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Merge pull request #120 from michelole/issue-105
Refactor the code and add tests for cleaning
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Record date: | ||
Record date: 2067-05-22 | ||
FISHKILL MEDICAL CENTER | ||
Internal Medicine Associates | ||
33 Mercy Plaza | ||
Spencer, AK 72985 | ||
Robinson, John | ||
87496736 | ||
05/22/67 | ||
HISTORY OF PRESENT ILLNESS: Mr. Robinson is returning for follow up for arm fracture after falling off stage directing school production of Midsummer Night's Dream | ||
Arm remains in cast and sling; patient reports minor discomfort but is in good spirits | ||
x-ray showed fracture is healing; 2 more weeks with cast and sling recommended. | ||
Patient is concerned about weight gain as he is less active now with the cast | ||
Recommended walking; watching food intake | ||
Patient has history of diabetes and blood sugar control is slipping with lack of movement due to fracture | ||
HBA1c at last checkup was | ||
7.2 | ||
Recommend more increased monitoring of blood sugar while less active. | ||
PHYSICAL EXAMINATION: BP 136/80. Weight increased from 250 to 260 pounds | ||
Pulse is 71. | ||
ASSESSMENT AND PLAN | ||
1. Fracture healing well; 2 more weeks with cast and sling | ||
2. Weight | ||
Advised to increase amount of time walking. | ||
Avoid stages. | ||
3. HBA1c. Monitor more closely during next 2 weeks. | ||
Ann Stephenson, M.D. | ||
Record date: 2068-12-18 | ||
HPI: | ||
59 yo male with history of DM, family history of CAD presented with new chest pain and shortness of breath | ||
was found to have lateral STEMI | ||
Pain began 2 hours ago; patient called EMS when began to feel lightheaded | ||
Intubated on arrival for resiratory distress. | ||
ECG showed lateral ST elevations and a CT chest scan was negative for aortic dissection | ||
Blood sugars extremely elevated: 500s in the ED. | ||
On immediate LHC, a 100 occlusion of his OM1 was found and recannalized as well as stented with a Vision BMS, resulting in | ||
TIMI 2 flow | ||
An IABP was placed with initial augmented diastolic pressures recorded in the 80s; started on Levophed, Dobutamine and Dopamine. | ||
Record date: 2069-11-02 | ||
Mr. Robinson reported to the emergency department today with difficulty breathing and numbness in hands and feet | ||
Goes away after 15 minutes, but has been happening more frequently | ||
Patient has history of asthma, but says these symptoms do not match. | ||
PHYSICAL EXAMINATION: GENERAL APPEARANCE: No acute distress, pain-free | ||
VITAL SIGNS: Afebrile | ||
Pulse 95. Respirations 20. | ||
Blood pressure 135/85. Pulse oximetry is 90 on room air. | ||
CARDIAC: Regular rate and rhythm | ||
Normal S1 and S2. possible murmur; sent for evalution | ||
NECK: JVP 5 cm | ||
LUNGS: Labored breathing. | ||
ABDOMEN: Soft, nontender, and nondistended. | ||
Bood tests showed normal HBA1c levels. | ||
REVIEW OF SYSTEMS: As indicated. | ||
PAST MEDICAL HISTORY: insulin-dependent diabetes since 25yo, retinal neuropathy, asthma | ||
Obesity. | ||
MI treated here previously | ||
Ischemia. | ||
SOCIAL/FAMILY HISTORY: No alcohol | ||
Smoked in the past, quit 10 years ago | ||
Family history of ischemia and CAD | ||
MEDICATIONS: | ||
1. Provigil | ||
2. Atenolol | ||
3. Ativan. | ||
4. Glucophage 850 mg t.i.d. | ||
5. Humulin 15 units at night. | ||
6. Folate. | ||
7. Metoprolol. | ||
8. Cardia. | ||
9. Vitamin E. | ||
10. Coated aspirin. | ||
Recommended full cardiac evalution; possible need for stent | ||
Patient opted to return following day. |
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