. ___: BLOOD CULTURE X 1: PENDING. ___ 4:40 am URINE Source: Catheter. **FINAL REPORT ___ URINE CULTURE (Final ___: NO GROWTH. IMAGING ======= IMPRESSION: Left lower lobe opacity may reflect pneumonia. Comparing with prior radiograph would be helpful to determine progression or improvement. ###RESPONSE: WBC {White blood cell count}, RBC {Red blood cell count}, Hgb {Measurement of total hemoglobin concentration}, Hct {Hematocrit determination}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, RDWSD {Red cell distribution width determination}, Neuts {Neutrophil count}, Lymphs {Lymphocyte count}, Monos {Monocyte count}, Baso {Basophil count}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, Cl {Chloride measurement, blood}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, WBC {White blood cell count}, RBC {Red blood cell count}, Hgb {Measurement of total hemoglobin concentration}, Hct {Hematocrit determination}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, RDWSD {Red cell distribution width determination}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, Cl {Chloride measurement, blood}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, eAG {Glucose measurement estimated from glycated hemoglobin}, URINE Color-Straw {Normal urine color}, Ketone {Urinalysis, acetone or ketone bodies measurement}, pH {pH measurement}, RBC {Red blood cell count}, WBC {White blood cell count}, MICROBIOLOGY {Microbiology}, CULTURE {Blood culture}, CULTURE {Blood culture}, URINE CULTURE {Urine culture}, IMAGING {Imaging}, Left lower lobe {Structure of lower lobe of left lung}, opacity {Abnormally opaque structure}, pneumonia {Pneumonia}, radiograph {Plain radiography}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Brief Hospital Course: ___ year old gentleman with history of dementia, hypertension, and diabetes presenting with lethargy found to have LLL PNA complicated by hyperglycemia. # Community Acquired Left Lower Lobe Pneumonia: Patient was initially treated as an outpatient with azithromycin for suspected pneumonia, however, hyperglycemia ensued in the setting of pneumonia leading to admission to ___ (patient lives in a memory unit at ___ on ___ and they were concerned regarding his hyperglycemia). CXR at ___ confirmed left lower lobe pneumonia. He initially was started on levofloxacin and was subsequently transitioned to ceftriaxone and azithromycin. On admission, required supplemental O2 (up to 3L) but was quickly weaned back to room air. He was asymptomatic with normal saturation on room air for 3 days at the time of discharge, at which point he had taken 6 days of antibiotics and the decision was made to end his course. # Type II Diabetes Mellitus Complicated by Hyperglycemia: At Memory unit at ___ on the ___ patient had blood sugars in the high 300s. Given concern for the hyperglycemia, was transferred to ___ for evaluation. As noted above, etiology of the hyperglycemia was in the setting of pneumonia. At his facility he is on metformin 1000 mg PO BID and glipizide 2.5 mg PO daily. Initially, these were held and he was continued insulin sliding scale. He resumed his home glipizide and metformin. He remained hyperglycemia, so sitagliptin was added and metformin and glipizide were increased. He continued to require sliding scale insulin at discharge. During hospitalization, his hemoglobin A1C was noted to be 8.0%. As insulin administration in the Memory Unit at his facility is somewhat complicated, an attempt was made to develop an oral diabetes regimen. ___ Diabetes was consulted for further recommendations. They recommended the above regimen with a plan to increase his oral agents and try to wean off the sliding scale. If he is unable, the ___ clinic can change him to a basal bolus insulin regimen and rehab providers and family can determine how this will impact his living situation. # Hypertension: Continued lisinopril 30 mg PO daily. # Dementia: Alert and oriented x 1 at baseline. Continued meantime 5 mg PO BID. His home ___ was not on formulary at the hospital. He was discharged on memantine 5 mg PO BID and galantine 16 mg PO daily. TRANSITIOANL ISSUES ================= Transitional Issues: - needs vitamin D checked as an outpatient - ___ follow up - Patient was persistently hyperglycemic on metformin, glipizide, Januvia. Insulin sliding scale was added to the regimen. We recommend gradually increasing his glipizide and tapering down his sliding scale to get him off insulin and hopefully transition back to the memory unit. If he is unable to come off the insulin, the ___ clinic can transition him to a basal/bolus insulin regimen at his follow up appointment and if this is a barrier to returning to the memory unit, his long term residential situation will need to be re-addressed with family. - Code Status: DNR/DNI (confirmed, has MOLST) - Contact Information: ___ (___ ___ ###RESPONSE: dementia {Dementia}, hypertension {Hypertensive disorder, systemic arterial}, lethargy {Lethargy}, LLL {Structure of lower lobe of left lung}, PNA {Pneumonia}, hyperglycemia {Hyperglycemia}, Left Lower Lobe Pneumonia {Left lower zone pneumonia}, pneumonia {Pneumonia}, hyperglycemia {Hyperglycemia}, pneumonia {Pneumonia}, hyperglycemia {Hyperglycemia}, CXR {Plain chest X-ray}, left lower lobe pneumonia {Left lower zone pneumonia}, asymptomatic {Asymptomatic}, on room air {Breathing room air}, antibiotics {Antibiotic therapy}, Type II Diabetes Mellitus {Diabetes mellitus type 2}, Hyperglycemia {Hyperglycemia}, hyperglycemia {Hyperglycemia}, evaluation {Evaluation procedure}, hyperglycemia {Hyperglycemia}, pneumonia {Pneumonia}, hyperglycemia {Hyperglycemia}, oral {Administration of drug or medicament via oral route}, diabetes regimen {Diabetic care}, Diabetes {Diabetes mellitus}, regimen {Therapeutic regimen}, clinic {Outpatient care management}, insulin regimen {Insulin regime}, Hypertension {Hypertensive disorder, systemic arterial}, Dementia {Dementia}, Alert {Mentally alert}, oriented {Orientated}, baseline {Baseline state}, regimen {Therapeutic regimen}, clinic {Outpatient care management}, insulin regimen {Insulin regime}, DNR {Not for resuscitation}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Medications on Admission: The Preadmission Medication list is accurate and complete. 1. Aspirin 81 mg PO DAILY 2. Atorvastatin 10 mg PO QPM 3. galantamine 16 mg oral QDaily 4. GlipiZIDE 2.5 mg PO DAILY 5. Lisinopril 30 mg PO DAILY 6. Memantine 5 mg PO BID 7. MetFORMIN (Glucophage) 1000 mg PO BID 8. Vitamin D ___ UNIT PO Q21DAYS Discharge Medications: 1. Insulin SC Sliding Scale Fingerstick QACHS Insulin SC Sliding Scale using HUM Insulin 2. Januvia (SITagliptin) 100 mg oral DAILY 3. GlipiZIDE 5 mg PO BID 4. Aspirin 81 mg PO DAILY 5. Atorvastatin 10 mg PO QPM 6. galantamine 16 mg oral QDaily 7. Lisinopril 30 mg PO DAILY 8. Memantine 5 mg PO BID 9. MetFORMIN (Glucophage) 1000 mg PO BID 10. Vitamin D ___ UNIT PO Q21DAYS ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Discharge Disposition: Extended Care Facility: ___ Discharge Diagnosis: PRIMARY DIAGNOSIS ================ -Community Acquired Pneumonia -Type II Diabetes Mellitus -Dementia -Hypertension Discharge Condition: Mental Status: Confused - always. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). ###RESPONSE: Community Acquired Pneumonia {Community acquired pneumonia}, Type II Diabetes Mellitus {Diabetes mellitus type 2}, Dementia {Dementia}, Hypertension {Hypertensive disorder, systemic arterial}, Mental Status {Neurological mental status determination}, Confused {Clouded consciousness}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, Activity Status {Physical functional dependency}, Ambulatory - requires assistance or aid {Finding of walking aid use}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Discharge Instructions: Dear Mr. ___, You were admitted to ___ after you were noted to have elevated blood sugars. You were also noted to have a pneumonia. The reason for the elevated blood sugars was likely secondary to the underlying pneumonia. You initially required oxygen but after receiving intravenous antibiotics, you were able to breath comfortably on room air. in order to better control your blood sugars and optimize you on an oral medication regimen to control your blood sugars, you were seen by the Diabetes specialists at ___. They recommended continuing with metformin, glipizide and sitagliptin. You will remain on sliding scale insulin for now. This will be stopped if recovery from your illness or increased doses of your oral medications will allow. Best Wishes, Your ___ Care Team ###RESPONSE: pneumonia {Pneumonia}, pneumonia {Pneumonia}, intravenous antibiotics {Intravenous antibiotic therapy}, on room air {Breathing room air}, oral medication {Administration of drug or medicament via oral route}, regimen {Therapeutic regimen}, oral medications {Administration of drug or medicament via oral route}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Followup Instructions: ___ ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Name: ___ Unit No: ___ Admission Date: ___ Discharge Date: ___ Date of Birth: ___ Sex: M Service: MEDICINE ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Allergies: lisinopril / lorazepam Attending: ___. Chief Complaint: Left foot pain Major Surgical or Invasive Procedure: none ###RESPONSE: Left foot {Structure of left foot}, pain {Pain}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: History of Present Illness: ___ y/o M transfered from ___ today for angiogram/plasty with Dr. ___. He was originally admitted to ___ due to confusion and fatigue as well as dehydration. He was being treated for a pneumonia upon transfer. Pt. presents today to ___ with a year long history of left foot discomfort, specifically his left hallux, which ___ has been feeling worse over the past week. Pt. also states he has gout in his left foot. Medicine HPI: ___ yo M w/ PMH of COPD, CKD (unknown baseline cr), CVA with residual left arm paresis, and peripheral vascular disease who was transferred here for vascular surgery evaluation given problems with his toes. While on the floor he PEA arrested and was coded x 3 min, then while enroute to the ICU he PEA arrested again. Per mention, there was felt to be RV strain on a bedside informal TTE and therefore it was felt to likely be due to a pulmonary embolism so he was started on a heparin drip. He was tranisently on pressors and monitored with an A line. He was extubated on ___ without difficulty and was off pressors since then as well. He continues to be monitored on telemetry without any additional ectopy. Of note, prior to transfer, the patient was being examined and noted to have active hemorrhage from his prior Left AC IV site. He was laying in a large pool of blood. Stat Hct was stable and VS were wnl. The pressure was applied to stop the bleeding and the patient was cleaned up for transfer. ###RESPONSE: angiogram {Angiography}, confusion {Clouded consciousness}, fatigue {Fatigue}, dehydration {Dehydration}, pneumonia {Pneumonia}, left foot {Structure of left foot}, discomfort {Discomfort}, left {Structure of left hand}, hallux {Great toe structure}, gout {Inflammatory disorder due to increased blood urate level}, left foot {Structure of left foot}, COPD {Chronic obstructive lung disease}, CKD {Chronic kidney disease}, CVA {Cerebrovascular accident}, left arm {Left upper arm structure}, paresis {Muscle weakness}, peripheral vascular disease {Peripheral vascular disease}, evaluation {Evaluation procedure}, toes {Structure of all toes}, RV {Right cardiac ventricular structure}, strain {Muscle strain}, TTE {Transthoracic echocardiography}, pulmonary embolism {Pulmonary embolism}, heparin {Heparin therapy}, extubated {Removal of endotracheal tube}, telemetry {Cardiac telemetry}, hemorrhage {Hemorrhage}, Left {Left cerebral hemisphere structure}, Hct was stable {Stable hematocrit}, VS {Vital signs finding}, bleeding {Bleeding}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Past Medical History: Vascualr complications, chronic kidney disease, anemia, COPD, hisotry of pneumonia, failure to thrive, polyneuropathy with diabetes, hypertension, vascular dementia, idiopathic pulmonary fibrosis. Pt. is a poor historian but states he had a kidney removed. ###RESPONSE: Vascualr complications {Peripheral vascular complication}, chronic kidney disease {Chronic kidney disease}, anemia {Anemia}, COPD {Chronic obstructive lung disease}, pneumonia {Pneumonia}, failure to thrive {Failure to thrive}, polyneuropathy {Polyneuropathy}, diabetes {Diabetes mellitus}, hypertension {Hypertensive disorder, systemic arterial}, vascular dementia {Vascular dementia}, idiopathic pulmonary fibrosis {Idiopathic pulmonary fibrosis}, poor historian {Poor historian}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Social History: ___ ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Family History: n/c ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Physical Exam: VASCULAR SURGERY ADMISSION EXAM: not recorded MEDICINE ADMISSION EXAM: VS 98.0, 103/42, 82, 18, 98% 2L GEN: A+Ox2 (person and date, not to place but knows its a hospital), mildy hard of hearing. HEENT PEERLA, MMM, no elevated JVP. PULM moving good air bilaterally, no audible wheezes or crackles anteriorly CV RRR no mrg appreciated, no echymotic areas on his chest, no crepitus to palpation. mild tenderness on palpation there. ABD soft NT ND increased bowel sounds EXT WWP 2+ pulses palpable bilaterally, no c/c/e. LEft arm with dressing saturated in blood in a pool of blood NEURO CNs2-12 intact, left arm hemiparetic, moving lwoer extremities SKIN no ulcers or lesions Labs: Reviewed, please see below. DEATH EXAM: see death note under ###RESPONSE: VS {Vital signs finding}, GEN {General examination of patient}, Ox2 {Orientated}, person {Oriented to person}, place {Oriented to place}, hard of hearing {Hearing difficulty}, PEERLA {Pupils equal and reacting to light}, MMM {Moist oral mucosa}, elevated JVP {Raised jugular venous pressure}, PULM {Examination of respiratory system}, wheezes {Wheezing}, crackles {Respiratory crackles}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, no mrg {Heart sounds normal}, echymotic {Ecchymosis}, chest {Thoracic structure}, crepitus {Bone crepitus}, palpation {Palpation}, tenderness {Tenderness}, palpation {Palpation}, ABD soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, increased bowel sounds {Bowel sounds hyperactive}, EXT {Examination of limb}, WWP {Normal tissue perfusion}, 2+ pulses palpable {Peripheral pulses normal}, LEft arm {Left upper arm structure}, dressing {Application of dressing}, NEURO {Neurological examination}, CNs2-12 intact {Normal nervous system function}, left arm {Left upper arm structure}, hemiparetic {Muscle weakness}, lwoer extremities {Lower limb structure}, SKIN {Examination of skin}, ulcers {Ulcer}, lesions {Skin lesion}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Brief Hospital Course ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Pertinent Results: ADMISSION LABS: ___ 05:50PM BLOOD WBC-9.2 RBC-3.72* Hgb-12.1* Hct-37.5* MCV-101* MCH-32.5* MCHC-32.2 RDW-15.4 Plt ___ ___ 05:50PM BLOOD ___ PTT-34.5 ___ ___ 05:50PM BLOOD Glucose-142* UreaN-27* Creat-1.7* Na-140 K-4.2 Cl-104 HCO3-24 AnGap-16 ___ 10:31PM BLOOD ALT-121* CK(CPK)-89 AlkPhos-100 Amylase-70 TotBili-0.6 ___ 05:50PM BLOOD Calcium-9.1 Phos-3.1 Mg-2.0 ___ 10:30PM BLOOD Type-ART pO2-82* pCO2-37 pH-7.09* calTCO2-12* Base XS--18 ___ 10:30PM BLOOD Glucose-202* Lactate-12.5* Na-140 K-5.2* Cl-113* ___ 10:30PM BLOOD freeCa-1.25 LABS ON DAY OF DEATH: ___ 01:36AM BLOOD WBC-12.0* RBC-3.23* Hgb-10.6* Hct-32.0* MCV-99* MCH-32.6* MCHC-33.0 RDW-15.3 Plt ___ ___ 08:00PM BLOOD Hct-33.4* ___ 01:36AM BLOOD Glucose-98 UreaN-39* Creat-2.3* Na-146* K-4.1 Cl-111* HCO3-21* AnGap-18 ___ 01:36AM BLOOD ALT-123* AST-136* AlkPhos-110 Amylase-162* TotBili-0.9 ___ 01:36AM BLOOD Calcium-8.8 Phos-3.8 Mg-2.1 ___ 09:07AM BLOOD Type-ART pO2-113* pCO2-31* pH-7.46* calTCO2-23 Base XS-0 ___ 09:07AM BLOOD O2 Sat-98 ___ 01:43AM BLOOD freeCa-1.14 PERTINENT MICRO: NONE PERTINENT IMAGING: EKG: Sinus rhythm. Generalized low voltage. Q-T interval prolongation. T wave abnormalities. No previous tracing available for comparison. Clinical correlation is suggested. Read ___. IntervalsAxes ___ ___ ADMISSION CXR: ___ male patient with left lower extremity ischemia, scheduled for angio but presenting with pneumonia. Evaluate for interval change. Patient's condition required examination in sitting position using AP frontal and left lateral views. There is moderate cardiac enlargement, predominantly involving the left heart. The thoracic aorta is of ordinary dimension but demonstrates advanced walled calcifications both in the aortic arch as well as in the entire ascending aorta. Aortic valve calcifications are suspected on the lateral view. There exists a diffuse haze over the entire left-sided hemithorax and thickening of the left-sided pleural space is noted along the left lateral chest wall. There exists some crowded vasculature in the left lower lobe area in retrocardiac position possibly suggesting some atelectasis but acute discrete parenchymal infiltrates identifying a pneumonia cannot be seen. The right hemithorax is better penetrated and there is no evidence of pleural thickenings on that side. Also, the lateral pleural sinuses are free, thus no evidence of acute pleural effusion is present. Accessible areas of the pulmonary vasculature do not demonstrate any advanced CHF or pulmonary edema. Our records do not include a previous chest examination, thus there is no possibility to comment on interval changes FOLLOW UP CXR: As compared to the previous radiograph, the patient has been extubated. The signs previously indicative of pulmonary edema have substantially decreased. However, there still is a mild-to-moderate left pleural effusion with subsequent retrocardiac atelectasis. Moderate cardiomegaly. No evidence of pneumonia. ###RESPONSE: WBC {White blood cell count}, RBC {Red blood cell count}, Hgb {Measurement of total hemoglobin concentration}, Hct {Hematocrit determination}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, PTT {Partial thromboplastin time, activated}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, Cl {Chloride measurement, blood}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, ALT {Alanine aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, pH {pH measurement}, Glucose {Glucose measurement, blood}, Na {Blood sodium measurement}, K {Blood potassium measurement}, RBC {Red blood cell count}, Hgb {Measurement of total hemoglobin concentration}, Hct {Hematocrit determination}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, Hct {Hematocrit determination}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, Cl {Chloride measurement, blood}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, pH {pH measurement}, EKG {Electrocardiographic procedure}, Sinus rhythm {Sinus rhythm}, Q-T interval prolongation {Prolonged QT interval}, T wave abnormalities {Electrocardiographic T wave abnormal}, left lower extremity {Structure of left lower limb}, ischemia {Ischemia}, angio {Angiography}, pneumonia {Pneumonia}, sitting position {Sitting position}, AP {Diagnostic radiography, anteroposterior}, lateral {Diagnostic radiography of chest, lateral}, cardiac enlargement {Hypertrophic cardiomegaly}, left heart {Structure of left side of heart}, thoracic aorta {Thoracic aorta structure}, calcifications {Pathologic calcification, calcified structure}, aortic arch {Aortic arch structure}, entire ascending aorta {Entire ascending aorta}, Aortic valve calcifications {Aortic valve calcification}, lateral {Diagnostic radiography of chest, lateral}, left-sided hemithorax {Entire left thorax}, thickening {Increased thickness}, left-sided pleural {Left pleura structure}, chest wall {Chest wall structure}, left lower lobe {Structure of lower lobe of left lung}, atelectasis {Atelectasis}, infiltrates {Infiltration}, pneumonia {Pneumonia}, right hemithorax {Right thorax structure}, pleural thickenings {Thickening of pleura}, pleural effusion {Pleural effusion}, pulmonary vasculature {Structure of pulmonary blood vessel}, CHF {Congestive heart failure}, pulmonary edema {Pulmonary edema}, radiograph {Plain radiography}, signs {Sign}, pulmonary edema {Pulmonary edema}, pleural effusion {Pleural effusion}, atelectasis {Atelectasis}, cardiomegaly {Cardiomegaly}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Brief Hospital Course: This ___ y/o M was transferred from ___ with a chief complaint of L foot pain which he has had for about ___ year. He was brought to ___ to have an angiogram/plasty with Dr. ___. Upon presentation to us patient was currently on antibiotics for treatment of pneumonia. He stated his foot was painful, specifically his left hallux. It was decided to change his oral antibiotics (Levaquin) to IV antibiotics and wait for his pneumonia to resolve before taking the patient for Angio. On hospital night 1 patient arrested presumably due to a pulmonary embolism. He was successfully resuscitated and transferred to the CVICU intubated on vasopressors and NO. A heparin gtt was empirically started given dilated RV as seen on bedside echo. it was also noted that he was no longer producing any urine. On hospital day 2 the patient was extubated and had oxygen sats of 94% with 50% mask. All pressors were stopped and his kidney function began to return (UO was between ___ cc/hr). A renal consult was called. Patient was transferred from the Vascular Surgery service to the medical service, given his complicated course, and the decision that he would hold off on any vascular decision. Prior to admission to the internal medicine service late on the evening of ___, pt was noted to be bleeding from a pulled IV site with substantial amount of blood pooled beneath is arm. A stat hematocrit was performed prior to transfer which was stable. His VS were stable. Once patient arrived to the medicine floor, he was monitored on telemetry given his recent PEA arrest. He was continued on IV antibiotics for his previously diagnosed pneumonia, although it was noted he had no pneumonia on his current CXR. He was continued on IV heparin gtt for presumed PE on a tighter therapeutic range given his recent bleeding, with plans to repeat a formal TTE in the morning and pursue further workup of his PEA arrest. Of note, the patient's spouse had a lengthy discussion with the on call ___ resident and it was determined that the patient would continue to have a DNR code status (intubation acceptable). Once on the floor, a repeat hematocrit was to be drawn given his recent bleeding. However, this could not be drawn given patient's confusion and agitation which was acute in nature. He was given a dose of zyprexa for agitation and shortly thereafter was noted to convert to asystole on the tele monitor. The nightfloat intern was called to pronounce the patient. The death note is copied below: Death Note ___ Called to patient's bedside because of asystole on telemetry. He was not responsive to voice or pain. Pulses absent. No heart sounds or breath sounds present. Pupils not reactive to light. His most recent code status is DNR. No resuscitative attempts made. Patient pronounced dead at 3:42 am on ___. Wife ___ notified, she declined autopsy. Attending of record, ___, notified. ###RESPONSE: foot pain {Foot pain}, angiogram {Angiography}, plasty {Angioplasty of blood vessel}, antibiotics {Antibiotic therapy}, pneumonia {Pneumonia}, foot was painful {Foot pain}, hallux {Great toe structure}, oral antibiotics {Oral antibiotic therapy}, IV antibiotics {Intravenous antibiotic therapy}, pneumonia {Pneumonia}, pulmonary embolism {Pulmonary embolism}, resuscitated {Resuscitation}, intubated {Intubation}, heparin {Heparin therapy}, dilated RV {Dilatation of right cardiac ventricle}, echo {Echocardiography}, extubated {Removal of endotracheal tube}, kidney function {Renal function monitoring}, bleeding {Bleeding}, arm {Upper limb structure}, VS {Vital signs finding}, stable {Patient's condition stable}, telemetry {Cardiac telemetry}, IV antibiotics {Intravenous antibiotic therapy}, pneumonia {Pneumonia}, pneumonia {Pneumonia}, CXR {Plain chest X-ray}, IV {Administration of drug or medicament via intravenous route}, heparin {Heparin therapy}, PE {Pulmonary embolism}, bleeding {Bleeding}, TTE {Transthoracic echocardiography}, workup {Evaluation procedure}, DNR {Not for resuscitation}, bleeding {Bleeding}, confusion {Clouded consciousness}, agitation {Feeling agitated}, agitation {Feeling agitated}, asystole {Asystole}, tele {Cardiac telemetry}, asystole {Asystole}, telemetry {Cardiac telemetry}, responsive to voice {Responds to voice}, pain {Finding of response to pain}, Pulses absent {Absent pulse}, No heart sounds {Heart sound inaudible}, breath sounds {Absent breath sounds}, Pupils not reactive to light {No pupillary reaction to light}, DNR {Not for resuscitation}, Patient pronounced dead {Patient status determination, deceased}, autopsy {Consent for postmortem declined}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Medications on Admission: Levofloxacin 500mg qd x3days albuterol nebulizer 4x daily ranitidine HCL 150mg qd multivitamin qd PO Lidocaine HCL 1 patch Glipizide 5mg qd po gabapentin 300mg poqd colace 100mg po qd clopidogrel 75mg Vit D 1000 units qd PO aspirin 81mg qd allopurinol ___ qd acetaminophen 325mg qd Venlafaxine HCL 37.5 mg hs Mirtazapine 7.5 mg hs Pravastatin 40mg qd Insuline Sliding scale Insuline Glargine 18 U Ferrous Sulfate 325mg bid po Carvedilol 12.5 bid tramadol 50mg q6h prn pain milk of mag 10 ml po prn constipation Discharge Medications: EXPIRED ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Discharge Disposition: Expired Discharge Diagnosis: EXPIRED Discharge Condition: EXPIRED ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Discharge Instructions: EXPIRED ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Followup Instructions: ___ ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Name: ___ Unit No: ___ Admission Date: ___ Discharge Date: ___ Date of Birth: ___ Sex: F Service: MEDICINE ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Allergies: Abacavir Sulfate / Aspirin / fluconazole / levetiracetam / morphine Attending: ___. Chief Complaint: fevers and diarrhea Major Surgical or Invasive Procedure: Endoscopy and Colonoscopy ___ ###RESPONSE: Abacavir Sulfate {Allergy to abacavir}, Aspirin {Allergy to aspirin}, fluconazole {Allergy to fluconazole}, levetiracetam {Allergy to lofepramine}, morphine {Allergy to morphine}, fevers {Fever}, diarrhea {Diarrhea}, Endoscopy {Endoscopy}, Colonoscopy {Colonoscopy}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: History of Present Illness: Ms ___ is a ___ with HIV/AIDS with poor medication compliance(CD4 24(3%), HIV VL 70K ___, depression, and hx of seizures, who was recently admitted with fever, non-bloody diarrhea, and ___ (___), who now re-presets with similar symptoms. She notes that she was in her usual state of health until approximately ___ when she noticed a fever to 103. She denied any other symptoms at that time; no sinus congestion, headache, body ache, sore throat, cough, shortness of breath, abdominal pain, nausea, vomiting, or diarrhea. She took some Tylenol and fever resolved. She felt very constipated so took some castor oil on ___. This resulted in copious non-bloody diarrhea. She intermittently had fever up to 102 so decided to present to the ED on ___, and she was admitted from ___. Her labs were notable for Cr of 1.8 from baseline of 0.8 just 6 days prior. LFTs were slightly elevated at AST/ALT of 139/42, AP 128, Tbili 0.2. UA and CXR were negative. Extensive stools studies were negative. She was started empirically on ciprofloxacin and metronidazole which were stopped by ID recs. She now represents with fevers, diarrhea, nausea and mylagias. She reports 4 loose bowel movements in the past few days. Today she checked her fever which was 102 which promted the ED visit. She denies any sick contact or travel history. No raw food. In the ED, initial VS were 102.2 123 115/98 20 93% . Exam notable for: TTP in LLQ, no rebound or gaurding. Labs showed WBC of 7.0, H/H at baseline (11.8/34.8), plt 175. BMP notable for elevated Cr of 1.5 (basline 0.7-0.8), Na 137, Cl 94. ALT: 39 AST: 111 AP: 155 Tbili: 0.3 Alb: 3.2 Imaging showed no acute cardiopulmonary process. Received ceftriaxone, flagyl per ID recs, 2L NS, and tylenol 1g. ###RESPONSE: HIV {Human immunodeficiency virus infection}, AIDS {Acquired immune deficiency syndrome}, HIV {Human immunodeficiency virus infection}, depression {Depressive disorder}, seizures {Seizure}, fever {Fever}, bloody diarrhea {Hemorrhagic diarrhea}, fever {Fever}, sinus congestion {Congestion of nasal sinus}, headache {Headache}, body ache {Generalized aches and pains}, sore throat {Sore throat}, cough {Cough}, shortness of breath {Dyspnea}, abdominal pain {Abdominal pain}, nausea, vomiting {Nausea and vomiting}, diarrhea {Diarrhea}, fever {Fever}, resolved {Problem resolved}, constipated {Constipation}, bloody diarrhea {Hemorrhagic diarrhea}, fever {Fever}, Cr {Finding of creatinine level}, baseline {Baseline state}, LFTs {Hepatic function panel}, elevated {Finding of increased blood pressure}, AST {Aspartate aminotransferase measurement}, ALT {Alanine aminotransferase measurement}, AP {Alkaline phosphatase measurement}, UA {Urinalysis}, CXR {Plain chest X-ray}, stools studies {Stool microscopy}, ID {Infectious disease}, fevers {Fever}, diarrhea {Diarrhea}, nausea {Nausea}, mylagias {Muscle pain}, loose bowel movements {Loose stool}, fever {Fever}, VS {Vital signs finding}, Exam {Examination of abdomen}, TTP in LLQ {Tenderness of left lower quadrant of abdomen}, rebound {Rebound tenderness}, gaurding {Abdominal guarding}, WBC {White blood cell count}, H/H {Measurement of total hemoglobin concentration and hematocrit}, baseline {Baseline state}, BMP {Serum metabolic panel}, elevated Cr {Serum creatinine above reference range}, basline {Baseline state}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, AP {Alkaline phosphatase measurement}, Imaging {Imaging}, ID {Infectious disease}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Past Medical History: - AIDS (resistant disease - followed by ID, Dr. ___ -- CD4 nadir 8 in ___, improved to 77 in ___ -- CD4 20 ___ -- HIV Viral Load in ___ - 159,154 copies/ml -- Opportunistic infections: esophageal candidiasis -- CIN II-III s/p LEEP procedure -- several mutations listed in OMR problem list - Depression - Gastritis secondary to H. Pylori - Nephrolithiasis - Cervical spondylosis - Migraines - Excision of left wrist ganglion cyst ___ - Genital and vaginal condyloma - Left carpal tunnel syndrome - S/p open cholecystectomy - H/o right sided Bell's palsy - H/o diverticulitis with microperforation (patient is not clear of this history) - H/o CMV esophagitis and ?colitis ###RESPONSE: AIDS {Acquired immune deficiency syndrome}, disease {Disease}, ID {Infectious disease}, improved {Patient's condition improved}, HIV Viral Load {Human immunodeficiency virus viral load}, infections {Infectious disease}, esophageal candidiasis {Candidiasis of the esophagus}, CIN {Cervical intraepithelial neoplasia}, LEEP {Loop electrosurgical excision procedure}, procedure {Procedure}, mutations {Genetic mutation}, problem {Problem}, Depression {Depressive disorder}, Gastritis secondary to H. Pylori {Gastritis caused by Helicobacter pylori}, Nephrolithiasis {Kidney stone}, Cervical spondylosis {Cervical spondylosis}, Migraines {Migraine}, Excision {Excision}, left wrist {Structure of left wrist region}, ganglion cyst {Ganglion cyst}, Genital {Genital structure}, vaginal condyloma {Condyloma acuminata of vagina}, Left {Left upper arm structure}, carpal tunnel syndrome {Carpal tunnel syndrome}, cholecystectomy {Cholecystectomy}, right sided {Structure of right facial muscle}, Bell's palsy {Bell's palsy}, diverticulitis {Diverticulitis}, CMV esophagitis {Esophagitis caused by Cytomegalovirus}, colitis {Cytomegaloviral colitis}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Social History: ___ ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Family History: Mother alive with a history of hypertension. Father deceased from stroke. Three sisters and six brothers alive. No children. ###RESPONSE: alive {Alive}, hypertension {Hypertensive disorder, systemic arterial}, deceased {Dead}, stroke {Cerebrovascular accident}, alive {Alive}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Physical Exam: On Admission: ------------- Vitals: 98.2 117/56 97 100%RA General: Alert, oriented, ill appearing, fatigued HEENT: Sclera anicteric, dry mucous membranes, oropharynx clear without exudates Neck: Supple, no cervical or supraclavicular LAD CV: Regular rate and rhythm, normal S1 + S2, ___ systolic murmur in the apex Lungs: Clear to auscultation bilaterally, no wheezes, rales, rhonchi Abdomen: Soft, non-distended, very mild tenderness in the lower abdomen, bowel sounds present, no rebound or guarding Ext: Warm, well perfused, no edema Neuro: Alert and oriented x 3, CNII-XII intact Skin: no rashes At Discharge: ------------- VS - 98 128-150/70-101 52-104 17 99% RA General: Alert, oriented, chronically ill-appearing woman in NAD HEENT: Sclera anicteric, MMM, oropharynx clear without exudates Neck: Supple, no cervical or supraclavicular LAD CV: Regular rate and rhythm, normal S1 + S2, ___ systolic murmur in the apex Lungs: Clear to auscultation bilaterally, no wheezes, rales, rhonchi Abdomen: Soft, non-distended, nontender, bowel sounds present, no rebound or guarding Ext: Warm, well perfused, no edema Neuro: Alert and oriented x 3, CNII-XII intact Skin: no rashes ###RESPONSE: Vitals {Vital signs finding}, RA {Breathing room air}, General {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, fatigued {Fatigue}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, dry mucous membranes {Mucous membrane dryness}, oropharynx clear {Pharynx normal}, exudates {Exudate}, Neck {Physical examination procedure}, Supple {Normal movement of neck}, cervical {Cervical lymphadenopathy}, supraclavicular {Supraclavicular lymphadenopathy}, LAD {Lymphadenopathy}, CV {Cardiovascular physical examination}, Regular rate and rhythm {Normal heart rate}, normal S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, murmur {Murmur}, apex {Structure of apex of heart}, Lungs {Examination of respiratory system}, Clear to auscultation bilaterally {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, rhonchi {Wheeze - rhonchi}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, non-distended {Normal abdominal contour}, tenderness {Tenderness}, lower abdomen {Lower abdomen structure}, bowel sounds present {Normal bowel sounds}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, Ext {Examination of limb}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, edema {Edema}, Neuro {Neurological examination}, Alert {Mentally alert}, oriented {Orientated}, CNII {Optic nerve structure}, XII intact {Intact hypoglossal nerve}, Skin {Examination of skin}, rashes {Eruption of skin}, VS {Vital signs finding}, RA {Breathing room air}, General {General examination of patient}, Alert {Mentally alert}, oriented {Oriented to person}, ill-appearing {Looks ill}, NAD {Distress}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, MMM {Moist oral mucosa}, oropharynx clear {Pharynx normal}, exudates {Exudate}, Neck {Neck structure}, Supple {Normal movement of neck}, cervical {Cervical lymphadenopathy}, supraclavicular {Supraclavicular lymphadenopathy}, LAD {Lymphadenopathy}, CV {Cardiovascular physical examination}, Regular rate and rhythm {Normal heart rate}, normal S1 + S2 {Heart sounds normal}, systolic murmur {Systolic murmur}, apex {Structure of apex of heart}, Lungs {Lung structure}, Clear to auscultation bilaterally {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, rhonchi {Wheeze - rhonchi}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, non-distended {Normal abdominal contour}, nontender {Tenderness}, bowel sounds present {Normal bowel sounds}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, Ext {Examination of limb}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, edema {Edema}, Neuro {Neurological examination}, Alert {Mentally alert}, oriented x 3 {Oriented to person, time and place}, CNII {Optic nerve structure}, XII intact {Intact hypoglossal nerve}, Skin {Examination of skin}, rashes {Eruption of skin}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Pertinent Results: Labs on Admission: ------------------ ___ 05:00PM WBC-7.0 RBC-3.99* HGB-11.8* HCT-34.8* MCV-87 MCH-29.7 MCHC-34.0 RDW-15.0 ___ 05:00PM NEUTS-59 BANDS-0 ___ MONOS-14* EOS-0 BASOS-1 ATYPS-2* ___ MYELOS-0 ___ 05:00PM PLT SMR-NORMAL PLT COUNT-175 ___ 05:00PM HYPOCHROM-NORMAL ANISOCYT-NORMAL POIKILOCY-NORMAL MACROCYT-NORMAL MICROCYT-NORMAL POLYCHROM-OCCASIONAL OVALOCYT-OCCASIONAL ___ 05:00PM GLUCOSE-92 UREA N-23* CREAT-1.5* SODIUM-137 POTASSIUM-4.0 CHLORIDE-94* TOTAL CO2-22 ANION GAP-25* ___ 05:00PM ALT(SGPT)-39 AST(SGOT)-111* ALK PHOS-155* TOT BILI-0.3 ___ 05:00PM ALBUMIN-3.2* CALCIUM-9.1 PHOSPHATE-4.4 MAGNESIUM-1.6 ___ 05:00PM LIPASE-57 ___ 05:17PM LACTATE-1.8 Micro Data: ----------- All stool cultures, stains, O&P were negative. Blood culturtes negative to date. Urine cx negative to date. Cryptococcal antigen and toxoplasma IgG negative. CMV Viral Load (Final ___: 984 IU/mL. C.difficile negative. Cryptosporidium/ giardia negative. Imaging Reports: ---------------- CT Abdomen/ Pelvis with contrast: 1. Small amount of free fluid in the pelvis, which may be physiologic. 2. No GI abnormality to explain the patient's diarrhea 3. Postcholecystectomy 4. Degenerative disc L4-5 EGD/ Colonoscopy Report: EGD ___: Small white plaques in mid-esophagus, ? of mild candidiasis. (biopsy) Erythema and petechiae in the whole stomach compatible with mild gastritis (biopsy) Normal mucosa in the duodenum (biopsy) Otherwise normal EGD to third part of the duodenum Colonoscopy ___: Diverticulosis of the scattered throughout the colon Erythema and small erosions in the left colon (biopsy) The terminal ileum mucosa appeared normal. (biopsy) Otherwise normal colonoscopy to cecum and terminal ileum EGD/ COLONOSCOPY PATHOLOGY REPORT: 1. Mid esophagus: - Active esophagitis with numerous intraepithelial lymphocytes and scattered eosinophils and neutophils. - GMS stain for fungal organisms is negative with satisfactory control. 2.. Gastric/stomach: - Corpus/antral mucosa with mild chronic inactive gastritis. - Immunostain for Helicobacter species is in progress and the results will be reported in a revised report. 3. Duodenum: - Duodenal mucosa, within normal limits. 4. Terminal ileum: - Small intestinal mucosa, within normal limits. 5. Random colon: - Colonic mucosa, within normal limits. Addendum yet to be finalized by pathology at time of discharge: evidence of CMV on esophageal biopsies; no evidence of CMV on clononic biopsies. ###RESPONSE: WBC {White blood cell count}, RBC {Red blood cell count}, HGB {Measurement of total hemoglobin concentration}, HCT {Hematocrit determination}, MCV {Erythrocyte mean corpuscular volume determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, NEUTS {Neutrophil count}, MONOS {Monocyte count}, EOS {Eosinophil count}, GLUCOSE {Glucose measurement, blood}, CREAT {Creatinine measurement}, SODIUM {Sodium measurement}, POTASSIUM {Potassium measurement}, CHLORIDE {Chloride measurement, blood}, TOTAL CO2 {Blood total carbon dioxide (calculated)}, ANION GAP {Anion gap measurement}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, PHOS {Phosphate, total measurement}, TOT BILI {Bilirubin, total measurement}, ALBUMIN {Albumin measurement}, CALCIUM {Blood calcium measurement}, stool cultures {Stool culture}, O&P {Finding of presence of ova cysts and parasites}, Blood culturtes {Blood culture}, Urine cx {Urine culture}, IgG {Immunoglobulin G measurement}, Viral Load {Viral load}, pelvis {Structure of pelvis}, GI {Gastrointestinal tract finding}, diarrhea {Diarrhea}, Degenerative {Degenerative abnormality}, L4 {Bone structure of L4}, 5 {Bone structure of L5}, EGD {Esophagogastroduodenoscopy}, plaques {Plaque}, esophagus {Esophageal structure}, candidiasis {Candidiasis}, biopsy {Biopsy}, Erythema {Erythema}, petechiae {Petechia}, stomach {Stomach structure}, gastritis {Gastritis}, biopsy {Biopsy}, mucosa {Vaginal mucous membrane structure}, duodenum {Duodenal structure}, biopsy {Biopsy}, EGD {Esophagogastroduodenoscopy}, third part of the duodenum {Structure of inferior portion of duodenum}, Diverticulosis {Diverticulosis of colon}, colon {Colon structure}, Erythema {Erythema}, erosions {Superficial ulcer}, left colon {Left colon structure}, biopsy {Biopsy}, terminal ileum {Structure of distal portion of ileum}, mucosa {Vaginal mucous membrane structure}, biopsy {Biopsy}, colonoscopy {Colonoscopy}, cecum {Cecum structure}, terminal ileum {Structure of distal portion of ileum}, esophagus {Esophageal structure}, esophagitis {Esophagitis}, fungal {Mycosis}, Corpus {Gastric corpus structure}, antral {Pyloric antrum structure}, mucosa {Vaginal mucous membrane structure}, chronic {Chronic gastritis}, gastritis {Gastritis}, Duodenal mucosa {Duodenal mucous membrane structure}, Small {Structure of small intestine}, intestinal mucosa {Intestinal mucous membrane structure}, Colonic mucosa {Colonic mucous membrane structure}, CMV {Cytomegalovirus infection}, esophageal biopsies {Biopsy of esophagus}, no evidence {No abnormality detected}, CMV {Cytomegalovirus infection}, clononic biopsies {Biopsy of colon}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Brief Hospital Course: ___ with HIV/AIDS with poor medication compliance(CD4 24(3%), HIV VL 70K ___, depression, and hx of seizures, who was recently admitted with fever, non-bloody diarrhea, and ___ (___), who now re-presets with similar symptoms. # Fevers/ Diarrhea: Most likely secondary to CMV given she had a positive CMV viral load to >900. Given her low CD4 status, differential was broad and included other opportunistic infections as well as non-opportunistic infections. Less likely to be ischemic or inflammatory. ___ with evidence of esophagitis with concern for contribution from ?___ as well as some mild colitis in left colon, biopsies taken, revealing evidence of CMV in the esophagus, however, no evidence of CMV in the colon. She was started on IV gancyclovir and transitioned to PO valgancyclovir, to complete a ___ week course, to be determined by outpatient ID. Also started a 14 day course of fluconazole, for ___ esophagitis. Ophthalmology was consulted, and patient was without evidence of CMV retinitis. All other workup, including stool studies, clultures and serum cryptococcal antigen were negative. Her diarrhea and fevers resolved and her diet was advanced without issues. Of note, discontinued empiric CTX/flagyl that were initially started in the ED given low concern for bacterial infection. All of the above was done in consultation with the infectious disease service. # Fevers: As above unifying diagnosis would be infectious colitis possibly from an opportunistic infection as described above. However given her AIDS and CMV viremia, fever could also represent other systemic infection. CXR without any consolidations. The patient did not appear septic. Infectious workup results detailed above. Discharged on valgancyclovir and fluconazole as above. # ___: Baseline Cr 1 which was elevated to 1.5 on admission. Most likely pre-renal vs ATN in the setting of diarrhea and poor po intake, however, given that she has remained in the 1.4 to 1.5 range on a subacute time period, this may represent a new baseline. Renally dosed all medications, with changes made to include HIV meds that were less nephrotoxic. Avoided NSAIDS, contrast and other nephrotoxic meds as much as possible. Discharge creatinine was 1.4. # HIV AIDS: History of med non-complaince however currently reports taking her HIV meds. Cannot use Stribild given ___ For HIV: Discontinued Stribild. Continued with dolutegravir 50mg daily, darunavir 800mg PO daily, cobicistat 100mg daily, lamivudine 150mg PO daily per ID recs. Darunavir and cobicistat were prescribed as a combination pill at time of discharge. Of note, she does have a history of non-adherence to HAART; in the setting of depression she states she became tired of taking the medications and self-discontinued them. Her mother and brother are unaware of her diagnosis; sister is aware and per pt, provides support. ***TRANSITIONAL ISSUES*** - history of poor adherence to HAART - Patient should have at least yearly dilated eye exams, sooner if any issues and this was discussed with the patient. She can follow up at ___ or by an outside ophthalmologist. - to complete 14 day course of PO fluconazole, end date ___. - to complete ___ week course of valgancyclovir (exact course to be determined by outpatient ID physician) (trsnaitioned to PO on ___. - patient with anemia, and borderline low B12, should have MMA checked as an outpatient (likely effect of HAART therapy). ###RESPONSE: HIV {Human immunodeficiency virus infection}, AIDS {Acquired immune deficiency syndrome}, HIV {Human immunodeficiency virus infection}, depression {Depressive disorder}, seizures {Seizure}, fever {Fever}, bloody diarrhea {Hemorrhagic diarrhea}, Fevers {Fever}, Diarrhea {Diarrhea}, CMV {Cytomegalovirus infection}, CMV {Cytomegalovirus infection}, viral load {Viral load}, infections {Infectious disease}, infections {Infectious disease}, ischemic {Ischemia}, inflammatory {Inflammatory disorder}, esophagitis {Esophagitis}, colitis {Colitis}, left colon {Left colon structure}, biopsies {Biopsy}, CMV {Cytomegalovirus infection}, esophagus {Esophageal structure}, no evidence {No abnormality detected}, CMV {Cytomegalovirus infection}, colon {Colon structure}, IV {Administration of drug or medicament via intravenous route}, ID {Infectious disease}, esophagitis {Esophagitis}, CMV retinitis {Cytomegaloviral retinitis}, stool studies {Stool microscopy}, clultures {Stool culture}, diarrhea {Diarrhea}, fevers {Fever}, resolved {Problem resolved}, diet {Normal diet}, CTX {Contraction of uterus during labor}, bacterial infection {Bacterial infectious disease}, infectious disease service {Infectious diseases service}, Fevers {Fever}, infectious colitis {Infectious colitis}, infection {Infectious disease}, AIDS {Acquired immune deficiency syndrome}, CMV viremia {Cytomegalovirus viremia}, fever {Fever}, systemic infection {Sepsis}, CXR {Plain chest X-ray}, consolidations {Consolidation}, septic {Sepsis}, Infectious {Infectious disease}, Baseline {Baseline state}, Cr {Finding of creatinine level}, elevated {Serum creatinine above reference range}, renal {Kidney structure}, ATN {Acute tubular necrosis}, diarrhea {Diarrhea}, poor po intake {Decrease in appetite}, baseline {Baseline state}, HIV {Human immunodeficiency virus infection}, creatinine {Creatinine measurement}, HIV {Human immunodeficiency virus infection}, AIDS {Acquired immune deficiency syndrome}, non-complaince {Drug compliance poor}, HIV {Human immunodeficiency virus infection}, HIV {Human immunodeficiency virus infection}, ID {Infectious diseases service}, depression {Depressive disorder}, dilated {Dilated pupil}, eye {Structure of eye proper}, exams {Ophthalmic examination and evaluation}, ID {Infectious disease}, anemia {Anemia}, low B12 {Cobalamin deficiency}, therapy {Therapy}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Medications on Admission: The Preadmission Medication list is accurate and complete. 1. Atovaquone Suspension 1500 mg PO DAILY 2. Azithromycin 600 mg PO 2X/WEEK (WE,SA) 3. Darunavir 800 mg PO DAILY 4. Prochlorperazine 5 mg PO DAILY PRN nausea 5. Stribild 1 TAB PO DAILY 6. camphor-menthol 0.5 % topical bid:prn 7. Ensure (food supplemt, lactose-reduced) 1 can oral daily 8. Triamcinolone Acetonide 0.1% Cream 1 Appl TP BID Discharge Medications: 1. Atovaquone Suspension 1500 mg PO DAILY 2. Azithromycin 600 mg PO 2X/WEEK (WE,SA) 3. Dolutegravir 50 mg PO DAILY RX *dolutegravir [___] 50 mg 1 tablet(s) by mouth daily Disp #*30 Tablet Refills:*1 RX *dolutegravir [___] 50 mg 1 tablet(s) by mouth daily Disp #*30 Tablet Refills:*1 4. Fluconazole 200 mg PO Q24H RX *fluconazole [Diflucan] 200 mg 1 tablet(s) by mouth daily Disp #*11 Tablet Refills:*0 5. LaMIVudine 150 mg PO DAILY RX *lamivudine [Epivir] 150 mg 1 tablet(s) by mouth daily Disp #*30 Tablet Refills:*1 6. camphor-menthol 0.5 % topical bid:prn 7. Ensure (food supplemt, lactose-reduced) 1 can oral daily 8. Prochlorperazine 5 mg PO DAILY PRN nausea 9. Triamcinolone Acetonide 0.1% Cream 1 Appl TP BID 10. ValGANCIclovir 450 mg PO Q12H RX *valganciclovir 450 mg 1 tablet(s) by mouth twice a day Disp #*60 Tablet Refills:*0 11. darunavir-cobicistat 800-150 mg-mg oral DAILY RX *darunavir-cobicistat [Prezcobix] 800 mg-150 mg 1 tablet(s) by mouth daily Disp #*30 Tablet Refills:*1 ###RESPONSE: mg {Blood magnesium measurement}, mg {Blood magnesium measurement}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Discharge Disposition: Home Discharge Diagnosis: Primary Diagnosis: ------------------ - CMV viremia - ___ and CMV esophagitis - fevers and diarrhea SECONDARY DIAGNOSES: -------------------- -AIDS Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. ###RESPONSE: CMV viremia {Cytomegalovirus viremia}, CMV esophagitis {Esophagitis caused by Cytomegalovirus}, fevers {Fever}, diarrhea {Diarrhea}, AIDS {Acquired immune deficiency syndrome}, Mental Status {Neurological mental status determination}, Clear {Normal breath sounds}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, Activity Status {Physical functional dependency}, Ambulatory - Independent {Independent walking}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Discharge Instructions: Dear Ms. ___, It was a pleasure taking care of you during your hospital stay at ___. You came in because you were having fevers and diarrhea. Our infectious disease doctors ___ and recommended a complete infectious workup. Our lab tests revealed that you had a virus in your blood, called cytomegalovirus, that may have been causing your symptoms. We treated you with an antiviral, called valgancyclovir, a medication which you should continue to take for three to six weeks (your doctor ___ tell you how long exactly). You should also continue to take fluconazole for two weeks. Your symptoms have resolved and it is now safe for you to be discharged. Please be sure to take ALL of your medications as prescribed and keep your follow-up appointments. We wish you the very best! Sincerely, Your ___ Team ###RESPONSE: fevers {Fever}, diarrhea {Diarrhea}, infectious disease {Infectious disease}, infectious {Infectious disease}, cytomegalovirus {Cytomegalovirus infection}, medication {Patient medication education}, resolved {Problem resolved}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Followup Instructions: ___ ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Name: ___ Unit No: ___ Admission Date: ___ Discharge Date: ___ Date of Birth: ___ Sex: M Service: SURGERY ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Allergies: No Known Allergies / Adverse Drug Reactions Attending: ___. Chief Complaint: Adenocarcinoma of the bile duct Major Surgical or Invasive Procedure: ___: 1. Diagnostic laparoscopy 2. Pancreaticoduodenectomy with extended bile duct resection 3. Open cholecystectomy 4. Placement of Golden Fiducials for Cyperknife therapy ###RESPONSE: No Known Allergies {Allergic disposition}, Adverse Drug Reactions {Propensity to adverse reactions to drug}, Adenocarcinoma of the bile duct {Primary adenocarcinoma of bile duct}, laparoscopy {Laparoscopy}, Pancreaticoduodenectomy {Pancreaticoduodenectomy}, bile duct resection {Resection of extrahepatic bile duct}, cholecystectomy {Cholecystectomy}, Placement {Implantation procedure}, therapy {Therapy}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: History of Present Illness: Mr. ___ is a ___ year old with PMH of HTN and BPH who initially presented with 1 week of diarrhea, a few days of dark colored urine and pruritus, found to have an elevated T bilirubin, abnormal abdominal ultrasound and CT scan which showed a 25 mm gallstone as well as intrahepatic and common hepatic duct dilatation, concerning for possible malignancy. MRCP was performed which confirmed a 3.5cm segment of distal common hepatic and proximal come bile duct with irregular enhancement with necrotic periportal ___ s/f nodal involvement. He then underwent ERCP on ___ which confirmed a malignant-appearing stricture in the proximal CBD with plastic stent placement. His ampullar was normal and cholangiogram demonstrated a 2cm long, malignant appearing stricture in the proximal CBD. Cytology from the ERCP brushings were consistent for adenocarcinoma. He will undergo a whipple procedure. ###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, BPH {Benign prostatic hyperplasia}, diarrhea {Diarrhea}, dark colored urine {Urine looks dark}, pruritus {Itching of skin}, elevated T bilirubin {Total bilirubin above reference range}, abnormal abdominal ultrasound {Ultrasonography of abdomen abnormal}, CT scan {Computed tomography of abdomen abnormal}, gallstone {Gallbladder calculus}, intrahepatic {Intrahepatic biliary tract structure}, common hepatic duct {Structure of common hepatic duct}, dilatation {Dilatation}, malignancy {Malignant neoplasm}, MRCP {Magnetic resonance cholangiopancreatography}, distal common hepatic {Structure of common bile duct, distal}, proximal come bile duct {Structure of common bile duct, proximal}, necrotic {Necrosis}, ERCP {Endoscopic retrograde cholangiopancreatography}, stricture {Stricture}, proximal CBD {Structure of common bile duct, proximal}, stent placement {Placement of stent}, cholangiogram {Cholangiogram}, stricture {Stricture}, proximal CBD {Structure of common bile duct, proximal}, ERCP {Endoscopic retrograde cholangiopancreatography}, adenocarcinoma {Adenocarcinoma}, whipple procedure {Pancreaticoduodenectomy}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Past Medical History: - Hypertension - BPH - Arthritis - Prior Carpal Tunnel Surgery R Wrist ###RESPONSE: Hypertension {Hypertensive disorder, systemic arterial}, BPH {Benign prostatic hyperplasia}, Arthritis {Arthritis}, Carpal Tunnel {Carpal tunnel syndrome}, Surgery {Surgical procedure}, R Wrist {Structure of right wrist region}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Social History: ___ ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Family History: father - CAD mother - pancreatic cancer brother - HTN Physical ___: Prior To Discharge: VS: 98.6, 68, 134/71, 18, 94% RA GEN: Pleasant male without acute distress HEENT: NC/AT, PERRL, EOMI, no scleral icterus CV: RRR PULM: CTAB ABD: Bilateral subcostal incision open to air with staples and c/d/I. RLQ with old JP site x 2, lateral with single suture, medial open to air EXTR: Warm, no c/c/e ###RESPONSE: CAD {Coronary arteriosclerosis}, pancreatic cancer {Malignant tumor of pancreas}, HTN {Hypertensive disorder, systemic arterial}, VS {Vital signs finding}, GEN {General examination of patient}, distress {Distress}, NC {Normal head}, PERRL {Pupils equal and reacting to light}, EOMI {Normal ocular motility}, scleral icterus {Scleral icterus}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, PULM {Examination of respiratory system}, CTAB {Normal breath sounds}, ABD {Examination of abdomen}, subcostal incision {Subcostal incision}, RLQ {Structure of right lower quadrant of abdomen}, EXTR {Examination of limb}, Warm {Warm skin}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Pertinent Results: RECENT LABS: ___ 05:25AM BLOOD WBC-8.4 RBC-3.76* Hgb-11.7* Hct-35.5* MCV-94 MCH-31.1 MCHC-33.0 RDW-16.2* RDWSD-55.7* Plt ___ ___ 05:25AM BLOOD Glucose-143* UreaN-12 Creat-0.6 Na-144 K-3.9 Cl-102 HCO3-31 AnGap-11 ___ 04:40PM ASCITES Amylase-8 ___ 04:40PM ASCITES Amylase-8 MICROBIOLOGY: ___ 2:00 pm SWAB BILE CULTURE. Fluid should not be sent in swab transport media. Submit fluids in a capped syringe (no needle), red top tube, or sterile cup. **FINAL REPORT ___ GRAM STAIN (Final ___: 1+ (<1 per 1000X FIELD): POLYMORPHONUCLEAR LEUKOCYTES. NO MICROORGANISMS SEEN. WOUND CULTURE (Final ___: ESCHERICHIA COLI. SPARSE GROWTH. Cefazolin interpretative criteria are based on a dosage regimen of 2g every 8h. ESCHERICHIA COLI. SPARSE GROWTH. Cefazolin interpretative criteria are based on a dosage regimen of 2g every 8h. SECOND MORPHOLOGY. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ ESCHERICHIA COLI | ESCHERICHIA COLI | | AMPICILLIN------------ <=2 S 4 S AMPICILLIN/SULBACTAM-- <=2 S <=2 S CEFAZOLIN------------- <=4 S <=4 S CEFEPIME-------------- <=1 S <=1 S CEFTAZIDIME----------- <=1 S <=1 S CEFTRIAXONE----------- <=1 S <=1 S CIPROFLOXACIN---------<=0.25 S <=0.25 S GENTAMICIN------------ <=1 S <=1 S MEROPENEM-------------<=0.25 S <=0.25 S PIPERACILLIN/TAZO----- <=4 S <=4 S TOBRAMYCIN------------ <=1 S <=1 S TRIMETHOPRIM/SULFA---- <=1 S <=1 S ###RESPONSE: WBC {White blood cell count}, RBC {Red blood cell count}, Hgb {Measurement of total hemoglobin concentration}, Hct {Hematocrit determination}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, RDWSD {Red cell distribution width determination}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, Cl {Chloride measurement, blood}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, CULTURE {Microbial culture}, GRAM STAIN {Gram stain method}, WOUND CULTURE {Wound microscopy, culture and sensitivities}, SENSITIVITIES {Antimicrobial susceptibility test}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Brief Hospital Course: The patient with biopsy proven adenocarcinoma was admitted to the HPB Surgical Service on ___ for elective operation. On ___, the patient underwent pylorus-preserving pancreaticoduodenectomy (Whipple) and open cholecystectomy, intraoperative patient spiked a fever and was continued on Zosyn for empiric coverage post operative, bile and blood cultures were sent (please see the Operative Note for details). After a brief, uneventful stay in the PACU, the patient arrived on the floor NPO with an NG tube, on IV fluids, with a foley catheter and a JP drain x 2 in place, and epidural catheter for pain control. The patient was hemodynamically stable. The ___ hospital course was uneventful and followed the Whipple Clinical Pathway without major deviations. Post-operative pain was initially well controlled with epidural analgesia, which was converted to oral pain medication when tolerating clear liquids. The NG tube was discontinued on POD# 2, and the foley catheter discontinued at midnight of POD# 4. The patient subsequently voided without problem. The patient was started on sips of clears on POD# 3, which was progressively advanced as tolerated to a regular diet by POD# 6. JP amylase was sent in the evening of POD#6; the posterior JP was discontinued on POD# 6, and anterior JP was discontinued on POD 7 as the output and amylase level were low. Patient was transitioned from Zosyn to PO Cipro on POD 4 to complete 7 days total. Patient remained afebrile with WBC within normal limits prior to discharge. During this hospitalization, the patient ambulated early and frequently, was adherent with respiratory toilet and incentive spirrometry, and actively participated in the plan of care. The patient received subcutaneous heparin and venodyne boots were used during this stay. He was transitioned to ___ Lovenox prior to discharge. The patient's blood sugar was monitored regularly throughout the stay; no insulin was required on discharge. At the time of discharge on ___, the patient was doing well, afebrile with stable vital signs. The patient was tolerating a regular diet, ambulating, voiding without assistance, and pain was well controlled. The patient was discharged home without services. The patient received discharge teaching and follow-up instructions with understanding verbalized and agreement with the discharge plan. ###RESPONSE: biopsy {Biopsy}, adenocarcinoma {Adenocarcinoma}, elective operation {Optional surgery}, pylorus-preserving pancreaticoduodenectomy {Pylorus-sparing Whipple operation}, cholecystectomy {Cholecystectomy}, fever {Fever}, post operative {Postoperative state}, blood cultures {Blood culture}, NPO {Nil by mouth}, IV fluids {Administration of intravenous fluids}, foley catheter {Urinary catheter in situ}, pain control {Pain control}, hemodynamically stable {Hemodynamically stable}, Post-operative pain {Postoperative pain}, epidural analgesia {Epidural anesthesia}, oral {Administration of drug or medicament via oral route}, pain medication {Administration of analgesic}, voided without problem {Normal micturition}, regular diet {Normal diet}, amylase level {Amylase measurement}, incentive spirrometry {Incentive spirometry}, blood sugar {Glucose measurement, blood}, stable vital signs {Normal vital signs}, regular diet {Normal diet}, ambulating {Fully mobile}, voiding without assistance {Continence independent}, pain was well controlled {Demonstrates adequate pain control}, teaching {Patient education}, discharge plan {Discharge planning}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Medications on Admission: Lisinopril-HCTZ ___ QD Finasteride 5 QD Pravastatin 20 QD Discharge Medications: 1. Acetaminophen ___ mg PO Q8H:PRN Pain - Mild do not exceed more then 3000 mg/day 2. Docusate Sodium 100 mg PO BID RX *docusate sodium 100 mg 1 capsule(s) by mouth twice a day Disp #*60 Capsule Refills:*0 3. Enoxaparin Sodium 40 mg SC DAILY RX *enoxaparin 40 mg/0.4 mL 40 mg SC once a day Disp #*30 Syringe Refills:*0 4. lisinopril-hydrochlorothiazide ___ mg oral DAILY 5. Metoclopramide 10 mg PO QIDACHS RX *metoclopramide HCl 10 mg 1 tab by mouth QIDACHS Disp #*56 Tablet Refills:*0 6. OxyCODONE (Immediate Release) 5 mg PO Q4H:PRN Pain - Moderate RX *oxycodone 5 mg 1 tablet(s) by mouth every six (6) hours Disp #*20 Tablet Refills:*0 7. Pantoprazole 40 mg PO Q24H RX *pantoprazole 40 mg 1 tablet(s) by mouth once a day Disp #*30 Tablet Refills:*11 8. Senna 8.6 mg PO BID 9. Finasteride 5 mg PO DAILY 10. Pravastatin 20 mg PO QPM ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Discharge Disposition: Home Discharge Diagnosis: Locally advanced cholangiocarcinoma Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. ###RESPONSE: cholangiocarcinoma {Cholangiocarcinoma}, Mental Status {Neurological mental status determination}, Clear {Chest clear}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, Activity Status {Physical functional dependency}, Ambulatory - Independent {Independent walking}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Discharge Instructions: Mr. ___, You were admitted to the surgery service at ___ for surgical resection of your biliary duct mass. You have done well in the post operative period and are now safe to return home to complete your recovery with the following instructions: . Please call Dr. ___ office at ___ or Office RNs at ___ if you have any questions or concerns. . Please resume all regular home medications , unless specifically advised not to take a particular medication. Also, please take any new medications as prescribed. Please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. Avoid lifting weights greater than ___ lbs until you follow-up with your surgeon, who will instruct you further regarding activity restrictions. Avoid driving or operating heavy machinery while taking pain medications. Please follow-up with your surgeon and Primary Care Provider (PCP) as advised. Incision Care: *Please call your doctor or nurse practitioner if you have increased pain, swelling, redness, or drainage from the incision site. *Avoid swimming and baths until your follow-up appointment. *You may shower, and wash surgical incisions with a mild soap and warm water. Gently pat the area dry. *If you have staples, they will be removed at your follow-up appointment. ###RESPONSE: surgical resection {Surgical removal}, biliary duct {Bile duct structure}, mass {Mass of pancreas}, post operative {Postoperative state}, increased pain {Increased pain}, swelling {Swelling}, redness {Redness of skin over lesion}, drainage {Discharge}, incision site {Surgical incision wound}, surgical incisions {Surgical incision wound}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Followup Instructions: ___ ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Name: ___ Unit No: ___ Admission Date: ___ Discharge Date: ___ Date of Birth: ___ Sex: M Service: MEDICINE ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Allergies: Cefaclor / Aspirin Attending: ___. Chief Complaint: Feeling hot/cold, paresthesias Major Surgical or Invasive Procedure: None ###RESPONSE: Aspirin {Allergy to aspirin}, Feeling hot/cold {Sensation of hot and cold}, paresthesias {Paresthesia}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: History of Present Illness: ___ year-old man presented to ___ for his fourth ___ visit for a strange constellation of symptoms including a strange feeling like water in his stomach, abdominal pain, a feeling of fecal urgency, and warm tingling up into his chest and down his leg. He reported a total duration of about three weeks for these symptoms. His most dramatic symptom had been a strange sensation of hot and cold. He reported he would have a very cold feeling in his abdomen associated with some pain that was most intense in the right upper quadrant. This would be followed by a warm, dry feeling in his chest. He reported after these symptoms he would have a feeling of fecal urgency and almost invariably have a bowel movement. Additionally, associated with these episodes he endorsed shortness of breath, mild chest pain, diaphoresis, and a presyncopal feeling. He acknowledged these symptoms would lead to a great deal of anxiety, which would make him feel worse, but was very insistent the anxiety developed after and in response to the symptoms. He denied actually syncope. He did report various areas of paresthesia as part of these spells in a band down his arm or leg. These symptoms led to at least three previous ___ evaluations and he had a CT Abdomen (reportedly benign), multiple ECG's and multiple sets of labs with attempts to empirically treat for PNA, asthma flare, and influenza. There had been some discussion of sending urine metanephrines and both his PCP and an ___ physician at ___ recommended this but it was deferred as he was completing a steroid course. He reported none of these symptoms had improved with any of the measures recommended at other hospitals and he continued to be very worried something dangerous was occurring. Over the last three days preceding his presentation these symptoms had been more marked and he had a chronic sensation of discomfort in his abdomen. When he awoke on the morning of presentation he had a right frontal headache as well as his other symptoms so he called ___ and the physician on call, Dr ___ him to the ___ for further work up. In the ___ VS 99. 100 132/87 18 100%. Physical exam was notable for wheezing so he received albuterol inhaler. He also received buprenorphine-naloxone ___. He had a benign head CT and was admitted to the floor. REVIEW OF SYSTEMS: + per HPI. Also positive for cough and URI symptoms. Negative for constipation, ememesis, melena, hematochezia, palpitations, dysuria, hematuria, confusion, syncope. ###RESPONSE: stomach {Stomach structure}, abdominal pain {Abdominal pain}, fecal urgency {Urgent desire for stool}, warm {Sensation of being warm}, tingling {Tingling of skin}, chest {Thoracic structure}, leg {Lower limb structure}, sensation of hot and cold {Sensation of hot and cold}, cold feeling {Sensation of being cold}, abdomen {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, pain {Chest pain}, right upper quadrant {Structure of right upper quadrant of abdomen}, warm {Sensation of being warm}, dry {Xeroderma}, chest {Thoracic structure}, fecal urgency {Urgent desire for stool}, shortness of breath {Dyspnea}, chest pain {Chest pain}, diaphoresis {Excessive sweating}, presyncopal {Near syncope}, anxiety {Anxiety}, anxiety {Anxiety}, syncope {Syncope}, paresthesia {Paresthesia}, arm {Upper limb structure}, leg {Lower limb structure}, evaluations {Evaluation procedure}, CT Abdomen {Computed tomography of abdomen}, ECG {Electrocardiographic procedure}, PNA {Pneumonia}, asthma {Asthma}, influenza {Influenza}, steroid {Steroid therapy}, improved {Patient's condition improved}, discomfort in his abdomen {Abdominal discomfort}, frontal headache {Frontal headache}, work up {Evaluation procedure}, VS {Vital signs finding}, wheezing {Wheezing}, head CT {Computed tomography of head}, cough {Cough}, URI {Upper respiratory infection}, constipation {Constipation}, melena {Melena}, hematochezia {Hematochezia}, palpitations {Palpitations}, dysuria {Dysuria}, hematuria {Blood in urine}, confusion {Clouded consciousness}, syncope {Syncope}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Past Medical History: -Cerbral palsy -Asthma -Hep C positive -Anxiety -History of substance abuse on naloxone -S/P left shoulder surgeries * 2 -He reports an episode of acute kidney injury during his period of substance abuse, he reports he not require dialysis but this was discussed ###RESPONSE: Cerbral palsy {Cerebral palsy}, Asthma {Asthma}, Hep C {Viral hepatitis type C}, Anxiety {Anxiety}, substance abuse {Substance abuse}, left shoulder {Structure of left shoulder region}, surgeries {Surgical procedure}, acute kidney injury {Acute kidney injury}, substance abuse {Substance abuse}, dialysis {Dialysis procedure}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Social History: ___ ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Family History: Didn't know his father but heard something about an adrenal tumor in him. Mother had brain aneurysm and has had cardiac stents in ___ (mother is currently actively using drugs). ###RESPONSE: adrenal tumor {Neoplasm of adrenal gland}, brain {Brain structure}, aneurysm {Aneurysm}, stents {Insertion of arterial stent}, using drugs {Drug abuse}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Physical Exam: On Admission: VS: T 98.1, P 76, BP 128/95, RR 18, O2 99% on RA Gen: Anxious young man in NAD, diaphoretic HEENT: Normocephalic, anicteric, MMM, OP clear without lesions Neck: No masses or thyroid nodules appreciated CV: RRR, no M/R/G; there is no jugular venous distension appreciated Pulm: Resps unlabored, bilateral expiratory wheezes, good air movement. Abd: Mild abdominal tenderness diffusely but no guarding or rebound, no organomegaly or masses appreciated Extrem: Warm and well perfused, no C/C/E Neuro: A and O*3, CNII-XII exam showed normal movement, complained decreased sensation V2-V3 on R side, strength ___ in all extremities Psych: Very anxious affect On Discharge: Neuro: Right V2-V3 sensation normal, but new left face numb sensation. Anal: Skin abrasion around anus, but no vesicles, condyloma, erythema, or fluctuance. ###RESPONSE: VS {Vital signs finding}, BP {Blood pressure finding}, RR {Finding of rate of respiration}, RA {Breathing room air}, Gen {General examination of patient}, Anxious {Anxiety}, NAD {No abnormality detected}, diaphoretic {Excessive sweating}, HEENT {Physical examination procedure}, Normocephalic {Normal head}, anicteric {White sclera}, MMM {Moist oral mucosa}, OP clear {Pharynx normal}, lesions {Lesion}, Neck {Physical examination procedure}, masses {Mass of neck}, thyroid nodules {Thyroid nodule}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, no M/R/G {Heart sounds normal}, jugular venous distension {Jugular venous engorgement}, Pulm {Examination of respiratory system}, Resp {Examination of respiratory system}, unlabored {Breathing easily}, wheezes {Wheezing}, good air movement {Breath normal}, Abd {Examination of abdomen}, tenderness {Tenderness}, guarding {Abdominal guarding}, rebound {Rebound tenderness}, organomegaly {Abdominal organomegaly}, masses {Abdominal mass}, Extrem {Examination of limb}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, Neuro {Neurological examination}, CNII-XII {Cranial nerve finding}, decreased sensation {Hypesthesia}, all extremities {All extremities}, Psych {Neurological mental status determination}, anxious {Anxiety}, affect {Mood finding}, Neuro {Neurological examination}, sensation normal {Normal sensation}, left face {Structure of left half of face}, numb {Numbness}, Skin {Examination of skin}, abrasion {Abrasion}, anus {Anal structure}, vesicles {Vesicle}, condyloma {Condyloma}, erythema {Erythema}, fluctuance {Fluctuant}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Pertinent Results: =================== LABORATORY RESULTS =================== On Presentation: Na 140, K 4.6, Cl 101, HCO3 28, BUN 16, Cr 0.7, Glu 121 WBC 10, Hb 15.5, Hct 43.3, MCV 83, Plt 290 --N 65.2, L 30.8, M 2.6, E 0.2, B 1.1 ___ 15.4, PTT 30.1, INR 1.3 Ca ___, Mg 2.1, P 3.6 TropT< 0.01 ALT 19, AST 19, AP 41, LDH 184, TBili 0.5 TSH-1.2 T4-10.0 T3-139 Tox: ASA-NEG Acetmnp-NEG Bnzodzp-NEG Barbitr-NEG Tricycl-NEG UA: Mod Bact, 30 protein On Discharge: WBC-7.2 RBC-4.92 Hgb-14.5 Hct-40.2 MCV-82 RDW-13.2 Plt ___ Glucose-107* UreaN-19 Creat-0.7 Na-138 K-4.3 Cl-101 HCO3-27 ============= MICROBIOLOGY ============= Urine Culture ___: No Growth Monospot ___: Negative ============== OTHER STUDIES ============== CT Head W/O Contrast ___: IMPRESSION: No acute intracranial process. Sphenoid sinus disease. Chest Radiograph ___: IMPRESSION: No acute intrathoracic process. ECG: Sinus bradycardia at 83. Nl axis and intervals. J point elevation anteriorly. No acute ST or TW abnormalities. ###RESPONSE: RBC {Red blood cell count}, Hgb {Measurement of total hemoglobin concentration}, Hct {Hematocrit determination}, MCV {Erythrocyte mean corpuscular volume determination}, RDW {Red cell distribution width determination}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, HCO3 {Blood bicarbonate measurement}, Urine Culture {Urine culture}, Sphenoid sinus disease {Disorder of sphenoidal sinus}, ECG: Sinus bradycardia {Electrocardiogram: sinus bradycardia}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Brief Hospital Course: This is a ___ year old male with history of anxiety, substance abuse, and asthma presenting with three weeks of strange symptoms and multiple ___ evals. 1) Chills/ Warm Sensation/ Paresthesias/ Paresthesias/ Presyncope: The patient presented for at least his fourth visit for a complicated set of somatic symptoms including feeling hot or cold, migrating paresthesias, fecal urgency, and presyncope. His febrile symptoms are, of course, concerning for infection and his neurological symptoms and fever raise concern for neurogenic or cardiogenic syncope vs seizure. The patient was monitored >24 hours and had multiple episodes of this symptom complex. Vital signs were checked numerous times and he was monitored on telemetry. There were no episodes of concerning arrhythmia, hemodynamic instability, fevers, chills, or other appreciable physical exam finding with the exception of the patient being somewhat diaphoretic and having some mild, diffuse tenderness to palpation on his abdomen. A wide range of labs were checked and no significant abnormalities were detected. Ultimate diagnosis remains unclear though the team has considerable suspicion of anxiety or atypical panic attacks given the patient's marked anxiety and the lack of physical findings. Other possible etiologies would be vasovagal (near) syncope perhaps initiated by a viral syndrome that caused loose stools and nausea (though neither of these GI symptoms were reported during this hospitalization). His CT head was benign and pretest probability of stroke or severe intracranial process with NO hard neurological deficits on exam in this young, healthy man would be very low. Other much less likely diagnostic possibilities would be pheochromocytoma or carcinoid, both of which can cause flushing spells (carcinoid would better explain fecal urgency) though one would expect at least some vital sign abnormalities during the episodes. Ultimately, the very benign nature of the tests and data from monitoring were discussed with the patient and Dr ___ at ___ ___. Given the difficulties with initiating 24 hour urine monitoring and sending send-out tests in an ultimately VERY stable looking man tests of 5-HIAA and urine metanephrines were deferred. We explained to the patient that though we were unable to give a specific diagnosis findings were suggestive of something not immediately dangerous, which he found reassuring. The patient was discharged to follow up with his PCP for further ___ of these symptoms. 2) Wheezing/ SOB: Patient has history of asthma and was wheezing on presentation. He was given albuterol inhaler in house. 3) History of substance abuse: He was continued on his home buprenorphine-naloxone. He tolerated a full diet. He received subcutaneous heparin for DVT prophylaxis. He was full code. ###RESPONSE: anxiety {Anxiety}, substance abuse {Substance abuse}, asthma {Asthma}, Chills {Chill}, Warm Sensation {Sensation of being warm}, Paresthesias {Paresthesia}, Paresthesias {Paresthesia}, Presyncope {Near syncope}, feeling hot or cold {Sensation of hot and cold}, paresthesias {Paresthesia}, fecal urgency {Urgent desire for stool}, presyncope {Near syncope}, febrile {Fever}, infection {Infectious disease}, neurological symptoms {Neurological symptom}, fever {Fever}, cardiogenic syncope {Cardiac syncope}, seizure {Seizure}, telemetry {Cardiac telemetry}, arrhythmia {Cardiac arrhythmia}, hemodynamic instability {Hemodynamic instability}, fevers {Fever}, chills {Chill}, diaphoretic {Excessive sweating}, tenderness to palpation {Abdominal tenderness}, abdomen {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, no significant abnormalities {No abnormality detected}, anxiety {Anxiety}, panic attacks {Panic attack}, anxiety {Anxiety}, vasovagal {Vasovagal syncope}, near) syncope {Near syncope}, viral syndrome {Nonspecific syndrome suggestive of viral illness}, loose stools {Loose stool}, nausea {Nausea}, GI symptoms {Gastrointestinal symptom}, CT head {Computed tomography of head}, stroke {Cerebrovascular accident}, neurological deficits {Neurological deficit}, pheochromocytoma {Pheochromocytoma}, carcinoid {Carcinoid syndrome}, flushing {Flushing}, fecal urgency {Urgent desire for stool}, stable {Patient's condition stable}, reassuring {Reassuring}, follow up {Follow-up arranged}, Wheezing {Wheezing}, SOB {Dyspnea}, asthma {Asthma}, wheezing {Wheezing}, substance abuse {Substance abuse}, heparin {Heparin therapy}, DVT prophylaxis {Prevention of deep vein thrombosis}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Medications on Admission: Buprenorphine-Naloxone ___ mg PO QAM, ___ mg PO QPM Discharge Medications: 1. buprenorphine-naloxone ___ mg Tablet, Sublingual Sig: One (1) Tablet Sublingual QAM (once a day (in the morning)). 2. Suboxone ___ mg Tablet, Sublingual Sig: Two (2) tabs Sublingual at bedtime. 3. acetaminophen 325 mg Tablet Sig: ___ Tablets PO Q6H (every 6 hours) as needed for fever, pain. ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Discharge Disposition: Home Discharge Diagnosis: Primary Diagnoses: --Somatic symptoms NOS, suspected viral syndrome vs vasovagal --Asthma Secondary Diagnosis: -History of opiate addiction on suboxone maintenance Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. ###RESPONSE: Somatic symptoms {Somatic pain}, viral syndrome {Nonspecific syndrome suggestive of viral illness}, vasovagal {Vasovagal syncope}, Asthma {Asthma}, addiction {Addiction}, Mental Status {Neurological mental status determination}, Clear {Normal state of mind}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, interactive {Does communicate}, Activity Status {Physical functional dependency}, Ambulatory - Independent {Independent walking}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Discharge Instructions: You were admitted due to concerns about the symptoms you have been having including sensation of hot and cold, urgency to go to the bathroom, abdominal discomfort, shortness of breath, and feeling as if you might pass out. You were admitted and monitored overnight. You have had no vital sign abnormalities, dangerous cardiac rhythms, and your labs were unremarkable. A CT scan showed no major intracranial process. It is unclear what is causing your symptoms. Most likely you had a viral syndrome that exacerbated your asthma and perhaps is causing something called vasovagal episodes, during which you may feel lightheaded. There are a few other rare illnesses that could cause some of these symptoms but these require 24 hour urine corrections and take some time to return. These were deferred as an inpatient but will be pursued as an outpatient by your PCP. Your medications have not been changed. Please continue to take your Suboxone as prescribed. ###RESPONSE: sensation of hot and cold {Sensation of hot and cold}, abdominal discomfort {Abdominal discomfort}, shortness of breath {Dyspnea}, cardiac rhythms {Finding of heart rhythm}, unremarkable {No abnormality detected}, CT scan {Computed tomography}, viral syndrome {Nonspecific syndrome suggestive of viral illness}, asthma {Asthma}, vasovagal {Vasovagal syncope}, lightheaded {Lightheadedness}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Followup Instructions: ___ ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Name: ___ Unit No: ___ Admission Date: ___ Discharge Date: ___ Date of Birth: ___ Sex: F Service: MEDICINE ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Allergies: Codeine Attending: ___. Chief Complaint: diarrhea Major Surgical or Invasive Procedure: none ###RESPONSE: Codeine {Allergy to codeine}, diarrhea {Diarrhea}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: History of Present Illness: The patient is a ___ w/ no significant PMH who presents with 3 days diarrhea. She has not had F/C/N/V/NS. She had increasing abdominal pain overnight and bloody diarrhea this morning. She was sent in by ___ for evaluation. In the ED she was afebrile, 98.9, 59, 115/70, 15, 100% RA. She was given IV Cipro and Flagyl. CT abd showed pancolitis with rectal sparing. She was admitted to medicine for further management. ROS: -Constitutional: []WNL []Weight loss []Fatigue/Malaise []Fever []Chills/Rigors []Nightsweats []Anorexia -Eyes: []WNL []Blurry Vision []Diplopia []Loss of Vision []Photophobia -ENT: []WNL []Dry Mouth []Oral ulcers []Bleeding gums/nose []Tinnitus []Sinus pain []Sore throat -Cardiac: []WNL []Chest pain []Palpitations ___ edema []Orthopnea/PND []DOE -Respiratory: []WNL []SOB []Pleuritic pain []Hemoptysis []Cough -Gastrointestinal: []WNL []Nausea []Vomiting []Abdominal pain []Abdominal Swelling []Diarrhea []Constipation []Hematemesis []Hematochezia []Melena -Heme/Lymph: []WNL []Bleeding []Bruising []Lymphadenopathy -GU: []WNL []Incontinence/Retention []Dysuria []Hematuria []Discharge []Menorrhagia -Skin: []WNL []Rash []Pruritus -Endocrine: []WNL []Change in skin/hair []Loss of energy []Heat/Cold intolerance -Musculoskeletal: []WNL []Myalgias []Arthralgias []Back pain -Neurological: []Numbness of extremities []Weakness of extremities []Parasthesias []Dizziness/Lightheaded []Vertigo []Confusion []Headache -Psychiatric: []WNL []Depression []Suicidal Ideation -Allergy/Immunological: [] WNL []Seasonal Allergies ###RESPONSE: diarrhea {Diarrhea}, F/C {Fever with chills}, N/V {Nausea and vomiting}, abdominal pain {Abdominal pain}, bloody diarrhea {Hemorrhagic diarrhea}, evaluation {Evaluation procedure}, afebrile {Fever}, RA {Breathing room air}, CT abd {Computed tomography of abdomen}, pancolitis {Ulcerative pancolitis}, rectal {Rectum structure}, WNL {No abnormality detected}, Weight loss {Weight loss}, Fatigue {Fatigue}, Malaise {Malaise}, Fever {Fever}, Chills {Chill}, Rigors {Rigor}, Nightsweats {Night sweats}, Anorexia {Loss of appetite}, Eyes {Ophthalmic examination and evaluation}, WNL {No abnormality detected}, Blurry Vision {Blurring of visual image}, Diplopia {Diplopia}, Loss of Vision {Functional visual loss}, Photophobia {Photophobia}, ENT {Ear, nose and throat examination}, WNL {No abnormality detected}, Dry Mouth {Mucous membrane dryness}, Oral ulcers {Ulcer of mouth}, Bleeding gums {Bleeding gums}, nose {Bleeding from nose}, Tinnitus {Tinnitus}, Sinus {Nasal sinus structure}, pain {Pain}, Sore throat {Sore throat}, Cardiac {Cardiovascular physical examination}, WNL {No abnormality detected}, Chest pain {Chest pain}, Palpitations {Palpitations}, edema {Edema}, Orthopnea {Orthopnea}, PND {Paroxysmal nocturnal dyspnea}, DOE {Dyspnea on exertion}, Respiratory {Examination of respiratory system}, WNL {No abnormality detected}, SOB {Dyspnea}, Pleuritic pain {Pleuritic pain}, Hemoptysis {Hemoptysis}, Cough {Cough}, Gastrointestinal {Examination of digestive system}, WNL {No abnormality detected}, Nausea {Nausea}, Vomiting {Vomiting}, Abdominal pain {Abdominal pain}, Abdominal Swelling {Swollen abdomen}, Diarrhea {Diarrhea}, Constipation {Constipation}, Hematemesis {Hematemesis}, Hematochezia {Hematochezia}, Melena {Melena}, Lymph {Lymphatic system physical examination}, WNL {No abnormality detected}, Bleeding {Bleeding}, Bruising {Contusion}, Lymphadenopathy {Lymphadenopathy}, GU {Examination of genitourinary system}, WNL {No abnormality detected}, Incontinence {Incontinence}, Retention {Retention of urine}, Dysuria {Dysuria}, Hematuria {Blood in urine}, Menorrhagia {Menorrhagia}, Skin {Examination of skin}, WNL {No abnormality detected}, Rash {Eruption of skin}, Pruritus {Itching of skin}, WNL {No abnormality detected}, skin {Skin structure}, hair {Hair structure}, Loss of energy {Lack of energy}, Heat {Intolerant of heat}, Cold intolerance {Intolerant of cold}, Musculoskeletal {Musculoskeletal system physical examination}, WNL {No abnormality detected}, Myalgias {Muscle pain}, Arthralgias {Joint pain}, Back pain {Backache}, Neurological {Neurological examination}, Numbness {Numbness}, extremities {All extremities}, Weakness {Asthenia}, extremities {All extremities}, Parasthesias {Paresthesia}, Dizziness {Dizziness}, Lightheaded {Lightheadedness}, Vertigo {Vertigo}, Confusion {Clouded consciousness}, Headache {Headache}, Psychiatric {Psychiatry procedure or service}, WNL {No abnormality detected}, Depression {Depressive disorder}, Suicidal Ideation {Suicidal thoughts}, WNL {No abnormality detected}, Seasonal Allergies {Seasonal allergy}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Past Medical History: None ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Social History: ___ ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Family History: Grandfather with colon CA. No h/o IBD. ###RESPONSE: colon CA {Malignant neoplasm of colon}, IBD {Inflammatory bowel disease}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Physical Exam: ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Physical Exam: Appearance: NAD Vitals: T: 99.4 BP: 114/79 HR: 58 RR: 18 O2: 99% RA Eyes: EOMI, PERRL, conjunctiva clear, noninjected, anicteric, no exudate ENT: Moist Neck: No JVD, no LAD Cardiovascular: RRR, nl S1/S2, no m/r/g Respiratory: CTA bilaterally, comfortable, no wheezing, no ronchi, no rales Gastrointestinal: soft, tender in umbilical and hypogastric region, non-distended, no hepatosplenomegaly, normal bowel sounds Musculoskeletal/Extremities: no clubbing, no cyanosis, no joint swelling, no edema in the bilateral extremities Neurological: Alert and oriented x3, fluent speech, sensation WNL, moves all four extremities Integument: warm, no rash, no ulcer Psychiatric: appropriate, pleasant ###RESPONSE: Physical Exam {Physical examination procedure}, Appearance {Finding of general observation of appearance}, NAD {No abnormality detected}, Vitals {Vital signs finding}, T {Body temperature finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, O2 {Oxygen saturation measurement}, RA {Breathing room air}, Eyes {Ophthalmic examination and evaluation}, EOMI {Normal ocular motility}, PERRL {Pupils equal and reacting to light}, conjunctiva clear {Conjunctiva normal}, anicteric {White sclera}, exudate {Exudate}, ENT {Abdominal tenderness}, Moist {Moist oral mucosa}, Neck {Physical examination procedure}, JVD {Jugular venous engorgement}, LAD {Lymphadenopathy}, Cardiovascular {Cardiovascular physical examination}, RRR {Normal heart rate}, S2 {Normal second heart sound, S>2<}, no m/r/g {Heart sounds normal}, Respiratory {Examination of respiratory system}, CTA {Normal breath sounds}, wheezing {Wheezing}, ronchi {Wheeze - rhonchi}, rales {Respiratory crackles}, Gastrointestinal {Examination of digestive system}, soft {Abdomen soft}, tender {Abdominal tenderness}, umbilical {Umbilical region structure}, hypogastric region {Hypogastric region structure}, non-distended {Normal abdominal contour}, hepatosplenomegaly {Hepatosplenomegaly}, normal bowel sounds {Normal bowel sounds}, Musculoskeletal {Musculoskeletal system physical examination}, Extremities {Examination of limb}, clubbing {Clubbing}, cyanosis {Cyanosis}, joint swelling {Joint swelling}, edema {Edema}, extremities {Examination of limb}, Neurologic {Neurological examination}, Alert {Mentally alert}, oriented {Orientated}, fluent speech {Finding of fluency of speech}, sensation WNL {Normal sensation}, moves all four extremities {Does move all four limbs}, Integument {Examination of skin}, warm {Warm skin}, rash {Eruption of skin}, ulcer {Ulcer}, Psychiatric {Psychiatry procedure or service}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Pertinent Results: ___ 11:00AM GLUCOSE-90 UREA N-10 CREAT-0.9 SODIUM-143 POTASSIUM-4.1 CHLORIDE-105 TOTAL CO2-27 ANION GAP-15 ___ 11:00AM ALT(SGPT)-26 AST(SGOT)-29 ALK PHOS-107 TOT BILI-0.4 ___ 11:00AM LIPASE-30 ___ 11:00AM WBC-6.3 RBC-4.18* HGB-12.6 HCT-35.7* MCV-85 MCH-30.1 MCHC-35.2* RDW-13.2 ___ 11:00AM PLT COUNT-217 ___ 12:50PM URINE COLOR-Yellow APPEAR-Clear SP ___ ___ 12:50PM URINE BLOOD-NEG NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-8.0 LEUK-SM ___ 12:50PM URINE ___ BACTERIA-FEW YEAST-NONE ___ CT abd/pelvis: Pancolitis, worst along the cecum. Findings may be secondary to infectious or inflammatory process. ###RESPONSE: GLUCOSE {Glucose measurement, blood}, CREAT {Creatinine measurement}, SODIUM {Sodium measurement}, POTASSIUM {Potassium measurement}, CHLORIDE {Chloride measurement, blood}, TOTAL CO2 {Blood total carbon dioxide (calculated)}, ANION GAP {Anion gap measurement}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, PHOS {Phosphate, total measurement}, WBC {White blood cell count}, RBC {Red blood cell count}, HGB {Measurement of total hemoglobin concentration}, HCT {Hematocrit determination}, MCV {Erythrocyte mean corpuscular volume determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, COLOR {Color finding}, PROTEIN {Measurement of protein in urine}, KETONE {Urinalysis, acetone or ketone bodies measurement}, BILIRUBIN {Bilirubin measurement, urine}, PH {pH measurement}, AST {Aspartate aminotransferase measurement}, cecum {Cecum structure}, infectious {Infectious disease}, inflammatory {Inflammatory disorder}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Brief Hospital Course: A/P: ___ w/ no significant PMH presents with 3 days diarrhea, 1 day worsening abdominal pain. ## diarrhea/abdominal pain: colitis identified on CT, most likely infectious, especially given occupational risk factor, but cannot rule out inflammatory bowel disease. Stool was sent for culture including C. diff. Her diarrhea improved with empiric Cipro/Flagyl, and she tolerated clears. Her pain improved with Tylenol and oxycodone x1. As she was tolerating clears and PO meds and her diarrhea was improving, she was discharged home with strong recommendations to followup in Healthcare Associates within the week. She will be contacted if the stool cultures return positive and indicate a change in therapy. her her symptoms do not improve with a 7-day course of Abx, a flex sig in GI clinic would be considered to evaluate for evidence of IBD. ###RESPONSE: diarrhea {Diarrhea}, worsening {Increased pain}, abdominal pain {Abdominal pain}, diarrhea {Diarrhea}, abdominal pain {Abdominal pain}, colitis {Colitis}, CT {Computed tomography}, infectious {Infectious disease}, inflammatory bowel disease {Inflammatory bowel disease}, Stool was sent for culture {Stool culture}, diarrhea {Diarrhea}, improved {Patient's condition improved}, pain improved {Sensation of pain reduced}, diarrhea {Diarrhea}, improving {Patient's condition improved}, stool cultures {Stool culture}, Abx {Antibiotic therapy}, IBD {Inflammatory bowel disease}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Medications on Admission: multivitamin Discharge Medications: 1. Ciprofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours) for 6 days. Disp:*12 Tablet(s)* Refills:*0* 2. Metronidazole 500 mg Tablet Sig: One (1) Tablet PO Q8H (every 8 hours) for 6 days. Disp:*18 Tablet(s)* Refills:*0* 3. Acetaminophen 500 mg Tablet Sig: ___ Tablets PO Q6H (every 6 hours) as needed. ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Discharge Disposition: Home Discharge Diagnosis: Primary: colitis of presumed infectious origin Discharge Condition: good, stable, tolerating liquids ###RESPONSE: colitis {Colitis}, infectious {Infectious disease}, good {Patient's condition satisfactory}, stable {Patient's condition stable}, tolerating liquids {Tolerating oral fluid}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Discharge Instructions: You were evaluated for diarrhea and abdominal cramping and were found to have inflammation of the colon (colitis) on CT scan. This is most likely due to an infection, although inflammatory bowel disease is also possible. As your diarrhea improved and you were able to keep down fluids, you should be safe for discharge home. Some stool culture results were pending at the time of discharge, and you should follow up early next week at Healthcare Associates for results and consideration of further testing depending on your symptoms. Take antibiotics (Flagyl and Cipro) as directed. If you have worsening abdominal pain, lightheadedness, significant blood in your stool, inability to keep down food or liquid, fevers or chills, see ___ Health Services or come to the emergency room. ###RESPONSE: diarrhea {Diarrhea}, abdominal cramping {Stomach cramps}, inflammation {Inflammatory disorder}, colon {Colon structure}, colitis {Colitis}, CT scan {Computed tomography}, infection {Infectious disease}, inflammatory bowel disease {Inflammatory bowel disease}, diarrhea {Diarrhea}, improved {Patient's condition improved}, keep down fluids {Tolerating oral fluid}, stool culture {Stool culture}, antibiotics {Antibiotic therapy}, worsening {Increased pain}, abdominal pain {Abdominal pain}, lightheadedness {Lightheadedness}, blood in your stool {Hematochezia}, fevers {Fever}, chills {Chill}

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Followup Instructions: ___ ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Name: ___ Unit No: ___ Admission Date: ___ Discharge Date: ___ Date of Birth: ___ Sex: M Service: ORTHOPAEDICS ###RESPONSE: EMPTY: No SNOMED annotations found in this fragment

###HUMAN: Your task is to process the following fragment of a medical note, retrieving and listing all SNOMED annotations found inside. You will return an "EMPTY: No SNOMED annotations found in this fragment" if there are none. For any that you find, you will return a list of: "text {annotation}", where 'text' is the part of the text that corresponds to the annotation, and 'annotation' is the corresponding SNOMED-CT annotation. This is the text to analyze: ###TEXT: Allergies: Patient recorded as having No Known Allergies to Drugs Attending: ___. Chief Complaint: Bilaterally heel pain Major Surgical or Invasive Procedure: None ###RESPONSE: Drugs {Allergy to drug}, heel pain {Heel pain}