diff --git "a/train.csv" "b/train.csv"
new file mode 100644--- /dev/null
+++ "b/train.csv"
@@ -0,0 +1,52460 @@
+text
+"###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: 
+Penicillins
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Biliary pancreatitis
+ 
+Major Surgical or Invasive Procedure:
+___: Laparoscopic cholecystectomy
+
+ 
+
+###RESPONSE: Penicillins {Allergy to penicillin}, Biliary pancreatitis {Gallstone pancreatitis}, Laparoscopic cholecystectomy {Laparoscopic cholecystectomy}"
+"###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 ___ man who had severe biliary 
+pancreatitis resulting in pancreatic necrosis for which he was 
+treated with nasojejunal feedings and pancreatic rest.  He had 
+initially had multisystem organ failure, which improved. Mr. 
+___ has a large postnecrotic pseudocyst, which has been 
+drained through a minimally invasive approach into his GI tract. 
+ He has some debris, but this is not currently infected. The 
+patient was followed by Dr. ___ in his ___ 
+clinic to discuss cholecystectomy. After discussion of all 
+risks, benefits and possible outcomes, patient was scheduled for 
+elective cholecystectomy on ___.
+ 
+
+###RESPONSE: biliary 
+pancreatitis {Gallstone pancreatitis}, pancreatic necrosis {Necrosis of pancreas}, nasojejunal feedings {Nasojejunal feeding}, pancreatic rest {Ectopic pancreas}, multisystem organ failure {Multiple organ failure}, improved {Patient's condition improved}, pseudocyst {Pseudocyst}, drained {Incision AND drainage}, GI tract {Gastrointestinal tract structure}, clinic {Outpatient care management}, cholecystectomy {Cholecystectomy}, discussion {Discussion}, cholecystectomy {Cholecystectomy}"
+"###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:
+Hiatal Hernia  
+___ esophagus  
+Esophageal ulcer  
+anxiety  
+Back pain 
+ 
+
+###RESPONSE: Hiatal Hernia {Hiatal hernia}, esophagus {Esophageal structure}, Esophageal ulcer {Ulcer of esophagus}, anxiety {Anxiety}, Back pain {Backache}"
+"###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 passed of metastatic lung cancer. Father alive, had CVA 
+and MI.  No  history of pancreatic malignancy  
+
+ 
+
+###RESPONSE: metastatic lung cancer {Metastatic malignant neoplasm to lung}, alive {Alive}, CVA {Cerebrovascular accident}, pancreatic malignancy {Malignant tumor of pancreas}"
+"###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:
+Prior Discharge:
+VS: 98.3, 83, 137/69, 16, 98% RA
+GEN: NAD, AAO x 3
+CV: RRR
+PULM: CTAB
+ABD: Laparoscopic incisions open to air with dermabond and c/d/i
+EXTR: Warm, +pp, no c/c/e
+ 
+
+###RESPONSE: VS {Vital signs finding}, RA {Breathing room air}, GEN {General examination of patient}, NAD {No abnormality detected}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, PULM {Examination of respiratory system}, CTAB {Normal breath sounds}, ABD {Examination of abdomen}, Laparoscopic {Laparoscopic procedure}, incisions {Surgical incision wound}, EXTR {Examination of limb}, Warm {Warm skin}, c {Cyanosis}, e {Edema of extremity}"
+"###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:
+Pathology: Pending
+ 
+
+###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: Brief Hospital Course:
+The patient with history of gallstone pancreatitis was admitted 
+to the HPB Surgical Service on ___ after he underwent 
+laparoscopic cholecystectomy. After a brief, uneventful stay in 
+the PACU, the patient arrived on the floor tolerating regular 
+diet , on IV fluids, and Dilaudid PCA for pain control.  The 
+patient was hemodynamically stable.
+Pain was well controlled. Diet was tolerated well. The patient 
+voided without problem. The patient received subcutaneous 
+heparin and venodyne boots were used during this stay.
+At the time of discharge, 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: gallstone pancreatitis {Gallstone pancreatitis}, laparoscopic cholecystectomy {Laparoscopic cholecystectomy}, PACU {Postanesthesia care}, regular 
+diet {Normal diet}, IV fluids {Administration of intravenous fluids}, PCA {Patient controlled analgesia}, pain control {Pain control}, hemodynamically stable {Hemodynamically stable}, Pain was well controlled {Demonstrates adequate pain control}, Diet was tolerated well {Diet good}, voided without problem {Normal micturition}, heparin {Heparin therapy}, afebrile {Fever}, 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}, instructions {Recommendation to}, 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:
+alprazolam 1"", oxycodone 7.5mg prn, protonix 40'
+ 
+Discharge Medications:
+1. ALPRAZolam 1 mg PO BID 
+2. Docusate Sodium 100 mg PO BID 
+3. HYDROmorphone (Dilaudid) ___ mg PO Q3H:PRN pain 
+RX *hydromorphone [Dilaudid] 2 mg ___ tablet(s) by mouth Q3H 
+Disp #*120 Tablet Refills:*0
+4. Pantoprazole 40 mg PO Q24H 
+
+ 
+
+###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:
+Biliary pancreatitis
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Biliary pancreatitis {Gallstone pancreatitis}, Mental Status {Neurological mental status determination}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, interactive {Does communicate}, 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 to the surgery service at ___ for surgical 
+resection of your gallbladder. You have done well in the post 
+operative period and are now safe to return home to complete 
+your recovery with the following instructions:
+.
+Call Dr. ___ office at ___ if you have any 
+questions or concerns. During off hours: call Operator at 
+___ and ask to ___ team.
+.
+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.
+
+ 
+
+###RESPONSE: surgical 
+resection of your gallbladder {Cholecystectomy}, post 
+operative {Postoperative state}, medications {Patient medication education}, medication {Medication education}, medications {Medication education}, ambulate {Ambulation training}, drink adequate amounts of fluids {Fluid intake education}, Avoid lifting 
+weights {Functional activity education}, follow-up {Follow-up arranged}, activity 
+restrictions {Functional activity education}, while taking pain 
+medications {Patient medication education}, Primary Care {Primary care management}, PCP {Primary care management}, increased pain {Increased pain}, swelling {Swelling}, redness {Redness of skin over lesion}, drainage {Discharge}, incision 
+site {Surgical incision wound}, shower {Functional activity education}, 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: 
+No Known Allergies / Adverse Drug Reactions
+ 
+Attending: ___
+ 
+Chief Complaint:
+CHIEF COMPLAINT: Chest pain, NSTEMI
+ 
+Major Surgical or Invasive Procedure:
+Cardiac Catheterization
+
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, Chest pain {Chest pain}, NSTEMI {Acute non-ST segment elevation myocardial infarction}, 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:
+___ year old man with a h/o COPD who p/w chest pain and elevated 
+troponin. Had CP on ___ after eating, resolved, did not 
+seek medical care. CP recurrent ___ and once again, resolved 
+with rest. Starting ___ at 2PM he developed left-sided and 
+substernal CP that radiated to the left arm.  He described the 
+feeling as heavy pressure and stated that he felt lightheaded 
+and had a chill but no diaphoresis, nausea, or vomiting. Had 
+baseline SOB due to COPD which had been getting progressively 
+worse over the past few months but isn't acutely worse at this 
+time. Had never had CP before ___, no history of heart 
+disease.  
+  
+Initially went to ___ where ekg showed mildly peaked T 
+waves laterally and poor R wave progression but no STE or STD. 
+Baseline BP was in the 120s, after NTG x 1 dropped to ___ 
+systolic, was fluid responsive. CP 6 --> 3 after NTG, and then 
+resolved with 2.5mg IV morphine. Also given duonebs due to 
+wheezing on exam. Trop 0.157, MBI 10. Patient had taken ASA 81mg 
+earlier today so was given additional ASA for a total 325mg. 
+Guaic negative so heparin gtt was started and patient was 
+transferred to ___.  
+  
+In the ___ ED initial VS were 98.1, 84, 136/83, 16, 98% on 2L. 
+No labs done. CXR showed flattened diaphragms but no acute 
+process. Patient was continued on heparin gtt. VS prior to 
+transfer were 97.6, 57, 132/80, 14, 98% on 2L.  
+ 
+On the floor patient was comfortable and denied any chest pain 
+or other complaints. He admitted that he had lost 10 lbs in the 
+past two weeks. 
+
+ 
+
+###RESPONSE: COPD {Chronic obstructive lung disease}, chest pain {Chest pain}, elevated 
+troponin {Troponin I above reference range}, CP {Chest pain}, resolved {Problem resolved}, medical care {Medical care}, CP {Chest pain}, recurrent {Recurrent disease}, resolved {Problem resolved}, left-sided and 
+substernal CP {Left sided chest pain}, radiated to the left arm {Pain radiating to left arm}, pressure {Tight chest}, lightheaded {Lightheadedness}, chill {Chill}, diaphoresis {Excessive sweating}, nausea {Nausea}, vomiting {Vomiting}, baseline {Baseline state}, SOB {Dyspnea}, COPD {Chronic obstructive lung disease}, worse {Patient's condition worsened}, worse {Patient's condition worsened}, heart 
+disease {Heart disease}, R wave progression {Electrocardiographic R wave abnormal}, STE {ST segment elevation}, STD {ST segment depression}, Baseline {Baseline state}, NTG {Administration of prophylactic glyceryl trinitrate}, NTG {Administration of prophylactic glyceryl trinitrate}, resolved {Problem resolved}, wheezing {Wheezing}, exam {Physical examination procedure}, Trop {Troponin measurement}, ASA {Administration of aspirin}, ASA {Administration of aspirin}, negative {No pathologic diagnosis}, heparin {Heparin therapy}, started {New medication added}, labs {Laboratory test}, CXR {Plain chest X-ray}, diaphragms {Diaphragmatic finding}, no acute {No abnormality detected}, heparin {Heparin therapy}, comfortable {Comfortable appearance}, chest pain {Chest 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: Past Medical History:
+PAST MEDICAL HISTORY:  
+1. CARDIAC RISK FACTORS: Hypertension  
+2. CARDIAC HISTORY:  None 
+3. OTHER PAST MEDICAL HISTORY: COPD
+ 
+
+###RESPONSE: CARDIAC RISK FACTORS {Assessment for risk of cardiovascular disease}, Hypertension {Hypertensive disorder, systemic arterial}, COPD {Chronic obstructive lung 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: 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 and father both died of stroke.  Pt was worked up for 
+stroke w/negative results.
+ 
+
+###RESPONSE: died {Dead}, stroke {Cerebrovascular accident}, worked up {Evaluation procedure}, stroke {Cerebrovascular accident}, negative {No pathologic diagnosis}"
+"###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:
+VS- T 98 BP 104-128/64-88 HR 58-62 RR ___ pO2 98(RA)
+Wt: 64.5 kg  
+GENERAL- Patient appears comfortable in bed. Oriented x3. Mood, 
+affect appropriate.  
+HEENT- Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no 
+pallor or cyanosis of the oral mucosa.  
+NECK- No JVD.  
+CARDIAC- PMI located in ___ intercostal space, midclavicular 
+line. RR, normal S1, S2. No m/r/g. No thrills, lifts. No S3 or 
+S4.  
+LUNGS- No chest wall deformities, scoliosis or kyphosis. Resp 
+were unlabored, no accessory muscle use. CTAB; expiratory wheeze 
+audible from anterior and posterior.  
+ABDOMEN- Soft, NTND. No HSM or tenderness.  
+EXTREMITIES- No c/c/e.  
+SKIN- No stasis dermatitis, ulcers, scars, or xanthomas.  
+PULSES- Carotid 2+ DP 2+ ___ 2
+
+Discharge:
+VS- T 98.5 BP 96-117/60-74 HR ___ RR 18 pO2 95(RA)
+I/O: ___ 
+GENERAL- Patient appears comfortable in bed. Oriented x3. Mood, 
+affect appropriate.  
+NECK- No JVD.  
+CARDIAC- PMI located in ___ intercostal space, midclavicular 
+line. RR, normal S1, S2. No m/r/g. No thrills, lifts. No S3 or 
+S4.  
+LUNGS- No chest wall deformities, scoliosis or kyphosis. Resp 
+were unlabored, no accessory muscle use. CTAB; expiratory wheeze 
+audible from anterior and posterior.  
+ABDOMEN- Soft, NTND. No HSM or tenderness.  
+EXTREMITIES- No c/c/e.  R radial dressing clean, dry and intact. 
+
+SKIN- No stasis dermatitis, ulcers, scars, or xanthomas.  
+PULSES- Carotid 2+ DP 2+ ___ 2+ 
+ 
+
+###RESPONSE: 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}, comfortable {Comfortable appearance}, Oriented x3 {Oriented to person, time and place}, Mood {Level of mood - normal}, affect {Mood finding}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, PERRL {Pupils equal and reacting to light}, EOMI {Normal ocular motility}, Conjunctiva were pink {Conjunctiva normal}, pallor {Pallor of skin of face}, cyanosis {Cyanosis}, oral mucosa {Oral mucous membrane structure}, NECK {Physical examination procedure}, JVD {Jugular venous engorgement}, CARDIAC {Cardiovascular physical examination}, PMI {Finding of apex beat}, intercostal space {Structure of intercostal space}, midclavicular 
+line {Midclavicular line}, RR {Finding of rate of respiration}, normal S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, No m/r/g {Heart sounds normal}, thrills {Thrill}, lifts {Precordial heave}, No S3 {Third heart sound, S>3<, inaudible}, LUNGS {Examination of respiratory system}, chest wall deformities {Deformity of chest wall}, scoliosis {Scoliosis deformity of spine}, kyphosis {Kyphosis deformity of spine}, Resp {Examination of respiratory system}, accessory muscle {Accessory skeletal muscle}, CTAB {Normal breath sounds}, expiratory wheeze {Expiratory wheezing}, ABDOMEN {Examination of abdomen}, Soft {Abdomen soft}, ND {Swollen abdomen}, HSM {Hepatosplenomegaly}, tenderness {Tenderness}, EXTREMITIES {Examination of limb}, No c/c/e {No abnormality detected}, SKIN {Examination of skin}, stasis dermatitis {Stasis dermatitis}, ulcers {Ulcer}, scars {Scar}, xanthomas {Xanthomatosis}, Carotid 2 {Normal carotid arterial pulse}, DP 2 {Dorsalis pulse present}, comfortable {Comfortable appearance}, Oriented x3 {Oriented to person, time and place}, Mood {Level of mood - normal}, affect appropriate {Appropriate affect}, JVD {Jugular venous engorgement}, PMI {Finding of apex beat}, intercostal space {Structure of intercostal space}, midclavicular 
+line {Midclavicular line}, normal S1, S2 {Heart sounds normal}, No m/r/g {Heart sounds normal}, thrills {Thrill}, lifts {Precordial heave}, No S3 {Third heart sound, S>3<, inaudible}, chest wall deformities {Deformity of chest wall}, scoliosis {Scoliosis deformity of spine}, kyphosis {Kyphosis deformity of spine}, Resp 
+were unlabored {Breathing easily}, accessory muscle use {Accessory respiratory muscles used}, CTAB {Normal breath sounds}, expiratory wheeze {Expiratory wheezing}, ABDOMEN- Soft {Abdomen soft}, NTND {Abdominal tenderness}, HSM {Hepatosplenomegaly}, tenderness {Tenderness}, No c/c/e {No abnormality detected}, radial {Radial pulse present}, clean, dry and intact {Wound healing well}, stasis dermatitis {Stasis dermatitis}, ulcers {Ulcer}, scars {Scar}, xanthomas {Xanthomatosis}, Carotid 2 {Normal carotid arterial pulse}, DP 2 {Dorsalis pulse present}"
+"###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:
+___ 06:25AM BLOOD WBC-8.4 RBC-4.06* Hgb-12.8* Hct-39.7* 
+MCV-98 MCH-31.7 MCHC-32.4 RDW-12.4 Plt ___
+___ 06:25AM BLOOD ___ PTT-108.5* ___
+___ 06:25AM BLOOD CK(CPK)-640*
+___ 06:25AM BLOOD CK-MB-81* MB Indx-12.7* cTropnT-0.67*
+___ 06:25AM BLOOD Calcium-8.6 Phos-3.4 Mg-2.0
+
+Discharge:
+___ 06:25AM BLOOD WBC-8.4 RBC-4.06* Hgb-12.8* Hct-39.7* 
+MCV-98 MCH-31.7 MCHC-32.4 RDW-12.4 Plt ___
+___ 06:42AM BLOOD Glucose-95 UreaN-8 Creat-0.9 Na-139 K-4.0 
+Cl-106 HCO3-27 AnGap-10
+___ 06:42AM BLOOD CK(CPK)-438*
+___ 06:42AM BLOOD CK-MB-35* MB Indx-8.0* cTropnT-1.45*
+___ 06:42AM BLOOD Calcium-8.1* Phos-2.9 Mg-2.0
+
+
+###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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, PTT {Partial thromboplastin time, activated}, CK(CPK {Creatine kinase measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac 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}, MCV {Erythrocyte mean corpuscular volume determination}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, BLOOD Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, CK(CPK {Creatine kinase measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total 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: Studies:
+CHEST (PORTABLE AP) ___ (final) ""No acute cardiopulmonary 
+process""
+
+Cardiac Cath ___ (prelim)  ""FINAL DIAGNOSIS: 1. One vessel 
+coronary artery disease with total occlusion of the mid-RCA.  
+The pLCx and mLAD were also noted to have ulcerated plaques of 
+~40%. 2. Borderline systemic systolic arterial hypotension. 3. 
+Successful angioplasty of the mid RCA total occlusion with a 3.0 
+mm balloon. 4. Successful angioplasty of the more proximal RCA 
+with a 3.0 mm balloon.""
+
+ECHO ___ (final) ""The left atrium is normal in size. There 
+is mild symmetric left ventricular hypertrophy. The left 
+ventricular cavity size is normal. There is mild regional left 
+ventricular systolic dysfunction with basal to mid inferior 
+akinesis/hypokinesis. Tissue Doppler imaging suggests a normal 
+left ventricular filling pressure (PCWP<12mmHg). Right 
+ventricular chamber size and free wall motion are normal. The 
+aortic valve leaflets (3) are mildly thickened. There is no 
+aortic valve stenosis. No aortic regurgitation is seen. The 
+mitral valve leaflets are mildly thickened. Trivial mitral 
+regurgitation is seen. There is mild pulmonary artery systolic 
+hypertension. There is a trivial/physiologic pericardial 
+effusion""
+
+Pending Results:
+None
+ 
+
+###RESPONSE: CHEST (PORTABLE AP {Plain x-ray of chest anteroposterior view}, No acute {No abnormality detected}, Cardiac Cath {Cardiac catheterization}, One vessel 
+coronary artery disease {Single coronary vessel disease}, total occlusion {Complete obstruction}, mid-RCA {Structure of mid portion of right coronary artery}, mLAD {Structure of mid portion of anterior descending branch of left coronary artery}, plaques {Plaque}, systolic arterial hypotension {Abnormal systolic arterial pressure}, angioplasty {Angioplasty of blood vessel}, mid RCA {Structure of mid portion of right coronary artery}, total occlusion {Complete obstruction}, angioplasty {Angioplasty of blood vessel}, proximal {Structure of proximal portion of anterior descending branch of left coronary artery}, RCA {Right coronary artery structure}, ECHO {Echocardiography}, left atrium {Left atrial structure}, normal in size {Normal size}, mild symmetric left ventricular hypertrophy {Mild left ventricular hypertrophy}, left 
+ventricular cavity {Structure of cavity of left cardiac ventricle}, size is normal {Normal size}, mild {Symptom mild}, left 
+ventricular systolic dysfunction {Left ventricular systolic dysfunction}, basal {Structure of base of heart}, akinesis {Akinesia}, hypokinesis {Hypokinesis of cardiac wall}, Tissue Doppler imaging {Doppler ultrasonography of heart tissue}, left ventricular {Left cardiac ventricular structure}, filling pressure {Normal cardiac flow}, Right 
+ventricular chamber {Right cardiac ventricular structure}, size {Normal size}, wall motion are normal {Normal ventricular wall motion}, aortic valve leaflets {Structure of cusp of aortic valve}, mildly thickened {Increased thickness}, aortic valve stenosis {Aortic valve stenosis}, aortic regurgitation {Aortic valve regurgitation}, mitral valve leaflets are mildly thickened {Thickened mitral leaflet}, Trivial mitral 
+regurgitation {Mild mitral valve regurgitation}, pulmonary artery systolic 
+hypertension {Pulmonary hypertensive arterial disease}, pericardial 
+effusion {Pericardial effusion}"
+"###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 man with a h/o COPD, HTN who p/w chest pain and 
+elevated troponin without ST elevation.  
+  
+# NSTEMI: CK peaked at 640, troponin at 1.45.  He remained chest 
+pain free following admission. Patient underwent cardiac cath 
+___, revealing total occlusion of mid-RCA, which was opened with 
+balloon angioplasty.  Another more distal lesion in the RCA was 
+also opened with balloon angioplasty.  Echo following 
+catheterization showed normal EF with with basal to mid inferior 
+akinesis/hypokinesis. He was discharged on high dose aspirin, 
+high dose atorvastatin, prasugrel and beta blocker.     
+ 
+# COPD: Was stable on home albuterol/advair  
+  
+# HTN: Was stable in house; on admission, lowered lisinopril 
+dose to accomodate the addition of beta blocker.
+
+Transitional Issues:
+-Follow up with Dr. ___ in ___ weeks.
+
+ 
+
+###RESPONSE: COPD {Chronic obstructive lung disease}, HTN {Hypertensive disorder, systemic arterial}, chest pain {Chest pain}, elevated troponin {Troponin I above reference range}, ST elevation {ST segment elevation}, NSTEMI {Acute non-ST segment elevation myocardial infarction}, troponin {Troponin measurement}, chest 
+pain {Chest pain}, cardiac cath {Cardiac catheterization}, total occlusion {Complete obstruction}, mid-RCA {Structure of mid portion of right coronary artery}, balloon angioplasty {Angioplasty of artery}, distal {Structure of distal portion of right coronary artery}, lesion {Lesion}, RCA {Right coronary artery structure}, balloon angioplasty {Angioplasty of artery}, Echo {Echocardiography}, catheterization {Cardiac catheterization}, normal {Electrocardiogram normal}, basal {Structure of base of heart}, akinesis {Akinesia}, hypokinesis {Hypokinesis of cardiac wall}, aspirin {Administration of aspirin}, COPD {Chronic obstructive lung disease}, stable {Patient's condition stable}, HTN {Hypertensive disorder, systemic arterial}, stable {Patient's condition stable}, Follow up {Follow-up arranged}"
+"###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:
+MEDICATIONS: 
+- Albuterol HFA 90mcg BID:prn  
+- Advair HFA BID  
+- Lisinopril 20mg daily
+ 
+Discharge Medications:
+1. Albuterol Inhaler 1 PUFF IH BID:PRN SOB 
+2. Atorvastatin 80 mg PO DAILY 
+RX *atorvastatin 80 mg 1 Tablet(s) by mouth once a day Disp #*30 
+Capsule Refills:*0
+3. Fluticasone-Salmeterol Diskus (250/50)  1 INH IH BID 
+4. Prasugrel 10 mg PO DAILY 
+RX *Effient 10 mg 1 Tablet(s) by mouth once a day Disp #*30 
+Capsule Refills:*0
+5. Aspirin 325 mg PO DAILY 
+RX *aspirin 325 mg 1 Tablet(s) by mouth once a day Disp #*30 
+Capsule Refills:*0
+6. Lisinopril 10 mg PO DAILY 
+RX *lisinopril 10 mg 1 Tablet(s) by mouth once a day Disp #*30 
+Capsule Refills:*0
+7. Metoprolol Succinate XL 12.5 mg PO DAILY 
+hold for SBP <100, HR <60 
+RX *metoprolol succinate 25 mg 0.5 (One half) Tablet(s) by mouth 
+once a day Disp #*15 Capsule 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:
+Primary: NSTEMI
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: NSTEMI {Acute non-ST segment elevation myocardial infarction}, Mental Status {Neurological mental status determination}, Clear {Normal state of mind}, Alert {Mentally alert}, interactive {Does communicate}, 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 to the ___ 
+with chest pain. While you were here, you had a cardiac 
+cathetization which showed blockage of one of the arteries that 
+feeds your heart (""Right Coronary Artery"").  The blockage was 
+opened with a balloon angioplasty and you had increased blood 
+flow to the heart and your symptoms improved.
+
+It was a pleasure taking care of you during your hospital stay.
+ 
+
+###RESPONSE: chest pain {Chest pain}, cardiac 
+cathetization {Cardiac catheterization}, blockage {Coronary artery stenosis}, arteries {Coronary artery structure}, heart {Heart structure}, Right Coronary Artery {Right coronary artery structure}, blockage {Coronary artery stenosis}, balloon angioplasty {Angioplasty of artery}, increased blood 
+flow {Increased vascular flow}, heart {Heart structure}, improved {Patient's condition improved}"
+"###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: 
+Sanctura XR
+ 
+Attending: ___.
+ 
+Chief Complaint:
+chest pain
+ 
+Major Surgical or Invasive Procedure:
+___ Left heart cardiac catheterization
+ 
+
+###RESPONSE: chest pain {Chest pain}, Left heart cardiac catheterization {Catheterization of left heart}"
+"###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 an ___ year-old lady with a PMH of NSTEMI s/p 
+BMS to mid-LAD in ___, hypothyroidism and recurrent UTIs, now 
+presenting with chest pain, concerning for NSTEMI.
+
+Patient reports having three nights of severe chest pain over 
+the past three nights at rest.  Pain worsened last night.  Notes 
+that pain is squeezing across the tops of her breasts, 
+associated with dyspnea and diaphoresis, consistent with pain 
+experienced at the time of prior MI.  Each pain episode lasted 
+about ___ minutes, with about three episodes per night.  Last 
+night, pain was worse than before.  She did not take any meds 
+for her pain, just went back to sleep.  At worst, it was about 
+an ___ in severity.  With one episode, she had associated 
+palpitations. 
+
+Additionally, she reports ""difficulty breathing"" with walking, 
+at any distance.  She also reports ongoing slight swelling in 
+her legs and pain with urination.
+
+When she saw her PCP this morning, she was referred to the 
+emergency room for evaluation.  On arrival to the ED, her 
+initial vital signs were: 97.9 62 125/63 18 96%.  She reported 
+that her chest pain had been resolved since last night.  EKG 
+showed NSR @ 64 bpm, LAD, IVCD, TWI in V2-V5.  Labs were 
+consistent with troponin 0.08; chemistry panel with chloride 
+110, bicarb 21, Cr 1.2; H/H 10.6/32.7.  UA with large ___, WBC 
+66, few bacteria.  UCx was sent.  Patient was given aspirin 81 
+mg, clopidogrel 75 mg and nitrofurantoin 100 mg.  She was also 
+started on a heparin drip.  Vital signs prior to transfer were: 
+98.0 64 134/64 18 98%.
+
+On arrival to the floor, she reported no chest pain or 
+discomfort.
+ 
+On review of systems, she denies any prior history of stroke, 
+TIA, deep venous thrombosis, pulmonary embolism, bleeding at the 
+time of surgery, myalgias, joint pains, cough, hemoptysis, black 
+stools or red stools. She denies recent fevers, chills or 
+rigors. S/he denies exertional buttock or calf pain. All of the 
+other review of systems were negative.  
+ 
+Cardiac review of systems is notable for absence of paroxysmal 
+nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope 
+or presyncope.  
+ 
+
+###RESPONSE: NSTEMI {Acute non-ST segment elevation myocardial infarction}, BMS {Placement of stent in coronary artery}, mid-LAD {Structure of mid portion of anterior descending branch of left coronary artery}, hypothyroidism {Hypothyroidism}, recurrent UTIs {Recurrent urinary tract infection}, chest pain {Chest pain}, NSTEMI {Acute non-ST segment elevation myocardial infarction}, severe {Symptom severe}, chest pain {Chest pain at rest}, at rest {Chest pain at rest}, Pain worsened {Increased pain}, pain is squeezing {Squeezing chest pain}, breasts {Breast structure}, dyspnea {Dyspnea}, diaphoresis {Excessive sweating}, pain {Chest pain}, MI {Myocardial infarction}, pain {Pain}, pain {Pain}, worse {Increased pain}, did not take any meds {Does not take medication}, pain {Pain}, palpitations {Palpitations}, difficulty breathing {Difficulty breathing}, walking {Does walk}, swelling in 
+her legs {Swelling of lower limb}, pain with urination {Dysuria}, emergency {Emergency treatment management}, evaluation {Evaluation procedure}, vital signs {Vital signs finding}, chest pain {Chest pain}, resolved {Problem resolved}, EKG {Electrocardiographic procedure}, NSR {Normal sinus rhythm}, LAD {Left axis deviation}, IVCD {Intraventricular conduction defect}, TWI {Inverted T wave}, V2 {Lead site V2}, V5 {Lead site V5}, Labs {Laboratory test}, troponin {Troponin measurement}, chloride {Chloride measurement, blood}, bicarb {Blood bicarbonate measurement}, Cr {Creatinine measurement}, H/H {Measurement of total hemoglobin concentration and hematocrit}, UA {Urinalysis}, WBC {White blood cell count}, bacteria {Bacteriuria}, UCx {Urine culture}, aspirin {Administration of aspirin}, started {New medication added}, heparin drip {Continuous infusion of heparin}, Vital signs {Vital signs finding}, chest pain {Chest pain}, discomfort {Discomfort}, review of systems {Review of systems}, stroke {Cerebrovascular accident}, TIA {Transient ischemic attack}, deep venous thrombosis {Deep venous thrombosis}, pulmonary embolism {Pulmonary embolism}, bleeding {Bleeding}, surgery {Surgical procedure}, myalgias {Muscle pain}, joint pains {Joint pain}, cough {Cough}, hemoptysis {Hemoptysis}, black 
+stools {Dark stools}, red stools {Red stools}, fevers {Fever}, chills {Chill}, rigors {Rigor}, exertional {Pain provoked by exertion}, buttock {Pain in buttock}, calf pain {Pain in calf}, review of systems {Review of systems}, negative {No abnormality detected}, Cardiac review of systems {Cardiovascular physical examination}, paroxysmal 
+nocturnal dyspnea {Paroxysmal nocturnal dyspnea}, orthopnea {Orthopnea}, ankle edema {Ankle edema}, palpitations {Palpitations}, syncope {Syncope}, presyncope {Near 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:
+PAST MEDICAL HISTORY:  
+1. CARDIAC RISK FACTORS: -Diabetes, +Dyslipidemia, -Hypertension 
+ 
+2. CARDIAC HISTORY:   
+- PERCUTANEOUS CORONARY INTERVENTIONS:  NSTEMI s/p BMS to LAD 
+___
+3. OTHER PAST MEDICAL HISTORY:  
+1. Recurrent urinary tract infection, followed by ___.
+2. History of bronchitis.
+3. Hypercholesterolemia.
+4. Bilateral chronic venous insufficiency.
+5. Hypothyroidism.
+6. Depression.
+7. Anemia.
+8. Hearing loss.
+9. Insomnia.
+10. History of vaginal prolapse.
+
+PAST SURGICAL HISTORY:
+1. Cholecystectomy.
+2. TAH/BSO.
+ 
+
+###RESPONSE: CARDIAC RISK FACTORS {Assessment for risk of cardiovascular disease}, Diabetes {Diabetes mellitus}, Dyslipidemia {Dyslipidemia}, Hypertension {Hypertensive disorder, systemic arterial}, PERCUTANEOUS CORONARY INTERVENTIONS {Percutaneous coronary intervention}, NSTEMI {Acute non-ST segment elevation myocardial infarction}, BMS {Placement of stent in coronary artery}, LAD {Structure of anterior descending branch of left coronary artery}, Recurrent urinary tract infection {Recurrent urinary tract infection}, bronchitis {Bronchitis}, Hypercholesterolemia {Hypercholesterolemia}, chronic venous insufficiency {Peripheral venous insufficiency}, Hypothyroidism {Hypothyroidism}, Depression {Depressive disorder}, Anemia {Anemia}, Hearing loss {Hearing loss}, Insomnia {Insomnia}, vaginal {Vaginal structure}, prolapse {Prolapse}, Cholecystectomy {Cholecystectomy}, TAH/BSO {Total abdominal hysterectomy with bilateral salpingo-oophorectomy}"
+"###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 died age ___ ""old age.""  Father died age ___ of colon 
+cancer.  Both were in a nursing home and died within 12 days of 
+one another.
+ 
+
+###RESPONSE: died {Dead}, old age {Old-age}, died {Dead}, colon 
+cancer {Malignant neoplasm of colon}, died {Dead}"
+"###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: 98.0  117/70  62  18  95%RA
+General: Comfortable, elderly, well-appearing, NAD.
+HEENT: MMM, no scleral icterus, clear oropharynx.
+Neck: 2+ carotid pulses, no JVD.
+CV: I/VI systolic murmur at RUSB, nl S1/S2, RRR.
+Lungs: CTAB, resp unlabored, no accessory muscle use
+Abdomen: Soft, ND/NT, NABS
+Back: No CVA tenderness
+GU: No foley
+Ext: 1+ non-pitting edema around ankles bilaterally
+Neuro: Awake, alert and oriented x3, CNs II-XII intact and 
+symmetric. Moving all extremities.
+Skin: No rashes.
+PULSES: 2+ distal pulses.
+
+DISCHARGE PHYSICAL EXAM:
+VS: T 97.8 BP 153/77 HR 68 RR 20 SaO2 97% on RA
+General: Comfortable, elderly, well-appearing, NAD.
+HEENT: MMM, EOMI
+Neck: JVP ~ 8cm H2O.
+CV: RRR, ___ SEM, nl S1/S2.
+Lungs: CTAB, resp unlabored, no accessory muscle use
+Abdomen: Soft, ND/NT, NABS
+Back: No CVA tenderness
+GU: No foley
+Ext: 1+ pitting edema around ankles bilaterally
+Neuro: Awake, alert and oriented x3, CNs II-XII intact and 
+symmetric. Moving all extremities.
+Skin: No rashes.
+PULSES: 2+ distal pulses.
+ 
+
+###RESPONSE: PHYSICAL EXAM {Physical examination procedure}, VS {Vital signs finding}, RA {Breathing room air}, General {General examination of patient}, Comfortable {Comfortable appearance}, well-appearing {Well cared for appearance}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, MMM {Moist oral mucosa}, scleral icterus {Scleral icterus}, oropharynx {Oropharyngeal structure}, Neck {Physical examination procedure}, 2+ carotid pulses {Carotid pulse present}, JVD {Jugular venous engorgement}, CV {Cardiovascular physical examination}, murmur {Murmur}, S2 {Normal second heart sound, S>2<}, RRR {Normal heart rate}, Lungs {Examination of respiratory system}, CTAB {Normal breath sounds}, resp unlabored {Breathing easily}, accessory muscle {Accessory skeletal muscle}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, ND {Swollen abdomen}, NT {Abdominal tenderness}, NABS {Normal bowel sounds}, CV {Cardiovascular physical examination}, tenderness {Tenderness}, GU {Examination of genitourinary system}, Ext {Examination of limb}, edema {Edema}, ankles {Ankle region structure}, Neuro {Neurological examination}, Awake {Awake}, alert {Mentally alert}, oriented {Orientated}, CNs II-XII {Cranial nerve structure}, intact {No abnormality detected}, all extremities {All extremities}, Skin {Examination of skin}, rashes {Eruption of skin}, PULSES {Pulse finding}, 2+ distal pulses {Peripheral pulses normal}, VS {Vital signs finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, SaO2 {Finding of oxygen saturation}, RA {Breathing room air}, General {General examination of patient}, Comfortable {Comfortable appearance}, well-appearing {Well cared for appearance}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, MMM {Moist oral mucosa}, EOMI {Normal ocular motility}, Neck {Physical examination procedure}, JVP {Finding of jugular venous pressure}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, SEM {Ejection murmur}, nl S1/S2 {Heart sounds normal}, Lungs {Examination of respiratory system}, CTAB {Normal breath sounds}, resp unlabored {Breathing easily}, accessory muscle use {Accessory respiratory muscles used}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, ND {Swollen abdomen}, NT {Abdominal tenderness}, NABS {Normal bowel sounds}, CVA tenderness {Renal angle tenderness}, Ext {Examination of limb}, edema {Edema}, ankles {Ankle region structure}, Neuro {Neurological examination}, Awake {Awake}, alert {Mentally alert}, oriented x3 {Oriented to person, time and place}, CNs II-XII {Cranial nerve structure}, intact {No abnormality detected}, Moving all extremities {Does move all four limbs}, Skin {Examination of skin}, rashes {Eruption of skin}, PULSES {Pulse finding}, 2+ distal pulses {Peripheral pulses normal}"
+"###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:
+___ 04:00PM BLOOD WBC-4.0 RBC-3.87* Hgb-10.6* Hct-32.7* 
+MCV-85 MCH-27.5 MCHC-32.5 RDW-15.3 Plt ___
+___ 04:00PM BLOOD Neuts-50.0 ___ Monos-6.0 Eos-3.8 
+Baso-0.7
+___ 04:16PM BLOOD ___ PTT-26.9 ___
+___ 07:38AM BLOOD Glucose-99 UreaN-15 Creat-1.0 Na-143 
+K-3.9 Cl-108 HCO3-24 AnGap-15
+___ 07:38AM BLOOD Calcium-8.4 Phos-3.8 Mg-2.1
+___ 04:00PM BLOOD CK(CPK)-144
+___ 04:00PM BLOOD CK-MB-3
+___ 04:00PM BLOOD cTropnT-0.08*
+___ 04:40PM URINE Color-Yellow Appear-Clear Sp ___
+___ 04:40PM URINE RBC-0 WBC-66* Bacteri-FEW Yeast-NONE 
+Epi-1
+
+PERTINENT LABS:
+___ 08:41PM BLOOD CK(CPK)-161
+___ 08:41PM BLOOD CK-MB-3 cTropnT-0.06*
+___ 09:51PM BLOOD CK(CPK)-175
+___ 09:51PM BLOOD CK-MB-4 cTropnT-0.10*
+___ 07:38AM BLOOD cTropnT-0.11*
+
+DISCHARGE LABS:
+___ 07:38AM BLOOD WBC-5.1 RBC-4.13* Hgb-11.3* Hct-34.2* 
+MCV-83 MCH-27.3 MCHC-33.0 RDW-15.4 Plt ___
+___ 07:38AM BLOOD ___ PTT-28.9 ___
+___ 07:38AM BLOOD Glucose-99 UreaN-15 Creat-1.0 Na-143 
+K-3.9 Cl-108 HCO3-24 AnGap-15
+___ 07:38AM BLOOD Calcium-8.4 Phos-3.8 Mg-2.1
+
+MICROBIOLOGY:
+___ URINE CULTURE: Time Taken Not Noted     Log-In 
+Date/Time: ___ 5:12 pm
+      URINE      TAKEN FROM ___. 
+   URINE CULTURE (Preliminary): 
+      STAPHYLOCOCCUS, COAGULASE NEGATIVE.    >100,000 
+ORGANISMS/ML.. 
+      AEROCOCCUS VIRIDANS.    10,000-100,000 ORGANISMS/ML.. 
+
+IMAGING:
+___ CXR PA/lat: 2 views were obtained of the chest.  The 
+lungs are well expanded and clear.  Retrocardiac density likely 
+corresponds to a small hiatal hernia.  There is no pleural 
+effusion or pneumothorax.  The heart is normal size with normal 
+cardiomediastinal contours. 
+IMPRESSION: No acute intrathoracic process.  Small hiatal 
+hernia.   
+
+___ LEFT HEART CARDIAC CATHETERIZATION: Approach via 
+___ catheter in R radial artery.
+Hemodynamic Measurements (mmHg):
+Baseline
+SiteSysDiasEndMeanA WaveV WaveHR
+LV     ___
+
+Contrast Summary:
+Contrast Total (ml)
+Optiray (ioversol 320 mg/ml)80
+
+Radiation Dosage:
+Effective Equivalent Dose Index (mGy)___
+
+Radiology Summary:
+Total Runs
+Total Fluoro Time (minutes) 9.0
+
+Findings:
+ESTIMATED blood loss:  < 25 cc
+Hemodynamics: (see above) 
+Coronary angiography:  right dominant
+LMCA:  Normal
+LAD:  99% restenosis in the mid LAD within the bare metal stent 
+with TIMI 1 flow into the distal LAD. The diagonal branch 
+remained patent and was a large vessel. 
+LCX:  Large vessel vessel with a large OMB1 and birfurcating 
+OMB/PLB to the posterior wall.  There were minor lumen 
+irregularities in the LCx.
+RCA:  The RCA had minor irregularities and gave rise to a small 
+PDA and RPLB.
+
+Interventional details:
+The patient presented with a NSTEMI following bare metal stent 
+placement in the mid LAD in ___.  She re-developed 
+unstable symptoms and proceeded with cardiac catheterization.
+Unfractionated heparin and eptifibatide were used for 
+anticoagulation.
+
+Using a ___ Fr XB3.5 guiding catheter and a 0.014 BMW wire, the 
+LAD in-stent restenosis was dilated with a 2.5 mm Cutting 
+Balloon.  A 2.5 mm x 26 mm Resolute drug eluting stent was 
+placed in the mid LAD and deployed at 14 atms.  A 2.75 mm x 15 
+mm balloon was inflated to 24 atms throughout the stent.   This 
+resulted in no residual stenosis within the stent and TIMI 3 
+flow into the distal vessel. 
+
+The procedure was performed from the right radial artery without 
+complications. 
+
+ASSESSMENT
+1. Single vessel CAD with in-stent restenosis in the bare metal 
+stent in the mLAD
+2. Successful drug-eluting stent of the mid LAD
+PLAN
+1. Aspirin indefinitely
+2. Clopidogrel for up to one year
+
+___ TTE: The left atrium and right atrium are normal in 
+cavity size. Left ventricular wall thickness, cavity size and 
+regional/global systolic function are normal (LVEF >55%). The 
+right ventricular cavity is mildly dilated with normal free wall 
+contractility. The diameters of aorta at the sinus, ascending 
+and arch levels are normal. The aortic valve leaflets (3) are 
+mildly thickened but aortic stenosis is not present. Mild (1+) 
+aortic regurgitation is seen. The mitral valve leaflets are 
+mildly thickened. There is no mitral valve prolapse. Mild (1+) 
+mitral regurgitation is seen. Moderate [2+] tricuspid 
+regurgitation is seen. There is mild pulmonary artery systolic 
+hypertension. There is no pericardial effusion. 
+IMPRESSION: Normal global and regional biventricular systolic 
+function. Mild aortic regurgitation. Mild mitral regurgitation. 
+Moderate tricuspid regurgitation. Mild pulmonary hypertension.
+Compared with the prior study (images reviewed) of ___, LV 
+systolic function has normalized.   
+ 
+
+###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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, Plt {Platelet count}, Neuts {Neutrophil count}, Monos {Monocyte count}, Eos {Eosinophil count}, Baso {Basophil count}, PTT {Partial thromboplastin time, activated}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium 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}, CK(CPK {Creatine kinase measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, URINE {Evaluation of urine specimen}, Color {Color finding}, Appear-Clear {Urine looks clear}, URINE {Evaluation of urine specimen}, RBC {Red blood cell count}, WBC {White blood cell count}, Bacteri {Bacteriuria}, Yeast {Urine microscopy for yeasts}, CK(CPK {Creatine kinase measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, CK(CPK {Creatine kinase measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, Plt {Platelet count}, PTT {Partial thromboplastin time, activated}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium 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}, URINE CULTURE {Urine culture}, URINE {Evaluation of urine specimen}, URINE CULTURE {Urine culture}, NEGATIVE {No pathologic diagnosis}, CXR PA/lat {Diagnostic radiography of chest, combined posteroanterior and lateral}, chest {Thoracic structure}, lungs {Lung structure}, clear {No abnormality detected}, density {Abnormally opaque structure}, hiatal hernia {Hiatal hernia}, pleural 
+effusion {Pleural effusion}, pneumothorax {Left pneumothorax}, heart {Heart structure}, normal size {Normal size}, normal {No abnormality detected}, cardiomediastinal {Mediastinal structure}, No acute intrathoracic process {No abnormality detected}, hiatal 
+hernia {Hiatal hernia}, LEFT HEART CARDIAC CATHETERIZATION {Catheterization of left heart}, catheter {Catheterization of left heart}, R radial artery {Structure of right radial artery}, Baseline {Baseline state}, blood loss {Hemorrhage}, Hemodynamics {Hemodynamic monitoring}, Coronary angiography {Angiography of coronary artery}, LMCA {Structure of left coronary artery main stem}, Normal {Normal appearance}, LAD {Structure of anterior descending branch of left coronary artery}, restenosis {Coronary stent stenosis}, mid LAD {Structure of mid portion of anterior descending branch of left coronary artery}, stent {Placement of stent in coronary artery}, TIMI 1 flow {Thrombolysis in Myocardial Infarction grade 1: penetration without perfusion}, distal LAD {Structure of distal portion of anterior descending branch of left coronary artery}, diagonal {Structure of diagonal branch of anterior descending branch of left coronary artery}, patent {Coronary artery patent}, large vessel {Large blood vessel structure}, LCX {Structure of circumflex branch of left coronary artery}, Large vessel {Large blood vessel structure}, vessel {Structure of circumflex branch of left coronary artery}, OMB1 {Structure of first obtuse marginal branch of circumflex branch of left coronary artery}, OMB {Structure of obtuse marginal branch of circumflex branch of left coronary artery}, PLB {Structure of left posterior lateral branch of circumflex branch of left coronary artery}, posterior {Structure of diaphragmatic surface of heart}, wall {Cardiac wall structure}, lumen 
+irregularities {Luminal irregularities of coronary artery}, LCx {Structure of circumflex branch of left coronary artery}, RCA {Right coronary artery structure}, RCA {Right coronary artery structure}, irregularities {Luminal irregularities of coronary artery}, PDA {Structure of posterior descending coronary artery}, RPLB {Structure of posterior lateral branch of right coronary artery}, NSTEMI {Acute non-ST segment elevation myocardial infarction}, stent 
+placement {Placement of stent in coronary artery}, mid LAD {Structure of mid portion of anterior descending branch of left coronary artery}, unstable {Patient's condition unstable}, cardiac catheterization {Catheterization of left heart}, heparin {Heparin therapy}, anticoagulation {Anticoagulant therapy}, catheter {Catheterization of left heart}, LAD {Structure of anterior descending branch of left coronary artery}, in-stent restenosis {Coronary stent stenosis}, dilated {Dilatation}, drug eluting stent {Endovascular insertion of drug eluting stent}, placed {Implantation procedure}, mid LAD {Structure of mid portion of anterior descending branch of left coronary artery}, stent {Placement of stent in coronary artery}, stenosis {Stenosis}, stent {Placement of stent in coronary artery}, TIMI 3 {Thrombolysis in Myocardial Infarction grade 3: complete perfusion}, distal vessel {Structure of distal portion of anterior descending branch of left coronary artery}, procedure {Procedure}, right radial artery {Structure of right radial artery}, Single vessel CAD {Single coronary vessel disease}, in-stent restenosis {Coronary stent stenosis}, stent {Placement of stent in coronary artery}, mLAD {Structure of mid portion of anterior descending branch of left coronary artery}, drug-eluting stent {Endovascular insertion of drug eluting stent}, mid LAD {Structure of mid portion of anterior descending branch of left coronary artery}, Aspirin {Administration of aspirin}, TTE {Transthoracic echocardiography}, left atrium {Left atrial structure}, right atrium {Right atrial structure}, normal in 
+cavity size {Normal size}, Left ventricular wall {Left cardiac ventricular structure}, thickness {Normal thickness}, cavity {Structure of cavity of left cardiac ventricle}, size {Normal size}, regional/global systolic function are normal {Normal left ventricular systolic function and wall motion}, right ventricular cavity is mildly dilated {Dilatation of right cardiac ventricle}, normal {No abnormality detected}, wall 
+contractility {Finding of right ventricular wall motion}, aorta at the sinus {Structure of sinus of Valsalva}, ascending {Ascending aorta structure}, arch {Aortic arch structure}, normal {Normal appearance}, aortic valve leaflets {Structure of cusp of aortic valve}, mildly thickened {Increased thickness}, aortic stenosis {Aortic valve stenosis}, Mild (1+) 
+aortic regurgitation {Mild aortic valve regurgitation}, mitral valve leaflets are 
+mildly thickened {Thickened mitral leaflet}, mitral valve prolapse {Mitral valve prolapse}, Mild (1+) 
+mitral regurgitation {Mild mitral valve regurgitation}, Moderate [2+] tricuspid 
+regurgitation {Moderate tricuspid valve regurgitation}, pulmonary artery systolic 
+hypertension {Pulmonary hypertensive arterial disease}, pericardial effusion {Pericardial effusion}, Normal global and regional biventricular systolic 
+function {Normal left ventricular systolic function and wall motion}, Mild aortic regurgitation {Mild aortic valve regurgitation}, Mild mitral regurgitation {Mild mitral valve regurgitation}, Moderate tricuspid regurgitation {Moderate tricuspid valve regurgitation}, Mild pulmonary hypertension {Mild pulmonary hypertension}, study {Evaluation procedure}, LV 
+systolic function has normalized {Normal left ventricular systolic function and wall motion}"
+"###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:
+Ms. ___ is an ___ year-old lady with a PMH of NSTEMI s/p 
+BMS to mid-LAD in ___, hypothyroidism and recurrent UTIs, 
+admitted with chest pain, found to have unstable angina due to 
+in-stent restenosis. Admission was complicated by a urinary 
+tract infection.
+
+ACTIVE ISSUES: 
+# Unstable angina: History of NSTEMI with BMS to LAD in ___, 
+and presented with chest pain that was c/w prior and concerning 
+for NSTEMI, as accompanied by elevated troponin (0.08). The 
+timing of her symptoms was quite concerning for in-stent 
+restenosis. She had no EKG changes. Her troponin initially 
+trended down to 0.06, and was accompanied by a low CK-MB at 3. 
+She received aspirin 325 mg PO, clopidogrel 300 mg PO, and was 
+started on a heparin drip on arrival. On ___, she was taken 
+to the cath lab for left heart cath. This revealed 99% 
+restenosis in the mid LAD within the bare metal stent with TIMI 
+1 flow into the distal LAD, with no other angiographically 
+significant disease. A single drug-eluting stent was placed in 
+the mid LAD. She was placed on an integrellin drip following the 
+catheterization, and this therapy was complicated by some oozing 
+from her peripheral IV site. She had no drop in her blood counts 
+with this bleeding. Aspirin should be continued indefinitely, 
+and clopidogrel should for continued for up to one year after 
+discharge.
+
+# Urinary tract infection: Patient reproted dysuria, accompanied 
+by evidence of a UTI on UA (WBC 66 with few bacteria). Recurrent 
+UTIs due to anatomy. She had been on ciprofloxacin 250 mg PO BID 
+prior to admission. She was given one dose of nitrofurantoin in 
+ED, and then was transitioned back to ciprofloxacin 250 mg PO 
+BID. She will continue her previous course of ciprofloxacin 
+after discharge.
+
+CHRONIC ISSUES:
+# Systolic CHF: After her NSTEMI in ___, patient had an EF 
+that was decreased to 40%. On admission, she had mild edema at 
+the ankles, but no other overt signs of volume overload. 
+Following her cardiac cath on ___, a repeat TTE showed 
+improved EF to > 55%, along with normal global/regional 
+biventricular systolic function, mild aortic regurgitation, mild 
+mitral regurgitation, moderate tricuspid regurgitation, and mild 
+pulmonary hypertension (TR gradient 32 mmHg). She was continued 
+on her home aspirin, beta blocker, lisinopril and atorvastatin.
+
+# GERD: Omeprazole was changed to pantoprazole, as omeprazole 
+interacts with clopidogrel.
+
+# Hypothyroidism: Continued home levothyroxine.
+
+# Hyperlipidemia: Continued home atorvastatin.
+ 
+# Depression: Continued home mirtazipine.
+ 
+
+TRANSITIONAL ISSUES:  
+# Continue aspirin indefinitely. Continue clopidogrel until 
+instructed by cardiologist to stop.
+# CODE:  full (confirmed with patient)
+# CONTACT: Patient. HCP is daughter ___ (Phone number: 
+___, Cell phone: ___, ___ work 
+___ Alternate is son ___ ___
+ 
+___ on Admission:
+The Preadmission Medication list may be inaccurate and requires 
+futher investigation.
+1. Aspirin EC 81 mg PO DAILY 
+2. Levothyroxine Sodium 75 mcg PO DAILY 
+3. Mirtazapine 15 mg PO HS 
+4. Omeprazole 20 mg PO DAILY 
+5. Vitamin D 1000 UNIT PO DAILY 
+6. Atorvastatin 80 mg PO DAILY 
+7. Ciprofloxacin HCl 250 mg PO Q12H 
+1st dose was ___ last day ___. Clopidogrel 75 mg PO DAILY 
+9. Lisinopril 2.5 mg PO DAILY 
+10. melatonin *NF* 3 mg Oral HS 
+11. Centrum Silver *NF* (multivitamin-minerals-lutein;<br>mv 
+with min-lycopene-lutein;<br>mv-min-folic acid-lutein) 
+0.4-300-250 mg-mcg-mcg Oral daily 
+12. Detrol LA *NF* (tolterodine) 4 mg Oral daily 
+13. magnesium *NF* 250 mg Oral HS 
+14. Metoprolol Succinate XL 25 mg PO DAILY 
+
+ 
+Discharge Medications:
+1. Atorvastatin 80 mg PO DAILY 
+RX *atorvastatin 80 mg 1 tablet(s) by mouth once a day Disp #*30 
+Tablet Refills:*0
+2. Ciprofloxacin HCl 250 mg PO Q12H 
+3. Clopidogrel 75 mg PO DAILY 
+RX *clopidogrel 75 mg 1 tablet(s) by mouth once a day Disp #*30 
+Tablet Refills:*0
+4. Levothyroxine Sodium 75 mcg PO DAILY 
+5. Metoprolol Succinate XL 25 mg PO DAILY 
+6. Mirtazapine 15 mg PO HS 
+7. Vitamin D 1000 UNIT PO DAILY 
+8. Nitroglycerin SL 0.3 mg SL PRN chest pain 
+RX *nitroglycerin 0.4 mg 1 tablet sublingually every 5 minutes 
+Disp #*30 Tablet Refills:*0
+9. Pantoprazole 40 mg PO Q24H 
+RX *pantoprazole 40 mg 1 tablet,delayed release (___) by 
+mouth daily Disp #*30 Tablet Refills:*0
+10. Centrum Silver *NF* (multivitamin-minerals-lutein;<br>mv 
+with min-lycopene-lutein;<br>mv-min-folic acid-lutein) 
+0.4-300-250 mg-mcg-mcg Oral daily 
+11. Detrol LA *NF* (tolterodine) 4 mg Oral daily 
+12. Lisinopril 2.5 mg PO DAILY 
+13. magnesium *NF* 250 mg Oral HS 
+14. melatonin *NF* 3 mg Oral HS 
+15. Aspirin EC 325 mg PO DAILY 
+RX *aspirin 325 mg 1 tablet(s) by mouth once a day Disp #*30 
+Tablet Refills:*0
+ 
+
+###RESPONSE: NSTEMI {Acute non-ST segment elevation myocardial infarction}, BMS {Placement of stent in coronary artery}, mid-LAD {Structure of mid portion of anterior descending branch of left coronary artery}, hypothyroidism {Hypothyroidism}, recurrent UTIs {Recurrent urinary tract infection}, chest pain {Chest pain}, unstable angina {Preinfarction syndrome}, in-stent restenosis {Coronary stent stenosis}, urinary 
+tract infection {Urinary tract infectious disease}, Unstable angina {Preinfarction syndrome}, NSTEMI {Acute non-ST segment elevation myocardial infarction}, BMS {Placement of stent in coronary artery}, LAD {Structure of anterior descending branch of left coronary artery}, chest pain {Chest pain}, NSTEMI {Acute non-ST segment elevation myocardial infarction}, in-stent 
+restenosis {Coronary stent stenosis}, no EKG changes {Electrocardiogram normal}, troponin {Troponin measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, aspirin {Administration of aspirin}, started {New medication added}, heparin drip {Continuous infusion of heparin}, left heart cath {Catheterization of left heart}, restenosis {Coronary stent stenosis}, mid LAD {Structure of mid portion of anterior descending branch of left coronary artery}, stent {Placement of stent in coronary artery}, TIMI 
+1 flow {Thrombolysis in Myocardial Infarction grade 1: penetration without perfusion}, distal LAD {Structure of distal portion of anterior descending branch of left coronary artery}, disease {Disease}, drug-eluting stent was placed {Endovascular insertion of drug eluting stent}, mid LAD {Structure of mid portion of anterior descending branch of left coronary artery}, catheterization {Catheterization of left heart}, therapy {Therapy}, oozing {Bleeding}, peripheral IV site {Assessment of peripheral intravenous catheter site}, no drop {No abnormality detected}, blood counts {Blood test}, bleeding {Bleeding}, Aspirin {Administration of aspirin}, Urinary tract infection {Urinary tract infectious disease}, dysuria {Dysuria}, UTI {Urinary tract infectious disease}, UA {Urinalysis}, WBC {White blood cell count}, bacteria {Bacteriuria}, Recurrent 
+UTIs {Recurrent urinary tract infection}, ciprofloxacin {Antibiotic therapy}, ciprofloxacin {Antibiotic therapy}, ciprofloxacin {Antibiotic therapy}, Systolic CHF {Chronic systolic heart failure}, NSTEMI {Acute non-ST segment elevation myocardial infarction}, mild {Symptom mild}, edema at 
+the ankles {Ankle edema}, signs {Sign}, volume overload {Hypervolemia}, cardiac cath {Catheterization of left heart}, TTE {Transthoracic echocardiography}, improved {Patient's condition improved}, normal {Normal appearance}, biventricular {Cardiac ventricular structure}, systolic function {Normal cardiac output}, mild aortic regurgitation {Mild aortic valve regurgitation}, mild 
+mitral regurgitation {Mild mitral valve regurgitation}, moderate tricuspid regurgitation {Moderate tricuspid valve regurgitation}, mild 
+pulmonary hypertension {Mild pulmonary hypertension}, aspirin {Administration of aspirin}, GERD {Gastroesophageal reflux disease}, changed {Change of medication}, Hypothyroidism {Hypothyroidism}, Hyperlipidemia {Hyperlipidemia}, Depression {Depressive disorder}, aspirin {Administration of aspirin}, investigation {Evaluation procedure}, 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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+PRIMARY DIAGNOSIS: unstable angina
+SECONDARY DIAGNOSES: CAD, hyperlipidemia, hypothyroidism
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+ 
+
+###RESPONSE: Disposition:
+Home {Home health aide service management}, unstable angina {Preinfarction syndrome}, CAD {Coronary arteriosclerosis}, hyperlipidemia {Hyperlipidemia}, hypothyroidism {Hypothyroidism}, 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 {Assessment of mobility}, 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 to participate in your care here at ___ 
+___!  You were admitted with chest 
+pain that was similar to the pain that you had with your heart 
+attack in ___.  You underwent a cardiac catheterization, 
+which showed a stenosis in your old stent, which was opened with 
+a new stent.
+
+Please continue to take all of your medications as you were 
+prior to this admission.  Your omeprazole was changed to 
+pantoprazole (a similar medication), as omeprazole had an 
+interaction with your other medications.
+
+Please see below from your follow-up appointments.
+
+Wishing you all the best!
+ 
+
+###RESPONSE: chest 
+pain {Chest pain}, pain {Pain}, heart 
+attack {Myocardial infarction}, cardiac catheterization {Cardiac catheterization}, stenosis in your old stent {Coronary stent stenosis}, stent {Placement of stent in coronary artery}, continue {Recommendation to continue with drug treatment}, changed {Change of medication}, interaction with your other medications {Drug interactions identified - drug changed}"
+"###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: 
+Bactrim / Sulfa (Sulfonamide Antibiotics)
+ 
+Attending: ___.
+ 
+Chief Complaint:
+dyspnea
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: Bactrim {Allergy to sulfamethoxazole and/or trimethoprim}, Sulfa {Allergy to sulfonamide antibiotic}, Sulfonamide Antibiotics {Allergy to sulfonamide antibiotic}, dyspnea {Dyspnea}"
+"###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 PMH significant for CAD s/p PCI who presents with 
+dyspnea associated with 4 pillow orthopnea and lower extremity 
+edema. The patient reports missing 2 doses of lasix this week. 
+The patient also complains of productive cough.  
+
+The patient reports he was treated for 'pneumonia' by his PCP in 
+late ___. Review of OMR shows no infiltrate on CXR and a 
+Z-pack was prescribed. He recovered from that illness, but has 
+developed worsening dyspnea and cough over the last two weeks. 
+Today, his daughter visited him and was worried about his 
+wheezing. She called PCP office and NP recommended going to 
+urgent care. At ___ urgent ___, reportedly chest 
+x-ray demonstrated bilateral pulmonary edema and patient was 
+sent to the ED.  
+
+In the ED initial vitals were: T99.0 HR133 BP137/74 RR18 96%RA. 
+Labs were significant for: troponin 0.01, BNP 1406 (no prior 
+levels), flu negative. CXR showed mild pulmonary vascular 
+congestion with small bilateral pleural effusions. EKG showed 
+Afib with RVR. The patient was given metoprolol 5mg IV x 2, 40 
+iv lasix, and duonebs. His heart rate remained labile in the ED. 
+Vitals prior to transfer were: T98.8 HR110-130 ___ RR20 
+97%RA. 
+ 
+On the floor, he continues to have cough. Denies sob, cp.  
+
+Review of Systems:  
+(+) per HPI  
+(-) fever, chills, night sweats, headache, vision changes, 
+rhinorrhea, congestion, sore throat, chest pain, abdominal pain, 
+nausea, vomiting, diarrhea, constipation, BRBPR, melena, 
+hematochezia, dysuria, hematuria.
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}, PCI {Percutaneous coronary intervention}, dyspnea {Dyspnea}, orthopnea {Orthopnea}, lower extremity 
+edema {Edema of lower extremity}, lasix {Diuretic therapy}, productive cough {Productive cough}, pneumonia {Pneumonia}, PCP {Primary care management}, infiltrate {Infiltration}, CXR {Plain chest X-ray}, worsening {Patient's condition worsened}, dyspnea {Dyspnea}, cough {Cough}, worried {Worried}, wheezing {Wheezing}, called {Informing doctor}, PCP {Primary care management}, chest 
+x-ray {Plain chest X-ray}, bilateral pulmonary {Both lungs}, edema {Pulmonary edema}, vitals {Vital signs finding}, Labs {Laboratory test}, troponin {Troponin measurement}, BNP {Brain natriuretic peptide measurement}, CXR {Plain chest X-ray}, mild {Symptom mild}, pulmonary vascular 
+congestion {Pulmonary congestion}, bilateral pleural effusions {Bilateral pleural effusion}, EKG {Electrocardiographic procedure}, Afib with RVR {Atrial fibrillation with rapid ventricular response}, lasix {Diuretic therapy}, heart rate {Finding of heart rate}, Vitals {Vital signs finding}, cough {Cough}, Review of Systems {Review of systems}, fever {Fever}, chills {Chill}, night sweats {Night sweats}, headache {Headache}, vision changes {Visual disturbance}, rhinorrhea {Nasal discharge}, congestion {Nasal congestion}, sore throat {Sore throat}, chest pain {Chest pain}, abdominal pain {Abdominal pain}, nausea, vomiting, diarrhea {Nausea, vomiting and diarrhea}, constipation {Constipation}, BRBPR {Hematochezia}, melena {Melena}, hematochezia {Hematochezia}, dysuria {Dysuria}, hematuria {Blood in urine}"
+"###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:
+- CAD with MI at ___, s/p PCI with DES to pLAD in ___ (cardiac 
+cath showed collateralized total occlusion of the RCA and an 80% 
+proximal LAD lesion)  
+- DM2L HbA1c 6.8% in ___  
+- Afib on coumadin  
+- Hyperlipidemia  
+- Hypertension  
+- Bradycardia causing syncope s/p PPM ___ EnPulse)  
+- S/p Rt carotid endarterectomoy in ___  
+- Psoriasis  
+- Kidney stones
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}, PCI {Percutaneous coronary intervention}, DES {Endovascular insertion of drug eluting stent}, cardiac 
+cath {Cardiac catheterization}, total occlusion {Complete obstruction}, RCA {Right coronary artery structure}, proximal LAD {Structure of proximal portion of anterior descending branch of left coronary artery}, lesion {Lesion}, HbA1c {Hemoglobin A1c measurement}, Afib {Atrial fibrillation}, coumadin {Warfarin therapy}, Hyperlipidemia {Hyperlipidemia}, Hypertension {Hypertensive disorder, systemic arterial}, Bradycardia {Bradycardia}, syncope {Syncope}, PPM {Permanent cardiac pacemaker}, carotid endarterectomoy {Carotid endarterectomy}, Psoriasis {Psoriasis}, Kidney stones {Kidney stone}"
+"###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 had diabetes. MI in her ___.  
+- Father had diabetes and emphysema. MI in his ___.  
+- Brother has CAD.
+ 
+
+###RESPONSE: diabetes {Diabetes mellitus}, diabetes {Diabetes mellitus}, emphysema {Emphysema}, CAD {Coronary arteriosclerosis}"
+"###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:
+=====================
+Vitals - T:98.0 BP:131/65 HR:120 RR:18 02 sat:95%RA wt 132.9kg  
+GENERAL: NAD, A&Ox3, pleasant  
+HEENT: MMM, good dentition  
+NECK: nontender supple neck, JVD to midneck at 45 degrees  
+CARDIAC: irregularly irregular, S1/S2, no murmurs, gallops, or 
+rubs  
+LUNG: Mild expiratory wheezes throughout, good air movement, no 
+crackles.  
+ABDOMEN: obese, +BS, nontender in all quadrants, no 
+rebound/guarding  
+EXTREMITIES: 3+ edema to thighs bilaterally, moving all 4 
+extremities with purpose  
+SKIN: warm and well perfused, erythematous rash to bilateral 
+elbows with overlying silvery scale
+
+DISCHARGE PHYSICAL:
+======================
+Vitals: 97.3, 100-136/52-78, 59-126, 18, 98 on RA
+Weight on admission 132.9
+DISCHARGE WEIGHT: 125.7
+General: well appearing, obese male in NAD
+Neck: unable to appreciate JVP
+Lungs: CTA b/l, non-labored breathing
+CV: ___, normal rate, normal S1/S2, no m/r/g
+Abdomen: +BS, soft, obese, NT/ND
+Ext: 1+ edema to ankles bilaterally
+ 
+
+###RESPONSE: Vitals {Vital signs finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, 02 sat {Oxygen saturation measurement}, RA {Breathing room air}, GENERAL {General examination of patient}, NAD {No abnormality detected}, Ox3 {Oriented to person, time and place}, HEENT {Physical examination procedure}, MMM {Moist oral mucosa}, good dentition {Normal dentition}, NECK {Physical examination procedure}, nontender {Abdominal tenderness}, supple {Normal movement of neck}, JVD {Jugular venous engorgement}, CARDIAC {Cardiovascular physical examination}, irregularly irregular {Heart irregularly irregular}, S2 {Normal second heart sound, S>2<}, murmurs {Murmur}, gallops {Gallop rhythm}, rubs {Pericardial friction rub}, LUNG {Examination of respiratory system}, Mild {Symptom mild}, wheezes {Wheezing}, good air movement {Breath normal}, crackles {Respiratory crackles}, ABDOMEN {Examination of abdomen}, obese {Obese}, nontender {Abdominal tenderness}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, EXTREMITIES {Examination of limb}, edema {Edema}, thighs {Thigh structure}, moving all 4 
+extremities {Does move all four limbs}, SKIN {Examination of skin}, warm {Warm skin}, well perfused {Normal tissue perfusion}, erythema {Erythema}, rash {Eruption of skin}, elbows {Skin structure of elbow}, Vitals {Vital signs finding}, Weight {Weight finding}, WEIGHT {Weight finding}, well appearing {Well cared for appearance}, obese {Obese}, NAD {Distress}, JVP {Finding of jugular venous pressure}, CTA b/l {Normal breath sounds}, labored breathing {Labored breathing}, normal rate {Normal heart rate}, normal S1/S2 {Heart sounds normal}, no m/r/g {Heart sounds normal}, soft {Abdomen soft}, obese {Obese}, edema to ankles {Ankle 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:
+====================
+___ 09:15PM BLOOD WBC-10.0 RBC-3.99* Hgb-12.5* Hct-37.4* 
+MCV-94 MCH-31.4 MCHC-33.4 RDW-15.7* Plt ___
+___ 09:15PM BLOOD Neuts-67.8 ___ Monos-9.3 Eos-3.5 
+Baso-0.3
+___ 08:55AM BLOOD ___ PTT-37.1* ___
+___ 09:15PM BLOOD Glucose-129* UreaN-19 Creat-1.2 Na-145 
+K-3.6 Cl-102 HCO3-29 AnGap-18
+___ 09:15PM BLOOD proBNP-1406*
+___ 09:15PM BLOOD cTropnT-0.01
+___ 08:55AM BLOOD Calcium-9.1 Phos-3.4 Mg-1.7
+___ 08:55AM BLOOD TSH-2.6
+___ 09:51PM BLOOD Lactate-2.0
+
+DISCHARGE LABS:
+===================
+___ 05:28AM BLOOD WBC-9.0 RBC-4.24* Hgb-13.2* Hct-39.6* 
+MCV-93 MCH-31.1 MCHC-33.4 RDW-15.2 Plt ___
+___ 05:28AM BLOOD ___
+___ 05:28AM BLOOD Glucose-148* UreaN-35* Creat-1.5* Na-140 
+K-3.8 Cl-96 HCO3-31 AnGap-17
+___ 05:28AM BLOOD Calcium-9.2 Phos-4.0 Mg-2.2
+___ 06:35AM BLOOD proBNP-569
+
+STUDIES:
+===================
+
+CXR (___):
+FINDINGS:
+Left-sided dual-chamber pacemaker device is noted with leads 
+terminating in the right atrium and right ventricle.  Cardiac 
+silhouette size remains top normal. Mediastinal and hilar 
+contours are unchanged. The aorta is diffusely calcified.  There 
+is mild upper zone vascular redistribution with pulmonary 
+vascular indistinctness suggestive of mild pulmonary vascular 
+congestion. Small bilateral pleural effusions are demonstrated. 
+Patchy opacities in the lung bases may reflect atelectasis 
+though infection is difficult to exclude. No pneumothorax is 
+present. No acute osseous abnormality is visualized. 
+
+IMPRESSION:
+Patchy bibasilar airspace opacities, possibly atelectasis though 
+infection is not completely excluded.  Mild pulmonary vascular 
+congestion with small bilateral pleural effusions 
+
+ECHOCARDIOGRAM (___):
+
+The left atrium is moderately dilated. The right atrium is 
+dilated. The estimated right atrial pressure is ___ mmHg. There 
+is moderate symmetric left ventricular hypertrophy. The left 
+ventricular cavity size is normal. Regional left ventricular 
+wall motion is normal. Overall left ventricular systolic 
+function is normal (LVEF>55%). Right ventricular chamber size 
+and free wall motion are normal. The aortic valve leaflets (3) 
+are mildly thickened. There is no aortic valve stenosis. No 
+aortic regurgitation is seen. The mitral valve leaflets are 
+mildly thickened. Trivial mitral regurgitation is seen. The 
+estimated pulmonary artery systolic pressure is normal. There is 
+a trivial/physiologic pericardial effusion. 
+
+IMPRESSION: Symmetric LVH with normal global and regional 
+biventricular systolic function. Normal estimated intracardiac 
+filling pressures.
+
+Compared with the prior study (images reviewed) of ___, 
+the findings are similar.
+ 
+
+###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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, Neuts {Neutrophil count}, Monos {Monocyte count}, Eos {Eosinophil count}, Baso {Basophil 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}, proBNP {N-terminal pro-brain natriuretic peptide measurement}, cTropnT {Troponin T cardiac measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, TSH {Thyroid stimulating hormone measurement}, Lactate {Lactic acid 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {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}, proBNP {N-terminal pro-brain natriuretic peptide measurement}, Left-sided dual-chamber pacemaker {Cardiac pacemaker in situ}, right atrium {Right atrial structure}, right ventricle {Right cardiac ventricular structure}, Cardiac {Heart structure}, size {Normal size}, normal {No abnormality detected}, Mediastinal {Mediastinal structure}, hilar {Structure of hilum of lung}, unchanged {Patient condition unchanged}, aorta {Aortic structure}, calcified {Pathologic calcification, calcified structure}, mild {Symptom mild}, vascular {Blood vessel structure}, redistribution {Redistribution}, pulmonary 
+vascular {Structure of pulmonary blood vessel}, mild {Symptom mild}, pulmonary vascular 
+congestion {Pulmonary congestion}, bilateral pleural effusions {Bilateral pleural effusion}, opacities {Abnormally opaque structure}, lung bases {Structure of base of lung}, atelectasis {Atelectasis}, infection {Infectious disease}, pneumothorax {Pneumothorax}, No acute {No abnormality detected}, osseous {Bone structure}, abnormality {No abnormality detected}, bibasilar {Structure of base of lung}, opacities {Abnormally opaque structure}, atelectasis {Atelectasis}, infection {Infectious disease}, Mild {Symptom mild}, pulmonary vascular 
+congestion {Pulmonary congestion}, bilateral pleural effusions {Bilateral pleural effusion}, left atrium is moderately dilated {Left atrial dilatation}, right atrium is 
+dilated {Right atrial dilatation}, right atrial {Right atrial structure}, moderate symmetric left ventricular hypertrophy {Moderate left ventricular hypertrophy}, left 
+ventricular cavity {Structure of cavity of left cardiac ventricle}, size is normal {Normal size}, left ventricular 
+wall motion is normal {Finding of left ventricular wall motion}, left ventricular systolic 
+function is normal {Finding of left ventricular blood flow}, Right ventricular chamber {Right cardiac ventricular structure}, size {Normal size}, wall motion are normal {Normal ventricular wall motion}, aortic valve leaflets {Structure of cusp of aortic valve}, mildly thickened {Increased thickness}, aortic valve stenosis {Aortic valve stenosis}, aortic regurgitation {Aortic valve regurgitation}, mitral valve leaflets are 
+mildly thickened {Thickened mitral leaflet}, Trivial mitral regurgitation {Mild mitral valve regurgitation}, pulmonary artery {Pulmonary artery structure}, systolic pressure is normal {Normal systolic arterial pressure}, pericardial effusion {Pericardial effusion}, LVH {Left ventricular hypertrophy}, normal global and regional 
+biventricular systolic function {Normal left ventricular systolic function and wall motion}, filling {Normal cardiac flow}, pressures {Pressure}, study {Evaluation 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: Brief Hospital Course:
+___ with PMH significant for HFpEF and CAD with 3-vessel 
+disease s/p DES to m-pLAD in ___ who presents with dyspnea and 
+worsening ___ edema. He was diuresed with a lasix gtt ___ 
+mg/hr) and boluses PRN. He had an ECHO here which showed EF > 
+55%, similar to last ECHO in ___. Prior to discharge, he was 
+transitioned to torsemide 40 mg daily.
+
+DRY WEIGHT: 125.7 kg
+
+#Acute on chronic decompensated diastolic CHF: Admission weight 
+132.9 kg, dry weight 125.7 BNP 1400 on admission down to 569 
+prior to discharge. Missing 2 lasix doses prior to admission may 
+have been trigger.
+- Discharge with: Torsemide 40 mg PO daily 
+- metoprolol succinate 300 mg daily
+- TTE showed preserved EF (>55%)
+
+#Afib w/ RVR: ___ be due to acute CHF exacerbation plus missing 
+___ home metoprolol dose. S/p 5 mg IV metop x 2 in the ED and 
+additional 25mg po metop once on the floor.
+- Metoprolol succinate as above
+- Continued warfarin (minor dose adjustment)
+
+#CAD: MI at ___, s/p PCI with DES to pLAD in ___ (cardiac cath 
+showed collateralized total occlusion of the RCA and an 80% 
+proximal LAD lesion). Currently no CP. EKG unchanged from prior. 
+Trop neg x 1.
+- Continue atorva 80, ASA 81, metop as above
+
+#DM2: HbA1c 6.8% in ___. 
+- Held metformin, will restart on discharge
+- SSI while in house
+
+#HTN: Home lisin/HCTZ discontinued for ___ in ___. Given 
+preserved EF, it is not necessary that he be on an ACE for heart 
+failure.
+- Continued metop as above
+
+#Psoriasis:
+- Continued betamethasone cream
+
+TRANSITIONAL ISSUES:
+[ ] Patient will need f/u labs within 1 week - Rx for ___ - 
+to monitor Cr (slightly elevated prior to d/c)
+[ ] Patient needs close cardiology follow up for further 
+titrating of home diuretics
+[ ] INR on ___, followed by ___ ACMS
+ 
+
+###RESPONSE: HFpEF {Heart failure with normal ejection fraction}, CAD {Coronary arteriosclerosis}, 3-vessel 
+disease {Triple vessel disease of the heart}, DES {Endovascular insertion of drug eluting stent}, dyspnea {Dyspnea}, worsening {Patient's condition worsened}, edema {Edema}, diuresed {Diuretic therapy}, lasix {Diuretic therapy}, ECHO {Echocardiography}, ECHO {Echocardiography}, WEIGHT {Weight finding}, chronic decompensated diastolic CHF {Heart failure with normal ejection fraction}, weight {Weight finding}, weight {Weight finding}, BNP {Brain natriuretic peptide measurement}, lasix {Diuretic therapy}, TTE {Transthoracic echocardiography}, Afib w/ RVR {Atrial fibrillation with rapid ventricular response}, acute CHF exacerbation {Acute exacerbation of chronic congestive heart failure}, warfarin {Warfarin therapy}, CAD {Coronary arteriosclerosis}, PCI {Percutaneous coronary intervention}, DES {Endovascular insertion of drug eluting stent}, cardiac cath {Cardiac catheterization}, total occlusion {Complete obstruction}, RCA {Right coronary artery structure}, proximal LAD {Structure of proximal portion of anterior descending branch of left coronary artery}, lesion {Lesion}, EKG {Electrocardiographic procedure}, unchanged {Patient condition unchanged}, Trop {Troponin measurement}, ASA {Administration of aspirin}, DM2 {Diabetes mellitus type 2}, HbA1c {Hemoglobin A1c measurement}, Held {Recommendation to stop drug treatment}, restart {Restart of medication}, SSI {Sliding scale insulin regime}, HTN {Hypertensive disorder, systemic arterial}, discontinued {Recommendation to stop drug treatment}, heart 
+failure {Heart failure}, labs {Laboratory test}, monitor {Monitoring for signs and symptoms of infection}, elevated {Serum creatinine above reference range}, cardiology {Cardiology service}, follow up {Follow-up arranged}, diuretics {Diuretic therapy}, INR {Calculation of international normalized ratio}"
+"###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. Metoprolol Tartrate 50 mg PO BID 
+2. MetFORMIN (Glucophage) 1000 mg PO BID 
+3. Warfarin ___ mg PO DAILY16 
+4. Furosemide 40 mg PO DAILY 
+5. Multivitamins 1 TAB PO DAILY 
+6. Nitroglycerin SL 0.4 mg SL Q5MIN:PRN chest pain 
+7. Aspirin 81 mg PO DAILY 
+8. Atorvastatin 80 mg PO QPM 
+9. Betamethasone Dipro 0.05% Cream 1 Appl TP BID 
+10. Albuterol Inhaler 2 PUFF IH Q6H:PRN sob 
+
+ 
+Discharge Medications:
+1. Outpatient Lab Work
+Please check CHEM-7 (ICD-9 428.30)
+and INR (ICD-9 427.31)
+Fax to ___, MD at ___
+2. Aspirin 81 mg PO DAILY 
+3. Atorvastatin 80 mg PO QPM 
+4. Betamethasone Dipro 0.05% Cream 1 Appl TP BID 
+5. Nitroglycerin SL 0.4 mg SL Q5MIN:PRN chest pain 
+6. Warfarin 10 mg PO 4X/WEEK (___) 
+RX *warfarin 5 mg 2 tablet(s) by mouth every ___, 
+___ Disp #*80 Tablet Refills:*0
+7. Warfarin 7.5 mg PO 3X/WEEK (___) 
+RX *warfarin 2.5 mg 3 tablet(s) by mouth every ___, 
+___ Disp #*30 Tablet Refills:*0
+8. Metoprolol Succinate XL 300 mg PO DAILY 
+RX *metoprolol succinate 100 mg 3 tablet(s) by mouth daily Disp 
+#*90 Tablet Refills:*0
+9. Torsemide 40 mg PO DAILY 
+RX *torsemide 20 mg 2 tablet(s) by mouth daily Disp #*60 Tablet 
+Refills:*0
+10. Albuterol Inhaler 2 PUFF IH Q6H:PRN sob 
+11. MetFORMIN (Glucophage) 1000 mg PO BID 
+12. Multivitamins 1 TAB PO DAILY 
+ 
+
+###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:
+acute on chronic diastolic heart failure exacerbation
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: acute on chronic diastolic heart failure {Acute on chronic diastolic heart failure}, Mental Status {Neurological mental status determination}, Clear {Normal state of mind}, Alert {Mentally alert}, interactive {Does communicate}, 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 Mr. ___,
+
+You were admitted to the hospital for leg swelling and shortness 
+of breath. We found out that you had a heart failure 
+exacerbation. To treat this, we gave you a medicine (Lasix) to 
+make you pee and closely monitored your fluid status and your 
+labs. Your swelling and breathing improved and your labs showed 
+that your heart was recovering. We did an echocardiogram 
+(ultrasound of the heart) which showed that there had not been 
+any changes since your previous one.
+
+We changed some of your heart failure medications. You should 
+review your medication list carefully. You should weigh yourself 
+every day and call your doctor if your weight goes up by more 
+than 3 lbs. You also need to have labs checked within 1 week 
+(ideally on ___. On ___, you should call your 
+primary care doctor or cardiologist to schedule an appointment 
+within a week. Their numbers are below.
+
+It was a pleasure taking care of you.
+
+Sincerely,
+Your ___ Care Team
+ 
+
+###RESPONSE: leg swelling {Leg swelling symptom}, shortness 
+of breath {Dyspnea}, heart failure {Heart failure}, Lasix {Diuretic therapy}, monitored {Monitoring procedure}, labs {Laboratory test}, swelling {Swelling}, breathing {Difficulty breathing}, improved {Patient's condition improved}, labs {Laboratory test}, heart {Heart structure}, echocardiogram {Echocardiography}, ultrasound {Echocardiography}, heart {Heart structure}, changed {Change of medication}, heart failure {Heart failure}, medications {Administration of drug or medicament}, medication {Administration of drug or medicament}, weight goes up {Weight increased}, labs {Laboratory test}, checked {Monitoring procedure}, primary care {Primary care management}"
+"###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: 
+Penicillins
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Shortness of breath
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: Penicillins {Allergy to penicillin}, Shortness of breath {Dyspnea}"
+"###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:
+This is a ___ year old male with history of HTN, HLD, CAD, CHF 
+(EF 55-60% in ___, Diabetes on insulin, hx of CVA, recently 
+diagnosed pericardial effusion, p/w acute-onset altered mental 
+status, unsteadiness, urinary incontinence today. 
+
+Patient's son is the one who provided the history.  Patient's 
+son states that patient was sleeping in this morning, and much 
+less responsive. He reports that patient woke up with a blank 
+stare.  Patient was also acutely noted to be incontinent of 
+urine once.  His son reports that he was unable to walk around 
+steadily, and was having difficulty hold onto the walls/walker 
+to get around. Since then, he has been much less verbal with 
+difficulty with speech. At home, he was also endorsing some 
+L-sided abdominal and back pain. Son denies any falls or 
+headstrike. Son denies any fevers/chills; He does endorse some 
+wheezing but no chest pain, no 
+nausea/vomiting/diarrhea/constipation, no new swelling or focal 
+weakness anywhere aside from today's episode of generalized 
+weakness and unsteadiness on his feet. Of note, patient is on 
+Plavix. 
+
+In the ED, initial vitals: 99.4 102 186/90 15 98%  
+Labs were signficant for potassium of 5.3, but sample was 
+hemolyzed. Creatinine was 3.7 from baseline 1.8. pO2 from venous 
+O2 sats were 25. Patient triggered for shortness of breath. At 
+the time he was shaking, tachycardic to 100s; 94% on RA; placed 
+on NRB with improvement to 100%; rhonchi on L > R. Portable CXR 
+showing increased fluid overload. Patient was given Vancomycin 
+1g, Cefepime 1g, albuterol/ipratropium nebs, furosemide 40mg, 
+tylenol ___, 1L NS.
+
+On transfer, vitals were: 101.8 105 161/87 33 100% bipap   
+
+On arrival to the MICU, patient was on BiPap.  Patient's son 
+reports that his mental status is back to baseline.  He also 
+reports that his grandson had a URI in the last week.  Patient's 
+lasix dose was also decreased by half to 20mg last month.
+
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, HLD {Hyperlipidemia}, CAD {Coronary arteriosclerosis}, CHF {Congestive heart failure}, Diabetes {Diabetes mellitus}, CVA {Cerebrovascular accident}, pericardial effusion {Pericardial effusion}, altered mental 
+status {Altered mental status}, unsteadiness {General unsteadiness}, urinary incontinence {Urinary incontinence}, sleeping {Asleep}, less responsive {Slowness and poor responsiveness}, incontinent of 
+urine {Urinary incontinence}, unable to walk {Unable to walk}, verbal {Vocal and verbal behavior finding}, difficulty with speech {Has difficulty with speech}, L-sided abdominal {Left sided abdominal pain}, back pain {Backache}, falls {Falls}, headstrike {Injury of head}, fevers {Fever}, chills {Chill}, wheezing {Wheezing}, chest pain {Chest pain}, nausea/vomiting/diarrhea {Nausea, vomiting and diarrhea}, constipation {Constipation}, swelling {Swelling}, weakness {Asthenia}, weakness {Asthenia}, unsteadiness {General unsteadiness}, feet {Foot structure}, vitals {Vital signs finding}, potassium {Potassium measurement}, Creatinine {Creatinine measurement}, baseline {Baseline state}, venous {Venous structure}, O2 sats {Finding of oxygen saturation}, shortness of breath {Dyspnea}, shaking {Tremor}, tachycardic {Tachycardia}, placed {Implantation procedure}, NRB {Oxygen administration by mask}, improvement {Patient's condition improved}, rhonchi {Wheeze - rhonchi}, L {Left thorax structure}, R {Right thorax structure}, CXR {Plain chest X-ray}, fluid overload {Hypervolemia}, vitals {Vital signs finding}, bipap {Bilevel positive airway pressure titration}, BiPap {Bilevel positive airway pressure titration}, mental status {Mental state finding}, baseline {Baseline state}, URI {Upper respiratory infection}, lasix {Diuretic 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:
+- Stroke in ___
+- Hypertension, medication changes as above.  His blood pressure
+at home at been 150-180 systolic in ___, but not
+recently measuring.  Had been ~ 153/82 on ___ before
+hydralazine increased. 
+- Hypercholesterolemia, on Statin
+- Diabetes, on insulin (Lantus and Humalog SS)
+- Orthostasis and possible convulsive syncope, as above
+- Toes amputated on right owing to diabetes
+- Cataracts - no surgery
+- Diabetic neuropathy, on gabapentin 100/300
+
+ 
+
+###RESPONSE: Stroke {Cerebrovascular accident}, Hypertension {Hypertensive disorder, systemic arterial}, medication changes {Change of medication}, blood pressure {On treatment for hypertension}, Hypercholesterolemia {Hypercholesterolemia}, Diabetes {Diabetes mellitus}, Orthostasis {Orthostatic hypotension}, convulsive syncope {Convulsive syncope}, Toes amputated {Amputation of toe}, right {Structure of right foot}, diabetes {Diabetes mellitus}, Cataracts {Cataract}, surgery {Surgical procedure}, Diabetic neuropathy {Neuropathy due to diabetes mellitus}"
+"###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:
+Possible stroke in parents, one definitely diabetic.
+
+ 
+
+###RESPONSE: stroke {Cerebrovascular accident}, diabetic {Diabetes mellitus}"
+"###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:
+Vitals- T:100.8 BP:185/78 P:92 R: 18 O2: 100 on 2L NC  
+GENERAL: Alert, oriented to name and place. No acute distress  
+HEENT: Sclera anicteric, MMM, oropharynx clear  
+NECK: supple, JVP not elevated, no LAD  
+LUNGS: Bilateral crackles 
+CV: Regular rate and rhythm, normal S1 S2, no murmurs, rubs, 
+gallops  
+ABD: soft, non-tender, distended c/w obesity, bowel sounds 
+present, no rebound tenderness or guarding, no organomegaly  
+EXT: Amputated toes  
+NEURO: Power ___ bilaterally in both lower and upper 
+extremities. Dyspraxic when trying to follow commands with left 
+upper extremity. Cn II-XII grossly intact.  
+
+DISCHARGE PHYSICAL EXAM:
+VS - 98.0 157/70 70 18 100% on RA
+GENERAL: Alert, oriented to name and place. No acute distress  
+HEENT: Sclera anicteric, MMM, oropharynx clear, swelling of the 
+eye noted  
+NECK: supple, JVP not elevated, no LAD  
+LUNGS: Crackles appreciated occasionally in bilateral lung 
+fields, good air movement, breathing comfortably without use of 
+accessory muscles  
+CV: Regular rate and rhythm, normal S1 S2, no murmurs, rubs, 
+gallops  
+ABD: soft, non-tender, distended c/w obesity, bowel sounds 
+present, no rebound tenderness or guarding, no organomegaly  
+EXT: Amputated toes, patient has an erythematous rash on the 
+back which is not pruritic, not spreading  
+NEURO: Power ___ bilaterally in both lower and upper 
+extremities. Dyspraxic when trying to follow commands with left 
+upper extremity. Cn II-XII grossly intact.  
+
+ 
+
+###RESPONSE: PHYSICAL EXAM {Physical examination procedure}, Vitals {Vital signs finding}, BP {Blood pressure finding}, NC {Normal head}, GENERAL {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, place {Oriented to place}, No acute {No abnormality detected}, distress {Distress}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, MMM {Moist oral mucosa}, oropharynx clear {Pharynx normal}, NECK {Physical examination procedure}, supple {Normal movement of neck}, JVP not elevated {Normal jugular venous pressure}, LAD {Lymphadenopathy}, LUNGS {Examination of respiratory system}, crackles {Respiratory crackles}, 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<}, murmurs {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, ABD {Examination of abdomen}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, distended {Swollen abdomen}, obesity {Obesity}, bowel sounds 
+present {Normal bowel sounds}, rebound {Rebound tenderness}, tenderness {Tenderness}, guarding {Abdominal guarding}, organomegaly {Abdominal organomegaly}, EXT {Examination of limb}, Amputated toes {Amputation of toe}, NEURO {Neurological examination}, lower {Lower limb structure}, upper 
+extremities {Upper limb structure}, Dyspraxic {Dyspraxia}, follow commands {Normal motor response to command}, left 
+upper extremity {Structure of left upper limb}, grossly intact {Normal nervous system function}, VS {Vital signs finding}, RA {Breathing room air}, RA {Breathing room air}, Alert {Mentally alert}, oriented to name {Oriented to person}, place {Oriented to place}, No acute {No abnormality detected}, distress {Distress}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, MMM {Moist oral mucosa}, oropharynx clear {Pharynx normal}, swelling {Swelling}, eye {Structure of eye proper}, NECK {Physical examination procedure}, supple {Normal movement of neck}, JVP not elevated {Normal jugular venous pressure}, LAD {Lymphadenopathy}, LUNGS {Examination of respiratory system}, Crackles {Respiratory crackles}, lung 
+fields {Structure of lung field}, good {No abnormality detected}, breathing comfortably {Breathing easily}, accessory muscles {Accessory skeletal muscle}, CV {Cardiovascular physical examination}, Regular rate and rhythm {Normal heart rate}, normal S1 S2 {Heart sounds normal}, murmurs {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, ABD {Examination of abdomen}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, distended {Swollen abdomen}, obesity {Obesity}, bowel sounds 
+present {Normal bowel sounds}, rebound tenderness {Rebound tenderness}, guarding {Abdominal guarding}, organomegaly {Abdominal organomegaly}, EXT {Examination of limb}, Amputated toes {Amputation of toe}, erythematous rash {Erythematous rash}, back {Structure of back of trunk}, pruritic {Pruritic disorder of skin}, NEURO {Neurological examination}, lower {Lower limb structure}, upper 
+extremities {Upper limb structure}, Dyspraxic {Dyspraxia}, follow commands {Normal motor response to command}, left 
+upper extremity {Structure of left upper limb}, Cn II-XII grossly intact {Normal central nervous system}"
+"###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:
+
+___ 03:25PM   PLT COUNT-105*
+___ 03:25PM   NEUTS-81.3* LYMPHS-10.7* MONOS-7.3 EOS-0.5 
+BASOS-0.1
+___ 03:25PM   WBC-8.7 RBC-3.25* HGB-9.8* HCT-28.1* MCV-87 
+MCH-30.2 MCHC-34.9 RDW-15.2
+___ 03:25PM   ALBUMIN-3.5 CALCIUM-9.2 PHOSPHATE-3.0 
+MAGNESIUM-2.1
+___ 03:25PM   CK-MB-1 cTropnT-<0.01 ___
+___ 03:25PM   LIPASE-22
+___ 03:25PM   ALT(SGPT)-16 AST(SGOT)-34 ALK PHOS-52 TOT 
+BILI-0.5
+___ 03:25PM   estGFR-Using this
+___ 03:25PM   GLUCOSE-147* UREA N-47* CREAT-3.7*# 
+SODIUM-139 POTASSIUM-5.3* CHLORIDE-105 TOTAL CO2-24 ANION GAP-15
+___ 03:38PM   ___ TO  PTT-UNABLE TO  ___ 
+TO 
+___ 03:40PM   LACTATE-1.2
+___ 04:45PM   ___ PTT-29.9 ___
+___ 05:25PM URINE  RBC-4* WBC-1 BACTERIA-FEW YEAST-NONE 
+EPI-0
+___ 05:25PM URINE  BLOOD-SM  NITRITE-NEG PROTEIN-300 
+GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-6.0 
+LEUK-NEG
+___ 05:25PM URINE  COLOR-Yellow APPEAR-Hazy SP ___
+___ 05:25PM URINE  UHOLD-HOLD
+___ 05:25PM URINE  HOURS-RANDOM UREA N-692 CREAT-121 
+SODIUM-57 POTASSIUM-37 CHLORIDE-49
+___ 07:35PM OTHER BODY FLUID  FluAPCR-NEGATIVE 
+FluBPCR-NEGATIVE
+___ 08:04PM   O2 SAT-31
+___ 08:04PM   ___ PO2-25* PCO2-51* PH-7.30* TOTAL 
+CO2-26 BASE XS--2
+
+___ CXR:  
+Mild pulmonary edema, without pleural effusions
+.  
+___ CXR:  
+Cardiomegaly with pulmonary edema, progressed since prior study 
+dated ___ CT head:  
+No acute intracranial abnormality  
+
+___ CT abdomen:  
+1. Small bilateral layering at nonhemorrhagic pleural effusions, 
+right greater than left.  
+2. Moderate diverticular disease of the sigmoid colon without 
+evidence of diverticulitis.  
+EKG: rate 97, sinus, 1st degree A-V block (PR 226ms) otherwise 
+normal intervals, normal axis; ___ ST-T wave changes, 
+non-specific; TWI in I and avL no longer noted (since comparison 
+___  
+
+___: Renal U/S:
+IMPRESSION:  
+5 mm nonobstructing left lower pole renal stone and a sub cm 
+left lower pole simple renal cyst. Otherwise, normal renal 
+ultrasound. 
+
+ 
+
+###RESPONSE: NEUTS {Neutrophil count}, LYMPHS {Lymphocyte count}, MONOS {Monocyte count}, EOS {Eosinophil count}, 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}, ALBUMIN {Albumin measurement}, CALCIUM {Blood calcium measurement}, cTropnT {Troponin T cardiac measurement}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, PHOS {Phosphate, total measurement}, TOT 
+BILI {Bilirubin, total measurement}, GLUCOSE {Glucose measurement, blood}, CREAT {Creatinine measurement}, POTASSIUM {Potassium measurement}, CHLORIDE {Chloride measurement, blood}, TOTAL CO2 {Blood total carbon dioxide (calculated)}, ANION GAP {Anion gap measurement}, PTT {Partial thromboplastin time, activated}, PTT {Partial thromboplastin time, activated}, URINE {Urine culture}, RBC {Red blood cell count}, WBC {White blood cell count}, AST {Aspartate aminotransferase measurement}, PROTEIN {Measurement of protein in urine}, KETONE {Urinalysis, acetone or ketone bodies measurement}, BILIRUBIN {Bilirubin measurement, urine}, PH {pH measurement}, URINE {Urine culture}, COLOR {Color finding}, URINE {Urine culture}, URINE {Urine culture}, CREAT {Creatinine measurement}, POTASSIUM {Potassium measurement}, CHLORIDE {Chloride measurement, blood}, O2 SAT {Oxygen saturation measurement}, PH {pH measurement}, CXR {Plain chest X-ray}, Mild {Symptom mild}, edema {Edema}, pleural effusions {Pleural effusion}, CXR {Plain chest X-ray}, Cardiomegaly {Cardiomegaly}, edema {Edema}, No acute {No abnormality detected}, intracranial {Intracranial structure}, abnormality {No abnormality detected}, nonhemorrhagic {Hemorrhage}, pleural effusions {Pleural effusion}, right {Structure of right side of abdomen}, left {Structure of left side of abdomen}, Moderate {Symptom moderate}, disease {Disease}, sigmoid colon {Sigmoid colon structure}, diverticulitis {Diverticulitis}, EKG {Electrocardiographic procedure}, rate {Finding of heart rate}, sinus {Sinus rhythm}, 1st degree A-V block {First degree atrioventricular block}, normal {No abnormality detected}, intervals {Finding of electrocardiogram waveform}, normal {No abnormality detected}, axis {Electrocardiographic axis finding}, ST-T wave changes {Electrocardiographic ST segment changes}, TWI {Inverted T wave}, nonobstructing {Obstruction}, left lower pole renal {Structure of lower pole of left kidney}, stone {Kidney stone}, left lower pole {Structure of lower pole of left kidney}, simple renal cyst {Simple renal cyst}, normal {No abnormality detected}, renal 
+ultrasound {Echography of kidney}"
+"###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 HTN, HLD, CAD, dCHF 
+(EF 55-60% in ___, Diabetes on insulin, hx of CVA, recently 
+diagnosed pericardial effusion, p/w acute-onset altered mental 
+status, unsteadiness, urinary incontinence found to also be in 
+respiratory distress.
+
+#RESPIRATORY DISTRESS: Likely ___ flash pulmonary edema. Patient 
+being resuscitated with fluid and was also very hypertensive in 
+the ED to 180s systolic. From at___ notes, diuretics were also 
+decreased to 20mg which could have predisposed him to having an 
+episode of flash pulmonary edema. BNP on arrival was in the 
+11000s favoring acute diastolic CHF exacerbation. Patient was 
+placed on fluid restriction and diuresed with 40mg IV lasix. 
+However patient was also febrile to 101 in the ED and has had hx 
+of prior stroke, so there was some concern for aspiration. He 
+was therefore covered broadly with vanc/cefepime/flagyl (flagyl 
+added given concern for aspiration) but these antibiotics were 
+discontinued after a few days given lack of clinical evidence of 
+pneumonia. The patient's shortness of breath improved with 
+diuresis alone and he never complained of cough, had an elevated 
+WBC count, or was febrile after being admitted. An echo was 
+performed which compared favorably with his prior echo in ___ 
+with no changes in ejection fraction.
+
+#ALTERED MENTAL STATUS: Unclear etiology. Patient does have hx 
+of stroke but CT head was negative for  acute intracranial 
+process.  Given urinary incontinence, gait instability, normal 
+pressure hydrocephalus is also on differential but no prominence 
+of ventricles on CT head. Infectious etiology also on 
+differential given fevers in setting of AMS.  Patient could have 
+also suffered a seizure given urinary incontinence although no 
+prior hx of seizures.  Infectious work up sent off which came 
+back negative.  Patient was back to baseline upon arrival to the 
+ICU and his mental status was stable and at his baseline 
+throughout admission. The most likely etiology of his acute 
+mental status decompensation is pulmonary edema and resulting 
+respiratory distress.  
+
+#Acute on chronic kidney disease: Patient had an increase from 
+his baseline creatinine of 3.3 to 4.1 which trended back down to 
+3.7. CKD thought to be due to worsening DM. Most likely etiology 
+is pre-renal due to to infection/dehydration. His creatinine was 
+trended daily and a renal ultrasound was negative for 
+obstruction or hydronephrosis.  
+
+#CHF: Patient has hx of dCHF. Echo on this admission reveals 
+preserved EF without new regional wall motion abnormalities when 
+compared with that from ___. Fluid restriction to 1.5L and 
+2g Na diet were employed with daily weights and strict ins and 
+outs recorded. His metoprolol 100 qdaily was increased to 150 
+qdaily for improved BP control. 
+
+#CAD: Patient's last cath was in ___ which was negative. ___ 
+cath showed moderate single vessel disease and was advised to be 
+medically managed. His home aspirin, statin, and metprolol were 
+continued while he was hospitalized.
+
+#HX OF STROKE: Patient has suffered stroke in the past and has 
+been on dual antiplatelet therapy since then. His home plavix 
+and aspirin were continued. 
+
+#HYPERTENSION: Hypertensive to 180s systolic on admission. Goal 
+BP for this elderly gentleman is 160s systolic, will attempt to 
+control BP in light of flash pulmonary edema on admission. His 
+home hydralazine and metoprolol were continued, and his 
+metporolol dose was increased to provide better control of his 
+blood pressures at home.  
+  
+#DM - Stable, patient's home lantus regimen was continued with 
+additional insulin sliding scale while hospitalized.
+
+TRANSITIONAL ISSUES: 
+-The patient had a mild erythematous rash on his back which he 
+did not find bothersome and is most likely due to a heat rash vs 
+mild allergic reaction. He was treated with ceterizine and was 
+asymptomatic. Please ensure this rash clears.
+
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, HLD {Hyperlipidemia}, CAD {Coronary arteriosclerosis}, dCHF {Diastolic heart failure}, Diabetes {Diabetes mellitus}, CVA {Cerebrovascular accident}, pericardial effusion {Pericardial effusion}, altered mental 
+status {Altered mental status}, unsteadiness {General unsteadiness}, urinary incontinence {Urinary incontinence}, respiratory distress {Respiratory distress}, RESPIRATORY DISTRESS {Respiratory distress}, flash pulmonary edema {Acute pulmonary edema}, resuscitated {Resuscitation}, fluid {Administration of intravenous fluids}, hypertensive {Hypertensive disorder, systemic arterial}, diuretics {Diuretic therapy}, flash pulmonary edema {Acute pulmonary edema}, BNP {Brain natriuretic peptide measurement}, CHF exacerbation {Exacerbation of congestive heart failure}, fluid restriction {Fluid restriction}, diuresed {Diuretic therapy}, lasix {Diuretic therapy}, febrile {Fever}, stroke {Cerebrovascular accident}, aspiration {Aspiration pneumonia}, aspiration {Aspiration pneumonia}, antibiotics {Antibiotic therapy}, pneumonia {Pneumonia}, shortness of breath {Dyspnea}, improved {Patient's condition improved}, diuresis {Diuresis}, cough {Cough}, elevated 
+WBC count {Blood leukocyte number above reference range}, febrile {Fever}, echo {Echocardiography}, echo {Echocardiography}, ALTERED MENTAL STATUS {Altered mental status}, stroke {Cerebrovascular accident}, CT head {Computed tomography of head}, negative {No abnormality detected}, intracranial {Intracranial structure}, urinary incontinence {Urinary incontinence}, gait instability {Unsteady when walking}, normal 
+pressure hydrocephalus {Normal pressure hydrocephalus}, ventricles {Brain ventricle structure}, CT head {Computed tomography of head}, Infectious {Infectious disease}, fevers {Fever}, AMS {Altered mental status}, seizure {Seizure}, urinary incontinence {Urinary incontinence}, seizures {Seizure}, Infectious {Infectious disease}, negative {No abnormality detected}, baseline {Baseline state}, ICU {Admission to intensive care unit}, mental status {Altered mental status}, stable {Patient's condition stable}, baseline {Baseline state}, mental status {Altered mental status}, decompensation {Decompensation}, pulmonary edema {Pulmonary edema}, respiratory distress {Respiratory distress}, Acute on chronic kidney disease {Acute-on-chronic renal failure}, baseline {Baseline state}, creatinine {Creatinine measurement}, CKD {Chronic kidney disease}, DM {Diabetes mellitus}, pre-renal {Pre-renal acute kidney injury}, infection {Infectious disease}, dehydration {Dehydration}, creatinine {Creatinine measurement}, renal ultrasound {Echography of kidney}, negative {No abnormality detected}, obstruction {Obstruction}, hydronephrosis {Hydronephrosis}, CHF {Congestive heart failure}, dCHF {Diastolic heart failure}, Echo {Echocardiography}, without new regional wall motion abnormalities {Normal ventricular wall motion}, Fluid restriction {Fluid restriction}, diet {Dietary finding}, weights {Weight finding}, improved {Patient's condition improved}, BP {Blood pressure finding}, CAD {Coronary arteriosclerosis}, cath {Cardiac catheterization}, negative {No abnormality detected}, cath {Cardiac catheterization}, single vessel disease {Single coronary vessel disease}, aspirin {Administration of aspirin}, STROKE {Cerebrovascular accident}, stroke {Cerebrovascular accident}, antiplatelet therapy {Platelet aggregation inhibitor therapy}, aspirin {Administration of aspirin}, HYPERTENSION {Hypertensive disorder, systemic arterial}, Hypertensive {Hypertensive disorder, systemic arterial}, systolic {Blood pressure finding}, BP {Blood pressure finding}, systolic {Blood pressure finding}, BP {Blood pressure finding}, flash pulmonary edema {Acute pulmonary edema}, blood pressures {On treatment for hypertension}, DM {Diabetes mellitus}, Stable {Patient's condition stable}, regimen {Therapeutic regimen}, insulin sliding scale {Sliding scale insulin regime}, mild {Symptom mild}, erythematous rash {Erythematous rash}, back {Structure of back of trunk}, heat rash {Prickly heat}, mild {Symptom mild}, allergic reaction {Allergic reaction}, asymptomatic {Asymptomatic}, rash {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: Medications on Admission:
+The Preadmission Medication list is accurate and complete.
+1. Amlodipine 10 mg PO DAILY 
+2. Aspirin 325 mg PO DAILY 
+3. Atorvastatin 40 mg PO DAILY 
+4. Clopidogrel 75 mg PO DAILY 
+5. Gabapentin 100 mg PO DAILY 
+6. Gabapentin 300 mg PO HS 
+7. Latanoprost 0.005% Ophth. Soln. 1 DROP BOTH EYES HS 
+8. Metoprolol Succinate XL 100 mg PO DAILY 
+9. HydrALAzine 25 mg PO TID 
+10. Glargine 20 Units Breakfast
+11. Calcitriol 0.25 mcg PO EVERY OTHER DAY 3x/weekly 
+12. Furosemide 20 mg PO DAILY 
+13. Vitamin D 1000 UNIT PO DAILY 
+14. Nitroglycerin SL 0.4 mg SL Q5MIN:PRN chest pain 
+15. Acetaminophen 650 mg PO Q12H:PRN pain, fever 
+
+ 
+Discharge Medications:
+1. Acetaminophen 650 mg PO Q12H:PRN pain, fever 
+2. Amlodipine 10 mg PO DAILY 
+3. Aspirin 325 mg PO DAILY 
+4. Atorvastatin 40 mg PO DAILY 
+5. Calcitriol 0.25 mcg PO EVERY OTHER DAY 3x/weekly 
+6. Clopidogrel 75 mg PO DAILY 
+7. Gabapentin 100 mg PO DAILY 
+8. Gabapentin 300 mg PO HS 
+9. HydrALAzine 25 mg PO TID 
+10. Glargine 20 Units Breakfast
+11. Metoprolol Succinate XL 150 mg PO DAILY 
+RX *metoprolol succinate 50 mg 3 tablet(s) by mouth qdaily Disp 
+#*90 Tablet Refills:*0
+12. Latanoprost 0.005% Ophth. Soln. 1 DROP BOTH EYES HS 
+13. Nitroglycerin SL 0.4 mg SL Q5MIN:PRN chest pain 
+14. Vitamin D 1000 UNIT PO DAILY 
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Primary Diagnosis: Acute diastolic congestive heart failure 
+exacerbation
+
+Secondary Diagnosis: Diabetes mellitus, coronary artery disease
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, diastolic congestive heart failure {Diastolic heart failure}, Diabetes mellitus {Diabetes mellitus}, coronary artery disease {Coronary arteriosclerosis}, Mental Status {Neurological mental status determination}, Clear {No abnormality detected}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, interactive {Does communicate}, 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. ___,
+
+It was a pleasure caring for you at the ___ 
+___. You were admitted because you were having 
+shortness of breath and fevers. We determined that your 
+shortness of breath was likely due to an acute exacerbation of 
+your heart failure and haveing too much fluid in your lungs. We 
+gave you a medication to help you remove the fluid from your 
+lungs. Your kidney function was also slightly worse than usual 
+while you were admitted. We closely followed it while you were 
+hospitalized and it returned to what is normal for you. We also 
+noticed that your blood pressure was somewhat high while you 
+were here, so we increased one of your blood pressure 
+medications (metoprolol). This is noted on the medication list 
+you will be given at discharge.
+
+Sincerely,
+
+Your ___ Team
+ 
+
+###RESPONSE: shortness of breath {Dyspnea}, fevers {Fever}, shortness of breath {Dyspnea}, acute exacerbation {Acute exacerbation of chronic obstructive airways disease}, heart failure {Heart failure}, fluid in your lungs {Pleural effusion}, medication {Patient medication education}, fluid {Administration of intravenous fluids}, lungs {Lung structure}, kidney {Kidney structure}, normal {No abnormality detected}, blood pressure {Blood pressure finding}, blood pressure 
+medications {Antihypertensive therapy}, medication {Patient medication education}"
+"###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: 
+No Known Allergies / Adverse Drug Reactions
+ 
+Attending: ___.
+ 
+Chief Complaint:
+presyncope (feeling faint, acute vision changes, palpitations, 
+tightness in his chest)
+ 
+Major Surgical or Invasive Procedure:
+none
+
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, presyncope {Near syncope}, feeling faint {Feeling faint}, palpitations {Palpitations}, chest {Thoracic 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: History of Present Illness:
+___ F h/o presyncopal episodes the in the last 2 days, 
+associated with dyspnea as well as diaphoresis. Patient also 
+reports increased shortness of breath on exertion.
+
+Two days prior to admission, the patient was standing in the 
+bathroom (no full bladder, not moving bowels) when she 
+experienced narrowing of her visual fields, disequilibium (not 
+vertiginous without nausea) sudden in onset. This was followed 
+by a tightening in the throat, diaphoresis, and heart 
+palpaitations. This resolved over the course of ___ minutes 
+after she sat down. There was no hearing involvement or loss of 
+consciousness. This was witness by her husband, who thought she 
+looked pale.
+
+The day prior to admission, she had a second, similar episode 
+while standing in the kitchen. This resolved in approximately 15 
+minutes. Again, this did not occur after standing from sitting 
+nor was there any obvious vagal trigger. She was not exerting 
+herself at the time. 
+
+Notably, she is not light-headed when she stands. She has had no 
+chest pain whatsoever. She describes one episode of questionable 
+DOE recently but has not had more than very mild limitation of 
+activity or swelling of the ankles. She denies orthopnea. She 
+has no cardiac history. She has no history of anxiety and the 
+episodes have not involved any feeling of impending doom/near 
+death.
+
+In the ED, initial vs were 97.6 60 192/88 16 98% RA.  Received 
+ASA 325, 1L NS, and labs were all unremarkable (CBC, Chem 7, 
+troponin-t, CK). EKG as well as initial troponin were negative 
+for any acute ischemic disease. Remainder of laboratory work was 
+reassuring. Her chest x-ray was normal for any acute 
+cardiopulmonary disease. This imaging did reveal a left humeral 
+enchondroma.
+
+The patient was high risk according to ___ Syncope Criteria, 
+she will be admitted to medicine for further evaluation of 
+possible arrhythmia, left ventricular outflow obstruction, ACS, 
+or other cardiac etiology. Patient denies any chest pain or 
+shortness of breath this time. Hemodynamically stable. Her VS 
+prior to admission were 58 156/64 13 98% RA Pain: 0.
+ 
+On arrival to the floor, patient reports feeling at her 
+baseline. She reported the above history and was hemodynamically 
+stable. 
+ 
+ 
+
+###RESPONSE: dyspnea {Dyspnea}, diaphoresis {Excessive sweating}, shortness of breath on exertion {Dyspnea on exertion}, standing {Orthostatic body position}, bladder {Urinary bladder structure}, moving bowels {Finding of defecation}, narrowing of her visual fields {Generalized visual field constriction}, disequilibium {Unsteady when standing}, nausea {Nausea}, throat {Structure of anterior portion of neck}, diaphoresis {Excessive sweating}, heart {Heart structure}, palpaitations {Palpitations}, loss of 
+consciousness {Loss of consciousness}, standing {Orthostatic body position}, standing {Orthostatic body position}, sitting {Sitting position}, chest pain {Chest pain}, ankles {Ankle region structure}, orthopnea {Orthopnea}, anxiety {Anxiety}, feeling of impending doom/ {Sense of impending doom}, unremarkable {No abnormality detected}, acute ischemic disease {Acute ischemic heart disease}, chest x-ray {Plain chest X-ray}, cardiopulmonary disease {Cor pulmonale}, imaging {Imaging}, enchondroma {Enchondroma}, Syncope {Syncope}, arrhythmia {Cardiac arrhythmia}, ACS {Acute coronary syndrome}, chest pain {Chest pain}, shortness of breath {Dyspnea}, Hemodynamically stable {Hemodynamically stable}, Pain {Pain}, hemodynamically 
+stable {Hemodynamically stable}"
+"###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
+-Varicose veins
+-Bilateral cataract removal
+-Laparoscopic gastric bypass (___)
+-Hiatal hernia s/p repair
+-Broke left arm/hand with crush injury? Surgical intervention 
+with external fixation
+-Varicose vein stripping (left leg)
+ 
+
+###RESPONSE: Hypertension {Hypertensive disorder, systemic arterial}, Hyperlipidemia {Hyperlipidemia}, Varicose veins {Venous varices}, Bilateral cataract removal {Extraction of cataract of bilateral eyes}, Laparoscopic gastric bypass {Laparoscopic bypass of stomach}, Hiatal hernia {Hiatal hernia}, repair {Surgical repair}, left arm {Left upper arm structure}, hand {Hand structure}, crush injury {Crushing injury}, Surgical intervention {Surgical procedure}, external fixation {External fixation of bone}, Varicose vein stripping {Varicose vein stripping}, left leg {Structure of left lower limb}"
+"###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:
+Brother has history of ""heart rhythm irregularities"" diagnosed 
+as a teenager because of an episode of syncope
+Mother deceased at age ___ of uterian cancer
+Father deceased at age ___ due to stroke
+
+ 
+
+###RESPONSE: heart rhythm irregularities {Irregular heart beat}, syncope {Syncope}, uterian cancer {Malignant neoplasm of uterus}, stroke {Cerebrovascular accident}"
+"###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 98.5 139/69 62 20 97% on RA
+GEN Alert, oriented, no acute distress  
+HEENT NCAT MMM EOMI sclera anicteric, OP clear  
+NECK supple, no JVD, no LAD  
+PULM Good aeration, CTAB no wheezes, rales, ronchi  
+CV RRR normal S1/S2, no mrg
+ABD soft, obese abdomen with normoactive bowel sounds, 
+nondistended, nontender with no rubs or gallops, with no obvious 
+hernia
+EXT WWP 2+ pulses palpable bilaterally, trace pretibial edema 
+bilaterally, with many varicose veins scattered across both legs
+NEURO Alert, fluent, linear, prompt, CNs2-12 intact save an 
+exotropia with positive cover/uncover (no diplopia), motor 
+function grossly normal, sensory function intact, no cerebellar 
+abnormalities, reflexes 1+ globally, gait deferred.
+SKIN no ulcers or lesions
+
+DISCHARGE PHYSICAL EXAM:
+afebrile, 100% RA
+Laying flat: 160/64 58
+Sitting: 160/70 57
+Standing: 173/84 ___
+GEN Pt is a very pleasant well nourished woman who is alert, 
+oriented, and in no acute distress. She is fully conversant, 
+speaking full sentences, without becoming short of breath. She 
+easily moves from the chair to the bed without assistence or 
+changes in breathing.
+HEENT NCAT MMM EOMI sclera anicteric, OP clear, permanent 
+eyebrow and eyeliner tattoos
+NECK supple, no JVD, no LAD
+PULM Good aeration, CTAB with scattered wheezes, rales, ronchi
+CV RRR normal S1/S2, no mrg
+ABD soft, obese abdomen with normoactive bowel sounds, 
+nondistended, nontender with no rubs or gallops, with no obvious 
+hernia
+EXT WWP 2+ pulses palpable bilaterally, trace pretibial edema 
+bilaterally, with many varicose veins scattered across both legs
+NEURO CNs2-12 intact, motor function grossly normal
+SKIN no ulcers or lesions 
+ 
+
+###RESPONSE: PHYSICAL EXAM {Physical examination procedure}, VS {Vital signs finding}, RA {Breathing room air}, GEN {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, distress {Distress}, HEENT {Physical examination procedure}, NC {Normal head}, MMM {Moist oral mucosa}, EOMI {Normal ocular motility}, sclera anicteric {White sclera}, OP clear {Pharynx normal}, supple {Normal movement of neck}, JVD {Jugular venous engorgement}, LAD {Lymphadenopathy}, PULM {Examination of respiratory system}, CTAB {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, ronchi {Wheeze - rhonchi}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, normal S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, ABD {Examination of abdomen}, soft {Abdomen soft}, obese abdomen {Obese abdomen}, normoactive bowel sounds {Normal bowel sounds}, nondistended {Normal abdominal contour}, nontender {Abdominal tenderness}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, hernia {Examination of limb}, WWP {Normal tissue perfusion}, edema {Edema}, varicose veins {Venous varices}, both legs {Both lower legs}, NEURO {Neurological examination}, Alert {Mentally alert}, exotropia {Exotropia}, diplopia {Diplopia}, motor 
+function grossly normal {Normal motor response to command}, reflexes {Normal reflex}, SKIN {Examination of skin}, ulcers {Ulcer}, lesions {Lesion}, RA {Breathing room air}, Sitting {Sitting position}, Standing {Orthostatic body position}, well nourished {Well nourished}, distress {Distress}, moves {Does move from lying to sitting}, sclera anicteric {White sclera}, eyebrow {Eyebrow structure}, tattoos {Tattoo of skin}, wheezes {Wheezing}, rales {Respiratory crackles}, ABD soft {Abdomen soft}, obese abdomen {Obese abdomen}, normoactive bowel sounds {Normal bowel sounds}, hernia {Herniated structure}, 2+ pulses palpable {Peripheral pulses normal}, edema {Edema}, varicose veins {Venous varices}, both legs {Both lower legs}, NEURO {Neurological examination}, motor function grossly normal {Normal motor response to command}, 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: Pertinent Results:
+Admission labs:
+___ 02:20PM   GLUCOSE-92 UREA N-16 CREAT-0.7 SODIUM-141 
+POTASSIUM-3.6 CHLORIDE-100 TOTAL CO2-30 ANION GAP-15
+___ 02:20PM   estGFR-Using this
+___ 02:20PM   NEUTS-49.8* ___ MONOS-4.5 EOS-4.0 
+BASOS-0.8
+___ 02:20PM   PLT COUNT-314
+___ 07:25AM BLOOD WBC-4.1 RBC-4.82 Hgb-15.0 Hct-44.9 MCV-93 
+MCH-31.1 MCHC-33.5 RDW-13.5 Plt ___
+___ 07:25AM BLOOD Glucose-95 UreaN-14 Creat-0.8 Na-144 
+K-4.1 Cl-101 HCO3-35* AnGap-12
+___ 02:01AM BLOOD CK-MB-3 cTropnT-<0.01
+___ 02:20PM BLOOD cTropnT-<0.01
+___ 02:20PM BLOOD CK(CPK)-181
+
+Imaging:
+Chest PA and Lateral (___)
+IMPRESSION: 
+1.  No acute chest abnormality. 
+2.  Chondroid matrix within the left humeral head likely 
+represents a benign entity such as enchondroma.  If there is 
+pain referable to this region, this could be better evaluated 
+with MRI to exclude a more aggressive chondroid lesion. 
+
+Carotid doppler study:
+ 
+Realtime evaluation of the carotid bifurcations shows no 
+significant plaque on 
+either side.  Peak systolic and end diastolic velocities are 
+unremarkable.  
+The ICA/CCA ratio is 1.2 on both sides.  The vertebral arteries 
+demonstrate 
+prograde flow. 
+  
+IMPRESSION:  Normal bilateral carotid Doppler.  No evidence of 
+plaque or 
+hemodynamically significant stenosis. 
+
+  
+Discharge labs:
+___ 07:25AM BLOOD WBC-4.1 RBC-4.82 Hgb-15.0 Hct-44.9 MCV-93 
+MCH-31.1 MCHC-33.5 RDW-13.5 Plt ___
+___ 07:25AM BLOOD Plt ___
+___ 07:25AM BLOOD Glucose-95 UreaN-14 Creat-0.8 Na-144 
+K-4.1 Cl-101 HCO3-35* AnGap-12
+___ 02:01AM BLOOD CK-MB-3 cTropnT-<0.01
+___ 07:25AM BLOOD Calcium-9.6 Phos-4.1 Mg-2.___ h/o HTN, HLD, and obesity s/p gastric bypass (___) who p/w 
+pre-syncope most consistent with vasovagal. 
+ 
+ACTIVE ISSUES:
+# Presyncope: Her episodes have some characteristics of 
+vasovagal episodes. She describes prodromal symptoms consistent 
+with those preceeding a neurocardiogenic/vasovagal episode, 
+including diaphoresis, weakness, transient vision loss, and 
+increased heart rate. Episodes occurred while patient was 
+standing, not with exercise or time of situational or emotional 
+stress, again more consistent with a neurocardiogenic etiology. 
+They do not sound like orthostasis by history, nor is she 
+orthostatic on exam. Given the lack of symptoms during exertion, 
+arrhythmia is less likely although her brother does apparently 
+have some form of malignant arrhythmia. Seizure and stroke are 
+not on the differential. She has no reason to be hypoglycemic, 
+although her episodes do sound somewhat reminiscent of transient 
+hypoglycemia. 
+
+The patient was observed overnight during which she was 
+asymptomatic and no events recorded on telemetry. Her serial 
+troponins were negative with no abnormalities seen on EKG. She 
+was discharged with ___ of hearts and will follow up with 
+cardiology as an outpatient.
+
+INACTIVE ISSUES:
+# HTN: continue ASA, HCTZ
+# HLD: continue pravastatin
+# GERD: continue omeprazole
+
+TRANSITIONAL ISSUES:
+# SYNCOPE: Follow up with cardiology with ___ of Hearts monitor
+# ENDOCHRONDROMA: Follow up with PCP given the incidental 
+finding of enchondroma on radiographic imaging. Consider 
+possible MRI as an outpatient
+ 
+
+###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}, NEUTS {Neutrophil count}, MONOS {Monocyte count}, EOS {Eosinophil count}, 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}, 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}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, Chest PA {Plain x-ray of chest posteroanterior view}, chest {Thoracic structure}, left humeral head {Bone structure of left humerus}, enchondroma {Enchondroma}, pain {Pain}, MRI {Magnetic resonance imaging}, lesion {Finding of lesion}, carotid bifurcations {Structure of carotid bifurcation}, plaque {Plaque}, unremarkable {No abnormality detected}, vertebral arteries {Structure of vertebral artery}, plaque {Plaque}, stenosis {Stenosis}, 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}, 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}, cTropnT {Troponin T cardiac measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, obesity {Obesity}, gastric bypass {Bypass of stomach}, pre-syncope {Near syncope}, Presyncope {Near syncope}, diaphoresis {Excessive sweating}, weakness {Asthenia}, increased heart rate {Tachycardia}, standing {Orthostatic body position}, emotional 
+stress {Emotional stress}, arrhythmia {Cardiac arrhythmia}, arrhythmia {Cardiac arrhythmia}, Seizure {Seizure}, stroke {Cerebrovascular accident}, hypoglycemia {Hypoglycemia}, asymptomatic {Asymptomatic}, no abnormalities seen {No pathologic diagnosis}, hearts {Cardiovascular physical examination}, follow up with 
+cardiology as an outpatient {Follow-up in outpatient clinic}, SYNCOPE {Syncope}, Follow up with cardiology {Follow-up cardiac assessment}, enchondroma {Enchondroma}, imaging {Imaging}, MRI {Magnetic resonance imaging}"
+"###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:
+Preadmission medications listed are correct and complete.  
+Information was obtained from Patient.
+1. Pravastatin 20 mg PO DAILY 
+2. Omeprazole 20 mg PO DAILY 
+3. Aspirin 81 mg PO DAILY 
+4. Hydrochlorothiazide 25 mg PO DAILY 
+hold for sbp < 100 
+
+ 
+Discharge Medications:
+1. Aspirin 81 mg PO DAILY 
+2. Hydrochlorothiazide 25 mg PO DAILY 
+hold for sbp < 100 
+3. Omeprazole 20 mg PO DAILY 
+4. Pravastatin 20 mg PO DAILY 
+
+ 
+
+###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 Diagnosis: pre-syncope
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: pre-syncope {Near syncope}, Mental Status {Neurological mental status determination}, Level of Consciousness {Assessment of consciousness level}"
+"###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 ___, 
+
+___ was a pleasure taking care of you.  You were admitted to the 
+___ for ___ 
+(dizziness, feeling as if will pass out) symptoms prior to your 
+presentation. 
+
+Our diagnostic work-up did not reveal any abnormality.  You 
+should follow-up with your primary care physician, and we have 
+also organized to have you follow-up with a cardiologist. 
+ 
+
+###RESPONSE: dizziness {Dizziness}"
+"###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: 
+Bactrim / Codeine
+ 
+Attending: ___.
+ 
+Chief Complaint:
+R knee hematoma/pain/swelling
+ 
+Major Surgical or Invasive Procedure:
+R knee/thigh I&D/arthrotomy
+
+ 
+
+###RESPONSE: Bactrim {Allergy to sulfamethoxazole and/or trimethoprim}, Codeine {Allergy to codeine}, R knee hematoma {Hematoma of right knee region}, pain {Pain of knee region}, swelling {Swollen knee}, R knee {Structure of right knee region}, thigh {Thigh structure}, arthrotomy {Arthrotomy}"
+"###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:
+This is a ___ year old gentleman with HIV (last CD4 210, VL
+150,000 per patient), followed at ___, restarted on HAART 3
+weeks ago, who initially presented with right thigh and knee 
+pain
+and swelling as well as fevers and is now found to have septic
+arthritis of the right knee.
+
+His current series of events began ___ weeks ago when he
+was struck twice on the right thigh by a dishcart (he works in a
+restaurant). He developed immediate pain afterwards which he
+treated by icing it and with ibuprofen. He was seen in the ED 
+and
+placed in an air cast which he wore for the next 3.5 weeks. The
+injury did not break the skin as far as he is aware.
+
+He subsequently developed a large bruise which became
+increasingly swollen and painful. He was then seen about 10 days
+ago by his PCP and told to stop wearing the air cast. By the 
+next
+morning the leg had become significantly more swollen. He
+developed fevers to 102.8 at home which he felt were likely due
+to the pain and thus did not seek further evaluation at that
+time. The fevers broke when he iced his knee. His pain continued
+to get worse however and he continued to have fevers. He reports
+not being able to bend his knee since the initial injury. 
+
+He finally presented to the ED on ___. Imaging in the ED was
+suboptimal due to patient pain but showed a massive soft tissue
+density in the anterior thigh with a broad differential 
+including
+hematoma. His knee was aspirated and irrigated with fluid 
+showing
+WBC of 192,500 with 92% PMNs and 111 RBCs. Labs showed WBC count
+10.0, ESR 128, and CRP of 217.9.
+
+ 
+
+###RESPONSE: HIV {Human immunodeficiency virus infection}, restarted {Restart of medication}, right thigh {Thigh pain}, knee 
+pain {Pain of knee region}, swelling {Swelling}, fevers {Fever}, septic
+arthritis {Bacterial arthritis}, right knee {Structure of right knee region}, right thigh {Structure of right thigh}, pain {Pain}, placed in an air cast {Application of cast}, injury {Traumatic injury}, bruise {Contusion}, swollen {Swelling}, painful {Pain}, leg had become significantly more swollen {Swelling of lower limb}, fevers {Fever}, pain {Pain}, evaluation {Evaluation procedure}, fevers {Fever}, iced {Application of ice}, knee {Knee region structure}, pain {Pain}, fevers {Fever}, able to bend his knee {Normal active range of knee flexion}, injury {Traumatic injury}, Imaging {Imaging}, pain {Pain}, soft tissue {Structure of soft tissue}, density {Abnormally opaque structure}, anterior thigh {Femoral region structure}, hematoma {Hematoma}, knee {Knee region structure}, WBC {White blood cell count}, WBC count {White blood cell count}, ESR {Erythrocyte sedimentation rate measurement}, CRP {C-reactive protein 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: Past Medical History:
+HIV, diagnosed ___, restarted on HAART ___
+GERD
+seizure
+s/p ORIF L elbow 
+Transaminits with biopsy suggesting fatty liver
+Shingle and chicken pox
+PTSD
+Anxiety
+
+ 
+
+###RESPONSE: HIV {Human immunodeficiency virus infection}, restarted {Restart of medication}, GERD {Gastroesophageal reflux disease}, seizure {Seizure}, ORIF {Open reduction of fracture with internal fixation}, L elbow {Left elbow region structure}, Transaminits {Aspartate transaminase level above reference range}, biopsy {Biopsy}, fatty liver {Steatosis of liver}, Shingle {Herpes zoster}, chicken pox {Varicella}, PTSD {Posttraumatic stress disorder}, Anxiety {Anxiety}"
+"###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:
+His mother is deceased at age ___ from lung cancer.  She was also 
+a heavy drinker.  His father is deceased at age ___ from suicide. 
+ He has no brothers and no sisters.
+
+ 
+
+###RESPONSE: deceased {Dead}, lung cancer {Malignant tumor of lung}, heavy drinker {Heavy drinker}, deceased {Dead}"
+"###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:
+VS: Tm 101.0 Tc 98.1 128/72 64 20 100/3L\
+General: NAD  
+EENT: EOM grossly intact, sclerae anicteric, moist mucous
+membranes
+CV: RRR, II/VI SEM (which he has previously been told he has), 
+no
+rubs or gallops  
+Pulmonary: clear to auscultation bilaterally w/o wheezes /
+rhonchi / rales  
+Extremities: right thigh and knee extensively wrapped with drain
+collecting serosanguinous fluid, appear warm and well perfused, 
+SKIN: no rashes, no jaundice  
+NEURO: awake, alert and oriented x3, CN grossly intact, 
+sensation
+intact in lower extremities bilaterally
+PSYCH: irritable, non-anxious, oherwise normal affect
+
+ 
+
+###RESPONSE: VS {Vital signs finding}, General {General examination of patient}, NAD {No abnormality detected}, NT {Abdominal tenderness}, grossly intact {Normal nervous system function}, sclerae anicteric {White sclera}, moist mucous
+membranes {Moist oral mucosa}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, SEM {Ejection murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, Pulm {Examination of respiratory system}, clear to auscultation bilaterally {Normal breath sounds}, rhonchi {Wheeze - rhonchi}, rales {Respiratory crackles}, Extremities {Examination of limb}, right thigh {Structure of right thigh}, knee {Knee region structure}, collecting serosanguinous fluid {Serosanguineous discharge from wound}, warm {Warm skin}, well perfused {Normal tissue perfusion}, SKIN {Examination of skin}, rashes {Eruption of skin}, jaundice {Jaundice}, NEURO {Neurological examination}, awake {Awake}, alert {Mentally alert}, oriented {Orientated}, grossly intact {Normal nervous system function}, sensation
+intact {Normal sensation}, lower extremities {Lower limb structure}, irritable {Feeling irritable}, anxious {Anxiety}, affect {Mood finding}"
+"###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:
+___ 04:20PM BLOOD WBC-10.0# RBC-3.44*# Hgb-10.4*# 
+Hct-28.7*# MCV-84 MCH-30.2 MCHC-36.2* RDW-13.9 Plt ___
+___ 05:15AM BLOOD WBC-6.9 RBC-3.32* Hgb-9.9* Hct-28.3* 
+MCV-85 MCH-29.9 MCHC-35.1* RDW-14.7 Plt ___
+___ 04:20PM BLOOD Neuts-87.5* Bands-0 Lymphs-6.4* Monos-3.4 
+Eos-2.3 Baso-0.4
+___ 04:20PM BLOOD ESR-128*
+___ 06:35AM BLOOD Glucose-98 UreaN-10 Creat-0.7 Na-134 
+K-3.9 Cl-101 HCO3-24 AnGap-13
+___ 06:20AM BLOOD ALT-61* AST-71* LD(LDH)-156 AlkPhos-72 
+TotBili-1.6*
+___ 04:20PM BLOOD CRP-217.9*
+ 
+
+###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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, 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}, 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}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total 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: Brief Hospital Course:
+Mr ___ was admitted to the orthopaedics service from the 
+ED on ___.  On ___ he went to the OR for the above 
+listed procedure.  Please read the operative note for more 
+detail.  After being extubated, he was taken to the PACU where 
+he did well and was then taken to the floor.  His pain was well 
+controlled while on the floor and the tolerated a regular diet.  
+After verifying a set of blood cultures negative for at least 48 
+hours, he had a PICC line placed for home IV antibiotics.  After 
+receiving teaching on how to care for the picc he was discharged 
+to home with ___ and home ___.  
+ 
+
+###RESPONSE: procedure {Procedure}, extubated {Removal of endotracheal tube}, pain was well 
+controlled {Demonstrates adequate pain control}, regular diet {Normal diet}, blood cultures {Blood culture}, negative {No abnormality detected}, PICC line placed {Insertion of peripherally inserted central catheter}, IV antibiotics {Intravenous antibiotic therapy}, teaching {Patient education}"
+"###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:
+Truvada (tenofovir and emtricitabine)
+Norvir (Ritonavir) 100mg daily
+Atazanavir 300 mg daily
+Sertraline 50mg daily
+Buproprion 200mg SR daily
+Alprazolam 1mg PRN insomnia
+
+ 
+Discharge Medications:
+1. Wheelchair
+with elevating leg rests.
+Disp # 1
+Diagnosis: Right Knee infection
+2. nafcillin in D2.4W 2 gram/100 mL Piggyback Sig: Two (2) grams 
+Intravenous Q4H (every 4 hours) for 4 weeks: ID to manage total 
+length of treatment.
+Disp:*qs * Refills:*0*
+3. enoxaparin 40 mg/0.4 mL Syringe Sig: One (1) syringe 
+Subcutaneous Q8PM () for 3 weeks.
+Disp:*21 syringe* Refills:*0*
+4. bupropion HCl 100 mg Tablet Extended Release Sig: Two (2) 
+Tablet Extended Release PO QAM (once a day (in the morning)).  
+5. hydrocortisone 2.5 % Cream Sig: One (1) Appl Rectal PRN (as 
+needed) as needed for irritation.  
+6. ritonavir 100 mg Capsule Sig: One (1) Capsule PO DAILY 
+(Daily).  
+7. sertraline 50 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 
+ 
+8. emtricitabine-tenofovir 200-300 mg Tablet Sig: One (1) Tablet 
+PO DAILY (Daily).  
+9. atazanavir 150 mg Capsule Sig: Two (2) Capsule PO DAILY 
+(Daily).  
+10. heparin, porcine (PF) 10 unit/mL Syringe Sig: Ten (10) ML 
+Intravenous PRN (as needed) as needed for line flush.  
+11. oxycodone 5 mg Tablet Sig: ___ Tablets PO Q4H (every 4 
+hours) as needed for Pain.
+Disp:*40 Tablet(s)* Refills:*0*
+12. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID 
+(2 times a day).  
+13. alum-mag hydroxide-simeth 200-200-20 mg/5 mL Suspension Sig: 
+___ MLs PO Q6H (every 6 hours) as needed for Dyspepsia.  
+14. bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) 
+Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed for 
+Constipation.  
+15. magnesium hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) 
+ML PO BID (2 times a day) as needed for Constipation.  
+16. ZOFRAN ODT 4 mg Tablet, Rapid Dissolve Sig: One (1) Tablet, 
+Rapid Dissolve PO every eight (8) hours as needed for nausea.
+Disp:*40 Tablet, Rapid Dissolve(s)* 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 With Service
+ 
+Facility:
+___ 
+ 
+Discharge Diagnosis:
+R knee septic arthritis
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, R knee septic arthritis {Infective arthritis of right knee}, Mental Status {Neurological mental status determination}, Alert {Mentally alert}, interactive {Does communicate}, 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:
+Wound Care: 
+
+-Keep Incision dry. 
+
+-Do not soak the incision in a bath or pool.  
+
+-Keep pin sites clean and dry.
+
+-Sutures/staples will be removed at your first post-operative 
+visit.
+
+ 
+
+Activity: 
+
+-Continue to be weight bearing on your right leg.  
+
+-You should not lift anything greater than 5 pounds. 
+
+-Elevate Right leg to reduce swelling and pain.
+
+-Do not remove splint/brace.  Keep splint/brace dry.
+
+ 
+
+Other Instructions
+
+- Resume your regular diet. 
+
+- Avoid nicotine products to optimize healing. 
+
+- Resume your home medications. Take all medications as 
+instructed. 
+
+- Continue taking the Lovenox to prevent blood clots.
+
+-You have also been given Additional Medications to control your 
+pain.  Please allow 72 hours for refill of narcotic 
+prescriptions, so plan ahead.  You can either have them mailed 
+to your home or pick them up at the clinic located on ___. 
+ We are not allowed to call in narcotic (oxycontin, oxycodone, 
+percocet) prescriptions to the pharmacy.   In addition, we are 
+only allowed to write for pain medications for 90 days from the 
+date of surgery.
+
+- Narcotic pain medication may cause drowsiness.  Do not drink 
+alcohol while taking narcotic medications.  Do not operate any 
+motor vehicle or machinery while taking narcotic pain 
+medications.  Taking more than recommended may cause serious 
+breathing problems.
+
+If you have questions, concerns or experience any of the below 
+danger signs then please call your doctor at ___ or go 
+to your local emergency room.
+
+Physical Therapy:
+Activity:   Activity:  Activity as tolerated
+ Right lower extremity:  Full weight bearing, CPM 
+Encourage turn, cough and deep breathe q2h when awake
+
+Treatments Frequency:
+Site: Right knee
+Description: surgical site with staples intact, minimal serosang 
+drainage. Dsd/kerlix c/d/i
+Care: dsg changes gauze to dry daily
+
+ 
+
+###RESPONSE: Sutures {Removal of suture}, staples will be removed {Removal of staples}, weight bearing {Weight-bearing}, right leg {Structure of right lower limb}, should not lift {Recommendation to avoid activity}, Right leg {Structure of right lower limb}, swelling {Swelling}, pain {Pain}, splint {Application of splint}, splint {Application of splint}, regular diet {Normal diet}, control your 
+pain {Pain control}, narcotic {Narcotherapy}, prescriptions {Prescription}, narcotic {Narcotherapy}, pain medications {Administration of analgesic}, Narcotic {Narcotherapy}, pain medication {Administration of analgesic}, drowsiness {Drowsy}, Do not drink 
+alcohol {Education about alcohol consumption}, narcotic medications {Narcotherapy}, while taking narcotic pain 
+medications {Narcotics education}, Full weight bearing {Full weight-bearing gait training}, cough and deep breathe {Deep breathing and coughing exercises}, Right knee {Structure of right knee region}, surgical site {Operative site}, serosang 
+drainage {Serosanguineous discharge from 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:   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: 
+pcn
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Diarrhea, nausea, chest discomfort
+ 
+Major Surgical or Invasive Procedure:
+___ Placement
+ 
+
+###RESPONSE: pcn {Allergy to penicillin}, Diarrhea {Diarrhea}, nausea {Nausea}, chest discomfort {Chest discomfort}, Placement {Implantation 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:
+___ female with stage IV endometrial cancer on 
+anastrazole, DM2, CAD, CKD, chronic respiratory failure with 
+hypoxemia on home oxygen, and morbid obesity presents from her 
+PCP's office with gastrointestinal illness and chest discomfort. 
+
+
+She was in her usual state of health until ___, when she 
+experienced the onset of fever, headache, diarrhea, heaving 
+(mostly dry), and malaise. She noted some chest discomfort 
+accompanying the dry heaves that felt ""like someone punching 
+her"" in the chest (not like the pressure she felt with her prior 
+MI). Her PCP was concerned about EKG changes, and sent her to 
+the hospital.
+
+She has a history of cardiac disease, including an MI in ___. 
+At that time, she was cathed and found to have significant 
+disease but due to intolerance of the procedure no intervention 
+was carried out. She has been medically managed in the interim.
+
+In the ED, initial vitals were T 99.4 HR 72 BP 102/45 RR 18 SpO2 
+98%2L. CT head w/o contrast was unremarkable.  CXR showed mild 
+cardiomegaly with central vascular congestion. Labs were 
+remarkable for K of 3.0 for which she was given 40meq potassium. 
+Vitals prior to transfer were T 100.4 HR 66 BP 129/69 RR 18 
+SpO296%2L. 
+
+On the floor, vitals are stable and she feels better. She denies 
+heaves, chest pain, difficulty breathing, nausea, or abdominal 
+pain. She does endorse ongoing diarrhea.
+
+ 
+
+###RESPONSE: stage IV {Clinical stage IV}, endometrial cancer {Endometrial carcinoma}, DM2 {Diabetes mellitus type 2}, CAD {Coronary arteriosclerosis}, CKD {Chronic kidney disease}, chronic respiratory failure {Chronic respiratory failure}, hypoxemia {Hypoxemia}, morbid obesity {Morbid obesity}, gastrointestinal illness {Disorder of gastrointestinal tract}, chest discomfort {Chest discomfort}, fever {Fever}, headache {Headache}, diarrhea {Diarrhea}, heaving {Retching}, malaise {Malaise}, chest discomfort {Chest discomfort}, dry heaves {Retching}, chest {Thoracic structure}, pressure {Tight chest}, MI {Myocardial infarction}, EKG changes {Electrocardiogram abnormal}, cardiac disease {Heart disease}, MI {Myocardial infarction}, cathed {Cardiac catheterization}, disease {Disease}, procedure {Procedure}, vitals {Vital signs finding}, SpO2 {Finding of oxygen saturation}, CT head w/o contrast {Computed tomography of head without contrast}, unremarkable {No abnormality detected}, CXR {Plain chest X-ray}, cardiomegaly {Cardiomegaly}, vascular {Blood vessel structure}, congestion {Congestion}, Labs {Laboratory test}, potassium {Potassium measurement}, Vitals {Vital signs finding}, vitals are stable {Normal vital signs}, feels better {Patient's condition improved}, heaves {Retching}, chest pain {Chest pain}, difficulty breathing {Difficulty breathing}, nausea {Nausea}, abdominal 
+pain {Abdominal pain}, 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: Past Medical History:
+Endometrial cancer: Diagnosed ___, Stage IV, s/p hysterectomy 
+and radiation, on anastrazole
+DM2: Latest HbA1C 4.5 (___)
+CAD: ___ ___, underwent cardiac catheterization 
+without intervention
+Chronic respiratory failure: 2L home oxygen
+CKD stage 3
+HTN
+hypothyroidism
+thrombocytopenia
+anemia
+depression
+ 
+
+###RESPONSE: Endometrial cancer {Endometrial carcinoma}, Stage IV {Clinical stage IV}, hysterectomy {Hysterectomy}, radiation {Radiation oncology AND/OR radiotherapy}, DM2 {Diabetes mellitus type 2}, HbA1C {Hemoglobin A1c measurement}, CAD {Coronary arteriosclerosis}, cardiac catheterization {Cardiac catheterization}, Chronic respiratory failure {Chronic respiratory failure}, CKD stage 3 {Chronic kidney disease stage 3}, HTN {Hypertensive disorder, systemic arterial}, hypothyroidism {Hypothyroidism}, thrombocytopenia {Thrombocytopenic disorder}, anemia {Anemia}, depression {Depressive 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: 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 died at ___ after ___ MIs
+Mother died at ___, had CHF
+Sister died of breast cancer
+ 
+
+###RESPONSE: died {Dead}, MIs {Myocardial infarction}, died {Dead}, CHF {Congestive heart failure}, died {Dead}, breast cancer {Malignant neoplasm of breast}"
+"###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:
+VS: T 98.4 BP 105/52 HR 64 RR 20 SpO2 98%2L
+General: Obese woman sleeping in hospital bed, easily arousable. 
+
+HEENT: NCAT, MMM, no teeth
+Neck: Supple, no LAD, no JVD
+CV: Distant heart sounds. Regular rate and rhythm, no M/R/G 
+appreciated.
+Lungs: Clear to auscultation bilaterally.
+Abdomen: Obese, soft, non-distended, non-tender. Bowel sounds 
+present.
+GU: Deferred
+Ext: Warm, 2+ distal pulses bilaterally, darkened skin around 
+ankles (?stasis dermatitis), no edema 
+Neuro: Alert, oriented, moving all extremities
+
+Discharge:
+VS: T 97.8 BP 104/52 HR (not recorded) RR 18 SpO2 94%RA
+General: Obese woman in hospital bed, no distress.  
+HEENT: NCAT, mucous membranes moist  
+Neck: Supple, no LAD  
+CV: Regular rate and rhythm, distant heart sounds, no 
+appreciable murmurs/rubs/gallops  
+Lungs: Poor aeration throughout, otherwise clear to auscultation
+Abdomen: Obese, soft, non-distended. Bowel sounds present.  
+Ext: Warm, 2+ distal pulses bilaterally, darkened skin around 
+ankles (?stasis dermatitis), 2+ pitting edema
+Neuro: Alert, oriented, moving all extremities  
+
+ 
+
+###RESPONSE: VS {Vital signs finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, SpO2 {Finding of oxygen saturation}, General {General examination of patient}, Obese {Obese}, sleeping in hospital bed {Inpatient stay}, HEENT {Physical examination procedure}, NC {Normal head}, MMM {Moist oral mucosa}, no teeth {Edentulous}, Neck {Physical examination procedure}, Supple {Normal movement of neck}, LAD {Lymphadenopathy}, JVD {Jugular venous engorgement}, CV {Cardiovascular physical examination}, Distant heart sounds {Heart sounds diminished}, Regular rate and rhythm {Normal heart rate}, no M/R/G {Heart sounds normal}, Lungs {Examination of respiratory system}, Clear to auscultation bilaterally {Normal breath sounds}, Abdomen {Examination of abdomen}, Obese {Obese abdomen}, soft {Abdomen soft}, non-distended {Normal abdominal contour}, non-tender {Abdominal tenderness}, Bowel sounds 
+present {Normal bowel sounds}, GU {Examination of genitourinary system}, Ext {Examination of limb}, Warm {Warm skin}, 2+ distal pulses {Peripheral pulses normal}, darkened {Dark color}, skin around 
+ankles {Skin structure of ankle}, stasis dermatitis {Stasis dermatitis}, edema {Edema}, Neuro {Neurological examination}, Alert {Mentally alert}, oriented {Orientated}, all extremities {All extremities}, VS {Vital signs finding}, SpO2 {Finding of oxygen saturation}, RA {Breathing room air}, General {General examination of patient}, Obese {Obese}, distress {Distress}, HEENT {Physical examination procedure}, NCAT {Normal head}, mucous membranes moist {Moist oral mucosa}, Neck {Physical examination procedure}, Supple {Normal movement of neck}, LAD {Lymphadenopathy}, CV {Cardiovascular physical examination}, Regular rate and rhythm {Normal heart rate}, distant heart sounds {Heart sounds diminished}, murmurs {Heart murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, Lungs {Examination of respiratory system}, clear to auscultation {Normal breath sounds}, Abdomen {Examination of abdomen}, Obese {Obese abdomen}, soft {Abdomen soft}, non-distended {Normal abdominal contour}, Bowel sounds present {Normal bowel sounds}, Ext {Examination of limb}, Warm {Warm skin}, 2+ distal pulses {Peripheral pulses normal}, darkened {Dark color}, skin around 
+ankles {Skin structure of ankle}, stasis dermatitis {Stasis dermatitis}, 2+ pitting edema {2+ pitting edema}, Neuro {Neurological examination}, Alert {Mentally alert}, oriented {Oriented to person}, moving all extremities {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:
+___ 01:50PM BLOOD WBC-6.8 RBC-3.51* Hgb-9.5* Hct-29.2* 
+MCV-83 MCH-27.1 MCHC-32.5 RDW-15.7* Plt Ct-62*
+___ 08:25AM BLOOD WBC-5.2 RBC-3.67* Hgb-10.0* Hct-30.8* 
+MCV-84 MCH-27.2 MCHC-32.5 RDW-15.8* Plt Ct-59*
+___ 07:15AM BLOOD WBC-3.7* RBC-3.13* Hgb-8.4* Hct-26.3* 
+MCV-84 MCH-26.9* MCHC-32.1 RDW-15.2 Plt Ct-46*
+___ 01:30PM BLOOD WBC-3.4* RBC-3.12* Hgb-8.4* Hct-26.4* 
+MCV-85 MCH-27.0 MCHC-31.9 RDW-15.3 Plt Ct-51*
+___ 05:40AM BLOOD WBC-3.0* RBC-3.23* Hgb-8.9* Hct-27.3* 
+MCV-84 MCH-27.6 MCHC-32.7 RDW-15.4 Plt Ct-53*
+___ 05:36AM BLOOD WBC-1.9* RBC-3.08* Hgb-8.2* Hct-25.6* 
+MCV-83 MCH-26.6* MCHC-31.9 RDW-15.2 Plt Ct-54*
+___ 07:15AM BLOOD WBC-1.5* RBC-2.89* Hgb-7.7* Hct-24.0* 
+MCV-83 MCH-26.6* MCHC-32.0 RDW-15.2 Plt Ct-71*
+___ 03:40PM BLOOD WBC-2.2* RBC-3.07* Hgb-8.2* Hct-26.0* 
+MCV-85 MCH-26.8* MCHC-31.6 RDW-15.3 Plt Ct-88*
+___ 07:00AM BLOOD WBC-1.5* RBC-2.79* Hgb-7.6* Hct-23.6* 
+MCV-85 MCH-27.4 MCHC-32.4 RDW-15.2 Plt Ct-81*
+___ 01:20PM BLOOD WBC-1.9* RBC-3.24* Hgb-8.6* Hct-27.4* 
+MCV-85 MCH-26.6* MCHC-31.5 RDW-15.1 Plt Ct-93*
+___ 06:35AM BLOOD WBC-1.9* RBC-2.88* Hgb-7.9* Hct-24.2* 
+MCV-84 MCH-27.5 MCHC-32.6 RDW-15.2 Plt Ct-90*
+
+___ 01:50PM BLOOD Neuts-87.6* Lymphs-6.4* Monos-5.7 Eos-0.1 
+Baso-0.1
+___ 05:36AM BLOOD Neuts-73.4* Lymphs-17.0* Monos-7.0 
+Eos-2.3 Baso-0.3
+___ 07:15AM BLOOD Neuts-65 Bands-0 ___ Monos-5 Eos-5* 
+Baso-0 ___ Myelos-0
+___ 06:35AM BLOOD Neuts-61.4 ___ Monos-12.3* 
+Eos-1.5 Baso-0.9
+
+___ 01:50PM BLOOD Glucose-165* UreaN-19 Creat-1.0 Na-140 
+K-3.0* Cl-98 HCO3-33* AnGap-12
+___ 05:40AM BLOOD Glucose-103* UreaN-23* Creat-1.1 Na-135 
+K-3.8 Cl-101 HCO3-30 AnGap-8
+___ 06:35AM BLOOD Glucose-101* UreaN-16 Creat-0.7 Na-139 
+K-4.1 Cl-103 HCO3-31 AnGap-9
+
+___ 01:50PM BLOOD CK(CPK)-26*
+___ 08:35PM BLOOD ALT-23 AST-28 CK(CPK)-20* AlkPhos-158* 
+TotBili-1.8*
+___ 05:36AM BLOOD CK(CPK)-11*
+___ 07:00AM BLOOD ALT-24 AST-35 LD(LDH)-165 AlkPhos-288* 
+TotBili-0.3
+___ 06:35AM BLOOD ALT-31 AST-48* AlkPhos-297* TotBili-0.3
+
+___ 01:50PM BLOOD CK-MB-1 cTropnT-0.21*
+___ 08:35PM BLOOD CK-MB-1 cTropnT-0.17*
+___ 03:15AM BLOOD CK-MB-1 cTropnT-0.16*
+___ 08:25AM BLOOD CK-MB-1 cTropnT-0.19*
+___ 07:15AM BLOOD CK-MB-1 cTropnT-0.14*
+
+___ 01:50PM BLOOD Calcium-8.0* Phos-1.2* Mg-1.3*
+___ 05:40AM BLOOD Calcium-8.0* Phos-2.6* Mg-2.0
+___ 06:35AM BLOOD Calcium-8.2* Phos-2.5* Mg-1.6
+
+Imaging
+___ CHEST (PA & LAT): IMPRESSION:  Mild cardiomegaly with 
+central vascular congestion, but without frank edema.
+
+___ CT HEAD W/O CONTRAST: IMPRESSION:  No acute 
+intracranial process.  Small hypodensity in the left centrum 
+semiovale may relate to small vessel ischemic change, however, 
+given assymetric with the right side, nonurgent brain MRI would 
+further evaluate.
+
+___  Cardiovascular ECHO: Poor echo windows. The left 
+atrium is mildly dilated. There is mild symmetric left 
+ventricular hypertrophy with normal cavity size and global 
+systolic function (LVEF>55%). Due to suboptimal technical 
+quality, a focal wall motion abnormality cannot be fully 
+excluded. There is no ventricular septal defect. Right 
+ventricular chamber size and free wall motion are normal. The 
+aortic root is mildly dilated at the sinus level. The aortic 
+valve leaflets (3) are mildly thickened but aortic stenosis is 
+not present. Mild (1+) aortic regurgitation is seen. The mitral 
+valve appears structurally normal with trivial mitral 
+regurgitation. The pulmonary artery systolic pressure could not 
+be determined. There is no pericardial effusion. 
+
+___ RENAL U.S.: IMPRESSION: 1.  No definite ultrasound 
+findings to suggest pyelonephritis, although this diagnosis 
+cannot be excluded sonographically.  2.1 cm hypoechoic lesion in 
+the
+right upper renal pole, poorly visualized and indeterminate; 
+this could represent a cyst but in the current clinical setting, 
+focal infection or abscess cannot be excluded.  Per the 
+patient's report, there has been a recent abdominal CT performed 
+at ___ comparison to this study is recommended.  Of 
+note, if this study is uploaded into PACS, an addendum could be 
+issued at that time.  If this study cannot be obtained, further 
+evaluation could be performed with CT. 3.  Right lower pole 15 
+mm cyst or calyceal diverticulum.  4.  Possible duplex right 
+kidney.  
+
+___ CT ABD & PELVIS WITH CO: IMPRESSION: 1.  Large 
+rim-enhancing fluid collection along the lower abdominal 
+incision site, likely a seroma, is stable to slightly smaller 
+since ___. 
+Recommended clinical correlation to assess for possible 
+superinfection. 2.  No intra-abdominal pathology identified to 
+explain the patient's symptoms. 3.  Unexplained massive 
+splenomegaly.
+4.  Cholelithiasis.
+
+___ CHEST PORT. LINE PLACEM: IMPRESSION: 1.  Right PICC at 
+the cavoatrial junction. 2.  Stable cardiomegaly.
+
+MICROBIOLOGY
+___ 3:15 am BLOOD CULTURE      RIGHT ARM. 
+
+                            **FINAL REPORT ___
+
+   Blood Culture, Routine (Final ___: 
+      ESCHERICHIA COLI.    FINAL SENSITIVITIES. 
+         Cefazolin interpretative criteria are based on a dosage 
+regimen of
+         2g every 8h. 
+
+                              SENSITIVITIES: MIC expressed in 
+MCG/ML
+                      
+_________________________________________________________
+                             ESCHERICHIA COLI
+                             |   
+AMPICILLIN------------  =>32 R
+AMPICILLIN/SULBACTAM--    16 I
+CEFAZOLIN-------------   <=4 S
+CEFEPIME--------------   <=1 S
+CEFTAZIDIME-----------   <=1 S
+CEFTRIAXONE-----------   <=1 S
+CIPROFLOXACIN---------<=0.25 S
+GENTAMICIN------------   <=1 S
+MEROPENEM-------------<=0.25 S
+PIPERACILLIN/TAZO-----   <=4 S
+TOBRAMYCIN------------   <=1 S
+TRIMETHOPRIM/SULFA----   <=1 S
+
+ 
+
+###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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, 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}, 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}, Baso {Basophil count}, Neuts {Neutrophil count}, Lymphs {Lymphocyte count}, Monos {Monocyte count}, Baso {Basophil count}, Neuts {Neutrophil count}, Monos {Monocyte count}, Eos {Eosinophil count}, Baso {Basophil count}, Neuts {Neutrophil 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}, 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}, 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}, CK(CPK {Creatine kinase measurement}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, CK(CPK {Creatine kinase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, CK(CPK {Creatine kinase measurement}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, LDH {Serum total lactate dehydrogenase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Imaging {Imaging}, CHEST (PA {Plain x-ray of chest posteroanterior view}, cardiomegaly {Cardiomegaly}, vascular {Blood vessel structure}, congestion {Congestion}, edema {Edema}, AST {Aspartate aminotransferase measurement}, No acute {No abnormality detected}, intracranial {Intracranial structure}, centrum 
+semiovale {Structure of centrum semiovale}, small vessel {Structure of small blood vessel (organ)}, ischemic change {Ischemia}, right side {Structure of right half of head}, brain MRI {Magnetic resonance imaging of brain}, evaluate {Evaluation procedure}, Cardiovascular ECHO {Echocardiography}, echo {Echocardiography}, left 
+atrium {Left atrial structure}, dilated {Dilatation}, mild symmetric left 
+ventricular hypertrophy {Mild left ventricular hypertrophy}, normal cavity {Normal size cardiac chamber}, systolic function {Normal left ventricular systolic function and wall motion}, focal wall motion abnormality {Left ventricular wall motion abnormality}, ventricular septal defect {Ventricular septal defect}, Right 
+ventricular chamber {Right cardiac ventricular structure}, size {Normal size}, wall motion are normal {Normal ventricular wall motion}, aortic root is mildly dilated {Aortic root dilatation}, sinus {Structure of sinus of Valsalva}, aortic 
+valve leaflets {Structure of cardiac valve leaflet}, mildly thickened {Increased thickness}, aortic stenosis {Aortic valve stenosis}, Mild (1+) aortic regurgitation {Mild mitral valve regurgitation}, mitral 
+valve {Mitral valve structure}, trivial mitral 
+regurgitation {Mild mitral valve regurgitation}, pulmonary artery {Pulmonary artery structure}, systolic pressure {Normal systolic arterial pressure}, pericardial effusion {Pericardial effusion}, RENAL U.S {Echography of kidney}, ultrasound 
+findings {Ultrasound scan finding}, pyelonephritis {Pyelonephritis}, lesion {Lesion}, right upper renal pole {Structure of upper pole of right kidney}, cyst {Cyst of kidney}, infection {Infectious disease}, abscess {Abscess}, evaluation {Evaluation procedure}, Right lower pole {Structure of lower pole of right kidney}, cyst {Cyst}, calyceal diverticulum {Diverticulum of renal calyx}, duplex {Double kidney}, right 
+kidney {Right kidney structure}, fluid collection {Accumulation of fluid}, lower abdominal {Lower abdomen structure}, seroma {Seroma}, stable {Patient's condition stable}, infection {Infectious disease}, intra-abdominal {Structure of intraabdominal region}, pathology {Abnormal histology findings}, mass {Mass}, splenomegaly {Splenomegaly}, Cholelithiasis {Calculus in biliary tract}, CHEST {Thoracic structure}, Right {Structure of right half of chest wall}, PICC {Peripherally inserted central venous catheter in situ}, Stable {Symptom not changed}, cardiomegaly {Cardiomegaly}, MICROBIOLOGY {Microbiology}, CULTURE {Blood culture}, RIGHT ARM {Right upper arm structure}, Blood Culture {Blood culture}, regimen {Therapeutic regimen}"
+"###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:
+___ female with stage IV endometrial cancer on 
+anastrazole, DM2, CAD, CKD, chronic respiratory failure with 
+hypoxemia on home oxygen, and morbid obesity presents from her 
+PCP's office with chest discomfort and possible EKG changes in 
+the context of a gastrointestinal illness.
+.
+# Nausea/vomiting/diarrhea  
+Patient presented following three days of diarrhea, nausea, and 
+dry heaving. This was more severe than her chronic diarrhea from 
+radiation, and was likely the result of a viral or bacterial 
+gastroenteritis. Stool studies and C. diff testing were 
+negative, and according to the patient's oncologist, Arimidex 
+was not likely causative. Ondansetron was originally given for 
+nausea but this was changed to compazine given concern about QTc 
+prolongation. The nausea and vomiting resolved over the course 
+of the hospital stay, and the diarrhea improved significantly.
+. 
+# Chest pain  
+Patient presented with chest discomfort that occurred in the 
+context of dry heaving. Her PCP was concerned about EKG changes 
+(septal Q waves and T wave inversions), especially concerning 
+given the patient's significant history of CAD, including an MI 
+that led to a cardiac catheterization in ___ (occlusion of the 
+cardiac vessels was found at that time but patient did not 
+tolerate the procedure and no intervention was done). However, 
+following admission the patient noted that the discomfort was 
+different from the pressure she had felt during her prior MI, 
+and repeat EKG was similar to prior baseline (___). Troponins 
+were elevated to 0.21 but downtrended. The overall presentation 
+was not considered highly concerning for acute coronary 
+syndrome, so anticoagulation was avoided given baseline 
+thrombocytopenia. Cardiology (Atrius) was consulted and agreed 
+that this was likely demand ischemia in the context of 
+hypovolemia rather than ACS.
+.  
+# Fever/GNR bacteremia (E.Coli)
+Febrile to 100.4 at ED, and had several further low-grade fevers 
+on the floor. UA was positive for nitrites, and given diarrhea, 
+GI was considered another possible source of infection. She was 
+started on Bactrim on ___, but this was changed to meropenem on 
+___ when blood cultures grew gram negative rods. This was 
+continued despite final culture results showing pan-sensitive E. 
+coli due to concern about cross-reactivity of cephalosporins 
+with a penicillin allergy and fluoroquinolones in the context of 
+prolonged QTc. ID consulted and determined that it was likely 
+safe for her to try ceftriaxone, which she did on ___, and she 
+was discharged on this after PICC placement.  Surveillance blood 
+cultures were negative.  Renal U/S and CT scan of abd/pelvis 
+were obtained, which did not show evidence of abscess.  She did 
+have a fluid collection in the abdomen, but this is known from 
+prior imaging approximately 1 month ago, and has improved in 
+size.  The collection is most likely a seroma.  
+.
+#Pancytopenia  
+Downtrending WBCs (to 1.5), hematocrit, and platelets; she was 
+placed on neutropenic precautions. Possibly secondary to 
+infection, antibiotics (Bactrim or meropenem), or other 
+medication effect. OSH records showed baseline WBCs over past 
+few months in 3s following radiation treatment. Although the 
+levels did not return to baseline, they stabilized prior to 
+discharge, and she will follow up with her outpatient providers.
+ .
+# Elevated bicarb  
+Bicarb elevated to 33 on admission, likely representing a 
+metabolic alkalosis due to GI losses from diarrhea. Metabolic 
+compensation for a chronic respiratory acidosis may also have 
+contributed.  Trended down shortly after admission.
+.
+# Diabetes  
+Patient's home NPH was continued, and she was placed on an 
+insulin sliding scale.
+.
+# Endometrial cancer  
+Completed radiation therapy; not a candidate for chemo. Arimidex 
+was continued.
+.
+TRANSITIONAL ISSUES
+1.  complete course of IV antibiotics for E. coli bacteremia
+2.  repeat CBC in 2 days to monitor leukopenia, anemia, 
+thrombocytopenia
+3.  repeat LFT's at PCP ___
+4.  non-emergent MRI head to evaluate small hypodensity seen on 
+CT head from ___ (see below for report)
+5.  consider serial imaging of abdomen to monitor lesions in 
+right kidney and fluid collection in abdomen. 
+.
+ 
+
+###RESPONSE: stage IV {Clinical stage IV}, endometrial cancer {Endometrial carcinoma}, DM2 {Diabetes mellitus type 2}, CAD {Coronary arteriosclerosis}, CKD {Chronic kidney disease}, chronic respiratory failure {Chronic respiratory failure}, hypoxemia {Hypoxemia}, morbid obesity {Morbid obesity}, chest discomfort {Chest discomfort}, EKG changes {Electrocardiogram abnormal}, gastrointestinal illness {Disorder of gastrointestinal tract}, Nausea/vomiting/diarrhea {Nausea, vomiting and diarrhea}, diarrhea {Diarrhea}, nausea {Nausea}, dry heaving {Retching}, severe {Symptom severe}, chronic diarrhea {Chronic diarrhea}, radiation {Radiation oncology AND/OR radiotherapy}, viral {Viral gastroenteritis}, bacterial 
+gastroenteritis {Bacterial gastroenteritis}, Stool studies {Stool microscopy}, nausea {Nausea}, changed {Change of medication}, QTc 
+prolongation {Prolonged QT interval}, nausea and vomiting {Nausea and vomiting}, resolved {Problem resolved}, diarrhea {Diarrhea}, improved {Patient's condition improved}, Chest pain {Chest pain}, chest discomfort {Chest discomfort}, dry heaving {Retching}, EKG changes {Electrocardiogram abnormal}, Q waves {Finding of electrocardiogram Q wave}, T wave inversions {Inverted T wave}, CAD {Coronary arteriosclerosis}, MI {Myocardial infarction}, cardiac catheterization {Cardiac catheterization}, occlusion {Complete obstruction}, cardiac {Heart structure}, vessels {Blood vessel structure}, procedure {Procedure}, discomfort {Discomfort}, pressure {Tight chest}, MI {Myocardial infarction}, EKG {Electrocardiographic procedure}, baseline {Baseline state}, Troponins {Troponin measurement}, elevated {Elevation}, acute coronary 
+syndrome {Acute coronary syndrome}, anticoagulation {Anticoagulant therapy}, baseline {Baseline state}, thrombocytopenia {Thrombocytopenic disorder}, Cardiology {Cardiology service}, demand ischemia {Ischemia co-occurrent and due to increased oxygen demand}, hypovolemia {Hypovolemia}, ACS {Acute coronary syndrome}, Fever {Fever}, GNR bacteremia {Bacteremia caused by Gram-negative bacteria}, E.Coli {Infection caused by Escherichia coli}, Febrile {Fever}, low-grade fevers {Low grade pyrexia}, UA {Urinalysis}, positive for nitrites {Nitrite detected in urine}, diarrhea {Diarrhea}, GI {Infection of gastrointestinal tract}, infection {Local infection of wound}, changed {Change of medication}, blood cultures {Blood culture}, culture {Microbial culture}, E. 
+coli {Infection caused by Escherichia coli}, penicillin allergy {Allergy to penicillin}, prolonged QTc {Prolonged QT interval}, PICC placement {Insertion of peripherally inserted central catheter}, Surveillance blood 
+cultures {Infection surveillance}, negative {No pathologic diagnosis}, Renal U/S {Echography of kidney}, CT scan of abd/pelvis {Computed tomography of abdomen and pelvis}, abscess {Abscess}, fluid collection {Accumulation of fluid}, abdomen {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, imaging {Imaging}, improved {Patient's condition improved}, seroma {Seroma}, Pancytopenia {Pancytopenia}, Downtrending {Serial hematocrit determinations}, WBCs {White blood cell count}, hematocrit {Hematocrit determination}, platelets {Platelet}, neutropenic {Neutropenia}, precautions {Safety precautions}, infection {Infectious disease}, antibiotics {Antibiotic therapy}, medication {Antibiotic therapy}, e WBCs {White blood cell count}, radiation {Radiation oncology AND/OR radiotherapy}, baseline {Baseline state}, stabilized {Stable hematocrit}, Elevated bicarb  {Serum bicarbonate above reference range}, Bicarb elevated {Serum bicarbonate above reference range}, metabolic alkalosis {Metabolic alkalosis}, GI losses {Volume depletion, gastrointestinal loss}, diarrhea {Diarrhea}, chronic respiratory acidosis {Chronic respiratory acidosis}, Diabetes {Diabetes mellitus}, insulin sliding scale {Sliding scale insulin regime}, Endometrial cancer {Endometrial carcinoma}, radiation therapy {Radiation oncology AND/OR radiotherapy}, chemo {Chemotherapy}, IV antibiotics {Intravenous antibiotic therapy}, E. coli bacteremia {Bacteremia caused by Coliform}, CBC {Complete blood count}, monitor {Monitoring for signs and symptoms of infection}, leukopenia {Leukopenia}, anemia {Anemia}, thrombocytopenia {Thrombocytopenic disorder}, LFT's {Hepatic function panel}, MRI head {Magnetic resonance imaging of head}, CT head {Computed tomography of head}, imaging of abdomen {Imaging of abdomen}, lesions {Lesion}, right kidney {Right kidney structure}, fluid collection {Accumulation of fluid}, abdomen {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}"
+"###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. Levothyroxine Sodium 100 mcg PO DAILY 
+2. anastrozole *NF* 1 mg Oral daily 
+3. Omeprazole 40 mg PO DAILY 
+4. Fluoxetine 40 mg PO DAILY 
+5. Simvastatin 20 mg PO DAILY 
+6. Isosorbide Mononitrate (Extended Release) 120 mg PO DAILY 
+7. Lisinopril 5 mg PO DAILY 
+8. Metoprolol Succinate XL 100 mg PO BID 
+9. Aspirin 81 mg PO DAILY 
+10. TraZODone 25 mg PO HS 
+11. Nitroglycerin SL 0.4 mg SL PRN chest pain 
+12. OxycoDONE (Immediate Release)  5 mg PO Q4H:PRN pain 
+13. Naproxen 220 mg PO Q8H:PRN pain 
+14. Humulin N 15 Units Breakfast
+Humulin N 15 Units Bedtime
+
+ 
+Discharge Medications:
+1. anastrozole *NF* 1 mg Oral daily 
+2. Aspirin 81 mg PO DAILY 
+3. Fluoxetine 40 mg PO DAILY 
+4. Humulin N 15 Units Breakfast
+Humulin N 15 Units Bedtime
+5. Isosorbide Mononitrate (Extended Release) 120 mg PO DAILY 
+6. Levothyroxine Sodium 100 mcg PO DAILY 
+7. Lisinopril 5 mg PO DAILY 
+8. Metoprolol Succinate XL 100 mg PO BID 
+9. Nitroglycerin SL 0.4 mg SL PRN chest pain 
+10. Omeprazole 40 mg PO DAILY 
+11. OxycoDONE (Immediate Release)  5 mg PO Q4H:PRN pain 
+12. Simvastatin 20 mg PO DAILY 
+13. TraZODone 25 mg PO HS 
+14. Naproxen 220 mg PO Q8H:PRN pain 
+15. CeftriaXONE 2 gm IV Q24H 
+RX *ceftriaxone 2 gram 2 g IV once daily Disp #*7 Syringe 
+Refills:*0
+16. Outpatient Lab Work
+Please check CBC with differential on ___ and fax results to 
+PCP ___ MD Phone: ___ 
+Fax: ___ 
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+1. Diarrhea
+2. Urinary tract infection
+3. GNR bacteremia
+4. Pancytopenia
+5. Demand ischemia
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, Diarrhea {Diarrhea}, Urinary tract infection {Urinary tract infectious disease}, GNR bacteremia {Bacteremia caused by Gram-negative bacteria}, Pancytopenia {Pancytopenia}, Demand ischemia {Ischemia co-occurrent and due to increased oxygen demand}, 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}, assistance or aid (walker 
+or cane) {Assistance with walking using device}"
+"###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. ___,
+You were admitted to the hospital at ___ 
+___ from ___ to ___ for assessment of your 
+chest pain and nausea/vomiting.  Your symptoms resolved on their 
+own but you were found to have a bacterial infection in your 
+blood.  You were started on antibiotics and will continue these 
+at home until ___.  Your blood counts were found to be low 
+but stable; you will need repeat blood work drawn by the 
+visiting nurse on ___.  Please continue to speak with your 
+primary care doctor and oncologist regarding these findings. 
+
+While you were here, a CAT scan of the head was performed 
+showing a small area of asymmetry; please speak with your 
+primary care doctor regarding ___ nonurgent MRI for further 
+evaluation. 
+
+It was a pleasure caring for you during your admission at ___.
+ 
+
+###RESPONSE: assessment {Evaluation procedure}, chest pain {Chest pain}, nausea/vomiting {Nausea and vomiting}, resolved {Problem resolved}, bacterial infection {Bacterial infectious disease}, blood {Blood culture}, antibiotics {Antibiotic therapy}, blood counts {Blood test}, stable {Patient's condition stable}, blood {Blood test}, CAT scan of the head {Computed tomography of head}, MRI {Magnetic resonance imaging}, evaluation {Evaluation 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: 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: OBSTETRICS/GYNECOLOGY
+ 
+
+###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: 
+Shellfish Derived
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Incisional pain
+ 
+Major Surgical or Invasive Procedure:
+Scar injection
+
+ 
+
+###RESPONSE: Shellfish {Allergy to shellfish}, Incisional {Surgical incision wound}, pain {Pain}, Scar {Scar}, injection {Injection}"
+"###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:
+___ s/p TAH/BSO on ___ who presented to ED with 
+abdominal pain x 10d.  Pain started after having large BM 10d 
+ago - she stood up from the toilet and was instantly doubled 
+over in pain.  It was the first BM since before her surgery.  
+The pain at that time was deep abdominal in location and has 
+overall improved since that time, turning into the what she 
+describes as ""gas pain"". She has had 2 BM since that time, ___ 
+ago and again 2 days ago.  She has been taking colace BID.
+
+She started having burning pain on her ___ skin and 
+""about 4 layers deep to the skin"" in the same area roughly 8 
+days ago.  ""It feels like my skin is on fire.""  Touching her 
+skin exacerbates the pain.  She reports that even when sleeping, 
+when her sheets touch the ___ skin, it wakes her 
+from
+sleep.  She is unable to wear underpants or pants ___ to pain. 
+She has never experienced this before; she recovered well after 
+her liposuction procedure.
+
++ nausea when pain is worst, denies emesis.  Tolerating liquids, 
+pudding, and yogurt.  Passing flatus.  Denies fevers, chills, 
+abnormal vaginal discharge or bleeding.  Has had occasional hot 
+flashes and vaginal dryness.  Not sexually active.
+
+In the ED, she received morphine 8mg IV, zofran 4mg IV, and 
+dilaudid 0.5 IV.  The dilaudid has had the best effect.  She had 
+2L of NS.
+ 
+
+###RESPONSE: TAH/BSO {Total abdominal hysterectomy with bilateral salpingo-oophorectomy}, abdominal pain {Abdominal pain}, Pain {Abdominal pain}, BM {Passes stool completely}, pain {Abdominal pain}, BM {Passes stool completely}, surgery {Surgical procedure}, pain {Abdominal pain}, abdominal {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, improved {Patient's condition improved}, pain {Pain}, BM {Passes stool completely}, burning pain {Burning pain}, skin {Skin structure}, skin {Skin structure}, skin {Skin structure}, skin {Skin structure}, pain {Abdominal pain}, sleeping {Asleep}, skin {Skin structure}, pain {Pain}, liposuction procedure {Liposuction of subcutaneous tissue}, nausea {Nausea}, pain {Pain}, emesis {Vomiting}, Tolerating liquids {Tolerating oral fluid}, Passing flatus {Passing flatus}, fevers {Fever}, chills {Chill}, abnormal vaginal discharge {Vaginal discharge problem}, bleeding {Bleeding from vagina}, hot 
+flashes {Menopausal flushing}, vaginal dryness {Vaginal dryness}, Not sexually active {Currently not sexually active}, IV {Intravenous therapy}, IV {Intravenous therapy}, IV {Intravenous 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:
+GYNHx:
+- denies h/o abnl pap, last pap ___ neg
+- Denies h/o STI
+- female partners
+
+___: GO
+
+PMH: Mild asthma, chronic back pain - disc degeneration, GERD,
+Depression, Insomnia
+
+PSH: 
+- TAH BSO as above
+- Liposuction x 2, ___ - stomach and thighs
+ 
+
+###RESPONSE: abnl pap {Abnormal cervical smear}, STI {Sexually transmitted infectious disease}, Mild asthma {Mild asthma}, chronic back pain {Chronic back pain}, disc degeneration {Degeneration of intervertebral disc}, GERD {Gastroesophageal reflux disease}, Depression {Depressive disorder}, Insomnia {Insomnia}, TAH BSO {Total abdominal hysterectomy with bilateral salpingo-oophorectomy}, Liposuction {Liposuction of subcutaneous tissue}, stomach {Stomach structure}, thighs {Structure of left thigh}"
+"###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:
+NC
+ 
+
+###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:
+On admission: 
+VS:  98.9    67   112/70   16   98RA
+uncomfortable appearing
+RRR
+CTAB
+abd - soft, mildly distended +tympany, esp in upper quadrants; 
+mostly TTP in 5cm circumferential area around incision, from 
+below umbilicus to the mons.  no crepitus.  no cutaneous 
+numbness.
+
+inc: Pfannensteil, well healed, partially epithelialized, no 
+erythema, exudates, or induration
+
+ext NT b/l
+pelvic: deferred
+
+ 
+
+###RESPONSE: Physical Exam {Physical examination procedure}, VS {Vital signs finding}, RA {Breathing room air}, RRR {Normal heart rate}, CTAB {Normal breath sounds}, soft {Abdomen soft}, distended {Swollen abdomen}, tympany {Abdomen tympanitic}, upper quadrants {Structure of upper abdominal quadrant}, TTP {Tenderness}, incision {Abdomen incision}, umbilicus {Umbilical structure}, mons {Mons pubis structure}, crepitus {Subcutaneous crepitus}, cutaneous 
+numbness {Numbness of skin}, well healed {Surgical wound, healed}, epithelialized {Epithelialization}, erythema {Erythema}, exudates {Exudate}, induration {Induration}, ext {Examination of limb}, NT {Abdominal tenderness}, pelvic {Manual pelvic examination}"
+"###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:
+___ 07:15PM BLOOD WBC-6.3 RBC-4.60 Hgb-10.3* Hct-33.8* 
+MCV-74* MCH-22.5* MCHC-30.6* RDW-14.1 Plt ___
+___ 06:20AM BLOOD WBC-5.4 RBC-4.25 Hgb-9.8* Hct-32.3* 
+MCV-76* MCH-23.0* MCHC-30.2* RDW-13.9 Plt ___
+___ 07:15PM BLOOD Neuts-61.0 ___ Monos-3.5 Eos-3.5 
+Baso-0.5
+___ 07:15PM BLOOD Glucose-101* UreaN-9 Creat-0.9 Na-137 
+K-4.3 Cl-102 HCO3-27 AnGap-12
+___ 06:20AM BLOOD Glucose-90 UreaN-13 Creat-1.0 Na-137 
+K-4.4 Cl-100 HCO3-28 AnGap-13
+___ 06:20AM BLOOD Calcium-9.8 Phos-4.0 Mg-2.2
+
+___ 02:58AM URINE Blood-TR Nitrite-NEG Protein-30 
+Glucose-NEG Ketone-NEG Bilirub-NEG Urobiln-NEG pH-5.5 Leuks-TR
+___ 02:58AM URINE RBC-2 WBC-0 Bacteri-NONE Yeast-NONE 
+Epi-22
+URINE CULTURE (Final ___: 
+      MIXED BACTERIAL FLORA ( >= 3 COLONY TYPES), CONSISTENT 
+WITH SKIN
+      AND/OR GENITAL CONTAMINATION. 
+
+CT ___: IMPRESSION: No definite intra-abdominal abscess. There 
+is a small amount of fluid at the operative site, not 
+unanticipated. 
+
+ 
+
+###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}, 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}, Monos {Monocyte count}, Eos {Eosinophil 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}, 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}, URINE Blood {Blood in urine}, Protein {Measurement of protein in urine}, Ketone {Urinalysis, acetone or ketone bodies measurement}, pH {pH measurement}, URINE {Evaluation of urine specimen}, RBC {Red blood cell count}, WBC {White blood cell count}, URINE CULTURE {Urine culture}, SKIN {Skin structure}, intra-abdominal abscess {Abdominal abscess}, fluid {Effusion}, operative site {Operative site}"
+"###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:
+Ms. ___ was admitted from the ED early on ___ with abdominal 
+pain and incisional pain. CT had demonstrated no acute 
+intraabdominal process. Her pain was felt to be consistent with 
+post-operative neuropathy. She was started on tylenol, motrin, 
+and dilaudid prn for pain. She was started on a bowel regimen. 
+The chronic pain service saw her later that morning and 
+performed an incisional injection with steroids and bupivicaine. 
+She was also started on gabapentin. She had some immediate 
+relief of her pain, however the majority of the benefit wore off 
+after several hours. Lidocaine patches were applied with 
+excellent relief. She reported a good decrease in her pain where 
+she was able to tolerate some touch and the feel of 
+clothing/blankets on her skin. She did remain constipated, but 
+felt ready for discharge home on ___. Follow-up with the 
+chronic pain clinic was arranged.
+ 
+
+###RESPONSE: abdominal 
+pain {Abdominal pain}, incisional {Surgical incision wound}, pain {Pain}, CT {Computed tomography}, intraabdominal {Structure of intraabdominal region}, pain {Abdominal pain}, post-operative {Postoperative state}, neuropathy {Neuropathy}, pain {Abdominal pain}, bowel {Intestinal structure}, regimen {Therapeutic regimen}, pain service saw {Seen by pain management service}, incisional {Surgical incision wound}, injection {Injection}, steroids {Steroid therapy}, pain {Abdominal pain}, pain {Abdominal pain}, skin {Skin structure}, constipated {Constipation}, ready for discharge {Ready for discharge}, chronic pain {Chronic 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: Medications on Admission:
+percocet prn, colace, prilosec  
+ 
+Discharge Medications:
+1. Ibuprofen 600 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 
+hours) as needed for pain.
+Disp:*60 Tablet(s)* Refills:*0*
+2. Acetaminophen 500 mg Tablet Sig: ___ Tablets PO Q6H (every 6 
+hours) as needed for pain.  
+3. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO TID (3 
+times a day).
+Disp:*90 Capsule(s)* Refills:*2*
+4. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) 
+Tablet, Delayed Release (E.C.) PO DAILY (Daily).
+Disp:*60 Tablet, Delayed Release (E.C.)(s)* Refills:*0*
+5. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) 
+Capsule, Delayed Release(E.C.) PO BID (2 times a day).  
+6. Gabapentin 300 mg Capsule Sig: One (1) Capsule PO TID (3 
+times a day).
+Disp:*90 Capsule(s)* Refills:*2*
+7. Hydromorphone 2 mg Tablet Sig: ___ Tablets PO every four (4) 
+hours as needed for pain.
+Disp:*50 Tablet(s)* Refills:*0*
+8. Lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: 
+Two (2) patch Topical DAILY (Daily): Keep on for 12 hours, off 
+for 12 hours .
+Disp:*20 patch* Refills:*2*
+
+ 
+
+###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:
+Cutaneous neuropathy
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Cutaneous {Skin structure}, neuropathy {Neuropathy}, Mental Status {Neurological mental status determination}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, interactive {Does communicate}, 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 for nerve pain around your incision. You 
+received an injection of an anesthetic and steroid which helped 
+lessen the pain. We started you on a medication called 
+gabapentin which should start to work in a few days. You also 
+were given lidocaine patches to put on your skin and a narcotic 
+called dilaudid to help lessen the pain until the steroid 
+medication starts to work. You should also continue to take 
+Ibuprofen and colace. It is important to drink lots of fluid to 
+help keep your stools soft.
+ 
+
+###RESPONSE: nerve {Nerve structure}, pain {Pain}, incision {Surgical incision wound}, injection {Injection}, steroid {Steroid therapy}, pain {Pain}, medication {Prescription of drug}, skin {Skin structure}, pain {Pain}, steroid 
+medication {Steroid therapy}, drink lots of fluid {Fluid intake encouragement}, stools soft {Soft stool}"
+"###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: OBSTETRICS/GYNECOLOGY
+ 
+
+###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:
+nausea/vomiting
+ 
+Major Surgical or Invasive Procedure:
+none
+ 
+
+###RESPONSE: nausea/vomiting {Nausea and vomiting}"
+"###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:
+Patient is a ___ year old G1P0 at approximately 15+2 weeks by 
+unsure LMP of ___ presenting to the ED with nausea and 
+vomiting unable to tolerate PO intake for 3 days. Patient 
+reports a history of hyperemesis gravidarum since about 8 weeks 
+gestation. She was seen for an initial prenatal visit by 
+RN-Midwife at ___. She denies having had 
+any ultrasounds yet. She has had her initial prenatal labs. She 
+had a prescription for PO Zofran which she said was not helping. 
+She was seen twice at the ___ urgent care unit for IVF and IV 
+antiemetics. Symptoms persisted for 1 month before spontaneous 
+resolving. Her symptoms recurred on ___ with severe nausea and 
+vomiting. Last meal was chicken soup on that date which she 
+could not keep down. She has tried water and ginger ale which 
+also makes her nauseated. She is not currently taking any 
+antiemetics.
+
+ROS: (+) Back/shoulder pain with emesis, (+) epigastric pain 
+with emesis, (+) chills, (+) 8 lb weight loss. Denies fever, 
+myalgias, diarrhea, SOB, dizziness, rhinorrhea, cough. No sick 
+contacts. Seasonal flu shot 1 month ago. No H1N1.
+ 
+
+###RESPONSE: nausea and 
+vomiting {Nausea and vomiting}, hyperemesis gravidarum {Excessive vomiting in pregnancy}, gestation {Pregnancy}, initial prenatal visit {Prenatal initial visit}, ultrasounds {Ultrasonography}, prescription {Prescription}, IVF {Administration of intravenous fluids}, IV {Administration of drug or medicament via intravenous route}, resolving {Patient's condition improved}, nausea and 
+vomiting {Nausea and vomiting}, nauseated {Nausea}, shoulder pain {Shoulder pain}, emesis {Vomiting}, epigastric pain {Epigastric pain}, emesis {Vomiting}, chills {Chill}, weight loss {Weight loss}, fever {Fever}, myalgias {Muscle pain}, diarrhea {Diarrhea}, SOB {Dyspnea}, dizziness {Dizziness}, rhinorrhea {Nasal discharge}, cough {Cough}, Seasonal flu shot {Administration of vaccine product containing only Influenza virus antigen}"
+"###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:
+PRENATAL COURSE
+___ ___ by 17wk U/S (changed from initial ___ ___
+*)Labs: A+/Ab-,RI,HbsAg-,RPRnr,HIV-,GC/CT-
+*)CF negative, nl hgb electrophoresis
+*)No screening/ultrasound prior to this admission
+
+PAST OBSTETRIC HISTORY
+G1
+
+PAST GYNECOLOGIC HISTORY
+- no paps yet
+- denies STDs
+- normal menses
+
+PAST MEDICAL HISTORY
+denies
+
+PAST SURGICAL HISTORY
+denies
+ 
+
+###RESPONSE: U/S {Ultrasonography}, HIV {Human immunodeficiency virus infection}, GC {Gonorrhea}, CT {Chlamydia culture}, hgb {Measurement of total hemoglobin concentration}, electrophoresis {Electrophoresis measurement}, ultrasound {Ultrasonography}"
+"###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:
+noncontributory
+ 
+
+###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:
+(on admission)
+PE: T 97.8->98.4, BP 129/62->103/56, P ___, RR 20, O2 100%
+FHR: 156 bpm
+GENERAL: appears tired and weak, lying in stretcher.
+CV: RRR
+ABDOMEN: soft, gravid, tender to palpation in epigastrium, 
+mildly
+tender RLQ
+EXTREMITIES: no edema
+
+(___) RUQ ULTRASOUND
+IMPRESSION: 
+Normal-appearing gallbladder. No findings to suggest acute 
+cholecystitis. 
+  
+___ FETAL SURVEY
+There is a single live intrauterine pregnancy with fetus in 
+cephalic position.  The placenta is fundal. There is no evidence 
+of previa. There is a normal amount of amniotic fluid. Views of 
+the head, face, stomach, cord insertion site, bladder were 
+normal. There is an echogenic focus in the left cardiac 
+ventricle. There is polydactyly in the left hand and probably 
+polydactyly in the left foot. Both kidneys show caliectasis 
+measuring 3 mm.
+  
+The following biometric data were obtained:
+BPD: 17 weeks 2 days  
+HC: 16 weeks 6 days 
+AC: 17 weeks 4 days 
+FL: 17 weeks 5 days 
+  
+AGE BY ULTRASOUND: 17 weeks 2 days
+AGE BY LMP: 15 weeks 3 days
+EFW: 199g
+
+IMPRESSION: Single live intrauterine pregnancy at 17 weeks 2 
+days. There is an echogenic focus in the left ventricle. 
+Bilateral caliectasis without hydronephrosis. Left hand 
+polydactyly.
+ 
+
+###RESPONSE: BP {Blood pressure finding}, RR {Finding of rate of respiration}, FHR {Finding of heart rate}, GENERAL {General examination of patient}, tired {Tired}, weak {Asthenia}, lying {Lying in bed}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, ABDOMEN {Examination of abdomen}, soft {Abdomen soft}, gravid {Finding of gravida}, tender {Abdominal tenderness}, palpation {Palpation}, epigastrium {Epigastric region structure}, tender {Abdominal tenderness}, RLQ {Right lower quadrant pain}, EXTREMITIES {Examination of limb}, edema {Edema}, RA {Breathing room air}, ND {Swollen abdomen}, gallbladder {Gallbladder structure}, acute 
+cholecystitis {Acute cholecystitis}, single live intrauterine pregnancy {Fetus present}, fetus {Entire fetus}, cephalic position {Cephalic fetal presentation}, placenta {Placental structure}, fundal {Structure of fundus uteri}, no evidence {No abnormality detected}, previa {Placenta previa}, normal amount of amniotic fluid {Amniotic fluid volume within reference range}, head {Fetal head structure}, face {Face structure}, stomach {Stomach structure}, cord insertion site {Umbilical cord structure}, bladder {Urinary bladder structure}, left cardiac 
+ventricle {Left cardiac ventricular structure}, polydactyly {Polydactyly}, left hand {Structure of left hand}, polydactyly {Polydactyly}, left foot {Structure of left foot}, Both kidneys {Both kidneys}, caliectasis {Dilatation of calyx}, BPD {Bronchopulmonary dysplasia of newborn}, ULTRASOUND {Ultrasonography}, Single live intrauterine pregnancy {Fetus present}, left ventricle {Left cardiac ventricular structure}, caliectasis {Dilatation of calyx}, hydronephrosis {Hydronephrosis}, Left hand {Structure of left hand}, polydactyly {Polydactyly}"
+"###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:
+___ WBC-12.7 RBC-3.63 Hgb-10.7 Hct-32.5 MCV-89 Plt-460
+___ Neuts-90.2 ___ Monos-2.1 Eos-0.2 Baso-0.1
+___ ___ PTT-30.7 ___
+
+___ Glu-97 BUN-4 Cre-0.5 Na-138 K-3.4 Cl-107 HCO3-14
+___ Glu-89 BUN-3 Creat-0.4 Na-139 K-3.1 Cl-111 HCO3-16
+___ Glu-86 BUN-2 Creat-0.3 Na-138 K-3.2 Cl-109 HCO3-18
+___ ALT-9 AST-13 AlkPhos-48 TotBili-0.5 Lipase-17
+___ Calcium-8.7 Phos-2.1 Mg-1.5 TSH-0.062
+___ Calcium-8.4 Phos-3.8 Mg-2.0
+___ Calcium-7.7 Phos-2.6 Mg-1.5
+___ BLOOD T4-11.0 T3-149 Lactate-0.9
+
+___ BLOOD ASA-NEG Ethanol-NEG Acetmnp-NEG Bnzodzp-NEG 
+Barbitr-NEG Tricycl-NEG
+
+HELICOBACTER PYLORI ANTIBODY TEST (Final ___: 
+  NEGATIVE BY EIA
+
+URINE CULTURE (Final ___: 
+  MIXED BACTERIAL FLORA ( >= 3 COLONY TYPES), CONSISTENT
+  WITH SKIN AND/OR GENITAL CONTAMINATION
+ 
+
+###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}, Neuts {Neutrophil count}, Monos {Monocyte count}, Eos {Eosinophil count}, Baso {Basophil count}, PTT {Partial thromboplastin time, activated}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, HCO3 {Blood bicarbonate measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, HCO3 {Blood bicarbonate measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, HCO3 {Blood bicarbonate 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}, TSH {Thyroid stimulating hormone measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, URINE CULTURE {Urine culture}, GENITAL {Genital 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:
+___ G1 admitted at 17+1 weeks gestation with hyperemesis.
+.
+Ms ___ was admitted for IV hydration, antiemetics, and 
+electrolyte repletion. She complained of epigastric pain and she 
+underwent a right upper quandrant ultrasound which was normal. 
+Her ___ was recalculated based on her full fetal survey. An 
+additional finding on her fetal survey included an echogenic 
+focus in the left ventricle and bilateral caliectasis without 
+hydronephrosis, and left hand polydactyly. Ms ___ was 
+counseled regarding these findings and opted to have a Quad 
+Screen and declined an amniocentesis. The Quad screen was sent 
+during this admission. By hospital day #3, she was tolerating 
+po's and was discharged home. She will have close outpatient 
+followup.
+ 
+
+###RESPONSE: gestation {Pregnancy}, hyperemesis {Hyperemesis}, IV hydration {Administration of intravenous fluids}, electrolyte repletion {Administration of electrolytes}, epigastric pain {Epigastric pain}, right upper quandrant ultrasound {Ultrasonography of abdomen, right upper quadrant and epigastrium}, left ventricle {Left cardiac ventricular structure}, caliectasis {Dilatation of calyx}, hydronephrosis {Hydronephrosis}, left hand {Structure of left hand}, polydactyly {Polydactyly}, Quad {Measurement of alpha fetoprotein and human chorionic gonadotropin and unconjugated estriol in serum or plasma specimen}, amniocentesis {Amniocentesis}, Quad {Measurement of alpha fetoprotein and human chorionic gonadotropin and unconjugated estriol in serum or plasma specimen}"
+"###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:
+Flintstones vitamins
+ 
+
+###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:
+pregnancy at 17 weeks gestation
+hyperemesis
+ 
+Discharge Condition:
+stable
+ 
+
+###RESPONSE: pregnancy {Pregnancy}, 17 weeks gestation {Gestation period, 17 weeks}, hyperemesis {Hyperemesis}, stable {Patient's condition stable}"
+"###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:
+try to stay hydrated. Use medication as needed for your nausea. 
+call your doctor with any abdominal pain/cramping, leaking of 
+fluid, vaginal bleeding, fevers > 100.4, persistent 
+nausea/vomiting, unable to tolerate fluids, or with any 
+questions or concerns you may have
+ 
+
+###RESPONSE: nausea {Nausea}, abdominal pain {Abdominal pain}, cramping {Cramping pain}, leaking {Discharge}, fluid {Effusion}, vaginal bleeding {Bleeding from vagina}, fevers {Fever}, nausea/vomiting {Nausea and vomiting}, fluids {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: 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: 
+Patient recorded as having No Known Allergies to Drugs
+ 
+Attending: ___
+ 
+Chief Complaint:
+Shortness of Breath
+ 
+Major Surgical or Invasive Procedure:
+None
+ 
+
+###RESPONSE: Shortness of Breath {Dyspnea}"
+"###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 ___ yo F w/hx of afib on coumadin, COPD, MR, TR 
+who presented on ___ from her nursing home with falls and 
+questionable left facial droop.  She was initially a code stroke 
+in the ED.  She was evaluated by neurology who determined that 
+she did not have a stroke and she did not require further 
+neurologic evaluation.  She had CT head noncon and CTA 
+head/neck, both were negative. She also had a negative urine and 
+CXR except cardiomegaly.  On admission she required 3L NC.  Over 
+the course of her hospitalization she has developed worsening 
+hypoxia so that in the evening of ___ she required 100% 
+facemask.  She was given 40mg IV Lasix and urinated 1700ml and 
+improved to 2L NC.  CTA done overnight showed no PE but did show 
+bileratal pleural effusions L>R with LLL collapse and 
+mediastinal lymphadenopathy.  Over the course of the day on 
+___ she again had worsening oxygen requirement and developed 
+worsening tachycardia with afib and RVR.  Blood pressure was 
+stable in the 130s-140s/80s-90s.
+.
+On arrival to the ICU, she is breathing comfortably. She denies 
+shortness of breath, chest pain, palpitations.  She has not had 
+fevers, chills or night sweats.  She has no cough.
+.
+Review of systems: 
+(+) Per HPI
+(-) Denies fever, chills, night sweats, recent weight loss or 
+gain. Denies headache, sinus tenderness, rhinorrhea or 
+congestion. Denies cough, shortness of breath, or wheezing. 
+Denies chest pain, chest pressure, palpitations, or weakness. 
+Denies nausea, vomiting, diarrhea, constipation, abdominal pain, 
+or changes in bowel habits. Denies dysuria, frequency, or 
+urgency. Denies arthralgias or myalgias. Denies rashes or skin 
+changes. 
+
+ 
+
+###RESPONSE: afib {Atrial fibrillation}, COPD {Chronic obstructive lung disease}, MR {Mitral valve regurgitation}, falls {Falls}, left {Structure of left half of face}, facial droop {Weakness of face muscles}, stroke {Cerebrovascular accident}, evaluated by neurology {Seen by neurologist}, stroke {Cerebrovascular accident}, neurologic evaluation {Neurological examination}, CT head {Computed tomography of head}, CTA 
+head/neck {Computed tomography angiography of head and neck with contrast}, negative {No abnormality detected}, negative {No abnormality detected}, CXR {Plain chest X-ray}, cardiomegaly {Cardiomegaly}, NC {Oxygen administration by nasal cannula}, worsening {Patient's condition worsened}, hypoxia {Hypoxia}, 100% 
+facemask {Oxygen administration by mask}, IV {Intravenous therapy}, improved {Patient's condition improved}, NC {Oxygen administration by nasal cannula}, CTA {Computed tomography angiography with contrast}, PE {Pulmonary embolism}, bileratal pleural effusions {Bilateral pleural effusion}, LLL {Structure of lower lobe of left lung}, collapse {Atelectasis}, mediastinal lymphadenopathy {Mediastinal lymphadenopathy}, worsening {Patient's condition worsened}, worsening {Patient's condition worsened}, tachycardia {Tachycardia}, afib and RVR {Atrial fibrillation with rapid ventricular response}, Blood pressure was 
+stable {Stable blood pressure}, ICU {Patient transfer to intensive care unit}, breathing comfortably {Breathing easily}, shortness of breath {Dyspnea}, chest pain {Chest pain}, palpitations {Palpitations}, fevers {Fever}, chills {Chill}, night sweats {Night sweats}, cough {Cough}, Review of systems {Review of systems}, fever {Fever}, chills {Chill}, night sweats {Night sweats}, recent weight loss {Recent weight loss}, gain {Recent weight gain}, headache {Headache}, sinus tenderness {Tenderness over frontal sinus}, rhinorrhea {Nasal discharge}, congestion {Nasal congestion}, Denies cough {Does not cough}, shortness of breath {Dyspnea}, wheezing {Wheezing}, chest pain {Chest pain}, chest pressure {Tight chest}, palpitations {Palpitations}, weakness {Asthenia}, nausea, vomiting, diarrhea {Nausea, vomiting and diarrhea}, constipation {Constipation}, abdominal pain {Abdominal pain}, changes in bowel habits {Altered bowel function}, 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:
+-Afib on warfarin  
+-Chronic leukocytosis and thrombocytosis  
+-COPD  
+-Mitral and tricuspid regurgitation  
+-Chronic gait instability  
+-HTN  
+-Depression  
+-s/p back surgery for tumor resection on spinal cord. Did not 
+received chemo or radiation per son.  
+-Spinal stenosis  
+-Hysterectomy  
+-Osteoporosis  
+-GERD  
+ 
+
+###RESPONSE: Afib {Atrial fibrillation}, on warfarin {Warfarin therapy}, leukocytosis {Leukocytosis}, thrombocytosis {Thrombocytosis}, COPD {Chronic obstructive lung disease}, Mitral {Mitral valve regurgitation}, tricuspid regurgitation {Tricuspid valve regurgitation}, gait instability  {Unsteady when walking}, HTN {Hypertensive disorder, systemic arterial}, Depression {Depressive disorder}, back {Structure of back of trunk}, surgery {Surgical procedure}, tumor resection {Excision of neoplasm}, spinal cord {Spinal cord structure}, chemo {Chemotherapy}, radiation {Radiation oncology AND/OR radiotherapy}, Spinal stenosis {Spinal stenosis}, Hysterectomy {Hysterectomy}, Osteoporosis {Osteoporosis}, GERD  {Gastroesophageal reflux 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: 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:
+Family Hx: son with CAD s/p MI  
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}, MI {Myocardial infarction}"
+"###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:
+Vitals: T: BP: P: R: 18 O2:  
+General: Alert, oriented, breathing in the ___ without clear 
+distress
+HEENT: Sclera anicteric, MMM, oropharynx clear
+Neck: supple, JVP not elevated, no LAD
+Lungs: Decreased breath sounds at the bases bilaterally, L 
+moreso than R side. No crackles or wheezes.
+CV: Tachycardic, irregular, no mumurs appreciated.
+Abdomen:  soft, non-tender, non-distended, bowel sounds present, 
+no rebound tenderness or guarding, no organomegaly
+GU: + foley
+Ext: warm, well perfused, 2+ pulses, R leg wrapped in bandages.
+
+ 
+
+###RESPONSE: Physical Exam {Physical examination procedure}, Vitals {Vital signs finding}, BP {Blood pressure finding}, General {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, distress {Distress}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, MMM {Moist oral mucosa}, oropharynx clear {Pharynx normal}, Neck {Physical examination procedure}, supple {Normal movement of neck}, JVP not elevated {Normal jugular venous pressure}, LAD {Lymphadenopathy}, Lungs {Examination of respiratory system}, Decreased breath sounds {Decreased breath sounds}, bases {Structure of base of lung}, L {Structure of base of left lung}, R side {Structure of base of right lung}, crackles {Respiratory crackles}, wheezes {Wheezing}, CV {Cardiovascular physical examination}, Tachycardic {Tachycardia}, irregular {Irregular heart beat}, mumurs {Heart murmur}, Abdomen {Examination of abdomen}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, bowel sounds present {Normal bowel sounds}, rebound {Rebound tenderness}, tenderness {Tenderness}, guarding {Abdominal guarding}, organomegaly {Abdominal organomegaly}, GU {Examination of genitourinary system}, Ext {Examination of limb}, warm {Warm skin}, well perfused {Normal tissue perfusion}, 2+ pulses {Peripheral pulses normal}, R leg {Structure of right lower leg}, wrapped in bandages {Application of bandage}"
+"###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:
+___ 06:24PM URINE  HOURS-RANDOM
+___ 06:24PM URINE  UHOLD-HOLD
+___ 06:24PM URINE  COLOR-Straw APPEAR-Clear SP ___
+___ 06:24PM URINE  BLOOD-NEG NITRITE-NEG PROTEIN-NEG 
+GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 
+LEUK-NEG
+___ 05:38PM   GLUCOSE-112* UREA N-23* CREAT-1.0 SODIUM-144 
+POTASSIUM-4.2 CHLORIDE-108 TOTAL CO2-24 ANION GAP-16
+___ 05:38PM   estGFR-Using this
+___ 05:38PM   WBC-20.3* RBC-6.11* HGB-10.7* HCT-38.6 
+MCV-63* MCH-17.6* MCHC-27.8* RDW-19.3*
+___ 05:38PM   PLT COUNT-657*
+___ 05:38PM   ___ PTT-31.7 ___
+ 
+
+###RESPONSE: COLOR {Color finding}, PROTEIN {Measurement of protein in urine}, KETONE {Urinalysis, acetone or ketone bodies measurement}, BILIRUBIN {Bilirubin measurement, urine}, PH {pH measurement}, 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}, 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}"
+"###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:
+Patient transferred to ICU with worsening hypoxia and afib with 
+RVR.
+
+1. Hypoxia:  On admission patient had a new oxygen requirement, 
+3L nasal cannula, while at baseline she was on room air.  
+Throughout her admission, patient denied shortness of breath but 
+did complain of fatigue.  Given her rapid heart rate, the 
+patient underwent a CTA to rule out PE.  CTA showed bilateral 
+pleural effusions with LLL collapse, but no PE.  Given CTA 
+findings her initial presentation was thought to be secondary to 
+heart failure, possibly exacerbated by a fib w/ RVR and she was 
+diuresed with po lasix.  CTA did show extensive mediastinal 
+lymphadenopathy and so infectious vs. malignant etiologies were 
+considered.  
+.
+Over the course of her hospitalization, she required two 
+admissions to the MICU.  On ___ she decompensated with 
+hypoxia and A-fib with RVR with a question of aspiration event. 
+Her a-fib was managed by increasing metoprolol dose and digoxin 
+loading/maintenance with good HR (70s-80s) and BP control 
+(110-120s).  Given the rise in WBC, she was started and 
+completed an 8 day course for HCAP with vanc and zosyn.  She was 
+diuresed in the with iv lasix.  A TEE was done that showed 
+diastolic dysfunction and BNP was elevated to 10K.  CE were 
+trended but were flat.  She was transferred to the floor for 
+further management. 
+.
+On the floor patient improved with diuresis and antibiotic 
+course.  Her leukocytosis also downtrended.  Speech and swallow 
+consulted who did not see si/sx of aspiration.  However, there 
+remained concern that patient was aspirating and she was placed 
+on aspiration precautions.  She had another episode of hypoxia 
+with afib and RVR requiring NRB; ABG on NRB showed 7.52/36/65/30 
+with lactate 4.8.  She was transferred to the MICU a second 
+time.  A repeat Chest CT was concerning for right middle lobe 
+pneumonia, patient weaned off to nasal cannula and lactate 
+trended down.  Patient was diuresed and transferred back to the 
+floor.  On ___, patient spiked a fever, and was started on iv 
+meropenem and vanc for an 8 day course of aspiration pneumonia, 
+and pan-cultured.  She improved with antibiotics and 
+defervesced.  Urine and blood culture showed no growth on 
+discharge.
+.
+Patient was managed with chest ___ and aggressive pulmonary 
+toilet.  Pulmonology was consulted, who agreed with management 
+of antibiotics, diuresis, and BP/rate control.  Given her 
+anatomy thoracentesis thought to be unlikely to result in 
+re-expansion of her left lung.  Goals of care were discussed 
+further with patient.  Patient decided that further MICU 
+transfers were not align with her goals of care and decided to 
+be DNI.  Patient was discharged to nursing facility with plans 
+to transition to hospice care.  Ultimately decision was made 
+with family and patient for do not hospitalize as this would not 
+be consistent with patient's goals of care.
+- Continue iv vanc and meropenem until ___ to complete 8 
+day course
+- Continue nasal cannula, wean as tolerated
+- Patient has decided to be: DNR/DNI/DNH
+.
+2. Afib with RVR: This may have been precipitated by lung 
+etiology given hypoxia.  Blood pressure was initially stable 
+though dipped into the low 100s systolic.  She was on Metoprolol 
+on admission which was increased to 75mg PO TID.  Patient had 
+several episodes of RVR to 160s which were managed with gentle 
+bolus, with minimal response, then IV metoprolol and IV dilt.  
+She was ruled out for an MI, and infectious work up was 
+revealing for pneumonia.  Her coumadin was initially held given 
+her history of falls.  This was restarted during her 
+hospitalization.  However, as patient remained hypoxic and weak, 
+further discussions regarding risk/benefit of coumadin were had 
+with patient and son. Ultimately, the immediate risks of bleed 
+were thought to outweigh the long-run benefits. Coumadin was 
+stopped on discharge.
+- Hold metoprolol or diltiazam if SBP<100, HR<60
+.
+3. Acute Heart Failure: CT scans notable for bilateral pleural 
+effusions. A TTE was done that showed EF 55%, RV moderately 
+dilated with mild global free wall hypokinesis. CE were 
+negative.  She was maintained with lasix, bb, ccb, and digoxin.  
+She was transitioned from iv lasix to 40mg PO lasix, to keep net 
+even to 500cc net negative.
+- Suspect that lasix dose will need to be reduced.  When patient 
+stops iv antibiotics please determine new lasix dose by PO 
+intake and fluid status.  Consider reducing dose back to home 
+dose of 10mg daily.
+.
+4. Extensive Mediastinal Lymphadenopathy: This was seen on CTA 
+and the differential thought to include infection vs. 
+malignancy.  On repeat imaging, there was small improvement in 
+lymphadenopathy after diuresis and antibiotic treatment.  
+Pulmonology consulted and given goals of care (as stated above), 
+further invasive work up was not in line with patient's wishes.  
+As stated above she spiked a temp ___ and was pan-cultured and 
+started on ___ x8days for aspiration pna.
+.
+5. Leukocytosis: Seen by hematologist Dr. ___ at ___, 
+with leukocytosis in the past in ___.  Throughout her 
+admission, WBC ranged from 9 to 30 w/ primarily PMN diff (90s).  
+She was treated for pneumonia infection with two course of 
+antibiotics which improved her leukocytosis.
+.
+6. Thrombocytosis: It was confirmed w/ her outpatient 
+hematologist that patient has a known JACK2 mutation by PCR.  
+She was continued on Hydroxyurea 3 days per week.
+ 
+
+###RESPONSE: transferred to ICU {Patient transfer to intensive care unit}, worsening {Patient's condition worsened}, hypoxia {Hypoxia}, afib with 
+RVR {Atrial fibrillation with rapid ventricular response}, Hypoxia {Hypoxia}, nasal cannula {Oxygen administration by nasal cannula}, baseline {Baseline state}, on room air {Breathing room air}, shortness of breath {Dyspnea}, fatigue {Fatigue}, rapid heart rate {Tachycardia}, CTA {Computed tomography angiography with contrast}, PE {Pulmonary embolism}, CTA {Computed tomography angiography with contrast}, bilateral 
+pleural effusions {Bilateral pleural effusion}, LLL {Structure of lower lobe of left lung}, collapse {Atelectasis}, PE {Pulmonary embolism}, CTA {Computed tomography angiography with contrast}, heart failure {Heart failure}, a fib w/ RVR {Atrial fibrillation with rapid ventricular response}, diuresed {Diuretic therapy}, lasix {Diuretic therapy}, CTA {Computed tomography angiography with contrast}, mediastinal 
+lymphadenopathy {Mediastinal lymphadenopathy}, infectious {Infectious disease}, malignant {Malignant neoplasm}, admissions to the MICU {Admission to intensive care unit}, hypoxia {Hypoxia}, A-fib with RVR {Atrial fibrillation with rapid ventricular response}, aspiration {Aspiration}, a-fib {Atrial fibrillation}, good HR (70s-80s) {Normal heart rate}, BP control 
+(110-120s) {Normal blood pressure}, WBC {White blood cell count}, HCAP {Nosocomial pneumonia}, diuresed {Diuretic therapy}, lasix {Diuretic therapy}, TEE {Transesophageal echocardiography}, diastolic dysfunction {Diastolic dysfunction}, BNP {Brain natriuretic peptide measurement}, improved {Patient's condition improved}, diuresis {Diuretic therapy}, antibiotic {Antibiotic therapy}, leukocytosis {Leukocytosis}, Speech and swallow 
+consulted {Speech therapy assessment}, aspiration {Aspiration}, aspiration precautions {Aspiration precautions}, hypoxia {Hypoxia}, afib and RVR {Atrial fibrillation with rapid ventricular response}, NRB {Oxygen administration by mask}, ABG {Analysis of arterial blood gases and pH}, NRB {Oxygen administration by mask}, lactate {Lactic acid measurement}, transferred to the MICU {Patient transfer to intensive care unit}, Chest CT {Computed tomography of chest}, right middle lobe 
+pneumonia {Right middle zone pneumonia}, nasal cannula {Oxygen administration by nasal cannula}, lactate {Lactic acid measurement}, diuresed {Diuretic therapy}, fever {Fever}, aspiration pneumonia {Aspiration pneumonia}, pan-cultured {Microbial culture}, improved {Patient's condition improved}, antibiotics {Antibiotic therapy}, Urine {Urine culture}, blood culture {Blood culture}, chest {Thoracic structure}, pulmonary 
+toilet {Airway toilet}, antibiotics {Antibiotic therapy}, diuresis {Diuretic therapy}, rate {Rate measurement}, thoracentesis {Thoracentesis}, left lung {Left lung structure}, hospice care {Hospice care}, nasal cannula {Oxygen administration by nasal cannula}, DNR {Not for resuscitation}, Afib with RVR {Atrial fibrillation with rapid ventricular response}, lung {Lung structure}, hypoxia {Hypoxia}, Blood pressure {Blood pressure finding}, stable {Patient's condition stable}, low 100s systolic {Decreased systolic arterial pressure}, RVR {Atrial fibrillation with rapid ventricular response}, IV {Intravenous therapy}, IV {Intravenous therapy}, MI {Myocardial infarction}, infectious {Infectious disease}, pneumonia {Pneumonia}, falls {Falls}, hypoxic {Hypoxia}, weak {Asthenia}, discussions {Discussion}, bleed {Bleeding}, SBP {Decreased systolic arterial pressure}, HR {Bradycardia}, Acute Heart Failure {Acute heart failure}, CT scans {Computed tomography}, bilateral pleural 
+effusions {Bilateral pleural effusion}, TTE {Transthoracic echocardiography}, RV moderately 
+dilated {Dilatation of right cardiac ventricle}, wall hypokinesis {Hypokinesis of cardiac wall}, CE {Contrast echocardiography}, negative {No abnormality detected}, lasix {Diuretic therapy}, iv {Intravenous therapy}, lasix {Diuretic therapy}, lasix {Diuretic therapy}, lasix {Diuretic therapy}, iv antibiotics {Intravenous antibiotic therapy}, lasix {Diuretic therapy}, Mediastinal Lymphadenopathy {Mediastinal lymphadenopathy}, CTA {Computed tomography angiography with contrast}, infection {Infectious disease}, malignancy {Malignant neoplasm}, imaging {Imaging}, lymphadenopathy {Lymphadenopathy}, diuresis {Diuretic therapy}, antibiotic {Antibiotic therapy}, spiked a temp {Fever}, pan-cultured {Microbial culture}, aspiration pna {Aspiration pneumonia}, Leukocytosis {Leukocytosis}, Seen by hematologist {Seen by hematologist}, leukocytosis {Leukocytosis}, WBC {White blood cell count}, pneumonia {Pneumonia}, infection {Infectious disease}, antibiotics {Antibiotic therapy}, improved {Patient's condition improved}, leukocytosis {Leukocytosis}, Thrombocytosis {Thrombocytosis}"
+"###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:
+1. Omeprazole 40 mg daily  
+2. Aspirin 81 mg daily  
+3. Mirtazapine 45 mg QHS  
+4. Escitalopram 20 mg daily  
+5. Tiotropium Bromide 18 mcg inh daily  
+6. Fluticasone-Salmeterol 250-50 mcg/Dose inh BID  
+7. Metoprolol 50 mg BID  
+8. Diltiazem 120 mg daily  
+9. Coumadin 4 mg daily  
+10. Cephalexin 500mg TID (started pm of ___  
+11. APAP 650mg q4h prn  
+12. Colace 100mg BID  
+13. Hydroxyurea 500mg ___  
+14. MVI daily  
+15. Senna 2 tabs QHS  
+16. Milk of Mg 30ml QID prn  
+17. Furosemide 10mg daily  
+.
+
+ 
+Discharge Medications:
+1. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: Two (2) 
+Capsule, Delayed Release(E.C.) PO DAILY (Daily).  
+2. Mirtazapine 15 mg Tablet Sig: Three (3) Tablet PO HS (at 
+bedtime).  
+3. Escitalopram 10 mg Tablet Sig: Two (2) Tablet PO DAILY 
+(Daily).  
+4. Digoxin 125 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+
+5. Metoprolol Tartrate 25 mg Tablet Sig: Three (3) Tablet PO TID 
+(3 times a day).  
+6. Diltiazem HCl 120 mg Capsule, Sust. Release 24 hr Sig: One 
+(1) Capsule, Sust. Release 24 hr PO once a day.  
+7. Aspirin 81 mg Tablet Sig: One (1) Tablet PO once a day.  
+8. Acetaminophen 500 mg Tablet Sig: Two (2) Tablet PO TID (3 
+times a day) as needed for pain.  
+9. Hydroxyurea 500 mg Capsule Sig: One (1) Capsule PO 3X/WEEK 
+(___).  
+10. Multivitamin     Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+11. Senna 8.6 mg Tablet Sig: One (1) Tablet PO HS (at bedtime) 
+as needed for constipation.  
+12. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID 
+(2 times a day).  
+13. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1)  
+Injection TID (3 times a day).  
+14. Vancomycin in D5W 1 gram/200 mL Piggyback Sig: 1000 (1000) 
+mg Intravenous Q48H (every 48 hours) for 8 days: To be completed 
+___.  
+15. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) 
+ML PO Q6H (every 6 hours) as needed for constipation.  
+16. Fluticasone-Salmeterol 250-50 mcg/Dose Disk with Device Sig: 
+One (1)  Inhalation twice a day.  
+17. Furosemide 20 mg Tablet Sig: Two (2) Tablet PO DAILY 
+(Daily).  
+18. Lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: 
+One (1) Adhesive Patch, Medicated Topical DAILY (Daily).  
+19. Ipratropium Bromide 0.02 % Solution Sig: One (1)  Inhalation 
+every six (6) hours.  
+20. Metoprolol Succinate 200 mg Tablet Sustained Release 24 hr 
+Sig: One (1) Tablet Sustained Release 24 hr PO DAILY (Daily).  
+21. Metoprolol Succinate 25 mg Tablet Sustained Release 24 hr 
+Sig: One (1) Tablet Sustained Release 24 hr PO once a day.  
+22. Meropenem 500 mg Recon Soln Sig: One (1) Recon Soln 
+Intravenous Q8H (every 8 hours) for 8 days: To be completed 
+___.  
+
+ 
+
+###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:
+___
+ 
+___ Diagnosis:
+Primary:
+Acute CHF exacerbation
+Pneumonia
+Lung collapse
+Atrial fibrillation with rapid ventricular rate
+
+ 
+Discharge Condition:
+A&Ox3
+
+ 
+
+###RESPONSE: Acute CHF exacerbation {Acute exacerbation of chronic congestive heart failure}, Pneumonia {Pneumonia}, Lung collapse {Atelectasis}, Atrial fibrillation with rapid ventricular rate {Atrial fibrillation with rapid ventricular response}"
+"###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:
+We had the pleasure of taking care of you while you were at the 
+___.  You were admitted because you fell and because of 
+shortness of breath.  Your shortness of breath was from volume 
+overload from your heart failure, lung collapse, and infection.  
+We treated you with lasix, antibiotics, and inhalers.  You also 
+had a very fast heart rate due to your atrial fibrillation.  We 
+increased your metoprolol and started you on a new medication 
+called digoxin.  While you were here we did a chest CT that 
+showed opacities and enlarged lymph nodes in the lung.  A 
+pulmonologist saw you and you agreed that you did not want 
+further invasive testing.  You also decided that you did not 
+want any ICU tranfers and to change your code status from do not 
+resuscitate (DNR) and okay to intubate, to DNR/DNI (do not 
+resuscitate and do not intubate). 
+
+We have made the following changes to your medications:
+1. We have changed your metoprolol to metoprolol succinate daily 
+for your atrial fibrillation
+2. We have started you on digoxin for atrial fibrillation
+3. We have stopped your cephalexin
+4. We have started you on lidocaine patch for pain
+5. We have started you on vancomycin and meropenem for 
+aspiration pneumonia
+6. We have increased your lasix dose to 40mg daily
+7. We have stopped your coumadin
+
+If you feel lightheaded or your blood pressure drops, you should 
+not take your lasix.
+ 
+
+###RESPONSE: fell {Elderly fall}, shortness of breath {Dyspnea}, shortness of breath {Dyspnea}, volume 
+overload {Hypervolemia}, heart failure {Heart failure}, lung collapse {Atelectasis}, infection {Infectious disease}, lasix {Diuretic therapy}, antibiotics {Antibiotic therapy}, inhalers {Oxygen therapy}, fast heart rate {Tachycardia}, atrial fibrillation {Atrial fibrillation}, increased {Increasing dosage of medication}, medication {Patient medication education}, chest CT {Computed tomography of chest}, opacities {Abnormally opaque structure}, enlarged lymph nodes {Lymphadenopathy}, lung {Lung structure}, ICU tranfers {Patient transfer to intensive care unit}, do not 
+resuscitate {Not for resuscitation}, DNR {Not for resuscitation}, DNR {Not for resuscitation}, do not 
+resuscitate {Not for resuscitation}, atrial fibrillation {Atrial fibrillation}, atrial fibrillation {Atrial fibrillation}, pain {Pain}, aspiration pneumonia {Aspiration pneumonia}, lasix {Diuretic therapy}, lightheaded {Lightheadedness}, blood pressure drops {Decreased blood oxygen pressure}, lasix {Diuretic 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: 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:
+achalasia
+ 
+Major Surgical or Invasive Procedure:
+___: ___ myotomy and partial fundoplication
+
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, achalasia {Achalasia}, myotomy {Division of muscle}, partial fundoplication {Partial fundoplication}"
+"###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 ___ with h/o Marfan Syndrome c/b aortic
+aneurysm, ASD and mitral valve regurgitation s/p aortic root
+replacement, MVR and ASD repair who p/w worsening dysphagia c/f
+achalasia. Briefly, patient reports onset of difficulty fully
+swallowing food beginning ___ years ago. Since then, his symptoms
+have progressed to significant chest pain with PO intake. He
+reports the sensation of food becoming stuck in his chest that 
+is
+only able to be swallowed after he drinks large volumes of 
+water.
+This in turn causes significant nausea, some emesis, and
+regurgitation of undigested foods. He reports an 11 lb weight
+loss in recent months, but has been able to gain this back with
+conscious efforts to eat full meals despite symptoms. He has 
+been
+evaluated via esophageal manometry and was found to have 100%
+failure of esophageal contractions with all swallows and lack of
+obvious ___. He underwent confirmatory barium swallow
+that also demonstrated dilation of esophagus proximal to ___ 
+with
+significant delay in passage of a barium tablet without numerous
+sips of water. After thorough GI evaluation, he was diagnosed
+with presumed Type 2 achalasia and is now referred to surgical
+clinic for operative evaluation.
+
+On further review, the patient reports intermittent chest pain
+for which he sometimes presents to the ED for evaluation. He 
+most
+recently underwent exercise stress test on ___ that was
+negative for any signs of myocardial ischemia. He also
+intermittently develops profuse epistaxis (not on
+anticoagulation), for which he has seen his PCP and was
+reportedly prescribed nasal sprays and reassured by his PCP. He
+otherwise denies fevers/chills, severe abdominal pain, SOB,
+dysuria.
+
+ 
+
+###RESPONSE: Marfan Syndrome {Marfan's syndrome}, aortic
+aneurysm {Aortic aneurysm}, ASD {Atrial septal defect}, mitral valve regurgitation {Mitral valve regurgitation}, aortic root
+replacement {Replacement of aortic root}, ASD repair {Closure of atrial septal defect}, dysphagia {Dysphagia}, achalasia {Achalasia}, chest pain {Chest pain}, nausea {Nausea}, emesis {Vomiting}, regurgitation of undigested foods {Regurgitation of food}, weight
+loss {Weight loss}, esophageal manometry {Esophageal manometry}, esophageal contractions {Nutcracker esophagus}, swallows {Does swallow}, barium swallow {Barium swallow}, dilation of esophagus {Dilation of esophagus}, GI evaluation {Evaluation of gastrointestinal tract}, achalasia {Achalasia}, surgical {Surgical procedure}, evaluation {Evaluation procedure}, chest pain {Chest pain}, evaluation {Evaluation procedure}, exercise stress test {Exercise tolerance test}, signs {Sign}, myocardial ischemia {Myocardial ischemia}, epistaxis {Bleeding from nose}, fevers {Fever}, chills {Chill}, abdominal pain {Abdominal pain}, dysuria {Dysuria}"
+"###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:
+Ascending aortic aneurysm
+Gastroesophageal Reflux Disease
+Lactose intolerance
+Marfan's syndrome
+
+Past Surgical History
+-MV repair and ASD closure (___) by Dr. ___ aortic root replacement
+with a 32 mm Valsalva Dacron graft and ascending aortic
+replacement with a 24 mm Gelweave tube graft.
+
+ 
+
+###RESPONSE: Ascending aortic aneurysm {Aneurysm of ascending aorta}, Gastroesophageal Reflux Disease {Gastroesophageal reflux disease}, Lactose intolerance {Intolerance to lactose}, Marfan's syndrome {Marfan's syndrome}, -MV repair {Repair of mitral valve}, ASD closure {Closure of atrial septal defect}, aortic root replacement {Replacement of aortic root}, Dacron graft {Polyethylene terephthalate graft operations on aorta}, ascending aortic
+replacement {Replacement of ascending aorta}, graft {Structure of transplant}"
+"###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, brother and sister with ___. Father died at 
+age ___, brother died at age ___, and sister died at age ___.
+
+ 
+
+###RESPONSE: died {Dead}, died {Dead}, died {Dead}"
+"###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:
+Vitals _______
+GEN: A&Ox3, NAD, resting comfortably 
+HEENT: NCAT, EOMI, sclera anicteric. 
+CV: Regular
+PULM: no respiratory distress, CTAB. 
+ABD: soft, mild tenderness, ND, no rebound or guarding, lap 
+sites
+c/d/i with one mildly saturated 
+EXT: warm, well-perfused, no edema 
+ 
+
+###RESPONSE: Vitals {Vital signs finding}, GEN {General examination of patient}, Ox3 {Oriented to person, time and place}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, NC {Normal head}, EOMI {Normal ocular motility}, sclera anicteric {White sclera}, CV {Cardiovascular physical examination}, PULM {Examination of respiratory system}, distress {Distress}, CTAB {Normal breath sounds}, ABD {Examination of abdomen}, soft {Abdomen soft}, tenderness {Tenderness}, ND {Swollen abdomen}, 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:
+___ 06:15AM BLOOD WBC-8.8 RBC-4.53* Hgb-13.5* Hct-39.4* 
+MCV-87 MCH-29.8 MCHC-34.3 RDW-13.8 RDWSD-43.4 Plt ___
+___ 06:15AM BLOOD Glucose-119* UreaN-11 Creat-0.8 Na-137 
+K-4.4 Cl-100 HCO3-24 AnGap-13
+___ 06:15AM BLOOD Calcium-9.1 Phos-4.9* Mg-1.8
+ 
+
+###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}, Calcium {Blood calcium measurement}, Phos {Phosphate, total 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: Brief Hospital Course:
+ The patient presented to pre-op on ___. Patient was 
+evaluated by anaesthesia.  
+ The patient was taken to the operating room for ___ 
+myotomy and partial fundoplication. There were no adverse events 
+in the operating room; please see the operative note for 
+details. Pt was taken to the PACU until stable, then transferred 
+to the ward for observation.  
+ Neuro: The patient was alert and oriented throughout 
+hospitalization; pain was initially managed with a PCA. Pain was 
+very well controlled. The patient was then transitioned to 
+liquid oral pain medication.
+ CV: The patient remained stable from a cardiovascular 
+standpoint; vital signs were routinely monitored.  
+ Pulmonary: The patient remained stable from a pulmonary 
+standpoint; vital signs were routinely monitored. Good pulmonary 
+toilet, early ambulation and incentive spirometry were 
+encouraged throughout hospitalization.  
+ GI/GU/FEN: The patient was initially kept NPO. Afterwards, the 
+patient was started on a clears diet, which he tolerated well. 
+Subsequently he was advanced to a mechanical soft diet which he 
+tolerated well without nausea or vomiting. 
+ ID: The patient's fever curves were closely watched for signs 
+of infection, of which there were none.  
+ HEME: The patient's blood counts were closely watched for signs 
+of bleeding, of which there were none.  
+ Prophylaxis: The patient received subcutaneous heparin and ___ 
+dyne boots were used during this stay and was encouraged to get 
+up and ambulate as early as possible.  
+ At the time of discharge, the patient was doing well, afebrile 
+and hemodynamically stable. The patient was tolerating a 
+mechanical soft diet, ambulating, voiding without assistance, 
+and pain was well controlled. The patient received discharge 
+teaching and follow-up instructions with understanding 
+verbalized and agreement with the discharge plan.  
+
+ 
+
+###RESPONSE: myotomy {Division of muscle}, partial fundoplication {Partial fundoplication}, stable {Patient's condition stable}, Neuro {Neurological examination}, alert {Mentally alert}, pain {Pain}, Pain was 
+very well controlled {Demonstrates adequate pain control}, stable {Patient's condition stable}, vital signs were routinely monitored {Monitoring of blood pressure, temperature, pulse rate and respiratory rate}, stable {Patient's condition stable}, vital signs were routinely monitored {Monitoring of blood pressure, temperature, pulse rate and respiratory rate}, incentive spirometry {Incentive spirometry}, diet {Dietary finding}, mechanical soft diet {Soft diet}, nausea {Nausea}, vomiting {Vomiting}, fever {Fever}, watched for signs 
+of infection {Monitoring for signs and symptoms of infection}, signs {Sign}, bleeding {Bleeding}, Prophylaxis {Preventive procedure}, hemodynamically stable {Hemodynamically stable}, mechanical soft diet {Soft diet}, voiding without assistance {Continence independent}, pain was well controlled {Demonstrates adequate pain control}"
+"###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:
+AMOXICILLIN - amoxicillin 500 mg capsule. 4 capsule(s) by mouth 
+Once as needed for ___ minutes prior to dental procedure
+ATENOLOL - atenolol 25 mg tablet. 1 tablet(s) by mouth once a 
+day
+GABAPENTIN - gabapentin 300 mg capsule. 1 capsule(s) by mouth 
+three times daily
+OMEPRAZOLE - omeprazole 40 mg capsule,delayed release. 1 
+capsule(s) by mouth in am
+
+ 
+Discharge Medications:
+1.  Acetaminophen (Liquid) 650 mg PO Q4H:PRN Pain - Mild 
+RX *acetaminophen 500 mg/15 mL 30 mL by mouth every eight (8) 
+hours Disp #*450 Milliliter Refills:*0 
+2.  Omeprazole 40 mg PO DAILY 
+RX *omeprazole 40 mg 1 capsule(s) by mouth Daily Disp #*30 
+Capsule Refills:*0 
+3.  OxycoDONE Liquid 5 mg PO Q4H:PRN Pain - Moderate 
+RX *oxycodone 5 mg/5 mL ___ mL by mouth every four (4) hours 
+Disp ___ Milliliter Milliliter Refills:*0 
+4.  Atenolol 25 mg PO DAILY  
+5.  Gabapentin 300 mg PO BID  
+
+ 
+
+###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:
+achalasia
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: achalasia {Achalasia}, Mental Status {Neurological mental status determination}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, 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 Mr ___,
+
+It was a pleasure taking care of you here at ___ 
+___. You were admitted to our hospital for 
+___ myotomy and partial fundoplication on ___. You 
+tolerated the procedure well and are ambulating, tolerating a 
+regular diet, and your pain is controlled by pain medications by 
+mouth. You are now ready to be discharged to home. Please follow 
+the recommendations below to ensure a speedy and uneventful 
+recovery. 
+
+ACTIVITY:
+- Do not drive until you have stopped taking pain medicine and 
+feel you could respond in an emergency.
+- You may climb stairs. You should continue to walk several 
+times a day. 
+- You may go outside, but avoid traveling long distances until 
+you see your surgeon at your next visit. 
+- You may start some light exercise when you feel comfortable. 
+Slowly increase your activity back to your baseline as 
+tolerated.
+- Heavy exercise may be started after 6 weeks, but use common 
+sense and go slowly at first. 
+- No heavy lifting (10 pounds or more) until cleared by your 
+surgeon, usually about 6 weeks. 
+- You may resume sexual activity unless your doctor has told you 
+otherwise.
+
+HOW YOU MAY FEEL: 
+- You may feel weak or ""washed out"" for 6 weeks. You might want 
+to nap often. Simple tasks may exhaust you.
+- You may have a sore throat because of a tube that was in your 
+throat during the surgery.
+
+YOUR BOWELS:
+- Constipation is a common side effect of narcotic pain medicine 
+such as oxycodone. If needed, you may take a stool softener 
+(such as Colace, one capsule) or gentle laxative (such as milk 
+of magnesia, 1 tbs) twice a day. You can get both of these 
+medicines without a prescription.
+- If you go 48 hours without a bowel movement, or have pain 
+moving the bowels, call your surgeon.
+- After some operations, diarrhea can occur. If you get 
+diarrhea, don't take anti-diarrhea medicines. Drink plenty of 
+fluids and see if it goes away. If it does not go away, or is 
+severe and you feel ill, please call your surgeon.
+
+PAIN MANAGEMENT:
+- You are being discharged with a prescription for oxycodone for 
+pain control. You may take liquid Tylenol as directed, not to 
+exceed 3500mg in 24 hours. Take regularly for a few days after 
+surgery but you may skip a dose or increase time between doses 
+if you are not having pain until you no longer need it. You may 
+take the oxycodone for moderate and severe pain not controlled 
+by the Tylenol. You may take a stool softener while on narcotics 
+to help prevent the constipation that they may cause. Slowly 
+wean off these medications as tolerated. 
+- Your pain should get better day by day. If you find the pain 
+is getting worse instead of better, please contact your surgeon.
+
+If you experience any of the following, please contact your 
+surgeon: 
+- sharp pain or any severe pain that lasts several hours
+- chest pain, pressure, squeezing, or tightness
+- cough, shortness of breath, wheezing
+- pain that is getting worse over time or pain with fever
+- shaking chills, fever of more than 101
+- a drastic change in nature or quality of your pain
+- nausea and vomiting, inability to tolerate fluids, food, or 
+your medications
+- if you are getting dehydrated (dry mouth, rapid heart beat, 
+feeling dizzy or faint especially while standing)
+-any change in your symptoms or any symptoms that concern you
+
+Additional: 
+*- pain that is getting worse over time, or going to your chest 
+or back
+*- urinary:  burning or blood in your urine or the inability to 
+urinate
+
+MEDICATIONS:
+- Take all the medicines you were on before the operation just 
+as you did before, unless you have been told differently.
+- If you have any questions about what medicine to take or not 
+to take, please call your surgeon. 
+
+WOUND CARE: 
+-Dressing Removal:***
+-You may shower with any bandage strips that may be covering 
+your wound. Do not scrub and do not soak or swim, and pat the 
+incision dry. If you have steri strips, they will fall off by 
+themselves in ___ weeks. If any are still on in two weeks and 
+the edges are curling up, you may carefully peel them off.  
+
+-Do not take baths, soak, or swim for 6 weeks after surgery 
+unless told otherwise by your surgical team. 
+-Notify your surgeon if you notice abnormal (foul smelling, 
+bloody, pus, etc) or increased drainage from your incision site, 
+opening of your incision, or increased pain or bruising. Watch 
+for signs of infection such as redness, streaking of your skin, 
+swelling, increased pain, or increased drainage. 
+
+Please call with any questions or concerns. Thank you for 
+allowing us to participate in your care. We hope you have a 
+quick return to your usual life and activities. 
+
+-- Your ___ Care Team
+
+ 
+
+###RESPONSE: myotomy {Division of muscle}, partial fundoplication {Partial fundoplication}, procedure {Procedure}, tolerating a 
+regular diet {Tolerating normal diet}, pain {Pain}, climb stairs {Does walk up stairs}, walk {Walking practice}, exercise {Exercises}, exercise {Exercises}, washed out {Exhaustion}, sore throat {Sore throat}, throat {Structure of anterior portion of neck}, surgery {Surgical procedure}, Constipation {Constipation}, prescription {Prescription}, pain {Pain}, bowels {Intestinal structure}, diarrhea {Diarrhea}, diarrhea {Diarrhea}, diarrhea {Diarrhea}, prescription {Prescription}, pain control {Pain control}, after 
+surgery {Postoperative state}, pain {Pain}, severe pain {Severe pain}, constipation {Constipation}, pain {Pain}, pain {Pain}, sharp pain {Sharp pain}, severe pain {Severe pain}, chest pain {Chest pain}, pressure {Tight chest}, squeezing {Squeezing chest pain}, tightness {Tight chest}, cough {Cough}, shortness of breath {Dyspnea}, wheezing {Wheezing}, pain {Pain}, pain {Pain}, fever {Fever}, shaking {Tremor}, chills {Chill}, fever {Fever}, pain {Pain}, nausea and vomiting {Nausea and vomiting}, dehydrated {Dehydration}, dry mouth {Xerostomia}, rapid heart beat {Tachycardia}, dizzy {Dizziness}, faint {Feeling faint}, standing {Orthostatic body position}, pain {Pain}, chest {Radiating chest pain}, blood in your urine {Blood in urine}, operation {Surgical procedure}, WOUND CARE {Wound care}, -Dressing Removal {Removal of dressing}, wound {Wound}, incision {Surgical incision wound}, soak {Soak}, after surgery {Postoperative state}, drainage {Wound discharge}, incision site {Surgical incision wound}, incision {Surgical incision wound}, increased pain {Increased pain}, bruising {Contusion}, signs of infection {Monitoring for signs and symptoms of infection}, redness {Redness of skin over lesion}, skin {Skin structure}, swelling {Swelling}, increased pain {Increased pain}, drainage {Wound discharge}"
+"###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: 
+Hydrochlorothiazide / Lipitor / Ultram
+ 
+Attending: ___.
+ 
+Chief Complaint:
+___, poor PO intake
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: Hydrochlorothiazide {Allergy to hydrochlorothiazide}, Lipitor {Allergy to atorvastatin}, poor PO intake {Decrease in appetite}"
+"###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 F referred in by her PCP. Patient has history of severe 
+AS (peak gradient of 58, mean of 35, EF55% in ___, dCHF, HTN. 
+She went in to her PCP with dyspnea on exertion, and routine 
+labs showed a BUN/Cr of 50/2.4 so patient referred into ___ 
+ED. She has had increased Lasix dosing, and decreased PO intake 
+(has had increased GERD recently and thus not tolerating 
+excellent PO, has plans for GI f/u in coming weeks). In this 
+context, patient has had dyspnea while ambulating. On ROS she 
+denies fever/chills/chest pain, shortness of breath at rest. 
+Denies any urinary/stool changes, does have +left knee pain and 
+is s/p left TKR. Left knee pain radiates up to left groin, is 
+chronic and patient did not take her Tylenol today for it.
+In the ED, initial vitals were: 97.6 84 145/89 16 100% RA
+- Exam significant for LLL mild crackles and occ. wheeze
+___ RUSB SEM
+- Labs were significant for unremarkable CBC, BUN/Creat 50/2.4
+- Imaging revealed: (own read) no acute intrathoracic process
+- The patient was given tyelnol x1
+Admitted for work-up ___ and possible TTE.
+Vitals prior to transfer were: 97.7 77 143/64 24 97% RA
+Upon arrival to the floor, pt appears well.
+REVIEW OF SYSTEMS:
+(+) Per HPI
+(-) Denies fever, chills, night sweats, recent weight loss or 
+gain. Denies headache, sinus tenderness, rhinorrhea or 
+congestion. Denies chest pain or tightness, palpitations. Denies 
+nausea, vomiting, diarrhea, constipation or abdominal pain. No 
+recent change in bowel or bladder habits. No dysuria. Denies 
+arthralgias or myalgias.
+ 
+
+###RESPONSE: dCHF {Decompensated chronic heart failure}, HTN {Hypertensive disorder, systemic arterial}, dyspnea on exertion {Dyspnea on exertion}, decreased PO intake {Inadequate oral intake}, GERD {Gastroesophageal reflux disease}, dyspnea while ambulating {Dyspnea on exertion}, fever {Fever}, chills {Chill}, chest pain {Chest pain}, shortness of breath {Dyspnea}, urinary {Urinary incontinence}, stool {Hematochezia}, left knee {Structure of left knee region}, pain {Pain of knee region}, left TKR {Total replacement of left knee joint}, Left knee {Structure of left knee region}, pain {Pain of knee region}, radiates {Radiating pain}, left groin {Left inguinal region structure}, chronic {Chronic pain}, vitals {Vital signs finding}, RA {Breathing room air}, Exam {Physical examination procedure}, LLL {Structure of lower lobe of left lung}, crackles {Respiratory crackles}, wheeze {Wheezing}, SEM {Ejection murmur}, unremarkable {No abnormality detected}, CBC {Complete blood count}, work-up {Evaluation procedure}, TTE {Transthoracic echocardiography}, Vitals {Vital signs finding}, RA {Breathing room air}, 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}, chest pain {Chest pain}, tightness {Tight chest}, palpitations {Palpitations}, nausea, vomiting, diarrhea {Nausea, vomiting and diarrhea}, constipation {Constipation}, abdominal pain {Abdominal pain}, change in bowel {Altered bowel function}, bladder habits {Alteration in patterns of urinary elimination}, dysuria {Dysuria}, arthralgias {Joint pain}, myalgias {Muscle 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: Past Medical History:
+- Hypertension  
+- Hyperchloseterolemia  
+- AAA - infra-renal 
+- GERD  
+- Left Renal Mass  
+-> nodular enhancing solid/cystic left renal mass 16x13mm  
+- Spinal stenosis  
+-> with symptoms and signs of radicular compression with an MRI  
+
+from ___ disclosing severe spinal stenosis at the L4-L5 level,  
+
+grade 1 spondylolisthesis of L4 over L5, severe foraminal 
+stenosis  
+at L4-L5 and mild-to-moderate stenosis at L3-L4  
+- degenerative joint disease of ankles and knees secondary to 
+severe  
+mechanical alterations w/ Tricompartmental OA of left knee 
+thyroid nodules 
+.  
+Cardiac Risk Factors: (-)Diabetes, (+) Dyslipidemia and 
+Hypertension  
+
+ 
+
+###RESPONSE: Hypertension {Hypertensive disorder, systemic arterial}, Hyperchloseterolemia {Hypercholesterolemia}, AAA - infra-renal {Aneurysm of infrarenal abdominal aorta}, GERD {Gastroesophageal reflux disease}, Left Renal {Left kidney structure}, Mass {Nodule of lung}, left renal {Left kidney structure}, mass {Nodule of lung}, Spinal stenosis {Spinal stenosis}, signs {Sign}, compression {Compression}, MRI {Magnetic resonance imaging}, spinal stenosis {Spinal stenosis}, L4 {Entire body of fourth lumbar vertebra}, L5 {Entire body of fifth lumbar vertebra}, grade 1 spondylolisthesis {Spondylolisthesis, grade 1}, L4 {Entire body of fourth lumbar vertebra}, L5 {Entire body of fifth lumbar vertebra}, foraminal 
+stenosis {Stenosis of lumbar vertebral foramen}, L4 {Entire body of fourth lumbar vertebra}, L5 {Entire body of fifth lumbar vertebra}, stenosis {Stenosis}, L3 {Entire body of third lumbar vertebra}, L4 {Entire body of fourth lumbar vertebra}, degenerative joint disease of ankles {Osteoarthritis of ankle}, knees {Osteoarthritis of knee}, OA {Osteoarthritis of knee}, left knee {Structure of left knee region}, thyroid nodules {Thyroid nodule}, Cardiac Risk Factors {Assessment for risk of cardiovascular disease}, Diabetes {Diabetes mellitus}, Dyslipidemia {Dyslipidemia}, Hypertension {Hypertensive disorder, systemic arterial}"
+"###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:
+Non contributory
+ 
+
+###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:
+ADMISSION PHYSICAL EXAM:
+===================
+Vitals: 96.9 156/76 69 16 100%RA
+wt 67.25
+General: Alert, oriented, no acute distress
+HEENT: Sclera anicteric, MMM, oropharynx clear, EOMI, PERRL
+Neck: Supple, JVP mildly elevated, no LAD
+CV: Regular rate and rhythm, normal S1 + S2, SEM ___ at LUSB
+Lungs: Clear to auscultation bilaterally, no wheezes, rales, 
+rhonchi
+Abdomen: Soft, non-tender, non-distended, bowel sounds present, 
+no organomegaly, no rebound or guarding
+GU: No foley
+Ext: Warm, well perfused, 2+ pulses, no clubbing, cyanosis or 
+edema
+Neuro: AAOx3
+
+DISCHARGE PHYSICAL EXAM:
+====================
+Vitals:  Tc 98.0 HR 64 BP 120-160/50-70 RR 16 SpO2 100%RA Wt 
+67.6kg
+General: Alert, oriented, no acute distress  
+ HEENT: Sclera anicteric, MMM, oropharynx clear, EOMI, PERRL  
+ Neck: Supple, JVP mildly elevated, no LAD  
+ CV: Regular rate and rhythm, normal S1 + S2, SEM ___ at LUSB  
+ Lungs: Mild bibasilar crackles, no wheezes
+ Abdomen: Soft, non-tender, non-distended, bowel sounds present, 
+no organomegaly, no rebound or guarding  
+ GU: No foley  
+ Ext: Warm, well perfused, 2+ pulses, no clubbing, cyanosis or 
+edema  
+ Neuro: AAOx2 (said year was ___
+ 
+
+###RESPONSE: PHYSICAL EXAM {Physical examination procedure}, Vitals {Vital signs finding}, RA {Breathing room air}, General {General examination of patient}, Alert {Mentally alert}, 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}, elevated {Raised jugular venous pressure}, 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<}, SEM {Ejection murmur}, 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-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, 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}, Ox3 {Oriented to person, time and place}, Vitals {Vital signs finding}, HR {Finding of heart rate}, BP {Blood pressure finding}, RR {Finding of rate of respiration}, RA {Breathing room air}, General {General examination of patient}, Alert {Mentally alert}, 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}, JVP {Finding of jugular venous pressure}, elevated {Raised jugular venous pressure}, LAD {Lymphadenopathy}, CV {Cardiovascular physical examination}, Regular rate and rhythm {Normal heart rate}, normal S1 + S2 {Heart sounds normal}, SEM {Ejection murmur}, Lungs {Examination of respiratory system}, bibasilar {Structure of base of lung}, crackles {Respiratory crackles}, wheezes {Wheezing}, 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}, foley {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}"
+"###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:
+
+___ 10:36AM BLOOD WBC-9.3 RBC-4.32 Hgb-12.0 Hct-38.0 MCV-88 
+MCH-27.8 MCHC-31.6* RDW-14.3 RDWSD-45.7 Plt ___
+___ 10:36AM BLOOD Neuts-72.5* ___ Monos-5.2 
+Eos-0.7* Baso-0.2 Im ___ AbsNeut-6.76* AbsLymp-1.97 
+AbsMono-0.49 AbsEos-0.07 AbsBaso-0.02
+___ 10:36AM BLOOD UreaN-50* Creat-2.4*# Na-139 K-4.0 Cl-99
+___ 10:36AM BLOOD proBNP-199
+___ 10:36AM BLOOD 25VitD-29*
+___ 06:04PM URINE Hours-RANDOM UreaN-625 Creat-79 Na-66 
+K-30 Cl-51
+___ 06:04PM URINE Osmolal-453
+
+OTHER PERTINENT LABS:
+
+___ 10:36AM BLOOD UreaN-50* Creat-2.4*# Na-139 K-4.0 Cl-99
+___ 06:57AM BLOOD Glucose-86 UreaN-51* Creat-2.2* Na-139 
+K-4.3 Cl-105 HCO3-23 AnGap-15
+___ 03:05PM BLOOD Glucose-94 UreaN-47* Creat-2.0* Na-139 
+K-4.3 Cl-104 HCO3-23 AnGap-16
+___ 07:17AM BLOOD Glucose-82 UreaN-34* Creat-1.5* Na-141 
+K-4.1 Cl-108 HCO3-22 AnGap-15
+___ 10:36AM BLOOD 25VitD-29*
+
+IMAGING:
+CXR ___ - No acute intrathoracic process.
+
+MICRO: none
+
+DISCHARGE LABS:
+___ 07:55AM BLOOD WBC-5.2 RBC-3.95 Hgb-10.7* Hct-34.5 
+MCV-87 MCH-27.1 MCHC-31.0* RDW-14.0 RDWSD-45.1 Plt ___
+___ 07:55AM BLOOD Glucose-81 UreaN-29* Creat-1.4* Na-143 
+K-4.4 Cl-107 HCO3-26 AnGap-14
+___ 07:55AM BLOOD Calcium-9.4 Phos-3.2 Mg-1.8
+ 
+
+###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}, RDWSD {Red cell distribution width determination}, Neuts {Neutrophil count}, Monos {Monocyte count}, Baso {Basophil count}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, proBNP {N-terminal pro-brain natriuretic peptide measurement}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, Cl {Chloride measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, 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}, 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}, 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}, CXR {Plain chest X-ray}, 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}"
+"###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:
+SUMMARY:
+___ y/o F referred in by her PCP. Patient has history of severe 
+AS (peak gradient of 58, mean of 35, EF55% in ___, dCHF, HTN. 
+She went in to her PCP with dyspnea on exertion, and routine 
+labs showed a BUN/Cr of 50/2.4 in setting of increased lasix 
+dosing x3 days and decreased PO intake.  
+
+___ on CKD:  
+ Baseline Creat 1.3. Admitted with Cr 2.4 in setting of 
+increased lasix dosing last week, decreased PO intake over past 
+week due to worsening reflux after eating spicy food. SCr 
+improved with IV fluids. Creatinine was 1.4 after PO intake only 
+for 1 day prior to discharge
+
+#chronic compensated diastolic heart failure:  
+No e/o acute fluid overload. Above ___ likely in setting of 
+overdiuresis and poor PO intake. Held home lasix upon discharge.
+
+#HTN: Continued home amplodipine 
+ 
+#GERD: Continued omeprazole, ranitidine. Patient states her 
+reflux was much improved while inpatient, although she reports 
+taking her outpatient medications as prescribed. She lives with 
+her son and daughter-in-law. Patient is well versed in her 
+medications, though she takes them herself out of the bottles 
+each day.
+ 
+#Vitamin D deficiency: Continued home vitamin D  
+
+TRANSITIONAL ISSUES:
+- Discharge weight: 67.6 kg
+- ___: Please check CMP to monitor Creatinine/electrolytes on 
+___ or ___ and fax results to patient's PCP ___ 
+___ at ___.
+- Patient states poor PO intake due to reflux/GERD exacerbation. 
+Improved on home regimen while inpatient. Defer additional 
+management of outpatient GERD medications to PCP.
+- Furosemide was held during hospitalization given ___ and fluid 
+resuscitation. Defer restarting this medication to 
+PCP/Cardiologist.
+- Recommend continued goals of care discussion with PCP. Patient 
+may benefit from palliative care/hospice referral.
+- DNR/DNI 
+- contact: ___ (son/HCP) ___ 
+ 
+___ on Admission:
+The Preadmission Medication list is accurate and complete.
+1. Amlodipine 10 mg PO DAILY 
+2. Aspirin 81 mg PO DAILY 
+3. Omeprazole 20 mg PO BID 
+4. Pravastatin 20 mg PO DAILY 
+5. Furosemide 20 mg PO DAILY 
+6. Ranitidine 150 mg PO QHS 
+7. Vitamin D ___ UNIT PO DAILY 
+8. Polyethylene Glycol 17 g PO DAILY:PRN constipation 
+9. Acetaminophen 650 mg PO QHS 
+
+ 
+Discharge Medications:
+1. Amlodipine 10 mg PO DAILY 
+2. Aspirin 81 mg PO DAILY 
+3. Omeprazole 20 mg PO BID 
+4. Pravastatin 20 mg PO DAILY 
+5. Ranitidine 150 mg PO QHS 
+6. Vitamin D ___ UNIT PO DAILY 
+7. Polyethylene Glycol 17 g PO DAILY:PRN constipation 
+8. Acetaminophen 650 mg PO QHS 
+
+ 
+
+###RESPONSE: dCHF {Decompensated chronic heart failure}, HTN {Hypertensive disorder, systemic arterial}, dyspnea on exertion {Dyspnea on exertion}, lasix {Diuretic therapy}, decreased PO intake {Inadequate oral intake}, CKD {Chronic kidney disease}, Baseline {Baseline state}, lasix {Diuretic therapy}, decreased PO intake {Inadequate oral intake}, reflux {Gastric reflux}, improved {Patient's condition improved}, IV fluids {Administration of intravenous fluids}, compensated {Compensated cardiac failure}, diastolic heart failure {Diastolic heart failure}, fluid overload {Hypervolemia}, poor PO intake {Decrease in appetite}, lasix {Diuretic therapy}, HTN {Hypertensive disorder, systemic arterial}, GERD {Gastroesophageal reflux disease}, reflux {Gastric reflux}, improved {Patient's condition improved}, Vitamin D deficiency {Vitamin D deficiency}, weight {Weight finding}, Creatinine {Creatinine measurement}, poor PO intake {Decrease in appetite}, reflux {Gastric reflux}, GERD {Gastroesophageal reflux disease}, GERD {Gastroesophageal reflux disease}, palliative care {Palliative care}, hospice {Hospice care}, referral {Patient referral}, DNR {Not for resuscitation}, constipation {Constipation}"
+"###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+PRIMARY: 
+-acute kidney injury 
+
+SECONDARY: 
+-hypertension
+-gastroenterologist 
+-severe aortic stenosis
+-chronic compensated diastolic congestive heart failure 
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, acute kidney injury {Acute kidney injury}, hypertension {Hypertensive disorder, systemic arterial}, aortic stenosis {Aortic valve stenosis}, compensated {Compensated cardiac failure}, diastolic congestive heart failure {Diastolic heart failure}, 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 - requires assistance or aid {Finding of walking aid use}, cane {Uses single walking stick}"
+"###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 caring for you at the ___ 
+___. You were recently admitted for elevated 
+creatinine, a measure of your kidney function. You were treated 
+with IV fluids and improved. Please ensure that you are eating 
+and drinking well at home, as dehydration is likely the cause. 
+Please discuss optimizing your reflux medication regimen with 
+your primary care doctor.
+
+Please continue taking all of your medications as prescribed and 
+keep all of your follow-up appointments.
+
+It was a pleasure caring for you.
+
+Sincerely,
+Your ___ care team
+ 
+
+###RESPONSE: elevated 
+creatinine {Serum creatinine above reference range}, IV fluids {Administration of intravenous fluids}, improved {Patient's condition improved}, dehydration {Dehydration}, reflux {Gastric reflux}, regimen {Therapeutic regimen}"
+"###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: 
+Codeine / Peanut
+ 
+Attending: ___
+ 
+Chief Complaint:
+Cough
+ 
+Major Surgical or Invasive Procedure:
+Right thoracentesis with drainage of 5 cc purulent fluid 
+___
+
+ 
+
+###RESPONSE: Codeine {Allergy to codeine}, Peanut {Allergy to peanut}, Cough {Cough}, thoracentesis {Thoracentesis}, drainage {Drainage procedure}, purulent fluid {Purulent discharge}"
+"###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 male with history of atrial 
+fibrillation on warfarin, esophageal diverticulum/dysphagia, and 
+blindness here with chronic non-productive cough and new 
+right-sided pleuritic chest pain developing ___ the last 48 
+hours. His pain is characterized by a ___ stabbing sensation at 
+worst (now ___ relived with analgesic medications but worsened 
+with inspiration or movement. His pain radiates to his 
+back/shouders. He has had similar pain ___ the past, most 
+recently ___ ___, and has received diagnoses of pneumonia. He 
+denies subjective fevers at home, fatigue, hoarseness, malaise, 
+lymphadenopathy, diaphoresis, left-sided chest pain, 
+lightheadedness, nausea, vomiting, or other somatic complaints.
+
+Per OMR, he was admitted on ___ (and discharged same day) 
+with a diagnosis of mutifocal pneumonia after presenting with 
+left-sided pleuritic chest pain; discharged with prescription 
+for 5 days of levofloxacin and recommendations to have repeat 
+CXR to evaluate for resolution of pneumonia. Presented later to 
+PCP ___ ___ with non-productive cough but without other 
+symptoms/signs of pneumonia - diagnosed with latent pleural 
+irritation secondary to bronchitis. He has not had imaging ___ 
+the interval from ___ until now.
+
+___ the ED, initial VS were 99.0, 83, 156/81, 16, 100%. Initial 
+labs demonstrated leukocytosis with 14,600 WBCs, of which 88% 
+were PMNs. A CXR revealed bibasilar airspace opacities and 
+possible left pleural effusion. His d-dimer was 882. A 
+subsequent CTA chest demonstrated possible right-sided empyema 
+and LLL, RML multifocal pneumonia. He received 1g ceftriaxone 
+and 500mg azithromycin initially at 2330 on ___. He required 
+an extended stay ___ the ED due to bed availability and was then 
+managed by ___, who added 150mg clindamcyin at 0140 on ___ 
+due to empyema presence. He was started on some of his home 
+medications, including warfarin 5mg daily, atenolol, and 
+mirtazapine. He required acetaminophen, tramadol, and oxycodone 
+for control of pleuritic pain. IP was consulted, who recommended 
+discontinuing warfarin (INR was 2.0) and considering FFP for 
+reversal of anticoagulation pending possible thoracentesis 
+and/or chest tube placement. He remained afebrile during his 
+time ___ the ED.
+
+ROS:
+(+) Per HPI
+(-) Denies fatigue, subjective fever, fatigue, weight change, 
+headache, tinnitus, dysphagia, odynophagia, hoarseness, 
+palpitations, dyspnea, paroxysmal nocturnal dyspnea, orthopnea, 
+abdominal pain, nausea, vomiting, diarrhea, melena, 
+hematochezia, lymphadenopathy, dysuria, new bruising, new 
+bleeding, rash, or other somatic complaints.
+ 
+
+###RESPONSE: atrial 
+fibrillation {Atrial fibrillation}, on warfarin {Warfarin therapy}, esophageal diverticulum {Diverticulum of esophagus}, dysphagia {Dysphagia}, chronic {Chronic disease}, non-productive cough {Dry cough}, right-sided pleuritic chest pain {Right sided chest pain}, pain {Pain}, stabbing {Stabbing pain}, worsened {Increased pain}, pain {Pain}, shouders {Shoulder region structure}, pain {Pain}, pneumonia {Pneumonia}, fevers {Fever}, fatigue {Fatigue}, hoarseness {Hoarse}, malaise {Malaise}, lymphadenopathy {Lymphadenopathy}, diaphoresis {Excessive sweating}, left-sided chest pain {Left sided chest pain}, lightheadedness {Lightheadedness}, nausea, vomiting {Nausea and vomiting}, pneumonia {Pneumonia}, left-sided {Left sided chest pain}, pleuritic chest pain {Pleuritic pain}, prescription {Prescription}, recommendations to {Recommendation to}, CXR {Plain chest X-ray}, pneumonia {Pneumonia}, PCP {Primary care management}, non-productive cough {Dry cough}, signs {Sign}, pneumonia {Pneumonia}, bronchitis {Bronchitis}, imaging {Imaging}, leukocytosis {Leukocytosis}, CXR {Plain chest X-ray}, bibasilar {Structure of base of lung}, opacities {Abnormally opaque structure}, left {Structure of left pleural cavity}, pleural effusion {Pleural effusion}, CTA chest {Computed tomography angiography of chest with contrast}, right-sided {Right lung structure}, empyema {Empyema}, LLL {Structure of lower lobe of left lung}, RML {Right middle zone pneumonia}, pneumonia {Pneumonia}, empyema {Empyema}, pleuritic pain {Pleuritic pain}, anticoagulation {Anticoagulant therapy}, thoracentesis {Thoracentesis}, chest tube placement {Insertion of pleural tube drain}, fatigue {Fatigue}, fever {Fever}, fatigue {Fatigue}, headache {Headache}, tinnitus {Tinnitus}, dysphagia {Dysphagia}, odynophagia {Swallowing painful}, hoarseness {Hoarse}, palpitations {Palpitations}, dyspnea {Dyspnea}, paroxysmal nocturnal dyspnea {Paroxysmal nocturnal dyspnea}, orthopnea {Orthopnea}, abdominal pain {Abdominal pain}, nausea, vomiting, diarrhea {Nausea, vomiting and diarrhea}, melena {Melena}, hematochezia {Hematochezia}, lymphadenopathy {Lymphadenopathy}, dysuria {Dysuria}, bruising {Contusion}, bleeding {Bleeding}, rash {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: Past Medical History:
+- atrial fibrillation on warfarin
+- benign prostatic hypertrophy previously with chronic 
+indwelling Foley now s/p TURP
+- esophageal diverticulum leading to dysphagia
+- HTN
+- blindness secondary to macular degeneration on left, retinal 
+detachment on right
+- gait disorder
+- kyphoscoliosis
+- left inguinal herniorrhaphy ___
+- neuropathy
+ 
+
+###RESPONSE: atrial fibrillation {Atrial fibrillation}, on warfarin {Warfarin therapy}, benign prostatic hypertrophy {Benign prostatic hyperplasia}, Foley {Catheterization of urinary bladder}, TURP {Transurethral prostatectomy}, esophageal diverticulum {Diverticulum of esophagus}, dysphagia {Dysphagia}, HTN {Hypertensive disorder, systemic arterial}, blindness {Blindness AND/OR vision impairment level}, macular degeneration {Degenerative disorder of macula}, left {Structure of macula lutea of left eye}, retinal 
+detachment {Retinal detachment}, right {Structure of retina of right eye}, gait disorder {Abnormal gait}, kyphoscoliosis {Kyphosis deformity of spine}, left {Structure of left inguinal canal}, inguinal herniorrhaphy {Repair of inguinal hernia using surgical sutures}, neuropathy {Neuropathy}"
+"###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 with history of MI
+
+ 
+
+###RESPONSE: MI {Myocardial infarction}"
+"###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 on arrival to floor: 97.8, 146/62, 89, 18, 0.99 on 3L NC
+ Gen: NAD, AAOx3, comfortably lying ___ bed and conversant
+ HEENT: NC/AT, right pupil clouded, yellowed and orbit sunken ___ 
+socket, left pupil cloudy; sclera anicteric; oropharynx clear 
+without exudate or erythema, mucosa moist but slightly dry; no 
+LAD
+ CV: irregularly irregular, no m/r/g
+ Pulm: difficult to assess as patient moving small volumes of 
+air, but lung sounds decreased at left posterior bases 
+associated with left-sided dullness to percussion and egophany
+ Abd: BS+, soft, NT, ND, no HSM, no palpable masses, ___ 
+negative
+ MSK: dorsalis pedis and radial pulses 2+ bilaterally, no c/c/e
+ Neuro: oriented x3, CNII-XII intact, moving all extremities, 
+sensation grossly intact
+
+DISCHARGE PHYSICAL EXAM:
+Unchanged.
+ 
+
+###RESPONSE: PHYSICAL EXAM {Physical examination procedure}, VS {Vital signs finding}, NC {Normal head}, Gen {General examination of patient}, NAD {No abnormality detected}, Ox3 {Oriented to person, time and place}, lying {Lying in bed}, HEENT {Physical examination procedure}, NC {Normal head}, right pupil {Structure of pupil of right eye}, yellowed {Scleral icterus}, orbit sunken {Sunken eyes}, left pupil {Structure of pupil of left eye}, sclera anicteric {White sclera}, oropharynx clear {Pharynx normal}, exudate {Exudate}, erythema {Erythema}, mucosa moist {Moist oral mucosa}, LAD {Lymphadenopathy}, CV {Cardiovascular physical examination}, irregularly irregular {Heart irregularly irregular}, no m/r/g {Heart sounds normal}, Pulm {Examination of respiratory system}, lung sounds decreased {Decreased breath sounds}, bases {Structure of base of lung}, left-sided {Structure of left half of chest wall}, dullness to percussion {Dullness to percussion over Traube's space}, egophany {Egophony}, Abd {Examination of abdomen}, BS+ {Normal bowel sounds}, soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, HSM {Hepatosplenomegaly}, palpable masses {Palpable mass}, MSK {Musculoskeletal system physical examination}, dorsalis pedis {Dorsalis pulse present}, radial pulses 2+ bilaterally {Normal radial pulse}, Neuro {Neurological examination}, oriented {Orientated}, CNII {Optic nerve structure}, XII intact {Intact hypoglossal nerve}, all extremities {All extremities}, sensation grossly intact {Normal sensation}"
+"###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:
+___ 04:45PM BLOOD WBC-14.6* RBC-4.38* Hgb-13.7* Hct-41.7 
+MCV-95 MCH-31.2 MCHC-32.7 RDW-13.7 Plt ___
+___ 04:45PM BLOOD Neuts-88.0* Lymphs-5.5* Monos-5.4 Eos-0.9 
+Baso-0.2
+___ 03:09AM BLOOD ___
+___ 04:45PM BLOOD Glucose-122* UreaN-15 Creat-0.8 Na-141 
+K-5.0 Cl-103 HCO3-29 AnGap-14
+___ 04:45PM BLOOD ALT-11 AST-16 AlkPhos-120 TotBili-0.7
+___ 04:45PM BLOOD Lipase-17
+___ 04:45PM BLOOD Albumin-3.3*
+___ 08:55AM BLOOD Calcium-8.5 Phos-2.6* Mg-2.1
+___ 04:58PM BLOOD Lactate-1.7
+
+DISCHARGE LABS:
+___ 05:22AM BLOOD WBC-14.3* RBC-4.17* Hgb-12.7* Hct-40.1 
+MCV-96 MCH-30.5 MCHC-31.7 RDW-13.6 Plt ___
+___ 05:22AM BLOOD Neuts-87.7* Lymphs-5.5* Monos-6.1 Eos-0.7 
+Baso-0.1
+___ 05:22AM BLOOD ___
+
+MICROBIOLOGY:
+___ 10:15 am FLUID,OTHER      RT LUNG EMPYEMA. 
+
+   GRAM STAIN (Final ___: 
+      3+  ___ per 1000X FIELD):   POLYMORPHONUCLEAR 
+LEUKOCYTES. 
+      3+  ___ per 1000X FIELD):   GRAM POSITIVE COCCI. 
+                                    ___ PAIRS, CHAINS, AND 
+CLUSTERS. 
+      1+    (<1 per 1000X FIELD):   GRAM POSITIVE ROD(S). 
+      SMEAR REVIEWED; RESULTS CONFIRMED. 
+      Reported to and read back by ___ ___ ___ 240PM. 
+
+   FLUID CULTURE (Preliminary): 
+      STREPTOCOCCUS ANGINOSUS (___) GROUP.    MODERATE 
+GROWTH. 
+
+   ANAEROBIC CULTURE (Preliminary):    NO ANAEROBES ISOLATED. 
+
+Blood culture ___ x 2: no growth
+
+STUDIES:
+- Video swallow study ___: IMPRESSION: Penetration with 
+nectar thick liquid and aspiration with thin consistency barium.
+
+- CT guided thoracentesis ___: IMPRESSION: CT-guided 
+empyema aspiration yielding 6 cc of purulent tan pus. 
+Microbiology and cytology are pending.
+
+- CTA CHEST W AND W/O CONTRAST ___:
+IMPRESSION:
+1.  No evidence of pulmonary embolism or acute aortic pathology. 
+
+2.  Multifocal pulmonary opacities, most confluent ___ the left 
+lower lobe and ___ the right middle lobe, compatible with 
+multifocal pneumonia.  Enhancing small fluid collection ___ the 
+right mid lung pleural space concerning for empyema. 
+3.  Moderate sized right pleural effusion. 
+
+- CTA CHEST W AND W/O CONTRAST ___:
+IMPRESSION: 
+1.  Multiple bilateral nodular opacities, with the most 
+confluence at the left base, consistent with multifocal 
+pneumonia.  A dedicated chest CT after resolution of symptoms 
+can be considered to evaluate for nodules. 
+2.  Stable left adrenal nodule, likely an adenoma.  
+3.  No evidence of a pulmonary embolism or acute aortic injury. 
+
+ 
+
+###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}, 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}, Albumin {Albumin 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}, Neuts {Neutrophil count}, Lymphs {Lymphocyte count}, Monos {Monocyte count}, Eos {Eosinophil count}, LUNG {Lung structure}, EMPYEMA {Empyema}, GRAM STAIN {Gram stain method}, CULTURE {Microbial culture}, ANAEROBIC CULTURE {Anaerobic microbial culture}, Blood culture {Blood culture}, Video swallow study {Videofluoroscopy swallow}, nectar thick liquid {Dietary liquid consistency - nectar thick liquid}, aspiration {Pulmonary aspiration}, consistency {Consistency finding}, CT guided thoracentesis {Thoracentesis using computed tomography guidance}, empyema aspiration {Drainage of empyema}, purulent {Purulent}, pus {Pus}, Microbiology {Microbiology}, cytology {Cytology examination - general}, pulmonary embolism {Pulmonary embolism}, aortic {Aortic structure}, pulmonary {Lung structure}, opacities {Abnormally opaque structure}, left 
+lower lobe {Structure of lower lobe of left lung}, right middle lobe {Structure of middle lobe of right lung}, pneumonia {Pneumonia}, fluid collection {Accumulation of fluid}, right mid lung pleural space {Structure of right pleural cavity}, empyema {Empyema}, right {Structure of right pleural cavity}, pleural effusion {Pleural effusion}, CTA CHEST W {Computed tomography angiography of chest with contrast}, W/O CONTRAST {Computed tomography of chest without contrast}, opacities {Abnormally opaque structure}, left base {Structure of base of left lung}, pneumonia {Pneumonia}, chest CT {Computed tomography of chest}, nodules {Nodule}, left adrenal {Structure of left adrenal gland}, nodule {Nodule}, adenoma {Adenoma}, pulmonary embolism {Pulmonary embolism}, aortic injury {Injury of aorta}"
+"###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:
+Mr. ___ was admitted to ___ on ___ for workup and 
+treatment of multifocal pneumonia. His hospital course is as 
+follows:
+
+1) Multifocal right middle lobe and left lower lobe pneumonia 
+with right parapneumonic effusion: suspicion of empyema ___ 
+setting of esophageal diverticulum and dysphagia. History of 
+multifocal pneumonia ___ ___, similar clinically. Patient 
+remained afebrile, with stable vital signs throughout admission. 
+Initially the patient was started on ceftriaxone, azithromycin, 
+and clindamycin. Given likely aspiration pneumonia, he underwent 
+video swallow study as above. Per speech pathology 
+recommendations, diet should be nectar thickened liquids, soft 
+solids; POs while upright w/ oral care before meals.  He 
+underwent CT-guided thoracentesis and drainage of 5 cc purulent 
+fluid at ___ location on ___. Initial gram stain of pleural 
+fluid growing 3+ GPCs and 1+ GPRs.  Patient treated with 
+clindamycin and levofloxacin per ID recs, which will continue 
+for four weeks.  He will require follow-up ___ ___ clinic to 
+determine resolution of pneumonia and determination of 
+antibiotic duration.  Patient's white blood cell count was 
+rising on day of discharge, but with no change ___ clinical 
+status.  Patient should have a CBC checked on ___ to follow up 
+this finding.
+
+2) Atrial fibrillation/anticoagulation - CHADS2 score equal to 
+2. Taking 4 mg daily of warfarin at home. Rate controlled with 
+atenolol. INR was mildly prolonged on arrival, suggestive of 
+inhibition of metabolism by antibiotics. Temporarily 
+discontinued warfarin ___, then restarted 4mg 
+daily on ___ after thoracentesis completed. Continued atenolol 
+daily. INR on discharge equal to 1.7.
+
+3) Hypertension - Well-controlled. Continued home atenolol.
+
+4) Benign prostatic hypertrophy previously with chronic 
+indwelling Foley now s/p TURP - No issues throughout admission. 
+Voiding regularly.
+
+5) Blindness secondary to macular degeneration on left, retinal 
+detachment on right - Chronic, stable. Redirected as necessary. 
+Continued home levobunolol.
+
+TRANSITIONAL ISSUES:
+- Please check kidney function and CBC on ___
+- Small 5-mm nodule ___ the right lobe of the thyroid may need 
+dedicated imaging, such as ultrasound.
+- ___ recs: okay for rehab or home w 24hr assistance and home ___
+- Will require follow-up with PCP ___ ___
+- Will require follow-up ___ ___ clinic to determine resolution of 
+pneumonia and determination of antibiotic duration.
+- Will need CT scan ___ weeks after discharge to follow-up 
+resolution of pneumonia.
+ 
+
+###RESPONSE: pneumonia {Pneumonia}, right middle lobe {Structure of middle lobe of right lung}, left lower lobe pneumonia {Structure of lower lobe of left lung}, right {Right lung structure}, parapneumonic effusion {Pleural effusion associated with pulmonary infection}, empyema {Empyema}, esophageal diverticulum {Diverticulum of esophagus}, dysphagia {Dysphagia}, pneumonia {Pneumonia}, stable vital signs {Normal vital signs}, aspiration pneumonia {Aspiration pneumonia}, video swallow study {Videofluoroscopy swallow}, diet should be nectar thickened liquids {Dietary liquid consistency - nectar thick liquid}, soft 
+solids {Soft diet}, CT-guided thoracentesis {Thoracentesis using computed tomography guidance}, drainage {Drainage procedure}, purulent 
+fluid {Purulent discharge}, gram stain {Gram stain method}, pleural 
+fluid {Pleural fluid examination abnormal}, require follow-up {Requires follow-up}, pneumonia {Pneumonia}, antibiotic {Antibiotic therapy}, white blood cell count {White blood cell count}, CBC {Complete blood count}, follow up {Follow-up status}, Atrial fibrillation {Atrial fibrillation}, anticoagulation {Anticoagulant therapy}, antibiotics {Antibiotic therapy}, thoracentesis {Thoracentesis}, Hypertension {Hypertensive disorder, systemic arterial}, Benign prostatic hypertrophy {Benign prostatic hyperplasia}, Foley {Catheterization of urinary bladder}, TURP {Transurethral prostatectomy}, Voiding {Micturition finding}, Blindness {Blindness AND/OR vision impairment level}, macular degeneration {Degenerative disorder of macula}, left {Structure of macula lutea of left eye}, retinal 
+detachment {Retinal detachment}, right {Structure of retina of right eye}, Chronic {Chronic disease}, stable {Patient's condition stable}, check kidney function {Renal function monitoring}, CBC {Complete blood count}, nodule {Nodule}, right lobe of the thyroid {Structure of right lobe of thyroid gland}, imaging {Imaging}, ultrasound {Ultrasonography}, require follow-up {Requires follow-up}, PCP {Primary care management}, require follow-up {Requires follow-up}, pneumonia {Pneumonia}, antibiotic {Antibiotic therapy}, CT scan {Computed tomography}, follow-up {Follow-up status}, 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: Medications on Admission:
+The Preadmission Medication list is accurate and complete.
+1. Atenolol 25 mg PO DAILY 
+Hold for HR<60 or sBP<100. 
+2. Levobunolol 0.25% 1 DROP LEFT EYE DAILY 
+3. Mirtazapine 30 mg PO HS 
+4. Warfarin 4 mg PO DAILY16 
+5. Docusate Sodium 100 mg PO BID 
+6. DiphenhydrAMINE 25 mg PO HS:PRN insomnia 
+7. Acetaminophen 500 mg PO Q6H:PRN pain 
+
+ 
+Discharge Medications:
+1. Acetaminophen 500 mg PO Q6H:PRN pain 
+2. Atenolol 25 mg PO DAILY 
+Hold for HR<60 or sBP<100. 
+3. Docusate Sodium 100 mg PO BID 
+4. Levobunolol 0.25% 1 DROP LEFT EYE DAILY 
+5. Mirtazapine 30 mg PO HS 
+6. DiphenhydrAMINE 25 mg PO HS:PRN insomnia 
+7. Warfarin 4 mg PO DAILY16 
+8. Clindamycin 300 mg PO Q6H 
+RX *clindamycin HCl [Cleocin] 300 mg 1 capsule(s) by mouth every 
+six (6) hours Disp #*120 Capsule Refills:*0
+9. Levofloxacin 500 mg PO DAILY 
+RX *levofloxacin [Levaquin] 500 mg 1 tablet(s) by mouth daily 
+Disp #*30 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:
+Extended Care
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+PRIMARY:
+- multifocal pneumonia with complicated parapneumonic effusion, 
+empyema
+SECONDARY:
+- dysphagia secondary to esophageal diverticulum
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+
+ 
+
+###RESPONSE: pneumonia {Pneumonia}, parapneumonic effusion {Pleural effusion associated with pulmonary infection}, empyema {Empyema}, dysphagia {Dysphagia}, esophageal diverticulum {Diverticulum of esophagus}, Mental Status {Neurological mental status determination}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, interactive {Does communicate}, 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. ___,
+
+Thank you for choosing ___ for your medical care. You were 
+admitted with pain ___ your chest caused by a pneumonia. Your 
+pneumonia is probably caused by swallowing dysfunction.
+
+You are now ready for discharge. Please take all your 
+medications as instructed by your doctors. Please keep all of 
+your appointments with your doctors, and bring a copy of your 
+medications to these visits. Upon discharge, please call your 
+PCP, ___, at ___ or return to the ED if you 
+experience any of the following: loss of conciousness, fever, 
+chest pain, trouble breathing, coughing up blood or pus, 
+palpitations, lightheadedness, or any other symptoms that 
+concern you.
+
+It is important that you take precautions while eating to 
+minimize the risk of choking or inhaling small bits of food. You 
+must sit fully upright while eating and take only small sips of 
+liquids. Swallow twice for each bite and sip and clear your 
+throat after each swallow. Clean and rinse your mouth before 
+each meal to decrease the amount of bacteria ___ your throat. You 
+should remain seated upright for one hour after meals.
+ 
+
+###RESPONSE: medical care {Medical care}, pain {Pain}, chest {Thoracic structure}, pneumonia {Pneumonia}, pneumonia {Pneumonia}, ready for discharge {Ready for discharge}, PCP {Primary care management}, loss of conciousness {Loss of consciousness}, fever {Fever}, chest pain {Chest pain}, trouble breathing {Difficulty breathing}, coughing up blood {Hemoptysis}, pus {Pus}, palpitations {Palpitations}, lightheadedness {Lightheadedness}, choking {Choking}, mouth {Mouth region structure}, throat {Structure of anterior portion of neck}"
+"###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: OBSTETRICS/GYNECOLOGY
+ 
+
+###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: 
+Compazine / Percocet
+ 
+Attending: ___
+ 
+Chief Complaint:
+Post dates pregnancy
+ 
+Major Surgical or Invasive Procedure:
+none
+
+ 
+
+###RESPONSE: Post dates pregnancy {Prolonged pregnancy}"
+"###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:
+___ G7P2 at 41___ presents to L&D for cytotec induction of
+labor. She has not had her cervix checked in Dr ___.
+She does not have a ride home. She was seen earlier today in the
+ED with a URI and was prescribed azithromycin and prednisone but
+has not filled those prescriptions. 
+
+Denies VB, LOF, ctx. Reports AFM. No CP/SOB/wheeze. No HA/visual
+changes/RUQ pain.
+
+ 
+
+###RESPONSE: induction of
+labor {Induction of labor}, cervix {Cervix uteri structure}, URI {Upper respiratory infection}, VB {Bleeding from vagina}, LOF {Amniotic fluid leaking}, ctx {Contraction of uterus during labor}, AFM {Fetal movement finding}, CP {Chest pain}, SOB {Dyspnea}, wheeze {Wheezing}, HA {Headache}, visual
+changes {Sight deteriorating}, RUQ pain {Right upper quadrant 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: Past Medical History:
+PNC:
+- ___: ___ by 6week u/s not c/w LMP 
+- Labs: A+/Ab-/RI/RPR NR/HBsAg-/GBS unk
+- FFS, GLT, GBS results not available but normal per pt
+Issues:
+- current pregnancy dated by 6 wk ultrasound- reportedly had IUD
+in place; ultrasound failed to demonstrate IUD within or outside
+of uterus.  
+- Per Dr ___, uncomplicated antenatal course, other 
+than
+episode of trauma at 28 wks.
+- ultrasound at 40.1 wks noted an EFW of 3341g ___ 
+percentile).
+- h/o crack cocaine use w/ prior pregnancy, now clean
+- h/o domestic violence
+- h/o pre-eclampsia w/previous pregnancy
+
+PAST OBSTETRIC HISTORY: records inconsistent.
+G7P2
+___ SVD, c/b pre-E, 7#7 
+___ SVD, 6#6
+SAB x 3
+TAB x 1
+
+PAST GYNECOLOGICAL HISTORY
+- h/o Chlamydia, TOC neg
+- h/o abnl pap, LSIL at initial OB visit
+
+PAST MEDICAL HISTORY
+- Asthma, no steriods, no intubation, last hospitalized ___ ago,
+uses daughter's inhaler
+- h/o ADD/ADHD, depression, anxiety, PTSD, ?bipolar d/o, 
+multiple
+suicide attempts
+- Pulmonary nodule, PPD negative ___
+
+PAST SURGICAL HISTORY
+- tonsillectomy
+- drainage abscess R elbow
+- D&C x2
+
+ 
+
+###RESPONSE: Labs {Laboratory test}, FFS {Fetal fibronectin measurement}, GLT {Glucose load test}, pregnancy {Pregnancy}, ultrasound {Ultrasonography}, IUD
+in place {Intrauterine contraceptive device in situ}, ultrasound {Ultrasonography}, uterus {Uterine structure}, uncomplicated antenatal course {Normal pregnancy}, trauma {Traumatic injury}, ultrasound {Ultrasonography}, cocaine {Cocaine abuse}, pregnancy {Pregnancy}, pre-eclampsia {Pre-eclampsia}, previous pregnancy {Previous pregnancies}, SAB {Miscarriage}, TAB {Therapeutic abortion procedure}, Chlamydia {Chlamydial infection}, abnl pap {Abnormal cervical smear}, LSIL {Low-grade squamous intraepithelial lesion}, Asthma {Asthma}, steriods {Steroid therapy}, intubation {Intubation}, ADD/ADHD {Attention deficit hyperactivity disorder}, depression {Depressive disorder}, anxiety {Anxiety}, PTSD {Posttraumatic stress disorder}, bipolar d/o {Bipolar disorder}, suicide attempts {Suicidal intent}, Pulmonary nodule {Nodule of lung}, PPD {Mantoux: positive}, tonsillectomy {Tonsillectomy}, drainage {Drainage procedure}, abscess {Abscess}, R elbow {Right elbow region structure}, D&C {Dilation and curettage of uterus}"
+"###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:
+non-contributory
+ 
+
+###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:
+Exam on admission: 
+VS 98.0 75 129/75 18 98-99%RA, ___ 145
+A&O NARD
+RRR
+CTAB no wheezes, rare bronchial breath sounds
+Abd soft, gravid nontender
+EFW 8# by ___
+Ext NT no edema
+
+SVE ___
+Toco ___
+FHT 140/mod/+accels/-decels
+
+ 
+
+###RESPONSE: VS {Vital signs finding}, RA {Breathing room air}, A {Mentally alert}, O {Orientated}, RRR {Normal heart rate}, CTAB {Normal breath sounds}, wheezes {Wheezing}, bronchi {Wheeze - rhonchi}, Abd {Examination of abdomen}, soft {Abdomen soft}, gravid {Abdominal pregnancy}, nontender {Abdominal tenderness}, Ext {Examination of limb}, NT {Abdominal tenderness}, 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:
+___ 08:56AM BLOOD WBC-13.0* RBC-3.47* Hgb-9.9* Hct-29.5* 
+MCV-85 MCH-28.5 MCHC-33.5 RDW-14.1 Plt ___
+___ 12:19PM BLOOD WBC-14.4* RBC-3.87* Hgb-11.1* Hct-32.8* 
+MCV-85 MCH-28.8 MCHC-33.9 RDW-14.0 Plt ___
+___ 12:19PM BLOOD Neuts-71.3* ___ Monos-5.0 Eos-0.6 
+Baso-0.2
+___ 12:19PM BLOOD Glucose-92 UreaN-5* Creat-0.5 Na-138 
+K-3.9 Cl-106 HCO3-20* AnGap-16
+___ 10:26PM URINE Blood-NEG Nitrite-NEG Protein-30 
+Glucose-300 Ketone-80 Bilirub-NEG Urobiln-2* pH-6.0 Leuks-NEG
+___ 12:19PM URINE Blood-NEG Nitrite-NEG Protein-NEG 
+Glucose-NEG Ketone-NEG Bilirub-NEG Urobiln-2* pH-6.5 Leuks-NEG
+ 
+
+###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}, 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}, Monos {Monocyte count}, Eos {Eosinophil 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}, URINE Blood {Blood in urine}, Protein {Measurement of protein in urine}, Ketone {Urinalysis, acetone or ketone bodies measurement}, pH {pH measurement}, URINE Blood {Blood in urine}, Protein {Measurement of protein in urine}, Ketone {Urinalysis, acetone or ketone bodies measurement}, pH {pH 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: Brief Hospital Course:
+Ms. ___ was admitted to the L+D for post dates induction of 
+labor. She had a succesful induction with cytotec and pitocin 
+and delivered a liveborn infant without complications. 
+
+Her post-partum course was uncomplicated.  Social work saw her 
+due to her complex history.  Her pani was well controlled, she 
+was ambulatory and eating a regular diet. She was discharged on 
+post-partum day 2 with follow-up. 
+ 
+
+###RESPONSE: post dates {Prolonged pregnancy}, induction of 
+labor {Induction of labor}, post-partum {Postpartum state}, regular diet {Normal diet}, post-partum {Postpartum state}"
+"###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:
+- PNV
+- albuterol (___)
+- prescribed azithromycin (Zpack) and prednisone in ED, rx not
+yet filled
+
+ 
+Discharge Medications:
+1. Motrin 800 mg Tablet Sig: One (1) Tablet PO every six (6) 
+hours as needed for pain.
+Disp:*30 Tablet(s)* 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:
+s/p vaginal delivery
+
+ 
+Discharge Condition:
+stable
+
+ 
+
+###RESPONSE: vaginal delivery {Vaginal delivery}, stable {Patient's condition stable}"
+"###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:
+No heavy lifting or intercourse
+ 
+
+###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: 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: 
+No Known Allergies / Adverse Drug Reactions
+ 
+Attending: ___.
+ 
+Chief Complaint:
+R ankle fracture dislocation, open
+ 
+Major Surgical or Invasive Procedure:
+ORIF R ankle and I&D ___
+
+ 
+
+###RESPONSE: No Known Allergies {Allergic disposition}, Adverse Drug Reactions {Propensity to adverse reactions to drug}, R ankle {Structure of right ankle}, fracture {Open fracture}, dislocation {Dislocation}, ORIF {Open reduction of fracture with internal fixation}, R ankle {Structure of right ankle}, I&D {Incision AND drainage}"
+"###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:
+Chief Complaint:  ankle pain
+Reason for Orthopedics Consult: management of open fracture
+ 
+HISTORY OF PRESENT ILLNESS: 
+Patient is a ___ yo male previously healhty presenting w/ fall 
+from 6 feet, from ladder. Patient landed on LLE w/ forced 
+eversion and subsequent open fracture/dislocation. Denies head 
+strike or LOC. Denies neck pain, back pain, chest pain, abd 
+pain. Denies pelvic or thigh pain. 
+
+Was emergently reduced in ED under conscious sedation. 
+
+In the ED, initial vitals were 77 160/60 16 100%.  Per the ED, 
+the patient's exam did not show evidence of neurovascular 
+symptoms.
+
+Review of systems:  
+(+) Per HPI  
+(-) Denies fever, chills, night sweats, recent weight loss or 
+gain. Denies headache, neck or back pain. Denies cough, 
+shortness of breath, chest pain. Denies nausea, vomiting, 
+diarrhea, abdominal pain, or changes in bowel habits. Denies 
+dysuria, frequency, or urgency. 
+ 
+PAST MEDICAL HISTORY:  
+none
+ 
+MEDICATIONS:  
+none
+ 
+ALLERGIES:  
+NKDA
+ 
+SOCIAL HISTORY:  
+Denies alcohol, drugs, smoking
+ 
+PHYSICAL EXAM:  
+GENERAL: Alert, oriented, no acute distress  
+HEENT: Sclera anicteric, MMM, oropharynx clear  
+NECK: C-spine is non-tender to palpation
+LUNGS: Clear to auscultation bilaterally
+CV: Regular rate and rhythm, 
+ABD: soft, non-tender, non-distended, 
+PELVIS: stable
+EXT: open fracture/likely dislocation of LLE at level of distal 
+tibia. +DP. Unable to assess.  Warm, well perfused, 2+ pulses, 
+no clubbing, cyanosis or edema. ___
+
+ 
+Labs: pending
+ 
+Images:  
+  
+
+ASSESSMENT & PLAN:  
+___ yo male w/ type II open fracture/dislocation of distal 
+tib/fib.  
+
+1. Ancef 2g, tetanus
+2. Imaging
+3. Admit to ___ for surgical repair
+4. Preop labs
+
+ 
+
+###RESPONSE: ankle pain {Ankle pain}, open fracture {Open fracture}, fall {Falls}, LLE {Structure of left lower limb}, eversion {Eversion}, open fracture {Open fracture}, dislocation {Dislocation}, head 
+strike {Injury of head}, LOC {Loss of consciousness}, neck pain {Neck pain}, back pain {Backache}, chest pain {Chest pain}, abd 
+pain {Abdominal pain}, pelvic {Pain in pelvis}, thigh pain {Thigh pain}, conscious sedation {Induction of conscious sedation}, vitals {Vital signs finding}, neurovascular 
+symptoms {Neurological symptom}, fever {Fever}, chills {Chill}, night sweats {Night sweats}, recent weight loss {Recent weight loss}, gain {Weight gain}, headache {Headache}, neck {Neck pain}, back pain {Backache}, Denies cough {Does not cough}, shortness of breath {Dyspnea}, chest pain {Chest pain}, nausea {Nausea}, vomiting {Vomiting}, diarrhea {Diarrhea}, abdominal pain {Abdominal pain}, changes in bowel habits {Altered bowel function}, dysuria {Dysuria}, frequency {Finding of frequency of urination}, urgency {Urgent desire to urinate}, smoking {Smoker}, GENERAL {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, distress {Distress}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, MMM {Moist oral mucosa}, oropharynx {Oropharyngeal structure}, NECK {Physical examination procedure}, C-spine {Structure of cervical vertebral column}, non-tender {Cervical spine normal}, palpation {Palpation}, LUNGS {Examination of respiratory system}, Clear to auscultation bilaterally {Normal breath sounds}, CV {Cardiovascular physical examination}, Regular rate and rhythm {Normal heart rate}, ABD {Examination of abdomen}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, PELVIS {Structure of pelvis}, EXT {Examination of limb}, open fracture {Open fracture}, dislocation {Dislocation}, LLE {Structure of left lower limb}, distal 
+tibia {Bone structure of distal tibia}, DP {Structure of dorsalis pedis artery}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, 2+ pulses {Peripheral pulses normal}, clubbing {Clubbing}, cyanosis {Cyanosis}, edema {Edema}, open fracture {Open fracture}, dislocation {Dislocation}, distal 
+tib {Bone structure of distal tibia}, fib {Bone structure of distal fibula}, tetanus {Tetanus}, Imaging {Imaging}, surgical repair {Surgical repair}"
+"###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:
+not contributory
+ 
+
+###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:
+AFVSS
+NAD
+RLE: 
+dressing c/d/i
+___ intact dp/t
+___
+ 
+
+###RESPONSE: VS {Vital signs finding}, NAD {No abnormality detected}, RLE {Structure of right lower limb}, dressing {Application of dressing}"
+"###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}"
+"###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. male with history of hypertrophic cardiomyopathy 
+presents from outside hospital with bilateral calcaneus 
+fractures.  The patient reports that earlier today he was up on 
+a ladder, approximately 8 feet off of the ground.  The bottom of 
+the ladder started to slide backwards, and the ladder fell to 
+the ground.  He landed on his feet, and felt immediate heel pain 
+bilaterally. The patient denies head strike, LOC, or back pain.  
+
+
+He reports no other pain or injury.  He was seen at ___ 
+___ and had plain films of his bilateral ankle/feet which 
+revealed bilateral comminuted heel fractures.  He was 
+transferred to ___ for further management.
+
+He denies recent fever, cough, chest pain, shortness of breath, 
+n/v/d, and abodminal pain.
+
+ 
+
+###RESPONSE: hypertrophic cardiomyopathy {Hypertrophic cardiomyopathy}, calcaneus 
+fractures {Fracture of calcaneus}, fell {Falls}, feet {Foot structure}, heel pain {Heel pain}, head strike {Injury of head}, LOC {Loss of consciousness}, back pain {Backache}, pain {Pain}, injury {Traumatic or non-traumatic injury}, plain films {Plain radiography}, bilateral ankle {Both ankles}, feet {Both feet}, comminuted {Fracture, comminuted}, heel fractures {Fracture of calcaneus}, fever {Fever}, cough {Cough}, chest pain {Chest pain}, shortness of breath {Dyspnea}, n/v/d {Nausea, vomiting and diarrhea}, abodminal pain {Abdominal 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: Past Medical History:
+(1) Hypertrophic Cardiomyopathy
+(2) Depression
+
+ 
+
+###RESPONSE: Hypertrophic Cardiomyopathy {Hypertrophic cardiomyopathy}, Depression {Depressive 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: 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:
+non-contributory
+ 
+
+###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 Evaluation Exam
+Sensorium:           Awake (x) Awake impaired () Unconscious ()
+Airway:              Intubated () Not intubated (x)
+Breathing:           Stable (x) Unstable ()
+Circulation:         Stable (x)   Unstable ()
+
+Musculoskeletal Exam
+Neck   Normal (x)  Abnormal ()   Comments:
+Spine  Normal (x)  Abnormal ()   Comments:
+Clavicle
+     R Normal (x)  Abnormal ()   Comments:
+     L Normal (x)  Abnormal ()   Comments:
+Shoulder
+     R Normal (x)  Abnormal ()   Comments:
+     L Normal (x)  Abnormal ()   Comments:
+Arm
+     R Normal (x)  Abnormal ()   Comments:
+     L Normal (x)  Abnormal ()   Comments:
+Elbow
+     R Normal (x)  Abnormal ()   Comments:
+     L Normal (x)  Abnormal ()   Comments:
+Forearm
+     R Normal (x)  Abnormal ()   Comments:
+     L Normal (x)  Abnormal ()   Comments:
+Wrist
+     R Normal (x)  Abnormal ()   Comments:
+     L Normal (x)  Abnormal ()   Comments:
+Hand
+     R Normal ()  Abnormal (x)   Comments: superficial abrasions
+over dorsum of right hand.
+     L Normal (x)  Abnormal ()   Comments:
+Pelvis
+     R Normal (x)  Abnormal ()    Comments:
+     L Normal (x)  Abnormal ()    Comments:
+Hip
+     R Normal (x)  Abnormal ()    Comments:
+     L Normal (x)  Abnormal ()    Comments:
+Thigh
+     R Normal (x)  Abnormal ()    Comments:
+     L Normal (x)  Abnormal ()    Comments:
+Knee
+     R Normal (x)  Abnormal ()    Comments:
+     L Normal (x)  Abnormal ()    Comments:
+Leg
+     R Normal (x)  Abnormal ()    Comments:
+     L Normal (x)  Abnormal ()    Comments:
+Ankle
+     R Normal ()  Abnormal (x)    Comments: mild edema,
+tenderness to palpation of the heel, plantar surface. No 
+palpable
+deformity. 2+ ___ pulses. Normal sensation, normal capillary
+refill.
+     L Normal ()  Abnormal (x)    Comments: moderate edema,
+tenderness to palpation of the heel, plantar surface. No 
+palpable
+deformity. 2+ ___ pulses. Normal sensation, normal capillary
+refill.
+Foot
+     R Normal ()  Abnormal (x)    Comments: see above
+     L Normal ()  Abnormal (x)    Comments: see above
+
+Vascular:
+Radial   R Palpable (x) Non-palpable () Doppler ()
+         L Palpable (x) Non-palpable () Doppler ()
+Ulnar    R Palpable (x) Non-palpable () Doppler ()
+         L Palpable (x) Non-palpable () Doppler ()
+DP       R Palpable (x) Non-palpable () Doppler ()
+         L Palpable (x) Non-palpable () Doppler ()
+___       R Palpable (x) Non-palpable () Doppler ()
+         L Palpable (x) Non-palpable () Doppler ()
+
+Neuro:
+Deltoid    R (5) L (5)
+Biceps     R (5) L (5)
+Triceps    R (5) L (5)
+Wrist Flx  R (5) L (5)
+Wrist Ext  R (5) L (5)
+Finger Flx R (5) L (5)
+Finger Ext R (5) L (5)
+Thumb Ext  R (5) L (5)
+___ DIP    R (5) L (5)
+Index Abd  R (5) L (5)
+Thumd Add  R (5) L (5)
+Quad       R (5) L (5)
+Ant Tib    R (5) L (5)
+___        R ___ limited by pain) L ___, limited by pain)
+Peroneal   R ___ limited by pain) L ___ limited by pain)
+___         R ___ limited by pain) L ___ limited by pain)
+
+ 
+
+###RESPONSE: General {General examination of patient}, Sensorium {Structure of sensory nervous system}, Awake {Awake}, Awake {Awake}, Unconscious {Unconscious}, Airway {Airway structure}, Intubated {Intubation}, intubated {Intubation}, Breathing {Examination of respiratory system}, Stable {Patient's condition stable}, Unstable {Patient's condition unstable}, Circulation {Cardiovascular examination and evaluation}, Stable {Patient's condition stable}, Unstable {Patient's condition unstable}, Musculoskeletal Exam {Musculoskeletal system physical examination}, Spine {Structure of vertebral column}, Clavicle {Bone structure of clavicle}, Shoulder {Structure of right shoulder region}, R {Structure of right shoulder region}, L {Structure of left shoulder region}, Arm {Upper limb structure}, R {Right upper arm structure}, L {Left upper arm structure}, Elbow {Elbow region structure}, R {Right elbow region structure}, L {Left elbow region structure}, Forearm {Forearm structure}, R {Structure of right forearm}, L {Structure of left forearm}, Wrist {Structure of left wrist region}, R {Structure of right wrist region}, L {Structure of left wrist region}, Hand {Hand structure}, R {Structure of right hand}, superficial abrasions {Abrasion}, dorsum of right hand {Structure of dorsum of right hand}, L {Structure of left hand}, Pelvis {Structure of pelvis}, L {Structure of left half of pelvis}, Hip {Hip region structure}, R {Right hip region structure}, L {Left hip region structure}, Thigh {Thigh structure}, R {Structure of right thigh}, L {Structure of left thigh}, Knee {Structure of left knee region}, R {Structure of right knee region}, L {Structure of left knee region}, Leg {Lower limb structure}, R {Structure of right lower leg}, L {Structure of left lower leg}, Ankle {Ankle region structure}, R {Structure of right ankle}, mild {Symptom mild}, edema {Edema}, tenderness {Tenderness}, palpation {Palpation}, heel {Heel structure}, palpable {Finding by palpation}, deformity {Deformity}, pulses {Normal pulse}, Normal sensation {Normal sensation}, capillary
+refill {Capillary refill}, L {Structure of left ankle}, moderate {Symptom moderate}, edema {Edema}, tenderness {Tenderness}, palpation {Palpation}, heel {Heel structure}, palpable {Finding by palpation}, deformity {Deformity}, pulses {Normal pulse}, Normal sensation {Normal sensation}, capillary
+refill {Capillary refill}, Foot {Foot structure}, R {Structure of right foot}, L {Structure of left foot}, Radial {Structure of radial artery}, R {Structure of right radial artery}, Palpable {Finding by palpation}, palpable {Finding by palpation}, L {Structure of left radial artery}, Palpable {Finding by palpation}, palpable {Finding by palpation}, Ulnar {Structure of ulnar vessel}, R {Structure of right ulnar artery}, Palpable {Finding by palpation}, palpable {Finding by palpation}, L {Structure of left ulnar artery}, Palpable {Finding by palpation}, palpable {Finding by palpation}, R {Structure of right dorsalis pedis artery}, Palpable {Finding by palpation}, palpable {Finding by palpation}, L {Structure of left dorsalis pedis artery}, Palpable {Finding by palpation}, palpable {Finding by palpation}, Palpable {Finding by palpation}, palpable {Finding by palpation}, Neuro {Neurological examination}, Deltoid {Structure of deltoid muscle}, Biceps {Biceps brachii muscle structure}, R {Structure of right biceps brachii muscle}, L {Structure of left biceps brachii muscle}, Triceps {Triceps brachii muscle structure}, Wrist {Structure of left wrist region}, Flx {Structure of flexor of wrist joint}, Wrist {Structure of left wrist region}, Finger {Finger structure}, Finger {Finger structure}, Thumb {Thumb structure}, DIP {Structure of distal interphalangeal joint}, Index {Index finger structure}, Abd {Structure of adductor muscle}, Thumd {Thumb structure}, Add {Structure of adductor muscle}, Quad {Structure of quadriceps femoris muscle}, Ant Tib {Tibialis anterior muscle structure}, pain {Pain}, pain {Pain}, Peroneal {Structure of peroneal artery}, pain {Pain}, pain {Pain}, pain {Pain}, 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: Pertinent Results:
+___ 06:40PM   GLUCOSE-91 UREA N-11 CREAT-0.9 SODIUM-140 
+POTASSIUM-4.4 CHLORIDE-100 TOTAL CO2-27 ANION GAP-17
+___ 06:40PM   WBC-10.2 RBC-4.39* HGB-14.0 HCT-40.1 MCV-91 
+MCH-31.8 MCHC-34.9 RDW-13.7
+___ 06:40PM   NEUTS-74.6* LYMPHS-16.6* MONOS-7.0 EOS-1.1 
+BASOS-0.7
+ 
+
+###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}, 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}, LYMPHS {Lymphocyte count}, MONOS {Monocyte count}, EOS {Eosinophil count}"
+"###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:
+Mr. ___ was evaluated in the emergency room by the 
+orthopaedic trauma service and found to have bilateral calcaneal 
+fractures. He was admitted to ortho for pain control and 
+bilateral bulky ___ casts were placed.  He was evaluated by 
+physical therapy during his hospital stay.
+
+On the floor he was given a regular diet with PO pain meds.  At 
+the time of discharge he was afebrile with stable vital signs, 
+tolerating a regular diet, voiding spontaneously, and with his 
+pain well controled.
+
+ 
+
+ 
+
+###RESPONSE: trauma {Traumatic injury}, calcaneal 
+fractures {Fracture of calcaneus}, pain control {Pain control}, casts {Cast}, placed {Implantation procedure}, evaluated by 
+physical therapy {Physical therapy management}, regular diet {Normal diet}, pain {Pain}, afebrile {Fever}, stable vital signs {Normal vital signs}, regular diet {Normal diet}, voiding spontaneously {Normal micturition}, pain well controled {Demonstrates adequate pain control}"
+"###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:
+(1) Atenolol 50mg PO daily
+(2) Paxil 20mg PO daily
+
+ 
+Discharge Medications:
+1. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 
+6 hours).
+Disp:*240 Tablet(s)* Refills:*2*
+2. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 
+times a day).
+Disp:*60 Capsule(s)* Refills:*2*
+3. Lovenox 40 mg/0.4 mL Syringe Sig: One (1) injection 
+Subcutaneous once a day for 4 weeks.
+Disp:*28 1* Refills:*0*
+4. atenolol 50 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+5. paroxetine HCl 20 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+6. oxycodone 5 mg Tablet Sig: ___ Tablets PO Q3H (every 3 hours) 
+as needed for Pain.
+Disp:*90 Tablet(s)* 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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Bilateral calcaneal fractures
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+
+ 
+
+###RESPONSE: calcaneal fractures {Fracture of calcaneus}, Mental Status {Neurological mental status determination}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, interactive {Does communicate}, 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:
+Wound Care: 
+- Keep Incision clean and dry. 
+- Do not soak the incision in a bath or pool. 
+
+Activity: 
+- Continue to be non-weight bearing on both of your legs.
+
+Other Instructions
+- Resume your regular diet. 
+- Avoid nicotine products to optimize healing. 
+- Resume your home medications. Take all medications as 
+instructed. 
+- Continue taking the Lovenox to prevent blood clots.
+- You have also been given Additional Medications to control 
+your pain. Please allow 72 hours ___ through ___, 9am to 
+4pm) for refill of narcotic prescriptions, so plan ahead. There 
+will be no prescription refils on ___, or 
+holidays. You can either have them mailed to your home or pick 
+them up at the clinic located on ___. We are not allowed 
+to call in narcotic (oxycontin, oxycodone, percocet) 
+prescriptions to the pharmacy. In addition, we are only allowed 
+to write for pain medications for 90 days from the date of 
+surgery.
+- Narcotic pain medication may cause drowsiness. Do not drink 
+alcohol while taking narcotic medications. Do not operate any 
+motor vehicle or machinery while taking narcotic pain 
+medications. Taking more than recommended may cause serious 
+breathing problems.
+
+If you have questions, concerns or experience any of the below 
+danger signs then please call your doctor at ___ or go 
+to your local emergency room.
+ 
+
+###RESPONSE: Wound Care {Wound care}, Incision {Incision}, soak {Soak}, incision {Incision}, Activity {Functional activity education}, non-weight bearing {Non-weight-bearing}, legs {Lower limb structure}, regular diet {Normal diet}, medications {Patient medication education}, medications {Patient medication education}, blood clots {Blood clot}, Medications {Patient medication education}, pain {Pain}, narcotic {Narcotherapy}, prescriptions {Prescription}, prescription {Prescription}, narcotic {Narcotherapy}, prescriptions {Prescription}, pain medications {Administration of analgesic}, surgery {Surgical procedure}, Narcotic {Narcotherapy}, pain medication {Administration of analgesic}, drowsiness {Drowsy}, Do not drink 
+alcohol {Education about alcohol consumption}, while taking narcotic {Narcotherapy}, medications {Patient medication education}, while taking narcotic {Narcotherapy}, pain 
+medications {Administration of analgesic}, breathing problems {Abnormal breathing}, signs {Sign}"
+"###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: 
+Penicillins / Bactrim / Prochlorperazine / Sulfa (Sulfonamide 
+Antibiotics) / Quinolones / Pineapple / Erythromycin Base / 
+Metoclopramide
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Abdominal Pain 
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: Penicillins {Allergy to penicillin}, Bactrim {Allergy to sulfamethoxazole and/or trimethoprim}, Prochlorperazine {Allergy to prochlorperazine}, Sulfonamide 
+Antibiotics {Allergy to sulfonamide antibiotic}, Pineapple {Allergy to pineapple}, Erythromycin {Allergy to erythromycin}, Metoclopramide {Allergy to metoclopramide}, Abdominal Pain {Abdominal 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:
+Ms. ___ is a ___ year old female with a h/o kidney stones who 
+presents with several days of RUQ/flank pain and a distended 
+abdomen. The pain began ___ after eating when she started 
+having nausea and then vomited. Over the next few days she had 
+what she describes as a ""belly ache"" with some associated nausea 
+and one episode of emesis on ___. During the week she was 
+able to tolerate po's then noted an increase in urinary 
+frequency and thought she could feel a kidney stone passing, but 
+when the pain didn't improve she called her PCP's office on 
+___. She was seen by her PCP for evaluation of her 
+abdominal pain, who was concerned about a kidney stone vs. 
+gallbladder pathology so she had a noncontrast abdominal CT scan 
+done. The CT scan showed a 17mm likely cyst in her liver and two 
+kidney stones on the left, but since the cyst had increased in 
+size and she continued to have pain she was referred to the ER 
+for further evaluation.  
+.  
+In the ED, initial vs were: 98.6, 77, 125/80, 18, 100% on RA. 
+Patient was given morphine x 2 for pain, which improved her pain 
+but did not last that long, had an ultrasound of her abdomen 
+that showed a left sided 5mm non-obstructing kidney stone and 
+two likely liver hemangiomas. Labs showed all LFT's within 
+normal limits, lipase of 44, HCT of 34.2, u/a with a small 
+amount of blood, and was admitted for further work up of her 
+abdominal pain.  
+.  
+On the floor initial VS were: 96.2, 110/80, 88, 18, 99% on RA, 
+currently her pain is ___, improved to ___ with morphine. 
+Describes the belly pain as diffuse and dull, flank pain is 
+sharp.  
+.  
+Review of systems:  
+(+) Per HPI  
+(-) Denies fever, chills, night sweats, recent weight loss or 
+gain. Denies headache, sinus tenderness, rhinorrhea or 
+congestion. Denied cough, shortness of breath. Denied chest pain 
+or tightness, palpitations. Denied nausea, vomiting, diarrhea, 
+constipation. No recent change in bowel habits. No dysuria. 
+Denied arthralgias or myalgias.  
+
+ 
+
+###RESPONSE: kidney stones {Kidney stone}, RUQ {Right upper quadrant pain}, flank pain {Flank pain}, distended 
+abdomen {Swollen abdomen}, pain {Abdominal pain}, nausea {Nausea}, vomited {Vomiting}, belly ache {Stomach ache}, nausea {Nausea}, emesis {Vomiting}, increase in urinary 
+frequency {Increased frequency of urination}, kidney stone {Kidney stone}, pain {Pain}, evaluation {Evaluation procedure}, abdominal pain {Abdominal pain}, kidney stone {Kidney stone}, gallbladder {Gallbladder structure}, noncontrast abdominal CT scan {Computed tomography of abdomen without contrast}, CT scan {Computed tomography of abdomen without contrast}, cyst in her liver {Cyst of liver}, kidney stones {Kidney stone}, left {Left kidney structure}, cyst {Cyst of liver}, pain {Pain}, evaluation {Evaluation procedure}, RA {Breathing room air}, improved {Patient's condition improved}, pain {Pain}, ultrasound of her abdomen {Ultrasonography of abdomen}, left {Left kidney structure}, kidney stone {Kidney stone}, liver hemangiomas {Hemangioma of liver}, LFT's within 
+normal limits {Liver function tests within reference range}, u/a {Urinalysis}, abdominal pain {Abdominal pain}, RA {Breathing room air}, pain {Abdominal pain}, improved {Patient's condition improved}, belly pain {Abdominal pain}, diffuse {Diffuse pain}, dull {Dull pain}, flank pain {Flank pain}, sharp {Sharp pain}, 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}, cough {Cough}, shortness of breath {Dyspnea}, chest pain {Chest pain}, tightness {Tight chest}, palpitations {Palpitations}, nausea, vomiting {Nausea and vomiting}, diarrhea {Diarrhea}, constipation {Constipation}, change in bowel habits {Altered bowel function}, dysuria {Dysuria}, arthralgias {Joint pain}, myalgias {Muscle 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: Past Medical History:
+(per patient and atrius records)  
+Kidney Stones  
+Asthma  
+Anemia  
+Sickle cell trait  
+hx hematuria  
+endometriosis
+Hx Abnormal Pap
+
+ 
+
+###RESPONSE: Kidney Stones {Kidney stone}, Asthma {Asthma}, Anemia {Anemia}, Sickle cell trait {Sickle cell trait}, hematuria {Blood in urine}, endometriosis {Endometriosis}"
+"###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 with HTN, DM, RA and interstitial cystitis  
+Two maternal aunts with breast cancer  
+One paternal aunt with colon cancer  
+
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, DM {Diabetes mellitus}, RA {Rheumatoid arthritis}, interstitial cystitis {Chronic interstitial cystitis}, breast cancer {Malignant neoplasm of breast}, colon cancer {Malignant neoplasm 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: Physical Exam:
+Vitals: T: 98 BP: 102/68 P: 77 (70-80s) R: 18 O2: 99% on RA  
+General: WDWN young AA female, appearing in mild discomfort  
+HEENT: NCAT, EOMI, MMM, OP clear  
+Neck: supple  
+Lungs: Clear to auscultation bilaterally, no wheezes, rales, 
+ronchi  
+CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, 
+gallops  
+Abdomen: soft, mildly distended, TTP in epigastric region, RUQ 
+and RLQ, no rebound tenderness or guarding  
+Back: no spinal tenderness, +right CVA tenderness  
+Ext: Warm, well perfused, 2+ pulses, no clubbing, cyanosis or 
+edema  
+
+ 
+
+###RESPONSE: Vitals {Vital signs finding}, BP {Blood pressure finding}, RA {Breathing room air}, General {General examination of patient}, WDWN {Well nourished}, mild {Symptom mild}, discomfort {Discomfort}, HEENT {Physical examination procedure}, NC {Normal head}, EOMI {Normal ocular motility}, MMM {Moist oral mucosa}, OP clear {Pharynx normal}, Neck {Physical examination procedure}, supple {Normal movement of neck}, Lungs {Examination of respiratory system}, Clear to auscultation bilaterally {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, ronchi {Wheeze - rhonchi}, 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<}, murmurs {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, Abdomen {Examination of abdomen}, soft {Abdomen soft}, distended {Swollen abdomen}, TTP {Tenderness}, epigastric region {Tenderness of epigastrium}, RUQ {Tenderness of right upper quadrant of abdomen}, RLQ {Tenderness of right lower quadrant of abdomen}, rebound {Rebound tenderness}, tenderness {Tenderness}, guarding {Abdominal guarding}, spinal {Structure of vertebral column}, tenderness {Tenderness}, CV {Cardiovascular physical examination}, tenderness {Tenderness}, Ext {Examination of limb}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, clubbing {Clubbing}, cyanosis {Cyanosis}, 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:
+Laboratory Findings
+___ 08:33PM BLOOD WBC-5.4# RBC-3.95* Hgb-12.1 Hct-34.2*# 
+MCV-87 MCH-30.6 MCHC-35.3* RDW-13.0 Plt ___
+___ 08:33PM BLOOD Neuts-48.5* ___ Monos-6.8 
+Eos-5.2* Baso-0.5
+___ 08:33PM BLOOD Glucose-88 UreaN-10 Creat-0.6 Na-141 
+K-3.6 Cl-110* HCO3-23 AnGap-12
+___ 08:33PM BLOOD ALT-15 AST-22 AlkPhos-58 TotBili-0.4
+___ 08:33PM BLOOD Albumin-4.2
+___ 10:05AM BLOOD Calcium-8.6 Phos-2.9 Mg-1.8
+___ 06:50AM BLOOD WBC-4.6 RBC-3.84* Hgb-11.9* Hct-33.3* 
+MCV-87 MCH-30.9 MCHC-35.7* RDW-12.7 Plt ___
+___ 06:50AM BLOOD Glucose-84 UreaN-9 Creat-0.7 Na-139 K-3.7 
+Cl-107 HCO3-23 AnGap-13
+
+----------------
+Microbiology:
+----------------
+___ 08:33PM URINE Color-Yellow Appear-Clear Sp ___
+___ 08:33PM URINE Blood-SM Nitrite-NEG Protein-NEG 
+Glucose-NEG Ketone-NEG Bilirub-NEG Urobiln-1 pH-5.0 Leuks-NEG
+___ 08:33PM URINE ___ Bacteri-MOD Yeast-NONE 
+___
+URINE CULTURE (Final ___:    <10,000 organisms/ml. (final 
+report)
+
+----------------
+Imaging
+----------------
+Abdominal Ultrasound ___:
+There is normal echogenicity of the liver. There is no extra- or 
+
+intra-hepatic biliary duct dilatation. There are two hyperechoic 
+lesions in the liver with no convincing vascularity, one 
+measuring 1.8 x 2.1 x 2 cm and second one measuring 8 x 8 x ___ile duct measures 3 mm. The portal vein is 
+patent. The left kidney measures 10.2 cm. There is a 5-mm 
+nonobstructing stone in the upper pole of the left kidney. The 
+right kidney measures 10 cm. There is no evidence of 
+hydronephrosis. There is no free fluid. The spleen is normal 
+measuring 7.3 cm. Evaluation of pancreas is slightly suboptimal 
+due to overlapping bowel gas; however, no gross abnormality of 
+the pancreatic head. Urinary bladder appears within normal 
+limits.   
+IMPRESSION: 
+1. Two hyperechoic liver lesions in the right liver lobe, with 
+no convincing vascularity, with imaging characteristics most 
+suggestive of liver hemangioma. 
+2. 5-mm nonobstructive stone in the upper pole of the left 
+kidney. No 
+hydronephrosis. 
+3. Patent main portal vein. 
+
+ 
+
+###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}, 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}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, Albumin {Albumin 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}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, Protein {Measurement of protein in urine}, Ketone {Urinalysis, acetone or ketone bodies measurement}, pH {pH measurement}, liver {Liver structure}, intra-hepatic biliary duct {Intrahepatic biliary tract structure}, dilatation {Dilatation}, lesions {Lesion}, liver {Liver structure}, ile duct {Bile duct structure}, portal vein {Portal vein structure}, left kidney {Left kidney structure}, stone {Calculus}, upper pole of the left kidney {Structure of upper pole of left kidney}, right kidney {Right kidney structure}, no evidence {No abnormality detected}, hydronephrosis {Hydronephrosis}, free fluid {Effusion}, spleen {Splenic structure}, pancreas {Pancreatic structure}, no gross abnormality {No abnormality detected}, pancreatic head {Structure of head of pancreas}, Urinary bladder {Urinary bladder structure}, liver lesions {Lesion of liver}, right liver lobe {Structure of right lobe of liver}, liver hemangioma {Hemangioma of liver}, stone {Calculus}, upper pole of the left 
+kidney {Structure of upper pole of left kidney}, hydronephrosis {Hydronephrosis}, portal vein {Portal vein 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:
+This is a ___ year old female with a history of kidney stones who 
+presents with a one week history of right sided crampy abdominal 
+pain, found to have a left-sided kidney stone and liver cyst on 
+abdominal ultrasound.  
+
+.  
+# Abdominal Pain: No clear etiology, but felt to be most likely 
+related to passage of a kidney stone on the right.  The patient 
+described a crampy abdominal pain located on the right, and had 
+right and left CVA tenderness on examination.  She was started 
+on tamsulosin given the presence of a 5mm stone on that side.  
+However, she experienced dizziness, so this medication was 
+stopped.  Additionally, the patient mentioned experiencing a 
+painful big toe during a prior episode of passing a kidney 
+stone. While she did not pass a stone that could be collected 
+for laboratory evaluation, the possibility of hyperuricemia and 
+concurrent gout was considered, and the patient was given 
+information regarding a low uric acid diet.  Her pain resolved 
+spontaneously during the admission, and she was able to tolerate 
+a regular diet at discharge.  She was instructed to contact her 
+PCP regarding further workup for her kidney stones.
+.  
+# Liver lesions: Outpatient CT records were obtained, which 
+noted growth of a liver lesion ___ 7 mm to 17 mm since ___. 
+The report did not specify whether this lesion was consistent 
+with a cyst or hemangioma, and suggested MRI for further 
+characterization.  An ultrasound during admission identified 
+cysts consistent with hemangiomas.  This lesion was felt to be 
+unrelated to her current episode of abdominal pain.  The patient 
+preferred to undergo MRI as an outpatient, and was instructed to 
+contact her PCP regarding scheduling this test on discharge.
+.
+# Migraine HA: The patient reported a history of migraine 
+headaches, for which she had taken fioricet in the past, 
+although this had been discontinued by her PCP for unknown 
+reasons.  While admitted, she did experience a migraine that was 
+partially relieved with acetaminophen and tramadol.  She 
+requested a trial of motrin for headaches, and was discharged 
+with a prescription for several doses of Motrin 800 mg.  She was 
+instructed to discuss this medication further with her PCP if 
+effective and she would like to continue.
+.
+# Asthma: The patient denied any asthmatic symptoms, and was 
+continued on her home dose of flovent and albuterol prn.  
+  
+
+ 
+
+###RESPONSE: kidney stones {Kidney stone}, right sided {Right sided abdominal pain}, crampy {Stomach cramps}, abdominal 
+pain {Abdominal pain}, kidney stone {Kidney stone}, liver cyst {Cyst of liver}, abdominal ultrasound {Ultrasonography of abdomen}, Abdominal Pain {Abdominal pain}, kidney stone {Kidney stone}, right {Right kidney structure}, crampy {Stomach cramps}, abdominal pain {Abdominal pain}, right {Structure of right half of abdomen lateral to midsagittal plane}, CVA tenderness {Renal angle tenderness}, stone {Calculus}, dizziness {Dizziness}, painful {Pain in toe}, big toe {Great toe structure}, kidney 
+stone {Kidney stone}, stone {Calculus}, hyperuricemia {Hyperuricemia}, gout {Inflammatory disorder due to increased blood urate level}, pain resolved {No present pain}, regular diet {Normal diet}, workup {Evaluation procedure}, kidney stones {Kidney stone}, Liver lesions {Lesion of liver}, CT {Computed tomography of abdomen}, liver lesion {Lesion of liver}, lesion {Lesion}, cyst {Cyst}, hemangioma {Hemangioma}, MRI {Magnetic resonance imaging}, ultrasound {Ultrasonography}, cysts {Cyst}, hemangiomas {Hemangioma}, lesion {Lesion}, abdominal pain {Abdominal pain}, MRI {Magnetic resonance imaging}, Migraine HA {Migraine}, migraine 
+headaches {Migraine}, migraine {Migraine}, headaches {Headache}, Asthma {Asthma}, asthmatic {Asthma}"
+"###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:
+Flovent 2puffs daily  
+Albuterol PRN  
+
+ 
+Discharge Medications:
+1. fluticasone 110 mcg/Actuation Aerosol Sig: Two (2) Puff 
+Inhalation DAILY (Daily).  
+2. albuterol sulfate 90 mcg/Actuation HFA Aerosol Inhaler Sig: 
+___  Inhalation every six (6) hours as needed for shortness of 
+breath or wheezing.  
+3. Motrin 800 mg Tablet Sig: One (1) Tablet PO once a day as 
+needed for headache.
+Disp:*10 Tablet(s)* Refills:*0*
+4. acetaminophen 500 mg Tablet Sig: ___ Tablets PO Q6H (every 6 
+hours) as needed for pain, headache.  
+
+ 
+
+###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:
+Nephrolithiasis
+Liver cysts
+Migraine headaches
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Nephrolithiasis {Kidney stone}, Liver cysts {Cyst of liver}, Migraine headaches {Migraine}, Mental Status {Neurological mental status determination}, 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. ___,
+
+You were admitted to the hospital for severe abdominal pain.  
+You underwent an abdominal ultrasound that showed a cyst in your 
+liver and a kidney stone on the left.  We think that you likely 
+passed a kidney stone on the right, which caused your pain.  You 
+should call your PCP on ___ to discuss scheduling an MRI to 
+better evaluate your liver cyst.
+
+We made the following changes to your medications:
+-Start Motrin to use for headache for the next several days.  If 
+you would like to continue with this medication, please discuss 
+it with your PCP.
+ 
+
+###RESPONSE: abdominal pain {Abdominal pain}, abdominal ultrasound {Ultrasonography of abdomen}, cyst in your 
+liver {Cyst of liver}, kidney stone {Kidney stone}, left {Left kidney structure}, kidney stone {Kidney stone}, right {Right kidney structure}, pain {Abdominal pain}, MRI {Magnetic resonance imaging}, liver cyst {Cyst of liver}, headache {Headache}"
+"###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: NEUROLOGY
+ 
+
+###RESPONSE: NEUROLOGY {Neurological examination}"
+"###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:
+stroke
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, stroke {Cerebrovascular accident}"
+"###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 lovely ___ yo woman with PMH significant for
+Alzheimer dementia, HTN, HLD, and hypothyroid who presents after
+subacute stroke was found on out patient MRI. The patient lives
+in an assisted living in ___. She started acting ""more
+confused"" this past ___ (10 days PTA). Most notable she
+walked into several other apartments when she was looking for 
+her
+own. She went to see his PCP on ___ and was found to have a
+positive UA and was started on ___ (started on ___. Over
+this weekend she was at a wedding with her daughter and kept
+asking for someone to bring her food, while there was an
+untouched plate sitting in front of her. on ___ she did the
+same with a glass of juice. The patient's daughter asked her PCP
+to order an MRI which was done and showed a subacute infarct on
+the right.  
+
+On neuro ROS: the pt denies headache, loss of vision, blurred
+vision, diplopia, oscilopsia, dysarthria, dysphagia, drop
+attacks, lightheadedness, vertigo, tinnitus or hearing
+difficulty. Denies difficulties producing or comprehending
+speech. Denies focal weakness, numbness, paresthesias. No bowel
+or bladder incontinence or retention. Denies difficulty with
+gait. 
+
+On general ROS: the pt denies recent fever or chills. No night
+sweats or recent weight loss or gain. Denies cough, shortness of
+breath. Denies chest pain or tightness, palpitations. Denies
+nausea, vomiting, diarrhea, constipation or abdominal pain. No
+recent change in bowel or bladder habits. No dysuria. Denies
+arthralgias or myalgias. Denies rash.
+ 
+
+###RESPONSE: Alzheimer dementia {Alzheimer's disease}, HTN {Hypertensive disorder, systemic arterial}, HLD {Hyperlipidemia}, hypothyroid {Hypothyroidism}, stroke {Cerebrovascular accident}, MRI {Magnetic resonance imaging of brain}, confused {Clouded consciousness}, positive {Detected by measurement}, UA {Urine examination}, MRI {Magnetic resonance imaging}, infarct {Infarct}, right {Structure of right half of body}, neuro {Neurological examination}, headache {Headache}, loss of vision {Functional visual loss}, blurred
+vision {Blurring of visual image}, diplopia {Diplopia}, oscilopsia {Finding of movement of visual image}, dysarthria {Dysarthria}, dysphagia {Dysphagia}, drop
+attacks {Drop attack}, lightheadedness {Lightheadedness}, vertigo {Vertigo}, tinnitus {Tinnitus}, hearing
+difficulty {Hearing difficulty}, difficulties producing or comprehending
+speech {Difficulty comprehending speech}, weakness {Asthenia}, numbness {Numbness}, paresthesias {Paresthesia}, bowel {Incontinence of feces}, bladder incontinence {Urinary incontinence}, retention {Retention}, difficulty with
+gait {Abnormal gait}, general {General examination of patient}, fever {Fever}, chills {Chill}, night
+sweats {Night sweats}, recent weight loss {Recent weight loss}, gain {Recent weight gain}, Denies cough {Does not cough}, shortness of
+breath {Dyspnea}, chest pain {Chest pain}, tightness {Tight chest}, palpitations {Palpitations}, nausea, vomiting, diarrhea {Nausea, vomiting and diarrhea}, constipation {Constipation}, abdominal pain {Abdominal pain}, change in bowel {Altered bowel function}, bladder habits {Alteration in patterns of urinary elimination}, dysuria {Dysuria}, arthralgias {Joint pain}, myalgias {Muscle pain}, rash {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: Past Medical History:
+Dementia 
+hypothyroidism 
+HTN
+HLD 
+
+ 
+
+###RESPONSE: Dementia {Dementia}, hypothyroidism {Hypothyroidism}, HTN {Hypertensive disorder, systemic arterial}, HLD {Hyperlipidemia}"
+"###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:
+non-contributory
+ 
+
+###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:
+ADMISSION PHYSICAL EXAM:
+T: 97 HR: 84 BP: 158/80 RR: 18 Sat: 99%
+
+GENERAL MEDICAL EXAMINATION:
+General appearance: alert, in no apparent distress
+HEENT: Neck is supple. Sclera are non-injected. Mucous membranes
+are moist. No carotid bruit 
+CV: Heart rate is regular
+Lungs: Clear to auscultation bilaterally without wheezing or
+crackles. 
+Abdomen: soft, non-tender
+Extremities: No evidence of deformities. No contractures. 
+Skin: No visible rashes. Warm and well perfused.
+
+NEUROLOGICAL EXAMINATION:
+Mental Status: Awake and alert. oriented to ___ and
+___, location was ""a place for head problems"". she was able
+to repeat that she was at ___ (where her
+daughter works) but could not recall this moments later. She
+could also not recall that she was here due to a stroke despite
+several explanations. Inattentive with slow DOWB. Language is
+fluent and appropriate with intact comprehension, repetition and
+naming of both high and low frequency objects. Normal prosody.
+There were no paraphasic errors. Speech was not dysarthric. Able
+to follow both midline and appendicular commands. No neglect,
+left/right confusion or finger agnosia.  No apraxia for salute 
+or
+brush your teeth. + palomental on left. no grasp. 
+
+Cranial Nerves:
+I: not tested
+II: dense homonymous hemianopsia on left. could not visualize
+fundi. 
+III-IV-VI: pupils equally round, reactive to light - small. 
+Eyes were eso deviated. With both eyes open left eye did not
+cross midline to the left. when tested separately EOMI. could 
+not
+test saccads as patient had difficulty finding objects in space.
+she denies diplopia. 
+V: Symmetric perception of LT in V1-3 
+VII: Face is symmetric at rest and with activation; symmetric
+speed and excursion with smile.
+VIII: Hearing intact to finger rub bl
+IX-X: Palate elevates symmetrically
+XI: Shoulder shrug and head rotation ___ bl 
+XII: No tongue deviation or fasciculations
+
+Pt only describes the R side of the stroke cards. She lists
+details in the scene (drawers, water, dish) but can not describe
+the whole image at all. She seem to do the same when asked to
+look at my face (eyes, neck, mouth, nose...) but does not seem 
+to
+see my face. she has trouble locating objects in space both by
+sight and sound, event when placed in her good field. 
+
+Motor: Normal muscle bulk and tone throughout. No pronator drift
+or rebound
+Strength:
+  Delt Bic Tri WrE FFl FE IO IP Quad Ham TA ___
+L  5    ___   ___  5   5    5  5     5     5   5
+R  5    ___   ___  5   5    5  5     5     5   5
+
+Reflexes:
+  Bi Tri ___ Pat Ach
+L  2  2    2    2   1
+R  2  2    2    2   1
+Toes are down going bilaterally.
+
+Sensory: normal and symmetric perception of pinprick, light
+touch, vibration and temperature. Proprioception is intact. No
+agraphesthesia or astereognosis. No extinction to DSS.
+
+Coordination: Finger to nose without dysmetria bilaterally. No
+intention tremor. RAM were symmetric with regard to cadence and
+speed, no dysdiadochokinesia noted.
+
+Gait: not tested. 
+========================================================
+DISCHARGE PHYSICAL EXAM:
+NEUROLOGICAL EXAMINATION:
+Mental Status: Awake and alert. Very hard of hearing. She cannot 
+say why she is in the hospital. Language is fluent and 
+appropriate with intact comprehension, repetition and naming of 
+both high and low frequency objects. Normal prosody. There were 
+no paraphasic errors. Speech was not dysarthric. Able to follow 
+both midline and appendicular commands. Left sided neglect.  
+
+Cranial Nerves:
+I: not tested
+II: dense homonymous hemianopsia on left. could not visualize
+fundi. 
+III-IV-VI: pupils equally round, reactive to light, EOMI. 
+V: Symmetric perception of LT in V1-3 
+VII: Face is symmetric at rest and with activation; symmetric
+speed and excursion with smile.
+VIII: Hearing intact to finger rub bl
+IX-X: Palate elevates symmetrically
+XI: Shoulder shrug and head rotation ___ bl 
+XII: No tongue deviation or fasciculations
+
+Motor: Normal muscle bulk and tone throughout. No pronator drift
+or rebound
+Strength:
+  Delt Bic Tri WrE FFl FE IO IP Quad Ham TA ___
+L  5    ___   ___  5   5    5  5     5     5   5
+R  5    ___   ___  5   5    5  5     5     5   5
+
+Reflexes:
+  Bi Tri ___ Pat Ach
+L  2  2    2    2   1
+R  2  2    2    2   1
+Toes are down going bilaterally.
+
+Sensory: normal and symmetric perception of pinprick, light
+touch, vibration and temperature. Proprioception is intact. No
+agraphesthesia or astereognosis. No extinction to DSS.
+
+Coordination: Finger to nose without dysmetria bilaterally. 
+
+Gait: not tested. 
+
+ 
+
+###RESPONSE: PHYSICAL EXAM {Physical examination procedure}, T {Body temperature finding}, HR {Finding of heart rate}, BP {Blood pressure finding}, RR {Finding of rate of respiration}, Sat {Finding of oxygen saturation}, General {General examination of patient}, appearance {Finding of general observation of appearance}, alert {Mentally alert}, distress {Distress}, HEENT {Physical examination procedure}, Neck {Neck structure}, supple {Normal movement of neck}, Sclera {Scleral structure}, Mucous membranes
+are moist {Moist oral mucosa}, carotid bruit {Carotid bruit}, CV {Cardiovascular physical examination}, Heart rate is regular {Normal heart rate}, Lungs {Examination of respiratory system}, Clear to auscultation bilaterally {Normal breath sounds}, wheezing {Wheezing}, crackles {Respiratory crackles}, Abdomen {Examination of abdomen}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, Extremities {Examination of limb}, No evidence {No abnormality detected}, deformities {Deformity}, contractures {Contracture}, Skin {Examination of skin}, rashes {Eruption of skin}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, Mental Status {Neurological mental status determination}, Awake {Awake}, alert {Mentally alert}, oriented {Orientated}, head {Head structure}, problems {Problem}, stroke {Cerebrovascular accident}, fluent {Does speak fluently}, intact {Normal sensation}, comprehension {Does comprehend language}, repetition {Verbal repetition}, naming of both high and low frequency objects {Able to recognize objects}, Normal prosody {Able to use prosody in speech}, paraphasic {Paraphasia}, Speech {Speech finding}, dysarthric {Dysarthria}, neglect {Hemi-neglect}, left/right confusion {Right-left disorientation}, finger agnosia {Finger agnosia}, apraxia {Apraxia}, II {Optic nerve structure}, homonymous hemianopsia on left {Left homonymous hemianopsia}, could not visualize
+fundi {Inadequate visualization of fundus of eye}, III {Oculomotor nerve structure}, IV {Trochlear nerve structure}, VI {Abducens nerve structure}, pupils equally round {Pupil size and shape normal}, reactive to light {Finding of pupil reaction to light}, small {Constricted pupil}, Eyes were eso deviated {Esotropia}, both eyes {Structure of both eyes}, left eye {Left eye structure}, EOMI {Normal ocular motility}, test saccads {Saccadic velocity test}, difficulty finding objects in space {Cognitive deficit in visuospatial function}, diplopia {Diplopia}, V {Trigeminal nerve structure}, Symmetric {Facial symmetry}, perception {Psychological finding of perception}, VII {Facial nerve structure}, Face {Face structure}, symmetric {Facial symmetry}, symmetric {Facial symmetry}, smile {Smiles}, VIII {Vestibulocochlear nerve structure}, Hearing intact {Hearing normal}, finger rub bl {Hearing examination}, IX {Glossopharyngeal nerve structure}, X {Vagus nerve structure}, Palate elevates {Does elevate soft palate}, XI {Accessory nerve structure}, Shoulder {Shoulder region structure}, head {Head structure}, XII {Hypoglossal nerve structure}, tongue {Tongue structure}, deviation {Displacement}, fasciculations {Fasciculation of tongue}, stroke {Cerebrovascular accident}, cards {Cardiology service}, trouble locating objects in space {Cognitive deficit in visuospatial function}, Motor {Motor testing}, Normal muscle bulk {Skeletal muscle size normal}, tone {Normal tone in skeletal muscle}, pronator drift {Downward drift of outstretched supinated arm}, rebound {Rebound tenderness}, Delt {Structure of deltoid muscle}, Bic {Biceps brachii muscle structure}, Tri {Triceps brachii muscle structure}, WrE {Structure of extensor of wrist joint}, FFl {Structure of flexor digitorum superficialis muscle of hand}, FE {Structure of extensor of interphalangeal joint of finger}, IO {Inferior oblique muscle structure}, IP {Interphalangeal joint structure}, Quad {Structure of quadriceps femoris muscle}, Ham {Posterior muscle of thigh structure}, TA {Tibialis anterior muscle structure}, Bi {Biceps brachii muscle structure}, Tri {Triceps brachii muscle structure}, Toes {Structure of all toes}, Sensory {Sensory testing}, normal {No abnormality detected}, symmetric {Facial symmetry}, perception {Psychological finding of perception}, pinprick {Normal pin prick discrimination}, light
+touch {Light touch sensation present}, vibration {Finding of vibration sense}, temperature {Finding of temperature sense}, Proprioception is intact {Normal joint position sense}, agraphesthesia {Graphesthesia finding}, astereognosis {Tactile agnosia}, Coordination {Finding related to coordination / incoordination}, Finger to nose {Finger-to-nose test}, dysmetria {Dysmetria}, intention tremor {Intention tremor}, dysdiadochokinesia {Dysdiadochokinesis}, Gait {Gait normal}, NEUROLOGICAL EXAMINATION {Neurological examination}, Mental Status {Neurological mental status determination}, Awake {Awake}, alert {Mentally alert}, hard of hearing {Hearing loss}, fluent {Does speak fluently}, intact {Normal sensation}, comprehension {Able to comprehend language}, repetition {Verbal repetition}, naming of 
+both high and low frequency objects {Able to recognize objects}, Normal {No abnormality detected}, prosody {Able to use prosody in speech}, paraphasic {Paraphasia}, Speech {Speech finding}, dysarthric {Dysarthria}, Left sided neglect {Hemi-neglect}, Cranial Nerves {Cranial nerve structure}, I {Olfactory nerve structure}, II {Optic nerve structure}, homonymous hemianopsia on left {Left homonymous hemianopsia}, could not visualize
+fundi {Inadequate visualization of fundus of eye}, III {Oculomotor nerve structure}, IV {Trochlear nerve structure}, VI {Abducens nerve structure}, pupils equally round {Pupil size and shape normal}, reactive to light {Finding of pupil reaction to light}, EOMI {Normal ocular motility}, V {Trigeminal nerve structure}, Symmetric {Facial symmetry}, perception {Psychological finding of perception}, VII {Facial nerve structure}, Face {Face structure}, symmetric {Facial symmetry}, symmetric {Facial symmetry}, smile {Smiles}, VIII {Vestibulocochlear nerve structure}, Hearing intact {Hearing normal}, finger rub bl {Hearing examination}, IX {Glossopharyngeal nerve structure}, X {Vagus nerve structure}, Palate elevates {Does elevate soft palate}, XI {Accessory nerve structure}, Shoulder {Structure of right shoulder region}, head {Head structure}, XII {Hypoglossal nerve structure}, tongue {Tongue structure}, deviation {Displacement}, fasciculations {Fasciculation of tongue}, Motor {Motor testing}, Normal muscle bulk {Skeletal muscle size normal}, tone {Normal tone in skeletal muscle}, pronator drift {Downward drift of outstretched supinated arm}, rebound {Rebound tenderness}, Strength {Examination of muscle power}, Delt {Structure of deltoid muscle}, Bic {Biceps brachii muscle structure}, Tri {Triceps brachii muscle structure}, WrE {Structure of extensor of wrist joint}, FFl {Structure of flexor digitorum superficialis muscle of hand}, FE {Structure of extensor of interphalangeal joint of finger}, IO {Inferior oblique muscle structure}, IP {Interphalangeal joint structure}, Quad {Structure of quadriceps femoris muscle}, Ham {Posterior muscle of thigh structure}, TA {Tibialis anterior muscle structure}, Reflexes {Reflex finding}, Bi {Biceps brachii muscle structure}, Tri {Triceps brachii muscle structure}, Toes {Structure of all toes}, Sensory {Sensory testing}, normal {No abnormality detected}, symmetric {Facial symmetry}, perception {Psychological finding of perception}, pinprick {Normal pin prick discrimination}, light
+touch {Light touch sensation present}, vibration {Finding of vibration sense}, temperature {Finding of temperature sense}, Proprioception is intact {Normal joint position sense}, agraphesthesia {Graphesthesia finding}, astereognosis {Tactile agnosia}, Coordination {Finding related to coordination / incoordination}, Finger to nose {Finger-to-nose test}, dysmetria {Dysmetria}, Gait {Gait normal}"
+"###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:
+___ 07:00PM BLOOD WBC-5.7 RBC-4.37 Hgb-12.6 Hct-40.2 MCV-92 
+MCH-28.8 MCHC-31.3* RDW-13.6 RDWSD-46.2 Plt ___
+___ 07:00PM BLOOD Neuts-58.6 ___ Monos-10.2 Eos-3.0 
+Baso-0.5 Im ___ AbsNeut-3.32 AbsLymp-1.55 AbsMono-0.58 
+AbsEos-0.17 AbsBaso-0.03
+___ 07:00PM BLOOD ___ PTT-32.0 ___
+___ 07:00PM BLOOD Glucose-93 UreaN-22* Creat-1.0 Na-141 
+K-5.4* Cl-104 HCO3-26 AnGap-16
+___ 12:53PM BLOOD ALT-9 AST-16 AlkPhos-68 TotBili-1.0
+___ 12:53PM BLOOD Albumin-4.4 Calcium-10.0 Phos-3.6 Mg-2.4
+___ 12:53PM BLOOD %HbA1c-5.9 eAG-123
+___ 12:53PM BLOOD TSH-3.6
+
+IMAGING:
+MRI BRAIN ___:
+1.  Moderate-sized acute infarction involving the right 
+parietotemporal 
+region, with associated small internal microhemorrhages. 
+2.  Additional findings of moderate global cerebral atrophy and 
+small vessel ischemic disease. 
+3.  A punctate susceptibility focus of the left occipital 
+parietal lobe, which may represent prior microhemorrhage. 
+
+CTA HEAD AND NECK ___ (PRELIM):
+NCHCT: Hypodensity in the right temporoparietal lobe corresponds 
+to the areas of restricted diffusion on the patients recent MRI, 
+consistent with patients known infarction. 
+  
+CTA: No definite vascular abnormalities identified in the region 
+of the known infarction in the right temporoparietal region. No 
+aneurysms identified. 
+
+TTE ___:
+The left atrium is normal in size. No left atrial mass/thrombus 
+seen (best excluded by transesophageal echocardiography). There 
+is mild symmetric left ventricular hypertrophy with normal 
+cavity size and regional/global systolic function (LVEF>55%). 
+Diastolic function could not be assessed. Right ventricular 
+chamber size and free wall motion are normal. The aortic valve 
+leaflets (3) are mildly thickened but aortic stenosis is not 
+present. Mild (1+) aortic regurgitation is seen. The mitral 
+valve leaflets are mildly thickened. The estimated pulmonary 
+artery systolic pressure is normal. There is no pericardial 
+effusion. 
+
+IMPRESSION: Suboptimal image quality. No cardiac source of 
+embolism identified. Mild symmetric left ventricular hypertrophy 
+with preserved regional/global systolic function. Mild aortic 
+regurgitation.  
+
+DISCHARGE LABS:
+___ 12:53PM BLOOD WBC-6.2 RBC-4.63 Hgb-13.4 Hct-42.3 MCV-91 
+MCH-28.9 MCHC-31.7* RDW-13.6 RDWSD-45.4 Plt ___
+___ 12:53PM BLOOD ___ PTT-33.9 ___
+___ 12:53PM BLOOD Glucose-73 UreaN-18 Creat-1.1 Na-142 
+K-4.4 Cl-103 HCO3-26 AnGap-17
+ 
+
+###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}, RDWSD {Red cell distribution width determination}, Neuts {Neutrophil 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}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, Albumin {Albumin measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, eAG {Glucose measurement estimated from glycated hemoglobin}, TSH {Thyroid stimulating hormone measurement}, MRI BRAIN {Magnetic resonance imaging of brain}, Moderate {Symptom moderate}, infarction {Infarct}, right 
+parietotemporal 
+region {Right temporal and parietal lobes (combined site)}, small internal microhemorrhages {Silent micro-hemorrhage of brain}, moderate {Symptom moderate}, cerebral atrophy {Cerebral atrophy}, small vessel {Structure of small blood vessel (organ)}, ischemic disease {Ischemia}, left occipital 
+parietal lobe {Left parietal and occipital lobes (combined site)}, NCHCT {Computed tomography of head without contrast}, Hypodensity {Decreased radiologic density}, right temporoparietal lobe {Right temporal and parietal lobes (combined site)}, MRI {Magnetic resonance imaging of brain}, infarction {Infarct}, CTA {Computed tomography angiography of head with contrast}, vascular {Blood vessel structure}, abnormalities {No abnormality detected}, infarction {Infarct}, right temporoparietal region {Right temporal and parietal lobes (combined site)}, aneurysms {Aneurysm}, left atrium {Left atrial structure}, normal in size {Normal size}, left atrial {Left atrial structure}, mass {Mass}, thrombus {Thrombus}, transesophageal echocardiography {Transesophageal echocardiography}, mild symmetric left ventricular hypertrophy {Mild left ventricular hypertrophy}, normal 
+cavity {Normal size cardiac chamber}, regional/global systolic function {Normal left ventricular systolic function and wall motion}, Right ventricular 
+chamber {Right cardiac ventricular structure}, wall motion are normal {Normal ventricular wall motion}, aortic valve 
+leaflets {Structure of cardiac valve leaflet}, mildly thickened {Increased thickness}, aortic stenosis {Aortic valve stenosis}, Mild (1+) aortic regurgitation {Mild mitral valve regurgitation}, mitral 
+valve leaflets are mildly thickened {Thickened mitral leaflet}, pulmonary 
+artery {Pulmonary artery structure}, systolic pressure is normal {Normal systolic arterial pressure}, pericardial 
+effusion {Pericardial effusion}, cardiac {Heart structure}, embolism {Embolism}, Mild symmetric left ventricular hypertrophy {Mild left ventricular hypertrophy}, regional/global systolic function {Normal left ventricular systolic function and wall motion}, aortic 
+regurgitation {Aortic valve regurgitation}, 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}, RDWSD {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}"
+"###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:
+Ms ___ is an ___ yo woman with PMH significant for Alzheimer 
+dementia, HTN, HLD, and hypothyroidism who presented with left 
+sided neglect with acute right temporoparietal infarct. 
+
+# Right temporoparietal infarct: Patient presented with left 
+sided neglect and possible left sided field cut. She was placed 
+on aspirin 325mg and atorvastatin 40mg and MRI confirmed acute 
+infarction involving the right parietotemporal 
+region, with associated small internal microhemorrhages. CTA was 
+unremarkable. She was monitored on telemetry but there were no 
+episodes of atrial fibrillation to account for stroke. HbA1C and 
+lipid panel were within normal limits. TTE did not show any 
+evidence of left atrial thrombus or PFO. Given her age and 
+mental status, it was decided not to pursue long term cardiac 
+monitoring for evaluation of atrial fibrillation. Patient had 
+difficulty tolerating telemetry monitors while hospitalized and 
+it would not change management as the team decided they would 
+not start anti-coagulation in this patient even if atrial 
+fibrillation was found. She will continue on aspirin as an 
+outpatient and follow-up with stroke neurology as ab outpatient. 
+  
+
+# UTI: Patient was found to have a UTI on admission and treated 
+with 3 days of Ciprofloxacin HCl 250 mg PO/NG Q12H.  
+
+# Hypothyroidism: She was continued on Levothyroxine Sodium 75 
+mcg PO/NG DAILY. 
+
+# HTN: She was continued on Lisinopril 5 mg PO/NG DAILY.  
+
+Transitional issues: 
+-continue on aspirin 81mg 
+-HCP: ___ (daughter) ___ 
+-currently Full code, continue to address goals of care
+ 
+
+###RESPONSE: Alzheimer 
+dementia {Alzheimer's disease}, HTN {Hypertensive disorder, systemic arterial}, HLD {Hyperlipidemia}, hypothyroidism {Hypothyroidism}, left 
+sided neglect {Hemi-neglect}, right temporoparietal {Right temporal and parietal lobes (combined site)}, infarct {Infarct}, Right temporoparietal {Right temporal and parietal lobes (combined site)}, infarct {Infarct}, left 
+sided neglect {Hemi-neglect}, left sided field cut {Visual field defect of left eye}, aspirin {Administration of aspirin}, MRI {Magnetic resonance imaging of brain}, infarction {Infarct}, right parietotemporal 
+region {Right temporal and parietal lobes (combined site)}, small internal microhemorrhages {Silent micro-hemorrhage of brain}, CTA {Computed tomography angiography with contrast}, unremarkable {No abnormality detected}, monitored {Monitoring procedure}, telemetry {Electroencephalogram telemetry}, atrial fibrillation {Atrial fibrillation}, stroke {Cerebrovascular accident}, within normal limits {Measurement finding within reference range}, TTE {Transthoracic echocardiography}, left atrial thrombus {Thrombus of left atrium}, PFO {Patent foramen ovale}, mental status {Altered mental status}, cardiac 
+monitoring {Cardiac monitoring}, evaluation {Evaluation procedure}, atrial fibrillation {Atrial fibrillation}, telemetry monitors {Telehealth monitoring}, anti-coagulation {Anticoagulant therapy}, atrial 
+fibrillation {Atrial fibrillation}, stroke {Cerebrovascular accident}, neurology {Neurological examination}, UTI {Urinary tract infectious disease}, UTI {Urinary tract infectious disease}, Hypothyroidism {Hypothyroidism}, HTN {Hypertensive disorder, systemic arterial}"
+"###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. melatonin 3 mg oral QHS:PRN insomnia 
+3. Levothyroxine Sodium 75 mcg PO DAILY 
+4. Lisinopril 5 mg PO DAILY 
+5. Lovastatin 40 mg oral QHS 
+
+ 
+Discharge Medications:
+1. Levothyroxine Sodium 75 mcg PO DAILY 
+2. Lisinopril 5 mg PO DAILY 
+3. melatonin 3 mg oral QHS:PRN insomnia 
+4. Lovastatin 40 mg ORAL QHS 
+5. Aspirin 325 mg PO DAILY 
+
+ 
+
+###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:
+___
+ 
+___ Diagnosis:
+Primary diagnosis:
+Right parietotemporal stroke
+
+Secondary diagnosis:
+Urinary Tract Infection
+
+ 
+Discharge Condition:
+Mental Status: Confused - sometimes.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+
+ 
+
+###RESPONSE: Right parietotemporal {Right temporal and parietal lobes (combined site)}, stroke {Cerebrovascular accident}, Urinary Tract Infection {Urinary tract infectious disease}, Mental Status {Neurological mental status determination}, Confused {Clouded consciousness}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, interactive {Does communicate}, 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 Ms. ___, 
+
+You were admitted to ___ with a stroke. Your heart rhythm was 
+monitored but there was no evidence of an abnormal rhythm 
+causing the stroke. You did not have any evidence of clot in 
+your heart on ultrasound so the cause of your stroke remains 
+unclear. You should continue to take aspirin and you will 
+follow-up with neurology at the appointments scheduled below. 
+
+It was a pleasure taking care of you, 
+Your ___ Neurologists
+ 
+
+###RESPONSE: stroke {Cerebrovascular accident}, heart rhythm {Finding of heart rhythm}, no evidence {No abnormality detected}, abnormal rhythm {Cardiac arrhythmia}, stroke {Cerebrovascular accident}, clot {Blood clot}, heart {Heart structure}, ultrasound {Ultrasonography}, stroke {Cerebrovascular accident}, follow-up with neurology {Follow-up neurological assessment}"
+"###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:
+chest pain
+ 
+Major Surgical or Invasive Procedure:
+cardiac catheterization
+ 
+
+###RESPONSE: chest pain {Chest pain}, 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 a ___ with h/o diabetes, HTN, HLD, DM who 
+presented to OSH for chest pain and was transferred for trop 
+elevation .08.
+
+Mr. ___ in normal state of health until 1 week prior to 
+presentation when he started experiencing recurrent episodes of 
+chest pain.  Pain is typically on the left side of his chest and 
+sometimes radiates to his neck, left arm and back. Described as 
+a tightness or squeezing. Pain sometimes goes away after ___
+minutes but most recently has been persistent for ___ hours. He 
+endorses significant fatigue over the past week as well, night 
+sweats for the past 2 days, prominent cough of 7 days' duration 
+and loose stools for the past ___ days.  He endorses one episode 
+of nausea/emesis on ___. Denies diaphoresis.  He has not been 
+very active over the past week though notes no relation to
+exertion. 2 weeks ago he was able to play hockey as he often 
+does with no issue. Also with some DOE.  Reports if was cutting 
+the lawn would have to take breaks. 
+
+He presented to ___, where he was found to have elevated 
+trop at 0.08. Otherwise, labs were unremarkable and chest X-ray 
+showed no abnormality. He had CTA chest that showed no PE and no 
+dissection. He was treated with aspirin (325) and was 
+transferred for consideration for cath.
+
+In the ED here, he had stable vital signs. His troponin here was 
+negative. EKG showed normal sinus rhythm at 66bpm, normal axis 
+and intervals, early R wave progression, without any ST 
+elevations/depressions, T wave inversions, or Q waves. He was 
+given sublingual nitro with no resolution of symptoms. He was
+also given 12.5mg metoprolol tartrate, atorvastatin 80mg, and 
+started on a heparin gtt.
+ 
+On arrival to the cardiology ward, patient corroborates the 
+above history.  He currently is experiencing ___ chest pain and 
+notes no relief of his last dose of sublingual nitrogen.  He is 
+no longer having sweats or shortness of breath but it does 
+endorse increased frequency of stool. 
+ 
+ 
+
+###RESPONSE: diabetes {Diabetes mellitus}, HTN {Hypertensive disorder, systemic arterial}, HLD {Hyperlipidemia}, chest pain {Chest pain}, trop {Troponin measurement}, elevation {Measurement finding above reference range}, recurrent {Recurrent disease}, chest pain {Chest pain}, Pain {Pain}, left side of his chest {Structure of left half of chest wall}, radiates {Radiating pain}, neck {Pain radiating to neck}, left arm {Pain radiating to left arm}, tightness {Tight chest}, squeezing {Squeezing chest pain}, Pain {Pain}, fatigue {Fatigue}, night 
+sweats {Night sweats}, cough {Cough}, loose stools {Loose stool}, nausea {Nausea}, emesis {Vomiting}, diaphoresis {Excessive sweating}, not been 
+very active {Physical deconditioning}, exertion {Finding related to exertion}, play hockey {Physically active}, DOE {Dyspnea on exertion}, elevated 
+trop {Troponin I above reference range}, labs {Laboratory test}, unremarkable {No abnormality detected}, chest X-ray {Plain chest X-ray}, no abnormality {Imaging result normal}, CTA chest {Computed tomography angiography of chest with contrast}, PE {Pulmonary embolism}, dissection {Dissection of aorta}, aspirin {Administration of aspirin}, cath {Cardiac catheterization}, stable vital signs {Normal vital signs}, troponin {Troponin measurement}, negative {No pathologic diagnosis}, EKG {Electrocardiographic procedure}, normal sinus rhythm {Electrocardiogram: normal sinus rhythm}, normal {Electrocardiogram normal}, axis {Electrocardiographic axis finding}, intervals {Finding of electrocardiogram waveform}, R wave progression {Electrocardiographic R wave abnormal}, ST 
+elevations {ST segment elevation}, depressions {ST segment depression}, T wave inversions {Inverted T wave}, Q waves {Finding of electrocardiogram Q wave}, no resolution of symptoms {Symptom not changed}, started {New medication added}, cardiology {Cardiology service}, chest pain {Chest pain}, relief {Pain relief}, last dose {Evaluation of response to medications}, sweats {Sweating}, shortness of breath {Dyspnea}, increased frequency of stool {Increased frequency of defecation}"
+"###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:
+1. CARDIAC RISK FACTORS  
+- Diabetes  
+- Hypertension  
+- Dyslipidemia  
+2. CARDIAC HISTORY  
+- CAD - mid 50% LAD - no intervention 
+3. OTHER PAST MEDICAL HISTORY
+- Appendectomy
+- Diverticulitis
+ 
+ 
+
+###RESPONSE: CARDIAC RISK FACTORS {Assessment for risk of cardiovascular disease}, Diabetes {Diabetes mellitus}, Hypertension {Hypertensive disorder, systemic arterial}, Dyslipidemia {Dyslipidemia}, CAD {Coronary arteriosclerosis}, LAD {Structure of anterior descending branch of left coronary artery}, Appendectomy {Excision of appendix}, Diverticulitis {Diverticulitis}"
+"###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:
+FatherAliveHad an ' irrgeular heart rate and had ICD or
+pacemaker placed'
+MotherAliveNo Significant Medical History
+SisterAliveNo Significant Medical History
+ 
+
+###RESPONSE: irrgeular heart rate {Pulse irregular}, ICD {Implantation of automatic cardiac defibrillator}, pacemaker placed {Implantation of cardiac pacemaker}"
+"###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 EXAMINATION:  
+=====================  
+VS: Temp 98.0 BP 139 / 87 HR 68 RR 17SaO2 96%Ra
+GENERAL: NAD, well appearin man in NAD. Ruddy complexion
+HEENT: AT/NC, anicteric sclera, MMM
+NECK: supple, no LAD
+CV: RRR, S1/S2, no murmurs, gallops, or rubs. JVD < 10 cm at 90 
+degrees
+PULM: CTAB, no wheezes, rales, rhonchi, breathing comfortably 
+without use of accessory muscles
+GI: abdomen soft, nondistended, nontender in all quadrants, no 
+rebound/guarding, no hepatosplenomegaly
+EXTREMITIES:trace edema b/l, at baseline per patient
+PULSES: 2+ radial pulses bilaterally
+NEURO: Alert, moving all 4 extremities with purpose, face 
+symmetric
+DERM: warm and well perfused, no excoriations or lesions, no 
+rashes
+
+Discharge Exam: 
+GENERAL: NAD, well appearing man in NAD. Ruddy complexion
+HEENT: AT/NC, anicteric sclera
+NECK: supple, no LAD, no elevated JVD
+CV: RRR, S1/S2, no murmurs, gallops, or rubs. 
+PULM: CTAB, no wheezes, rales, rhonchi, breathing comfortably 
+without use of accessory muscles
+GI: abdomen soft, nondistended, nontender, no hepatosplenomegaly
+EXTREMITIES: no edema b/l, right arm with dressing over cath 
+site without strike through, bruit, and with perfusion of distal 
+extremities, no evidence hematoma 
+Neuro: sensation to light touch in right hand, strength ___ in 
+B/l hands, movement of bilateral fingers with intention. 
+ 
+
+###RESPONSE: PHYSICAL EXAMINATION {Physical examination procedure}, VS {Vital signs finding}, Temp {Body temperature finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, GENERAL {General examination of patient}, NAD {No abnormality detected}, well appearin {Well cared for appearance}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, NC {Normal head}, anicteric sclera {White sclera}, MMM {Moist oral mucosa}, NECK {Physical examination procedure}, supple {Normal movement of neck}, LAD {Lymphadenopathy}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, S2 {Normal second heart sound, S>2<}, murmurs {Murmur}, gallops {Gallop rhythm}, rubs {Pericardial friction rub}, JVD {Jugular venous engorgement}, PULM {Examination of respiratory system}, CTAB {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, rhonchi {Wheeze - rhonchi}, breathing comfortably {Breathing easily}, accessory muscles {Accessory skeletal muscle}, GI {Examination of digestive system}, soft {Abdomen soft}, nondistended {Normal abdominal contour}, nontender {Abdominal tenderness}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, hepatosplenomegaly {Hepatosplenomegaly}, EXTREMITIES {Examination of limb}, edema {Edema}, baseline {Baseline state}, radial pulses {Radial pulse present}, NEURO {Neurological examination}, Alert {Mentally alert}, moving all 4 extremities {Does move all four limbs}, face 
+symmetric {Facial symmetry}, warm {Warm skin}, well perfused {Normal tissue perfusion}, excoriations {Excoriation}, lesions {Lesion}, rashes {Eruption of skin}, GENERAL {General examination of patient}, NAD {No abnormality detected}, well appearing {Well cared for appearance}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, NC {Normal head}, anicteric sclera {White sclera}, NECK {Physical examination procedure}, supple {Normal movement of neck}, LAD {Lymphadenopathy}, JVD {Jugular venous engorgement}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, S2 {Normal second heart sound, S>2<}, murmurs {Murmur}, gallops {Gallop rhythm}, rubs {Pericardial friction rub}, PULM {Examination of respiratory system}, CTAB {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, rhonchi {Wheeze - rhonchi}, breathing comfortably {Breathing easily}, accessory muscles {Accessory skeletal muscle}, GI {Examination of digestive system}, soft {Abdomen soft}, nondistended {Normal abdominal contour}, nontender {Abdominal tenderness}, hepatosplenomegaly {Hepatosplenomegaly}, EXTREMITIES {Examination of limb}, edema {Edema}, right arm {Structure of right upper limb}, cath 
+site {Vascular catheter insertion site}, bruit {Bruit}, perfusion {Normal tissue perfusion}, distal 
+extremities {Structure of distal lower limb artery}, no evidence {No abnormality detected}, hematoma {Hematoma}, Neuro {Neurological examination}, sensation to light touch {Light touch sensation present}, right hand {Structure of right hand}, B/l hands {Both hands}, bilateral {Both hands}, fingers {Finger 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: Pertinent Results:
+ADMISSION
+___ 11:20PM   WBC-5.6 RBC-4.45* HGB-14.8 HCT-41.5 MCV-93 
+MCH-33.3* MCHC-35.7 RDW-12.1 RDWSD-41.4
+___ 11:20PM   NEUTS-41.7 ___ MONOS-11.2 EOS-1.8 
+BASOS-1.1* AbsNeut-2.35 AbsLymp-2.49 AbsMono-0.63 AbsEos-0.10 
+AbsBaso-0.06
+___ 11:20PM   ___ PTT-27.1 ___
+___ 11:20PM   GLUCOSE-98 UREA N-12 CREAT-1.0 SODIUM-139 
+POTASSIUM-4.9 CHLORIDE-103 TOTAL CO2-21* ANION GAP-15
+___ 11:20PM   ALT(SGPT)-42* AST(SGOT)-34 CK(CPK)-72 ALK 
+PHOS-63 TOT BILI-0.5
+___ 11:20PM   LIPASE-44
+___ 11:20PM   cTropnT-<0.01
+___ 11:20PM   CK-MB-<1
+___ 11:20PM   ALBUMIN-3.9
+___ 10:45PM URINE  COLOR-Straw APPEAR-Clear SP ___
+___ 10:45PM URINE  BLOOD-NEG NITRITE-NEG PROTEIN-TR* 
+GLUCOSE-NEG KETONE-TR* BILIRUBIN-NEG UROBILNGN-NEG PH-6.5 
+LEUK-NEG
+___ 10:45PM URINE  RBC-1 WBC-<1 BACTERIA-NONE YEAST-NONE 
+EPI-<1
+ 
+PERTINENT STUDIES:
+___ CATH
+Coronary Anatomy
+Right dominant
+LM: No disease.
+LAD: Focal 50% eccentric stenosis in mid vessel.
+LCx: No significant disease.
+RCA: No significant disease.
+ 
+Impressions:
+Intermediate mid LAD disease.
+ 
+Recommendations
+Med Rx. If patient has persistent angina or evidence of 
+ischemia, could do mid LAD PCI in future.
+
+Discharge Labs: 
+
+___ 06:33AM BLOOD WBC-6.6 RBC-4.86 Hgb-15.7 Hct-45.6 MCV-94 
+MCH-32.3* MCHC-34.4 RDW-12.1 RDWSD-42.3 Plt ___
+___ 06:33AM BLOOD Plt ___
+___ 06:33AM BLOOD Glucose-123* UreaN-15 Creat-1.1 Na-141 
+K-4.8 Cl-102 HCO3-28 AnGap-11
+___ 06:33AM BLOOD Calcium-9.5 Phos-3.3 Mg-2.___ year old man with PMHx DM2, HTN, HLD, who presented with 
+chest pain at rest and found to have NSTEMI with moderate 
+coronary artery disease on cardiac catheterization, not thought 
+to be contributing to chest pain and no intervention was done. 
+Patient was started on aspirin, high dose atorvastatin and PRN 
+sublingual nitroglycerin and discharged with Cardiology follow 
+up.
+
+Active Issues
+# NSTEMI:
+Presented with chest pain at rest concern for unstable angina. 
+Etiology unclear as underwent coronary angiogram and had only 
+moderate 50% mid LAD disease not thought to be responsible for 
+his chest pain. Patient started on ___, high dose statin and 
+PRN SL NTG and discharged with Cardiology follow up.
+ 
+Chronic Issues
+# HTN: continued home felodipine
+# HLD: increased atorvastatin
+# Depression: continued home citalopram
+# Anxiety: continued home lorazepam
+ 
+Transitional Issues:
+[ ] new diagnosis of CAD: started on ASA 81, high dose 
+atorvastatin, PRN SL NTG
+[ ] please obtain TTE as outpatient
+
+ 
+
+###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}, 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}, MONOS {Monocyte count}, EOS {Eosinophil count}, BASOS {Basophil count}, PTT {Partial thromboplastin time, activated}, GLUCOSE {Glucose measurement, blood}, UREA N {Blood urea nitrogen measurement}, 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}, CK(CPK {Creatine kinase measurement}, ALK 
+PHOS {Alkaline phosphatase measurement}, TOT BILI {Bilirubin, total measurement}, LIPASE {Triacylglycerol lipase measurement}, cTropnT {Troponin T cardiac measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, ALBUMIN {Albumin measurement}, COLOR {Color finding}, APPEAR-Clear {Urine looks clear}, NEG {No abnormality detected}, PROTEIN {Measurement of protein in urine}, GLUCOSE-NEG {Urine glucose not detected}, KETONE {Urinalysis, acetone or ketone bodies measurement}, BILIRUBIN {Bilirubin measurement, urine}, NEG {No abnormality detected}, UROBILNGN {Urobilinogen measurement, urine}, NEG {No abnormality detected}, PH {pH measurement}, LEUK-NEG {Urine leukocytes not detected}, URINE {Evaluation of urine specimen}, RBC {Red blood cell count}, WBC {White blood cell count}, AST {Aspartate aminotransferase measurement}, CATH {Cardiac catheterization}, Coronary Anatomy {Coronary artery finding}, Right dominant {Right dominant coronary system}, No disease {No abnormality detected}, LAD {Structure of anterior descending branch of left coronary artery}, stenosis {Stenosis of mid portion of anterior descending branch of left coronary artery}, mid vessel {Structure of mid portion of anterior descending branch of left coronary artery}, No significant disease {No abnormality detected}, RCA {Right coronary artery structure}, No significant disease {No abnormality detected}, mid LAD disease {Stenosis of mid portion of anterior descending branch of left coronary artery}, angina {Angina}, ischemia {Ischemia}, mid LAD {Structure of mid portion of anterior descending branch of left coronary artery}, PCI {Percutaneous coronary intervention}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, RDWSD {Red cell distribution width determination}, BLOOD 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}, DM2 {Diabetes mellitus type 2}, HTN {Hypertensive disorder, systemic arterial}, HLD {Hyperlipidemia}, chest pain at rest {Chest pain at rest}, NSTEMI {Acute non-ST segment elevation myocardial infarction}, moderate {Symptom moderate}, coronary artery disease {Coronary arteriosclerosis}, cardiac catheterization {Cardiac catheterization}, chest pain {Chest pain}, started {New medication added}, aspirin {Administration of aspirin}, nitroglycerin {Administration of prophylactic glyceryl trinitrate}, Cardiology {Cardiology service}, follow 
+up {Follow-up arranged}, chest pain at rest {Chest pain at rest}, unstable angina {Preinfarction syndrome}, coronary angiogram {Angiography of coronary artery}, mid LAD disease {Stenosis of mid portion of anterior descending branch of left coronary artery}, chest pain {Chest pain}, started {New medication added}, NTG {Administration of prophylactic glyceryl trinitrate}, Cardiology {Cardiology service}, follow up {Follow-up arranged}, HTN {Hypertensive disorder, systemic arterial}, HLD {Hyperlipidemia}, increased {Increasing dosage of medication}, Depression {Depressive disorder}, Anxiety {Anxiety}, CAD {Coronary arteriosclerosis}, started {New medication added}, ASA {Administration of aspirin}, NTG {Administration of prophylactic glyceryl trinitrate}, TTE {Transthoracic echocardiography}"
+"###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. MetFORMIN XR (Glucophage XR) 500 mg PO DAILY 
+2. Citalopram 20 mg PO DAILY 
+3. Atorvastatin 40 mg PO QPM 
+4. Zolpidem Tartrate 10 mg PO QHS:PRN Insomnia 
+5. LORazepam 1 mg PO BID:PRN Anxiety 
+6. Felodipine 10 mg PO DAILY 
+
+ 
+Discharge Medications:
+1.  Aspirin 81 mg PO DAILY  
+2.  Nitroglycerin SL 0.4 mg SL Q5MIN:PRN chest pain 
+RX *nitroglycerin 0.4 mg 1 tablet(s) sublingually Q5minutes Disp 
+#*25 Tablet Refills:*0 
+3.  Atorvastatin 80 mg PO QPM  
+4.  Citalopram 20 mg PO DAILY  
+5.  Felodipine 10 mg PO DAILY  
+6.  LORazepam 1 mg PO BID:PRN Anxiety  
+7.  MetFORMIN XR (Glucophage XR) 500 mg PO DAILY  
+8.  Zolpidem Tartrate 10 mg PO QHS:PRN Insomnia  
+
+ 
+
+###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:
+# Coronary artery disease
+# Non-ST elevation myocardial infarction
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+ 
+
+###RESPONSE: Coronary artery disease {Coronary arteriosclerosis}, Non-ST elevation myocardial infarction {Acute non-ST segment elevation myocardial infarction}, Mental Status {Neurological mental status determination}, Clear {Normal state of mind}, Alert {Mentally alert}, interactive {Does communicate}, 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 Mr. ___,  
+ 
+It was a pleasure taking care of you at the ___ 
+___!  
+ 
+WHY WAS I IN THE HOSPITAL?  
+==========================  
+- You were admitted because you had chest pain
+ 
+WHAT HAPPENED IN THE HOSPITAL?  
+==============================  
+- You were admitted to the hospital because you had chest pain. 
+You were found to have had a heart attack. Your heart arteries 
+were examined (cardiac catheterization) which showed a blockage 
+of one of the arteries. This blockage was not enough to limit 
+the flow in your artery and was not thought to be the reason for 
+your pain.
+- We increased your home medications to take the stress off the 
+heart
+  
+WHAT SHOULD I DO WHEN I GO HOME?  
+================================  
+- Please take your medications as prescribed
+- Please follow up with your primary care doctor
+- Please return to hospital if you have chest pain that does not 
+go away or gets worse when you are being active.
+
+Thank you for allowing us to be involved in your care, we wish 
+you all the best!  
+ 
+Your ___ Healthcare Team  
+ 
+
+ 
+
+###RESPONSE: chest pain {Chest pain}, chest pain {Chest pain}, heart attack {Myocardial infarction}, heart arteries {Coronary artery structure}, cardiac catheterization {Cardiac catheterization}, blockage {Coronary artery stenosis}, arteries {Coronary artery structure}, blockage {Coronary artery stenosis}, artery {Structure of intracranial artery}, pain {Pain}, increased {Increased pain}, medications {Administration of drug or medicament}, heart {Heart structure}, take your medications as prescribed {Recommendation to continue with drug treatment}, follow up {Follow-up arranged}, primary care {Primary care management}, chest pain {Chest pain}, worse {Increased pain}, active {Physically active}"
+"###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: 
+No Known Allergies / Adverse Drug Reactions
+ 
+Attending: ___.
+ 
+Chief Complaint:
+chest pain, dizziness
+ 
+Major Surgical or Invasive Procedure:
+none 
+
+ 
+
+###RESPONSE: chest pain {Chest pain}, dizziness {Dizziness}"
+"###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 woman with a history of HTN who presents with one 
+week of chest pain.  She describes the chest pain as a constant, 
+___, left-sided burning sensation that radiates to the back. 
+Pain has been progressively worsening over the week. It is worst 
+in the mornings, when pain is associated with weakness and 
+fatigue.  It is also worse when she exerts her left arm (e.g. 
+cutting vegtables), but not with generalized exertion.  She 
+states current pain is distinct from heartburn symptoms which 
+she had experienced in the past.  Associated symptoms include 
+general weakness, fatigue, and mild DOE throughout the week. She 
+denies nausea, or diaphoresis.  No fevers, sweats or rigors but 
+did have some chills today.  
+.
+She went to see her PCP today due to her ongoing symptoms.  At 
+the PCP's office SL NG was administered with almost immediate 
+relief within seconds. She also recieved Aspirin 325mg. She was 
+referred to the ED for further workup.  
+.  
+Of note:  Patient has prior history of admission to ___ ___ years 
+ago with chest pain similar to current pain. At the time, pain 
+developed acutely while was shoveling snow and was stronger than 
+current complaints but similar in distribution and quality. She 
+says she spent several days in the hospital and was told her 
+heart was ""damaged"". No PTCA was done. She says she had a second 
+admission to ___ ___ years ago for difficult to control HTN.  She 
+takes her BP meds regularly.
+. 
+In the ED, initial Vitals: 99.2 66 185/88 18 99% 2L.  Labs were 
+notable for absence of leukocytosis and Hct 33.  The patient was 
+ruled out for MI by cardiac enzymes x 2 and EKG.  The patient 
+underwent CXR that showed left basilar atelectasis versus 
+infiltrate.  CTA chest ruled out aortic dissection and 
+demonstrated extensive bronchiectasis in the right middle lobe 
+and bilateral lower lobes.  Levoquin was administered prior to 
+admission for possible infiltrate.  Prior to transfer, VS: 97.8, 
+180/70, 57, 17, 98% ra.   
+.  
+On the floor, patient feels well.  She states her pain had 
+resolved completley after NG at ___'s office. She has no further 
+complaints.  She denies any recent or past known aspiration 
+events. She had no recent travel, no sick or animal exposures 
+and denies any history of TB or industrial exposures.  
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, chest pain {Chest pain}, chest pain {Chest pain}, constant {Constant pain}, left-sided {Left sided chest pain}, burning sensation {Burning sensation}, radiates {Radiating pain}, Pain {Pain}, worsening {Increased pain}, pain {Pain}, weakness {Asthenia}, fatigue {Fatigue}, worse {Patient's condition worsened}, left arm {Left upper arm structure}, exertion {Chest pain on exertion}, pain {Pain}, heartburn {Heartburn}, general weakness {Asthenia}, fatigue {Fatigue}, mild {Symptom mild}, DOE {Dyspnea on exertion}, nausea {Nausea}, diaphoresis {Excessive sweating}, No fevers {Temperature normal}, sweats {Sweating}, rigors {Rigor}, chills {Chill}, PCP {Primary care management}, PCP {Primary care management}, relief {Pain relief}, Aspirin {Administration of aspirin}, referred to the ED {Referral to accident and emergency service}, workup {Evaluation procedure}, chest pain {Chest pain}, pain {Pain}, pain {Pain}, heart {Heart structure}, PTCA {Percutaneous transluminal coronary angioplasty}, difficult to control HTN {Poor hypertension control}, Vitals {Vital signs finding}, Labs {Laboratory test}, leukocytosis {Leukocytosis}, cardiac enzymes {Finding of cardiac enzyme levels}, EKG {Electrocardiographic procedure}, CXR {Plain chest X-ray}, left basilar {Structure of lower lobe of left lung}, atelectasis {Atelectasis}, infiltrate {Infiltration}, CTA chest {Computed tomography of chest}, aortic dissection {Dissection of aorta}, bronchiectasis {Bronchiectasis}, right middle lobe {Structure of middle lobe of right lung}, bilateral {Both lungs}, lower lobes {Structure of lower lobe of lung}, infiltrate {Infiltration}, patient feels well {Patient feels well}, pain {Pain}, resolved {Problem resolved}, aspiration {Aspiration}, travel {Travel abroad}"
+"###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:
+- HTN  
+- Pneumonia ___ years ago treated as out patient  
+- ? of cardiac ""event"" - see HPI.  
+- s/p left salpingectomy > ___ years ago.  
+
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, Pneumonia {Pneumonia}, cardiac {Heart disease}, left salpingectomy {Left salpingectomy}"
+"###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 died of ""heart attack"" at age ___  
+- Father had MI at age ___  
+- no siblings or biological children  
+
+ 
+
+###RESPONSE: died {Dead}, heart attack {Myocardial infarction}"
+"###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:  
+VS - Temp 96.1 F, 161/79 BP , HR 57 , R 18 , 97 O2-sat % RA  
+GENERAL - well-appearing in NAD, comfortable, appropriate  
+HEENT - NC/AT, PERRLA, EOMI, sclerae anicteric, MMM, OP clear  
+NECK - supple, no thyromegaly, no JVD, no carotid bruits  
+CHEST: some reproducible pain in left paravertebral area, mild 
+scoliosis  
+LUNGS - CTA bilat, no r/rh/wh, good air movement, resp 
+unlabored, no accessory muscle use  
+HEART - PMI is hyperdynamic but not displaced, RRR, no MRG, a 
+third heart sound is heard possibly S4.  
+ABDOMEN - NABS, soft/NT/ND, no masses or HSM, no 
+rebound/guarding  
+EXTREMITIES - WWP, no c/c/e, 2+ peripheral pulses (radials, DPs) 
+ 
+SKIN - no rashes or lesions  
+LYMPH - no cervical, axillary, or inguinal LAD  
+NEURO - awake, A&Ox3, CNs II-XII grossly intact, muscle strength 
+___ throughout, sensation grossly intact throughout, DTRs 2+ and 
+symmetric, cerebellar exam intact.  
+. 
+Discharge Physical Exam:  
+VS: 97.3 136/74 55 18 97%RA  
+GENERAL - well-appearing in NAD, comfortable  
+NECK - supple, no JVD, no carotid bruits  
+CHEST: non-tender to palpation  
+LUNGS - mild dry crackles in bases, good air movement, resp 
+unlabored  
+HEART - RRR, no MRG  
+ABDOMEN - NABS, soft/NT/ND, no masses or HSM, no 
+rebound/guarding  
+EXTREMITIES - WWP, no c/c/e, 2+ peripheral pulses (radials, DPs) 
+ 
+SKIN - no rashes or lesions  
+LYMPH - no cervical, axillary, or inguinal LAD  
+NEURO - awake, A&Ox3, CNs II-XII grossly intact, muscle strength 
+___ throughout, sensation grossly intact throughout, DTRs 2+ and 
+symmetric, cerebellar exam intact.  
+
+ 
+
+###RESPONSE: Physical Exam {Physical examination procedure}, VS {Vital signs finding}, Temp {Body temperature finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, O2-sat {Oxygen saturation measurement}, RA {Breathing room air}, GENERAL {General examination of patient}, well-appearing {Well cared for appearance}, NAD {No abnormality detected}, comfortable {Comfortable appearance}, HEENT {Physical examination procedure}, NC {Normal head}, PERRLA {Pupils equal, react to light and accommodation}, EOMI {Normal ocular motility}, sclerae anicteric {White sclera}, MMM {Moist oral mucosa}, OP clear {Pharynx normal}, NECK {Physical examination procedure}, supple {Normal movement of neck}, thyromegaly {Goiter}, JVD {Jugular venous engorgement}, carotid bruits {Carotid bruit}, pain {Pain}, left {Structure of left half of chest wall}, paravertebral {Structure of paravertebral region}, mild {Symptom mild}, scoliosis {Scoliosis deformity of spine}, LUNGS {Examination of respiratory system}, CTA {Normal breath sounds}, rh/wh {Wheeze - rhonchi}, good air movement {Breath normal}, resp 
+unlabored {Breathing easily}, accessory muscle {Accessory skeletal muscle}, HEART {Cardiovascular physical examination}, PMI {Finding of apex beat}, hyperdynamic {Hyperdynamic circulation}, displaced {Apex beat displaced}, RRR {Normal heart rate}, no MRG {Heart sounds normal}, third heart sound {Third heart sound}, ABDOMEN {Examination of abdomen}, NABS {Normal bowel sounds}, soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, masses {Abdominal mass}, HSM {Hepatosplenomegaly}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, EXTREMITIES {Examination of limb}, WWP {Normal tissue perfusion}, no c/c/e {No abnormality detected}, 2+ peripheral pulses {Peripheral pulse present}, radials {Radial pulse present}, SKIN {Examination of skin}, rashes {Eruption of skin}, lesions {Lesion}, cervical {Cervical lymphadenopathy}, axillary {Axillary lymphadenopathy}, LAD {Lymphadenopathy}, NEURO {Neurological examination}, awake {Awake}, Ox3 {Oriented to person, time and place}, grossly intact {Normal nervous system function}, muscle strength {Normal muscle function}, sensation grossly intact {Normal sensation}, DTRs 2 {Normal tendon reflex}, exam {Physical examination procedure}, Physical Exam {Physical examination procedure}, VS {Vital signs finding}, RA {Breathing room air}, GENERAL {General examination of patient}, well-appearing {Well cared for appearance}, NAD {No abnormality detected}, comfortable {Comfortable appearance}, NECK {Physical examination procedure}, supple {Normal movement of neck}, JVD {Jugular venous engorgement}, carotid bruits {Carotid bruit}, non-tender {Abdominal tenderness}, palpation {Palpation}, LUNGS {Examination of respiratory system}, mild {Symptom mild}, crackles {Respiratory crackles}, bases {Structure of base of lung}, good air movement {Breath normal}, resp 
+unlabored {Breathing easily}, HEART {Cardiovascular physical examination}, RRR {Normal heart rate}, no MRG {Heart sounds normal}, ABDOMEN {Examination of abdomen}, NABS {Normal bowel sounds}, soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, masses {Abdominal mass}, HSM {Hepatosplenomegaly}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, EXTREMITIES {Examination of limb}, WWP {Normal tissue perfusion}, no c/c/e {No abnormality detected}, 2+ peripheral pulses {Peripheral pulse present}, radials {Radial pulse present}, SKIN {Examination of skin}, rashes {Eruption of skin}, lesions {Lesion}, cervical {Cervical lymphadenopathy}, axillary {Axillary lymphadenopathy}, LAD {Lymphadenopathy}, NEURO {Neurological examination}, awake {Awake}, Ox3 {Oriented to person, time and place}, grossly intact {Normal nervous system function}, muscle strength {Normal muscle function}, sensation grossly intact {Normal sensation}, DTRs 2 {Normal tendon reflex}, exam {Physical examination 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: Pertinent Results:
+Admission Labs:  
+___ 07:06PM BLOOD WBC-5.4 RBC-3.72* Hgb-11.2* Hct-33.6* 
+MCV-90 MCH-30.0 MCHC-33.3 RDW-13.2 Plt ___
+___ 04:32PM BLOOD Glucose-125* UreaN-20 Creat-1.1 Na-141 
+K-4.0 Cl-104 HCO3-26 AnGap-15
+___ 04:32PM BLOOD LD(LDH)-186
+___ 10:45PM BLOOD Cholest-204*
+___ 10:45PM BLOOD Triglyc-67 HDL-63 CHOL/HD-3.2 LDLcalc-128
+___ 04:32PM BLOOD %HbA1c-5.5 eAG-111
+___ 07:20PM BLOOD Lactate-1.0
+. 
+Discharge Labs:  
+___ 06:25AM BLOOD WBC-5.6 RBC-3.65* Hgb-11.1* Hct-32.8* 
+MCV-90 MCH-30.3 MCHC-33.7 RDW-13.1 Plt ___
+___ 06:25AM BLOOD Glucose-94 UreaN-32* Creat-1.1 Na-144 
+K-3.5 Cl-108 HCO3-28 AnGap-12
+___ 06:25AM BLOOD Calcium-9.2 Phos-4.4 Mg-1.8
+. 
+Cardiac Enzyme trend:  
+___ 04:32PM BLOOD cTropnT-<0.01
+___ 10:45PM BLOOD cTropnT-<0.01
+___ 06:25AM BLOOD CK-MB-2 cTropnT-<0.01
+. 
+Urine:  
+___ 04:33PM URINE Color-Straw Appear-Clear Sp ___
+___ 04:33PM URINE Blood-NEG Nitrite-NEG Protein-NEG 
+Glucose-NEG Ketone-NEG Bilirub-NEG Urobiln-NEG pH-7.0 Leuks-NEG
+___ 4:33 pm URINE CULTURE (Final ___:    NO GROWTH. 
+. 
+CXR ___:  
+Findings: PA and lateral view of the chest, no prior. There is 
+subtle left 
+basilar opacity, potentially atelectasis, however, infiltrate is 
+not excluded. In addition, there is a 7-mm nodular opacity 
+projecting in the suprahilar region on the left. Elsewhere, the 
+lungs are grossly clear, costophrenic angles are sharp. The 
+cardiomediastinal silhouette is within normal limits.  Osseous 
+and soft tissue structures are unremarkable. 
+IMPRESSION: Left basilar atelectasis versus infiltrate. Possible 
+left 
+suprahilar nodule. These findings can be followed up on the 
+upcoming chest 
+CT, which has been ordered. 
+. 
+CTA chest/abdomen/pelvis ___:  
+1. No evidence of aortic dissection. 
+2. Bilateral adrenal nodules measuring 10 mm on the left and 8 
+mm on the 
+right, incompletely characterized on this single phase study. 
+Further 
+evaluation could be performed with an adrenal protocol CT or MR. 
+
+3. Extensive bronchiectasis with associated reticulation and 
+ground glass 
+opacity in the basilar aspects of the right middle lobe and both 
+lower lobes, possibly secondary to chronic aspiration or prior 
+infection, although an intrinsic lung process, such as 
+non-specific interstitial fibrosis, cannot be excluded. 
+4. Right renal simple cyst. Additional left renal tiny 
+hypodensities are too small to characterize, but are 
+statistically simple cysts. 
+5. Small quantity of free fluid in the dependent portion of the 
+pelvis is a nonspecific finding, but not typically seen in a 
+female patient of this age. 
+6. Moderate lumbar spinal stenosis at L3-L4 and L4-L5. 
+. 
+Cardiac Perfusion Persantine ___:  
+The image quality is adequate but limited due to soft tissue and 
+breast 
+attenuation. There is activity adjacent to the heart in the 
+stress images. 
+Left ventricular cavity size is normal.  Rest and stress 
+perfusion images reveal uniform tracer uptake throughout the 
+left ventricular myocardium.  
+Gated images reveal normal wall motion.  The calculated left 
+ventricular ejection fraction is 57% with an EDV of 102 ml. 
+. 
+Stress Portion ___:  No anginal type symptoms or ischemic ECG 
+changes. 
+. 
+MRI head ___:  
+1. There is no evidence of acute or subacute intracranial 
+pathology. 
+2. A few foci of high signal intensity are identified in the 
+subcortical 
+white matter of the right frontal region, which are nonspecific 
+and may 
+represent chronic microvascular ischemic changes. 
+ 
+
+###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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {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}, LDH {Lactate dehydrogenase measurement}, Cholest {Cholesterol measurement}, Triglyc {Triglycerides measurement}, HDL {High density lipoprotein measurement}, CHOL/HD {Cholesterol/High density lipoprotein ratio measurement}, LDLcalc {Calculated low density lipoprotein cholesterol level}, HbA1c {Hemoglobin A1c measurement}, eAG {Glucose measurement estimated from glycated hemoglobin}, Lactate {Lactic acid 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {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}, Cardiac Enzyme {Cardiac enzymes/isoenzymes measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, Urine {Urinalysis}, URINE Color-Straw {Normal urine color}, Appear-Clear {Urine looks clear}, URINE Blood {Urine blood test}, NEG {No abnormality detected}, Nitrite-NEG {Nitrite not detected in urine}, Protein-NEG {Urine protein not detected}, Glucose-NEG {Urine glucose not detected}, Ketone-NEG {Urine ketones not detected}, NEG {No abnormality detected}, Urobiln-NEG {Urine urobilinogen not detected}, pH {pH measurement}, Leuks-NEG {Urine leukocytes not detected}, URINE CULTURE {Urine culture}, NO GROWTH {No organism isolated by microbiologic culture}, CXR {Plain chest X-ray}, PA and lateral view of the chest {Plain chest X-ray}, left 
+basilar {Structure of lower lobe of left lung}, opacity {Abnormally opaque structure}, atelectasis {Atelectasis}, infiltrate {Infiltration}, nodular {Nodule of lung}, opacity {Abnormally opaque structure}, region on the left {Structure of hilar lymph node}, lungs {Lung structure}, clear {Normal lung}, costophrenic angles {Structure of costophrenic angle}, cardiomediastinal {Mediastinal structure}, normal {No abnormality detected}, Osseous {Bone structure}, soft tissue {Structure of soft tissue}, unremarkable {Imaging result normal}, Left basilar {Structure of lower lobe of left lung}, atelectasis {Atelectasis}, infiltrate {Infiltration}, left {Left lung structure}, nodule {Nodule}, abdomen/pelvis {Computed tomography of abdomen and pelvis}, No evidence {No abnormality detected}, aortic dissection {Dissection of aorta}, Bilateral adrenal {Bilateral adrenal glands}, nodules {Nodule}, left {Structure of left adrenal gland}, right {Structure of right adrenal gland}, study {Evaluation procedure}, evaluation {Evaluation procedure}, bronchiectasis {Bronchiectasis}, opacity {Abnormally opaque structure}, basilar {Structure of base of lung}, right middle lobe {Structure of middle lobe of right lung}, lower lobes {Structure of lower lobe of lung}, chronic {Chronic disease}, aspiration {Aspiration pneumonia}, infection {Infectious disease}, lung {Lung structure}, interstitial fibrosis {Interstitial fibrosis}, Right {Right kidney structure}, renal {Kidney structure}, simple cyst {Simple cyst}, left renal {Left kidney structure}, simple cysts {Simple cyst}, free fluid {Effusion}, pelvis {Structure of pelvis}, Moderate {Symptom moderate}, lumbar spinal stenosis {Spinal stenosis of lumbar region}, L4-L5 {Intervertebral disc structure of fourth lumbar vertebra}, soft tissue {Structure of soft tissue}, breast {Breast structure}, heart {Heart structure}, stress {Radionuclide myocardial perfusion stress study}, Left ventricular cavity {Structure of cavity of left cardiac ventricle}, size is normal {Normal size}, stress 
+perfusion images {Radionuclide myocardial perfusion stress study}, left ventricular myocardium {Structure of myocardium of left ventricle}, normal wall motion {Normal ventricular wall motion}, left 
+ventricular {Left cardiac ventricular structure}, Stress {Radionuclide myocardial perfusion stress study}, anginal {Angina}, ischemic {Ischemia}, ECG {Electrocardiographic procedure}, MRI head {Magnetic resonance imaging of head}, no evidence {No abnormality detected}, intracranial {Intracranial structure}, white matter {Cerebral white matter structure}, right frontal region {Right frontal lobe structure}, chronic {Chronic disease}, microvascular {Structure of small blood vessel (organ)}, ischemic changes {Ischemia}"
+"###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 woman with a history of HTN admitted with 1 week of 
+chest pain, hospitalization complicated by dizziness.  
+.  
+# Chest pain: Patient presented to the emergency department with 
+a week of left-sided stabbing, burning chest pain that radiates 
+to the back.  In the emergency department, she was ruled out for 
+myocardial infarction by enzymes and EKG.  She underwent CTA 
+chest/abdomen/pelvis, that did not show evidence of pulmonary 
+embolism or aortic dissection.  Stress test was performed given 
+the patient's risk factors that showed normal myocardial 
+perfusion and function, and absence of cardiac symptoms with 
+stress.  CT did show extensive bronchiectasis and ground glass 
+opacities, likely representing ___ syndrome in the 
+context of the patient's chest pain, associated with fatigue and 
+malaise.  Given absence of fevers and cough, there is no 
+indication for antibiotic therapy.  The patient should undergo 
+follow-up CT in 3 months to evaluate for evolving ground glass 
+opacities.   
+.  
+# Dizziness: During admission, patient endorsed 2 weeks of 
+dizziness that occurred with sudden onset.  She had no focal 
+neurologic deficits on exam.  MRI brain did not show evidence of 
+an acute cerebral process.  Orthostatics were negative and the 
+patient was not bradycardic.  However, given the patient's 
+description of symptoms and borderline-low blood pressure, 
+labetalol was decreased to 200 mg BID.  The patient was seen by 
+physical therapy, and was found to be safe to discharge home.  
+.  
+# Bilateral adrenal nodules: Incidental finding on CT. ___ be of 
+concern given history of difficult-to-control hypertension.  The 
+patient will need dedicated adrenal imaging as an outpatient.  
+___ consider functional adrenal studies to evaluate for cause of 
+poorly-controlled hypertension.  
+.  
+# normocytic anemia: Patient admitted with mild normocytic 
+anemia without known baseline.  Anemia remained stable 
+throughout admission.  No evidence of bleed.  The patient should 
+follow up with her primary care physician regarding her anemia.  
+
+.
+# HTN: chronic.  The patient was normotensive to mildly 
+hypotensive during admission on home regimen of lisinopril and 
+labetalol.  Prior to discharge, the patient's labetalol was 
+decreased to 200 mg BID.  She remained normotensive.  She should 
+follow up with her PCP for ___ blood pressure check on discharge.  
+
+.  
+# CODE: full code  
+================================================================
+TRANSITIONAL ISSUES:
+# Patient should undergo repeat CT chest in 3 months (___) to 
+evaluate ground glass opacities 
+# Patient should undergo dedicated adrenal imaging to evaluate 
+bilateral adrenal nodules.  ___ consider functional studies of 
+nodules.   
+# Patient should follow up with PCP for BP check, as labetalol 
+was decreased on admission.  
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, chest pain {Chest pain}, dizziness {Dizziness}, Chest pain {Chest pain}, emergency {Emergency treatment management}, left-sided {Left sided chest pain}, stabbing {Stabbing pain}, burning chest pain {Burning chest pain}, radiates {Radiating pain}, emergency {Emergency treatment management}, myocardial infarction {Myocardial infarction}, EKG {Electrocardiographic procedure}, CTA 
+chest {Computed tomography angiography of chest with contrast}, abdomen/pelvis {Computed tomography of abdomen and pelvis}, pulmonary 
+embolism {Pulmonary embolism}, aortic dissection {Dissection of aorta}, Stress test {Radionuclide myocardial perfusion stress study}, normal myocardial 
+perfusion {Myocardial perfusion normal}, cardiac {Heart structure}, stress {Radionuclide myocardial perfusion stress study}, bronchiectasis {Bronchiectasis}, ground glass 
+opacities {Ground glass lung opacity}, syndrome {Disease}, chest pain {Chest pain}, fatigue {Fatigue}, malaise {Malaise}, fevers {Fever}, cough {Cough}, antibiotic therapy {Antibiotic therapy}, follow-up {Follow-up arranged}, evaluate {Evaluation procedure}, ground glass 
+opacities {Ground glass lung opacity}, Dizziness {Dizziness}, dizziness {Dizziness}, neurologic deficits {Neurological deficit}, exam {Evaluation procedure}, MRI brain {Magnetic resonance imaging of brain}, Orthostatics {Orthostatic hypotension}, negative {No pathologic diagnosis}, bradycardic {Bradycardia}, low blood pressure {Low blood pressure}, physical therapy {Physical therapy procedure}, Bilateral adrenal {Bilateral adrenal glands}, nodules {Nodule}, difficult-to-control hypertension {Poor hypertension control}, adrenal imaging {Adrenal imaging}, studies {Evaluation procedure}, evaluate {Evaluation procedure}, poorly-controlled hypertension. {Poor hypertension control}, normocytic anemia {Normocytic anemia}, mild {Symptom mild}, normocytic 
+anemia {Normocytic anemia}, baseline {Baseline state}, Anemia {Anemia}, stable {Patient's condition stable}, No evidence {No abnormality detected}, bleed {Hemorrhage}, follow up {Follow-up arranged}, primary care {Primary care management}, anemia {Anemia}, HTN {Hypertensive disorder, systemic arterial}, chronic {Chronic disease}, normotensive {Normal blood pressure}, hypotensive {Low blood pressure}, regimen {Therapeutic regimen}, lisinopril {Angiotensin converting enzyme inhibitor therapy}, normotensive {Normal blood pressure}, follow up {Follow-up arranged}, PCP {Primary care management}, blood pressure {Finding of increased blood pressure}, CT chest {Computed tomography of chest}, evaluate {Evaluation procedure}, ground glass opacities {Ground glass lung opacity}, adrenal imaging {Adrenal imaging}, evaluate {Evaluation procedure}, bilateral adrenal {Bilateral adrenal glands}, nodules {Nodule}, studies {Evaluation procedure}, nodules {Thyroid nodule}, follow up {Follow-up arranged}, PCP {Primary care management}, BP check {Blood pressure monitoring}"
+"###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:
+1. Lisinopril 40mg daily  
+2. Labetolol 400mg BOD  
+3. Aspirin 81mg daily 
+
+ 
+Discharge Medications:
+1. lisinopril 40 mg Tablet Sig: One (1) Tablet PO once a day.
+Disp:*90 Tablet(s)* Refills:*0*
+2. labetalol 200 mg Tablet Sig: One (1) Tablet PO BID (2 times a 
+day).
+Disp:*180 Tablet(s)* Refills:*0*
+3. aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) 
+Tablet, Delayed Release (E.C.) PO once a day.  
+
+ 
+
+###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 DIAGNOSIS:  atypical chest pain, dizziness   
+SECONDARY DIAGNOSIS: Hypertension, bilateral adrenal nodules, 
+normocytic anemia 
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: atypical chest pain {Atypical chest pain}, dizziness {Dizziness}, Hypertension {Hypertensive disorder, systemic arterial}, bilateral adrena {Bilateral adrenal glands}, nodules {Nodule}, normocytic anemia {Normocytic anemia}, Mental Status {Neurological mental status determination}, Clear {Normal state of mind}, Alert {Mentally alert}, interactive {Does communicate}, 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:
+Ms. ___, 
+.
+You were admitted to the hospital with two weeks of left-sided 
+chest pain.  On CT scan, you were found to have changes in your 
+lung, concerning for an infection that does not need treatment 
+with antibiotics at this time.  You were also found to have 
+small nodules in your adrenal glands.  Your chest pain resolved. 
+ You should follow up with your primary care physician for ___ 
+repeat CT scan in 3 months to evaluate for changes in your lung 
+findings and adrenal glands.  You had a stress test that showed 
+no acute problems with your heart.  During your hospitalization, 
+you were also noted to have dizziness and a feeling of weakness 
+in your left leg.  We did not note any weakness on physical 
+exam.  You underwent an MRI that showed no evidence of acute 
+stroke.  You were seen by physical therapy who recommended that 
+you walk with a walker (given to you during admission) at all 
+times.  You should follow up with your PCP on discharge.  
+. 
+Medications changed this admission:  
+DECREASE labetalol to 200 mg twice daily   
+ 
+
+###RESPONSE: left-sided 
+chest pain {Left sided chest pain}, CT scan {Computed tomography}, lung {Lung structure}, infection {Infectious disease}, antibiotics {Antibiotic therapy}, nodules {Nodule}, adrenal glands {Bilateral adrenal glands}, chest {Chest pain}, pain resolved {No present pain}, primary care {Primary care management}, CT scan {Computed tomography}, evaluate {Evaluation procedure}, lung 
+findings {Lung finding}, adrenal glands {Bilateral adrenal glands}, stress test {Cardiovascular stress testing}, no acute {No abnormality detected}, problems {Problem}, heart {Heart structure}, dizziness {Dizziness}, weakness {Asthenia}, left leg {Structure of left lower limb}, weakness {Asthenia}, physical 
+exam {Physical examination procedure}, MRI {Magnetic resonance imaging of head}, no evidence {No abnormality detected}, stroke {Cerebrovascular accident}, physical therapy {Physical therapy procedure}, walker {Uses zimmer frame}, PCP {Primary care management}, Medications changed {Change of medication}, DECREASE {Medication decreased}"
+"###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: 
+No Known Allergies / Adverse Drug Reactions
+ 
+Attending: ___
+ 
+Chief Complaint:
+Chest pain
+ 
+Major Surgical or Invasive Procedure:
+Cardiac catheterization with two DES ___
+
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, Chest pain {Chest pain}, 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:
+Ms. ___ is ___ ___ with history of HTN, HLD p/w exertional 
+chest pain. 
+
+She first noticed central chest burning with walking 2 weeks 
+ago. Since then she has had chest burning with exertion almost 
+every day. No associated dyspnea, diaphoresis, nausea. She was 
+evaluated at ___'s office today and was found to have new ECG 
+changes (poor R wave progression, T wave flattening V4,5,6). She 
+received got full dose ASA and was sent to ED for further 
+evaluation. 
+
+Of not she has no previous history of chest pain. No recent 
+fevers/chills, abdominal pain, or dyspnea. 
+
+In the ED, intial vitals were: 98.3 67 135/94 16 98% RA  
+Labs/studies notable for: Trop 0.02
+
+UA notable for leukocytosis with 17 WBCs. Normal CBC and 
+electrolytes. Guaiac negative. 
+
+Atrius on call cardiology was consulted from the ED. Per their 
+recommendations, she was started on heparin drip and admitted to 
+cardiology for unstable angina, consideration of cardiac 
+catheterization. 
+
+Of note, she is followed by Dr. ___. Previous ECG in 
+___ showed LVH and small inferior Q waves. She had stress 
+echo ___ with exercise duration of 9:27 without angina (beta 
+blocker was held by patient for the test). ECG response was 
+non-diagnostic without ischemia. Mild LVH was noted.
+ 
+On the floor she reported no chest pain.  
+
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, exertional 
+chest pain. {Chest pain on exertion}, chest burning {Burning chest pain}, chest burning {Burning chest pain}, dyspnea {Dyspnea}, diaphoresis {Excessive sweating}, nausea {Nausea}, evaluation {Evaluation procedure}, chest pain {Chest pain}, fevers {Fever}, chills {Chill}, abdominal pain {Abdominal pain}, dyspnea {Dyspnea}, UA {Urinalysis}, leukocytosis {Leukocytosis}, unstable angina {Preinfarction syndrome}, cardiac 
+catheterization {Cardiac catheterization}, stress 
+echo ___ {Stress echocardiography}, exercise {Exercises}, angina {Angina}, ischemia {Ischemia}, chest pain {Chest 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: Past Medical History:
+HTN
+h/o diverticulitis 
+Glaucoma
+
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, diverticulitis {Diverticulitis}, Glaucoma {Glaucoma}"
+"###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:
+Diabetes mother, father.
+Maternal grandmother CAD/PVD; Diabetes - Unknown Type; 
+Hyperlipidemia; Hypertension; Stroke
+Sister breast cancer  
+ 
+
+###RESPONSE: Diabetes {Diabetes mellitus}, CAD {Coronary arteriosclerosis}, Diabetes {Diabetes mellitus}, Hyperlipidemia {Hyperlipidemia}, Hypertension {Hypertensive disorder, systemic arterial}, Stroke {Cerebrovascular accident}, breast cancer {Malignant neoplasm of breast}"
+"###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 EXAMINATION:  
+VS: 98.2 160/90 74 18 99%ra  wt 71kg 
+GENERAL: NAD. Oriented x3. Mood, affect appropriate.  
+HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were 
+pink, no pallor or cyanosis of the oral mucosa. No xanthelasma.  
+
+NECK: no elev JVP  
+CARDIAC: PMI located in ___ intercostal space, midclavicular 
+line. RR, normal S1, S2. No murmurs/rubs/gallops. No thrills, 
+lifts. 
+LUNGS: No chest wall deformities, scoliosis or kyphosis. Resp 
+were unlabored, no accessory muscle use. No crackles, wheezes or 
+rhonchi.  
+ABDOMEN: Soft, NTND. No HSM or tenderness.  
+EXTREMITIES: No c/c/e. No femoral bruits.  
+SKIN: No stasis dermatitis, ulcers, scars, or xanthomas.  
+PULSES:  Distal pulses palpable and symmetric
+
+DISCHARGE PHYSICAL EXAMINATION:  
+VS: 99.4 98.7 113/68 80 20 98RA
+GENERAL: NAD. Oriented x3. Mood, affect appropriate.  
+HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were 
+pink, no pallor or cyanosis of the oral mucosa. No xanthelasma.  
+
+NECK: no elev JVP  
+CARDIAC: PMI located in ___ intercostal space, midclavicular 
+line. RR, normal S1, S2. No murmurs/rubs/gallops. No thrills, 
+lifts. 
+LUNGS: No chest wall deformities, scoliosis or kyphosis. Resp 
+were unlabored, no accessory muscle use. No crackles, wheezes or 
+rhonchi.  
+ABDOMEN: Soft, NTND. No HSM or tenderness.  
+EXTREMITIES: No c/c/e. No femoral bruits.  
+SKIN: No stasis dermatitis, ulcers, scars, or xanthomas. 
+PULSES:  Distal pulses palpable and symmetric
+ 
+
+###RESPONSE: PHYSICAL EXAMINATION {Physical examination procedure}, VS {Vital signs finding}, GENERAL {General examination of patient}, NAD {No abnormality detected}, Oriented x3 {Oriented to person, time and place}, Mood {Level of mood - normal}, affect {Mood finding}, HEENT {Physical examination procedure}, NC {Normal head}, Sclera anicteric {White sclera}, PERRL {Pupils equal and reacting to light}, EOMI {Normal ocular motility}, Conjunctiva {Conjunctival structure}, cyanosis {Cyanosis}, oral mucosa {Oral mucous membrane structure}, xanthelasma {Xanthelasma}, NECK {Physical examination procedure}, JVP {Finding of jugular venous pressure}, CARDIAC {Cardiovascular physical examination}, intercostal space {Structure of intercostal space}, midclavicular 
+line {Midclavicular line}, RR {Finding of rate of respiration}, normal S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, murmurs {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, thrills {Thrill}, LUNGS {Examination of respiratory system}, chest wall deformities {Deformity of chest wall}, scoliosis {Scoliosis deformity of spine}, kyphosis {Kyphosis deformity of spine}, Resp {Examination of respiratory system}, accessory muscle {Accessory skeletal muscle}, crackles {Respiratory crackles}, wheezes {Wheezing}, rhonchi {Wheeze - rhonchi}, ABDOMEN {Examination of abdomen}, Soft {Abdomen soft}, ND {Swollen abdomen}, HSM {Hepatosplenomegaly}, tenderness {Tenderness}, EXTREMITIES {Examination of limb}, femoral bruits {Femoral bruit}, SKIN {Examination of skin}, stasis dermatitis {Stasis dermatitis}, ulcers {Ulcer}, scars {Scar}, xanthomas {Xanthomatosis}, pulses {Normal pulse}, PHYSICAL EXAMINATION {Physical examination procedure}, VS {Vital signs finding}, RA {Breathing room air}, GENERAL {General examination of patient}, NAD {No abnormality detected}, Oriented x3 {Oriented to person, time and place}, Mood {Level of mood - normal}, affect {Mood finding}, HEENT {Physical examination procedure}, NC {Normal head}, Sclera anicteric {White sclera}, PERRL {Pupils equal and reacting to light}, EOMI {Normal ocular motility}, Conjunctiva {Conjunctival structure}, cyanosis {Cyanosis}, oral mucosa {Oral mucous membrane structure}, xanthelasma {Xanthelasma}, NECK {Physical examination procedure}, JVP {Finding of jugular venous pressure}, CARDIAC {Cardiovascular physical examination}, intercostal space {Structure of intercostal space}, midclavicular 
+line {Midclavicular line}, RR {Finding of rate of respiration}, normal S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, murmurs {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, thrills {Thrill}, LUNGS {Examination of respiratory system}, chest wall deformities {Deformity of chest wall}, scoliosis {Scoliosis deformity of spine}, kyphosis {Kyphosis deformity of spine}, Resp {Examination of respiratory system}, accessory muscle {Accessory skeletal muscle}, crackles {Respiratory crackles}, wheezes {Wheezing}, rhonchi {Wheeze - rhonchi}, ABDOMEN {Examination of abdomen}, Soft {Abdomen soft}, ND {Swollen abdomen}, HSM {Hepatosplenomegaly}, tenderness {Tenderness}, EXTREMITIES {Examination of limb}, femoral bruits {Femoral bruit}, SKIN {Examination of skin}, stasis dermatitis {Stasis dermatitis}, ulcers {Ulcer}, scars {Scar}, xanthomas {Xanthomatosis}, pulses {Normal pulse}"
+"###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:
+SELECTED LABORATORY TESTS:
+___ 04:56PM BLOOD WBC-5.0 RBC-4.67 Hgb-13.0 Hct-38.9 MCV-83 
+MCH-27.9 MCHC-33.4 RDW-13.8 Plt ___
+___ 05:10AM BLOOD WBC-5.3 RBC-4.41 Hgb-12.2 Hct-36.3 MCV-82 
+MCH-27.7 MCHC-33.6 RDW-13.4 Plt ___
+___ 04:56PM BLOOD Neuts-30.4* Lymphs-61.4* Monos-4.8 
+Eos-2.5 Baso-0.9
+___ 04:56PM BLOOD ___ PTT-29.8 ___
+___ 04:56PM BLOOD Glucose-162* UreaN-14 Creat-0.9 Na-142 
+K-3.9 Cl-103 HCO3-25 AnGap-18
+___ 05:10AM BLOOD Glucose-102* UreaN-19 Creat-0.9 Na-141 
+K-4.0 Cl-105 HCO3-26 AnGap-14
+___ 05:10AM BLOOD CK(CPK)-131
+___ 04:56PM BLOOD cTropnT-0.02*
+___ 05:10AM BLOOD CK-MB-2 cTropnT-0.02*
+___ 11:00AM BLOOD cTropnT-0.01
+___ 07:15PM BLOOD CK-MB-6 cTropnT-0.08*
+___ 05:05AM BLOOD CK-MB-25* MB Indx-8.5* cTropnT-0.17*
+___ 11:00AM BLOOD CK-MB-21* MB Indx-6.8* cTropnT-0.19*
+___ 05:10AM BLOOD CK-MB-7 cTropnT-0.23*
+___ 05:10AM BLOOD Calcium-9.7 Phos-4.0 Mg-2.1
+
+CXR ___: No acute cardiopulmonary abnormality
+ 
+
+###RESPONSE: LABORATORY TESTS {Laboratory test}, 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}, 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}, Lymphs {Lymphocyte count}, Monos {Monocyte count}, Baso {Basophil 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}, 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}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, CXR {Plain chest X-ray}"
+"###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:
+Ms. ___ is ___ ___ with history of HTN, HLD now presenting with 
+exertional chest pain. 
+
+She had increasing frequency of exertional chest pain, with 
+office EKG showing T wave flattening. Troponin 0.02 in ED. She 
+underwent cardiac catheterization on ___. She was noted to have 
+proximal RCA 100% focal stenosis, (3.8x18 DES) and mid RCA 80% 
+tubular stenosis (3x30 DES). Catheterization also demonstrated 
+LAD ___ proximal stenosis, first diagonal 50-60% proximal 
+stenosis. She was subsequently continued on clopidogrel, 
+aspirin, atorvastatin, and atenolol. Troponin and CK-MB was 
+elevated in the post-procedural setting with subsequent 
+normalization of CK-MB suggesting resolving cardiac injury.
+
+TRANSITION ISSUES:
+- She will need close followup in the post-procedural setting 
+for unstable angina
+- She will benefit from cardiac rehabilitation
+
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, exertional chest pain {Chest pain on exertion}, exertional chest pain {Chest pain on exertion}, cardiac catheterization {Cardiac catheterization}, stenosis {Stenosis}, stenosis {Stenosis}, Catheterization {Catheterization}, LAD {Structure of anterior descending branch of left coronary artery}, stenosis {Stenosis}, stenosis {Stenosis}, injury {Traumatic or non-traumatic injury}, unstable angina {Preinfarction syndrome}, cardiac rehabilitation {Cardiac rehabilitation}"
+"###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. Amlodipine 2.5 mg PO DAILY 
+2. Atenolol 50 mg PO DAILY 
+3. Atorvastatin 20 mg PO QPM 
+
+ 
+Discharge Medications:
+1. Atenolol 50 mg PO DAILY 
+2. Atorvastatin 80 mg PO QPM 
+RX *atorvastatin 80 mg 1 tablet(s) by mouth Once every evening 
+Disp #*30 Tablet Refills:*0
+3. Aspirin 81 mg PO DAILY 
+RX *aspirin 81 mg 1 tablet(s) by mouth Once a day Disp #*30 
+Tablet Refills:*0
+4. Clopidogrel 75 mg PO DAILY 
+RX *clopidogrel 75 mg 1 tablet(s) by mouth Once a day Disp #*30 
+Tablet Refills:*0
+5. Lisinopril 2.5 mg PO DAILY 
+RX *lisinopril 2.5 mg 1 tablet(s) by mouth Once a day Disp #*30 
+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:
+PRIMARY DIAGNOSIS:
+Unstable angina, complete occlusion of RCA
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Unstable angina {Preinfarction syndrome}, occlusion {Complete obstruction}, Mental Status {Neurological mental status determination}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, 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 being part of your care at ___. You were 
+admitted to the hospital due to chest pain and concerning 
+findings on EKG. You had cardiac catheterization which showed 
+blockage of the blood vessels in the heart. A stent was placed. 
+You were monitored after the procedure and were found to be safe 
+for discharge.
+
+After discharge please follow up with your outpatient providers 
+as described below.
+ 
+
+###RESPONSE: chest pain {Chest pain}, cardiac catheterization {Cardiac catheterization}, blood vessels {Blood vessel structure}, heart {Heart structure}, procedure {Procedure}, follow up {Follow-up status}"
+"###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: 
+Penicillins / Darvon / lisinopril
+ 
+Attending: ___
+ 
+Chief Complaint:
+Dyspnea
+ 
+Major Surgical or Invasive Procedure:
+None
+ 
+
+###RESPONSE: Penicillins {Allergy to penicillin}, Darvon {Allergy to dextropropoxyphene}, lisinopril {Non-allergic hypersensitivity to angiotensin-converting enzyme inhibitor}, Dyspnea {Dyspnea}"
+"###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 PMHx of COPD, OSA on CPAP, current smoker, and HTN 
+presenting with increasing shortness of breath, cough, and chest 
+tightness similar to prior COPD exacerbations.
+
+Patient was in her USOH until a couple of weeks ago when she 
+developed a cold (rhinorrhea, cough, sinus pressure, etc.). She 
+reports that at that time she also started to have some 
+worsening dyspnea and whezzing. She called her pulmonologist 
+(Dr. ___ and was prescribed a short course of prednisone. She 
+got slightly better when she again noticed the return of her 
+symptoms over the last week. She also noted that her cough which 
+is usually dry or productive of clear/white sputum had become 
+productive of yellow/green sputum. She also developed worsening 
+wheezing and chest tightness. Compounding her issues, she ran 
+out of her home nebulizer treatments which she thought had been 
+helping to keep her symptoms at bay. Denied fevers, abdominal 
+pain, vomiting, diarrhea, constipation, or myalgias. Reports 
+mild chills and nausea. She then decided to come into the ___ 
+ED for evaluation.  
+ 
+In the ED:  
+Initial vital signs were notable for T 98.9, HR 86, BP 142/96, 
+RR 40, O2 92% on RA.  
+
+Labs were notable for:  
+- WBC 12.9, Hbg 10.6  
+- VBG pH 7.39, pCO2 51, O2sat 95  
+- Chemistries, renal function wnl, troponin neg x 1 CXR showed a 
+subtle increase in opacity at the right lung base, which could 
+be due to overlapping structures, but could not exclude definite 
+consolidation.  
+
+Patient was given:  
+- 500mg IV azithromycin  
+- 40mg PO prednisone  
+- Duonebs  
+
+The pt triggered in the ED for tachypnea and chest tightness, 
+with respiratory rates in the ___. Both the pt's tachypnea and 
+symptoms improved after administration of duonebs. She was 
+admitted to the medicine service for further management.  
+
+Upon arrival to the floor, the patient was breathing comfortably 
+and said that her SOB seemed to have improved after the 
+nebulizer treatments in the ED. She was hungry and requested 
+dinner. 
+ 
+Regarding the pt's relevant pulmonary history, recent pulmonary 
+function tests demonstrate features of moderate obstruction. She 
+has an FEV1 of 42% predicted with an FVC of 53% predicted ratio 
+62%. She continues to smoke cigarettes daily but is down to 
+about one cig every other day.  
+ 
+
+###RESPONSE: COPD {Chronic obstructive lung disease}, OSA {Obstructive sleep apnea syndrome}, CPAP {Continuous positive airway pressure ventilation treatment}, current smoker {Smoker}, HTN {Hypertensive disorder, systemic arterial}, increasing {Patient's condition worsened}, shortness of breath {Dyspnea}, cough {Cough}, chest 
+tightness {Tight chest}, COPD exacerbations {Acute exacerbation of chronic obstructive airways disease}, cold {Common cold}, rhinorrhea {Nasal discharge}, cough {Cough}, sinus pressure {Sensation of nasal sinus pressure}, worsening {Patient's condition worsened}, dyspnea {Dyspnea}, whezzing {Wheezing}, called {Informing doctor}, cough {Cough}, dry {Dry cough}, clear {Productive cough -clear sputum}, white sputum {White sputum}, yellow {Productive cough-yellow sputum}, green sputum {Productive cough -green sputum}, worsening {Patient's condition worsened}, wheezing {Wheezing}, chest tightness {Tight chest}, nebulizer treatments {Nebulizer therapy}, fevers {Fever}, abdominal 
+pain {Abdominal pain}, vomiting {Vomiting}, diarrhea {Diarrhea}, constipation {Constipation}, myalgias {Muscle pain}, mild {Symptom mild}, chills {Chill}, nausea {Nausea}, evaluation {Evaluation procedure}, vital signs {Vital signs finding}, HR {Finding of heart rate}, BP {Blood pressure finding}, RR {Finding of rate of respiration}, O2 {Oxygen saturation measurement}, RA {Breathing room air}, WBC {White blood cell count}, Hbg {Measurement of total hemoglobin concentration}, VBG {Blood gases, venous measurement}, pH {pH measurement}, pCO2 {Measurement of venous partial pressure of carbon dioxide}, O2sat {Venous oxygen saturation measurement}, renal function wnl {Renal function tests within reference range}, troponin {Troponin measurement}, neg {No abnormality detected}, CXR {Plain chest X-ray}, opacity {Abnormally opaque structure}, right lung base {Structure of base of right lung}, overlapping structures {Overriding structures}, consolidation {Lung consolidation}, azithromycin {Antibiotic therapy}, tachypnea {Tachypnea}, chest tightness {Tight chest}, respiratory rates {Finding of rate of respiration}, tachypnea {Tachypnea}, improved {Patient's condition improved}, breathing comfortably {Breathing easily}, SOB {Dyspnea}, improved {Patient's condition improved}, nebulizer treatments {Nebulizer therapy}, hungry {Hungry}, pulmonary {Respiratory tract structure}, pulmonary 
+function tests {Measurement of respiratory function}, moderate {Symptom moderate}, obstruction {Finding of respiratory obstruction}, smoke {Smoker}"
+"###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:
+ - DMII  
+ - HTN  
+ - COPD  
+ - Asthma  
+ - Anxiety/Depression  
+ - Osteoarthritis  
+ - IBS  
+ - Seasonal allergies  
+ - Hx of EtOH use disorder
+ - Obesity  
+ - OSA  
+ - Thyroid mass 
+ 
+
+###RESPONSE: DMII {Diabetes mellitus type 2}, HTN {Hypertensive disorder, systemic arterial}, COPD {Chronic obstructive lung disease}, Asthma {Asthma}, Anxiety/Depression {Mixed anxiety and depressive disorder}, Osteoarthritis {Osteoarthritis}, IBS {Irritable bowel syndrome}, Seasonal allergies {Seasonal allergy}, EtOH use disorder {Alcoholism}, Obesity {Obesity}, OSA {Obstructive sleep apnea syndrome}, Thyroid mass {Mass of thyroid gland}"
+"###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 with T2DM 
+- Father with T2DM
+- Sister with HTN  
+- Unknown cancers in grandparents on both sides 
+ 
+
+###RESPONSE: T2DM {Diabetes mellitus type 2}, T2DM {Diabetes mellitus type 2}, HTN {Hypertensive disorder, systemic arterial}, cancers {Malignant neoplasm 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: Physical Exam:
+ADMISSION PHYSICAL EXAM:
+========================
+VITALS: 98.1 137 / 85 76 18 96 2L nc   
+GENERAL: Pleasant F in NAD. At times w/ some dyspnea while 
+speaking during interview 
+HEENT: NCAT, MMM 
+CARDIAC: Heart sounds distant, RRR, no m/r/g  
+LUNGS: Decreased breath sounds throughout, no significant 
+wheezing   
+ABDOMEN: Obese, soft, NT/ND, BS+
+EXTREMITIES: WWP, no c/c/e  
+NEUROLOGIC: AAOx3, grossly intact
+
+DISCHARGE PHYSICAL EXAM:
+========================
+GENERAL: Sitting on edge of bed in NAD
+HEENT: NCAT, MMM, R lobe of thyroid enlarged 
+CARDIAC: RRR, no m/r/g  
+LUNGS: coarse breath sounds b/l, no wheezes, breathing
+comfortably on room air
+ABDOMEN: obese, soft, NT/ND, BS+
+EXTREMITIES: WWP, bilateral 2+ nonpitting edema L>R
+NEUROLOGIC: AAOx3, no focal deficits
+
+ 
+
+###RESPONSE: PHYSICAL EXAM {Physical examination procedure}, VITALS {Vital signs finding}, 2L nc {Oxygen administration by nasal cannula}, GENERAL {General examination of patient}, NAD {No abnormality detected}, dyspnea {Dyspnea}, HEENT {Physical examination procedure}, NC {Normal head}, MMM {Moist oral mucosa}, CARDIAC {Cardiovascular physical examination}, Heart {Cardiovascular physical examination}, RRR {Normal heart rate}, no m/r/g {Heart sounds normal}, LUNGS {Examination of respiratory system}, Decreased breath sounds {Decreased breath sounds}, wheezing {Wheezing}, ABDOMEN {Examination of abdomen}, Obese {Obese}, soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, BS+ {Normal bowel sounds}, EXTREMITIES {Examination of limb}, WWP {Normal tissue perfusion}, no c/c/e {No abnormality detected}, NEURO {Neurological examination}, GI {Examination of digestive system}, Ox3 {Oriented to person, time and place}, grossly intact {Normal nervous system function}, RA {Breathing room air}, Sitting {Sitting position}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, NCAT {Normal head}, MMM {Moist oral mucosa}, R lobe {Structure of right lobe of thyroid gland}, thyroid enlarged {Goiter}, CARDIAC {Cardiovascular physical examination}, RRR {Normal heart rate}, no m/r/g {Heart sounds normal}, LUNGS {Examination of respiratory system}, breath sounds {Finding of breath sounds}, wheezes {Wheezing}, breathing
+comfortably on room air {Breathing easily}, ABDOMEN {Examination of abdomen}, obese {Obese}, soft {Abdomen soft}, BS+ {Normal bowel sounds}, EXTREMITIES {Examination of limb}, WWP {Normal tissue perfusion}, bilateral {Edema of bilateral lower limbs}, edema {Edema}, NEURO {Neurological examination}, Ox3 {Oriented to person, time and place}, no focal deficits {Normal nervous system function}"
+"###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:
+===============
+___ 04:49PM BLOOD WBC-12.9* RBC-4.36 Hgb-10.6* Hct-36.8 
+MCV-84 MCH-24.3* MCHC-28.8* RDW-16.7* RDWSD-51.1* Plt ___
+___ 04:49PM BLOOD Neuts-68.6 ___ Monos-7.8 Eos-2.6 
+Baso-0.3 Im ___ AbsNeut-8.84* AbsLymp-2.59 AbsMono-1.01* 
+AbsEos-0.34 AbsBaso-0.04
+___ 04:49PM BLOOD Glucose-96 UreaN-9 Creat-0.7 Na-143 K-5.0 
+Cl-103 HCO3-29 AnGap-11
+___ 04:49PM BLOOD cTropnT-<0.01
+___ 04:59PM BLOOD ___ pO2-132* pCO2-51* pH-7.39 
+calTCO2-32* Base XS-5
+___ 04:59PM BLOOD O2 Sat-95
+
+PERTINENT LABS:
+===============
+___ 08:31AM BLOOD proBNP-35
+
+IMAGING:
+========
+___ CXR Portable
+IMPRESSION:  
+Subtle increase in opacity at the right lung base may be due to 
+overlap of 
+structures, but underlying consolidation is difficult to 
+exclude. Consider 
+dedicated PA and lateral views if/when patient able, for better 
+evaluation.
+
+___ CXR PA/Lateral
+IMPRESSION:  
+Cardiomediastinal silhouette is within normal limits.  On the 
+prior study, there was suggestion of an opacity at the right 
+base; however, on today's study, this is not present.  There is 
+mild prominence of the pulmonary interstitial markings 
+suggestive of mild pulmonary edema.  No definite consolidation 
+or pneumothoraces are seen.
+
+___ LENIs
+IMPRESSION:  
+No evidence of deep venous thrombosis in the right or left lower 
+extremity veins. No evidence of medial popliteal fossa (___) 
+cyst. 
+
+___ Thyroid Ultrasound
+IMPRESSION:
+1. Numerous confluent nodules in the right lobe suggest an 
+overall stable 
+appearance although specific measurements are difficult to 
+obtain due to 
+differences in scanning technique. 
+2. Two left lobe nodules are minimally increased in size 
+compared to the prior ultrasound.  No new worrisome nodule is 
+identified within the thyroid gland. 
+
+MICRO:
+======
+___ BCx x2: NGTD
+
+DISCHARGE LABS:
+===============
+___ 05:30AM BLOOD WBC-16.8* RBC-3.92 Hgb-9.4* Hct-33.1* 
+MCV-84 MCH-24.0* MCHC-28.4* RDW-16.9* RDWSD-51.9* Plt ___
+___ 05:30AM BLOOD Glucose-157* UreaN-19 Creat-0.8 Na-141 
+K-4.6 Cl-102 HCO3-30 AnGap-9*
+___ 05:30AM BLOOD Calcium-10.7* Phos-3.5 Mg-2.1
+ 
+
+###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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, RDWSD {Red cell distribution width determination}, Plt {Platelet count}, Neuts {Neutrophil count}, Monos {Monocyte count}, Eos {Eosinophil count}, Baso {Basophil count}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, cTropnT {Troponin T cardiac measurement}, pO2 {Measurement of partial pressure of oxygen in blood}, pCO2 {Measurement of partial pressure of carbon dioxide in blood}, pH {pH measurement}, calTCO2 {Blood total carbon dioxide (calculated)}, Base XS {Delta base, blood}, O2 Sat {Oxygen saturation measurement}, proBNP {N-terminal pro-brain natriuretic peptide measurement}, CXR {Plain chest X-ray}, Portable {Portable X-ray}, opacity {Abnormally opaque structure}, right lung base {Structure of base of right lung}, consolidation {Lung consolidation}, lateral {Diagnostic radiography of chest, lateral}, evaluation {Evaluation procedure}, CXR PA/Lateral {Diagnostic radiography of chest, combined posteroanterior and lateral}, Cardiomediastinal {Mediastinal structure}, normal {Normal appearance}, study {Evaluation procedure}, opacity {Abnormally opaque structure}, right 
+base {Structure of base of right lung}, study {Evaluation procedure}, mild {Symptom mild}, pulmonary {Lung structure}, mild {Symptom mild}, pulmonary edema {Pulmonary edema}, consolidation {Lung consolidation}, pneumothoraces {Pneumothorax}, No evidence {No abnormality detected}, deep venous thrombosis {Deep venous thrombosis}, right {Structure of vein of right lower limb}, left lower 
+extremity veins {Structure of vein of left lower limb}, No evidence {No abnormality detected}, medial {Structure of medial aspect of knee}, popliteal fossa {Popliteal fossa structure}, cyst {Cyst}, Thyroid Ultrasound {Ultrasound scan of thyroid}, nodules {Thyroid nodule}, right lobe {Structure of right lobe of thyroid gland}, stable 
+appearance {Patient's condition stable}, measurements {Measurement procedure}, left lobe {Structure of left lobe of thyroid gland}, nodules {Thyroid nodule}, increased in size {Increased size}, ultrasound {Ultrasonography}, nodule {Thyroid nodule}, thyroid gland {Thyroid structure}, BCx {Blood culture}, NGTD {No abnormality detected}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, RDWSD {Red cell distribution width determination}, Plt {Platelet count}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium 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}"
+"###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:
+Ms. ___ is a ___ year old woman with a history of COPD, OSA 
+on CPAP, current smoking, and HTN who presented with increasing 
+shortness of breath, cough, and chest tightness similar to prior 
+COPD exacerbations. 
+ 
+ACUTE ISSUES:  
+============== 
+#COPD EXACERBATION: 
+Ms. ___ presented with dyspnea, cough with changes in 
+sputum production, and chest tightness consistent with her prior 
+COPD exacerbations. This episode was likely triggered by a 
+recent URI and unfortunately exacerbated by her running out of 
+her home nebulizer treatments. CXR PA/lateral did not 
+demonstrate overlying pneumonia and flu swab was negative. She 
+was initiated on a 5 day course of PO prednisone 40mg and 
+azithromycin (___), treated with duonebs and albuterol, and 
+managed symptomatically for her cough.
+
+#LOWER EXTREMITY EDEMA:
+Ms. ___ also endorsed bilateral non-pitting edema, left 
+worse than right, for one week. LENIs were negative for DVT or 
+popliteal fossa cyst. There were no other signs of volume 
+overload on exam, and her BNP was 35. The edema could be an 
+amlodipine side effect, though would not expect asymmetry and 
+she has been on this medication (at the same dosage) for 
+multiple years.
+
+STABLE ISSUES:  
+===============  
+#THYROID MASS:
+Previously noted to be benign per biopsy results at ___, however 
+increasing in size per review of OMR. Ms. ___ was due to 
+have repeat thyroid U/S roughly 6 months ago, but had yet to 
+receive it in the outpatient setting. Therefore the study was 
+performed while the patient was admitted. This demonstrated 
+""Numerous confluent nodules in the right lobe suggest an overall 
+stable appearance although specific measurements are difficult 
+to obtain due to differences in scanning technique. Two left 
+lobe nodules are minimally increased in size compared to the 
+prior ultrasound.  No new worrisome nodule is identified within 
+the thyroid gland."" Patient to follow up with PCP regarding 
+these findings.
+
+#CODE: Full (presumed)  
+#CONTACT: ___ (sister) - ___
+
+TRANSITIONAL ISSUES:
+=====================
+[ ] Requires PCP ___ of thyroid ultrasound findings
+[ ] Can consider discontinuing amlodipine to see if lower 
+extremity edema resolves.
+ 
+
+###RESPONSE: COPD {Chronic obstructive lung disease}, OSA {Obstructive sleep apnea syndrome}, CPAP {Continuous positive airway pressure ventilation treatment}, smoking {Smoker}, HTN {Hypertensive disorder, systemic arterial}, increasing {Patient's condition worsened}, shortness of breath {Dyspnea}, cough {Cough}, chest tightness {Tight chest}, COPD exacerbations {Acute exacerbation of chronic obstructive airways disease}, COPD EXACERBATION {Acute exacerbation of chronic obstructive airways disease}, dyspnea {Dyspnea}, cough {Cough}, sputum production {Productive cough}, chest tightness {Tight chest}, COPD exacerbations {Acute exacerbation of chronic obstructive airways disease}, URI {Upper respiratory infection}, nebulizer treatments {Nebulizer therapy}, CXR PA/lateral {Diagnostic radiography of chest, combined posteroanterior and lateral}, pneumonia {Pneumonia}, negative {No pathologic diagnosis}, azithromycin {Antibiotic therapy}, cough {Cough}, bilateral {Edema of bilateral lower limbs}, non-pitting edema {Non-pitting edema}, left {Structure of left lower limb}, worse {Patient's condition worsened}, right {Structure of right lower limb}, negative {No pathologic diagnosis}, DVT {Deep venous thrombosis}, popliteal fossa {Popliteal fossa structure}, cyst {Cyst}, signs {Sign}, volume 
+overload {Hypervolemia}, exam {Cardiovascular investigation}, BNP {Brain natriuretic peptide measurement}, edema {Edema}, side effect {Medication side effects present}, medication {Administration of drug or medicament}, benign {Benign neoplasm of thyroid gland}, biopsy {Biopsy of thyroid}, increasing in size {Increased size}, thyroid U/S {Ultrasound scan of thyroid}, study {Evaluation procedure}, nodules {Thyroid nodule}, right lobe {Structure of right lobe of thyroid gland}, stable appearance {Patient's condition stable}, measurements {Measurement procedure}, left 
+lobe {Structure of left lobe of thyroid gland}, nodules {Thyroid nodule}, increased in size {Increased size}, ultrasound {Ultrasound scan of thyroid}, nodule {Thyroid nodule}, thyroid gland {Thyroid structure}, PCP {Primary care management}, thyroid {Ultrasound scan of thyroid}, ultrasound findings {Ultrasound scan finding}, lower 
+extremity edema {Edema of lower extremity}, resolves {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: Medications on Admission:
+The Preadmission Medication list is accurate and complete.
+1. Amlodipine 10 mg PO DAILY 
+2. Atorvastatin 40 mg PO QPM 
+3. Fluticasone-Salmeterol Diskus (500/50)  1 INH IH BID 
+4. Ipratropium-Albuterol Neb 1 NEB NEB Q6H:PRN SOB/wheeze 
+5. Losartan Potassium 100 mg PO DAILY 
+6. Sertraline 125 mg PO DAILY 
+7. Albuterol Inhaler ___ PUFF IH Q4H:PRN cough/wheezing 
+8. ammonium lactate 12 % topical DAILY 
+9. BuPROPion XL (Once Daily) 150 mg PO DAILY 
+10. diclofenac sodium 1 % topical BID 
+11. Gabapentin 300 mg PO TID 
+12. MetFORMIN XR (Glucophage XR) 500 mg PO DAILY 
+13. Tiotropium Bromide 1 CAP IH DAILY 
+14. Aspirin 81 mg PO DAILY 
+
+ 
+Discharge Medications:
+1.  Benzonatate 100 mg PO TID:PRN Cough 
+RX *benzonatate 100 mg 1 capsule(s) by mouth Three times per day 
+Disp #*45 Capsule Refills:*0 
+2.  Guaifenesin-Dextromethorphan 5 mL PO Q6H:PRN Cough 
+RX *dextromethorphan-guaifenesin [Adult Cough Formula DM Max] 
+200 mg-10 mg/5 mL 5 mL by mouth Every 6 hours as needed Disp #*1 
+Bottle Refills:*0 
+3.  Albuterol Inhaler ___ PUFF IH Q4H:PRN cough/wheezing 
+RX *albuterol sulfate [ProAir HFA] 90 mcg ___ puffs IH every 4 
+to 6 hours Disp #*1 Inhaler Refills:*0 
+4.  Amlodipine 10 mg PO DAILY  
+5.  ammonium lactate 12 % topical DAILY  
+6.  Aspirin 81 mg PO DAILY  
+7.  Atorvastatin 40 mg PO QPM  
+8.  BuPROPion XL (Once Daily) 150 mg PO DAILY  
+9.  diclofenac sodium 1 % topical BID  
+10.  Fluticasone-Salmeterol Diskus (500/50)  1 INH IH BID  
+11.  Gabapentin 300 mg PO TID  
+12.  Ipratropium-Albuterol Neb 1 NEB NEB Q6H:PRN SOB/wheeze  
+13.  Losartan Potassium 100 mg PO DAILY  
+14.  MetFORMIN XR (Glucophage XR) 500 mg PO DAILY 
+Do Not Crush  
+15.  Sertraline 125 mg PO DAILY  
+16.  Tiotropium Bromide 1 CAP IH DAILY  
+
+ 
+
+###RESPONSE: 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:
+#Chronic Obstructive Pulmonary Disease Exacerbation
+
+Secondary Diagnosis:
+#Thyroid Mass
+#Bilateral Lower Extremity Edema
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Chronic Obstructive Pulmonary Disease Exacerbation {Acute exacerbation of chronic obstructive airways disease}, Thyroid Mass {Mass of thyroid gland}, Bilateral Lower Extremity Edema {Edema of bilateral lower limbs}, 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:
+Dear Ms. ___,
+
+It was a pleasure taking care of you at the ___ 
+___.
+
+Why did you come to the hospital?
+- You came to the hospital because you were having a cough and 
+shortness of breath.
+
+What did you receive in the hospital?
+- You were treated for a COPD exacerbation with steroids and 
+antibiotics.
+- You had an ultrasound of your thyroid which did not show any 
+new worrisome nodules.
+
+What should you do once you leave the hospital?
+- Please take all of your medications as prescribed and attend 
+all of your follow up appointments as scheduled.
+
+We wish you all the best!
+- Your ___ Care Team
+ 
+
+###RESPONSE: cough {Cough}, shortness of breath {Dyspnea}, COPD exacerbation {Acute exacerbation of chronic obstructive airways disease}, steroids {Steroid therapy}, antibiotics {Antibiotic therapy}, ultrasound of your thyroid {Ultrasound scan of thyroid}, nodules {Thyroid nodule}, take all of your medications as prescribed {Patient medication education}"
+"###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: 
+Levofloxacin / gabapentin
+ 
+Attending: ___.
+ 
+Chief Complaint:
+cough, dyspnea
+ 
+Major Surgical or Invasive Procedure:
+None
+ 
+
+###RESPONSE: Levofloxacin {Allergy to levofloxacin}, gabapentin {Allergy to gabapentin}, cough {Cough}, dyspnea {Dyspnea}"
+"###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 ___ y/o M with a PMHx of COPD not on home O2, 
+CKD baseline Cr 2.8, CAD, heart block with pacemaker placement, 
+BPH and NIDDM who p/w with shortness of breath for ___ days. 
+Patient notes a productive cough with greenish sputum as well as 
+malaise. At baseline he is able to ambulate long distances but 
+recently, has been slowly getting short of breath, which got 
+worse on day of admission when even getting to the bathroom was 
+taxing. He reports chills but no fever or rigors. He checked his 
+temperature at home which was not elevated. He denies chest 
+pain, abdominal pain, dysuria, rhinorrhea, myalgias or 
+headaches. In the ED, initial VS were 98.9 75 183/70 18 100% RA. 
+Exam significant for diffuse wheezing with good air movement and 
+oxygen saturations in 97-100% on 3L. Labs significant for K 5.4, 
+Cr 3.1 (baseline 2.8), WBC 9.6, H/H 12.3/36.8. Flu A/B PCR 
+positive for Influenza A. CXR significant for possible 
+superimposed consolidation at the right lung base. The patient 
+received albuterol/ipatropium nebs, ceftriaxone 1 g IV, 
+azithromycin 500 mg PO, and 60 mg PO prednisone. On transfer to 
+the floor, patient was febrile to 100.6 80 185/75 18 98% 2L 
+Nasal Cannula. On arrival to the floor, his dyspnea is improved 
+after breathing treatments. Patient reports significant cough 
+even at rest. He reports getting winded just talking for long 
+periods of time.   
+
+ 
+
+###RESPONSE: COPD {Chronic obstructive lung disease}, home O2 {Home oxygen therapy}, CKD {Chronic kidney disease}, baseline {Baseline state}, Cr {Creatine measurement}, CAD {Coronary arteriosclerosis}, heart block {Heart block}, pacemaker placement {Implantation of cardiac pacemaker}, BPH {Benign prostatic hyperplasia}, NIDDM {Diabetes mellitus type 2}, shortness of breath {Dyspnea}, productive cough {Productive cough}, greenish sputum {Productive cough -green sputum}, malaise {Malaise}, baseline {Baseline state}, able to ambulate {Able to walk}, short of breath {Dyspnea}, worse {Patient's condition worsened}, chills {Chill}, no fever {Temperature normal}, rigors {Rigor}, checked his 
+temperature {Monitoring of patient temperature}, not elevated {Temperature normal}, chest 
+pain {Chest pain}, abdominal pain {Abdominal pain}, dysuria {Dysuria}, rhinorrhea {Nasal discharge}, myalgias {Muscle pain}, headaches {Headache}, Exam {Physical examination procedure}, wheezing {Wheezing}, good air movement {Breath normal}, oxygen saturations {Finding of oxygen saturation}, Labs {Laboratory test}, K {Blood potassium measurement}, Cr {Creatine measurement}, baseline {Baseline state}, WBC {White blood cell count}, H/H {Measurement of total hemoglobin concentration and hematocrit}, Flu A/B PCR {Analysis using quantitative fluorescent polymerase chain reaction technique}, Influenza A {Influenza A virus present}, CXR {Plain chest X-ray}, consolidation {Lung consolidation}, right lung base {Structure of base of right lung}, nebs {Nebulizer therapy}, azithromycin {Antibiotic therapy}, prednisone {Steroid therapy}, febrile {Fever}, Nasal Cannula {Oxygen administration by nasal cannula}, dyspnea {Dyspnea}, improved {Patient's condition improved}, breathing treatments {Inhalation therapy procedure}, cough {Cough}, at rest {Cough at rest}, winded {Winded}"
+"###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:
+DM (diabetes mellitus), type 2, uncontrolled, with renal 
+complications  
+Abdominal aortic aneurysm  
+Back pain  
+Hypertension  
+Pacemaker for heart block  
+Vitamin B 12 deficiency  
+Chronic kidney disease (CKD), stage IV (severe)  
+SPINAL STENOSIS, UNSPEC SITE  
+CORONARY ARTERY DISEASE, UNSPEC VESSEL TYPE  
+COPD 
+BPH
+GERD
+Hypercholesterolemia
+Asbestosis
+Macular degeneration
+Iron deficiency anemia
+s/p left TKR
+s/p carotid endarterectomy
+
+ 
+
+###RESPONSE: DM (diabetes mellitus), type 2, uncontrolled {Type II diabetes mellitus uncontrolled}, renal 
+complications {Renal disorder due to type 2 diabetes mellitus}, Abdominal aortic aneurysm {Abdominal aortic aneurysm}, Back pain {Backache}, Hypertension {Hypertensive disorder, systemic arterial}, Pacemaker {Implantation of cardiac pacemaker}, heart block {Heart block}, Vitamin B 12 deficiency {Cobalamin deficiency}, Chronic kidney disease {Chronic kidney disease}, CKD), stage IV {Chronic kidney disease stage 4}, SPINAL STENOSIS {Spinal stenosis}, CORONARY ARTERY DISEASE {Coronary arteriosclerosis}, COPD {Chronic obstructive lung disease}, BPH {Benign prostatic hyperplasia}, GERD {Gastroesophageal reflux disease}, Hypercholesterolemia {Hypercholesterolemia}, Asbestosis {Asbestosis}, Macular degeneration {Degenerative disorder of macula}, Iron deficiency anemia {Iron deficiency anemia}, left TKR {Total replacement of left knee joint}, carotid endarterectomy {Carotid endarterectomy}"
+"###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:
+non-contributory 
+ 
+
+###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:
+ADMISSION PHYSICAL EXAM:  
+VS - 98.0 165/63 (165-183/63-79) 71 22 98% 2L NC 
+I/O: -500mL
+GENERAL: Alert and oriented x 3. NAD  
+HEENT: AT/NC, EOMI, PERRL, anicteric sclerae, pink conjunctivae, 
+patent nares, MMM, good dentition, nontender supple neck, no 
+LAD, no JVD  
+CARDIAC: RRR, S1/S2, no murmurs, gallops, or rubs  
+LUNG: Faint expiratory wheezes with good air entry. Decreased 
+breath sounds in right lung base. 
+ABDOMEN: obese, nontender, nondistended, normoactive BS 
+EXTREMITIES: 1+ pretibial edema. moving all extremities well, no 
+cyanosis,or clubbing PULSES: 2+ DP pulses bilaterally  
+NEURO: CN II-XII intact  
+SKIN: warm and well perfused, no excoriations or lesions, no 
+rashes  
+
+DISCHARGE PHYSICAL EXAM:
+Objective:  
+VS - 98.3 70 18 161/76 96 on 0.5% 
+BG ___ 181
+Wt 92.9<-92.9
+___ 
+GENERAL: Alert and oriented x 3. NAD  
+HEENT: AT/NC, EOMI, PERRL, anicteric sclerae, pink conjunctivae, 
+patent nares, MMM, good dentition, nontender supple neck, no 
+LAD, no JVD  
+CARDIAC: RRR, S1/S2, no murmurs, gallops, or rubs  
+LUNG: CTAB. No wheezes, rhonchi. 
+ABDOMEN: obese, nontender, nondistended, normoactive BS 
+EXTREMITIES: 2+ pitting edema to ankles; moving all extremities 
+well, no cyanosis,or clubbing 
+PULSES: 2+ DP pulses bilaterally  
+NEURO: CN II-XII intact  
+SKIN: warm and well perfused, no excoriations or lesions, no 
+rashes
+ 
+
+###RESPONSE: PHYSICAL EXAM {Physical examination procedure}, VS {Vital signs finding}, NC {Normal head}, I/O {Measuring intake and output}, GENERAL {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, NC {Normal head}, EOMI {Normal ocular motility}, PERRL {Pupils equal and reacting to light}, anicteric sclerae {White sclera}, pink conjunctivae {Conjunctiva normal}, nares {Structure of anterior naris}, MMM {Moist oral mucosa}, good dentition {Normal dentition}, nontender {Abdominal tenderness}, supple {Normal movement of neck}, LAD {Lymphadenopathy}, JVD {Jugular venous engorgement}, CARDIAC {Cardiovascular physical examination}, RRR {Normal heart rate}, S2 {Normal second heart sound, S>2<}, murmurs {Murmur}, gallops {Gallop rhythm}, rubs {Pericardial friction rub}, LUNG {Examination of respiratory system}, wheezes {Wheezing}, good {Normal breath sounds}, air entry {Audible inspiration}, Decreased 
+breath sounds {Decreased breath sounds}, right lung base {Structure of base of right lung}, ABDOMEN {Examination of abdomen}, obese {Obese}, nontender {Abdominal tenderness}, nondistended {Normal abdominal contour}, normoactive BS {Normal bowel sounds}, EXTREMITIES {Examination of limb}, edema {Edema}, all extremities {All extremities}, cyanosis {Cyanosis}, clubbing {Clubbing}, PULSES {Pulse finding}, 2+ DP pulses {Dorsalis pulse present}, NEURO {Neurological examination}, CN II-XII intact {Normal central nervous system}, SKIN {Examination of skin}, warm {Warm skin}, well perfused {Normal tissue perfusion}, excoriations {Excoriation}, lesions {Lesion}, rashes {Eruption of skin}, VS {Vital signs finding}, RA {Breathing room air}, Alert {Mentally alert}, oriented x 3 {Oriented to person, time and place}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, AT/NC {Normal head}, EOMI {Normal ocular motility}, PERRL {Pupils equal and reacting to light}, anicteric sclerae {White sclera}, pink conjunctivae {Conjunctiva normal}, nares {Structure of anterior naris}, MMM {Moist oral mucosa}, good dentition {Normal dentition}, nontender {Tenderness of neck}, supple neck {Normal movement of neck}, LAD {Lymphadenopathy}, JVD {Jugular venous engorgement}, CARDIAC {Cardiovascular physical examination}, RRR {Normal heart rate}, S1/S2 {Heart sounds normal}, murmurs {Heart murmur}, gallops {Gallop rhythm}, rubs {Pericardial friction rub}, LUNG {Examination of respiratory system}, CTAB {Normal breath sounds}, wheezes, rhonchi {Wheeze - rhonchi}, ABDOMEN {Examination of abdomen}, obese {Obese}, nontender {Abdominal tenderness}, nondistended {Normal abdominal contour}, normoactive BS {Normal bowel sounds}, EXTREMITIES {Examination of limb}, edema {Edema}, ankles {Ankle edema}, moving all extremities {Does move all four limbs}, cyanosis {Cyanosis}, clubbing {Clubbing}, PULSES {Pulse finding}, 2+ DP pulses {Dorsalis pulse present}, NEURO {Neurological examination}, CN II-XII intact {Normal central nervous system}, SKIN {Examination of skin}, warm {Warm skin}, well perfused {Normal tissue perfusion}, excoriations {Excoriation}, lesions {Skin lesion}, 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:
+ADMISSION LABS:
+___ 02:55PM BLOOD WBC-9.6 RBC-4.05* Hgb-12.3* Hct-36.8* 
+MCV-91 MCH-30.5 MCHC-33.6 RDW-14.3 Plt ___
+___ 02:55PM BLOOD Neuts-91.8* Lymphs-3.3* Monos-2.6 Eos-2.0 
+Baso-0.2
+___ 02:55PM BLOOD Glucose-164* UreaN-45* Creat-3.1* Na-142 
+K-5.4* Cl-107 HCO3-24 AnGap-16
+___ 07:30AM BLOOD proBNP-3750*
+___ 07:30AM BLOOD Calcium-8.7 Phos-3.9 Mg-1.8
+
+IMAGING:
+___ CXR  
+Calcified pleural plaques. Although there is no prior to assess 
+for interval change, there is suspected superimposed 
+consolidation at the right lung base which could represent 
+pneumonia. Correlation with prior exams would be helpful to 
+assess for interval change. Followup will be necessary.  
+
+EKG ___ per Atrius  
+Underlying sinus rhythm with 1st degree AV block  
+
+PFTS ___  
+FEV1/FVC .62 (87% predicted) 
+
+___ RENAL ULTRASOUND: IMPRESSION: Preliminary 
+Report:Slightly increased parenchymal echogenicity bilaterally 
+may be seen in the setting of chronic renal disease. No 
+hydronephrosis. 
+
+DISCHARGE LABS:
+
+___ 06:20AM BLOOD WBC-7.1 RBC-3.85* Hgb-11.8* Hct-34.4* 
+MCV-89 MCH-30.5 MCHC-34.2 RDW-14.0 Plt ___
+___ 06:20AM BLOOD Glucose-127* UreaN-70* Creat-3.7* Na-139 
+K-4.5 Cl-105 HCO3-23 AnGap-16
+___ 06:20AM BLOOD Calcium-9.0 Phos-3.8 Mg-2.___ year old male with hx of COPD p/w with increased shortness of 
+breath. He was found to have influenza, COPD exacerbation, ___ 
+on CKD and lower extremity edema. He was treated with 
+oseltamivir, prednisone, and azithromcyin. He left against 
+medical advice one day prior to planned discharge. 
+
+# Influenza/pneumonia: Patient presented with fever, cough with 
+green sputum and flu positivity with CXR suggesting right lung 
+consolidation. Patient received ceftriaxone and azithromycin in 
+the ED for bacterial pneumonia/COPD exacerbation and was started 
+on Oseltamivir for influenza. Given that patient appeared 
+clinically well without elevated wbc, ceftriaxone was 
+discontinued (as bacterial pneumonia was less suspected). His 
+cough improved with treatment. He was unable to be weaned off of 
+supplemental O2 (ambulatory saturation on discharge 86%) and he 
+was discharged with supplemental O2. Lingering O2 requirment 
+likely due to infection in setting of COPD. 
+
+# Acute on chronic kidney injury: Most likely due to obstruction 
+secondary to BPH. Admission creatinine was 3.1, up from a 
+baseline of 2.8. FeNA was 11%, consistent with obstruction. 
+Patient had good urine output, so he did not have foley placed. 
+Renal ultrasound showed no hydronephrosis. Cr continued to 
+uptrend and stabilized at 3.7. FeUrea on day of discharge was 
+53%, suggestive of more of an intrinsic pathology - likely ATN 
+secondary to obstructive acute kidney injury. He also had 
+increased UOP, suggestive of post-ATN diuresis. 
+
+ # Lower extremity edema: Patient presented with 3+ pitting 
+edema to the knees bilaterally. He does not have a history of 
+congestive heart failure but BNP was elevated to 3750, which is 
+consistent with heart failure diagnosis. Patient received IVFs 
+on admission which may have further exacerbated the issue. No 
+evidence to suggest heart failure causing his dyspnea symptoms. 
+No lasix was given due to ___, however, patient autodiuresed and 
+swelling was minimal on discharge. He should have outpatient 
+echocardiogram. 
+
+# Nausea: Patient had onset of nausea and difficulty tolerating 
+PO. He reported that this sometimes occurs at home. He was given 
+reglan and a GI cocktail with little effect. Most likely due to 
+oseltamivir side effect vs, less likely, gastroparesis. Patient 
+was tolerating clears when he left against medical advice. 
+
+# COPD with acute exacerbation: Patient has a history of COPD 
+not on home O2. His presentation was also consistent with a COPD 
+exacerbation. He received steroids and azithromycin in the ED. 
+He continued PO prednisone for a planned 5 day total course. He 
+was unable to be weaned off of supplemental O2 (ambulatory 
+saturation on discharge 86%) and he was discharged with 
+supplemental O2. Lingering O2 requirment likely due to infection 
+in setting of COPD. 
+
+# Hyperkalemia: Likely from CKD. This was within normal limits 
+on discharge. 
+
+# Type 2 DM (diabetes mellitus), noninsulin dependent: Last 
+HbA1C 6.5 in ___. Patient on glimepiride at home. 
+Glimepiride was held on admission but restarted on discharge.  
+
+# Hypertension: He continued home labetalol and amlodipine. 
+
+# CAD: He continued home aspirin and statin.  
+
+# BPH: He continued home finasteride and tamsulosin 
+
+TRANSITIONAL ISSUES:
+-Discharge weight: 92.9 kg
+-Needs TTE to evaluate new CHF
+-Patient will continue prednisone 40mg, azithromycin and 
+oseltamivir until ___ need to increase Tamsulosin given symptoms of BPH causing 
+___
+-Patient's blood glucoses elevated while on prednisone 
+-Patient was started on preventative COPD medications
+-Patient will need oxygen on discharge given drop in sats while 
+ambulating.
+ 
+
+###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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, Plt {Platelet count}, Neuts {Neutrophil count}, Lymphs {Lymphocyte count}, Monos {Monocyte count}, Eos {Eosinophil 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}, proBNP {N-terminal pro-brain natriuretic peptide measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, CXR {Plain chest X-ray}, Calcified {Pathologic calcification, calcified structure}, pleural plaques {Pleural plaque}, consolidation {Lung consolidation}, right lung base {Structure of base of right lung}, pneumonia {Pneumonia}, exams {Evaluation procedure}, EKG {Electrocardiographic procedure}, sinus rhythm {Sinus rhythm}, 1st degree AV block {First degree atrioventricular block}, PFTS {Measurement of respiratory function}, FVC {Finding of forced vital capacity}, RENAL ULTRASOUND {Echography of kidney}, chronic renal disease {Chronic kidney disease}, hydronephrosis {Hydronephrosis}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, Plt {Platelet 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}, COPD {Chronic obstructive lung disease}, increased {Patient's condition worsened}, shortness of 
+breath {Dyspnea}, influenza {Influenza}, COPD exacerbation {Acute exacerbation of chronic obstructive airways disease}, CKD {Chronic kidney disease}, lower extremity edema {Edema of lower extremity}, prednisone {Steroid therapy}, azithromcyin {Antibiotic therapy}, left against 
+medical advice {Left against medical advice}, Influenza {Influenza}, pneumonia {Pneumonia}, fever {Fever}, cough {Productive cough}, green sputum {Productive cough -green sputum}, CXR {Plain chest X-ray}, right {Right lung structure}, lung 
+consolidation {Lung consolidation}, azithromycin {Antibiotic therapy}, bacterial pneumonia {Bacterial pneumonia}, COPD exacerbation {Acute exacerbation of chronic obstructive airways disease}, started {New medication added}, influenza {Influenza}, elevated wbc {White blood cell count outside reference range}, discontinued {Recommendation to stop drug treatment}, bacterial pneumonia {Bacterial pneumonia}, cough {Cough}, improved with treatment {Good therapeutic response}, O2 {Oxygen therapy}, saturation {Finding of oxygen saturation}, O2 {Oxygen therapy}, infection {Infectious disease}, COPD {Chronic obstructive lung disease}, Acute on chronic kidney injury {Acute-on-chronic renal failure}, obstruction {Urinary tract obstruction}, BPH {Benign prostatic hyperplasia}, creatinine {Creatinine measurement}, baseline {Baseline state}, FeNA {Measurement of fractional excretion of sodium}, obstruction {Urinary tract obstruction}, good urine output {Increased urine output}, foley placed {Catheterization of urinary bladder}, Renal ultrasound {Echography of kidney}, hydronephrosis {Hydronephrosis}, Cr {Creatine measurement}, uptrend {Serum creatinine above reference range}, ATN {Acute tubular necrosis}, obstructive {Urinary tract obstruction}, acute kidney injury {Acute kidney injury}, increased UOP {Increased urine output}, ATN {Acute tubular necrosis}, diuresis {Diuresis}, Lower extremity edema {Edema of lower extremity}, 3+ pitting 
+edema {3+ pitting edema}, knees {Edema of knee}, congestive heart failure {Congestive heart failure}, BNP {Brain natriuretic peptide measurement}, elevated {Complement level above reference range}, heart failure {Heart failure}, IVFs {Administration of intravenous fluids}, No 
+evidence {No abnormality detected}, heart failure {Heart failure}, dyspnea {Dyspnea}, lasix {Diuretic therapy}, autodiuresed {Increased urine output}, swelling {Swelling}, minimal {Symptom mild}, echocardiogram {Echocardiography}, Nausea {Nausea}, nausea {Nausea}, tolerating {Tolerating diet}, side effect {Medication side effects present}, gastroparesis {Gastroparesis}, tolerating clears {Tolerating oral fluid}, left against medical advice {Left against medical advice}, COPD {Chronic obstructive lung disease}, acute exacerbation {Acute exacerbation of chronic obstructive airways disease}, COPD {Chronic obstructive lung disease}, home O2 {Home oxygen therapy}, COPD 
+exacerbation {Acute exacerbation of chronic obstructive airways disease}, steroids {Steroid therapy}, azithromycin {Antibiotic therapy}, prednisone {Steroid therapy}, O2 {Oxygen therapy}, saturation {Finding of oxygen saturation}, O2 {Oxygen therapy}, infection {Infectious disease}, COPD {Chronic obstructive lung disease}, Hyperkalemia {Hyperkalemia}, CKD {Chronic kidney disease}, normal {Serum potassium level within reference range}, Type 2 DM (diabetes mellitus) {Diabetes mellitus type 2}, HbA1C {Hemoglobin A1c measurement}, held {Recommendation to stop drug treatment}, restarted {Restart of medication}, Hypertension {Hypertensive disorder, systemic arterial}, CAD {Coronary arteriosclerosis}, aspirin {Administration of aspirin}, statin {Administration of prophylactic statin}, BPH {Benign prostatic hyperplasia}, weight {Weight finding}, TTE {Transthoracic echocardiography}, evaluate {Evaluation procedure}, CHF {Congestive heart failure}, prednisone {Steroid therapy}, azithromycin {Antibiotic therapy}, BPH {Benign prostatic hyperplasia}, blood glucoses elevated {Glucose in blood specimen above reference range}, prednisone {Steroid therapy}, started {New medication added}, COPD {Chronic obstructive lung disease}, drop in sats {Oxygen saturation below reference range}, ambulating {Fully mobile}"
+"###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. Calcitriol 0.25 mcg PO EVERY OTHER DAY 
+2. Labetalol 200 mg PO BID 
+3. Pantoprazole 40 mg PO Q12H 
+4. Pravastatin 40 mg PO QPM 
+5. Amlodipine 5 mg PO DAILY 
+6. Tamsulosin 0.4 mg PO DAILY 
+7. glimepiride 1 mg oral BID 
+8. Finasteride 5 mg PO DAILY 
+9. Oxycodone-Acetaminophen (5mg-325mg) 1 TAB PO Q8H:PRN Pain 
+10. Cyanocobalamin 1000 mcg PO DAILY 
+11. Ocuvite (vit C-vit E-lutein-min-om-3) 150-30-5-150 
+mg-unit-mg-mg oral daily 
+12. Aspirin 81 mg PO DAILY 
+
+ 
+Discharge Medications:
+1. Amlodipine 5 mg PO DAILY 
+2. Aspirin 81 mg PO DAILY 
+3. Calcitriol 0.25 mcg PO EVERY OTHER DAY 
+4. Cyanocobalamin 1000 mcg PO DAILY 
+5. Finasteride 5 mg PO DAILY 
+6. Labetalol 200 mg PO BID 
+7. Oxycodone-Acetaminophen (5mg-325mg) 1 TAB PO Q8H:PRN Pain 
+8. Pantoprazole 40 mg PO Q12H 
+9. Pravastatin 40 mg PO QPM 
+10. Tamsulosin 0.4 mg PO DAILY 
+11. Azithromycin 250 mg PO Q24H 
+RX *azithromycin 250 mg 1 tablet(s) by mouth daily Disp #*1 
+Tablet Refills:*0
+12. OSELTAMivir 30 mg PO Q24H Duration: 4 Days 
+RX *oseltamivir [Tamiflu] 30 mg 1 capsule(s) by mouth daily Disp 
+#*1 Capsule Refills:*0
+13. PredniSONE 40 mg PO DAILY Duration: 4 Days 
+RX *prednisone 20 mg 2 tablet(s) by mouth daily Disp #*2 Tablet 
+Refills:*0
+14. Tessalon Perles (benzonatate) 100 mg ORAL TID:PRN cough 
+RX *benzonatate 100 mg 1 capsule(s) by mouth TID PRN Disp #*30 
+Capsule Refills:*0
+15. glimepiride 1 mg ORAL BID 
+16. Ocuvite (vit C-vit E-lutein-min-om-3) 150-30-5-150 
+mg-unit-mg-mg oral daily 
+17. Symbicort (budesonide-formoterol) 160-4.5 mcg/actuation 
+inhalation BID 
+RX *budesonide-formoterol [Symbicort] 160 mcg-4.5 mcg/actuation 
+1 160 mcg-4.5 mcg inhaled twice a day Disp #*1 Inhaler 
+Refills:*0
+18. Albuterol Inhaler 2 PUFF IH Q4H:PRN shortness of breath, 
+wheezing 
+RX *albuterol sulfate [ProAir HFA] 90 mcg 2 puffs inhaled Q4H 
+PRN Disp #*1 Inhaler 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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Primary diagnosis:
+Influenza
+Pneumonia
+
+Secondary diagnosis:
+___ on CKD
+Lower extremity edema
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, Influenza {Influenza}, Pneumonia {Pneumonia}, CKD {Chronic kidney disease}, Lower extremity edema {Edema of lower extremity}, 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:
+Dear Mr. ___, 
+
+You were admitted to ___ with shortness of breath and cough 
+and found to have the flu with superimposed pneumonia. You also 
+had a COPD exacerbation. You were treated for these and your 
+symptoms improved. You also had acute kidney injury which was 
+thought to be from your enlarged prostate. 
+
+Given the swelling in your legs, there is concern for a 
+condition in your heart called congestive heart failure. You 
+should talk to your primary care doctor about the next steps in 
+treatment. You may need to get an ultrasound of your heart to 
+get a better look at your heart. 
+
+It is very important that you finish taking all of your 
+medications and follow-up with your primary care doctor on ___. 
+
+
+Despite our recommendation to stay an extra night in the 
+hospital, you left ___ against our medical advice. 
+
+It was a pleasure taking care of you, 
+Your ___ Doctors
+ 
+___ Instructions:
+___
+
+###RESPONSE: shortness of breath {Dyspnea}, cough {Cough}, pneumonia {Pneumonia}, COPD exacerbation {Acute exacerbation of chronic obstructive airways disease}, improved {Patient's condition improved}, acute kidney injury {Acute kidney injury}, enlarged prostate {Large prostate}, swelling {Edema of lower extremity}, legs {Lower limb structure}, heart {Heart structure}, congestive heart failure {Congestive heart failure}, primary care {Primary care management}, ultrasound of your heart {Echocardiography}, heart {Heart structure}, finish taking all of your 
+medications {Patient medication education}, follow-up {Follow-up arranged}, primary care {Primary care management}, recommendation to {Recommendation to continue with treatment}, against our medical advice {Left against medical advice}"
+"###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:
+Chest Pain
+ 
+Major Surgical or Invasive Procedure:
+___: Left heart cath
+
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, Chest Pain {Chest pain}, Left heart cath {Catheterization of left heart}"
+"###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 majority of the history of obtained through the patient's 
+son and chart review as the patient does not speak ___.  
+Mr. ___ is a ___ year old gentleman with history of CAD s/p 
+3v CABG in ___, HTN, HLD, DM type II who presents with chest 
+pain.  
+Substernal chest pain, ___, per patient's son similar to the 
+pain that lead to his CABG started last night associated with 
+palpitations, diaporesis and dyspnea. The severe pain lasted ___ 
+hrs. It improved overnight to ___. He was having difficulty 
+sleeping last night because of the pain. He didn't tell anyone 
+until his son came back home from work today. Today he tried to 
+go down some stairs in his 2 story house and became very 
+dyspenic and felt palpitations.  
+His son took him to ___ where initial vitals were 
+97.3, 76, ___. Significant labs include WBC 13.3. 
+BUN/Cr ___. Trop I 0.160 (ref range ___, BNP 58. CXR 
+there without acute processes. EKG shows LVH but otherwise no 
+evidence of ischemia. He was given ASA 325mg, Nitro SL x 2 and 
+Nitro paste with resolution of symptoms and correction of 
+hypertension. Vital sign prior to transfer to ___ 134/86 64 16 
+100%RA.  
+In the ED intial vitals were: 96.9 70 150/78 18 99% 0  
+Labs: 11.3 WBC with 12.7% eos. BUN/Cr ___.  
+Patient was given: nitro SL x2 with and nitro paste at the OSH 
+and morphine 5mg IV once in the ED. Trop <0.01.  
+Vitals on transfer: 98 72 120/72 16 97% RA  
+On the floor patient currently without chest pain.  
+ 
+
+###RESPONSE: does not speak {Does not speak}, CAD {Coronary arteriosclerosis}, CABG {Coronary artery bypass grafting}, HTN {Hypertensive disorder, systemic arterial}, HLD {Hyperlipidemia}, DM type II {Diabetes mellitus type 2}, chest 
+pain {Chest pain}, Substernal chest pain {Retrosternal pain}, pain {Pain}, CABG {Coronary artery bypass grafting}, palpitations {Palpitations}, diaporesis {Excessive sweating}, dyspnea {Dyspnea}, severe pain {Severe pain}, improved {Patient's condition improved}, difficulty 
+sleeping {Difficulty sleeping}, pain {Pain}, dyspenic {Dyspnea}, palpitations {Palpitations}, labs {Laboratory test}, WBC {White blood cell count}, BUN/Cr {Blood urea nitrogen/creatinine ratio}, Trop I {Troponin I measurement}, BNP {Brain natriuretic peptide measurement}, CXR {Plain chest X-ray}, EKG {Electrocardiographic procedure}, LVH {Left ventricular hypertrophy}, no 
+evidence of ischemia {Electrocardiogram: no myocardial ischemia}, ASA {Administration of aspirin}, resolution {Problem resolved}, hypertension {Hypertensive disorder, systemic arterial}, Vital sign {Vital signs finding}, vitals {Vital signs finding}, Labs {Laboratory test}, WBC {White blood cell count}, BUN/Cr {Blood urea nitrogen/creatinine ratio}, Trop {Troponin measurement}, Vitals {Vital signs finding}, chest pain {Chest 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: Past Medical History:
+PAST MEDICAL HISTORY:  
+1. CARDIAC RISK FACTORS: Diabetes, Dyslipidemia, Hypertension  
+2. CARDIAC HISTORY:  
+- CABG: 3v CABG in ___. LIMA graft to the LAD and vein grafts 
+to a circumflex marginal and the distal right coronary artery.  
+- PERCUTANEOUS CORONARY INTERVENTIONS: None  
+- PACING/ICD: None  
+3. OTHER PAST MEDICAL HISTORY:  
+CAD - 3 vessel disease s/p CABG  
+HTN  
+DM type II  
+HLD  
+___ disease  
+Macroscopic hematuria  
+Proteinuria  
+cataracts s/p removal of in ___ c/b enucleated eye  
+urinary incontinence  
+ 
+
+###RESPONSE: CARDIAC RISK FACTORS {Assessment for risk of cardiovascular disease}, Diabetes {Diabetes mellitus}, Dyslipidemia {Dyslipidemia}, Hypertension {Hypertensive disorder, systemic arterial}, CABG {Coronary artery bypass grafting}, 3v CABG {Coronary artery bypass grafts x 3}, LIMA graft {Internal mammary-coronary artery bypass graft}, LAD {Structure of anterior descending branch of left coronary artery}, vein grafts {Venous graft}, circumflex marginal {Structure of obtuse marginal branch of circumflex branch of left coronary artery}, distal right coronary artery {Structure of distal portion of right coronary artery}, PERCUTANEOUS CORONARY INTERVENTIONS {Percutaneous coronary intervention}, PACING {Cardiac pacing}, ICD {Automatic implantable cardiac defibrillator in situ}, CAD {Coronary arteriosclerosis}, 3 vessel disease {Triple vessel disease of the heart}, CABG {Coronary artery bypass grafting}, HTN {Hypertensive disorder, systemic arterial}, DM type II {Diabetes mellitus type 2}, HLD {Hyperlipidemia}, Macroscopic hematuria {Frank hematuria}, Proteinuria {Proteinuria}, cataracts {Cataract}, urinary incontinence {Urinary incontinence}"
+"###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 with ?MI at unknown age. Otherwise no known history of 
+arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise 
+non-contributory.  
+ 
+
+###RESPONSE: MI {Myocardial infarction}, arrhythmia {Cardiac arrhythmia}, cardiomyopathies {Cardiomyopathy}, sudden cardiac death {Sudden cardiac death}"
+"###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 EXAMINATION:  
+VS: 97.8 77 176/91 20 100%RA  
+GENERAL: NAD  
+HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were 
+pink, no pallor or cyanosis of the oral mucosa. No xanthelasma.  
+
+NECK: Supple with JVP of 8 cm.  
+CARDIAC: PMI located in ___ intercostal space, midclavicular 
+line. RR, normal S1, S2. No m/r/g. No thrills, lifts. No S3 or 
+S4.  
+LUNGS: No chest wall deformities, scoliosis or kyphosis. Resp 
+were unlabored, no accessory muscle use. CTAB, no crackles, 
+wheezes or rhonchi.  
+ABDOMEN: Soft, NTND. No HSM or tenderness. Abd aorta not 
+enlarged by palpation. No abdominal bruits.  
+EXTREMITIES: No c/c/e. 
+
+ 
+ 
+
+###RESPONSE: PHYSICAL EXAMINATION {Physical examination procedure}, VS {Vital signs finding}, RA {Breathing room air}, GENERAL {General examination of patient}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, NC {Normal head}, Sclera anicteric {White sclera}, PERRL {Pupils equal and reacting to light}, EOMI {Normal ocular motility}, Conjunctiva were 
+pink {Conjunctiva normal}, pallor {Pallor of skin of face}, cyanosis {Cyanosis}, oral mucosa {Oral mucous membrane structure}, xanthelasma {Xanthelasma}, NECK {Physical examination procedure}, Supple {Normal movement of neck}, JVP {Finding of jugular venous pressure}, CARDIAC {Cardiovascular physical examination}, PMI {Finding of apex beat}, intercostal space {Structure of intercostal space}, midclavicular 
+line {Midclavicular line}, RR {Finding of rate of respiration}, normal S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, No m/r/g {Heart sounds normal}, thrills {Thrill}, lifts {Precordial heave}, No S3 {Third heart sound, S>3<, inaudible}, S4 {Fourth heart sound, S>4<, inaudible}, LUNGS {Examination of respiratory system}, chest wall deformities {Deformity of chest wall}, scoliosis {Scoliosis deformity of spine}, kyphosis {Kyphosis deformity of spine}, Resp {Examination of respiratory system}, accessory muscle {Accessory skeletal muscle}, CTAB {Normal breath sounds}, crackles {Respiratory crackles}, wheezes {Wheezing}, rhonchi {Wheeze - rhonchi}, ABDOMEN {Examination of abdomen}, Soft {Abdomen soft}, ND {Swollen abdomen}, HSM {Hepatosplenomegaly}, tenderness {Tenderness}, Abd {Examination of abdomen}, enlarged {Enlargement}, palpation {Palpation}, abdominal bruits {Abdominal bruit}, EXTREMITIES {Examination of limb}"
+"###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
+___ 12:15AM BLOOD WBC-11.3* RBC-4.98 Hgb-13.8* Hct-41.3 
+MCV-83 MCH-27.8 MCHC-33.5 RDW-14.6 Plt ___
+___ 12:15AM BLOOD Neuts-64.1 ___ Monos-3.6 
+Eos-12.7* Baso-0.7
+___ 12:15AM BLOOD ___ PTT-38.8* ___
+___ 12:15AM BLOOD Glucose-146* UreaN-27* Creat-1.4* Na-138 
+K-5.1 Cl-105 HCO3-22 AnGap-16
+___ 12:15AM BLOOD CK(CPK)-98
+___ 12:15AM BLOOD CK-MB-5
+___ 12:15AM BLOOD cTropnT-0.01
+___ 06:00AM BLOOD cTropnT-<0.01
+___ 12:15AM BLOOD Calcium-9.0 Phos-3.1 Mg-2.3
+
+Discharge LAbs: 
+
+Pertinent 
+###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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, Plt {Platelet count}, Neuts {Neutrophil count}, Monos {Monocyte count}, Eos {Eosinophil count}, Baso {Basophil count}, PTT {Partial thromboplastin time, activated}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, CK(CPK {Creatine kinase measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total 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: Studies:
+CT Abd/Pelvis ___
+IMPRESSION: 
+1. Small retroperitoneal hematoma with hemorrhage extending into 
+a right inguinal hernia sac and alongside the right spermatic 
+cord.
+2. Small hiatal hernia.
+3. Calcifications within the pancreas, likely sequela of chronic 
+pancreatitis.
+
+Echo ___:
+The left atrium is normal in size. The estimated right atrial 
+pressure is ___ mmHg. There is mild symmetric left ventricular 
+hypertrophy with normal cavity size and regional/global systolic 
+function (LVEF>55%). Right ventricular chamber size and free 
+wall motion are normal. The diameters of aorta at the sinus, 
+ascending and arch levels are normal. The aortic valve leaflets 
+(3) appear structurally normal with good leaflet excursion and 
+no aortic stenosis or aortic regurgitation. The mitral valve 
+leaflets are mildly thickened. Trivial mitral regurgitation is 
+seen. There is borderline pulmonary artery systolic 
+hypertension. There is no pericardial effusion. 
+
+IMPRESSION: Normal biventricular size and global systolic 
+function. Mild to moderate tricuspid regurgitation.
+
+Compared with the prior study (images reviewed) of ___, 
+the basal inferior wall has normal function on the current 
+study. 
+
+L Heart Cath: 
+Report pending, please see finalized report when available
+ 
+
+###RESPONSE: CT Abd/Pelvis {Computed tomography of abdomen and pelvis}, retroperitoneal hematoma {Retroperitoneal hematoma}, hemorrhage {Hemorrhage}, right inguinal hernia {Right inguinal hernia}, sac {Hernia sac}, right spermatic 
+cord {Structure of right spermatic cord}, hiatal hernia {Hiatal hernia}, Calcifications {Pathologic calcification, calcified structure}, pancreas {Pancreatic structure}, chronic 
+pancreatitis {Chronic pancreatitis}, left atrium {Left atrial structure}, normal in size {Normal size}, right atrial {Right atrial structure}, mild symmetric left ventricular 
+hypertrophy {Mild left ventricular hypertrophy}, normal cavity size {Normal size}, regional/global systolic 
+function {Normal left ventricular systolic function and wall motion}, Right ventricular chamber {Right cardiac ventricular structure}, size {Normal size}, wall motion are normal {Normal ventricular wall motion}, aorta at the sinus {Structure of sinus of Valsalva}, ascending {Ascending aorta structure}, arch {Aortic arch structure}, normal {Normal size}, aortic valve leaflets {Structure of cardiac valve leaflet}, structurally normal {Aortic valve normal}, aortic stenosis {Aortic valve stenosis}, aortic regurgitation {Aortic valve regurgitation}, mitral valve 
+leaflets are mildly thickened {Thickened mitral leaflet}, Trivial mitral regurgitation {Mild mitral valve regurgitation}, pulmonary artery systolic 
+hypertension {Pulmonary hypertensive arterial disease}, pericardial effusion {Pericardial effusion}, biventricular {Cardiac ventricular structure}, size {Normal size}, systolic 
+function {Normal left ventricular systolic function and wall motion}, Mild {Mild tricuspid valve regurgitation}, moderate tricuspid regurgitation {Moderate tricuspid valve regurgitation}, inferior wall {Structure of myocardium of diaphragmatic region}, normal function {Normal cardiac function}, L Heart Cath {Catheterization of left heart}"
+"###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:
+___ w/ hx of CAD s/p CABG in ___ transferred from OSH for chest 
+pain and shortness of breath. 
+
+Active Issues:
+#Chest pain: Negative trops but found to have V5-V6 depression 
+on subsequent EKG, concerning for new ischemia. He was diuresed 
+given his shortness of breath with improvement and taken to cath 
+lab where angiogram showed occluded SVG to OM, appearing chronic 
+in nature. Medically optimized and continued on nitro gtt post 
+procedure for blood pressure control as symptoms had resolved 
+prior to cath. Echo showed Normal biventricular size and global 
+systolic function. Mild to moderate tricuspid regurgitation.
+
+#Hematoma: Patient complained of groin pain at cath site, though 
+no tenderness to palpation or signs of hematoma. He was found to 
+have a small RP hematoma which was not significant in size and 
+therefore was managed expectantly. 
+
+Chronic Issues:
+# CAD. s/p 3V CABG in ___. LIMA graft to the LAD and vein 
+grafts to a circumflex marginal and the distal right coronary 
+artery. Continued on ASA, metoprolol, and  Atorvastatin.  
+
+# CKD. Patient's Cr 1.4 appears to be baseline. Cr 1.3 in ___ 
+and per PCP note, recent admission to ___ Cr was 1.4  
+
+# HTN: continued amlodipine at home dose 2.5 BID
+
+# DM type II: continued on home lantus 40mg QHS, held 70/30 
+whiel inpatient and given ISS with adequate control of blood 
+glucose.  
+
+# HLD: Atorvasatin as above was continued. 
+
+# Esosinophillia. Patient has had chronic esosinophilla. Given 
+country of origin, sent Strongyloides IgG, pending at time of 
+discharge.  
+
+# ___ disease: continued on home dose Carbidopa-Levodopa. 
+ 
+
+Transitional Issues
+#Consider transitioning to metoprolol succinate as an 
+outpatient, and uptitration as needed. Could consider carvedilol 
+for better HTN and rate control
+#Imdur uptitrated to assist with angina, cont as needed as an 
+outpatient
+___ not used given hx of hyperkalemia
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}, CABG {Coronary artery bypass grafting}, chest 
+pain {Chest pain}, shortness of breath {Dyspnea}, Chest pain {Chest pain}, trops {Troponin measurement}, V5 {Lead site V5}, V6 {Lead site V6}, EKG {Electrocardiographic procedure}, ischemia {Ischemia}, diuresed {Diuretic therapy}, shortness of breath {Dyspnea}, improvement {Patient's condition improved}, angiogram {Angiography}, occluded {Complete obstruction}, SVG {Aortocoronary artery bypass graft with saphenous vein graft}, OM {Structure of obtuse marginal branch of circumflex branch of left coronary artery}, chronic {Chronic total occlusion of coronary artery}, cath {Cardiac catheterization}, Echo {Echocardiography}, biventricular {Cardiac ventricular structure}, size {Normal size}, systolic function {Normal left ventricular systolic function and wall motion}, Mild {Mild tricuspid valve regurgitation}, moderate tricuspid regurgitation {Moderate tricuspid valve regurgitation}, Hematoma {Hematoma}, groin pain {Inguinal pain}, cath site {Vascular catheter insertion site}, tenderness to palpation {Abdominal tenderness}, signs {Sign}, hematoma {Hematoma}, RP hematoma {Retroperitoneal hematoma}, CAD {Coronary arteriosclerosis}, 3V CABG {Coronary artery bypass grafts x 3}, LIMA graft {Coronary artery bypass grafting using free left internal thoracic artery graft}, LAD {Structure of anterior descending branch of left coronary artery}, vein 
+grafts {Venous graft}, circumflex marginal {Structure of obtuse marginal branch of circumflex branch of left coronary artery}, distal right coronary 
+artery {Structure of distal portion of right coronary artery}, CKD {Chronic kidney disease}, Cr {Finding of creatinine level}, Cr {Finding of creatinine level}, Cr {Finding of creatinine level}, HTN {Hypertensive disorder, systemic arterial}, DM type II {Diabetes mellitus type 2}, HLD {Hyperlipidemia}, Esosinophillia {Eosinophil count above reference range}, esosinophilla {Eosinophil count above reference range}, HTN {Hypertensive disorder, systemic arterial}, angina {Angina}, hyperkalemia {Hyperkalemia}"
+"###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. Isosorbide Mononitrate (Extended Release) 30 mg PO DAILY 
+2. Metoprolol Tartrate 50 mg PO BID 
+3. Aspirin 81 mg PO DAILY 
+4. Docusate Sodium 200 mg PO DAILY 
+5. Senna 17.2 mg PO BID:PRN constipation 
+6. Atorvastatin 40 mg PO QPM 
+7. Amlodipine 2.5 mg PO BID 
+8. Carbidopa-Levodopa (___) 2 TAB PO TID 
+9. 70/30 25 Units Breakfast
+70/30 25 Units Dinner
+Humalog 40 Units Bedtime
+
+ 
+Discharge Medications:
+1. Amlodipine 2.5 mg PO BID 
+2. Aspirin 81 mg PO DAILY 
+3. Atorvastatin 40 mg PO QPM 
+4. Carbidopa-Levodopa (___) 2 TAB PO TID 
+5. Docusate Sodium 200 mg PO DAILY 
+6. 70/30 25 Units Breakfast
+70/30 25 Units Dinner
+Humalog 40 Units Bedtime
+7. Isosorbide Mononitrate (Extended Release) 60 mg PO DAILY 
+RX *isosorbide mononitrate 60 mg 1 tablet(s) by mouth daily Disp 
+#*30 Tablet Refills:*0
+8. Metoprolol Tartrate 50 mg PO BID 
+9. Senna 17.2 mg PO BID:PRN constipation 
+10. Nitroglycerin SL 0.4 mg SL Q5MIN:PRN chest pain 
+RX *nitroglycerin 0.4 mg 1 tablet(s) sublingually q5min:prn Disp 
+#*100 Tablet Refills:*0
+11. Cane
+LENGTH OF NEED: 13 MONTHS
+EQUIPMENT: STANDARD CANE
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Primary Diagnosis:
+Chest pain
+Coronary ARtery Disease
+Secondary Diagnoses:
+Chronic Kidney Disease
+DIabetes Mellitus, Type 2
+Hypertension
+Hyperlipidemia
+___ Disease
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, Chest pain {Chest pain}, Coronary ARtery Disease {Coronary arteriosclerosis}, Chronic Kidney Disease {Chronic kidney disease}, DIabetes Mellitus, Type 2 {Diabetes mellitus type 2}, Hypertension {Hypertensive disorder, systemic arterial}, Hyperlipidemia {Hyperlipidemia}, 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:
+Dear Mr. ___,
+
+You were admitted for chest pain in the presence of complex 
+coronary disease.  You had changes in your EKG which was 
+concerning for new blockage and were taken for a cardiac 
+catherization.  You were found to have a chronically occluded 
+vessel from your previous coronary bypass surgery.  An echo was 
+ordered, but was not obtained to monitor your heart function and 
+should be ordered by your primary cardiologist if desired.  You 
+were having groin pain which kept you in the hospital for one 
+additional night and was controlled.
+
+We have increased your dose of imdur. You should continue your 
+remaining medications.
+
+Please follow up with your PCP/cardiologist next week. Please 
+call your PCP on the next business day to make an appointment.  
+He is aware of your hospitalization.
+
+Please be well.
+
+Your ___ Team
+ 
+
+###RESPONSE: chest pain {Chest pain}, coronary disease {Coronary arteriosclerosis}, EKG {Electrocardiographic procedure}, blockage {Coronary occlusion}, cardiac 
+catherization {Cardiac catheterization}, occluded 
+vessel {Coronary artery bypass graft occlusion}, coronary bypass surgery {Coronary artery bypass grafting}, echo {Echocardiography}, groin pain {Inguinal pain}, increased {Increasing dosage of medication}"
+"###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: 
+Aspirin
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Chest Discomfort
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: Aspirin {Allergy to aspirin}, Chest Discomfort {Chest discomfort}"
+"###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:
+EVENTS / HISTORY OF PRESENTING ILLNESS: The pt is a ___ F with 
+PMH of Asthma admitted with complains of sub-scapular chest pain 
+radiating to the back for the past week. Pain has been constant 
+in nature, with cramping. No numbness/tingling in the arms and 
+legs. Pt Pt reports her symptoms began two weeks ago after 
+breaking into fever, did not take temp., and night sweats. She 
+then developed diffuse muscles aches greatest over her breasts, 
+chest wall and upper extremities b/l. Denies changes with 
+position. States it is mildly worse with deep inspiration. She 
+does report increased physical activity over the past two weeks 
+with ___ cleaning. Denies pain at rest. She denies recent 
+sick contacts. No travel history. Reports night sweats for past 
+two weeks. The pt does relate significant EtOH history, drinking 
+approx 1 glass of wine every other day, then on the weeks she 
+drinks one bottle on ___, then ___ gladsses on ___. 
+Reports remote cocaine history, clean for past ___ years. Pt 
+reports history of asthma, no change is symptoms and no increase 
+in albuterol usage, reports no change of symptoms with exertion, 
+does have occassional dyspnea.  
+.  
+In the ED, Vitals T 98.4, HR 72, RR 18, BP 121/98, Sat 95% RA. 
+She was given aspirin 325mg daily and motrin 600mg once. On 
+arrival to the floor the patient is resting comfortably and in 
+no acute distress.  
+.
+
+.  
+.  
+On review of systems, she denies any prior history of stroke, 
+TIA, deep venous thrombosis, pulmonary embolism, bleeding at the 
+time of surgery, joint pains, cough, hemoptysis, black stools or 
+red stools. She denies exertional buttock or calf pain. All of 
+the other review of systems were negative.  
+.  
+Cardiac review of systems is notable for absence of chest pain, 
+dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, 
+ankle edema, palpitations, syncope or presyncope. 
+ 
+
+###RESPONSE: Asthma {Asthma}, chest pain {Chest pain}, radiating {Radiating pain}, Pain {Pain}, constant {Constant pain}, cramping {Cramping pain}, numbness/tingling {Numbness and tingling sensation of skin}, arms {Upper limb structure}, legs {Lower limb structure}, fever {Fever}, temp {Body temperature finding}, night sweats {Night sweats}, diffuse {Diffuse pain}, muscles aches {Muscle pain}, breasts {Breast structure}, chest wall {Chest wall structure}, upper extremities {Upper limb structure}, position {Pain provoked by movement}, worse {Increased pain}, increased physical activity {Increased physical activity}, pain at rest {Pain provoked by rest}, travel {Travel abroad}, night sweats {Night sweats}, EtOH {Alcohol abuse}, drinking {Current drinker of alcohol}, drinks {Current drinker of alcohol}, cocaine {Cocaine abuse}, asthma {Asthma}, exertion {Dyspnea on exertion}, dyspnea {Dyspnea}, Vitals {Vital signs finding}, aspirin {Administration of aspirin}, comfortably {Breathing easily}, no acute {No abnormality detected}, distress {Distress}, review of systems {Review of systems}, stroke {Cerebrovascular accident}, TIA {Transient ischemic attack}, deep venous thrombosis {Deep venous thrombosis}, pulmonary embolism {Pulmonary embolism}, bleeding {Bleeding}, surgery {Surgical procedure}, joint pains {Joint pain}, cough {Cough}, hemoptysis {Hemoptysis}, black stools {Dark stools}, red stools {Red stools}, exertional {Pain provoked by exertion}, buttock {Pain in buttock}, calf pain {Pain in calf}, review of systems {Review of systems}, negative {No pathologic diagnosis}, Cardiac review of systems {Cardiovascular physical examination}, chest pain {Chest pain}, dyspnea on exertion {Dyspnea on exertion}, paroxysmal nocturnal dyspnea {Paroxysmal nocturnal dyspnea}, orthopnea {Orthopnea}, ankle edema {Ankle edema}, palpitations {Palpitations}, syncope {Syncope}, presyncope {Near 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:
+HTN  
+Obesity  
+Endometriosis  
+Asthma  
+Stress Incontinence  
+Cardiac Risk Factors: Hypertension  
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, Obesity {Obesity}, Endometriosis {Endometriosis}, Asthma {Asthma}, Stress Incontinence {Genuine stress incontinence}, Cardiac Risk Factors {Assessment for risk of cardiovascular disease}, Hypertension {Hypertensive disorder, systemic arterial}"
+"###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:
+There is a family history of father MI age ___.  
+
+ 
+
+###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:
+VS - T 98.8, HR 76, BP 134/62, O2 98%2L  
+Gen: WDWN middle aged female in NAD. Oriented x3. Mood, affect 
+appropriate.  
+HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were 
+pink, no pallor or cyanosis of the oral mucosa. No xanthalesma.  
+
+Neck: Supple with flat JVP.  
+CV: PMI located in ___ intercostal space, midclavicular line. 
+RR, normal S1, S2. No m/r/g. No thrills, lifts. No S3 or S4.  
+Chest: No chest wall deformities, scoliosis or kyphosis. Resp 
+were unlabored, no accessory muscle use. CTAB, no crackles, 
+wheezes or rhonchi.  
+TTP over left breast, substernal chest tenderness to palp, also 
+tenderness over shoulders and triceps  
+Abd: Soft, NT/ND. No HSM or tenderness. Abd aorta not enlarged 
+by palpation. No abdominial bruits.  
+Ext: No c/c/e. No femoral bruits.  
+Skin: No stasis dermatitis, ulcers, scars, or xanthomas.  
+.  
+Pulses:  
+Right: Carotid 2+ Femoral 2+ DP 2+ ___ 2+  
+Left: Carotid 2+ Femoral 2+ DP 2+ ___ 2+  
+
+ 
+
+###RESPONSE: VS {Vital signs finding}, HR {Finding of heart rate}, BP {Blood pressure finding}, Gen {General examination of patient}, WDWN {Well nourished}, middle aged {Middle-age}, NAD {No abnormality detected}, Oriented x3 {Oriented to person, time and place}, Mood {Level of mood - normal}, affect {Mood finding}, HEENT {Physical examination procedure}, NC {Normal head}, Sclera anicteric {White sclera}, PERRL {Pupils equal and reacting to light}, EOMI {Normal ocular motility}, Conjunctiva were 
+pink {Conjunctiva normal}, pallor {Pallor of skin of face}, cyanosis {Cyanosis}, oral mucosa {Oral mucous membrane structure}, xanthalesma {Xanthelasma}, Neck {Physical examination procedure}, Supple {Normal movement of neck}, JVP {Finding of jugular venous pressure}, CV {Cardiovascular physical examination}, PMI {Finding of apex beat}, intercostal space {Structure of intercostal space}, midclavicular line {Midclavicular line}, RR {Finding of rate of respiration}, normal S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, No m/r/g {Heart sounds normal}, thrills {Thrill}, lifts {Precordial heave}, No S3 {Third heart sound, S>3<, inaudible}, Chest {Examination of respiratory system}, chest wall deformities {Deformity of chest wall}, scoliosis {Scoliosis deformity of spine}, kyphosis {Kyphosis deformity of spine}, Resp {Examination of respiratory system}, accessory muscle {Accessory skeletal muscle}, CTAB {Normal breath sounds}, crackles {Respiratory crackles}, wheezes {Wheezing}, rhonchi {Wheeze - rhonchi}, TTP {Tenderness}, left breast {Left breast structure}, substernal {Structure of substernal region}, tenderness {Tenderness}, palp {Palpation of abdomen}, tenderness {Tenderness}, shoulders {Shoulder region structure}, triceps {Triceps brachii muscle structure}, Abd {Examination of abdomen}, Soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, HSM {Hepatosplenomegaly}, tenderness {Tenderness}, Abd {Examination of abdomen}, enlarged {Enlargement}, palpation {Palpation}, abdominial bruits {Abdominal bruit}, Ext {Examination of limb}, No c/c/e {No abnormality detected}, femoral bruits {Femoral bruit}, Skin {Examination of skin}, stasis dermatitis {Stasis dermatitis}, ulcers {Ulcer}, scars {Scar}, xanthomas {Xanthomatosis}, Carotid 2 {Normal carotid arterial pulse}, 2+ DP {Dorsalis pulse present}, Carotid 2 {Normal carotid arterial pulse}, 2+ DP {Dorsalis pulse present}"
+"###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:
+___ 03:20PM   WBC-4.1# RBC-3.98* HGB-11.6* HCT-34.8* MCV-87 
+MCH-29.2 MCHC-33.5 RDW-14.0
+___ 03:20PM   NEUTS-19* BANDS-0 LYMPHS-66* MONOS-10 EOS-4 
+BASOS-0 ATYPS-1* ___ MYELOS-0
+___ 03:20PM   PLT SMR-NORMAL PLT COUNT-309
+___ 03:20PM   ___ PTT-26.1 ___
+___ 03:20PM   ASA-NEG ETHANOL-NEG ACETMNPHN-NEG 
+bnzodzpn-NEG barbitrt-NEG tricyclic-NEG
+___ 03:20PM   TSH-0.90
+___ 03:20PM   ALT(SGPT)-33 AST(SGOT)-46* CK(CPK)-936* ALK 
+PHOS-38* TOT BILI-0.2
+___ 03:20PM BLOOD ALT-33 AST-46* CK(CPK)-936* AlkPhos-38* 
+TotBili-0.2
+___ 03:20PM BLOOD CK-MB-9 cTropnT-0.03*
+___ 09:32PM BLOOD CK(CPK)-777*
+___ 09:32PM BLOOD CK-MB-7 cTropnT-0.02*
+___ 06:00AM BLOOD CK-MB-5 cTropnT-0.01
+___ 06:00AM BLOOD CK(CPK)-609*
+.
+CXR ___
+FINDINGS: Lung volumes are diminished. No consolidation or 
+superimposed edema is evident. Mild tortuosity of the thoracic 
+aorta is again demonstrated. The cardiac silhouette is within 
+normal limits for size accounting for patient and technical 
+factors. No effusion or pneumothorax is noted. The visualized 
+osseous structures are unremarkable.
+
+IMPRESSION: Low lung volumes, but otherwise, no superimposed 
+acute process.
+.
+EKG demonstrated NSR, Nl axis and intervals, low voltage in AVF, 
+TWF V5 and V6 with no significant change compared with prior 
+dated ___.  
+
+ 
+
+###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}, 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}, BASOS {Basophil count}, PLT {Platelet count}, NORMAL {No abnormality detected}, PLT COUNT {Platelet count}, PTT {Partial thromboplastin time, activated}, ASA {Aspirin specific immunoglobulin E antibody measurement}, NEG {No abnormality detected}, ETHANOL {Blood ethanol measurement}, NEG {No abnormality detected}, ACETMNPHN {Acetaminophen measurement}, NEG {No abnormality detected}, bnzodzpn {Benzodiazepine measurement}, NEG {No abnormality detected}, barbitrt {Barbiturates measurement}, NEG {No abnormality detected}, tricyclic {Tricyclic antidepressant measurement}, NEG {No abnormality detected}, TSH {Thyroid stimulating hormone measurement}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, CK(CPK {Creatine kinase measurement}, ALK 
+PHOS {Alkaline phosphatase measurement}, TOT BILI {Bilirubin, total measurement}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, CK(CPK {Creatine kinase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, CK(CPK {Creatine kinase measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, CK(CPK {Creatine kinase measurement}, CXR {Plain chest X-ray}, Lung volumes {Finding of respiratory volume}, consolidation {Consolidation}, edema {Edema}, Mild {Symptom mild}, tortuosity {Tortuosity}, thoracic 
+aorta {Thoracic aorta structure}, cardiac {Heart structure}, normal {Normal size}, size {Normal size}, effusion {Pleural effusion}, pneumothorax {Pneumothorax}, osseous structures {Bone structure}, unremarkable {Imaging result normal}, lung volumes {Finding of respiratory volume}, EKG {Electrocardiographic procedure}, NSR {Normal sinus rhythm}, axis {Electrocardiographic axis finding}, intervals {Finding of electrocardiogram waveform}, AVF {aVF}, TWF {Flattened T wave}, no significant {No abnormality detected}"
+"###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:
+Patient is a ___ F with PMH of Asthma admitted with complains 
+of diffuse muscle aches including sub-scapular chest pain 
+radiating to the back for the past week, found to have elevated 
+CK to 936  
+.  
+#. Diffuse Musculoskeletal Pain - Pt presented with complaints 
+of diffuse musculoskeletal pain, worse with movement and found 
+to have elevated CK to 900s. In reviewing labs pt with 
+chronically elevated CK of unclear etiology. Etiology may be 
+recent overuse at home in the setting of deconditioning vs viral 
+myositis. Pt had recent fever/chills prior to onset of muscle 
+pain, could be consistent with infectious etiology. Pt may also 
+have myositis related to EtOH use. She ruled out for myocardial 
+ischemia with three sets of negative cardiac enzymes. She was 
+discharged home with close outpatient follow up for further 
+management. 
+.  
+#. Rhythm - NSR  
+.  
+#. Asthma - pt denies symptoms of dyspnea currently, no wheezing 
+on exam. Continued on outpatient regimen of advair and albuterol 
+ 
+.  
+#. HTN - continue HCTZ  
+.  
+ 
+
+###RESPONSE: Asthma {Asthma}, diffuse {Diffuse pain}, muscle aches {Muscle pain}, chest pain {Chest pain}, radiating {Radiating pain}, elevated 
+CK {Creatine kinase level above reference range}, Diffuse {Diffuse pain}, Musculoskeletal Pain {Musculoskeletal pain}, diffuse {Diffuse pain}, musculoskeletal pain {Musculoskeletal pain}, worse {Increased pain}, elevated CK {Creatine kinase level above reference range}, labs {Laboratory test}, elevated CK {Creatine kinase level above reference range}, viral 
+myositis {Viral myositis}, fever {Fever}, chills {Chill}, muscle 
+pain {Muscle pain}, infectious {Infectious disease}, myositis {Myositis}, EtOH use {Finding of alcohol intake}, myocardial 
+ischemia {Myocardial ischemia}, negative cardiac enzymes {Cardiac enzymes within reference range}, outpatient follow up {Follow-up arranged}, Rhythm {Normal sinus rhythm}, NSR {Normal sinus rhythm}, Asthma {Asthma}, dyspnea {Dyspnea}, wheezing {Wheezing}, exam {Physical examination procedure}, regimen {Therapeutic regimen}, HTN {Hypertensive disorder, systemic arterial}"
+"###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:
+CURRENT MEDICATIONS:  
+Albuterol Sulfate - 0.083 % (0.83 mg/mL) Solution for  
+Nebulization - 1 vial po every six (6) hours as needed for SOB  
+Albuterol Sulfate - 90 mcg HFA Aerosol Inhaler - 2 puffs po 
+every  
+six (6) hours as needed for SOB  
+Citalopram - 40 mg Tablet - 1 and ___ Tablet(s) by mouth once a  
+
+day  
+Fluticasone-Salmeterol [Advair Diskus] - 500 mcg-50 mcg/Dose 
+Disk  
+with Device - one puff disk twice a day  
+Hydrochlorothiazide - 25 mg Tablet - 1 (One) Tablet(s) by mouth  
+
+once a day  
+Montelukast [Singulair] - 10 mg Tablet - 1 Tablet(s) by mouth  
+once a day  
+Medications - OTC  
+Omeprazole Magnesium [Prilosec OTC] - 20 mg Tablet, Delayed  
+Release (E.C.) - 1 Tablet(s) by mouth once a day  
+ 
+Discharge Medications:
+1. Albuterol Sulfate 2.5 mg/3 mL Solution for Nebulization Sig: 
+One (1)  Inhalation Q6H (every 6 hours) as needed for 
+wheeze/SOB.  
+2. Albuterol 90 mcg/Actuation Aerosol Sig: One (1)  Inhalation 
+every ___ hours as needed for shortness of breath or wheezing.  
+3. Advair Diskus 500-50 mcg/Dose Disk with Device Sig: One (1)  
+Inhalation once a day.  
+4. Citalopram 40 mg Tablet Sig: 1.5 Tablets PO once a day.  
+5. Hydrochlorothiazide 12.5 mg Capsule Sig: One (1) Capsule PO 
+DAILY (Daily).  
+6. Montelukast 10 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+7. Omeprazole 20 mg Tablet, Delayed Release (E.C.) Sig: One (1) 
+Tablet, Delayed Release (E.C.) PO once a day.  
+
+ 
+
+###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:
+1. Myositis
+
+ 
+Discharge Condition:
+Afebrile, VSS, ambulating without assistance
+
+ 
+
+###RESPONSE: Myositis {Myositis}, Afebrile {Fever}, VSS {Vital signs finding}, ambulating without assistance {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 with diffuse muscle pain. You have undergone 
+bloodwork that has demonstrated no evidence of damage to your 
+heart as a cause of this pain. Your bloodwork did show an 
+elevation of a muscle enyme called creatine kinase. You will 
+follow up with Dr. ___ as an outpatient for continued workup.
+.
+Your medications have not changed. Please continue to take your 
+medications as directed. 
+.
+Please return or call your primary care physician if you develop 
+worsening musculoskeletal pain, or if you develop chest pain or 
+shortness of breath. 
+ 
+
+###RESPONSE: diffuse {Diffuse pain}, muscle pain {Muscle pain}, no evidence {No abnormality detected}, damage {Damage}, heart {Heart structure}, pain {Pain}, elevation {Measurement finding above reference range}, muscle {Skeletal and/or smooth muscle structure}, called {Informing doctor}, creatine {Creatine measurement}, follow up {Follow-up arranged}, workup {Evaluation procedure}, changed {Change of medication}, primary care {Primary care management}, worsening {Increased pain}, musculoskeletal pain {Musculoskeletal pain}, chest pain {Chest pain}, shortness of breath {Dyspnea}"
+"###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: 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: 
+Ativan / Amoxicillin / Bactrim / Codeine / ibuprofen / Lamictal 
+/ naproxen / Tetanus Toxoid,Fluid / Cephalexin / Peanuts / Sulfa 
+(Sulfonamide Antibiotics) / golytely / citrate of magnesia / 
+Lithium
+ 
+Attending: ___.
+ 
+Chief Complaint:
+diverticulitis
+ 
+Major Surgical or Invasive Procedure:
+none
+
+ 
+
+###RESPONSE: Amoxicillin {Allergy to amoxicillin}, Bactrim {Allergy to sulfamethoxazole and/or trimethoprim}, Codeine {Allergy to codeine}, ibuprofen {Allergy to ibuprofen}, Tetanus {Tetanus}, Sulfonamide Antibiotics {Allergy to sulfonamide antibiotic}, diverticulitis {Diverticulitis}"
+"###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 multiple medical problems, including ESRD ___ lithium 
+toxicity on PD , admitted to ___ on ___ with abdominal 
+pain and fever to 102 at home. She had a prior admission on 
+___ with similar symptoms; at that time the workup was 
+negative and she was give levofloxacin x5 days for presumptive 
+pneumonia. On representation to ___, her WBC was elevated 
+to 16.5. Peritoneal fluid was sent and demosntrated ___ WBC with 
+no organisms on gram stain. A CT scan was obtained with 
+demonstrated diverticulitis and likely contained perforation 
+with concern for pelvic abscess. She was started on levaquin and 
+flagyl and recommended for percutanous drainage. However given 
+her extensive past surgical history here at ___, the family 
+requested transfer to ___ for further work up and 
+management.
+
+ROS: Endorses 20lb wt loss over the past few months
+ 
+
+###RESPONSE: problems {Problem}, ESRD {End-stage renal disease}, lithium 
+toxicity {Lithium poisoning}, abdominal 
+pain {Abdominal pain}, fever {Fever}, workup {Evaluation procedure}, pneumonia {Pneumonia}, gram stain {Gram stain method}, CT scan {Computed tomography}, diverticulitis {Diverticulitis}, perforation {Perforation}, pelvic abscess {Pelvic abscess}, drainage {Drainage procedure}, 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: Past Medical History:
+PMH: tracheostomy ___ for prolonged respiratory failure, 
+hyponatremic seizure following GoLytely prep ___, ESRD for 
+lithium toxicity, on HD, bipolar, GERD, HTN, breast cancer, 
+diverticulosis 
+
+PSH: parathyroidectomy with reimplantation in left arm, left 
+foot surgery in ___, right knee surgery in ___, lumpectomy for 
+breast cancer (DCIS), status post radiation, repeat mammograms 
+were all negative, history of tonsillectomy in the past. 
+
+ 
+
+###RESPONSE: tracheostomy {Exteriorization of trachea}, respiratory failure {Respiratory failure}, seizure {Seizure}, ESRD {End-stage renal disease}, lithium toxicity {Lithium poisoning}, HD {Hemodialysis}, GERD {Gastroesophageal reflux disease}, HTN {Hypertensive disorder, systemic arterial}, breast cancer {Malignant neoplasm of breast}, diverticulosis {Diverticulosis of large intestine}, parathyroidectomy {Parathyroidectomy}, reimplantation {Reimplantation}, left arm {Left upper arm structure}, left 
+foot {Structure of left foot}, surgery {Surgical procedure}, right knee {Structure of right knee region}, surgery {Surgical procedure}, lumpectomy {Excision of mass}, breast cancer {Malignant neoplasm of breast}, radiation {Radiation oncology AND/OR radiotherapy}, mammograms {Mammography}, tonsillectomy {Tonsillectomy}"
+"###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 with ovarian CA
+Father with CAD
+
+ 
+
+###RESPONSE: ovarian {Malignant tumor of ovary}, CAD {Coronary arteriosclerosis}"
+"###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:
+VS: 99.1  73  117/64  18  100%ra
+PE:
+ Gen: A&Ox3, NAD, pleasant and comfortable appearing
+ CV: RRR
+ Pulm: CTAB, easy WOB
+ Abd: abd soft, mildly distended. PD catheter site in RLQ. 
+Mildly
+TTP RUQ/LUQ/LLQ, worst in LLQ.
+ Ext: WWP, trace periph edema bilat, L > R
+ 
+
+###RESPONSE: VS {Vital signs finding}, Gen {General examination of patient}, Ox3 {Oriented to person, time and place}, NAD {No abnormality detected}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, Pulm {Examination of respiratory system}, CTAB {Normal breath sounds}, WOB {Breathing easily}, Abd {Examination of abdomen}, abd soft {Abdomen soft}, distended {Swollen abdomen}, RLQ {Right lower quadrant pain}, TTP {Thrombotic thrombocytopenic purpura}, RUQ {Structure of right upper quadrant of abdomen}, LUQ {Structure of left upper quadrant of abdomen}, LLQ {Structure of left lower quadrant of abdomen}, LLQ {Structure of left lower quadrant of abdomen}, Ext {Examination of limb}, WWP {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:
+___ 09:15PM   GLUCOSE-87 UREA N-52* CREAT-10.1*# 
+SODIUM-132* POTASSIUM-4.2 CHLORIDE-93* TOTAL CO2-29 ANION GAP-14
+___ 09:15PM   ALT(SGPT)-17 AST(SGOT)-15 ALK PHOS-311* TOT 
+BILI-0.2
+___ 09:15PM   ALBUMIN-2.5* CALCIUM-7.6* PHOSPHATE-4.3 
+MAGNESIUM-1.6
+___ 09:15PM   LITHIUM-0.9
+___ 09:15PM   WBC-5.4 RBC-2.32*# HGB-7.4*# HCT-25.1*# 
+MCV-108* MCH-31.9 MCHC-29.4* RDW-19.1*
+___ 09:15PM   NEUTS-77.4* LYMPHS-12.7* MONOS-7.0 EOS-2.7 
+BASOS-0.1
+___ 09:15PM   ___ PTT-31.5 ___
+ 
+
+###RESPONSE: GLUCOSE {Glucose measurement, blood}, CREAT {Creatinine 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}, ALBUMIN {Albumin measurement}, CALCIUM {Blood calcium 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}, NEUTS {Neutrophil count}, LYMPHS {Lymphocyte count}, MONOS {Monocyte count}, EOS {Eosinophil count}, PTT {Partial thromboplastin time, activated}"
+"###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:
+Ms. ___ was admitted to the Transplant Surgery Service 
+under the care of Dr. ___ on ___. She 
+was transferred from ___ in ___ with 
+a colonic microperforation in the setting of diverticulitis. 
+This was of particular concern given her concurrent use of 
+peritoneal dialysis for renal replacement therapy for her long 
+standing history of ESRD. Upon admission, physical exam and 
+vital signs were un concerning for systemic infection. She was 
+afebrile, did not have evidence of cellulitis around her PD 
+catheter exit site, and did not have leukocytosis.
+
+Levofloxacin and metronidazole were administered to treat Ms. 
+___ diverticulitis. She was kept NPO. Abdominal pain 
+resolved. Nephrology followed and managed the peritoneal 
+dialysis adding heparin for fibrin in dialysate. Diet was 
+resumed and well tolerated. 
+
+Throughout the course of her admission, Ms. ___ home 
+medications to treat her psychiatric and medical co morbidities 
+were continued. Vital signs remained stable, she was pain free 
+and was oob to chair with assist. 
+
+She will f/u with her local nephrologist. Vitamin D and 
+calcitriol were started and Cinacalcet stopped. Atenolol and 
+Nifedipine were also stopped for SBPs in ___. Heart rates ranged 
+between ___. She was instructed to f/u with her 
+nephrologist. 
+ 
+
+###RESPONSE: colonic microperforation in the setting of diverticulitis {Diverticulitis of colon with perforation}, peritoneal dialysis {Peritoneal dialysis}, renal replacement therapy {Continuous renal replacement therapy}, ESRD {End-stage renal disease}, vital signs {Vital signs finding}, systemic infection {Sepsis}, cellulitis {Cellulitis}, catheter exit site {Catheter exit site}, leukocytosis {Leukocytosis}, diverticulitis {Diverticulitis}, NPO {Nil by mouth}, Abdominal pain {Abdominal pain}, peritoneal 
+dialysis {Peritoneal dialysis}, Diet {Dietary finding}, medications {Administration of drug or medicament}, psychiatric {Psychiatric symptom}, Vital signs {Vital signs finding}, stable {Normal vital signs}, Heart rates {Finding of heart rate}"
+"###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:
+fluoxetine 20 qam, lithium 150 qam 150qpm prn, goal level 0.7. 
+antenerol 25 qpm. zyprexa 10mg qpm, ___ prn for agitation, 
+dialyvite 800 qam, iron 65mg qd, prilosec 20mg BID, topiramate 
+25mg qpm, colace 100mg BID, procrit 40,000 ___, sensipar 30mg 
+qd, senna prn, renvela TID with meals
+ 
+Discharge Medications:
+1. Docusate Sodium 100 mg PO BID 
+2. Fluoxetine 20 mg PO DAILY 
+3. Lithium Carbonate 150 mg PO DAILY 
+4. OLANZapine 10 mg PO DAILY 
+additional doses PRN agitation 
+5. Omeprazole 20 mg PO BID 
+6. Calcitriol 0.25 mcg PO DAILY 
+RX *calcitriol 0.25 mcg 1 capsule(s) by mouth once a day Disp 
+#*30 Capsule Refills:*2
+7. Heparin Flush (1000 units/mL) 1000 UNIT DWELL QID 
+each 1 liter dwell IP for fibrin  
+8. Lactulose 30 mL PO BID 
+RX *lactulose 20 gram/30 mL 30 ml by mouth twice a day Disp #*1 
+Bottle Refills:*2
+9. Levofloxacin 250 mg PO Q24H Duration: 8 Days 
+RX *levofloxacin [Levaquin] 250 mg 1 tablet(s) by mouth once a 
+day Disp #*8 Tablet Refills:*0
+10. Lorazepam 1 mg PO HS:PRN insomnia 
+11. MetRONIDAZOLE (FLagyl) 500 mg PO Q8H 
+RX *metronidazole [Flagyl] 500 mg 1 tablet(s) by mouth every 
+eight (8) hours Disp #*24 Tablet Refills:*0
+12. Miconazole Powder 2% 1 Appl TP BID 
+13. Tucks Hemorrhoidal Oint 1% 1 Appl PR PRN hemorrhoidal pain 
+14. Vitamin D 50,000 UNIT PO 1X/WEEK (___) 
+RX *ergocalciferol (vitamin D2) [Vitamin D2] 50,000 unit 1 
+capsule(s) by mouth once a week Disp #*12 Capsule Refills:*0
+15. Epoetin Alfa 40,000 units SC Q ___ 
+16. Senna 1 TAB PO BID:PRN constipation 
+17. OLANZapine 5 mg PO ASDIR 
+Please assess patient for leg tingling, restlessness and give 
+this additional dose. Will likely need while doing CAPD 
+18. Topiramate (Topamax) 25 mg PO DAILY 
+19. DIALYVITE 800 *NF* (B complex-C-folic acid-Zn) 0.8 mg Oral 
+Daily 
+20. Ferrous Sulfate 325 mg PO DAILY 
+
+ 
+
+###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:
+diverticulitis
+colonic microperforation
+ESRD
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+
+ 
+
+###RESPONSE: diverticulitis {Diverticulitis}, colonic {Colon structure}, ESRD {End-stage renal disease}, 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:
+Please call Dr. ___ office ___ if you have 
+any of the following: temperature of 101 or greater, chills, 
+increased abdominal pain, nausea, vomiting, peritoneal effluent 
+appears cloudy or bloody, or has a foul smell, bloody stool or 
+diarrhea
+-continue with peritoneal dialysis
+-finish antibiotics as prescribed
+-atenolol and nifedipine stopped for low blood pressure
+ 
+
+###RESPONSE: chills {Chill}, abdominal pain {Abdominal pain}, nausea, vomiting {Nausea and vomiting}, peritoneal effluent 
+appears cloudy or bloody {Peritoneal fluid abnormal}, bloody stool {Hematochezia}, diarrhea {Diarrhea}, peritoneal dialysis {Peritoneal dialysis}, antibiotics {Antibiotic therapy}, low blood pressure {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: 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: 
+vancomycin in D5W
+ 
+Attending: ___.
+ 
+Chief Complaint:
+lightheadedness
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: lightheadedness {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: History of Present Illness:
+Mr. ___ is a ___ male with the past medical
+history of COPD on 2L NC, CAD s/p CABG, DM, afib s/p ablation,
+who presents with lightheadedness.
+
+Per patient, he notes that he ""felt like I was having a stroke"".
+He said that just prior to presentation he got up out of the car
+and felt like he was going to fall down and that the ground was
+rushing up at him.  He sat back down in the car and the feeling
+subsided in ___ minutes.  He denies a spinning sensation or a
+disequilibrium type feeling.  No chest pain, SOB, palpitations,
+f/c/s.  No numbness, tingling, LOS or weakness anywhere.
+
+He reports he has similar episodes ___, in which he
+experiences symptoms like he is being ""electrocuted.""  He calls
+these mini-strokes, though he does not have a h/o CVA.  He has
+not seen a neurologist for these given infrequency; he has
+discussed this with his PCP.  
+
+Currently he feels well without complaints or concerns.  No
+further episodes.  Denies current dizziness, headache, fevers,
+cough, chest pain, abd pain, N/V/D, or double vision.  He checks
+his fingersticks weekly and they have been running between
+120-140s. No recent medication changes. 
+
+In the ED, VSS.  He had a head CT which was wnl.  Labs were
+notable for Cr 2.1, elevated from his baseline, so he received 1
+liter of LR in the ED.  He also had positive orthostatics while
+there.  
+
+ 
+
+###RESPONSE: COPD {Chronic obstructive lung disease}, 2L NC {Oxygen administration by nasal cannula}, CAD {Coronary arteriosclerosis}, CABG {Coronary artery bypass grafting}, DM {Diabetes mellitus}, afib {Atrial fibrillation}, ablation {Catheter ablation of arrhythmogenic focus}, lightheadedness {Lightheadedness}, spinning sensation {Vertigo}, chest pain {Chest pain}, SOB {Dyspnea}, palpitations {Palpitations}, numbness, tingling {Numbness and tingling sensation of skin}, LOS {Loss of consciousness}, weakness {Asthenia}, CVA {Cerebrovascular accident}, feels well {Well in self}, dizziness {Dizziness}, headache {Headache}, fevers {Fever}, cough {Cough}, chest pain {Chest pain}, abd pain {Abdominal pain}, N/V/D {Nausea, vomiting and diarrhea}, double vision {Diplopia}, medication changes {Change of medication}, VSS {Vital signs finding}, head CT {Computed tomography of head}, baseline {Baseline state}, orthostatics {Orthostatic body position}"
+"###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:
+Asthma/COPD
+CAD status post CABG
+Atrial fibrillation status post ablation
+PVD status post subclavian artery stent
+Right shoulder osteoarthritis
+Cataracts
+Osteoporosis
+Chronic kidney injury
+Diabetes mellitus
+Hypertension
+Cholelithiasis
+Allergic rhinitis
+History of alcohol misuse
+History of cognitive deficits
+History of depression
+ 
+
+###RESPONSE: Asthma {Asthma}, COPD {Chronic obstructive lung disease}, CAD {Coronary arteriosclerosis}, CABG {Coronary artery bypass grafting}, Atrial fibrillation {Atrial fibrillation}, ablation {Catheter ablation of arrhythmogenic focus}, PVD {Peripheral vascular disease}, subclavian artery stent {Insertion of stent into subclavian artery}, Right shoulder {Structure of right shoulder region}, osteoarthritis {Osteoarthritis}, Cataracts {Cataract}, Osteoporosis {Osteoporosis}, Chronic kidney injury {Chronic kidney disease}, Diabetes mellitus {Diabetes mellitus}, Hypertension {Hypertensive disorder, systemic arterial}, Cholelithiasis {Calculus in biliary tract}, Allergic rhinitis {Allergic rhinitis}, alcohol misuse {Alcohol abuse}, cognitive deficits {Impaired cognition}, depression {Depressive 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: 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 with lung cancer and father with CVA.
+ 
+
+###RESPONSE: lung cancer {Malignant tumor of lung}, CVA {Cerebrovascular accident}"
+"###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 EXAM:
+VITALS: Afebrile and vital signs stable except for SBP 180s
+GENERAL: Alert and in no apparent distress
+EYES: Anicteric, pupils equally round
+ENT: Ears and nose without visible erythema, masses, or trauma. 
+Oropharynx without visible lesion, erythema or exudate, MM
+slightly dry. 
+CV: Heart regular, no murmur, no S3, no S4.  No JVD.
+RESP: Lungs clear to auscultation with good air movement
+bilaterally.  Breathing is non-labored
+GI: Abdomen soft, non-distended, non-tender to palpation.  Bowel
+sounds present.  No HSM
+GU: No suprapubic fullness or tenderness to palpation
+MSK: Neck supple, moves all extremities, strength grossly full
+and symmetric bilaterally in all limbs
+SKIN: No rashes or ulcerations noted
+NEURO: Alert, oriented, face symmetric, gaze conjugate with 
+EOMI,
+speech fluent, moves all limbs, sensation to light touch grossly
+intact throughout
+PSYCH: pleasant, appropriate affect
+
+DISCHARGE EXAM:
+VITALS: Afebrile and vital signs stable except for SBP 180s
+GENERAL: Alert and in no apparent distress
+EYES: Anicteric, pupils equally round
+ENT: Ears and nose without visible erythema, masses, or trauma. 
+Oropharynx without visible lesion, erythema or exudate, MM
+slightly dry. 
+CV: Heart regular, no murmur, no S3, no S4.  No JVD.
+RESP: Lungs clear to auscultation with good air movement
+bilaterally.  Breathing is non-labored
+GI: Abdomen soft, non-distended, non-tender to palpation.  Bowel
+sounds present.  No HSM
+GU: No suprapubic fullness or tenderness to palpation
+MSK: Neck supple, moves all extremities, strength grossly full
+and symmetric bilaterally in all limbs
+SKIN: No rashes or ulcerations noted
+NEURO: Alert, oriented, face symmetric, gaze conjugate with 
+EOMI,
+speech fluent, moves all limbs, sensation to light touch grossly
+intact throughout
+PSYCH: pleasant, appropriate affect
+ 
+
+###RESPONSE: VITALS {Vital signs finding}, vital signs {Vital signs finding}, stable {Normal vital signs}, SBP {Blood pressure finding}, GENERAL {General examination of patient}, Alert {Mentally alert}, distress {Distress}, Anicteric {White sclera}, pupils equally round {Pupil size and shape normal}, ENT {Abdominal tenderness}, Ears {Ear structure}, nose {Nasal structure}, erythema {Erythema}, masses {Mass of body structure}, trauma {Traumatic injury}, Oropharynx {Oropharyngeal structure}, lesion {Lesion}, erythema {Erythema}, exudate {Exudate}, MM
+slightly dry {Mucous membrane dryness}, CV {Cardiovascular physical examination}, Heart {Cardiovascular physical examination}, murmur {Murmur}, no S3 {Third heart sound, S>3<, inaudible}, no S4 {Fourth heart sound, S>4<, inaudible}, JVD {Jugular venous engorgement}, RESP {Examination of respiratory system}, Lungs {Examination of respiratory system}, GI {Examination of digestive system}, soft {Abdomen soft}, non-distended {Normal abdominal contour}, non-tender {Abdominal tenderness}, palpation {Palpation}, Bowel
+sounds present {Normal bowel sounds}, HSM {Hepatosplenomegaly}, GU {Examination of genitourinary system}, suprapubic {Hypogastric region structure}, tenderness {Tenderness}, palpation {Palpation}, supple {Normal movement of neck}, all extremities {All extremities}, symmetric bilaterally in all limbs {Normal bilateral upper limbs and bilateral lower limbs}, SKIN {Examination of skin}, rashes {Eruption of skin}, ulcerations {Ulcer}, NEURO {Neurological examination}, Alert {Mentally alert}, oriented {Orientated}, face symmetric {Facial symmetry}, EOMI {Normal ocular motility}, speech fluent {Does speak fluently}, moves all limbs {Does move all four limbs}, sensation to light touch grossly
+intact {Normal light touch sensation}, affect {Mood finding}, VITALS {Vital signs finding}, vital signs {Vital signs finding}, stable {Normal vital signs}, GENERAL {General examination of patient}, Alert {Mentally alert}, distress {Distress}, Anicteric {White sclera}, pupils equally round {Pupil size and shape normal}, ENT {Ear, nose and throat examination}, Ears {Ear structure}, nose {Nasal structure}, erythema {Erythema}, masses {Mass of body structure}, trauma {Traumatic injury}, Oropharynx {Oropharyngeal structure}, lesion {Lesion}, erythema {Erythema}, exudate {Exudate}, CV {Cardiovascular physical examination}, Heart regular {Normal sinus rhythm}, murmur {Heart murmur}, no S3 {Third heart sound, S>3<, inaudible}, no S4 {Fourth heart sound, S>4<, inaudible}, RESP {Examination of respiratory system}, Lungs clear to auscultation {Normal breath sounds}, GI {Examination of digestive system}, Abdomen soft {Abdomen soft}, non-distended {Normal abdominal contour}, tender to palpation {Abdominal tenderness}, Bowel
+sounds present {Normal bowel sounds}, HSM {Hepatosplenomegaly}, GU {Examination of genitourinary system}, suprapubic {Hypogastric region structure}, tenderness to palpation {Tenderness}, moves all extremities {Does move all four limbs}, symmetric bilaterally in all limbs {Normal bilateral upper limbs and bilateral lower limbs}, SKIN {Examination of skin}, rashes {Eruption of skin}, ulcerations {Ulcer}, NEURO {Neurological examination}, Alert {Mentally alert}, oriented {Oriented to person}, face symmetric {Facial symmetry}, EOMI {Normal ocular motility}, speech fluent {Does speak fluently}, moves all limbs {Does move all four limbs}, sensation to light touch grossly
+intact {Normal light touch sensation}, appropriate affect {Appropriate affect}"
+"###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:
+___ 11:20AM BLOOD WBC-8.0 RBC-4.44* Hgb-14.3 Hct-44.3 
+MCV-100* MCH-32.2* MCHC-32.3 RDW-13.3 RDWSD-48.7* Plt ___
+___ 11:20AM BLOOD Neuts-56.5 ___ Monos-13.0 Eos-6.1 
+Baso-0.9 Im ___ AbsNeut-4.53 AbsLymp-1.87 AbsMono-1.04* 
+AbsEos-0.49 AbsBaso-0.07
+___ 11:20AM BLOOD Glucose-125* UreaN-35* Creat-2.1* Na-139 
+K-4.6 Cl-104 HCO3-18* AnGap-17
+___ 11:20AM BLOOD Calcium-9.2 Phos-3.4 Mg-2.4
+___ 11:40AM BLOOD Lactate-2.4*
+
+DISCHARGE LABS:
+___ 06:22AM BLOOD Glucose-113* UreaN-29* Creat-1.5* Na-141 
+K-4.9 Cl-109* HCO3-18* AnGap-14
+___ 06:22AM BLOOD WBC-7.3 RBC-4.29* Hgb-14.3 Hct-43.1 
+MCV-101* MCH-33.3* MCHC-33.2 RDW-13.1 RDWSD-48.0* Plt ___
+
+NCHCT: There is a large CSF density lesion in the right middle 
+cranial fossa 
+unchanged from prior and most likely representing a large 
+arachnoid cyst.  
+There is no intra-axial or extra-axial hemorrhage, edema, shift 
+of normally 
+midline structures, or evidence of acute major vascular 
+territorial 
+infarction.  Age related involutional changes are again noted.  
+Ventricles are 
+stable in size.  Minimal periventricular white matter 
+hypodensities are again 
+noted consistent with chronic microvascular ischemic disease.  
+The imaged bony 
+structures are intact.  Imaged paranasal sinuses, mastoid air 
+cells and middle 
+ear cavities appear well aerated.  Dense carotid siphon 
+calcification is 
+noted. 
+  
+IMPRESSION:  
+  
+No acute intracranial process.  Large arachnoid cyst within the 
+right middle 
+cranial fossa. 
+
+ 
+
+###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}, Monos {Monocyte count}, Eos {Eosinophil 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}, 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}, 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}, NCHCT {Computed tomography of head without contrast}, density {Abnormally opaque structure}, lesion {Lesion}, middle 
+cranial fossa {Structure of middle fossa of cranial cavity}, arachnoid cyst {Arachnoid cyst}, intra-axial or extra-axial hemorrhage {Cerebral hemorrhage}, edema {Edema}, shift 
+of normally 
+midline structures {Midline shift of brain}, vascular 
+territorial {Vascular structure within brain}, infarction {Infarct}, Ventricles {Brain ventricle structure}, periventricular white matter {Structure of periventricular white matter}, chronic {Chronic disease}, ischemic disease {Ischemia}, paranasal sinuses {Nasal sinus structure}, mastoid air 
+cells {Structure of mastoid cell}, middle 
+ear cavities {Middle ear structure}, carotid siphon {Structure of carotid siphon}, calcification {Pathologic calcification, calcified structure}, arachnoid cyst {Arachnoid cyst}, middle 
+cranial fossa {Structure of middle fossa of cranial cavity}"
+"###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:
+Mr. ___ is a ___ male with PMH of COPD on 2L NC, 
+CAD s/p CABG, DM, Afib s/p ablation, who presents with 
+lightheadedness and was found to have ___ and orthostatic 
+hypotension.
+
+ACUTE/ACTIVE PROBLEMS:
+# Lightheadedness/presyncope: Neuro exam was normal on 
+admission. He did not have arrhythmias or signs of ischemia on 
+EKG and telemetry overnight was without arrhythmia. NCHCT was 
+normal, without evidence of stroke/bleed. Based on history, his 
+episode appeared more consistent with presyncope, and 
+orthostatic vital signs support this diagnosis. He also had ___ 
+that improved with IVF which is evidence of dehydration though 
+he denies that he has had reduced intake. Even though ___ 
+improved, he continued to have orthostatic VS with SBP going 
+from 160 to 100 from lying to standing. Could possibly have 
+autonomic dysfunction as he does not appear dehydrated anymore.
+
+# ___ on CKD stage III - His Cr was elevated at 2.1 which 
+improved to 1.5 with 1L IVF which is his baseline. Losartan was 
+held on admission but restarted at discharge.
+
+#Orthostatic hypotension: Patient had positive orthostatic vital 
+signs on admission and also after IVF, concerning for some 
+possible autonomic dysfunction versus medication effect. Now 
+that Cr is improved, will discharge on losartan for HTN, but 
+will hold amlodipine as it can worsen orthostatic hypotension.
+
+#Metabolic acidosis: Bicarb was 18 even with improvement in ___. 
+Based on prior nephrology note, has history of metabolic 
+acidosis which had been attributed to his CKD. Continue to 
+monitor and follow up with ___ clinic.
+
+#Macrocytic anemia: Has normal Hgb but with MCV elevated to low 
+100s. VitB12 and folate in the past few years have been normal. 
+Could possibly be due to alcohol intake. No diagnosis of liver 
+disease, but hasn't had an ultrasound in ___ records. MDS is 
+also on differential.
+
+CHRONIC/STABLE PROBLEMS:
+# CAD s/p CABG - continued ASA, ezetimibe 
+# COPD on 2L - continued advair, albuterol prn, loratidine
+# Afib - s/p ablation
+# DM - ___ qid, placed on SS in hospital, held Januvia. Restarted 
+Januvia on discharge.
+
+TRANSITIONAL ISSUES:
+- For syncope work up, could consider TTE as outpatient, though 
+no evidence of valvular abnormality on cardiac exam. Last TTE 
+was ___.
+- Follow up BP and increase medications as needed, but would 
+avoid CCB and beta blockers due to potential to worsen 
+orthostatic hypotension
+- Should have evaluation for macrocytic anemia. Consider liver 
+ultrasound. Has follow up with hematology in ___.
+- Repeat Cr at next clinic visit.
+ 
+
+###RESPONSE: COPD {Chronic obstructive lung disease}, 2L NC {Oxygen administration by nasal cannula}, CAD {Coronary arteriosclerosis}, CABG {Coronary artery bypass grafting}, DM {Diabetes mellitus}, Afib {Atrial fibrillation}, ablation {Catheter ablation of arrhythmogenic focus}, lightheadedness {Lightheadedness}, orthostatic 
+hypotension {Orthostatic hypotension}, Lightheadedness {Lightheadedness}, presyncope {Near syncope}, Neuro exam was normal {Normal nervous system function}, arrhythmias {Cardiac arrhythmia}, signs {Sign}, ischemia {Ischemia}, EKG {Electrocardiographic procedure}, telemetry {Electroencephalogram telemetry}, arrhythmia {Cardiac arrhythmia}, NCHCT {Computed tomography of head without contrast}, stroke {Cerebrovascular accident}, bleed {Hemorrhage}, presyncope {Near syncope}, orthostatic {Orthostatic body position}, vital signs {Vital signs finding}, improved {Patient's condition improved}, IVF {Administration of intravenous fluids}, dehydration {Dehydration}, improved {Patient's condition improved}, orthostatic {Orthostatic body position}, dehydrated {Dehydration}, CKD stage III {Chronic kidney disease stage 3}, improved {Patient's condition improved}, IVF {Administration of intravenous fluids}, baseline {Baseline state}, Orthostatic hypotension {Orthostatic hypotension}, orthostatic {Orthostatic body position}, vital 
+signs {Vital signs finding}, IVF {Administration of intravenous fluids}, improved {Patient's condition improved}, HTN {Hypertensive disorder, systemic arterial}, orthostatic hypotension {Orthostatic hypotension}, Metabolic acidosis {Metabolic acidosis}, metabolic 
+acidosis {Metabolic acidosis}, CKD {Chronic kidney disease}, Macrocytic anemia {Macrocytic anemia}, normal Hgb {Hemoglobin within reference range}, MCV elevated {Mean corpuscular volume above reference range}, liver 
+disease {Disorder of liver}, ultrasound {Ultrasonography}, MDS {Myelodysplastic syndrome}, CAD {Coronary arteriosclerosis}, CABG {Coronary artery bypass grafting}, COPD {Chronic obstructive lung disease}, Afib {Atrial fibrillation}, ablation {Catheter ablation of arrhythmogenic focus}, DM {Diabetes mellitus}, syncope {Syncope}, TTE {Transthoracic echocardiography}, no evidence {No abnormality detected}, valvular abnormality {Valvular insufficiency}, cardiac exam {Cardiovascular physical examination}, TTE {Transthoracic echocardiography}, orthostatic hypotension {Orthostatic hypotension}, evaluation {Evaluation procedure}, macrocytic anemia {Macrocytic anemia}, liver {Disorder of liver}, ultrasound {Ultrasonography}"
+"###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. Losartan Potassium 25 mg PO DAILY 
+2. BuPROPion XL (Once Daily) 150 mg PO BID 
+3. Mirtazapine 15 mg PO QHS 
+4. Ezetimibe 10 mg PO DAILY 
+5. Fluticasone Propionate NASAL 1 SPRY NU DAILY:PRN allergy 
+symptoms 
+6. amLODIPine 5 mg PO DAILY 
+7. Atorvastatin 80 mg PO QPM 
+8. Multivitamins 1 TAB PO DAILY 
+9. Nitroglycerin SL 0.3 mg SL Q5MIN:PRN chest pain 
+10. Fluticasone-Salmeterol Diskus (250/50)  1 INH IH BID 
+11. Aspirin 325 mg PO DAILY 
+12. Loratadine 10 mg PO DAILY 
+13. albuterol sulfate 90 mcg/actuation inhalation Q4H:PRN 
+
+ 
+Discharge Medications:
+1.  albuterol sulfate 90 mcg/actuation inhalation Q4H:PRN  
+2.  Aspirin 325 mg PO DAILY  
+3.  Atorvastatin 80 mg PO QPM  
+4.  BuPROPion XL (Once Daily) 150 mg PO BID  
+5.  Ezetimibe 10 mg PO DAILY  
+6.  Fluticasone Propionate NASAL 1 SPRY NU DAILY:PRN allergy 
+symptoms  
+7.  Fluticasone-Salmeterol Diskus (250/50)  1 INH IH BID  
+8.  Loratadine 10 mg PO DAILY  
+9.  Losartan Potassium 25 mg PO DAILY  
+10.  Mirtazapine 15 mg PO QHS  
+11.  Multivitamins 1 TAB PO DAILY  
+12.  Nitroglycerin SL 0.3 mg SL Q5MIN:PRN chest 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:
+Acute kidney injury
+Pre-syncope
+Orthostatic hypotension versus autonomic dysfunction
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Acute kidney injury {Acute kidney injury}, Pre-syncope {Near syncope}, Orthostatic hypotension {Orthostatic hypotension}, 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 Mr. ___,
+
+You were admitted to ___ for an episode of feeling like you 
+were going to pass out.
+
+You were found to have acute kidney injury, likely due to 
+dehydration. You received IV fluids and your kidney function 
+improved back to normal.
+
+You were also found to have orthostatic hypotension, which means 
+that your blood pressure gets low when you stand. You need to go 
+from sitting to standing very slowly and walk carefully when you 
+are out of the hospital so you do not pass out/faint.
+
+Sincerely,
+Your ___ Team
+ 
+
+###RESPONSE: acute kidney injury {Acute kidney injury}, dehydration {Dehydration}, IV fluids {Administration of intravenous fluids}, kidney function 
+improved back to normal {Normal renal function}, orthostatic hypotension {Orthostatic hypotension}, blood pressure {Finding of increased blood pressure}, stand {Does stand}, sitting {Sitting position}, standing {Orthostatic body position}"
+"###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: CARDIOTHORACIC
+ 
+
+###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:
+Chest pain
+ 
+Major Surgical or Invasive Procedure:
+CABG ___ 
+
+ 
+
+###RESPONSE: No Known Allergies {Allergic disposition}, Adverse Drug Reactions {Propensity to adverse reactions to drug}, Chest pain {Chest pain}, CABG {Coronary artery bypass grafting}"
+"###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 man with a history of diabetes, 
+hyperlipidemia, hypertension, and smoking. Over the past two 
+weeks, he noted multiple episodes of chest pain mostly occuring 
+at rest. He described the pain as retrosternal, radiating to his 
+face and left jaw, lasting minutes to an hour, and occuring ___ 
+times per day. On the morning of presentation, he had more of a 
+grabbing/pressure like pain in his left chest. He also endorsed 
+headache and shortness of breath. He presented to the emergency 
+department for further evaulation. A CTA was performed to rule 
+out dissection and was negative. Initial troponin was positive 
+at 0.24. An EKG demonstrated a right bundle branch block and ST 
+depressions in leads V4-V6. Cardiology was consulted in the ER 
+and he was started on IV heparin with plan for cardiac 
+catheterization. Cardiac catheterization revealed multivessel 
+coronary artery disease and he was referred to cardiac surgery 
+for evaluation.
+ 
+
+###RESPONSE: diabetes {Diabetes mellitus}, hyperlipidemia {Hyperlipidemia}, hypertension {Hypertensive disorder, systemic arterial}, smoking {Smoker}, chest pain {Chest pain}, pain {Pain}, retrosternal {Retrosternal pain}, radiating {Radiating pain}, face {Face structure}, jaw {Pain radiating to jaw}, pressure {Tight chest}, pain {Chest pain}, left chest {Structure of left half of chest wall}, headache {Headache}, shortness of breath {Dyspnea}, evaulation {Evaluation procedure}, CTA {Computed tomography angiography with contrast}, EKG {Electrocardiographic procedure}, right bundle branch block {Right bundle branch block}, ST 
+depressions {ST segment depression}, leads V4 {Lead site V4}, V6 {Lead site V6}, cardiac 
+catheterization {Cardiac catheterization}, Cardiac catheterization {Cardiac catheterization}, coronary artery disease {Coronary arteriosclerosis}, evaluation {Evaluation 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: Past Medical History:
+PMHx:
+1. Hypertension, essential [401.9] ___ new RBBB on routine EKG. 
+___: adenosine MIBI neg for ischemia.
+2. DM (diabetes mellitus), type 2 with neurological 
+complications [250.60]
+3. Hypercholesterolemia [272.0] ___
+4. OBESITY UNSPEC [278.00] ___
+5. GAIT ABNMLTY [781.2] ___
+6. IMPOTENCE DUE TO ERECTILE DYSFUNCTION [607.84] ___
+7. SLEEP APNEA - OBSTRUCTIVE [327.23] ___. Stopped CPAP
+8. MENIERE'S DISEASE, UNSPEC [386.00]
+9. DERMATITIS - SEBORRHEIC, UNSPEC [690.10]
+10. CHRONIC DAILY HEADACHE
+PSHx:
+• ___ pilonidal sinus/cyst ___
+• ___ 2.1-3 cm
+lipoma on back
+• Tarsal tunnel release ___
+left foot with partial plantar fasciectomy & spur removal
+• ___ ___
+left thumb CMC jt
+CAD-s/p CABG ___
+ 
+
+###RESPONSE: Hypertension, essential {Essential hypertension}, RBBB on routine EKG {Electrocardiographic right bundle branch block}, MIBI {Radionuclide myocardial perfusion study}, ischemia {Ischemia}, DM {Diabetes mellitus}, diabetes mellitus), type 2 {Diabetes mellitus type 2}, neurological 
+complications {Disorder of nervous system due to diabetes mellitus}, Hypercholesterolemia {Hypercholesterolemia}, OBESITY {Obesity}, GAIT ABNMLTY {Abnormal gait}, ERECTILE DYSFUNCTION {Erectile dysfunction}, SLEEP APNEA - OBSTRUCTIVE {Obstructive sleep apnea syndrome}, CPAP {Continuous positive airway pressure ventilation treatment}, MENIERE'S DISEASE {Ménière's disease}, DERMATITIS {Seborrheic dermatitis}, DAILY HEADACHE {Daily headache}, pilonidal sinus {Hair sinus}, cyst {Pilonidal cyst}, lipoma {Lipoma}, back {Structure of back of trunk}, Tarsal tunnel release {Tarsal tunnel release}, left foot {Structure of left foot}, partial plantar fasciectomy {Partial fasciectomy of plantar fascia}, left thumb {Structure of left thumb}, CMC jt {Carpometacarpal joint structure}, CAD {Coronary arteriosclerosis}, CABG {Coronary artery bypass grafting}"
+"###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:
+Non-contributory
+ 
+
+###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:
+Vitals-  98.1, 142/81, 65, 18, 99% RA
+General: NAD, sitting comfortably in bed, jovial and pleasant
+HEENT: MMM, EOMI, no icterus
+Cardiac: Normocardic, regular, no MRG
+Vascular: JVP visible 2-3cm above sternal angle with HOB at 30 
+degr. Extr wwp with 2+ radial, dp/pt pulses. 
+Lungs: no incr WOB sitting upright. minimal bibasilar crackles, 
+incr RR with lying flat but no increase in subjective dyspnea 
+Abdomen: obese, nontender - otherwise limited by habitus 
+GU: no foley 
+Neuro: AOX3, grossly nonfocal
+Skin: dry skin on LEs with absent hair, otherwise no lesions
+
+ 
+
+###RESPONSE: Vitals {Vital signs finding}, RA {Breathing room air}, General {General examination of patient}, NAD {No abnormality detected}, sitting {Sitting position}, HEENT {Physical examination procedure}, MMM {Moist oral mucosa}, EOMI {Normal ocular motility}, icterus {Jaundice}, Cardiac {Cardiovascular physical examination}, regular {Normal heart rate}, no MRG {Heart sounds normal}, JVP {Finding of jugular venous pressure}, sternal angle {Structure of sternal angle}, Extr {Limb structure}, 2+ radial {Normal radial pulse}, Lungs {Examination of respiratory system}, WOB {Labored breathing}, sitting {Sitting position}, crackles {Respiratory crackles}, RR {Finding of rate of respiration}, dyspnea {Dyspnea}, Abdomen {Examination of abdomen}, obese {Obese abdomen}, nontender {Abdominal tenderness}, GU {Examination of genitourinary system}, foley {Urinary catheter in situ}, Neuro {Neurological examination}, Skin {Examination of skin}, dry skin {Xeroderma}, absent hair {Hair absent}, lesions {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: Pertinent Results:
+TEE ___:
+Findings  
+LEFT ATRIUM: No spontaneous echo contrast or thrombus in the 
+___ or the RA/RAA. 
+RIGHT ATRIUM/INTERATRIAL SEPTUM: Normal RA size. No ASD by 2D or 
+color Doppler. 
+LEFT VENTRICLE: Mild symmetric LV hypertrophy with normal cavity 
+size, and global systolic function (biplane LVEF>55%). 
+RIGHT VENTRICLE: Normal RV chamber size and free wall motion. 
+AORTA: Normal aortic diameter at the sinus level. Focal 
+calcifications in aortic root. Normal ascending aorta diameter. 
+Focal calcifications in ascending aorta. Normal aortic arch 
+diameter. 
+AORTIC VALVE: Mildly thickened aortic valve leaflets (3). No AS. 
+Trace AR. 
+MITRAL VALVE: Mildly thickened mitral valve leaflets. Trivial 
+MR. 
+___ VALVE: Normal tricuspid valve leaflets with trivial 
+TR. 
+PULMONIC VALVE/PULMONARY ARTERY: Normal pulmonic valve leaflet. 
+No PS. Physiologic PR. 
+PERICARDIUM: No pericardial effusion. 
+
+PRE-BYPASS: 
+No spontaneous echo contrast or thrombus is seen in the body of 
+the left atrium/left atrial appendage or the body of the right 
+atrium/right atrial appendage. No atrial septal defect is seen 
+by 2D or color Doppler. Mild symmetric left ventricular 
+hypertrophy with normal cavity size, and global systolic 
+function (biplane LVEF = 55 %). Right ventricular chamber size 
+and free wall motion are normal. The aortic valve leaflets (3) 
+are mildly thickened but aortic stenosis is not present. Trace 
+aortic regurgitation is seen. The mitral valve leaflets are 
+mildly thickened. Trivial mitral regurgitation is seen. There is 
+no pericardial effusion. POST-BYPASS: 
+Preserved biventricular systolic function.
+LVEF 55%.
+Intact thoracic aorta.
+No other new findings.   
+
+___ 07:24AM BLOOD WBC-15.7* RBC-4.37* Hgb-13.5* Hct-38.6* 
+MCV-88 MCH-31.0 MCHC-35.1* RDW-15.2 Plt ___
+___ 07:10AM BLOOD WBC-13.6* RBC-4.27* Hgb-13.3* Hct-37.7* 
+MCV-88 MCH-31.2 MCHC-35.3* RDW-15.1 Plt ___
+___ 07:05AM BLOOD WBC-10.3 RBC-3.83* Hgb-12.0* Hct-34.2* 
+MCV-89 MCH-31.3 MCHC-35.1* RDW-15.1 Plt ___
+___ 12:50PM BLOOD Na-133 K-4.4 Cl-95*
+___ 07:24AM BLOOD Glucose-155* UreaN-25* Creat-1.2 Na-133 
+K-5.2* Cl-95* HCO3-22 AnGap-21*
+___ 12:50PM BLOOD UreaN-21* Creat-1.1 Na-133 K-4.9 Cl-96 
+HCO3-26 AnGap-16
+___ 07:05AM BLOOD Glucose-114* UreaN-21* Creat-1.1 Na-136 
+K-5.0 Cl-99 HCO3-25 AnGap-17
+___ 06:30AM BLOOD Glucose-85 UreaN-26* Creat-1.1 Na-136 
+K-4.2 Cl-98 HCO3-28 AnGap-14
+___ 05:05AM BLOOD Glucose-144* UreaN-27* Creat-0.9 Na-135 
+K-4.0 Cl-99 HCO3-27 AnGap-13
+ 
+
+###RESPONSE: TEE {Transesophageal echocardiography}, thrombus {Thrombus}, RA {Right atrial structure}, RA {Right atrial structure}, ASD {Atrial septal defect}, color Doppler {Color Doppler ultrasound}, LV hypertrophy {Left ventricular hypertrophy}, RV chamber {Structure of cavity of right cardiac ventricle}, free wall motion {Normal ventricular wall motion}, AORTA {Aortic structure}, aortic {Aortic structure}, Focal 
+calcifications {Focal calcium deposition, calcified structure}, aortic root {Supraaortic valve area structure}, ascending aorta {Ascending aorta structure}, Focal calcifications {Focal calcium deposition, calcified structure}, ascending aorta {Ascending aorta structure}, aortic arch {Aortic arch structure}, AORTIC VALVE {Aortic valve structure}, Mildly thickened {Increased thickness}, aortic valve leaflets {Structure of cusp of aortic valve}, AS {Aortic valve stenosis}, AR {Aortic valve regurgitation}, Mildly thickened {Increased thickness}, mitral valve leaflets {Structure of leaflet of mitral valve}, MR {Mitral valve regurgitation}, tricuspid valve leaflets {Structure of leaflet of tricuspid valve}, PULMONIC VALVE {Pulmonary valve structure}, PULMONARY ARTERY {Pulmonary artery structure}, pulmonic valve leaflet {Structure of cusp of pulmonic valve}, PS {Pulmonic valve stenosis}, PR {Pulmonic valve regurgitation}, PERICARDIUM {Pericardial structure}, pericardial effusion {Pericardial effusion}, thrombus {Thrombus}, left atrium {Left atrial structure}, left atrial appendage {Entire left auricular appendage}, right 
+atrium {Right atrial structure}, right atrial appendage {Structure of right auricular appendage}, atrial septal defect {Atrial septal defect}, color Doppler {Color Doppler ultrasound}, Mild symmetric left ventricular 
+hypertrophy {Mild left ventricular hypertrophy}, normal cavity {Normal size cardiac chamber}, Right ventricular chamber {Structure of cavity of right cardiac ventricle}, wall motion are normal {Normal ventricular wall motion}, aortic valve leaflets {Structure of cusp of aortic valve}, mildly thickened {Increased thickness}, aortic stenosis {Aortic valve stenosis}, aortic regurgitation {Aortic valve regurgitation}, mitral valve leaflets are 
+mildly thickened {Thickened mitral leaflet}, mitral regurgitation {Mitral valve regurgitation}, pericardial effusion {Pericardial effusion}, biventricular {Cardiac ventricular structure}, thoracic aorta {Thoracic aorta structure}, 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}, 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}, 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}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, 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}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, AnGap {Anion gap measurement}, 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}, 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}, 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}"
+"###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:
+He underwent routine preoperative testing and evaluation. 
+Carotid ultrasound revealed bilateral carotid artery stenosis, 
+right > left. The vascular surgery service was consulted. Given 
+that he is asypmtomatic, recommendation is to follow up with Dr. 
+___ as an outpatient for further evaluation. He remained 
+hemodynamically stable and was taken to the operating room on 
+___. He underwent coronary artery bypass grafting x 3. 
+Please see operative note for full details. He tolerated the 
+procedure well and was transferred to the CVICU in stable 
+condition for recovery and invasive monitoring. 
+ 
+He weaned from sedation, awoke neurologically intact and was 
+extubated on POD 1. He was weaned from inotropic and vasopressor 
+support. Beta blocker was initiated and he was diuresed toward 
+his preoperative weight. His chest tubes were discontinued on 
+POD#1 and his epicardial pacing wires were discontinued on 
+POD#3.  He had a +UTI and was started on Bactrim. He was started 
+on Kefzol for sternal drainage which resolved by the time 
+discharge and kefzol was stopped. He remained hemodynamically 
+stable and was transferred to the telemetry floor for further 
+recovery.  He was evaluated by the physical therapy service for 
+assistance with strength and mobility and rehab was recommended. 
+By the time of discharge on POD #8 he was ambulating with 
+supervision,  the sternal wound was healing without redness or 
+drainage, and pain was controlled with oral analgesics. He was 
+discharged to ___ Rehab in good condition with appropriate 
+follow up instructions.
+ 
+
+###RESPONSE: evaluation {Evaluation procedure}, Carotid ultrasound {Ultrasonography of carotid artery}, carotid artery stenosis {Carotid artery stenosis}, right {Structure of right carotid artery}, left {Structure of left carotid artery}, asypmtomatic {Asymptomatic}, evaluation {Evaluation procedure}, hemodynamically stable {Hemodynamically stable}, coronary artery bypass grafting {Coronary artery bypass grafting}, stable 
+condition {Patient's condition stable}, neurologically intact {Normal nervous system function}, extubated {Removal of endotracheal tube}, vasopressor 
+support {Vasopressor therapy}, diuresed {Diuretic therapy}, epicardial pacing {Insertion of epicardial electrode for temporary cardiac pacing}, UTI {Urinary tract infectious disease}, sternal {Structure of sternal region}, drainage {Wound discharge}, hemodynamically 
+stable {Hemodynamically stable}, ambulating {Fully mobile}, supervision {Supervision}, sternal {Structure of sternal region}, wound was healing {Wound healing well}, redness {Redness of skin over lesion}, drainage {Discharge}, pain was controlled with oral analgesics {Demonstrates adequate pain control}"
+"###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. ClonazePAM 1 mg PO BID 
+2. Simvastatin 80 mg PO DAILY 
+3. Aspirin 81 mg PO DAILY 
+4. Diazepam 5 mg PO PRN nausea 
+5. Lisinopril 5 mg PO DAILY 
+6. MetFORMIN (Glucophage) 1000 mg PO BID 
+7. Glargine 38 Units Dinner
+8. fluocinolone acetonide oil 0.01 % otic DAILY 
+9. Omeprazole 40 mg PO DAILY 
+10. Propranolol LA 60 mg PO DAILY 
+11. Fluticasone Propionate NASAL 2 SPRY NU DAILY 
+12. TraZODone 100 mg PO QHS:PRN insomnia 
+13. Acetaminophen 325-650 mg PO Q6H:PRN pain 
+
+ 
+Discharge Medications:
+1. Acetaminophen 650 mg PO Q4H:PRN pain, fever 
+2. Aspirin EC 81 mg PO DAILY 
+3. ClonazePAM 1 mg PO BID:PRN anxiety 
+RX *clonazepam 1 mg 1 tablet(s) by mouth twice a day Disp #*65 
+Tablet Refills:*0
+4. Fluticasone Propionate NASAL 2 SPRY NU DAILY 
+5. Glargine 38 Units Dinner
+6. MetFORMIN (Glucophage) 1000 mg PO BID 
+7. Omeprazole 40 mg PO DAILY 
+8. Simvastatin 80 mg PO DAILY 
+9. TraZODone 100 mg PO QHS:PRN insomnia 
+10. BuPROPion (Sustained Release) 150 mg PO BID 
+11. Docusate Sodium 100 mg PO BID 
+12. Fluocinolone Acetonide 0.01% Solution 1 Appl TP DAILY 
+13. Ipratropium Bromide Neb 1 NEB IH Q6H:PRN wheezes 
+14. Metoprolol Tartrate 25 mg PO BID 
+15. OxycoDONE (Immediate Release)  ___ mg PO Q6H:PRN pain 
+RX *oxycodone 5 mg ___ tablet(s) by mouth very 6 hours Disp #*65 
+Tablet Refills:*0
+16. Sulfameth/Trimethoprim DS 1 TAB PO BID Duration: 5 Days 
+17. Furosemide 20 mg PO BID Duration: 5 Days 
+18. Potassium Chloride 20 mEq PO DAILY Duration: 5 Days 
+19. fluocinolone acetonide oil 0.01 % otic DAILY 
+20. Atorvastatin 80 mg PO QPM 
+21. Diazepam 5 mg PO PRN nausea 
+RX *diazepam 5 mg 1 tablet by mouth prn Disp #*25 Tablet 
+Refills:*0
+22. Outpatient Lab Work
+plaese check BUN/Creat on ___  and if greater than 1.3, please 
+continue to follow until off lasix and bactrim and returns to 
+baseline of 1.0
+
+ 
+
+###RESPONSE: lasix {Diuretic 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: Discharge Disposition:
+Extended Care
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Primary: NSTEMI
+Secondary:
+IDDM
+HTN
+Hyperlipidemia
+GERD, s/p gastric ulcer ___ yrs ago
+vertigo
+chronic back pain
+chronic headaches
+deaf left ear
+coronary artery disease s/p CABG ___
+Past Surgical History: prostatectomy ___
+
+ 
+Discharge Condition:
+Alert and oriented x3 nonfocal 
+Ambulating with steady gait
+Incisional pain managed with Oxycodone 
+Incisions: 
+Sternal - healing well, no erythema or drainage 
+Leg Left - healing well, no erythema or drainage. 
+Edema trace
+ 
+
+ 
+
+###RESPONSE: NSTEMI {Acute non-ST segment elevation myocardial infarction}, IDDM {Diabetes mellitus type 1}, HTN {Hypertensive disorder, systemic arterial}, Hyperlipidemia {Hyperlipidemia}, GERD {Gastroesophageal reflux disease}, gastric ulcer {Gastric ulcer}, vertigo {Vertigo}, chronic back pain {Chronic back pain}, chronic headaches {Chronic headache disorder}, deaf left ear {Deafness of left ear}, coronary artery disease {Coronary arteriosclerosis}, CABG {Coronary artery bypass grafting}, prostatectomy {Prostatectomy}, Alert {Mentally alert}, oriented x3 {Oriented to person, time and place}, Ambulating {Fully mobile}, steady gait {Gait normal}, Incisional {Surgical incision wound}, pain {Pain}, Incisions {Surgical incision wound}, Sternal {Structure of sternal region}, healing well {Wound healing well}, erythema {Erythema}, drainage {Discharge}, Leg Left {Structure of left lower leg}, healing well {Wound healing well}, erythema {Erythema}, drainage {Discharge}, 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: Discharge Instructions:
+Please shower daily including washing incisions gently with mild 
+soap, no baths or swimming until cleared by surgeon. Look at 
+your incisions daily for redness or drainage
+Please NO lotions, cream, powder, or ointments to incisions 
+Each morning you should weigh yourself and then in the evening 
+take your temperature, these should be written down on the chart 
+
+No driving for approximately one month and while taking 
+narcotics, will be discussed at follow up appointment with 
+surgeon when you will be able to drive 
+No lifting more than 10 pounds for 10 weeks
+Please call with any questions or concerns ___
+**Please call cardiac surgery office with any questions or 
+concerns ___. Answering service will contact on call 
+person during off hours**
+
+ 
+
+###RESPONSE: incisions {Surgical incision wound}, redness {Redness of skin over lesion}, drainage {Discharge}, 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: 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: 
+___
+ 
+Attending: ___.
+ 
+Chief Complaint:
+s/p mechanical fall
+ 
+Major Surgical or Invasive Procedure:
+None
+ 
+
+###RESPONSE: fall {Falls}"
+"###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:
+___ PMHx CAD s/p CABG, 2 prior colon surgeries, presenting as 
+transfer from ___ for trauma eval for R ___ rib 
+fractures due to mechanical fall. Patient reports trying to get 
+into his walker at his ___ this evening, when he tripped and 
+fell onto his right side. Denies LOC or headstrike. He sustained 
+a laceration to his R forearm and was sent to an OSH. head CT 
+head, torso, abdomen, CXR and x-ray R hand, found to have 
+non-displaced fractures of ___ to 9th ribs on right.
+
+Upon evaluation in the ED, patient appears comfortable and NAD. 
+He is breathing well on room air, although his breaths still 
+appear to be shallow. He demonstrates significant pain along his 
+right flank.
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}, CABG {Coronary artery bypass grafting}, colon {Colon structure}, surgeries {Surgical procedure}, trauma {Traumatic injury}, eval {Evaluation procedure}, rib 
+fractures {Fracture of multiple ribs}, fall {Falls}, walker {Uses zimmer frame}, fell {Falls}, right side {Structure of right half of body}, LOC {Loss of consciousness}, headstrike {Injury of head}, laceration {Laceration}, R forearm {Structure of right forearm}, head {Head structure}, CT 
+head {Computed tomography of head}, torso {Computed tomography of chest}, abdomen {Computed tomography of abdomen}, CXR {Plain chest X-ray}, x-ray R hand {Plain X-ray of right hand}, non-displaced fractures {Undisplaced fracture}, 9th ribs {Bone structure of ninth rib}, evaluation {Evaluation procedure}, comfortable {Comfortable appearance}, NAD {No abnormality detected}, breathing well on room air {Breathing room air}, shallow {Shallow breathing}, pain along his 
+right flank {Right flank 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: Past Medical History:
+PMHx: CHF, CODP, CKD, anemia
+ 
+
+###RESPONSE: CHF {Congestive heart failure}, CODP {Chronic obstructive lung disease}, CKD {Chronic kidney disease}, anemia {Anemia}"
+"###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:
+Non-contributory 
+ 
+
+###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:
+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:|
+R ribs TTP along mid-axillary line, most prominent at rib 9. No 
+flail chest, no ecchymosis. Lungs clear anteriorly, pt refuses 
+to sit up for posterior exam. Head NCAT. R forearm with ~3 x 4 
+cm area of denuded skin.
+
+Discharge Physical Exam:
+VS: T: 97.4 PO BP: 113/68 L Sitting HR: 79 RR: 16 O2: 96% Ra 
+GEN: A+Ox3, NAD
+HEENT: atraumatic, MMM
+CV: RRR
+PULM: CTA b/l
+ABD: soft, non-distended, non-tender to palpation
+EXT: wwp, trace edema b/l UE.  RUE abrasions with mepilex 
+ 
+
+###RESPONSE: Physical Exam {Physical examination procedure}, TTP {Tenderness}, mid-axillary line {Midaxillary line}, rib 9 {Bone structure of ninth rib}, flail chest {Flail chest}, ecchymosis {Ecchymosis}, Lungs {Examination of respiratory system}, NC {Normal head}, R forearm {Structure of right forearm}, denuded skin {Denuded skin}, VS {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}, GEN {General examination of patient}, A+Ox3 {Oriented to person, time and place}, NAD {No abnormality detected}, atraumatic {No injuries apparent}, MMM {Moist oral mucosa}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, PULM {Examination of respiratory system}, CTA b/l {Normal breath sounds}, ABD {Examination of abdomen}, soft {Abdomen soft}, non-distended {Normal abdominal contour}, tender {Abdominal tenderness}, EXT {Examination of limb}, edema b/l UE {Edema of bilateral upper limbs}, RUE {Structure of right upper limb}, abrasions {Abrasion}"
+"###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:
+IMAGING:
+
+OSH Right Hand x-ray ___
+Impression - No acute abnormality identified
+
+OSH CT Chest w/ contrast ___
+Impression - nondisplaced fractures of the lateral right ___ 
+through 9th ribs
+
+OSH CT abd/pelvis w/ contrast ___
+Impression - No acute abnormality idenitified
+
+OSH CT C-spine w/o contrast ___
+Impression - there are degenerative disc and facet findings. No 
+acute abnormality identified
+
+LABS:
+
+___ 09:09PM   GLUCOSE-102* UREA N-20 CREAT-1.2 SODIUM-138 
+POTASSIUM-4.3 CHLORIDE-102 TOTAL CO2-21* ANION GAP-15
+___ 09:09PM   CALCIUM-8.4 PHOSPHATE-3.5 MAGNESIUM-2.0
+___ 09:09PM   WBC-6.7 RBC-3.03* HGB-11.1* HCT-33.0* 
+MCV-109* MCH-36.6* MCHC-33.6 RDW-16.3* RDWSD-65.7*
+___ 09:09PM   NEUTS-79.7* LYMPHS-7.6* MONOS-9.3 EOS-2.4 
+BASOS-0.4 IM ___ AbsNeut-5.34 AbsLymp-0.51* AbsMono-0.62 
+AbsEos-0.16 AbsBaso-0.03
+___ 09:09PM   PLT SMR-LOW* PLT COUNT-90*
+___ 09:09PM   ___ PTT-31.6 ___
+ 
+
+###RESPONSE: IMAGING {Imaging}, x-ray {Radiographic imaging procedure}, No acute abnormality {No abnormality detected}, nondisplaced fractures {Undisplaced fracture}, 9th ribs {Bone structure of ninth rib}, No acute abnormality {No abnormality detected}, degenerative disc {Degeneration of intervertebral disc}, facet {Osteoarthritis of spinal facet joint}, No 
+acute abnormality {No abnormality detected}, GLUCOSE {Glucose measurement, blood}, UREA N {Blood urea nitrogen measurement}, 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}, CALCIUM {Blood calcium measurement}, PHOSPHATE {Phosphate, total measurement}, MAGNESIUM {Blood magnesium 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}, 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}, EOS {Eosinophil count}, BASOS {Basophil count}, PLT {Platelet count}, PLT COUNT {Platelet count}, PTT {Partial thromboplastin time, activated}"
+"###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:
+Mr. ___ is a ___ who presented as transfer from ___ 
+for trauma evaluation for right ___ rib fractures s/p 
+mechanical fall. The patient was admitted to the trauma surgery 
+service for respiratory monitoring and pulmonary toilet. Pain 
+was managed with acetaminophen and tramadol. 
+
+The patient was alert and oriented throughout hospitalization.  
+The patient remained stable from a cardiovascular and pulmonary 
+standpoint. Vital signs were routinely monitored. Good pulmonary 
+toilet, early ambulation and incentive spirometry were 
+encouraged throughout hospitalization. The patient tolerated a 
+regular diet. The patient's fever curves were closely watched 
+for signs of infection, of which there were none. The patient's 
+blood counts were closely watched for signs of bleeding, of 
+which there were none. The patient received subcutaneous heparin 
+and ___ dyne boots were used during this stay and was 
+encouraged to get up and ambulate as early as possible.
+
+The patient worked with Physical Therapy and ___ recommended 
+discharge to home with home physical therapy. At the time of 
+discharge, the patient was doing well, afebrile and 
+hemodynamically stable.  The patient was tolerating a diet, 
+ambulating, voiding without assistance, and pain was well 
+controlled.  The patient received discharge teaching and 
+follow-up instructions with understanding verbalized and 
+agreement with the discharge plan.
+
+ 
+
+###RESPONSE: trauma {Traumatic injury}, evaluation {Evaluation procedure}, right {Bone structure of right rib}, rib fractures {Fracture of multiple ribs}, fall {Falls}, respiratory monitoring {Monitoring of respiration}, pulmonary toilet {Airway toilet}, Pain {Pain}, alert {Mentally alert}, oriented {Orientated}, stable {Patient's condition stable}, Vital signs were routinely monitored {Monitoring of blood pressure, temperature, pulse rate and respiratory rate}, pulmonary 
+toilet {Airway toilet}, ambulation {Ambulation training}, incentive spirometry {Incentive spirometry}, tolerated a 
+regular diet {Tolerating normal diet}, fever {Fever}, watched 
+for signs of infection {Monitoring for signs and symptoms of infection}, blood counts {Cell count}, signs {Sign}, bleeding {Bleeding}, subcutaneous heparin {Subcutaneous injection of heparin}, ambulate {Ambulation training}, Physical Therapy {Physical therapy procedure}, physical therapy {Physical therapy procedure}, afebrile {Temperature normal}, hemodynamically stable {Hemodynamically stable}, tolerating a diet {Tolerating diet}, ambulating {Fully mobile}, voiding without assistance {Continence independent}, pain was well 
+controlled {Demonstrates adequate pain control}"
+"###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:
+Tylenol
+Diltiazem ER 120mg
+Flovent 220mcg HFA BID
+Folic acid 1mg
+Furosemide 20mg
+Guaifensin 10cc q4 prn cough
+Ipratropium-albuterol q4 prn
+Loperamide 2mg TID prn
+Methotrexate 2.5mg (7.5mg weekly on ___
+Omeprazole 20mg daily
+Pro-air HFA 90mcg inhaler
+Procrit 40,000 ___
+Spiriva 18mcg
+Trazodone 50mg qhs
+Vitamin B12 1000mcg daily
+
+ 
+Discharge Medications:
+1.  Acetaminophen ___ mg PO Q6H:PRN Pain - Mild 
+RX *acetaminophen 500 mg ___ tablet(s) by mouth every six (6) 
+hours Disp #*40 Tablet Refills:*0 
+2.  Docusate Sodium 100 mg PO BID:PRN constipation   
+3.  Lidocaine 5% Patch 1 PTCH TD DAILY 
+apply patch and leave on for 12 hours, and then remove and leave 
+off for 12 hours  
+RX *lidocaine 5 % Apply one patch to area of rib pain Daily Disp 
+#*7 Patch Refills:*0 
+4.  TraMADol 25 mg PO Q6H:PRN pain 
+RX *tramadol 50 mg 0.5 (One half) tablet(s) by mouth every six 
+(6) hours Disp #*15 Tablet Refills:*0 
+5.  Cyanocobalamin 1000 mcg PO DAILY  
+6.  Diltiazem Extended-Release 120 mg PO DAILY  
+7.  Epoetin ___ ___  Units SC WEEKLY   
+8.  Flovent HFA (fluticasone) 220 mcg/actuation inhalation BID  
+9.  FoLIC Acid 1 mg PO DAILY  
+10.  Furosemide 20 mg PO DAILY  
+11.  Ipratropium-Albuterol Neb 1 NEB NEB Q4H:PRN wheezing  
+12.  LOPERamide 2 mg PO TID:PRN diarrhea   
+13.  Methotrexate 7.5 mg PO 1X/WEEK (___)  
+14.  Omeprazole 20 mg PO DAILY  
+15.  ProAir HFA (albuterol sulfate) 90 mcg/actuation inhalation 
+Q4H:PRN  
+16.  Tiotropium Bromide 1 CAP IH DAILY  
+17.  TraZODone 50 mg PO QHS  
+
+ 
+
+###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:
+-Right ___ rib fractures 
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Right {Bone structure of right rib}, rib fractures {Fracture of rib}, 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:
+Dear Mr. ___, 
+
+You were transferred to ___ in 
+___ with multiple right-sided rib fractures after a fall.  
+You were admitted to the Trauma Surgery Service for pain control 
+and to monitor your breathing. While in the hospital, you worked 
+with Physical Therapy and it is recommended that you have 
+Physical Therapy services come to your home to help you regain 
+your strength. You are now ready to be discharged home.  Please 
+note the following discharge instructions:
+
+* Your injury caused right-sided rib fractures which can cause 
+severe pain and subsequently cause you to take shallow breaths 
+because of the pain.
+ 
+* You should take your pain medication as directed to stay ahead 
+of the pain otherwise you won't be able to take deep breaths. If 
+the pain medication is too sedating take half the dose and 
+notify your physician.
+ 
+* Pneumonia is a complication of rib fractures.  In order to 
+decrease your risk you must use your incentive spirometer 4 
+times every hour while awake.  This will help expand the small 
+airways in your lungs and assist in coughing up secretions that 
+pool in the lungs.
+ 
+* You will be more comfortable if you use a cough pillow to hold 
+against your chest and guard your rib cage while coughing and 
+deep breathing.
+ 
+* Symptomatic relief with ice packs or heating pads for short 
+periods may ease the pain.
+ 
+* Narcotic pain medication can cause constipation therefore you 
+should take a stool softener twice daily and increase your fluid 
+and fiber intake if possible.
+ 
+* Do NOT smoke
+ 
+* If your doctor allows, non-steroidal ___ drugs 
+are very effective in controlling pain ( ie, Ibuprofen, Motrin, 
+Advil, Aleve, Naprosyn) but they have their own set of side 
+effects so make sure your doctor approves.
+ 
+* Return to the Emergency Room right away for any acute 
+shortness of breath, increased pain or crackling sensation 
+around your ribs (crepitus).
+
+ 
+ 
+
+###RESPONSE: right-sided {Bone structure of right rib}, rib fractures {Fracture of multiple ribs}, fall {Falls}, pain control {Pain control}, monitor {Monitoring for signs and symptoms of infection}, injury {Traumatic injury}, right-sided {Bone structure of right rib}, rib fractures {Fracture of multiple ribs}, severe pain {Severe pain}, shallow breaths {Shallow breathing}, pain {Pain}, pain medication {Administration of analgesic}, pain {Pain}, able to take deep breaths {Able to take deep breaths}, pain medication {Administration of analgesic}, Pneumonia {Pneumonia}, rib fractures {Fracture of multiple ribs}, decrease your risk {Preventive procedure}, use your incentive spirometer {Incentive spirometry}, airways {Airway structure}, lungs {Lung structure}, lungs {Lung structure}, chest {Thoracic structure}, rib cage {Thoracic cage structure}, coughing and 
+deep breathing {Deep breathing and coughing exercises}, relief {Pain relief}, ice packs {Application of ice}, heating pads {Heat therapy}, pain {Pain}, constipation {Constipation}, take a stool softener {Administration of laxative}, increase your fluid {Fluid intake encouragement}, fiber intake {High fiber diet education}, Do NOT smoke {Smoking cessation education}, controlling pain {Pain control}, shortness of breath {Dyspnea}, increased pain {Increased pain}, crackling {Respiratory crackles}, ribs {Bone structure of rib}, crepitus {Bone crepitus}"
+"###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: 
+Morphine / Aspirin / Methocarbamol / Meperidine / Hydrocodone
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Dyspnea
+ 
+Major Surgical or Invasive Procedure:
+None
+ 
+
+###RESPONSE: Morphine {Allergy to morphine}, Aspirin {Allergy to aspirin}, Dyspnea {Dyspnea}"
+"###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 PMH of CHF, AAA, and chronic back pain presenting from 
+Rehab with confusion and disorientation, found to have a T=101, 
+SaO2=88%. She was sent to the emergency room for further 
+evaluation. In the emergency room she was somnolent, but 
+arousable, and was confused and disoriented. She was transiently 
+hypotensive and received ___ of IVF. CXR was consistent with 
+pneumonia and she was given Vancomycin, Levofloxacin, and Zosyn. 
+She was then transferred to the MICU for further management.
+ 
+
+###RESPONSE: CHF {Congestive heart failure}, AAA {Abdominal aortic aneurysm}, chronic back pain {Chronic back pain}, confusion {Clouded consciousness}, disorientation {Disorientated}, SaO2 {Finding of oxygen saturation}, emergency {Emergency treatment management}, evaluation {Evaluation procedure}, emergency {Emergency treatment management}, confused {Clouded consciousness}, disoriented {Disorientated}, hypotensive {Low blood pressure}, IVF {Administration of intravenous fluids}, CXR {Plain chest X-ray}, pneumonia {Pneumonia}, Vancomycin {Antibiotic therapy}, Levofloxacin {Antibiotic therapy}, transferred to the MICU {Patient transfer to intensive care unit}"
+"###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:
+CHF: EF unknown
+AAA
+Back Pain
+GERD
+Depression
+ 
+
+###RESPONSE: CHF {Congestive heart failure}, AAA {Abdominal aortic aneurysm}, Back Pain {Backache}, GERD {Gastroesophageal reflux disease}, Depression {Depressive 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: 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:
+Non-contributory
+ 
+
+###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:
+T=95.7  HR=71  BP=99/39  RR=22   SpO2=92%
+General: NAD
+HEENT: Anicteric
+CV: RR, ___ systolic murmur
+Pulm: crackles on R>L, dullness at L base
+Abd: soft, NTND, positive bowel sounds
+Ext: no edema
+
+ 
+
+###RESPONSE: HR {Finding of heart rate}, BP {Blood pressure finding}, RR {Finding of rate of respiration}, SpO2 {Finding of oxygen saturation}, General {General examination of patient}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, Anicteric {White sclera}, CV {Cardiovascular physical examination}, RR {Finding of rate of respiration}, murmur {Murmur}, Pulm {Examination of respiratory system}, crackles {Respiratory crackles}, dullness {Chest dull to percussion}, L base {Structure of base of left lung}, Abd {Examination of abdomen}, soft {Abdomen soft}, ND {Swollen abdomen}, Ext {Examination of limb}, 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:
+___ 06:06PM   TYPE-ART RATES-/28 PO2-98 PCO2-53* PH-7.32* 
+TOTAL CO2-29 BASE XS-0 INTUBATED-NOT INTUBA
+___ 02:07PM   LACTATE-1.2
+___ 01:58PM   GLUCOSE-106* UREA N-22* CREAT-1.4* SODIUM-142 
+POTASSIUM-3.9 CHLORIDE-105 TOTAL CO2-28 ANION GAP-13
+___ 01:58PM   ALT(SGPT)-14 AST(SGOT)-22 ALK PHOS-179* TOT 
+BILI-0.6
+___ 01:58PM   LIPASE-11
+___ 01:58PM   proBNP-___*
+___ 01:58PM   WBC-19.4*# RBC-3.26*# HGB-8.8*# HCT-28.9*# 
+MCV-89 MCH-26.9* MCHC-30.4* RDW-16.5*
+___ 01:58PM   ___ PTT-27.8 ___
+
+___ 07:10PM 
+WBC RBC Hgb Hct MCV MCH MCHC RDW Plt Ct
+6.8 3.55* 9.6* 30.4* 86 27.0 31.6 17.3* 443*
+
+Glucose UreaN Creat Na K Cl HCO3 AnGap
+112* 14 1.2* 142 3.6 104 31 11
+
+___ 15:27 ECHO
+
+The left atrium is elongated. No atrial septal defect is seen by 
+2D or color Doppler. The right atrial pressure is indeterminate. 
+There is mild symmetric left ventricular hypertrophy with normal 
+cavity size and regional/global systolic function (LVEF>55%). 
+There is no ventricular septal defect. Right ventricular chamber 
+size and free wall motion are normal. The diameters of aorta at 
+the sinus, ascending and arch levels are normal. The aortic 
+valve leaflets (3) are mildly thickened. There is mild aortic 
+valve stenosis (valve area 1.2-1.9cm2). No aortic regurgitation 
+is seen. The mitral valve leaflets are mildly thickened. There 
+is no mitral valve prolapse. Trivial mitral regurgitation is 
+seen. The tricuspid valve leaflets are mildly thickened. There 
+is moderate pulmonary artery systolic hypertension. There is a 
+trivial/physiologic pericardial effusion.  
+
+___ CXR
+In comparison with the study of ___, there is again 
+enlargement
+of the cardiac silhouette with evidence of some pulmonary 
+vascular congestion. Areas of increased opacification are seen 
+at both bases with apparent silhouetting the hemidiaphragm. This 
+most likely represents combination of atelectasis and effusion, 
+though superimposed pneumonia be definitely excluded.
+ 
+
+###RESPONSE: PO2 {Oxygen measurement, partial pressure, arterial}, PCO2 {Measurement of arterial partial pressure of carbon dioxide}, PH {pH measurement}, TOTAL CO2 {Blood total carbon dioxide (calculated)}, BASE XS {Delta base, blood}, INTUBATED {Intubation}, GLUCOSE {Glucose measurement, blood}, UREA N {Blood urea nitrogen measurement}, 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}, LIPASE {Triacylglycerol lipase measurement}, proBNP {N-terminal pro-brain natriuretic peptide 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, PTT {Partial thromboplastin time, activated}, WBC {White blood cell count}, RBC {Red blood cell count}, Hct {Hematocrit determination}, MCV {Erythrocyte mean corpuscular volume determination}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, ECHO {Echocardiography}, left atrium is elongated {Left atrial enlargement}, atrial septal defect {Atrial septal defect}, color Doppler {Color Doppler ultrasound}, right atrial {Right atrial structure}, mild symmetric left ventricular hypertrophy {Mild left ventricular hypertrophy}, normal 
+cavity size {Normal size}, regional/global systolic function {Normal left ventricular systolic function and wall motion}, ventricular septal defect {Ventricular septal defect}, Right ventricular chamber {Right cardiac ventricular structure}, size {Normal size}, wall motion are normal {Normal ventricular wall motion}, aorta at 
+the sinus {Structure of sinus of Valsalva}, ascending {Ascending aorta structure}, arch {Aortic arch structure}, normal {No abnormality detected}, aortic 
+valve leaflets {Structure of cardiac valve leaflet}, mildly thickened {Increased thickness}, mild aortic 
+valve stenosis {Mild stenosis of aortic valve}, aortic regurgitation {Aortic valve regurgitation}, mitral valve leaflets are mildly thickened {Thickened mitral leaflet}, mitral valve prolapse {Mitral valve prolapse}, Trivial mitral regurgitation {Mild mitral valve regurgitation}, tricuspid valve leaflets are mildly thickened {Tricuspid leaflet thickened}, moderate pulmonary artery systolic hypertension {Moderate pulmonary hypertension}, pericardial effusion {Pericardial effusion}, CXR {Plain chest X-ray}, study {Evaluation procedure}, enlargement {Enlargement}, cardiac {Heart structure}, pulmonary 
+vascular congestion {Pulmonary congestion}, opacification {Abnormally opaque structure}, bases {Structure of base of lung}, atelectasis {Atelectasis}, effusion {Pleural effusion}, 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: Brief Hospital Course:
+___ with PMH of CHF, depression, AAA, GERD presenting with 
+altered mental status and hypotension, found to have sepsis 
+likely due to a multi-lobar pneumonia admitted to the ICU for 
+two days and transferred to medical floor on ___. She did 
+not require tracheal intubation in the ICU.
+
+1. Pneumonia: Urine legionella negative, blood cultures (NGTD 
+from ___, viral culture negative. Patient improved on 
+Vanc/Zosyn with steady improvement in her oxygen saturation to 
+normal on RA at the time of discharge. She received an 8day 
+course of antibiotics, then they were discontinued.  Oxygen was 
+given and eventually weaned off.  Asnoted above, she did not 
+require tracheal intubation in the ICU.
+
+2. Dyspnea: Likely multifactorial due to pneumonia, and a 
+component of diastolic congestive heart failure with volume 
+resuscitation in the ER. Initial BNP elevated, and blood 
+tests/EKG did not reveal suggestive myocardial injury. Patient 
+responded well to intermittent doses of Lasix 10mg IV. 
+
+3. Hypertension: Pt had episodes of hypotension at presentation; 
+on the general medicine floor she remained intermitently 
+hypertensive to SBP=180 despite Labetalol 200mg BID, which is 
+her home regiment. Elevated values tended to be right before 
+next dose of medicine is given; otherwise relatively 
+well-controlled.  on discharge =150s/70s
+
+4. Chronic diastolic CHF: TTE obtained this hospitalization 
+showed EF>55%, no echocardiographic evidence of diastolic 
+dysfunction, only mild LVH on TTE. She was continued on 
+Labetalol as above for BP and rate control.
+
+5. Anemia: Hct improved slowly to 31 at the time of discharge, 
+MCV=89, baseline unknown. Given MCV, likely due to anemia of 
+chronic disease, eval studies were consistent with this.
+
+6. Lumbar disc disease - s/p lumbar surgery.  Back pain was 
+slightly worse in hospital and so her Oxycontin to increased to 
+40mg BID on ___ with good effect.  Not requireing breakthrough 
+pain.  Valium was decreased to 2mg BID, and she's being 
+discharged on 2mg once daily prn anxiety. She has not displayed 
+high levels of anxiety, though the valium had been given to her 
+prior to hospitalization more to help any spasm component of her 
+back pain. 
+
+ 
+ 
+
+###RESPONSE: CHF {Congestive heart failure}, depression {Depressive disorder}, AAA {Abdominal aortic aneurysm}, GERD {Gastroesophageal reflux disease}, altered mental status {Altered mental status}, hypotension {Low blood pressure}, sepsis {Sepsis}, lobar pneumonia {Lobar pneumonia}, ICU {Patient transfer to intensive care unit}, tracheal intubation {Insertion of endotracheal tube}, ICU {Patient transfer to intensive care unit}, Pneumonia {Pneumonia}, Urine {Urinalysis}, legionella {Legionella infection}, blood cultures {Blood culture}, viral culture {Viral culture}, improved {Patient's condition improved}, Vanc {Antibiotic therapy}, improvement {Patient's condition improved}, oxygen saturation to 
+normal {Oxygen saturation within reference range}, antibiotics {Antibiotic therapy}, discontinued {Recommendation to stop drug treatment}, tracheal intubation {Insertion of endotracheal tube}, ICU {Patient transfer to intensive care unit}, Dyspnea {Dyspnea}, pneumonia {Pneumonia}, diastolic congestive heart failure {Heart failure with normal ejection fraction}, volume 
+resuscitation {Oxygen therapy}, BNP {Brain natriuretic peptide measurement}, blood 
+tests {Blood test}, EKG {Electrocardiographic procedure}, injury {Traumatic or non-traumatic injury}, responded well {Good therapeutic response}, Lasix {Diuretic therapy}, Hypertension {Hypertensive disorder, systemic arterial}, hypotension {Low blood pressure}, hypertensive {Finding of increased blood pressure}, SBP {Increased systolic arterial pressure}, regiment {Therapeutic regimen}, Elevated {Finding of increased blood pressure}, well-controlled {Disease condition determination, well controlled}, Chronic diastolic CHF {Chronic diastolic heart failure}, TTE {Transthoracic echocardiography}, echocardiographic {Echocardiography}, diastolic 
+dysfunction {Diastolic dysfunction}, mild LVH {Mild left ventricular hypertrophy}, TTE {Transthoracic echocardiography}, Anemia {Anemia}, improved {Patient's condition improved}, MCV {Erythrocyte mean corpuscular volume determination}, baseline {Baseline state}, MCV {Erythrocyte mean corpuscular volume determination}, anemia of 
+chronic disease {Anemia of chronic disorder}, eval {Evaluation procedure}, studies {Evaluation procedure}, Lumbar disc disease {Disorder of lumbar disc}, Back pain {Backache}, worse {Increased pain}, good effect {Good therapeutic response}, breakthrough 
+pain {Breakthrough pain}, anxiety {Anxiety}, levels of anxiety {Level of anxiety}, spasm {Spasm}, back pain {Backache}"
+"###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:
+Lidoderm patch
+Levothyroxine 25mcg po qday
+prilosec 20mg po qday
+cymbalta 60mg po qday
+colace 100mg po bid
+labetalol 200mg po bid
+xoycontin 30mg po bid
+senna 1 tablet po bid
+diazepam 5mg po q6h prn anxiety
+oxycodone 10mg po q6 prn pain
+mvi daily
+lyrica 50mg po qday
+robitussin prn
+ 
+Discharge Medications:
+1. Acetaminophen 325 mg Tablet Sig: ___ Tablets PO Q6H (every 6 
+hours) as needed for pain, fever.  
+2. Levothyroxine 25 mcg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+3. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) 
+Capsule, Delayed Release(E.C.) PO DAILY (Daily).  
+4. Duloxetine 30 mg Capsule, Delayed Release(E.C.) Sig: Two (2) 
+Capsule, Delayed Release(E.C.) PO DAILY (Daily).  
+5. Oxycodone 40 mg Tablet Sustained Release 12 hr Sig: One (1) 
+Tablet Sustained Release 12 hr PO Q12H (every 12 hours) as 
+needed for chronic back pain.  
+6. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 
+times a day).  
+7. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) dose 
+Injection TID (3 times a day).  
+8. Ipratropium Bromide 0.02 % Solution Sig: One (1) neb 
+Inhalation Q6H (every 6 hours) as needed for shortness of breath 
+or wheezing.  
+9. Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for 
+Nebulization Sig: One (1) neb Inhalation Q6H (every 6 hours) as 
+needed for wheeze, shortness of breath.  
+10. Diazepam 2 mg Tablet Sig: One (1) Tablet PO once a day as 
+needed for anxiety.  
+11. Labetalol 200 mg Tablet Sig: One (1) Tablet PO BID (2 times 
+a day).  
+
+ 
+
+###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:
+Pneumonia
+Congestive Heart Failure (diastolic)
+Low Back Pain
+
+ 
+Discharge Condition:
+Improved
+
+ 
+
+###RESPONSE: Pneumonia {Pneumonia}, Congestive Heart Failure {Congestive heart failure}, diastolic {Diastolic heart failure}, Low Back Pain {Low back pain}, Improved {Patient's condition improved}"
+"###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 with pneumonia and sepsis and treated for this 
+in the ICU and hospital floor with antibiotics and have 
+completed this course.  You had an ultrasound of the heart which 
+was normal. Your back pain medication was adjusted for increased 
+pain.  If you have fever, cough, shortness of breath, chest pain 
+or worsening back pain, please have this evaluated by your 
+doctor.
+ 
+
+###RESPONSE: pneumonia {Pneumonia}, sepsis {Sepsis}, ICU {Patient transfer to intensive care unit}, antibiotics {Antibiotic therapy}, ultrasound {Ultrasonography}, heart {Heart structure}, normal {No abnormality detected}, pain medication {Administration of analgesic}, adjusted {Drug dosage altered}, increased 
+pain {Increased pain}, fever {Fever}, cough {Cough}, shortness of breath {Dyspnea}, chest pain {Chest pain}, worsening {Increased pain}, back pain {Backache}, evaluated {Evaluation 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: 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: UROLOGY
+ 
+
+###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: 
+Bactrim DS
+ 
+Attending: ___.
+ 
+Chief Complaint:
+hematuria, urinary retention
+ 
+Major Surgical or Invasive Procedure:
+___ Dr. ___, bladder biopsy
+
+ 
+
+###RESPONSE: Bactrim {Allergy to sulfamethoxazole and/or trimethoprim}, hematuria {Blood in urine}, urinary retention {Retention of urine}, bladder biopsy {Biopsy of bladder}"
+"###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 ___ with a history of BPH.  He states that he saw 
+a urologist more than ___ years ago and was started on terazosin. 
+ He also underwent urodynamics and cystoscopy around ___ years 
+ago and was told that he will likely need an operation.  
+Yesterday, he presented to the ED in urinary retention following 
+4 days of weak stream.  A foley was placed and he was found to 
+have a UTI.  He was discharged with a 7d course of cipro.  Last 
+night he noticed blood in his catheter which got progressibly 
+darker in appearanced.  He returned to the ED this morning.  His 
+catheter was changed to a 3 way foley, he was hand irrigated 
+with return of clots and he was placed on CBI.  A few hours 
+later his drainage became bloody again and he was hand irrigated 
+with further return of clots. 
+
+ 
+
+###RESPONSE: BPH {Benign prostatic hyperplasia}, urodynamics {Urodynamic studies}, cystoscopy {Transurethral cystoscopy}, operation {Surgical procedure}, urinary retention {Retention of urine}, weak stream {Poor stream of urine}, foley was placed {Introduction of urinary catheter}, UTI {Urinary tract infectious disease}, blood {Blood in urine}, catheter was changed {Change of urethral catheter}, foley {Catheterization of urinary bladder}, hand irrigated {Manual bladder washout through catheter}, clots {Blood clot}, CBI {Monitoring of continuous bladder irrigation}, s hand irrigated {Manual bladder washout through catheter}, clots {Blood clot}"
+"###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:
+Diabetes type 2, complicated by retinopathy
+h/o syphilis
+Angioedema
+Glaucoma
+BPH
+spinal stenosis
+s/p laminectomy
+Paget's disease
+s/p shoulder surgery
+gout
+lichen planus
+
+ 
+
+###RESPONSE: Diabetes type 2 {Diabetes mellitus type 2}, retinopathy {Retinal disorder}, syphilis {Syphilis}, Angioedema {Angioedema}, Glaucoma {Glaucoma}, BPH {Benign prostatic hyperplasia}, spinal stenosis {Spinal stenosis}, laminectomy {Excision of lamina of vertebra}, Paget's disease {Osteitis deformans}, shoulder {Structure of left shoulder region}, surgery {Surgical procedure}, gout {Inflammatory disorder due to increased blood urate level}, lichen planus {Lichen planus}"
+"###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: Physical Exam:
+nad
+Abd soft, nt/nd
+Foley with clear yellow urine
+ 
+
+###RESPONSE: nad {No abnormality detected}, soft {Abdomen soft}, Foley {Urinary catheter in situ}, clear yellow urine {Urine looks clear}"
+"###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:
+___ 08:30PM   HCT-37.7*
+___ 11:00AM   GLUCOSE-238* UREA N-19 CREAT-1.1 SODIUM-142 
+POTASSIUM-3.6 CHLORIDE-104 TOTAL CO2-27 ANION GAP-15
+___ 3:15 pm URINE     Site: CLEAN CATCH
+
+                            **FINAL REPORT ___
+
+   URINE CULTURE (Final ___: 
+      KLEBSIELLA PNEUMONIAE.    >100,000 ORGANISMS/ML.. 
+         Piperacillin/tazobactam sensitivity testing available 
+on request. 
+
+                              SENSITIVITIES: MIC expressed in 
+MCG/ML
+                      
+_________________________________________________________
+                             KLEBSIELLA PNEUMONIAE
+                             |   
+AMPICILLIN/SULBACTAM--     4 S
+CEFAZOLIN-------------   <=4 S
+CEFEPIME--------------   <=1 S
+CEFTAZIDIME-----------   <=1 S
+CEFTRIAXONE-----------   <=1 S
+CIPROFLOXACIN---------<=0.25 S
+GENTAMICIN------------   <=1 S
+MEROPENEM-------------<=0.25 S
+NITROFURANTOIN--------    ___ I
+TOBRAMYCIN------------   <=1 S
+TRIMETHOPRIM/SULFA----   <=1 S
+
+___ 07:04PM BLOOD WBC-13.4* RBC-3.76* Hgb-11.2* Hct-34.0* 
+MCV-90 MCH-29.7 MCHC-32.8 RDW-13.7 Plt ___
+___ 07:18AM BLOOD WBC-12.1* RBC-3.62* Hgb-10.6* Hct-32.4* 
+MCV-90 MCH-29.4 MCHC-32.8 RDW-13.8 Plt ___
+___ 07:18AM BLOOD Glucose-122* UreaN-14 Creat-1.2 Na-139 
+K-3.7 Cl-102 HCO3-29 AnGap-12
+ 
+
+###RESPONSE: HCT {Hematocrit determination}, 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}, URINE {Urine culture}, CATCH {Urine specimen collection, clean catch}, URINE CULTURE {Urine culture}, sensitivity {Antimicrobial susceptibility test}, SENSITIVITIES {Antimicrobial susceptibility test}, 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}, 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}, 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}"
+"###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 was admitted to Dr. ___ service with 
+hematuria.  He underwent conservative management with CBI but 
+continued to have hematuria when the CBI was clamped.  On HD3 he 
+underwent cystoscopy and bladder biopsy. No obvious bleeding 
+source was identified. No concerning intraoperative events 
+occurred; please see dictated operative note for details. The 
+patient received ___ antibiotic prophylaxis. On POD1 
+he underwent a voiding trial but failed and a foley was 
+replaced.  The evening of POD1 he developed fevers and chills.  
+His WBC was elevated to 13.  Urine and blood cultures were 
+obtained and are still pending.  CXR was normal.  He deferveced 
+on POD2 and his WBC count was decreasing.  At discharge, 
+patient's pain well controlled with oral pain medications, 
+tolerating regular diet, ambulating without assistance, and 
+urine is clear yellow. He will be discharged with a total 3 week 
+course of cipro.  He is given explicit instructions to call Dr. 
+___ follow-up next week to have the catheter removed.
+ 
+
+###RESPONSE: hematuria {Blood in urine}, conservative management {Conservative therapy}, CBI {Irrigation of urinary bladder}, hematuria {Blood in urine}, CBI {Irrigation of urinary bladder}, clamped {Application of clamp}, cystoscopy and bladder biopsy {Cystoscopy and biopsy of bladder}, bleeding {Bleeding}, intraoperative {Intraoperative state}, operative {Surgical procedure}, antibiotic prophylaxis {Administration of prophylactic antibiotic}, voiding {Normal micturition}, foley {Catheterization of urinary bladder}, replaced {Catheterization of urinary bladder}, fevers {Fever}, chills {Chill}, WBC {White blood cell count}, Urine {Urine culture}, blood cultures {Blood culture}, CXR was normal {Standard chest X-ray normal}, WBC count {White blood cell count}, pain well controlled {Demonstrates adequate pain control}, oral {Administration of drug or medicament via oral route}, pain medications {Administration of analgesic}, tolerating {Tolerating diet}, regular diet {Normal diet}, ambulating without assistance {Independent walking}, urine is clear yellow {Urine looks clear}, instructions {Recommendation to}, catheter removed {Removal of urinary system catheter}"
+"###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:
+BIMATOPROST [LUMIGAN] - 0.03 % Drops - one drop each eye once a
+day
+METFORMIN - 500 mg Tablet - 1 Tablet(s) by mouth twice a day
+TADALAFIL [CIALIS] - 20 mg Tablet - one Tablet(s) by mouth 60 
+min
+prior to intercourse Do not take more than once per day.
+TERAZOSIN - 5 mg Capsule - 1 Capsule(s) by mouth once a day
+TRIAMCINOLONE ACETONIDE - 0.1 % Ointment - apply after shower
+every other day
+ASPIRIN -  (OTC) - 81 mg Tablet, Delayed Release (E.C.) - 1
+Tablet(s) by mouth once a day
+ERGOCALCIFEROL (VITAMIN D2) [VITAMIN D] -  (OTC; record) - 
+Dosage
+uncertain
+GARLIC -  (OTC) - Dosage uncertain
+
+ 
+Discharge Medications:
+1. bacitracin zinc 500 unit/g Ointment Sig: One (1) Appl Topical 
+QID (4 times a day).  
+2. ciprofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q12H 
+(every 12 hours) for 16 days.
+Disp:*32 Tablet(s)* Refills:*0*
+3. cholecalciferol (vitamin D3) 400 unit Tablet Sig: Two (2) 
+Tablet PO DAILY (Daily).  
+4. latanoprost 0.005 % Drops Sig: One (1) Drop Ophthalmic DAILY 
+(Daily).  
+5. finasteride 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
+Disp:*30 Tablet(s)* Refills:*2*
+6. terazosin 5 mg Capsule Sig: Two (2) Capsule PO HS (at 
+bedtime).
+Disp:*30 Capsule(s)* Refills:*2*
+7. oxycodone 5 mg Tablet Sig: 0.5 Tablet PO Q4H (every 4 hours) 
+as needed for pain.
+Disp:*15 Tablet(s)* Refills:*0*
+8. acetaminophen 500 mg Tablet Sig: Two (2) Tablet PO Q6H (every 
+6 hours).  
+9. metformin 500 mg Tablet Sig: One (1) Tablet PO BID (2 times a 
+day).  
+10. Colace 100 mg Capsule Sig: One (1) Capsule PO twice a day: 
+hold if diarrhea.
+Disp:*60 Capsule(s)* Refills:*2*
+
+ 
+
+###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:
+hematuria, BPH
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: hematuria {Blood in urine}, BPH {Benign prostatic hyperplasia}, Mental Status {Neurological mental status determination}, Clear {Normal breath sounds}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, interactive {Does communicate}, 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:
+-No vigorous physical activity for 2 weeks. 
+
+ 
+
+-Expect to see occasional blood in your urine and to experience 
+urgency and frequecy over the next month. 
+
+ 
+
+-You may shower and bathe normally. 
+
+ 
+
+-Tylenol should be your first line pain medication, a narcotic 
+pain medication has been prescribed for breakthough pain >4.  
+Replace Tylenol with narcotic pain medication.  Max daily 
+Tylenol dose is 4gm, note that narcotic pain medication also 
+contains Tylenol (acetaminophen)
+
+ 
+
+-Do not drive or drink alcohol while taking narcotics
+
+ 
+
+-Colace has been prescribed to avoid post surgical constipation 
+and constipation related to narcotic pain medication, 
+discontinue if loose stool or diarrhea develops.
+
+ 
+
+-Resume all of your home medications, except hold NSAID 
+(aspirin,  and ibuprofen containing products such as advil & 
+motrin,) until you see your urologist in follow-up
+
+ 
+
+ -Resume all of your home medications, but please avoid 
+aspirin/advil for one week.   
+
+- Ciprofloxacin has been prescribed.  You will take a total of 3 
+week course.
+ 
+
+-Call Dr. ___ (___) for follow-up AND if you 
+have any questions (page Dr. ___ at ___. 
+
+ 
+
+ -If you have fevers > 101.5 F, vomiting, severe abdominal pain, 
+or inability to urinate, call your doctor or go to the nearest 
+emergency room.
+
+ 
+
+###RESPONSE: activity {Functional activity education}, blood in your urine {Blood in urine}, urgency {Urgent desire to urinate}, frequecy {Increased frequency of urination}, may shower {Wound treatment education}, Tylenol {Administration of analgesic}, pain medication {Administration of analgesic}, narcotic {Narcotherapy}, pain medication {Administration of analgesic}, breakthough pain {Breakthrough pain}, Tylenol {Administration of analgesic}, narcotic {Narcotherapy}, pain medication {Administration of analgesic}, Tylenol {Administration of analgesic}, narcotic {Narcotherapy}, pain medication {Administration of analgesic}, Tylenol {Administration of analgesic}, Do not drive {Recommendation to avoid activity of daily living}, post surgical {Postoperative state}, constipation {Constipation}, constipation {Constipation}, narcotic {Narcotherapy}, pain medication {Administration of analgesic}, loose stool {Loose stool}, diarrhea {Diarrhea}, aspirin {Administration of aspirin}, aspirin {Administration of aspirin}, Ciprofloxacin {Antibiotic therapy}, fevers {Fever}, vomiting {Vomiting}, abdominal pain {Abdominal pain}, inability to urinate {Retention of urine}, call your doctor {Informing doctor}, emergency {Emergency treatment}"
+"###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: 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: 
+No Known Allergies / Adverse Drug Reactions
+ 
+Attending: ___
+ 
+Chief Complaint:
+charcot arthropathy
+ 
+Major Surgical or Invasive Procedure:
+___
+1. Closed treatment right bimalleolar ankle fracture with
+    manipulation.
+2. Tenotomy, right Achilles tendon.
+3. Flexor hallucis longus tendon release.
+4. Flexor digitorum longus release.
+5. Posterior tibial tendon release.
+
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, charcot arthropathy {Charcot's arthropathy}, right {Structure of right ankle}, bimalleolar ankle fracture {Bimalleolar fracture of ankle}, manipulation {Manipulation}, Tenotomy {Tenotomy}, right Achilles tendon {Structure of right Achilles tendon}, Flexor hallucis longus tendon {Structure of flexor hallucis longus tendon}, release {Release}, Flexor digitorum longus {Flexor digitorum longus muscle structure}, release {Release}, Posterior tibial tendon {Tendon structure of posterior tibial muscle}, release {Release}"
+"###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:
+I am seeing your patient today in the ___ clinic.  I am
+seeing this patient today for review.  She has had unfortunately
+a fall approximately one and half weeks ago.  She had a twisting
+injury.  She has had pain in the ankle since that time.
+
+She does not describe any changes in her health.  Her past
+medical history has been documented including diabetes.
+
+I examined her today and found that she has some tenderness on
+deep palpation of medial or lateral aspects of her ankle.  No
+complaints of any calf pain or calf swelling to suggest deep 
+vein
+thrombosis or pulmonary embolus.
+
+IMAGING:  I reviewed her x-rays that show evidence of an acute
+fracture involving her ankle joint, specifically a bimalleolar
+ankle fracture.  She does have underlying Charcot arthropathy.
+
+ASSESSMENT AND PLAN:  I had a discussion today with ___
+regarding management.  I am concerned regarding her new 
+fracture.
+ We have talked about treatment.  We have talked about surgical
+intervention to address her deformity; however, I am concerned
+about adding additional hardware because of her history of
+noncompliance and the risk of deep infection that may require
+additional procedures including a possible below-knee 
+amputation.
+
+We will go ahead and make the appropriate arrangements for her 
+to
+have her procedure done to stabilize the ankle and again, we 
+will
+try to avoid any hardware that would not be removed at a later
+date.  She also is aware of the possibility that she may require
+a fusion type procedure as if she continues to have instability
+involving the ankle.
+
+I have answered all of her questions.  She was given specific
+instructions regarding followup.  She is to remain
+nonweightbearing.  She understands signs and symptoms associated
+with deep vein thrombosis and pulmonary embolus.
+
+ 
+
+###RESPONSE: fall {Falls}, twisting
+injury {Rotation injury}, pain in the ankle {Ankle pain}, tenderness {Tenderness}, deep palpation {Deep palpation}, medial {Structure of medial aspect of ankle}, lateral aspects {Structure of lateral aspect of ankle}, ankle {Ankle region structure}, No
+complaints {No complaints}, calf pain {Pain in calf}, calf swelling {Swollen calf}, deep 
+vein
+thrombosis {Deep venous thrombosis}, pulmonary embolus {Pulmonary embolism}, IMAGING {Imaging}, x-rays {Radiographic imaging procedure}, fracture {Fracture}, ankle joint {Ankle joint structure}, bimalleolar
+ankle fracture {Bimalleolar fracture of ankle}, Charcot arthropathy {Charcot's arthropathy}, fracture {Fracture}, surgical
+intervention {Surgical procedure}, deformity {Deformity}, infection {Infectious disease}, procedures {Procedure}, below-knee 
+amputation {Amputation of leg through tibia and fibula}, ankle {Ankle region structure}, fusion type procedure {Fusion procedure}, ankle {Ankle region structure}, signs {Sign}, deep vein thrombosis {Deep venous thrombosis}, pulmonary embolus {Pulmonary embolism}"
+"###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:
+PMH: 
+type 1 DM
+alport syndrome
+htn
+hypercholesterolemia
+
+PSH:
+vp shunt 
+c-section
+
+ 
+
+###RESPONSE: type 1 DM {Diabetes mellitus type 1}, alport syndrome {Alport syndrome}, htn {Hypertensive disorder, systemic arterial}, hypercholesterolemia {Hypercholesterolemia}, shunt {Surgical fistula}, c-section {Cesarean section}"
+"###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:
+non contributory
+ 
+
+###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:
+splint c/d/i
+neurovascularly intact distally
+foot wwp
+ 
+
+###RESPONSE: splint {Application of splint}, neurovascularly intact {Normal peripheral neurovascular function}, foot {Foot 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: Pertinent Results:
+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: Brief Hospital Course:
+The patient was admitted to the orthopaedic surgery service and 
+was taken to the operating room for above described procedure. 
+Please see separately dictated operative report for details. The 
+surgery was uncomplicated and the patient tolerated the 
+procedure well. Patient received perioperative IV antibiotics.
+
+Otherwise, pain was initially controlled with a PCA followed by 
+a transition to oral pain medications on POD#1.  The patient 
+received lovenox for DVT prophylaxis starting on the morning of 
+POD#1.  The patient was seen daily by physical therapy.   
+
+At the time of discharge the patient was tolerating a regular 
+diet and feeling well.  The patient was afebrile with stable 
+vital signs.  The patient's  pain was adequately controlled on 
+an oral regimen. The operative extremity was neurovascularly 
+intact.   The patient is non-weight-bearing on the operative 
+lower extremity.
+ 
+She is discharged to home in stable condition with prescriptions 
+for oxycodone and lovenox
+ 
+
+###RESPONSE: surgery {Surgical procedure}, IV antibiotics {Intravenous antibiotic therapy}, pain {Pain}, PCA {Patient controlled analgesia}, oral {Administration of drug or medicament via oral route}, pain medications {Administration of analgesic}, DVT prophylaxis {Prevention of deep vein thrombosis}, physical therapy {Physical therapy procedure}, regular 
+diet {Normal diet}, feeling well {Well in self}, afebrile {Fever}, stable 
+vital signs {Normal vital signs}, pain was adequately controlled {Demonstrates adequate pain control}, oral {Administration of drug or medicament via oral route}, regimen {Therapeutic regimen}, operative {Operative site}, extremity {Limb structure}, neurovascularly 
+intact {Normal peripheral neurovascular function}, non-weight-bearing {Non-weight-bearing}, operative {Operative site}, lower extremity {Lower limb structure}, stable condition {Patient's condition stable}"
+"###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:
+Medications - Prescription
+AMLODIPINE - 10 mg Tablet - take 1 Tablet(s) by mouth once a day
+ENALAPRIL MALEATE - 20 mg Tablet - take 1 Tablet(s) by mouth
+twice a day
+INSULIN GLARGINE [LANTUS] - 100 unit/mL Solution - use as
+directed twice a day
+INSULIN LISPRO [HUMALOG] - 100 unit/mL Solution - use as 
+directed
+four times a day
+PAROXETINE HCL [PAXIL] - 10 mg Tablet - take 1 Tablet(s) by 
+mouth
+once a day
+PRAVASTATIN - 40 mg Tablet - take 1 Tablet(s) by mouth at 
+bedtime
+SULFAMETHOXAZOLE-TRIMETHOPRIM - 800 mg-160 mg Tablet - take 1
+Tablet(s) by mouth twice a day
+ 
+Medications - OTC
+BLOOD SUGAR DIAGNOSTIC [FREESTYLE LITE STRIPS] -   Strip - use 
+as
+directed to measure blood glucose four times a day
+INSULIN SYRINGE-NEEDLE U-100 [BD INSULIN SYRINGE ULTRA-FINE] - 
+30
+gauge X ___ Syringe - use as directed 8 times a day as needed
+for glucose level
+
+ 
+Discharge Medications:
+1. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 
+6 hours) as needed for pain.  
+2. amlodipine 5 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily).  
+
+3. enalapril maleate 10 mg Tablet Sig: Two (2) Tablet PO BID (2 
+times a day).  
+4. pravastatin 20 mg Tablet Sig: Two (2) Tablet PO HS (at 
+bedtime).  
+5. oxycodone 5 mg Tablet Sig: ___ Tablets PO Q4H (every 4 hours) 
+as needed for Pain.  
+6. enoxaparin 40 mg/0.4 mL Syringe Sig: One (1) syringe 
+Subcutaneous Q 24H (Every 24 Hours).  
+
+ 
+
+###RESPONSE: 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:
+charcot arthropathy
+
+ 
+Discharge Condition:
+home.  stable.  alert and oriented x3.
+
+ 
+
+###RESPONSE: charcot arthropathy {Charcot's arthropathy}, stable {Patient's condition stable}, alert {Mentally alert}, oriented x3 {Oriented to person, time and place}"
+"###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:
+1. Please return to the emergency department or notify your 
+physician if you experience any of the following: severe pain 
+not relieved by medication, increased swelling, decreased 
+sensation, difficulty with movement, fevers greater than 101.5, 
+shaking chills, increasing redness or drainage from the incision 
+site, chest pain, shortness of breath or any other concerns.
+
+2. Please follow up with your primary physician regarding this 
+admission and any new medications and refills.  
+ 
+3. Resume your home medications unless otherwise instructed.
+
+ 
+4. You have been given medications for pain control. Please do 
+not drive, operate heavy machinery, or drink alcohol while 
+taking these medications. As your pain decreases, take fewer 
+tablets and increase the time between doses. This medication can 
+cause constipation, so you should drink plenty of water daily 
+and take a stool softener (such as colace) as needed to prevent 
+this side effect.  Call your surgeons office 3 days before you 
+are out of medication so that it can be refilled.  These 
+medications cannot be called into your pharmacy and must be 
+picked up in the clinic or mailed to your house.  Please allow 
+an extra 2 days if you would like your medication mailed to your 
+home.
+
+ 
+5. Please call your surgeon's office to schedule or confirm your 
+follow-up appointment in two (2) weeks.
+
+ 
+6. Please DO NOT take any non-steroidal anti-inflammatory 
+medications (NSAIDs such as celebrex, ibuprofen, advil, aleve, 
+motrin, etc).
+
+ 
+7. ANTICOAGULATION: Please continue your lovenox for four (4) 
+weeks to help prevent deep vein thrombosis (blood clots).  
+
+ 
+8. CAST CARE: Please keep your cast clean, dry and intact. 
+
+ 
+9. ACTIVITY: Non-weight bearing on the operative extremity
+ 
+
+###RESPONSE: severe pain {Severe pain}, swelling {Swelling}, decreased 
+sensation {Hypesthesia}, difficulty with movement {Difficulty moving}, fevers {Fever}, shaking {Tremor}, chills {Chill}, redness {Redness of skin over lesion}, drainage {Wound discharge}, incision 
+site {Surgical incision wound}, chest pain {Chest pain}, shortness of breath {Dyspnea}, medications {Patient medication education}, medications {Patient medication education}, medications {Patient medication education}, pain control {Pain control}, drink alcohol {Current drinker of alcohol}, while 
+taking these medications {Patient medication education}, pain decreases {Sensation of pain reduced}, constipation {Constipation}, take a stool softener {Administration of laxative}, side effect {Medication side effects present}, medication so that it can be refilled {Medication prefill education}, medications {Patient medication education}, medication {Patient medication education}, non-steroidal anti-inflammatory 
+medications {Non-steroidal anti-inflammatory agent therapy}, ANTICOAGULATION {Anticoagulant therapy}, prevent deep vein thrombosis {Prevention of deep vein thrombosis}, blood clots {Blood clot}, CAST CARE {Cast care}, cast {Cast}, clean, dry and intact {Wound healing well}, ACTIVITY {Functional activity education}, Non-weight bearing {Non-weight-bearing}, operative {Operative site}, extremity {Limb 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: 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: 
+Lincosamides / Penicillins
+ 
+Attending: ___
+ 
+Chief Complaint:
+Presentation for TIPS procedure
+ 
+Major Surgical or Invasive Procedure:
+TIPS
+
+ 
+
+###RESPONSE: Penicillins {Allergy to penicillin}, TIPS procedure {Transjugular intrahepatic portosystemic shunt}, TIPS {Transjugular intrahepatic portosystemic shunt}"
+"###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 a PMHx of ___ cirrhosis c/b refractory ascites and 
+esophageal varices who presents for direct admission to the ET 
+service for TIPS procedure given now weekly need for 
+paracenteses and abdominal pain.  Pt dx with NASH in ___ 
+following her gastric bypass and had no symptoms until ___ when 
+she started to have increased abdominal girth and abd pain.  Pt 
+has had weekly paracentesis for refractory ascites, most 
+recently ___ where 9L was taken off. She has complaints today of 
+dull abd pain given length of time since last tap.  
+
+Pt had EGD on ___ which revealed two lower esophageal 
+varices. Had one episode of HE one month ago when she missed her 
+lactulose. Pt notes persistent issues with varying constipation 
+and diarrhea and requires lactulose for BM's. Had 3 BM's 
+yesterday, denies melena/ BRBPR/ hematemesis.
+
+ 
+
+###RESPONSE: cirrhosis {Cirrhosis of liver}, refractory ascites {Refractory ascites}, esophageal varices {Esophageal varices}, TIPS procedure {Transjugular intrahepatic portosystemic shunt}, paracenteses {Abdominal paracentesis}, abdominal pain {Abdominal pain}, NASH {Nonalcoholic steatohepatitis}, gastric bypass {Bypass of stomach}, increased abdominal girth {Swollen abdomen}, abd pain {Abdominal pain}, paracentesis {Abdominal paracentesis}, refractory ascites {Refractory ascites}, dull {Dull pain}, abd pain {Abdominal pain}, tap {Abdominal paracentesis}, EGD {Esophagogastroduodenoscopy}, esophageal 
+varices {Esophageal varices}, HE {Hepatic encephalopathy}, constipation {Constipation}, diarrhea {Diarrhea}, BM {Defecation care}, BM {Finding of defecation}, melena {Melena}, BRBPR {Hematochezia}, hematemesis {Hematemesis}"
+"###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:
+NASH cirrhosis with portal hypertension c/b refractory ascites, 
+esophageal varices (EGD on ___
+ITP
+Obesity s/p gastric bypass surgery in ___
+CCY in ___
+C-section ___
+
+ 
+
+###RESPONSE: NASH {Nonalcoholic steatohepatitis}, cirrhosis {Cirrhosis of liver}, portal hypertension {Portal hypertension}, refractory ascites {Refractory ascites}, esophageal varices {Esophageal varices}, EGD {Esophagogastroduodenoscopy}, ITP {Chronic idiopathic thrombocytopenic purpura}, Obesity {Obesity}, gastric bypass {Bypass of stomach}, surgery {Surgical procedure}, CCY {Cholecystectomy}, C-section {Cesarean section}"
+"###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:
+Great uncle died of ""liver disease"" at age ___, possible HCC
+
+ 
+
+###RESPONSE: died {Dead}, liver disease {Disorder of liver}, HCC {Liver cell carcinoma}"
+"###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:
+Physical exam on admission:
+Vitals-  97.9 118/64 83 18 99% RA
+General:  Alert, oriented, pleasant, sitting up in bed
+HEENT:  NCAT, PERRL, EOMI, MMM, oropharynx clear
+Neck:  supple, no JVD, no LAD
+CV:  RRR, nl S1 and S2, no m/r/g
+Lungs:  CTAB without wheeze or crackles
+Abdomen:  obese, distended with + fluid wave, non-tender, no 
+appreciable organomegaly
+GU:  no foley
+Ext:  Warm and dry, 2+ peripheral pulses, trace pedal edema, no 
+cyanosis
+Neuro:  AOx3, CN2-12 grossly intact, moves all extremities 
+freely
+Skin:  varicose veins noted on bilateral ___, no rash or lesions
+
+On discharge:
+
+Vitals:  Tm 98.3 Tc 97.9 HR 88 BP 127/67 RR 20 
+
+###RESPONSE: Physical Exam {Physical examination procedure}, Vitals {Vital signs finding}, RA {Breathing room air}, General {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, sitting {Sitting position}, HEENT {Physical examination procedure}, NC {Normal head}, PERRL {Pupils equal and reacting to light}, EOMI {Normal ocular motility}, MMM {Moist oral mucosa}, oropharynx clear {Pharynx normal}, Neck {Physical examination procedure}, supple {Normal movement of neck}, JVD {Jugular venous engorgement}, LAD {Lymphadenopathy}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, S2 {Normal second heart sound, S>2<}, no m/r/g {Heart sounds normal}, Lungs {Examination of respiratory system}, CTAB {Normal breath sounds}, wheeze {Wheezing}, crackles {Respiratory crackles}, Abdomen {Examination of abdomen}, obese {Obese abdomen}, distended {Swollen abdomen}, fluid {Effusion}, non-tender {Abdominal tenderness}, organomegaly {Abdominal organomegaly}, GU {Examination of genitourinary system}, Ext {Examination of limb}, Warm {Warm skin}, 2+ peripheral pulses {Peripheral pulses normal}, edema {Edema}, cyanosis {Cyanosis}, Neuro {Neurological examination}, AOx3 {Oriented to person, time and place}, 12 {Hypoglossal nerve structure}, grossly intact {Normal nervous system function}, all extremities {All extremities}, Skin {Examination of skin}, varicose veins {Venous varices}, rash {Eruption of skin}, lesions {Lesion}, Vitals {Vital signs finding}, HR {Finding of heart rate}, BP {Blood pressure finding}, RR {Finding of rate of respiration}"
+"###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: 
+Gen: WDWN, no acute distress, sitting in chair
+HENT: no scleral icterus
+CV: RRR, no m/r/g
+Pulm: CTA in all fields, no wheezes or ronchi
+Abd: obese, distended, mild tenderness to palpation in RUQ, hard 
+enlarged liver palpated. RUQ wound bandaged, clean dry and 
+intact.
+Ext: 2+ DP pulses bilaterally
+Neuro: A&Ox3, fine tremor but no asterixis 
+
+ 
+
+###RESPONSE: Physical Exam {Physical examination procedure}, Gen {General examination of patient}, WDWN {Well nourished}, no acute {No abnormality detected}, distress {Distress}, sitting {Sitting position}, HENT {Physical examination procedure}, scleral icterus {Scleral icterus}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, no m/r/g {Heart sounds normal}, Pulm {Examination of respiratory system}, CTA {Normal breath sounds}, wheezes {Wheezing}, ronchi {Wheeze - rhonchi}, Abd {Examination of abdomen}, obese {Obese abdomen}, distended {Swollen abdomen}, mild {Symptom mild}, tenderness to palpation in RUQ {Tenderness of right upper quadrant of abdomen}, enlarged liver {Large liver}, palpated {Palpation of abdomen}, RUQ {Structure of right upper quadrant of abdomen}, wound {Surgical incision wound}, bandaged {Application of bandage}, clean dry and 
+intact {Wound healing well}, Ext {Examination of limb}, 2+ DP pulses {All pulses present in bilateral lower limbs}, Neuro {Neurological examination}, A&Ox3 {Oriented to person, time and place}, fine tremor {Fine tremor}, asterixis {Asterixis}"
+"###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:
+Pertinent labs on admission:
+
+___ 05:11PM BLOOD WBC-3.4* RBC-3.61* Hgb-7.4* Hct-25.8* 
+MCV-72* MCH-20.5* MCHC-28.7* RDW-20.7* RDWSD-53.4* Plt Ct-77*
+___ 05:11PM BLOOD ___ PTT-30.1 ___
+___ 05:11PM BLOOD Glucose-127* UreaN-10 Creat-0.8 Na-132* 
+K-3.6 Cl-99 HCO3-23 AnGap-14
+___ 05:11PM BLOOD ALT-15 AST-47* AlkPhos-226* TotBili-0.7 
+DirBili-0.3 IndBili-0.4
+___ 05:11PM BLOOD Albumin-3.0* Calcium-9.0 Phos-3.5 Mg-1.7
+___ 05:11PM BLOOD HCG-<5
+
+Reports:
+Hepatic ultrasound with doppler studies ___
+FINDINGS:  
+  
+Liver:  The hepatic parenchyma is coarsened and nodular.  
+Nofocal liver 
+lesions are identified.  There is a moderate amount of ascites. 
+Bile ducts:  There is no intrahepatic biliary ductal dilation.  
+The common 
+hepatic duct measures 2 mm. 
+Gallbladder:  The gallbladder surgically absent. 
+Pancreas:  The pancreas is largely obscured by overlying bowel 
+gas, with 
+imaged portions of the pancreas appearing within normal limits. 
+Spleen:  The spleen is markedly enlarged, and measures greater 
+than 18.3 cm. 
+Kidneys:  Limited sagittal views of the right kidney demonstrate 
+no evidence 
+of hydronephrosis. 
+  
+Doppler evaluation: 
+The main portal vein is patent, with flow in the appropriate 
+direction.  The 
+right and left portal veins are patent, with antegrade flow. 
+The main hepatic artery is patent, with appropriate waveform. 
+Right, middle and left hepatic veins are patent, with 
+appropriate waveforms. 
+  
+IMPRESSION: 
+  
+  
+1. Patent hepatic vasculature with appropriate direction of 
+flow. 
+2. Cirrhosis and sequela of portal hypertension including marked 
+splenomegaly 
+and a moderate amount of ascites. 
+3. Status post cholecystectomy. 
+
+Micro:
+
+Pertinent labs on discharge:
+
+___ 05:45PM BLOOD WBC-2.8* RBC-3.44* Hgb-7.4* Hct-25.6* 
+MCV-74* MCH-21.5* MCHC-28.9* RDW-20.5* RDWSD-53.5* Plt Ct-66*
+___ 04:33AM BLOOD Glucose-133* UreaN-13 Creat-0.9 Na-129* 
+K-4.0 Cl-97 HCO3-23 AnGap-13
+___ 04:33AM BLOOD ALT-100* AST-258* AlkPhos-212* 
+TotBili-1.4
+___ 04:33AM BLOOD Calcium-8.9 Phos-3.3 Mg-1.9
+___ 04:50AM BLOOD Albumin-3.0* Calcium-9.0 Phos-3.9 Mg-1.___ female with ITP and NASH cirrhosis c/b portal HTN resulting 
+in refractory ascites requiring large volume (___) paracenteses 
+qWeek presenting for TIPS procedure.
+
+#NASH cirrhosis c/b esophageal varicies, refractory ascites and 
+hepatic encephalopathy: Pt with persistent disease and symptoms 
+since ___. Has been previously evaluated for 
+transplant, however, it was decided to undergo TIPS given weekly 
+need for large volume paracenteses and abdominal pain.
+
+#NASH cirrhosis c/b esophageal varicies, refractory ascites and 
+hepatic encephalopathy: Pt with persistent disease and symptoms 
+since ___. Has been previously evaluated for 
+transplant, however, it was decided to undergo TIPS given weekly 
+need for large volume paracenteses and abdominal pain. 
+Complicated TIPS completed ___. Specifically, right hepatic 
+vein to right portal vein TIPS placed, complicated by suspected 
+dissection of the portal vein and jailing of right PV posterior 
+branches. TIPS was extended into main PV with luminex stents, 
+dilated to 10 mm. post procedure gradient approx 15, similar to 
+preprocedure gradient. 5 L paracentesis. approx 470 cc contrast 
+used. Pt reported abd soreness ""like punched"" which improved 
+with oxycodone. LFTs and Cr bumped. Creatinine normalized with 
+500cc 5% albumin for suspected contrast-induced nephropathy vs 
+HRS. Will obtain f/u ultrasound in 1 week post-discharge and f/u 
+with hepatology as arranged. Pt was maintained on lactulose 
+without evidence of hepatic encephalopathy throughout her stay.
+
+#Hypotension - likely secondary to cirrhosis. Held home lasix, 
+spironolactone, nadolol for labile blood pressure and optimizing 
+renal blood flow which may be restarted per hepatology as an 
+outpatient. 
+
+#Anemia - likely secondary to chronic liver disease
+- required 1U pRBC during stay with Hg 6.7 and appropriate rise 
+in Hg to 7.4 prior to discharge. 
+
+# History of ITP:
+-Stable during hospitalization. Plt ranged 66-103
+
+ 
+
+###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}, 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}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, Albumin {Albumin measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Hepatic ultrasound with doppler {Doppler ultrasonography of liver and portal system}, Liver {Liver structure}, hepatic parenchyma {Structure of parenchyma of liver}, nodular {Nodule}, liver 
+lesions {Lesion of liver}, ascites {Ascites}, Bile ducts {Bile duct structure}, intrahepatic biliary ductal {Intrahepatic biliary tract structure}, dilation {Dilatation}, common 
+hepatic duct {Structure of common hepatic duct}, Gallbladder {Gallbladder structure}, gallbladder surgically absent {Gallbladder not seen}, Pancreas {Pancreatic structure}, pancreas {Pancreatic structure}, bowel {Intestinal structure}, pancreas {Pancreatic structure}, Spleen {Splenic structure}, spleen is markedly enlarged {Splenomegaly}, Kidneys {Kidney structure}, right kidney {Right kidney structure}, no evidence {No abnormality detected}, hydronephrosis {Hydronephrosis}, evaluation {Evaluation procedure}, portal vein {Portal vein structure}, right {Structure of right main branch of portal vein}, left portal veins {Structure of left main branch of portal vein}, hepatic artery {Structure of hepatic artery}, Right {Structure of right main branch of portal vein}, middle {Structure of middle hepatic vein}, left hepatic veins {Structure of left hepatic vein}, hepatic vasculature {Vascular structure of liver}, Cirrhosis {Cirrhosis of liver}, portal hypertension {Portal hypertension}, splenomegaly {Splenomegaly}, ascites {Ascites}, Status post {Postoperative state}, cholecystectomy {Cholecystectomy}, 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}, BLOOD 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}, Albumin {Albumin measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, ITP {Chronic idiopathic thrombocytopenic purpura}, NASH {Nonalcoholic steatohepatitis}, cirrhosis {Cirrhosis of liver}, portal HTN {Portal hypertension}, refractory ascites {Refractory ascites}, paracenteses {Abdominal paracentesis}, TIPS procedure {Transjugular intrahepatic portosystemic shunt}, NASH {Nonalcoholic steatohepatitis}, cirrhosis {Cirrhosis of liver}, esophageal varicies {Esophageal varices}, refractory ascites {Refractory ascites}, hepatic encephalopathy {Hepatic encephalopathy}, disease {Disease}, transplant {Transplantation of liver}, TIPS {Transjugular intrahepatic portosystemic shunt}, paracenteses {Abdominal paracentesis}, abdominal pain {Abdominal pain}, NASH {Nonalcoholic steatohepatitis}, cirrhosis {Cirrhosis of liver}, esophageal varicies {Esophageal varices}, refractory ascites {Refractory ascites}, hepatic encephalopathy {Hepatic encephalopathy}, disease {Disease}, transplant {Transplantation of liver}, TIPS {Transjugular intrahepatic portosystemic shunt}, paracenteses {Abdominal paracentesis}, abdominal pain {Abdominal pain}, TIPS {Transjugular intrahepatic portosystemic shunt}, right hepatic 
+vein {Structure of right hepatic vein}, right portal vein {Structure of right main branch of portal vein}, TIPS {Transjugular intrahepatic portosystemic shunt}, placed {Implantation procedure}, dissection {Dissection procedure}, portal vein {Portal vein structure}, right PV {Structure of right main branch of portal vein}, TIPS {Transjugular intrahepatic portosystemic shunt}, PV {Pulmonary valve structure}, stents {Insertion of arterial stent}, dilated {Dilatation}, procedure {Procedure}, paracentesis {Abdominal paracentesis}, abd soreness {Abdominal pain}, improved {Patient's condition improved}, LFTs {Hepatic function panel}, Cr {Finding of creatinine level}, Creatinine normalized {Serum creatinine within reference range}, albumin {Administration of albumin}, contrast-induced nephropath {Acute kidney injury caused by contrast agent}, HRS {Hepatorenal syndrome}, ultrasound {Ultrasonography}, hepatic encephalopathy {Hepatic encephalopathy}, Hypotension {Low blood pressure}, cirrhosis {Cirrhosis of liver}, lasix {Diuretic therapy}, labile blood pressure {Labile blood pressure}, renal {Kidney structure}, restarted {Restart of medication}, Anemia {Anemia}, chronic liver disease {Chronic liver disease}, 1U pRBC {Transfusion of packed red blood cells}, ITP {Chronic idiopathic thrombocytopenic purpura}, Stable {Patient's condition stable}"
+"###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. Furosemide 20 mg PO DAILY 
+2. Lactulose 30 mL PO TID 
+3. Nadolol 20 mg PO DAILY 
+4. Omeprazole 20 mg PO BID 
+5. Spironolactone 150 mg PO DAILY 
+6. Vitamin D 400 UNIT PO DAILY 
+
+ 
+Discharge Medications:
+1. Omeprazole 20 mg PO BID 
+2. Lactulose 30 mL PO TID 
+3. Vitamin D 400 UNIT PO DAILY 
+4. OxycoDONE (Immediate Release)  2.5 mg PO Q6H:PRN pain 
+RX *oxycodone 5 mg 1 tablet(s) by mouth every six hours Disp #*5 
+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:
+Primary diagnosis
+NASH cirrhosis s/p TIPS procedure
+
+Secondary diagnoses:
+ITP
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: NASH {Nonalcoholic steatohepatitis}, cirrhosis {Cirrhosis of liver}, TIPS procedure {Transjugular intrahepatic portosystemic shunt}, ITP {Chronic idiopathic thrombocytopenic purpura}, Mental Status {Neurological mental status determination}, Clear {Normal breath sounds}, 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:
+Dear Ms. ___,
+
+It was a pleasure taking part in your care during your recent 
+hospitalization at ___. You 
+were hospitalized for a TIPS procedure. Your blood pressure was 
+low at times during this admission so we stopped your blood 
+pressure medications including furosemide, nadolol, and 
+spironolactone. Please discuss with your liver doctor when to 
+restart these medications.
+
+Please follow-up with all appointments listed below and take 
+your medications as prescribed.
+
+Again, it was a pleasure taking part in your care-
+
+-Your ___ Care Team
+ 
+                             ___ MD ___
+ 
+Completed by: ___
+
+###RESPONSE: TIPS procedure {Transjugular intrahepatic portosystemic shunt}, blood pressure {Blood pressure monitoring}, blood 
+pressure medications {Antihypertensive therapy}, liver {Liver structure}, medications {Administration of drug or medicament}"
+"###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:
+nausea, vomiting, diarrhea
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: No Known Allergies {Allergic disposition}, Adverse Drug Reactions {Propensity to adverse reactions to drug}, nausea, vomiting, diarrhea {Nausea, vomiting and 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:
+___ y/o M with a past medical history of hypertension
+NIDDM2, HLD, stable angina, hearing loss and metastatic 
+pancreatic cancer s/p ___ on palliative chemotherapy 
+presenting with 6 days of diarrhea and 2 days of nausea and 
+vomiting. He notes ___ episodes of watery, non-bloody diarrhea 
+every day for the past 6 days. He also complains of several days 
+of nausea and vomiting. He also complains of one episode of 
+night sweats and chills on day prior to admission. Notes he has 
+been unable to take POs and has been feeling dehydrated and 
+lightheaded.  He denies abdominal pain,
+fevers, bloody stools, chest pain and SOB. The patient had his 
+most recent session of chemotherapy on ___ and his prior 
+session was held in the setting of acute illness. He denies any 
+recent sick contacts.
+
+Of note, he was recently hospitalized ___ for chest 
+pain when he was found to be febrile and have a UTI and GNR 
+bacteremia.
+
+ED course:
+In the ED, patient was noted to have nausea, vomiting and 
+diarrhea. He received 1L IVF, Zofran and morphine for pain 
+control. CT A/P showed mild proctitis so he was admitted for 
+further workup.
+
+ 
+
+###RESPONSE: hypertension {Hypertensive disorder, systemic arterial}, NIDDM2 {Diabetes mellitus type 2}, HLD {Hyperlipidemia}, stable angina {Stable angina}, hearing loss {Hearing loss}, metastatic 
+pancreatic cancer {Metastatic carcinoma to head of pancreas}, palliative chemotherapy {Administration of palliative antineoplastic agent}, diarrhea {Diarrhea}, nausea and 
+vomiting {Nausea and vomiting}, bloody diarrhea {Hemorrhagic diarrhea}, nausea and vomiting {Nausea and vomiting}, night sweats {Night sweats}, chills {Chill}, dehydrated {Dehydration}, lightheaded {Lightheadedness}, abdominal pain {Abdominal pain}, fevers {Fever}, bloody stools {Hematochezia}, chest pain {Chest pain}, SOB {Dyspnea}, chemotherapy {Chemotherapy}, chest 
+pain {Chest pain}, febrile {Fever}, UTI {Urinary tract infectious disease}, GNR 
+bacteremia {Bacteremia caused by Gram-negative bacteria}, nausea, vomiting and 
+diarrhea {Nausea, vomiting and diarrhea}, IVF {Administration of intravenous fluids}, morphine {Allergy to morphine}, pain 
+control {Pain control}, CT A/P {Computed tomography of abdomen and pelvis}, mild {Symptom mild}, proctitis {Proctitis}, workup {Evaluation 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: Past Medical History:
+PAST MEDICAL HISTORY:
+T2D,HLD,HTN,stable angina and hearing loss. 
+
+See OMR for detailed oncologic history: Briefly, 
+
+___: dx with pancreatic cancer ___ s/p Whipple
+Adjuvant gemcitabine and Abraxane until ___ 
+___- additional chemotherapy for metatastatic liver lesions
+___- worsening metastatic liver lesions
+
+PAST SURGICAL HISTORY: 
+___ ___ 
+
+ 
+
+###RESPONSE: T2D {Diabetes mellitus type 2}, HLD {Hyperlipidemia}, HTN {Hypertensive disorder, systemic arterial}, stable angina {Stable angina}, hearing loss {Hearing loss}, pancreatic cancer {Carcinoma of pancreas}, chemotherapy {Chemotherapy}, metatastatic liver {Metastatic malignant neoplasm to liver}, metastatic liver {Metastatic malignant neoplasm to liver}"
+"###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 prostate cancer, brother liver cancer.
+ 
+
+###RESPONSE: prostate cancer {Carcinoma of prostate}, liver cancer {Malignant neoplasm of liver}"
+"###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
+Vitals: ___ 1126 Temp: 98.0 PO BP: 130/72 HR: 88 RR: 18 O2
+sat: 99% O2 delivery: RA   
+General: Awake, cooperative, NAD.
+HEENT: Pupils react normally to light. Oropharynx is clear.
+Neck: Supple
+Lungs: Clear with no wheezing, rhonchi or rales.
+Cardiovascular: Regular rate and rhythm. Normal S1 and S2 no
+m/r/g.
+Abdomen: soft, tender to palpation in epigastric area.
+non-distended. periumbilical surgical scar. No suprapubic
+tenderness. There is no 
+organomegaly or appreciable mass. Bowel sounds are hyperactive.
+Back: No CVA tenderness. 
+Extremities: No edema, 2+ pedal pulses
+Neurologic: Cranial nerves II through XII are intact. No focal
+motor or sensory deficits are noted.
+
+DISCHARGE PHYSICAL EXAM
+Vitals:  ___ 2314 Temp: 97.9 PO BP: 155/70 HR: 77 RR: 20 O2
+sat: 98% O2 delivery: Ra 
+General: Awake, cooperative, NAD.
+HEENT: Pupils react normally to light. Oropharynx is clear.
+Neck: Supple
+Lungs: Clear with no wheezing, rhonchi or rales.
+Cardiovascular: Regular rate and rhythm. Normal S1 and S2 no
+m/r/g.
+Abdomen: soft, non-tender, non-distended. periumbilical surgical
+scar. No suprapubic tenderness. There is no 
+organomegaly or appreciable mass. normal bowel sounds.
+Back: No CVA tenderness. 
+Extremities: No edema, 2+ pedal pulses
+Neurologic: Cranial nerves II through XII are intact. No focal
+motor or sensory deficits are noted.
+
+ 
+
+###RESPONSE: PHYSICAL EXAM {Physical examination procedure}, Vitals {Vital signs finding}, Temp {Body temperature finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, O2
+sat {Oxygen saturation measurement}, RA {Breathing room air}, General {General examination of patient}, Awake {Awake}, cooperative {Cooperative mental state}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, Pupils react normally to light {Pupil afferent light reaction normal}, Oropharynx is clear {Pharynx normal}, Neck {Physical examination procedure}, Supple {Normal movement of neck}, Lungs {Examination of respiratory system}, Clear {Normal breath sounds}, wheezing {Wheezing}, rhonchi {Wheeze - rhonchi}, rales {Respiratory crackles}, Cardiovascular {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<}, no
+m/r/g {Heart sounds normal}, Abdomen {Examination of abdomen}, soft {Abdomen soft}, tender {Abdominal tenderness}, palpation {Palpation}, epigastric {Epigastric region structure}, non-distended {Normal abdominal contour}, surgical scar {Surgical scar}, suprapubic {Hypogastric region structure}, tenderness {Tenderness}, organomegaly {Abdominal organomegaly}, mass {Abdominal mass}, Bowel sounds are hyperactive {Bowel sounds hyperactive}, CV {Cardiovascular physical examination}, tenderness {Tenderness}, Extremities {Examination of limb}, edema {Edema}, 2+ pedal pulses {Normal foot pulse}, Neurologic {Neurological examination}, Cranial nerves II {Optic nerve structure}, XII {Hypoglossal nerve structure}, motor {Motor testing}, sensory {Sensory testing}, deficits {Neurological deficit}, PHYSICAL EXAM {Physical examination procedure}, Vitals {Vital signs finding}, Temp {Body temperature finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, O2
+sat {Oxygen saturation measurement}, Ra {Breathing room air}, General {General examination of patient}, Awake {Awake}, cooperative {Cooperative mental state}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, Pupils react normally to light {Pupil afferent light reaction normal}, Oropharynx is clear {Pharynx normal}, Neck {Physical examination procedure}, Supple {Normal movement of neck}, Lungs {Examination of respiratory system}, Clear {Normal breath sounds}, wheezing {Wheezing}, rhonchi {Wheeze - rhonchi}, rales {Respiratory crackles}, Cardiovascular {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<}, no
+m/r/g {Heart sounds normal}, Abdomen {Examination of abdomen}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, surgical
+scar {Surgical scar}, suprapubic {Hypogastric region structure}, tenderness {Tenderness}, organomegaly {Abdominal organomegaly}, mass {Abdominal mass}, normal bowel sounds {Normal bowel sounds}, CV {Cardiovascular physical examination}, tenderness {Tenderness}, Extremities {Examination of limb}, edema {Edema}, 2+ pedal pulses {Normal foot pulse}, Neurologic {Neurological examination}, Cranial nerves II {Optic nerve structure}, XII {Hypoglossal nerve structure}, motor {Motor testing}, sensory {Sensory testing}, deficits {Neurological deficit}"
+"###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
+___ 11:07PM BLOOD WBC-7.7 RBC-3.31* Hgb-9.8* Hct-32.9* 
+MCV-99* MCH-29.6 MCHC-29.8* RDW-16.3* RDWSD-60.0* Plt ___
+___ 11:07PM BLOOD Neuts-87.0* Lymphs-10.4* Monos-1.3* 
+Eos-0.7* Baso-0.1 Im ___ AbsNeut-6.67* AbsLymp-0.80* 
+AbsMono-0.10* AbsEos-0.05 AbsBaso-0.01
+___ 11:07PM BLOOD Glucose-195* UreaN-20 Creat-0.9 Na-132* 
+K-4.9 Cl-98 HCO3-21* AnGap-13
+___ 11:07PM BLOOD ALT-37 AST-26 AlkPhos-859* TotBili-0.9
+___ 11:07PM BLOOD Albumin-3.5
+
+DISCHARGE LABS
+___ 05:25AM BLOOD WBC-3.0* RBC-2.56* Hgb-7.5* Hct-23.8* 
+MCV-93 MCH-29.3 MCHC-31.5* RDW-15.8* RDWSD-53.8* Plt ___
+___ 05:25AM BLOOD Neuts-70.2 ___ Monos-3.9* 
+Eos-0.7* Baso-0.4 AbsNeut-1.98 AbsLymp-0.68* AbsMono-0.11* 
+AbsEos-0.02* AbsBaso-0.01
+___ 05:25AM BLOOD Glucose-134* UreaN-9 Creat-0.7 Na-139 
+K-3.6 Cl-104 HCO3-22 AnGap-13
+___ 05:25AM BLOOD Calcium-8.5 Phos-3.1 Mg-1.9
+
+MICRO
+
+___ 7:43 pm URINE      Source: ___. 
+
+                            **FINAL REPORT ___
+
+   Legionella Urinary Antigen  (Final ___: 
+      NEGATIVE FOR LEGIONELLA SEROGROUP 1 ANTIGEN. 
+
+___ 7:43 pm STOOL     CONSISTENCY: LOOSE      Source: 
+Stool. 
+
+                            **FINAL REPORT ___
+
+   C. difficile PCR (Final ___: 
+      NEGATIVE. 
+___ 7:43 pm STOOL     CONSISTENCY: LOOSE      Source: 
+Stool. 
+
+                            **FINAL REPORT ___
+
+   FECAL CULTURE (Final ___:    NO SALMONELLA OR SHIGELLA 
+FOUND. 
+
+   CAMPYLOBACTER CULTURE (Final ___:    NO CAMPYLOBACTER 
+FOUND. 
+
+   OVA + PARASITES (Final ___: 
+      NO OVA AND PARASITES SEEN. 
+      . 
+      This test does not reliably detect Cryptosporidium, 
+Cyclospora or
+      Microsporidium. While most cases of Giardia are detected 
+by routine
+      O+P, the Giardia antigen test may enhance detection when 
+organisms
+      are rare. 
+      . 
+      FEW POLYMORPHONUCLEAR LEUKOCYTES. 
+___ 12:40 am BLOOD CULTURE      Source: Line-Port. 
+
+   Blood Culture, Routine (Pending):    No growth to date. 
+
+___ 9:05 am STOOL     CONSISTENCY: LOOSE      Source: 
+Stool. 
+
+                            **FINAL REPORT ___
+
+   OVA + PARASITES (Final ___: 
+      NO OVA AND PARASITES SEEN. 
+      . 
+      This test does not reliably detect Cryptosporidium, 
+Cyclospora or
+      Microsporidium. While most cases of Giardia are detected 
+by routine
+      O+P, the Giardia antigen test may enhance detection when 
+organisms
+      are rare. 
+      . 
+      FEW POLYMORPHONUCLEAR LEUKOCYTES. 
+
+___ 9:21 am URINE      Source: ___. 
+
+                            **FINAL REPORT ___
+
+   URINE CULTURE (Final ___: 
+      ESCHERICHIA COLI.    >100,000 CFU/mL.  PRESUMPTIVE 
+IDENTIFICATION. 
+         Cefazolin interpretative criteria are based on a dosage 
+regimen of
+         2g every 8h. 
+
+                              SENSITIVITIES: MIC expressed in 
+MCG/ML
+                      
+_________________________________________________________
+                             ESCHERICHIA COLI
+                             |   
+AMPICILLIN------------     8 S
+AMPICILLIN/SULBACTAM--     4 S
+CEFAZOLIN-------------   <=4 S
+CEFEPIME--------------   <=1 S
+CEFTAZIDIME-----------   <=1 S
+CEFTRIAXONE-----------   <=1 S
+CIPROFLOXACIN---------   0.5 S
+GENTAMICIN------------   <=1 S
+MEROPENEM-------------<=0.25 S
+NITROFURANTOIN--------  <=16 S
+PIPERACILLIN/TAZO-----   <=4 S
+TOBRAMYCIN------------   <=1 S
+TRIMETHOPRIM/SULFA----   <=1 S
+
+___ 6:13 pm BLOOD CULTURE      Source: Line-POC. 
+
+   Blood Culture, Routine (Pending):    No growth to date. 
+
+___ 7:20 pm BLOOD CULTURE      Source: Line-POC. 
+
+   Blood Culture, Routine (Pending):    No growth to date. 
+
+IMAGING
+CT ABD/PELVIS ___
+1. Likely mild proctitis without a perirectal abscess or bowel 
+obstruction. 
+2. The known metastatic lesion in the right hepatic lobe 
+measuring up to 6.6 cm, is slightly large in size since prior 
+exam from ___, when it measured up to 6.2 cm.  The 
+adjacent hepatic parenchyma in segment VI and VII enhances 
+heterogeneously raising suspicion for satellite metastases. 
+Unchanged appearance of occluded right hepatic vein and right 
+branch of the portal vein. 
+3. Subacute healing pathologic fracture is again seen in the 
+left lateral 
+tenth rib.  Unchanged compression deformities of the L3-L5 
+vertebrae. 
+
+ 
+
+###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}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, Albumin {Albumin 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}, Neuts {Neutrophil 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}, CULTURE {Microbial culture}, CULTURE {Microbial culture}, CULTURE {Blood culture}, Blood Culture {Blood culture}, URINE CULTURE {Urine culture}, CULTURE {Blood culture}, Blood Culture {Blood culture}, CULTURE {Blood culture}, Blood Culture {Blood culture}, IMAGING {Imaging}, proctitis {Proctitis}, perirectal abscess {Perirectal abscess}, bowel 
+obstruction {Intestinal obstruction}, metastatic {Metastatic malignant neoplasm}, lesion {Lesion}, right hepatic lobe {Structure of right lobe of liver}, hepatic parenchyma {Structure of parenchyma of liver}, metastases {Metastatic malignant neoplasm}, occluded {Complete obstruction}, right hepatic vein {Structure of right hepatic vein}, right 
+branch of the portal vein {Structure of right main branch of portal vein}, healing {Structure resulting from tissue repair process}, pathologic fracture {Pathologic fracture}, tenth rib {Bone structure of tenth rib}, compression {Compression}, deformities {Deformity}, L3 {Bone structure of L3}, L5 {Bone structure of L5}, vertebrae {Bone structure of L3}"
+"###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:
+___ y/o M with a past medical history of hypertension NIDDM2, 
+HLD, stable angina, hearing loss and metastatic pancreatic 
+cancer s/p Whipple on palliative chemotherapy, who presented 
+with 6 days of diarrhea and 2 days of nausea and
+vomiting likely ___ recent chemotherapy and a urinary tract 
+infection.
+
+ACUTE ISSUES
+#Complicated urinary tract infection
+Despite lack of symptoms, due to a history of recurrent urinary 
+infections and ongoing fevers, we sent for a UA and urine 
+culture. The patient was found to have a grossly positive UA and 
+culture grew pan-sensitive E. Coli. The patient was initially 
+placed on Zosyn and was discharged to complete a 7 day course of 
+Bactrim DS. Given recurrent urinary tract infections, urology 
+was consulted and they recommended continuing prophylactic 
+Bactrim SS indefinitely. He will be following up with urology 
+outpatient.
+
+#Diarrhea, nausea, vomiting
+#Poor PO intake
+Patient with one week of diarrhea and several days of nausea and 
+vomiting. C4D1 of chemotherapy was ___. Diarrhea is a 
+common adverse effect of onivyde. Given patient had a 2 month 
+break from chemotherapy, it is possible that this was a rebound 
+effect in the setting of drug break. The patient was also 
+complaining of chills and sweats concerning for possible 
+infectious etiology. During his last admission, he had GNR 
+bacteremia and was treated with meropenem and discharged on 
+ertapenem with course finishing ___. On this admission, C. 
+Diff and Legionella were negative. Nausea and vomiting resolved 
+rapidly with symptomatic treatment. He was able to eat, but 
+continued to have diarrhea throughout hospital course. It 
+resolved prior to discharge with loperamide. Stool, blood and 
+urine cultures were all negative to date.
+
+#Proctitis:
+CT with mild proctitis. DDx included anal fissures/fistulas, C. 
+Diff, diverticulitis, infectious, IBD, traumatic. In this case, 
+it was likely due to inflammation from severe diarrhea.
+
+#Hyponatremia:
+This was noted on admission and believed to be likely hypotonic 
+hypovolemic in the setting of poor PO intake and less likely 
+SIADH. Na was noted to be 133 on ___ at appointment prior for 
+chemotherapy, and believed to be ___ poor PO intake. Na 138 on 
+___.
+
+#Metastatic pancreatic cancer
+Followed by oncologist Dr. ___. His current regimen is 
+___ which he recently received on ___ for 
+palliative chemotherapy. Palliative care was consulted to 
+discuss GOC and symptom management. Patient will follow closely 
+with Dr. ___ discharge to discuss next steps.
+
+CHRONIC ISSUES
+#Anemia
+Baseline around ___ at recent admission. Patient remained around 
+baseline and did not require any transfusions. 
+
+#Hx of stable angina
+EKG on admission with no evidence of ST segment changes. 
+Troponins negative x1.
+
+#Hypertension:
+He was continued on amlodipine, lisinopril. Metoprolol was held 
+during this admission as it was held on discharge at last 
+admission. Given blood pressures were slightly elevated while 
+inpatient, patient may benefit from restarting metoprolol.
+
+#Diabetes:
+Patient placed on insulin sliding scale while inpatient.
+
+TRANSITIONAL ISSUES
+[]Last day of Bactrim DS for UTI ___
+[]Given recurrent UTIs, urology consulted and recommended 
+prophylactic Bactrim SS indefinitely, will need to follow 
+closely with urology outpatient
+[]Patient has had numerous hospitalizations and poor tolerance 
+to chemo, would benefit from conversations with outpatient 
+oncologist Dr. ___ plan moving forward
+[]Will need ongoing conversations regarding code status
+[]Nausea, vomiting and diarrhea resolved with symptomatic 
+treatment but will likely require titration of symptomatic 
+medications to ensure doesn't become constipated; encourage 
+patient to take loperamide for symptomatic relief
+[]Patient seems somewhat confused about medication regimen, 
+would benefit from clarification or help with medication 
+management
+[]BPs mostly 140s/60s while inpatient but going up to SBPs 160s 
+prior to discharge on amlodipine and lisinopril. metoprolol was 
+held on discharge but patient would benefit from ongoing BP 
+monitoring and may need to restart metoprolol.
+[]Patient would benefit from ongoing follow up with nutrition as 
+PO intake appears somewhat poor at baseline and albumin was 3.1.
+
+___) ___ 
+#CODE STATUS: FULL 
+ 
+
+###RESPONSE: hypertension {Hypertensive disorder, systemic arterial}, NIDDM2 {Diabetes mellitus type 2}, HLD {Hyperlipidemia}, stable angina {Stable angina}, hearing loss {Hearing loss}, metastatic pancreatic 
+cancer {Metastatic carcinoma to head of pancreas}, Whipple {Pancreaticoduodenectomy}, palliative chemotherapy {Administration of palliative antineoplastic agent}, diarrhea {Diarrhea}, nausea and
+vomiting {Nausea and vomiting}, chemotherapy {Chemotherapy}, urinary tract 
+infection {Urinary tract infectious disease}, urinary tract infection {Urinary tract infectious disease}, urinary {Urinary tract infectious disease}, infections {Infectious disease}, fevers {Fever}, UA {Urinalysis}, urine 
+culture {Urine culture}, UA {Urinalysis}, culture {Microbial culture}, recurrent urinary tract infections {Recurrent urinary tract infection}, Diarrhea {Diarrhea}, nausea, vomiting {Nausea and vomiting}, Poor PO intake {Decrease in appetite}, diarrhea {Diarrhea}, nausea and 
+vomiting {Nausea and vomiting}, chemotherapy {Chemotherapy}, Diarrhea {Diarrhea}, chemotherapy {Chemotherapy}, rebound 
+effect {Medication rebound effect}, chills {Chill}, sweats {Sweating}, infectious {Infectious disease}, GNR 
+bacteremia {Bacteremia caused by Gram-negative bacteria}, Nausea and vomiting {Nausea and vomiting}, resolved {Problem resolved}, able to eat {Able to eat}, diarrhea {Diarrhea}, resolved {Problem resolved}, Stool {Hematochezia}, urine cultures {Urine culture}, CT {Computed tomography}, proctitis {Proctitis}, anal fissures {Anal fissure}, fistulas {Fistula}, diverticulitis {Diverticulitis}, infectious {Infectious disease}, IBD {Inflammatory bowel disease}, traumatic {Traumatic injury}, inflammation {Inflammatory disorder}, severe diarrhea {Severe diarrhea}, hypovolemic {Hypovolemia}, poor PO intake {Decrease in appetite}, SIADH {Syndrome of inappropriate vasopressin secretion}, chemotherapy {Chemotherapy}, poor PO intake {Decrease in appetite}, Metastatic pancreatic cancer {Metastatic carcinoma to pancreas}, regimen {Therapeutic regimen}, palliative chemotherapy {Administration of palliative antineoplastic agent}, symptom management {Symptom management}, Anemia {Anemia}, Baseline {Baseline state}, baseline {Baseline state}, transfusions {Transfusion}, stable angina {Stable angina}, EKG {Electrocardiographic procedure}, ST segment changes {Finding of electrocardiogram ST segment}, Troponins {Troponin measurement}, blood pressures {Blood pressure monitoring}, elevated {Finding of increased blood pressure}, insulin sliding scale {Sliding scale insulin regime}, UTI {Urinary tract infectious disease}, recurrent UTIs {Recurrent urinary tract infection}, chemo {Chemotherapy}, Nausea, vomiting and diarrhea {Nausea, vomiting and diarrhea}, resolved {Problem resolved}, medications {Prescription of drug}, constipated {Constipation}, medication {Prescription of drug}, regimen {Therapeutic regimen}, medication 
+management {Procedure related to management of drug administration}, BP 
+monitoring {Blood pressure monitoring}"
+"###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. amLODIPine 10 mg PO DAILY 
+2. Aspirin 81 mg PO DAILY 
+3. Atorvastatin 20 mg PO QPM 
+4. Creon 12 2 CAP PO QIDWMHS 
+5. Finasteride 5 mg PO DAILY 
+6. Isosorbide Mononitrate (Extended Release) 60 mg PO DAILY 
+7. Lisinopril 5 mg PO DAILY 
+8. Polyethylene Glycol 17 g PO DAILY 
+9. Senna 17.2 mg PO BID 
+10. LOPERamide 2 mg PO QID:PRN diarrhea 
+11. Magnesium Oxide 400 mg PO DAILY 
+12. MetFORMIN (Glucophage) 850 mg PO DAILY 
+13. Metoprolol Succinate XL 100 mg PO DAILY 
+14. Nitroglycerin SL 0.4 mg SL Q5MIN:PRN chest pain 
+
+ 
+Discharge Medications:
+1.  Sulfameth/Trimethoprim DS 1 TAB PO BID Duration: 5 Days 
+RX *sulfamethoxazole-trimethoprim 800 mg-160 mg 1 tablet(s) by 
+mouth twice a day Disp #*10 Tablet Refills:*0 
+2.  Sulfameth/Trimethoprim SS 1 TAB PO DAILY 
+Take this medication after you finish Bactrim DS to prevent 
+recurrent urinary infection 
+RX *sulfamethoxazole-trimethoprim 400 mg-80 mg 1 tablet(s) by 
+mouth every day Disp #*30 Tablet Refills:*0 
+3.  amLODIPine 10 mg PO DAILY  
+4.  Aspirin 81 mg PO DAILY  
+5.  Atorvastatin 20 mg PO QPM  
+6.  Creon 12 2 CAP PO QIDWMHS  
+7.  Finasteride 5 mg PO DAILY  
+8.  Isosorbide Mononitrate (Extended Release) 60 mg PO DAILY  
+9.  Lisinopril 5 mg PO DAILY  
+10.  LOPERamide 2 mg PO QID:PRN diarrhea 
+RX *loperamide 2 mg 1 tablet by mouth every 6 hours Disp #*60 
+Capsule Refills:*0 
+11.  MetFORMIN (Glucophage) 850 mg PO DAILY  
+12.  Nitroglycerin SL 0.4 mg SL Q5MIN:PRN chest pain  
+13.  Polyethylene Glycol 17 g PO DAILY  
+14.  Senna 17.2 mg PO BID  
+15. HELD- Magnesium Oxide 400 mg PO DAILY  This medication was 
+held. Do not restart Magnesium Oxide until your doctor tells you 
+to
+16. HELD- Metoprolol Succinate XL 100 mg PO DAILY  This 
+medication was held. Do not restart Metoprolol Succinate XL 
+until your doctor tells you to
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+PRIMARY DIAGNOSIS
+Complicated urinary tract infection
+Diarrhea
+
+SECONDARY DIAGNOSES
+metastatic pancreatic cancer
+hyponatremia
+proctitis
+anemia
+hypertension
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, urinary tract infection {Urinary tract infectious disease}, Diarrhea {Diarrhea}, metastatic pancreatic cancer {Metastatic carcinoma to pancreas}, hyponatremia {Hyponatremia}, proctitis {Proctitis}, anemia {Anemia}, hypertension {Hypertensive disorder, systemic arterial}, 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 Mr. ___, 
+
+It was a pleasure caring for you at ___ 
+___.
+
+WHY WAS I IN THE HOSPITAL?
+- You came to the hospital because you were nauseous and were 
+having diarrhea and vomiting all week.
+
+WHAT HAPPENED TO ME IN THE HOSPITAL?
+- We gave you lots of fluids through the IV and you felt better
+- You were found to have a urinary infection and we gave you 
+antibiotics
+- We gave you medications for your nausea and diarrhea and you 
+felt better
+- You were able to eat and stopped having diarrhea so you were 
+discharged home
+
+WHAT SHOULD I DO AFTER I LEAVE THE HOSPITAL?
+- Be sure to take the DOUBLE STRENGTH Bactrim until ___ 
+after this switch to the SINGLE STRENGTH Bactrim and only take 
+one of those tablets daily until you talk to the urologists
+- Continue to take all your medicines and keep your 
+appointments.
+- Please come back to the hospital if you have any worsening of 
+your nausea, vomiting, diarrhea, dehydration or if you are 
+unable to eat and drink.
+
+We wish you the best!
+
+Sincerely,
+Your ___ Team
+
+ 
+
+###RESPONSE: nauseous {Nausea}, diarrhea and vomiting {Diarrhea and vomiting}, fluids {Administration of fluid therapy}, IV {Administration of drug or medicament via intravenous route}, urinary infection {Urinary tract infectious disease}, antibiotics {Antibiotic therapy}, medications {Prescription of drug}, nausea {Nausea}, diarrhea {Diarrhea}, able to eat {Able to eat}, diarrhea {Diarrhea}, nausea, vomiting, diarrhea {Nausea, vomiting and diarrhea}, dehydration {Dehydration}, unable to eat {Unable to eat}"
+"###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: 
+Morphine
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Chest pain 
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: Morphine {Allergy to morphine}, Chest pain {Chest 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:
+
+###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: History of Present Illness: ___ yo man with h/o ""small heart 
+attack ___ years ago"", ESRD (on HD for ___ years, urinates 
+3x/day), HTN, HLP, DM, presents with chest pain and SOB since 
+late afternoon today. He was sitting on his bed when he suddenly 
+developed ___ substernal chest heaviness, that may have 
+radiated to the back. This was associated with SOB, but no N/V, 
+sweats, dizziness, numbness or tingling. There was no 
+association of his pain with food, position, breathing, or 
+cough. He's never had this pain before. When he had the ""mild 
+heart attack"" ___ years ago, he cannot recal if this pain was 
+similar. He decided to present to the ED.
+.
+In the ED, initial vs were: 98 118/48 60 16 99%RA. Patient was 
+given . Vitals on transfer were 98.3 55 136/58 14 100%2LNC. ASA 
+325mg PO ONCE, morphine 4mg IV ONCE, 1gm tylenol PO ONCE
+.
+On the floor,
+.
+Review of sytems:
+(+) Per HPI
+(-) Denies fever, chills, night sweats, recent weight loss or 
+gain. Denies headache, sinus tenderness, rhinorrhea or 
+congestion. Denied cough, shortness of breath. Denied 
+palpitations. Denied nausea, vomiting, diarrhea, constipation. 
+No recent change in bowel or bladder habits. 
+ 
+
+###RESPONSE: heart 
+attack {Myocardial infarction}, ESRD (on HD {End stage renal failure on dialysis}, urinates {Micturition finding}, HTN {Hypertensive disorder, systemic arterial}, HLP {Hyperlipidemia}, DM {Diabetes mellitus}, chest pain {Chest pain}, SOB {Dyspnea}, sitting {Sitting position}, substernal {Structure of substernal region}, chest heaviness {Tight chest}, radiated {Radiating pain}, back {Structure of back of trunk}, SOB {Dyspnea}, N/V {Nausea and vomiting}, sweats {Sweating}, dizziness {Dizziness}, numbness {Numbness}, tingling {Pins and needles}, pain {Pain}, food {Pain provoked by eating}, position {Pain provoked by movement}, breathing {Pain provoked by breathing}, cough {Pain provoked by coughing}, pain {Pain}, heart attack {Myocardial infarction}, pain {Pain}, Vitals {Vital signs finding}, ASA {Administration of aspirin}, tylenol {Administration of analgesic}, fever {Fever}, chills {Chill}, night sweats {Night sweats}, recent weight loss {Recent weight loss}, gain {Recent weight gain}, headache {Headache}, sinus tenderness {Tenderness over frontal sinus}, rhinorrhea {Nasal discharge}, congestion {Nasal congestion}, cough {Cough}, shortness of breath {Dyspnea}, palpitations {Palpitations}, nausea, vomiting, diarrhea {Nausea, vomiting and diarrhea}, constipation {Constipation}, change in bowel {Altered bowel function}, bladder habits {Alteration in patterns of urinary elimination}"
+"###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:
+1) ESRD on HD for ___ years
+2) ""Mild heart attack"" at ___ in ___
+3) HTN
+4) HLP
+5) DM
+6) ?Dementia 
+ 
+
+###RESPONSE: ESRD on HD {End stage renal failure on dialysis}, heart attack {Myocardial infarction}, HTN {Hypertensive disorder, systemic arterial}, HLP {Hyperlipidemia}, DM {Diabetes mellitus}, Dementia {Dementia}"
+"###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:
+
+###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:
+Patient's father died of an MI in mid ___. No other personal or 
+family history of heart disease or blood clot.
+ 
+
+###RESPONSE: died {Dead}, MI {Myocardial infarction}, heart disease {Heart disease}, blood clot {Blood clot}"
+"###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:
+Vitals: 96.5 150/68 66 18 100%2LNC
+General: Alert, oriented x ___ (says he's in ___, can't recall 
+city, says he's in hospital can't recall name, says ___ can't 
+recall date) no acute distress
+HEENT: Sclera anicteric, MMM, oropharynx clear
+Neck: supple, JVP not elevated
+Lungs: Clear to auscultation bilaterally, no wheezes, rales, 
+ronchi except bibasilar rhales
+CV: Regular rate and rhythm, normal S1 + S2, soft ___ SM at apex 
+no rubs, gallops
+Abdomen: soft, non-tender, non-distended, bowel sounds present, 
+no rebound tenderness or guarding, no organomegaly
+GU: no foley
+Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or 
+edema 
+ 
+
+###RESPONSE: Vitals {Vital signs finding}, NC {Normal head}, General {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, no acute {No abnormality detected}, distress {Distress}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, MMM {Moist oral mucosa}, oropharynx clear {Pharynx normal}, Neck {Physical examination procedure}, supple {Normal movement of neck}, JVP not elevated {Normal jugular venous pressure}, Lungs {Examination of respiratory system}, Clear to auscultation bilaterally {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, ronchi {Wheeze - rhonchi}, bibasilar {Structure of base of lung}, rhales {Respiratory crackles}, 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<}, soft {Abdomen soft}, apex {Structure of apex of heart}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, Abdomen {Examination of abdomen}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, bowel sounds present {Normal bowel sounds}, rebound {Rebound tenderness}, tenderness {Tenderness}, guarding {Abdominal guarding}, organomegaly {Abdominal organomegaly}, 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}"
+"###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:
+___ 02:25PM BLOOD WBC-8.0 RBC-3.74* Hgb-12.1* Hct-36.5* 
+MCV-98 MCH-32.4* MCHC-33.2 RDW-16.5* Plt ___
+___ 02:25PM BLOOD Neuts-57.8 ___ Monos-5.9 Eos-2.5 
+Baso-0.7
+___ 02:25PM BLOOD ___ PTT-22.1 ___
+___ 02:25PM BLOOD Glucose-137* UreaN-45* Creat-6.4* Na-139 
+K-3.1* Cl-91* HCO3-36* AnGap-15
+___ 02:25PM BLOOD ALT-4 AST-11 LD(LDH)-110 CK(CPK)-33* 
+AlkPhos-58 Amylase-74 TotBili-0.5
+___ 02:25PM BLOOD proBNP-699*
+___ 02:25PM BLOOD cTropnT-0.02*
+___ 11:59PM BLOOD CK-MB-NotDone cTropnT-0.03*
+___ 07:10AM BLOOD CK-MB-NotDone cTropnT-0.02*
+___ 07:10AM BLOOD Calcium-9.4 Phos-4.9* Mg-2.1
+___ 02:25PM BLOOD Albumin-4.0
+
+REPORTS: 
+
+___   Radiology CARDIAC PERFUSION PERSA  Left 
+ventricular cavity size is normal. The end-diastolic volume is 
+129 ml.
+Rest and stress perfusion images reveal a small region of 
+decreased tracer
+uptake along the inferior wall of the left ventricle, although 
+this may be due to artifact generated by adjacent soft tissue. 
+There is no change in tracer uptake on stress versus rest 
+images.
+Gated images reveal normal wall motion.
+The calculated left ventricular ejection fraction is 68 %.
+No prior studies are available for comparison.
+IMPRESSION: 1. No reversible myocardial perfusion defect. 2. 
+Focal decreased tracer uptake in the left ventricular inferior 
+wall is likely due to artifact from adjacent soft tissue; 
+alternatively this could represent a mild fixed perfusion 
+defect.
+     
+___   Cardiology STRESS ___: ___ yo 
+man with h/o HTN, HL and type II DM requiring
+insulin; s/p ""small heart attack"" ___ years ago was referred to 
+evaluate
+an atypical chest discomfort and shortness of breath. The 
+patient was
+administered 0.142 mg/kg/min of Persantine over 4 minutes. No 
+chest,
+back, neck or arm discomforts were reported by the patient 
+during the
+procedure. No significant ST segment changes were noted. The 
+rhythm was
+sinus with no ectopy noted. An appropriate heart rate and blood 
+pressure
+response to the Persantine infusion was noted. Post-infusion, 
+the
+patient was administered 125 mg Aminophylline IV.
+IMPRESSION: No anginal symptoms or ischemic ST segment changes 
+to
+Persantine. Appropriate heart rate and blood pressure response 
+to
+Persantine infusion. Nuclear report sent separately.  
+ 
+___   Radiology CHEST (PA & LAT)   
+FINDINGS: Lung volumes are mildly diminished. Hazy subsegmental 
+atelectasis
+is seen in both lung bases. No consolidation or edema is 
+evident. The
+mediastinum is unremarkable. The cardiac silhouette is 
+borderline enlarged
+even accounting for patient and technical factors. No effusion 
+or
+pneumothorax is noted. The osseous structures are grossly 
+unremarkable.
+IMPRESSION: Low lung volumes with hazy bibasilar atelectasis. 
+Otherwise, no
+acute pulmonary process.
+
+DISCHARGE LABS: 
+
+___ 06:35AM BLOOD WBC-7.0 RBC-3.83* Hgb-12.5* Hct-37.1* 
+MCV-97 MCH-32.6* MCHC-33.6 RDW-15.5 Plt ___
+___ 06:35AM BLOOD Glucose-103* UreaN-53* Creat-6.7*# Na-141 
+K-3.5 Cl-96 HCO3-31 AnGap-18
+___ 06:35AM BLOOD Calcium-9.5 Phos-4.7* Mg-1.___ yo man with h/o ""small heart attack ___ years ago"", ESRD (on HD 
+for ___ years, urinates 3x/day), HTN, HLP, DM, presents with 
+chest pain and SOB since late afternoon today.
+.
+# Chest pain: Unclear etiology, ACS thought to be unlikely given 
+atypically pain, no EKG changes, negative enzymes, and negative 
+PMIBI results. LFTs including amylase/lipase were wnl. CXR 
+negative for any acute process. PE unlikely given lack of risk 
+factors, such as tachycardia, recent surgery/travel, hemoptysis, 
+DVT sx, h/o cancer or DVT/PE. Mild volume overload secondary to 
+ESRD was thought to be a possible cause, which was resolved 
+after HD. Pt was initially treated with ACS protocol with ASA 
+325mg PO daily, Plavix 75mg PO Daily, Atorvastatin 80mg PO 
+daily. We continued Metoprolol tartrate 200mg PO HS, Continue 
+Cozaar 50mg PO Daily. Once PMIBI was negative plavix was DC'd, 
+ASA dropped back to 81 and pt's original simvastatin 40 was 
+restarted.  
+.
+# ESRD: On HD for ___ years. Continued HD ___, with 
+renal following. 
+.
+# HTN: Continued BB and ___ per above
+.
+# HLP: Atorvastatin per above
+.
+# DM: Continued home Lantus 28 units plus SSI.
+.
+# Dementia: Continued carbidopa and levadopa.
+ 
+
+###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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, Plt {Platelet count}, Neuts {Neutrophil count}, Monos {Monocyte count}, Eos {Eosinophil count}, Baso {Basophil count}, PTT {Partial thromboplastin time, activated}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, LDH {Serum total lactate dehydrogenase measurement}, CK(CPK {Creatine kinase measurement}, AlkPhos {Alkaline phosphatase measurement}, Amylase {Amylase measurement}, TotBili {Bilirubin, total measurement}, proBNP {N-terminal pro-brain natriuretic peptide measurement}, cTropnT {Troponin T cardiac measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Albumin {Albumin measurement}, Radiology CARDIAC PERFUSION {Radionuclide myocardial perfusion study}, Left 
+ventricular cavity {Structure of cavity of left cardiac ventricle}, size is normal {Normal size}, stress perfusion images {Radionuclide myocardial perfusion stress study}, inferior wall {Structure of myocardium of diaphragmatic region}, left ventricle {Left cardiac ventricular structure}, artifact {Artifact}, soft tissue {Structure of soft tissue}, stress {Radionuclide myocardial perfusion stress study}, normal wall motion {Normal ventricular wall motion}, left ventricular {Structure of myocardium of left ventricle}, studies {Evaluation procedure}, reversible myocardial perfusion defect {Reversible myocardial perfusion defect}, left ventricular {Structure of myocardium of left ventricle}, inferior 
+wall {Structure of myocardium of diaphragmatic region}, artifact {Artifact}, soft tissue {Structure of soft tissue}, perfusion 
+defect {Myocardial perfusion defect}, HTN {Hypertensive disorder, systemic arterial}, HL {Hyperlipidemia}, type II DM {Diabetes mellitus type 2}, insulin {Insulin regime}, heart attack {Myocardial infarction}, evaluate {Evaluation procedure}, atypical {Atypical chest pain}, chest discomfort {Chest discomfort}, shortness of breath {Dyspnea}, chest {Thoracic structure}, back {Structure of back of trunk}, neck {Neck structure}, arm {Upper limb structure}, discomforts {Discomfort}, procedure {Procedure}, ST segment changes {Electrocardiographic ST segment changes}, rhythm was
+sinus {Normal sinus rhythm}, heart rate {Finding of heart rate}, blood 
+pressure {Blood pressure finding}, infusion {Infusion}, infusion {Infusion}, anginal symptoms {Angina}, ischemic {Ischemia}, ST segment changes {Electrocardiographic ST segment changes}, heart rate {Finding of heart rate}, blood pressure {Blood pressure finding}, infusion {Infusion}, Radiology CHEST (PA & LAT) {Diagnostic radiography of chest, combined posteroanterior and lateral}, Lung volumes {Finding of respiratory volume}, atelectasis {Atelectasis}, lung bases {Structure of base of lung}, consolidation {Consolidation}, edema {Edema}, mediastinum {Mediastinal structure}, unremarkable {No abnormality detected}, cardiac {Heart structure}, enlarged {Enlargement}, effusion {Pleural effusion}, pneumothorax {Pneumothorax}, osseous structures {Bone structure}, unremarkable {No abnormality detected}, lung volumes {Finding of respiratory volume}, bibasilar {Structure of base of lung}, atelectasis {Atelectasis}, no
+acute {No abnormality detected}, pulmonary {Lung structure}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, Plt {Platelet count}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium 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}, heart attack {Myocardial infarction}, ESRD (on HD {End stage renal failure on dialysis}, urinates {Micturition finding}, HTN {Hypertensive disorder, systemic arterial}, HLP {Hyperlipidemia}, DM {Diabetes mellitus}, chest pain {Chest pain}, SOB {Dyspnea}, Chest pain {Chest pain}, ACS {Acute coronary syndrome}, atypically pain {Atypical chest pain}, no EKG changes {Electrocardiogram normal}, negative enzymes {Cardiac enzymes within reference range}, negative {No abnormality detected}, PMIBI {Radionuclide myocardial perfusion study}, LFTs {Hepatic function panel}, amylase {Amylase measurement}, lipase {Serum lipase measurement}, wnl {Liver function tests within reference range}, CXR {Plain chest X-ray}, PE {Pulmonary embolism}, tachycardia {Tachycardia}, surgery {Surgical procedure}, travel {Travel abroad}, hemoptysis {Hemoptysis}, DVT {Deep venous thrombosis}, cancer {Malignant neoplasm}, DVT {Deep venous thrombosis}, PE {Pulmonary embolism}, volume overload {Hypervolemia}, ESRD {End-stage renal disease}, resolved {Problem resolved}, HD {Hemodialysis}, ACS {Acute coronary syndrome}, ASA {Administration of aspirin}, PMIBI {Radionuclide myocardial perfusion study}, negative {No abnormality detected}, ASA {Administration of aspirin}, restarted {Restart of medication}, ESRD {End stage renal failure on dialysis}, HD {Hemodialysis}, HD {Hemodialysis}, HTN {Hypertensive disorder, systemic arterial}, HLP {Hyperlipidemia}, DM {Diabetes mellitus}, SSI {Sliding scale insulin regime}, Dementia {Dementia}"
+"###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:
+1) Aspirin 81mg PO daily
+2) Simvastatin 40mg PO daily
+3) Losartan 50mg PO daily
+4) Nexium 40mg PO Daily
+5) Sevelamer carbonate 800mg PO TID
+6) Nephrocaps 1 cap PO Daily
+7) Ambien 10mg PO HS
+8) Trazadone 100mg PO HS
+9) Insulin glargine 28 units daily
+10) Sliding scale insulin
+11) Carbidopa-Levodopa (___) 2 tab PO TID
+12) Metoprolol XL 200mg PO HS 
+ 
+Discharge Medications:
+1. Aspirin 81 mg Tablet Sig: One (1) Tablet PO once a day.  
+2. Nexium 40 mg Capsule, Delayed Release(E.C.) Sig: One (1) 
+Capsule, Delayed Release(E.C.) PO once a day.  
+3. Losartan 25 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily).  
+4. Zolpidem 5 mg Tablet Sig: Two (2) Tablet PO HS (at bedtime).  
+
+5. Trazodone 100 mg Tablet Sig: One (1) Tablet PO HS (at 
+bedtime).  
+6. Sevelamer Carbonate 800 mg Tablet Sig: One (1) Tablet PO TID 
+W/MEALS (3 TIMES A DAY WITH MEALS).  
+7. Carbidopa-Levodopa ___ mg Tablet Sig: Two (2) Tablet PO 
+TID (3 times a day).  
+8. B Complex-Vitamin C-Folic Acid 1 mg Capsule Sig: One (1) Cap 
+PO DAILY (Daily).  
+9. Metoprolol Succinate 100 mg Tablet Sustained Release 24 hr 
+Sig: Two (2) Tablet Sustained Release 24 hr PO HS (at bedtime).  
+
+10. Insulin Glargine 100 unit/mL Solution Sig: ___ (28) 
+Units Subcutaneous once a day: Plus sliding scale. .  
+11. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO once a day.  
+
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+1) Atypical chest pain
+2) Musculoskeletal chest pain 
+3) End stage renal disease
+
+ 
+Discharge Condition:
+Mental Status: Confused - sometimes.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, Atypical chest pain {Atypical chest pain}, Musculoskeletal chest pain {Musculoskeletal chest pain}, End stage renal disease {End-stage renal disease}, Mental Status {Neurological mental status determination}, Confused {Clouded consciousness}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, interactive {Does communicate}, Activity Status {Physical functional dependency}, Ambulatory - requires assistance or aid {Finding of walking aid use}, walker {Uses zimmer frame}, cane {Uses single walking stick}"
+"###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:
+It was a pleasure to take care of you here at ___. You were 
+admitted for chest pain. Fortunately, an stress test was 
+negative for any evidence of heart disease. Also, our testing 
+revealed that you did not have a heart attack. You will be 
+discharged home with physical therapy. 
+
+We have not made the any changes to your medications.
+
+ 
+
+###RESPONSE: chest pain {Chest pain}, stress test {Radionuclide myocardial perfusion stress study}, negative {No abnormality detected}, heart disease {Heart disease}, heart attack {Myocardial infarction}, physical therapy {Physical therapy procedure}, changes to your medications {Change of medication}"
+"###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: 
+Keflex / Augmentin / Amoxicillin
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Shortness of breath.
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: Keflex {Allergy to cefalexin}, Augmentin {Antibiotic therapy}, Amoxicillin {Allergy to amoxicillin}, Shortness of breath {Dyspnea}"
+"###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:
+ Mrs. ___ is a ___ y.o. female with a past history of 
+COPD/Asthma, who reported increased dyspnea over approximately 
+one week.  Apparently, her husband came home almost a week ago 
+with a ""cold"" and she then developed a non-productive cough, 
+malaise, dyspnea on exertion and eventually an inability to 
+sleep due to dyspnea.  She denied the presence of fevers, 
+chills, or chest pain.  Over the past 3 days her dyspnea 
+increased and today she appeared in significant distress.  She 
+was brought to the ED.  She has had several admissions in the 
+past for dyspnea/COPD exacerbation, has been on BiPAP, never 
+been intubated.
+.  
+In the ED on arrival, VS:  Temp 98.8; BP 129/61; HR 95; RR 28; 
+SpO2 80% on RA.  She arrived ambulatory from home with family 
+(who reported cough productive with yellow sputum).  Blood gases 
+after 3.5 L for 4 minutes revealed hypoxia with PO2 61 and PCO2 
+47.  She received 3 combivent nebs with marked improvement. A 
+CXR was suggestive of pneumonia.  She was given prednisone and 
+levofloxacin and admitted for COPD exacerbation/pneumonia.  On 
+transfer to the floor, VS: Temp 98.8; BP 140/47; HR 102; RR 20; 
+SpO2 93% on 3L.
+.  
+Currently, her dyspnea is much better.  She denied chest pain, 
+or other symptoms.  Her daughter, a nurse, was with her and able 
+to assist with much of the history, as the patient reproted her 
+memory was poor.  Her daughter reported that the patient became 
+confused during previous admission.
+.  
+ROS: Denies fever, chills, night sweats, headache, vision 
+changes, rhinorrhea, congestion, sore throat, chest pain, 
+abdominal pain, nausea, vomiting, diarrhea, constipation, BRBPR, 
+melena, hematochezia, dysuria, hematuria.  She refuses to have a 
+mammogram or colonoscopy.
+
+ 
+
+###RESPONSE: COPD {Chronic obstructive lung disease}, Asthma {Asthma}, increased {Patient's condition worsened}, dyspnea {Dyspnea}, cold {Common cold}, non-productive cough {Dry cough}, malaise {Malaise}, dyspnea on exertion {Dyspnea on exertion}, dyspnea {Dyspnea}, fevers {Fever}, chills {Chill}, chest pain {Chest pain}, dyspnea {Dyspnea}, increased {Patient's condition worsened}, distress {Distress}, dyspnea {Dyspnea}, COPD exacerbation {Acute exacerbation of chronic obstructive airways disease}, BiPAP {Bilevel positive airway pressure titration}, intubated {Insertion of endotracheal tube}, VS {Vital signs finding}, Temp {Body temperature finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, SpO2 {Finding of oxygen saturation}, RA {Breathing room air}, cough productive {Productive cough}, yellow sputum {Yellow sputum}, Blood gases {Blood gas measurement}, hypoxia {Hypoxia}, PO2 {Measurement of venous partial pressure of oxygen}, PCO2 {Measurement of venous partial pressure of carbon dioxide}, nebs {Nebulizer therapy}, improvement {Patient's condition improved}, CXR {Plain chest X-ray}, pneumonia {Pneumonia}, prednisone {Steroid therapy}, levofloxacin {Antibiotic therapy}, COPD exacerbation {Acute exacerbation of chronic obstructive airways disease}, pneumonia {Pneumonia}, VS {Vital signs finding}, Temp {Body temperature finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, SpO2 {Finding of oxygen saturation}, dyspnea {Dyspnea}, chest pain {Chest pain}, memory was poor. {Memory impairment}, confused {Clouded consciousness}, ROS {Review of systems}, fever {Fever}, chills {Chill}, night sweats {Night sweats}, headache {Headache}, vision 
+changes {Visual disturbance}, rhinorrhea {Nasal discharge}, congestion {Nasal congestion}, sore throat {Sore throat}, chest pain {Chest pain}, abdominal pain {Abdominal pain}, nausea, vomiting, diarrhea {Nausea, vomiting and diarrhea}, constipation {Constipation}, BRBPR {Hematochezia}, melena {Melena}, hematochezia {Hematochezia}, dysuria {Dysuria}, hematuria {Blood in urine}, mammogram {Mammography}, 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: Past Medical History:
+1. COPD/Ashtma
+2. Hypertension
+3. Hyperlipidemia
+4. Type II Diabetes
+5. Peripheral Neuropathy
+6. s/p MRSA osteomyelitis in right foot with 3 surgical 
+debridements
+7. s/p MRSA bacteremia in ___. ?Dementia (reported by daughter)
+9. Bilateral cataract surgery
+ 
+
+###RESPONSE: COPD {Chronic obstructive lung disease}, Ashtma {Asthma}, Hypertension {Hypertensive disorder, systemic arterial}, Hyperlipidemia {Hyperlipidemia}, Type II Diabetes {Diabetes mellitus type 2}, Peripheral Neuropathy {Peripheral nerve disease}, MRSA {Methicillin resistant Staphylococcus aureus infection}, surgical {Surgical procedure}, debridements {Debridement}, MRSA bacteremia {Bacteremia caused by Methicillin resistant Staphylococcus aureus}, Dementia {Dementia}, Bilateral cataract surgery {Surgery of cataract of bilateral eyes}"
+"###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:
+Her father was a smoker and exposed to asbestos, died of lung 
+cancer at age ___.  Her mother died form with complications from 
+Alzheimer's at age ___.  One sister survived breast CA.
+ 
+
+###RESPONSE: smoker {Smoker}, died {Dead}, lung 
+cancer {Malignant tumor of lung}, died {Dead}, Alzheimer {Alzheimer's disease}, breast CA {Malignant neoplasm of breast}"
+"###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:
+Vitals - T: 99.3; BP: 128/76; HR: 100; RR: 20; SpO2: 93% on 3L
+GENERAL: Pleasant, female with mild respiratory distress.  
+Speaks in near full sentences, slight tachypnea.
+HEENT: Normocephalic, atraumatic. Conjunctiva moist and pink. No 
+scleral icterus. PERRLA, EOMs intact. Mucosa pink and moist. 
+Neck Supple, No LAD, No thyromegaly.  
+CARDIAC: Regular rhythm, tachy rate. Normal S1, S2. No murmurs, 
+rubs or ___. No gross JVD.
+LUNGS: Good, equal chest excursion.  Lung sounds with rales and 
+rhonchi in right lower lobe, slight in left base.  Scattered 
+expiratory wheezes throughout.  No egophony.
+ABDOMEN: Protuberant.  Positive bowel sounds.  Soft, non-tender 
+to palpation. 
+EXTREMITIES: No peripheral edema, positive pain in left calf, 2+ 
+dorsalis pedis pulses.  Noted deformed toenails and prior 
+surgery on right foot.
+SKIN: Pink/hot/dry.  No rashes/lesions, ecchymoses.  
+NEURO: A&Ox3. Appropriate, seems slightly confused, refers many 
+answers to daughter. CN ___ grossly intact. Sensation and 
+moevement grossly intact in all extremities.
+PSYCH: Listens and responds to questions appropriately, 
+pleasant. 
+ 
+
+###RESPONSE: Vitals {Vital signs finding}, T {Body temperature finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, SpO2 {Finding of oxygen saturation}, GENERAL {General examination of patient}, distress {Distress}, Speaks {Does speak}, full sentences {Able to complete sentence in one breath}, tachypnea {Tachypnea}, HEENT {Physical examination procedure}, Normocephalic {Normal head}, atraumatic {No injuries apparent}, Conjunctiva moist and pink {Finding of moistness of eye}, scleral icterus {Scleral icterus}, PERRLA {Pupils equal, react to light and accommodation}, EOMs {Ophthalmic examination and evaluation}, intact {No abnormality detected}, Mucosa pink and moist {Moist oral mucosa}, Supple {Normal movement of neck}, LAD {Lymphadenopathy}, thyromegaly {Goiter}, CARDIAC {Cardiovascular physical examination}, Regular rhythm {Normal sinus rhythm}, tachy {Tachycardia}, rate {Finding of heart rate}, Normal S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, murmurs {Murmur}, rubs {Pericardial friction rub}, JVD {Jugular venous engorgement}, LUNGS {Examination of respiratory system}, Good {Normal breath sounds}, chest excursion {Finding of chest expansion}, Lung {Lung structure}, rales {Respiratory crackles}, rhonchi {Wheeze - rhonchi}, right lower lobe {Structure of lower lobe of right lung}, left base {Structure of base of left lung}, wheezes {Wheezing}, egophony {Egophony}, ABDOMEN {Examination of abdomen}, Protuberant {Swollen abdomen}, Positive bowel sounds {Normal bowel sounds}, Soft {Abdomen soft}, non-tender {Abdominal tenderness}, palpation {Palpation}, EXTREMITIES {Examination of limb}, edema {Edema}, pain {Pain}, left calf {Structure of calf of left lower leg}, 2+ 
+dorsalis pedis {Dorsalis pulse present}, pulses {Pulse finding}, right foot {Structure of soft tissue of dorsum of right foot}, SKIN {Examination of skin}, Pink {Pink skin}, hot {Hot skin}, dry {Xeroderma}, rashes {Eruption of skin}, lesions {Lesion}, ecchymoses {Ecchymosis}, NEURO {Neurological examination}, Ox3 {Oriented to person, time and place}, Appropriate {Appropriate affect}, confused {Clouded consciousness}, grossly intact {Normal nervous system function}, Sensation {Finding of sensation by site}, grossly intact {Normal nervous system function}, all extremities {All extremities}, PSYCH {Psychological assessment}"
+"###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:
+IMAGING: 
+CXR ___ - IMPRESSION: Patchy airspace opacities, most 
+notable in the right lung base, but also in the right mid lung 
+and likely also left lower lung. Findings are concerning for 
+aspiration or pneumonia. 
+.
+MICROBIOLOGY:  Blood cultures ___ - pending
+.
+LAB DATA:
+LABS ON ADMISSION:
+___ 10:45AM BLOOD WBC-19.3* RBC-5.09 Hgb-14.9 Hct-44.3 
+MCV-87 MCH-29.3 MCHC-33.7 RDW-14.2 Plt ___
+___ 10:45AM BLOOD Neuts-86.3* Lymphs-9.0* Monos-3.8 Eos-0.7 
+Baso-0.2
+___ 10:45AM BLOOD Plt ___
+___ 10:45AM BLOOD Glucose-170* UreaN-24* Creat-1.0 Na-139 
+K-4.6 Cl-99 HCO3-28 AnGap-17
+___ 10:45AM BLOOD cTropnT-<0.01
+___ 10:45AM BLOOD CK-MB-5
+___ 10:50AM BLOOD Type-ART pO2-61* pCO2-47* pH-7.40 
+calTCO2-30 Base XS-2
+___ 10:50AM BLOOD Lactate-1.0
+.
+LABS ON DISCHARGE:
+ 
+
+###RESPONSE: IMAGING {Imaging}, CXR {Plain chest X-ray}, opacities {Abnormally opaque structure}, right lung base {Structure of base of right lung}, right mid lung {Structure of middle lobe of right lung}, left lower lung {Structure of lower lobe of left lung}, aspiration {Aspiration pneumonia}, pneumonia {Pneumonia}, MICROBIOLOGY {Microbiology}, Blood cultures {Blood culture}, 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}, 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}, Baso {Basophil count}, BLOOD 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}, cTropnT {Troponin T cardiac measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, ART {Arterial specimen collection for laboratory test}, pH {pH measurement}, calTCO2 {Blood total carbon dioxide (calculated)}, Base XS {Delta base, blood}, Lactate {Lactic acid 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: Brief Hospital Course:
+___ y.o. woman with a past history of COPD and asthma that 
+presented with increasing dyspnea and cough.  
+.  
+# Dyspnea: Likely due to COPD exacerbation with pneumonia 
+suggested by CXR. ___ have occured in the setting of a URI given 
+her husband's recent cold symptoms, but may also be due 
+COPD/asthma exacerbation alone. Respiratory status has improved 
+significantly since she presented to the ED. Infleunza was 
+negative Does not appear to be volume overloaded, making CHF 
+less likely. PE unlikely given her presentation and response to 
+bronchodilators. Given her baseline respiratory dysfunction, she 
+will likely need pulmonary rehab prior to returning home. She is 
+not a candidate for home oxygen because she continues to smoke.  
+If she can quit, she should start on nighttime home oxygen. 
+Smoking cessation was discussed.  She had a nicotine patch and 
+was discharged on chantix.  She plans not to smoke on this 
+medication and knows to watch for depression and altered dreams.
+She was discharged with a steroid taper, plan to complete a 10 
+day course of antibiotics, and nebs for COPD/Asthma.  She should 
+continue oxygen as needed. 
+.  
+Leukocytosis: Elevated WBC prior to steroids. Decreased during 
+admission. Likely related to pneumonia, as suggested by CXR. 
+This trended down.  
+.  
+# Hypertension: Well controlled with home medications. HCTZ, 
+metoprolol and norvasc were continued, BP remained stable.  
+.  
+# Type II Diabetes: Glucose checks qid, standing coverage with 
+70/30 and sliding scale.  Her 70/30 was increased while on 
+prednisone and she was started on metformin.
+.  
+# Hyperlipidemia: Continued her simvastatin.  
+.  
+# Peripheral Neuropathy: Continued with her gabapentin.  
+.  
+# ? Dementia: Patient is on aricept, she and her daughter 
+reported forgetfulness. Aricept was continued and she was 
+monitored closely for delerium.  
+.  
+# CODE: Remains FULL code at this time. Patient did express that 
+she may not want to be resuscitated/intubated, but further 
+discussion with patient and family is required. She does not 
+have a health care proxy.  
+.  
+# CONTACT: With patient and her daughter.  
+
+ 
+
+###RESPONSE: COPD {Chronic obstructive lung disease}, asthma {Asthma}, increasing {Patient's condition worsened}, dyspnea {Dyspnea}, cough {Cough}, Dyspnea {Dyspnea}, COPD exacerbation {Acute exacerbation of chronic obstructive airways disease}, pneumonia {Pneumonia}, CXR {Plain chest X-ray}, URI {Upper respiratory infection}, cold {Common cold}, COPD {Chronic obstructive lung disease}, asthma exacerbation {Exacerbation of asthma}, Respiratory status {Monitoring of respiration}, improved {Patient's condition improved}, Infleunza {Influenza}, negative {No pathologic diagnosis}, volume overloaded {Hypervolemia}, CHF {Congestive heart failure}, PE {Pulmonary embolism}, baseline {Baseline state}, respiratory {Respiratory function finding}, dysfunction {Functional disorder}, pulmonary rehab {Pulmonary rehabilitation}, home oxygen {Home oxygen therapy}, smoke {Smoker}, home oxygen {Home oxygen therapy}, Smoking cessation {Smoking cessation education}, smoke {Smoker}, medication {Administration of drug or medicament}, depression {Depressive disorder}, steroid {Steroid therapy}, taper {Medication decreased}, antibiotics {Antibiotic therapy}, nebs {Nebulizer therapy}, COPD {Chronic obstructive lung disease}, Asthma {Asthma}, oxygen {Oxygen therapy}, Leukocytosis {Leukocytosis}, Elevated WBC {White blood cell count outside reference range}, steroids {Steroid therapy}, pneumonia {Pneumonia}, CXR {Plain chest X-ray}, Hypertension {Hypertensive disorder, systemic arterial}, Well controlled {Disease condition determination, well controlled}, medications {Administration of drug or medicament}, stable {Stable blood pressure}, Type II Diabetes {Diabetes mellitus type 2}, Glucose {Glucose measurement, blood}, sliding scale {Sliding scale insulin regime}, increased {Increasing dosage of medication}, prednisone {Steroid therapy}, started {New medication added}, Hyperlipidemia {Hyperlipidemia}, Peripheral Neuropathy {Peripheral nerve disease}, Dementia {Dementia}, forgetfulness {Forgetful}, monitored {Monitoring procedure}, delerium {Delirium}, resuscitated {Resuscitation}, intubated {Insertion of endotracheal tube}"
+"###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:
+Albuterol - 90mcg aerosol prn
+Citalopram - 10 mg PO daily
+Fluticasone-Salmeterol (Advair) - 250 mcg-50 mcg inhaled bid
+Gabapentin - 300 mg PO qhs
+HCTZ - 25 mg PO daily
+Metoprolol Succinatate - 150 mg PO daily
+Simvastatin - 40 mg PO qhs
+ASA - 81 mg PO daily
+Norvasc - 5 mg PO daily
+Aricept - 5 mg PO daily
+Insulin NPH and Regular (Humulin 70/30) - 32 units, QAM and QPM
+ 
+Discharge Medications:
+1. Prednisone 10 mg Tablet Sig: as directed Tablet PO once a day 
+for 12 days: 6 tabs for 2 days, then 4 tabs for 2 days, then 3 
+tabs for 2 days, then 2 tabs for 2 days, then 1 tab for 2 days 
+then ___ tab for 2 days.
+Disp:*43 Tablet(s)* Refills:*0*
+2. Albuterol Sulfate 90 mcg/Actuation HFA Aerosol Inhaler Sig: 
+___  Inhalation every four (4) hours as needed for shortness of 
+breath or wheezing.  
+3. Chantix 0.5(11)-1(3X14) mg Tablets, Dose Pack Sig: ___ 
+Tablets, Dose Packs PO as directed for 11 weeks: 0.5 mg daily 
+for 3 days, then 0.5 mg BID for 4 days, then 1 mg BID.
+Disp:*1 Tablets, Dose Pack(s)* Refills:*0*
+4. Citalopram 10 mg Tablet Sig: One (1) Tablet PO once a day.  
+5. Fluticasone-Salmeterol 250-50 mcg/Dose Disk with Device Sig: 
+One (1) Disk with Device Inhalation BID (2 times a day).  
+6. Gabapentin 300 mg Capsule Sig: One (1) Capsule PO HS (at 
+bedtime).  
+7. Hydrochlorothiazide 12.5 mg Capsule Sig: Two (2) Capsule PO 
+DAILY (Daily).  
+8. Metoprolol Succinate 50 mg Tablet Sustained Release 24 hr 
+Sig: Three (3) Tablet Sustained Release 24 hr PO once a day.  
+9. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+10. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable 
+PO DAILY (Daily).  
+11. Amlodipine 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 
+ 
+12. Donepezil 5 mg Tablet Sig: One (1) Tablet PO HS (at 
+bedtime).  
+13. Insulin NPH & Regular Human 100 unit/mL (70-30) Suspension 
+Sig: ___ (32)  Subcutaneous twice a day: Take 40 units 
+twice daily for the next ___ days while on prednisone.  
+14. Tiotropium Bromide 18 mcg Capsule, w/Inhalation Device Sig: 
+One (1) Inh Inhalation once a day.
+Disp:*QS 1 month unit* Refills:*2*
+15. Cefpodoxime 200 mg Tablet Sig: One (1) Tablet PO twice a day 
+for 7 days.
+Disp:*14 Tablet(s)* Refills:*0*
+16. Azithromycin 250 mg Tablet Sig: One (1) Tablet PO Q24H 
+(every 24 hours) for 7 days.  
+17. Metformin 500 mg Tablet Sig: One (1) Tablet PO BID (2 times 
+a day).
+Disp:*60 Tablet(s)* Refills:*2*
+
+ 
+
+###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:
+Priamry: COPD exacerbation, penumonia.
+Secondary: Hypertension, Type II Diabetes, Hyperlipidemia, 
+Peripheral Neuropathy, Dementia: 
+
+ 
+Discharge Condition:
+Stable
+ 
+
+###RESPONSE: COPD exacerbation {Acute exacerbation of chronic obstructive airways disease}, penumonia {Pneumonia}, Hypertension {Hypertensive disorder, systemic arterial}, Type II Diabetes {Diabetes mellitus type 2}, Hyperlipidemia {Hyperlipidemia}, Peripheral Neuropathy {Peripheral nerve disease}, Dementia {Dementia}, Stable {Patient's condition stable}"
+"###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 for shortness of breath.  You were treated a 
+COPD exacerbation and pneumonia and were given frequent 
+nebulizers, supplemental oxygen, oral steroids and antibiotics 
+with improvement in your breathing.  You were also given a 
+nicotine patch and encouraged to stop or reduce your smoking, 
+which is likely contributing to your condition.  
+
+You were started on a new medication, chantix, to help with 
+smoking cessation.  Please watch for depressed mood or strange 
+dreams on this medication and report these symptoms to your PCP.
+
+You were started on Spireva for better COPD control as well as a 
+taper of prednisone.  You were given increased insulin and 
+metformin to help control your blood sugars while on the 
+prednisone.  You should comeplete a 10 day course of 
+antibiotics.
+
+Please call your primary care physician or come to the emergency 
+room if you experience worsening breathing difficulties that do 
+not respond to inhalers, fevers, chills, chest pain, or other 
+concerning symptoms.
+
+ 
+
+###RESPONSE: shortness of breath {Dyspnea}, COPD exacerbation {Acute exacerbation of chronic obstructive airways disease}, pneumonia {Pneumonia}, nebulizers {Nebulizer therapy}, supplemental oxygen {Oxygen therapy support}, oral {Administration of drug or medicament via oral route}, steroids {Steroid therapy}, antibiotics {Antibiotic therapy}, improvement {Patient's condition improved}, reduce your smoking {Smoking cessation education}, started {New medication added}, new medication {New medication commenced}, smoking cessation {Smoking cessation education}, depressed mood {Depressed mood}, medication {Administration of drug or medicament}, PCP {Primary care management}, started {New medication added}, COPD {Chronic obstructive lung disease}, taper {Medication decreased}, prednisone {Steroid therapy}, increased {Increasing dosage of medication}, insulin {Insulin regime}, metformin {Allergy to metformin}, blood sugars {Blood sugar management}, prednisone {Steroid therapy}, antibiotics {Antibiotic therapy}, primary care {Primary care management}, emergency {Emergency treatment management}, breathing difficulties {Difficulty breathing}, fevers {Fever}, chills {Chill}, chest pain {Chest 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: 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: 
+Aspirin / Penicillins / Codeine / Inderal / Isordil Titradose / 
+Iodine-Iodine Containing / Celexa / Glucophage / Atorvastatin / 
+Dilaudid (PF) / Vioxx / Levofloxacin / Hydralazine And 
+Derivatives / Ondansetron / Carbapenem / Lidocaine / 
+Nortriptyline / Fosfomycin / Morphine / Trimethoprim / Latex
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Chest pain
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: Aspirin {Allergy to aspirin}, Penicillins {Allergy to penicillin}, Codeine {Allergy to codeine}, Iodine-Iodine {Allergy to iodine compound}, Atorvastatin {Allergy to atorvastatin}, Levofloxacin {Allergy to levofloxacin}, Morphine {Allergy to morphine}, Latex {Allergy to Hevea brasiliensis latex protein}, Chest pain {Chest 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:
+Ms. ___ is a ___ year old female with CAD, HTN, Type II DM, CKD 
+and a history of bradycardia with Wenckebach rhythm, CVA, s/p 
+DVT with indwelling IVC filter w/o coumadin, presenting with 
+___ substernal chest pressure radiating to the left arm as well 
+as jaw while waiting for dermatology appointment.  
+In the ED, initial vitals were 98.6 76 150/82 16 98% 2L NC  
+Labs and imaging significant for clear CXR, Cr 1.2 (baseline), 
+troponin T <0.01  
+Patient started on nitro gtt, heparin bolus and gtt, started on 
+2L n/c and was transferred to floor for further w/u.  
+Vitals on transfer were 97.1, 73, 134/60, 24, 93% 2L  
+.  
+On arrival to the floor, patient denies CP, states has improved. 
+She only notes feeling of general malaise. Denies DOE, SOB, 
+cough, F/C/S. She notes that the pain had started at about 
+10:45, and remained constant until about 4pm when it improved.  
+.  
+Pt had admission for chest pain ___, was ruled out for MI 
+with echo and CE, felt to have large anxiety component to pain 
+at that time.  
+REVIEW OF SYSTEMS  
+On review of systems, she denies any prior history of pulmonary 
+embolism, bleeding at the time of surgery, myalgias, joint 
+pains, cough, hemoptysis, black stools or red stools. She denies 
+recent fevers, chills or rigors. She denies exertional buttock 
+or calf pain. All of the other review of systems were negative.  
+
+.  
+Cardiac review of systems is notable for absence of dyspnea on 
+exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, 
+palpitations, syncope or presyncope.  
+
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}, HTN {Hypertensive disorder, systemic arterial}, Type II DM {Diabetes mellitus type 2}, CKD {Chronic kidney disease}, bradycardia {Bradycardia}, rhythm {Irregular heart beat}, CVA {Cerebrovascular accident}, DVT {Deep venous thrombosis}, IVC filter {Inferior vena cava filter in situ}, coumadin {Anticoagulant therapy}, chest pressure {Tight chest}, radiating to the left arm {Pain radiating to left arm}, jaw {Pain radiating to jaw}, vitals {Vital signs finding}, NC {Oxygen administration by nasal cannula}, imaging {Imaging}, clear {Chest clear}, CXR {Plain chest X-ray}, baseline {Baseline state}, troponin {Troponin measurement}, heparin {Heparin therapy}, Vitals {Vital signs finding}, CP {Chest pain}, improved {Patient's condition improved}, malaise {Malaise}, DOE {Dyspnea on exertion}, SOB {Dyspnea}, cough {Cough}, F/C {Fever with chills}, pain {Chest pain}, constant {Constant pain}, improved {Patient's condition improved}, chest pain {Chest pain}, MI {Myocardial infarction}, echo {Echocardiography}, anxiety {Anxiety}, pain {Chest pain}, review of systems {Review of systems}, pulmonary 
+embolism {Pulmonary embolism}, bleeding {Bleeding}, surgery {Surgical procedure}, myalgias {Muscle pain}, joint 
+pains {Joint pain}, cough {Cough}, hemoptysis {Hemoptysis}, black stools {Dark stools}, red stools {Red stools}, fevers {Fever}, chills {Chill}, rigors {Rigor}, buttock {Pain in buttock}, calf pain {Pain in calf}, review of systems {Review of systems}, Cardiac {Heart disease}, review of systems {Review of systems}, dyspnea on 
+exertion {Dyspnea on exertion}, paroxysmal nocturnal dyspnea {Paroxysmal nocturnal dyspnea}, orthopnea {Orthopnea}, ankle edema {Ankle edema}, palpitations {Palpitations}, syncope {Syncope}, presyncope {Near 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:
+- CAD: Cardiac cath ___ showed 50% mid LAD, 50% OM1 lesions c/b 
+
+coronary aneurysm
+- HTN  
+- Diabetes mellitus, type 2
+- CRI: baseline creatinine 0.9-1.2
+- Asymptomatic bradycardia w/ ___ rhythm in past
+- s/p CVA with residual left sided weakness in ___  
+- h/o DVT in ___ post-op from back surgery, s/p IVC filter  
+- L1-2 discectomy, L5-S1 fusion, R sided L2-3 and L3-4 w/ 
+residual right leg weakness, now wheelchair bound when going 
+outside but uses a walker at home
+- Cervical stenosis on ___ MRI: mild stenosis C3-4, moderate 
+
+stenosis C4-5, C5-6
+- Foraminotomy
+- Recurrent UTIs, on chronic suppressive methenamine  
+- Arthritis  
+- Cervical spondylosis  
+- Osteoporosis  
+- GERD
+- s/p: appendectomy, hysterectomy, tonsillectomy, lap 
+cholecystectomy in ___, cataract surgery x 2
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}, Cardiac cath {Cardiac catheterization}, mid LAD {Structure of mid portion of anterior descending branch of left coronary artery}, OM1 {Structure of first obtuse marginal branch of circumflex branch of left coronary artery}, lesions {Lesion}, coronary aneurysm {Aneurysm of coronary vessels}, HTN {Hypertensive disorder, systemic arterial}, Diabetes mellitus, type 2 {Diabetes mellitus type 2}, CRI {Chronic renal insufficiency}, baseline {Baseline state}, creatinine {Creatinine measurement}, Asymptomatic bradycardia {Asymptomatic bradycardia}, rhythm {Irregular heart beat}, CVA {Cerebrovascular accident}, left sided weakness {Left hemiparesis}, DVT {Deep venous thrombosis}, post-op {Postoperative state}, surgery {Surgical procedure}, IVC filter {Inferior vena cava filter in situ}, discectomy {Chondrectomy of spine}, L5-S1 {Structure of intervertebral disc of L5 and S1}, fusion {Spinal arthrodesis}, right leg weakness {Right hemiparesis}, wheelchair bound {Does mobilize using wheelchair}, Cervical stenosis {Spinal stenosis in cervical region}, MRI {Magnetic resonance imaging}, stenosis {Stenosis}, stenosis {Stenosis}, Foraminotomy {Foraminotomy}, Recurrent UTIs {Recurrent urinary tract infection}, Arthritis {Arthritis}, Cervical spondylosis {Cervical spondylosis}, Osteoporosis {Osteoporosis}, GERD {Gastroesophageal reflux disease}, appendectomy {Excision of appendix}, hysterectomy {Hysterectomy}, tonsillectomy {Tonsillectomy}, lap 
+cholecystectomy {Laparoscopic cholecystectomy}, cataract surgery {Cataract surgery}"
+"###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 died at age ___ of CAD. Father died ___ CAD. 2 brothers 
+died at ___ of CAD. Sister: ___. Sister: lung cancer. 3 
+brothers: diabetes and CAD. 3 daughters: 1 with ""hole in her 
+heart"", 1 with learning disability, 1 died of melanoma ___ years 
+ago.
+ 
+
+###RESPONSE: died {Dead}, CAD {Coronary arteriosclerosis}, died {Dead}, CAD {Coronary arteriosclerosis}, died {Dead}, CAD {Coronary arteriosclerosis}, lung cancer {Malignant tumor of lung}, CAD {Coronary arteriosclerosis}, ""hole in her 
+heart"" {Atrial septal defect}, learning disability {Developmental academic disorder}, died {Dead}, melanoma {Malignant melanoma 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: Physical Exam:
+Admission PE:
+GENERAL: ___ F in NAD. Oriented x3. Mood, affect appropriate.  
+HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were 
+pink, no pallor or cyanosis of the oral mucosa. No xanthalesma. 
+No Carotid Bruits.  
+NECK: Supple with JVP of 2 cm.  
+CARDIAC: PMI located in ___ intercostal space, midclavicular 
+line. RR, normal S1, S2. No m/r/g. No thrills, lifts. No S3 or 
+S4.  
+LUNGS: No chest wall deformities, scoliosis or kyphosis. Resp 
+were unlabored, no accessory muscle use. Few crackles b/l at the 
+bases  
+ABDOMEN: Soft, NTND. No HSM or tenderness. Abd aorta not 
+enlarged by palpation. No abdominial bruits.  
+EXTREMITIES: No c/c/e. No femoral bruits.  
+SKIN: No stasis dermatitis, ulcers, scars, or xanthomas.  
+PULSES:  
+Right: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ ___ 2+  
+Left: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ ___ 2+  
+
+Discharge PE:
+T 97.6 126/66 HR 78 RR 20 96% RA
+GENERAL: WDWN F in NAD. Oriented x3. Mood, affect appropriate.  
+HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were 
+pink, no pallor or cyanosis of the oral mucosa. No xanthalesma. 
+No Carotid Bruits.  
+NECK: Supple with JVP of 2 cm.  
+CARDIAC: PMI located in ___ intercostal space, midclavicular 
+line. RR, normal S1, S2. No m/r/g. No thrills, lifts. No S3 or 
+S4.  
+LUNGS: No chest wall deformities, scoliosis or kyphosis. Resp 
+were unlabored, no accessory muscle use. Few crackles b/l at the 
+bases  
+ABDOMEN: Soft, NTND. No HSM or tenderness. Abd aorta not 
+enlarged by palpation. No abdominial bruits.  
+EXTREMITIES: No c/c/e. No femoral bruits.  
+SKIN: No stasis dermatitis, ulcers, scars, or xanthomas.  
+PULSES:  
+Right: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ ___ 2+  
+Left: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ ___ 2+  
+
+ 
+
+###RESPONSE: GENERAL {General examination of patient}, NAD {No abnormality detected}, Oriented x3 {Oriented to person, time and place}, Mood {Level of mood - normal}, affect {Mood finding}, HEENT {Physical examination procedure}, NC {Normal head}, Sclera anicteric {White sclera}, PERRL {Pupils equal and reacting to light}, EOMI {Normal ocular motility}, Conjunctiva {Conjunctival structure}, pallor {Pallor of skin of face}, cyanosis {Cyanosis}, oral mucosa {Oral mucous membrane structure}, xanthalesma {Xanthelasma}, Carotid Bruits {Carotid bruit}, NECK {Physical examination procedure}, Supple {Normal movement of neck}, JVP {Finding of jugular venous pressure}, CARDIAC {Cardiovascular physical examination}, intercostal space {Structure of intercostal space}, midclavicular 
+line {Midclavicular line}, RR {Finding of rate of respiration}, normal S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, No m/r/g {Heart sounds normal}, thrills {Thrill}, lifts {Does lift}, No S3 {Third heart sound, S>3<, inaudible}, LUNGS {Examination of respiratory system}, chest wall deformities {Deformity of chest wall}, scoliosis {Scoliosis deformity of spine}, kyphosis {Kyphosis deformity of spine}, Resp {Examination of respiratory system}, accessory muscle {Accessory skeletal muscle}, crackles {Respiratory crackles}, bases {Structure of base of lung}, ABDOMEN {Examination of abdomen}, Soft {Abdomen soft}, ND {Swollen abdomen}, HSM {Hepatosplenomegaly}, tenderness {Tenderness}, Abd {Examination of abdomen}, enlarged {Enlargement}, palpation {Palpation}, abdominial bruits {Abdominal bruit}, EXTREMITIES {Examination of limb}, femoral bruits {Femoral bruit}, SKIN {Examination of skin}, stasis dermatitis {Stasis dermatitis}, ulcers {Ulcer}, scars {Scar}, xanthomas {Xanthomatosis}, Right {Right coronary artery structure}, Carotid {Carotid artery structure}, Femoral {Structure of femoral artery}, DP {Structure of dorsalis pedis artery}, Left {Structure of left carotid artery}, Carotid {Carotid artery structure}, Femoral {Structure of femoral artery}, DP {Structure of dorsalis pedis artery}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, RA {Breathing room air}, WDWN {Well nourished}, NAD {Distress}, Oriented x3 {Oriented to person, time and place}, Mood {Level of mood - normal}, affect {Mood finding}, NCAT {Normal head}, Sclera anicteric {White sclera}, PERRL {Pupils equal and reacting to light}, EOMI {Normal ocular motility}, Conjunctiva {Conjunctival structure}, pallor {Pallor of skin of face}, cyanosis {Cyanosis}, oral mucosa {Oral mucous membrane structure}, xanthalesma {Xanthelasma}, Carotid Bruits {Carotid bruit}, Supple {Normal movement of neck}, JVP {Finding of jugular venous pressure}, intercostal space {Structure of intercostal space}, midclavicular 
+line {Midclavicular line}, RR {Finding of rate of respiration}, normal S1, S2 {Heart sounds normal}, No m/r/g {Heart sounds normal}, thrills {Thrill}, lifts {Does lift}, No S3 {Third heart sound, S>3<, inaudible}, chest wall deformities {Deformity of chest wall}, scoliosis {Scoliosis deformity of spine}, kyphosis {Kyphosis deformity of spine}, Resp 
+were unlabored {Breathing easily}, accessory muscle {Accessory skeletal muscle}, crackles {Respiratory crackles}, bases {Structure of base of lung}, Soft {Abdomen soft}, NTND {Abdominal tenderness}, HSM {Hepatosplenomegaly}, tenderness {Tenderness}, Abd aorta {Abdominal aorta structure}, enlarged {Enlargement}, palpation {Palpation}, abdominial bruits {Abdominal bruit}, femoral bruits {Femoral bruit}, stasis dermatitis {Stasis dermatitis}, ulcers {Ulcer}, scars {Scar}, xanthomas {Xanthomatosis}, Right {Right coronary artery structure}, Carotid {Carotid artery structure}, Femoral {Structure of femoral artery}, DP {Structure of dorsalis pedis artery}, Left {Structure of left carotid artery}, Carotid {Carotid artery structure}, Femoral {Structure of femoral artery}, DP {Structure of dorsalis pedis artery}"
+"###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:
+___ 11:45AM BLOOD WBC-6.1 RBC-3.45* Hgb-10.8* Hct-31.8* 
+MCV-92 MCH-31.3 MCHC-34.0 RDW-13.7 Plt ___
+___ 11:45AM BLOOD Neuts-60.5 ___ Monos-6.3 Eos-1.8 
+Baso-0.7
+___ 11:45AM BLOOD ___ PTT-20.5* ___
+___ 11:45AM BLOOD Glucose-277* UreaN-18 Creat-1.2* Na-140 
+K-4.5 Cl-104 HCO3-26 AnGap-15
+___ 08:45PM BLOOD CK(CPK)-48
+___ 11:45AM BLOOD cTropnT-<0.01
+___ 08:45PM BLOOD CK-MB-2 cTropnT-<0.01
+___ 06:13AM BLOOD Calcium-8.7 Phos-4.1 Mg-2.0
+UA negative
+
+___ CXR: No acute cardiopulmonary process
+
+Discharge labs:
+
+___ 06:13AM BLOOD WBC-6.0 RBC-3.30* Hgb-10.3* Hct-30.7* 
+MCV-93 MCH-31.3 MCHC-33.7 RDW-13.8 Plt ___
+___ 06:13AM BLOOD ___ PTT-69.1* ___
+___ 06:13AM BLOOD Plt ___
+___ 06:13AM BLOOD Glucose-156* UreaN-15 Creat-1.1 Na-141 
+K-4.2 Cl-108 HCO___ AnGap-___ year old female with CAD, HTN, Type II DM, CKD and a history 
+of bradycardia with ___ rhythm, CVA, s/p DVT with 
+indwelling IVC filter w/o coumadin, presenting with ___ left 
+sided jaw, neck, chest, torso pain lasting for ___ hours.  
+
+# Atypical chest pain: Has long history of chest pain with 
+previous cath in ___ showing normal arteries and stress echo in 
+___ showing evidence of old infarct with no inducible 
+ischemia. CE negative x2. No acute changes on EKG. Has long 
+history of similar pain. Given history, ACS is possible and she 
+was ruled out with enzymes and seriel EKGs. Other possibilities 
+included anxiety/psychosomatic component which has been 
+documented in past. She has cervical stenosis which may have had 
+component. ___ have had musculoskeletal sprain/strain/pull.  PE 
+was unlikely given no tachycardia, no pleuritic component, no 
+s/s DVT, s/p IVC filter. Pna unlikely given no infiltrate on 
+CXR, no cough, no F/C/S.
+--On the floor she was weaned off nitro gtt with no return of 
+her pain, and stopped heparin. No events noted on telemetry.  
+ticlopidine was continued as pt allergic to asa.  Simvastatin 
+was continued - patient had a documented allergy as ""elevated 
+CPK"" however pt has been on this medication at home for some 
+time without documented CPK elevations. No issues while in 
+house.  Acetaminophen was used PRN for pain, further analgesic 
+options were limited given extensive allergy list.  No beta 
+blocker was started as patient has documented allergy to 
+propanolol.  Patient had a negative UA and UTI was unlikely 
+cause.
+  
+#nausea: was controlled with home prn compazine.  
+
+# Normocytic anemia: stable  during admission
+ 
+# Hypertension: patient not currently treated, has been on ACE-I 
+in past but blood pressures were controlled while in house.
+ 
+# Diabetes Mellitus Type II- stable on sliding scale insulin in 
+house
+# CKD - At baseline. Cr remained stable.  
+# H/o cerebrovascular accident - stable. continued ticlopidine.  
+
+# GERD - stable. continued home omeprazole.  
+.  
+FEN: Cardiac Heart Healthy  
+.  
+ACCESS: PIV's  while in house
+.  
+PROPHYLAXIS:  
+-DVT ppx with heparin gtt followed by sub cutaneous heparin.  
+-Pain management with tylenol  
+-Bowel regimen with senna/colace  
+.  
+CODE: full  
+
+Transitional issues:
+-Atypical chest pain:  Felt very unlikely to be cardiac.  
+Definitive diagnosis was difficult.  She does have previously 
+diagnosed CAD, but does not tolerate beta blockers or aspirin.
+-Social work/psych:  ___ benefit from seeing a therapist 
+regarding anxiety. This has been broached with her in the past 
+and may be worth speaking to her about again.
+ 
+
+###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}, 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}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, UA {Urinalysis}, CXR {Plain chest X-ray}, 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}, BLOOD Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, Cl {Chloride measurement, blood}, AnGap {Anion gap measurement}, CAD {Coronary arteriosclerosis}, HTN {Hypertensive disorder, systemic arterial}, Type II DM {Diabetes mellitus type 2}, CKD {Chronic kidney disease}, bradycardia {Bradycardia}, rhythm {Irregular heart beat}, CVA {Cerebrovascular accident}, DVT {Deep venous thrombosis}, IVC filter {Inferior vena cava filter in situ}, coumadin {Anticoagulant therapy}, jaw {Pain radiating to jaw}, neck {Neck pain}, chest {Chest pain}, torso {Trunk structure}, pain {Pain}, Atypical chest pain {Atypical chest pain}, chest pain {Chest pain}, cath {Cardiac catheterization}, arteries {Arterial structure}, stress echo {Stress echocardiography}, old infarct {Healed infarct}, ischemia {Ischemia}, EKG {Electrocardiographic procedure}, pain {Chest pain}, ACS {Acute coronary syndrome}, EKGs {Electrocardiographic procedure}, anxiety {Anxiety}, cervical stenosis {Spinal stenosis in cervical region}, musculoskeletal sprain/strain/pull {Muscle strain}, PE {Pulmonary embolism}, tachycardia {Tachycardia}, pleuritic {Pleuritic pain}, DVT {Deep venous thrombosis}, IVC filter {Inferior vena cava filter in situ}, Pna {Pneumonia}, infiltrate {Infiltration}, CXR {Plain chest X-ray}, cough {Cough}, F/C {Fever with chills}, pain {Chest pain}, heparin {Heparin therapy}, telemetry {Cardiac telemetry}, allergy {Allergic disposition}, ""elevated 
+CPK"" {Serum creatine kinase MB isoenzyme measurement}, pain {Pain}, allergy {Allergic disposition}, allergy to 
+propanolol {Allergy to propranolol}, UA {Urinalysis}, UTI {Urinary tract infectious disease}, nausea {Nausea}, Normocytic anemia {Normocytic anemia}, stable {Patient's condition stable}, Hypertension {Hypertensive disorder, systemic arterial}, blood pressures {Blood pressure monitoring}, Diabetes Mellitus Type II {Diabetes mellitus type 2}, sliding scale insulin {Sliding scale insulin regime}, CKD {Chronic kidney disease}, baseline {Baseline state}, stable {Patient's condition stable}, cerebrovascular accident {Cerebrovascular accident}, stable {Patient's condition stable}, GERD {Gastroesophageal reflux disease}, stable {Patient's condition stable}, Cardiac {Heart structure}, Heart {Heart structure}, PROPHYLAXIS {Preventive procedure}, DVT {Deep venous thrombosis}, ppx {Preventive procedure}, heparin {Heparin therapy}, cutaneous {Skin structure}, heparin {Heparin therapy}, Pain management {Pain management}, Bowel {Normal bowel habits}, regimen {Therapeutic regimen}, Atypical chest pain {Atypical chest pain}, cardiac {Heart disease}, CAD {Coronary arteriosclerosis}, anxiety {Anxiety}"
+"###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:
+1. gabapentin 100 mg Capsule Sig: One (1) Capsule PO HS (at 
+bedtime).  
+2. gabapentin 300 mg Capsule Sig: One (1) Capsule PO QAM (once a 
+
+day (in the morning)).  
+3. meclizine 12.5 mg Tablet Sig: One (1) Tablet PO three times a 
+
+day as needed for dizziness.  
+4. omeprazole 40 mg Capsule, Delayed Release(E.C.) Sig: One (1) 
+Capsule, Delayed Release(E.C.) PO once a day.  
+5. prochlorperazine maleate 5 mg Tablet Sig: One (1) Tablet PO 
+every six (6) hours as needed for nausea.  
+6. simvastatin 40 mg Tablet Sig: One (1) Tablet PO once a day.  
+7. alum-mag hydroxide-simeth 200-200-20 mg/5 mL Suspension Sig: 
+___ MLs PO QID (4 times a day) as needed for heartburn.  
+8. ticlopidine 250 mg Tablet Sig: One (1) Tablet PO BID (2 times 
+
+a day).  
+9. Lantus 100 unit/mL Solution Sig: Fifteen (15) units 
+Subcutaneous at bedtime.
+
+ 
+Discharge Medications:
+1. gabapentin 100 mg Capsule Sig: One (1) Capsule PO HS (at 
+bedtime). Capsule(s) 
+2. gabapentin 300 mg Capsule Sig: One (1) Capsule PO QAM (once a 
+day (in the morning)).  
+3. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: Two (2) 
+Capsule, Delayed Release(E.C.) PO DAILY (Daily).  
+4. prochlorperazine maleate 10 mg Tablet Sig: One (1) Tablet PO 
+Q6H (every 6 hours) as needed for Nausea.  
+5. ticlopidine 250 mg Tablet Sig: One (1) Tablet PO BID (2 times 
+a day).  
+6. meclizine 12.5 mg Tablet Sig: One (1) Tablet PO three times a 
+day as needed for nausea.  
+7. Lantus 100 unit/mL Solution Sig: Fifteen (15) Units 
+Subcutaneous At bedtime.  
+8. simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Atypical chest pain with normal cardiac enzymes and no 
+electrocardiogram changes.
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, Atypical chest pain {Atypical chest pain}, cardiac enzymes {Finding of cardiac enzyme levels}, electrocardiogram {Electrocardiographic procedure}, 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:
+Dear Ms. ___,
+It was a pleasure taking care of you in the hospital.  You were 
+admitted for chest pain.  The major concern was that this was 
+related to your heart.  All the testing done, including lab work 
+and EKGs were very reassuring and it was unlikely this was 
+related to a problem with your heart.  It may have been related 
+to your cervical stenosis or it may have been a muscle pull, 
+strain, or sprain.  You should keep taking all of your 
+medications exactly as prescribed.
+
+ 
+
+###RESPONSE: chest pain {Chest pain}, heart {Heart structure}, EKGs {Electrocardiographic procedure}, problem {Problem}, heart {Heart structure}, cervical stenosis {Spinal stenosis in cervical region}, strain {Muscle strain}, sprain {Sprain}, medications {Medication education}"
+"###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: 
+Bactrim / Claritin / Sulfa (Sulfonamide Antibiotics)
+ 
+Attending: ___.
+ 
+Chief Complaint:
+chest pain
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: Bactrim {Allergy to sulfamethoxazole and/or trimethoprim}, Claritin {Allergy to histamine H1 receptor antagonist}, Sulfa {Allergy to sulfonamide antibiotic}, Sulfonamide Antibiotics {Allergy to sulfonamide antibiotic}, chest pain {Chest 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:
+___ CAD with NSTEMI in ___ s/p DES to LAD s/p in ___ DES 
+to LCX presenting with onset of rightsided cp (typical of his 
+angina equivilant). Pain started at rest around 1pm. resolved 
+s/p nitroX2. No CP since then. Pt denies SOB, n,v, diaphoresis, 
+dizziness, lightheaded. Of note, had a URI type illness ___ 
+weeks ago that has resolved, but now has sporadic non-productive 
+cough. 
+
+In the ED, initial vitals were:  98.1 64 162/76 96RA  
+- Labs were significant for WBC 17. Initial trop<.01, MN trop 
+.02, and 02AM trop .03. 
+- Imaging revealed  CXR with patchy R base opacity, most likely 
+atelectasis, but could be consistent with PNA in the right 
+clinical setting.
+- The patient was given Asp 325,g, levofloxacin 750mg, 
+atorvastatin 80mg. Was started on heparin gtt.  
+Vitals prior to transfer were: 56 105/55 18 94% RA  
+
+Upon arrival to the floor, pt CP free. No SOB, dizziness, 
+lightheadedness. 
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}, NSTEMI {Acute non-ST segment elevation myocardial infarction}, DES {Endovascular insertion of drug eluting stent}, LAD {Structure of anterior descending branch of left coronary artery}, DES {Endovascular insertion of drug eluting stent}, LCX {Structure of circumflex branch of left coronary artery}, angina {Angina}, Pain {Pain}, at rest {Chest pain at rest}, resolved {Problem resolved}, SOB {Dyspnea}, n,v {Nausea and vomiting}, diaphoresis {Excessive sweating}, dizziness {Dizziness}, lightheaded {Lightheadedness}, URI {Upper respiratory infection}, resolved {Problem resolved}, non-productive 
+cough {Dry cough}, vitals {Vital signs finding}, RA {Breathing room air}, Labs {Laboratory test}, WBC {White blood cell count}, trop {Troponin measurement}, trop {Troponin measurement}, trop {Troponin measurement}, Imaging {Imaging}, CXR {Plain chest X-ray}, R base {Structure of base of right lung}, opacity {Abnormally opaque structure}, atelectasis {Atelectasis}, PNA {Pneumonia}, levofloxacin {Antibiotic therapy}, started {New medication added}, heparin {Heparin therapy}, Vitals {Vital signs finding}, RA {Breathing room air}, CP {Chest pain}, SOB {Dyspnea}, dizziness {Dizziness}, lightheadedness {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: Past Medical History:
+- Hypertension  
+- CAD with NSTEMI in ___ s/p DES to LAD s/p in ___ DES to 
+LCX 
+- COPD not on oxygen  
+- Chronic lymphocytic leukemia  
+- Prostate cancer  
+- DVT and PE in ___  
+- GERD  
+- Raynaud's syndrome  
+- Osteoarthritis of left knee  
+- Osteoporosis  
+- Spinal stenosis  
+- Attention deficit disorder  
+- Anxiety and depression
+ 
+
+###RESPONSE: Hypertension {Hypertensive disorder, systemic arterial}, CAD {Coronary arteriosclerosis}, NSTEMI {Acute non-ST segment elevation myocardial infarction}, DES {Endovascular insertion of drug eluting stent}, LAD {Structure of anterior descending branch of left coronary artery}, DES {Endovascular insertion of drug eluting stent}, LCX {Structure of circumflex branch of left coronary artery}, COPD {Chronic obstructive lung disease}, oxygen {Oxygen therapy}, Chronic lymphocytic leukemia {Chronic lymphoid leukemia, disease}, Prostate cancer {Carcinoma of prostate}, DVT {Deep venous thrombosis}, GERD {Gastroesophageal reflux disease}, Raynaud's syndrome {Raynaud's disease}, Osteoarthritis of left knee {Osteoarthritis of left knee joint}, Osteoporosis {Osteoporosis}, Spinal stenosis {Spinal stenosis}, Attention deficit disorder {Attention deficit hyperactivity disorder, predominantly inattentive type}, Anxiety {Anxiety}, depression {Depressive 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: 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:
+- Sister has a brain tumor.
+- No family history of early MI, arrhythmia, cardiomyopathies, 
+or 
+sudden cardiac death; father had colon cancer
+ 
+
+###RESPONSE: brain tumor {Neoplasm of brain}, MI {Myocardial infarction}, arrhythmia {Cardiac arrhythmia}, cardiomyopathies {Cardiomyopathy}, sudden cardiac death {Sudden cardiac death}, colon cancer {Malignant neoplasm 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: Physical Exam:
+ADMISSION
+Vitals:  98.1 131/73 58 18 94/1L Wt 86.5kg
+General: Alert, oriented, no acute distress  
+HEENT: Sclera anicteric, MMM, oropharynx clear, EOMI, PERRL  
+Neck: Supple, JVP not elevated, no LAD  
+CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, 
+gallops  
+Lungs: Clear to auscultation bilaterally, no wheezes, rales, 
+rhonchi  
+Abdomen: Soft, non-tender, non-distended, bowel sounds present, 
+no organomegaly, no rebound or guarding  
+GU: No foley  
+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  
+
+DISCHARGE
+Vitals:  t 98 BP 140/70 HR 58 RR 18 94/1L 
+General: Alert, oriented, no acute distress  
+HEENT: Sclera anicteric, MMM, oropharynx clear, EOMI, PERRL  
+Neck: Supple, JVP not elevated, no LAD  
+CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, 
+gallops  
+Lungs: right base with rhonchi, no rales or wheezing. left lung 
+CTA.   
+Abdomen: Soft, non-tender, non-distended, bowel sounds present, 
+no organomegaly, no rebound or guarding  
+GU: No foley  
+Ext: Warm, well perfused, 2+ pulses, no clubbing, cyanosis or 
+edema 
+ 
+
+###RESPONSE: Vitals {Vital signs finding}, 1L {Oxygen therapy}, Wt {Weight finding}, General {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, no acute {No abnormality detected}, 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 not elevated {Normal jugular venous pressure}, 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<}, murmurs {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, 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-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, bowel sounds present {Normal bowel sounds}, organomegaly {Abdominal organomegaly}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, GU {Examination of genitourinary system}, foley {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-XII intact {Normal central nervous system}, upper {Upper limb structure}, lower extremities {Lower limb structure}, normal sensation {Normal sensation}, 2+ reflexes {Normal reflex}, Vitals {Vital signs finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, 1L {Oxygen therapy}, General {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, no acute {No abnormality detected}, 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 not elevated {Normal jugular venous pressure}, 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<}, murmurs {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, Lungs {Examination of respiratory system}, right base {Structure of base of right lung}, rhonchi {Wheeze - rhonchi}, rales {Respiratory crackles}, wheezing {Wheezing}, left lung {Left lung structure}, CTA {Normal breath sounds}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, bowel sounds present {Normal bowel sounds}, organomegaly {Abdominal organomegaly}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, GU {Examination of genitourinary system}, foley {Urinary catheter in situ}, Ext {Examination of limb}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, 2+ pulses {Peripheral pulse present}, clubbing {Clubbing}, cyanosis {Cyanosis}, 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:
+=======================================================
+LABS
+
+ADMISSION
+___ 06:10PM BLOOD WBC-17.0* RBC-5.11 Hgb-13.8 Hct-42.8 
+MCV-84 MCH-27.0 MCHC-32.2 RDW-18.4* RDWSD-53.7* Plt ___
+___ 06:10PM BLOOD ___ PTT-30.3 ___
+___ 06:10PM BLOOD Glucose-95 UreaN-32* Creat-1.2 Na-137 
+K-4.8 Cl-101 HCO3-24 AnGap-17
+
+CARDIAC BIOMARKERS
+___ 06:10PM BLOOD cTropnT-<0.01
+___ 12:00AM BLOOD cTropnT-0.02*
+___ 01:50AM BLOOD cTropnT-0.03*
+___ 09:00AM BLOOD cTropnT-0.03*
+___ 03:40PM BLOOD cTropnT-0.03*
+___ 10:04PM BLOOD cTropnT-0.02*
+___ 10:00AM BLOOD cTropnT-0.01
+
+DISCHARGE
+___ 10:00AM BLOOD WBC-15.8* RBC-5.37 Hgb-14.4 Hct-45.5 
+MCV-85 MCH-26.8 MCHC-31.6* RDW-19.1* RDWSD-55.3* Plt ___
+___ 10:00AM BLOOD Glucose-145* UreaN-28* Creat-1.3* Na-139 
+K-4.2 Cl-101 HCO3-26 AnGap-16
+
+=======================================================
+MICRO
+
+___ CULTUREBlood Culture, 
+Routine-PENDINGINPATIENT
+
+___ CULTUREBlood Culture, 
+Routine-PENDINGINPATIENT
+
+___ CULTURE-FINALINPATIENT
+No growth
+
+=======================================================
+IMAGING/STUDIES
+
+___
+Signnificant baseline artifact. Sinus rhythm. Diffuse 
+non-specific ST segment straightening throughout. Compared to 
+tracing #1 non-specific repolarization abnormalities are new and 
+suggest an ongoing pharmacologic metabolic process. Clinical 
+correlation is suggested. TRACING #2
+Read ___
+ Intervals  Axes
+RatePRQRSQTQTc (___)  ___
+___
+ 
+   
+___ (PA & LAT)
+Patchy right base opacity most likely due to atelectasis, 
+although infectious process is difficult to exclude in the 
+appropriate clinical setting.  
+
+___
+Sinus rhythm. Tracing is within normal limits. Compared to the 
+previous
+tracing of ___ the rate is minimally faster and no longer 
+technically
+bradycardic. TRACING #1
+Read ___
+ Intervals  Axes
+RatePRQRSQTQTc (___)  ___
+___
+
+ 
+
+###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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, RDWSD {Red cell distribution width determination}, Plt {Platelet count}, PTT {Partial thromboplastin time, activated}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, CARDIAC {Heart structure}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, RDWSD {Red cell distribution width determination}, Plt {Platelet count}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, CULTURE {Microbial culture}, CULTURE {Microbial culture}, Culture {Blood culture}, CULTURE {Microbial culture}, No growth {No organism isolated by microbiologic culture}, IMAGING {Imaging}, STUDIES {Evaluation procedure}, baseline {Baseline state}, artifact {Artifact}, Sinus rhythm {Sinus rhythm}, non-specific ST segment straightening {Nonspecific ST-T abnormality on electrocardiogram}, abnormalities {Imaging result abnormal}, Intervals {Finding of electrocardiogram waveform}, (PA & LAT) {Diagnostic radiography of chest, combined posteroanterior and lateral}, right base {Structure of base of right lung}, opacity {Abnormally opaque structure}, atelectasis {Atelectasis}, infectious process {Infectious disease}, Sinus rhythm {Sinus rhythm}, normal {Electrocardiogram normal}, rate {Finding of heart rate}, bradycardic {Bradycardia}, Intervals {Finding of electrocardiogram waveform}"
+"###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:
+Mr. ___ is an ___ yo man with a history of NSTEMI s/p s/p 
+DES to LAD (___), LCX (___) who presented with right sided 
+light chest pressure at rest which was similar to his previous 
+NSTEMIs. Of note, he described holding his aspirin and 
+clopidogrel for a Dermatology procedure.
+
+ACTIVE PROBLEMS
+# NSTEMI
+# Community acquired pneumonia
+
+He was noted to have an NSTEMI with troponins peaking at 0.03. 
+His EKG was unremarkable for ischemic change, normal sinus 
+rhythm, TWI in V1, no STE, unchanged from prior. He was placed 
+on a heparin gtt with a plan for cardiac catheterization. 
+However, patient declined cardiac catheterization given his 
+desire for no invasive procedures. He also declines reversal of 
+code status from DNR/DNI for procedures. He is on Plavix, 
+aspirin, carvidilol, atorvastatin 80, and lisinopril-HCTZ at 
+home, and these were continued. Also, we counseled the patient 
+yesterday that he could NOT,
+under any circumstances, discontinue his DAPT without a 
+cardiologist's permission.
+
+In addition, he was noted to have a retrocardiac opacity, 
+leukocytosis, and a history of cough x2-3 weeks. He was started 
+on levofloxacin 750 mg x5 days with planned course from 
+___.
+
+Unfortunately, before our team could prepare his discharge 
+paperwork, he walked to the nursing station dressed and shouted 
+that we had ""no regard for patient care."" I asked him to stay 
+for just a few minutes so that we could prepare the ___ and 
+homemaker services he had requested earlier, but he declined, 
+saying that we were just trying to ""CYA."" He did not leave with 
+his prescription for levofloxacin, or his ___ services 
+arranged. We forwarded this information to PCP and ___ 
+in hopes they can assist with his follow-up care. 
+
+TRANSITIONAL ISSUES
+- NSTEMI likely precipitated by holding DAPT - iterate in the 
+outpatient setting that he cannot discontinue these medications
+- Levofloxacin 750 mg daily (___) for community acquired 
+PNA was prescribed but NOT completed, and he should be queried 
+specifically for PNA symptoms at next outpatient f/u
+- Patient planned for cardiology appointment in ___ with 
+Dr. ___ would recommend follow up in the next month 
+with cardiology. Patient vocalized that he would make an 
+appointment within the next month to see cardiology. 
+ 
+
+###RESPONSE: NSTEMI {Acute non-ST segment elevation myocardial infarction}, DES {Endovascular insertion of drug eluting stent}, LAD {Structure of anterior descending branch of left coronary artery}, LCX {Structure of circumflex branch of left coronary artery}, right sided {Right thorax structure}, at rest {Chest pain at rest}, NSTEMIs {Acute non-ST segment elevation myocardial infarction}, aspirin {Administration of aspirin}, PROBLEMS {Problem}, NSTEMI {Acute non-ST segment elevation myocardial infarction}, Community acquired pneumonia {Community acquired pneumonia}, NSTEMI {Acute non-ST segment elevation myocardial infarction}, troponins {Troponin measurement}, EKG {Electrocardiographic procedure}, unremarkable {No abnormality detected}, ischemic change {Ischemia}, normal sinus 
+rhythm {Electrocardiogram: normal sinus rhythm}, TWI {Inverted T wave}, V1 {Lead site V1}, STE {ST segment elevation}, unchanged {Patient condition unchanged}, heparin {Heparin therapy}, cardiac catheterization {Cardiac catheterization}, cardiac catheterization {Cardiac catheterization}, procedures {Procedure}, DNR {Not for resuscitation}, procedures {Surgical procedure}, Plavix {Administration of prophylactic clopidogrel}, aspirin {Administration of aspirin}, could NOT,
+under any circumstances, discontinue {Recommendation to continue with drug treatment}, opacity {Abnormally opaque structure}, leukocytosis {Leukocytosis}, cough {Cough}, started {New medication added}, levofloxacin {Antibiotic therapy}, walked {Does walk}, leave {Left against medical advice}, prescription {Prescription}, levofloxacin {Antibiotic therapy}, PCP {Primary care management}, follow-up care {Postoperative procedure education}, NSTEMI {Acute non-ST segment elevation myocardial infarction}, cannot discontinue these medications {Recommendation to continue with drug treatment}, Levofloxacin {Antibiotic therapy}, community acquired 
+PNA {Community acquired pneumonia}, PNA {Pneumonia}, cardiology appointment {Cardiac care management}, follow up {Follow-up arranged}, cardiology {Cardiology service}, make an 
+appointment {Follow-up arranged}, cardiology {Cardiology 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: Medications on Admission:
+The Preadmission Medication list is accurate and complete.
+1. Amlodipine 10 mg PO DAILY 
+2. Aspirin 81 mg PO DAILY 
+3. BuPROPion (Sustained Release) 300 mg PO QAM 
+4. Clopidogrel 75 mg PO DAILY 
+5. DiphenhydrAMINE 25 mg PO QHS insomnia 
+6. Fluticasone Propionate NASAL 2 SPRY NU DAILY PRN 
+7. Lorazepam 1.5 mg PO QHS insomnia 
+8. Multivitamins 1 TAB PO DAILY 
+9. Omeprazole 20 mg PO DAILY 
+10. AndroGel (testosterone) 1.25 gram/ actuation (1 %) 
+transdermal 5 pumps daily 
+11. lisinopril-hydrochlorothiazide ___ mg ORAL DAILY 
+12. Nitroglycerin SL 0.4 mg SL Q5MIN:PRN chest pain 
+13. Atorvastatin 80 mg PO QPM 
+14. Carvedilol 6.25 mg PO BID 
+15. Amphetamine-Dextroamphetamine 10 mg PO TID 
+16. glucosamine-chondroitin unknown strength oral 2 tablets PO 
+daily 
+17. Ascorbic Acid ___ mg PO DAILY 
+18. Benefiber Clear SF (dextrin) (wheat dextrin) 3 gram/3.5 gram 
+oral with meals 
+19. azelastine 137 mcg (0.1 %) nasal 2 sprays NU BID as needed 
+
+ 
+Discharge Medications:
+1. Amlodipine 10 mg PO DAILY 
+2. Amphetamine-Dextroamphetamine 10 mg PO TID 
+3. Aspirin 81 mg PO DAILY 
+4. Atorvastatin 80 mg PO QPM 
+5. BuPROPion (Sustained Release) 300 mg PO QAM 
+6. Clopidogrel 75 mg PO DAILY 
+7. DiphenhydrAMINE 25 mg PO QHS insomnia 
+8. Fluticasone Propionate NASAL 2 SPRY NU DAILY PRN 
+9. Lorazepam 1.5 mg PO QHS insomnia 
+10. Multivitamins 1 TAB PO DAILY 
+11. Omeprazole 20 mg PO DAILY 
+12. Carvedilol 6.25 mg PO BID 
+13. Levofloxacin 750 mg PO DAILY 
+RX *levofloxacin 750 mg 1 tablet(s) by mouth daily Disp #*2 
+Tablet Refills:*0
+14. AndroGel (testosterone) 1.25 gram/ actuation (1 %) 
+transdermal 5 pumps daily 
+15. Ascorbic Acid ___ mg PO DAILY 
+16. azelastine 137 mcg (0.1 %) nasal 2 sprays NU BID as needed 
+17. Benefiber Clear SF (dextrin) (wheat dextrin) 3 gram/3.5 gram 
+oral with meals 
+18. glucosamine-chondroitin 0 strength ORAL 2 TABLETS PO DAILY 
+19. Nitroglycerin SL 0.4 mg SL Q5MIN:PRN chest pain 
+20. lisinopril-hydrochlorothiazide ___ mg ORAL DAILY 
+
+ 
+
+###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:
+NSTEMI
+community acquired PNA
+
+Secondary:
+CAD w/ NSTEMI s/p DES to LAD ___ DES to LCX (___)
+COPD
+HTN
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: NSTEMI {Acute non-ST segment elevation myocardial infarction}, community acquired PNA {Community acquired pneumonia}, CAD {Coronary arteriosclerosis}, NSTEMI {Acute non-ST segment elevation myocardial infarction}, DES {Endovascular insertion of drug eluting stent}, LAD {Structure of anterior descending branch of left coronary artery}, DES {Endovascular insertion of drug eluting stent}, LCX {Structure of circumflex branch of left coronary artery}, COPD {Chronic obstructive lung disease}, HTN {Hypertensive disorder, systemic arterial}, 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:
+Dear Mr. ___, 
+
+You were seen at ___ for the light chest 
+pressure you felt in your chest that was the same as you 
+experienced before with your heart attacks. You did have 
+elevation of troponins, which indicates a lack of blood flow to 
+your heart. This is concerning for ischemia, or the beginning of 
+a heart attack. We placed you on a medication called heparin to 
+prevent ischemia. Your troponins trended down, and your EKG was 
+normal. You were seen by our cardiology team, who felt that you 
+should have a cardiac catheterization to evaluate your heart 
+vessels and stents. You declined this procedure as it is not 
+within your goals of care. 
+
+In addition, you were noted to have a pneumonia, and we are 
+treating you with antibiotics. Please continue these until 
+___.
+
+We are keeping you on your home medications. Please follow up 
+with your appointments that we have arranged. Please follow up 
+with your cardiologist Dr. ___ the next month as we 
+discussed.
+
+It was a pleasure taking care of you.
+
+Your ___ team
+ 
+
+###RESPONSE: chest 
+pressure {Tight chest}, chest {Thoracic structure}, heart attacks {Myocardial infarction}, elevation {Measurement finding above reference range}, troponins {Troponin measurement}, lack of blood flow {Decreased vascular flow}, heart {Heart structure}, ischemia {Ischemia}, heart attack {Myocardial infarction}, medication {Administration of drug or medicament}, heparin {Heparin therapy}, prevent {Preventive procedure}, ischemia {Ischemia}, troponins {Troponin measurement}, EKG {Electrocardiographic procedure}, normal {Electrocardiogram normal}, cardiology {Cardiology service}, cardiac catheterization {Cardiac catheterization}, evaluate {Evaluation procedure}, heart 
+vessels {Coronary artery structure}, stents {Coronary stent patent}, procedure {Procedure}, pneumonia {Pneumonia}, antibiotics {Antibiotic therapy}, keeping {Recommendation to continue with drug treatment}, medications {Administration of drug or medicament}, follow up {Follow-up arranged}, follow up {Follow-up arranged}"
+"###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: 
+No Known Allergies / Adverse Drug Reactions
+ 
+Attending: ___.
+ 
+Chief Complaint:
+none
+ 
+Major Surgical or Invasive Procedure:
+None.
+
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}"
+"###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:
+___ ___ speaking, with h/o dementia living in senior 
+apartment who presented with reported suicidal ideation. History 
+is gathered mainly from reports as pt poor historian. Per EMS a 
+family member at the scene stated that the pt was upset about 
+breaking up with her boyfriend and has had increased depression. 
+Tried to jump out of a window and family had to restrain her. 
+EMS found her calm, cooperative, and smiling.  
+.  
+In the ED, initial VS: 98.1 64 160/75 20 99%. She was noted to 
+only be oriented to person and needed a sitter for wandering 
+off, but was pleasant and cooperative. Through interpreter in 
+the ED, the only positive ROS was pain with urination. The ED 
+housestaff spoke to the son who stated he's having a hard time 
+taking care of her. Case management contacted in the ED -- 
+because of her dementia she needs to have a guardian or HCP 
+assigned before she can placed and requires admission in the 
+meantime.  
+.  
+Psych saw the pt who noted her to be disoriented at baseline, 
+unable to provide any history or details of what happened, no SI 
+or HI; they note severe memory deficits and baseline is 
+wandering and getting lost, unable to recall family, unable to 
+feed or bathe self but can feed herself.  
+
+ 
+
+###RESPONSE: dementia {Dementia}, suicidal ideation {Suicidal thoughts}, poor historian {Poor historian}, upset {Feeling upset}, depression {Depressive disorder}, calm {Feeling calm}, cooperative {Cooperative mental state}, smiling {Smiling}, VS {Vital signs finding}, oriented to person {Oriented to person}, wandering {Wandering}, cooperative {Cooperative mental state}, ROS {Review of systems}, pain with urination {Dysuria}, dementia {Dementia}, memory deficits {Memory impairment}, wandering {Wandering}, getting lost {Getting lost}, bathe self {Unable to bath self}, can feed herself {Able to feed self}"
+"###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:
+- Dementia -> per husband patient has had this diagnosis for ___ 
+ 
+years. She apparently does not remember family members names  
+intermittently, she gets lost, has a history of falls, per notes 
+with neuropsychologist Dr. ___ also has been having a long 
+history of word finding-difficulty. According to her husband, 
+her cognitive baseline is that she is alert & oriented to person 
+only. She cannot dress or bathe herself but she can eat 
+independently. She usually is talkative and understands commands 
+and conversations.  
+- Diabetes (Type 2)  
+- Psoriasis  
+- Hypertension  
+- Depression  
+- cholecystectomy  
+- hysterectomy  
+- Breast cancer status post lumpectomy, radiation, and CMF  
+chemotherapy. This was stage I invasive mucinous carcinoma of  
+the right breast diagnosed in ___.  
+
+ 
+
+ 
+
+###RESPONSE: Dementia {Dementia}, gets lost {Getting lost}, word finding-difficulty {Word finding difficulty}, alert {Mentally alert}, oriented to person {Oriented to person}, cannot dress {Unable to dress}, bathe {Unable to bath self}, can eat 
+independently {Able to feed self}, Diabetes (Type 2) {Diabetes mellitus type 2}, Psoriasis {Psoriasis}, Hypertension {Hypertensive disorder, systemic arterial}, Depression {Depressive disorder}, cholecystectomy {Cholecystectomy}, hysterectomy {Hysterectomy}, Breast cancer {Malignant neoplasm of breast}, status post {Postoperative state}, lumpectomy {Excision of mass}, radiation {Radiation oncology AND/OR radiotherapy}, chemotherapy {Chemotherapy}, mucinous carcinoma {Mucinous adenocarcinoma}, right breast {Right breast 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: 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:
+Unknown
+ 
+
+###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:
+ADMISSION EXAM:
+98.2 134/82 72 20 98%RA  
+Overweight elderly F, sleeping soundly but easily awoken, 
+appears well, comfortable  
+EOMI, no scleral icterus  
+CTAB no w/c/r/r  
+RRR without m/g  
+Obese NT ND, benign  
+No BLE edema, cyanasis, mottling,  
+CN ___ grossly intact, speech normal, moving all extremities  
+
+DISCHARGE EXAM:
+97.2 121/51 79 16 99%
+Overweight elderly F, sleeping soundly but easily awoken, 
+appears well, comfortable  
+EOMI, no scleral icterus  
+CTAB no w/c/r/r  
+RRR without m/g  
+Obese NT ND, benign  
+No BLE edema, cyanasis, mottling,  
+CN ___ grossly intact, speech normal, moving all extremities 
+ 
+
+###RESPONSE: RA {Breathing room air}, Overweight {Overweight}, sleeping {Asleep}, comfortable {Comfortable appearance}, EOMI {Normal ocular motility}, scleral icterus {Scleral icterus}, CTAB {Normal breath sounds}, w {Wheezing}, c {Respiratory crackles}, RRR {Normal heart rate}, m {Heart murmur}, g {Gallop rhythm}, Obese {Obese}, NT {Abdominal tenderness}, ND {Swollen abdomen}, BLE {Edema of bilateral lower legs}, edema {Edema}, cyanasis {Cyanosis}, mottling {Mottling}, CN {Cranial nerve structure}, grossly intact {Normal nervous system function}, speech {Speech finding}, normal {No abnormality detected}, all extremities {All extremities}, Overweight {Overweight}, sleeping {Asleep}, comfortable {Comfortable appearance}, EOMI {Normal ocular motility}, scleral icterus {Scleral icterus}, CTAB {Normal breath sounds}, w {Wheezing}, c {Respiratory crackles}, RRR {Normal heart rate}, m {Heart murmur}, g {Gallop rhythm}, Obese {Obese}, BLE {Edema of bilateral lower legs}, edema {Edema}, cyanasis {Cyanosis}, mottling {Mottling}, CN {Cranial nerve structure}, grossly intact {Normal nervous system function}, speech {Speech finding}, normal {No abnormality detected}, moving all extremities {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:
+___ 09:48PM   WBC-8.7 RBC-3.95* HGB-11.4* HCT-33.9* MCV-86 
+MCH-28.9 MCHC-33.6 RDW-14.5
+___ 09:48PM   NEUTS-68.2 ___ MONOS-5.3 EOS-4.6* 
+BASOS-1.2
+___ 09:48PM   ASA-NEG ETHANOL-NEG ACETMNPHN-NEG 
+bnzodzpn-NEG barbitrt-NEG tricyclic-NEG
+___ 09:48PM   GLUCOSE-100 UREA N-26* CREAT-1.0 SODIUM-132* 
+POTASSIUM-4.2 CHLORIDE-97 TOTAL CO2-24 ANION GAP-15
+ 
+
+###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}"
+"###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:
+PATIENT: ___ yo F history of dementia, HTN, DM2 who presents with 
+failure to thrive, admitted for ~1 months awaiting guardianship 
+papers and nursing home placement.
+.
+ACUTE ISSUES:
+# Failure to thrive - Initially brought to the ED for question 
+of suicidal ideation. Family members reported she tried to jump 
+out the window. Further evaluation by psychiatry revealed 
+worsening dementia and a lack of caregivers in the home. 
+Patient's husband had recently moved back to ___, and 
+she was unable to care for herself at home. Patient's son 
+___ was contacted and agree to guardianship. Paperwork was 
+filed with the courts and with approval of guardianship she was 
+discharged to nursing home.
+.
+CHRONIC ISSUES:
+# Dementia - continued on home memantine in the hospital. 
+Consistently alert but not oriented. Spent most of her time 
+walking around the unit. Easily re-directable. Not agitated. 
+There was a question of whether she was taking exelon at home, 
+this was not given during her hospitalization. 
+.
+# Diabetes type II - It was confirmed through her pharmacy that 
+she was taking metformin 1000mg BID. This was held during her 
+hospital stay and instead she was maintained on an insulin 
+sliding scale. At discharge, her metformin will be restarted. 
+.
+# Hypertension - We continued on home regimen of amlopidine, 
+HTCZ, and lisinopril. Atenolol was held given good BP control.
+
+ 
+
+###RESPONSE: dementia {Dementia}, HTN {Hypertensive disorder, systemic arterial}, DM2 {Diabetes mellitus type 2}, failure to thrive {Failure to thrive}, Failure to thrive {Failure to thrive}, suicidal ideation {Suicidal thoughts}, worsening {Patient's condition worsened}, dementia {Dementia}, Dementia {Dementia}, alert {Mentally alert}, agitated {Feeling agitated}, .
+# Diabetes type II {Diabetes mellitus type 2}, insulin 
+sliding scale {Sliding scale insulin regime}, Hypertension {Hypertensive disorder, systemic arterial}"
+"###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:
+Confirmed with her pharmacy: 
+ferrous sulfate 325 daily
+multivit
+namenda 10 mg BID
+HCTZ 25 mg daily
+lisinopril 20 mg daily
+lipitor 20 mg daily
+metformin 1 gm BID
+amlodipine 5 mg daily
+atenolol 50 daily
+
+ 
+Discharge Medications:
+1. memantine 10 mg Tablet Sig: One (1) Tablet PO BID (2 times a 
+day).  
+2. atorvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+3. multivitamin     Tablet Sig: One (1) Tablet PO DAILY (Daily). 
+ 
+4. hydrochlorothiazide 12.5 mg Capsule Sig: One (1) Capsule PO 
+DAILY (Daily).  
+5. lisinopril 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 
+ 
+6. metformin 500 mg Tablet Sig: Two (2) Tablet PO twice a day.  
+7. amlodipine 5 mg Tablet Sig: One (1) Tablet PO once a day.  
+8. aspirin 325 mg Tablet Sig: One (1) Tablet PO once a day.  
+9. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO once a 
+day as needed for constipation.  
+10. senna 8.6 mg Capsule Sig: One (1) Capsule PO once a day as 
+needed for constipation.  
+11. ferrous sulfate 325 mg (65 mg iron) Tablet Sig: One (1) 
+Tablet PO once a day.  
+12. Tylenol ___ mg Tablet Sig: ___ Tablets PO four times a day 
+as needed for 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:
+Extended Care
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+PRIMARY DIAGNOSIS:
+- Dementia
+
+SECONDARY DIAGNOSES:
+- Diabetes (Type 2)  
+- Psoriasis  
+- Hypertension  
+- Depression  
+- Cholecystectomy  
+- Hysterectomy  
+- Breast cancer status post lumpectomy, radiation, and CMF  
+chemotherapy. This was stage I invasive mucinous carcinoma of  
+the right breast diagnosed in ___.  
+
+ 
+Discharge Condition:
+Mental Status: Confused - always.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Dementia {Dementia}, Diabetes (Type 2) {Diabetes mellitus type 2}, Psoriasis {Psoriasis}, Hypertension {Hypertensive disorder, systemic arterial}, Depression {Depressive disorder}, Cholecystectomy {Cholecystectomy}, Hysterectomy {Hysterectomy}, Breast cancer {Malignant neoplasm of breast}, status post {Postoperative state}, lumpectomy {Excision of mass}, radiation {Radiation oncology AND/OR radiotherapy}, chemotherapy {Chemotherapy}, mucinous carcinoma {Mucinous adenocarcinoma}, right breast {Right breast structure}, Mental Status {Neurological mental status determination}, Confused {Clouded consciousness}, 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:
+It was a pleasure to participate in Ms. ___ care while she 
+was in the hospital.  She was admitted to the hospital after her 
+family had some concerns about her behavior.  According to her 
+family, she had been trying to jump out of a window.  Our 
+psychiatry team evaluated Ms. ___ upon her presentation and 
+determined that she was not suicidal.  It was thought that her 
+concerning behavior represented confusion due to her dementia.  
+Ms. ___ primary caretaker was her boyfriend, but he recently 
+moved back to ___.  Ms. ___ is unable to care for 
+herself without the assistance of others.  Prior to this 
+hospitalization, she did not have a guardian. Her son ___ 
+agreed to be her guardian and paperwork for guardianship was 
+processed.
+
+ 
+
+###RESPONSE: suicidal {Suicidal}, confusion {Clouded consciousness}, dementia {Dementia}"
+"###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:
+chest pain
+ 
+Major Surgical or Invasive Procedure:
+None.
+
+ 
+
+###RESPONSE: chest pain {Chest 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:
+___ with PMH of NIDDM, smoking,
+CAD s/p MI (___), PCI in ___ at ___ who presents as transfer
+from ___ with NSTEMI. 
+  
+ Pain started on ___ morning while at work as a ___ 
+___.
+Per pt, pain similar to chest pain from previous MI. Episodic
+pain lasting ~15 mins. Per pt, not currently on sublingual
+nitroglycerin. Pain epigastric, shartp, ___, and radiates
+episodically to R or L chest. No diaphoresis, nausea, vomiting,
+or chest pressure.
+  
+ Went to ___ where he had trop elevated to 0.131. He AMA'd after
+not feeling staff were addressing his needs.  
+
+At ___: s/p 4x ASA 81, 4,000U IV heparin @ ___ 140-160s systolic
+Cr 1.4
+Trop I 0.10
+
+ During initial eval, had brief episode of CP lasting a few
+seconds that resolved. CP free currently. Denies headache,
+dizziness, fever, chills, SOB, abdominal pain, nausea vomiting,
+or dysuria.  
+ 
+In the ED initial vitals were: 98 82 184/99 14 100% RA  
+ ED Exam:  
+ Gen: NAD  
+ HEENT: PERRLA, EOMI, MMM, oropharynx clear  
+ Lungs: bibasilar crackles, otherwise CTAB  
+ CV: RRR, no murmurs  
+ Abd: soft NTND  
+ Ext: WWP, no edema  
+ 
+EKG (___)- J point elevation in T2& V3 without reciprocal
+changes.  
+
+ Labs notable for:  
+ 1) CBC 10.4, Hb 16.5, plt 189  
+ 2) BNP 16  
+ 3) Trop-T <0.01 x2  
+ 4) BMP: Na 143, K 4.1, Cl 103, HCO3 21, BUN 17, Cr 1.3, AG 19  
+ 5) Coags: INR 1.2, PTT 150  
+ 6) U/A: negative bacteria/nitr, 2 WBC, 0 RBC  
+ 
+Patient was given:  
+ ___ 17:13 IV Heparin 900 units/hr  
+ ___ 19:14 IV Heparin Stopped As Directed  
+ ___ 20:20 IV Heparin Restarted 500 units/hr  
+ 
+Vitals on transfer: ___ pain 97.6 72 173/94 23 98% RA  
+ 
+On the floor: 
+
+He reports he presented initially to ___, and from there went to
+___.
+He reports his chest pain started after he had gone to see his
+sister. He reports he was sitting in his car, and all of a 
+sudden
+he felt like his heart was beating fast with some pressure. He
+reports this pain radiated upward. 
+He reports that he did nothing for the pain at that time, and
+drove to ___. He reports the pain came and went a few more 
+times.
+
+He reports he was given some medications. 
+He reports that this pain lasts about 20 minutes and then goes
+away.
+
+He reports that he is not currently having any pain or pressure
+for at least a few hours. 
+
+Denies dizziness, lightheadedness. Denies pain elsewhere except
+for some pain in the back of his neck with extension which is
+new. Denies blurry or double vision. Denies SOB. 
+Denies f/c, nausea, vomiting, diarrhea, constipation. 
+Denies recent infections. Denies DOE. Denies syncope. 
+
+He reports remote history of MI (___) and catheterization with
+stent placement at ___. 
+
+REVIEW OF SYSTEMS:  
+ Positive per HPI.  
+
+ 
+
+###RESPONSE: NIDDM {Diabetes mellitus type 2}, smoking {Smoker}, CAD {Coronary arteriosclerosis}, MI {Myocardial infarction}, PCI {Percutaneous coronary intervention}, NSTEMI {Acute non-ST segment elevation myocardial infarction}, Pain {Pain}, pain {Pain}, chest pain {Chest pain}, MI {Myocardial infarction}, Episodic
+pain {Intermittent pain}, Pain epigastric {Epigastric pain}, radiates
+episodically to R or L chest {Radiating chest pain}, diaphoresis {Excessive sweating}, nausea, vomiting {Nausea and vomiting}, chest pressure {Tight chest}, trop elevated {Troponin I above reference range}, AMA'd {Patient self-discharge against medical advice}, IV {Intravenous therapy}, heparin {Heparin therapy}, 140-160s systolic {Increased systolic arterial pressure}, Trop {Troponin measurement}, CP {Chest pain}, resolved {Problem resolved}, CP {Chest pain}, headache {Headache}, dizziness {Dizziness}, fever {Fever}, chills {Chill}, SOB {Dyspnea}, abdominal pain {Abdominal pain}, nausea vomiting {Nausea and vomiting}, dysuria {Dysuria}, vitals {Vital signs finding}, RA {Breathing room air}, Exam {Physical examination procedure}, Gen {General examination of patient}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, PERRLA {Pupils equal, react to light and accommodation}, EOMI {Normal ocular motility}, MMM {Moist oral mucosa}, oropharynx {Oropharyngeal structure}, Lungs {Examination of respiratory system}, bibasilar {Structure of base of lung}, crackles {Respiratory crackles}, CTAB {Normal breath sounds}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, murmurs {Murmur}, Abd {Examination of abdomen}, soft {Abdomen soft}, NTND {Abdominal tenderness}, Ext {Examination of limb}, WWP {Normal tissue perfusion}, edema {Edema}, EKG {Electrocardiographic procedure}, elevation in T2& V3 {Electrocardiogram abnormal}, CBC {Complete blood count}, BNP {Brain natriuretic peptide measurement}, Trop {Troponin measurement}, BMP {Serum metabolic panel}, BUN {Blood urea nitrogen measurement}, INR {Calculation of international normalized ratio}, U/A {Urinalysis}, negative {No abnormality detected}, bacteria {Bacteriuria}, WBC {White blood cell count}, RBC {Red blood cell count}, IV {Intravenous therapy}, Heparin {Heparin therapy}, IV {Intravenous therapy}, Heparin {Heparin therapy}, IV {Intravenous therapy}, Heparin {Heparin therapy}, Restarted {Restart of medication}, Vitals {Vital signs finding}, pain {Pain}, RA {Breathing room air}, chest pain {Chest pain}, sitting {Sitting position}, heart was beating fast {Tachycardia}, pressure {Tight chest}, pain radiated {Radiating pain}, pain {Pain}, pain came and went a few more 
+times {Intermittent pain}, medications {Administration of drug or medicament}, pain {Pain}, pain {Pain}, pressure {Tight chest}, dizziness {Dizziness}, lightheadedness {Lightheadedness}, pain {Pain}, pain {Pain}, back of his neck {Cervical region back structure}, blurry {Blurring of visual image}, double vision {Diplopia}, SOB {Dyspnea}, nausea, vomiting, diarrhea {Nausea, vomiting and diarrhea}, constipation {Constipation}, infections {Infectious disease}, DOE {Dyspnea on exertion}, syncope {Syncope}, MI {Myocardial infarction}, catheterization {Cardiac catheterization}, stent placement {Placement of stent in coronary artery}, REVIEW OF SYSTEMS {Review of systems}"
+"###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:
+ 1. CARDIAC RISK FACTORS  
+- NIDDM
+-Tobacco use
+
+ 2. CARDIAC HISTORY  
+- CAD s/p MI (___)
+- PCI in ___ at ___
+ 
+ 3. OTHER PAST MEDICAL HISTORY  
+-None
+ 
+Past surgical history: 
+cyst removal (unknown date)
+ 
+
+###RESPONSE: CARDIAC RISK FACTORS {Assessment for risk of cardiovascular disease}, NIDDM {Diabetes mellitus type 2}, Tobacco use {Tobacco user}, CARDIAC {Heart disease}, CAD {Coronary arteriosclerosis}, MI {Myocardial infarction}, PCI {Percutaneous coronary intervention}, cyst {Cyst}, removal {Aneurysmectomy}"
+"###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:
+No family history of early MI, arrhythmia, cardiomyopathies, or
+sudden cardiac death.  
+ 
+
+###RESPONSE: MI {Myocardial infarction}, arrhythmia {Cardiac arrhythmia}, cardiomyopathies {Cardiomyopathy}, sudden cardiac death {Sudden cardiac death}"
+"###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
+
+Vital Signs:  2345 98.2 PO 150 / 84 L Sitting 95 18 94 Ra 
+General: Patient is well appearing in no acute distress,
+cooperative with exam.  Laying flat in bed without difficulty.
+Eyes: no conjunctival injection or scleral icterus.
+Head, ears, nose, and throat: Normocephalic.  Atraumatic. 
+Ears grossly normal bilaterally. Nose grossly normal. MMM
+Neck: Supple with full ROM.  Does experience pain with
+hyperextension of neck, however full range of motion with no
+stiffness.  Some muscular tenderness in bilateral cervical 
+spine.
+No bony deformities.  JVP not elevated.
+Respiratory/chest: No respiratory distress, speaks in full
+sentences.  Crackles noted in lung bases bilaterally, no wheezes
+noted.
+Cardiovascular: RRR no m/r/g, normal S1/S2
+Gastrointestinal: Abdomen is soft.  No distension.  + bowel
+sounds.  No tenderness. No rebound.
+Back: No tenderness. No CVAT
+Musculoskeletal: Normal muscle tone, moving all extremities.  No
+calf tenderness.  No lower extremity edema.
+Skin: Warm and well perfused.  No obvious rash.  No obvious
+erythema/ecchymosis.
+Neurologic: Alert and oriented x 3, no focal deficits.
+
+Discharge
+
+Vital Signs:  97.4 PO 148 / 83 83 20 99 Ra 
+General: comfortable, lying in bed, flat, without difficulty
+breathing
+
+Neck: Supple w/ JVP not elevated.
+Respiratory/chest: CTAB
+Cardiovascular: RRR no m/r/g, normal S1/S2
+Gastrointestinal: Abdomen is soft.  NTND, +BS
+Extremities: no ___, WWP 
+Neurologic: Alert and oriented x 3, moving all extremities with
+purpose
+ 
+
+###RESPONSE: Physical Exam {Physical examination procedure}, Vital Signs {Vital signs finding}, Sitting {Sitting position}, 4 Ra {Breathing room air}, General {General examination of patient}, well appearing {Well cared for appearance}, no acute {No abnormality detected}, distress {Distress}, cooperative {Cooperative mental state}, exam {Physical examination procedure}, Laying flat in bed {Lying in bed}, Eyes {Ophthalmic examination and evaluation}, conjunctival injection {Conjunctival hyperemia}, scleral icterus {Scleral icterus}, Head {Head structure}, ears {Ear structure}, nose {Nasal structure}, throat {Structure of anterior portion of neck}, Normocephalic {Normal head}, Atraumatic {No injuries apparent}, Ears grossly normal bilaterally {Ear normal}, Nose grossly normal {Nose normal}, MMM {Moist oral mucosa}, Neck {Physical examination procedure}, Supple {Normal movement of neck}, full ROM {Normal range of cervical spine movement}, pain {Pain}, hyperextension {Hyperextension}, neck {Neck structure}, stiffness {Stiff neck}, tenderness {Tenderness}, bony deformities {Deformity of bone}, JVP not elevated {Normal jugular venous pressure}, Respiratory {Examination of respiratory system}, chest {Examination of respiratory system}, distress {Distress}, speaks {Does speak}, Crackles {Respiratory crackles}, bases {Structure of base of lung}, wheezes {Wheezing}, Cardiovascular {Cardiovascular physical examination}, RRR {Normal heart rate}, no m/r/g {Heart sounds normal}, normal S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, Gastrointestinal {Examination of digestive system}, soft {Abdomen soft}, distension {Swollen abdomen}, + bowel
+sounds {Normal bowel sounds}, tenderness {Tenderness}, rebound {Rebound tenderness}, Back {Structure of back of trunk}, tenderness {Tenderness}, CV {Cardiovascular physical examination}, Musculoskeletal {Musculoskeletal system physical examination}, Normal muscle tone {Normal tone in skeletal muscle}, all extremities {All extremities}, tenderness {Tenderness}, edema {Edema}, Skin {Examination of skin}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, rash {Eruption of skin}, erythema {Erythema}, ecchymosis {Ecchymosis}, Neurologic {Neurological examination}, Alert {Mentally alert}, oriented {Orientated}, no focal deficits {Normal nervous system function}, Vital Signs {Vital signs finding}, Ra {Breathing room air}, General {General examination of patient}, comfortable {Comfortable appearance}, lying in bed {Lying in bed}, difficulty
+breathing {Difficulty breathing}, Neck {Physical examination procedure}, Supple {Normal movement of neck}, JVP not elevated {Normal jugular venous pressure}, Respiratory {Examination of respiratory system}, chest {Examination of respiratory system}, CTAB {Normal breath sounds}, Cardiovascular {Cardiovascular physical examination}, RRR {Normal heart rate}, no m/r/g {Heart sounds normal}, normal S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, Gastrointestinal {Examination of digestive system}, soft {Abdomen soft}, ND {Swollen abdomen}, +BS {Normal bowel sounds}, Extremities {Examination of limb}, WWP {Normal tissue perfusion}, Neurologic {Neurological examination}, Alert {Mentally alert}, oriented {Orientated}, all extremities {All extremities}"
+"###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:
+Studies
+
+Stress test ___
+
+% MAX HRT RATE ACHIEVED:  89
+
+IMPRESSION: Poor exercise tolerance with the test being 
+terminated 
+secondary to an exaggerated systolic blood pressure response 
+with 
+exercise. No anginal symptoms or ischemic ST segment changes. 
+Echo 
+report sent separately. 
+
+TTE ___
+
+The patient exercised for 4 minutes and 30 seconds according to 
+a Modified ___ treadmill protocol ___ METS) reaching a peak 
+heart rate of 142 bpm and a peak blood pressure of 256/80 mmHg. 
+The test was stopped because of a hypertensive response. This 
+level of exercise represents a poor exercise tolerance for age 
+and gender. In response to stress, the ECG showed no ST-T wave 
+changes (see exercise report for details). with an abnormal 
+increase in blood pressure/hypertensive response and a normal 
+heart rate response to stress. 
+ .
+ Resting images were acquired at a heart rate of 63 bpm and a 
+blood pressure of 170/96 mmHg. These demonstrated normal 
+regional and global left ventricular systolic function. Right 
+ventricular free wall motion is normal. There is no pericardial 
+effusion. Doppler demonstrated no aortic stenosis, aortic 
+regurgitation or significant mitral regurgitation or resting 
+LVOT gradient. .
+
+ Echo images were acquired within 46 seconds after peak stress 
+at heart rates of 131 - 108 bpm. These demonstrated appropriate 
+augmentation of all left ventricular segments with slight 
+decrease in cavity size. There was augmentation of right 
+ventricular free wall motion. 
+
+ IMPRESSION: Test stopped because of hypertension. No ECG or 2D 
+echocardiographic evidence of inducible ischemia to achieved 
+workload. Marked hypertensive response to exercise.
+
+Admission labs
+
+___ 04:47PM BLOOD WBC-10.4* RBC-5.76 Hgb-16.5 Hct-49.5 
+MCV-86 MCH-28.6 MCHC-33.3 RDW-15.4 RDWSD-47.5* Plt ___
+___ 04:47PM BLOOD Neuts-37 Bands-0 ___ Monos-8 Eos-1 
+Baso-0 Atyps-3* ___ Myelos-0 AbsNeut-3.85 AbsLymp-5.62* 
+AbsMono-0.83* AbsEos-0.10 AbsBaso-0.00*
+___ 05:06PM BLOOD ___ PTT-150* ___
+___ 04:47PM BLOOD Glucose-154* UreaN-17 Creat-1.3* Na-143 
+K-4.1 Cl-103 HCO3-21* AnGap-19*
+___ 05:57AM BLOOD ALT-20 AST-22 LD(LDH)-216 AlkPhos-77 
+TotBili-0.5
+___ 04:47PM BLOOD cTropnT-<0.01 proBNP-16
+___ 05:06PM BLOOD proBNP-16
+___ 05:06PM BLOOD cTropnT-<0.01
+___ 12:10AM BLOOD cTropnT-<0.01 proBNP-19
+___ 04:47PM BLOOD Calcium-9.3 Phos-2.9 Mg-2.2
+
+Discharge
+
+___ 06:40AM BLOOD ___ PTT-35.1 ___
+___ 06:40AM BLOOD Glucose-129* UreaN-20 Creat-1.2 Na-143 
+K-4.3 Cl-103 HCO3-23 AnGap-17
+___ 06:40AM BLOOD Calcium-9.4 Phos-3.6 Mg-2.___ with PMH of NIDDM, smoking, CAD s/p MI (___), PCI in ___ 
+who presents as transfer from ___ with NSTEMI. 
+
+ACUTE ISSUES: 
+============= 
+#NSTEMI
+#CAD s/p PCI in ___
+The patien's presentation in the setting of his significant 
+coronary artery disease, status post PCI, and similarity of 
+chest pain to prior episodes when he was diagnosed with MI, was 
+consistent with an ischemic process underlying his chest pain. 
+Elevated troponin at OSH prior to arrival was consistent with 
+NSTEMI. Troponins at ___ were negative and EKGs after transfer 
+negative for changes suggesting active ischemia. Given these 
+negative findings, IV heparin was discontinued and the patient 
+underwent a stress test for further risk stratification which 
+was negative for anginal symptoms or ischemic ST segment changes 
+in the setting of appropiate heart rate response to exercise. 
+Given the stress test results, the decision was made to defer 
+cardiac catheterization at this point. Aspirin and high dose 
+atorvastatin were continued. In addition, the patient was 
+started on metoprolol to optimize anti-anginal treatment and 
+lisinopril for blood pressure management.
+
+___
+Cr 1.3 on admission, baseline unknown; improved to 1.2 in ED. 
+Creatinine on discharge stable at 1.2. Potassium stable at 4.3. 
+Please obtain BMP on follow up with one to two weeks to monitor 
+renal function and potassium
+
+CHRONIC ISSUES: 
+=============== 
+#Hypertension
+The patient had been on lisinopril as an outpatient in the past 
+(but wasn't taking any his medications for several months prior 
+to admission). No anti-hypertensives were given on admission in 
+setting of initial ___ and potential catheterization. Systolic 
+blood pressures were subsequently between 150-160 and the 
+patient was started on Lisinopril 10mg dialy.
+- Follow-up as an outpatient with uptitration of 
+anti-hypertensives as tolerated is recommended. 
+
+#Non-insulin dependent diabetes
+A1c 6.7% on labs ___ at ___. Patient does not report any
+medications to treat this issue at this time. Not started on 
+Metformin as he was newly started on Lisinopril with possible 
+worsening of his renal function 
+- Metformin should be started as an outpatient if his renal 
+function allows
+
+TRANSITIONAL ISSUES
+===================
+[] Discharge Creatinine 1.2; potassium on discharge 4.3 (both 
+stable) [] Please repeat BMP within two weeks of discharge to 
+ensure resolution ___ and to monitor potassium (newly started 
+on Lisinopril)
+[] Newly started on Lisinopril 20mg daily - follow-up blood 
+pressure, consider uptitration of lisinopril as tolerated by 
+renal function and electrolytes
+[] Patient also started on Metoprolol succinate 25mg, aspirin 
+81mg daily and atorvastatin 80mg daily during this admission; 
+please continue this medications in the outpatient setting
+[] Follow-up on blood sugar and HBA1c, consider initiating 
+metformin going forward pending renal function
+
+#CODE STATUS: FULL, confirmed 
+#CONTACT: Silnola (sister) ___ 
+ 
+
+###RESPONSE: Stress test {Electrocardiogram with exercise test}, HRT RATE {Finding of heart rate}, Poor exercise tolerance {Impaired exercise tolerance}, exaggerated systolic blood pressure {Increased systolic arterial pressure}, exercise {Exercises}, anginal symptoms {Angina}, ischemic {Ischemia}, ST segment changes {Electrocardiographic ST segment changes}, Echo {Echocardiography}, TTE {Transthoracic echocardiography}, exercised {Exercises}, heart rate {Finding of heart rate}, peak blood pressure {Increased systolic arterial pressure}, hypertensive {Increased systolic arterial pressure}, exercise {Exercises}, poor exercise tolerance {Impaired exercise tolerance}, stress {Electrocardiogram with exercise test}, ECG {Electrocardiographic procedure}, no ST-T wave 
+changes {Electrocardiogram normal}, exercise {Electrocardiogram with exercise test}, increase in blood pressure {Increased systolic arterial pressure}, hypertensive {Increased systolic arterial pressure}, normal 
+heart rate {Normal heart rate}, stress {Electrocardiogram with exercise test}, heart rate {Finding of heart rate}, blood pressure {Blood pressure finding}, normal 
+regional and global left ventricular systolic function {Echocardiogram shows normal left ventricular function}, Right 
+ventricular {Right cardiac ventricular structure}, free wall motion is normal {Normal ventricular wall motion}, pericardial 
+effusion {Pericardial effusion}, Doppler {Doppler ultrasound}, aortic stenosis {Aortic valve stenosis}, aortic 
+regurgitation {Aortic valve regurgitation}, mitral regurgitation {Mitral valve regurgitation}, Echo {Echocardiography}, stress {Physical stress}, heart rates {Finding of heart rate}, left ventricular segments {Structure of segment of left cardiac ventricle}, decrease {Decreased size}, cavity {Structure of cavity of left cardiac ventricle}, right 
+ventricular {Right cardiac ventricular structure}, free wall motion {Normal ventricular wall motion}, hypertension {Hypertensive disorder, systemic arterial}, ECG {Electrocardiographic procedure}, echocardiographic {Echocardiography}, ischemia {Ischemia}, hypertensive {Hypertensive disorder, systemic arterial}, exercise {Exercises}, 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}, 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}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, LDH {Serum total lactate dehydrogenase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, cTropnT {Troponin T cardiac measurement}, proBNP {N-terminal pro-brain natriuretic peptide measurement}, proBNP {N-terminal pro-brain natriuretic peptide measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, proBNP {N-terminal pro-brain natriuretic peptide measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, 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}, NIDDM {Diabetes mellitus type 2}, smoking {Smoker}, CAD {Coronary arteriosclerosis}, MI {Myocardial infarction}, PCI {Percutaneous coronary intervention}, NSTEMI {Acute non-ST segment elevation myocardial infarction}, NSTEMI {Acute non-ST segment elevation myocardial infarction}, CAD {Coronary arteriosclerosis}, PCI {Percutaneous coronary intervention}, disease {Disease}, status post {Postoperative state}, PCI {Percutaneous coronary intervention}, chest pain {Chest pain}, MI {Myocardial infarction}, ischemic {Ischemia}, chest pain {Chest pain}, Elevated troponin {Troponin I above reference range}, NSTEMI {Acute non-ST segment elevation myocardial infarction}, Troponins {Troponin measurement}, negative {No abnormality detected}, EKGs {Electrocardiographic procedure}, negative {No abnormality detected}, ischemia {Ischemia}, negative {No abnormality detected}, IV {Intravenous therapy}, heparin {Heparin therapy}, discontinued {Recommendation to stop drug treatment}, stress test {Electrocardiogram with exercise test}, negative {No abnormality detected}, anginal symptoms {Angina}, ST segment changes {Finding of electrocardiogram ST segment}, heart rate {Finding of heart rate}, exercise {Electrocardiogram with exercise test}, stress test {Electrocardiogram with exercise test}, cardiac catheterization {Cardiac catheterization}, Aspirin {Administration of aspirin}, anginal {Angina}, lisinopril {Angiotensin converting enzyme inhibitor therapy}, blood pressure management {Angiotensin converting enzyme inhibitor therapy}, Cr {Creatinine measurement}, baseline {Baseline state}, improved {Patient's condition improved}, Creatinine {Creatinine measurement}, stable {Patient's condition stable}, Potassium {Potassium measurement}, stable {Patient's condition stable}, BMP {Serum metabolic panel}, monitor 
+renal function {Renal function monitoring}, potassium {Potassium measurement}, Hypertension {Hypertensive disorder, systemic arterial}, lisinopril {Angiotensin converting enzyme inhibitor therapy}, wasn't taking any his medications {Does not take medication}, anti-hypertensives {On treatment for hypertension}, catheterization {Cardiac catheterization}, Systolic 
+blood pressures were subsequently between 150-160 {Increased systolic arterial pressure}, Lisinopril {Angiotensin converting enzyme inhibitor therapy}, uptitration {Increasing dosage of medication}, anti-hypertensives {On treatment for hypertension}, Non-insulin dependent diabetes {Diabetes mellitus type 2}, does not report any
+medications to treat {Does not take medication}, Lisinopril {Angiotensin converting enzyme inhibitor therapy}, worsening of his renal function {Decreased renal function}, if his renal 
+function allows {Renal function monitoring}, Creatinine {Creatinine measurement}, potassium {Potassium measurement}, stable {Patient's condition stable}, BMP {Serum metabolic panel}, Lisinopril {Angiotensin converting enzyme inhibitor therapy}, Lisinopril {Angiotensin converting enzyme inhibitor therapy}, blood 
+pressure {Blood pressure monitoring}, r uptitration {Increasing dosage of medication}, lisinopril {Angiotensin converting enzyme inhibitor therapy}, renal function {Renal function monitoring}, electrolytes {Electrolyte monitoring}, aspirin {Administration of aspirin}, continue this medications {Recommendation to continue with drug treatment}, blood sugar {Blood sugar management}, pending renal function {Renal function monitoring}"
+"###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.  Aspirin 81 mg PO DAILY 
+RX *aspirin [Adult Low Dose Aspirin] 81 mg 1 tablet(s) by mouth 
+daily Disp #*30 Tablet Refills:*0 
+2.  Atorvastatin 80 mg PO QPM 
+RX *atorvastatin 80 mg 1 tablet(s) by mouth QPM Disp #*30 Tablet 
+Refills:*0 
+3.  Lisinopril 20 mg PO DAILY 
+RX *lisinopril 20 mg 1 tablet(s) by mouth daily Disp #*30 Tablet 
+Refills:*0 
+4.  Metoprolol Succinate XL 25 mg PO DAILY 
+RX *metoprolol succinate 25 mg 1 tablet(s) by mouth daily Disp 
+#*30 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:
+Primary diagnoses:
+#Unstable angina
+#CAD s/p PCI in ___
+___
+
+Secondary diagnoses:
+#Hypertension
+#Non-insulin dependent diabetes mellitus
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Unstable angina {Preinfarction syndrome}, CAD {Coronary arteriosclerosis}, PCI {Percutaneous coronary intervention}, Hypertension {Hypertensive disorder, systemic arterial}, Non-insulin dependent diabetes mellitus {Diabetes mellitus type 2}, 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:
+Dear Mr ___,
+
+It was a pleasure taking care of you at ___!
+
+Why was I admitted to the hospital?
+- you had two episodes of chest pain that were similar in 
+character to the pain you had in the past when you had a heart 
+attack
+- the current episodes were likely caused by a minor heart 
+attack. You underwent a test that showed you were able to 
+exercise appropriately. Therefore, you did not require any 
+intervention at this point.
+- You were started on medications to help prevent future 
+episodes of chest pain
+
+What should I do after discharge?
+- Please take all the medications as prescribed (your were newly 
+started on aspirin, metoprolol, lisinopril, and atorvastatin)
+- Please follow up with your new PCP as below for further 
+management of your blood pressure
+- Please see an MD or go to the emergency department in case of 
+recurrent or new symptoms
+
+All the best,
+
+Your ___ care team
+ 
+
+###RESPONSE: chest pain {Chest pain}, pain {Pain}, heart 
+attack {Myocardial infarction}, heart 
+attack {Myocardial infarction}, exercise {Exercises}, medications {Administration of drug or medicament}, chest pain {Chest pain}, medications {Patient medication education}, aspirin {Administration of aspirin}, lisinopril {Angiotensin converting enzyme inhibitor therapy}, PCP {Primary care management}, management of your blood pressure {Blood pressure monitoring}"
+"###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:
+Metastatic Renal Cell Cancer
+ 
+Major Surgical or Invasive Procedure:
+Central Line placmeent and removal
+
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, Metastatic Renal Cell Cancer {Metastatic renal cell carcinoma}, Central Line placmeent {Insertion of peripherally inserted central catheter}, removal {Removal of central venous line}"
+"###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 man with a history of T2 renal cell
+carcinoma, s/p left nephrectomy on ___, who was recently
+found to have pulmonary metastases.
+
+In ___, he noted left back pain, which he thought was
+activity-related after working out.  A CT scan showed a 7 cm 
+left
+kidney mass. Additional imaging showed no evidence of metastatic
+disease at the time and a nephrectomy was done on ___ which
+revealed clear cell renal cell carcinoma.  A follow-up CT scan
+done in ___ showed right-sided pulmonary nodules, the largest 
+of
+which was 1 cm in size.  Repeat CT scan down ___ revealed 5
+masses in the right lung, the largest of which was > 3 cm in
+size. A PET scan done ___ showed these pulmonary masses as
+well as a mass in the right tonsillar tissue measuring 1.8 cm in
+size with an SVU of 6.2 and nonspecific uptake in the left
+parotid.  He was seen by ENT on ___, who recommended
+observation and follow-up in 1 month. A CT-guided biopsy of the
+right lung mass was obtained on ___ and showed metastatic
+renal cell carcinoma. He passed all screenign tests and is here 
+to begin cycle 1 week 1 of HD Il-2. He feels excellent and ROS 
+negative. 
+ 
+
+###RESPONSE: renal cell
+carcinoma {Renal cell carcinoma}, left nephrectomy {Excision of left kidney}, pulmonary metastases {Metastatic malignant neoplasm to lung}, back pain {Backache}, CT scan {Computed tomography}, left {Left kidney structure}, kidney mass {Renal mass}, imaging {Imaging}, no evidence {No abnormality detected}, metastatic
+disease {Metastatic malignant neoplasm}, nephrectomy {Total excision of left kidney}, clear cell renal cell carcinoma {Clear cell renal cell carcinoma}, CT scan {Computed tomography}, right-sided {Right lung structure}, pulmonary nodules {Nodule of lung}, CT scan {Computed tomography}, masses {Lung mass}, right lung {Right lung structure}, PET scan {Positron emission tomography}, pulmonary masses {Nodule of lung}, mass {Mass of body structure}, right tonsillar tissue {Right faucial tonsil structure}, left
+parotid {Structure of left parotid gland}, CT-guided biopsy {Computed tomography guided biopsy}, right {Right lung structure}, metastatic
+renal cell carcinoma {Metastatic renal cell carcinoma}, HD {Hemodialysis}"
+"###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:
+alcohol abuse, in AA
+anxiety and depression
+ 
+
+###RESPONSE: alcohol abuse {Alcohol abuse}, anxiety {Anxiety}, depression {Depressive 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: 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:
+He reports a mother with pancreatic cancer.  His father had
+diabetes and hypertension.  He has 1 brother and 1 sister who 
+are
+healthy.
+
+ 
+
+###RESPONSE: pancreatic cancer {Malignant tumor of pancreas}, diabetes {Diabetes mellitus}, hypertension {Hypertensive disorder, systemic arterial}"
+"###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:
+GEN: Well appearing gentleman in no acute distress. 
+Ht: 67 inches             Wt: 168.3 lbs
+VS: ___   O2 sat 99%RA
+HEENT: clear, atraumatic, anicteric.
+CV: RRR without MGR
+RESP: CTA, no wheezes or rhonchi
+ABD: Soft, nontender BS positive
+M/S: ROM intact
+Lymph: No lympadenopathy in the bilateral axillary, 
+supraclavicular, ingunal, cervical nodes. 
+Neuro: No focal deficit on exam
+ 
+
+###RESPONSE: GEN {General examination of patient}, Well appearing {Well cared for appearance}, distress {Distress}, VS {Vital signs finding}, O2 sat {Oxygen saturation measurement}, RA {Breathing room air}, HEENT {Physical examination procedure}, clear {Normal breath sounds}, atraumatic {No injuries apparent}, anicteric {White sclera}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, RESP {Examination of respiratory system}, CTA {Normal breath sounds}, wheezes {Wheezing}, rhonchi {Wheeze - rhonchi}, ABD {Examination of abdomen}, Soft {Abdomen soft}, nontender {Abdominal tenderness}, BS {Normal bowel sounds}, ROM {Range of motion activity}, intact {Normal sensation}, Lymph {Lymphatic system physical examination}, lympadenopathy {Lymphadenopathy}, axillary {Axillary lymph node structure}, supraclavicular {Structure of supraclavicular lymph node}, ingunal {Inguinal lymph node structure}, cervical nodes {Cervical lymph node structure}, Neuro {Neurological examination}, No focal deficit {Normal nervous system function}"
+"###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:
+___ 11:55AM   GLUCOSE-93 UREA N-12 CREAT-1.1 SODIUM-139 
+POTASSIUM-4.5 CHLORIDE-104 TOTAL CO2-31 ANION GAP-9
+___ 11:55AM   estGFR-Using this
+___ 11:55AM   ALT(SGPT)-13 AST(SGOT)-16 CK(CPK)-147 TOT 
+BILI-0.3
+___ 11:55AM   ALBUMIN-4.1 CALCIUM-9.3 PHOSPHATE-3.4 
+MAGNESIUM-1.8
+___ 11:55AM   WBC-6.4 RBC-4.06* HGB-12.6* HCT-37.8* MCV-93 
+MCH-31.0 MCHC-33.3 RDW-12.8
+___ 11:55AM   PLT COUNT-206
+___ 11:55AM   ___ PTT-29.7 ___
+___ 04:00AM BLOOD WBC-4.3 RBC-4.14* Hgb-12.5* Hct-36.8* 
+MCV-89 MCH-30.3 MCHC-34.1 RDW-12.7 Plt Ct-98*
+___ 04:00AM BLOOD Plt Ct-98*
+___ 04:00AM BLOOD Glucose-119* UreaN-15 Creat-1.2 Na-137 
+K-4.5 Cl-106 HCO3-19* AnGap-17
+___ 04:00AM BLOOD ALT-50* AST-44* CK(CPK)-40* TotBili-1.7*
+___ 04:00AM BLOOD Albumin-2.8* Calcium-7.7* Phos-2.7 
+Mg-1.5*
+___ 04:03AM BLOOD WBC-7.6# RBC-3.88* Hgb-12.0* Hct-34.2* 
+MCV-88 MCH-30.9 MCHC-35.0 RDW-12.7 Plt Ct-91*
+___ 04:03AM BLOOD Glucose-104* UreaN-16 Creat-1.2 Na-135 
+K-4.3 Cl-104 HCO3-24 AnGap-11
+___ 12:00PM BLOOD CK(CPK)-38*
+___ 04:03AM BLOOD ALT-61* AST-46* CK(CPK)-47 TotBili-1.6*
+___ 04:03AM BLOOD Albumin-2.5* Calcium-7.9* Phos-2.6* 
+Mg-1.9
+ 
+
+###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}, TOT 
+BILI {Bilirubin, total measurement}, ALBUMIN {Albumin measurement}, CALCIUM {Blood calcium 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}, PTT {Partial thromboplastin time, activated}, 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}, 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}, TotBili {Bilirubin, total measurement}, Albumin {Albumin measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total 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}, 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}, TotBili {Bilirubin, total measurement}, Albumin {Albumin measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total 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: Brief Hospital Course:
+Mr. ___ was admitted for HD IL-2 cycle 1 week 1.
+Upon arrival to ___, informed consent was obtained for HD 
+IL-2. He then underwent central line placement with chest X-ray 
+confirmation of placement. 
+He received HD IL-2, 45.7 Million Units IV Q8H. He recieved 
+total of ___ doses this week. His course was complicated by 
+chills, rigors, fever, diarrhea, and pruritus. Of all, chills 
+and rigors were difficult to control given he refused all 
+controlled medications such as lorazepam and demerol due to his 
+past medical history of ETOH ause and being in AA. He also had 
+thrombocytopenia of PLT 98k. On day 5,  with increased fatigue, 
+malaise, rigors after each dose, he refused fruther doses and 
+this was agreed by our team as well. 
+His central line was removed on day 6 and was discharged to home 
+in stable condition on ___. 
+ 
+
+###RESPONSE: HD {Hemodialysis}, informed consent {Informed consent for procedure}, HD {Hemodialysis}, central line placement {Insertion of peripherally inserted central catheter}, chest X-ray {Plain chest X-ray}, placement {Implantation procedure}, HD {Hemodialysis}, IV {Administration of drug or medicament via intravenous route}, chills {Chill}, rigors {Rigor}, fever {Fever}, diarrhea {Diarrhea}, pruritus {Itching of skin}, chills {Chill}, rigors {Rigor}, ETOH ause {Alcohol abuse}, thrombocytopenia {Thrombocytopenic disorder}, fatigue {Fatigue}, malaise {Malaise}, rigors {Rigor}, central line was removed {Removal of central venous line}, stable condition {Patient's condition stable}"
+"###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:
+fluoxetin 40 mg 2 tabs a day
+ 
+Discharge Medications:
+1. diphenhydramine HCl 25 mg Capsule Sig: ___ Capsules PO Q6H 
+(every 6 hours) as needed for pruritis.
+Disp:*30 Capsule(s)* Refills:*0*
+2. cephalexin 500 mg Capsule Sig: One (1) Capsule PO BID (2 
+times a day) for 5 days.
+Disp:*10 Capsule(s)* Refills:*0*
+3. oral wound care products     Gel in Packet Sig: Fifteen (15) 
+ML Mucous membrane TID (3 times a day) as needed for mucositis.
+Disp:*500 ML(s)* Refills:*0*
+4. ondansetron 8 mg Tablet, Rapid Dissolve Sig: One (1) Tablet, 
+Rapid Dissolve PO every eight (8) hours.
+Disp:*60 Tablet, Rapid Dissolve(s)* Refills:*2*
+5. furosemide 20 mg Tablet Sig: One (1) Tablet PO once a day for 
+5 days.
+Disp:*5 Tablet(s)* Refills:*0*
+6. camphor-menthol 0.5-0.5 % Lotion Sig: One (1) Appl Topical 
+QID (4 times a day) as needed for pruritus.
+Disp:*1 bottle* Refills:*3*
+
+ 
+
+###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:
+Metastatic Renal Cell CA
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+
+ 
+
+###RESPONSE: Metastatic Renal Cell CA {Metastatic renal cell carcinoma}, Mental Status {Neurological mental status determination}, Clear {Normal state of mind}"
+"###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:
+Please call ___, RN for any issues after discharge.
+___
+ 
+
+###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: 
+Lisinopril / alcohol
+ 
+Attending: ___
+ 
+Chief Complaint:
+atrial fibrillation with RVR
+ 
+Major Surgical or Invasive Procedure:
+none
+ 
+
+###RESPONSE: Lisinopril {Non-allergic hypersensitivity to lisinopril}, alcohol {Allergy to ethyl alcohol}, atrial fibrillation with RVR {Atrial fibrillation with rapid ventricular response}"
+"###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:
+___ presents with tachycardia. Patient with recent admission for 
+atrial fibrillation with RVR at that time underwent 
+cardioversion and was started on low-dose 
+metoprolol. Now with returned for tachycardia to the 150s. 
+Patient was reportedly feeling weak at home and noted to be 
+orthostatic. She was additionally noted to have highly variable 
+heart rate with irregular heart rhythm. At time of evaluation 
+she denies any acute complaints however is noted to be 
+tachycardic from the 120s to 150s. Patient states she has been 
+taking her metoprolol as prescribed.
+ 
+In the ED, initial vitals were 97.8 74 128/50 16 97% ra. Labs 
+significant for unremarkable CBC and CHem7 with the exception of 
+BUN 21, glucose 127, phos 2.0, Lactate: 1.9. UA unremarkable. 
+Urine and blood cultures sent. CXR showed cardiomegaly and small 
+bilateral effusions. No superimposed acute cardiopulmonary 
+process. Patient was evaluated by cardiology in the ED and 
+admitted for AF with RVR, for rate control with beta blocker 
+uptitration. VS prior to transfer include 98.8 113 122/78 20 98% 
+RA.
+
+On the floor, patient is comfortable without any recent chest 
+pain, palpitations, shortness of breath, lightheadedness with 
+walking to the bathroom or peripheral edema. She states she 
+cannot feel that her heart rate is fast.
+ 
+On review of systems, she denies any prior history of stroke, 
+TIA, deep venous thrombosis, pulmonary embolism, bleeding at the 
+time of surgery, myalgias, joint pains, cough, hemoptysis, black 
+stools or red stools. She denies recent fevers, chills or 
+rigors. She denies exertional buttock or calf pain. All of the 
+other review of systems were negative.  
+ 
+Cardiac review of systems is notable for absence of chest pain, 
+dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, 
+ankle edema, palpitations, syncope or presyncope.  
+
+ 
+
+###RESPONSE: tachycardia {Tachycardia}, atrial fibrillation with RVR {Atrial fibrillation with rapid ventricular response}, cardioversion {Cardioversion}, tachycardia {Tachycardia}, feeling weak {Asthenia}, orthostatic {Orthostatic body position}, variable 
+heart rate {Alteration in heart rate}, irregular heart rhythm {Irregular heart beat}, evaluation {Evaluation procedure}, tachycardic {Tachycardia}, vitals {Vital signs finding}, ra {Breathing room air}, unremarkable {No abnormality detected}, CBC {Complete blood count}, BUN {Blood urea nitrogen measurement}, Lactate {Lactic acid measurement}, UA unremarkable {Urinalysis = no abnormality}, Urine {Urine culture}, blood cultures {Blood culture}, CXR {Plain chest X-ray}, cardiomegaly {Cardiomegaly}, small {Symptom mild}, bilateral effusions {Bilateral pleural effusion}, cardiology {Cardiology service}, AF with RVR {Atrial fibrillation with rapid ventricular response}, uptitration {Increasing dosage of medication}, VS {Vital signs finding}, RA {Breathing room air}, chest 
+pain {Chest pain}, palpitations {Palpitations}, shortness of breath {Dyspnea}, lightheadedness {Lightheadedness}, walking {Does walk}, peripheral edema {Peripheral edema}, heart rate is fast {Tachycardia}, review of systems {Review of systems}, stroke {Cerebrovascular accident}, TIA {Transient ischemic attack}, deep venous thrombosis {Deep venous thrombosis}, pulmonary embolism {Pulmonary embolism}, bleeding {Bleeding}, surgery {Surgical procedure}, myalgias {Muscle pain}, joint pains {Joint pain}, cough {Cough}, hemoptysis {Hemoptysis}, black 
+stools {Dark stools}, red stools {Red stools}, fevers {Fever}, chills {Chill}, rigors {Rigor}, buttock {Pain in buttock}, calf pain {Pain in calf}, review of systems {Review of systems}, negative {No abnormality detected}, Cardiac {Cardiovascular physical examination}, review of systems {Review of systems}, chest pain {Chest pain}, dyspnea on exertion {Dyspnea on exertion}, paroxysmal nocturnal dyspnea {Paroxysmal nocturnal dyspnea}, orthopnea {Orthopnea}, ankle edema {Ankle edema}, palpitations {Palpitations}, syncope {Syncope}, presyncope {Near 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:
+1. CARDIAC RISK FACTORS: + Hypertension  
+2. CARDIAC HISTORY: afib
+3. OTHER PAST MEDICAL HISTORY:                             
+CATARACT                                                        
+DEGENERATIVE JOINT DISEASE                                       
+
+OSTEOPOROSIS                                                    
+PELVIC FRACTURE                                                 
+TINNITUS                                                        
+RETINAL VASCULAR OCCLUSION                                      
+H/O COLLES' FRACTURE                                            
+H/O HEMATURIA S/P CYSTOSCOPY                                 
+H/O PROLAPSE VAGINAL WALL W/O UTERINE PROLAPSE 
+H/O SYNCOPE   
+
+ 
+
+###RESPONSE: CARDIAC RISK FACTORS {Assessment for risk of cardiovascular disease}, Hypertension {Hypertensive disorder, systemic arterial}, CARDIAC {Heart structure}, afib {Atrial fibrillation}, CATARACT {Cataract}, DEGENERATIVE JOINT DISEASE {Osteoarthritis}, OSTEOPOROSIS {Osteoporosis}, PELVIC FRACTURE {Fracture of pelvis}, TINNITUS {Tinnitus}, RETINAL VASCULAR OCCLUSION {Retinal vascular occlusion}, COLLES' FRACTURE {Colles' fracture}, HEMATURIA {Blood in urine}, CYSTOSCOPY {Transurethral cystoscopy}, PROLAPSE VAGINAL WALL {Vaginal wall prolapse}, UTERINE PROLAPSE {Uterine prolapse}, 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: 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:
+non-contributory to this 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:
+On Admission:
+VS: 98.1 123/71 120s-140s 16 93%RA wt 38kg (discharged at 
+36.4kg) 
+GENERAL: awake and alert, in NAD, pleasant
+HEENT: AT/NC, + cataracts, anicteric sclera, good dentition  
+NECK: JVP not elevated    
+CARDIAC: irreg irreg, no Murmurs appreciated  
+LUNG: bibasilar crackles  
+ABDOMEN: soft, non-tender, non-distended   
+EXT: warm and well-perfused, no edema 
+NEURO: alert, neuro exam grossly non-focal 
+
+On Discharge:
+Vitals: 97.5  104/76(80-123/46-73)  97(68-136)  16  92%RA 
+weight: 38.1kg from 38kg at admission (last discharge at 36.4kg)
+GENERAL: awake and alert, in NAD  
+HEENT: AT/NC, HOH, anicteric sclera, good dentition  
+NECK: JVP of 6  
+CARDIAC: RRR, no Murmurs appreciated  
+LUNG: bibasilar crackles, no wheezing  
+ABDOMEN: soft, non-tender, non-distended  
+EXT: warm and well-perfused, no edema.  
+NEURO: alert, neuro exam grossly non-focal  
+ 
+
+###RESPONSE: VS {Vital signs finding}, RA {Breathing room air}, wt {Weight finding}, GENERAL {General examination of patient}, awake {Awake}, alert {Mentally alert}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, NC {Normal head}, cataracts {Cataract}, anicteric sclera {White sclera}, good dentition {Normal dentition}, NECK {Physical examination procedure}, JVP not elevated {Normal jugular venous pressure}, CARDIAC {Cardiovascular physical examination}, irreg irreg {Pulse irregularly irregular}, Murmurs {Heart murmur}, LUNG {Examination of respiratory system}, bibasilar {Structure of base of lung}, crackles {Respiratory crackles}, ABDOMEN {Examination of abdomen}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, EXT {Examination of limb}, warm {Warm skin}, well-perfused {Normal tissue perfusion}, edema {Edema}, NEURO {Neurological examination}, alert {Mentally alert}, neuro exam {Neurological examination}, Vitals {Vital signs finding}, RA {Breathing room air}, weight {Weight finding}, GENERAL {General examination of patient}, awake {Awake}, alert {Mentally alert}, NAD {No abnormality detected}, HOH {Hearing loss}, anicteric sclera {White sclera}, good dentition {Normal dentition}, JVP {Finding of jugular venous pressure}, CARDIAC {Cardiovascular physical examination}, RRR {Normal heart rate}, Murmurs {Heart murmur}, LUNG {Examination of respiratory system}, bibasilar {Structure of base of lung}, crackles {Respiratory crackles}, wheezing {Wheezing}, ABDOMEN {Examination of abdomen}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, EXT {Examination of limb}, warm {Warm skin}, well-perfused {Normal tissue perfusion}, edema {Edema}, NEURO {Neurological examination}, alert {Mentally alert}, neuro exam {Neurological examination}"
+"###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:
+On Admission:
+___ 01:49PM URINE  COLOR-Yellow APPEAR-Clear SP ___
+___ 01:49PM URINE  BLOOD-MOD NITRITE-NEG PROTEIN-30 
+GLUCOSE-300 KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-6.0 
+LEUK-TR
+___ 01:49PM URINE  RBC-30* WBC-4 BACTERIA-NONE YEAST-NONE 
+EPI-6
+___ 01:49PM URINE  MUCOUS-FEW
+___ 01:33PM   LACTATE-1.9
+___ 01:15PM   GLUCOSE-127* UREA N-21* CREAT-0.6 SODIUM-138 
+POTASSIUM-3.9 CHLORIDE-103 TOTAL CO2-26 ANION GAP-13
+___ 01:15PM   CALCIUM-8.6 PHOSPHATE-2.0*# MAGNESIUM-2.2
+___ 01:15PM   WBC-5.9 RBC-4.02* HGB-11.5* HCT-36.6 MCV-91 
+MCH-28.7 MCHC-31.5 RDW-15.7*
+___ 01:15PM   NEUTS-64.9 ___ MONOS-10.6 EOS-1.2 
+BASOS-1.4
+___ 01:15PM   PLT COUNT-324
+
+Other Pertinent Labs:
+___ 06:10AM BLOOD ___ PTT-36.7* ___
+___ 06:10AM BLOOD ALT-37 AST-20 AlkPhos-72 TotBili-0.4
+
+On Dishcarge:
+___ 06:20AM BLOOD WBC-3.9* RBC-3.64* Hgb-10.7* Hct-34.0* 
+MCV-93 MCH-29.5 MCHC-31.6 RDW-15.6* Plt ___
+___ 06:20AM BLOOD Glucose-79 UreaN-20 Creat-0.6 Na-136 
+K-4.7 Cl-103 HCO3-28 AnGap-10
+___ 06:20AM BLOOD Mg-2.1
+
+Imaging:
+CXR ___:
+Cardiomegaly and small bilateral effusions.  No superimposed 
+acute cardiopulmonary process. 
+
+EKG:  ___:
+afib with RVR, rate 127, normal axis, nonspecific ST changes 
+laterally and Q waves w/TWI in III, aVF similar to last 
+admission
+
+ 
+
+###RESPONSE: URINE {Evaluation of urine specimen}, COLOR {Color finding}, Clear {Urine looks clear}, PROTEIN {Measurement of protein in urine}, KETONE {Urinalysis, acetone or ketone bodies measurement}, BILIRUBIN {Bilirubin measurement, urine}, PH {pH measurement}, URINE {Evaluation of urine specimen}, RBC {Red blood cell count}, WBC {White blood cell count}, AST {Aspartate aminotransferase measurement}, URINE {Evaluation of urine specimen}, 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}, CALCIUM {Blood calcium 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}, NEUTS {Neutrophil count}, MONOS {Monocyte count}, EOS {Eosinophil count}, PTT {Partial thromboplastin time, activated}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total 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}, BLOOD 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}, Mg {Blood magnesium measurement}, CXR {Plain chest X-ray}, Cardiomegaly {Cardiomegaly}, bilateral effusions {Bilateral pleural effusion}, afib with RVR {Atrial fibrillation with rapid ventricular response}, normal {No abnormality detected}, axis {Electrocardiographic axis finding}, ST changes {Electrocardiographic ST segment changes}, TWI {Inverted T wave}, III {Lead III}, aVF {Finding present on electrocardiogram}"
+"###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 history of hypertension, presented with recurrent 
+atrial fibrillation with RVR s/p cardioversion on ___.
+ 
+# Atrial fibrillation with rapid ventricular response: CHADS2=3 
+(HTN, CHF, Age). Underwent workup for etiology of new atrial 
+fibrillation at last admission. She returned with rapid atrial 
+fibrillation but no signs of systolic heart failure 
+exacerbation. Rate control strategy was favored given paroxysmal 
+nature of her atrial fibrillation despite being euvolemic as 
+volume overload was initially felt to be a contributing factor. 
+She was rate controlled on increased dose of metoprolol and her 
+symptoms of fatigue resolved. She also continued Rivaroxaban for 
+stroke prevention. 
+   
+# Chronic Systolic Congestive Heart Failure Exacerbation: Has 
+dilated cardiomyopathy. Appears euvolemic on exam with flat JVP. 
+She has crackles but no dyspnea or other signs of volume 
+overload on exam. She was discharged on low dose of lasix to 
+take outpatient to prevent volume overload as her JVP had 
+increased slightly over the course of the hospitalization 
+(although remains <10) and her weight was increased from her 
+prior discharge weight. She is now lacking her atrial kick to 
+aid with forward flow. She was instructed to monitor her weights 
+outpatient. 
+
+# Leg Pain: Felt to be from trochanteric bursitis outpatient. No 
+acute fracture was seen on imaging. DVT was ruled out with 
+ultrasound last admission. Continued Tylenol for pain control 
+and physical therapy was consulted.
+
+# Hypertension: Her home olmesartan and Felodipine continued to 
+be held from last admission. Metoprolol was given per above. She 
+should restart her ___ outpatient as she has systolic heart 
+failure if her blood pressure permits. 
+  
+
+HOSPITAL ISSUES:   
+- Code: Full Code  
+- should have BP check at follow up outpatient visit and restart 
+___ if BP allows
+- CTA last hospitalization showed incidental finding of 
+narrowing of the left 
+mainstem bronchus with soft tissue fullness posteriorly and 
+distal esophageal thickening. This can be further worked up if 
+clinically indicated.
+
+ 
+
+###RESPONSE: hypertension {Hypertensive disorder, systemic arterial}, recurrent {Recurrent disease}, atrial fibrillation with RVR {Atrial fibrillation with rapid ventricular response}, cardioversion {Cardioversion}, Atrial fibrillation with rapid ventricular response {Atrial fibrillation with rapid ventricular response}, HTN {Hypertensive disorder, systemic arterial}, CHF {Congestive heart failure}, workup {Evaluation procedure}, atrial 
+fibrillation {Atrial fibrillation}, rapid atrial 
+fibrillation {Rapid atrial fibrillation}, signs {Sign}, systolic heart failure {Systolic heart failure}, atrial fibrillation {Atrial fibrillation}, euvolemic {Normal blood volume}, volume overload {Hypervolemia}, fatigue {Fatigue}, resolved {Problem resolved}, Rivaroxaban {Administration of prophylactic anticoagulant}, stroke prevention {Stroke prevention}, Chronic {Chronic congestive heart failure}, Systolic Congestive Heart Failure {Congestive heart failure due to left ventricular systolic dysfunction}, dilated cardiomyopathy {Congestive cardiomyopathy}, euvolemic {Normal blood volume}, exam {Physical examination procedure}, flat JVP {Normal jugular venous pressure}, crackles {Respiratory crackles}, dyspnea {Dyspnea}, signs {Sign}, volume 
+overload {Hypervolemia}, exam {Physical examination procedure}, lasix {Diuretic therapy}, volume overload {Hypervolemia}, JVP had 
+increased {Raised jugular venous pressure}, weight was increased {Weight increased}, weight {Weight finding}, atrial {Atrial structure}, monitor her weights {Weight monitoring}, Leg Pain {Pain in lower limb}, trochanteric bursitis {Greater trochanteric pain syndrome}, No 
+acute {No abnormality detected}, fracture {Fracture}, imaging {Imaging}, DVT {Deep venous thrombosis}, ultrasound {Ultrasonography}, Tylenol {Administration of analgesic}, pain control {Pain control}, physical therapy {Physical therapy procedure}, Hypertension {Hypertensive disorder, systemic arterial}, restart {Restart of medication}, systolic heart 
+failure {Systolic heart failure}, blood pressure {Blood pressure monitoring}, BP check {Blood pressure monitoring}, restart {Restart of medication}, CTA {Computed tomography angiography with contrast}, narrowing {Narrowing}, left {Structure of left bronchus}, bronchus {Bronchial structure}, soft tissue {Structure of soft tissue}, distal esophageal {Structure of lower third of esophagus}, thickening {Increased thickness}, worked up {Evaluation 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:
+The Preadmission Medication list is accurate and complete.
+1. Calcium Carbonate 1250 mg PO DAILY 
+2. Metoprolol Succinate XL 25 mg PO DAILY 
+3. Rivaroxaban 15 mg PO DAILY 
+4. alendronate 70 mg oral weekly 
+5. Estrogens Conjugated 1 gm VG PRN daily 
+
+ 
+Discharge Medications:
+1. Calcium Carbonate 1250 mg PO DAILY 
+2. Metoprolol Succinate XL 75 mg PO BID 
+RX *metoprolol succinate 25 mg 3 tablet extended release 24 
+hr(s) by mouth twice a day Disp #*180 Tablet Refills:*0
+3. Rivaroxaban 15 mg PO DAILY 
+4. alendronate 70 mg oral weekly 
+5. Estrogens Conjugated 1 gm VG PRN daily 
+6. Furosemide 10 mg PO DAILY 
+RX *furosemide 20 mg 0.5 (One half) tablet(s) by mouth once a 
+day Disp #*20 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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+atrial fibrillation with rapid ventricular response
+chronic systolic heart failure
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+ 
+
+###RESPONSE: Home {Home health aide service management}, With Service {Home health aide service management}, atrial fibrillation with rapid ventricular response {Atrial fibrillation with rapid ventricular response}, chronic systolic heart failure {Chronic systolic heart failure}, Mental Status {Neurological mental status determination}, Clear {No abnormality detected}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, interactive {Does communicate}, 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 seeing you again during your recent 
+hospitalization at ___. You were admitted to the hospital 
+again because your heart rhythm returned into atrial 
+fibrillation and was beating very fast. We increased your dose 
+of metoprolol and now your heart rate is better controlled. 
+
+Please take your medications as prescribed and go to your clinic 
+appointments shown below. Remember to weigh yourself every 
+morning and call your doctor if your weight goes up more than 3 
+lbs.
+ 
+
+###RESPONSE: heart rhythm {Finding of heart rhythm}, atrial 
+fibrillation {Atrial fibrillation}, beating very fast {Tachycardia}, heart rate {Finding of heart rate}, better controlled {Disease condition determination, well controlled}, take your medications as prescribed {Patient medication education}, clinic {Outpatient care management}, weigh yourself every 
+morning {Weight monitoring}, weight goes up {Weight increased}"
+"###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: 
+Penicillins / Ace Inhibitors / Aspirin / Rifaximin / Tramadol / 
+Plavix / morphine / Statins-Hmg-Coa Reductase Inhibitors / 
+Effexor XR
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Chest pain
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: Penicillins {Allergy to penicillin}, Ace Inhibitors {Allergy to acetylcholinesterase inhibitor}, Aspirin {Allergy to aspirin}, Tramadol {Allergy to tramadol}, morphine {Allergy to morphine}, Statins-Hmg-Coa Reductase Inhibitors {Allergy to 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor}, Chest pain {Chest 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:
+Patient is a ___ year old female, history of CAD (MI ___ s/p
+PCIx2 to ramus intermedius, TTE ___, pAF (on Coumadin),
+moderate AS, HTN, anemia, dementia, GERD, and hx breast cancer
+(s/p R mastectomy with XRT) who presents with chest pain. 
+Patient
+reports that symptoms began 2 or 3 days ago. She reports 8 out 
+of
+10 substernal chest ""pressure."" Mild dyspnea with cough. No
+hemoptysis. Denies fever, chills, nausea, vomiting, change in
+bowel or bladder function, change in vision or hearing, 
+bruising,
+adenopathy, new rash or lesion.
+
+She is somewhat difficult to get a clear history from w/r/t her
+pain. When it initially started about 48 hours ago, it awoke her
+up out of her sleep. She doesn't recall anything that improved 
+or
+made it worse, but since then it has been rather episodic
+throughout the day. She has felt generally ""low energy"" and thus
+has not been moving about all that much, but when she has 
+exerted
+herself she does not think that brought about the pain or made 
+it
+any worse. She does think that she has felt generally weaker
+while exerting herself over the last week or so.
+
+In the ED initial vitals were: 
+
+97.3 56 155/65 16 97% RA 
+ 
+Labs/studies notable for:
+
+___: 35.8  PTT: 43.3  INR: 3.3  
+
+5.1 > 12.1/37.1 < 230 
+  
+ALT: 36 AP: 85 Tbili: 0.4 Alb: 4.2 
+AST: 45 
+
+CK: 295  MB: 8  Trop-T: 0.02 
+
+135  97  29   
+-------------< 82 
+4.2  23  1.2  
+
+UA negative
+
+Trop 0.02 --> 0.01
+
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}, MI {Myocardial infarction}, PCI {Percutaneous coronary intervention}, ramus intermedius {Structure of coronary intermediate artery}, TTE {Transthoracic echocardiography}, pAF {Paroxysmal atrial fibrillation}, moderate AS {Moderate stenosis of aortic valve}, HTN {Hypertensive disorder, systemic arterial}, anemia {Anemia}, dementia {Dementia}, GERD {Gastroesophageal reflux disease}, breast cancer {Malignant neoplasm of breast}, R mastectomy {Mastectomy of right breast}, XRT {X-ray beam therapy}, chest pain {Chest pain}, substernal {Structure of substernal region}, chest ""pressure {Tight chest}, dyspnea {Dyspnea}, cough {Cough}, hemoptysis {Hemoptysis}, fever {Fever}, chills {Chill}, nausea {Nausea}, vomiting {Vomiting}, change in
+bowel {Altered bowel function}, bladder function {Altered bladder function}, bruising {Contusion}, adenopathy {Lymphadenopathy}, rash {Eruption of skin}, lesion {Lesion}, pain {Pain}, improved {Patient's condition improved}, 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: Past Medical History:
+HYPONATREMIA  
+ ATRIAL FIBRILLATION on Coumadin  
+ BREAST CANCER TWICE IN RIGHT BREAST  
+ lumpectomy and xrt s/p mastectomy ___  
+ CORONARY ARTERY DISEASE  
+ s/p ramus stent ___, negative exercise echo ___  
+ CORONARY ARTERY DISEASE  
+ ___ cath 3-v disease with PCTA ramus of circ  
+ DEPRESSION  
+ GASTROESOPHAGEAL REFLUX  
+ HYPERTENSION  
+ OSTEOARTHRITIS  
+ OSTEOPOROSIS  
+ ANXIETY  
+ MDD WITH PSYCHOTIC FEATURES  
+ GAD  
+ CATARACT  
+ AORTIC SCLEROSIS  
+
+ 
+
+###RESPONSE: HYPONATREMIA {Hyponatremia}, ATRIAL FIBRILLATION {Atrial fibrillation}, BREAST CANCER {Malignant neoplasm of breast}, RIGHT BREAST {Right breast structure}, lumpectomy {Lumpectomy of breast}, xrt {X-ray beam therapy}, mastectomy {Excision of breast}, CORONARY ARTERY DISEASE {Coronary arteriosclerosis}, stent {Insertion of arterial stent}, exercise echo {Exercise stress echocardiography}, CORONARY ARTERY DISEASE {Coronary arteriosclerosis}, cath {Cardiac catheterization}, 3-v disease {Triple vessel disease of the heart}, PCTA {Percutaneous transluminal coronary angioplasty}, DEPRESSION {Depressive disorder}, GASTROESOPHAGEAL REFLUX {Gastroesophageal reflux disease}, HYPERTENSION {Hypertensive disorder, systemic arterial}, OSTEOARTHRITIS {Osteoarthritis}, OSTEOPOROSIS {Osteoporosis}, ANXIETY {Anxiety}, MDD WITH PSYCHOTIC FEATURES {Major depression with psychotic features}, GAD {Generalized anxiety disorder}, CATARACT {Cataract}, AORTIC SCLEROSIS {Aortic valve sclerosis}"
+"###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:
+FAMILY PSYCHIATRIC HISTORY: brother with ___ (in ___
+Mother died of AD at age ___
+Father died of MI age ___. 
+
+ 
+
+###RESPONSE: died {Dead}, died {Dead}, MI {Myocardial infarction}"
+"###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:  ___ 0200 Temp: 98.0 PO BP: 150/63 L Lying HR: 58 RR: 
+18
+O2 sat: 99% O2 delivery: Ra 
+GENERAL: Cachectic elderly woman, lying comfortably in bed, NAD
+HEENT: Normocephalic atraumatic. Sclera anicteric. PERRL. EOMI.
+Conjunctiva were pink. No pallor or cyanosis of the oral mucosa.
+No xanthelasma.  
+NECK: No JVD.
+CARDIAC: PMI located in ___ intercostal space, midclavicular
+line. Regular rate and rhythm. ___, late peaking cresc/decresc
+murmur best heart at LUSB, radiating to carotids with delayed
+carotid upstroke.   
+LUNGS: No chest wall deformities or tenderness. Respiration is
+unlabored with no accessory muscle use. No crackles, wheezes or
+rhonchi.  
+ABDOMEN: Soft, non-tender, non-distended. No hepatomegaly. No
+splenomegaly.  
+EXTREMITIES: Warm, well perfused. No clubbing, cyanosis, or
+peripheral edema.  
+SKIN: No significant skin lesions or rashes.  
+PULSES: Distal pulses palpable and symmetric. 
+
+DISCHARGE PHYSICAL EXAM
+=====================================
+Temp: 97.7 (Tm 98.8), BP: 159/72 (113-159/53-72), HR: 69
+(52-69), RR: 18 (___), O2 sat: 97% (96-98), O2 delivery: Ra,
+Wt: 92.15 lb/41.8 kg
+GENERAL: Cachectic elderly woman, lying comfortably in bed, NAD
+HEENT: Normocephalic atraumatic. Sclera anicteric. PERRL. EOMI.
+Conjunctiva were pink. No pallor or cyanosis of the oral mucosa.
+No xanthelasma.  
+NECK: No JVD.
+CARDIAC: PMI located in ___ intercostal space, midclavicular
+line. Regular rate and rhythm. ___, late peaking cresc/decresc
+murmur best heart at LUSB, radiating to carotids with delayed
+carotid upstroke.   
+LUNGS: No chest wall deformities or tenderness. Respiration is
+unlabored with no accessory muscle use. No crackles, wheezes or
+rhonchi.  
+ABDOMEN: Soft, non-tender, non-distended. No hepatomegaly. No
+splenomegaly.  
+EXTREMITIES: Warm, well perfused. No clubbing, cyanosis, or
+peripheral edema.  
+SKIN: No significant skin lesions or rashes.  
+PULSES: Distal pulses palpable and symmetric.
+
+ 
+
+###RESPONSE: PHYSICAL EXAM {Physical examination procedure}, VS {Vital signs finding}, Temp {Body temperature finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, O2 sat {Oxygen saturation measurement}, GENERAL {General examination of patient}, Cachectic {Cachexia}, lying comfortably in bed {Lying in bed}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, Normocephalic {Normal head}, atraumatic {No injuries apparent}, Sclera anicteric {White sclera}, PERRL {Pupils equal and reacting to light}, EOMI {Normal ocular motility}, Conjunctiva {Conjunctival structure}, cyanosis {Cyanosis}, oral mucosa {Oral mucous membrane structure}, xanthelasma {Xanthelasma}, NECK {Physical examination procedure}, JVD {Jugular venous engorgement}, CARDIAC {Cardiovascular physical examination}, intercostal space {Structure of intercostal space}, midclavicular
+line {Midclavicular line}, Regular rate {Normal heart rate}, murmur {Murmur}, LUSB {Structure of upper parasternal region}, carotids {Carotid artery structure}, LUNGS {Examination of respiratory system}, chest wall deformities {Deformity of chest wall}, tenderness {Tenderness}, Respiration {Examination of respiratory system}, unlabored {Breathing easily}, accessory muscle {Accessory skeletal muscle}, crackles {Respiratory crackles}, wheezes {Wheezing}, rhonchi {Wheeze - rhonchi}, ABDOMEN {Examination of abdomen}, Soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, hepatomegaly {Large liver}, splenomegaly {Splenomegaly}, EXTREMITIES {Examination of limb}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, clubbing {Clubbing}, cyanosis {Cyanosis}, edema {Edema}, SKIN {Examination of skin}, lesions {Lesion}, rashes {Eruption of skin}, pulses palpable {Peripheral pulse palpable}, PHYSICAL EXAM {Physical examination procedure}, Temp {Body temperature finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, O2 sat {Oxygen saturation measurement}, GENERAL {General examination of patient}, Cachectic {Cachexia}, lying comfortably in bed {Lying in bed}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, Normocephalic {Normal head}, atraumatic {No injuries apparent}, Sclera anicteric {White sclera}, PERRL {Pupils equal and reacting to light}, EOMI {Normal ocular motility}, Conjunctiva {Conjunctival structure}, cyanosis {Cyanosis}, oral mucosa {Oral mucous membrane structure}, xanthelasma {Xanthelasma}, NECK {Physical examination procedure}, JVD {Jugular venous engorgement}, CARDIAC {Cardiovascular physical examination}, intercostal space {Structure of intercostal space}, midclavicular
+line {Midclavicular line}, Regular rate {Normal heart rate}, murmur {Murmur}, LUSB {Structure of upper parasternal region}, carotids {Carotid artery structure}, LUNGS {Examination of respiratory system}, chest wall deformities {Deformity of chest wall}, tenderness {Tenderness}, Respiration {Examination of respiratory system}, unlabored {Breathing easily}, accessory muscle {Accessory skeletal muscle}, crackles {Respiratory crackles}, wheezes {Wheezing}, rhonchi {Wheeze - rhonchi}, ABDOMEN {Examination of abdomen}, Soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, hepatomegaly {Large liver}, splenomegaly {Splenomegaly}, EXTREMITIES {Examination of limb}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, clubbing {Clubbing}, cyanosis {Cyanosis}, edema {Edema}, SKIN {Examination of skin}, lesions {Lesion}, rashes {Eruption of skin}, pulses palpable {Peripheral pulse palpable}"
+"###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
+=====================
+___ 02:10PM   cTropnT-<0.01
+___ 12:29PM URINE  HOURS-RANDOM
+___ 12:29PM URINE  UHOLD-HOLD
+___ 12:29PM URINE  COLOR-Straw APPEAR-Clear SP ___
+___ 12:29PM URINE  BLOOD-NEG NITRITE-NEG PROTEIN-NEG 
+GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-7.5 
+LEUK-NEG
+___ 08:15AM   GLUCOSE-82 UREA N-29* CREAT-1.2* SODIUM-135 
+POTASSIUM-4.2 CHLORIDE-97 TOTAL CO2-23 ANION GAP-15
+___ 08:15AM   estGFR-Using this
+___ 08:15AM   ALT(SGPT)-36 AST(SGOT)-45* CK(CPK)-295* ALK 
+PHOS-85 TOT BILI-0.4
+___ 08:15AM   LIPASE-46
+___ 08:15AM   CK-MB-8 cTropnT-0.02*
+___ 08:15AM   ALBUMIN-4.2 CALCIUM-9.5 PHOSPHATE-3.0 
+MAGNESIUM-2.1
+___ 08:15AM   WBC-5.1 RBC-3.90 HGB-12.1 HCT-37.1 MCV-95 
+MCH-31.0 MCHC-32.6 RDW-14.0 RDWSD-49.2*
+___ 08:15AM   NEUTS-59.3 ___ MONOS-12.4 EOS-1.6 
+BASOS-1.2* IM ___ AbsNeut-3.02 AbsLymp-1.29 AbsMono-0.63 
+AbsEos-0.08 AbsBaso-0.06
+___ 08:15AM   PLT COUNT-230
+___ 08:15AM   PLT COUNT-230
+
+PERTINENT STUDIES
+========================
+CARDIAC PERFUSION PHARM ___
+Normal myocardial perfusion exam. The ejection fraction is 70%.
+
+CXR ___
+No acute cardiopulmonary abnormality.
+
+TTE ___
+Vigorous left ventricular systolic function. Severe aortic 
+stenosis with mild aortic regurgitation. Mild mitral and 
+tricuspid regurgitation. Borderline pulmonary hypertension.
+
+STRESS TEST ___
+Non-anginal type symptoms in the absence of significant ST 
+segment changes. Resting systolic hypertension with an 
+appropriate 
+hemodynamic response to vasodilator stress. Nuclear report sent 
+separately. 
+
+DISCHARGE LABS
+========================
+___ 08:40AM BLOOD WBC-5.1 RBC-3.58* Hgb-11.2 Hct-34.9 
+MCV-98 MCH-31.3 MCHC-32.1 RDW-14.2 RDWSD-51.8* Plt ___
+___ 07:33PM BLOOD ___ PTT-40.6* ___
+___ 08:40AM BLOOD Glucose-75 UreaN-28* Creat-1.1 Na-137 
+K-4.3 Cl-101 HCO3-23 AnGap-13
+___ 08:40AM BLOOD CK(CPK)-191
+___ 08:40AM BLOOD CRP-7.3*
+ 
+
+###RESPONSE: cTropnT {Troponin T cardiac measurement}, COLOR {Color finding}, PROTEIN {Measurement of protein in urine}, KETONE {Urinalysis, acetone or ketone bodies measurement}, BILIRUBIN {Bilirubin measurement, urine}, PH {pH measurement}, 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}, TOT BILI {Bilirubin, total measurement}, cTropnT {Troponin T cardiac measurement}, ALBUMIN {Albumin measurement}, CALCIUM {Blood calcium 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}, RDWSD {Red cell distribution width determination}, NEUTS {Neutrophil count}, MONOS {Monocyte count}, EOS {Eosinophil count}, CXR {Plain chest X-ray}, TTE {Transthoracic echocardiography}, aortic 
+stenosis {Aortic valve stenosis}, mild aortic regurgitation {Mild aortic valve regurgitation}, Mild mitral {Mild mitral valve regurgitation}, tricuspid regurgitation {Tricuspid valve regurgitation}, pulmonary hypertension {Pulmonary hypertension}, ST 
+segment changes {Electrocardiographic ST segment changes}, systolic hypertension {Systolic hypertension}, 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}, 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}"
+"###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:
+====================
+PATIENT SUMMARY:
+====================
+___ year old female, history of CAD (MI ___ s/p PCIx2 to ramus
+intermedius, TTE ___, pAF (on Coumadin), moderate AS, HTN,
+anemia, dementia, GERD, and hx breast cancer (s/p R mastectomy
+with XRT) who presents with chest pain, possibly anginal vs.
+symptomatic severe AS vs. non-cardiac.
+
+CORONARIES: Diffuse 3VD
+PUMP: Preserved EF (70%)
+RHYTHM: pAF
+
+====================
+ACTIVE ISSUES
+====================
+
+#Chest pain
+#CAD (MI ___ s/p PCIx2 to ramus intermedius, last cath ___
+with 3VD, declining intervention)
+Suspect that some of her chest pain is anginal in nature, though
+not entirely clear from her history. Low concern for ACS given 
+very mild trop elevation which was downtrending and no ischemic 
+EKG changes. Pmibi was reassuring. Notably long acting nitrates 
+have resulted in HA in the past. Beta blocker not uptitrated due 
+to resting bradycardia. Also, she recently had two episodic 
+visits for diffuse muscle aches and fatigue, with labs showing 
+mildly elevated CK; statin was discontinued in this setting. ASA 
+was also held on her last admission due to concern for GIB. Her 
+symptoms were resolved on the day of discharge.
+
+#pAF: On warfarin. INR on admission 3.3 so Warfarin held on 
+admission day but resumed on ___. Patient was in sinus this 
+admission. Continued Amiodarone but Carvedilol 3.125 BID held 
+due to resting bradycardia. INR on discharge was 2.3.
+
+#Moderate-Severe AS: AS valve area of 1cm, with mean gradient 
+36.
+This is slightly worsened in the past year with prior area
+measured at 1.1cm with mean gradient in the low ___. Aortic 
+stenosis will be discussed further at outpatient visit with 
+___.
+
+#Diffuse muscle aches: Given vague nature of symptoms, certainly 
+possible that her pain was related to neither AS nor ischemic 
+heart disease. Interestingly, her CK and AST were both elevated 
+on admission likely indicating some skeletal muscle breakdown. 
+Statin induced myopathy is certainly possible so continued to 
+hold her Atorvastatin, though other myopathies should be 
+considered. CRP mildly elevated and ESR pending on discharge. 
+TSH also checked which was normal. 
+
+#HTN: Holding carvedilol but continued amlodipine as above.
+
+#Dementia
+#Anxiety:
+Continued home wellbutrin and mirtazapine.
+
+#CKD: Appeared to be at baseline Cr from most recent checks. Cr 
+on discharge was 1.1.
+
+#H/o breast CA s/p R mastectomy with XRT
+
+====================
+TRANSITIONAL ISSUES:
+====================
+- New Meds: None
+- Stopped/Held Meds: Carvedilol 3.125mg BID
+- Changed Meds: None
+- Discharge weight: 41.8 kg (92.15 lb) 
+- Discharge creatinine: 1.1
+
+[] Held carvedilol in the setting of resting bradycardia. Please 
+consider restarting if heart rates allow.
+[] Warfarin held on ___ because patient was supratherapeutic 
+but resumed her home dose prior to discharge
+
+# CONTACT: HCP: ___ (Nephew)
+Phone number: ___ 
+Cell phone: ___ 
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}, MI {Myocardial infarction}, PCI {Electrocardiographic ST segment changes}, ramus
+intermedius {Structure of coronary intermediate artery}, TTE {Transthoracic echocardiography}, pAF {Paroxysmal atrial fibrillation}, moderate AS {Moderate stenosis of aortic valve}, HTN {Hypertensive disorder, systemic arterial}, anemia {Anemia}, dementia {Dementia}, GERD {Gastroesophageal reflux disease}, breast cancer {Malignant neoplasm of breast}, R mastectomy {Mastectomy of right breast}, XRT {X-ray beam therapy}, chest pain {Chest pain}, 3VD {Triple vessel disease of the heart}, pAF {Paroxysmal atrial fibrillation}, Chest pain {Chest pain}, CAD {Coronary arteriosclerosis}, MI {Myocardial infarction}, PCI {Electrocardiographic ST segment changes}, ramus intermedius {Structure of coronary intermediate artery}, cath {Cardiac catheterization}, 3VD {Triple vessel disease of the heart}, chest pain {Chest pain}, ACS {Acute coronary syndrome}, ischemic 
+EKG changes {Electrocardiographic myocardial ischemia}, HA {Headache}, bradycardia {Bradycardia}, muscle aches {Muscle pain}, fatigue {Fatigue}, elevated CK {Creatine kinase level above reference range}, GIB {Gastrointestinal hemorrhage}, pAF {Paroxysmal atrial fibrillation}, On warfarin {Warfarin therapy}, sinus {Sinus rhythm}, bradycardia {Bradycardia}, AS {Aortic valve stenosis}, AS {Aortic valve stenosis}, Aortic 
+stenosis {Aortic valve stenosis}, muscle aches {Muscle pain}, pain {Muscle pain}, AS {Aortic valve stenosis}, ischemic 
+heart disease {Ischemic heart disease}, CK {Creatine kinase level above reference range}, AST were both elevated {Aspartate aminotransferase serum level above reference range}, skeletal muscle {Skeletal muscle structure}, myopathy {Disorder of skeletal AND/OR smooth muscle}, myopathies {Disorder of skeletal AND/OR smooth muscle}, CRP mildly elevated {C-reactive protein above reference range}, TSH also checked which was normal {Serum thyroid stimulating hormone level within reference range}, HTN {Hypertensive disorder, systemic arterial}, Dementia {Dementia}, CKD {Chronic kidney disease}, breast CA {Malignant neoplasm of breast}, R mastectomy {Mastectomy of right breast}, XRT {X-ray beam therapy}, bradycardia {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: Medications on Admission:
+The Preadmission Medication list is accurate and complete.
+1. Acetaminophen 650 mg PO Q4H:PRN Pain - Mild 
+2. Amiodarone 100 mg PO DAILY 
+3. amLODIPine 2.5 mg PO DAILY 
+4. Carvedilol 3.125 mg PO BID 
+5. Docusate Sodium 100 mg PO BID 
+6. Dorzolamide 2% Ophth. Soln. 1 DROP BOTH EYES TID 
+7. Milk of Magnesia 30 mL PO DAILY:PRN Constipation - Second 
+Line 
+8. Mirtazapine 7.5 mg PO QHS 
+9. Polyethylene Glycol 17 g PO DAILY 
+10. Senna 17.2 mg PO QHS 
+11. Warfarin 2 mg PO 4X/WEEK (___) 
+12. Warfarin 1.5 mg PO 3X/WEEK (___) 
+13. Azopt (brinzolamide) 1 % ophthalmic (eye) TID 
+14. BuPROPion 100 mg PO BID 
+15. Chlorpheniramine-Hydrocodone 5 mL PO Q6H:PRN cough 
+16. Citracal + D Petites (calcium citrate-vitamin D3) 200 mg 
+calcium -250 unit oral BID 
+17. Furosemide 20 mg PO DAILY 
+18. Mag-Al Plus (alum-mag hydroxide-simeth) 200-200-20 mg/5 mL 
+oral TID 
+19. melatonin 1 mg oral QHS 
+20. Sucralfate 0.5 gm PO TID:PRN stomach upset 
+21. trimethobenzamide 300 mg oral Q8H:PRN nausea 
+22. Vitamin D 1000 UNIT PO DAILY 
+23. Pantoprazole 40 mg PO Q24H 
+
+ 
+Discharge Medications:
+1.  Warfarin 1.5 mg PO DAILY16  
+2.  Acetaminophen 650 mg PO Q4H:PRN Pain - Mild  
+3.  Amiodarone 100 mg PO DAILY  
+4.  amLODIPine 2.5 mg PO DAILY  
+5.  Azopt (brinzolamide) 1 % ophthalmic (eye) TID  
+6.  BuPROPion 100 mg PO BID  
+7.  Chlorpheniramine-Hydrocodone 5 mL PO Q6H:PRN cough  
+8.  Citracal + D Petites (calcium citrate-vitamin D3) 200 mg 
+calcium -250 unit oral BID  
+9.  Docusate Sodium 100 mg PO BID  
+10.  Dorzolamide 2% Ophth. Soln. 1 DROP BOTH EYES TID  
+11.  Furosemide 20 mg PO DAILY  
+12.  Mag-Al Plus (alum-mag hydroxide-simeth) 200-200-20 mg/5 mL 
+oral TID  
+13.  melatonin 1 mg oral QHS  
+14.  Milk of Magnesia 30 mL PO DAILY:PRN Constipation - Second 
+Line  
+15.  Mirtazapine 7.5 mg PO QHS  
+16.  Pantoprazole 40 mg PO Q24H  
+17.  Polyethylene Glycol 17 g PO DAILY  
+18.  Senna 17.2 mg PO QHS  
+19.  Sucralfate 0.5 gm PO TID:PRN stomach upset  
+20.  trimethobenzamide 300 mg oral Q8H:PRN nausea  
+21.  Vitamin D 1000 UNIT PO DAILY  
+22.  Warfarin 2 mg PO 4X/WEEK (___)  
+
+ 
+
+###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
+====================
+non-coronary chest pain
+
+SECONDARY DIAGNOSIS
+====================
+coronary artery disease
+aortic stenosis
+
+ 
+Discharge Condition:
+Mental Status: Confused - sometimes.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+
+ 
+
+###RESPONSE: non-coronary chest pain {Non-cardiac chest pain}, coronary artery disease {Coronary arteriosclerosis}, aortic stenosis {Aortic valve stenosis}, Mental Status {Neurological mental status determination}, Confused {Clouded consciousness}, 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:
+Dear Ms. ___,  
+
+It was a pleasure taking part in your care here at ___!  
+
+Why was I admitted to the hospital?  
+- You were admitted for chest pain and fatigue
+
+What was done for me while I was in the hospital?  
+- You underwent a stress test which was normal.
+- Your medicines were changed to improve your symptoms. 
+
+What should I do when I leave the hospital?  
+- Please continue to take your medicines as prescribed and 
+follow up with your outpatient providers.
+
+We wish you the best!
+
+Sincerely,  
+Your ___ Care Team  
+
+ 
+
+###RESPONSE: chest pain {Chest pain}, fatigue {Fatigue}, stress test {Electrocardiogram with exercise 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: 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: 
+Latex
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Chest pain
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: Latex {Allergy to Hevea brasiliensis latex protein}, Chest pain {Chest 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:
+___ with h/o liver transplant ___ (HBV) on prograf, IDDM, HLD 
+with chest pain. Briefly, pt developed severe 
+epigastric/substernal pain this morning. Pain was severe and 
+woke him up. He describes it as crampy, nonradiating. Pain was 
+constant and unremitting, lasting for approximately 3 hours. It 
+was associated with 3x episodes of vomiting with some relief of 
+pain. It was not affected by position. No 
+light-headedness/dizziness. No abdominal pain. Pt notes he had a 
+very large meal earlier that night. He has never had this type 
+of pain before. He has never had an esopohogram before and 
+denies any history of DES. No history of esophageal injury. No 
+recent dysphagia/odynophagia. No recent sick contacts/illnesses. 
+Mild SOB, which patient attributes to not being able to take a 
+deep breath from pain.
+
+In the ambulance, pt received 2x nitro without improvement in 
+sx.
+
+On admission to the ED, VS were: 96.4 100 97/62 20 97% 4L. Labs 
+significant for Cr 1.4, ALT/AST: ___, AP 86, TBili 0.5, Lipase 
+42. Trops negative x2. EKG grossly unchanged from prior. CTA 
+negative for PE, and CXR negative for any acute process. Pt was 
+given zofran, morphine x2, GI ocktail, donnatal with improvement 
+in symptoms. Pt desated to 92% on RA, and he was placed back on 
+nasal cannula and admitted for workup of chest pain an hypoxia.
+
+On arrival, VS were: 99.5; 130/85; 80; 16; 97% 2LNC. Pt reported 
+feeling much better. He continues to have some mild chest pain 
+which is worse with deep breaths.
+
+ 
+
+###RESPONSE: liver transplant {Transplanted liver present}, HBV {Viral hepatitis type B}, IDDM {Diabetes mellitus type 1}, HLD {Hyperlipidemia}, chest pain {Chest pain}, severe {Severe pain}, epigastric {Epigastric pain}, substernal {Retrosternal pain}, pain {Pain}, Pain was severe {Severe pain}, crampy {Cramping pain}, Pain {Pain}, constant {Constant pain}, vomiting {Vomiting}, pain {Pain}, light-headedness {Lightheadedness}, dizziness {Dizziness}, abdominal pain {Abdominal pain}, pain {Pain}, DES {Endovascular insertion of drug eluting stent}, esophageal injury {Injury of esophagus}, dysphagia {Dysphagia}, odynophagia {Swallowing painful}, illnesses {Illness}, Mild {Symptom mild}, SOB {Dyspnea}, deep breath {Deep breathing}, pain {Pain}, improvement {Patient's condition improved}, Labs {Laboratory test}, TBili {Bilirubin, total measurement}, Lipase {Serum lipase measurement}, Trops {Troponin measurement}, negative {No pathologic diagnosis}, EKG {Electrocardiographic procedure}, CTA {Computed tomography angiography with contrast}, negative {No pathologic diagnosis}, PE {Pulmonary embolism}, CXR negative {Standard chest X-ray normal}, improvement {Patient's condition improved}, desated {Oxygen saturation below reference range}, placed back on 
+nasal cannula {Oxygen administration by nasal cannula}, workup {Evaluation procedure}, chest pain {Chest pain}, hypoxia {Hypoxia}, 2LNC {Oxygen administration by nasal cannula}, mild {Symptom mild}, chest pain {Chest pain}, worse {Increased pain}, deep breaths {Deep breathing}"
+"###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:
+HepB cirrhosis s/p OLT in ___
+-On Prograf
+Hepatitis B on ___ and HepaGam
+IDDM
+HLD
+
+ 
+
+###RESPONSE: HepB cirrhosis {Cirrhosis of liver due to hepatitis B}, OLT {Orthotopic transplantation of whole liver}, Hepatitis B {Viral hepatitis type B}, IDDM {Diabetes mellitus type 1}, HLD {Hyperlipidemia}"
+"###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:
+DM, HTN, HLD
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, HLD {Hyperlipidemia}"
+"###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:
+General: Pleasant, well-appearing NAD.
+HEENT: NC/AT. MMM. EOMI.
+LAD: No LAD appreciated
+CV: RRR. No MRG.
+Pulmonary: CTAB. No wheezes, rales, rhonchi
+Abdomen: +BS. Soft, NTND. Long horizontal incision over 
+epigastric region well-healed. No HSM appreciated.
+Extremities: WWP. 2+ DP pulese, equal bilaterally. No c/c/e
+Neuro: CNII-XII grossly intact
+
+On Discharge:
+General: Pleasant, well-appearing NAD.
+HEENT: NC/AT. MMM. EOMI.
+LAD: No LAD appreciated
+CV: RRR. No MRG.
+Pulmonary: CTAB. No wheezes, rales, rhonchi
+Abdomen: +BS. Soft, NTND. Long horizontal incision over 
+epigastric region well-healed. No HSM appreciated.
+Extremities: WWP. 2+ DP pulese, equal bilaterally. No c/c/e
+Neuro: CNII-XII grossly intact
+ 
+
+###RESPONSE: General {General examination of patient}, well-appearing {Well cared for appearance}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, NC {Normal head}, MMM {Moist oral mucosa}, EOMI {Normal ocular motility}, LAD {Lymphadenopathy}, LAD {Lymphadenopathy}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, No MRG {Heart sounds normal}, Pulm {Examination of respiratory system}, CTAB {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, rhonchi {Wheeze - rhonchi}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, ND {Swollen abdomen}, incision {Surgical incision wound}, epigastric region {Epigastric region structure}, well-healed {Wound healed}, HSM {Hepatosplenomegaly}, Extremities {Examination of limb}, WWP {Normal tissue perfusion}, 2+ DP {Dorsalis pulse present}, No c/c/e {No abnormality detected}, Neuro {Neurological examination}, grossly intact {Normal nervous system function}, well-appearing {Well cared for appearance}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, NC/AT {Normal head}, MMM {Moist oral mucosa}, EOMI {Normal ocular motility}, LAD {Examination of lymph nodes}, LAD {Lymphadenopathy}, RRR {Normal heart rate}, No MRG {Heart sounds normal}, CTAB {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, rhonchi {Wheeze - rhonchi}, Soft {Abdomen soft}, NTND {Abdominal tenderness}, incision {Surgical incision wound}, epigastric region {Epigastric region structure}, well-healed {Wound healed}, HSM {Hepatosplenomegaly}, WWP {Normal tissue perfusion}, 2+ DP {Dorsalis pulse present}, No c/c/e {No abnormality detected}, Neuro {Neurological examination}, CNII-XII grossly intact {Normal nervous system function}"
+"###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:
+On Admission:
+___ 05:30AM BLOOD WBC-10.5# RBC-4.63 Hgb-14.6 Hct-40.7 
+MCV-88 MCH-31.6 MCHC-36.0* RDW-14.8 Plt ___
+___ 05:30AM BLOOD ___ PTT-23.1* ___
+___ 05:30AM BLOOD Glucose-216* UreaN-22* Creat-1.4* Na-139 
+K-4.4 Cl-101 HCO3-27 AnGap-15
+___ 05:30AM BLOOD ALT-23 AST-26 AlkPhos-86 TotBili-0.5
+
+Troponins:
+___ 05:30AM BLOOD cTropnT-<0.01
+___ 11:36AM BLOOD cTropnT-<0.01
+
+On Discharge:
+___ 04:35AM BLOOD WBC-8.1 RBC-4.40* Hgb-13.8* Hct-39.1* 
+MCV-89 MCH-31.3 MCHC-35.3* RDW-14.3 Plt ___
+___ 04:35AM BLOOD ___ PTT-28.4 ___
+___ 04:35AM BLOOD Glucose-145* UreaN-23* Creat-1.4* Na-139 
+K-4.6 Cl-98 HCO3-30 AnGap-16
+___ 04:35AM BLOOD ALT-19 AST-23 AlkPhos-79 TotBili-0.9
+___ 04:35AM BLOOD Calcium-9.5 Phos-1.8* Mg-1.9
+___ 04:35AM BLOOD tacroFK-3.1*
+
+Microbiology:
+None
+
+Imaging:
+___ CTA Chest
+IMPRESSION:  
+1. No pulmonary embolism. 
+2. Small pericardial effusion. 
+3. Few pulmonary nodules measuring up to 4 mm.  Followup in ___ 
+year is 
+recommended there is high risk for lung malignancy. 
+4. Paraesophageal varices. 
+
+___ CXR:
+IMPRESSION:    
+1.  Mild vascular congestion. 
+2.  Chronic small right pleural effusion versus pleural 
+thickening. 
+2.  Left lower lobe atelectasis with elevation of left 
+hemidiaphragm. 
+
+___ ECG:
+Sinus rhythm. Compared to the previous tracing of ___ there 
+are no 
+significant changes. 
+
+ 
+
+###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}, 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}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, PTT {Partial thromboplastin time, activated}, BLOOD 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}, CTA Chest {Computed tomography angiography of chest with contrast}, pulmonary embolism {Pulmonary embolism}, pericardial effusion {Pericardial effusion}, pulmonary nodules {Nodule of lung}, Followup {Follow-up consultation}, lung malignancy {Metastatic malignant neoplasm to lung}, Paraesophageal varices {Esophageal varices}, Mild {Symptom mild}, vascular {Blood vessel structure}, congestion {Congestion}, Chronic {Chronic disease}, right {Right pleura structure}, pleural effusion {Pleural effusion}, pleural 
+thickening {Thickening of pleura}, Left lower lobe {Structure of lower lobe of left lung}, atelectasis {Atelectasis}, elevation {Elevated diaphragm}, left 
+hemidiaphragm {Structure of left hemidiaphragm}, ECG:
+Sinus rhythm {Electrocardiogram: sinus rhythm}"
+"###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 pmhx of HBV cirrhosis (sp xplant in ___, IDDM, HLD, 
+CKD, h/o strongyloides, h/o fasciola who presented with SSCP 
+following a large meal. 
+
+#Chest pain: Felt to be esophageal spasm in the setting of GERD. 
+EKG unchanged from prior and tropopnins were negative. CTA 
+otherwise negative for PE. Pt was started on a PPI, and he had 
+only minor recurrence of chest pain after coming to the floor. 
+Pt was discharged with a PPT as well as a plan for follow up EGD 
+with possible barium swallow.
+
+#Shortness of Breath: Pt's shortness of breath was felt to be 
+related to his inability to take a deep breath due to pain. His 
+desaturation in the ED may have been related to the pain 
+medications he was administered. Pt's oxygen was quickly weanes 
+off an admission, and his respiratory status remained stable 
+during this admission.
+
+#Hepatitis B: Pt was continued on ___
+
+#Cirrhosis s/p OLT: MELD score 10. Pt was continued on home 
+Prograf. Level was 3.1 on morning of discharge.
+
+#Pulmonary nodules: Pt was incidentally found to have pulmonary 
+nodules on CTA, and it was recommended that they be followed up 
+in ___ year if pt felt to be high risk for malignancy.
+
+Transitional:
+[] Please consider up-titration of PPI
+[] Pt will be scheduled for follow-up EGD +/- barium swallow - 
+manometry may be indicated in the future
+[] Consider f/u of pulmonary nodules in ___ year
+ 
+
+###RESPONSE: HBV cirrhosis {Cirrhosis of liver due to hepatitis B}, xplant {Transplanted liver present}, IDDM {Diabetes mellitus type 1}, HLD {Hyperlipidemia}, CKD {Chronic kidney disease}, strongyloides {Infection caused by Strongyloides}, fasciola {Infection caused by Fasciola}, Chest pain {Chest pain}, esophageal spasm {Diffuse spasm of esophagus}, GERD {Gastroesophageal reflux disease}, EKG {Electrocardiographic procedure}, tropopnins {Troponin measurement}, negative {No pathologic diagnosis}, CTA {Computed tomography angiography of chest with contrast}, negative {No pathologic diagnosis}, PE {Pulmonary embolism}, started {New medication added}, PPI {Proton pump inhibitor therapy}, chest pain {Chest pain}, follow up {Follow-up arranged}, EGD {Esophagogastroduodenoscopy}, barium swallow {Barium swallow}, Shortness of Breath {Dyspnea}, shortness of breath {Dyspnea}, inability to take a deep breath {Unable to take deep breaths}, pain {Pain}, desaturation {Oxygen saturation below reference range}, pain 
+medications {Administration of analgesic}, respiratory status {Monitoring of respiration}, stable {Patient's condition stable}, Hepatitis B {Viral hepatitis type B}, Cirrhosis {Cirrhosis of liver}, OLT {Orthotopic transplantation of whole liver}, Prograf. Level {Blood tacrolimus level}, Pulmonary nodules {Nodule of lung}, pulmonary 
+nodules {Nodule of lung}, CTA {Computed tomography angiography of chest with contrast}, risk for malignancy {At increased risk of malignancy}, PPI {Proton pump inhibitor therapy}, follow-up {Follow-up arranged}, EGD {Esophagogastroduodenoscopy}, barium swallow {Barium swallow}, manometry {Esophageal manometry}, pulmonary nodules {Nodule of lung}"
+"###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. Pravastatin 40 mg PO QPM 
+2. Phosphorus 250 mg PO TID W/MEALS 
+3. Amoxicillin ___ mg PO ONE HOUR PRIOR TO DENTAL SURGERY 
+4. Tacrolimus 0.5 mg PO Q12H 
+5. Multivitamins W/minerals 1 TAB PO DAILY 
+6. Entecavir 1 mg PO DAILY 
+7. Escitalopram Oxalate 10 mg PO DAILY 
+8. Sulfameth/Trimethoprim SS 1 TAB PO DAILY 
+9. GlipiZIDE 7.5 mg PO QAM 
+10. GlipiZIDE 10 mg PO QPM 
+11. Calcitriol 0.25 mcg PO BID 
+12. Glargine 28 Units Bedtime
+Insulin SC Sliding Scale using HUM Insulin
+13. Hepatitis B Immun Globulin (HepaGam B) 5000 UNIT IV Q4 
+MONTHS 
+
+ 
+Discharge Medications:
+1. Calcitriol 0.25 mcg PO BID 
+2. Entecavir 1 mg PO DAILY 
+3. Escitalopram Oxalate 10 mg PO DAILY 
+4. Glargine 28 Units Bedtime
+Insulin SC Sliding Scale using HUM Insulin
+5. Multivitamins W/minerals 1 TAB PO DAILY 
+6. Phosphorus 250 mg PO TID W/MEALS 
+7. Pravastatin 40 mg PO QPM 
+8. Sulfameth/Trimethoprim SS 1 TAB PO DAILY 
+9. Tacrolimus 0.5 mg PO Q12H 
+10. Omeprazole 20 mg PO BID 
+RX *omeprazole 20 mg 1 capsule(s) by mouth twice a day Disp #*60 
+Capsule Refills:*0
+11. Amoxicillin ___ mg PO ONE HOUR PRIOR TO DENTAL SURGERY 
+___. GlipiZIDE 7.5 mg PO QAM 
+13. GlipiZIDE 10 mg PO QPM 
+14. Hepatitis B Immun Globulin (HepaGam B) 5000 UNIT IV Q4 
+MONTHS 
+
+ 
+
+###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: 
+Esophageal spasm
+Gastroesophageal reflux disease
+Chest pain
+
+Secondary:
+Diabetes
+Chronic kidney disease
+Hepatitis B
+Hyperlipidemia
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Esophageal spasm {Diffuse spasm of esophagus}, Gastroesophageal reflux disease {Gastroesophageal reflux disease}, Chest pain {Chest pain}, Diabetes {Diabetes mellitus type 1}, Chronic kidney disease {Chronic kidney disease}, Hepatitis B {Viral hepatitis type B}, Hyperlipidemia {Hyperlipidemia}, Clear {Normal state of mind}, Alert {Mentally alert}, interactive {Does communicate}, 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 Dr. ___, 
+
+___ was a pleasure to participate in your care. You were admitted 
+for chest pain. You were found to have no evidence of cardiac 
+ischemia or pulmonary embolism. Your symptoms improved with a 
+proton pump inhibitor. We believe that your symptoms may have 
+been due to gastric reflux or esophageal spasm. Please follow up 
+with your Gastroenterologist for outpatient endoscopy and barium 
+enema. 
+
+Best Regards,
+Your ___ Medicine Team
+ 
+
+###RESPONSE: chest pain {Chest pain}, no evidence {No abnormality detected}, cardiac 
+ischemia {Myocardial ischemia}, pulmonary embolism {Pulmonary embolism}, improved {Patient's condition improved}, proton pump inhibitor {Proton pump inhibitor therapy}, gastric reflux {Gastric reflux}, esophageal spasm {Diffuse spasm of esophagus}, follow up {Follow-up arranged}, endoscopy {Endoscopy}, barium 
+enema {Barium enema}"
+"###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: 
+Penicillins / Amoxicillin
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Back and Left Leg Pain
+ 
+Major Surgical or Invasive Procedure:
+PROCEDURES: ___
+1. Anterior lumbar interbody fusion, L4-L5, L5-S1.
+2. Anterior interbody cage placement L4-L5, L5-S1.
+
+PROCEDURES: ___
+1. L5 laminectomy, L4 laminotomy
+2. Posterior Spinal Instrumented Fusion L4-S1 
+
+ 
+
+###RESPONSE: Penicillins {Allergy to penicillin}, Amoxicillin {Allergy to amoxicillin}, Back {Structure of back of trunk}, Left Leg Pain {Pain in left lower limb}, Anterior lumbar interbody fusion {Interbody fusion of lumbar spine by anterior approach}, L4-L5 {Intervertebral disc structure of fourth lumbar vertebra}, L5-S1 {Structure of intervertebral disc of L5 and S1}, placement {Implantation procedure}, L4-L5 {Intervertebral disc structure of fourth lumbar vertebra}, L5-S1 {Structure of intervertebral disc of L5 and S1}, L5 {Structure of lamina of fifth lumbar vertebra}, laminectomy {Excision of lamina of vertebra}, L4 {Structure of lamina of fourth lumbar vertebra}, laminotomy {Laminotomy}, Posterior Spinal Instrumented {Posterior spinal instrumentation}, Fusion {Fusion procedure}, L4 {Bone structure of L4}, S1 {Structure of first sacral vertebra}"
+"###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:
+This patient presented with persistent back and left-sided leg 
+pain.  This goes down in an L5 distribution. It is approximately 
+60% back, 40% leg and it goes down the outside of his leg, 
+outside of his calf, top of his foot.  He had
+an injury approximately ___ years ago while wrestling and he wore
+a back brace for two to three months due to spondylolisthesis. 
+He has been followed at ___.  He has been good
+for approximately five to ___ years, but the past six months 
+have
+been significantly bothersome for him.  He had a recent child; 
+he
+is unable to pick the child up.  He has had no injections
+recently.  He discontinued physical therapy secondary to pain. 
+It is ___ ___nd ___ with activity.  His mom is with him
+today.  He has a history of anxiety and chest pain and he had a
+workup for cardiac chest pain, which was negative and with a
+diagnosis of stress.  He is on Lamictal and Geodon for bipolar
+depression.  He is allergic to amoxicillin.  He smokes
+approximately half a pack a day, which is a decrease from the 
+two
+packs.
+
+His films were reviewed, which show a grade ___ 
+spondylolisthesis
+at L5-S1 with spondylolysis.  An MRI was reviewed from 
+___
+from ___ MRI, which shows a bilateral L5 spondylolysis and
+L5-S1 spondylolisthesis that is grade 2.  There is severe
+foraminal stenosis bilaterally.
+
+On physical examination, he is an alert and oriented male. 
+Affect is within normal limits.  He has an antalgic gait.  He 
+has
+___ strength bilaterally with a ___ ___ and abductors.  His
+sensation is grossly intact to light touch.  He has a positive
+straight leg raise approximately 70 degrees.  No pain with
+internal rotation of hips.  Distal pulses intact.  Calves are
+soft.  No signs of atrophy.
+
+This is a patient with a grade ___ spondylolisthesis, who by
+report was a grade 1 and followed at ___.  He 
+has
+severe left back as well as left lower extremity radicular
+symptoms.  We talked about possible surgical intervention.  This
+would either be an anterior-posterior fusion with interbody 
+cages
+from ___ versus a strut graft through the sacrum and L5 combined
+with a posterolateral fusion.  We discussed this at length as
+well as risks and benefits using models as MRI.  All questions
+were answered.  I would like to obtain a CT scan and see him 
+back
+in followup.  I gave him a surgical packet and asked him to look
+at the animations and come back with any questions.  Given his
+x-rays and MRIs as well as clinical symptoms, I do recommend
+surgical intervention.
+
+ 
+
+###RESPONSE: back {Structure of back of trunk}, left-sided leg 
+pain {Pain in left lower limb}, L5 {Bone structure of L5}, back {Structure of back of trunk}, leg {Structure of left lower leg}, leg {Structure of left lower leg}, calf {Structure of calf of right lower leg}, foot {Structure of right foot}, injury {Traumatic or non-traumatic injury}, wore
+a back brace {Application of back brace}, spondylolisthesis {Spondylolisthesis}, unable to pick the child up {Unable to pick up objects}, injections {Injection}, physical therapy {Physical therapy procedure}, pain {Abdominal pain}, anxiety {Anxiety}, chest pain {Chest pain}, cardiac chest pain {Cardiac chest pain}, stress {Stress}, bipolar {Bipolar disorder}, depression {Depressive disorder}, allergic to amoxicillin {Allergy to amoxicillin}, smokes {Smoker}, spondylolisthesis {Spondylolisthesis}, L5 {Bone structure of L5}, S1 {Structure of first sacral vertebra}, spondylolysis {Spondylolysis}, MRI {Magnetic resonance imaging}, MRI {Magnetic resonance imaging}, L5 {Bone structure of L5}, spondylolysis {Spondylolysis}, L5 {Bone structure of L5}, S1 {Structure of first sacral vertebra}, spondylolisthesis that is grade 2 {Spondylolisthesis, grade 2}, foraminal stenosis {Stenosis of lumbar vertebral foramen}, physical examination {Physical examination procedure}, alert {Mentally alert}, oriented {Orientated}, Affect {Mood finding}, antalgic gait {Antalgic gait}, sensation {Normal sensation}, intact to light touch {Light touch sensation present}, straight leg raise {Finding of straight leg raise}, pain {Abdominal pain}, internal rotation of hips {Structure of internal rotator of hip joint}, Calves {Structure of calf of leg}, atrophy {Atrophy}, spondylolisthesis {Spondylolisthesis}, grade 1 {Spondylolisthesis, grade 1}, t back {Structure of back of trunk}, left lower extremity {Structure of left lower limb}, radicular
+symptoms {Radicular pain}, surgical intervention {Surgical procedure}, fusion {Fusion procedure}, sacrum {Structure of sacral vertebral column}, L5 {Bone structure of L5}, fusion {Fusion procedure}, MRI {Magnetic resonance imaging}, CT scan {Computed tomography of abdomen}, x-rays {Radiographic imaging procedure}, MRIs {Magnetic resonance imaging}, surgical intervention {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: Past Medical History:
+see HPI
+ 
+
+###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:
+see HPI
+ 
+
+###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:
+see HPI
+ 
+
+###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:
+___ 07:09AM BLOOD ALT-24 AST-18 LD(LDH)-148 AlkPhos-81 
+TotBili-1.6*
+___ 05:00AM BLOOD Glucose-135* UreaN-10 Creat-0.7 Na-137 
+K-4.8 Cl-103 HCO3-28 AnGap-11
+___ 05:00AM BLOOD WBC-12.2* RBC-3.43* Hgb-10.7* Hct-30.6* 
+MCV-89 MCH-31.2 MCHC-35.1* RDW-12.3 Plt ___
+ 
+
+###RESPONSE: ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, 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}, 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}"
+"###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:
+Patient was admitted to the ___ Spine Surgery Service and 
+taken to the Operating Room for the above procedure.   The two 
+portions of the surgery were staged apart by four days.  Refer 
+to the dictated operative notes for further details.  The 
+surgeries were without complication and the patient was 
+transferred to the PACU in a stable condition each time.  
+TEDs/pnemoboots were used for postoperative DVT prophylaxis.  
+Intravenous antibiotics were continued for 24hrs postop per 
+standard protocol. Initial postop pain was controlled with a 
+PCA.  Diet was advanced as tolerated.  The patient was 
+transitioned to oral pain medication when tolerating PO diet.  
+Foley was removed on POD#1.  Physical therapy was consulted for 
+mobilization OOB to ambulate.  Hospital course was otherwise 
+unremarkable.  On the day of discharge the patient was afebrile 
+with stable vital signs, comfortable on oral pain control and 
+tolerating a regular diet. 
+ 
+
+###RESPONSE: procedure {Surgical procedure}, surgery {Surgical procedure}, stable condition {Patient's condition stable}, TEDs {Application of antithromboembolic stockings}, postoperative {Postoperative state}, DVT prophylaxis {Prevention of deep vein thrombosis}, Intravenous antibiotics {Intravenous antibiotic therapy}, pain was controlled {Demonstrates adequate pain control}, PCA {Patient controlled analgesia}, Diet was advanced as tolerated {Advance diet as tolerated}, oral {Administration of drug or medicament via oral route}, pain medication {Administration of analgesic}, diet {Dietary finding}, Foley was removed {Removal of urinary bladder catheter}, mobilization {Mobilization}, ambulate {Ambulation training}, unremarkable {No abnormality detected}, afebrile {Fever}, stable vital signs {Normal vital signs}, oral {Administration of drug or medicament via oral route}, pain control {Pain control}, regular diet {Normal diet}"
+"###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:
+1. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: Two (2) 
+Capsule, Delayed Release(E.C.) PO DAILY (Daily).  
+2. lamotrigine 100 mg Tablet Sig: Three (3) Tablet PO DAILY 
+(Daily).  
+3. ziprasidone HCl 20 mg Capsule Sig: One (1) Capsule PO QHS 
+(once a day (at bedtime)).  
+
+ 
+Discharge Medications:
+1. bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal 
+once a day as needed for constipation for 3 doses.  
+2. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: Two (2) 
+Capsule, Delayed Release(E.C.) PO DAILY (Daily).  
+3. lamotrigine 100 mg Tablet Sig: Three (3) Tablet PO DAILY 
+(Daily).  
+4. ziprasidone HCl 20 mg Capsule Sig: One (1) Capsule PO QHS 
+(once a day (at bedtime)).  
+5. oxycodone-acetaminophen ___ mg Tablet Sig: ___ Tablets PO 
+Q4H (every 4 hours) as needed for pain.
+Disp:*60 Tablet(s)* Refills:*0*
+6. senna 8.6 mg Tablet Sig: One (1) Tablet PO QHS (once a day 
+(at bedtime)) as needed for constipation.  
+
+ 
+
+###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:
+L5-S1 Anterior Spondylolisthesis
+
+ 
+Discharge Condition:
+A+Ox3
+Ambulate as tolerated
+
+ 
+
+###RESPONSE: 5-S1 {Structure of first sacral vertebra}, Spondylolisthesis {Spondylolisthesis}, Ox3 {Oriented to person, time and place}"
+"###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 have undergone the following operation: Lumbar Decompression 
+With Fusion
+
+Immediately after the operation:
+
+-Activity: You should not lift anything greater than 10 lbs for 
+2 weeks. You will be more comfortable if you do not sit or stand 
+more than ~45 minutes without getting up and walking around.
+
+-Rehabilitation/ Physical Therapy: 
+o2-3 times a day you should go for a walk for ___ minutes as 
+part of your recovery.  You can walk as much as you can 
+tolerate. 
+oLimit any kind of lifting.
+
+-Diet: Eat a normal healthy diet. You may have some 
+constipation after surgery.  You have been given medication to 
+help with this issue.
+
+-Brace: You may have been given a brace. This brace is to be 
+worn when you are walking. You may take it off when sitting in a 
+chair or while lying in bed.
+
+-Wound Care: Remove the dressing in 2 days.  If the incision is 
+draining cover it with a new sterile dressing.  If it is dry 
+then you can leave the incision open to the air.  Once the 
+incision is completely dry (usually ___ days after the 
+operation) you may take a shower. Do not soak the incision in a 
+bath or pool.  If the incision starts draining at anytime after 
+surgery, do not get the incision wet. Cover it with a sterile 
+dressing.  Call the office. 
+
+-You should resume taking your normal home medications.
+
+-You have also been given Additional Medications to control 
+your pain.  Please allow 72 hours for refill of narcotic 
+prescriptions, so please plan ahead.  You can either have them 
+mailed to your home or pick them up at the clinic located on 
+___ 2.  We are not allowed to call in or fax narcotic 
+prescriptions (oxycontin, oxycodone, percocet) to your pharmacy. 
+ In addition, we are only allowed to write for pain medications 
+for 90 days from the date of surgery.
+
+ 
+
+###RESPONSE: operation {Surgical procedure}, Lumbar Decompression {Decompression of lumbar spine}, Fusion {Lumbar spinal fusion}, operation {Surgical procedure}, Activity {Functional activity education}, Rehabilitation/ Physical Therapy {Physical rehabilitation therapy procedure}, Diet {Dietary finding}, healthy diet {Healthy diet}, constipation {Constipation}, surgery {Surgical procedure}, medication {Administration of drug or medicament}, Brace {Application of back brace}, sitting {Sitting position}, lying in bed {Lying in bed}, Wound Care {Wound treatment education}, dressing {Application of dressing}, incision {Surgical incision wound}, draining {Wound discharge}, sterile dressing {Application of dressing, sterile}, incision {Surgical incision wound}, incision {Surgical incision wound}, operation {Surgical procedure}, soak {Soak}, incision {Surgical incision wound}, incision {Surgical incision wound}, draining {Wound discharge}, surgery {Surgical procedure}, incision {Surgical incision wound}, sterile 
+dressing {Application of dressing, sterile}, medications {Administration of drug or medicament}, pain {Pain}, prescriptions {Prescription}, prescriptions {Prescription}, pain medications {Administration of analgesic}, surgery {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: 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
+ 
+Major Surgical or Invasive Procedure:
+NONE
+ 
+
+###RESPONSE: Dyspnea {Dyspnea}"
+"###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 ___ man with multiple medical problems 
+most notable for HTN, COPD, HFpEF, Afib on Coumadin who presents 
+with dyspnea. Of note, the patient was discharged on ___ 
+following treatment for community acquired pneumonia. The 
+patient was found to have RML consolidation, initially treated 
+with IV CTX and Azithromycin and transitioned to Levofloxacin x7 
+day total course (last day ___.
+
+Patient complained of increasing dyspnea. EMS called, patient 
+was not initially hypoxic but hypertensive SBP 210s, patient 
+given nitro spray x3 and started on BiPAP. Patient brought to 
+___ ED. In the ED, initial vitals:  T 97.5 HR 89 BP 107/67 RR 
+19 SpO2 100% cpap. Exam notable for respiratory distress and 
+increased work of breathing. No evidence of JVD ___ edema. 
+Initial labs notable for lactate 1.3 and VBG pH 7.29 pCO2 66 pO2 
+36. The patient was given Albuterol/Ipratropium Nebs and 
+Methylpred 125 mg IV x1.
+
+On arrival to the MICU,  ___ y/o ___ man with 
+multiple medical problems most notable for HTN, COPD, HFpEF, 
+Afib on Coumadin who presents with dyspnea. Of note, the patient 
+was discharged on ___ following treatment for community 
+acquired pneumonia. The patient was found to have RML 
+consolidation, initially treated with IV CTX and Azithromycin 
+and transitioned to Levofloxacin x7 day total course (last day 
+___.
+
+ 
+
+###RESPONSE: problems {Problem}, HTN {Hypertensive disorder, systemic arterial}, COPD {Chronic obstructive lung disease}, HFpEF {Heart failure with normal ejection fraction}, Afib {Atrial fibrillation}, Coumadin {Anticoagulant therapy}, dyspnea {Dyspnea}, community acquired pneumonia {Community acquired pneumonia}, RML {Right middle zone pneumonia}, consolidation {Consolidation}, IV {Administration of drug or medicament via intravenous route}, dyspnea {Dyspnea}, hypoxic {Hypoxia}, hypertensive {Finding of increased blood pressure}, BiPAP {Bilevel positive airway pressure titration}, vitals {Vital signs finding}, HR {Finding of heart rate}, BP {Blood pressure finding}, RR {Finding of rate of respiration}, cpap {Continuous positive airway pressure ventilation treatment}, respiratory distress {Respiratory distress}, No evidence {No abnormality detected}, JVD {Jugular venous engorgement}, edema {Edema}, IV {Administration of drug or medicament via intravenous route}, problems {Problem}, HTN {Hypertensive disorder, systemic arterial}, COPD {Chronic obstructive lung disease}, HFpEF {Heart failure with normal ejection fraction}, Afib {Atrial fibrillation}, Coumadin {Anticoagulant therapy}, dyspnea {Dyspnea}, community 
+acquired pneumonia {Community acquired pneumonia}, RML {Right middle zone pneumonia}, consolidation {Consolidation}, IV {Administration of drug or medicament via intravenous 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: Past Medical History:
+- Hyperlipidemia
+- Hypertension   
+- COPD  
+- CHF  
+- Atrial fibrillation (CHADS=3)  
+- Gout   
+ 
+
+###RESPONSE: Hyperlipidemia {Hyperlipidemia}, Hypertension {Hypertensive disorder, systemic arterial}, COPD {Chronic obstructive lung disease}, CHF {Congestive heart failure}, Atrial fibrillation {Atrial fibrillation}, Gout {Inflammatory disorder due to increased blood urate level}"
+"###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:
+No cardiac disease, HTN, DM in family.
+ 
+
+###RESPONSE: cardiac disease {Heart disease}, HTN {Hypertensive disorder, systemic arterial}, DM {Diabetes mellitus}"
+"###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-  T 97.9 BP138/67 HR78 RR20 SaO2 98RA
+GENERAL: Alert, oriented, no acute distress  
+HEENT: Sclera anicteric, MMM, oropharynx clear  
+NECK: supple, JVP not elevated, no LAD  
+LUNGS: Clear to auscultation bilaterally, no wheezes, rales, 
+rhonchi  
+CV: Regular rate and rhythm, normal S1 S2, no murmurs, rubs, 
+gallops  
+ABD: soft, non-tender, non-distended, bowel sounds present, no 
+rebound tenderness or guarding, no organomegaly  
+EXT: Warm, well perfused, 2+ pulses, no clubbing, cyanosis or 
+edema
+  
+ON DISCHARGE:
+=============
+Vitals- T 97.7 Tmax98.1 BP 126-148/64-87 HR ___ RR ___ 98% 
+RA
+General- Alert, oriented, no acute distress, seated in chair at 
+bedside  
+HEENT- Sclera anicteric, MMM, oropharynx clear  
+Neck- supple, JVP not elevated, no LAD  
+Lungs- Minimal wheezes diffusely, decreased breath sounds at 
+bases
+CV- Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, 
+gallops  
+Abdomen- soft, non-tender, non-distended, bowel sounds present, 
+no rebound tenderness or guarding, no organomegaly  
+Ext- warm, well perfused, 2+ pulses, no clubbing, cyanosis or 
+edema  
+Neuro- Moving all 4 limbs without focal neuro deficits
+ 
+
+###RESPONSE: Vitals {Vital signs finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, SaO2 {Finding of oxygen saturation}, RA {Breathing room air}, GENERAL {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, distress {Distress}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, MMM {Moist oral mucosa}, oropharynx clear {Pharynx normal}, NECK {Physical examination procedure}, supple {Normal movement of neck}, JVP not elevated {Normal jugular venous pressure}, LAD {Lymphadenopathy}, LUNGS {Examination of respiratory system}, Clear to auscultation bilaterally {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, rhonchi {Wheeze - rhonchi}, 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<}, murmurs {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, ABD {Examination of abdomen}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, bowel sounds present {Normal bowel sounds}, rebound {Rebound tenderness}, tenderness {Tenderness}, guarding {Abdominal guarding}, organomegaly {Abdominal organomegaly}, EXT {Examination of limb}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, 2+ pulses {Peripheral pulses normal}, clubbing {Clubbing}, cyanosis {Cyanosis}, edema {Edema}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, RA {Breathing room air}, Alert {Mentally alert}, oriented {Oriented to person}, distress {Distress}, seated {Sitting position}, Sclera anicteric {White sclera}, MMM {Moist oral mucosa}, oropharynx clear {Pharynx normal}, Neck- supple {Normal movement of neck}, JVP not elevated {Normal jugular venous pressure}, LAD {Lymphadenopathy}, wheezes {Wheezing}, decreased breath sounds {Decreased breath sounds}, bases {Structure of base of lung}, Regular rate and rhythm {Normal heart rate}, normal S1 + S2 {Heart sounds normal}, murmurs {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, Abdomen- soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, bowel sounds present {Normal bowel sounds}, rebound tenderness {Rebound tenderness}, guarding {Abdominal guarding}, organomegaly {Abdominal organomegaly}, warm {Warm skin}, well perfused {Normal tissue perfusion}, 2+ pulses {Peripheral pulses normal}, clubbing {Clubbing}, cyanosis {Cyanosis}, edema {Edema}, Moving all 4 limbs {Does move all four limbs}, neuro deficits {Neurological deficit}"
+"###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:
+ON ADMISSION:
+=============
+___ 09:24PM BLOOD WBC-9.5 RBC-5.11 Hgb-10.9* Hct-35.7* 
+MCV-70* MCH-21.3* MCHC-30.5* RDW-17.9* RDWSD-42.6 Plt ___
+___ 09:24PM BLOOD Neuts-55.6 ___ Monos-9.8 Eos-3.5 
+Baso-0.7 Im ___ AbsNeut-5.25 AbsLymp-2.85 AbsMono-0.93* 
+AbsEos-0.33 AbsBaso-0.07
+___ 09:24PM BLOOD ___ PTT-37.6* ___
+___ 09:24PM BLOOD Plt ___
+___ 09:24PM BLOOD Glucose-138* UreaN-16 Creat-1.3* Na-137 
+K-3.9 Cl-96 HCO3-28 AnGap-17
+___ 09:24PM BLOOD ALT-14 AST-24 AlkPhos-112 TotBili-0.3
+___ 09:24PM BLOOD proBNP-1603*
+___ 09:24PM BLOOD cTropnT-<0.01
+___ 02:53PM BLOOD CK-MB-3 cTropnT-0.03*
+___ 09:24PM BLOOD Albumin-4.1
+___ 09:28PM BLOOD ___ pO2-36* pCO2-66* pH-7.29* 
+calTCO2-33* Base XS-2
+___ 09:28PM BLOOD Lactate-1.3
+
+STUDIES AND IMAGING
+___ PORTABLE CXR
+Resolved pneumonia.  Limited evaluation of the lung apices.  No 
+convincing 
+evidence for pneumonia or edema. 
+
+ON DISCHARGE:
+=============
+___ 06:45AM BLOOD WBC-10.0 RBC-4.89 Hgb-10.4* Hct-33.5* 
+MCV-69* MCH-21.3* MCHC-31.0* RDW-18.0* RDWSD-41.5 Plt ___
+___ 06:45AM BLOOD Plt ___
+___ 06:45AM BLOOD Glucose-116* UreaN-23* Creat-1.0 Na-136 
+K-3.8 Cl-95* HCO3-33* AnGap-12
+___ 06:45AM BLOOD Calcium-9.1 Phos-3.1 Mg-1.7
+___ 07:45AM BLOOD Lactate-2.___ old ___ man, ___'s Witness, with dCHF, HTN, 
+COPD, AF on coumadin p/w dyspnea, without pain. 
+
+MICU COURSE:
+============
+# Hypercarbic respiratory failure. Pt admitted after course of 
+treatment for CAP with increased dyspnea.  In the the MICU, put 
+on BiPAP, PEEP8 FiO2 50% on arrival, breathing comfortably. 
+Received ipratropium/albuterol nebs x3, methylprednisolone in 
+the ED. Given the findings of the chest X-ray showing 
+hyperinflated lungs, there was an initial concern is for COPD 
+exacerbation. Patient started on standing duonebs, prn 
+albuterol, azithromycin: 500mg x 1, 250mg x 4 days and 
+prednisone 40 mg daily for five day course.  However, on ___ 
+lactate noted to be uptrending from 3.4 to 5.5 despite fluids 
+and IV thiamine.  CXR at this time showed RLL consolidation, 
+started Vanc/Cefepime for ___ vs aspiration PNA. Speech/swallow 
+eval was ordered but no frank aspiration noted at bedside.  Of 
+note, he was going to be called out to the medical floor on 
+___ but lactate persistently elevated to 3's. Given no other 
+signs of hypoperfusion, ICU team attributed his elevated lactate 
+to frequent nebs.  
+
+FLOOR COURSE:
+=============
+#Acute COPD exacerbation: Continued treatment for ___ and COPD 
+exacerbation with 7 day course of Levofloxacin (first day ___, 
+last day ___ and 5 days of prednisone (first day ___, last 
+day ___. BNP was at his baseline at roughly 1600. Patient was 
+on standing duonebs and albuterol PRN.
+
+#Leukocytosis: Initially elevated then improved to 10 on ___. 
+Likely secondary to prednisone.
+
+#Acute Renal Failure: Creatinine initially 1.3 and held home 
+bumetanide. Creatinine down to 1.0 on ___.
+
+CHRONIC ISSUES  
+#dCHF: Creatinine initially 1.3 and held home bumetanide. 
+Restarted home bumetanide 3.5mg daily, clinically appears 
+euvolemic on exam.
+
+#HTN: Continued carvedilol, valsartan, diltiazem
+  
+#AF: Rate controlled, continued home diltiazem and carvedilol. 
+Warfarin held for INR 3.4 on ___. 
+
+#Gout: Continued allopurinol.
+
+#Anemia:  Microcytic anemia with low iron in ___ gave 1 
+dose ferric gluconate here. Can work up further as outpatient if 
+within patients goals of care.
+
+***TRANSITIONAL ISSUES:***
+- Continue Levofloxacin 750mg PO QDay until last day ___
+- Warfarin held for supratherapeutic INR (INR 3.4 on ___, INR 
+needs to be monitored and Warfarin restarted accordingly
+- Consider anemia work up as outpatient
+ 
+
+###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}, Monos {Monocyte count}, Eos {Eosinophil count}, PTT {Partial thromboplastin time, activated}, BLOOD 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}, proBNP {N-terminal pro-brain natriuretic peptide measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, Albumin {Albumin measurement}, pH {pH measurement}, CXR {Plain chest X-ray}, Resolved {Problem resolved}, pneumonia {Pneumonia}, evaluation {Evaluation procedure}, lung apices {Structure of apex of lung}, pneumonia {Pneumonia}, edema {Edema}, 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}, BLOOD 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}, dCHF {Chronic diastolic heart failure}, HTN {Hypertensive disorder, systemic arterial}, COPD {Chronic obstructive lung disease}, AF {Atrial fibrillation}, coumadin {Anticoagulant therapy}, dyspnea {Dyspnea}, without pain {No present pain}, Hypercarbic respiratory failure {Hypercapnic respiratory failure}, CAP {Community acquired pneumonia}, dyspnea {Dyspnea}, BiPAP {Bilevel positive airway pressure titration}, breathing comfortably {Breathing easily}, chest X-ray {Plain chest X-ray}, hyperinflated {Chest over-expanded}, COPD 
+exacerbation {Acute exacerbation of chronic obstructive airways disease}, fluids {Administration of fluid therapy}, IV {Administration of drug or medicament via intravenous route}, CXR {Plain chest X-ray}, RLL {Structure of lower lobe of right lung}, consolidation {Consolidation}, aspiration PNA {Aspiration pneumonia}, Speech/swallow 
+eval {Evaluation of oral and pharyngeal swallowing function}, aspiration {Pulmonary aspiration}, signs {Sign}, Acute COPD exacerbation {Acute exacerbation of chronic obstructive airways disease}, COPD 
+exacerbation {Acute exacerbation of chronic obstructive airways disease}, BNP {Brain natriuretic peptide measurement}, baseline {Baseline state}, Leukocytosis {Leukocytosis}, improved {Patient's condition improved}, Acute Renal Failure {Acute kidney injury}, Creatinine {Creatinine measurement}, Creatinine {Creatinine measurement}, CHRONIC ISSUES {Chronic disease}, dCHF {Chronic diastolic heart failure}, Creatinine {Creatinine measurement}, euvolemic {Normal blood volume}, exam {Physical examination procedure}, HTN {Hypertensive disorder, systemic arterial}, AF {Atrial fibrillation}, Gout {Inflammatory disorder due to increased blood urate level}, Anemia {Anemia}, Microcytic anemia {Microcytic anemia}, work up {Evaluation procedure}, anemia {Anemia}, work up {Evaluation 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:
+The Preadmission Medication list is accurate and complete.
+1. Acetaminophen 500 mg PO Q8H:PRN pain 
+2. albuterol sulfate 2.5 /3 mL (0.083 %) INHALATION BID:PRN 
+shortness of breath 
+3. Allopurinol ___ mg PO DAILY 
+4. Benzonatate 100 mg PO TID 
+5. Bumetanide 3.5 mg PO DAILY 
+6. Carvedilol 6.25 mg PO BID 
+7. Diltiazem Extended-Release 120 mg PO DAILY 
+8. Docusate Sodium 200 mg PO BID 
+9. Fluticasone Propionate 110mcg 2 PUFF IH BID 
+10. Ipratropium Bromide Neb 1 NEB IH BID 
+11. Senna 8.6 mg PO BID 
+12. Valsartan 40 mg PO BID 
+13. Warfarin 4 mg PO DAILY16 
+
+ 
+Discharge Medications:
+1. Acetaminophen 500 mg PO Q8H:PRN pain 
+2. albuterol sulfate 2.5 /3 mL (0.083 %) INHALATION BID:PRN 
+shortness of breath 
+3. Allopurinol ___ mg PO DAILY 
+4. Benzonatate 100 mg PO TID 
+5. Bumetanide 3.5 mg PO DAILY 
+6. Carvedilol 6.25 mg PO BID 
+7. Diltiazem Extended-Release 120 mg PO DAILY 
+8. Docusate Sodium 200 mg PO BID 
+9. Fluticasone Propionate 110mcg 2 PUFF IH BID 
+10. Senna 8.6 mg PO BID 
+11. Valsartan 40 mg PO BID 
+12. Ipratropium Bromide Neb 1 NEB IH BID 
+13. Levofloxacin 750 mg PO DAILY 
+RX *levofloxacin 750 mg 1 tablet(s) by mouth once a day Disp #*2 
+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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Primary:
+Hypercapnia Respiratory Failure
+COPD exacerbation
+___
+
+Secondary:
+___
+HTN
+Atrial fibrillation
+Gout
+Anemia
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, Hypercapnia Respiratory Failure {Hypercapnic respiratory failure}, COPD exacerbation {Acute exacerbation of chronic obstructive airways disease}, HTN {Hypertensive disorder, systemic arterial}, Atrial fibrillation {Atrial fibrillation}, Gout {Inflammatory disorder due to increased blood urate level}, Anemia {Anemia}, Mental Status {Neurological mental status determination}, Alert {Mentally alert}, 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 Mr. ___,
+
+You were admitted to ___ on ___ because you were having 
+trouble breathing. We found that you were having a severe 
+exacerbation of your COPD as well as pneumonia. We treated you 
+with antibiotics and steroids and your breathing improved. You 
+were also found to have an acute injury of the kidneys, but we 
+gave you fluids and your kidneys recovered.
+
+It was a pleasure taking care of you!
+-Your BI___ team
+ 
+
+###RESPONSE: trouble breathing {Difficulty breathing}, COPD {Chronic obstructive lung disease}, pneumonia {Pneumonia}, antibiotics {Antibiotic therapy}, steroids {Steroid therapy}, improved {Patient's condition improved}, injury {Traumatic or non-traumatic injury}, kidneys {Kidney structure}, fluids {Administration of fluid therapy}, kidneys recovered {Normal renal function}"
+"###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: 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:
+Right non-healing foot ulcer
+ 
+Major Surgical or Invasive Procedure:
+Right lower extremity Angiogram with stent placement to the 
+distal SFA/popliteal artery.
+
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, healing {Structure resulting from tissue repair process}, foot ulcer {Ulcer of foot}, Right lower extremity Angiogram {Angiography of artery of right lower limb}, stent placement {Placement of stent}, SFA {Structure of superficial femoral artery}, popliteal artery {Structure of popliteal artery}"
+"###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. ___ presents with chronic right
+calcaneal ulcer. It has been present for approximately 6 months.
+She also reports calf pain on ambulation to suggest 
+claudication. Her foot ulcer has been followed by podiatry.  She 
+presents for a RLE angiogram for further evaluation and possible 
+intervention of RLE peripheral vascular disease.
+
+ 
+
+###RESPONSE: chronic right
+calcaneal ulcer {Chronic ulcer of right heel}, calf pain {Pain in calf}, ambulation {Pain aggravated by walking}, claudication {Intermittent claudication}, foot ulcer {Ulcer of foot}, RLE angiogram {Angiography of artery of right lower limb}, evaluation {Evaluation procedure}, RLE {Structure of right lower limb}, peripheral vascular disease {Peripheral vascular 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:
+- CAD, s/p stent ___
+- Non-healing foot wound
+- Diabetes Mellitus , type II 
+- Hypertension  
+- Hyperlipidemia
+- anxiety
+ 
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}, stent {Insertion of arterial stent}, Non-healing foot wound {Chronic ulcer of right foot}, Diabetes Mellitus , type II {Diabetes mellitus type 2}, Hypertension {Hypertensive disorder, systemic arterial}, Hyperlipidemia {Hyperlipidemia}, anxiety {Anxiety}"
+"###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:
+significant for CAD in father and diabetes mellitis, type II in 
+mother
+
+ 
+Physical ___:
+Vital Signs: 98.3  79  150/79  18  98%/RA
+General: alert and oriented x 3, lying in bed in NAD
+HEENT: atraumatic, skin anicteric, MMM, no lymphadenopathy 
+appreciated
+CV: RRR
+Pulm: breathing unlabored
+Abd: Soft, NT, ND
+Left groin puncture site: well approximated, soft, no 
+ecchymosis, no drainage
+Extremities: 
+Pulses: (___):
+R: P/ /D/faintly palpable L: P/ /D/D
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}, diabetes mellitis, type II {Diabetes mellitus type 2}, Vital Signs {Vital signs finding}, RA {Breathing room air}, General {General examination of patient}, alert {Mentally alert}, oriented x 3 {Oriented to person, time and place}, lying in bed {Lying in bed}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, atraumatic {No injuries apparent}, skin anicteric {Normal color of skin}, MMM {Moist oral mucosa}, lymphadenopathy {Lymphadenopathy}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, Pulm {Examination of respiratory system}, unlabored {Breathing easily}, Abd {Examination of abdomen}, Soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, Left groin {Left inguinal region structure}, puncture site {Insertion site}, well approximated {Wound healing well}, soft {Abdomen soft}, ecchymosis {Ecchymosis}, drainage {Wound discharge}, Extremities {Examination of limb}, Pulses {Normal pulse}, palpable {Finding by palpation}"
+"###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:
+___ 06:02AM BLOOD Hct-31.9*
+___ 06:02AM BLOOD Creat-0.8 K-4.___ with PMH signifcant for CAD, s/p stenting in ___, HTN, DM, 
+and HLD who presents with a 6 month history of a non-healing 
+right heel ulcer. She was admitted on ___ for a right lower 
+extremity angiogram.  As a result of findings, a bare metal 
+stent was placed in  distal SFA/popliteal artery and at the end 
+of the case, patient had dopplerable ___ signals bilaterally.  
+For full details of the surgical procedure please see the 
+dictated operative report. Patient tolerated the procedure well. 
+ She requested to stay over night which provided opportunity for 
+continued monitoring of her groin puncture site. She did have 
+some bleeding overnight which was quickly controlled with manual 
+pressure.  It continues to do well and on exam has no further 
+drainage. Her diet was advanced to a house diet which she 
+tolerated well.  She was able to void on her own QS and was able 
+to ambulate with her walker in her room.
+
+Paient had a bare metal stent placed in her distal SFA which 
+will require a 30 day course of clopidogrel.  Patient reports a 
+history of clopidogrel use since placement of coronary stents in 
+___ but she reports she no longer requires it.  She was advised 
+to follow up with cardiology for further guidance on that.  She 
+should continue her daily ASA 81mg.
+
+Patient has a PMH of Diabetes Mellitus which was stable during 
+admission.  Her home medication, metformin was held and her 
+blood sugars were addressed with SSI.
+
+Patient has a PMH of HTN, which was stable during admission, 
+however, the patient had some confusion about which doses and 
+medications she should be taking.  The PCP office, Dr. ___, 
+as well as the pharmacy, was contacted by this author and 
+several discrepancies were found between patient's recollection 
+and PCPs recommendations.  ___ services have been arranged to 
+follow the patient after discharge and a request was made to 
+have the RN complete a medication reconciliation with the 
+patient at home.  The current medication list from this 
+discharge is complete and accurate per the PCP ___. PCP ___ 
+follow up with ___ findings at patient's follow up appt.
+
+Patient will also need to follow up with vascular surgery for a 
+RLE duplex and office visit in approximately 1 month. Patient 
+should continue to follow up with Podiatry for her right heel 
+ulcer and should off-load the heel to assist with healing.
+
+Patient is discharged home with services in an improved and 
+stable condition.
+
+ 
+ 
+
+###RESPONSE: Hct {Hematocrit determination}, Creat {Creatinine measurement}, K {Blood potassium measurement}, CAD {Coronary arteriosclerosis}, stenting {Insertion of arterial stent}, HTN {Hypertensive disorder, systemic arterial}, DM {Diabetes mellitus}, HLD {Hyperlipidemia}, non-healing 
+right heel ulcer. {Chronic ulcer of right heel}, right lower 
+extremity angiogram {Angiography of artery of right lower limb}, stent was placed {Placement of stent}, SFA/popliteal artery {Femoral and popliteal arteries (combined site)}, surgical procedure {Surgical procedure}, procedure {Procedure}, monitoring {Monitoring procedure}, groin {Inguinal region structure}, puncture site {Insertion site}, bleeding {Bleeding}, pressure {Application of dressing, pressure}, drainage {Wound discharge}, diet was advanced {Advance diet as tolerated}, diet {Dietary regime}, able to void {Normal micturition}, able 
+to ambulate {Able to walk}, walker {Uses zimmer frame}, stent placed {Placement of stent}, SFA {Structure of superficial femoral artery}, placement of coronary stents {Placement of stent in coronary artery}, follow up with cardiology {Follow-up cardiac assessment}, Diabetes Mellitus {Diabetes mellitus}, stable {Patient's condition stable}, blood sugars {Blood sugar management}, SSI {Sliding scale insulin regime}, HTN {Hypertensive disorder, systemic arterial}, stable {Patient's condition stable}, PCP {Primary care management}, PCP {Primary care management}, medication reconciliation {Medication reconciliation}, PCP {Primary care management}, PCP {Primary care management}, vascular surgery {Vascular surgery procedure}, RLE {Structure of right lower limb}, duplex {Duplex ultrasonography of veins of lower limb}, right heel {Structure of right heel}, heel {Heel structure}, healing {Structure resulting from tissue repair process}, improved {Patient's condition improved}, stable {Patient's condition stable}"
+"###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. amLODIPine 5 mg PO DAILY 
+3. Clopidogrel 75 mg PO DAILY 
+4. Dorzolamide 2%/Timolol 0.5% Ophth. 1 DROP BOTH EYES BID 
+5. losartan 50 mg oral DAILY 
+6. MetFORMIN (Glucophage) 1000 mg PO TAKE 500MG IN AM AND 1000MG 
+IN ___ 
+7. Omeprazole 20 mg PO DAILY 
+8. Pravastatin 10 mg PO QPM 
+9. RisperiDONE 1 mg PO DAILY 
+10. Collagenase Ointment 1 Appl TP DAILY 
+
+ 
+Discharge Medications:
+1.  Acetaminophen 1000 mg PO Q8H  
+2.  Clopidogrel 75 mg PO DAILY 
+Take for 30 days only 
+RX *clopidogrel 75 mg 1 tablet(s) by mouth once a day Disp #*30 
+Tablet Refills:*0 
+3.  amLODIPine 5 mg PO DAILY  
+4.  Aspirin 81 mg PO DAILY  
+5.  Collagenase Ointment 1 Appl TP DAILY  
+6.  Dorzolamide 2%/Timolol 0.5% Ophth. 1 DROP BOTH EYES BID  
+7.  Losartan Potassium 50 mg PO DAILY  
+8.  losartan 50 mg oral DAILY  
+9.  MetFORMIN (Glucophage) 1000 mg PO TAKE 500MG IN AM AND 
+1000MG IN ___  
+10.  Omeprazole 20 mg PO DAILY  
+11.  Pravastatin 10 mg PO QPM  
+12.  RisperiDONE 1 mg PO DAILY  
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Primary: Peripheral vascular disease with non-healing ulcer
+
+Secondary: Diabetes Mellitus- type II, Hypertension, 
+hyperlipidemia
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, Peripheral vascular disease {Peripheral vascular disease}, healing ulcer {Healing ulcer}, Diabetes Mellitus- type II {Diabetes mellitus type 2}, Hypertension {Hypertensive disorder, systemic arterial}, hyperlipidemia {Hyperlipidemia}, Mental Status {Neurological mental status determination}, Clear {Normal state of mind}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, interactive {Does communicate}, 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:
+Ms. ___,
+
+It was a pleasure taking care of you at ___ 
+___.  You were admitted to the hospital after a 
+peripheral angiogram.   To do the test, a small puncture was 
+made in one of your arteries.  The puncture site heals on its 
+own: there are no stitches to remove.   You tolerated the 
+procedure well and are now ready to be discharged from the 
+hospital.   Please follow the recommendations below to ensure a 
+speedy and uneventful recovery.
+
+Peripheral Angiography
+Puncture Site Care
+For one week:
+•Do not take a tub bath, go swimming or use a Jacuzzi or hot 
+tub.
+•Use only mild soap and water to gently clean the area around 
+the puncture site. 
+•Gently pat the puncture site dry after showering. 
+•Do not use powders, lotions, or ointments in the area of the 
+puncture site. 
+
+You may remove the bandage and shower the day after the 
+procedure.  You may leave the bandage off. 
+You may have a small bruise around the puncture site.  This is 
+normal and will go away one-two weeks. 
+Activity 
+For the first 48 hours: 
+•Do not drive for 48 hours after the procedure
+For the first week:
+•Do not lift, push , pull or carry anything heavier than 10 
+pounds
+•Do not do any exercises or activity that causes you to hold 
+your breath or bear down with abdominal muscles.   Take care not 
+to put strain on your abdominal muscles when coughing, sneezing, 
+or moving your bowels.
+After one week:
+•You may go back to all your regular activities, including 
+sexual activity.  We suggest you begin your exercise program at 
+half of your usual routine for the first few days.   You may 
+then gradually work back to your full routine.
+Medications:
+Before you leave the hospital, you will be given a list of all 
+the medicine you should take at home.  If a medication that you 
+normally take is not on the list or a medication that you do not 
+take is on the list please discuss it with the team!  
+
+For  Problems or Questions:
+Call ___ in an emergency such as:
+•Sudden, brisk bleeding or swelling at the groin puncture site 
+that does not stop after applying pressure for ___ minutes
+•Bleeding that is associated with nausea, weakness, or 
+fainting.
+Call the vascular surgery office (___) right away if 
+you have any of the following. (Please note that someone is 
+available 24 hours a day, 7 days a week)
+•Swelling, bleeding, drainage, or discomfort at the puncture 
+site that is new or increasing since discharge from the hospital
+•Any change in sensation or temperature in your legs
+•Fever of 101 or greater
+•Any questions or concerns about recovery from your angiogram 
+
+ 
+
+###RESPONSE: angiogram {Angiography}, puncture {Puncture}, arteries {Arterial structure}, puncture site {Insertion site}, stitches {Removal of suture}, procedure {Procedure}, Peripheral Angiography {Angiography of peripheral vascular system}, Puncture Site {Insertion site}, puncture site {Insertion site}, puncture site {Insertion site}, puncture site {Insertion site}, shower {Functional activity education}, procedure {Procedure}, bruise {Contusion}, puncture site {Insertion site}, normal {No abnormality detected}, Activity {Functional activity education}, Do not drive {Recommendation to avoid activity of daily living}, procedure {Procedure}, lift {Does lift}, push {Does push}, pull {Does pull}, carry {Does carry}, exercises {Exercises}, activity {Functional activity education}, abdominal muscles {Entire skeletal muscle of abdomen}, strain {Muscle strain}, abdominal muscles {Entire skeletal muscle of abdomen}, coughing {Cough}, sneezing {Sneezing}, bowels {Intestinal structure}, activities {Functional activity education}, sexual activity {Finding relating to sexual behavior}, exercise {Exercises}, bleeding {Bleeding}, swelling {Swelling}, groin {Inguinal region structure}, puncture site {Insertion site}, pressure {Application of dressing, pressure}, Bleeding {Bleeding}, nausea {Nausea}, weakness {Asthenia}, fainting {Syncope}, Swelling {Swelling}, bleeding {Bleeding}, drainage {Wound discharge}, discomfort {Discomfort}, puncture 
+site {Insertion site}, change in sensation {Altered sensation of skin}, temperature {Body temperature finding}, legs {Lower limb structure}, Fever {Fever}, angiogram {Angiography}"
+"###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: 
+Bactrim / Ampicillin / Sulfa (Sulfonamide Antibiotics) / 
+cefuroxime / Gadolinium-Containing Contrast Media / gluten / 
+nadolol / Pneumovax 23
+ 
+Attending: ___
+ 
+Chief Complaint:
+low grade fevers, abdominal pain  
+ 
+Major Surgical or Invasive Procedure:
+___ line placement
+
+ 
+
+###RESPONSE: Ampicillin {Allergy to ampicillin}, Sulfonamide Antibiotics {Allergy to sulfonamide antibiotic}, 
+cefuroxime {Allergy to cefuroxime}, Contrast Media {Allergy to contrast media}, gluten {Allergy to gluten}, nadolol {Allergy to nadolol}, low grade fevers {Low grade pyrexia}, abdominal pain {Abdominal 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:
+Mrs. ___ is a ___ year-old lady with a history of cirrhosis 
+due to PSC complicated by ascites, encephalopathy and varices 
+being admitted directly from clinic due to low grade fevers and 
+abdominal pain in the setting of recurrent ascending 
+cholangitis.  
+Mrs. ___ has been having chill and low grade fevers 
+(100.0-100.4) with a peak temperature at 100.7 today. She has 
+also been having RUQ discomfort, nausea requiring her to take 
+her prn ondansetron. She also reports some mild arthralgias and 
+fatigue that are typical for her when she has an episode of 
+cholangitis.  
+In clinic , initial vitals were: 98.5 | 114/53 | 84 | 16 | 99%RA 
+ 
+Labs were notable for:  
+*CBC: 5.2 > 10.5/34.0 < 266  
+*Na 140 | K 4.3 | Cl 101 | HCO3 29 | BUN 13 | Cr 0.7  
+*AST 51 | ALT 46 | AP 292 | TB 1.1 | INR 1.2  
+*UA negative  
+*1xBCx drawn  
+Patient was directly admitted to ___ 10.  
+Currently, she complains of mild nausea and abdominal 
+discomfort. Does not feel feverish anymore. Denies recent gluten 
+exposure although household not gluten-free, uses same pots and 
+pans.  
+ 
+
+###RESPONSE: cirrhosis {Cirrhosis of liver}, PSC {Primary sclerosing cholangitis}, ascites {Ascites}, encephalopathy {Disorder of brain}, varices {Esophageal varices}, low grade fevers {Low grade pyrexia}, abdominal pain {Abdominal pain}, ascending 
+cholangitis {Ascending cholangitis}, chill {Chill}, low grade fevers {Low grade pyrexia}, temperature {Body temperature finding}, RUQ {Right upper quadrant pain}, discomfort {Discomfort}, nausea {Nausea}, mild {Symptom mild}, arthralgias {Joint pain}, fatigue {Fatigue}, cholangitis {Cholangitis}, vitals {Vital signs finding}, RA {Breathing room air}, CBC {Complete blood count}, UA {Urinalysis}, negative {No abnormality detected}, mild {Symptom mild}, nausea {Nausea}, abdominal 
+discomfort {Abdominal discomfort}, feel feverish {Feeling feverish}, gluten {Allergy to gluten}"
+"###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:
+PAST MEDICAL HISTORY:
+- Primary sclerosing cholangitis (PSC)
+- History of recurrent cholangitis requiring hospitalization and 
+
+IV antibiotics
+- ___ Laparoscopic cholecystectomy with liver biopsy 
+showing bile ductular proliferation and very focal early, 
+incomplete 
+nodule formation (stage ___ fibrosis)
+- Celiac sprue (diagnosed by biopsy, slightly elevated tTG) 
+- Hypertension
+- GERD  
+- Hypothyroidim  
+- OSA previously on CPAP - negative on repeat testing  
+- (?) IBD (Crohn disease diagnosed at ___ at the age of ___, but 
+questionable diagnosis as no symptoms for over ___
+ 
+
+###RESPONSE: Primary sclerosing cholangitis {Primary sclerosing cholangitis}, recurrent cholangitis {Recurrent cholangitis}, IV antibiotics {Intravenous antibiotic therapy}, Laparoscopic cholecystectomy {Laparoscopic cholecystectomy}, liver biopsy {Biopsy of liver}, nodule {Nodule}, fibrosis {Fibrosis}, Celiac sprue {Celiac disease}, biopsy {Biopsy}, elevated {Measurement finding above reference range}, tTG {Serum tissue transglutaminase level}, Hypertension {Hypertensive disorder, systemic arterial}, GERD {Gastroesophageal reflux disease}, Hypothyroidim {Hypothyroidism}, OSA {Obstructive sleep apnea syndrome}, on CPAP {Dependence on continuous positive airway pressure ventilation}, negative {No abnormality detected}, IBD {Inflammatory bowel disease}, Crohn disease {Crohn's 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: 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:
+Daughter has ___ disease. The patient denies a history of 
+premature cardiac disease such as MI, arrhythmia or sudden 
+cardiac death. No history of liver disease. Sister with 
+endometrial cancer and thyroid condition. Other sister and a 
+brother with thyroid condition. Father with CAD, DM. Mother with 
+thyroid disease and peritoneal cancer.
+ 
+
+###RESPONSE: cardiac disease {Heart disease}, MI {Myocardial infarction}, arrhythmia {Cardiac arrhythmia}, sudden 
+cardiac death {Sudden cardiac death}, liver disease {Disorder of liver}, endometrial cancer {Endometrial carcinoma}, thyroid condition {Disorder of thyroid gland}, thyroid condition {Disorder of thyroid gland}, CAD {Coronary arteriosclerosis}, DM {Diabetes mellitus}, thyroid disease {Disorder of thyroid gland}, peritoneal cancer {Malignant tumor of peritoneum}"
+"###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 EXAM: 
+===============
+VS: 98.7 | 108/60 | 76 | 18 | 98%RA  
+General: Well-appearing, alert and oriented, no acute distress  
+HEENT: No scleral icterus or conjunctival pallor, MMM  
+Neck: No JVD, no LAD  
+CV: RRR, no murmurs/rubs/gallops  
+Lungs: Clear to auscultation bilaterally  
+Abdomen: non-distended, soft, mild tenderness in RUQ, no rebound 
+ 
+GU: no Foley  
+Ext: WWP, 1+ bilateral lower extremity edema  
+Neuro: AOx3, no asterixis, fluent speech, no focal deficits  
+Skin: Tanned skin, no lesions  
+
+DISCHARGE EXAM:
+===============
+VS: 98.6 tm: 98.8 67 (64-72) 101/51 (95-108/46-58) 18 100RA  
+General: Well-appearing, alert and oriented, no acute distress  
+HEENT: No scleral icterus or conjunctival pallor, MMM  
+Neck: No JVD, no LAD  
+CV: RRR, ___ systolic ejection murmur, no rubs/gallops  
+Lungs: Clear to auscultation bilaterally  
+Abdomen: non-distended, soft, mild tenderness in RUQ, no rebound 
+ 
+GU: no Foley  
+Ext: WWP, 1+ bilateral lower extremity edema  
+Neuro: AOx3 fluent speech, no focal deficits  
+Skin: Tanned skin, no lesions 
+ 
+
+###RESPONSE: VS {Vital signs finding}, RA {Breathing room air}, General {General examination of patient}, Well-appearing {Well cared for appearance}, alert {Mentally alert}, oriented {Orientated}, distress {Distress}, HEENT {Physical examination procedure}, scleral icterus {Scleral icterus}, conjunctival pallor {Pale conjunctiva}, MMM {Moist oral mucosa}, Neck {Physical examination procedure}, JVD {Jugular venous engorgement}, LAD {Lymphadenopathy}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, murmurs {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, Lungs {Examination of respiratory system}, Clear to auscultation bilaterally {Normal breath sounds}, Abdomen {Examination of abdomen}, non-distended {Normal abdominal contour}, soft {Abdomen soft}, mild {Symptom mild}, tenderness {Tenderness}, RUQ {Structure of right upper quadrant of abdomen}, rebound {Rebound tenderness}, GU {Examination of genitourinary system}, Foley {Urinary catheter in situ}, Ext {Examination of limb}, WWP {Normal tissue perfusion}, edema {Edema}, Neuro {Neurological examination}, AOx3 {Oriented to person, time and place}, asterixis {Asterixis}, fluent speech {Finding of fluency of speech}, no focal deficits {Normal nervous system function}, Skin {Examination of skin}, lesions {Lesion}, VS {Vital signs finding}, General {General examination of patient}, Well-appearing {Well cared for appearance}, alert {Mentally alert}, oriented {Oriented to person}, distress {Distress}, scleral icterus {Scleral icterus}, conjunctival pallor {Pale conjunctiva}, MMM {Moist oral mucosa}, Neck {Neck structure}, JVD {Jugular venous engorgement}, LAD {Lymphadenopathy}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, systolic ejection murmur {Systolic murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, Lungs {Examination of respiratory system}, Clear to auscultation bilaterally {Normal breath sounds}, Abdomen {Examination of abdomen}, soft {Abdomen soft}, mild {Symptom mild}, tenderness {Tenderness}, RUQ {Structure of right upper quadrant of abdomen}, rebound {Rebound tenderness}, GU {Examination of genitourinary system}, Foley {Urinary catheter in situ}, Ext {Examination of limb}, WWP {Normal tissue perfusion}, bilateral lower extremity edema {Edema of bilateral lower limbs}, Neuro {Neurological examination}, AOx3 {Oriented to person, time and place}, fluent speech {Finding of fluency of speech}, no focal deficits {Normal nervous system function}, Skin {Examination of skin}, 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: Pertinent Results:
+ADMISSION LABS:
+===============
+___ 11:15AM BLOOD WBC-5.2 RBC-3.99 Hgb-10.5* Hct-34.0 
+MCV-85 MCH-26.3 MCHC-30.9* RDW-22.2* RDWSD-68.0* Plt ___
+___ 11:15AM BLOOD Neuts-67.0 Lymphs-12.8* Monos-15.3* 
+Eos-3.9 Baso-0.8 Im ___ AbsNeut-3.45 AbsLymp-0.66* 
+AbsMono-0.79 AbsEos-0.20 AbsBaso-0.04
+___ 11:15AM BLOOD ___
+___ 11:15AM BLOOD UreaN-13 Creat-0.7 Na-140 K-4.3 Cl-101 
+HCO3-29 AnGap-14
+___ 11:15AM BLOOD ALT-46* AST-51* AlkPhos-292* TotBili-1.1
+___ 11:15AM BLOOD Albumin-4.2
+___ 11:15AM BLOOD AFP-2.0
+
+MICROBIOLOGY: 
+==============
+URINE CULTURE (Final ___:    NO GROWTH. 
+
+Blood culture x3: PENDING, NGTD
+
+DISCHARGE LABS:
+===============
+
+___ 06:24AM BLOOD WBC-3.4* RBC-3.57* Hgb-9.5* Hct-31.2* 
+MCV-87 MCH-26.6 MCHC-30.4* RDW-22.3* RDWSD-71.2* Plt ___
+___ 06:24AM BLOOD ___ PTT-39.9* ___
+___ 06:24AM BLOOD Glucose-119* UreaN-9 Creat-0.5 Na-141 
+K-4.2 Cl-107 HCO3-26 AnGap-12
+___ 06:24AM BLOOD ALT-31 AST-30 AlkPhos-257* TotBili-0.6
+___ 06:24AM BLOOD Calcium-8.9 Phos-3.9 Mg-2.0
+ 
+
+###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}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, AnGap {Anion gap measurement}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, Albumin {Albumin measurement}, MICROBIOLOGY {Microbiology}, URINE CULTURE {Urine culture}, Blood culture {Blood culture}, 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}, 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}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total 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: Brief Hospital Course:
+Mrs. ___ is a ___ year-old woman with a history of cirrhosis 
+due to PSC complicated by ascites, encephalopathy and varices 
+being admitted directly from clinic due to low grade fevers and 
+abdominal pain in the setting of history of recurrent ascending 
+cholangitis.  
+
+#FEVERS/RUQ tenderness: Low grade fever at home with RUQ 
+discomfort and associated nausea. On presentation she was 
+afebrile and hemodynamically stable. She was found to have no 
+leukocytosis and her LFTS were at baseline, AST: 51, ALT: 46, 
+AP: 292, Tb: 1.1.  Lipase was WNL. MRCP was not done given her 
+recent unchanged MRCP in ___.  Given her history of recurrent 
+ascending cholangitis with resistant organisms, treatment for 
+presumed cholangitis was initiated.  Blood cultures were sent, 
+with no growth to date. Hepatology was consulted and she was 
+initially started on meropenem per their recommendations. She 
+was then switched to cefepime/flagyl which she tolerated well. 
+Her pain and nausea improved and she continued to be afebrile 
+and hemodynamically stable.  A picc line was placed and she 
+ultimately was switched to ertapenem on discharge for a total 14 
+day course. 
+
+#PSC: There was low concern for new stenotic lesion given recent 
+stable MRCP in ___. She was continued on her home ursodiol, 
+cholestyramine and hydroxyzine.   
+
+# CIRRHOSIS: Due to PSC. Childs class B. MELD 9. She was 
+continued on rifaximin. Her home diuretics were held in the 
+setting of infection. They were not resumed on discharge given 
+soft blood pressures in the ___ range.
+* Transplant status: unclear  
+* Hepatic encephalopathy: Cont rifaximin, only takes lactulose 
+prn  
+* Fluid status: holding diuretics  
+* h/o SBP: no hx, protein 0.9
+* Variceal status: 2x grade II varices s/p banding  
+
+TRANSITIONAL ISSUES:
+=====================
+- Lasix and spironolactone were held in the setting of 
+infection, blood pressures lower than baseline thoughout 
+admission without evidence of volume overload, please 
+re-evaluate at follow-up appointment 
+- f/u blood cx
+- receiving ertapenem 1G daily via ___ line with ___ services, 
+will need PICC removed after last day of antibiotics on ___
+ 
+
+###RESPONSE: cirrhosis {Cirrhosis of liver}, PSC {Primary sclerosing cholangitis}, ascites {Ascites}, encephalopathy {Disorder of brain}, varices {Esophageal varices}, low grade fevers {Low grade pyrexia}, abdominal pain {Abdominal pain}, ascending 
+cholangitis {Ascending cholangitis}, FEVERS {Fever}, RUQ tenderness {Tenderness of right upper quadrant of abdomen}, Low grade fever {Low grade pyrexia}, RUQ {Right upper quadrant pain}, discomfort {Discomfort}, nausea {Nausea}, afebrile {Temperature normal}, hemodynamically stable {Hemodynamically stable}, leukocytosis {Leukocytosis}, LFTS {Hepatic function panel}, baseline {Baseline state}, AST {Aspartate aminotransferase measurement}, ALT {Alanine aminotransferase measurement}, AP {Alkaline phosphatase measurement}, Tb {Finding of bilirubin level}, Lipase {Serum lipase measurement}, WNL {No abnormality detected}, MRCP {Magnetic resonance cholangiopancreatography}, MRCP {Magnetic resonance cholangiopancreatography}, ascending cholangitis {Ascending cholangitis}, cholangitis {Cholangitis}, Blood cultures {Blood culture}, pain {Abdominal pain}, nausea {Nausea}, improved {Patient's condition improved}, afebrile {Fever}, hemodynamically stable {Hemodynamically stable}, picc line was placed {Percutaneous transluminal insertion of peripherally inserted central catheter}, PSC {Primary sclerosing cholangitis}, stenotic lesion {Stenosis of bile duct}, MRCP {Magnetic resonance cholangiopancreatography}, CIRRHOSIS {Cirrhosis of liver}, PSC {Primary sclerosing cholangitis}, diuretics {Diuretic therapy}, infection {Infectious disease}, soft blood pressures {Low blood pressure}, Hepatic encephalopathy {Hepatic encephalopathy}, diuretics {Diuretic therapy}, SBP {Primary bacterial peritonitis}, varices {Esophageal varices}, banding {Banding}, infection {Infectious disease}, blood pressures lower than baseline {Low blood pressure}, volume overload {Hypervolemia}, blood cx {Blood culture}, PICC {Peripherally inserted central venous catheter in situ}, removed {Removal of catheter}, antibiotics {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: Medications on Admission:
+The Preadmission Medication list is accurate and complete.
+1. Ondansetron 4 mg PO BID:PRN nausea 
+2. Cholestyramine 4 gm PO DAILY 
+3. Escitalopram Oxalate 20 mg PO DAILY 
+4. Furosemide 40 mg PO BID 
+5. HydrOXYzine 50 mg PO QHS:PRN itching 
+6. Lactulose 15 mL PO BID:PRN confusion 
+7. Levothyroxine Sodium 75 mcg PO DAILY 
+8. Omeprazole 40 mg PO DAILY 
+9. Rifaximin 550 mg PO BID 
+10. Spironolactone 100 mg PO BID 
+11. Temazepam 15 mg PO QHS:PRN insomnia 
+12. Ursodiol 300 mg PO TID 
+13. Ferrous Sulfate 325 mg PO DAILY 
+14. Multivitamins 1 TAB PO DAILY 
+
+ 
+Discharge Medications:
+1. Ertapenem Sodium 1 g IV ONCE cholangitis Duration: 1 Dose 
+Continue until last dose on ___.  
+RX *ertapenem [Invanz] 1 gram 1 gram IV daily Disp #*12 Vial 
+Refills:*0
+2. Cholestyramine 4 gm PO DAILY 
+3. Escitalopram Oxalate 20 mg PO DAILY 
+4. HydrOXYzine 50 mg PO QHS:PRN itching 
+5. Lactulose 15 mL PO BID:PRN confusion 
+6. Levothyroxine Sodium 75 mcg PO DAILY 
+7. Multivitamins 1 TAB PO DAILY 
+8. Omeprazole 40 mg PO DAILY 
+9. Rifaximin 550 mg PO BID 
+10. Temazepam 15 mg PO QHS:PRN insomnia 
+11. Ursodiol 300 mg PO TID 
+12. Ferrous Sulfate 325 mg PO DAILY 
+13. Ondansetron 4 mg PO BID:PRN nausea 
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+PRIMARY DIAGNOSIS:
+CHOLANGITIS
+PSC
+
+SECONDARY DIAGNOSIS: 
+Cirrhosis ___ PSC
+recurrent cholangitis 
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, CHOLANGITIS {Cholangitis}, PSC {Primary sclerosing cholangitis}, Cirrhosis {Cirrhosis of liver}, PSC {Primary sclerosing cholangitis}, recurrent cholangitis {Recurrent cholangitis}, Mental Status {Neurological mental status determination}, 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. ___, 
+
+You came into the hospital because you were having low grade 
+fevers and abdominal pain. You were treated with antibiotics for 
+cholangitis and monitored in the hospital. Your pain improved on 
+antibiotics. Your spironolactone and lasix were held because of 
+your infection. You were given a PICC line and arranged to have 
+antibiotics through the PICC line for a total course of 14 days. 
+You were instructed to stop taking your lasix and spironolactone 
+on discharge because your blood pressures have been lower than 
+usual.  The liver clinic will call you with a follow-up 
+appointment with Dr. ___. 
+
+It was a pleasure being involved in your care!
+
+Your ___ Team  
+ 
+
+###RESPONSE: low grade 
+fevers {Low grade pyrexia}, abdominal pain {Abdominal pain}, treated with antibiotics {Antibiotic therapy}, cholangitis {Cholangitis}, pain {Pain}, improved {Patient's condition improved}, antibiotics {Antibiotic therapy}, lasix {Diuretic therapy}, infection {Infectious disease}, PICC line {Percutaneous transluminal insertion of peripherally inserted central catheter}, antibiotics {Antibiotic therapy}, PICC line {Peripherally inserted central venous catheter in situ}, lasix {Diuretic therapy}, blood pressures have been lower {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: 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: 
+Compazine / Tree Nut
+ 
+Attending: ___
+ 
+___ Complaint:
+SOB, cough
+ 
+Major Surgical or Invasive Procedure:
+none
+
+ 
+
+###RESPONSE: Compazine {Allergy to prochlorperazine}, Tree Nut {Allergy to tree nut}, SOB {Dyspnea}, cough {Cough}"
+"###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:
+___ hx of COPD, s/p trach x2, multiple intubations for resp 
+failure who presents with worsening SOB for over a week. Pt had 
+been completing prednisone taper however the past several days 
+she noted increas in cough and sputum production. Also reports 
+chest tightness which began yesterday which she describes as 
+pleuritic, non-radiating and non-exertional States she has had 
+similar symptoms in past with severe COPD flares. Denies 
+abdominal pain or emesis although states she did have decreased 
+appetite and nausea yesterday. No dysuria. States she was not 
+having known fevers at home although does not appear to have 
+been taking temperature. Did take a dose of PO levo today as 
+well. Sick contacts include her mother who is currently 
+hospitalized with a COPD exacerbation and possible pna. Had been 
+using xopenex nebs at home.
+
+On arrival to the ED, VS: 102.0 ___ 28 100% 15L NRB. 
+After nebs, VS: HR 160s 220/100. Pt started on nitroglycerin 
+gtt. Also received CTX,  azithro and 125 mg methylprednisone. Pt 
+required ICU transfer given nonrebreather requirement.
+ 
+On the floor, VS: 98.7, 133/87, HR 119, 96% on 2L NC. Pt states 
+her breathing is much improved. She does now have a headache. 
+Chest tightness still present although has improved as 
+respiratory status improving.
+ 
+Review of systems:  
+(+) Per HPI  
+(-) Denies recent weight loss or gain.  Denies chest pain, chest 
+pressure, palpitations, or weakness. Denies nausea, vomiting, 
+diarrhea, constipation, abdominal pain, or changes in bowel 
+habits. Denies dysuria, frequency, or urgency. Denies 
+arthralgias or myalgias. Denies rashes or skin changes.  
+
+ 
+
+###RESPONSE: COPD {Chronic obstructive lung disease}, trach {Exteriorization of trachea}, intubations {Insertion of endotracheal tube}, resp 
+failure {Respiratory failure}, worsening {Patient's condition worsened}, SOB {Dyspnea}, prednisone {Steroid therapy}, taper {Medication decreased}, cough {Cough}, sputum production {Sputum finding}, chest tightness {Tight chest}, pleuritic {Pleuritic pain}, radiating {Radiating pain}, exertional {Chest pain on exertion}, severe {Symptom severe}, COPD flares {Acute exacerbation of chronic obstructive airways disease}, abdominal pain {Abdominal pain}, emesis {Vomiting}, decreased 
+appetite {Decrease in appetite}, nausea {Nausea}, dysuria {Dysuria}, fevers {Fever}, taking temperature {Temperature taking}, COPD exacerbation {Acute exacerbation of chronic obstructive airways disease}, VS {Vital signs finding}, NRB {Oxygen administration by mask}, VS {Vital signs finding}, HR {Finding of heart rate}, started {New medication added}, ICU transfer {Patient transfer to intensive care unit}, VS {Vital signs finding}, HR {Finding of heart rate}, 2L NC {Oxygen administration by nasal cannula}, breathing {Difficulty breathing}, improved {Patient's condition improved}, headache {Headache}, Chest tightness {Tight chest}, improved {Patient's condition improved}, respiratory {Respiratory function finding}, improving {Patient's condition improved}, recent weight loss {Recent weight loss}, gain {Recent weight gain}, chest pain {Chest pain}, chest 
+pressure {Tight chest}, palpitations {Palpitations}, weakness {Asthenia}, nausea, vomiting, 
+diarrhea {Nausea, vomiting and diarrhea}, constipation {Constipation}, abdominal pain {Abdominal pain}, changes in bowel 
+habits {Altered bowel function}, 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:
+1. COPD, PFTs in ___ with FEV1 0.30 (13%), FVC 1.02 (34%) and  
+FVC/FEV1 38% - on Home O2 at 3L NC, on chronic steroids, hx of  
+prolonged intubation requiring trach for resp failure in ___,  
+
+___. She was recently taken off the lung transplant list at the 
+ 
+___ due to compression fractures. Has 
+previous history of asthma per OMR  
+2. Hypertension  
+3. Anxiety  
+4. Leukocytosis of unknown etiology with negative BMBx.  
+5. Osteoporosis with compression fractures  
+6. Shoulder pain  
+7. History of positive PPD s/p 6mos of isoniazid  
+8. Mitral valve prolapse  
+9. Obstructive sleep apnea on BiPAP ___ every night)  
+
+ 
+
+###RESPONSE: COPD {Chronic obstructive lung disease}, PFTs {Measurement of respiratory function}, FEV {Finding of forced expired volume}, FVC {Finding of forced vital capacity}, Home O2 {Home oxygen therapy}, 3L NC {Oxygen administration by nasal cannula}, steroids {Steroid therapy}, intubation {Insertion of endotracheal tube}, trach {Exteriorization of trachea}, resp failure {Respiratory failure}, lung transplant {Transplant of lung}, compression fractures {Compression fracture}, asthma {Asthma}, Hypertension {Hypertensive disorder, systemic arterial}, Anxiety {Anxiety}, Leukocytosis {Leukocytosis}, negative {No pathologic diagnosis}, BMBx {Bone marrow sampling}, Osteoporosis {Osteoporosis}, compression fractures {Compression fracture}, Shoulder pain {Shoulder pain}, positive PPD {Mantoux: positive}, Mitral valve prolapse {Mitral valve prolapse}, Obstructive sleep apnea {Obstructive sleep apnea syndrome}, BiPAP {Bilevel positive airway pressure titration}"
+"###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:
+Great uncle had MI in ___, Maternal & Paternal GMs had CVAs in 
+___.
+
+ 
+
+###RESPONSE: CVAs {Cerebrovascular accident}"
+"###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:  
+Vitals:  98.7, 133/87, HR 119, 96% on 2L NC.
+General: Alert, oriented, no acute distress, pursed lips 
+breathing, no notable conversational dyspnea  
+HEENT: Sclera anicteric, dry MM, oropharynx clear  
+Neck: supple, JVP not elevated, no LAD  
+Lungs: decreased breath sounds bilaterally, unable to appreciate 
+wheezing 
+CV: tachy, normal S1 + S2, no murmurs, rubs, gallops  
+Abdomen: soft, non-tender, non-distended, bowel sounds present, 
+no rebound tenderness or guarding, no organomegaly  
+GU: no foley  
+Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or 
+edema 
+
+DISCHARGE PHYSICAL EXAM:
+General: Alert, oriented, no acute distress, pursed lips 
+breathing, no notable conversational dyspnea  
+HEENT: Sclera anicteric, dry MM, oropharynx clear, no dental 
+pain, no evidence of swelling/fullness of floor of mouth, no 
+dilation of whartons duct
+Neck: supple, JVP not elevated, large soft mildly tender left 
+cervical mass, unchanged from prior 
+Lungs: decreased breath sounds bilaterally, unable to appreciate 
+wheezing 
+CV: tachy, normal S1 + S2, no murmurs, rubs, gallops  
+Abdomen: soft, non-tender, non-distended, bowel sounds present, 
+no rebound tenderness or guarding, no organomegaly  
+GU: no foley  
+Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or 
+edema
+
+ 
+
+ 
+
+ 
+
+###RESPONSE: PHYSICAL EXAM {Physical examination procedure}, Vitals {Vital signs finding}, HR {Finding of heart rate}, NC {Normal head}, General {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, no acute {No abnormality detected}, distress {Distress}, pursed lips 
+breathing {Pursed-lip breathing}, dyspnea {Dyspnea}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, dry MM {Mucous membrane dryness}, oropharynx clear {Pharynx normal}, Neck {Physical examination procedure}, supple {Normal movement of neck}, JVP not elevated {Normal jugular venous pressure}, LAD {Lymphadenopathy}, Lungs {Examination of respiratory system}, decreased breath sounds {Decreased breath sounds}, wheezing {Wheezing}, CV {Cardiovascular physical examination}, tachy {Tachycardia}, normal S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, murmurs {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, Abdomen {Examination of abdomen}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, bowel sounds present {Normal bowel sounds}, rebound {Rebound tenderness}, tenderness {Tenderness}, guarding {Abdominal guarding}, organomegaly {Abdominal organomegaly}, GU {Examination of genitourinary system}, foley {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}, General {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, no acute {No abnormality detected}, distress {Distress}, pursed lips 
+breathing {Pursed-lip breathing}, dyspnea {Dyspnea}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, dry MM {Mucous membrane dryness}, oropharynx clear {Pharynx normal}, dental 
+pain {Toothache}, no evidence {No abnormality detected}, swelling {Swelling of oral cavity structure}, floor of mouth {Floor of mouth structure}, dilation of whartons duct {Dilation of Wharton's duct}, Neck {Physical examination procedure}, supple {Normal movement of neck}, JVP not elevated {Normal jugular venous pressure}, soft {Mass of soft tissue}, tender {Tenderness of neck}, left {Structure of left half of neck}, cervical mass {Mass of neck}, Lungs {Examination of respiratory system}, decreased breath sounds {Decreased breath sounds}, wheezing {Wheezing}, CV {Cardiovascular physical examination}, tachy {Tachycardia}, normal S1 + S2 {Heart sounds normal}, murmurs {Heart murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, Abdomen {Examination of abdomen}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, bowel sounds present {Normal bowel sounds}, rebound tenderness {Rebound tenderness}, guarding {Abdominal guarding}, organomegaly {Abdominal organomegaly}, GU {Examination of genitourinary system}, foley {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}"
+"###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:
+___ 09:59PM   TYPE-ART PO2-289* PCO2-53* PH-7.44 TOTAL 
+CO2-37* BASE XS-10 INTUBATED-NOT INTUBA
+___ 09:59PM   O2 SAT-99
+___ 09:43PM   LACTATE-2.4*
+___ 09:35PM   GLUCOSE-138* UREA N-10 CREAT-0.7 SODIUM-136 
+POTASSIUM-4.2 CHLORIDE-95* TOTAL CO2-34* ANION GAP-11
+___ 09:35PM   estGFR-Using this
+___ 09:35PM   cTropnT-<0.01
+___ 09:35PM   CALCIUM-9.3 PHOSPHATE-2.1* MAGNESIUM-1.6
+___ 09:35PM   WBC-16.2*# RBC-4.39 HGB-13.2 HCT-39.9 MCV-91 
+MCH-30.0 MCHC-33.0 RDW-12.7
+___ 09:35PM   NEUTS-86.9* LYMPHS-6.3* MONOS-6.2 EOS-0.4 
+BASOS-0.2
+___ 09:35PM   PLT COUNT-358
+___ 09:35PM   ___ PTT-26.9 ___
+
+MICRO:
+BLOOD CX-NEG X2
+=======
+Final Report 
+PORTABLE CHEST:  ___. 
+  
+HISTORY:  ___ female with respiratory distress.  
+Question pneumonia. 
+  
+COMPARISON:  ___. 
+  
+FINDINGS:  Streaky linear opacities are again seen, similar to 
+prior and may 
+be due to atelectasis.  There is no confluent consolidation.  
+Costophrenic 
+angles are sharp.  The cardiomediastinal silhouette is within 
+normal limits.  
+Rounded calcific density overlying the anterior left seventh rib 
+is compatible 
+with calcification at the costochondral junction.  No acute 
+osseous 
+abnormality is detected. 
+  
+IMPRESSION:  No focal consolidations to suggest pneumonia. 
+
+=======
+
+Final Report CT NECK W/CONTRAST (EG:PAROTIDS) Study Date of 
+___ 1:45 ___
+HISTORY:  History of COPD with shortness of breath and 2new 
+eft-sided tender 
+neck mass.  Rule out infection versus mass. 
+  
+COMPARISON:  Prior neck soft tissue ultrasound from ___. 
+  
+TECHNIQUE:  Routine enhanced MDCT study of the neck was 
+performed with images 
+obtained from the skullbase to the thoracic inlet using 3 mm 
+thick sections.  
+Coronal and sagittal reformations were performed.  
+  
+Total exam DLP:  394 mGy-cm. 
+  
+FINDINGS: 
+  
+Evaluation of the aerodigestive tract demonstrates no exophytic 
+mucosal mass, 
+there is no focal mass effect.  There is mild mucosal thickening 
+of the 
+maxillary sinuses bilaterally and ethmoidal air cells, worse on 
+the left.  
+Evaluation of the cervical lymph chains demonstrate no 
+pathologic 
+lymphadenopathy by imaging criteria.  The thyroid gland is 
+normal.  The left 
+salivary gland appears slightly larger than the left however no 
+focal 
+abnormality is identified.  Adjacent to the left salivary gland 
+however, there 
+is a heterogeneous soft tissue lesion similar in appearance to 
+the left 
+parotid gland, measuring 2 x 2 cm and demonstrating fat density. 
+ This lesion 
+seems to connect to the parotid gland and could correlate to the 
+lesion 
+identified on prior ultrasound.  There appears to be surrounding 
+fat stranding 
+and thickening of the adjacent tissues (5 b: 36, 04:39).  There 
+is however no 
+definite enhancement to suggest abscess formation.  Neck vessels 
+enhance 
+bilaterally without significant stenosis.   
+  
+IMPRESSION: 
+  
+2 x 2 cm heterogeneous soft tissue lesion adjacent to the left 
+salivary gland 
+with apparent connection to the parotid gland, similar in 
+appearance to 
+parotid tissue, demonstrating fatty density and surrounding fat 
+stranding 
+could represent an extension of normal parotid tissue with 
+possible early 
+signs of inflammatory changes, given surrounding fat stranding.  
+However, no 
+definite enhancement is seen to suggest abscess formation. This 
+lesion likely 
+correlates to lesion seen on prior ultrasound. 
+  
+The study and the report were reviewed by the staff radiologist. 
+
+  
+___. ___ 
+___. ___ 
+___: SAT ___ 5:10 ___ 
+
+DISCHARGE LABS:
+
+___ 04:59AM BLOOD WBC-11.4* RBC-4.42 Hgb-13.1 Hct-40.3 
+MCV-91 MCH-29.7 MCHC-32.6 RDW-12.9 Plt ___
+___ 04:59AM BLOOD Glucose-96 UreaN-12 Creat-0.7 Na-135 
+K-3.9 Cl-88* HCO3-41* AnGap-10
+___ 04:59AM BLOOD Calcium-8.9 Phos-3.9 Mg-2.___ hx of COPD, s/p trach x2, multiple intubations for 
+respiratory failure who presents with worsening SOB for over a 
+week, now with cough, increased sputum production and fevers for 
+2 days. Patient was treated for COPD exacerbation
+
+#COPD exacerbation: Patient with history of debilitating COPD, 
+on home oxygen. Patient received nebs, 125 mg methylpred, CTX 
+and azithro in ED with improvement of respiratory status. In the 
+ICU patient was treated with course of azithromycin and 
+Prednisone 60mg daily. Patient with continued improvement in 
+respiratory status with standing Albuterol and Tiotroprium nebs. 
+Plan for ***Prednisone taper for total 2 weeks (down from 60mg x 
+7 days): ___ - ___ => Prednisone 40mg daily; ___ => 
+Prednisone 20mg daily; ___ => Prednisone 10mg daily. 
+Then STOP ___.
+
+# Acute non-suppurative Parotitis: Patient with tender left neck 
+swelling noted on ___, U/S and CT scan with possible early 
+inflamation vs. extension of parotid tissue. No evidence of 
+abcess or stones on imaging and no purulence on exam. Patient 
+received several doses of IV clindamycin and was generally well 
+appearing. Low suspicion of MRSA. Discussed with ENT who 
+reviewed imaging, and agreed patient could be stepped down to PO 
+antibiotics. Discharged on Augmentin 875mg BID x 10 days ending 
+___. Continue sialigogues (i.e. lemon wedges, lozenges every 
+few hours to promote salivation).
+
+#HTN: Pt hypertensive to SBP 220 in ED after receiving nebs. 
+Improved with nitro gtt. Stable (133/87) now on floor. Patient 
+restarted on home dose of Verapamil with improvement in 
+hypertension. Patient should follow up with outpatient PCP for 
+consideration of additional antihypertensive.
+
+#Chest Tightness: Patient reports pleuritic CP which she has had 
+in past during COPD exacerbations. Unlikely cardiac: 
+non-exertional, non-radiating, troponins negative. Pain resolved 
+while inpatient.
+
+#Anxiety: Patient with significant anxiety associated with 
+tachycardia to 130s. Significant improvement with Lorazepam 
+0.5mg q4 hours. Switched to clonazepam at discharge.
+
+#Depression: Continued on home dose Lexapro while inpatient.
+
+TRANSITIONAL ISSUES
+- Patient is MRSA nasal swab positive.
+1) COPD: Patient with end stage lung disease. Discharged to ___ 
+and will require close outpatient follow up.
+2) Hypertension: Patient hypertensive while hospitalized. Please 
+consider addition of second antihypertensive as an outpatient.
+3) Suspected mild Parotitis: Augmentin 875mg BID x 10 days 
+ending ___.
+***Broaden to IV antibiotics, add MRSA coverage, and obtain 
+urgent ENT evaluation if patient has worsening parotitis 
+symptoms including high fevers, purulence, redness tracking down 
+the neck, or Trismus***
+4) Prednisone taper as above.
+
+ 
+
+###RESPONSE: ART {Arterial specimen collection for laboratory test}, PO2 {Oxygen measurement, partial pressure, arterial}, PCO2 {Measurement of arterial partial pressure of carbon dioxide}, PH {pH measurement}, TOTAL 
+CO2 {Blood total carbon dioxide (calculated)}, BASE XS {Delta base, blood}, O2 SAT {Oxygen saturation measurement}, GLUCOSE {Glucose measurement, blood}, UREA N {Blood urea nitrogen measurement}, 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}, cTropnT {Troponin T cardiac measurement}, CALCIUM {Blood calcium measurement}, PHOSPHATE {Phosphate, total measurement}, MAGNESIUM {Blood magnesium 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}, 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}, BASOS {Basophil count}, PLT COUNT {Platelet count}, PTT {Partial thromboplastin time, activated}, BLOOD CX {Blood culture}, NEG {No abnormality detected}, PORTABLE {Portable X-ray}, CHEST {Plain chest X-ray}, respiratory distress {Respiratory distress}, pneumonia {Pneumonia}, opacities {Abnormally opaque structure}, atelectasis {Atelectasis}, consolidation {Lung consolidation}, Costophrenic 
+angles {Structure of costophrenic angle}, cardiomediastinal {Mediastinal structure}, normal {No abnormality detected}, calcific {Pathologic calcification, calcified structure}, density {Abnormally opaque structure}, left {Bone structure of left rib}, seventh rib {Bone structure of seventh rib}, calcification {Pathologic calcification, calcified structure}, costochondral junction {Structure of seventh costochondral junction}, No acute {No abnormality detected}, osseous {Bone structure}, consolidations {Lung consolidation}, pneumonia {Pneumonia}, CT NECK W/CONTRAST {Computed tomography of neck with contrast}, PAROTIDS {Parotid gland structure}, Study {Evaluation procedure}, COPD {Chronic obstructive lung disease}, shortness of breath {Dyspnea}, eft-sided {Structure of left half of neck}, tender {Tenderness of neck}, neck mass {Mass of neck}, Rule out {Evaluation procedure}, infection {Infectious disease}, mass {Mass of body structure}, neck soft tissue ultrasound {Ultrasonography of mass of soft tissue of neck}, CT study of the neck {Computed tomography of neck}, skullbase {Base of skull structure}, thoracic inlet {Structure of thoracic inlet}, Evaluation {Evaluation procedure}, mass {Mass of body structure}, mild {Symptom mild}, mucosal {Mucous membrane structure}, thickening {Increased thickness}, maxillary sinuses {Maxillary sinus structure}, ethmoidal air cells {Ethmoid sinus structure}, worse {Patient's condition worsened}, left {Structure of left half of head}, Evaluation {Evaluation procedure}, cervical lymph chains {Cervical lymph node structure}, no 
+pathologic {No pathologic diagnosis}, lymphadenopathy {Cervical lymphadenopathy}, imaging {Imaging}, thyroid gland {Thyroid structure}, normal {No abnormality detected}, left 
+salivary gland {Structure of left salivary gland}, larger {Increased size}, no 
+focal 
+abnormality {No abnormality detected}, left salivary gland {Structure of left salivary gland}, soft tissue lesion {Soft tissue lesion}, left 
+parotid gland {Structure of left parotid gland}, fat density {Lesion with fat containing (radiolucent) density}, lesion {Lesion}, parotid gland {Parotid gland structure}, lesion {Lesion}, ultrasound {Ultrasonography}, thickening {Increased thickness}, tissues {Body tissue structure}, abscess {Abscess}, Neck vessels {Vascular structure of neck}, stenosis {Stenosis}, soft tissue lesion {Soft tissue lesion}, left 
+salivary gland {Structure of left salivary gland}, parotid gland {Parotid gland structure}, parotid tissue {Structure of interstitial tissue of parotid gland}, fatty density {Lesion with fat containing (radiolucent) density}, extension {Abnormal extension}, normal {No abnormality detected}, parotid tissue {Structure of interstitial tissue of parotid gland}, signs {Sign}, inflammatory {Inflammatory disorder}, abscess {Abscess}, lesion {Lesion}, lesion {Lesion}, ultrasound {Ultrasonography}, study {Evaluation procedure}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium 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}, COPD {Chronic obstructive lung disease}, trach {Exteriorization of trachea}, intubations {Insertion of endotracheal tube}, respiratory failure {Respiratory failure}, worsening {Patient's condition worsened}, SOB {Dyspnea}, cough {Cough}, increased {Patient's condition worsened}, sputum production {Sputum finding}, fevers {Fever}, COPD exacerbation {Acute exacerbation of chronic obstructive airways disease}, COPD exacerbation {Acute exacerbation of chronic obstructive airways disease}, COPD {Chronic obstructive lung disease}, home oxygen {Home oxygen therapy}, improvement {Patient's condition improved}, respiratory {Respiratory function finding}, ICU {Admission to intensive care unit}, azithromycin {Antibiotic therapy}, Prednisone {Steroid therapy}, improvement {Patient's condition improved}, respiratory {Respiratory function finding}, taper {Medication decreased}, Prednisone {Steroid therapy}, Prednisone {Steroid therapy}, Prednisone {Steroid therapy}, Parotitis {Parotitis}, tender {Tenderness of neck}, left {Structure of left half of neck}, neck 
+swelling {Neck swelling}, U/S {Ultrasonography of mass of soft tissue of neck}, CT scan {Computed tomography of neck}, inflamation {Inflammatory disorder}, parotid tissue {Structure of interstitial tissue of parotid gland}, No evidence {No abnormality detected}, abcess {Abscess}, stones {Calculus}, imaging {Imaging}, purulence {Purulent discharge}, exam {Evaluation procedure}, IV clindamycin {Intravenous antibiotic therapy}, well 
+appearing {Normal appearance}, MRSA {Methicillin resistant Staphylococcus aureus infection}, imaging {Imaging}, PO 
+antibiotics {Oral antibiotic therapy}, Augmentin {Antibiotic therapy}, HTN {Hypertensive disorder, systemic arterial}, hypertensive {Finding of increased blood pressure}, SBP {Increased systolic arterial pressure}, nebs {Nebulizer therapy}, Improved {Patient's condition improved}, Stable {Patient's condition stable}, restarted {Restart of medication}, improvement {Patient's condition improved}, hypertension {Hypertensive disorder, systemic arterial}, PCP {Primary care management}, antihypertensive {Antihypertensive therapy}, Chest Tightness {Tight chest}, pleuritic CP {Pleuritic pain}, COPD exacerbations {Acute exacerbation of chronic obstructive airways disease}, cardiac {Heart disease}, exertional {Chest pain on exertion}, radiating {Radiating pain}, troponins {Troponin measurement}, negative {No abnormality detected}, Pain resolved {No present pain}, Anxiety {Anxiety}, anxiety {Anxiety}, tachycardia {Tachycardia}, improvement {Patient's condition improved}, Switched {Change of medication}, Depression {Depressive disorder}, MRSA {Methicillin resistant Staphylococcus aureus infection}, nasal swab {Taking nasal swab}, COPD {Chronic obstructive lung disease}, lung disease {Disorder of lung}, outpatient follow up {Outpatient care management}, Hypertension {Hypertensive disorder, systemic arterial}, hypertensive {Hypertensive disorder, systemic arterial}, antihypertensive {Antihypertensive therapy}, mild {Symptom mild}, Parotitis {Parotitis}, Augmentin {Antibiotic therapy}, IV antibiotics {Intravenous antibiotic therapy}, MRSA {Methicillin resistant Staphylococcus aureus infection}, ENT {Ear, nose and throat examination}, evaluation {Evaluation procedure}, worsening {Patient's condition worsened}, parotitis {Parotitis}, fevers {Fever}, purulence {Purulent discharge}, redness {Redness of skin over lesion}, neck {Neck structure}, Trismus {Trismus}, Prednisone {Steroid 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 may be inaccurate and requires 
+futher investigation.
+1. Tiotropium Bromide 1 CAP IH DAILY 
+2. Benzonatate 100 mg PO TID 
+3. Verapamil SR 240 mg PO QAM 
+4. Verapamil SR 120 mg PO QHS 
+5. Ipratropium Bromide MDI 2 PUFF IH QID 
+6. Furosemide 20 mg PO ONCE 
+7. Fluticasone-Salmeterol Diskus (500/50)  1 INH IH BID 
+8. Omeprazole 20 mg PO DAILY 
+9. Calcitrate-Vitamin D (calcium citrate-vitamin D3) 315mg-200 
+unit oral 2 tablets Qday 
+10. Levalbuterol Neb 0.63 mg/3 mL inhalation q4 hrs 
+11. Escitalopram Oxalate 10 mg PO DAILY 
+12. TraZODone 150 mg PO HS:PRN insomnia 
+13. Vitamin D 1000 UNIT PO DAILY 
+14. Albuterol Inhaler 2 PUFF IH Q4H:PRN dyspnea 
+
+ 
+Discharge Medications:
+1. Escitalopram Oxalate 10 mg PO DAILY 
+2. Furosemide 20 mg PO DAILY 
+3. Levalbuterol Neb 1.26 mg INHALATION Q4H Wheezing, SOB 
+4. TraZODone 50 mg PO HS:PRN insomnia 
+5. Verapamil SR 240 mg PO QAM 
+6. Verapamil SR 120 mg PO QHS 
+7. Acetaminophen 650 mg PO Q6H:PRN pain 
+8. Amoxicillin-Clavulanic Acid ___ mg PO Q12H Duration: 10 Days 
+9. Cepastat (Phenol) Lozenge 1 LOZ PO Q2H:PRN Sore throat 
+10. Docusate Sodium 100 mg PO BID 
+11. Ipratropium Bromide Neb 1 NEB IH Q6H SOB 
+12. Polyethylene Glycol 17 g PO DAILY:PRN constipation 
+13. Senna 1 TAB PO BID 
+14. Benzonatate 100 mg PO TID 
+15. Calcitrate-Vitamin D (calcium citrate-vitamin D3) 315mg-200 
+unit oral 2 tablets Qday 
+16. Fluticasone-Salmeterol Diskus (500/50)  1 INH IH BID 
+17. Omeprazole 20 mg PO DAILY 
+18. Vitamin D 1000 UNIT PO DAILY 
+19. PredniSONE 40 mg PO DAILY Duration: 1 Day 
+Start: Tomorrow - ___, First Dose: First Routine 
+Administration Time 
+Total 2 week taper beginning ___ at 60mg 
+20. PredniSONE 20 mg PO DAILY Duration: 2 Days 
+Start: After 40 mg tapered dose 
+Total 2 week taper beginning ___ at 60mg 
+21. PredniSONE 10 mg PO DAILY Duration: 2 Days 
+Start: After 20 mg tapered dose 
+Total 2 week taper beginning ___ at 60mg 
+22. Lemon wedges
+Q4H to promote salivation while treating Parotid Gland infection
+23. ClonazePAM 0.5 mg PO BID:PRN anxiety 
+RX *clonazepam 0.5 mg 1 tablet(s) by mouth twice a day as needed 
+Disp #*10 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:
+Extended Care
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+COPD exacerbation
+parotidis
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: COPD exacerbation {Acute exacerbation of chronic obstructive airways disease}, parotidis {Parotitis}, 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:
+Dear Ms. ___, it was a pleasure taking care of you during your 
+stay at ___. You were admitted for a COPD exacerbation. 
+You were treated with antibiotics, steroids and nebulizers. Your 
+breathing improved. While you were here you developed an 
+inflammation of your parotid gland. You should continue on 
+antibiotics for this inflammation.
+ 
+
+###RESPONSE: COPD exacerbation {Acute exacerbation of chronic obstructive airways disease}, treated with antibiotics {Antibiotic therapy}, steroids {Steroid therapy}, nebulizers {Nebulizer therapy}, breathing {Finding of respiration}, improved {Patient's condition improved}, inflammation {Inflammatory disorder}, parotid gland {Parotid gland structure}, antibiotics {Antibiotic therapy}, inflammation {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: 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: 
+Tetracyclines
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Chest pain 
+ 
+Major Surgical or Invasive Procedure:
+none
+
+ 
+
+###RESPONSE: Tetracyclines {Allergy to tetracycline}, Chest pain {Chest 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:
+This is a ___ year-old female with a history of HTN who presents 
+with chest pain.  
+.  
+For a couple weeks, pt has been feeling fatigued, generalized 
+weakness, increased frequency of headaches. Her symptoms 
+worsened 4 days ago. Her headache has been persistent the last 4 
+days despite motrin, tylenol, zanaflex, excedrin, and zonegran. 
+She has had these headaches before. She describes a frontal 
+headache, throbbing, currently ___. No photophobia, neck 
+stiffness. She also noted chills, but have them with her 
+hypothyeroidism. She also reports watery diarrhea over the 
+weekend. No abdominal pain. She has her worsening nausea. No 
+vomiting. No fevers. No sick contacts.  
+.  
+Over the years, she has had chest pain intermittently, 
+associated with stress. The chest pain started 2 weeks ago but 
+intensified over the weekend. She describes the pain as a heavy 
+substernal pressure radiating down to her left arm. This pain 
+started ___ and worsened until today, prompting her go to 
+the ED. She feels the pain is worse when she bends over. It does 
+not worsen with deep breaths. She was noted to be pale, 
+diaphoretic today while at therapy. She has chronic nausea and 
+palpitations. No dizziness, SOB. No recent exertion.  
+.  
+Of note, pt has had chronic nausea for the past ___ years and was 
+evaluated by GI over the summer. EGD showed gastritis and grade 
+2 esophagitis; gastric emptying study was normal.  
+.  
+In the ED, initial vitals were T: 97.1 BP: 129/81 HR: 79 RR: 22 
+O2Sat: 98RA. EKG showed sinus bradycardia with HR of ___ without 
+acute signs of ischemia. She received ASA, toradol x2, and SL 
+NTG x2 with improvement of CP from 6->4. 2 sets of CEs neg.  
+.  
+Currently her CP is at a 6, improved from 10 this AM. She 
+believes the NTG helped the most. Her HA has improved with 
+Toradol.  
+.  
+ROS: The patient denies any orthopnea, PND, lower extremity 
+oedema, cough, sinus problems, nasal congestion, sore throat, 
+urinary frequency, urgency, dysuria, vision changes, focal 
+weakness, rash.  
+.  
+
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, chest pain {Chest pain}, fatigued {Fatigue}, weakness {Asthenia}, headaches {Headache}, worsened {Patient's condition worsened}, headache has been persistent {New daily persistent headache}, tylenol {Administration of analgesic}, headaches {Headache}, frontal 
+headache {Frontal headache}, throbbing {Throbbing pain}, photophobia {Photophobia}, neck 
+stiffness {Stiff neck}, chills {Chill}, hypothyeroidism {Hypothyroidism}, watery {Liquid stool}, diarrhea {Diarrhea}, abdominal pain {Abdominal pain}, worsening {Patient's condition worsened}, nausea {Nausea}, vomiting {Vomiting}, No fevers {Temperature normal}, chest pain {Chest pain}, stress {Stress}, chest pain {Chest pain}, pain {Chest pain}, substernal {Structure of substernal region}, pressure {Tight chest}, radiating down to her left arm {Pain radiating to left arm}, pain {Chest pain}, worsened {Increased pain}, pain {Chest pain}, worse {Increased pain}, worsen {Patient's condition worsened}, deep breaths {Deep breathing}, pale {Pale discoloration of entire skin of body}, diaphoretic {Excessive sweating}, therapy {Therapy}, chronic {Chronic disease}, nausea {Nausea}, palpitations {Palpitations}, dizziness {Dizziness}, SOB {Dyspnea}, chronic {Chronic disease}, nausea {Nausea}, evaluated {Evaluation procedure}, EGD {Esophagogastroduodenoscopy}, gastritis {Gastritis}, esophagitis {Esophagitis}, gastric emptying study {Gastric emptying study}, normal {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}, O2Sat {Oxygen saturation measurement}, RA {Breathing room air}, EKG {Electrocardiographic procedure}, sinus bradycardia {Sinus bradycardia}, HR {Finding of heart rate}, without 
+acute signs of ischemia {Electrocardiogram normal}, ASA {Administration of aspirin}, NTG {Administration of prophylactic glyceryl trinitrate}, improvement {Patient's condition improved}, CP {Chest pain}, CEs neg {Cardiac enzymes within reference range}, CP {Chest pain}, improved {Patient's condition improved}, NTG {Administration of prophylactic glyceryl trinitrate}, HA {Headache}, improved {Patient's condition improved}, ROS {Review of systems}, orthopnea {Orthopnea}, PND {Paroxysmal nocturnal dyspnea}, lower extremity 
+oedema {Edema of lower extremity}, cough {Cough}, sinus problems {Disorder of nasal sinus}, nasal congestion {Nasal congestion}, sore throat {Sore throat}, urinary frequency {Increased frequency of urination}, urgency {Urgent desire to urinate}, dysuria {Dysuria}, vision changes {Visual disturbance}, weakness {Asthenia}, rash {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: Past Medical History:
+HTN  
+Hypothyroidism  
+Migraine and tension headaches  
+MVP  
+Complex partial seizures  
+Sleep apnea, not tolerating CPAP at home  
+Depression/Generalized anxiety disorder  
+ADHD  
+Asthma  
+
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, Hypothyroidism {Hypothyroidism}, Migraine {Migraine}, tension headaches {Tension-type headache}, partial seizures {Focal onset epileptic seizure}, Sleep apnea {Sleep apnea}, CPAP at home {Uses home continuous positive airway pressure ventilation supply}, Depression {Depressive disorder}, Generalized anxiety disorder {Generalized anxiety disorder}, ADHD {Attention deficit hyperactivity disorder}, Asthma {Asthma}"
+"###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 with colorectal cancer, pancreatitis. No h/o MI.  
+Father died of MI at age of ___.  
+
+ 
+
+###RESPONSE: colorectal cancer {Malignant neoplasm of colon and/or rectum}, pancreatitis {Pancreatitis}, MI {Myocardial infarction}, died {Dead}, MI {Myocardial infarction}"
+"###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:
+Vitals: T: 97.8, BP: 138/94, HR: 61, RR: 20, O2Sat: 100RA  
+GEN: Well-appearing, obese female no acute distress  
+HEENT: EOMI, sclera anicteric, MMM, OP Clear  
+NECK: No JVD, no carotid bruits, no cervical lymphadenopathy, no 
+meningismus  
+COR: RRR, no M/G/R, normal S1 S2  
+PULM: Lungs CTAB, no W/R/R  
+CHEST: tender to palpation over sternum, L side of chest and L 
+arm  
+ABD: Obese, soft, mildly tender in LLQ, no rebound, no guarding, 
+ND, +BS  
+EXT: No C/C/E, 2+ DP pulses  
+
+ 
+
+###RESPONSE: Vitals {Vital signs finding}, T {Body temperature finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, O2Sat {Oxygen saturation measurement}, RA {Breathing room air}, GEN {General examination of patient}, Well-appearing {Well cared for appearance}, obese {Obese}, no acute {No abnormality detected}, distress {Distress}, HEENT {Physical examination procedure}, EOMI {Normal ocular motility}, sclera anicteric {White sclera}, MMM {Moist oral mucosa}, OP Clear {Pharynx normal}, NECK {Physical examination procedure}, JVD {Jugular venous engorgement}, carotid bruits {Carotid bruit}, cervical lymphadenopathy {Cervical lymphadenopathy}, meningismus {Meningeal irritation}, COR {Cardiovascular physical examination}, RRR {Normal heart rate}, no M/G/R {Heart sounds abnormal}, normal S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, PULM {Examination of respiratory system}, CTAB {Normal breath sounds}, no W/R/R {Normal breath sounds}, CHEST {Examination of respiratory system}, tender {Abdominal tenderness}, palpation {Palpation}, sternum {Bone structure of sternum}, L side of chest {Structure of left half of chest wall}, L 
+arm {Structure of left upper limb}, ABD {Examination of abdomen}, Obese {Obese}, soft {Abdomen soft}, tender {Abdominal tenderness}, LLQ {Structure of left lower quadrant of abdomen}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, ND {Swollen abdomen}, +BS {Normal bowel sounds}, EXT {Examination of limb}, No C/C/E {No abnormality detected}, 2+ DP pulses {Dorsalis pulse present}"
+"###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:
+troponins <0.01 x3
+ 
+
+###RESPONSE: troponins {Troponin 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: Brief Hospital Course:
+Assesment: This is a ___ year-old female with a history of HTN, 
+hypothyroidism, GAD who presents with chest pain, fatigue, and 
+headaches.  
+.
+Chest pain: Likely MSK given reproducible pain on exam. ___ also 
+be from esophagitis and gastritis, ? esophageal spasm as 
+improved with NTG. Unlikely pericarditis since no EKG changes. 
+Unlikely to be ACS given duration of symptoms without EKG 
+changes or increased CEs. Also had normal stress test in ___. 
+Patient had serial normal EKGs, CEs negative x3. 
+.  
+Headache: Pt reports it's consistent with her tension headaches 
+except not being relieved. Has improved with Toradol. No 
+meningimus, afebrile, no leukocytosis to suggest meninigitis.  
+cont. toradol  
+.  
+# Nausea: Has been thoroughly worked up by GI.  
+- start protonix
+- Compazine prn  
+.  
+# HTN: Well controlled.  
+- cont. propranolol  
+.  
+# Hypothyroidism: TSH WNL on admission.  
+- cont. levothyroxine.  
+.  
+# Complex partial seizures:  
+- cont. Lamictal.  
+.  
+# Sleep apnea, not tolerating CPAP at home:  
+- CPAP ordered  
+.  
+# Depression/Generalized anxiety disorder:  
+- cont.  
+.  
+# ADHD  
+- cont. Ritalin  
+.  
+# Asthma: Currently asymptomatic.  
+- albuterol prn  
+
+ 
+
+###RESPONSE: Assesment {Evaluation procedure}, HTN {Hypertensive disorder, systemic arterial}, hypothyroidism {Hypothyroidism}, GAD {Generalized anxiety disorder}, chest pain {Chest pain}, fatigue {Fatigue}, headaches {Headache}, Chest pain {Chest pain}, MSK {Structure of musculoskeletal system}, pain {Pain}, exam {Physical examination procedure}, esophagitis {Esophagitis}, gastritis {Gastritis}, esophageal spasm {Diffuse spasm of esophagus}, improved {Patient's condition improved}, NTG {Administration of prophylactic glyceryl trinitrate}, pericarditis {Pericarditis}, no EKG changes {Electrocardiogram normal}, ACS {Acute coronary syndrome}, without EKG 
+changes {Electrocardiogram normal}, increased CEs {Cardiac enzyme or marker above reference range}, normal {Electrocardiogram normal}, stress test {Cardiovascular stress testing}, normal EKGs {Electrocardiogram normal}, CEs negative {Cardiac enzymes within reference range}, Headache {Headache}, tension headaches {Tension-type headache}, improved {Patient's condition improved}, meningimus {Meningeal irritation}, afebrile {Temperature normal}, leukocytosis {Leukocytosis}, meninigitis {Meningitis}, Nausea {Nausea}, worked up {Evaluation procedure}, HTN {Hypertensive disorder, systemic arterial}, Well controlled {Disease condition determination, well controlled}, Hypothyroidism {Hypothyroidism}, TSH WNL {Serum thyroid stimulating hormone level within reference range}, partial seizures {Focal onset epileptic seizure}, Sleep apnea {Sleep apnea}, CPAP at home {Uses home continuous positive airway pressure ventilation supply}, CPAP {Continuous positive airway pressure ventilation treatment}, Depression {Depressive disorder}, Generalized anxiety disorder {Generalized anxiety disorder}, ADHD {Attention deficit hyperactivity disorder}, Asthma {Asthma}, asymptomatic {Asymptomatic}"
+"###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:
+ALBUTEROL SULFATE [PROAIR HFA] - 90 mcg HFA Aerosol Inhaler - 2  
+
+puffs by mouth every four (4) to six (6) hours as needed for  
+cough/wheezing  
+LAMOTRIGINE [LAMICTAL] - (Prescribed by Other Provider: ___ 
+ 
+- 200 mg Tablet - 1 (One) Tablet(s) by mouth twice a day  
+LEVOTHYROXINE SODIUM - 175MCG Tablet - ONE BY MOUTH EVERY DAY  
+METHYLPHENIDATE [RITALIN LA] - (Prescribed by Other Provider:  
+___ - 30 mg Capsule, Multiphasic Rel.50-50 - 2 (Two)  
+Capsule(s) by mouth once a day  
+PRAMIPEXOLE [MIRAPEX] - 0.125 mg Tablet - 1 (One) Tablet(s) by  
+mouth once a day 2 hours before sleep  
+PRAZOSIN - (Prescribed by Other Provider: ___ - 1 mg  
+Capsule - 1 (One) Capsule(s) by mouth three times a day  
+PROCHLORPERAZINE MALEATE - 10 mg Tablet - 1 Tablet(s) by mouth  
+twice a day  
+PROPRANOLOL - (Prescribed by Other Provider: ___ - 80 mg  
+Capsule, Sust. Release 24 hr - 1 (One) Capsule(s) by mouth once 
+a  
+day  
+TIZANIDINE [ZANAFLEX] - 4 mg Tablet - 1 Tablet(s) by mouth twice 
+ 
+a day  
+TRAZODONE - 100 mg Tablet - 2 Tablet(s) by mouth at bedtime ___  
+
+take additional tablet qhs prn sleeplessness  
+ZONISAMIDE [ZONEGRAN] - 100 mg Capsule - 2 Capsule(s) by mouth 
+at  
+bedtime  
+
+ 
+Discharge Medications:
+1. Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for 
+Nebulization Sig: One (1)  Inhalation Q6H (every 6 hours) as 
+needed.  
+2. Lamotrigine 100 mg Tablet Sig: Two (2) Tablet PO BID (2 times 
+a day).  
+3. Levothyroxine 175 mcg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+4. Methylphenidate 20 mg Tablet Sustained Release Sig: Three (3) 
+Tablet Sustained Release PO DAILY (Daily).  
+5. Pramipexole 0.125 mg Tablet Sig: One (1) Tablet PO qhs ().  
+6. Prazosin 1 mg Capsule Sig: One (1) Capsule PO TID (3 times a 
+day).  
+7. Prochlorperazine Maleate 10 mg Tablet Sig: One (1) Tablet PO 
+twice a day as needed for nausea.  
+8. Propranolol 80 mg Capsule,Sustained Action 24 hr Sig: One (1) 
+Capsule,Sustained Action 24 hr PO DAILY (Daily).  
+9. Tizanidine 2 mg Tablet Sig: Two (2) Tablet PO BID (2 times a 
+day).  
+10. Trazodone 100 mg Tablet Sig: Two (2) Tablet PO HS (at 
+bedtime) as needed.  
+11. Zonisamide 100 mg Capsule Sig: Two (2) Capsule PO QHS (once 
+a day (at bedtime)).  
+
+ 
+
+###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:
+Atypical Chest pain
+
+Secondary:
+HTN
+Hypothyroid
+GAD
+
+ 
+Discharge Condition:
+stable
+
+ 
+
+###RESPONSE: Atypical Chest pain {Atypical chest pain}, HTN {Hypertensive disorder, systemic arterial}, Hypothyroid {Hypothyroidism}, GAD {Generalized anxiety disorder}, stable {Patient's condition stable}"
+"###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 to the hospital with chest pain that was 
+thought to NOT be of cardiac origin per blood tests and EKGS.
+
+Please take all medications as prescribed
+
+Please call your doctor or return to the hosptial if you have 
+more chest pain, shortness of breath or any other concerning 
+symptoms
+ 
+
+###RESPONSE: chest pain {Chest pain}, cardiac {Heart structure}, blood tests {Blood test}, EKGS {Electrocardiographic procedure}, Please take all medications as prescribed {Patient medication education}, call your doctor {Informing doctor}, chest pain {Chest pain}, shortness of breath {Dyspnea}"
+"###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: 
+amlodipine
+ 
+Attending: ___.
+ 
+Chief Complaint:
+fever, dyspnea
+
+ 
+Major Surgical or Invasive Procedure:
+None
+ 
+
+###RESPONSE: amlodipine {Allergy to amlodipine}, fever {Fever}, dyspnea {Dyspnea}"
+"###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:
+___ h/o severe COPD not on home O2, s/p endobronchial coil 
+placement for stage 4 emphysema as part of a study on ___. Dc'd 
+home began having fevers, went to ___ local ___, admitted 
+___ (discharged yesterday) after treatment for pneumonia, 
+continued on PO levoquin. Presents today after speaking w/ study 
+coordinator who recommended he present here for further 
+evaluation if temp >100.4. Temp at home to 101. Increased 
+dyspnea from baseline. Denies CP. No n/v. Soft stool this AM, no 
+abd pain.
+In the ED initial vitals were: 99.4 102 146/74 18 100% RA. Pt 
+spiked to 100.2 and received tylenol.
+- Labs were significant for no leukocytosis, normal lactate, INR 
+1.4.
+- CXR was pending.
+- EKG was unchanged.
+- Patient was given IV vanc and zosyn, tylenol, duonebs x2, and 
+1L NS.
+On the floor, patient is resting fairly comfortably with his 
+wife at bedside. He reports that his breathing is still bad. He 
+confirms the above history and also adds the following: While 
+hospitalized at ___ in ___, his inpatient 
+MDs were communicating with Dr. ___ for 
+recommendations about his pulmonary management. He was started 
+on levaquin ___, which he took for one day and then was 
+changed to IV vanc/zosyn while in the hospital, but discharged 
+again on levaquin after improvement.
+He says that initially after the coil embolization ___ he felt 
+well for a few days. However, on the ___ following the 
+procedure (___), he began feeling unwell. On ___ he 
+developed a fever. Of note, his sputum after the procedure was 
+initially white with streaks of BRB but then changed to a rust 
+color after he got sick. Even with the antibiotics, he continued 
+to feel unwell. His sputum changed to a yellow mucous. He went 2 
+days without fevers, was discharged, and then had another fever 
+that night (last night). Denies flu like symptoms such as body 
+aches, HA, n/v/d. Most importantly, he reports that since being 
+unwell, his breathing really hasn't improved. He feels like he 
+is not moving any air. No CP or leg swelling. No diarrhea or 
+dysuria.
+Review of Systems:
+(+) per HPI. Remainder of 10 point ROS is negative.
+
+ 
+
+###RESPONSE: severe COPD {Severe chronic obstructive pulmonary disease}, home O2 {Home oxygen therapy}, endobronchial coil 
+placement {Endotracheal tube present}, emphysema {Emphysema}, study {Evaluation procedure}, fevers {Fever}, pneumonia {Pneumonia}, study {Evaluation procedure}, evaluation {Evaluation procedure}, temp {Body temperature finding}, Temp {Body temperature finding}, Increased {Patient's condition worsened}, dyspnea {Dyspnea}, baseline {Baseline state}, Soft stool {Soft stool}, abd pain {Abdominal pain}, vitals {Vital signs finding}, tylenol {Administration of analgesic}, Labs {Laboratory test}, leukocytosis {Leukocytosis}, normal {No abnormality detected}, lactate {Lactic acid measurement}, INR {Calculation of international normalized ratio}, CXR {Plain chest X-ray}, EKG {Electrocardiographic procedure}, unchanged {Patient condition unchanged}, vanc {Antibiotic therapy}, tylenol {Administration of analgesic}, comfortably {Breathing easily}, breathing {Difficulty breathing}, pulmonary {Pulmonary medicine service}, started {New medication added}, changed {Change of medication}, vanc {Antibiotic therapy}, improvement {Patient's condition improved}, embolization {Embolization procedure}, following the 
+procedure {Postoperative state}, feeling unwell {Malaise}, fever {Fever}, sputum {Sputum finding}, procedure {Procedure}, changed {Change of medication}, color {Color finding}, antibiotics {Antibiotic therapy}, feel unwell {Malaise}, sputum {Sputum finding}, yellow {Yellow sputum}, fevers {Fever}, fever {Fever}, flu like symptoms {Influenza-like symptoms}, body 
+aches {Generalized aches and pains}, n/v/d {Nausea, vomiting and diarrhea}, breathing {Difficulty breathing}, improved {Patient's condition improved}, leg swelling {Leg swelling symptom}, diarrhea {Diarrhea}, dysuria {Dysuria}, ROS {Review of systems}, negative {No pathologic diagnosis}"
+"###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:
+- Severe COPD/emphysema. FEV1 23% in ___, with significant
+hyperinflation. Negative for A1AT deficiency. No history of
+respiratory failure.
+- s/p RUL endobronchial coil placement ___
+- CAD s/p MI and PCI x2, in ___
+- Hypertension
+- Nephrolithiasis, with lithotripsy, stenting, and nephrostomies
+in the past.
+- Hypothyroidism
+- Systolic HF with EF 40% on ___
+
+ 
+
+###RESPONSE: Severe COPD {Severe chronic obstructive pulmonary disease}, emphysema {Emphysema}, hyperinflation {Hyperdistention}, Negative {No pathologic diagnosis}, A1AT deficiency {Alpha-1-antitrypsin deficiency}, respiratory failure {Respiratory failure}, endobronchial coil placement {Endotracheal tube present}, CAD {Coronary arteriosclerosis}, PCI {Percutaneous coronary intervention}, Hypertension {Hypertensive disorder, systemic arterial}, Nephrolithiasis {Kidney stone}, lithotripsy {Lithotripsy}, stenting {Insertion of arterial stent}, Hypothyroidism {Hypothyroidism}, Systolic {Systolic heart failure}"
+"###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:
+His grandfather had emphysema and asbestos exposure.
+
+ 
+
+###RESPONSE: emphysema {Emphysema}"
+"###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:
+Vitals: 98.3, 122/75, 80, 18, 97% on RA
+GENERAL: well nourished middle aged man lying in bed with O2 on 
+for comfort, AAOx3, NAD
+HEENT: AT/NC, EOMI, PERRL, anicteric sclera, pink conjunctiva, 
+MMM, good dentition
+NECK: no JVD
+CARDIAC: very difficult to auscultate, no murmurs, gallops, or 
+rubs appreciated
+LUNG: mild RUL crackles, overall poor air movement. no wheezing. 
+no use of accessory muscles. able to speak in full sentences.
+ABDOMEN: nondistended, +BS, nontender in all quadrants, no 
+rebound/guarding, no hepatosplenomegaly
+EXTREMITIES: no cyanosis, clubbing or edema, moving all 4 
+extremities with purpose
+NEURO: CN II-XII intact
+SKIN: warm and well perfused, no excoriations or lesions, no 
+rashes
+
+DISCHARGE PHYSICAL EXAM:
+Vitals: Tmax 98.6 Tc 97.8 122-133/78-79 HR ___ RR ___ 99% RA
+GEN: Well appearing, speaks in full sentences on room air
+Exam otherwise unchanged
+ 
+
+###RESPONSE: PHYSICAL EXAM {Physical examination procedure}, Vitals {Vital signs finding}, RA {Breathing room air}, GENERAL {General examination of patient}, well nourished {Well nourished}, middle aged {Middle-age}, lying in bed {Lying in bed}, Ox3 {Oriented to person, time and place}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, NC {Normal head}, EOMI {Normal ocular motility}, PERRL {Pupils equal and reacting to light}, anicteric sclera {White sclera}, pink conjunctiva {Conjunctival hyperemia}, MMM {Moist oral mucosa}, good dentition {Normal dentition}, NECK {Physical examination procedure}, JVD {Jugular venous engorgement}, CARDIAC {Cardiovascular physical examination}, murmurs {Murmur}, gallops {Gallop rhythm}, rubs {Pericardial friction rub}, LUNG {Examination of respiratory system}, mild {Symptom mild}, RUL {Structure of upper lobe of right lung}, crackles {Respiratory crackles}, poor air movement {Decreased breath sounds}, wheezing {Wheezing}, accessory muscles {Accessory skeletal muscle}, able to speak {Able to speak}, full sentences {Able to complete sentence in one breath}, ABDOMEN {Examination of abdomen}, nondistended {Normal abdominal contour}, nontender {Abdominal tenderness}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, hepatosplenomegaly {Hepatosplenomegaly}, EXTREMITIES {Examination of limb}, cyanosis {Cyanosis}, clubbing {Clubbing}, edema {Edema}, moving all 4 
+extremities {Does move all four limbs}, NEURO {Neurological examination}, CN II-XII intact {Normal central nervous system}, SKIN {Examination of skin}, warm {Warm skin}, well perfused {Normal tissue perfusion}, excoriations {Excoriation}, lesions {Lesion}, rashes {Eruption of skin}, Vitals {Vital signs finding}, RA {Breathing room air}, Well appearing {Well cared for appearance}, speaks {Does speak}, full sentences {Able to complete sentence in one breath}, on room air {Breathing room air}, Exam {Lung finding}, unchanged {Patient condition unchanged}"
+"###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:
+=======
+___ 03:10PM   GLUCOSE-140* UREA N-13 CREAT-1.0 SODIUM-138 
+POTASSIUM-4.3 CHLORIDE-101 TOTAL CO2-25 ANION GAP-16
+___ 03:10PM   WBC-8.6 RBC-4.21* HGB-12.6* HCT-37.3* MCV-89 
+MCH-30.0 MCHC-33.9 RDW-12.8
+___ 03:10PM   PLT COUNT-286
+___ 03:10PM   ___ PTT-29.6 ___
+___ 12:30PM URINE  COLOR-Yellow APPEAR-Clear SP ___
+___ 12:30PM URINE  BLOOD-TR NITRITE-NEG PROTEIN-TR 
+GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-7.0 
+LEUK-NEG
+___ 12:30PM URINE  RBC-7* WBC-5 BACTERIA-NONE YEAST-NONE 
+EPI-0
+___ 12:30AM   ___ COMMENTS-GREEN TOP
+___ 12:30AM   LACTATE-1.3 K+-4.1
+___ 12:20AM   GLUCOSE-105* UREA N-15 CREAT-1.0 SODIUM-136 
+POTASSIUM-5.6* CHLORIDE-100 TOTAL CO2-24 ANION GAP-18
+___ 12:20AM   WBC-11.0 RBC-4.42* HGB-13.5* HCT-38.9* MCV-88 
+MCH-30.5 MCHC-34.7 RDW-13.1
+___:20AM   NEUTS-71.8* LYMPHS-13.6* MONOS-11.7* EOS-2.0 
+BASOS-0.8
+___ 12:20AM   PLT COUNT-282
+___ 12:20AM   ___ PTT-28.4 ___
+___ 05:59AM BLOOD WBC-8.8 RBC-4.22* Hgb-12.6* Hct-37.6* 
+MCV-89 MCH-30.0 MCHC-33.6 RDW-12.9 Plt ___
+___ 05:59AM BLOOD Glucose-90 UreaN-20 Creat-1.1 Na-143 
+K-3.7 Cl-105 HCO3-28 AnGap-14
+___ 05:59AM BLOOD ALT-30 AST-16 AlkPhos-38* TotBili-0.3
+
+MICRO:
+========
+___ 11:45 am SPUTUM     Site: EXPECTORATED
+      Source: Expectorated. 
+
+   ACID FAST SMEAR (Final ___: 
+      NO ACID FAST BACILLI SEEN ON CONCENTRATED SMEAR. 
+
+   ACID FAST CULTURE (Preliminary): 
+
+___ 8:30 pm SPUTUM      Source: Expectorated. 
+
+   ACID FAST SMEAR (Final ___: 
+      NO ACID FAST BACILLI SEEN ON CONCENTRATED SMEAR. 
+
+   ACID FAST CULTURE (Preliminary): 
+
+   MTB Direct Amplification (Final ___: 
+      M. TUBERCULOSIS DNA NOT DETECTED BY NAAT: A negative NAAT 
+cannot rule
+      out TB  or other mycobacterial infection. 
+      NAAT results will be followed by confirmatory testing with
+      conventional culture and DST methods. This TB NAAT method 
+has not
+      been approved by FDA for clinical diagnostic purposes. 
+However, ___
+      ___ Institute (___) has established assay 
+performance by
+      in-house validation in accordance with ___ standards. 
+      TEST PERFORMED BY ___ LAB (___). 
+
+___ 11:36 am SPUTUM      Source: Expectorated. 
+
+   GRAM STAIN (Final ___: 
+      >25 PMNs and <10 epithelial cells/100X field. 
+      1+    (<1 per 1000X FIELD):   GRAM NEGATIVE ROD(S). 
+      1+    (<1 per 1000X FIELD):   GRAM POSITIVE COCCI IN 
+PAIRS. 
+
+   RESPIRATORY CULTURE (Final ___: 
+      SPARSE GROWTH Commensal Respiratory Flora. 
+      YEAST.    SPARSE GROWTH. 
+
+   FUNGAL CULTURE (Preliminary): 
+      YEAST. 
+
+   ACID FAST SMEAR (Final ___: 
+      NO ACID FAST BACILLI SEEN ON CONCENTRATED SMEAR. 
+
+   ACID FAST CULTURE (Pending): 
+
+___ 12:20 am BLOOD CULTURE
+
+   Blood Culture, Routine (Pending): 
+
+___ 10:54 am BRONCHIAL WASHINGS      RIGHT BRONCHIAL WASH. 
+
+   GRAM STAIN (Final ___: 
+      2+   ___ per 1000X FIELD):   POLYMORPHONUCLEAR 
+LEUKOCYTES. 
+      3+  ___ per 1000X FIELD):   GRAM NEGATIVE ROD(S). 
+
+   RESPIRATORY CULTURE (Final ___: 
+      ~4000/ML Commensal Respiratory Flora. 
+      PSEUDOMONAS AERUGINOSA.    >100,000 ORGANISMS/ML.. 
+         Piperacillin/Tazobactam sensitivity testing performed 
+by ___
+         ___.  MEROPENEM sensitivity testing performed by 
+___. 
+      ACHROMOBACTER SPECIES.    10,000-100,000 ORGANISMS/ML.. 
+         sensitivity testing performed by Microscan. 
+         MEROPENEM <= 1 MCG/ML.  Cefepime >16 MCG/ML. 
+      PSEUDOMONAS AERUGINOSA.    10,000-100,000 ORGANISMS/ML.. 
+         SECOND MORPHOLOGY. 
+         Piperacillin/Tazobactam sensitivity testing performed 
+by ___
+         ___. 
+
+                              SENSITIVITIES: MIC expressed in 
+MCG/ML
+                      
+_________________________________________________________
+                             PSEUDOMONAS AERUGINOSA
+                             |          ACHROMOBACTER SPECIES
+                             |          |          PSEUDOMONAS 
+AERUGINOSA
+                             |          |          |   
+CEFEPIME--------------    32 R          R        2 S
+CEFTAZIDIME-----------  =>64 R     =>32 R        4 S
+CEFTRIAXONE-----------               32 I
+CIPROFLOXACIN---------     2 I      =>4 R      0.5 S
+GENTAMICIN------------   <=1 S        2 S      <=1 S
+IMIPENEM--------------              <=1 S
+LEVOFLOXACIN----------              <=1 S
+MEROPENEM-------------       R          S   <=0.25 S
+PIPERACILLIN/TAZO-----       I      <=8 S          S
+TOBRAMYCIN------------   <=1 S        2 S      <=1 S
+TRIMETHOPRIM/SULFA----              <=2 S
+
+   ACID FAST SMEAR (Final ___: 
+      NO ACID FAST BACILLI SEEN ON CONCENTRATED SMEAR. 
+
+   ACID FAST CULTURE (Preliminary): 
+            MYCOBACTERIUM AVIUM COMPLEX. 
+         Identified by ___ Laboratory ,REPORT DATE: 
+___. 
+
+   FUNGAL CULTURE (Final ___: 
+      EXOPHIALA SPECIES.    1 COLONY. 
+
+IMAGING:
+=========
+___ Imaging CHEST (PA & LAT)      
+1. Large right upper lobe consolidation, concerning for 
+pneumonia versus 
+hemorrhage little change since ___. Concurrent 
+peribronchial 
+infiltration in the right middle and lower lobes has improved. 
+     
+___ Cardiovascular ECG 
+Sinus tachycardia. Borderline R wave progression. Borderline 
+leftward axis. Compared to the previous tracing of ___ the 
+rate is faster. The findings are otherwise similar. 
+  Intervals Axes 
+Rate PR QRS QT/QTc P QRS T 
+103 140 88 ___ ___ with h/o severe COPD s/p right sided endobronchial coil 
+placement on ___ admitted with fever, RUL infiltrate consistent 
+with PNA.
+
+# RUL bacterial pneumonia: Pt developed fever and increased 
+sputum production following last admission for endobronchial 
+coil placement. He was started on levofloxacin as an outpatient 
+and shortly after admitted to OSH where he received 
+vanc/piperacillin-tazobactam for several days and was discharged 
+home on levofloxacin. He experienced recurrent fever at home and 
+was advised to present to ___ where CXR showed RUL 
+consolidation infiltrate, most likely postobstructive PNA in 
+area of coiling procedure given fevers, change in sputum 
+production and temporary clinical improvement while on broad 
+spectrum abx at OSH. He was initially treated with 
+vanc/piperacillin-tazobactam /levofloxacin. Notably, BAL from 
+___ on last admission grew resistant pseudomonas. Patient at 
+risk for developing further antibiotic resistance given 
+interrupted courses of levofloxacin and vanc/zosyn in the week 
+prior to presentation. However, given clinical improvement, 
+antibiotics were narrowed to piperacillin-tazobactam in 
+consultation with ID with plan for 14 day total course with 
+close outpatient follow up. Sputum culture this admission grew 
+commensal respiratory flora and sparse yeast, which may 
+represent exophiala species felt to represent colonization on 
+prior BAL. Endobronchial coil removal was discussed with IP and 
+ID, but deferred given clinical improvement on antibiotics. 
+
+# COPD: Severe with FEV1 23% and reduced DLCO s/p endobronchial 
+coiling as above. Normally on prednisone 10mg daily, recently on 
+prednisone taper following coiling procedure. Increased to 60mg 
+on admission in case COPD symptoms were contributing to SOB. 
+Treated with prednisone 60mg daily x 5 day burst (d1 = ___. 
+Continued home advair, spiriva, zyrtec, montelukast.
+
+# ___: AFB cx from ___ BAL returned positive on ___. Patient 
+had history of partially treated ___ in ___ per Parters 
+records. Ruled out for active pulm TB with negative sputum AFB x 
+3. AFB cx from ___ sent to state lab and identified as ___. 
+
+# Emergency Contact: ___ ___ (wife)
+
+TRANSITIONAL ISSUES:
+====================
+# RUL Pseudomonal PNA: Discharged on piperacillin-tazobactam for 
+14 day total course (last day ___. If worsens clinically, 
+may require tobramycin given intermediate sensitivity of 
+pseudomonas from BAL ___ to pip-tazo. Has ID followup on 
+___. Will need labs to include CBC with differential, 
+Creatinine, LFTs in 5 days of discharge ___ or ___ 
+given upcoming ___) faxed to Dr. ___ 
+new ID provider ___ ___.
+# ___: Consider reattempting outpatient treatment, would require 
+prolonged course. ___ have positive AFB culture on future BALs 
+given known ___ infection.
+
+ 
+
+###RESPONSE: GLUCOSE {Glucose measurement, blood}, UREA N {Blood urea nitrogen measurement}, 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}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, PLT COUNT {Platelet count}, PTT {Partial thromboplastin time, activated}, URINE {Evaluation of urine specimen}, COLOR {Color finding}, PROTEIN {Measurement of protein in urine}, GLUCOSE-NEG {Urine glucose not detected}, KETONE-NEG {Urine ketones not detected}, BILIRUBIN {Bilirubin measurement, urine}, NEG {No abnormality detected}, UROBILNGN {Urobilinogen measurement, urine}, NEG {No abnormality detected}, PH {pH measurement}, LEUK-NEG {Urine leukocytes not detected}, URINE {Urinalysis}, RBC {Red blood cell count}, WBC {White blood cell count}, AST {Aspartate aminotransferase measurement}, GLUCOSE {Glucose measurement, blood}, UREA N {Blood urea nitrogen measurement}, 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}, 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}, 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}, BASOS {Basophil count}, PLT COUNT {Platelet count}, PTT {Partial thromboplastin time, activated}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {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}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, SPUTUM {Microbial culture of sputum}, ACID FAST {Acid fast bacilli culture}, ACID FAST {Acid fast bacilli culture}, ACID FAST {Acid fast bacilli culture}, CULTURE {Microbial culture}, SPUTUM {Microbial culture of sputum}, ACID FAST {Acid fast bacilli culture}, ACID FAST {Acid fast bacilli culture}, ACID FAST {Acid fast bacilli culture}, CULTURE {Microbial culture}, TUBERCULOSIS {Tuberculosis}, negative {No pathologic diagnosis}, infection {Infectious disease}, culture {Microbial culture}, SPUTUM {Microbial culture of sputum}, GRAM STAIN {Gram stain method}, epithelial cells {Epithelial cells present}, NEGATIVE {No pathologic diagnosis}, RESPIRATORY CULTURE {Respiratory microbial culture}, YEAST {Yeast culture}, FUNGAL {Mycology culture}, CULTURE {Microbial culture}, YEAST {Yeast culture}, ACID FAST {Acid fast bacilli culture}, ACID FAST {Acid fast bacilli culture}, ACID FAST {Acid fast bacilli culture}, CULTURE {Microbial culture}, BLOOD CULTURE {Blood culture}, Blood Culture {Blood culture}, BRONCHIAL WASHINGS {Lavage of bronchus}, RIGHT {Right lung structure}, BRONCHIAL {Bronchial structure}, WASH {Bronchoscopic lavage}, GRAM STAIN {Gram stain method}, POLYMORPHONUCLEAR 
+LEUKOCYTES {Polymorphonuclear leukocyte count}, NEGATIVE {No pathologic diagnosis}, RESPIRATORY CULTURE {Respiratory microbial culture}, sensitivity {Antimicrobial susceptibility test}, sensitivity {Antimicrobial susceptibility test}, sensitivity {Antimicrobial susceptibility test}, sensitivity {Antimicrobial susceptibility test}, SENSITIVITIES {Antimicrobial susceptibility test}, CIPROFLOXACIN {Antibiotic therapy}, LEVOFLOXACIN {Antibiotic therapy}, ACID FAST {Acid fast bacilli culture}, ACID FAST {Acid fast bacilli culture}, ACID FAST {Acid fast bacilli culture}, CULTURE {Microbial culture}, Laboratory {Laboratory test}, FUNGAL {Mycology culture}, CULTURE {Mycology culture}, Imaging CHEST (PA & LAT {Diagnostic radiography of chest, combined posteroanterior and lateral}, right upper lobe {Structure of bronchus of right upper lobe}, consolidation {Lung consolidation}, pneumonia {Pneumonia}, hemorrhage {Hemorrhage}, infiltration {Infiltration}, right {Right lung structure}, middle {Structure of middle lobe of right lung}, lower lobes {Structure of lower lobe of right lung}, improved {Patient's condition improved}, ECG {Electrocardiographic procedure}, Sinus tachycardia {Sinus tachycardia}, R wave progression {Electrocardiographic R wave abnormal}, axis {Electrocardiographic axis finding}, rate {Finding of heart rate}, Rate {Finding of heart rate}, QRS {Finding of electrocardiogram QRS complex}, QRS {Finding of electrocardiogram QRS complex}, severe COPD {Severe chronic obstructive pulmonary disease}, right sided {Right lung structure}, endobronchial coil 
+placement {Endotracheal tube present}, fever {Fever}, RUL {Structure of upper lobe of right lung}, infiltrate {Infiltration}, PNA {Pneumonia}, RUL {Structure of upper lobe of right lung}, bacterial pneumonia {Bacterial pneumonia}, fever {Fever}, increased {Patient's condition worsened}, sputum production {Productive cough}, placement {Implantation procedure}, started {New medication added}, levofloxacin {Antibiotic therapy}, vanc {Antibiotic therapy}, levofloxacin {Antibiotic therapy}, recurrent {Recurrent disease}, fever {Fever}, CXR {Plain chest X-ray}, RUL {Structure of upper lobe of right lung}, consolidation {Lung consolidation}, infiltrate {Infiltration}, PNA {Pneumonia}, procedure {Procedure}, fevers {Fever}, sputum 
+production {Sputum finding}, improvement {Patient's condition improved}, vanc {Antibiotic therapy}, levofloxacin {Antibiotic therapy}, BAL {Bronchoscopy and bronchoalveolar lavage}, antibiotic {Antibiotic therapy}, levofloxacin {Antibiotic therapy}, vanc {Antibiotic therapy}, improvement {Patient's condition improved}, antibiotics {Antibiotic therapy}, consultation {Consultation}, outpatient follow up {Outpatient care management}, Sputum culture {Microbial culture of sputum}, yeast {Yeast detected}, BAL {Bronchoscopy and bronchoalveolar lavage}, Endobronchial coil removal {Removal of endotracheal tube}, improvement {Patient's condition improved}, antibiotics {Antibiotic therapy}, COPD: Severe {Severe chronic obstructive pulmonary disease}, prednisone {Steroid therapy}, prednisone {Steroid therapy}, taper {Medication decreased}, procedure {Procedure}, Increased {Medication increased}, COPD {Chronic obstructive lung disease}, SOB {Dyspnea}, prednisone {Steroid therapy}, BAL {Bronchoscopy and bronchoalveolar lavage}, r active pulm TB {Active tuberculosis}, negative {No pathologic diagnosis}, sputum {Microbial culture of sputum}, RUL {Structure of upper lobe of right lung}, Pseudomonal PNA {Pneumonia caused by Pseudomonas}, worsens {Patient's condition worsened}, sensitivity {Antimicrobial susceptibility test}, BAL {Bronchoscopy and bronchoalveolar lavage}, labs {Laboratory test}, CBC {Complete blood count}, differential {Differential white cell count within reference range}, Creatinine {Creatinine measurement}, LFTs {Hepatic function panel}, AFB culture {Acid fast bacilli culture}, infection {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: Medications on Admission:
+The Preadmission Medication list is accurate and complete.
+1. Albuterol 0.083% Neb Soln 1 NEB IH Q6H:PRN SOB, wheeze 
+2. Cetirizine 10 mg PO DAILY 
+3. Fluticasone-Salmeterol Diskus (500/50)  1 INH IH BID 
+4. Guaifenesin ER 600 mg PO Q12H 
+5. Levothyroxine Sodium 150 mcg PO DAILY 
+6. Lorazepam 1 mg PO BID 
+7. Montelukast 10 mg PO DAILY 
+8. Losartan Potassium 25 mg PO DAILY 
+9. Tiotropium Bromide 1 CAP IH DAILY 
+10. Aspirin 81 mg PO DAILY 
+11. Multivitamins 1 TAB PO DAILY 
+12. Vitamin D 1000 UNIT PO DAILY 
+13. PredniSONE 10 mg PO DAILY 
+Start: After 20 mg tapered dose 
+14. Levofloxacin 500 mg PO Q24H 
+
+ 
+Discharge Medications:
+1. Albuterol 0.083% Neb Soln 1 NEB IH Q6H:PRN SOB, wheeze 
+2. Aspirin 81 mg PO DAILY 
+3. Cetirizine 10 mg PO DAILY 
+4. Fluticasone-Salmeterol Diskus (500/50)  1 INH IH BID 
+5. Guaifenesin ER 600 mg PO Q12H 
+6. Levothyroxine Sodium 150 mcg PO DAILY 
+7. Lorazepam 1 mg PO BID 
+8. Losartan Potassium 25 mg PO DAILY 
+9. Montelukast 10 mg PO DAILY 
+10. Multivitamins 1 TAB PO DAILY 
+11. Tiotropium Bromide 1 CAP IH DAILY 
+12. Vitamin D 1000 UNIT PO DAILY 
+13. Piperacillin-Tazobactam 4.5 g IV Q6H 
+RX *piperacillin-tazobactam 4.5 gram 4.5 gram IV Every 6 hours 
+Disp #*44 Vial Refills:*0
+14. PredniSONE 60 mg PO DAILY Duration: 1 Dose 
+Take on ___ and return to regular 10mg dosing after that. 
+RX *prednisone 20 mg 3 tablet(s) by mouth Once Disp #*3 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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Primary:
+Bacterial Pneumonia
+
+Secondary: 
+COPD
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, Bacterial Pneumonia {Bacterial pneumonia}, COPD {Chronic obstructive lung disease}, Mental Status {Neurological mental status determination}, Clear {Normal state of mind}, Alert {Mentally alert}, interactive {Does communicate}, 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 Mr. ___, 
+
+It was a pleasure participating in your care at ___. You were 
+admitted to the hospital for shortness of breath due to a 
+pneumonia. You were treated with IV antibiotics and should 
+continue to take them through your new ___ line for a total of 
+14 days (last day ___. You are scheduled to see Dr. ___ in 
+the ___ Diseases clinic to discuss whether you will need 
+additional antibiotics after that. Please follow up with the 
+interventional pulmonary doctors as ___. 
+
+We gave you high dose prednisone (60mg) in the hospital which 
+you should also take tomorrow to complete 5 days. On ___, you 
+may resume your normal dose of 10mg daily.
+ 
+
+###RESPONSE: shortness of breath {Dyspnea}, pneumonia {Pneumonia}, IV antibiotics {Intravenous antibiotic therapy}, antibiotics {Antibiotic therapy}, follow up {Follow-up arranged}, pulmonary {Pulmonary medicine service}, prednisone {Steroid 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: 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: 
+Penicillins / Latex
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Shortness of Breath
+ 
+Major Surgical or Invasive Procedure:
+Thoracentesis (x2)
+Chest Tube
+Bronchoscopy
+
+ 
+
+###RESPONSE: Penicillins {Allergy to penicillin}, Latex {Allergy to Hevea brasiliensis latex protein}, Shortness of Breath {Dyspnea}, Thoracentesis {Thoracentesis}, Chest Tube {Insertion of pleural tube drain}, Bronchoscopy {Bronchoscopy}"
+"###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 newly diagnosed Stage IV NSCLC, rapidly progrsesive, 
+presenting to clinic today with SOB. She was diagnosed on ___ 
+after a ___ week history of cough following which the patient 
+palpated a R supraclavicular node. One week ago the pt was seen 
+by medical oncology and is now s/p a right supraclavicular node 
+biopsy that revealed NSCLC. She presented for follow up PET/CT 
+and subsequently to clinic today. and found be hypoxic (O2 sat 
+___ on RA). The patient was recently started on prednisone 80 mg 
+daily by her PCP for the last 2 days without significant 
+improvement.  
+.  
+Upon further ROS: The pt denies fevers, chills, headache, chest 
+pain, nausea, vomitting, diarrhea, dysuria. The patient notes 
+mild constipation when taking Vicoden.  
+
+ 
+
+###RESPONSE: Stage IV NSCLC {Non-small cell carcinoma of lung, TNM stage 4}, progrsesive {Patient's condition worsened}, clinic {Outpatient care management}, SOB {Dyspnea}, cough {Cough}, palpated {Palpation}, R supraclavicular node {Structure of right supraclavicular lymph node}, supraclavicular node 
+biopsy {Supraclavicular lymph node biopsy}, NSCLC {Non-small cell lung cancer}, PET/CT {Positron emission tomography}, clinic {Outpatient care management}, hypoxic {Hypoxia}, O2 sat {Oxygen saturation measurement}, RA {Breathing room air}, PCP {Primary care management}, improvement {Patient's condition improved}, fevers {Fever}, chills {Chill}, headache {Headache}, chest 
+pain {Chest pain}, nausea {Nausea}, vomitting {Vomiting}, diarrhea {Diarrhea}, dysuria {Dysuria}, mild {Symptom mild}, constipation {Constipation}"
+"###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:
+Past Oncology History:  
+- Initial symptoms: cough, supraclavicular lymph node, nodular 
+mass lower abdomen  
+- CXR demonstrated R hilar mass. CT on ___ showed 3.5 X 3.7 
+cm R hilar mass with marked narrowing of the right upper lobe 
+bronchus and apparent obstruction of the posterior bronchus to 
+the right upper lobe. Bulky bilateral mediastinal 
+lymphadenopathy was noted. The  
+dominant lymph node mass in the right paratracheal region 
+measured 2.9 x 2.7 cm, with a dominant conglomerate nodal mass 
+in the precarinal lesion measuring 3.3 x 2.8 cm. Multiple lymph 
+nodes were identified throughout the mediastinum including the 
+prevascular space bilaterally, the posterior subcarinal space, 
+and the right hilum. There was a moderate dependent right 
+pleural effusion and a small left pleural effusion as well as a 
+small pericardial effusion. Also noted was a 2.8 x 1.9 cm nodule 
+within the periphery of the right upper lobe. Heterogeneous 
+enhancement of the left adrenal gland was seen, measuring 1.9 x 
+1.8 cm. In addition, an enlarged left supraclavicular lymph node 
+measured 1.4 x 1 cm. Several lucent vertebral body lesions were 
+identified in the lower thoracic spine.  
+- Excisional biopsy of the right supraclavicular lymph node on 
+___.  
+- Pathology: poorly differentiated neuroendocrine carcinoma of 
+pulmonary origin, probably best characterized as large cell 
+type, although there is considerable variation in cell size. No 
+e/o lymphoproliferative disorder.  
+.  
+
+###RESPONSE: cough {Cough}, supraclavicular lymph node {Structure of supraclavicular lymph node}, nodular 
+mass {Nodule}, lower abdomen {Lower abdomen structure}, CXR {Plain chest X-ray}, hilar mass {Mass of hilum}, CT {Computed tomography of abdomen}, hilar mass {Mass of hilum}, narrowing {Narrowing}, right upper lobe 
+bronchus {Structure of bronchus of right upper lobe}, obstruction {Obstruction}, posterior bronchus to 
+the right upper lobe {Structure of right upper lobe posterior segmental bronchus}, mediastinal 
+lymphadenopathy {Mediastinal lymphadenopathy}, lymph node {Structure of lymph node}, mass {Mass}, right paratracheal {Structure of right paratracheal lymph node}, mass {Mass}, precarinal {Structure of pretracheal lymph node}, lesion {Lesion}, lymph 
+nodes {Structure of lymph node}, mediastinum {Mediastinal lymph node structure}, prevascular {Structure of prevascular and/or retrotracheal lymph node}, subcarinal {Structure of subcarinal lymph node}, right hilum {Structure of hilum of right lung}, right {Right sphenoid sinus structure}, pleural effusion {Pleural effusion}, pleural effusion {Pleural effusion}, pericardial effusion {Pericardial effusion}, nodule {Nodule of lung}, right upper lobe {Structure of upper lobe of right lung}, enhancement {Adrenal hyperplasia}, left adrenal gland {Structure of left adrenal gland}, enlarged {Localized enlarged lymph nodes}, left supraclavicular lymph node {Structure of left supraclavicular lymph node}, vertebral body {Structure of body of vertebra}, lesions {Lesion}, thoracic spine {Structure of thoracic vertebral column}, Excisional biopsy {Excisional biopsy}, right supraclavicular lymph node {Structure of right supraclavicular lymph node}, Pathology {Abnormal histology findings}, poorly differentiated neuroendocrine carcinoma {Malignant poorly differentiated neuroendocrine carcinoma}, pulmonary {Examination of respiratory system}, large cell {Large cell carcinoma of lung}, variation in cell size {Cell size alteration}, lymphoproliferative disorder {Lymphoproliferative 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: Past Medical History:  
+1. L4/L5 spondylolisthesis with synovial cyst resected in  
+___.  
+2. Left piriformis syndrome.  
+3. Hypertension.  
+4. Status post hysterectomy in ___ for leiomyomata with foci of 
+ 
+atypical hyperplasia of the endometrium, focally involving an  
+endometrial polyp.  
+
+ 
+
+###RESPONSE: L4 {Bone structure of L4}, L5 {Bone structure of L5}, spondylolisthesis {Spondylolisthesis of lumbar vertebra}, synovial cyst resected {Excision of synovial cyst}, Left {Structure of left piriformis muscle}, piriformis syndrome {Piriformis syndrome}, Hypertension {Hypertensive disorder, systemic arterial}, Status post {Postoperative state}, hysterectomy {Hysterectomy}, leiomyomata {Leiomyoma}, atypical hyperplasia of the endometrium {Endometrioid intraepithelial neoplasia}, endometrial polyp {Polyp of endometrium}"
+"###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:
+The patient's mother died at age ___ from squamous cell carcinoma 
+of the oral cavity. Her father died of congestive heart failure 
+at age ___. She has no siblings. Her  paternal aunt was diagnosed 
+with breast cancer in her ___.  
+.  
+
+ 
+
+###RESPONSE: died {Dead}, squamous cell carcinoma {Squamous cell carcinoma}, oral cavity {Oral cavity structure}, died {Dead}, congestive heart failure {Congestive heart failure}, breast cancer {Malignant neoplasm of breast}"
+"###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:
+Tc 97.3 BP 125/79 HR 95 RR 28 93% 3L NC  
+Gen: Mild Distress, Sitting upright, AOx3  
+HEENT: PEERLA, EOMI, OP without exudates or erythema  
+Neck: Supple  
+Resp: Healing R supraclavicular bx site with palpable node, 
+bilateral diffuse expiratory wheezes, no accessory muscle use, 
+decreased BS at bases, coarse BS throughout.  
+Card: Regular, S1S2 No MRG  
+Abd: Palpable non-tender mobile 2cm nodule in LLQ, soft, 
+slightly protuberant, non-tender, non-distended, BS+  
+Extr: Trace edema bilaterally, Bilateral mild ulnar deviation of 
+the phalanges  
+Neuro: AOx3, CNII-XII tested and intact. ___ strength and 
+sensation in upper and lower extremities, normal finger to nose 
+bilaterally.  
+Psych: Patient visibly anxious but appropriate conversation.  
+
+ 
+
+###RESPONSE: BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, NC {Normal head}, Gen {General examination of patient}, Mild {Symptom mild}, Distress {Distress}, Sitting upright {Sitting upright}, AOx3 {Oriented to person, time and place}, HEENT {Physical examination procedure}, PEERLA {Pupils equal, react to light and accommodation}, EOMI {Normal ocular motility}, OP {Oropharyngeal structure}, exudates {Exudate}, erythema {Erythema}, Neck {Physical examination procedure}, Supple {Normal movement of neck}, Resp {Examination of respiratory system}, Healing {Structure resulting from tissue repair process}, R supraclavicular bx site with palpable node {Supraclavicular lymph node biopsy}, wheezes {Wheezing}, accessory muscle {Accessory skeletal muscle}, decreased BS {Decreased breath sounds}, bases {Structure of base of lung}, BS {Normal bowel sounds}, Card {Cardiovascular physical examination}, Regular {Normal heart rate}, S2 {Normal second heart sound, S>2<}, No MRG {Heart sounds normal}, Abd {Examination of abdomen}, Palpable {Finding by palpation}, non-tender {Abdominal tenderness}, nodule {Nodule}, LLQ {Structure of left lower quadrant of abdomen}, soft {Abdomen soft}, protuberant {Swollen abdomen}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, BS+ {Normal bowel sounds}, Extr {Examination of limb}, edema {Edema}, mild {Symptom mild}, ulnar deviation of 
+the phalanges {Ulnar deviation of fingers}, Neuro {Neurological examination}, AOx3 {Oriented to person, time and place}, XII {Hypoglossal nerve structure}, intact {Normal sensation}, sensation {Normal sensation}, upper {Upper limb structure}, lower extremities {Lower limb structure}, normal {No abnormality detected}, nose {Nasal structure}, Psych {Psychological assessment}, anxious {Anxiety}, appropriate conversation {Conversation content appropriate}"
+"###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:
+___ 04:40PM   WBC-25.2*# RBC-4.08* HGB-12.0 HCT-35.7* 
+MCV-88 MCH-29.5 MCHC-33.7 RDW-13.2
+___ 04:40PM   NEUTS-86.9* LYMPHS-5.3* MONOS-5.6 EOS-2.0 
+BASOS-0.3
+___ 04:40PM   PLT COUNT-570*
+___ 04:40PM   ___ PTT-35.1* ___
+___ 04:40PM   CALCIUM-9.7 PHOSPHATE-3.3 MAGNESIUM-2.5 URIC 
+ACID-4.5
+___ 04:40PM   CK-MB-5 cTropnT-<0.01 proBNP-2531*
+___ 04:40PM   LIPASE-23
+___ 04:40PM   ALT(SGPT)-26 AST(SGOT)-35 LD(LDH)-370* ALK 
+PHOS-148* AMYLASE-59 TOT BILI-0.2
+___ 04:40PM   GLUCOSE-69* UREA N-19 CREAT-0.7 SODIUM-130* 
+POTASSIUM-4.2 CHLORIDE-85* TOTAL CO2-26 ANION GAP-23*
+.
+CT Head ___
+IMPRESSION: There is no evidence of abnormal enhancement or 
+evidence of focal
+or diffuse lesions. There is no evidence of intracranial 
+hemorrhage, mass, or
+mass effect. No metastasic lesions are visulized, however CT 
+with contrast
+is not able to provide the same anatomical detail comparable to 
+MRI with and
+without contrast.
+.
+PET CT: ___
+MPRESSION: 1. Widespread metastatic disease. 2. Malignant soft 
+tissue nodule
+in the deep right breast is most likely a metastasis from lung 
+cancer (given
+second subcutaneous deposit in the anterior abdominal wall), but 
+the possibility
+of a second breast primary remains a remote consideration. 3. 
+Suspicious
+focus in the pancreas is also likely a metastasis, but again, a 
+primary
+malignancy would be difficult to entirely exclude.
+.
+ECHO: ___
+The left atrium is normal in size. Left ventricular wall 
+thicknesses are normal. The left ventricular cavity size is 
+normal. Overall left ventricular systolic function is normal 
+(LVEF 60-70%). Right ventricular chamber size and free wall 
+motion are normal. There are focal calcifications in the aortic 
+arch. The aortic valve leaflets (3) are mildly thickened but 
+aortic stenosis is not present. Trace aortic regurgitation is 
+seen. The mitral valve leaflets are mildly thickened. There is 
+no mitral valve prolapse. Trivial mitral regurgitation is seen. 
+There is mild pulmonary artery systolic hypertension. The main 
+pulmonary artery is dilated.
+.
+There is a small to moderate sized pericardial effusion. The 
+effusion appears circumferential. There is brief right atrial as 
+well as right ventricular free wall diastolic invagination. 
+However, there is no major respirophasic variation of right or 
+left ventriculart inflow. These findings suggest that increased 
+pericardial pressure is present, without major impairment of 
+ventricular filling or frank cardiac tamponade. Serial clinical 
+and echocardiographic followup is recommended. 
+.
+ECHO ___:
+Overall left ventricular systolic function is normal (LVEF>55%). 
+Right ventricular chamber size and free wall motion are normal. 
+The aortic valve leaflets (3) are mildly thickened. The mitral 
+valve leaflets are mildly thickened. There is a small to 
+moderate sized pericardial effusion. The effusion appears 
+circumferential. There are no echocardiographic signs of 
+tamponade. There is brief right atrial diastolic collapse. 
+.
+Compared with the prior study (images reviewed) of ___, no 
+right ventricular diastolic invagination is appreciated. The 
+pericardial effusion appears slightly smaller.
+.
+___:
+IMPRESSION:
+1. No evidence of aortic dissection or pulmonary embolism to the 
+subsegmental
+level.
+2. Increased dense nonenhancing right lower lobe consolidation 
+consistent
+with pneumonia, with additional increased predominantly 
+ground-glass
+consolidation / post obstructive changes (due to right hilar 
+mass /
+adenopathy) within the posterior portion of the left upper lobe 
+and adjacent
+to the right pleural effusion, which are also presumably 
+infectious in
+etiology. Please note reexpansion edema involving a portion of 
+the right lower
+lobe may also have a similar appearance.
+3. Increased enhancing atelectasis involving the left lower lobe 
+with left
+pleural fluid noted to insinuate around regions of ""drowned"" 
+lung.
+4. No significant interval change in the degree of previously 
+described
+adenopathy and a dominant right hilar mass, with stable mass 
+effect on right
+upper lobe and bronchus intermedius bronchi. Stable mass effect 
+on the right
+upper lobe pulmonary artery, which remains patent.
+5. Unchanged soft tissue density within the deep right breast, 
+which was
+noted to be FDG-avid.
+6. Unchanged background emphysema and interstitial septal 
+thickening, which
+is worrisome for lymphangitic carcinomatosis.
+7. Stable lytic metastatic lesions and thickening of the left 
+adrenal gland.
+.
+___:
+Cytology ReportPLEURAL FLUIDProcedure Date of ___
+  
+REPORT APPROVED ___
+SPECIMEN ___    ___    PLEURAL FLUID
+ 
+SPECIMEN DESCRIPTION: Received 1,300 ml of bloody fluid.
+  Prepared 1 ThinPrep slide.
+ 
+CLINICAL DATA: 73 with metastatic NSCLA with R pleural 
+effusion.
+PREVIOUS BIOPSIES:
+___ PLEURAL FLUID
+___ PERITONEAL WASHINGS
+REPORT ___. ___
+ 
+___: Pleural fluid:
+  
+  ATYPICAL.
+  
+  Clusters of atypical epithelioid cells on cell block
+  (___) only. The cells are negative for ___ 31,
+  B72.3, TTF-1 and CEA and cannot be further classified.
+  
+DIAGNOSED BY:
+___, CT(___)
+___, M.D.
+ 
+(___)
+.
+___: TTE
+Overall left ventricular systolic function is normal (LVEF>55%). 
+Right ventricular chamber size and free wall motion are normal. 
+The aortic valve leaflets are mildly thickened. The mitral valve 
+leaflets are mildly thickened. There is a small to moderate 
+sized pericardial effusion. The effusion appears 
+circumferential. No right ventricular diastolic collapse is 
+seen. There is brief right atrial diastolic collapse. There is 
+significant, accentuated respiratory variation in 
+mitral/tricuspid valve inflows, consistent with impaired 
+ventricular filling. 
+
+Compared with the prior study (images reviewed) of ___, 
+the resting heart rate is faster and respiratory variation in 
+mitral valve inflow is present (this may be secondary to other 
+entities than impending tamponade such as volume depletion or 
+lung disease). Left ventricular function is more vigorous. 
+.
+___: CXR
+FINDINGS: As compared to the previous examination, there is 
+increasing
+consolidation and volume loss in the right upper lobe. The 
+perihilar right
+lung areas, notably neighboring a hilar mass, are denser than on 
+the previous
+examination. A pre-existing right-sided pleural effusion is 
+unchanged, and
+the expansion of the right lower lobe is slightly improved as 
+compared to the
+previous exam. No pathologic changes in the left lung.
+.
+Discharge Labs:
+___ 06:40AM BLOOD WBC-4.6 RBC-3.37* Hgb-10.0* Hct-29.9* 
+MCV-89 MCH-29.7 MCHC-33.5 RDW-13.0 Plt ___
+___ 06:40AM BLOOD Plt ___
+___ 07:10AM BLOOD ___ PTT-33.6 ___
+___ 06:40AM BLOOD Glucose-97 UreaN-23* Creat-0.7 Na-136 
+K-3.8 Cl-100 HCO3-29 AnGap-11
+___ 07:10AM BLOOD ALT-12 AST-15 LD(LDH)-168 AlkPhos-91 
+TotBili-0.6
+___ 06:40AM BLOOD Calcium-8.2* Phos-2.6* Mg-2.___ with newly diagnosed metastatic NSCLC here with dyspnea and 
+new 02 requirement.
+.
+# Dyspnea, Hypoxia: The patients initial differential included 
+worsening atelectasis, bronchospasms, worsening effusions, 
+post-obstructive PNA, anxiety, anemia. The patient was admitted 
+on Prednsione 80mg PO Daily which was tapered down during her 
+hospital course in addition to receiving nebs PRN. CXR revealed 
+a large R sided effusion and the  pt underwent thoracentesis on 
+___ during which 2.1L were removed. That evening the pt had an 
+episode of desaturation requiring up to 10L with CXR evidence of 
+re-expansion pulmonary edema, this improved somewhat with 
+diuresis, but CT chest ___ showed marked worsening of effusions 
+& dense consolodate of RLL with ground glass opacities 
+surrounding. A second thoarcenetsis was then performed which was 
+complcated by a PTX after which a chest tube was placed for 24 
+hrs without complication. The patient was placed on Levo/Flagyl 
+for a questionable post-obstructive PNA. The chest tube was 
+removed and ___ 48hrs the patient an the patients 02 requirement 
+resolved. The patient was discharged on room air with home 02 
+PRN.
+.
+# Metastatic NSCLC: PET-CT revealed wide-spread metastatic 
+disease. Pathology ""poorly differentiated neuroendocrine 
+carcinoma of pulmonary origin, probably best characterized as 
+large cell type"". Potentially the etiology of the patients SOB. 
+The patient was initiated on her first cycle of 
+Cabroplatin/Etoposide on ___ for 3 days. The patient tolerated 
+the treatment during her hospital course without complications.
+.
+# Pericardial effusion: A pericardial effusion was noted on CT 
+prior to admittion. TTE (details above) revealed early signs of 
+tamponade on ___, this was improved on ___ echo. Care was 
+taken during diureses not to drop the patients BP. (The patient 
+tolerated doses of 20IV lasix, although 40IV lasix caused 
+asymptomatic drops to the mid ___ systolically). The patient 
+required no interventions and the patients TTE was repeated on 
+___ prior to d/c (details above).
+.
+# Anxiety: Continued anxiety over the past ___ weeks. Has been 
+taking Ativan and Valium while at home.The patient was continued 
+on Ativan 0.5-1mg as needed.
+.
+# HTN: BP controlled.The patients BP was exchanged (Toprol XL 
+50mg for Metoprolol 25mg PO BID) while in house.
+ 
+
+###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}, CALCIUM {Blood calcium measurement}, cTropnT {Troponin T cardiac measurement}, proBNP {N-terminal pro-brain natriuretic peptide measurement}, LIPASE {Triacylglycerol lipase measurement}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, LDH {Lactate dehydrogenase measurement}, TOT BILI {Bilirubin, total measurement}, 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}, no evidence {No abnormality detected}, enhancement {Refractive surgery enhancement}, lesions {Lesion}, no evidence {No abnormality detected}, intracranial 
+hemorrhage {Intracranial hemorrhage}, mass {Mass}, mass {Mass}, metastasic {Metastatic malignant neoplasm}, lesions {Lesion}, MRI with {Magnetic resonance imaging of head with contrast}, without contrast {Magnetic resonance imaging without contrast}, disease {Disease}, Malignant soft 
+tissue {Malignant neoplasm of soft tissue}, nodule {Nodule}, right breast {Metastatic malignant neoplasm to right breast}, metastasis from lung 
+cancer {Primary malignant neoplasm of lung}, subcutaneous {Subcutaneous tissue structure of anterior abdominal wall}, deposit {Deposition}, anterior abdominal wall {Anterior abdominal wall structure}, breast primary {Primary malignant neoplasm of breast}, pancreas is also likely a metastasis {Metastatic malignant neoplasm to pancreas}, primary
+malignancy {Primary malignant neoplasm of pancreas}, ECHO {Echocardiography}, left atrium {Left atrial structure}, normal in size {Normal size}, Left ventricular wall {Left cardiac ventricular structure}, thicknesses are normal {Normal thickness}, left ventricular cavity {Structure of cavity of left cardiac ventricle}, size is 
+normal {Normal size}, left ventricular systolic function {Normal left ventricular systolic function and wall motion}, normal {No abnormality detected}, Right ventricular chamber {Right cardiac ventricular structure}, wall 
+motion are normal {Normal ventricular wall motion}, focal calcifications {Focal calcium deposition, calcified structure}, aortic 
+arch {Aortic arch structure}, aortic valve leaflets {Structure of cardiac valve leaflet}, mildly thickened {Increased thickness}, aortic stenosis {Aortic valve stenosis}, aortic regurgitation {Aortic valve regurgitation}, mitral valve leaflets are mildly thickened {Thickened mitral leaflet}, mitral valve prolapse {Mitral valve prolapse}, Trivial mitral regurgitation {Mild mitral valve regurgitation}, mild {Mild mitral valve regurgitation}, pulmonary artery systolic hypertension {Pulmonary hypertensive arterial disease}, pulmonary artery is dilated {Dilatation of pulmonary artery}, pericardial effusion {Pericardial effusion}, effusion {Pericardial effusion}, right atrial {Right atrial structure}, right ventricular {Right cardiac ventricular structure}, wall {Cardiac wall structure}, invagination {Invagination}, right {Right cardiac ventricular structure}, left ventriculart {Left cardiac ventricular structure}, inflow {Abnormal cardiac flow}, pericardial {Pericardial structure}, pressure {Pressure}, impairment {Impairment}, ventricular {Cardiac ventricular structure}, filling {Abnormal cardiac flow}, cardiac tamponade {Cardiac tamponade}, echocardiographic {Echocardiography}, followup {Follow-up consultation}, left ventricular systolic function {Normal left ventricular systolic function and wall motion}, normal {No abnormality detected}, Right ventricular chamber {Right cardiac ventricular structure}, wall motion are normal {Normal ventricular wall motion}, aortic valve leaflets {Structure of cardiac valve leaflet}, mildly thickened {Increased thickness}, mitral 
+valve leaflets are mildly thickened {Thickened mitral leaflet}, pericardial effusion {Pericardial effusion}, effusion {Pericardial effusion}, echocardiographic {Echocardiography}, signs {Sign}, tamponade {Cardiac tamponade}, right atrial {Right atrial structure}, collapse {Collapse}, study {Evaluation procedure}, right ventricular {Right cardiac ventricular structure}, invagination {Invagination}, pericardial effusion {Pericardial effusion}, No evidence {No abnormality detected}, aortic dissection {Dissection of aorta}, pulmonary embolism {Pulmonary embolism}, right lower lobe {Structure of lower lobe of right lung}, consolidation {Lung consolidation}, pneumonia {Pneumonia}, ground-glass {Ground glass lung opacity}, consolidation {Lung consolidation}, obstructive {Obstruction}, hilar 
+mass {Mass of hilum}, adenopathy {Lymphadenopathy}, left upper lobe {Structure of upper lobe of left lung}, right {Right sphenoid sinus structure}, pleural effusion {Pleural effusion}, infectious {Infectious disease}, edema {Edema}, right lower
+lobe {Structure of lower lobe of right lung}, atelectasis {Atelectasis}, left lower lobe {Structure of lower lobe of left lung}, pleural fluid {Pleural effusion}, lung {Lung structure}, adenopathy {Lymphadenopathy}, hilar mass {Mass of hilum}, stable {Symptom not changed}, mass {Nodule of lung}, right
+upper lobe {Structure of upper lobe of right lung}, bronchus {Structure of right bronchus}, Stable {Symptom not changed}, mass {Nodule of lung}, right
+upper lobe pulmonary {Structure of upper lobe of right lung}, soft tissue {Structure of soft tissue}, density {Abnormally opaque structure}, right breast {Right breast structure}, FDG {Positron emission tomography with computed tomography using fluorodeoxyglucose (18-F)}, emphysema {Emphysema}, septal {Cardiac septum structure}, thickening {Increased thickness}, lymphangitic carcinomatosis {Lymphangitis carcinomatosa}, Stable {Patient's condition stable}, lytic {Lysis}, metastatic {Metastatic malignant neoplasm}, lesions {Lesion}, thickening {Increased thickness}, left 
+adrenal gland {Structure of left adrenal gland}, Cytology {Cytology examination - general}, PLEURAL FLUID {Pleural effusion}, SPECIMEN DESCRIPTION {Specimen description}, bloody fluid {Pleural fluid bloodstained}, metastatic {Metastatic malignant neoplasm}, NSCLA {Non-small cell lung cancer}, pleural 
+effusion {Pleural effusion}, BIOPSIES {Biopsy}, PLEURAL FLUID {Pleural effusion}, Pleural fluid {Pleural effusion}, cells {Cell structure}, cell {Cell structure}, block {Obstruction}, cells {Cell structure}, negative {No abnormality detected}, TTE {Transthoracic echocardiography}, left ventricular systolic function {Normal left ventricular systolic function and wall motion}, normal {No abnormality detected}, Right ventricular chamber {Right cardiac ventricular structure}, wall motion are normal {Normal ventricular wall motion}, aortic valve leaflets {Structure of cardiac valve leaflet}, mildly thickened {Increased thickness}, mitral valve 
+leaflets are mildly thickened {Thickened mitral leaflet}, pericardial effusion {Pericardial effusion}, effusion {Pericardial effusion}, right ventricular {Right cardiac ventricular structure}, collapse {Collapse}, right atrial {Right atrial structure}, collapse {Collapse}, respiratory {Examination of respiratory system}, mitral {Mitral valve regurgitation}, tricuspid valve {Tricuspid valve structure}, inflows {Abnormal cardiac flow}, impaired {Impairment}, ventricular {Cardiac ventricular structure}, filling {Abnormal cardiac flow}, study {Evaluation procedure}, heart rate is faster {Tachycardia}, respiratory {Examination of respiratory system}, mitral valve {Mitral valve structure}, inflow {Abnormal cardiac flow}, tamponade {Cardiac tamponade}, volume depletion {Decreased blood volume}, lung disease {Disorder of lung}, Left ventricular {Left cardiac ventricular structure}, CXR {Plain chest X-ray}, consolidation {Consolidation}, volume loss {Decreased size}, right upper lobe {Structure of upper lobe of right lung}, perihilar right
+lung areas {Structure of perihilar region of right lung}, hilar mass {Mass of hilum}, right-sided {Right breast structure}, pleural effusion {Pleural effusion}, right lower lobe {Structure of lower lobe of right lung}, improved {Patient's condition improved}, exam {Examination of respiratory system}, left lung {Left lung structure}, 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}, BLOOD 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}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, metastatic {Metastatic malignant neoplasm}, NSCLC {Non-small cell lung cancer}, dyspnea {Dyspnea}, Dyspnea {Dyspnea}, Hypoxia {Hypoxia}, worsening {Patient's condition worsened}, atelectasis {Atelectasis}, bronchospasms {Bronchospasm}, worsening {Patient's condition worsened}, effusions {Effusion}, post-obstructive PNA {Postobstructive pneumonia}, anxiety {Anxiety}, anemia {Anemia}, CXR {Plain chest X-ray}, R sided {Right pleura structure}, effusion {Pleural effusion}, thoracentesis {Thoracentesis}, removed {Drainage of pleural cavity}, desaturation {Oxygen saturation below reference range}, 10L {Oxygen therapy}, CXR {Plain chest X-ray}, pulmonary edema {Pulmonary edema}, improved {Patient's condition improved}, diuresis {Diuretic therapy}, CT chest {Computed tomography of chest}, worsening {Patient's condition worsened}, effusions {Pleural effusion}, RLL {Structure of lower lobe of right lung}, ground glass opacities {Ground glass lung opacity}, thoarcenetsis {Thoracentesis}, PTX {Pneumothorax}, chest tube was placed {Insertion of pleural tube drain}, on Levo/Flagyl {Antibiotic therapy}, post-obstructive PNA {Postobstructive pneumonia}, chest tube was 
+removed {Intercostal drain removal}, resolved {Problem resolved}, on room air {Breathing room air}, 02 {Oxygen therapy}, Metastatic {Metastatic malignant neoplasm}, NSCLC {Non-small cell lung cancer}, PET-CT {Positron emission tomography}, wide-spread metastatic 
+disease {Widespread metastatic malignant neoplastic disease}, Pathology {Abnormal histology findings}, poorly differentiated neuroendocrine 
+carcinoma {Malignant poorly differentiated neuroendocrine carcinoma}, pulmonary {Primary malignant neoplasm of lung}, large cell {Large cell carcinoma of lung}, SOB {Dyspnea}, Cabroplatin/Etoposide {Chemotherapy}, Pericardial effusion {Pericardial effusion}, pericardial effusion {Pericardial effusion}, TTE {Transthoracic echocardiography}, signs {Sign}, tamponade {Cardiac tamponade}, improved {Patient's condition improved}, echo {Echocardiography}, diureses {Diuretic therapy}, drop the patients BP {Finding of decreased blood pressure}, lasix {Diuretic therapy}, lasix {Diuretic therapy}, asymptomatic {Asymptomatic}, drops {Finding of decreased blood pressure}, TTE {Transthoracic echocardiography}, Anxiety {Anxiety}, anxiety {Anxiety}, HTN {Hypertensive disorder, systemic arterial}, BP {Blood pressure finding}, BP {Blood pressure finding}, exchanged {Change of medication}"
+"###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:
+HYDROCODONE-ACETAMINOPHEN - 5 mg-500 mg Tablet - ___ Tablet(s) 
+by  
+mouth every six (6) hours as needed for pain  
+LORAZEPAM - (Prescribed by Other Provider) - 1 mg Tablet -  
+Tablet(s) by mouth  
+METOPROLOL SUCCINATE - (Prescribed by Other Provider) - 50 mg  
+Tablet Sustained Release 24 hr - 1 (One) Tablet(s) by mouth qd  
+- OTC  
+ACETAMINOPHEN [TYLENOL ARTHRITIS] - (___) - 650 mg Tablet  
+Sustained Release - Tablet(s) by mouth as needed for pain  
+ASPIRIN [BABY ASPIRIN] - (OTC) - 81 mg Tablet, Chewable - 1  
+Tablet(s) by mouth once a day  
+DOCUSATE SODIUM [DOCUSIL] - 100 mg Capsule - 1 Capsule(s) by  
+mouth twice a day as needed for while on pain med HOLD if having 
+ 
+diarrhea  
+IBUPROFEN [MOTRIN] - (___) - 600 mg Tablet - 1 Tablet(s) by  
+mouth twice a day as needed for pain  
+
+ 
+Discharge Medications:
+1. Home O2 therapy ___
+Patient requires home O2 for hypoxia with malignant pleural 
+effusion
+2. Prednisone 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily) 
+for 4 days: to complete taper.
+Disp:*4 Tablet(s)* Refills:*0*
+3. Percocet ___ mg Tablet Sig: ___ Tablets PO every six (6) 
+hours as needed for pain: do not drive or drink alcohol with 
+this medication.  
+4. Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 
+hours) as needed for anxiety: do not drink or drink alcohol with 
+this medication.  
+5. Metoprolol Succinate 50 mg Tablet Sustained Release 24 hr 
+Sig: One (1) Tablet Sustained Release 24 hr PO once a day.  
+6. Tylenol ___ mg Tablet Sig: ___ Tablets PO every six (6) hours 
+as needed for pain.  
+7. Colace 100 mg Capsule Sig: One (1) Capsule PO twice a day.  
+
+ 
+
+###RESPONSE: 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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Primary Diagnosis:
+Community acquired pneumonia
+Pleural Effusion
+Pericardial effusion
+.
+Secondary Diagnosis:
+Non small cell lung cancer
+Anxiety
+
+ 
+Discharge Condition:
+Good, on RA. Desats to the high ___ when climbing stairs. At her 
+mental baseline.
+
+ 
+
+###RESPONSE: With Service {Home health aide service management}, Community acquired pneumonia {Community acquired pneumonia}, Pleural Effusion {Pleural effusion}, Pericardial effusion {Pericardial effusion}, Non small cell lung cancer {Non-small cell lung cancer}, Anxiety {Anxiety}, Good {Patient's condition satisfactory}, RA {Breathing room air}, climbing stairs {Difficulty walking up stairs}, mental {Mental state finding}, baseline {Baseline state}"
+"###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 with shortness of breath.  You were found to 
+have both a pneumonia and fluid in your lung (pleural effusion). 
+ You underwent a thoracentesis with removal of fluid in your 
+lung.  Your chest x rays have been stable since then, as well as 
+your echocardiogram.
+.
+Please continue your home medications as before.  You have 
+completed a course of antibiotics for presumed pneumonia.  
+Additionally, we are tapering your steroids starting by your 
+primary physician.  Please continue Prednisone 10mg daily for an 
+additional 4 days and then stop.
+.
+Please follow up with Dr. ___ on ___ as scheduled, and 
+follow up with Dr. ___ in 2 weeks to reassess your pericardial 
+effusion
+.
+Please return to the hospital if you experience worsening 
+shortness of breath, chest pain, high fever, or low blood 
+pressure
+ 
+
+###RESPONSE: shortness of breath {Dyspnea}, pneumonia {Pneumonia}, fluid in your lung {Pleural effusion}, pleural effusion {Pleural effusion}, thoracentesis {Thoracentesis}, removal {Removal}, fluid in your 
+lung {Pleural effusion}, chest x rays {Plain chest X-ray}, stable {Patient's condition stable}, echocardiogram {Echocardiography}, medications {Administration of drug or medicament}, antibiotics {Antibiotic therapy}, pneumonia {Pneumonia}, steroids {Steroid therapy}, primary physician {Primary care management}, follow up {Follow-up arranged}, pericardial 
+effusion {Pericardial effusion}, worsening {Patient's condition worsened}, shortness of breath {Dyspnea}, chest pain {Chest pain}, fever {Fever}, low blood 
+pressure {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: 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: 
+Penicillins / Citalopram
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Shortness of breath
+ 
+Major Surgical or Invasive Procedure:
+None 
+
+ 
+
+###RESPONSE: Penicillins {Allergy to penicillin}, Shortness of breath {Dyspnea}"
+"###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:
+___ woman with history of moderate COPD/asthma (FEV1 40% 
+pred. in ___, CAD, diastolic CHF, and aortic aneurysm who 
+presented to the emergency room overnight with several weeks of 
+SOB and cough productive of yellow sputum. Pt reports that 
+symptoms have been intermittent for several weeks; recently 
+symptoms have become worse. She was seen by her PCP ___ who 
+recommended that she keep her appointment with her pulmonologist 
+___ for consideration of initiation of daily low dose 
+prednisone. Of note, in the past pt has had issues with 
+noncompliance with meds. Pt reports that she has been using her 
+nebs more frequently recently given her SOB.  
+.  
+Her initial vitals in the ED were 100.4, 86, 136/89, 16, and 
+94%. Labs notable for no white count, normal electrolytes and 
+normal lactate (1.3). Chest x-ray notable for stable left 
+lingular nodule and linear opacities in the right mid lung. 
+There was no acute process. Nevertheless, the patient was 
+treated for CAP in the ED with ceftriaxone and azithromycin. She 
+was also treated with methylprednisolone and Combivent nebs for 
+presumptive COPD exacerbation. Blood cultures were drawn prior 
+to antibiotic administration. The patient was then admitted for 
+further treatment. Vitals at time of admit: 97.9, 77, 157/83, 
+18, 100% RA.  
+.  
+Review of Systems:  
+(+) Pt reports feeling nightsweats yesterday, nausea two days 
+ago, intermittent headaches (recently changed from amitriptyline 
+prn to daily), chronic constipation  
+(-) Denies rhinorrhea, sore throat, chest pain, palpitations, 
+abdominal pain  
+
+ 
+
+###RESPONSE: COPD {Chronic obstructive lung disease}, asthma {Asthma}, CAD {Coronary arteriosclerosis}, diastolic CHF {Heart failure with normal ejection fraction}, aortic aneurysm {Aortic aneurysm}, emergency {Emergency treatment management}, SOB {Dyspnea}, cough productive of yellow sputum {Productive cough-yellow sputum}, worse {Patient's condition worsened}, PCP {Primary care management}, prednisone {Steroid therapy}, noncompliance with meds {Non-compliance of drug therapy}, nebs {Nebulizer therapy}, SOB {Dyspnea}, vitals {Vital signs finding}, Labs {Laboratory test}, white count {White blood cell count outside reference range}, normal electrolytes {Electrolytes within reference range}, normal {No abnormality detected}, lactate {Lactic acid measurement}, Chest x-ray {Plain chest X-ray}, stable {Symptom not changed}, left {Left pleura structure}, lingular {Structure of lingular bronchus}, nodule {Nodule of lung}, opacities {Abnormally opaque structure}, right mid lung {Structure of middle lobe of right lung}, no acute {No abnormality detected}, CAP {Community acquired pneumonia}, azithromycin {Antibiotic therapy}, nebs {Nebulizer therapy}, COPD exacerbation {Acute exacerbation of chronic obstructive airways disease}, Blood cultures {Blood culture}, antibiotic {Antibiotic therapy}, Vitals {Vital signs finding}, Review of Systems {Review of systems}, nightsweats {Night sweats}, nausea {Nausea}, intermittent headaches {Intermittent headache}, changed {Change of medication}, chronic constipation {Chronic constipation}, rhinorrhea {Nasal discharge}, sore throat {Sore throat}, chest pain {Chest pain}, palpitations {Palpitations}, abdominal pain {Abdominal 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: Past Medical History:
+- Chronic obstructive pulmonary disease  
+- Asthma  
+- Hypertension  
+- Headaches  
+- Duodenal and stomach ulcers, s/p partial gastrectomy  
+- Aortic aneurysm  
+- Cataracts  
+- History of pulmonary nodule  
+- Diastolic CHF  
+
+ 
+
+###RESPONSE: Chronic obstructive pulmonary disease {Chronic obstructive lung disease}, Asthma {Asthma}, Hypertension {Hypertensive disorder, systemic arterial}, Headaches {Headache}, Duodenal {Ulcer of duodenum}, stomach ulcers {Gastric ulcer}, partial gastrectomy {Subtotal gastrectomy}, Aortic aneurysm {Aortic aneurysm}, Cataracts {Cataract}, pulmonary nodule {Nodule of lung}, Diastolic CHF {Heart failure with normal ejection fraction}"
+"###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:
+Non-contributory
+ 
+
+###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:
+On admission:
+VS: 98.1  140/80  72  24  100%4L 
+Gen: NAD. Alert and oriented x3. Mood and affect appropriate. 
+Pleasant and cooperative. Resting in bed.
+HEENT: NCAT. PERRL, EOMI, anicteric sclera. MMM, OP clear.
+Neck: Supple. JVP not elevated.  
+CV: RRR.  Normal S1, S2.  No murmur, rubs, or gallops.
+Chest: Faint diffuse wheezes, decreased breath sounds diffusely, 
+bibasilar crackles  
+Abd: BS present. Soft, NT, ND. No HSM detected.
+Ext: WWP, no cyanosis or clubbing. Trace ___ edema. Digital cap 
+refill <2 sec.  Distal pulses DP 2+, ___ 2+.
+Neuro/Psych: CNs II-XII intact. ___ strength in U/L extremities
+ 
+
+###RESPONSE: VS {Vital signs finding}, Gen {General examination of patient}, NAD {No abnormality detected}, Alert {Mentally alert}, oriented {Orientated}, Mood {Level of mood - normal}, affect {Mood finding}, cooperative {Cooperative mental state}, Resting in bed {Lying in bed}, HEENT {Physical examination procedure}, NC {Normal head}, PERRL {Pupils equal and reacting to light}, EOMI {Normal ocular motility}, anicteric sclera {White sclera}, MMM {Moist oral mucosa}, OP clear {Pharynx normal}, Neck {Physical examination procedure}, Supple {Normal movement of neck}, JVP not elevated {Normal jugular venous pressure}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, S2 {Normal second heart sound, S>2<}, murmur {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, Chest {Examination of respiratory system}, wheezes {Wheezing}, decreased breath sounds {Decreased breath sounds}, bibasilar {Structure of base of lung}, crackles {Respiratory crackles}, Abd {Examination of abdomen}, BS present {Normal bowel sounds}, Soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, HSM {Hepatosplenomegaly}, Ext {Examination of limb}, WWP {Normal tissue perfusion}, cyanosis {Cyanosis}, clubbing {Clubbing}, edema {Edema}, pulses {Pulse finding}, DP 2 {Dorsalis pulse present}, Neuro {Neurological examination}, CNs II-XII {Cranial nerve structure}, intact {No abnormality detected}, extremities {All extremities}"
+"###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
+--------------
+___ 01:00AM BLOOD WBC-4.1 RBC-4.26 Hgb-12.3 Hct-37.7 MCV-89 
+MCH-28.9 MCHC-32.6 RDW-14.0 Plt ___
+___ 01:00AM BLOOD Glucose-148* UreaN-14 Creat-0.8 Na-141 
+K-5.1 Cl-102 HCO3-31 AnGap-13
+___ 01:19AM BLOOD Lactate-1.3
+___ 1:00 am Blood Culture, Routine (Preliminary): 
+      STAPHYLOCOCCUS, COAGULASE NEGATIVE. 
+.
+DISCHARGE LABS
+--------------
+___ 07:20AM BLOOD WBC-5.3 RBC-4.20 Hgb-12.4 Hct-38.0 MCV-90 
+MCH-29.5 MCHC-32.6 RDW-14.7 Plt ___
+___ 07:20AM BLOOD Glucose-112* UreaN-26* Creat-0.8 Na-144 
+K-3.5 Cl-105 HCO3-26 AnGap-17
+___ 07:20AM BLOOD Calcium-9.0 Phos-4.2 Mg-2.0
+.
+IMAGING
+-------
+Chest (PA & LAT) ___:
+FRONTAL AND LATERAL VIEWS OF THE CHEST: Linear opacities in the 
+right lung are again seen, unchanged since the prior study and 
+likely relate to 
+scarring/nonspecific fibrosis. The left lingular nodular opacity 
+is not as discretely seen on this study but appears stable in 
+size. There is no new pleural effusion or pneumothorax. Mild 
+cardiomegaly is unchanged. The aorta remains tortuous. 
+  
+IMPRESSION: No acute intrathoracic process. Stable appearance of 
+scarring/fibrosis over the right mid lung and lingular nodular 
+density. 
+.
+MICROBIOLOGY
+------------
+___ 1:00 am BLOOD CULTURE
+
+   Blood Culture, Routine (Preliminary): 
+      STAPHYLOCOCCUS, COAGULASE NEGATIVE. 
+         Isolated from only one set in the previous five days. 
+         SENSITIVITIES PERFORMED ON REQUEST.. 
+
+   Aerobic Bottle Gram Stain (Final ___: 
+      Reported to and read back by ___ @ 5:54A 
+___. 
+      GRAM POSITIVE COCCI. 
+      IN PAIRS AND CLUSTERS.
+.
+Blood culture ___: pending, no growth to date
+
+ 
+
+###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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {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}, Lactate {Lactic acid measurement}, Blood Culture {Blood culture}, NEGATIVE {No pathologic diagnosis}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {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}, IMAGING {Imaging}, CHEST {Plain chest X-ray}, opacities {Abnormally opaque structure}, right lung {Right lung structure}, unchanged {Patient condition unchanged}, study {Evaluation procedure}, scarring {Scar}, fibrosis {Fibrosis}, left {Left pleura structure}, lingular {Structure of lingular bronchus}, nodular {Nodule of lung}, opacity {Abnormally opaque structure}, study {Evaluation procedure}, stable {Symptom not changed}, pleural effusion {Pleural effusion}, pneumothorax {Pneumothorax}, cardiomegaly {Cardiomegaly}, unchanged {Patient condition unchanged}, aorta {Aortic structure}, tortuous {Tortuosity}, No acute intrathoracic process {No abnormality detected}, scarring {Scar}, fibrosis {Fibrosis}, right mid lung {Structure of middle lobe of right lung}, lingular {Structure of lingular bronchus}, nodular {Nodule of lung}, density {Abnormally opaque structure}, MICROBIOLOGY {Microbiology}, BLOOD CULTURE {Blood culture}, Blood Culture {Blood culture}, NEGATIVE {No pathologic diagnosis}, SENSITIVITIES {Antimicrobial susceptibility test}, Gram Stain {Gram stain method}, Blood culture {Blood culture}, no growth {No organism isolated by microbiologic culture}"
+"###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:
+___ woman with history of moderate obstructive lung 
+disease presents with two weeks of shortness of breath and a 
+couple days of sputum production, with low-grade fevers in the 
+emergency room.  
+.  
+ACTIVE ISSUES
+-------------
+# Shortness of breath, productive cough, low-grade fever: 
+dyspnea likely secondary to COPD flare, possibly exacerbated by 
+viral bronchitis given cough and low grade temperature.  Chest 
+X-ray did not show pneumonia.  Patient was given standing 
+nebulizers and prednisone 60mg x 7 days without a taper.  She 
+was also treated with azithromycin x 5 days.  She was kept on 
+her home oxygen of 4 liters with maintenance of oxygen 
+saturations.
+.  
+INACTIVE ISSUES
+---------------
+# Diastolic CHF: Last TTE on ___ showed preserved ejection 
+fraction, and no significant valvular disease.  She appeared 
+euvolemic on exam.  Chest X-ray was without any large effusions. 
+ Patient was continued on her home dose of furosemide during 
+hospitalization. 
+.  
+# Aortic aneurysm: CTA performed on ___ showing slightly 
+enlarged aortic aneurysm measuring approximately 4.5 cm AP x 4.9 
+cm transversely (previously 4.2 cm in AP x 4.2 cm transverse).  
+She should follow-up with her PCP as an outpatient further 
+regarding this problem.
+. 
+# Hypertension: patient was continued on her home dose of lasix 
+and lisinopril. 
+.  
+# Headaches: patient was continued on her home dose of 
+amitryptiline.  
+.
+# Gastroesophageal reflux disease: patient was continued on home 
+proton pump inhibitor. 
+.
+TRANSITION OF CARE
+------------------
+# Follow-up: patient has pending blood cultures that should be 
+followed up upon discharge.  She will be scheduled by her 
+primary care provider for ___ follow-up 
+appointment.  She will also be seen by Pulmonary soon after 
+discharge for an initial assessment.
+.
+# Code status: patient is confirmed full code
+.
+# Communication:
+- Al (son): ___.  
+- ___ (son): ___. 
+ 
+
+###RESPONSE: moderate obstructive lung 
+disease {Moderate chronic obstructive pulmonary disease}, shortness of breath {Dyspnea}, sputum production {Productive cough}, low-grade fevers {Low grade pyrexia}, emergency {Emergency treatment management}, Shortness of breath {Dyspnea}, productive cough {Productive cough}, low-grade fever {Low grade pyrexia}, dyspnea {Dyspnea}, COPD flare {Acute exacerbation of chronic obstructive airways disease}, viral bronchitis {Viral bronchitis}, cough {Cough}, temperature {Body temperature above reference range}, Chest 
+X-ray {Plain chest X-ray}, pneumonia {Pneumonia}, nebulizers {Nebulizer therapy}, prednisone {Steroid therapy}, taper {Medication decreased}, azithromycin {Antibiotic therapy}, home oxygen {Home oxygen therapy}, oxygen 
+saturations {Finding of oxygen saturation}, Diastolic CHF {Heart failure with normal ejection fraction}, TTE {Transthoracic echocardiography}, valvular disease {Heart valve disorder}, euvolemic {Normal blood volume}, exam {Evaluation procedure}, Chest X-ray {Plain chest X-ray}, effusions {Pleural effusion}, Aortic aneurysm {Aortic aneurysm}, CTA {Computed tomography angiography with contrast}, enlarged {Enlargement}, aortic aneurysm {Aortic aneurysm}, PCP {Primary care management}, problem {Problem}, Hypertension {Hypertensive disorder, systemic arterial}, lasix {Diuretic therapy}, Headaches {Headache}, Gastroesophageal reflux disease {Gastroesophageal reflux disease}, proton pump inhibitor {Proton pump inhibitor therapy}, TRANSITION OF CARE {Transition of care}, blood cultures {Blood culture}, primary care {Primary care management}, Pulmonary {Pulmonary medicine service}, assessment {Evaluation 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:
+- albuterol 90 mcg HFA 2 puffs q6h prn  
+- amitryptiline 50 mg once daily at night  
+- budesonide 0.5 mg/2 mL solution for nebulizer bid  
+- furosemide 40 mg every morning  
+- ibuprofen 600 mg tid to qid prn  
+- ipratropium-albuterol nebs up to three times daily  
+- lactulose hs prn for constipation  
+- lisinopril 40 mg qday  
+- omeprazole 20 mg qday  
+- oxygen 4L at night  
+- acetaminophen prn  
+- multivitamin 
+ 
+Discharge Medications:
+1. amitriptyline 50 mg Tablet Sig: One (1) Tablet PO HS (at 
+bedtime).  
+2. furosemide 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 
+ 
+3. lactulose 10 gram/15 mL Syrup Sig: Thirty (30) ML PO DAILY 
+(Daily) as needed for constipation.  
+4. lisinopril 20 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 
+ 
+5. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) 
+Capsule, Delayed Release(E.C.) PO DAILY (Daily).  
+6. multivitamin     Tablet Sig: One (1) Tablet PO DAILY (Daily). 
+ 
+7. prednisone 20 mg Tablet Sig: Three (3) Tablet PO DAILY 
+(Daily) for 3 days.
+Disp:*9 Tablet(s)* Refills:*0*
+8. azithromycin 250 mg Tablet Sig: One (1) Tablet PO Q24H (every 
+24 hours) for 1 days.
+Disp:*1 Tablet(s)* Refills:*0*
+9. acetaminophen  Oral
+10. albuterol sulfate 90 mcg/Actuation HFA Aerosol Inhaler Sig: 
+Two (2) puffs Inhalation every six (6) hours as needed for 
+shortness of breath or wheezing.  
+11. budesonide 0.5 mg/2 mL Suspension for Nebulization Sig: One 
+(1)  Inhalation twice a day.  
+12. ipratropium-albuterol 0.5 mg-3 mg(2.5 mg base)/3 mL Solution 
+for Nebulization Sig: One (1)  Inhalation three times a day as 
+needed for shortness of breath or wheezing.  
+13. ibuprofen  Oral
+
+ 
+
+###RESPONSE: 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:
+
+Chronic obstructive pulmonary disease flare
+Bacteremia
+
+Secondary diagnosis: 
+
+Diastolic congestive heart failure
+Hypertension
+Aortic aneurysm
+Gastroesophageal reflux disease
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Chronic obstructive pulmonary disease flare {Acute exacerbation of chronic obstructive airways disease}, Bacteremia {Bacteremia}, Diastolic congestive heart failure {Heart failure with normal ejection fraction}, Hypertension {Hypertensive disorder, systemic arterial}, Aortic aneurysm {Aortic aneurysm}, Gastroesophageal reflux disease {Gastroesophageal reflux disease}, Mental Status {Neurological mental status determination}, Clear {Normal state of mind}, Alert {Mentally alert}, interactive {Does communicate}, 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 at the ___.  You came for 
+further evaluation of shortness of breath.  Further evaluation 
+suggested that you had a flare-up of your chronic obstructive 
+pulmonary disease.  It is very important that you continue to 
+take your medications as prescribed and follow up with your 
+primary care provider after discharge.
+
+The following changes have been made to your medications:
+1) Prednisone 60mg was started, which you should continue for 
+three more days, starting tomorrow
+2) Azithromycin 250mg was started, which you should continue for 
+one more day, starting tomorrow
+
+ 
+
+###RESPONSE: evaluation {Evaluation procedure}, shortness of breath {Dyspnea}, evaluation {Evaluation procedure}, flare-up of your chronic obstructive 
+pulmonary disease {Acute exacerbation of chronic obstructive airways disease}, continue to 
+take your medications as prescribed {Recommendation to continue with drug treatment}, primary care {Primary care management}, Prednisone {Steroid therapy}, started {New medication added}, Azithromycin {Antibiotic therapy}, started {New medication added}"
+"###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: 
+Sulfa (Sulfonamide Antibiotics)
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Shortness of Breath 
+ 
+Major Surgical or Invasive Procedure:
+None 
+
+ 
+
+###RESPONSE: Sulfonamide Antibiotics {Allergy to sulfonamide antibiotic}, Shortness of Breath {Dyspnea}"
+"###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:
+Patient is an ___ year old female with PMH of moderate-to-severe 
+COPD (on home 2L O2, no intubations/ICU stays) who presents from 
+home with shortness of breath for 4 days. Patient was last in 
+her usual state of health until 3 days prior to presentation 
+when she developed insidious onset shortness of breath with 
+cough. She had no fevers or chills and noted increased chest 
+congestion but is unable to expectorate. She presented to her 
+PCP's office 2 days PTA when she was prescribed prednisone and a 
+z-pak. Then on the day prior to this admission she presented to 
+the ___ ED for persistant SOB nad weakness. She was unable to 
+eat large quantities because of the shortness of breath. In the 
+ED she was treated with albuterol nebs and was discharged after 
+performing well on a walk test around the ED. Then, on the day 
+of presentation, patient's shortness of breath again became 
+suddenly worse. She was speaking in short sentences and 
+activities such as walking across the room or going to the 
+bathroom caused her severe dyspnea. She called the ambulance and 
+was taken back to the ED.
+.  
+In the ED, initial vital signs were T95.6, HR98, BP175/96, RR28, 
+O2sat99% 2L nasal prongs. Exam was significant for initially 
+speaking in 2 word sentences, and poor air entry b/l with no 
+wheezes/crackles. This improved with nebulizers and she was able 
+to speak in full sentences. ECG showed sinus tachycardia with no 
+acute ST-t wave changes. Troponin was <0.01. WBC count was 
+normal, and patient received prednisone 60mg, ipratropium and 
+albuterol nebs, and azithromycin 250mg. She had an episode of 
+desaturation to 86% on nebs and was placed on NIPPV (FiO2: 100 
+PEEP: 5 PS: 10) with improvement of sats up to 96%. Unable to 
+tolerate further bipap she was placed on 5LNC with O2sats 96%. 
+She received 1mg of IV ativan for anxiety. Vital signs prior to 
+transfer were T97.9 HR103 BP177/87 RR28 O2sat95% 5LNC.  
+. 
+On arrival to the MICU, intial VS were T98.1, HR99, BP152/90, 
+RR29, O2sat94% 5LNC. She reports improvement in her SOB. She 
+reports being hungry. She endorses a slight headache. She 
+reports having some loose stool that corresponds to when she 
+started azithromycin as an outpatient.  
+ 
+
+###RESPONSE: COPD {Chronic obstructive lung disease}, intubations {Intubation}, shortness of breath {Dyspnea}, cough {Cough}, fevers {Fever}, chills {Chill}, unable to expectorate {Unable to expectorate}, SOB {Dyspnea}, weakness {Asthenia}, unable to 
+eat {Unable to eat}, shortness of breath {Dyspnea}, shortness of breath {Dyspnea}, dyspnea {Dyspnea}, wheezes {Wheezing}, crackles {Respiratory crackles}, improved {Patient's condition improved}, nebulizers {Nebulizer therapy}, able 
+to speak {Able to speak}, ECG {Electrocardiographic procedure}, sinus tachycardia {Sinus tachycardia}, t wave changes {Electrocardiographic T wave abnormal}, Troponin {Troponin measurement}, WBC count was 
+normal {White blood cell count within reference range}, bipap {Bilevel positive airway pressure titration}, anxiety {Anxiety}, SOB {Dyspnea}, hungry {Hungry}, headache {Headache}, loose stool {Loose stool}"
+"###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:
+- Asthma
+- COPD
+- GERD
+- Anxiety
+- Osteopenia 
+- S/p cataract surgery
+- White coat HTN (BPs at home 120s-130s/70s-80s) 
+ 
+
+###RESPONSE: Asthma {Asthma}, COPD {Chronic obstructive lung disease}, GERD {Gastroesophageal reflux disease}, Anxiety {Anxiety}, Osteopenia {Osteopenia}, cataract surgery {Cataract surgery}, White coat HTN {Labile hypertension due to being in a clinical environment}"
+"###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 had angina. No other CAD, no cancers. Brother has 
+___.  
+
+ 
+
+###RESPONSE: angina {Angina}, CAD {Coronary arteriosclerosis}, cancers {Malignant neoplasm}"
+"###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 EXAM: 
+Vitals: T 98.1, HR 99, BP 152/90, RR 29, O2sat 94% 5LNC  
+General: Alert, oriented, no acute distress  
+HEENT: Sclera anicteric, MMM, oropharynx clear, EOMI, PERRL  
+Neck: Supple, JVP not elevated, no LAD  
+CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, 
+gallops  
+Lungs: Poor air movement bilaterally, diffuse rhonchi  
+Abdomen: Soft, non-tender, non-distended, bowel sounds present, 
+no organomegaly  
+GU: No foley  
+Ext: Warm, well perfused, no edema or cyanosis  
+Neuro: CNII-XII intact, ___ strength upper/lower extremities, 
+grossly normal sensation, gait deferred  
+.
+DISCHARGE EXAM: 
+VS: Tm 98.5, BP 164/82, P 70, R 18, 97-99% on 1L NC    
+GENERAL: NAD, comfortable, speaking in full sentences  
+HEENT: NC/AT, PERRLA, EOMI, sclerae anicteric, MMM, OP clear  
+NECK: Supple, no thyromegaly, no JVD
+HEART: RRR, nl S1-S2, no MRG
+LUNGS: Ronchorus BS throughout with diffuse expiratory wheezing 
+though improved 
+ABDOMEN: NABS, soft/NT/ND, no masses or HSM, no rebound/guarding
+EXTREMITIES: WWP, no c/c/e, 2+ peripheral pulses (radials, DPs)  
+
+SKIN: Scattered ecchymoses
+NEURO: Awake, A&Ox3, CNs II-XII grossly intact, strength and 
+sensation grossly intact 
+ 
+
+###RESPONSE: Vitals {Vital signs finding}, HR {Finding of heart rate}, BP {Blood pressure finding}, RR {Finding of rate of respiration}, NC {Normal head}, General {General examination of patient}, Alert {Mentally alert}, 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 not elevated {Normal jugular venous pressure}, 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<}, murmurs {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, Lungs {Examination of respiratory system}, rhonchi {Wheeze - rhonchi}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, bowel sounds present {Normal bowel sounds}, organomegaly {Abdominal organomegaly}, GU {Examination of genitourinary system}, foley {Urinary catheter in situ}, Ext {Examination of limb}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, edema {Edema}, cyanosis {Cyanosis}, 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}, gait deferred {Abnormal gait}, VS {Vital signs finding}, BP {Blood pressure finding}, NC {Normal head}, GENERAL {General examination of patient}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, NC {Normal head}, PERRLA {Pupils equal, react to light and accommodation}, EOMI {Normal ocular motility}, sclerae anicteric {White sclera}, MMM {Moist oral mucosa}, OP clear {Pharynx normal}, NECK {Physical examination procedure}, Supple {Normal movement of neck}, thyromegaly {Goiter}, JVD {Jugular venous engorgement}, HEART {Cardiovascular physical examination}, RRR {Normal heart rate}, S2 {Normal second heart sound, S>2<}, no MRG {Heart sounds normal}, LUNGS {Examination of respiratory system}, Ronchorus {Wheeze - rhonchi}, wheezing {Wheezing}, improved {Patient's condition improved}, ABDOMEN {Examination of abdomen}, NABS {Normal bowel sounds}, soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, masses {Abdominal mass}, HSM {Hepatosplenomegaly}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, EXTREMITIES {Examination of limb}, WWP {Normal tissue perfusion}, 2+ peripheral pulses {Peripheral pulses normal}, radials {Normal radial pulse}, SKIN {Examination of skin}, ecchymoses {Ecchymosis}, NEURO {Neurological examination}, Awake {Awake}, A {Mentally alert}, Ox3 {Oriented to person, time and place}, CNs II {Optic nerve structure}, XII {Hypoglossal nerve structure}, grossly intact {Normal nervous system function}, sensation grossly intact {Normal sensation}"
+"###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:
+___ 06:12PM BLOOD WBC-8.8 RBC-4.78 Hgb-14.1 Hct-42.5 MCV-89 
+MCH-29.6 MCHC-33.3 RDW-12.8 Plt ___
+___ 06:12PM BLOOD Neuts-91.7* Lymphs-6.7* Monos-1.4* Eos-0 
+Baso-0.2
+___ 06:12PM BLOOD Glucose-169* UreaN-18 Creat-0.9 Na-136 
+K-4.5 Cl-101 HCO3-23 AnGap-17
+___ 04:06AM BLOOD Calcium-9.3 Phos-3.9 Mg-2.3
+___ 09:55AM BLOOD cTropnT-<0.01
+___ 04:00PM URINE Color-Yellow Appear-Clear Sp ___
+___ 04:00PM URINE Blood-TR Nitrite-NEG Protein-TR 
+Glucose-150 Ketone-10 Bilirub-NEG Urobiln-NEG pH-5.0 Leuks-NEG
+___ 04:00PM URINE RBC-1 WBC-2 Bacteri-NONE Yeast-NONE Epi-1
+.
+DISCHARGE LABS:
+___ 08:00AM BLOOD WBC-11.9* RBC-4.66 Hgb-13.8 Hct-42.4 
+MCV-91 MCH-29.7 MCHC-32.6 RDW-12.6 Plt ___
+___ 08:00AM BLOOD Glucose-130* UreaN-27* Creat-0.9 Na-142 
+K-4.0 Cl-99 HCO3-34* AnGap-13
+___ 08:00AM BLOOD Calcium-9.5 Phos-3.6 Mg-2.0
+.
+MICRO:
+___ Blood cultures: no growth to date
+___ Urine culture: pending  
+.
+IMAGING:
+___ PA/LAT/OBLIQUE CXR: The heart is normal in size. The 
+mediastinal and hilar contours appear unchanged. The aortic arch 
+is calcified. Central pulmonary arteries are again prominent. 
+The chest is hyperinflated. Bronchovascular markings are 
+attenuated and irregular, particularly in the upper lungs, 
+suggesting obstructive pulmonary disease. A hiatal hernia is 
+probably small-to-moderate in size. No focal opacity is 
+identified. There is no pleural effusion or pneumothorax. Mild 
+degenerative changes are similar along the lower thoracic spine.
+IMPRESSION: Findings suggesting chronic obstructive pulmonary 
+disease. No evidence of pneumonia. Small-to-moderate hiatal 
+hernia. 
+ 
+
+###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}, Lymphs {Lymphocyte count}, Monos {Monocyte count}, Eos {Eosinophil 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}, cTropnT {Troponin T cardiac measurement}, Ketone {Urinalysis, acetone or ketone bodies measurement}, pH {pH measurement}, RBC {Red blood cell count}, WBC {White blood cell count}, 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}, 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}, Blood cultures {Blood culture}, Urine culture {Urine culture}, PA {Plain x-ray of chest posteroanterior view}, LAT {Diagnostic radiography of chest, lateral}, CXR {Plain chest X-ray}, heart {Heart structure}, normal in size {Normal size}, mediastinal {Mediastinal structure}, hilar {Hilar lymphadenopathy}, aortic arch {Aortic arch structure}, calcified {Pathologic calcification, calcified structure}, Central pulmonary arteries {Structure of central pulmonary artery}, chest is hyperinflated {Chest over-expanded}, upper lungs {Structure of upper zone of lung}, pulmonary disease {Disorder of lung}, hiatal hernia {Hiatal hernia}, opacity {Abnormally opaque structure}, pleural effusion {Pleural effusion}, pneumothorax {Pneumothorax}, thoracic spine {Structure of thoracic vertebral column}, chronic obstructive pulmonary 
+disease {Chronic obstructive lung disease}, pneumonia {Pneumonia}, hiatal 
+hernia {Hiatal hernia}"
+"###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 female with PMH of moderate-to-severe COPD (FEV1 37% 
+of predicted ___ on home O2 for exertion, who presented with 
+SOB secondary to a COPD exacerbation. 
+. 
+ACTIVE ISSUES: 
+# COPD exacerbation: Patient has moderate-severe COPD on 2LNC 
+home oxygen only with exertion, otherwise on room air. She 
+presented with 3 days of increasing shortness of breath 
+improving with bronchodilators and at one point requiring NIPPV 
+in the ED. She had a significant component of anxiety while in 
+the ED, exacerbating the tachypnea in addition to her COPD 
+flare, which has been the case in prior exacerbations as well 
+per discussion with her PCP. Overnight in the ICU she was easily 
+weaned to 91% oxygen on room air and was able to be transferred 
+to the medical floor. Although there was no evidence of 
+pneumonia on her CXR, she was continued on the azithromycin 
+which had been started by her PCP and completed ___ 5-day course. 
+She was also started on prednisone 60mg daily with plan for a 
+slow taper. Her Advair, Spiriva, and albuterol were continued 
+and she was treated with lorazepam prn for anxiety with good 
+effect. Upon discharge she was breathing comfortably with O2 
+sats in the mid-90s on 1L NC and was ambulating. She is 
+currently on prednisone 50mg daily with plan to taper as 
+follows: 40mg (___), 30mg (___), 20mg (___), 
+10mg (___), and then stop. She will have outpatient 
+pulmonary rehab and has f/u appointments scheduled with her PCP 
+and pulmonologist.   
+.
+# Hypertension: Patient's blood pressure was persistent elevated 
+in the 150s-160s with several readings in the 170s. She denies a 
+history of HTN and after discussing this with her PCP ___. 
+___ may be a component of white coat hypertension 
+and anxiety. We elected not to treat it at this time. She has a 
+f/u appointment with Dr. ___ at which time he will recheck 
+her BP and decide whether to start an antihypertensive agent.  
+.
+# UTI: Patient developed a mild leukocytosis (WBC 11.9) on the 
+day of discharge. She has been afebrile but UA revealed a UTI. 
+She states that she has a history of recurrent UTIs and has a 
+prescription for ciprofloxacin 250mg at home which is not 
+expired. She wishes to take her own medication at home and 
+states that she will take 1 pill BID for the next 3 days. She 
+understands warning signs that should prompt her to seek medical 
+attention such as worsening abdominal pain, flank pain, or 
+fevers. The urine culture is pending at the time of discharge. I 
+will follow this up and contact the patient and her PCP should 
+the organism return resistant to ciprofloxacin.   
+.
+INACTIVE ISSUES: 
+# Osteopenia: Continued Vitamin D supplementation.
+.
+TRANSITIONAL ISSUES: 
+# Opacity on CXR: Patient had a small opacity in the 
+costophrenic recess on the lateral view CXR. Unclear etiology 
+but stable since ___. Radiology recommends non-emergent CT scan 
+to evaluate. The patient is aware of this. 
+ 
+
+###RESPONSE: COPD {Chronic obstructive lung disease}, SOB {Dyspnea}, COPD exacerbation {Acute exacerbation of chronic obstructive airways disease}, COPD exacerbation {Acute exacerbation of chronic obstructive airways disease}, COPD {Chronic obstructive lung disease}, on room air {Breathing room air}, shortness of breath {Dyspnea}, anxiety {Anxiety}, tachypnea {Tachypnea}, COPD {Chronic obstructive lung disease}, on room air {Breathing room air}, pneumonia {Pneumonia}, CXR {Plain chest X-ray}, anxiety {Anxiety}, ambulating {Fully mobile}, Hypertension {Hypertensive disorder, systemic arterial}, blood pressure was persistent elevated {Finding of increased blood pressure}, HTN {Hypertensive disorder, systemic arterial}, white coat hypertension {Labile hypertension due to being in a clinical environment}, anxiety {Anxiety}, UTI {Urinary tract infectious disease}, leukocytosis {Leukocytosis}, afebrile {Fever}, UA {Urinalysis}, UTI {Urinary tract infectious disease}, recurrent UTIs {Recurrent urinary tract infection}, abdominal pain {Abdominal pain}, flank pain {Flank pain}, fevers {Fever}, urine culture {Urine culture}, Osteopenia {Osteopenia}, Opacity {Abnormally opaque structure}, CXR {Plain chest X-ray}, opacity {Abnormally opaque structure}, costophrenic recess {Structure of phrenicocostal sinus}, lateral view CXR {Diagnostic radiography of chest, lateral}, CT scan {Computed tomography}"
+"###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:
+1. Aspirin 81 mg PO 4X/WEEK (___) 
+Pt states she only takes it 4x/wk because of increased bruising 
+with daily dosing 
+2. Fluticasone-Salmeterol Diskus (250/50)  1 INH IH BID 
+3. Tiotropium Bromide 1 CAP IH DAILY 
+4. Vitamin D 800 UNIT PO DAILY 
+5. Albuterol Inhaler 2 PUFF IH Q4H:PRN shortness of breath 
+6. PredniSONE 40 mg PO DAILY Duration: 10 Days 
+started ___ by PCP 
+7. Azithromycin 250 mg PO Q24H Duration: 4 Days 
+Day 1 of z-pack was ___ from PCP 
+
+ 
+___:
+1. Aspirin 81 mg PO 4X/WEEK (___) 
+Pt states she only takes it 4x/wk because of increased bruising 
+with daily dosing 
+2. Fluticasone-Salmeterol Diskus (250/50)  1 INH IH BID 
+3. Tiotropium Bromide 1 CAP IH DAILY 
+4. Vitamin D 800 UNIT PO DAILY 
+5. Albuterol Inhaler 2 PUFF IH Q4H:PRN shortness of breath 
+6. Pulmonary rehab
+Patient requires outpatient pulmonary rehab.
+7. PredniSONE 40 mg PO daily Duration: 2 Days Start: In am 
+RX *prednisone 10 mg see below tablet(s) by mouth daily Disp 
+#*20 Tablet Refills:*0
+8. PredniSONE 30 mg PO daily Duration: 2 Days Start: After 40 mg 
+tapered dose. 
+9. PredniSONE 20 mg PO daily Duration: 2  Days Start: After 30 
+mg tapered dose. 
+10. PredniSONE 10 mg PO daily Duration: 2  Days Start: After 20 
+mg tapered dose. 
+ 
+
+###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:
+COPD 
+UTI 
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: COPD {Chronic obstructive lung disease}, UTI {Urinary tract infectious disease}, Mental Status {Neurological mental status determination}, Clear {Normal state of mind}, Alert {Mentally alert}, interactive {Does communicate}, 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:
+Ms. ___,
+.
+It was a pleasure caring for you at ___ 
+___. You were admitted with shortness of breath due 
+to an exacerbation of your COPD. We treated you with 
+azithromycin and prednisone and your breathing improved. You 
+should continue to use the oxygen at home while your breathing 
+continues to get better. We have arranged for you to attend 
+outpatient pulmonary rehab. 
+.
+You were found to have a urinary tract infection on the day of 
+discharge. You have a history of frequent UTIs and have 
+ciprofloxacin 250mg at home which you would prefer to take. When 
+you get home please take this medication twice daily for the 
+next 3 days as we discussed.  
+ 
+
+###RESPONSE: shortness of breath {Dyspnea}, exacerbation of your COPD {Acute exacerbation of chronic obstructive airways disease}, improved {Patient's condition improved}, urinary tract infection {Urinary tract infectious disease}, frequent UTIs {Recurrent urinary tract infection}"
+"###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: 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: 
+codeine
+ 
+Attending: ___
+ 
+Chief Complaint:
+Right hip pain
+ 
+Major Surgical or Invasive Procedure:
+Right total hip arthroplasty on ___
+
+ 
+
+###RESPONSE: codeine {Allergy to codeine}, Right hip {Right hip region structure}, pain {Hip pain}, Right total hip arthroplasty {Total replacement of right hip joint}"
+"###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. ___ has been having right knee and hip pain for several 
+months.  The pain has progressively worsened.  She has had 
+cortisone injections, which did not provide significant relief 
+in her knee.  She has groin pain, thigh pain and buttock pain as 
+well as knee pain.  She does not use an assistive device.  She 
+has taken anti-inflammatory medications and had physical 
+therapy.
+
+ 
+
+###RESPONSE: right knee {Structure of right knee region}, hip pain {Hip pain}, pain {Pain}, worsened {Increased pain}, cortisone injections {Injection of cortisone}, knee {Knee region structure}, groin pain {Inguinal pain}, thigh pain {Thigh pain}, buttock pain {Pain in buttock}, knee pain {Pain of knee region}, physical 
+therapy {Physical therapy 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: Past Medical History:
+1. adjustment disorder
+2. atrial fibrillation (cardiologist - Dr. ___, 
+___
+3. anxiety and depression
+4. vitamin B12 deficiency
+5. breast cancer (T1N0M0 invasive lobular adenocarcinoma
+s/p RTX/implant/tamoxifen for ___ years)
+6. colonic polyps (___)
+7. constipation
+8. hypertension
+9. osteopenia
+10. seasonal affective disorder
+11. gastric bypass 01
+12. SBO s/p exploratory laparotomy and small bowel resection 
+(___)
+
+ 
+
+###RESPONSE: adjustment disorder {Adjustment disorder}, atrial fibrillation {Atrial fibrillation}, anxiety {Anxiety}, depression {Depressive disorder}, vitamin B12 deficiency {Cobalamin deficiency}, breast cancer {Malignant neoplasm of breast}, lobular adenocarcinoma {Lobular carcinoma}, colonic polyps {Polyp of colon}, constipation {Constipation}, hypertension {Hypertensive disorder, systemic arterial}, osteopenia {Osteopenia}, seasonal affective disorder {Seasonal affective disorder}, gastric bypass {Bypass of stomach}, SBO {Small bowel obstruction}, exploratory laparotomy {Exploratory laparotomy}, small bowel resection {Small intestine excision}"
+"###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 deceased from recurrent non-Hodgkin's lymphoma. Multiple 
+family members with ovarian and breast ca at early ages (mother 
+with ovarian ca in her ___, 2 aunts with breast ca)
+ 
+
+###RESPONSE: deceased {Dead}, recurrent {Recurrent disease}, non-Hodgkin's lymphoma {Non-Hodgkin's lymphoma}, ovarian {Malignant tumor of ovary}, breast ca {Malignant neoplasm of breast}, ovarian ca {Malignant tumor of ovary}, breast ca {Malignant neoplasm of breast}"
+"###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:
+Well appearing in no acute distress  
+Afebrile with stable vital signs  
+Pain well-controlled  
+Respiratory: CTAB  
+Cardiovascular: RRR  
+Gastrointestinal: NT/ND  
+Genitourinary: Voiding independently  
+Neurologic: Intact with no focal deficits  
+Psychiatric: Pleasant, A&O x3  
+Musculoskeletal Lower Extremity:  
+* Incision healing well with staples  
+* Scant serosanguinous drainage  
+* Thigh full but soft  
+* No calf tenderness  
+* ___ strength  
+* SILT, NVI distally  
+* Toes warm
+
+ 
+
+###RESPONSE: Well appearing {Well cared for appearance}, distress {Distress}, Afebrile {Temperature normal}, stable vital signs {Normal vital signs}, Pain well-controlled {Demonstrates adequate pain control}, Respiratory {Examination of respiratory system}, CTAB {Normal breath sounds}, Cardiovascular {Cardiovascular physical examination}, RRR {Normal heart rate}, Gastrointestinal {Examination of digestive system}, NT {Abdominal tenderness}, ND {Swollen abdomen}, Gen {General examination of patient}, Voiding independently {Normal micturition}, Neurologic {Neurological examination}, Intact {Normal sensation}, no focal deficits {Normal nervous system function}, O x3 {Oriented to person, time and place}, Musculoskeletal {Musculoskeletal system physical examination}, Lower Extremity {Lower limb structure}, Incision {Surgical incision wound}, healing well {Wound healing well}, staples {Closure by staple}, serosanguinous drainage {Serosanguineous discharge from wound}, Thigh {Thigh structure}, soft {Abdomen soft}, tenderness {Tenderness}, SILT {Light touch sensation present}, NVI distally {Normal peripheral neurovascular function}, Toes {Structure of all toes}, 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:
+___ 05:58AM BLOOD WBC-12.0* RBC-2.48* Hgb-8.0* Hct-25.3* 
+MCV-102* MCH-32.3* MCHC-31.6* RDW-13.1 RDWSD-49.3* Plt ___
+___ 06:35AM BLOOD WBC-10.9* RBC-2.46* Hgb-7.9* Hct-25.1* 
+MCV-102* MCH-32.1* MCHC-31.5* RDW-13.2 RDWSD-49.2* Plt ___
+___ 05:48AM BLOOD WBC-9.8 RBC-2.68* Hgb-8.6* Hct-27.8* 
+MCV-104* MCH-32.1* MCHC-30.9* RDW-13.2 RDWSD-49.9* Plt ___
+___ 06:25AM BLOOD WBC-7.4 RBC-2.46* Hgb-8.0* Hct-25.5* 
+MCV-104* MCH-32.5* MCHC-31.4* RDW-13.2 RDWSD-49.7* Plt ___
+___ 05:48AM BLOOD WBC-7.7 RBC-2.94* Hgb-9.5* Hct-30.7* 
+MCV-104* MCH-32.3* MCHC-30.9* RDW-13.0 RDWSD-49.6* Plt ___
+___ 05:58AM BLOOD Plt ___
+___ 06:35AM BLOOD Plt ___
+___ 05:48AM BLOOD Plt ___
+___ 06:25AM BLOOD Plt ___
+___ 05:48AM BLOOD Plt ___
+___ 05:58AM BLOOD Glucose-90 UreaN-21* Creat-0.7 Na-138 
+K-3.7 Cl-101 HCO3-24 AnGap-17
+___ 06:35AM BLOOD Glucose-92 UreaN-22* Creat-0.7 Na-138 
+K-4.3 Cl-101 HCO3-26 AnGap-15
+___ 09:15AM BLOOD Glucose-111* UreaN-22* Creat-0.7 Na-135 
+K-4.4 Cl-99 HCO3-26 AnGap-14
+___ 06:25AM BLOOD Glucose-94 UreaN-23* Creat-0.9 Na-139 
+K-4.9 Cl-103 HCO3-26 AnGap-15
+___ 05:48AM BLOOD Glucose-107* UreaN-26* Creat-0.9 Na-134 
+K-5.0 Cl-99 HCO3-28 AnGap-12
+___ 09:15AM BLOOD CK-MB-2 cTropnT-<0.01
+___ 05:58AM BLOOD Calcium-8.3* Phos-2.6* Mg-1.7
+___ 06:35AM BLOOD Calcium-8.3* Phos-2.4* Mg-1.8
+___ 09:15AM BLOOD Calcium-8.5 Phos-2.7 Mg-2.0
+___ 06:25AM BLOOD Calcium-8.3* Phos-3.1 Mg-2.2
+___ 05:48AM BLOOD Calcium-8.3* Phos-4.5 Mg-1.7
+___ 06:35AM BLOOD TSH-0.57
+
+___ 10:20AM URINE Color-Yellow Appear-Hazy Sp ___
+___ 10:20AM URINE Blood-TR Nitrite-NEG Protein-30 
+Glucose-NEG Ketone-10 Bilirub-SM  Urobiln->12 pH-6.5 Leuks-SM 
+___ 10:20AM URINE RBC-3* WBC-9* Bacteri-FEW Yeast-NONE 
+Epi-12 TransE-<1
+___ 10:20AM URINE AmorphX-OCC
+___ 10:20AM URINE Mucous-RARE
+___ 10:20AM URINE
+ 
+
+###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}, 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}, 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}, 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}, 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}, 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}, 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}, 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}, 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}, cTropnT {Troponin T cardiac measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, TSH {Thyroid stimulating hormone measurement}, Protein {Measurement of protein in urine}, Ketone {Urinalysis, acetone or ketone bodies measurement}, pH {pH measurement}, RBC {Red blood cell count}, WBC {White blood cell count}"
+"###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 was admitted to the orthopedic surgery service and 
+was taken to the operating room for above described procedure. 
+Please see separately dictated operative report for details. The 
+surgery was uncomplicated and the patient tolerated the 
+procedure well. Patient received perioperative IV antibiotics.
+
+Postoperative course was remarkable for the following:
+Overnight on POD#0, the patient was given a 500 mL bolus for low 
+urine output.  She was unable to void and had to be straight 
+cath'ed x1.  After that, she was able to void independently 
+thereafter. On POD 3, patient became acutely delirious. EKG 
+demonstrated Afib with Rvr. Rate was controlled with metoprolol. 
+Medicine was consulted who recommended continuing the metoprolol 
+for rate control. CXR and KUB were obtained. U/A were obtained. 
+Imaging did not demonstrate acute findings other than 
+atelectasis. Troponins negative. On POD#4 she became agitated 
+and the patient's family was contacted to assist. On POD#5 
+patient was noted to have leukocytosis with WBC 12.0 and urinary 
+frequency with discomfort, u/a was consistent with infection, 
+she was started on Ciprofloxacin for 7 days. Upon discharge her 
+mental status was clear, alert, oriented, and cooperative. 
+
+Otherwise, pain was controlled with a combination of IV and oral 
+pain medications.  The patient received lovenox for DVT 
+prophylaxis starting on the morning of POD#1.  The surgical 
+dressing was changed and the Silverlon dressing was removed on 
+POD#2. The surgical incision was found to be clean and intact 
+without erythema or abnormal drainage. The patient was seen 
+daily by physical therapy. Labs were checked throughout the 
+hospital course and repleted accordingly. At the time of 
+discharge the patient was tolerating a regular diet and feeling 
+well.  The patient was afebrile with stable vital signs.  The 
+patient's hematocrit was acceptable and pain was adequately 
+controlled on an oral regimen. The operative extremity was 
+neurovascularly intact and the wound was benign.
+
+The patient's weight-bearing status is weight bearing as 
+tolerated on the operative extremity with posterior precautions. 
+Walker or two crutches at all times for 6 weeks.
+ 
+Ms. ___ discharged to rehab in stable condition.
+ 
+
+###RESPONSE: procedure {Procedure}, surgery {Surgical procedure}, IV antibiotics {Intravenous antibiotic therapy}, low 
+urine output {Decreased urine output}, unable to void {Retention of urine}, cath {Catheterization of urinary bladder}, able to void {Normal micturition}, delirious {Delirious}, EKG {Electrocardiographic procedure}, Afib with Rvr {Atrial fibrillation with rapid ventricular response}, CXR {Plain chest X-ray}, KUB {Radiography of kidney-ureter-bladder}, Imaging {Imaging}, atelectasis {Atelectasis}, Troponins {Troponin measurement}, negative {No abnormality detected}, agitated {Feeling agitated}, leukocytosis {Leukocytosis}, urinary 
+frequency {Increased frequency of urination}, discomfort {Discomfort}, infection {Infectious disease}, mental status {Neurological mental status determination}, clear {Normal state of mind}, alert {Mentally alert}, oriented {Orientated}, cooperative {Cooperative mental state}, pain was controlled {Pain control}, oral {Administration of drug or medicament via oral route}, pain medications {Administration of analgesic}, DVT 
+prophylaxis {Prevention of deep vein thrombosis}, surgical 
+dressing was changed {Change of dressing}, dressing was removed {Removal of dressing}, surgical incision {Surgical incision wound}, clean and intact {Wound healing well}, erythema {Erythema}, drainage {Wound discharge}, physical therapy {Physical therapy assessment}, Labs {Laboratory test}, feeling 
+well {Well in self}, afebrile {Fever}, stable vital signs {Normal vital signs}, hematocrit was acceptable {Stable hematocrit}, pain was adequately 
+controlled {Demonstrates adequate pain control}, operative {Operative site}, extremity {Limb structure}, neurovascularly intact {Normal peripheral neurovascular function}, weight bearing {Weight-bearing}, operative {Operative site}, extremity {Limb structure}, precautions {Safety precautions}, Walker {Uses zimmer frame}, two crutches {Uses two crutches for walking}, stable condition {Patient's condition stable}"
+"###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:
+1. ALPRAZolam 0.5 mg PO BID:PRN anxiety 
+2. Anastrozole 1 mg PO DAILY 
+3. Citalopram 20 mg PO DAILY 
+4. Lisinopril 2.5 mg PO DAILY 
+5. Omeprazole 20 mg PO BID 
+6. Mirtazapine 15 mg PO QHS:PRN insomnia 
+
+ 
+Discharge Medications:
+1.  Ciprofloxacin HCl 500 mg PO Q12H Duration: 7 Days  
+2.  Docusate Sodium 100 mg PO BID 
+3.  Enoxaparin Sodium 40 mg SC QD 
+4.  Metoprolol Tartrate 25 mg PO Q6H 
+Please increase dosage to 37.5mg q6H if HR > 110 consistently  
+5.  OxyCODONE--Acetaminophen (5mg-325mg) ___ TAB PO Q4H:PRN Pain 
+- Moderate  
+6.  Senna 8.6 mg PO BID  
+7.  ALPRAZolam 0.5 mg PO BID:PRN anxiety  
+8.  Anastrozole 1 mg PO DAILY  
+9.  Citalopram 20 mg PO DAILY  
+10.  Mirtazapine 15 mg PO QHS:PRN insomnia  
+11.  Omeprazole 20 mg PO BID  
+12. HELD- Lisinopril 2.5 mg PO DAILY  This medication was held. 
+Do not restart Lisinopril until SBP > 140
+ 
+
+###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:
+___
+ 
+___ Diagnosis:
+Right total hip arthroplasty 
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+
+ 
+
+###RESPONSE: Right total hip arthroplasty {Total replacement of right hip joint}, 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}, walker {Uses zimmer frame}, cane {Uses single walking stick}"
+"###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:
+1. Please return to the emergency department or notify your 
+physician if you experience any of the following: severe pain 
+not relieved by medication, increased swelling, decreased 
+sensation, difficulty with movement, fevers greater than 101.5, 
+shaking chills, increasing redness or drainage from the incision 
+site, chest pain, shortness of breath or any other concerns.
+ 
+2. Please follow up with your primary physician regarding this 
+admission and any new medications and refills. 
+ 
+3. Resume your home medications unless otherwise instructed.
+ 
+4. You have been given medications for pain control. Please do 
+not drive, operate heavy machinery, or drink alcohol while 
+taking these medications. As your pain decreases, take fewer 
+tablets and increase the time between doses. This medication can 
+cause constipation, so you should drink plenty of water daily 
+and take a stool softener (such as Colace) as needed to prevent 
+this side effect.  Call your surgeons office 3 days before you 
+are out of medication so that it can be refilled.  These 
+medications cannot be called into your pharmacy and must be 
+picked up in the clinic or mailed to your house.  Please allow 
+an extra 2 days if you would like your medication mailed to your 
+home.
+ 
+5. You may not drive a car until cleared to do so by your 
+surgeon.
+ 
+6. Please call your surgeon's office to schedule or confirm your 
+follow-up appointment.
+ 
+7. SWELLING: Ice the operative joint 20 minutes at a time, 
+especially after activity or physical therapy. Do not place ice 
+directly on the skin. Please DO NOT take any non-steroidal 
+anti-inflammatory medications (NSAIDs such as Celebrex, 
+ibuprofen, Advil, Aleve, Motrin, naproxen etc) until cleared by 
+your physician.
+ 
+8. ANTICOAGULATION: Please continue your Lovenox for four (4) 
+weeks to help prevent deep vein thrombosis (blood clots).  If 
+you were taking Aspirin prior to your surgery, please hold this 
+medication until you have completed your one-month course of 
+anticoagulation medication or unless cleared by your physician.  
+
+ 
+9. WOUND CARE: Please keep your incision clean and dry. It is 
+okay to shower five days after surgery but no tub baths, 
+swimming, or submerging your incision until after your four (4) 
+week checkup. Please place a dry sterile dressing on the wound 
+each day if there is drainage, otherwise leave it open to air. 
+Check wound regularly for signs of infection such as redness or 
+thick yellow drainage. Staples will be removed by the visiting 
+nurse or rehab facility in two (2) weeks. 
+ 
+10. ___ (once at home): Home ___, dressing changes as 
+instructed,  wound checks, and staple removal at two weeks after 
+surgery. 
+ 
+11. ACTIVITY: Weight bearing as tolerated with walker or 2 
+crutches at all times for six weeks.  Posterior precautions. No 
+strenuous exercise or heavy lifting until follow up appointment. 
+ Mobilize frequently. 
+
+Physical Therapy:
+WBAT RLE
+Posterior hip precautions x 3 months post-operatively
+Assistive device x 6 weeks post-op (i.e., 2 crutches, walker)
+Mobilize frequently
+
+Treatments Frequency:
+daily dressing changes as needed for drainage
+wound checks daily
+ice
+staple removal and replace with steri-strips on POD ___ by 
+___
+ 
+
+###RESPONSE: severe pain {Severe pain}, medication, increased {Medication increased}, swelling {Swelling}, decreased 
+sensation {Abnormal sensation}, difficulty with movement {Difficulty moving}, fevers {Fever}, shaking {Tremor}, chills {Chill}, redness {Redness of skin over lesion}, drainage {Wound discharge}, incision 
+site {Surgical incision wound}, chest pain {Chest pain}, shortness of breath {Dyspnea}, primary physician {Primary care management}, pain control {Pain control}, pain decreases {Sensation of pain reduced}, constipation {Constipation}, drink plenty of water {Fluid intake encouragement}, take a stool softener {Administration of laxative}, prevent 
+this side effect {Prevention of constipation}, medication so that it can be refilled {Medication prefill education}, SWELLING {Swelling}, operative joint {Operative site}, physical therapy {Physical therapy procedure}, skin {Skin structure}, ANTICOAGULATION {Anticoagulant therapy}, prevent deep vein thrombosis {Prevention of deep vein thrombosis}, blood clots {Blood clot}, anticoagulation {Anticoagulant therapy}, WOUND CARE {Wound care}, place a dry sterile dressing {Application of dressing}, wound {Wound}, drainage {Wound discharge}, Check wound {Wound assessment}, signs of infection {Monitoring for signs and symptoms of infection}, redness {Redness of skin over lesion}, drainage {Wound discharge}, Staples will be removed {Removal of staples}, dressing changes {Change of dressing}, wound checks {Wound assessment}, staple removal {Removal of staples}, Weight bearing {Weight-bearing}, walker {Uses zimmer frame}, 2 
+crutches {Uses two crutches for walking}, precautions {Safety precautions}, WBAT {Weight-bearing gait training}, RLE {Structure of right lower limb}, precautions {Safety precautions}, 2 crutches {Uses two crutches for walking}, walker {Uses zimmer frame}, dressing changes {Change of dressing}, drainage {Wound discharge}, wound checks {Wound assessment}, staple removal {Removal of staples}, steri-strips {Application of adhesive skin closure}"
+"###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: 
+Patient recorded as having No Known Allergies to Drugs
+ 
+Attending: ___.
+ 
+Chief Complaint:
+s/p Fall from bicycle, major blunt chest trauma
+ 
+Major Surgical or Invasive Procedure:
+None
+ 
+
+###RESPONSE: Fall {Falls}, blunt chest trauma {Blunt injury of thorax}"
+"###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:
+___ male helmeted bicyclist s/p fall from bicycle, flipping and 
+hitting back on pole. He was transported to ___ for further 
+care. 
+
+ 
+
+###RESPONSE: fall {Falls}"
+"###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:
+Asthma
+Pneumonia
+ 
+
+###RESPONSE: Asthma {Asthma}, 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:
+Noncontributory
+ 
+
+###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:
+___ 11:59AM   GLUCOSE-148* UREA N-14 CREAT-1.0 SODIUM-141 
+POTASSIUM-4.4 CHLORIDE-105 TOTAL CO2-25 ANION GAP-15
+___ 11:59AM   estGFR-Using this
+___ 11:59AM   WBC-7.3 RBC-5.57 HGB-14.5 HCT-43.3 MCV-78* 
+MCH-26.1* MCHC-33.6 RDW-13.3
+___ 11:59AM   NEUTS-60.3 ___ MONOS-3.5 EOS-2.3 
+BASOS-0.8
+___ 11:59AM   PLT COUNT-247
+
+CT Chest ___
+IMPRESSION: 
+  
+1. Numerous right-sided rib fractures, with fractures involving 
+multiple 
+sites within the ribs, placing the patient at risk for flail 
+chest. Associated moderate right hemothorax with pulmonary 
+contusion and small right pneumothorax with locules of air in 
+the right epicardial fat. 
+  
+2. Comminuted right scapular fracture. 
+
+Chest xray ___
+
+IMPRESSION: Newly apparent tiny right apical pneumothorax. 
+Blunting of the 
+right costophrenic sulcus consistent with a small effusion. 
+Increased density in the lower right chest consistent with 
+contusion probably unchanged. 
+Subsegmental atelectasis left base. Multiple rib fractures and 
+possible 
+fracture right scapula. 
+
+ 
+
+###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}, 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}, right-sided {Bone structure of right rib}, rib fractures {Fracture of rib}, fractures involving 
+multiple 
+sites within the ribs {Fracture of multiple ribs}, flail 
+chest {Flail chest}, right {Right lung structure}, hemothorax {Hemothorax}, pulmonary 
+contusion {Contusion of lung}, pneumothorax {Pneumothorax}, right {Right lung structure}, Comminuted {Fracture, comminuted}, scapular fracture. {Fracture of scapula}, Chest xray {Plain chest X-ray}, right apical {Structure of apex of right lung}, pneumothorax {Pneumothorax}, right {Right lung structure}, costophrenic sulcus {Structure of costophrenic angle}, effusion {Pleural effusion}, Increased density {Density above reference range}, right chest {Right thorax structure}, contusion {Contusion}, atelectasis {Atelectasis}, left base {Structure of base of left lung}, Multiple rib fractures {Fracture of multiple ribs}, fracture right scapula {Fracture of scapula}"
+"###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:
+He was admitted to the Trauma service for pain control and 
+pulmonary management related to his rib fractures. He was 
+initially placed on PCA and later changed over to oral 
+narcotics. Epidural analgesia was discussed with him for which 
+he declined. His oxygen saturations on room air were in the high 
+90's and he had little to no oxygen requirements.
+
+His right scapula fracture was managed non operatively and he 
+will follow up in Orthopedics clinic in 2 weeks.
+
+Adjunct pain therapy treatments were also implemented; around 
+the clock Tylenol, prn NSAID's and a Lidoderm patch were all 
+started. This regimen appeared to be effective as he was better 
+able to ambulate, use the incentive spirometer, cough and deep 
+breathe. A bowel regimen was also initiated.
+
+He was discharged to home with his wife on hospital day 4 with 
+instructions for follow up.
+ 
+
+###RESPONSE: pain control {Pain control}, rib fractures {Fracture of multiple ribs}, PCA {Patient controlled analgesia}, oral 
+narcotics {Administration of drug or medicament via oral route}, Epidural analgesia {Epidural anesthesia}, oxygen saturations {Finding of oxygen saturation}, on room air {Breathing room air}, scapula fracture {Fracture of scapula}, follow up {Follow-up arranged}, pain {Pain}, therapy {Therapy}, able to ambulate {Able to walk}, cough and deep 
+breathe {Deep breathing and coughing exercises}, bowel {Intestinal 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: Medications on Admission:
+Albuterol
+ 
+Discharge Medications:
+1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 
+times a day) as needed for pain.  
+2. Acetaminophen 500 mg Tablet Sig: Two (2) Tablet PO Q6H (every 
+6 hours).  
+3. Hydromorphone 4 mg Tablet Sig: ___ - 2 Tablet PO Q3H (every 
+3 hours) as needed for pain.
+Disp:*90 Tablet(s)* Refills:*0*
+4. Ibuprofen 600 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 
+hours): take with food.
+Disp:*120 Tablet(s)* Refills:*1*
+5. Lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: 
+One (1) Adhesive Patch, Medicated Topical DAILY (Daily): Apply 
+to right chest wall region. Remove old patch first.
+Disp:*30 Adhesive Patch, Medicated(s)* Refills:*1*
+6. Senna 8.6 mg Tablet Sig: Two (2) Tablet PO HS (at bedtime) as 
+needed for constipation.  
+7. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) 
+ML PO Q6H (every 6 hours) as needed for constipation.  
+8. Albuterol Sulfate 90 mcg/Actuation HFA Aerosol Inhaler Sig: 
+Two (2) Puffs Inhalation every six (6) hours as needed for 
+shortness of breath or wheezing.
+Disp:*1 * Refills:*1*
+
+ 
+
+###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:
+s/p Fall from bicycle
+Right communicated scapula fracture
+Multiple right rib fractures (posterior & lateral)
+Right hemothorax
+Small right apical pneumothorax
+ 
+Discharge Condition:
+Hemodynamically stable, tolerating a regular diet, pain 
+adequately controlled.
+ 
+
+###RESPONSE: Fall {Falls}, Right {Bone structure of right scapula}, communicated {Fracture, comminuted}, Multiple right rib fractures {Fracture of multiple ribs}, Right {Right lung structure}, hemothorax {Hemothorax}, right apical {Structure of apex of right lung}, pneumothorax {Pneumothorax}, Hemodynamically stable {Hemodynamically stable}, tolerating {Tolerating diet}, regular diet {Normal diet}, pain 
+adequately controlled {Demonstrates adequate pain control}"
+"###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:
+Return to the Emergency room if you develop any fevers, chills, 
+headaches, productive cough, shortness of breath, increased rib 
+pain not relieved with the medication prescribed, nausea, 
+vomiting, diarrhea and/or any other symptoms that are concerning 
+to you.
+
+It is important that you cough, deep breathe and use the 
+incentive spirometer every hour that you are awake in order to 
+minmize developing pneumonia which is commonly associated with 
+rib fractures.
+
+Take the pain medication as prescribed and continue the bowel 
+regimen while you are on narcotics in order to prevent 
+constipation.
+ 
+
+###RESPONSE: fevers {Fever}, chills {Chill}, headaches {Headache}, productive cough {Productive cough}, shortness of breath {Dyspnea}, rib 
+pain {Rib pain}, nausea, 
+vomiting, diarrhea {Nausea, vomiting and diarrhea}, cough {Cough}, awake {Awake}, pneumonia {Pneumonia}, rib fractures {Fracture of multiple ribs}, pain medication {Administration of analgesic}, bowel {Intestinal structure}, narcotics {Narcotherapy}, constipation {Constipation}"
+"###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: 
+Patient recorded as having No Known Allergies to Drugs
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Chest pain, headache.
+ 
+Major Surgical or Invasive Procedure:
+Stress MIBI.
+
+ 
+
+###RESPONSE: No Known Allergies to Drugs {Non-allergic hypersensitivity to drug or medicament}, Chest pain {Chest pain}, headache {Headache}, Stress {Electrocardiogram with exercise 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: History of Present Illness:
+This is a ___ yof with hx of Stroke, DM II diet controlled, HTN, 
+Hypercholesterolemia, Cervical Radiculopathy who presents from 
+home chest pain. Patient reports she had an episdode of ___ 
+""chest pressure"" today while she was reading a magazine. The 
+episode lasted for about 45 minutes and was not relieved with 
+NTG given by EMS. +nausea but no vomiting. She denies SOB, 
+palpitations or radiating pain with this episode. She has had 2 
+similar episodes in the last two weeks. She has history of GERD 
+in the past and stopped her Protonix because she was feeling 
+better. She started the Protonix because she had similar 
+episodes of chest pain a few years ago. The only difference is 
+the her current episodes are more severe. She denies any recent 
+chest burning, nightime cough but she does have an occasional 
+sour taste in her mouth. She also reports an episode of 'shaking 
+chills' today along with a ___ frontal headache. Headache was 
+associated with some body weakness and patient was worred she 
+was having another stroke. EMS was called and she came to ___ ED. 
+She denies any recent fevers, sweats, cough, abdominal pain, 
+diarrhea, dysuria, urinary frequency or hematuria. While in the 
+ED, the patient was noted to have gait difficulty. No vision 
+complaints. Neurology was consulted and symptoms resolved on 
+their examination. CT Head was performed and was similar to 
+prior dated ___. The patient and her daughter report that she 
+gets right sided weakness occasionally as a result of her prior 
+CVA. Currently, she denies any weakness or numbness.  
+In the ED: Temp 98.3, BP 132/63, HR 102, RR 20, 100% NRB. She 
+was given ASA 325mg x 1 and NS 1 Liter bolus. Neurology was 
+consulted as above for transient right sided weakness. She was 
+admitted for ___.
+ 
+
+###RESPONSE: Stroke {Cerebrovascular accident}, DM II diet controlled {Type 2 diabetes mellitus controlled by diet}, HTN {Hypertensive disorder, systemic arterial}, Hypercholesterolemia {Hypercholesterolemia}, Cervical Radiculopathy {Cervical radiculopathy}, chest pain {Chest pain}, chest pressure {Tight chest}, nausea {Nausea}, vomiting {Vomiting}, SOB {Dyspnea}, palpitations {Palpitations}, radiating pain {Radiating pain}, GERD {Gastroesophageal reflux disease}, feeling 
+better {Patient's condition improved}, chest pain {Chest pain}, chest burning {Burning chest pain}, cough {Cough}, sour taste {Unpleasant taste in mouth}, mouth {Mouth region structure}, shaking {Tremor}, chills {Chill}, frontal headache {Frontal headache}, Headache {Headache}, weakness {Asthenia}, stroke {Cerebrovascular accident}, fevers {Fever}, sweats {Sweating}, cough {Cough}, abdominal pain {Abdominal pain}, diarrhea {Diarrhea}, dysuria {Dysuria}, urinary frequency {Increased frequency of urination}, hematuria {Blood in urine}, gait difficulty {Abnormal gait}, No vision 
+complaints {Normal vision}, Neurology was consulted {Seen by neurologist}, resolved {Problem resolved}, CT Head {Computed tomography of head}, right sided weakness {Right hemiparesis}, CVA {Cerebrovascular accident}, weakness {Asthenia}, numbness {Numbness}, Temp {Body temperature finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, NRB {Oxygen administration by mask}, Neurology was 
+consulted {Seen by neurologist}, right sided weakness {Right hemiparesis}"
+"###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:
+CVA x 4 with residual mild right sided weakness  
+Diabetes Mellitus Type II, diet controlled  
+Hypertension  
+Hypercholesterolemia  
+Gastroesophageal Reflux Disease  
+Cervical radiculopathy  
+Diverticulitis
+ 
+
+###RESPONSE: CVA {Cerebrovascular accident}, right sided weakness {Right hemiparesis}, Diabetes Mellitus Type II, diet controlled {Type 2 diabetes mellitus controlled by diet}, Hypertension {Hypertensive disorder, systemic arterial}, Hypercholesterolemia {Hypercholesterolemia}, Gastroesophageal Reflux Disease {Gastroesophageal reflux disease}, Cervical radiculopathy {Cervical radiculopathy}, Diverticulitis {Diverticulitis}"
+"###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:
+1. brother - died late ___ w/ CVA
+2. brother - died lung ca (smoker)
+No hx of MI in first degree relative
+Mother with HTN
+ 
+
+###RESPONSE: died {Dead}, CVA {Cerebrovascular accident}, died {Dead}, lung ca {Malignant tumor of lung}, smoker {Smoker}, MI {Myocardial infarction}, HTN {Hypertensive disorder, systemic arterial}"
+"###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:
+VS: Temp 97.3, BP 108/61, HR 76, RR 20, 97% RA  
+GEN: Elderly in NAD, awake, alert  
+HEENT: EOMI, PERRL, sclera anicteric, conjunctivae clear, OP 
+moist and without lesion  
+NECK: Supple, no JVD  
+CV: Reg rate, normal S1, S2. No m/r/g.  
+CHEST: Resp were unlabored, no accessory muscle use. CTAB, no 
+crackles, wheezes or rhonchi.  
+ABD: Soft, NT, ND  
+EXT: No c/c/e  
+SKIN: No rash  
+Neuro: CN II-XII intact, ___ strenght right arm extension, ___ 
+strenght right leg extension, ___ strenght remaining 
+extremities, sensation intact, +brisk patellar reflex, other 
+reflexes normal, Gait unstable on right side on walking, no 
+pronator drift, no intention tremor, no ataxia  
+
+ 
+
+###RESPONSE: VS {Vital signs finding}, Temp {Body temperature finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, RA {Breathing room air}, GEN {General examination of patient}, NAD {No abnormality detected}, awake {Awake}, alert {Mentally alert}, HEENT {Physical examination procedure}, EOMI {Normal ocular motility}, PERRL {Pupils equal and reacting to light}, sclera anicteric {White sclera}, conjunctivae clear {Conjunctiva normal}, OP 
+moist {Moist oral mucosa}, lesion {Lesion}, NECK {Physical examination procedure}, Supple {Normal movement of neck}, JVD {Jugular venous engorgement}, CV {Cardiovascular physical examination}, Reg rate {Pulse regular}, normal S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, No m/r/g {Heart sounds normal}, CHEST {Thoracic structure}, Resp {Examination of respiratory system}, accessory muscle {Accessory skeletal muscle}, CTAB {Normal breath sounds}, crackles {Respiratory crackles}, wheezes {Wheezing}, rhonchi {Wheeze - rhonchi}, ABD {Examination of abdomen}, Soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, No c/c/e  {No abnormality detected}, SKIN {Examination of skin}, rash {Eruption of skin}, Neuro {Neurological examination}, CN II-XII {Normal central nervous system}, intact {Normal central nervous system}, strenght {Finding of power of skeletal muscle}, right arm {Structure of right upper limb}, extension {Abnormal extension}, strenght {Finding of power of skeletal muscle}, right leg {Structure of right lower limb}, extension {Abnormal extension}, strenght {Finding of power of skeletal muscle}, extremities {All extremities}, sensation intact {Normal sensation}, brisk patellar reflex {Knee reflex brisk}, reflexes normal {Normal reflex}, Gait unstable {Unsteady when walking}, right side {Structure of right half of body}, walking {Does walk}, pronator drift {Downward drift of outstretched supinated arm}, intention tremor {Intention tremor}, ataxia {Ataxia}"
+"###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:
+On Admission:
+___ 03:20PM   WBC-11.6* RBC-4.47 HGB-12.6 HCT-37.4 MCV-84 
+MCH-28.3 MCHC-33.8 RDW-14.6
+___ 03:20PM   NEUTS-91.7* LYMPHS-6.5* MONOS-0.7* EOS-0.8 
+BASOS-0.2
+___ 03:20PM   PLT COUNT-279
+___ 03:20PM   GLUCOSE-116* UREA N-16 CREAT-1.2* SODIUM-140 
+POTASSIUM-3.9 CHLORIDE-102 TOTAL CO2-28 ANION GAP-14
+___ 03:20PM   CK(CPK)-81
+___:20PM   CK-MB-NotDone
+___ 03:20PM   cTropnT-0.02*
+___ 03:20PM   ___ PTT-25.2 ___
+___ 08:40PM URINE  ___ BACTERIA-MOD YEAST-NONE 
+___ 08:40PM URINE  BLOOD-NEG NITRITE-NEG PROTEIN-NEG 
+GLUCOSE-NEG KETONE-TR BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-TR
+___ 08:40PM URINE  COLOR-Yellow APPEAR-Clear SP ___
+.
+CT head ___:
+No intracranial hemorrhage or evidence of acute major vascular 
+territorial infarct. Chronic microvascular ischemic changes 
+reidentified in the periventricular white matter.
+.
+Stress MIBIL:
+Limited exercise tolerance. No anginal type symptoms or ischemic 
+ECG changes seen at workload achieved. Nuclear report sent 
+separately.
+1. Normal myocardial perfusion. 2. Calculated LVEF is 63%. 
+
+ 
+
+###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}, LYMPHS {Lymphocyte 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}, cTropnT {Troponin T cardiac measurement}, PTT {Partial thromboplastin time, activated}, URINE {Urine culture}, AST {Aspartate aminotransferase measurement}, PROTEIN {Measurement of protein in urine}, BILIRUBIN {Bilirubin measurement, urine}, PH {pH measurement}, URINE {Evaluation of urine specimen}, COLOR {Color finding}, intracranial hemorrhage {Intracranial hemorrhage}, vascular {Blood vessel structure}, infarct {Infarct}, Chronic {Chronic disease}, ischemic {Ischemia}, periventricular white matter {Structure of periventricular white matter}, Limited exercise tolerance {Impaired exercise tolerance}, anginal {Angina}, ischemic {Ischemia}, ECG changes {Finding present on electrocardiogram}, Normal myocardial perfusion {Myocardial perfusion normal}"
+"###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:
+___ yof with hx of Stroke, DM II diet controlled, HTN, 
+Hypercholesterolemia, Cervical Radiculopathy who presents from 
+home with chest pain associated with shaking chills and 
+headache.  
+.  
+# Chest Pain: Chest pain was concerning for ACS as she felt 
+""chest pressure"" along with nausea and it lasted for 45 minutes. 
+Patient had negative cardiac enzymes x3 and serial ECG without 
+any changes. Patient was continued on her PPI for history of 
+GERD. Due to the concern with multiple risk factors and history, 
+patient had a stress MIBI that showed good HR of 137 (93% of 
+max) with product of ___, which does not suggest active 
+ischemia. However, her prognostic value was poor with 6:30 on a 
+Gervino protocol with ___ MTS. Patient did not have any 
+abnormalities on telemetry and is on tripple anti-platelet 
+therapy with aggrenox and plavix for her stroke that will 
+decrease her cardiovascular risk as well. Patient was continued 
+in her outpatient statin and ___. Will recommend starting 
+beta-blocker as outaptient; it was not started in house to 
+assess her neurologic status in the question of acute stroke and 
+severe headache.
+.  
+# Right Sided Weakness: Patient with prior history of CVA. 
+Patient had transient weakness today and was evaluated by Neuro 
+in the ED. CT Head was negative and symptoms have now resolved. 
+Patient and daughter report occasional right sided fatigue s/p 
+her prior CVA. She uses a can at baseline for ambulation. Due to 
+her prior strokes patient is in an atypical regimen with 
+aggrenox and plavix suggested by neurology. 
+.  
+# Headache: Patient had episode of Headache today along with her 
+chest pain and weakness. She has history of headaches similar to 
+this. Most likely etiology is her cervical spine disease. 
+Conservative measurements with ice-packs, soft collar and 
+tylenol were done.
+.  
+# Shaking chills: Patient with episode of shaking chills. 
+Afebrile since arrival but she does have a slightly elevated WBC 
+at 11.6. No signs of infection by history or exam. UA with Mod 
+bacteria but without pyuria. She was treated with a 3-day course 
+of ciprofloxacin to complete at home.
+.  
+# HTN: cont home Diovan; meeting ___-7 criteria while in 
+hospital. 
+.  
+# DM II: diet controlled. Patient was put in ISS with minimal 
+requirements and blood sugars 100-200 range.
+.  
+# Depression: cont home sertraline.  
+.  
+# FEN: Cardiac, diabetic diet.
+.  
+# Access: PIV.
+.  
+# PPx: heparin SC, bowel regimen.
+.  
+# Code: FULL CODE.
+.  
+# Dispo: Home with PCP follow up.  
+.  
+# Comm: With patient.
+
+ 
+
+###RESPONSE: Stroke {Cerebrovascular accident}, DM II diet controlled {Type 2 diabetes mellitus controlled by diet}, HTN {Hypertensive disorder, systemic arterial}, Hypercholesterolemia {Hypercholesterolemia}, Cervical Radiculopathy {Cervical radiculopathy}, chest pain {Chest pain}, shaking {Tremor}, chills {Chill}, headache {Headache}, Chest Pain {Chest pain}, Chest pain {Chest pain}, ACS {Acute coronary syndrome}, chest pressure {Tight chest}, nausea {Nausea}, negative cardiac enzymes {Cardiac enzymes within reference range}, ECG {Electrocardiographic procedure}, GERD {Gastroesophageal reflux disease}, stress {Electrocardiogram with exercise test}, HR {Finding of heart rate}, ischemia {Ischemia}, did not have any 
+abnormalities {No abnormality detected}, telemetry {Cardiac telemetry}, anti-platelet 
+therapy {Anticoagulant therapy}, stroke {Cerebrovascular accident}, decrease {Finding of decreased risk level}, cardiovascular {Cerebrovascular accident}, statin {Administration of prophylactic statin}, outaptient {Outpatient care management}, assess her neurologic status {Neurological examination}, stroke {Cerebrovascular accident}, headache {Headache}, Right Sided Weakness {Right hemiparesis}, CVA {Cerebrovascular accident}, weakness {Asthenia}, evaluated {Evaluation procedure}, Neuro {Neurology service}, CT Head {Computed tomography of head}, resolved {Problem resolved}, right sided {Structure of right half of body}, fatigue {Fatigue}, CVA {Cerebrovascular accident}, uses a can {Dependence on walking stick}, baseline {Baseline state}, strokes {Cerebrovascular accident}, regimen {Therapeutic regimen}, Headache {Headache}, Headache {Headache}, chest pain {Chest pain}, weakness {Asthenia}, headaches {Headache}, cervical spine disease {Disorder of cervical spine}, Conservative measurements {Conservative therapy}, ice {Application of ice}, collar {Application of cervical collar}, tylenol {Administration of analgesic}, Shaking {Tremor}, chills {Chill}, shaking {Tremor}, chills {Chill}, elevated WBC {White blood cell count outside reference range}, signs of infection {Monitoring for signs and symptoms of infection}, exam {Physical examination procedure}, UA {Urinalysis}, bacteria {Bacteriuria}, pyuria {Pyuria}, ciprofloxacin {Antibiotic therapy}, HTN {Hypertensive disorder, systemic arterial}, DM II {Diabetes mellitus type 2}, diet controlled {Type 2 diabetes mellitus controlled by diet}, ISS {Sliding scale insulin regime}, blood sugars {Glucose measurement, blood}, Depression {Depressive disorder}, FEN {Nutrition management}, Cardiac {Heart disease}, diabetic diet {Diabetic diet}, PIV {Peripheral intravenous catheter care}, PPx {Preventive procedure}, heparin SC {Subcutaneous injection of heparin}, bowel {Normal bowel habits}, regimen {Therapeutic regimen}, Dispo {Patient disposition}, PCP {Primary care management}, follow up {Follow-up arranged}"
+"###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:
+Plavix 75mg daily  
+Aggrenox 25mg-200mg cap BID  
+Folic Acid  
+Crestor 40mg qHS  
+Sertraline 25mg daily  
+Diovan 80mg BID  
+Calcium/Vit D  
+Protonix 40mg daily  
+Vit B12  
+Colace  
+Fish Oil
+ 
+Discharge Medications:
+1. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+2. Dipyridamole-Aspirin 200-25 mg Cap, Multiphasic Release 12 hr 
+Sig: One (1) Cap PO BID (2 times a day).  
+3. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+
+4. Rosuvastatin 20 mg Tablet Sig: Two (2) Tablet PO DAILY 
+(Daily).  
+5. Valsartan 80 mg Tablet Sig: One (1) Tablet PO BID (2 times a 
+day).  
+6. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) 
+Tablet, Chewable PO QID (4 times a day) as needed.  
+7. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: Four (4) 
+Tablet PO DAILY (Daily).  
+8. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 
+times a day).  
+9. Protonix 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) 
+Tablet, Delayed Release (E.C.) PO once a day.  
+10. Cyanocobalamin 500 mcg Tablet Sig: 0.5 Tablet PO DAILY 
+(Daily).  
+11. Ciprofloxacin 250 mg Tablet Sig: One (1) Tablet PO Q12H 
+(every 12 hours) for 2 days.
+Disp:*4 Tablet(s)* Refills:*0*
+12. Sertraline 25 mg Tablet Sig: One (1) Tablet PO once a day.  
+13. Fish Oil 1,000 mg Capsule Sig: One (1) Capsule PO once a 
+day.  
+
+ 
+
+###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 Diagnosis:
+Stable Coronary Artery Disease
+Cervicalgia
+.
+Secondary Diagnsis:
+CVA x 4 with residual mild right sided weakness  
+Diabetes Mellitus Type II, diet controlled  
+Hypertension  
+Hypercholesterolemia  
+Gastroesophageal Reflux Disease  
+
+ 
+Discharge Condition:
+Stable, pain free, walking, tolerating diet.
+
+ 
+
+###RESPONSE: Stable {Patient's condition stable}, Coronary Artery Disease {Coronary arteriosclerosis}, Cervicalgia {Neck pain}, CVA {Cerebrovascular accident}, mild {Symptom mild}, right sided weakness {Right hemiparesis}, Diabetes Mellitus Type II, diet controlled  {Type 2 diabetes mellitus controlled by diet}, Hypertension {Hypertensive disorder, systemic arterial}, Hypercholesterolemia {Hypercholesterolemia}, Gastroesophageal Reflux Disease {Gastroesophageal reflux disease}, Stable {Patient's condition stable}, pain {Pain}, walking {Does walk}, tolerating diet {Tolerating diet}"
+"###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 seen at ___ for chest pain. We were concern about 
+your heart and did some blood test, serial ECGs, heart monitor 
+(telemetry) and stress test that were all negative. This rules 
+you out as having an acute heart attack and puts you at low risk 
+from having one soon. We are sending you home with follow up 
+with your PCP.
+.
+You also have a headache and because of that you were seen by 
+the neurology stroke service who did not think you were having a 
+stroke. You had a CT scan that did not show any bleeding. Your 
+signs and symptoms are compatible with your cervical lessions 
+and we recommend conservative management with cold and pain 
+medication (Tylenol) as well as PCP follow up.
+.
+You were found to have a urinary tract infection and will need 
+to complete 3 days of antibiotics (ciprofloxacin). See attached 
+prescription.
+.
+Your medications were left unchanged.
+.
+If you notice any worsening in your weakness, new problems while 
+talking, facial droop, worsening of your chest pain or that it 
+last more than 15 minutes associated with sweating, bleeding or 
+anything else that concerns you please come back to the ER ASAP.
+.
+Please follow up as below.
+ 
+
+###RESPONSE: chest pain {Chest pain}, heart {Heart structure}, blood test {Blood test}, ECG {Electrocardiographic procedure}, heart monitor {Cardiac monitoring}, telemetry {Cardiac telemetry}, stress test {Electrocardiogram with exercise test}, negative {No abnormality detected}, acute heart attack {Acute myocardial infarction}, follow up {Follow-up arranged}, PCP {Primary care management}, headache {Headache}, seen by 
+the neurology stroke service {Seen by stroke service}, stroke {Cerebrovascular accident}, CT scan {Computed tomography}, bleeding {Bleeding}, signs {Sign}, cervical {Bone structure of cervical vertebra}, lessions {Lesion}, conservative management {Conservative therapy}, cold {Cryoanalgesia}, pain 
+medication {Administration of analgesic}, PCP {Primary care management}, follow up {Follow-up arranged}, urinary tract infection {Urinary tract infectious disease}, antibiotics {Antibiotic therapy}, prescription {Prescription}, medications {Prescription of drug}, weakness {Asthenia}, problems {Problem}, talking {Speech problem}, facial {Face structure}, chest pain {Chest pain}, sweating {Sweating}, bleeding {Bleeding}, ER {Emergency treatment management}"
+"###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:
+s/p Multiple gunshot wounds
+ 
+Major Surgical or Invasive Procedure:
+___ EXPLORATORY LAPAROTOMY 
+
+ 
+
+###RESPONSE: No Known Allergies {Allergic disposition}, Adverse Drug Reactions {Propensity to adverse reactions to drug}, gunshot wounds {Gunshot wound}, EXPLORATORY LAPAROTOMY {Exploratory laparotomy}"
+"###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 male who is s/p multiple gunshot wounds to abdomen 
+and left hand. He was transported from ___ 
+for further managemnt of his injuries.
+ 
+
+###RESPONSE: gunshot wounds {Gunshot wound}, abdomen {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, left hand {Structure of left hand}, injuries {Traumatic injury}"
+"###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:
+ Asthma, ?depression/ anxiety, ETOH use per family, h/o assault 
+ 
+
+###RESPONSE: Asthma {Asthma}, depression {Depressive disorder}, anxiety {Anxiety}, ETOH {Finding relating to alcohol drinking behavior}"
+"###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:
+Noncontributory
+ 
+
+###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:
+Upon presentation to ___:
+HR: 70 BP: 100/p Resp: bagged O(2)Sat: 100 Normal
+ 
+Constitutional: intubated, sedated
+HEENT: Normocephalic, atraumatic, Pupils equal, round and
+reactive to light
+ETT in place
+Chest: Clear to auscultation
+Cardiovascular: Regular Rate and Rhythm, Normal first and
+second heart sounds
+Abdominal: Soft, Nondistended
+GU/Flank: No costovertebral angle tenderness
+Extr/Back: No cyanosis, clubbing or edema
+Skin: Warm and dry, GSW to L chest, LLQ x2, R flank, L hip,
+R back, L thigh x 2, L thumb
+Neuro: intubated, sedated
+Psych: intubated, sedated
+___: No petechiae
+
+ 
+
+###RESPONSE: HR {Finding of heart rate}, BP {Blood pressure finding}, Resp {Examination of respiratory system}, bagged {Respiratory assist, manual}, intubated {Insertion of endotracheal tube}, sedated {Sedated}, HEENT {Physical examination procedure}, Normocephalic {Normal head}, atraumatic {No injuries apparent}, Pupils equal, round and
+reactive to light {Pupils equal and reacting to light}, ETT in place {Endotracheal tube present}, Chest {Examination of respiratory system}, Clear to auscultation {Normal breath sounds}, Cardiovascular {Cardiovascular physical examination}, Regular Rate and Rhythm {Normal heart rate}, Normal first and
+second heart sounds {Heart sounds normal}, Abd {Examination of abdomen}, Soft {Abdomen soft}, distended {Swollen abdomen}, GU {Examination of genitourinary system}, Flank {Flank structure}, tenderness {Tenderness}, Extr {Examination of limb}, Back {Structure of back of trunk}, cyanosis {Cyanosis}, clubbing {Clubbing}, edema {Edema}, Skin {Examination of skin}, Warm {Warm skin}, dry {Xeroderma}, GSW {Gunshot wound}, L chest {Structure of left half of chest wall}, LLQ {Structure of left lower quadrant of abdomen}, flank {Flank structure}, hip {Left hip region structure}, back {Structure of back of trunk}, L thigh {Structure of left thigh}, L thumb {Structure of left thumb}, Neuro {Neurological examination}, intubated {Insertion of endotracheal tube}, sedated {Sedated}, Psych {Neurological mental status determination}, intubated {Insertion of endotracheal tube}, sedated {Sedated}, petechiae {Petechia}"
+"###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:
+___ 09:20AM   GLUCOSE-111* UREA N-7 CREAT-0.7 SODIUM-143 
+POTASSIUM-3.0* CHLORIDE-109* TOTAL CO2-19* ANION GAP-18
+___ 09:20AM   CALCIUM-7.8* PHOSPHATE-3.3 MAGNESIUM-1.5*
+___ 09:20AM   WBC-6.2 RBC-3.94* HGB-12.3* HCT-34.3* MCV-87 
+MCH-31.2 MCHC-35.9* RDW-13.5
+___ 09:20AM   ___ PTT-25.3 ___
+___ 09:20AM   PLT COUNT-130*
+___ 07:13AM   GLUCOSE-88 LACTATE-3.2* K+-2.9* CL--109*
+
+IMAGING:  
+___: Femur AP: Known lucency in the left iliac bone. No 
+evidence of bullet fragments. The left femur shows normal 
+cortical borders, no evidence of cortical disruption suggesting 
+fracture. No soft tissue abnormalities.  
+___: CXR: no evidence of larger parenchymal abnormalities and  
+no pneumothorax. The abnormalities seen on the outside CT torso 
+from ___, 4:48 a.m., are not depicted on the chest 
+radiograph. Only the dorsal right 11th rib fracture is visible 
+on the edge-enhanced image.  
+___: AP chest and pelvis: A focal lucency within the left iliac 
+bone corresponds to a traumatic injury seen on the reference CT 
+torso examination from 4:48 a.m. No bullet fragments are 
+detected. A Foley catheter resides within the bladder, which is 
+opacified with contrast.  
+___: Hand: comminuted fracture at the head of the first 
+proximal phalanx is seen, with extension to the IP joint.  
+
+ 
+
+###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}, CALCIUM {Blood calcium 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}, PTT {Partial thromboplastin time, activated}, GLUCOSE {Glucose measurement, blood}, CL {Chloride measurement, blood}, IMAGING {Imaging}, Femur {Bone structure of femur}, AP {Diagnostic radiography, anteroposterior}, left iliac bone {Bone structure of left ilium}, No 
+evidence {No abnormality detected}, left femur {Structure of left femur}, no evidence {No abnormality detected}, disruption {Disruption}, fracture {Fracture}, soft tissue {Structure of soft tissue of thigh}, abnormalities {No abnormality detected}, CXR {Plain chest X-ray}, no evidence {No abnormality detected}, abnormalities {No abnormality detected}, pneumothorax {Pneumothorax}, abnormalities {Imaging result abnormal}, torso {Trunk structure}, chest 
+radiograph {Plain chest X-ray}, right {Bone structure of right rib}, rib fracture {Fracture of rib}, AP chest {Plain x-ray of chest anteroposterior view}, pelvis {Plain X-ray of pelvis, anteroposterior view}, left iliac 
+bone {Bone structure of left ilium}, traumatic injury {Traumatic injury}, torso {Trunk structure}, Foley catheter {Urinary catheter in situ}, bladder {Urinary bladder structure}, Hand {Hand structure}, comminuted fracture {Fracture, comminuted}, head {Structure of head of phalanx}, proximal phalanx {Bone structure of proximal phalanx of hand}, IP joint {Interphalangeal joint 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:
+He was admitted to the Acute Care Surgery team was taken from 
+the ED to the OR for exploratory laparotomy. He was transferred 
+to the Trauma SICU postoperatively  for close monitoring. He 
+remained hemodynamically stable and continued to have palpable 
+lower extremity pulses. He was extubated without difficulty and  
+was alert and responsive. Hand surgery was consulted for the 
+left open thumb fracture for which he was fitted with a spica 
+cast. Ultimately he will follow up as an outpatient with Hand 
+Surgery to discuss operative repair. His pain was controlled 
+with IV narcotics initially. On the ___ postoperative day his 
+diet was advanced. His wounds were closely monitored for signs 
+of infection and they remained clean. His vital signs were 
+stable and his urine output was adequate; he was then 
+transferred out of the ICU to the floor on POD 1. 
+
+Once transferred to the floor he progressed slowly primarily 
+limited by pain. His narcotics required several adjustments. 
+Toradol was added to his regimen which was helpful. At time of 
+discharge his pain is well controlled with Oxycodone and 
+Baclofen both prn.
+
+He was seen by Social work due to the nature of his trauma and 
+also due to +blood alcohol level. He was provided with 
+information pertaining to reactions to trauma.
+ 
+
+###RESPONSE: exploratory laparotomy {Exploratory laparotomy}, transferred 
+to the Trauma SICU {Patient transfer to intensive care unit}, postoperatively {Postoperative state}, monitoring {Monitoring response to treatment}, hemodynamically stable {Hemodynamically stable}, lower extremity pulses {Lower limb pulse present}, extubated {Removal of endotracheal tube}, alert {Mentally alert}, Hand surgery was consulted {Referral to hand surgery service}, left {Structure of left thumb}, thumb {Structure of left thumb}, fracture {Open fracture of hand}, fitted with a spica 
+cast {Application of thumb spica plaster cast}, Hand 
+Surgery {Referral to hand surgery service}, operative {Surgical procedure}, repair {Repair of finger}, pain was controlled {Pain control}, IV {Administration of drug or medicament via intravenous route}, narcotics {Narcotherapy}, postoperative {Postoperative state}, diet was advanced {Advance diet as tolerated}, wounds {Wound}, signs 
+of infection {Monitoring for signs and symptoms of infection}, remained clean {Wound healing well}, vital signs were 
+stable {Normal vital signs}, urine output {Finding of measures of urine output}, transferred out of the ICU {Discharge from intensive care service}, pain {Pain}, narcotics {Narcotherapy}, adjustments {Procedure related to management of drug administration}, regimen {Therapeutic regimen}, pain is well controlled {Demonstrates adequate pain control}, seen by Social work {Seen by social worker}, trauma {Traumatic injury}, blood alcohol level {Blood ethanol measurement}, trauma {Traumatic injury}"
+"###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:
+Denies
+ 
+Discharge Medications:
+1. Acetaminophen 1000 mg PO TID 
+2. Baclofen 10 mg PO TID 
+RX *baclofen 10 mg 1 tablet(s) by mouth three times a day Disp 
+#*21 Tablet Refills:*0
+3. Docusate Sodium 100 mg PO BID 
+4. OxycoDONE (Immediate Release)  ___ mg PO Q3H:PRN pain 
+RX *oxycodone 5 mg ___ tablet(s) by mouth every ___ hours as 
+needed Disp #*60 Tablet Refills:*0
+5. Senna 1 TAB PO BID:PRN constipation 
+
+ 
+
+###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:
+s/p Multiple Gunshot wounds to abdomen & left hand
+Injuires:
+Comminuted fracture of the left thumb proximal phalanx
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Gunshot wounds {Gunshot wound}, abdomen {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, left hand
+Injuires {Injury of left hand}, Comminuted fracture {Fracture, comminuted}, left thumb {Structure of left thumb}, proximal phalanx {Bone structure of proximal phalanx of hand}, 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 to the hopstial after sustaining multiple 
+gunshot wounds to your adbominal region and your left hand. You 
+underwent an operation to explore your abomen for internal organ 
+injuries and none were identified. You did sustain an open 
+fracture of your left thumb and was placed in a special cast. 
+You will need to follow up with the Orthopedic hand surgeon in 
+the next couple of weeks to discuss possible surgery. You have 
+staples along the incision in your abdomen and these will be 
+reomoved inthe next ___ days when you return for your 
+appointment in the Acute Care Surgery clinic. 
+
+You are being discharged on medications to treat the pain from 
+your operation. These medications will make you drowsy and 
+impair your ability to drive a motor vehicle or operate 
+machinery safely. You MUST  refrain from such activities while 
+taking these medications. 
+
+ 
+
+ 
+
+Please call your doctor or return to the emergency room if you 
+have any of the following:
+ 
+
+ * You experience new chest pain, pressure, squeezing or 
+ tightness.
+ 
+* New or worsening cough or wheezing.
+ 
+* If you are vomiting and cannot keep in fluids or your 
+ medications.
+ 
+* You are getting dehydrated due to continued vomiting, 
+ diarrhea or other reasons. Signs of dehydration include dry 
+ mouth, rapid heartbeat or feeling dizzy or faint when standing.
+ 
+* You see blood or dark/black material when you vomit or have a 
+ bowel movement.
+ 
+
+* You have shaking chills, or a fever greater than 101.5 (F) 
+ degrees or 38(C) degrees.
+ 
+* Any serious change in your symptoms, or any new symptoms that 
+ concern you. 
+ 
+* Please resume all regular home medications and take any new 
+meds 
+ as ordered.  
+
+Activity:
+No heavy lifting of items ___ pounds for 6 weeks. You may 
+resume moderate
+exercise at your discretion, no abdominal exercises.
+
+Wound Care:
+You may shower, no tub baths or swimming. 
+
+If there is clear drainage from your incisions, cover with 
+clean, dry gauze. 
+Please call the doctor if you have increased pain, swelling, 
+redness, or drainage from the incision sites.
+
+ 
+
+###RESPONSE: gunshot wounds {Gunshot wound}, adbominal {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, left hand {Structure of left hand}, operation {Surgical procedure}, explore your abomen {Exploratory laparotomy}, internal organ 
+injuries {Internal injury of abdominal organ}, open 
+fracture {Open fracture of hand}, left thumb {Structure of left thumb}, cast {Application of thumb spica plaster cast}, Orthopedic hand surgeon {Seen by orthopedic surgeon}, surgery {Surgical procedure}, incision {Abdomen incision}, abdomen {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, medications {Prescription of drug}, pain {Pain}, operation {Surgical procedure}, medications {Administration of analgesic}, drowsy {Drowsy}, impair your ability to drive a motor vehicle or operate 
+machinery safely {Patient should not drive or operate machinery}, activities {Functional activity education}, while 
+taking these medications {Patient medication education}, call your doctor {Informing doctor}, return to the emergency {Emergency treatment education}, chest pain {Chest pain}, pressure {Tight chest}, squeezing {Squeezing chest pain}, tightness {Tight chest}, cough {Cough}, wheezing {Wheezing}, vomiting {Vomiting}, cannot keep in fluids or your 
+ medications {Nausea and vomiting}, dehydrated {Dehydration}, vomiting {Vomiting}, diarrhea {Diarrhea}, Signs {Sign}, dehydration {Dehydration}, dry 
+ mouth {Xerostomia}, rapid heartbeat {Tachycardia}, dizzy {Dizziness}, faint {Feeling faint}, standing {Orthostatic body position}, blood or dark/black material when you vomit {Vomit contains blood}, bowel movement {Hematochezia}, shaking {Tremor}, chills {Chill}, fever {Fever}, resume all regular home medications {Patient medication education}, lifting {Does lift}, moderate
+exercise {Physical activity target moderate exercise}, abdominal exercises {Abdominal exercises}, may shower {Wound treatment education}, drainage {Wound discharge}, incisions {Surgical incision wound}, cover with 
+clean, dry gauze {Application of dressing}, increased pain {Increased pain}, swelling {Swelling}, redness {Redness of skin over lesion}, drainage {Wound discharge}, incision sites {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: 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: 
+Iodine; Iodine Containing / Penicillins
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Abdominal pain and RLE claudication
+ 
+Major Surgical or Invasive Procedure:
+Angiogram x 2, celiac and SMA angioplasty
+
+ 
+
+###RESPONSE: Iodine; Iodine {Allergy to iodine compound}, Penicillins {Allergy to penicillin}, Abdominal pain {Abdominal pain}, RLE {Structure of right lower limb}, claudication {Intermittent claudication}, Angiogram {Angiography}, celiac {Angioplasty of celiac artery}, SMA angioplasty {Angioplasty of superior mesenteric artery}"
+"###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 bilateral PVD presents with ___ abdominal pain
+which has become unbearable and worsening RLE claudication which
+has been controlled on oral pain medications.  He underwent an
+arteriogram in ___ that showed occluded SFA with runoff via
+the peroneal and ___, the AT was occluded.  Plans were made to
+bring him back for a Left Fem to AK-pop bypass, but he failed to
+keep his follow up appointments.  He now presents with worsening
+claudication in his right leg.  He can only walk a few steps now
+and then he gets pain in his calf and thigh.  Resting and
+percocet alleviate the pain.  This is much worse than it was a
+few months ago.  He does get pain in his left leg too, but his
+right leg is more severe.  He does not have rest pain.  He 
+denies
+fevers, chills, nausea, emesis, paresthesias in his feet, and
+weakness.  He has no lesions on his feet.  He quit smoking ___
+years ago but does have ___ cigs to calm his nerves.  His feet
+have never been cold or turned blue.
+
+ 
+
+###RESPONSE: PVD {Peripheral vascular disease}, abdominal pain {Abdominal pain}, RLE {Structure of right lower limb}, claudication {Intermittent claudication}, oral {Administration of drug or medicament via oral route}, pain medications {Administration of analgesic}, arteriogram {Angiography of artery}, SFA {Structure of superficial femoral artery}, peroneal {Structure of peroneal artery}, AT {Structure of anterior tibial artery}, Fem to AK-pop bypass {Femoral-popliteal artery bypass graft}, claudication {Intermittent claudication}, right leg {Structure of right lower leg}, walk {Does walk}, pain {Pain}, calf {Structure of calf of leg}, thigh {Structure of left thigh}, pain {Pain}, pain {Pain}, left leg {Structure of left lower limb}, right leg {Structure of right lower leg}, rest pain {Pain provoked by rest}, fevers {Fever}, chills {Chill}, nausea {Nausea}, emesis {Vomiting}, paresthesias {Paresthesia}, feet {Foot structure}, weakness {Weakness of foot}, lesions {Skin lesion}, feet {Foot structure}, quit smoking {Ex-smoker}, calm {Feeling calm}, feet {Foot 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: Past Medical History:
+1. HTN
+2. CAD, s/p CABG ___
+3. Hyperlipidemia
+4. Carotid artery disease, s/p L CEA approximately ___
+5. Taxus drug-eluting stent and a 2.0mm MiniVision stent
+6. PTCA & stenting Cypher ___ 3, LMA into ostial LAD, ___
+7. S/p CVA x 2 in ___, R-sided weakness & expressive aphasia, 
+(now
+improved)
+8. s/p Fall / foot trauma ___, no surgery, wheelchair bound 6 
+months
+9. GERD
+10. Depression
+11. DJD
+12. Chronic kidney disease 
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, CAD {Coronary arteriosclerosis}, CABG {Coronary artery bypass grafting}, Hyperlipidemia {Hyperlipidemia}, Carotid artery disease {Disorder of carotid artery}, L {Structure of left carotid artery}, CEA {Carotid endarterectomy}, drug-eluting stent {Endovascular insertion of drug eluting stent}, stent {Placement of stent}, PTCA {Percutaneous transluminal coronary angioplasty}, stenting {Insertion of arterial stent}, LMA {Structure of left coronary artery main stem}, LAD {Structure of anterior descending branch of left coronary artery}, CVA {Cerebrovascular accident}, R-sided weakness {Right hemiparesis}, expressive aphasia {Expressive dysphasia}, improved {Patient's condition improved}, Fall {Falls}, foot {Foot structure}, trauma {Traumatic injury}, surgery {Surgical procedure}, wheelchair bound {Does mobilize using wheelchair}, GERD {Gastroesophageal reflux disease}, Depression {Depressive disorder}, DJD {Osteoarthritis}, Chronic kidney disease {Chronic kidney 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: 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 died at age ___ of unknown cause. Mother died in her ___ 
+of Influenza. 
+ 
+
+###RESPONSE: died {Dead}, died {Dead}, Influenza {Influenza}"
+"###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:
+At time of discharge:
+
+AVSS
+A&O X 3, NAD
+PERRL, EOMI
+RRR
+CTAB
+Abdomen soft, nondistended, mild generalized tenderness, no 
+rebound or guarding
+___ warm
+Pulses: b/l fem 2+, pop, DP and ___ all dopplerable
+ 
+
+###RESPONSE: AVSS {Vital signs finding}, A {Mentally alert}, O X 3 {Oriented to person, time and place}, NAD {No abnormality detected}, PERRL {Pupils equal and reacting to light}, EOMI {Normal ocular motility}, RRR {Normal heart rate}, CTAB {Normal breath sounds}, soft {Abdomen soft}, nondistended {Normal abdominal contour}, mild {Symptom mild}, tenderness {Tenderness}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, warm {Warm skin}, Pulses {Pulse finding}, fem 2+ {Normal femoral pulse}"
+"###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:
+___ 07:10AM BLOOD WBC-10.0# RBC-3.39* Hgb-9.8* Hct-29.8* 
+MCV-88 MCH-28.8 MCHC-32.8 RDW-18.2* Plt ___
+___ 06:50AM BLOOD Hct-32.6*
+___ 06:50AM BLOOD UreaN-27* Creat-2.2* K-3.4
+___ 07:10AM BLOOD Calcium-8.8 Phos-3.8 Mg-1.8
+ 
+
+###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}, Hct {Hematocrit determination}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, K {Blood potassium measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total 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: Brief Hospital Course:
+Mr. ___ was admitted on ___ under the care of Dr. 
+___. He underwent ___ angiogram on ___ that showed occlusion 
+of the superficial femoral artery with
+reconstitution in the above-knee popliteal artery and 2-vessel 
+runoff to the foot.  Given these findings, the operation was 
+terminated at that point with a plan for surgical bypass at a 
+later point. The following day he underwent a mesenteric 
+angiogram via brachial approcah. He underwent balloon 
+angioplasty of iliac artery stenosis and balloon angioplasty of 
+SMA stenosis. Post-operatively he recovered well. He continued 
+to have generalized abdominal pain and a GI consult was 
+obtained. Since he had evidence of gastritis and duodenal ulcers 
+in ___ on EGD, and since he
+is unsure if he took PPI since then, the gastroenterologists 
+felt that remaining ulcers may also be contributing to the 
+abdominal pain. They recommended increasing PPI to 40 mg PO BID 
+for 2 weeks, avoiding NSAIDs and will consider repeat EGD as 
+outpatient if no improvement. He was discharged home on ___ 
+tolerating a regular diet but with similar abdominal complaints 
+as prior.
+ 
+
+###RESPONSE: angiogram {Angiography}, occlusion {Complete obstruction}, superficial femoral artery {Structure of superficial femoral artery}, above-knee popliteal artery {Structure of supragenicular popliteal artery}, vessel {Blood vessel structure}, foot {Foot structure}, operation {Surgical procedure}, surgical bypass {Construction of shunt}, mesenteric 
+angiogram {Angiography of mesenteric artery}, balloon 
+angioplasty {Angioplasty of artery}, iliac artery stenosis {Iliac artery stenosis}, balloon angioplasty of 
+SMA {Percutaneous balloon angioplasty of superior mesenteric artery}, stenosis {Stenosis}, Post-operatively {Postoperative state}, generalized abdominal pain {Generalized abdominal pain}, gastritis {Gastritis}, duodenal ulcers {Ulcer of duodenum}, EGD {Esophagogastroduodenoscopy}, ulcers {Ulcer}, abdominal pain {Abdominal pain}, EGD {Esophagogastroduodenoscopy}, tolerating {Tolerating diet}, regular diet {Normal diet}, abdominal {Abdominal 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: Medications on Admission:
+amlodipine 10mg daily, clonidine 0.1mg bid, isosorbide 
+mononitrate 180mg daily, metoprolol XL 50mg daily, omeprazole 
+40mg daily, papaverine 150mg bid, simvastatin 40mg daily, 
+aspirin 325mg daily, plavix 75mg daily, niacin 1000mg daily, 
+benicar 40mg daily, clonazepam 0.5mg tid, zolpidem 5mg daily, 
+MVI  
+ 
+Discharge Medications:
+1. Amlodipine 5 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily).  
+
+2. Clonidine 0.1 mg Tablet Sig: One (1) Tablet PO BID (2 times a 
+day).  
+3. Isosorbide Mononitrate 60 mg Tablet Sustained Release 24 hr 
+Sig: Three (3) Tablet Sustained Release 24 hr PO DAILY (Daily).  
+
+4. Metoprolol Succinate 50 mg Tablet Sustained Release 24 hr 
+Sig: One (1) Tablet Sustained Release 24 hr PO DAILY (Daily).  
+5. Papaverine 150 mg Capsule, Sustained Release Sig: One (1) 
+Capsule, Sustained Release PO Q12H (every 12 hours).  
+6. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+7. Niacin 500 mg Capsule, Sustained Release Sig: Two (2) 
+Capsule, Sustained Release PO DAILY (Daily).  
+8. Clonazepam 0.5 mg Tablet Sig: One (1) Tablet PO TID (3 times 
+a day).  
+9. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+10. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+11. Zolpidem 5 mg Tablet Sig: Two (2) Tablet PO HS (at bedtime). 
+ 
+12. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: Two (2) 
+Capsule, Delayed Release(E.C.) PO BID (2 times a day).  
+13. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID 
+(2 times a day).
+Disp:*60 Capsule(s)* Refills:*2*
+14. Percocet ___ mg Tablet Sig: ___ Tablets PO every ___ hours 
+as needed for pain.
+Disp:*80 Tablet(s)* 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:
+RLE ischemia 
+Abdominal pain
+
+ 
+Discharge Condition:
+Good
+
+ 
+
+###RESPONSE: RLE {Structure of right lower limb}, Abdominal pain {Abdominal pain}, Good {Patient's condition satisfactory}"
+"###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:
+Call your doctor or go to the ER if you experience any of the 
+following: fever > 101.5, severe pain, bleeding from groin, or 
+any other concerning symptoms
+ 
+
+###RESPONSE: Call your doctor {Informing doctor}, fever {Fever}, severe pain {Severe pain}, bleeding {Bleeding}, groin {Inguinal region 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: 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: 
+Penicillins / Prednisone
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Palpitations, diaphoresis
+ 
+Major Surgical or Invasive Procedure:
+___: Biopsy of retroperitoneal mass by ___ under 
+fluoroscopic guidance  
+
+ 
+
+###RESPONSE: Penicillins {Allergy to penicillin}, Prednisone {Allergy to prednisone}, Palpitations {Palpitations}, diaphoresis {Excessive sweating}, Biopsy of retroperitoneal mass by ___ under 
+fluoroscopic guidance {Biopsy of retroperitoneum using fluoroscopic guidance}"
+"###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:
+
+###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: History of Present Illness: This is a ___ YO M CAD, chronic, 
+likely diastolic CHF who is representing to the ED after 
+presenting with diaphoresis, nausea, presyncope at rehab.  After 
+being recently discharged from ___, while at rehab, he was 
+sitting in his wheelchair when he developed diaphoresis at rest. 
+ He did have a bowel movement about half hour prior to event.  
+Diaphoresis was associated with nausea and feeling of confusion. 
+ Experienced chest palpitations.  Unclear if Mr ___ lost 
+consciousness; denies any loss of stool or urine.  Discomfort 
+lasted about 10 minutes and then resolved; has not recurred. 
+Most recently he was admitted to the hospital on ___ 
+after being pushed down the stairs; he also had fevers and 
+chills at that point and was found to be hypotensive and in 
+renal failure.  He was transferred to the MICU briefly for 
+management; his hypotension was fluid responsive, his renal 
+failure responded to fluids.  He was started on vancomycin and 
+levoquin for pneumonia and was ruled out for influenza.  
+.
+In the ED one set of cardiac enzymes were obtained.  UA was done 
+which was positive and urine cultures were sent.  Aspirin was 
+given.  Chest X-ray was obtained which showed improving 
+bibasilar infiltrate compared to prior images.  EKG showed new 
+afib, rate controlled, with old T wave inversions (I, aVL, V5, 
+V6).  Lower extremity dopplers obtained which were negative.  
+His vitals in the ED were 84 112/75, 16, 96% RA.
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}, chronic {Chronic disease}, diastolic CHF {Heart failure with normal ejection fraction}, diaphoresis {Excessive sweating}, nausea {Nausea}, presyncope {Near syncope}, sitting {Sitting position}, diaphoresis {Excessive sweating}, bowel movement {Does defecate}, Diaphoresis {Excessive sweating}, nausea {Nausea}, confusion {Clouded consciousness}, chest {Thoracic structure}, palpitations {Palpitations}, lost 
+consciousness {Loss of consciousness}, loss of stool {Incontinence of feces}, urine {Urinary incontinence}, Discomfort {Discomfort}, resolved {Problem resolved}, fevers {Fever}, chills {Chill}, hypotensive {Low blood pressure}, renal failure {Renal failure syndrome}, transferred to the MICU {Patient transfer to intensive care unit}, hypotension {Low blood pressure}, fluid {Administration of fluid therapy}, renal 
+failure {Renal failure syndrome}, fluids {Administration of fluid therapy}, vancomycin {Antibiotic therapy}, pneumonia {Pneumonia}, influenza {Influenza}, cardiac enzymes {Cardiac enzymes/isoenzymes measurement}, UA {Urinalysis}, urine cultures {Urine culture}, Aspirin {Administration of aspirin}, Chest X-ray {Plain chest X-ray}, bibasilar {Structure of base of lung}, infiltrate {Infiltration}, EKG {Electrocardiographic procedure}, afib {Atrial fibrillation}, rate {Finding of heart rate}, T wave inversions {Inverted T wave}, I {Lead site V1}, aVL {aVL}, V5 {Lead site V5}, V6 {Lead site V6}, Lower extremity dopplers {Doppler ultrasonography of vascular structure of lower limb}, negative {No abnormality detected}, vitals {Vital signs finding}"
+"###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:
+1) HTN  
+2) DM - diet controlled, with neuropathy  
+3) CAD s/p MI ___ s/p CABG in ___ with multiple CHF  
+hospitalizations since then.  
+4) CHF  
+5) etoh abuse  
+6) Gout  
+7) CRI, baseline Cr 1.2; per patient ___ longterm NSAID use  
+
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, DM - diet controlled {Type 2 diabetes mellitus controlled by diet}, neuropathy {Neuropathy}, CAD {Coronary arteriosclerosis}, MI {Myocardial infarction}, CABG {Coronary artery bypass grafting}, CHF {Congestive heart failure}, CHF {Congestive heart failure}, etoh abuse {Alcohol abuse}, Gout {Inflammatory disorder due to increased blood urate level}, CRI {Chronic renal insufficiency}, baseline {Baseline state}"
+"###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:
+Significant for grandmother with CHF. 
+ 
+
+###RESPONSE: CHF {Congestive heart failure}"
+"###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: Physical Exam {Physical examination 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: Physical Exam:  98.9, 121/77, 74, 29, 96% RA
+Gen: Sitting up in bed in NAD
+Card: Irregular rhythm, no extrasystolic HS
+Resp: lungs CTAB
+Abd: soft NT ND
+Ext: no ___ edema
+Neuro: no focal deficits
+ 
+
+###RESPONSE: Physical Exam {Physical examination procedure}, RA {Breathing room air}, Gen {General examination of patient}, Sitting up in bed {Fowler's position}, NAD {No abnormality detected}, Card {Cardiovascular physical examination}, Irregular rhythm {Irregular heart beat}, Resp {Examination of respiratory system}, CTAB {Normal breath sounds}, Abd {Examination of abdomen}, soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, edema {Edema}, Neuro {Neurological examination}, no focal deficits {Normal nervous system function}"
+"###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:
+Electrolytes:
+GLUCOSE-117* UREA N-18 CREAT-1.4* SODIUM-141 POTASSIUM-3.8 
+CHLORIDE-103 TOTAL CO2-25 ANION GAP-17
+.
+Urine analysis:
+URINE  BLOOD-LG NITRITE-NEG PROTEIN-30 GLUCOSE-NEG KETONE-TR 
+BILIRUBIN-SM UROBILNGN-8* PH-7.0 LEUK-TR
+___ BACTERIA-RARE YEAST-NONE EPI-0
+.
+CARDIAC ENZYMES:
+CK-MB-2 cTropnT-<0.01
+cTropnT-<0.01
+cTropnT < 0.01
+.
+CEA: < 1
+PSA 0.9
+___: pending
+.
+EKG: Atrial fibrillation. Left axis deviation may be due to left 
+anterior 
+fascicular block, although it is non-diagnostic. Anterior 
+myocardial  
+infarction of indeterminate age but it may be old. Anterolateral 
+lead 
+ST-T wave abnormalities are non-specific but cannot exclude 
+ischemia. 
+Clinical correlation is suggested. Since the previous tracing of 
+___ 
+right precordial lead T wave changes appear less prominent but 
+there may be no significant change. 
+.
+Abd/pelvis CT:
+IMPRESSION: 
+1. Large conglomerate retroperitoneal lymphadenopathy along with 
+bilateral 
+common and external iliac lymphadenopathy with mediastinal 
+lymphadenopathy and right hilar lymphadenopathy raise concern 
+for the lymphoma. 
+2. Bilateral ground-glass opacity, increased interstitial 
+markings in the 
+right lung and micronodular lesions bilaterally, also concerning 
+for 
+lymphangitic spread. 
+3. 4.7 cm lesion in the interpolar region of the right kidney 
+likely also 
+represents lymphoma. (please note that the pattern of lymph 
+adenopathy is 
+unusual for metastases from renal cell carcinoma) 
+4. Spleen is elongated, measuring 16.9 cm. 
+.
+ECHO: The left atrium is dilated. Left ventricular wall 
+thickness, cavity size and regional/global systolic function are 
+normal (LVEF >55%). There is no ventricular septal defect. Right 
+ventricular chamber size and free wall motion are normal. The 
+ascending aorta is mildly dilated. The aortic valve leaflets (3) 
+are mildly thickened but aortic stenosis is not present. No 
+aortic regurgitation is seen. The mitral valve appears 
+structurally normal with trivial mitral regurgitation. There is 
+no mitral valve prolapse. The estimated pulmonary artery 
+systolic pressure is normal. There is no pericardial effusion. 
+
+IMPRESSION: Normal regional and global biventricular systolic 
+function. No pathologic valvular abnormality seen.  
+.
+
+ 
+
+###RESPONSE: Electrolytes {Electrolytes measurement}, CREAT {Creatinine measurement}, SODIUM {Sodium measurement}, POTASSIUM {Potassium measurement}, TOTAL CO2 {Blood total carbon dioxide (calculated)}, ANION GAP {Anion gap measurement}, Urine analysis {Urinalysis}, URINE  BLOOD {Urine blood test}, PROTEIN {Measurement of protein in urine}, GLUCOSE {Glucose measurement, blood}, KETONE {Urinalysis, acetone or ketone bodies measurement}, PH {pH measurement}, cTropnT {Troponin T cardiac measurement}, EKG {Electrocardiographic procedure}, Atrial fibrillation {Atrial fibrillation}, Left axis deviation {Left axis deviation}, left 
+anterior 
+fascicular block {Left anterior fascicular block}, myocardial  
+infarction {Myocardial infarction}, T wave abnormalities {Electrocardiographic T wave abnormal}, ischemia {Ischemia}, right {Structure of right side of heart}, T wave changes {Electrocardiographic T wave abnormal}, retroperitoneal lymphadenopathy {Retroperitoneal lymphadenopathy}, common {Iliac lymphadenopathy}, external iliac lymphadenopathy {External iliac lymphadenopathy}, mediastinal 
+lymphadenopathy {Mediastinal lymphadenopathy}, hilar lymphadenopathy {Hilar lymphadenopathy}, lymphoma {Malignant lymphoma}, ground-glass opacity {Ground glass lung opacity}, increased {Increased size}, right lung {Right lung structure}, lesions {Lesion}, lymphangitic spread {Lymphangitis carcinomatosa}, lesion {Lesion}, right kidney {Right kidney structure}, lymphoma {Malignant lymphoma}, lymph 
+adenopathy {Lymphadenopathy}, metastases {Metastatic malignant neoplasm to lung}, renal cell carcinoma {Renal cell carcinoma}, Spleen {Splenic structure}, ECHO {Echocardiography}, left atrium {Left atrial structure}, dilated {Dilatation}, Left ventricular wall {Left cardiac ventricular structure}, thickness {Normal thickness}, cavity {Structure of cavity of left cardiac ventricle}, size {Normal size}, regional/global systolic function are 
+normal {Normal left ventricular systolic function and wall motion}, ventricular septal defect {Ventricular septal defect}, Right 
+ventricular chamber {Right cardiac ventricular structure}, size {Normal size}, wall motion are normal {Normal ventricular wall motion}, ascending aorta {Ascending aorta structure}, dilated {Dilatation}, aortic valve leaflets {Structure of cardiac valve leaflet}, mildly thickened {Increased thickness}, aortic stenosis {Aortic valve stenosis}, aortic regurgitation {Aortic valve regurgitation}, mitral valve appears 
+structurally normal {Mitral valve normal}, trivial mitral regurgitation {Mild mitral valve regurgitation}, mitral valve prolapse {Mitral valve prolapse}, pulmonary artery {Pulmonary artery structure}, systolic pressure is normal {Normal systolic arterial pressure}, pericardial effusion {Pericardial effusion}, biventricular {Cardiac ventricular structure}, systolic 
+function {Normal left ventricular systolic function and wall motion}, No pathologic {No pathologic diagnosis}, valvular {Cardiac valve 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:
+1. Fevers/Neoplastic Process: Differential initially broad 
+encompassing hospital acquired pneumonia versus neoplastic 
+process.  A subacute neoplastic process is more likely given 
+several weeks-months of night sweats, malaise, and fevers with 
+finding of extensive retroperitoneal and mediastinal adenopathy 
+on CT.  Other possibly pertinent symptoms include note of 
+intermittent hematuria, intermittent abdominal discomfort.  
+Other laboratory findings of note: anemia, microscopic 
+hematuria, ESR > 100, CRP > upper limit of assay.  Preliminary 
+staining is suggestive of a carcinoma given findings of 
+organizing tubular structures seen on microscopy.  The type of 
+carcinoma is still under review but some stains are suggestive 
+of renal cell carcinoma.  CT suggests there is a renal nodule 
+that is less likely to be renal cell. At this point, we have 
+told Mr ___ that the culmination of our studies so far suggest 
+that he likely has an underlying carcinoma leading to his 
+constellation of symptoms, however this is not definitive, and 
+if it is a carcinoma, we don't yet have a finalized primary 
+source.  According to pathology, it should take an additional 
+week or so before the pathology report is finalized.  He was set 
+up for a primary care appointment with me on ___, and I emphasized the importance of follow-up.  
+.
+While he was in the hospital, we also evaluated other sources of 
+fever.  A chest x-ray revealed a multifocal pneumonia.  Given 
+his recent hospitalization, we treated this as a hospital 
+acquired pneumonia with an 8 day course of vancomycin and 
+cefepime and covered him with azithromycin for a 7 day course 
+for the possibility of atypicals.  His cough slowly improved 
+over the course of his hospitalization and his fevers trended 
+down.  He did not have any leukocytosis during the course of his 
+hospitalization.  At time of discharge, he was afebrile for > 48 
+hours and his antibiotics course was complete. 
+.
+2) Atrial fibrillation: Was found to be in new onset atrial 
+fibrillation in ED.  Unclear what precipitant of afib could be; 
+could be secondary to recent pneumonia/infection. Also has 
+significant mediastinal adenopathy; could represent infiltrative 
+or compressive process creating an irritant focus.  Had no RVR; 
+rates were 70 - 80.  CHADS score was +3.  Coumadin was started 
+with goal INR near 2.  Carvedilol was continued at dose of 12.5 
+mg BID.  He was discharged and set up with ___ 
+clinic. He was discharged with a ___ mg alternating dose 
+coumadin regimen.
+.
+3) Acute on Chronic renal failure: Creatinine was initially 
+elevated on presentation, however her electrolytes were 
+consistent with prerenal disease.  Following administration of 
+fluids, his creatinine resolved to below her baseline. 
+.
+4) Coronary artery disease:  Troponin levels were checked on 
+admission and were negative.  He was continued on his statin, 
+aspirin, beta blocker and Ace inhibitor.  His lisinopril was 
+held as this tended to precipitously decrease his blood pressure 
+< 80 systolic.  At time of discharge, his lisinopril continued 
+to be held.
+.
+5) Congestive heart failure: There was no evidence for fluid 
+overload; there were no rales on lung exam.  His JVP was not 
+elevated.  He has unilateral 1+ left lower extremity edema; he 
+was continued on lasix 80 mg daily.  
+.
+6) Left ankle pain: Differential is gout vs trauma from recent 
+fall.  Mild inflammatory changes seen along left foot (erythema, 
+decreased range of motion, mildly warm).  Started on colchicine 
+with improvement in symptoms.  Has crystal proven gout last year 
+after left ankle joint was tapped.  Was discharged with a 3 day 
+continued supply of colchicine.   
+.
+7) Dispo:  Was discharged to assisted living facility after 
+cleared by physical therapy.  Appointments were set up with 
+primary care and is being followed by ___ clinic.  
+ 
+
+###RESPONSE: Fevers {Fever}, hospital acquired pneumonia {Nosocomial pneumonia}, night sweats {Night sweats}, malaise {Malaise}, fevers {Fever}, retroperitoneal {Retroperitoneal lymphadenopathy}, mediastinal adenopathy {Mediastinal lymphadenopathy}, CT {Computed tomography}, hematuria {Blood in urine}, abdominal discomfort {Abdominal discomfort}, laboratory {Laboratory test}, anemia {Anemia}, microscopic 
+hematuria {Microscopic hematuria}, ESR {Erythrocyte sedimentation rate above reference range}, CRP {C-reactive protein measurement}, carcinoma {Carcinoma}, microscopy {Microscopy}, carcinoma {Carcinoma}, renal cell carcinoma {Renal cell carcinoma}, CT {Computed tomography}, renal {Kidney structure}, renal {Kidney structure}, cell {Cell structure}, carcinoma {Carcinoma}, carcinoma {Carcinoma}, fever {Fever}, chest x-ray {Plain chest X-ray}, pneumonia {Pneumonia}, hospital 
+acquired pneumonia {Nosocomial pneumonia}, vancomycin {Antibiotic therapy}, atypicals {Atypical pneumonia}, cough {Cough}, improved {Patient's condition improved}, fevers {Fever}, leukocytosis {Leukocytosis}, afebrile {Fever}, antibiotics {Antibiotic therapy}, Atrial fibrillation {Atrial fibrillation}, atrial 
+fibrillation {Atrial fibrillation}, afib {Atrial fibrillation}, pneumonia {Pneumonia}, infection {Infectious disease}, mediastinal adenopathy {Mediastinal lymphadenopathy}, infiltrative {Infiltration}, compressive {Compression}, RVR {Atrial fibrillation with rapid ventricular response}, rates {Finding of heart rate}, regimen {Therapeutic regimen}, Acute on Chronic renal failure {Acute-on-chronic renal failure}, Creatinine was initially 
+elevated {Serum creatinine above reference range}, electrolytes {Finding of electrolyte levels}, disease {Disease}, administration of 
+fluids {Administration of fluid therapy}, creatinine {Creatinine measurement}, resolved {Problem resolved}, baseline {Baseline state}, Coronary artery disease {Coronary arteriosclerosis}, Troponin {Troponin measurement}, checked {Monitoring procedure}, negative {No abnormality detected}, aspirin {Administration of aspirin}, lisinopril {Angiotensin converting enzyme inhibitor therapy}, decrease his blood pressure 
+< 80 systolic {Decreased systolic arterial pressure}, lisinopril {Angiotensin converting enzyme inhibitor therapy}, Congestive heart failure {Congestive heart failure}, no evidence {No abnormality detected}, fluid 
+overload {Hypervolemia}, rales {Respiratory crackles}, lung exam {Examination of respiratory system}, JVP was not 
+elevated {Normal jugular venous pressure}, left lower extremity edema {Edema of left lower limb}, lasix {Diuretic therapy}, Left ankle {Structure of left ankle}, pain {Pain}, gout {Inflammatory disorder due to increased blood urate level}, trauma {Traumatic injury}, fall {Falls}, Mild inflammatory {Mild inflammation}, left foot {Structure of left foot}, erythema {Erythema}, warm {Warm skin}, improvement {Patient's condition improved}, gout {Inflammatory disorder due to increased blood urate level}, left {Left hip region structure}, ankle joint {Ankle joint structure}, tapped {Arthrocentesis}, Dispo {Patient disposition}, physical therapy {Physical therapy assessment}"
+"###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 325 mg PO Daily   
+Citalopram 20mg PO daily  
+Carvedilol 12.5 mg PO BID   
+Omperazole 40mg PO daily  
+Simvastatin 80mg PO Daily 
+Clonzaepam 1mg PO TID  
+Trazodone 100mg PO QHS PRN   
+Colchicine 0.6mg PO Daily PRN Gout 
+Lisinopril 40mg PO Daily  
+Lasix 80mg PO daily 
+Ferrous Sulfate 325mg PO daily  
+NTG 0.3mg SL PRN  .
+MVI 1 Tab PO Daily  .
+Thiamine 100mg PO Daily .  
+Folate 1mg PO Daily  
+Acet 325mg PO Q6 PRN Pain . 
+Oxycodone 10 mg q6-8 hrs PRN .
+Lidoderm 5% adhesive patch topical 12 hrs on 12 hrs off
+ 
+Discharge Medications:
+1. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+2. Citalopram 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 
+ 
+3. Carvedilol 12.5 mg Tablet Sig: One (1) Tablet PO BID (2 times 
+a day).  
+4. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: Two (2) 
+Capsule, Delayed Release(E.C.) PO DAILY (Daily).  
+5. Simvastatin 40 mg Tablet Sig: Two (2) Tablet PO DAILY 
+(Daily).  
+6. Clonazepam 1 mg Tablet Sig: One (1) Tablet PO TID (3 times a 
+day).  
+7. Trazodone 50 mg Tablet Sig: Two (2) Tablet PO HS (at bedtime) 
+as needed for insomnia.  
+8. Furosemide 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 
+ 
+9. Ferrous Sulfate 325 mg (65 mg Iron) Tablet Sig: One (1) 
+Tablet PO DAILY (Daily).  
+10. Multivitamin     Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+11. Acetaminophen 325 mg Tablet Sig: One (1) Tablet PO Q6H 
+(every 6 hours) as needed for pain.  
+12. Lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: 
+One (1) Adhesive Patch, Medicated Topical DAILY (Daily).  
+13. Warfarin 2.5 mg Tablet Sig: Two (2) Tablet PO once a day: 
+two tablets daily at 4PM or as directed by your physician or 
+clinic.
+Disp:*60 Tablet(s)* Refills:*2*
+14. Nitroglycerin 0.3 mg Tablet, Sublingual Sig: One (1)  
+Sublingual PRN as needed for chest pain.  
+15. Colchicine 0.6 mg Tablet Sig: One (1) Tablet PO once a day.
+Disp:*3 Tablet(s)* Refills:*0*
+16. Oxycodone-Acetaminophen ___ mg Tablet Sig: One (1) Tablet 
+PO every ___ hours as needed for pain.
+Disp:*30 Tablet(s)* Refills:*0*
+17. Albuterol Sulfate 90 mcg/Actuation HFA Aerosol Inhaler Sig: 
+___ Puffs Inhalation Q4H (every 4 hours) as needed for shortness 
+of breath.
+Disp:*1 1* Refills:*0*
+18. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID 
+(2 times a day).  
+19. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a 
+day) as needed for constipation.  
+20. Maalox 200-200-20 mg/5 mL Suspension Sig: ___  PO PRN as 
+needed for pain.
+Disp:*1 1* 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:
+Extended Care
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+1. New onset atrial fibrillation
+2. Urinary tract infection
+3. Coronary disease
+4. Congestive heart failure
+
+ 
+Discharge Condition:
+Stable for rehab facility.  Saturating well on room air.
+
+ 
+
+###RESPONSE: atrial fibrillation {Atrial fibrillation}, Urinary tract infection {Urinary tract infectious disease}, Coronary disease {Coronary arteriosclerosis}, Congestive heart failure {Congestive heart failure}, Stable {Patient's condition stable}, on room air {Breathing room air}"
+"###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 ___,
+
+It was a pleasure caring for you while you were at ___ 
+___.  As you know, the result of some of our studies are 
+concerning for a cancer diagnosis, however we do not yet have 
+enough information to suggest what kind of cancer you may have.  
+In the coming weeks, these results should become clearer, and 
+this will help us to develop a plan.  You are not alone in this 
+challenge; there will be several doctors who ___ be 
+participating in your care.  The most important things for you 
+will be to keep your mind and body as healthy as you can so that 
+you can put your best foot forward.  You will be followed by me 
+in primary care so that I can coordinate all of your care in the 
+coming months.  Following up with all of your appointments is 
+one of your most important priorities.
+.
+I've explained some of the important points of your 
+hospitalization at ___ below:
+(1) When you came into the hospital, you had symptoms of fevers, 
+cough, and night sweats.  A lot of these symptoms could be 
+because of the possibility of cancer.  However, when we did a 
+chest x-ray, we found that you also had a pneumonia in your 
+lungs.  This could explain some of your symptoms.  We started 
+you on antibiotics for 8 days which led to improvement in your 
+cough and fevers.  
+(2) While you were hospitalized we found that your heart was 
+beating irregularly in a rhythm that we call atrial 
+fibrillation.  This can happen when you have an underlying 
+infection like pneumonia.  Sometimes this heart rhythm can lead 
+to formations of a clot in your heart which can increase your 
+risk of stroke.  To help treat this, we started you on a 
+medicine called coumadin, which helps to thin the blood.  This 
+medicine will require frequent monitoring of your labs and your 
+assisted living facility will help draw these.  It is important 
+that you take this medicine daily as directed to ensure that you 
+do not develop a clot.
+(3) While you were here you also developed pain in your left 
+foot that we felt was consistent with gout.  We started you on 
+colchicine which helped your pain and also increased your pain 
+medicine.  You will have enough colchicine for another three 
+days to continue to treat your gout.  
+.
+We made the following medication changes to your usual meds that 
+are summarized below:
+(1) You should take coumadin (the blood thinner) 5 mg every 
+___ and ___, and 2.5mg on ___, 
+___ and ___. This dose may be adjusted after we check 
+your blood. The ___ lab will be checking your 
+blood at your assisted living facility on ___. 
+From then on you will get labs checked every week so that your 
+dose can be adjusted appropriately.
+(2) You should stop taking lisinopril, a blood pressure medicine 
+that was decreasing your blood pressure too much.  You can 
+restart this as an outpatient as directed by your outpatient 
+team.
+(3) You should take colchicine 0.6 mg daily for another 3 days 
+after you leave the hospital.
+(4) You should take oxycodone 10 mg as needed every six hours 
+for pain.  
+(5) You can use your albuterol inhaler ___ puffs as needed for 
+wheezing and shortness of breath.
+(6) You can take maalox as needed for your stomach pain.
+.
+If you experience worsening fevers, diaphoresis, vomiting, 
+worsening cough, worsening blood in your urine, or any other 
+concerning symptoms, please let your primary care doctor know or 
+return to the emergency department.  
+ 
+
+###RESPONSE: cancer {Malignant neoplasm}, cancer {Malignant neoplasm}, fevers {Fever}, cough {Cough}, night sweats {Night sweats}, cancer {Malignant neoplasm}, chest x-ray {Plain chest X-ray}, pneumonia {Pneumonia}, lungs {Lung structure}, antibiotics {Antibiotic therapy}, improvement {Patient's condition improved}, cough {Cough}, fevers {Fever}, heart was 
+beating irregularly {Irregular heart beat}, rhythm {Irregular heart beat}, atrial 
+fibrillation {Atrial fibrillation}, infection {Infectious disease}, pneumonia {Pneumonia}, this heart rhythm {Irregular heart beat}, clot {Blood clot}, heart {Heart structure}, increase your 
+risk of stroke {At increased risk of cerebrovascular accident}, coumadin {Administration of prophylactic anticoagulant}, thin the blood {Anticoagulant therapy}, monitoring {Monitoring response to treatment}, clot {Blood clot}, pain {Pain}, left 
+foot {Structure of left foot}, gout {Inflammatory disorder due to increased blood urate level}, pain {Pain}, pain 
+medicine {Administration of analgesic}, gout {Inflammatory disorder due to increased blood urate level}, medication changes {Change of medication}, blood thinner {Anticoagulant therapy}, check 
+your blood {Blood test}, checking your 
+blood {Blood test}, stop taking {Recommendation to stop treatment}, lisinopril {Angiotensin converting enzyme inhibitor therapy}, blood pressure medicine {On treatment for hypertension}, decreasing your blood pressure {Finding of decreased blood pressure}, restart {Restart of medication}, pain {Pain}, wheezing {Wheezing}, shortness of breath {Dyspnea}, stomach pain {Stomach ache}, fevers {Fever}, diaphoresis {Excessive sweating}, vomiting {Vomiting}, cough {Cough}, blood in your urine {Blood in urine}"
+"###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: 
+Patient recorded as having No Known Allergies to Drugs
+ 
+Attending: ___
+ 
+Chief Complaint:
+BRBPR, LLQ pain
+ 
+Major Surgical or Invasive Procedure:
+.
+ 
+
+###RESPONSE: BRBPR {Hematochezia}, LLQ {Structure of left lower quadrant of abdomen}"
+"###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:
+This is a ___ yo F with h/o PAF on coumadin who presents with 
+BRBPR and LLQ pain X 3 days. Her symptoms began ___ night 
+when she began to experience BRBPR with minimal amounts of loose 
+stools. This was associated with crampy LLQ > RLQ pain. Denies 
+n/v, melena, fevers. + chills. These symptoms continued until 
+___ when the blood became less brisk with an increase in the 
+amount of loose stools. She attempted to keep well hydrated over 
+the weekend but began to feel increasingly lightheaded to the 
+point that she felt she may pass out if she stood up too 
+quickly. The pt has had BRBPR in the past ___ hemorrhoids but 
+reports those past episodes were not nearly as significant and 
+not accompanied by abdominal pain. She was recently started on a 
+baby ASA 1 week ago and also reports that her lasix dose was 
+increased 2 weeks ago. No recent antibiotics. Denies recent 
+change in diet, including increased ingestion of leafy, green 
+vegetables. She went to see her PCP today who noted her SBP to 
+be in the ___ (usual baseline 140s) and referred her to the ED 
+for further evaluation.  
+.  
+In the ED, pt AF, BP 97/49, HR 61. Rectal exam significant only 
+for small amounts of dried blood in the vault, NGL was negative. 
+Labs were significant for WBC 15.2, Hct 43.5, BUN 31, Cr 2.0, 
+lactate 1.4, and INR 17.1. A CT abd/pelvis was significant for 
+pancolitis. She was given 2 units FFP, 10 mg IV vitamin K, 
+protonix 40 IV X 1, levaquin 750 mg IV X 1, flagyl 500 mg IV X 
+1, and a total of 3 L IVFs. Repeat INR 2.6. She remained 
+hemodynamically stable and did not have any episodes of BRBPR in 
+the ED in spite of having several BMs. She was then admitted to 
+the ___ for further management.  
+.  
+ROS otherwise only positive for stable DOE. She is unable to 
+walk up a flight of stairs without becoming signicantly winded. 
+ROS otherwise negative.  
+.  
+
+ 
+
+###RESPONSE: PAF {Paroxysmal atrial fibrillation}, BRBPR {Hematochezia}, LLQ {Structure of left lower quadrant of abdomen}, BRBPR {Hematochezia}, minimal {Symptom mild}, loose 
+stools {Loose stool}, crampy {Stomach cramps}, LLQ {Structure of left lower quadrant of abdomen}, RLQ {Structure of right lower quadrant of abdomen}, n/v {Nausea and vomiting}, melena {Melena}, fevers {Fever}, chills {Chill}, loose stools {Loose stool}, lightheaded {Lightheadedness}, BRBPR {Hematochezia}, hemorrhoids {Hemorrhoids}, abdominal pain {Abdominal pain}, ASA {Administration of aspirin}, lasix {Diuretic therapy}, increased {Increasing dosage of medication}, antibiotics {Antibiotic therapy}, baseline {Baseline state}, evaluation {Evaluation procedure}, AF {Atrial fibrillation}, Rectal exam {Rectal examination}, WBC {White blood cell count}, BUN {Blood urea nitrogen measurement}, lactate {Lactic acid measurement}, INR {Calculation of international normalized ratio}, CT abd/pelvis {Computed tomography of abdomen and pelvis}, IVFs {Administration of intravenous fluids}, INR {Calculation of international normalized ratio}, hemodynamically stable {Hemodynamically stable}, BRBPR {Hematochezia}, ROS {Review of systems}, DOE {Dyspnea on exertion}, unable to 
+walk up a flight of stairs without becoming signicantly {Deterioration in ability to walk up stairs}, winded {Winded}, ROS {Review of systems}"
+"###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:
+PAF on coumadin  
+HTN (baseline BP 140/70s)  
+h/o CHF (EF 20% in ___, TTE in ___ with nl EF)  
+mod MR and TR  
+s/p PPM ___ syncope in ___, s/p dual chamber PPM replacement in 
+___  
+Melanoma s/p resection  
+Asthma  
+Depression  
+Breast cancer ___ years ago, s/p R lumpectomy and XRT, s/p L 
+lumpectomy in early ___ ___ yrs ago that was negative  
+Pancreatic lesion, reportedly extensively worked up ___ yrs ago 
+that was negative, stable lesion on serial CTs  
+Post granulomatous infection of liver and spleen  
+Seasonal allergies  
+Gout  
+
+ 
+
+###RESPONSE: PAF {Paroxysmal atrial fibrillation}, HTN {Hypertensive disorder, systemic arterial}, baseline {Baseline state}, BP {Blood pressure finding}, CHF {Congestive heart failure}, TTE {Transthoracic echocardiography}, MR {Mitral valve regurgitation}, PPM {Permanent cardiac pacemaker}, syncope {Syncope}, chamber {Cardiac chamber structure}, PPM replacement {Replacement of permanent transvenous electrodes}, Melanoma {Malignant melanoma of skin}, resection {Excision}, Asthma {Asthma}, Depression {Depressive disorder}, Breast cancer {Malignant neoplasm of breast}, R lumpectomy {Lumpectomy of right breast}, XRT {X-ray beam therapy}, L 
+lumpectomy {Lumpectomy of left breast}, negative {No pathologic diagnosis}, Pancreatic {Pancreatic structure}, lesion {Lesion}, negative {No pathologic diagnosis}, stable {Patient's condition stable}, lesion {Lesion}, CTs {Computed tomography}, granulomatous infection {Infective granuloma}, liver {Liver structure}, spleen {Splenic structure}, Seasonal allergies {Seasonal allergy}, Gout {Inflammatory disorder due to increased blood urate level}"
+"###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 with colon CA 
+ 
+
+###RESPONSE: colon CA {Neoplasm 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: Physical Exam:
+VS: Temp: 98.9 BP: 145/45 HR: 64 RR: 22 O2sat 100% on 2L NC  
+GEN: pleasant, comfortable, NAD  
+HEENT: PERRL, EOMI, anicteric, dry MM, op without lesions  
+NECK: supple, no LAD, jvd flat  
+RESP: + bibasilar rales that clear with deeper breaths  
+CV: RR, II/VI holosystolic murmur radiating to apex  
+ABD: Soft, diffusely TTP especially over LLQ, + guarding, + 
+rebound, normoactive BS, no HSM  
+EXT: no c/c/e, warm, good pulses  
+SKIN: no rashes/no jaundice  
+NEURO: AAOx3  
+RECTAL: guaiac positive, dried blood in vault  
+
+ 
+
+###RESPONSE: VS {Vital signs finding}, Temp {Body temperature finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, O2sat {Oxygen saturation measurement}, NC {Normal head}, GEN {General examination of patient}, comfortable {Comfortable appearance}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, PERRL {Pupils equal and reacting to light}, EOMI {Normal ocular motility}, anicteric {White sclera}, dry MM {Mucous membrane dryness}, op {Oropharyngeal structure}, lesions {Lesion}, NECK {Physical examination procedure}, supple {Normal movement of neck}, LAD {Lymphadenopathy}, jvd flat {Normal jugular venous pressure}, RESP {Examination of respiratory system}, bibasilar {Structure of base of lung}, rales {Respiratory crackles}, clear {Normal breath sounds}, CV {Cardiovascular physical examination}, RR {Finding of rate of respiration}, murmur {Murmur}, apex {Structure of apex of heart}, ABD {Examination of abdomen}, Soft {Abdomen soft}, TTP {Tenderness}, LLQ {Structure of left lower quadrant of abdomen}, guarding {Abdominal guarding}, rebound {Rebound tenderness}, normoactive BS {Normal bowel sounds}, HSM {Hepatosplenomegaly}, EXT {Examination of limb}, no c/c/e {No abnormality detected}, warm {Warm skin}, good pulses {Normal pulse}, SKIN {Examination of skin}, rashes {Eruption of skin}, jaundice {Jaundice}, NEURO {Neurological examination}, Ox3 {Oriented to person, time and place}, CTA {Normal breath sounds}, guaiac {Guaiac test for occult blood in feces specimen}"
+"###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:
+___ 04:35PM   GLUCOSE-95 UREA N-31* CREAT-2.0* SODIUM-136 
+POTASSIUM-3.9 CHLORIDE-100 TOTAL CO2-26 ANION GAP-14
+___ 04:35PM   CALCIUM-8.4 PHOSPHATE-3.8 MAGNESIUM-2.4
+___ 04:35PM   ALT(SGPT)-21 AST(SGOT)-35 LD(LDH)-370* 
+AMYLASE-71 TOT BILI-0.4 LIPASE-88*
+.
+___ 11:57PM   LACTATE-1.0
+___ 07:00PM   LACTATE-1.4
+.
+
+ 
+
+###RESPONSE: GLUCOSE {Glucose measurement, blood}, UREA N {Blood urea nitrogen measurement}, 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}, CALCIUM {Blood calcium measurement}, PHOSPHATE {Phosphate, total measurement}, MAGNESIUM {Blood magnesium measurement}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, LDH {Serum total lactate dehydrogenase measurement}, AMYLASE {Amylase measurement}, TOT BILI {Bilirubin, total measurement}, LIPASE {Triacylglycerol lipase 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: Brief Hospital Course:
+# Bright red blood per rectum- Evidence of pancolitis on initial 
+CT, stool studies significant for c diff colitis.  Bleeding 
+stopped once INR was corrected.  GI was consulted and suggest a 
+colonoscopy in about 4 weeks, after colitis has had time to 
+improve.  Follow up scheduled with GI, ___ to check INR and hct 
+3 times per week.  
+.
+# C Difficile colitis: Diarrhea improved on Flagyl, planned 14 
+day course.
+.
+# Supratherapeutic INR: Coumadin restarted prior to discharge 
+without GI bleed.  She was discharged on approx ___ the dose of 
+coumadin she was on prior to admission.  ___ to check INR 3 
+times per week.  Nutritionist saw pt to eduated re: food 
+restrictions while on coumadin.
+.
+# Falls/imbalance- Patient had a fall while in the ___ ICU 
+overnight, and hit her head (likely on an open cabinet door 
+adjacent to the toilet), requiring 3 stitches for a laceration. 
+A CT head was obtained immediately after and showed no acute 
+hemorrhage. There had been no significant events on telemetry 
+and no indication of pacemaker malfunction. A CT spine was 
+obtained and the read showed no fracture, and her C-spine was 
+cleared. Approximately 12 hours later, a nurse observed the 
+patient to be extremely unsteady on her feet, somewhat 
+tremulous, and not as easily conversant as prior. A second CT 
+head was obtained and was negative for edema or new subdural. 
+The patient was observed overnight on fall precautions and there 
+were no further events, and her mental status was at baseline. 
+The attending radiologist later re-read the C-spine study and 
+notified the team that there was possible cervical cord 
+compression.
+.
+# Cervical Cord compression w/o radiculopathy: Possible C6-C7 
+cord compression based on CT cervical spine. No associated 
+neurologic deficits. Neurosurgery was consulted and recommended 
+myelogram for further assessment. The family and patient chose 
+not to have the CT myelogram done.  They stated that they would 
+never opt for surgery, and if that was the only recommendation 
+to come out of CT myelogram, they felt there was no use for the 
+study.  Neurosurgery team confirmed this was in fact the case.  
+Family is aware that if symptoms develop, falls increase from 
+weakness, or any other concerns for symptomatic cord 
+compression, and they should see PCP immediately to discuss CT 
+myelogram and possible decompressive surgery.
+.
+#CKD, stage III: Pt in ARF at admission, resolved to baseline 
+creatinine of 1.3
+.
+#Chronic systolic heart failure: Past EF 20% per family, however 
+recent echo in ___ with EF > 60%.  Pt was continued on 
+isosorbide, metoprolol, lasix.  Lisinopril was held as pt 
+noticed that she had a chronic cough that had resolved during 
+the hospitalization while off of Lisinopril.  Plan is to hold 
+off on restarting, note any cough symptoms at home, and follow 
+up with PCP ___ 2 weeks to discuss whether Lisinopril could in 
+fact be cause of cough.  Also will need to discuss whether 
+alternative ___ needed.  Digoxin was held at request of family.  
+No recent CHF exacerbations, most recent EF >60%, and pacer 
+interrogations show atrial fibrillation despite therapuetic 
+digoxin levels.  They asked to stop this because they were 
+concerned that it may be the cause of the patients chronic 
+diarrhea.  They are aware that they will need to follow up with 
+cardiologist Dr. ___ need to restart digoxin.
+ 
+
+###RESPONSE: Bright red blood per rectum {Hematochezia}, CT {Computed tomography}, stool studies {Stool microscopy}, c diff colitis {Clostridium difficile colitis}, Bleeding {Bleeding}, INR {Calculation of international normalized ratio}, colonoscopy {Colonoscopy}, colitis {Colitis}, INR {Calculation of international normalized ratio}, C Difficile colitis {Clostridium difficile colitis}, Diarrhea {Diarrhea}, improved {Patient's condition improved}, INR {Calculation of international normalized ratio}, restarted {Restart of medication}, GI bleed {Gastrointestinal hemorrhage}, INR {Calculation of international normalized ratio}, food 
+restrictions {Restricting food intake}, Falls {Falls}, fall {Falls}, head {Head structure}, laceration {Laceration}, CT head {Computed tomography of head}, acute 
+hemorrhage {Acute hemorrhage}, telemetry {Electroencephalogram telemetry}, CT spine {Computed tomography of spine}, fracture {Fracture}, C-spine {Structure of cervical vertebral column}, unsteady on her feet {Unsteady when standing}, tremulous {Tremor}, CT 
+head {Computed tomography of head}, negative {No pathologic diagnosis}, edema {Edema}, fall {Falls}, precautions {Safety precautions}, baseline {Baseline state}, C-spine {Structure of cervical vertebral column}, cervical cord 
+compression {Compression of cervical spinal cord}, Cervical Cord compression {Compression of cervical spinal cord}, radiculopathy {Nerve root disorder}, C6-C7 {Structure of intervertebral foramen of sixth cervical vertebra}, cord compression {Compression of cervical spinal cord}, CT cervical spine {Computed tomography of cervical spine}, neurologic deficits {Neurological deficit}, myelogram {Myelogram}, CT myelogram {Computed tomography myelogram}, surgery {Surgical procedure}, CT myelogram {Computed tomography myelogram}, falls {Falls}, weakness {Asthenia}, cord 
+compression {Compression of cervical spinal cord}, CT 
+myelogram {Computed tomography myelogram}, surgery {Surgical procedure}, CKD, stage III {Chronic kidney disease stage 3}, ARF {Acute kidney injury}, baseline {Baseline state}, creatinine {Serum creatinine within reference range}, Chronic systolic heart failure {Chronic systolic heart failure}, echo {Echocardiography}, lasix {Diuretic therapy}, chronic cough {Chronic cough}, resolved {Problem resolved}, hold {Recommendation to stop drug treatment}, restarting {Restart of medication}, cough {Cough}, cough {Cough}, held {Recommendation to stop drug treatment}, CHF exacerbations {Exacerbation of congestive heart failure}, atrial fibrillation {Atrial fibrillation}, chronic 
+diarrhea {Chronic diarrhea}, restart {Restart of medication}"
+"###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:
+ASA 81 mg daily  
+Coumadin 4 mg daily  
+Zestril 10 mg daily  
+Lopressor 25 mg bid  
+Digoxin 125 mcg daily  
+Isosorbide dinitrate 20 mg bid  
+Lasix 40 mg qod, 20 mg qod  
+Singulair 10 mg daily  
+Prednisone 10 mg prn (for gout flares)  
+Allegra 60 mg bid  
+Advair 250/50 1 puff bid  
+Allopurinol ___ mg daily  
+Celexa 20 mg daily  
+Omeprazole 20 mg daily  
+Caltrate daily  
+.  
+
+ 
+Discharge Medications:
+1. Metronidazole 500 mg Tablet Sig: One (1) Tablet PO TID (3 
+times a day) for 9 days.
+Disp:*27 Tablet(s)* Refills:*0*
+2. Allopurinol ___ mg Tablet Sig: 1.5 Tablets PO DAILY (Daily).  
+
+3. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable 
+PO DAILY (Daily).  
+4. Warfarin 2 mg Tablet Sig: One (1) Tablet PO DAILY16 (Once 
+Daily at 16).
+Disp:*30 Tablet(s)* Refills:*0*
+5. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID 
+(2 times a day).  
+6. Isosorbide Dinitrate 20 mg Tablet Sig: One (1) Tablet PO 
+twice a day.  
+7. Lasix 40 mg Tablet Sig: One (1) Tablet PO every other day.  
+8. Lasix 20 mg Tablet Sig: One (1) Tablet PO every other day.  
+9. Montelukast 10 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+10. Fexofenadine 60 mg Tablet Sig: One (1) Tablet PO BID (2 
+times a day).  
+11. Fluticasone-Salmeterol 250-50 mcg/Dose Disk with Device Sig: 
+One (1) Disk with Device Inhalation BID (2 times a day).  
+12. Citalopram 20 mg Tablet Sig: Two (2) Tablet PO DAILY 
+(Daily).  
+13. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) 
+Capsule, Delayed Release(E.C.) PO once a day.  
+14. DISCONTINUED MEDICATIONS
+STOP TAKING DIGOXIN AND LISINOPRIL UNTIL YOU SEE ___. ___.
+15. INR checks
+Please check INR and Hct 3 times per week for the next 2 weeks.
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+c difficile colitis
+acute renal failure (now resolved)
+
+ 
+Discharge Condition:
+stable
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, c difficile colitis {Clostridium difficile colitis}, acute renal failure {Acute kidney injury}, resolved {Problem resolved}, stable {Patient's condition stable}"
+"###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:
+Please call your PCP with shortness of breath, weight gain of 
+more than 2 pounds in one day, dizziness, blood in stool, or 
+other concerning symptoms.
+ 
+
+###RESPONSE: shortness of breath {Dyspnea}, weight gain {Weight gain}, dizziness {Dizziness}, blood in stool {Hematochezia}"
+"###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: 
+Penicillins / Erythromycin Base / Codeine / Ultram / Oxycodone / 
+Lipitor / Vicodin / Combivent / Latex / simvastatin
+ 
+Attending: ___.
+ 
+Chief Complaint:
+SOB, cough
+ 
+Major Surgical or Invasive Procedure:
+none
+
+ 
+
+###RESPONSE: Penicillins {Allergy to penicillin}, Erythromycin {Allergy to erythromycin}, Codeine {Allergy to codeine}, Ultram {Allergy to tramadol}, Lipitor {Allergy to atorvastatin}, Latex {Allergy to Hevea brasiliensis latex protein}, simvastatin {Allergy to simvastatin}, SOB {Dyspnea}, cough {Cough}"
+"###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 COPD on home O2 at night, Pulmicort, 
+albuterol, history of fibromyalgia, hypertension, presenting 
+with two-day history of worsening shortness of breath and 
+wheezing. Symptoms started on ___ evening. Slight cough. No 
+fevers or chills. Does describe some body aches. No nausea or 
+vomiting or diarrhea. Went to ___'s office today where an x-ray 
+of the chest performed and showed no evidence of pneumonia. 
+Given her wheezing, just into the emergency department for 
+nebulizer treatments and steroid initiation.
+  
+In the ED, initial vital signs were 96.3 66 151/77 100% 2L NC. 
+Labs were notable for K of 3.1. Otherwise, no leukocytosis. CXR 
+was negative for pneumonia. Patient was given 60mg prednisone 
+and 750mg levofloxacin in addition to albuterol nebs. She was 
+also given 60 meq of potassium chloride. After several neb 
+treatments she was still notably tachypneic and wheezing. She 
+was admitted to the medicine service for management of COPD 
+exacerbation.
+ 
+On the floor, pt complains of 3 days of increased SOB and 
+wheezing with feeling of body aches and sore throat. She has a 
+___ year old grandson who she takes care of and thinks she may 
+have caught a cold from him. Denies increased sputum production. 
+Cough is increased but nonproductive. No fevers or chills.
+ 
+
+###RESPONSE: COPD {Chronic obstructive lung disease}, home O2 {Home oxygen therapy}, fibromyalgia {Fibromyalgia}, hypertension {Hypertensive disorder, systemic arterial}, worsening {Patient's condition worsened}, shortness of breath {Dyspnea}, wheezing {Wheezing}, cough {Cough}, No 
+fevers {Temperature normal}, chills {Chill}, body aches {Generalized aches and pains}, nausea {Nausea}, vomiting {Vomiting}, diarrhea {Diarrhea}, x-ray {Radiographic imaging procedure}, chest {Plain chest X-ray}, no evidence {No abnormality detected}, pneumonia {Pneumonia}, wheezing {Wheezing}, emergency {Emergency treatment management}, nebulizer treatments {Nebulizer therapy}, steroid {Steroid therapy}, vital signs {Vital signs finding}, 2L NC {Oxygen administration by nasal cannula}, Labs {Laboratory test}, K {Blood potassium measurement}, leukocytosis {Leukocytosis}, CXR {Plain chest X-ray}, negative {Standard chest X-ray normal}, pneumonia {Pneumonia}, prednisone {Steroid therapy}, levofloxacin {Antibiotic therapy}, nebs {Nebulizer therapy}, neb {Nebulizer therapy}, tachypneic {Tachypnea}, wheezing {Wheezing}, COPD 
+exacerbation {Acute exacerbation of chronic obstructive airways disease}, increased {Patient's condition worsened}, SOB {Dyspnea}, wheezing {Wheezing}, body aches {Generalized aches and pains}, sore throat {Sore throat}, cold {Common cold}, increased {Patient's condition worsened}, sputum production {Sputum finding}, Cough {Cough}, increased {Patient's condition worsened}, nonproductive {Dry cough}, No fevers {Temperature normal}, 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: Past Medical History:
+-COPD
+- Depression  
+- Chronic pain syndrome/fibromyalgia  
+- Low back pain  
+- s/p tibial plateau fracture  
+- Hypertension  
+- Hypokalemia  
+- GERD  
+- Tobacco abuse  
+- Hyperlipidemia  
+ 
+
+###RESPONSE: COPD {Chronic obstructive lung disease}, Depression {Depressive disorder}, Chronic pain syndrome {Chronic pain syndrome}, fibromyalgia {Fibromyalgia}, Low back pain {Low back pain}, tibial plateau fracture {Fracture of tibial plateau}, Hypertension {Hypertensive disorder, systemic arterial}, Hypokalemia {Hypokalemia}, GERD {Gastroesophageal reflux disease}, Tobacco abuse {Tobacco dependence syndrome}, Hyperlipidemia {Hyperlipidemia}"
+"###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 died of emphysema, colon cancer. Father died in his ___ 
+of heart problems (bypass, valve). Sister with pancreatitic 
+cancer, sister with HIV and breast cancer, brother died at ___ of 
+tuberculosis, brother with drug abuse and bad kidneys.  
+-sister: breast cancer
+-sister: pancreatic cancer
+-mother: gastric cancer
+-grand father: gastric cancer
+-Father: lung cancer, CAD
+ 
+ 
+
+###RESPONSE: died {Dead}, emphysema {Emphysema}, colon cancer {Malignant neoplasm of colon}, died {Dead}, heart problems {Heart disease}, bypass {Cardiac revascularization with bypass anastomosis}, valve {Cardiac valve structure}, pancreatitic 
+cancer {Malignant tumor of pancreas}, HIV {Human immunodeficiency virus infection}, breast cancer {Malignant neoplasm of breast}, died {Dead}, tuberculosis {Tuberculosis}, drug abuse {Drug abuse}, kidneys {Kidney disease}, breast cancer {Malignant neoplasm of breast}, pancreatic cancer {Malignant tumor of pancreas}, gastric cancer {Malignant tumor of stomach}, gastric cancer {Malignant tumor of stomach}, lung cancer {Malignant tumor of lung}, CAD {Coronary arteriosclerosis}"
+"###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 exam:
+Vitals- 97.9, 147/74, 81, 18, 96% on 2L
+General- Pleasant middle aged ___ woman breathing 
+comfortably in full sentences. Alert, oriented, no acute 
+distress.  
+HEENT- Sclera anicteric, MMM, PERRL, EOMI, oropharynx clear  
+Neck- supple, JVP not elevated 
+Lungs- diffuse posterior wheezing with poor air movement at the 
+apices but good air movement at the bases. No crackles or 
+rhonchi.
+CV- Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, 
+gallops  
+Abdomen- soft, non-tender, non-distended, bowel sounds present, 
+no rebound tenderness or guarding, no organomegaly  
+GU- no foley  
+Ext- warm, well perfused, 2+ pulses, no clubbing, cyanosis or 
+edema
+Neuro- CNs2-12 intact, motor function grossly normal
+
+Discharge exam:
+VS: 98.8, 120/77, 72, 18, 100% on 2L
+General- Pleasant middle aged ___ woman breathing 
+comfortably in full sentences. Alert, oriented, no acute 
+distress.  
+HEENT- Sclera anicteric, MMM, PERRL, EOMI, oropharynx clear  
+Neck- supple, JVP not elevated 
+Lungs- CTAB. No wheezes, crackles, or rhonchi.
+CV- Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, 
+gallops  
+Abdomen- soft, non-tender, non-distended, bowel sounds present, 
+no rebound tenderness or guarding, no organomegaly  
+GU- no foley  
+Ext- warm, well perfused, 2+ pulses, no clubbing, cyanosis or 
+edema
+Neuro- CNs2-12 intact, motor function grossly normal  
+ 
+
+###RESPONSE: Vitals {Vital signs finding}, 2L {Oxygen therapy}, General {General examination of patient}, middle aged {Middle-age}, breathing 
+comfortably {Breathing easily}, full sentences {Able to complete sentence in one breath}, Alert {Mentally alert}, oriented {Orientated}, no acute {No abnormality detected}, distress {Distress}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, MMM {Moist oral mucosa}, PERRL {Pupils equal and reacting to light}, EOMI {Normal ocular motility}, oropharynx clear {Pharynx normal}, Neck {Physical examination procedure}, supple {Normal movement of neck}, JVP not elevated {Normal jugular venous pressure}, Lungs {Examination of respiratory system}, wheezing {Wheezing}, apices {Structure of apex of lung}, good air movement {Breath normal}, bases {Structure of base of lung}, crackles {Respiratory crackles}, rhonchi {Wheeze - rhonchi}, 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<}, murmurs {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, Abdomen {Examination of abdomen}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, bowel sounds present {Normal bowel sounds}, rebound {Rebound tenderness}, tenderness {Tenderness}, guarding {Abdominal guarding}, organomegaly {Abdominal organomegaly}, GU {Examination of genitourinary system}, foley {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}, CNs2-12 {Cranial nerve structure}, intact {No abnormality detected}, motor function grossly normal {Normal motor response to command}, VS {Vital signs finding}, 2L {Oxygen therapy}, General {General examination of patient}, middle aged {Middle-age}, breathing 
+comfortably {Breathing easily}, full sentences {Able to complete sentence in one breath}, Alert {Mentally alert}, oriented {Orientated}, no acute {No abnormality detected}, distress {Distress}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, MMM {Moist oral mucosa}, PERRL {Pupils equal and reacting to light}, EOMI {Normal ocular motility}, oropharynx clear {Pharynx normal}, Neck- supple {Normal movement of neck}, JVP not elevated {Normal jugular venous pressure}, Lungs {Examination of respiratory system}, CTAB {Normal breath sounds}, wheezes {Wheezing}, crackles {Respiratory crackles}, rhonchi {Wheeze - rhonchi}, CV {Cardiovascular physical examination}, Regular rate and rhythm {Normal heart rate}, normal S1 + S2 {Heart sounds normal}, murmurs {Heart murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, Abdomen- soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, bowel sounds present {Normal bowel sounds}, rebound tenderness {Rebound tenderness}, guarding {Abdominal guarding}, organomegaly {Abdominal organomegaly}, GU {Physical examination procedure}, foley {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}, CNs2-12 {Cranial nerve structure}, intact {No abnormality detected}, motor function grossly normal {Normal motor response to command}"
+"###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:
+
+___ 02:00PM BLOOD WBC-6.0 RBC-3.76* Hgb-11.7* Hct-35.5* 
+MCV-94 MCH-31.1 MCHC-33.0 RDW-14.7 Plt ___
+___ 02:00PM BLOOD Neuts-76.4* Lymphs-17.0* Monos-2.9 
+Eos-3.3 Baso-0.3
+___ 02:00PM BLOOD Glucose-147* UreaN-15 Creat-0.7 Na-141 
+K-3.1* Cl-102 HCO3-30 AnGap-12
+___ 07:00AM BLOOD Calcium-10.2 Phos-3.4 Mg-2.0
+
+Discharge labs:
+
+___ 07:10AM BLOOD WBC-8.9 RBC-3.94* Hgb-11.9* Hct-36.7 
+MCV-93 MCH-30.2 MCHC-32.4 RDW-14.4 Plt ___
+___ 07:10AM BLOOD Glucose-89 UreaN-18 Creat-0.8 Na-144 
+K-3.8 Cl-104 HCO3-28 AnGap-16
+___ 07:10AM BLOOD Calcium-9.9 Phos-3.1 Mg-2.2
+
+Pertinent micro:
+
+Blood cultures pending x2
+
+Pertinent imaging:
+
+CXR: In comparison with study of ___, there is little change and 
+no
+evidence of acute cardiopulmonary disease.  There is a streak of 
+fibrosis or
+atelectasis again in the left mid zone.  Otherwise, no 
+pneumonia, vascular
+congestion, or pleural effusion.
+ 
+
+###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}, 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}, Baso {Basophil count}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium 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}, MCV {Erythrocyte mean corpuscular volume determination}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, BLOOD Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium 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}, Blood cultures {Blood culture}, CXR {Plain chest X-ray}, study {Evaluation procedure}, no
+evidence {No abnormality detected}, disease {Disease}, fibrosis {Fibrosis}, atelectasis {Atelectasis}, left {Left lung structure}, mid zone {Structure of middle zone of lung}, pneumonia {Pneumonia}, vascular {Blood vessel structure}, congestion {Congestion}, pleural effusion {Pleural effusion}"
+"###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 history of COPD, HTN, depression, fibromyalgia with 
+recent hospitalization for COPD flare who presents with acute 
+SOB and wheezing on exam consistent with recurrent COPD flare.
+
+# COPD with acute exacerbation: She appeared euvolemic with no 
+suspected CHF, normal TTE in ___. Positive URI symptoms 
+likely triggered flare. Of note, pt was supposed to follow up 
+with pulmonology for PFTs but had to reschedule. She was started 
+on a prednisone taper and a 3 day course of levaquin. Her 
+symptoms improved dramatically. She was discharged on flovent 
+instead of budesonide. Her home COPD medications were otherwise 
+unchanged. 
+
+# Hypokalemia: Etiology likely secondary to diuretic and/or 
+frequent administration of albuterol. She normally takes 20meq 
+KCl daily at home. HCTZ was held, and K improved. Blood 
+pressures remained well controlled. Recommend uptitrating 
+lisinopril as needed. 
+
+Chronic issues:
+# Anemia: Hct at baseline. History of normal iron studies. 
+# HTN: held HCTZ and continued lisinopril as above.
+# Fibromyalgia: continued home gabapentin and ibuprofen
+# Depression: continued home zoloft. SW consult.
+# PACT patient: PACT aware of admission, following.
+
+Transitional issues:
+# HCTZ discontinued; can uptitrate lisinopril as needed.
+# Budesonide d/c'd and flovent started
+ 
+
+###RESPONSE: COPD {Chronic obstructive lung disease}, HTN {Hypertensive disorder, systemic arterial}, depression {Depressive disorder}, fibromyalgia {Fibromyalgia}, COPD flare {Acute exacerbation of chronic obstructive airways disease}, SOB {Dyspnea}, wheezing {Wheezing}, exam {Physical examination procedure}, recurrent {Recurrent disease}, COPD flare {Acute exacerbation of chronic obstructive airways disease}, COPD {Chronic obstructive lung disease}, acute exacerbation {Acute exacerbation of chronic obstructive airways disease}, euvolemic {Normal blood volume}, CHF {Congestive heart failure}, normal {No abnormality detected}, TTE {Transthoracic echocardiography}, URI {Upper respiratory infection}, flare {Acute infective exacerbation of chronic obstructive airways disease}, PFTs {Measurement of respiratory function}, prednisone {Steroid therapy}, taper {Medication decreased}, improved {Patient's condition improved}, COPD {Chronic obstructive lung disease}, medications {Administration of drug or medicament}, Hypokalemia {Hypokalemia}, secondary {Medication side effects present}, diuretic {Diuretic therapy}, held {Recommendation to stop drug treatment}, K {Blood potassium measurement}, improved {Patient's condition improved}, Blood 
+pressures {Blood pressure monitoring}, well controlled {Disease condition determination, well controlled}, Anemia {Anemia}, Hct {Hematocrit determination}, baseline {Baseline state}, normal iron studies {Serum iron within reference range}, HTN {Hypertensive disorder, systemic arterial}, held {Recommendation to stop drug treatment}, lisinopril {Angiotensin converting enzyme inhibitor therapy}, Fibromyalgia {Fibromyalgia}, Depression {Depressive disorder}, discontinued {Recommendation to stop drug treatment}, started {New medication added}"
+"###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. Albuterol 0.083% Neb Soln 1 NEB IH Q6H:PRN SOB 
+2. Gabapentin 800 mg PO TID 
+3. Gabapentin 400 mg PO HS 
+4. Hydrochlorothiazide 25 mg PO DAILY 
+hold for sbp <100 
+5. Ibuprofen 800 mg PO Q8H:PRN pain 
+6. Lisinopril 5 mg PO DAILY 
+7. Pravastatin 80 mg PO DAILY 
+8. Sertraline 200 mg PO DAILY 
+9. Montelukast Sodium 10 mg PO DAILY 
+10. Albuterol Inhaler 2 PUFF IH Q4H:PRN SOB, wheezing 
+11. Budesonide Nasal Inhaler *NF* 90 mcg Other BID 
+12. Tiotropium Bromide 1 CAP IH DAILY 
+
+ 
+Discharge Medications:
+1. Albuterol 0.083% Neb Soln 1 NEB IH Q6H:PRN SOB 
+2. Gabapentin 800 mg PO TID 
+3. Gabapentin 400 mg PO HS 
+4. Ibuprofen 800 mg PO Q8H:PRN pain 
+5. Lisinopril 5 mg PO DAILY 
+6. Montelukast Sodium 10 mg PO DAILY 
+7. Pravastatin 80 mg PO DAILY 
+8. Sertraline 200 mg PO DAILY 
+9. Tiotropium Bromide 1 CAP IH DAILY 
+10. Fluticasone Propionate 110mcg 2 PUFF IH BID 
+11. Albuterol Inhaler 2 PUFF IH Q4H:PRN SOB, wheezing 
+12. PredniSONE 60 mg PO  once a day Duration: 1  Days  
+13. PredniSONE 40 mg PO  once a day Duration: 3 Days  Start: 
+After 60 mg tapered dose. 
+14. PredniSONE 30 mg PO once a day Duration: 3 Days  Start: 
+After 40 mg tapered dose. 
+15. PredniSONE 20 mg PO  once a day Duration: 3 Days  Start: 
+After 30 mg tapered dose. 
+16. PredniSONE 10 mg PO once a day Duration: 3 Days  Start: 
+After 20 mg tapered dose. 
+17. Fluconazole 150 mg PO ONCE Duration: 1 Doses  
+RX *fluconazole 150 mg 1 tablet(s) by mouth once Disp #*2 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:
+Chronic obstructive pulmonary disease
+Upper respiratory tract infection
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Chronic obstructive pulmonary disease {Chronic obstructive lung disease}, Upper respiratory tract infection {Upper respiratory infection}, 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:
+Dear ___,
+
+___ were admitted to ___ for shortness of breath likely 
+related to an exacerbation of your COPD. ___ were started on 
+antibiotics and a prednisone taper with nebulizers to help ___ 
+breathe. Your symptoms improved notably, and we now feel ___ are 
+safe to leave the hospital.
+
+We made the following changes to your medications:
+START prednisone 10mg 3 tabs x3 days, 3x 3 days, 2 x 3 days , 1 
+x 3 days (this is waiting at your pharmacy)
+START fluconazole 125mg once if ___ begin having symptoms of 
+yeast infection 
+START flovent (this is waiting at your pharmacy)
+STOP HCTZ
+STOP budesonide
+ 
+
+###RESPONSE: shortness of breath {Dyspnea}, exacerbation of your COPD {Acute exacerbation of chronic obstructive airways disease}, started {New medication added}, antibiotics {Antibiotic therapy}, prednisone {Steroid therapy}, nebulizers {Nebulizer therapy}, improved {Patient's condition improved}, prednisone {Steroid therapy}, yeast {Yeast detected}, infection {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: 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: 
+Patient recorded as having No Known Allergies to Drugs
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Hypotension, Fatigue/anemia  
+ 
+Major Surgical or Invasive Procedure:
+None
+ 
+
+###RESPONSE: Hypotension {Low blood pressure}, Fatigue {Fatigue}, anemia {Anemia}"
+"###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:
+This is an ___ year old ___ female who presents with one 
+month of progressive fatigue/weakness.  She has had significant 
+fatigue for the past 6 months, but this has become worse over 
+the last month, and she has been feeling dizzy everyday.  Her 
+daughter also notes that she looks paler than usual.  The 
+patient has mild DOE.  She has a known history of chronic anemia 
+with baseline HCT of ___ (in ___ of unclear etiology.  
+Per PCP records, she was evaluated at ___ several years ago 
+but no formal records of the results of that eval are known, 
+although the patient's daughter reports that ""no problem was 
+found"".  She presented to her PCP today for evaluation, where 
+immediate labs were sent and noted to have a Hct of 23.1 and 
+plts of 59 from a baseline of 134.  She was hypotensive in the 
+office, documented at 78/60, heart rate 93.  Her PCP called her 
+to come into the ___ ED due to the hypotension, as well as to 
+work up her anemia.  The patient denies fevers, chills, HA, 
+cough, chest pain, abdominal pain, N/V/D, vaginal bleeding, 
+dysuria, increased frequency, or rash.  She does note some 
+constipation, which has been a chronic issue, and her last bowel 
+movement was ___ years ago.  She has not had any episodes of 
+hematemesis, bloody or tarry stools.
+.  
+In the ED, initial VS were: T 100.4 HR 95 BP 119/63 RR 16 O2-sat 
+100% RA. The patient was given nothing in the ED.  Vitals on 
+transfer were T 99 HR 85 BP 106/60 RR19 O2-sat 98% RA.  
+.  
+On the floor, feels well but continues to feel fatigued.  
+.  
+Review of systems:  
+(+) Per HPI  
+(-) Denies fever, chills, night sweats. Denies headache, sinus 
+tenderness, rhinorrhea or congestion. Denied cough, shortness of 
+breath. Denied chest pain or tightness, palpitations. Denied 
+nausea, vomiting, diarrhea, or abdominal pain. No recent change 
+in bowel or bladder habits. No dysuria. Denied arthralgias or 
+myalgias.
+ 
+
+###RESPONSE: progressive {Patient's condition worsened}, fatigue {Fatigue}, weakness {Asthenia}, fatigue {Fatigue}, dizzy {Dizziness}, mild {Symptom mild}, DOE {Dyspnea on exertion}, chronic anemia {Chronic anemia}, baseline {Baseline state}, HCT {Hematocrit determination}, PCP {Primary care management}, evaluated {Evaluation procedure}, eval {Evaluation procedure}, problem {Problem}, PCP {Primary care management}, evaluation {Evaluation procedure}, labs {Laboratory test}, baseline {Baseline state}, hypotensive {Low blood pressure}, heart rate {Finding of heart rate}, PCP {Primary care management}, hypotension {Low blood pressure}, work up {Evaluation procedure}, anemia {Anemia}, fevers {Fever}, chills {Chill}, cough {Cough}, chest pain {Chest pain}, abdominal pain {Abdominal pain}, N/V/D {Nausea, vomiting and diarrhea}, vaginal bleeding {Bleeding from vagina}, dysuria {Dysuria}, increased frequency {Increased frequency of urination}, rash {Eruption of skin}, constipation {Constipation}, chronic issue {Chronic disease}, hematemesis {Hematemesis}, bloody {Hematochezia}, tarry stools {Melena}, O2-sat {Oxygen saturation measurement}, Vitals {Vital signs finding}, O2-sat {Oxygen saturation measurement}, feels well {Well in self}, fatigued {Fatigue}, Review of systems {Review of systems}, fever {Fever}, chills {Chill}, night sweats {Night sweats}, headache {Headache}, sinus 
+tenderness {Tenderness over frontal sinus}, rhinorrhea {Nasal discharge}, congestion {Nasal congestion}, cough {Cough}, shortness of 
+breath {Dyspnea}, chest pain {Chest pain}, tightness {Tight chest}, palpitations {Palpitations}, nausea, vomiting, diarrhea {Nausea, vomiting and diarrhea}, abdominal pain {Abdominal pain}, change 
+in bowel {Altered bowel function}, bladder habits {Alteration in patterns of urinary elimination}, dysuria {Dysuria}, arthralgias {Joint pain}, myalgias {Muscle 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: Past Medical History:
+# chronic anemia of unclear etiology, previously eval at ___, 
+family does not recall any abnormalities  
+# chronic constipation  
+# stress urinary incontinence  
+# osteoporosis  
+# osteoarthritis  
+# heart murmur  
+# mild dementia  
+# hematuria  
+# macular degeneration  
+# depression not on medications  
+# hyperlipidemia  
+# varicose veins in legs
+
+ 
+
+###RESPONSE: chronic anemia {Chronic anemia}, eval {Evaluation procedure}, chronic constipation {Chronic constipation}, stress urinary incontinence {Genuine stress incontinence}, osteoporosis {Osteoporosis}, osteoarthritis {Osteoarthritis}, heart murmur {Heart murmur}, dementia {Dementia}, hematuria {Blood in urine}, macular degeneration {Degenerative disorder of macula}, depression {Depressive disorder}, medications {Administration of drug or medicament}, hyperlipidemia {Hyperlipidemia}, varicose veins {Venous varices}, legs {Lower limb 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: 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:
+Patient's father died of stomach cancer prior to World War II.
+ 
+
+###RESPONSE: died {Dead}, 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:
+Vitals: T 98.2, BP 138/82, HR 78, RR 16, O2 97% RA  
+General: Alert, oriented, no acute distress, pale  
+HEENT: Sclera anicteric, MMM, oropharynx clear, pale conjunctiva 
+ 
+Neck: supple, JVP not elevated, no LAD  
+Lungs: Bibasilar crackles, L>R
+CV: Regular rate and rhythm, normal S1 + S2, ___ SEM loudest at 
+base
+Abdomen: soft, non-tender, non-distended, bowel sounds present, 
+no rebound tenderness or guarding, no organomegaly, guaiac 
+negative in ED  
+Pelvic: Performed in ED, per report, no uterus felt, no vaginal 
+bleeding seen  
+Ext: Warm, well perfused, 2+ pulses, no clubbing, cyanosis or 
+edema  
+Neuro: CN II-XII intact
+ 
+
+###RESPONSE: Vitals {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}, Alert {Mentally alert}, oriented {Orientated}, no acute {No abnormality detected}, distress {Distress}, pale {Pale complexion}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, MMM {Moist oral mucosa}, oropharynx clear {Pharynx normal}, pale conjunctiva {Pale conjunctiva}, Neck {Physical examination procedure}, supple {Normal movement of neck}, JVP not elevated {Normal jugular venous pressure}, LAD {Lymphadenopathy}, Lungs {Examination of respiratory system}, Bibasilar {Structure of base of lung}, crackles {Respiratory crackles}, 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<}, SEM {Ejection murmur}, Abdomen {Examination of abdomen}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, bowel sounds present {Normal bowel sounds}, rebound {Rebound tenderness}, tenderness {Tenderness}, guarding {Abdominal guarding}, organomegaly {Abdominal organomegaly}, guaiac {Guaiac test for occult blood in feces specimen}, negative {No pathologic diagnosis}, Pelvic {Manual pelvic examination}, uterus {Uterine structure}, vaginal 
+bleeding {Bleeding from vagina}, 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}, CN II-XII intact {Normal central nervous system}"
+"###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:
+___ 09:50PM   GLUCOSE-114* UREA N-26* CREAT-1.3* SODIUM-136 
+POTASSIUM-4.5 CHLORIDE-100 TOTAL CO2-28 ANION GAP-13
+___ 11:35AM   GLUCOSE-100
+___ 11:35AM   UREA N-20 CREAT-1.2* SODIUM-139 POTASSIUM-4.0 
+CHLORIDE-100 TOTAL CO2-28 ANION GAP-15
+___ 08:08AM BLOOD Glucose-93 UreaN-18 Creat-1.0 Na-136 
+K-4.0 Cl-102 HCO3-27 AnGap-11
+___ 08:08AM BLOOD Albumin-3.5 Calcium-8.4 Phos-3.5 Mg-2.0
+.
+Hematology:
+.
+___ 09:50PM   WBC-3.1* RBC-2.12* HGB-7.2* HCT-20.8* MCV-98 
+MCH-34.0* MCHC-34.7 RDW-16.7*
+___ 09:50PM   NEUTS-41* BANDS-1 LYMPHS-44* MONOS-12* EOS-0 
+BASOS-0 ATYPS-2* ___ MYELOS-0
+___ 09:50PM   HYPOCHROM-NORMAL ANISOCYT-1+ POIKILOCY-2+ 
+MACROCYT-1+ MICROCYT-NORMAL POLYCHROM-NORMAL OVALOCYT-2+
+___ 09:50PM   PLT SMR-VERY LOW PLT COUNT-52*
+___ 09:50PM   ___ PTT-28.1 ___
+___ 09:50PM   RET AUT-0.9*
+___ 10:49PM   D-DIMER-321
+___ 10:20PM   ___
+___ 11:35AM   WBC-4.0 RBC-2.25*# HGB-8.0* HCT-23.1* 
+MCV-102*# MCH-35.6*# MCHC-34.8 RDW-16.0*
+___ 11:35AM   PLT SMR-VERY LOW PLT COUNT-59*#
+___ 08:08AM BLOOD WBC-3.1* RBC-2.62* Hgb-8.7* Hct-24.3* 
+MCV-93 MCH-33.1* MCHC-35.7* RDW-17.4* Plt Ct-49*
+___ 08:08AM BLOOD Hypochr-1+ Anisocy-OCCASIONAL Poiklo-1+ 
+Macrocy-NORMAL Microcy-NORMAL Polychr-OCCASIONAL 
+Ovalocy-OCCASIONAL Tear ___
+___ 08:08AM BLOOD Plt Ct-49*
+___ 08:08AM BLOOD ___ PTT-28.8 ___
+.
+LFTs -
+.
+___ 09:50PM   LD(LDH)-158 CK(CPK)-34 TOT BILI-0.6 DIR 
+BILI-0.2 INDIR BIL-0.4
+___ 11:35AM   ALT(SGPT)-8 AST(SGOT)-15 ALK PHOS-69
+___ 11:35AM   TOT PROT-7.1 CALCIUM-8.9 CHOLEST-185
+___ 11:35AM   TRIGLYCER-69 HDL CHOL-76 CHOL/HDL-2.4 
+LDL(CALC)-95
+___ 08:08AM BLOOD ALT-7 AST-13 LD(LDH)-155 AlkPhos-65 
+TotBili-2.8*
+.
+___ 09:50PM   CK-MB-NotDone cTropnT-<0.01
+___ 09:50PM   TOT PROT-6.6 IRON-51
+___ 09:50PM   calTIBC-226* VIT ___ FOLATE-11.6 
+___ FERRITIN-447* TRF-174*
+___ 11:35AM   estGFR-Using this
+___ 11:35AM   TSH-1.3
+.
+ON DISCHARGE: ___ 09:10a   
+.
+139  102  18     
+------------< 97  gap 13
+3.9  28  1.0  
+.
+Ca: 8.8 Mg: 2.1 P: 3.2
+.
+    10.0           
+2.8 >--< 67  mcv 96
+    29.0
+.
+Urinalysis-
+.
+___ 05:40AM URINE Color-Straw Appear-Clear Sp ___
+___ 05:40AM URINE Blood-SM Nitrite-NEG Protein-NEG 
+Glucose-NEG Ketone-NEG Bilirub-NEG Urobiln-NEG pH-5.0 Leuks-NEG
+___ 05:40AM URINE ___ Bacteri-RARE Yeast-NONE 
+Epi-<1
+___ 05:40AM URINE Eos-NEGATIVE  
+___ 05:40AM URINE Hours-RANDOM UreaN-563 Creat-69 Na-72
+.
+MICROBIOLOGY:
+___: Blood Culture, Routine (Pending): x 2 
+___: URINE CULTURE - final - MIXED BACTERIAL FLORA ( >= 3 
+COLONY TYPES), CONSISTENT WITH SKIN AND/OR GENITAL 
+CONTAMINATION. 
+.
+IMAGING:
+.
+CXR (___): 
+Lung volumes are low resulting in vascular crowding. Minimally 
+increased interstitial markings, predominantly at the lung bases 
+may indicate an underlying interstitial abnormality. There is no 
+consolidation or pleural effusion. There is no pneumothorax. The 
+heart size is top normal. The aorta is tortuous and calcified. 
+There is no hilar or mediastinal enlargement. Pulmonary 
+vascularity is normal. Degenerative changes and ossification of 
+the anterior longitudinal ligament are noted in the spine. 
+IMPRESSIONS: No consolidation. No hilar enlargement. 
+.
+EKG (___): Normal sinus rhythm, left axis deviation, Right 
+bundle branch block with ? left anterior fascicular block. No 
+obvious ischemic changes.
+ 
+
+###RESPONSE: GLUCOSE {Glucose measurement, blood}, UREA N {Blood urea nitrogen measurement}, 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}, GLUCOSE {Glucose measurement, blood}, UREA N {Blood urea nitrogen measurement}, 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}, 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}, Albumin {Albumin 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}, MCV {Erythrocyte mean corpuscular volume 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}, BASOS {Basophil count}, PLT {Platelet count}, LOW {Platelet count below reference range}, PLT COUNT {Platelet count}, PTT {Partial thromboplastin time, activated}, D-DIMER {D-dimer assay}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, PLT {Platelet count}, LOW {Platelet count below reference range}, PLT COUNT {Platelet count}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, NORMAL {Normal size}, NORMAL {Normal size}, PTT {Partial thromboplastin time, activated}, LFTs {Hepatic function panel}, LDH {Lactate dehydrogenase measurement}, CK(CPK {Creatine kinase measurement}, TOT BILI {Bilirubin, total measurement}, BILI {Bilirubin measurement}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, ALK PHOS {Alkaline phosphatase measurement}, CALCIUM {Blood calcium measurement}, CHOLEST {Cholesterol measurement}, HDL {High density lipoprotein measurement}, HDL {High density lipoprotein measurement}, LDL(CALC) {Calculated low density lipoprotein cholesterol level}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, LDH {Lactate dehydrogenase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, FOLATE {Whole blood folate within reference range}, TSH {Thyroid stimulating hormone measurement}, Urinalysis {Urinalysis}, URINE Color-Straw {Normal urine color}, Appear-Clear {Urine looks clear}, URINE Blood {Urine blood test}, Nitrite-NEG {Nitrite not detected in urine}, Protein-NEG {Urine protein not detected}, Glucose-NEG {Urine glucose not detected}, Ketone-NEG {Urine ketones not detected}, NEG {No abnormality detected}, Urobiln-NEG {Urine urobilinogen not detected}, pH {pH measurement}, Leuks-NEG {Urine leukocytes not detected}, URINE {Evaluation of urine specimen}, Bacteri {Bacteriuria}, Yeast {Urine microscopy for yeasts}, URINE {Evaluation of urine specimen}, NEGATIVE {No pathologic diagnosis}, URINE {Evaluation of urine specimen}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, Blood Culture {Blood culture}, URINE CULTURE {Urine culture}, BACTERIAL {Bacterial infectious disease}, SKIN AND/OR GENITAL 
+CONTAMINATION. {Sample contaminated}, CXR {Plain chest X-ray}, Lung volumes {Finding of respiratory volume}, vascular crowding {Pulmonary hypertension}, lung bases {Structure of base of lung}, abnormality {Imaging result abnormal}, consolidation {Consolidation}, pleural effusion {Pleural effusion}, pneumothorax {Pneumothorax}, heart {Heart structure}, size {Normal size}, normal {Normal size}, aorta {Aortic structure}, tortuous {Tortuosity}, calcified {Pathologic calcification, calcified structure}, hilar {Structure of hilum of lung}, mediastinal {Mediastinal structure}, enlargement {Enlargement}, Pulmonary {Lung structure}, normal {Normal size}, Degenerative changes {Cervical spondylosis}, anterior longitudinal ligament {Anterior longitudinal ligament structure}, spine {Structure of vertebral column}, consolidation {Consolidation}, hilar {Hilar lymphadenopathy}, enlargement {Enlargement}, EKG {Electrocardiographic procedure}, Normal sinus rhythm {Electrocardiogram: normal sinus rhythm}, left axis deviation {Left axis deviation}, Right 
+bundle branch block with ? left anterior fascicular block {Right bundle branch block AND left anterior fascicular block}, ischemic changes {Ischemia}"
+"###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 an ___ year old female with chronic anemia who presents 
+with 1 month of fatigue and found to have worsening anemia, 
+thrombocytopenia, and ARF.  
+.  
+# Hypotension:  Pt presented to PCP ___ ___ with BP 78/60, but 
+BP has been stable and within normal limits since admission to 
+___.  Hypotension was potentially hypovolemic in nature, 
+although patient did not require fluids for resolution of low 
+BP.  The patient's orthostatics were negative during this 
+admission; an outpatient workup for orthostatic hypotension may 
+be worth considering, although the patient does not have a 
+history of falls and is otherwise asymptomatic.
+.
+# Anemia - Multiple possible causes, including aplastic anemia, 
+myelodysplastic syndrome, anemia of chronic disease, plasma cell 
+dyscrasias, blood loss, or hemolytic process.  Symptoms suggest 
+a relatively chronic process but HCT dropped from 23->21 in 12 
+hours on ___, suggesting a possibly accelerating process. 
+Possible slow GI bleed but less likely given guaiac negative and 
+constipation.  Hemolysis labs reportedly negative overnight, but 
+re-sent because could not find in system.  DIC very unlikely 
+given elevated fibrinogen, normal D-dimer, and normal coags.  
+Concern for TTP-HUS with anemia, thrombocytopenia, low grade 
+fever and ARF but no schistocytes seen on smear and again, no 
+evidence of hemolysis (elevated TBili on ___ likely 
+post-transfusional).  All cell lines down so possible marrow 
+process affecting production, especially with slight lymphocytic 
+predominance and atypicals on smear.  Previous Fe studies and 
+B12/folate normal.  Previous renal function normal and anemia is 
+normocytic, so anemia of chronic disease less likely.  SPEP 
+normal in ___, resent to r/o plasma cell dyscrasia.  No 
+chemotherapy, radiation exposure, or medications suggestive of 
+aplastic anemia.  MDS is ___ strong possibility given her age, 
+pancytopenia, low reticulocyte count.
+.
+Two peripheral IVs (18-gauge) were placed and 2 units PRBCs 
+given on ___, with an improvement in Hct to from 
+20.8->24.3->29.0 on ___.  Reticulocyte count was found to be 
+low at 0.9.  Iron studies did not suggest iron deficiency anemia 
+or B12/folate deficiency, although we will continue the 
+patient's outpatient iron supplementation regimen.  A peripheral 
+smear and SPEP/UPEP were sent and were pending at discharge.  
+Hematology-oncology saw the patient, agrees with our 
+differential of myelodysplastic syndrome vs. myelofibrosis and 
+recommended follow up in clinic for possible consideration of BM 
+biopsy which could provide definitive diagnosis, though the 
+extent that this would change management in this ___ year old 
+woman is unclear.
+.  
+# Thrombocytopenia: Similar concerns as above.  DIC and TTP were 
+thought to be unlikely in the absence of evidence for hemolysis. 
+ There is a possible production problem as noted above. Could be 
+ITP but that is a diagnosis of exclusion, and less likely given 
+the patient's pancytopenia.   
+.  
+# ARF: Pt had a mild elevation in creatinine to 1.3 (baseline 
+1.0) on admission, which resolved with transfusion and 
+hydration.  Likely related to anemia and relative hypovolemia. 
+BUN/Cr<20, suggestive of mild prerenal process.  Receiving 2 
+units of blood which should be a good volume challenge.  
+Creatinine improved with transfusion to 1.0 on ___.
+.  
+# Fever: Low grade temp to 100.4 in triage. No clear localizing 
+source. Will hold on abx unless decompensates.  CXR was negative 
+for consolidation, exam does show some dry crackles most likely 
+due to atalectasis.  Urinalysis was negative in detail, and 
+urine and blood cultures remain pending.
+.  
+# Osteoporosis: Reports not taking her fosamax due to concerns 
+about not being able to sit up long enough.  Will hold for now.  
+
+.
+ 
+
+###RESPONSE: chronic anemia {Chronic anemia}, fatigue {Fatigue}, worsening {Patient's condition worsened}, anemia {Anemia}, thrombocytopenia {Thrombocytopenic disorder}, ARF {Acute kidney injury}, Hypotension {Low blood pressure}, PCP {Primary care management}, stable {Stable blood pressure}, normal {Normal vital signs}, Hypotension {Low blood pressure}, hypovolemic {Hypovolemia}, fluids {Administration of fluid therapy}, resolution {Problem resolved}, low 
+BP {Low blood pressure}, orthostatics {Orthostatic hypotension}, negative {No pathologic diagnosis}, workup {Evaluation procedure}, orthostatic hypotension {Orthostatic hypotension}, falls {Falls}, asymptomatic {Asymptomatic}, Anemia {Anemia}, aplastic anemia {Aplastic anemia}, myelodysplastic syndrome {Myelodysplastic syndrome}, anemia of chronic disease {Anemia of chronic disorder}, plasma cell 
+dyscrasias {Plasma cell neoplasm}, blood loss {Hemorrhage}, chronic {Chronic disease}, HCT {Hematocrit determination}, GI bleed {Gastrointestinal hemorrhage}, guaiac {Guaiac test for occult blood in feces specimen}, negative {No pathologic diagnosis}, constipation {Constipation}, Hemolysis {Hemolysis}, labs {Laboratory test}, negative {No pathologic diagnosis}, DIC {Blood coagulation panel, disseminated intravascular coagulation}, elevated fibrinogen {Fibrinogen in blood above reference range}, normal coags {Coagulation/bleeding tests normal}, TTP {Thrombotic thrombocytopenic purpura}, HUS {Hemolytic uremic syndrome}, anemia {Anemia}, thrombocytopenia {Thrombocytopenic disorder}, low grade 
+fever {Low grade pyrexia}, ARF {Acute kidney injury}, no 
+evidence {No abnormality detected}, hemolysis {Hemolysis}, elevated TBili {Total bilirubin above reference range}, cell {Cell structure}, Fe studies {Iron kinetics study}, B12/folate {B12/folate level}, renal function normal {Normal renal function}, anemia is 
+normocytic {Normocytic anemia}, anemia of chronic disease {Anemia of chronic disorder}, SPEP 
+normal {Serum proteins within reference range}, plasma cell dyscrasia {Plasma cell neoplasm}, chemotherapy {Chemotherapy}, radiation {Radiation oncology AND/OR radiotherapy}, aplastic anemia {Aplastic anemia}, MDS {Myelodysplastic syndrome}, pancytopenia {Pancytopenia}, reticulocyte count {Reticulocyte count}, placed {Implantation procedure}, PRBCs 
+given {Transfusion of packed red blood cells}, improvement {Patient's condition improved}, Reticulocyte count {Reticulocyte count outside reference range}, studies {Evaluation procedure}, iron deficiency anemia {Iron deficiency anemia}, B12/folate deficiency {Combined B12 and folate deficiency anemia}, iron supplementation regimen {Iron supplement therapy}, SPEP {Serum protein electrophoresis}, UPEP {Urine protein electrophoresis}, myelodysplastic syndrome {Myelodysplastic syndrome}, myelofibrosis {Myelofibrosis}, BM 
+biopsy {Bone marrow sampling}, Thrombocytopenia {Thrombocytopenic disorder}, DIC {Disseminated intravascular coagulation}, TTP {Thrombotic thrombocytopenic purpura}, hemolysis {Hemolysis}, problem {Problem}, ITP {Chronic idiopathic thrombocytopenic purpura}, pancytopenia {Pancytopenia}, ARF {Acute kidney injury}, elevation in creatinine {Serum creatinine above reference range}, baseline {Baseline state}, resolved {Problem resolved}, transfusion {Transfusion}, hydration {Administration of fluid therapy}, anemia {Anemia}, relative hypovolemia {Relative hypovolemia}, BUN/Cr {Blood urea nitrogen/creatinine ratio}, mild {Symptom mild}, Creatinine {Creatinine measurement}, improved {Patient's condition improved}, transfusion {Transfusion}, Fever {Fever}, temp {Body temperature finding}, triage {Triage}, hold {Recommendation to stop drug treatment}, CXR {Plain chest X-ray}, negative {Standard chest X-ray normal}, consolidation {Consolidation}, exam {Evaluation procedure}, crackles {Respiratory crackles}, atalectasis {Atelectasis}, Urinalysis {Urinalysis}, negative {No pathologic diagnosis}, urine {Urine culture}, blood cultures {Blood culture}, Osteoporosis {Osteoporosis}, able to sit up {Able to sit up}, hold {Recommendation to stop drug treatment}"
+"###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:
+Ferrous Sulfate 352mg PO daily  
+Fosamax 70mg PO qwk  
+Trospium 20mg PO BID  
+Calc/Vit. D 1000U PO daily
+ 
+Discharge Medications:
+1. Fosamax 70 mg Tablet Sig: One (1) Tablet PO once a week.  
+2. Trospium 20 mg Tablet Sig: One (1) Tablet PO twice a day.  
+3. Ferrous Sulfate 325 mg (65 mg Iron) Tablet Sig: One (1) 
+Tablet PO once a day.  
+4. Cholecalciferol (Vitamin D3) 1,000 unit Capsule Sig: One (1) 
+Capsule PO once a day. Capsule(s) 
+5. Outpatient Lab Work
+Please check a CBC on ___ and have the results faxed to Dr. 
+___ (FAX ___
+
+ 
+
+###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:
+Anemia
+Pancytopenia
+Acute renal insufficiency
+Fever
+Hypotension
+
+Secondary:
+Osteoporosis
+Stress urinary incontinence
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent
+Level of Consciousness: Alert and interactive
+Activity Status: Ambulatory - Independent
+
+ 
+
+###RESPONSE: Anemia {Anemia}, Pancytopenia {Pancytopenia}, Acute renal insufficiency {Acute renal insufficiency}, Fever {Fever}, Hypotension {Low blood pressure}, Osteoporosis {Osteoporosis}, Stress urinary incontinence {Genuine stress incontinence}, Mental Status {Neurological mental status determination}, Clear {Normal state of mind}, 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 for weakness and fatigue and were found to 
+have a low red blood cell count (anemia).  You were given a 
+blood transfusion and your symptoms improved.  You were found to 
+have low platelets (thrombocytopenia) and white blood cell count 
+(leukopenia).  You were seen by the hematology-oncology team and 
+they felt the low cell lines may be due to a process of abnormal 
+blood cell proliferation or other cause of hindrance in the bone 
+marrow (myelodysplastic syndrome or myelofibrosis).  
+
+No changes were made to your medication regimen.  Please take 
+all of your home medications as prescribed.
+ 
+
+###RESPONSE: weakness {Asthenia}, fatigue {Fatigue}, red blood cell count {Red blood cell count}, anemia {Anemia}, blood transfusion {Transfusion of blood product}, improved {Patient's condition improved}, low platelets {Thrombocytopenic disorder}, thrombocytopenia {Thrombocytopenic disorder}, white blood cell count {White blood cell count}, leukopenia {Leukopenia}, abnormal 
+blood cell proliferation {Proliferation of hematopoietic cell type}, bone 
+marrow {Bone marrow structure}, myelodysplastic syndrome {Myelodysplastic syndrome}, myelofibrosis {Myelofibrosis}, changes were made to your medication {Change of medication}, regimen {Therapeutic regimen}, medications {Administration of drug or medicament}"
+"###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: CARDIOTHORACIC
+ 
+
+###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:
+Shortness of breath
+ 
+Major Surgical or Invasive Procedure:
+Left Thoracentesis- yield 1300mL
+
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, Shortness of breath {Dyspnea}, Thoracentesis {Thoracentesis}"
+"###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 man with a history of carotid 
+artery stenosis, chronic renal insufficiency, coronary artery 
+disease, hyperlipidemia, and hypertension. He developed upper 
+back pain in ___ and presented to an outside hospital. An 
+EKG demonstrated nonspecific ST changes. Cardiac catheterization 
+demonstrated severe multivessel coronary artery disease. He was
+transferred to ___ for surgical revascularization. He 
+underwent coronary artery bypass grafting x 5 on ___ with 
+Dr. ___. His postoperative course was complicated by acute blood 
+loss anemia requiring transfusion of PRBCs. He also had 
+intermitted atrial fibrillation and was started on Amiodarone 
+and Coumadin. He was discharged to rehab on postoperative day 5. 
+He has remained deconditioned at rehab. He has noted shortness 
+of breath and serosanguinous sternal drainage. WBC at rehab 
+yesterday was 15.8 and he was started on empiric Keflex. He 
+presented today for wound evaluation. Prior to his visit he 
+underwent a chest x-ray which demonstrated an increase in 
+moderate to large left pleural effusion with compressive 
+atelectasis. There was also a mildly enlarged cardiomediastinal 
+silhouette suspicious for pericardial effusion. Discussed his 
+case with Dr. ___ who is covering for Dr. ___. Plan to admit
+for observation.
+
+ 
+
+###RESPONSE: carotid 
+artery stenosis {Carotid artery stenosis}, chronic renal insufficiency {Chronic renal insufficiency}, coronary artery 
+disease {Coronary arteriosclerosis}, hyperlipidemia {Hyperlipidemia}, hypertension {Hypertensive disorder, systemic arterial}, upper 
+back pain {Thoracic back pain}, EKG {Electrocardiographic procedure}, ST changes {Electrocardiographic ST segment changes}, Cardiac catheterization {Cardiac catheterization}, coronary artery disease {Coronary arteriosclerosis}, surgical {Surgical procedure}, revascularization {Heart revascularization}, coronary artery bypass grafting x 5 {Coronary artery bypass grafts x 5}, postoperative course {Postoperative state}, acute blood 
+loss anemia {Acute posthemorrhagic anemia}, transfusion of PRBCs {Transfusion of packed red blood cells}, atrial fibrillation {Atrial fibrillation}, Coumadin {Anticoagulant therapy}, shortness 
+of breath {Dyspnea}, serosanguinous sternal drainage {Serosanguineous discharge from wound}, WBC {White blood cell count}, wound evaluation {Evaluation of wound healing progress}, chest x-ray {Plain chest X-ray}, pleural effusion {Pleural effusion}, compressive 
+atelectasis {Compression atelectasis}, enlarged {Enlargement}, pericardial effusion {Pericardial effusion}"
+"###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:
+Carotid Artery Stenosis
+Chronic Renal Insufficiency (Cre 1.2-1.4)
+Coronary Artery Disease
+Hyperlipidemia
+Hypertension
+Macular Degeneration 
+Non-ST Elevation Myocardial Infarction, ___ w/RCA stent
+Osteoarthritis  
+
+ 
+
+###RESPONSE: Carotid Artery Stenosis {Carotid artery stenosis}, Chronic Renal Insufficiency {Chronic renal insufficiency}, Coronary Artery Disease {Coronary arteriosclerosis}, Hyperlipidemia {Hyperlipidemia}, Hypertension {Hypertensive disorder, systemic arterial}, Macular Degeneration {Degenerative disorder of macula}, Non-ST Elevation Myocardial Infarction {Acute non-ST segment elevation myocardial infarction}, RCA {Right coronary artery structure}, stent {Insertion of arterial stent}, Osteoarthritis {Osteoarthritis}"
+"###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:
+No family history of early MI, arrhythmia, cardiomyopathies, or 
+sudden cardiac death; otherwise non-contributory.
+ 
+
+###RESPONSE: MI {Myocardial infarction}, arrhythmia {Cardiac arrhythmia}, cardiomyopathies {Cardiomyopathy}, sudden cardiac death {Sudden cardiac death}"
+"###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:
+HR: 78 SR.  BP: 137/80, right.  RR: 18.  O2 Sat: 97% RA
+Height: 66""  Weight: 172 lbs 
+
+General: Pleasant man, WDWN, lying in stretcher 
+Skin: Warm, dry, intact
+HEENT: PERRLA, EOMI, teeth in good repair 
+Neck: Supple, Full ROM 
+Chest: Diminished at bilateral bases, no crackles 
+Heart: Regular rate and rhythm, no murmur appreciated 
+Abdomen: Normal BS, soft, non-tender, non-distended 
+Extremities: Warm, well-perfused 
+Edema: 1+ edema bilaterally 
+Incision: ABD pad removed with scant serosanguinous drainage. 
+Wound well approximated without erythema. No click. 
+
+ 
+
+###RESPONSE: HR {Finding of heart rate}, BP {Blood pressure finding}, RR {Finding of rate of respiration}, O2 Sat {Oxygen saturation measurement}, RA {Breathing room air}, Height {Height / growth finding}, Weight {Weight finding}, General {General examination of patient}, WDWN {Well nourished}, lying {Lying in bed}, Skin {Examination of skin}, Warm {Warm skin}, dry {Xeroderma}, intact {Intact skin}, HEENT {Physical examination procedure}, PERRLA {Pupils equal, react to light and accommodation}, EOMI {Normal ocular motility}, teeth {Structure of dentition}, Neck {Physical examination procedure}, Supple {Normal movement of neck}, Full ROM {Normal range of cervical spine movement}, Chest {Examination of respiratory system}, bases {Structure of base of lung}, crackles {Respiratory crackles}, Heart {Cardiovascular physical examination}, Regular rate and rhythm {Normal heart rate}, murmur {Murmur}, Abdomen {Examination of abdomen}, Normal BS {Normal bowel sounds}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, Extremities {Examination of limb}, Warm {Warm skin}, well-perfused {Normal tissue perfusion}, edema {Edema}, Incision {Surgical incision wound}, ABD {Examination of abdomen}, removed {Removal}, serosanguinous drainage {Serosanguineous discharge from wound}, Wound {Wound}, well approximated {Wound healing well}, erythema {Erythema}"
+"###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:
+Transthoracic Echocardiogram (focused) ___
+Due to suboptimal technical quality, a focal wall motion 
+abnormality cannot be fully excluded. Overall left ventricular 
+systolic function is normal (LVEF>55%). Right ventricular 
+chamber size and free wall motion are normal. The aortic valve 
+leaflets (3) appear structurally normal with good leaflet 
+excursion and no aortic stenosis or aortic regurgitation. 
+Trivial mitral regurgitation is seen. There is a 
+trivial/physiologic pericardial effusion. 
+
+IMPRESSION: Trivial pericardial effusion. Normal global 
+biventricular systolic function.  
+
+Chest CT ___
+1. Large left pleural effusion with volume loss in the left 
+lower lobe, 
+lingula. 
+2. Mild partially hemorrhagic pericardial effusion. 
+.
+
+___ 05:07AM BLOOD WBC-16.8* RBC-3.68* Hgb-10.8* Hct-33.9* 
+MCV-92 MCH-29.3 MCHC-31.9* RDW-15.1 RDWSD-50.4* Plt ___
+___ 04:25AM BLOOD WBC-21.3* RBC-3.51* Hgb-10.1* Hct-32.3* 
+MCV-92 MCH-28.8 MCHC-31.3* RDW-15.3 RDWSD-51.4* Plt ___
+___ 05:07AM BLOOD ___ PTT-31.8 ___
+___ 04:25AM BLOOD ___
+___ 04:35AM BLOOD ___
+___ 05:01PM BLOOD ___ PTT-30.4 ___
+___ 05:07AM BLOOD Glucose-99 UreaN-30* Creat-1.4* Na-138 
+K-4.4 Cl-96 HCO3-27 AnGap-19
+___ 04:35AM BLOOD Glucose-95 UreaN-26* Creat-1.3* Na-137 
+K-3.9 Cl-98 HCO3-24 AnGap-19
+___ 05:07AM BLOOD ALT-82* AST-125* AlkPhos-184* 
+Amylase-159* TotBili-3.0*
+___ 04:25AM BLOOD ALT-77* AST-113* LD(LDH)-441* 
+AlkPhos-182* Amylase-140* TotBili-3.2*
+___ 05:07AM BLOOD Phos-4.3 Mg-2.3
+___ 04:35AM BLOOD Calcium-7.9* Phos-4.4 Mg-2.6
+ 
+
+###RESPONSE: Transthoracic Echocardiogram {Transthoracic echocardiography}, focal wall motion 
+abnormality {Left ventricular wall motion abnormality}, left ventricular 
+systolic function {Normal left ventricular systolic function and wall motion}, Right ventricular 
+chamber {Right cardiac ventricular structure}, wall motion are normal {Normal ventricular wall motion}, aortic valve 
+leaflets {Structure of cardiac valve leaflet}, structurally normal {Aortic valve normal}, leaflet {Structure of cardiac valve leaflet}, aortic stenosis {Aortic valve stenosis}, aortic regurgitation {Aortic valve regurgitation}, mitral regurgitation {Mitral valve regurgitation}, pericardial effusion {Pericardial effusion}, pericardial effusion {Pericardial effusion}, biventricular {Cardiac ventricular structure}, systolic function {Normal cardiac function}, pleural effusion {Pleural effusion}, volume loss {Lung volume test abnormal}, left 
+lower lobe {Structure of lower lobe of left lung}, lingula {Structure of lingula of left lung}, pericardial effusion {Pericardial effusion}, 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}, 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}, PTT {Partial thromboplastin time, activated}, 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}, 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}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, LDH {Serum lactate dehydrogenase level above reference range}, TotBili {Bilirubin, total measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total 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: Brief Hospital Course:
+He was admitted on ___ for further evaluation. A chest CT 
+demonstrated a large left pleural effusion. An echocardiogram 
+revealed a trivial pericardial effusion.  Warfarin was held for 
+procedure.   He underwent left sided thoracentesis on ___ 
+for a yield of 1300cc of serosanguinous fluid.  Overall, the 
+patient tolerated the procedure well.  Warfarin was resumed for 
+post-op afib.  LFTs noted to be elevated- labs will be repeated 
+as an outpatient.  He is discharged home after clearing ___ on 
+hospital day 3.  He will follow-up as directed.  
+ 
+
+###RESPONSE: evaluation {Evaluation procedure}, chest CT {Computed tomography of chest}, pleural effusion {Pleural effusion}, echocardiogram {Echocardiography}, pericardial effusion {Pericardial effusion}, procedure {Procedure}, thoracentesis {Thoracentesis}, fluid {Effusion}, procedure {Procedure}, post-op {Postoperative state}, afib {Atrial fibrillation}, LFTs {Hepatic function panel}, elevated {Finding of increased blood pressure}, follow-up {Follow-up arranged}"
+"###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 80 mg PO QPM 
+3. Amiodarone 400 mg PO BID 
+4. Docusate Sodium 100 mg PO BID 
+5. Furosemide 40 mg PO DAILY 
+___  MD to order daily dose PO DAILY16 afib 
+7. Metoprolol Tartrate 50 mg PO TID 
+8. OxyCODONE (Immediate Release) ___ mg PO Q4H:PRN Pain: 
+moderate/severe 
+9. Polyethylene Glycol 17 g PO DAILY 
+10. Potassium Chloride 20 mEq PO DAILY 
+11. Ranitidine 150 mg PO DAILY 
+
+ 
+Discharge Medications:
+1.  Amiodarone 200 mg PO DAILY 
+RX *amiodarone 200 mg 1 tablet(s) by mouth daily Disp #*30 
+Tablet Refills:*1 
+2.  Warfarin 2 mg PO DAILY16 afib 
+RX *warfarin 2 mg ___ tablet(s) by mouth daily Disp #*60 Tablet 
+Refills:*1 
+3.  Aspirin 81 mg PO DAILY 
+RX *aspirin [Aspir-Low] 81 mg 1 tablet(s) by mouth daily Disp 
+#*30 Tablet Refills:*1 
+4.  Atorvastatin 80 mg PO QPM 
+RX *atorvastatin 80 mg 1 tablet(s) by mouth qpm Disp #*30 Tablet 
+Refills:*0 
+5.  Docusate Sodium 100 mg PO BID 
+RX *docusate sodium 100 mg 1 capsule(s) by mouth twice a day 
+Disp #*60 Capsule Refills:*1 
+6.  Furosemide 40 mg PO DAILY Duration: 10 Days 
+RX *furosemide 40 mg 1 tablet(s) by mouth daily Disp #*10 Tablet 
+Refills:*0 
+7.  Metoprolol Tartrate 50 mg PO TID 
+RX *metoprolol tartrate 50 mg 1 tablet(s) by mouth three times a 
+day Disp #*90 Tablet Refills:*1 
+8.  OxyCODONE (Immediate Release) ___ mg PO Q4H:PRN Pain: 
+moderate/severe 
+RX *oxycodone 5 mg ___ tablet(s) by mouth every four (4) hours 
+Disp #*50 Tablet Refills:*0 
+9.  Polyethylene Glycol 17 g PO DAILY 
+RX *polyethylene glycol 3350 [Miralax] 17 gram 1 powder(s) by 
+mouth daily Disp #*10 Packet Refills:*0 
+10.  Potassium Chloride 20 mEq PO DAILY Duration: 10 Days 
+RX *potassium chloride 20 mEq 1 tablet(s) by mouth daily Disp 
+#*10 Tablet Refills:*0 
+11.  Ranitidine 150 mg PO DAILY 
+RX *ranitidine HCl 150 mg 1 tablet(s) by mouth daily Disp #*30 
+Tablet Refills:*1 
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Pleural Effusion
+
+Carotid Artery Stenosis
+Chronic Renal Insufficiency (Cre 1.2-1.4)
+Coronary Artery Disease
+Hyperlipidemia
+Hypertension
+Macular Degeneration 
+Non-ST Elevation Myocardial Infarction, ___ w/RCA stent
+Osteoarthritis  
+
+ 
+Discharge Condition:
+Alert and oriented x3 non-focal 
+Ambulating, deconditioned
+Incisional pain managed with oxycodone
+Incisions: 
+Sternal - healing well, no erythema or drainage 
+Leg/left- healing well, no erythema or drainage
+Edema: trace bilateral pedal
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, Pleural Effusion {Pleural effusion}, Carotid Artery Stenosis {Carotid artery stenosis}, Chronic Renal Insufficiency {Chronic renal insufficiency}, Coronary Artery Disease {Coronary arteriosclerosis}, Hyperlipidemia {Hyperlipidemia}, Hypertension {Hypertensive disorder, systemic arterial}, Macular Degeneration {Degenerative disorder of macula}, Non-ST Elevation Myocardial Infarction {Acute non-ST segment elevation myocardial infarction}, RCA {Right coronary artery structure}, stent {Insertion of arterial stent}, Osteoarthritis {Osteoarthritis}, Alert {Mentally alert}, oriented x3 {Oriented to person, time and place}, Ambulating {Fully mobile}, Incisional {Surgical incision wound}, pain {Pain}, Incisions {Surgical incision wound}, Sternal {Structure of sternal region}, healing well {Wound healing well}, erythema {Erythema}, drainage {Discharge}, Leg/left {Structure of left lower leg}, healing well {Wound healing well}, erythema {Erythema}, drainage {Discharge}, 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: Discharge Instructions:
+Please shower daily including washing incisions gently with mild 
+soap, no baths or swimming until cleared by surgeon. Look at 
+your incisions daily for redness or drainage
+Please NO lotions, cream, powder, or ointments to incisions 
+Each morning you should weigh yourself and then in the evening 
+take your temperature, these should be written down on the chart 
+
+No driving for one month or while taking narcotics. Driving will 
+be discussed at follow up appointment with surgeon-when you will 
+be able to drive 
+No lifting more than 10 pounds for 10 weeks
+
+**Please call cardiac surgery office with any questions or 
+concerns ___. Answering service will contact on call 
+person during off hours**
+ 
+
+###RESPONSE: shower {Able to shower self}, incisions {Surgical incision wound}, incisions {Surgical incision wound}, redness {Redness of skin over lesion}, drainage {Discharge}, incisions {Surgical incision wound}, while taking narcotics {Narcotics education}, No lifting {Functional activity education}"
+"###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: 
+all seafood / ibuprofen / bees / acetaminophen
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Groin pain
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: seafood {Allergy to seafood}, ibuprofen {Allergy to ibuprofen}, bees {Allergy to bee venom}, acetaminophen {Allergy to paracetamol}, Groin pain {Inguinal 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:
+The patient is a ___ woman with a past medical history 
+significant for HTN, T2DM, seizure disorder, Hepatitis C, and 
+schizoaffective disorder who presents with 10 days of R groin 
+pain.
+
+At baseline, she uses a walker to ambulate and takes Oxycodone 
+for diabetic neuropathy, which she describes a ""burning"" 
+sensation in her BLE. She was in her usual state of health until 
+2 weeks ago when she slipped on a banana peel and ended up in a 
+splits position. 2 days later, she noted R groin pain. On ___, 
+she was admitted to ___ with acute urinary retention likely 
+___ Oxycodone/Benadryl use and UTI and RLQ abdominal pain. Her 
+Benadryl was temporarily D/C'ed, and she was treated with a 
+course of Macrobid. In terms of her RLQ abdominal pain, acute 
+processes were ruled-out via CT and U/S. She reports that her 
+pain, which she clarifies was always R groin and not RLQ, 
+slightly improved on D/C, but has gradually worsened since then. 
+She describes this pain as non-radiating, pulsating pain that is 
+constant; exacerbated with movement; and accompanied by shooting 
+pains down her RLE. She endorses fevers (Tm 100.4) and chills, 
+but denies N/V, abdominal pain, changes in her bowel habits, or 
+urinary symptoms.
+
+In the ED, her initial vitals were T 99.8 HR 96 BP 144/77 RR 18 
+SaO2 97% on RA. Her physical examination was notable for R 
+inguinal TTP. Her laboratory results were notable for Na 131; 
+ALT 51 AST 87 Alk Phos 199 Tbili 1.7 Alb 3.0; and WBC 8.1. She 
+underwent RUQ U/S which was unchanged. She received IV Morphine 
+17 MG for pain. 
+
+Currently, she continues to report R groin pain and is 
+requesting pain medications. Otherwise, she has no additional 
+complaints.    
+
+REVIEW OF SYSTEMS: Per HPI, otherwise negative in detail.
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, T2DM {Diabetes mellitus type 2}, seizure disorder {Seizure disorder}, Hepatitis C {Viral hepatitis type C}, schizoaffective disorder {Schizoaffective disorder}, R groin 
+pain {Right inguinal pain}, baseline {Baseline state}, uses a walker to ambulate {Does mobilize using walker}, diabetic neuropathy {Neuropathy due to diabetes mellitus}, burning"" 
+sensation {Burning sensation}, BLE {Lower limb structure}, R groin pain {Right inguinal pain}, acute urinary retention {Acute retention of urine}, UTI {Urinary tract infectious disease}, RLQ abdominal pain {Right lower quadrant pain}, RLQ abdominal pain {Right lower quadrant pain}, CT {Computed tomography}, U/S {Ultrasonography of abdomen}, pain {Pain}, R groin {Right inguinal region structure}, RLQ {Structure of right lower quadrant of abdomen}, improved {Patient's condition improved}, D/C {Discharged from hospital}, worsened {Increased pain}, pain {Pain}, radiating {Radiating pain}, pulsating pain {Throbbing pain}, constant {Constant pain}, shooting 
+pains {Shooting pain}, RLE {Structure of right lower limb}, fevers {Fever}, chills {Chill}, N/V {Nausea and vomiting}, abdominal pain {Abdominal pain}, changes in her bowel habits {Altered bowel function}, urinary symptoms {Urinary symptom change}, HR {Finding of heart rate}, BP {Blood pressure finding}, RR {Finding of rate of respiration}, SaO2 {Finding of oxygen saturation}, RA {Breathing room air}, physical examination {Physical examination procedure}, R 
+inguinal {Right inguinal region structure}, TTP {Tenderness}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, WBC {White blood cell count}, RUQ {Structure of right upper quadrant of abdomen}, U/S {Ultrasonography of abdomen}, pain {Pain}, R groin pain {Right inguinal pain}, requesting pain medications {Analgesics requested}, negative {No abnormality detected}"
+"###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 
+Diabetes c/b neuropathy
+Seizure disorder
+Hepatitis C 
+Cirrhosis 
+Schizoaffective d/o
+Asthma
+Migraine headaches
+ 
+
+###RESPONSE: Hypertension {Hypertensive disorder, systemic arterial}, Diabetes c/b neuropathy {Neuropathy due to diabetes mellitus}, Seizure disorder {Seizure disorder}, Hepatitis C 
+Cirrhosis {Cirrhosis of liver due to chronic hepatitis C}, Schizoaffective {Schizoaffective disorder}, Asthma {Asthma}, Migraine headaches {Migraine}"
+"###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: HTN, DM, asthma
+Father: ___ disorder 
+Nephew, niece: ___
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, DM {Diabetes mellitus}, asthma {Asthma}, disorder {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:
+On Admission:
+Vitals: T 98.9 BP 129/75 HR 90 RR 17 SaO2 100% on RA
+General: Well-appearing, obese female lying comfortably in bed
+HEENT: Sclera anicteric, PERRLA, MMM, oropharynx clear  
+Neck: Supple, no JVD, no LAD
+Lungs: CTAB
+Heart: RRR, normal s1/2, no m/r/g  
+Abdomen: BS+, soft, NT/ND, no organomegaly  
+Back: No TTP, no CVA tenderness
+Ext: WWP, 2+ pulses, no edema
+Neuro: A&Ox3, CN II-XII intact
+R hip: TTP along inguinal region and lateral aspect, limited 
+passive and active ROM (compared to L), no erythema or warmth, 
+no masses
+
+On Discharge:
+VS: Tm 99.1 Tc 98.1 BP 125/59 (113-139/59-78) HR 108 (92-108) RR 
+18 SaO2 95% on RA
+I/O (8hrs) 600(PO)/BRP, (24hrs) 570(PO)/BRP, BM x1
+FSBG 107-201 
+General: Well-appearing, obese female lying comfortably in bed
+HEENT: Sclera anicteric, PERRLA, MMM, oropharynx clear  
+Neck: Supple, no JVD, no LAD
+Lungs: CTAB
+Heart: RRR, normal s1/2, no m/r/g  
+Abdomen: BS+, soft, NT/ND, no organomegaly  
+Back: No TTP, no CVA tenderness
+Ext: WWP, 2+ pulses, no edema
+Neuro: A&Ox3, CN II-XII intact
+R hip: TTP along inguinal region and lateral aspect, limited 
+passive and active ROM (compared to L), no erythema or warmth, 
+no masses
+ 
+
+###RESPONSE: Vitals {Vital signs finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, SaO2 {Finding of oxygen saturation}, RA {Breathing room air}, General {General examination of patient}, Well-appearing {Well cared for appearance}, obese {Obese}, lying comfortably in bed {Lying in bed}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, PERRLA {Pupils equal, react to light and accommodation}, MMM {Moist oral mucosa}, oropharynx clear {Pharynx normal}, Neck {Physical examination procedure}, Supple {Normal movement of neck}, JVD {Jugular venous engorgement}, LAD {Lymphadenopathy}, Lungs {Examination of respiratory system}, CTAB {Normal breath sounds}, Heart {Cardiovascular physical examination}, RRR {Normal heart rate}, normal s1 {Normal first heart sound, S>1<}, no m/r/g {Heart sounds normal}, Abdomen {Examination of abdomen}, BS+ {Normal bowel sounds}, soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, organomegaly {Abdominal organomegaly}, TTP {Tenderness}, CV {Cardiovascular physical examination}, tenderness {Tenderness}, WWP {Normal tissue perfusion}, 2+ pulses {Peripheral pulses normal}, edema {Edema}, Neuro {Neurological examination}, A {Mentally alert}, Ox3 {Oriented to person, time and place}, CN II-XII intact {Normal central nervous system}, R hip {Right hip region structure}, TTP {Tenderness}, inguinal region {Right inguinal region structure}, limited 
+passive and active ROM {Decreased range of hip movement}, erythema {Erythema}, warm {Warm skin}, masses {Mass}, VS {Vital signs finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, SaO2 {Finding of oxygen saturation}, RA {Breathing room air}, BM {Does defecate}, FSBG {Finding of blood glucose level}, General {General examination of patient}, Well-appearing {Well cared for appearance}, obese {Obese}, lying comfortably in bed {Lying in bed}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, PERRLA {Pupils equal, react to light and accommodation}, MMM {Moist oral mucosa}, oropharynx clear {Pharynx normal}, Neck {Physical examination procedure}, Supple {Normal movement of neck}, JVD {Jugular venous engorgement}, LAD {Lymphadenopathy}, Lungs {Examination of respiratory system}, CTAB {Normal breath sounds}, Heart {Cardiovascular physical examination}, RRR {Normal heart rate}, normal s1 {Normal first heart sound, S>1<}, no m/r/g {Heart sounds normal}, Abdomen {Examination of abdomen}, BS+ {Normal bowel sounds}, soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, organomegaly {Abdominal organomegaly}, TTP {Tenderness}, Ext {Examination of limb}, WWP {Normal tissue perfusion}, 2+ pulses {Peripheral pulses normal}, edema {Edema}, Neuro {Neurological examination}, A {Mentally alert}, Ox3 {Oriented to person, time and place}, CN II-XII intact {Normal central nervous system}, R hip {Right hip region structure}, TTP {Tenderness}, inguinal region {Right inguinal region structure}, limited 
+passive and active ROM {Decreased range of hip movement}, erythema {Erythema}, warmth {Joint warm}, masses {Mass}"
+"###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:
+On Admission:
+___ 08:20AM BLOOD WBC-8.1 RBC-3.35* Hgb-10.2* Hct-31.1* 
+MCV-93 MCH-30.6 MCHC-33.0 RDW-15.7* Plt ___
+___ 08:20AM BLOOD Neuts-73.3* ___ Monos-4.7 Eos-2.1 
+Baso-0.2
+___ 08:20AM BLOOD Plt ___
+___ 08:10AM BLOOD ___
+___ 08:20AM BLOOD Glucose-219* UreaN-4* Creat-0.5 Na-131* 
+K-3.8 Cl-96 HCO3-31 AnGap-8
+___ 08:20AM BLOOD ALT-51* AST-87* AlkPhos-199* TotBili-1.7*
+___ 08:20AM BLOOD Albumin-3.0* Calcium-8.2* Phos-2.5* 
+Mg-1.5*
+___ 08:36AM BLOOD Lactate-2.1*
+
+___ CXR:
+IMPRESSION: No acute intrathoracic process.
+
+___ RUQ U/S:
+IMPRESSION: 
+1. Nodular and coarsened liver compatible with cirrhosis without 
+focal lesions. 
+2. Splenomegaly. 
+3. No evidence of cholecystitis or choledocholithiasis.
+
+___ Hip XR:
+FINDINGS: Bony structures and joint spaces are essentially 
+within normal limits and symmetric bilaterally. No evidence of 
+fracture or dislocation. However, if there is strong clinical 
+concern for an occult fracture, cross-sectional imaging should 
+be obtained.
+
+___ MR-L spine:
+IMPRESSION: 
+Multilevel disc disease most notably at the L4-L5 level where 
+there is a right paracentral disc bulge with superimposed disc 
+extrusion extending superiorly into the right lateral recess.  
+This disc causes mass effect on the exiting right L4 nerve root 
+and traversing right L5 nerve root.
+
+___ MR-Hip (Prelim):
+IMPRESSION: 
+MR of the hip demonstrating extensive edema of multiple muscles 
+around the pelvic girdle, predominantly involving obturator 
+internus, externus, quadratus femoris and gluteus medius. This 
+is centered around the superior pubic ramus which demonstrates 
+mild bone edema but no fracture. Differentials for this 
+appearance include myositis, infection, lymphoma. Recommend 
+contrast enhanced MRI to further evaluate.
+
+___ MR-Hip with contrast:
+IMPRESSION: 
+The area of diffuse muscular and bone marrow edema enhances 
+avidly. The lack of any fluid collection or heterogenous 
+enhancement makes infection somewhat less likely, however 
+differential considerations also include tumor and 
+post-traumatic changes.   
+  
+Additional history was provided confirming recent trauma. Given 
+this additional information, post-traumatic change is the most 
+likely of the provided differentials. Follow-up with repeat MRI 
+in ___ weeks to ensure improvement/resolution is recommended. 
+ 
+On Discharge:
+___ 07:00AM BLOOD WBC-6.8 RBC-3.29* Hgb-10.2* Hct-30.5* 
+MCV-93 MCH-31.1 MCHC-33.5 RDW-15.7* Plt ___
+___ 08:10AM BLOOD ESR-98*
+___ 07:00AM BLOOD Glucose-175* UreaN-5* Creat-0.6 Na-130* 
+K-3.5 Cl-96 HCO3-29 AnGap-9
+___ 08:10AM BLOOD ALT-47* AST-88* LD(LDH)-282* CK(CPK)-155 
+AlkPhos-200* TotBili-1.9*
+___ 07:00AM BLOOD Calcium-8.2* Phos-4.0 Mg-1.5*
+___ 08:10AM BLOOD CRP-50.2*
+ 
+
+###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}, Monos {Monocyte count}, Eos {Eosinophil 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}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, Albumin {Albumin measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, No acute intrathoracic process {No abnormality detected}, liver {Liver structure}, cirrhosis {Cirrhosis of liver}, lesions {Lesion}, Splenomegaly {Splenomegaly}, No evidence {No abnormality detected}, cholecystitis {Cholecystitis}, choledocholithiasis {Common bile duct calculus}, Bony structures {Bone structure of hip joint region}, joint spaces {Structure of articular space}, normal {No abnormality detected}, No evidence {No abnormality detected}, fracture {Fracture}, dislocation {Dislocation}, fracture {Fracture}, imaging {Imaging}, disc disease {Disorder of lumbar disc}, right {Structure of right lumbar region of back}, disc {Intervertebral disc structure of fourth lumbar vertebra}, bulge {Swelling}, d disc 
+extrusion {Displacement of lumbar intervertebral disc}, right {Structure of right lumbar region of back}, lateral recess {Structure of transverse process of lumbar vertebra}, disc {Intervertebral disc structure of fourth lumbar vertebra}, L4 nerve root {Structure of spinal nerve root L4}, right {Structure of right lumbar region of back}, L5 nerve root {Structure of spinal nerve root L5}, MR of the hip {Magnetic resonance imaging of hip}, edema {Edema of skeletal muscle}, muscles 
+around the pelvic {Skeletal muscle structure of pelvis}, obturator 
+internus {Internal obturator muscle structure}, externus {External obturator muscle structure}, quadratus femoris {Structure of quadratus femoris muscle}, gluteus medius {Structure of gluteus medius muscle}, superior pubic ramus {Structure of superior ramus of pubis}, mild {Symptom mild}, bone edema {Edema of bone marrow}, fracture {Fracture}, appearance {Edema of skeletal muscle}, myositis {Myositis}, infection {Infectious disease}, lymphoma {Malignant lymphoma}, contrast enhanced MRI {Magnetic resonance imaging with contrast}, muscular {Edema of skeletal muscle}, bone marrow edema {Edema of bone marrow}, fluid collection {Accumulation of fluid}, infection {Infectious disease}, tumor {Neoplasm}, traumatic {Traumatic injury}, trauma {Traumatic injury}, traumatic {Traumatic injury}, MRI {Magnetic resonance imaging}, ensure {Evaluation procedure}, improvement {Patient's condition improved}, resolution {Problem resolved}, 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}, ESR {Finding of erythrocyte sedimentation rate}, BLOOD 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}, LDH {Lactate dehydrogenase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total 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: Brief Hospital Course:
+#R groin pain: The patient presented with R groin pain in the 
+setting of a fall. Her pain was likely ___ musculoskeletal 
+strain in the setting of trauma. However, given her low-grade 
+fevers and elevated inflammatory markers, septic joint was 
+considered. Her WBC was WNL, and her Hip-XR were unremarkable. 
+Her MR-Hip with and without contrast were consistent with 
+post-traumatic changes. Initially, there was concern for 
+lymphoma. However, her laboratory values were only notable for a 
+slightly elevated LDH (her baseline) and significantly elevated 
+ESR and CRP. She was given PO Oxycodone for pain in addition to 
+her home Sulindac, and she was discharged on a limited supply of 
+PO Oxycodone. ___ evaluated her and felt that she was safe to 
+return home with ___. Follow-up with repeat MRI in ___ weeks to 
+ensure improvement/resolution is recommended.
+
+#UTI: During her last admission, she was started on Macrobid for 
+a complicated UTI. She complicated her course prior to D/C.
+
+#HTN: Her home HCTZ was continued.
+
+#T2DM: Her home Metformin and NPH were continued, and she was 
+placed on ISS. Her home Glipizide was held and restarted on D/C. 
+For neuropathy, her home Gabapentin was continued.
+
+#Seizure disorder: Her home Phenytoin and Lamotrigine were 
+continued.
+
+#Schizoaffective disorder: Her home Abilify and Prazosin were 
+continued.
+
+#COPD: Her home Montelukast and nebs were continued.
+
+#Hyponatremia: She was admitted with Na 131, which is her 
+baseline and is likely ___ hypervolemia in the setting of liver 
+disease.
+
+#Chronic HCV/?Cirrhosis: She presented with ALT 51, AST 87, Alk 
+Phos 199, and Tbili 1.7, which is her baseline. Her U/S revealed 
+nodular liver and splenomegaly, unchanged from prior. Outpatient 
+follow-up with Liver Clinic was scheduled for ___.
+
+#Hypoalbuminemia: She was admitted with Alb 3.0, which is her 
+baseline and likely ___ liver disease. Per Nutrition, her Ensure 
+TID was continued.
+
+TRANSITIONAL ISSUES:
+1. She was treated with PO Oxycodone PRN and discharged on a 
+limited supply of PO Oxycodone.
+2. ___ evaluated her and felt that she was safe to return home 
+with ___.
+3. Follow-up with repeat MRI in ___ weeks to ensure 
+improvement/resolution is recommended.
+4. If her pain persists, please consider an outpatient Ortho 
+eval.
+5. Her urine and blood cultures will need to be followed-up.
+ 
+
+###RESPONSE: R groin pain {Right inguinal pain}, R groin pain {Right inguinal pain}, fall {Falls}, pain {Right inguinal pain}, musculoskeletal 
+strain {Muscle strain}, trauma {Traumatic injury}, low-grade 
+fevers {Low grade pyrexia}, elevated {Elevation}, inflammatory {Inflammatory disorder}, markers {Laboratory test}, septic joint {Bacterial arthritis}, WBC {White blood cell count}, WNL {No abnormality detected}, Hip-XR {Radiography of hip}, unremarkable {No abnormality detected}, MR-Hip with {Magnetic resonance imaging of hip with contrast}, d without contrast {Magnetic resonance imaging without contrast}, traumatic {Traumatic injury}, lymphoma {Malignant lymphoma}, elevated LDH {Serum lactate dehydrogenase level above reference range}, baseline {Baseline state}, elevated 
+ESR {Erythrocyte sedimentation rate above reference range}, CRP {C-reactive protein above reference range}, pain {Pain}, Follow-up {Follow-up arranged}, MRI {Magnetic resonance imaging}, ensure {Evaluation procedure}, improvement {Patient's condition improved}, resolution {Problem resolved}, UTI {Urinary tract infectious disease}, UTI {Urinary tract infectious disease}, HTN {Hypertensive disorder, systemic arterial}, T2DM {Diabetes mellitus type 2}, ISS {Sliding scale insulin regime}, restarted {Restart of medication}, neuropathy {Neuropathy}, Seizure disorder {Seizure disorder}, Schizoaffective disorder {Schizoaffective disorder}, COPD {Chronic obstructive lung disease}, Hyponatremia {Hyponatremia}, baseline {Baseline state}, hypervolemia {Hypervolemia}, liver 
+disease {Disorder of liver}, Chronic HCV/?Cirrhosis {Cirrhosis of liver due to chronic hepatitis C}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, baseline {Baseline state}, U/S {Ultrasonography of abdomen}, nodular liver {Nodule of liver}, splenomegaly {Splenomegaly}, Outpatient 
+follow-up {Follow-up arranged}, Clinic {Outpatient care management}, Hypoalbuminemia {Hypoalbuminemia}, baseline {Baseline state}, liver disease {Disorder of liver}, Nutrition {Under care of dietitian}, Ensure {Administration of nutritional supplement}, Follow-up {Follow-up arranged}, MRI {Magnetic resonance imaging}, ensure {Evaluation procedure}, improvement {Patient's condition improved}, resolution {Problem resolved}, pain {Right inguinal pain}, urine {Urine culture}, blood cultures {Blood culture}"
+"###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. TraMADOL (Ultram) 50 mg PO Q6H 
+2. Nitrofurantoin Monohyd (MacroBID) 100 mg PO Q12H 
+3. Zolpidem Tartrate 10 mg PO HS 
+4. Albuterol 0.083% Neb Soln 1 NEB IH Q6H:PRN SOB 
+5. Aripiprazole 30 mg PO DAILY 
+6. Gabapentin 800 mg PO TID 
+7. Hydrochlorothiazide 25 mg PO DAILY 
+8. NPH 25 Units Breakfast
+NPH 20 Units Bedtime
+9. Ipratropium Bromide Neb 1 NEB IH Q6H:PRN SOB 
+10. Lidocaine Viscous 2% 20 mL PO QID:PRN thrush 
+11. Montelukast Sodium 10 mg PO DAILY 
+12. Multivitamins 1 TAB PO DAILY 
+13. Omeprazole 20 mg PO DAILY 
+14. Phenytoin Sodium Extended 200 mg PO BID 
+15. Sumatriptan Succinate 50 mg PO ONCE MR1 migraine 
+16. Tiotropium Bromide 1 CAP IH DAILY 
+17. Albuterol Inhaler 2 PUFF IH Q6H:PRN SOB 
+18. Fluticasone-Salmeterol Diskus (100/50) 1 INH IH BID 
+19. GlipiZIDE 5 mg PO BID 
+20. MetFORMIN (Glucophage) 1000 mg PO BID 
+21. Symbicort *NF* (budesonide-formoterol) 160-4.5 mcg/actuation 
+INHALATION 2 PUFFS BID 
+22. Prazosin 2 mg PO QAM 
+23. Prazosin 8 mg PO QPM 
+24. LaMOTrigine 100 mg PO QAM 
+25. LaMOTrigine 200 mg PO QHS 
+26. Sulindac 200 mg PO BID
+ 
+Discharge Medications:
+1. Albuterol 0.083% Neb Soln 1 NEB IH Q6H:PRN SOB 
+2. Albuterol Inhaler 2 PUFF IH Q6H:PRN SOB 
+3. Aripiprazole 30 mg PO DAILY 
+4. Fluticasone-Salmeterol Diskus (100/50) 1 INH IH BID 
+5. Gabapentin 800 mg PO TID 
+6. Hydrochlorothiazide 25 mg PO DAILY 
+7. NPH 25 Units Breakfast
+NPH 20 Units Bedtime
+8. Ipratropium Bromide Neb 1 NEB IH Q6H:PRN SOB 
+9. LaMOTrigine 100 mg PO QAM 
+10. LaMOTrigine 200 mg PO QHS 
+11. MetFORMIN (Glucophage) 1000 mg PO BID 
+12. Montelukast Sodium 10 mg PO DAILY 
+13. Multivitamins 1 TAB PO DAILY 
+14. Omeprazole 20 mg PO DAILY 
+15. Phenytoin Sodium Extended 200 mg PO BID 
+16. Prazosin 2 mg PO QAM 
+17. Prazosin 8 mg PO QPM 
+18. Sulindac 200 mg PO BID 
+19. Tiotropium Bromide 1 CAP IH DAILY 
+20. Zolpidem Tartrate 5 mg PO HS:PRN insomnia 
+21. GlipiZIDE 5 mg PO BID 
+22. Lidocaine Viscous 2% 20 mL PO QID:PRN thrush 
+23. Symbicort *NF* (budesonide-formoterol) 160-4.5 mcg/actuation 
+INHALATION 2 PUFFS BID 
+24. OxycoDONE (Immediate Release)  ___ mg PO Q4H:PRN pain 
+do not drive while taking this medication 
+RX *oxycodone 5 mg 1 tablet(s) by mouth four times a day Disp 
+#*20 Tablet Refills:*0
+25. Docusate Sodium 100 mg PO BID 
+RX *docusate sodium 100 mg 1 capsule(s) by mouth twice a day 
+Disp #*20 Capsule Refills:*0
+26. Senna 1 TAB PO BID:PRN constipation 
+RX *sennosides [senna] 8.6 mg 1 tablet by mouth twice a day Disp 
+#*20 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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Groin pain
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+ 
+
+###RESPONSE: With Service {Home health aide service management}, Groin pain {Inguinal pain}, Mental Status {Neurological mental status determination}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, interactive {Does communicate}, 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 Ms. ___,
+
+It was a pleasure taking care of you while you were hospitalized 
+at ___. You were admitted to the hospital with right groin 
+pain. Your pain was likely due to a muscle tear. You were 
+treated and discharged with oral pain medications. Physical 
+Therapy evaluated you and felt that you were safe to return home 
+with physical therapy.
+
+Please take care to follow-up with your Primary Care physician.
+ 
+
+###RESPONSE: right groin 
+pain {Right inguinal pain}, pain {Right inguinal pain}, muscle tear {Rupture of muscle}, oral {Administration of drug or medicament via oral route}, pain medications {Administration of analgesic}, physical therapy {Physical therapy procedure}, Primary Care {Primary care management}"
+"###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: 
+Shellfish / Iodine / seasonal allergy / Dilaudid / novocaine
+ 
+Attending: ___.
+ 
+Chief Complaint:
+chemo
+ 
+Major Surgical or Invasive Procedure:
+port placement
+
+ 
+
+###RESPONSE: Shellfish {Allergy to shellfish}, Iodine {Allergy to iodine compound}, seasonal allergy {Seasonal allergy}, chemo {Chemotherapy}, port placement {Insertion of implantable venous access port}"
+"###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 ___ female with a history of
+marginal zone lymphoma in ___ with subsequent diagnosis of
+aggressive B cell lymphoma in ___.  She is s/p ISRT to her
+palate in ___ and surgical resection of left supraclavicular
+lymph node in ___ for marginal zone lymphoma.  She was found to
+have right leg edema with large mass in ___, and the biopsy
+confirmed mantle cell lymphoma, blastic variant.  She is s/p
+R-CHOP x 6 cycles in ___ and autologous transplant in ___. 
+PET/CT on ___ showed a new enlarged right inguinal lymph 
+node
+with FDG avidity compatible concerning for relapse.  Core biopsy
+of right inguinal lymph node on ___ was consistent with NHL;
+intermediate grade non-Hodgkin B-cell lymphoma. She appeared to
+have a single site of disease and it was reasonable to attempt
+radiation salvage as her systemic options were limited. This was
+completed on ___. Restaging in ___ consistent with 
+new
+PET avid periaortic node; bx consistent with relapsed aggressive
+B cell lymphoma. Patient presents for the second cycle of
+___.
+
+First cycle complicated by prolonged nausea, constipation and
+fatigue. 
+
+ 
+
+###RESPONSE: marginal zone lymphoma {Marginal zone lymphoma}, B cell lymphoma {B-cell lymphoma}, p ISRT {Radiation therapy care}, palate {Palatal structure}, surgical {Surgical procedure}, left supraclavicular
+lymph node {Structure of left supraclavicular lymph node}, marginal zone lymphoma {Marginal zone lymphoma}, right leg edema {Edema of right lower leg}, mass {Mass}, biopsy {Biopsy}, mantle cell lymphoma {Mantle cell lymphoma}, R-CHOP {Rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone chemotherapy regimen}, autologous transplant {Autogenous transplantation}, PET/CT {Positron emission tomography}, enlarged {Localized enlarged lymph nodes}, inguinal lymph 
+node {Inguinal lymph node structure}, Core biopsy {Core needle biopsy}, inguinal lymph node {Inguinal lymph node structure}, NHL {Non-Hodgkin's lymphoma}, intermediate grade non-Hodgkin B-cell lymphoma {Intermediate grade B-cell lymphoma}, disease {Disease}, radiation {Radiation oncology AND/OR radiotherapy}, PET {Positron emission tomography}, periaortic node {Structure of aortic lymph node}, bx {Biopsy finding}, B cell lymphoma {B-cell lymphoma}, nausea {Nausea}, constipation {Constipation}, fatigue {Fatigue}"
+"###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:
+PAST MEDICAL/SURGICAL HISTORY:  
+(1) HTN.  
+(2) Hyperlipidemia.  
+(3) ___ esophagus  
+(4) Partial thyroidectomy for multinodular hyperplasia.  
+(5) Colonic hyperplastic polyps.  
+(6) Meniere's disease.  
+(7) Degenerative disease of the lumbar spine.  
+(8) Heterozygous for FXI deficiency by report
+(9) Atrial fibrillation, on oral anticoagulation with warfarin.  
+
+(10) Lymphoma, as below 
+
+DETAILED ONCOLOGIC HISTORY: 
+History of extranodal marginal zone lymphoma of the palate 
+managed with excision and radiation in ___. Nodal recurrence of 
+mardinal zone lymphoma ___ that was excised. ___ patient was noted to have right lower extremity edema and 
+right inguinal LAD. Excisional biopsy consistent with an 
+aggressive B cell lymphoma, blastoid mantle cell.  
+R-CHOP x 6 cycles in ___ and autologous transplant in ___.  
+PET/CT on ___ showed a new enlarged right inguinal lymph 
+node with FDG avidity compatible concerning for relapse.  Core 
+biopsy of right inguinal lymph node on ___ was consistent 
+with NHL; intermediate grade non-Hodgkin B-cell lymphoma. She 
+appeared to have a single site of disease and it was reasonable 
+to attempt radiation salvage as her systemic options were 
+limited. This was completed on ___. Restaging in ___ 
+consistent with new PET avid periaortic node; bx consistent with 
+relapsed aggresive B cell lymphoma.
+C1 R-BAC ___ 
+
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, Hyperlipidemia {Hyperlipidemia}, esophagus {Esophageal structure}, thyroidectomy {Thyroidectomy}, multinodular hyperplasia {Multinodular hyperplasia}, Colonic {Colon structure}, hyperplastic polyps {Hyperplastic polyp}, Meniere's disease {Ménière's disease}, Degenerative disease of the lumbar spine.  {Lumbar spondylosis}, FXI deficiency {Factor XI deficiency}, Atrial fibrillation {Atrial fibrillation}, oral {Administration of drug or medicament via oral route}, anticoagulation {Anticoagulant therapy}, Lymphoma {Malignant lymphoma}, marginal zone lymphoma {Marginal zone lymphoma}, palate {Palatal structure}, excision {Excision}, radiation {Radiation oncology AND/OR radiotherapy}, mardinal zone lymphoma {Marginal zone lymphoma}, right lower extremity edema {Edema of right lower limb}, inguinal LAD {Inguinal lymphadenopathy}, Excisional biopsy {Excisional biopsy}, B cell lymphoma {B-cell lymphoma}, cell {Cell structure}, R-CHOP {Rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone chemotherapy regimen}, autologous transplant {Autogenous transplantation}, PET/CT {Positron emission tomography}, enlarged {Localized enlarged lymph nodes}, inguinal lymph 
+node {Inguinal lymph node structure}, Core 
+biopsy {Core needle biopsy}, inguinal lymph node {Inguinal lymph node structure}, NHL {Non-Hodgkin's lymphoma}, intermediate grade non-Hodgkin B-cell lymphoma {Intermediate grade B-cell lymphoma}, radiation {Radiation oncology AND/OR radiotherapy}, PET {Positron emission tomography}, B cell lymphoma {B-cell lymphoma}"
+"###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:
+Her father apparently had homozygous FXI deficiency, which 
+prompted testing in her (performed elsewhere). A niece was  
+diagnosed with a ""bad type of lymphoma.""  
+
+ 
+
+###RESPONSE: FXI deficiency {Factor XI deficiency}, lymphoma {Malignant lymphoma}"
+"###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:
+VS: T 98.8 max, now 98.3 BP 126/70 HR 62 RR 18 O2 100%
+Gen: WDWN NAD A&O x4
+HEENT: oropharynx moist, no lesions
+nodes: no LAD
+CV: RRR no m/r/g, not irregular
+LS: CTA
+Abd: soft NT -HSM +BS, no masses palpated
+Extr: no edema
+Skin: no rash
+Neuro: nonfocal, PERRLA, EOMI, no nystagmus, rapid hand 
+movements
+and truncal gait appropriate, unsteady at baseline on tandem 
+gait
+Access: POC with ecchymosis, ozzing resolved
+
+ 
+
+###RESPONSE: VS {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}, Gen {General examination of patient}, WDWN {Well nourished}, NAD {No abnormality detected}, A {Mentally alert}, O {Orientated}, HEENT {Physical examination procedure}, oropharynx {Oropharyngeal structure}, lesions {Lesion}, LAD {Lymphadenopathy}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, no m/r/g {Heart sounds normal}, irregular {Irregular heart beat}, LS {Examination of respiratory system}, CTA {Normal breath sounds}, Abd {Examination of abdomen}, soft {Abdomen soft}, NT {Abdominal tenderness}, HSM {Hepatosplenomegaly}, +BS {Normal bowel sounds}, masses {Mass}, palpated {Palpation}, Extr {Examination of limb}, edema {Edema}, Skin {Examination of skin}, rash {Eruption of skin}, Neuro {Neurological examination}, PERRLA {Pupils equal, react to light and accommodation}, EOMI {Normal ocular motility}, nystagmus {Nystagmus}, gait appropriate {Gait normal}, unsteady at baseline on tandem 
+gait {Tandem gait test - abnormal}, ecchymosis {Ecchymosis}"
+"###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:
+___ 12:11AM BLOOD WBC-2.6* RBC-2.26* Hgb-7.5* Hct-21.5* 
+MCV-95 MCH-33.3* MCHC-35.0 RDW-19.2* Plt ___
+___ 09:05AM BLOOD WBC-4.1 RBC-2.88* Hgb-9.0* Hct-27.3* 
+MCV-95 MCH-31.3 MCHC-33.0 RDW-18.2* Plt ___
+___ 12:11AM BLOOD Neuts-91.9* Lymphs-1.5* Monos-0.9* 
+Eos-5.5* Baso-0.2
+___ 09:05AM BLOOD Neuts-84* Bands-0 Lymphs-3* Monos-12* 
+Eos-0 Baso-1 ___ Myelos-0 NRBC-1*
+___ 12:11AM BLOOD Glucose-95 UreaN-16 Creat-0.7 Na-139 
+K-3.0* Cl-104 HCO3-27 AnGap-11
+___ 09:05AM BLOOD Glucose-103* UreaN-10 Creat-0.6 Na-140 
+K-3.9 Cl-105 HCO3-25 AnGap-14
+___ 12:11AM BLOOD Albumin-3.3* Calcium-7.7* Phos-4.7* 
+Mg-1.8
+___ 09:05AM BLOOD Albumin-4.0 Calcium-9.3 Phos-4.6* Mg-1.7 
+UricAcd-5.9*
+ 
+
+###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}, 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}, Baso {Basophil count}, 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}, 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}, Albumin {Albumin measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Albumin {Albumin measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total 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: Brief Hospital Course:
+___ year old female with multiply relapsed NHL
+admitted for cycle 2 of R-bendamustine cytarabine.
+
+# Lymphoma: -Rituxan 700mg IV (375mg/m2) D1
+           -Cytarabine 1540 IV (800mg/m2) D2-4
+           -Bendamustine 125mg IV (70mg/m2) D2-3
+           -Pred drops up until 48hrs after cytarabine completes
+          - IVF/antiemetics per protocol
+          - Neuro exams assessed prior to each dose of ara-c
+
+#Dyspnea: Resolved. may be combination of reactive airway flare 
+vs fluid
+overload vs URI. CXR shows some fluid, no signs of active
+infection. strict I/Os, diurese prn. resp swab PND.
+
+#Fever: non neutropenic, may be secondary to chemo vs URI. will
+send resp swab. b and u culture NTD, (u culture contaminate). 
+tylenol prn for relief.
+- fever resolved after 1 day
+
+# Nausea: supportive meds with dex, zofran pre chemo. add emend
+po D2-4. give script at d/c for zyprexa to prevent delayed n/v
+from last cycle. remind her to continue bowel regimen at d/c.
+
+# Prophylaxis: acyclovir. consider bactrim if will not be on
+coumadin.
+
+# Osteoarthritis: tramadol prn. tylenol prn for breakthrough.
+does not tolerate oxycodone-nausea. ___ evaluate, lifeline at 
+home and stable on feet. okay for safe discharge home.
+
+# Paroxysmal a fib: EKG overnight with fever on ___, rate 
+stable in
+70's, 80's. converted back with HR in 60's prior to discharge. 
+continue ___ go home with xarelto per primary 
+oncologist.
+
+# HTN: continue amlodipine with parameters
+
+# GERD: omeprazole daily
+
+# Hypothyroidism: continue synthroid daily
+
+# Hypercholestermia: hold during chemotherapy
+
+# DVT prophylaxis: restarted Lovenox after port placement, will 
+go home with xarelto
+# F/E/N: replace electrolytes prn. IVF as ordered.
+# Access: POC
+# code status Full
+# dispo: home, neulasta in clinic ___
+
+ 
+
+###RESPONSE: NHL {Non-Hodgkin's lymphoma}, Lymphoma {Malignant lymphoma}, Neuro exams {Neurological examination}, Dyspnea {Dyspnea}, Resolved {Problem resolved}, reactive airway flare {Reactive airway disease}, fluid
+overload {Hypervolemia}, URI {Upper respiratory infection}, CXR {Plain chest X-ray}, fluid {Effusion}, active
+infection {Infectious disease}, diurese {Diuresis}, swab {Taking of swab}, Fever {Fever}, neutropenic {Neutropenia}, chemo {Chemotherapy}, URI {Upper respiratory infection}, swab {Taking of swab}, b {Blood culture}, u culture {Urine culture}, (u culture {Urine culture}, fever {Fever}, resolved {Problem resolved}, Nausea {Nausea}, chemo {Chemotherapy}, n/v {Nausea and vomiting}, bowel regimen {Bowel care}, Prophylaxis {Preventive procedure}, Osteoarthritis {Osteoarthritis}, nausea {Nausea}, feet {Foot structure}, Paroxysmal a fib {Paroxysmal atrial fibrillation}, EKG {Electrocardiographic procedure}, fever {Fever}, rate 
+stable {Pulse rate stable}, HTN {Hypertensive disorder, systemic arterial}, GERD {Gastroesophageal reflux disease}, Hypothyroidism {Hypothyroidism}, Hypercholestermia {Hypercholesterolemia}, chemotherapy {Chemotherapy}, DVT prophylaxis {Prevention of deep vein thrombosis}, restarted {Restart of medication}, port placement {Insertion of implantable venous access port}, IVF {Administration of intravenous fluids}"
+"###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. Acetaminophen 650 mg PO Q6H:PRN pain 
+2. Acyclovir 400 mg PO Q8H 
+3. Amlodipine 2.5 mg PO DAILY 
+4. Fexofenadine 180 mg PO DAILY 
+5. Fluticasone Propionate NASAL ___ SPRY NU DAILY 
+6. FoLIC Acid 1 mg PO DAILY 
+7. Gabapentin 300 mg PO HS 
+8. Levothyroxine Sodium 50 mcg PO DAILY 
+9. Omeprazole 20 mg PO DAILY 
+10. Prochlorperazine 10 mg PO Q6H:PRN nausea 
+11. Sotalol 160 mg PO BID 
+12. Warfarin 2.5-5 mg PO ASDIR 
+13. Docusate Sodium 100 mg PO BID 
+14. Lorazepam 0.5-1 mg PO Q4H:PRN anxiety insomnia nausea 
+15. Polyethylene Glycol 17 g PO DAILY:PRN no bm in 24h 
+16. PrednisoLONE Acetate 1% Ophth. Susp. 2 DROP BOTH EYES QID 
+17. Senna 8.6 mg PO BID 
+18. TraMADOL (Ultram) 50 mg PO Q4H:PRN pain 
+19. Atorvastatin 20 mg PO QPM 
+20. Calcium 600 + D(3) (calcium carbonate-vitamin D3) 600 
+mg(1,500mg) -200 unit oral BID 
+21. Multivitamins 1 TAB PO DAILY 
+22. Vitamin D ___ UNIT PO DAILY 
+23. Ondansetron 8 mg PO Q8H:PRN nausea 
+
+ 
+Discharge Medications:
+1. Acetaminophen 650 mg PO Q6H:PRN pain 
+2. Acyclovir 400 mg PO Q8H 
+3. Docusate Sodium 100 mg PO BID 
+4. Fexofenadine 180 mg PO DAILY 
+5. Fluticasone Propionate NASAL ___ SPRY NU DAILY 
+6. Gabapentin 300 mg PO HS 
+7. Levothyroxine Sodium 50 mcg PO DAILY 
+8. Lorazepam 0.5-1 mg PO Q4H:PRN anxiety insomnia nausea 
+9. Omeprazole 20 mg PO DAILY 
+10. Polyethylene Glycol 17 g PO DAILY:PRN no bm in 24h 
+11. PrednisoLONE Acetate 1% Ophth. Susp. 2 DROP BOTH EYES QID 
+12. Prochlorperazine 10 mg PO Q6H:PRN nausea 
+13. Senna 8.6 mg PO BID 
+14. Sotalol 160 mg PO BID 
+15. TraMADOL (Ultram) 50 mg PO Q4H:PRN pain 
+16. Vitamin D ___ UNIT PO DAILY 
+17. Calcium 600 + D(3) (calcium carbonate-vitamin D3) 600 
+mg(1,500mg) -200 unit oral BID 
+18. FoLIC Acid 1 mg PO DAILY 
+19. Multivitamins 1 TAB PO DAILY 
+20. Ondansetron 8 mg PO Q8H:PRN nausea 
+21. Rivaroxaban 20 mg PO DAILY 
+RX *rivaroxaban [Xarelto] 20 mg 1 tablet(s) by mouth daily Disp 
+#*30 Tablet Refills:*2
+22. OLANZapine 5 mg PO HS 
+RX *olanzapine 5 mg 1 tablet(s) by mouth daily Disp #*30 Tablet 
+Refills:*0
+23. Allopurinol ___ mg PO DAILY 
+
+ 
+
+###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:
+lymphoma
+reactive airway disease
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: lymphoma {Malignant lymphoma}, reactive airway disease {Reactive airway disease}, Mental Status {Neurological mental status determination}, Clear {No abnormality detected}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, interactive {Does communicate}, 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:
+Ms. ___,
+
+You were admitted to receive chemotherapy. You tolerated this 
+well however developed worsening shortness of breath and cough 
+overnight on ___. We did a workup which was most consistent 
+with your history of asthma flare with an upper respiratory 
+infection and fluid overload. Your symptoms improved with 
+nebulizer treatment and lasix.
+
+You will follow up tomorrow in clinic to receive your neulasta 
+injection and to follow up with your outpatient team. Please do 
+not hesitate to call in the meantime with any fevers, chills, 
+worsening cough, shortness of breath, or any other concerns.
+ 
+
+###RESPONSE: chemotherapy {Chemotherapy}, shortness of breath {Dyspnea}, cough {Cough}, workup {Evaluation procedure}, asthma {Asthma}, upper respiratory 
+infection {Upper respiratory infection}, fluid overload {Hypervolemia}, improved {Patient's condition improved}, nebulizer treatment {Nebulizer therapy}, lasix {Diuretic therapy}, clinic {Outpatient care management}, injection {Injection}, fevers {Fever}, chills {Chill}, cough {Cough}, shortness of breath {Dyspnea}"
+"###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: 
+Ketorolac
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Chest pain and shortness of breath
+ 
+Major Surgical or Invasive Procedure:
+none
+
+ 
+
+###RESPONSE: Chest pain {Chest pain}, shortness of breath {Dyspnea}"
+"###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 woman from nursing facility presents with shortness 
+of breath with substernal chest pain since the morning of 
+admission.  The patient had no relief from 3 sublingual 
+nitroglycerin tablets, but got relief after receiving morphine 
+in the emergency department.  The chest pain was non-radiating 
+and ___.  She currently only complains of mild discomfort of 
+the chest.
+
+She denies fevers or chills, but did have a cough for the last 2 
+weeks productive of yellow phlegm.  She is staying at the 
+nursing facility because she is very debilitated from lower 
+extremity weakness and poor balance.  She can walk short 
+distances with a walker.  Denies orthopnea or PND.
+
+She denies headache, neck pain, abdominal pain, nausea, 
+vomiting, dysuria.  She does have urinary incontinence, but no 
+stool incontinence.  She complains of constipation.  She 
+endorses arthritic joint pain everywhere.  She does not have 
+confusion.
+ 
+
+###RESPONSE: shortness 
+of breath {Dyspnea}, substernal chest pain {Retrosternal pain}, relief after receiving morphine {Pain relieved by analgesic}, chest pain {Chest pain}, discomfort of 
+the chest {Chest discomfort}, fevers {Fever}, chills {Chill}, cough for the last 2 
+weeks productive {Productive cough}, lower 
+extremity weakness {Paresis of lower extremity}, poor balance {Poor balance}, walk short 
+distances with a walker {Does mobilize using walker}, orthopnea {Orthopnea}, headache {Headache}, neck pain {Pain radiating to neck}, abdominal pain {Abdominal pain}, nausea, 
+vomiting {Nausea and vomiting}, dysuria {Dysuria}, urinary incontinence {Urinary incontinence}, stool incontinence {Incontinence of feces}, constipation {Constipation}, joint pain {Joint pain}, confusion {Clouded consciousness}"
+"###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:
+1. CAD status post CABG in ___ with an EF of greater than 55% 
+2. Chronic Atrial fibrillation but recently in NSR, on 
+amiodarone but not on anti-coagulation
+3. Hypertension
+4. Diabetes mellitus type 2 
+5. Hypercholesterolemia
+6. Superficial spreading melanoma 
+7. Hip fracture with ORIF in ___
+8. Urinary tract infection 
+9. Thyroid disease
+10. Urinary incontinence
+11. Constipation
+12. Melanoma, locally metastatic with chemo ___
+13. Right humeral head fracture in ___
+14. s/p multiple falls 
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}, CABG {Coronary artery bypass grafting}, Chronic Atrial fibrillation {Chronic atrial fibrillation}, NSR {Normal sinus rhythm}, Hypertension {Hypertensive disorder, systemic arterial}, Diabetes mellitus type 2 {Diabetes mellitus type 2}, Hypercholesterolemia {Hypercholesterolemia}, Superficial spreading melanoma {Superficial spreading melanoma}, Hip fracture {Fracture of proximal end of femur}, ORIF {Open reduction of fracture with internal fixation}, Urinary tract infection {Urinary tract infectious disease}, Thyroid disease {Disorder of thyroid gland}, Urinary incontinence {Urinary incontinence}, Constipation {Constipation}, Melanoma {Malignant melanoma of skin}, metastatic {Metastatic malignant neoplasm}, chemo {Chemotherapy}, Right humeral head fracture {Closed fracture of capitellum of right humerus}, falls {Falls}"
+"###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:
+Non contributory
+
+ 
+
+###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:
+VS: 98.2 123/82 72 19 96% on 2L
+GEN: NAD, comfortable in bed, awake and alert
+HEENT: PERRL, EOMI, MMM, no oropharyngeal lesions
+NECK: Supple, JVP 7-8cm
+CHEST: CTAB
+CV: RRR, normal s1 and s2
+ABD: Soft, nontender, nondistended, bowel sounds present
+EXT: No lower extremity edema
+SKIN: No rash
+NEURO: CN ___ intact x mild decrease in hearing on right ear, 
+sensory intact throughout, strength ___ BUE/BLE, did not 
+ambulate patient, fluent speech
+PSYCH: Pleasant, calm
+ 
+
+###RESPONSE: VS {Vital signs finding}, GEN {General examination of patient}, NAD {No abnormality detected}, awake {Awake}, alert {Mentally alert}, HEENT {Physical examination procedure}, PERRL {Pupils equal and reacting to light}, EOMI {Normal ocular motility}, MMM {Moist oral mucosa}, lesions {Lesion}, NECK {Physical examination procedure}, Supple {Normal movement of neck}, JVP {Finding of jugular venous pressure}, CHEST {Examination of respiratory system}, CTAB {Normal breath sounds}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, normal s1 {Normal first heart sound, S>1<}, ABD {Examination of abdomen}, Soft {Abdomen soft}, nontender {Abdominal tenderness}, nondistended {Normal abdominal contour}, EXT {Examination of limb}, edema {Edema}, SKIN {Examination of skin}, rash {Eruption of skin}, NEURO {Neurological examination}, decrease in hearing on right ear, {Hearing test right abnormality}, fluent speech {Finding of fluency of speech}, PSYCH {Initial psychiatric assessment}, calm {Feeling calm}"
+"###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:
+___
+WBC-8.9 Hgb-12.7 Hct-38.5 MCV-88 Plt ___
+Neuts-72.2* ___ Monos-5.0 Eos-1.8 Baso-0.8
+
+___ PTT-28.4 ___
+
+Glucose-236* UreaN-36* Creat-1.1 Na-142 K-4.1 Cl-99 HCO3-32 
+AnGap-15
+
+CK(CPK)-62 cTropnT-0.06* proBNP-2636*
+
+URINE Color-Straw Appear-Clear Sp ___ Blood-NEG 
+Nitrite-NEG Protein-NEG Glucose-NEG Ketone-NEG Bilirub-NEG 
+Urobiln-NEG pH-5.0 Leuks-NEG
+
+CXR IMPRESSION: 
+Left lower lobe consolidation, possibly atelectasis but 
+infection 
+is not excluded. Small bilateral pleural effusions. 
+
+ 
+
+###RESPONSE: WBC {White blood cell count}, Hgb {Measurement of total hemoglobin concentration}, Hct {Hematocrit determination}, MCV {Erythrocyte mean corpuscular volume determination}, Monos {Monocyte count}, Eos {Eosinophil count}, Baso {Basophil count}, PTT {Partial thromboplastin time, activated}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, HCO3 {Blood bicarbonate measurement}, cTropnT {Troponin T cardiac measurement}, proBNP {N-terminal pro-brain natriuretic peptide measurement}, URINE Color-Straw {Normal urine color}, Protein {Measurement of protein in urine}, Glucose {Glucose measurement, blood}, Ketone {Urinalysis, acetone or ketone bodies measurement}, pH {pH measurement}, CXR {Plain chest X-ray}, Left lower lobe consolidation {Lung consolidation}, atelectasis {Atelectasis}, infection {Infectious disease}, pleural effusion {Pleural effusion}"
+"###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 woman admitted with chest pain and shortness of 
+breath with evidence of possible PNA on CXR. The patient 
+received Vancomycin and Levaquin in the ED for possible 
+pneumonia and Lasix 10mg IV for possible congestive heart 
+failure. During her hospital course, her presentation was less 
+consistent with congestive heart failure, furthermore she does 
+not have a history of heart failure. She was ruled out for 
+cardiac ischemia or arrythmia. Her symptoms are thought to be 
+related to mild pneumonia versus bronchitis. Throughout her stay 
+her vital signs were stable and she never required supplemental 
+oxygen. We increased her long acting Isosorbide mononitrate to 
+60 mg daily for better blood pressure control. She will need to 
+finish a 7 day course of Levofloxacin. She was seen by 
+cardiology in consultation, who felt that her chest pain may be 
+cardiac, but they recommended medical management at present (in 
+the absence of elevated cardiac enzymes and EKG changes) with 
+potential additional diagnostics (e.g. stress test) to be 
+pursued as an outpatient. She will need follow up with 
+cardiology, and a new echocardiogram. Both of these should be 
+scheduled by the rehab facility, as we could not make these 
+appointments over the weekend.  
+
+Her daytime blood sugars were high on multiple occasions. She 
+may benefit from oral anti-diabetic regiment, which could be 
+considered as outpatient. All her other chronic medical problems 
+were stable, and required no change in her treatment plan.  
+
+During this hospitalization she expressed the wish to be 
+DNR/DNI.
+ 
+
+###RESPONSE: chest pain {Chest pain}, shortness of 
+breath {Dyspnea}, PNA {Pneumonia}, CXR {Plain chest X-ray}, pneumonia {Pneumonia}, congestive heart 
+failure {Congestive heart failure}, congestive heart failure {Congestive heart failure}, heart failure {Heart failure}, cardiac ischemia {Myocardial ischemia}, arrythmia {Cardiac arrhythmia}, pneumonia {Pneumonia}, bronchitis {Bronchitis}, vital signs were stable {Normal vital signs}, consultation {Consultation}, chest pain {Chest pain}, cardiac {Heart disease}, elevated cardiac enzymes {Finding of cardiac enzyme levels}, EKG changes {Electrocardiogram abnormal}, stress test {Electrocardiogram with exercise test}, follow up with 
+cardiology {Follow-up cardiac assessment}, echocardiogram {Echocardiography}, blood sugars {Glucose measurement, blood}, oral {Administration of drug or medicament via oral route}, regiment {Therapeutic regimen}, problems {Problem}, stable {Patient's condition stable}"
+"###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:
+Levothyroxine 50mcg daily
+Aspirin 325mg daily
+Cyanocobalamin 1000mcg injection qmonth
+Senna 8.6mg 2 tabs daily
+Plavix 75mg daily
+Lisinopril 5mg daily
+Digoxin 0.125mg daily
+Metoprolol ER 100mg BID
+Isosorbide mononitrate 30mg daily
+Lidoderm 5% patch to knee 9am, remove at 9pm
+Bumetanide 2mg qam, 1mg qpm
+Glimepiride 2mg daily
+Crestor 10mg daily
+Sliding scale insulin
+Albuterol/Atrovent nebs prn
+ 
+Discharge Medications:
+1. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+2. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+3. Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for 
+Nebulization Sig: One (1) Nebulization Inhalation Q6H (every 6 
+hours) as needed for Bronchospasm.  
+4. Ipratropium Bromide 0.02 % Solution Sig: One (1) Inhalation 
+Inhalation Q6H (every 6 hours) as needed for wheezing.  
+5. Senna 8.6 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+6. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 
+times a day).  
+7. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) 
+Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed for 
+Constipation.  
+8. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 
+6 hours) as needed for Pain: please give prior to ambulation for 
+left ankle pain.  
+9. Levothyroxine 50 mcg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+10. Lisinopril 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 
+ 
+11. Digoxin 125 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 
+ 
+12. Metoprolol Succinate 100 mg Tablet Sustained Release 24 hr 
+Sig: One (1) Tablet Sustained Release 24 hr PO BID (2 times a 
+day).  
+13. Lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: 
+Two (2) Adhesive Patch, Medicated Topical DAILY (Daily): Apply 
+to one to right knee and one to left ankle at 9am, remove at 9pm 
+daily. 
+.  
+14. Rosuvastatin 5 mg Tablet Sig: Two (2) Tablet PO DAILY 
+(Daily).  
+15. Insulin Regular Human 100 unit/mL Solution Sig: as directed 
+per standard insulin sliding scale 1 to 12 Injection ASDIR (AS 
+DIRECTED).  
+16. Isosorbide Mononitrate 30 mg Tablet Sustained Release 24 hr 
+Sig: Two (2) Tablet Sustained Release 24 hr PO DAILY (Daily).  
+17. Levofloxacin 250 mg Tablet Sig: Three (3) Tablet PO Q48H 
+(every 48 hours) for 4 days.  
+18. Polyethylene Glycol 3350 17 gram/dose Powder Sig: One (1) 
+pack PO DAILY (Daily) as needed for constipation.  
+19. Guaifenesin 100 mg/5 mL Syrup Sig: ___ MLs PO Q6H (every 6 
+hours) as needed for cough.  
+20. Benzonatate 100 mg Capsule Sig: One (1) Capsule PO TID (3 
+times a day) for 5 days.  
+
+ 
+
+###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:
+Pneumonia
+Chest pain
+Secondary:
+Coronoray artery disease, Chronic Atrial fibrillation, 
+Hypertension, Diabetes mellitus type 2, Hypercholesterolemia, 
+Constipation
+
+ 
+Discharge Condition:
+Pain free, oxygen saturation 96% on RA
+
+ 
+
+###RESPONSE: Pneumonia {Pneumonia}, Chest pain {Chest pain}, Coronoray artery disease {Coronary arteriosclerosis}, Chronic Atrial fibrillation {Chronic atrial fibrillation}, Hypertension {Hypertensive disorder, systemic arterial}, Diabetes mellitus type 2 {Diabetes mellitus type 2}, Hypercholesterolemia {Hypercholesterolemia}, Constipation {Constipation}, Pain free {No present 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: Discharge Instructions:
+You were admitted with chest pain and cough. You are being 
+treated for mild lung infection and will need to continue taking 
+your antibiotic as prescribed. We evaluated you also for any 
+heart problem, however could not find any abnormality with your 
+heart. You will need a follow up appointment scheduled with your 
+cardiologist as an outaptient for ongoing managment of your 
+congestive heart failure.
+
+We increased your Isosorbid mononitrate to 60 mg daily
+you need to continue taking Levofloxacine for 4 more days (Q48H)
+ 
+ 
+
+###RESPONSE: chest pain {Chest pain}, cough {Cough}, lung infection {Infectious disease of lung}, antibiotic {Antibiotic therapy}, heart {Heart structure}, abnormality {No abnormality detected}, heart {Heart structure}, congestive heart failure {Congestive heart failure}"
+"###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: ___
+ 
+
+###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:
+fever, respiratory distress
+ 
+Major Surgical or Invasive Procedure:
+Intubation ___
+Extubation ___ 
+
+ 
+
+###RESPONSE: No Known Allergies {Allergic disposition}, Adverse Drug Reactions {Propensity to adverse reactions to drug}, fever {Fever}, respiratory distress {Respiratory distress}, Intubation {Insertion of endotracheal tube}, Extubation {Removal of endotracheal tube}"
+"###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:
+This is a ___ male with history of Alzheimer's,
+previously on hospice care (recently discharged), who presents
+with respiratory distress. Patient is nonverbal at baseline and
+significantly altered and unable to provide additional history.
+Today wife felt that he was increasingly sleepy and brought him
+here for evaluation. He had a fever last night. Seen by ___ visiting clinician on ___ for aspiration/pneumonia, 
+for
+which he received 10 day course of levofloxacin. Wife states he
+has not had a cough but he has been having noisy breathing. No
+vomiting or diarrhea. As he is nonverbal he has not been able to
+articulate any specific complaints.
+
+In the ED, patient minimally responsive on initial evaluation 
+and
+hypoxic to the mid ___ on room air. He had difficulty increasing
+oxygenation with nonrebreather and patient was too altered to
+tolerate BiPAP. Therefore he was intubated. Received 3L LR,
+vancomycin and cefepime in the ED. Chest x-ray suggestive of
+aspiration pneumonia. WBC elevated and Hct/Hgb suggested
+significant hemoconcentration.
+
+On my evaluation, patient was intubated and unable to 
+participate
+in history. He has previously had MOLST form with DNR/DNI
+completed ___. Per daughter, currently DNR/ok to intubate.
+
+In the ED, initial vitals: T100.8 HR139 BP145/94 RR20 SpO2 90%
+nrb  
+
+Exam:  
+General: Seated in bed, minimally responsive
+Head/eyes: Normocephalic/atraumatic. Pupils equal round and
+reactive to light.
+ENT/neck: Dry mucous membranes
+Chest/Resp: Tachypnea, poor air movement, rhonchorous
+Cardiovascular: Tachycardic, regular
+GI/abdominal: Soft, nondistended
+Musc/Extr/Back: No peripheral edema. 
+Skin: Warm and dry
+Psych: Poor mentation
+
+Labs:  Na 150  Cl 110  BUN34  Glu189  K4.0  Bicarb23  Cr1.2  
+AGap=17 
+Ca: 10.3 Mg: 2.7 P: 2.7
+ALT: 21 AP: 87 Tbili: 0.7 Alb: 3.8 
+AST: 15  Lip: 13     
+WBC 27.9  Hgb17.7/Hct 54.8 Plt326 
+Flu negative
+
+Imaging: 
+CXR ___: Lower lung opacities concerning for pneumonia versus
+the sequelae of aspiration. Possible pulmonary vascular
+congestion. 
+
+Consults: None 
+
+Interventions:  Intubation
+
+VS Prior to Transfer: T98.9 HR80 BP93/62 RR16 SpO296% Intubation 
+
+
+ROS: Positives as per HPI; otherwise negative.  
+ 
+
+###RESPONSE: Alzheimer {Alzheimer's disease}, hospice care {Hospice care}, discharged {Discharge from hospice}, respiratory distress {Respiratory distress}, nonverbal {Does not speak}, baseline {Baseline state}, sleepy {Drowsy}, evaluation {Evaluation procedure}, fever {Fever}, aspiration {Aspiration pneumonia}, pneumonia {Pneumonia}, levofloxacin {Antibiotic therapy}, cough {Cough}, noisy breathing {Noisy respiration}, vomiting {Vomiting}, diarrhea {Diarrhea}, nonverbal {Does not speak}, evaluation {Evaluation procedure}, hypoxic {Hypoxia}, on room air {Breathing room air}, oxygenation with nonrebreather {Oxygen administration by mask}, BiPAP {Bilevel positive airway pressure titration}, intubated {Insertion of endotracheal tube}, vancomycin {Antibiotic therapy}, Chest x-ray {Plain chest X-ray}, aspiration pneumonia {Aspiration pneumonia}, WBC elevated {White blood cell count outside reference range}, Hct {Hematocrit determination}, Hgb {Measurement of total hemoglobin concentration}, evaluation {Evaluation procedure}, intubated {Insertion of endotracheal tube}, DNR {Not for resuscitation}, DNR {Not for resuscitation}, vitals {Vital signs finding}, nrb {Oxygen administration by mask}, General {General examination of patient}, Seated {Sitting position}, Head/eyes {Physical examination procedure}, Normocephalic {Normal head}, atraumatic {No injuries apparent}, Pupils equal round and
+reactive to light {Pupils equal and reacting to light}, ENT/neck {Physical examination procedure}, Dry mucous membranes {Mucous membrane dryness}, Chest {Thoracic structure}, Resp {Examination of respiratory system}, Tachypnea {Tachypnea}, rhonchorous {Wheeze - rhonchi}, Cardiovascular {Cardiovascular physical examination}, Tachycardic {Tachycardia}, regular {Normal heart rate}, GI {Examination of digestive system}, abdominal {Examination of abdomen}, Soft {Abdomen soft}, nondistended {Normal abdominal contour}, Musc {Examination of muscle power}, Extr {Examination of limb}, peripheral edema {Peripheral edema}, Skin {Examination of skin}, Warm {Warm skin}, dry {Xeroderma}, Psych {Neurological mental status determination}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, WBC {White blood cell count}, Hct {Hematocrit determination}, Flu {Influenza}, Imaging {Imaging}, CXR {Plain chest X-ray}, Lower lung {Structure of lower lobe of lung}, opacities {Abnormally opaque structure}, pneumonia {Pneumonia}, sequelae {Sequelae of disorders}, aspiration {Aspiration pneumonia}, pulmonary vascular {Structure of pulmonary blood vessel}, congestion {Congestion}, Intubation {Insertion of endotracheal tube}, VS {Vital signs finding}, Intubation {Insertion of endotracheal tube}"
+"###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:
+Essential hypertension 
+Hypercholesteremia 
+Early onset Alzheimer's disease with behavioral disturbance 
+Aspiration pneumonia of both lower lobes 
+Slow transit constipation 
+ 
+
+###RESPONSE: Essential hypertension {Essential hypertension}, Hypercholesteremia {Hypercholesterolemia}, Early onset Alzheimer's disease with behavioral disturbance {Early onset Alzheimer's disease with behavioral disturbance}, Aspiration pneumonia {Aspiration pneumonia}, lower lobes {Structure of lower lobe of lung}, Slow transit constipation {Slow transit constipation}"
+"###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:
+Noncontributory
+ 
+
+###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:
+ADMISSION PHYSICAL EXAM: 
+======================== 
+VS: Reviewed in Metavision, HR 78 BP 93/64, SpO2 96%, RR 15 
+GEN: Intubated, sedated 
+EYES: Pupils equal and nonreactive  
+HENNT: Intubated, trachea midline 
+CV: RRR, no m/r/g
+RESP:  Mechanical breath sounds 
+GI: Bowel sounds present 
+MSK: No gross deformity, warm extremities 
+SKIN: No rashes or skin breakdown  
+NEURO: Intubated and sedated 
+PSYCH: Unable to assess 
+
+DISCHARGE PHYSICAL EXAM:
+========================
+Not examined fully as he is CMO; appeared comfortable, without 
+labored or rapid respirations. No response to voice or touch. No 
+grimacing, restlessness, or obvious signs of distress.
+
+ 
+
+###RESPONSE: PHYSICAL EXAM {Physical examination procedure}, VS {Vital signs finding}, HR {Finding of heart rate}, BP {Blood pressure finding}, RR {Finding of rate of respiration}, GEN {General examination of patient}, Intubated {Insertion of endotracheal tube}, sedated {Sedated}, EYES {Ophthalmic examination and evaluation}, Pupils equal {Pupils equal}, NT {Abdominal tenderness}, Intubated {Insertion of endotracheal tube}, trachea {Tracheal structure}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, no m/r/g {Heart sounds normal}, RESP {Examination of respiratory system}, GI {Examination of digestive system}, Bowel sounds present {Normal bowel sounds}, MSK {Musculoskeletal system physical examination}, deformity {Deformity}, warm {Warm skin}, SKIN {Examination of skin}, rashes {Eruption of skin}, skin breakdown {Broken skin}, NEURO {Neurological examination}, Intubated {Insertion of endotracheal tube}, sedated {Sedated}, PSYCH {Neurological mental status determination}, appeared comfortable {Comfortable appearance}, labored {Labored breathing}, rapid respirations {Tachypnea}, response to voice {Responds to voice}, touch {Finding of sensation of touch}, grimacing {Facial grimacing}, restlessness {Restlessness}, signs {Sign}, distress {Distress}"
+"###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: 
+===============
+___ 05:30PM BLOOD WBC-27.9* RBC-5.73 Hgb-17.7* Hct-54.8* 
+MCV-96 MCH-30.9 MCHC-32.3 RDW-13.5 RDWSD-47.8* Plt ___
+___ 05:30PM BLOOD Neuts-90.4* Lymphs-3.2* Monos-4.2* 
+Eos-0.0* Baso-0.4 Im ___ AbsNeut-25.18* AbsLymp-0.89* 
+AbsMono-1.18* AbsEos-0.00* AbsBaso-0.12*
+___ 05:59PM BLOOD ___ PTT-32.7 ___
+___ 05:30PM BLOOD Glucose-189* UreaN-34* Creat-1.2 Na-150* 
+K-4.0 Cl-110* HCO3-23 AnGap-17
+___ 05:30PM BLOOD ALT-21 AST-15 AlkPhos-87 TotBili-0.7
+___ 05:30PM BLOOD Lipase-13
+___ 05:30PM BLOOD Albumin-3.8 Calcium-10.3 Phos-2.7 Mg-2.7*
+___ 10:15AM BLOOD Triglyc-156*
+___ 06:37PM BLOOD Type-ART pO2-155* pCO2-29* pH-7.48* 
+calTCO2-22 Base XS-0
+___ 05:34PM BLOOD Lactate-2.3*
+
+LAST SET OF LABS BEFORE ___ MADE CMO (___):
+==============================================
+___ 11:53AM BLOOD WBC-8.7 RBC-3.71* Hgb-11.6* Hct-35.8* 
+MCV-97 MCH-31.3 MCHC-32.4 RDW-13.0 RDWSD-45.8 Plt ___
+___ 04:03AM BLOOD Glucose-85 UreaN-11 Creat-0.5 Na-141 
+K-4.2 Cl-111* HCO3-21* AnGap-9*
+___ 04:03AM BLOOD Calcium-8.3* Phos-3.7 Mg-2.3
+
+MICRO:
+======
+__________________________________________________________
+___ 7:24 pm SPUTUM      Source: Endotracheal. 
+
+                            **FINAL REPORT ___
+
+   GRAM STAIN (Final ___: 
+      >25 PMNs and <10 epithelial cells/100X field. 
+      NO MICROORGANISMS SEEN. 
+
+   RESPIRATORY CULTURE (Final ___: 
+      Commensal Respiratory Flora Absent. 
+      YEAST.    SPARSE GROWTH. 
+__________________________________________________________
+___ 8:00 am MRSA SCREEN      Source: Nasal swab. 
+
+                            **FINAL REPORT ___
+
+   MRSA SCREEN (Final ___:    No MRSA isolated. 
+__________________________________________________________
+___ 5:49 pm BLOOD CULTURE
+
+                            **FINAL REPORT ___
+
+   Blood Culture, Routine (Final ___:    NO GROWTH. 
+__________________________________________________________
+___ 5:30 pm BLOOD CULTURE
+
+                            **FINAL REPORT ___
+
+   Blood Culture, Routine (Final ___:    NO GROWTH. 
+
+IMAGING:
+========
+___ Imaging CHEST (PORTABLE AP) 
+1.  ET tube terminates 5.7 cm above the carina.  Consider slight 
+advancement for more optimal positioning.  OG tube positioned 
+appropriately. 
+2.  Lower lung opacities concerning for pneumonia versus the 
+sequelae of 
+aspiration.  Possible pulmonary vascular congestion. 
+
+___ Imaging CHEST (PORTABLE AP) 
+Lungs are low volume with bibasilar atelectasis.  Mild 
+interstitial edema is unchanged.  Support lines and tubes are 
+stable.  Cardiomediastinal silhouette is also unchanged.  Small 
+bilateral effusions left greater than right are unchanged.  No 
+pneumothorax is seen. 
+
+___-SPINE W/O CONTRAST 
+1. No evidence of acute fracture or malalignment. 
+2. Mild cervical spondylosis. 
+
+___ Imaging CT HEAD W/O CONTRAST 
+1. No evidence of an acute intracranial abnormality. 
+2. Severe parenchymal atrophy. 
+
+ 
+
+###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}, 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}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, Albumin {Administration of albumin}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Triglyc {Triglycerides measurement}, pH {pH 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}, BLOOD 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}, GRAM STAIN {Gram stain method}, cells {Cell structure}, RESPIRATORY CULTURE {Respiratory microbial culture}, MRSA SCREEN {Multi-resistant staphylococcus aureus screening}, Nasal {Nasal structure}, MRSA SCREEN {Multi-resistant staphylococcus aureus screening}, BLOOD CULTURE {Blood culture}, Blood Culture {Blood culture}, BLOOD CULTURE {Blood culture}, Blood Culture {Blood culture}, Imaging {Imaging}, CHEST (PORTABLE AP {Plain x-ray of chest anteroposterior view}, carina {Structure of carina of trachea}, for more optimal positioning {Checking position of endotracheal tube}, OG tube positioned {Checking position of nasogastric tube using X-ray}, Lower lung {Structure of lower lobe of lung}, opacities {Abnormally opaque structure}, pneumonia {Pneumonia}, sequelae {Sequelae of disorders}, aspiration {Aspiration pneumonia}, pulmonary vascular {Structure of pulmonary blood vessel}, congestion {Congestion}, Imaging {Imaging}, CHEST (PORTABLE AP {Plain x-ray of chest anteroposterior view}, Lungs {Lung structure}, low volume {Decreased size}, bibasilar {Structure of base of lung}, atelectasis {Atelectasis}, Mild {Symptom mild}, interstitial edema {Edema}, Small {Symptom mild}, bilateral effusions {Bilateral pleural effusion}, left {Left pleura structure}, right {Right pleura structure}, pneumothorax {Pneumothorax}, SPINE {Computed tomography of spine}, W/O CONTRAST {Computed tomography without contrast}, No evidence {No abnormality detected}, fracture {Fracture}, malalignment {Misalignment}, Mild {Symptom mild}, cervical spondylosis {Cervical spondylosis}, Imaging {Imaging}, CT HEAD W/O CONTRAST {Computed tomography of head without contrast}, No evidence {No abnormality detected}, intracranial {Intracranial structure}, abnormality {No abnormality detected}, atrophy {Atrophy}"
+"###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:
+Patient is ___ male with history of severe Alzheimer's, 
+previously on hospice who presented with respiratory failure 
+requiring urgent intubation. The patient's family was present 
+for goals of care discussion, and it was ultimately decided to 
+transition to comfort-focused care with hospice.
+
+ACUTE PROBLEMS:
+===============
+# Hypoxemic respiratory failure
+The patient was brought in from home with increasing somnolence, 
+cough, and labored breathing. He was hypoxemic to the ___ on 
+arrival to the emergency room. He was started on IV vancomycin 
+and cefepime. CXR suggested aspiration pneumonia. He was 
+intubated and transferred to the intensive care unit. The ICU 
+team discussed goals of care with the patient's family, who 
+decided that the patient would not want to be on a ventilator. 
+He was extubated and transferred to the general floor for 
+comfort care. Subsequent respiratory distress was management 
+with IV morphine gtt and then SL liquid morphine.
+
+# Hypovolemic hypernatremia
+Patient was given IV fluids with subsequent improvement.
+
+# Myoclonus
+# Encephalopathy
+Patient has dementia and is non-verbal at baseline, with acutely 
+worsened mental status in setting of infection. He was found to 
+have clonus of the extremities. Head CT and CT-spine were 
+unremarkable. There was low concern for seizures per neurology. 
+
+# Goals of care
+The patient was previously on hospice prior to this admission. 
+Due to respiratory failure, the family decided to change the 
+patient's code status to DNR/DNI, comfort care, with plan for 
+home hospice. The patient was maintained on oral morphine and 
+Ativan for comfort. 
+
+========================
+TRANSITIONAL ISSUES
+========================
+[ ] Patient is discharged to home hospice with scripts for 
+morphine and Ativan as needed for comfort.
+
+[x] The patient is safe to discharge today, and I spent [x] 
+<30min; [ ] >30min in discharge day management services.
+
+___, MD
+___
+Pager ___
+ 
+
+###RESPONSE: Alzheimer {Alzheimer's disease}, hospice {Hospice care}, respiratory failure {Respiratory failure}, intubation {Insertion of endotracheal tube}, discussion {Discussion}, hospice {Hospice care}, Hypoxemic respiratory failure {Hypoxemic respiratory failure}, somnolence {Drowsy}, cough {Cough}, labored breathing {Labored breathing}, hypoxemic {Hypoxemia}, IV {Administration of drug or medicament via intravenous route}, vancomycin {Antibiotic therapy}, CXR {Plain chest X-ray}, aspiration pneumonia {Aspiration pneumonia}, intubated {Insertion of endotracheal tube}, transferred to the intensive care unit {Patient transfer to intensive care unit}, extubated {Removal of endotracheal tube}, comfort care {Comfort measures}, respiratory distress {Respiratory distress}, IV {Administration of drug or medicament via intravenous route}, SL {Administration of substance via sublingual route}, liquid {Liquid}, Hypovolemic {Hypovolemia}, hypernatremia {Hypernatremia}, given IV fluids {Administration of intravenous fluids}, improvement {Patient's condition improved}, Myoclonus {Myoclonus}, Encephalopathy {Disorder of brain}, dementia {Dementia}, non-verbal {Does not speak}, baseline {Baseline state}, worsened mental status {Altered mental status}, infection {Infectious disease}, clonus {Clonus}, extremities {Limb structure}, Head CT {Computed tomography of head}, CT-spine {Computed tomography of spine}, unremarkable {No abnormality detected}, seizures {Seizure}, hospice {Hospice care}, respiratory failure {Respiratory failure}, DNR {Not for resuscitation}, comfort care {Comfort measures}, home hospice {Referral to hospice at home service}, oral {Administration of drug or medicament via oral route}, hospice {Referral to hospice at home 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: Medications on Admission:
+The Preadmission Medication list is accurate and complete.
+1. Torsemide 5 mg PO DAILY 
+2. Guaifenesin-CODEINE Phosphate ___ mL PO Q6H:PRN cough 
+3. Hyoscyamine 0.125 mg PO QID:PRN secretions 
+4. amLODIPine 10 mg PO DAILY 
+5. Pravastatin 20 mg PO QPM 
+6. Lisinopril 2.5 mg PO DAILY 
+7. Hydrochlorothiazide 25 mg PO DAILY 
+8. Donepezil 10 mg PO QHS 
+
+ 
+Discharge Medications:
+1.  Acetaminophen 1000 mg PO Q8H:PRN Pain - Mild/Fever  
+2.  Atropine Sulfate 1% ___ DROP SL Q4H:PRN excess secretions  
+3.  Glycopyrrolate 0.1-0.2 mg IV Q4H:PRN excess secretions  
+4.  LORazepam Oral Solution 0.5 mg PO Q6H:PRN agitation, anxiety 
+
+RX *lorazepam 2 mg/mL 0.25 ml by mouth Once every six hours 
+Refills:*0 
+5.  Morphine Sulfate (Concentrated Oral Solution) 20 mg/mL ___ 
+mg SL Q2H:PRN respiratory distress, pain 
+RX *morphine concentrate 100 mg/5 mL (20 mg/mL) 0.75-1.0 ml by 
+mouth Once every two hours Refills:*0 
+6.  Scopolamine Patch 1 PTCH TD Q72H  
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+PRIMARY:
+-Aspiration pneumonia
+-Acute hypoxemic respiratory failure 
+
+ 
+Discharge Condition:
+Mental Status: Confused - always.
+Level of Consciousness: Lethargic and not arousable.
+Activity Status: Bedbound.
+
+ 
+
+###RESPONSE: With Service {Referral to hospice at home service}, Aspiration pneumonia {Aspiration pneumonia}, Acute hypoxemic respiratory failure {Acute hypoxemic respiratory failure}, Mental Status {Neurological mental status determination}, Confused {Clouded consciousness}, Level of Consciousness {Assessment of consciousness level}, Lethargic {Lethargy}, Activity Status {Physical functional dependency}, Bedbound {Bed-ridden}"
+"###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. ___ and ___,  
+
+It was a pleasure caring for you at ___ 
+___.  
+
+WHY WERE YOU IN THE HOSPITAL?  
+- You were admitted to the hospital for difficulty breathing.
+
+WHAT HAPPENED WHEN YOU WERE IN THE HOSPITAL? 
+- You had a breathing tube placed and were connected to a 
+ventilator for your difficulty breathing.
+- Your family decided to remove the breathing tube and focus on 
+making you comfortable.  
+- You were connected with hospice care and arrangements were 
+made for you to go home on hospice.
+
+WHAT SHOULD YOU DO AFTER YOU LEAVE THE HOSPITAL?  
+- Enjoy spending time with your family and loved ones.
+ 
+Sincerely,  
+
+Your ___ Team
+ 
+
+###RESPONSE: difficulty breathing {Difficulty breathing}, breathing tube placed {Insertion of endotracheal tube}, ventilator {Ventilator care}, difficulty breathing {Difficulty breathing}, remove the breathing tube {Removal of endotracheal tube}, hospice care {Hospice care}, hospice {Referral to hospice at home 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: 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: 
+No Known Allergies / Adverse Drug Reactions
+ 
+Attending: ___.
+ 
+Chief Complaint:
+dyspnea, wheezing
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: dyspnea {Dyspnea}, wheezing {Wheezing}"
+"###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 ___ pMHx COPD, asthma, GERD, and metastatic
+carcinoma to the brain of unknown origin s/p resection and WBRT
+in ___ who presents with dyspnea/wheezing.   
+
+She states that she has had 2 weeks of progressive SOB which
+began with 1 week of URI-type symptoms. She states that she has
+had a new productive cough over the past week as well.  She is
+normally on 10 mg prednisone daily for her severe COPD, but 
+given
+her respiratory symptoms, she self-increased her daily 
+prednisone
+to 20 mg daily last week.  She has not had any fevers.  On day 
+of
+presentation, she states that she was at a barbeque outdoors 
+with
+significant pollen exposure (an environmental allergy for her)
+after which she became severely dyspneic.  She was brought by
+ambulance who noted that the patient was only able to speak 2
+word sentences at a timje.  
+
+Upon arrival to the ED, initial VS 99, 100, 160/90, 24, 94% on
+RA.  Her O2sats dropped to the upper ___ on RA while in the ED. 
+Initial labs showed wnl chemistries, WBC 10.2, Hgb 14.6.  CXR
+showed no focal consolidations.  The patient was given IV
+methylpred x 1, azithromycin, and duonebs prior to transfer to
+the floor.
+
+Upon arrival to the floor, the patient reports ongoing wheezing
+and no significant improvement of her respiratory symptoms after
+receiving IV methylpred in the ED. She states some abdominal 
+pain
+associated with cough.  She has no other acute medical
+complaints.
+ 
+Review of Systems:  
+(+) per HPI  
+(-) fever, chills, night sweats, headache, vision changes,
+rhinorrhea, congestion, sore throat, chest pain, abdominal pain,
+nausea, vomiting, diarrhea, constipation, BRBPR, melena,
+hematochezia, dysuria, hematuria.  
+ 
+ 
+
+###RESPONSE: COPD {Chronic obstructive lung disease}, asthma {Asthma}, GERD {Gastroesophageal reflux disease}, metastatic
+carcinoma to the brain {Metastatic malignant neoplasm to brain}, resection {Excision}, dyspnea {Dyspnea}, wheezing {Wheezing}, SOB {Dyspnea}, URI {Upper respiratory infection}, productive cough {Productive cough}, COPD {Chronic obstructive lung disease}, respiratory {Respiratory function finding}, fevers {Fever}, environmental allergy {Environmental allergy}, dyspneic {Dyspnea}, only able to speak 2
+word sentences at a timje {Difficulty talking}, VS {Vital signs finding}, RA {Breathing room air}, RA {Breathing room air}, wnl {No abnormality detected}, WBC {White blood cell count}, Hgb {Measurement of total hemoglobin concentration}, CXR {Plain chest X-ray}, consolidations {Consolidation}, IV {Administration of drug or medicament via intravenous route}, wheezing {Wheezing}, improvement {Patient's condition improved}, respiratory symptoms {Respiratory function finding}, IV {Administration of drug or medicament via intravenous route}, abdominal 
+pain {Abdominal pain}, cough {Cough}, Review of Systems {Review of systems}, fever {Fever}, chills {Chill}, night sweats {Night sweats}, headache {Headache}, vision changes {Visual disturbance}, rhinorrhea {Nasal discharge}, congestion {Nasal congestion}, sore throat {Sore throat}, chest pain {Chest pain}, abdominal pain {Abdominal pain}, nausea, vomiting, diarrhea {Nausea, vomiting and diarrhea}, constipation {Constipation}, BRBPR {Hematochezia}, melena {Melena}, hematochezia {Hematochezia}, dysuria {Dysuria}, hematuria {Blood in urine}"
+"###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:
+(per chart, confirmed with pt):
+- Asthma since childhood and COPD (multiple asthma attacks, 
+previously seen by Dr. ___ ___ FEV1 71% 
+predicted, FEV/FVC 46%, now follows with Dr. ___ 
+- Bipolar disorder (history of delusions of parasitosis and 
+depression, on SSI, resultant rash from scratching)
+- Brain Metastases  (dx in ___ with headaches;, MRI showed 2.4 
+
+x 1.1 cm size mass in the intraaxial location with surrounding 
+edema, consistent with metastatic disease; s/p left occipital 
+craniotomy and excision of the tumor on ___ Path showed 
+metastatic poorly differentiated carcinoma with unclear etiology 
+
+for a primary; ___ whole brain XRT; ___hest 
+with new speculated RUL nodule and enlarged lymph node, 
+enlarging on PET CT on ___
+- knee pain
+- recommended many times to have EGD and ___, pt declines 
+- GERD 
+- Substance abuse (crack cocaine)
+ 
+
+###RESPONSE: Asthma {Asthma}, childhood {Childhood}, COPD {Chronic obstructive lung disease}, asthma attacks {Exacerbation of asthma}, Bipolar disorder {Bipolar disorder}, delusions of parasitosis {Delusions of parasitosis}, depression {Depressive disorder}, rash {Eruption of skin}, Brain Metastases {Metastatic malignant neoplasm to brain}, headaches {Headache}, MRI {Magnetic resonance imaging of head}, mass {Mass}, edema {Edema}, metastatic disease {Metastatic malignant neoplasm}, left occipital {Left occipital lobe structure}, craniotomy {Craniotomy}, excision {Excision}, tumor {Neoplasm}, metastatic {Metastatic malignant neoplasm}, poorly differentiated carcinoma {Poorly differentiated carcinoma}, brain {Brain structure}, XRT {X-ray beam therapy}, RUL {Structure of upper lobe of right lung}, nodule {Nodule}, enlarged lymph node {Lymphadenopathy}, PET CT {Positron emission tomography}, knee pain {Pain of knee region}, EGD {Esophagogastroduodenoscopy}, GERD {Gastroesophageal reflux disease}, Substance abuse {Substance 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: 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:
+Aunt with lupus. Mother had lung cancer, sarcoid. Father with
+diabetes.  Brother hit by car.
+ 
+
+###RESPONSE: lupus {Lupus erythematosus}, lung cancer {Malignant tumor of lung}, sarcoid {Sarcoidosis}"
+"###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:
+Vitals- 98.9 PO 131 / 94 R ___
+GENERAL: well-appearing , appears comfortable, minimal increased 
+WOB with ambulation, able to speak in full sentences
+HEENT: MMM, NCAT, EOMI, anicteric sclera
+CARDIAC: Regular rhythm, normal rate, no murmurs/rubs/gallops. 
+No JVD.
+RESP: decreased air entry bilaterally, scattered wheeze 
+bilaterally, no accessory muscle 
+ABDOMEN:  soft, NTND, normoactive bowel sounds
+EXTREMITIES: wwp, no pitting edema of BLE
+SKIN: no rash or lesions
+NEUROLOGIC: AOx3, wnl gait, grossly nonfocal.
+ 
+
+###RESPONSE: Vitals {Vital signs finding}, GENERAL {General examination of patient}, WOB {Labored breathing}, able to speak {Able to speak}, HEENT {Physical examination procedure}, MMM {Moist oral mucosa}, NC {Normal head}, EOMI {Normal ocular motility}, anicteric sclera {White sclera}, CARDIAC {Cardiovascular physical examination}, Regular rhythm {Normal sinus rhythm}, normal rate {Normal heart rate}, murmurs {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, JVD {Jugular venous engorgement}, RESP {Examination of respiratory system}, decreased air entry {Decreased breath sounds}, wheeze {Wheezing}, accessory muscle {Accessory skeletal muscle}, ABDOMEN {Examination of abdomen}, soft {Abdomen soft}, ND {Swollen abdomen}, normoactive bowel sounds {Normal bowel sounds}, EXTREMITIES {Examination of limb}, wwp {Normal tissue perfusion}, edema {Edema}, BLE {Edema of bilateral lower legs}, SKIN {Examination of skin}, rash {Eruption of skin}, lesions {Lesion}, NEURO {Neurological examination}, GI {Examination of digestive system}, AOx3 {Oriented to person, time and place}, wnl {No abnormality detected}, gait {Gait normal}"
+"###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:
+___ 10:40PM BLOOD WBC-10.2*# RBC-4.92 Hgb-14.6 Hct-44.7 
+MCV-91 MCH-29.7 MCHC-32.7 RDW-14.8 RDWSD-49.6* Plt ___
+___ 10:40PM BLOOD Glucose-147* UreaN-14 Creat-0.8 Na-144 
+K-3.6 Cl-99 HCO3-31 AnGap-18
+
+Imaging/
+###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}"
+"###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: Studies:  
+___ CXR
+No acute cardiopulmonary process.
+
+Discharge:
+___ 06:35AM BLOOD WBC-11.8* RBC-4.81 Hgb-13.9 Hct-43.4 
+MCV-90 MCH-28.9 MCHC-32.0 RDW-14.9 RDWSD-49.5* Plt ___
+___ 06:35AM BLOOD Glucose-128* UreaN-18 Creat-0.7 Na-137 
+K-4.4 Cl-99 HCO3-26 AnGap-16
+ 
+
+###RESPONSE: CXR {Plain chest X-ray}, 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}, BLOOD 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}"
+"###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:
+Ms. ___ is a ___ pMHx COPD, asthma, GERD, and metastatic 
+carcinoma to the brain of unknown origin s/p resection and WBRT 
+in ___ who presented with an acute COPD exacerbation. No 
+fevers, but cough, wheeze and dyspnea consistent with COPD 
+exacerbation, likely precipitated by pollen exposure. Improved 
+slowly. Completed a 5-day course of azithromycin and placed on a 
+slow prednisone taper to be continued as an outpatient.  
+
+ 
+
+###RESPONSE: COPD {Chronic obstructive lung disease}, asthma {Asthma}, GERD {Gastroesophageal reflux disease}, metastatic 
+carcinoma to the brain {Metastatic malignant neoplasm to brain}, resection {Excision}, acute COPD exacerbation {Acute exacerbation of chronic obstructive airways disease}, fevers {Fever}, cough {Cough}, wheeze {Wheezing}, dyspnea {Dyspnea}, COPD 
+exacerbation {Acute exacerbation of chronic obstructive airways disease}, Improved {Patient's condition improved}"
+"###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. ProAir HFA (albuterol sulfate) 90 mcg/actuation inhalation 
+Q4H:PRN 
+2. Fluticasone-Salmeterol Diskus (500/50)  1 INH IH BID 
+3. Montelukast 10 mg PO DAILY 
+4. Omeprazole 20 mg PO DAILY 
+5. Tiotropium Bromide 1 CAP IH DAILY 
+6. Aspirin 81 mg PO DAILY 
+7. Cetirizine 10 mg PO DAILY 
+8. Multivitamins 1 TAB PO DAILY 
+9. PredniSONE 20 mg PO DAILY 
+
+ 
+Discharge Medications:
+1.  Pseudoephedrine 30 mg PO Q6H:PRN nasal congestion 
+RX *pseudoephedrine HCl [Nasal Decongestant (pseudoeph)] 30 mg 1 
+tablet(s) by mouth every six (6) hours Disp #*10 Tablet 
+Refills:*0 
+2.  Omeprazole 40 mg PO DAILY 
+RX *omeprazole 40 mg 1 capsule(s) by mouth daily Disp #*30 
+Capsule Refills:*0 
+3.  PredniSONE 50 mg PO DAILY 
+50 mg daily x 3 days, then decrease by 10 mg every 3 days until 
+taking 10 mg daily  
+Tapered dose - DOWN 
+RX *prednisone 10 mg 5 tablet(s) by mouth daily Disp #*60 Tablet 
+Refills:*0 
+4.  Aspirin 81 mg PO DAILY  
+5.  Cetirizine 10 mg PO DAILY  
+6.  Fluticasone-Salmeterol Diskus (500/50)  1 INH IH BID  
+7.  Montelukast 10 mg PO DAILY  
+8.  Multivitamins 1 TAB PO DAILY  
+9.  ProAir HFA (albuterol sulfate) 90 mcg/actuation inhalation 
+Q4H:PRN 
+RX *albuterol sulfate [ProAir HFA] 90 mcg 2 puffs INH every four 
+(4) hours Disp #*1 Inhaler Refills:*0 
+10.  Tiotropium Bromide 1 CAP ___ DAILY  
+
+ 
+
+###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:
+Asthma exacerbation
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Asthma exacerbation {Exacerbation of asthma}, Mental Status {Neurological mental status determination}, Alert {Mentally alert}, 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. ___, 
+
+You were admitted to the hospital with an asthma exacerbation. 
+You were treated with steroids and breathing treatments and you 
+improved.
+
+Please try to avoid cigarettes as they make your breathing 
+worse.  
+
+Please continue to take the prednisone (steroids) taper as 
+directed. 
+ 
+
+###RESPONSE: asthma exacerbation {Exacerbation of asthma}, steroids {Steroid therapy}, breathing treatments {Inhalation therapy procedure}, improved {Patient's condition improved}, steroids {Steroid 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: 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: 
+aspirin
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Chest Pain
+ 
+Major Surgical or Invasive Procedure:
+Cardiac Catheterization
+
+ 
+
+###RESPONSE: aspirin {Allergy to aspirin}, Chest Pain {Chest pain}, 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:
+___ HTN, DM, HL, CAD and b/l hearing loss pw chest pain and 
+abnormal stress test. Patient reports exertional, substernal 
+chest pain for the last 3 days. Relieved with rest. Denies 
+radiation. Saw neurologist today for evaluation of memory loss, 
+but when he described chest pain was referred for outpatient 
+stress test. The stress test was abnormal and he was referred 
+for ___. Patient reports ongoing ___ substernal chest pain 
+without SOB on arrival to 
+the ED.  
+
+Patient takes Plavix for remote history of CAD. Denies ASA use.  
+
+Chest pain nonreproducible in the ED.  
+
+In the ED initial vitals were: 97.7 56 138/70 16 96% RA  
+- Labs were significant for WBC 3.7 Hct 40.6 Plt 141, Cr 0.8, 
+INR 0.9, Troponin <0.01  
+- Patient was given Nitroglycerin SL, Aspirin 325, and started 
+on a heparin gtt. His pain resolved after the SL nitro and 
+aspirin  
+Vitals prior to transfer were: 97.6 52 ___ 97% RA  
+On the floor, the patient is sleeping comfortably. He denies 
+chest pain, dyspnea, fevers, chills, night sweats, headache, 
+vision changes, rhinorrhea, congestion, sore throat, cough, 
+shortness of breath, chest pain, abdominal pain, nausea, 
+vomiting, diarrhea, constipation, BRBPR, melena, hematochezia, 
+dysuria, hematuria.  
+
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, DM {Diabetes mellitus}, HL {Hyperlipidemia}, CAD {Coronary arteriosclerosis}, b/l hearing loss {Bilateral hearing loss}, chest pain {Chest pain}, abnormal stress test {Cardiovascular stress test abnormal}, exertional {Chest pain on exertion}, substernal 
+chest pain {Retrosternal pain}, Relieved with rest {Pain relief by rest}, radiation {Radiating pain}, evaluation {Evaluation procedure}, memory loss {Amnesia}, chest pain {Chest pain}, stress test {Cardiovascular stress testing}, stress test was abnormal {Cardiovascular stress test abnormal}, substernal chest pain {Retrosternal pain}, SOB {Dyspnea}, CAD {Coronary arteriosclerosis}, ASA use {Administration of aspirin}, Chest pain {Chest pain}, RA {Breathing room air}, Labs {Laboratory test}, WBC {White blood cell count}, Hct {Hematocrit determination}, Plt {Platelet count}, Cr {Creatinine measurement}, INR {Calculation of international normalized ratio}, Troponin {Troponin measurement}, Aspirin {Administration of aspirin}, heparin {Heparin therapy}, pain {Chest pain}, resolved {Problem resolved}, aspirin {Administration of aspirin}, Vitals {Vital signs finding}, RA {Breathing room air}, sleeping {Asleep}, chest pain {Chest pain}, dyspnea {Dyspnea}, fevers {Fever}, chills {Chill}, night sweats {Night sweats}, headache {Headache}, vision changes {Visual disturbance}, rhinorrhea {Nasal discharge}, congestion {Nasal congestion}, sore throat {Sore throat}, cough {Cough}, shortness of breath {Dyspnea}, chest pain {Chest pain}, abdominal pain {Abdominal pain}, nausea, 
+vomiting, diarrhea {Nausea, vomiting and diarrhea}, constipation {Constipation}, BRBPR {Hematochezia}, melena {Melena}, hematochezia {Hematochezia}, dysuria {Dysuria}, hematuria {Blood in urine}"
+"###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  
+SEASONAL ALLERGIC RHINITIS  
+HARD OF HEARING  
+PROSTATE INTRAEPITHELIAL NEOPLASIA  
+HYPERLIPIDEMIA  
+GASTROESOPHAGEAL REFLUX  
+CORONARY ARTERY DISEASE  
+ERECTILE DYSFUNCTION  
+GOUT  
+AZOTEMIA  
+ADENOMA  
+VENTRICULAR ECTOPIC ACTIVITY  
+ 
+
+###RESPONSE: HYPERTENSION {Hypertensive disorder, systemic arterial}, SEASONAL ALLERGIC RHINITIS {Seasonal allergic rhinitis}, HARD OF HEARING {Hearing loss}, PROSTATE INTRAEPITHELIAL NEOPLASIA {Prostatic intraepithelial neoplasia}, HYPERLIPIDEMIA {Hyperlipidemia}, GASTROESOPHAGEAL REFLUX {Gastroesophageal reflux disease}, CORONARY ARTERY DISEASE {Coronary arteriosclerosis}, ERECTILE DYSFUNCTION {Erectile dysfunction}, GOUT {Inflammatory disorder due to increased blood urate level}, AZOTEMIA {Azotemia}, ADENOMA {Adenoma}, VENTRICULAR ECTOPIC {Ventricular premature complex}"
+"###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: died in his ___ from iatrogenic injury, had some degree  
+
+of loss of right hand function several years prior to his death, 
+ 
+Mother: no medical issues  
+Brother: died at ___ from cancer, not sure which type  
+Sister: is ___, has memory problems,  
+Son: healthy  
+ 
+Physical ___:
+PHYSICAL EXAM ON ADMISSION:  
+Vitals - 97.9 152/92 56 18 99% RA  
+GENERAL: Lying comfortably, in NAD  
+HEENT: AT/NC, EOMI, PERRL, anicteric sclera, pink conjunctiva, 
+patent nares, MMM, good dentition  
+NECK: nontender supple neck, no LAD, no JVD  
+CARDIAC: RRR, S1/S2, no murmurs, gallops, or rubs  
+LUNG: CTAB, no wheezes, rales, rhonchi, breathing comfortably 
+without use of accessory muscles  
+ABDOMEN: nondistended, +BS, nontender in all quadrants, no 
+rebound/guarding, no hepatosplenomegaly  
+EXTREMITIES: moving all extremities well, no cyanosis, clubbing 
+or edema  
+PULSES: 2+ DP and radial pulses bilaterally  
+NEURO: CN II-XII intact  
+SKIN: warm and well perfused, no excoriations or lesions, no 
+rashes  
+
+PHYSICAL EXAM ON DISCHARGE:  
+Vitals - 98.0, 111-138/74-84, 52-59, rr18, 99% on RA
+GENERAL: Sleeping peacefull in bed, in NAD  
+HEENT: AT/NC, EOMI, PERRL, anicteric sclera, pink conjunctiva, 
+patent nares, MMM, good dentition  
+NECK: nontender supple neck, no LAD, no JVD  
+CARDIAC: RRR, S1/S2, no murmurs, gallops, or rubs  
+LUNG: CTAB, no wheezes, rales, rhonchi, breathing comfortably 
+without use of accessory muscles  
+ABDOMEN: nondistended, +BS, nontender in all quadrants, no 
+rebound/guarding, no hepatosplenomegaly  
+EXTREMITIES: moving all extremities well, no cyanosis, clubbing 
+or edema  
+PULSES: 2+ DP and radial pulses bilaterally  
+NEURO: CN II-XII intact  
+SKIN: warm and well perfused, no excoriations or lesions, no 
+rashes 
+ 
+
+###RESPONSE: died {Dead}, injury {Traumatic or non-traumatic injury}, loss of right hand function {Difficulty performing hand functions}, death {Dead}, died {Dead}, cancer {Malignant neoplastic disease}, memory problems {Memory impairment}, Vitals {Vital signs finding}, RA {Breathing room air}, GENERAL {General examination of patient}, Lying {Lying in bed}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, AT/NC {Normal head}, EOMI {Normal ocular motility}, PERRL {Pupils equal and reacting to light}, anicteric sclera {White sclera}, pink conjunctiva {Conjunctival hyperemia}, nares {Structure of anterior naris}, MMM {Moist oral mucosa}, good dentition {Normal dentition}, NECK {Physical examination procedure}, nontender {Tenderness of neck}, supple neck {Normal movement of neck}, LAD {Lymphadenopathy}, JVD {Jugular venous engorgement}, CARDIAC {Cardiovascular physical examination}, RRR {Normal heart rate}, S1/S2 {Heart sounds normal}, murmurs {Heart murmur}, gallops {Gallop rhythm}, rubs {Pericardial friction rub}, LUNG {Examination of respiratory system}, CTAB {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, rhonchi {Wheeze - rhonchi}, breathing comfortably {Breathing easily}, accessory muscles {Accessory skeletal muscle}, ABDOMEN {Examination of abdomen}, nondistended {Normal abdominal contour}, +BS {Normal bowel sounds}, nontender {Abdominal tenderness}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, hepatosplenomegaly {Hepatosplenomegaly}, EXTREMITIES {Examination of limb}, moving all extremities {Does move all four limbs}, cyanosis {Cyanosis}, clubbing {Clubbing}, edema {Edema}, PULSES {Pulse finding}, 2+ DP {Dorsalis pulse present}, radial pulses {Radial pulse present}, NEURO {Neurological examination}, CN II-XII intact {Normal central nervous system}, SKIN {Examination of skin}, warm {Warm skin}, well perfused {Normal tissue perfusion}, excoriations {Excoriation}, lesions {Skin lesion}, rashes {Eruption of skin}, Vitals {Vital signs finding}, RA {Breathing room air}, GENERAL {General examination of patient}, Sleeping {Asleep}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, AT/NC {Normal head}, EOMI {Normal ocular motility}, PERRL {Pupils equal and reacting to light}, anicteric sclera {White sclera}, pink conjunctiva {Conjunctival hyperemia}, nares {Structure of anterior naris}, MMM {Moist oral mucosa}, good dentition {Normal dentition}, NECK {Physical examination procedure}, nontender {Tenderness of neck}, supple neck {Normal movement of neck}, LAD {Lymphadenopathy}, JVD {Jugular venous engorgement}, CARDIAC {Cardiovascular physical examination}, RRR {Normal heart rate}, S1/S2 {Heart sounds normal}, murmurs {Heart murmur}, gallops {Gallop rhythm}, rubs {Pericardial friction rub}, LUNG {Examination of respiratory system}, CTAB {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, rhonchi {Wheeze - rhonchi}, breathing comfortably {Breathing easily}, accessory muscles {Accessory skeletal muscle}, ABDOMEN {Examination of abdomen}, nondistended {Normal abdominal contour}, +BS {Normal bowel sounds}, nontender {Abdominal tenderness}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, hepatosplenomegaly {Hepatosplenomegaly}, EXTREMITIES {Examination of limb}, moving all extremities {Does move all four limbs}, cyanosis {Cyanosis}, clubbing {Clubbing}, edema {Edema}, PULSES {Pulse finding}, 2+ DP {Dorsalis pulse present}, radial pulses {Radial pulse present}, NEURO {Neurological examination}, CN II-XII intact {Normal central nervous system}, SKIN {Examination of skin}, warm {Warm skin}, well perfused {Normal tissue perfusion}, excoriations {Excoriation}, lesions {Skin lesion}, 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:
+
+___ 05:45PM BLOOD WBC-3.7* RBC-4.09* Hgb-14.0 Hct-40.6 
+MCV-100* MCH-34.3* MCHC-34.5 RDW-12.8 Plt ___
+___ 05:45PM BLOOD Neuts-61.6 ___ Monos-8.1 Eos-4.8* 
+Baso-0.5
+___ 05:45PM BLOOD ___ PTT-29.9 ___
+___ 05:45PM BLOOD Glucose-86 UreaN-26* Creat-0.8 Na-138 
+K-4.4 Cl-94* HCO3-26 AnGap-22*
+___ 02:00PM BLOOD ALT-30 AST-24 AlkPhos-44 Amylase-83 
+TotBili-0.7
+___ 07:50AM BLOOD CK-MB-5 cTropnT-<0.01
+___ 05:45PM BLOOD cTropnT-<0.01
+___ 07:50AM BLOOD CK-MB-5 cTropnT-<0.01
+___ 07:50AM BLOOD Calcium-9.3 Phos-3.1 Mg-2.0 Cholest-159
+___ 07:50AM BLOOD %HbA1c-7.2* eAG-160*
+___ 07:50AM BLOOD Triglyc-386* HDL-33 CHOL/HD-4.8 
+LDLcalc-49
+
+LABS ON DISCHARGE:
+
+___ 07:35AM BLOOD WBC-4.0 RBC-4.72 Hgb-15.7 Hct-47.6 
+MCV-101* MCH-33.4* MCHC-33.0 RDW-13.3 Plt ___
+___ 07:35AM BLOOD Plt ___
+___ 07:35AM BLOOD Glucose-128* UreaN-24* Creat-1.3* Na-140 
+K-4.9 Cl-103 HCO3-30 AnGap-12
+___ 09:15AM BLOOD ALT-36 AST-38 AlkPhos-54 TotBili-0.8
+___ 07:35AM BLOOD Calcium-9.6 Phos-3.2 Mg-2.1
+
+STUDIES:
+___ (outpatient) STRESS TEST
+INTERPRETATION: This ___ year old man with a history of HTN, gout 
+and 
+HL was referred to the lab for evalution of chest discomfort. 
+The 
+patient exercised for 11 minutes of ___ protocol and stopped 
+for 
+fatigue. The estimated peak MET capacity was 11.9 which 
+represents an 
+excellent functional capacity for his age. Near peak exercise, 
+the 
+patient noted a non-progressive right sided chest discomfort. 
+This 
+resolved with rest by minute 2 of recovery. At peak exercise, 
+there was 
+1-1.5 mm horizontal ST segment depression in the inferolateral 
+leads. 
+This became downsloping in recovery and resovled with rest by 
+minute 7. 
+the rhythm was sinus with rare isolated apbs during exercise and 
+
+frequent isolated vpbs in recovery. Resting HTN with an 
+appropriate 
+increase in systolic BP with exercise and slight blunting or HR 
+on beta 
+blocker therapy. 
+IMPRESSION: Ischemic EKG changes with atypical chest discomfort. 
+
+Nuclear report sent separately. 
+
+___ EKG
+Rate PR QRS QT/QTc P QRS T 
+56 0 92 420/413 0 -3 55 
+Sinus bradycardia. Baseline artifact. Initial deflections in 
+leads III and aVF likely preclude prior inferior wall myocardial 
+infarction, as reported on ___. No diagnostic interim 
+change. Ventricular ectopy is absent. 
+
+___ CARDIAC PERFUSION
+IMPRESSION: 
+1. Reversible, large, moderate severity perfusion defect 
+involving the LCx territory. 
+2. Normal left ventricular cavity size and systolic function. 
+Compared with the study of ___, the defect is new. 
+
+___ CXR
+FINDINGS:   
+The lungs remain clear. The cardiomediastinal silhouette is 
+within normal 
+limits. Atherosclerotic calcifications are noted at the aortic 
+arch. No acute osseous abnormalities identified. 
+IMPRESSION:  
+No acute cardiopulmonary process. 
+
+___ CARDIAC CATH
+Coronary angiography:  right dominant
+LMCA:  20% minor irregularities
+LAD:   The LAD was heavily calcified with diffuse disease.  
+There was a large diagonal branch with a 80-90% stenosis at its
+origin.   Three was a large second diagonal branch with an 
+60-70%
+stenosis at its origin.   There was an 80% stenosis in the mid
+LAD and diffusely 80-90% stenosis in the mid LAD.  The distal 
+LAD
+had minor lumen irregularities. 
+LCX:  The LCX was a small vessel with an occlusion of the OMB.
+RCA: The RCA was a large dominant vessel.  It had a 50% stenosis
+in the distal RCA.  There was diffuse 60-70% disease throughout
+the PLSA.  There was a 90% stenosis in RPL2 . There were right 
+to
+left collaterals to the OMB.
+ASSESSMENT
+1. Severe three vessel coronary artery disease
+
+___ CARDIAC ECHO
+The left atrium is normal in size. No atrial septal defect is 
+seen by 2D or color Doppler. The estimated right atrial pressure 
+is ___ mmHg. There is mild symmetric left ventricular 
+hypertrophy with normal cavity size and global systolic function 
+(LVEF>55%). Right ventricular chamber size and free wall motion 
+are normal. The ascending aorta is mildly dilated. The aortic 
+valve leaflets (3) are mildly thickened but aortic stenosis is 
+not present. No aortic regurgitation is seen. The mitral valve 
+leaflets are mildly thickened. Mild (1+) mitral regurgitation is 
+seen. The estimated pulmonary artery systolic pressure is 
+normal. There is no pericardial effusion. 
+IMPRESSION: Preserved biventricular systolic function. Mildly 
+dilated ascending aorta. Mild mitral regurgitation. Normal 
+pulmonary artery systolic pressure.
+Compared with the prior study (images unavailable for review) of 
+___, the findings are similar.  
+
+ 
+
+###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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, Plt {Platelet count}, Neuts {Neutrophil count}, Monos {Monocyte count}, Eos {Eosinophil count}, Baso {Basophil count}, PTT {Partial thromboplastin time, activated}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium 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}, Amylase {Amylase measurement}, TotBili {Bilirubin, total measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Cholest {Cholesterol measurement}, HbA1c {Hemoglobin A1c measurement}, eAG {Glucose measurement estimated from glycated hemoglobin}, Triglyc {Triglycerides measurement}, HDL {High density lipoprotein measurement}, CHOL/HD {Cholesterol/High density lipoprotein ratio measurement}, LDLcalc {Calculated low density lipoprotein cholesterol level}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, Plt {Platelet count}, Plt {Platelet count}, BLOOD Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium 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}, STRESS TEST {Electrocardiogram with exercise test}, HTN {Hypertensive disorder, systemic arterial}, gout {Inflammatory disorder due to increased blood urate level}, HL {Hyperlipidemia}, evalution {Evaluation procedure}, chest discomfort {Chest discomfort}, exercised {Exercises}, fatigue {Fatigue}, MET {Electrocardiogram with exercise test}, exercise {Exercises}, progressive {Patient's condition worsened}, right sided {Right thorax structure}, chest discomfort {Chest discomfort}, resolved {Problem resolved}, exercise {Exercises}, ST segment depression {ST segment depression}, resovled with rest {Pain relief by rest}, rhythm was sinus {Sinus rhythm}, exercise {Exercises}, frequent isolated vpbs {Multiple premature ventricular complexes}, HTN {Hypertensive disorder, systemic arterial}, exercise {Exercises}, therapy {Therapy}, Ischemic EKG changes {Electrocardiographic myocardial ischemia}, atypical {Atypical chest pain}, chest discomfort {Chest discomfort}, EKG {Electrocardiographic procedure}, Rate {Finding of heart rate}, PR {Finding of electrocardiogram PR interval}, QRS {Finding of electrocardiogram QRS complex}, P {Finding of electrocardiogram P wave}, QRS {Finding of electrocardiogram QRS complex}, T {Finding of electrocardiogram T wave}, Sinus bradycardia {Sinus bradycardia}, Baseline {Baseline state}, artifact {Artifact}, leads III {Lead III}, aVF {aVF}, inferior wall {Structure of myocardium of diaphragmatic region}, Ventricular ectopy {Ventricular premature complex}, CARDIAC PERFUSION {Radionuclide myocardial perfusion study}, perfusion defect {Myocardial perfusion defect}, LCx {Structure of circumflex branch of left coronary artery}, left ventricular cavity {Structure of cavity of left cardiac ventricle}, size {Normal size}, systolic function {Normal left ventricular systolic function and wall motion}, study {Evaluation procedure}, CXR {Plain chest X-ray}, lungs {Lung structure}, clear {No abnormality detected}, cardiomediastinal {Mediastinal structure}, normal {No abnormality detected}, Atherosclerotic {Atherosclerosis}, calcifications {Pathologic calcification, calcified structure}, aortic 
+arch {Aortic arch structure}, No acute {No abnormality detected}, osseous {Bone structure}, No acute {No abnormality detected}, CARDIAC CATH {Cardiac catheterization}, Coronary angiography {Angiography of coronary artery}, LMCA {Structure of left coronary artery main stem}, irregularities {Luminal irregularities of coronary artery}, LAD {Structure of anterior descending branch of left coronary artery}, LAD {Structure of anterior descending branch of left coronary artery}, calcified {Pathologic calcification, calcified structure}, diffuse disease {Diffuse disease of coronary artery}, diagonal {Structure of diagonal branch of anterior descending branch of left coronary artery}, stenosis {Stenosis}, diagonal {Structure of diagonal branch of anterior descending branch of left coronary artery}, stenosis {Stenosis}, stenosis {Stenosis}, mid
+LAD {Structure of mid portion of anterior descending branch of left coronary artery}, stenosis {Stenosis}, mid LAD {Structure of mid portion of anterior descending branch of left coronary artery}, distal 
+LAD {Structure of distal portion of anterior descending branch of left coronary artery}, lumen irregularities {Luminal irregularities of coronary artery}, LCX {Structure of circumflex branch of left coronary artery}, LCX {Structure of circumflex branch of left coronary artery}, small vessel {Structure of small blood vessel (organ)}, occlusion {Complete obstruction}, OMB {Structure of obtuse marginal branch of circumflex branch of left coronary artery}, RCA {Right coronary artery structure}, RCA {Right coronary artery structure}, vessel {Blood vessel structure}, stenosis {Stenosis}, distal RCA {Structure of distal portion of right coronary artery}, diffuse 60-70% disease {Diffuse disease of coronary artery}, stenosis {Stenosis}, RPL2 {Structure of posterior lateral branch of right coronary artery}, right {Right coronary artery structure}, OMB {Structure of obtuse marginal branch of circumflex branch of left coronary artery}, ASSESSMENT {Evaluation procedure}, three vessel coronary artery disease {Triple vessel disease of the heart}, CARDIAC ECHO {Echocardiography}, left atrium {Left atrial structure}, normal in size {Normal size}, atrial septal defect {Atrial septal defect}, color Doppler {Color Doppler ultrasound}, right atrial {Right atrial structure}, mild symmetric left ventricular 
+hypertrophy {Mild left ventricular hypertrophy}, normal cavity size {Normal size}, systolic function {Normal left ventricular systolic function and wall motion}, Right ventricular chamber {Right cardiac ventricular structure}, size {Normal size}, wall motion 
+are normal {Normal ventricular wall motion}, ascending aorta is mildly dilated {Ascending aorta dilatation}, aortic 
+valve leaflets {Structure of cardiac valve leaflet}, mildly thickened {Increased thickness}, aortic stenosis {Aortic valve stenosis}, aortic regurgitation {Aortic valve regurgitation}, mitral valve 
+leaflets are mildly thickened {Thickened mitral leaflet}, Mild (1+) mitral regurgitation {Mild mitral valve regurgitation}, pulmonary artery {Pulmonary artery structure}, systolic pressure is 
+normal {Normal systolic arterial pressure}, pericardial effusion {Pericardial effusion}, biventricular {Cardiac ventricular structure}, systolic function {Normal left ventricular systolic function and wall motion}, dilated ascending aorta {Ascending aorta dilatation}, Mild mitral regurgitation {Mild mitral valve regurgitation}, pulmonary artery {Pulmonary artery structure}, systolic pressure {Normal systolic arterial pressure}, study {Evaluation 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: Brief Hospital Course:
+Mr. ___ is a ___ year old man with HTN, DM,HL, CAD and b/l hearing 
+loss presenting with new onset exertional angina abnormal stress 
+test who was found to have three vessel CAD.
+
+# Unstable Angina/CAD: Mr. ___ had been experiencing progressive 
+exertional, substernal chest pain and was sent for outpatient 
+studies by his neurologist. He had an abnormal stress test and 
+perfusion study showing a large reversible moderate severity 
+perfusion defect involving the Lcx territory, so he was sent to 
+the ER, where troponin was <0.01 and his EKG showed no ST 
+segment elevations. He was admitted and underwent a cardiac 
+catheterization that showed three vessel CAD.  He was then seen 
+by cardiac surgery for evaluation of cardiac ___ bypass graft 
+surgery.  This was scheduled for ___, after a 5 day 
+plavix wash-out period.  He was discharged with chlorhexidine 
+washes for ___ night and ___ morning, as well as 
+mupirocen nasal cream BID, and the time and place to present for 
+admission on ___ morning.  He was also set up for ___ as he 
+expressed concern about being able to complete his pre-op 
+regimen and take his medication as prescribed.  His Lisinopril 
+was held from discharge until after surgery as he had a mild 
+increase in creatinine.  His plavix was held.  His home atenoll 
+was converted to metoprolol and aspirin was started; these 
+medications were continued until surgery. His atorvastatin dose 
+was increased to 80mg daily, which was also continued.
+
+# Travel plasn:  A medical note was provided as he was no longer 
+able to travel as anticipated. 
+
+============================================
+TRANSITIONAL ISSUES
+============================================
+Mr ___ is a ___ year old man with HTN, DM,HLD and b/l hearing loss 
+presenting with new onset exertional angina who was found to 
+have 3 vessel CAD.
+- CAD: Seen by Cardiac surgery and planned for surgery on 
+___. Will need chlorhexidine wash ___ 
+morning before coming in. Will need to use Mupirocin cream ___ 
+tube in each nostril) twice a day between now and then.
+- Atenolol switched to metoprolol.
+- HbA1c 7.1%
+
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, DM {Diabetes mellitus}, HL {Hyperlipidemia}, CAD {Coronary arteriosclerosis}, b/l hearing 
+loss {Bilateral hearing loss}, exertional angina {Exercise-induced angina}, abnormal stress 
+test {Cardiovascular stress test abnormal}, three vessel CAD {Triple vessel disease of the heart}, Unstable Angina {Preinfarction syndrome}, CAD {Coronary arteriosclerosis}, progressive {Patient's condition worsened}, exertional {Chest pain on exertion}, substernal chest pain {Retrosternal pain}, studies {Evaluation procedure}, abnormal stress test {Cardiovascular stress test abnormal}, perfusion study {Radionuclide myocardial perfusion study}, perfusion defect {Myocardial perfusion defect}, Lcx {Structure of circumflex branch of left coronary artery}, troponin {Troponin measurement}, EKG {Electrocardiographic procedure}, ST 
+segment elevations {ST segment elevation}, cardiac 
+catheterization {Cardiac catheterization}, three vessel CAD {Triple vessel disease of the heart}, evaluation {Evaluation procedure}, cardiac {Heart structure}, bypass graft {Coronary artery bypass grafting}, surgery {Surgical procedure}, nasal {Administration of drug or medicament via nasal route}, after surgery {Postoperative state}, increase in creatinine {Serum creatinine above reference range}, plavix {Administration of prophylactic clopidogrel}, held {Recommendation to stop drug treatment}, converted {Change of medication}, aspirin {Administration of aspirin}, medications {Administration of drug or medicament}, surgery {Surgical procedure}, increased {Increasing dosage of medication}, Travel {Travel abroad}, travel {Travel abroad}, HTN {Hypertensive disorder, systemic arterial}, DM {Diabetes mellitus}, HLD {Hyperlipidemia}, b/l hearing loss {Bilateral hearing loss}, exertional angina {Exercise-induced angina}, 3 vessel CAD {Triple vessel disease of the heart}, CAD {Coronary arteriosclerosis}, surgery {Surgical procedure}, nostril {Structure of anterior naris}, HbA1c {Hemoglobin A1c 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: Medications on Admission:
+The Preadmission Medication list is accurate and complete.
+1. Allopurinol ___ mg PO DAILY 
+2. Atenolol 25 mg PO DAILY 
+3. Atorvastatin 40 mg PO DAILY 
+4. celecoxib 200 mg oral PRN gout attack 
+5. Clopidogrel 75 mg PO DAILY 
+6. Lisinopril 20 mg PO DAILY 
+7. Colchicine 0.6 mg PO DAILY 
+
+ 
+Discharge Medications:
+1. Atorvastatin 80 mg PO DAILY 
+RX *atorvastatin 80 mg 1 tablet(s) by mouth daily Disp #*30 
+Tablet Refills:*0
+2. Aspirin 81 mg PO DAILY 
+RX *aspirin 81 mg 1 tablet(s) by mouth daily Disp #*30 Tablet 
+Refills:*0
+3. Nitroglycerin SL 0.4 mg SL PRN chest pain 
+RX *nitroglycerin [Nitrostat] 0.4 mg 1 tablet(s) sublingually 
+every 5 minutes x 3 tablets Disp #*12 Tablet Refills:*0
+4. Mupirocin Nasal Ointment 2% 1 Appl NU BID Duration: 5 Days 
+RX *mupirocin calcium [Bactroban Nasal] 2 % 0.5 (One half) tube 
+in each nostril twice a day Disp #*6 Tube Refills:*0
+5. Allopurinol ___ mg PO DAILY 
+6. Metoprolol Succinate XL 25 mg PO DAILY 
+This replaces atenolol 
+RX *metoprolol succinate 25 mg 1 tablet(s) by mouth daily Disp 
+#*30 Tablet Refills:*0
+7. Colchicine 0.6 mg PO DAILY 
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Coronary Artery Disease
+
+ 
+Discharge Condition:
+Mental Status: Confused - mildly, occasionally.  Oriented x3.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, Coronary Artery Disease {Coronary arteriosclerosis}, Mental Status {Neurological mental status determination}, Confused {Clouded consciousness}, Oriented x3 {Oriented to person, time and place}, 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:
+Dear Mr. ___,
+
+You were admitted to ___ due to 
+chest pain.  A cardiac catheterization revealed that you have 
+coronary artery disease in the main three vessels in your heart. 
+ The recommended treatment is a coronary artery bypass graft 
+(CABG) surgery.  You were seen by the Cardiac Surgeons who plan 
+to perform the surgery on ___.
+
+Do not take plavix, NSAIDS (including celecoxib, ibuprofen), or 
+lisinopril until instructed to by your doctor after surgery. 
+Atenolol was also switched to metoprolol.  Continue to take your 
+other medications, including metoprolol and aspirin, as 
+prescribed.
+
+Please return to the hospital on ___ 6:00 AM as 
+instructed by the Cardiac Surgery team, and follow their 
+direction about soap scrubs and cream application in preparation 
+for surgery.  Nurses ___ visit your home to check on you 
+tomorrow. 
+
+It was a pleasure taking care of you.
+Sincerely,
+Your ___ Team
+
+ 
+
+###RESPONSE: chest pain {Chest pain}, cardiac catheterization {Cardiac catheterization}, coronary artery disease {Coronary arteriosclerosis}, three vessels in your heart {Triple vessel disease of the heart}, coronary artery bypass graft {Coronary artery bypass grafting}, CABG {Coronary artery bypass grafting}, surgery {Surgical procedure}, surgery {Coronary artery bypass grafting}, Do not take {Patient medication education}, after surgery {Postoperative state}, switched {Change of medication}, medications {Patient medication education}, aspirin {Administration of aspirin}, preparation 
+for surgery {Preoperative education}, home {Home health aide service management}"
+"###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: 
+Patient recorded as having No Known Allergies to Drugs
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Shortness of breath.
+ 
+Major Surgical or Invasive Procedure:
+Cardiac cath on ___ with DES to circumflex artery.
+
+ 
+
+###RESPONSE: No Known Allergies to Drugs {Non-allergic hypersensitivity to drug or medicament}, Shortness of breath {Dyspnea}, Cardiac cath {Cardiac catheterization}, circumflex artery {Structure of circumflex branch of left coronary artery}"
+"###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:
+___ M with a history of PVD, AAA repair, s/p CEA, HTN who was 
+seen by his outpatient Cardiologist 5 days ago. Per report, he 
+had a stress echo (official results not available). Patient was 
+set up for outpatient cath next week, but in the interim was 
+admitted to ___ with pulmonary edema. He had acute shortness of 
+breath on night of ___ and called EMS.  
+.  
+Presented to OSH complaining of shortness of breath x 5 days, 
+that has been getting progressively worse. One day prior to 
+admission to OSH he was short of breath climbing the stairs in 
+his house. That evening, while watching TV he had sudden onset 
+SOB. No CP, no palpitations. No nausea or vomiting. Patient did 
+become diaphoretic.  
+.  
+EMS noted BP 225/94, HR 130s, tachypneic. He was started on 
+CPAP, nebs, nitro gtt, lasix. Patient was admitted to the CCU at 
+OSH. Required 5L O2 nasal cannula.  
+Troponins of 0.112 --> 0.224 --> 0.305. CK 67-->48. CKMB 2.0--> 
+2.6. Cardiac index 3.0 --> 5.4. Of note, patient has not been 
+taking his home medications (including monopril, librium, and 
+simvastatin) per MD from the ___. ___ reason for this is unclear. 
+The patient is being transferred to ___ for catheterization.  
+.  
+On review of systems, he denies any prior history of stroke, 
+TIA, deep venous thrombosis, pulmonary embolism, bleeding at the 
+time of surgery, myalgias, joint pains, cough, hemoptysis, black 
+stools or red stools. He denies recent fevers, chills or rigors. 
+He endoreses exertional buttock and calf pain. All of the other 
+review of systems were negative.  
+.  
+Cardiac review of systems is notable for current absence of 
+chest pain, paroxysmal nocturnal dyspnea, orthopnea, ankle 
+edema, palpitations, syncope or presyncope.
+ 
+
+###RESPONSE: PVD {Peripheral vascular disease}, AAA repair {Repair of aneurysm of abdominal aorta}, CEA {Carotid endarterectomy}, HTN {Hypertensive disorder, systemic arterial}, stress echo {Stress echocardiography}, cath {Cardiac catheterization}, pulmonary edema {Pulmonary edema}, shortness of 
+breath {Dyspnea}, EMS {Emergency treatment management}, shortness of breath {Dyspnea}, short of breath {Dyspnea}, SOB {Dyspnea}, CP {Chest pain}, palpitations {Palpitations}, nausea {Nausea}, vomiting {Vomiting}, diaphoretic {Excessive sweating}, BP {Blood pressure finding}, HR {Finding of heart rate}, tachypneic {Tachypnea}, on 
+CPAP {Dependence on continuous positive airway pressure ventilation}, lasix {Diuretic therapy}, O2 nasal cannula {Oxygen administration by nasal cannula}, Troponins {Troponin measurement}, Cardiac {Heart structure}, catheterization {Cardiac catheterization}, review of systems {Review of systems}, stroke {Cerebrovascular accident}, TIA {Transient ischemic attack}, deep venous thrombosis {Deep venous thrombosis}, pulmonary embolism {Pulmonary embolism}, bleeding {Bleeding}, surgery {Surgical procedure}, myalgias {Muscle pain}, joint pains {Joint pain}, cough {Cough}, hemoptysis {Hemoptysis}, black 
+stools {Dark stools}, red stools {Red stools}, fevers {Fever}, chills {Chill}, rigors {Rigor}, buttock {Pain in buttock}, calf pain {Pain in calf}, review of systems {Review of systems}, negative {No abnormality detected}, Cardiac review of systems {Cardiovascular physical examination}, chest pain {Chest pain}, paroxysmal nocturnal dyspnea {Paroxysmal nocturnal dyspnea}, orthopnea {Orthopnea}, ankle 
+edema {Ankle edema}, palpitations {Palpitations}, syncope {Syncope}, presyncope {Near 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:
+___ M with a history of PVD, AAA repair, s/p CEA, HTN who was 
+seen by his outpatient Cardiologist 5 days ago. Per report, he 
+had a stress echo (official results not available). Patient was 
+set up for outpatient cath next week, but in the interim was 
+admitted to ___ with pulmonary edema. He had acute shortness of 
+breath on night of ___ and called EMS.  
+.  
+Presented to OSH complaining of shortness of breath x 5 days, 
+that has been getting progressively worse. One day prior to 
+admission to OSH he was short of breath climbing the stairs in 
+his house. That evening, while watching TV he had sudden onset 
+SOB. No CP, no palpitations. No nausea or vomiting. Patient did 
+become diaphoretic.  
+.  
+EMS noted BP 225/94, HR 130s, tachypneic. He was started on 
+CPAP, nebs, nitro gtt, lasix. Patient was admitted to the CCU at 
+OSH. Required 5L O2 nasal cannula.  
+Troponins of 0.112 --> 0.224 --> 0.305. CK 67-->48. CKMB 2.0--> 
+2.6. Cardiac index 3.0 --> 5.4. Of note, patient has not been 
+taking his home medications (including monopril, librium, and 
+simvastatin) per MD from the ___. ___ reason for this is unclear. 
+The patient is being transferred to ___ for catheterization.  
+.  
+On review of systems, he denies any prior history of stroke, 
+TIA, deep venous thrombosis, pulmonary embolism, bleeding at the 
+time of surgery, myalgias, joint pains, cough, hemoptysis, black 
+stools or red stools. He denies recent fevers, chills or rigors. 
+He endoreses exertional buttock and calf pain. All of the other 
+review of systems were negative.  
+.  
+Cardiac review of systems is notable for current absence of 
+chest pain, paroxysmal nocturnal dyspnea, orthopnea, ankle 
+edema, palpitations, syncope or presyncope.
+ 
+
+###RESPONSE: PVD {Peripheral vascular disease}, AAA repair {Repair of aneurysm of abdominal aorta}, CEA {Carotid endarterectomy}, HTN {Hypertensive disorder, systemic arterial}, stress echo {Stress echocardiography}, cath {Cardiac catheterization}, pulmonary edema {Pulmonary edema}, shortness of 
+breath {Dyspnea}, EMS {Emergency treatment management}, shortness of breath {Dyspnea}, short of breath {Dyspnea}, climbing the stairs {Difficulty walking up stairs}, SOB {Dyspnea}, CP {Chest pain}, palpitations {Palpitations}, nausea {Nausea}, vomiting {Vomiting}, diaphoretic {Excessive sweating}, BP {Blood pressure finding}, HR {Finding of heart rate}, tachypneic {Tachypnea}, on 
+CPAP {Dependence on continuous positive airway pressure ventilation}, lasix {Diuretic therapy}, O2 nasal cannula {Oxygen administration by nasal cannula}, Troponins {Troponin measurement}, Cardiac {Heart structure}, catheterization {Cardiac catheterization}, review of systems {Review of systems}, stroke {Cerebrovascular accident}, TIA {Transient ischemic attack}, deep venous thrombosis {Deep venous thrombosis}, pulmonary embolism {Pulmonary embolism}, bleeding {Bleeding}, surgery {Surgical procedure}, myalgias {Muscle pain}, joint pains {Joint pain}, cough {Cough}, hemoptysis {Hemoptysis}, black 
+stools {Dark stools}, red stools {Red stools}, fevers {Fever}, chills {Chill}, rigors {Rigor}, buttock {Pain in buttock}, calf pain {Pain in calf}, review of systems {Review of systems}, negative {No abnormality detected}, Cardiac review of systems {Cardiovascular physical examination}, chest pain {Chest pain}, paroxysmal nocturnal dyspnea {Paroxysmal nocturnal dyspnea}, orthopnea {Orthopnea}, ankle 
+edema {Ankle edema}, palpitations {Palpitations}, syncope {Syncope}, presyncope {Near 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: 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:
+Nonecontributory.
+ 
+
+###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:
+On Admission:
+___ 09:05PM   WBC-7.9 RBC-3.98* HGB-12.6* HCT-38.3* MCV-96 
+MCH-31.7 MCHC-32.9 RDW-16.1*
+___ 09:05PM   PLT COUNT-176
+___ 09:05PM   GLUCOSE-117* UREA N-27* CREAT-1.0 SODIUM-140 
+POTASSIUM-4.0 CHLORIDE-104 TOTAL CO2-24 ANION GAP-16
+___ 09:05PM   MAGNESIUM-2.2
+___ 09:05PM   CK-MB-NotDone cTropnT-0.01
+___ 09:05PM   CK(CPK)-49
+.
+Cardiac cath:
+1. Selective coronary angiography of this left dominant system 
+revealed 
+three vessel coronary artery disease. The LMCA was calcified 
+with 
+minimal disease.  The LAD had moderate disease, an ostial 90% 
+stenosis 
+at the diagonal artery near the ostium.  The LCX had an 80% 
+stenosis at 
+the mid segment.  The RCA was non dominant with diffuse high 
+grade 
+disease. 
+2. Resting hemodynamics demonstrated elevated LV filling 
+pressures, 
+moderate pulmonary artery hypertension, and a low cardiac index 
+(1.9). 
+3. Stenting of mid LCX with Xience 3x8 
+  
+FINAL DIAGNOSIS:     
+1. Two vessel coronary artery disease. 
+2. Diastolic dysfunction. 
+3. Moderate pulmonary hypertension. 
+4. Stenting of LCX with drug eluting stent. 
+ 
+
+###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}, 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}, cTropnT {Troponin T cardiac measurement}, coronary angiography {Angiography of coronary artery}, left {Catheterization of left heart}, three vessel coronary artery disease {Triple vessel disease of the heart}, LMCA {Structure of left coronary artery main stem}, calcified {Pathologic calcification, calcified structure}, minimal {Symptom mild}, disease {Disease}, LAD {Structure of anterior descending branch of left coronary artery}, disease {Disease}, ostial 90% 
+stenosis {Coronary ostium stenosis}, diagonal artery {Structure of diagonal branch of anterior descending branch of left coronary artery}, LCX {Structure of circumflex branch of left coronary artery}, mid segment {Structure of mid portion of circumflex branch of left coronary artery}, RCA {Right coronary artery structure}, diffuse high 
+grade 
+disease {Diffuse disease of coronary artery}, hemodynamics {Hemodynamic measurements}, elevated {Increased pressure}, LV {Left cardiac ventricular structure}, pressures {Pressure}, moderate pulmonary artery hypertension {Moderate pulmonary hypertension}, low cardiac index {Decreased cardiac index}, Stenting {Insertion of arterial stent}, mid LCX {Structure of mid portion of circumflex branch of left coronary artery}, Two vessel coronary artery disease {Double coronary vessel disease}, Diastolic dysfunction {Diastolic dysfunction}, Moderate pulmonary hypertension {Moderate pulmonary hypertension}, Stenting {Insertion of arterial stent}, LCX {Structure of circumflex branch of left coronary artery}, drug eluting stent {Endovascular insertion of drug eluting stent}"
+"###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:
+___ M with a history of PVD, AAA repair, s/p CEA, HTN who 
+presented with acute SOB, likely flash pulmonary edema, but ? of 
+NSTEMI with elevated trops at ___.  
+.  
+# CORONARIES: Patient recently admitted to ___ for shortness of 
+breath and was found to have pulmonary edema with borderline 
+Troponing I. He denied any chest pain, diaphoresis, leg 
+swelling. He was discharged with cardiology follow up and now is 
+admitted for further work up and cath. He was chest pain free 
+overnight and in the cardiac cath was found to have ostial 90% 
+stenosis at the diagonal artery near the ostium.  The LCX had an 
+80% stenosis at the mid segment. Since he has RCA atrophied with 
+a dominant LCV it was stented with a 3x5 Cypher stent. Since the 
+ostial lession was very small Dr. ___ not to stent it. 
+He was re-started on lisinopril, metoprolol and his statin, 
+aspirin and plavix were continued.
+.  
+# PUMP: Patient had ECHO in ___ with normal cardiac function 
+and per report had another at ___. He was euvolemic throughout 
+the admission.   
+.  
+# RHYTHM: NSR throughout admission.  
+.  
+# Hypertension. Patient had hypertensive emergency with flash 
+pulm edema on presentation to ___. He was weaned quickly off 
+BIPAP and nitro gtt and has been stable for > 24 hrs. He 
+diuresed well and on admission was euvolemic. Per his report his 
+PCP at the ___ stopped his antihypertensive, fosinopril ___ 
+months ago. He is currently normotensive and was transfered on 
+captopril. We started metoprolol due to CAD and re-started 
+low-dose lisinopril instead of captopril.
+.  
+# Hyperlipidemia: recently stopped lipitor for ? myalgias. 
+Patient was discharged on pravastatin, since he rememebered 
+similar problems with simavastain.
+.  
+FEN: Cardiac diet.
+.
+ACCESS: PIV's.
+.
+PROPHYLAXIS:  
+-DVT ppx with heparin SQ  
+-Pain management with tylenol.
+.
+CODE: Full code.
+.
+DISPO: Home.
+ 
+
+###RESPONSE: PVD {Peripheral vascular disease}, AAA repair {Repair of aneurysm of abdominal aorta}, CEA {Carotid endarterectomy}, HTN {Hypertensive disorder, systemic arterial}, SOB {Dyspnea}, flash pulmonary edema {Acute pulmonary edema}, NSTEMI {Acute non-ST segment elevation myocardial infarction}, elevated trops {Troponin I above reference range}, shortness of 
+breath {Dyspnea}, pulmonary edema {Pulmonary edema}, Troponing {Troponin measurement}, chest pain {Chest pain}, diaphoresis {Excessive sweating}, leg 
+swelling {Leg swelling symptom}, cardiology {Cardiology service}, work up {Evaluation procedure}, cath {Cardiac catheterization}, chest pain {Chest pain}, cardiac cath {Cardiac catheterization}, ostial 90% 
+stenosis {Coronary ostium stenosis}, diagonal artery {Structure of diagonal branch of anterior descending branch of left coronary artery}, LCX {Structure of diagonal branch of anterior descending branch of left coronary artery}, mid segment {Structure of mid portion of circumflex branch of left coronary artery}, RCA {Right coronary artery structure}, atrophied {Atrophy}, stented {Placement of stent in coronary artery}, Cypher stent {Endovascular insertion of drug eluting stent}, lession {Lesion}, stent {Placement of stent}, aspirin {Administration of aspirin}, ECHO {Echocardiography}, normal cardiac function {Normal cardiac function}, euvolemic {Normal blood volume}, NSR {Normal sinus rhythm}, Hypertension {Hypertensive disorder, systemic arterial}, hypertensive emergency {Hypertensive emergency}, flash 
+pulm edema {Acute pulmonary edema}, weaned quickly off 
+BIPAP {Dual pressure spontaneous ventilation support weaning protocol}, stable {Patient's condition stable}, diuresed {Diuretic therapy}, euvolemic {Normal blood volume}, PCP {Primary care management}, antihypertensive {Antihypertensive therapy}, normotensive {Normal blood pressure}, CAD {Coronary arteriosclerosis}, re-started 
+low-dose lisinopril {Restart of medication}, Hyperlipidemia {Hyperlipidemia}, myalgias {Muscle pain}, problems {Problem}, Cardiac {Cardiac care}, diet {Dietary finding}, PROPHYLAXIS {Preventive procedure}, DVT {Deep venous thrombosis}, ppx {Administration of prophylactic anticoagulant}, heparin {Heparin therapy}, Pain management {Pain management}, tylenol {Administration of analgesic}"
+"###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:
+ALENDRONATE - 70 mg po q ___  
+CHLORDIAZEPOXIDE HCL - 25 mg po daily PRN anxiety  
+FOSINOPRIL - 10 mg po qhs (STOPPED 2 Months prior)  
+SIMVASTATIN - 40 mg po qhs (STOPPED 2 Months prior)  
+MULTIVITAMIN po qd  
+ 
+Discharge Medications:
+1. Lisinopril 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
+Disp:*30 Tablet(s)* Refills:*0*
+2. Pravastatin 40 mg Tablet Sig: One (1) Tablet PO once a day.
+Disp:*30 Tablet(s)* Refills:*0*
+3. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).
+Disp:*30 Tablet(s)* Refills:*0*
+4. Aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1) 
+Tablet, Delayed Release (E.C.) PO DAILY (Daily).
+Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0*
+5. Multivitamin     Tablet Sig: One (1) Tablet PO DAILY (Daily). 
+ 
+6. Alendronate 70 mg Tablet Sig: One (1) Tablet PO QMON (every 
+___.  
+7. Atenolol 25 mg Tablet Sig: One (1) Tablet PO once a day.
+Disp:*30 Tablet(s)* Refills:*0*
+8. Vitamin D 2,000 unit Capsule Sig: One (1) Capsule PO once a 
+day.
+Disp:*30 Capsule(s)* 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:
+Primary Diagnosis:
+Coronary Artery Disease s/p cardiac cath with DES to circumflex 
+artery.
+
+ 
+Discharge Condition:
+Stable, 
+
+ 
+
+###RESPONSE: Coronary Artery Disease {Coronary arteriosclerosis}, cardiac cath {Cardiac catheterization}, DES {Endovascular insertion of drug eluting stent}, circumflex 
+artery {Structure of circumflex branch of left coronary artery}, Stable {Patient's condition stable}"
+"###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 electively admitted at the ___ for cardiac cath after 
+your abnormal stress test. You had multiple-vessel disease and 
+had a drug diluting (Xience) stent placed to one of your heart 
+arteries (circumflex artery). You will need to be in aspirin and 
+plavix for a year and have close cardiology follow up (See 
+appointments below).
+.
+If you have chest pain, palpitations, shortness of breath, groin 
+pain, bleeding or anything else that cocerns you, please come to 
+our ER.
+.
+Your medications were left unchanged, but:
+* You were started on lisinopril (5 mg Daily) to protect your 
+heart and blood pressure control. If the ___ can provide you with 
+a similar ACE inhibitor would be ok to switch, but talk to your 
+PCP or Dr. ___ there first.
+* You were started on pravastatin, that is similar to Lipitor or 
+Crestor, but cause muscle pain less often. We will need to try 
+several medications to see which one you are able to tolerate, 
+but your cholesterol must be tightly controlled.
+* You were started on low-dose beta-blocker to protect your 
+heart. You are being discharge in low-dose atenolol.
+* You are being put on maintainance dose of Vitamin D to 
+decrease further your cardiovascular read.
+* You were started on Aspirin and Plavix. YOU MUST NOT STOP them 
+for any reason, unless specifically ordered by a physician. You 
+cannot run out of this medicaion. Feel free to call Dr. ___ 
+you have any problems filling it!
+ 
+
+###RESPONSE: cardiac cath {Cardiac catheterization}, abnormal stress test {Cardiovascular stress test abnormal}, vessel disease {Coronary arteriosclerosis}, drug diluting (Xience) stent placed {Endovascular insertion of drug eluting stent}, heart 
+arteries {Coronary artery structure}, circumflex artery {Structure of circumflex branch of left coronary artery}, aspirin {Administration of aspirin}, cardiology {Cardiology service}, appointments {Follow-up arranged}, chest pain {Chest pain}, palpitations {Palpitations}, shortness of breath {Dyspnea}, groin 
+pain {Inguinal pain}, bleeding {Bleeding}, ER {Emergency treatment management}, to protect {Administration of prophylactic drug or medicament}, heart {Heart structure}, blood pressure {On treatment for hypertension}, talk {Discussion}, PCP {Primary care management}, muscle pain {Muscle pain}, protect {Administration of prophylactic drug or medicament}, heart {Heart structure}, cardiovascular read {Cardiovascular monitoring}, Aspirin {Administration of aspirin}, YOU MUST NOT STOP them {Recommendation to continue with drug treatment}, problems {Problem}"
+"###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:
+Wound erythema
+ 
+Major Surgical or Invasive Procedure:
+___: Feeding tube placement
+
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, Wound erythema {Wound erythema}, Feeding tube placement {Insertion of feeding tube into small intestine}"
+"###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 ETOH cirrhosis s/p combined liver &
+kidney transplant ___, ___ c/b biliary stricture and 
+chronic rejection now s/p re-transplant ___ with multiple
+re-admissions since then most recently for PNA (discharged
+___ who now presents with ___ erythema and
+purulent drainage c/f surgical site infection.  He first noticed
+the erythema and drainage yesterday, and denies fevers, chills,
+rigors, sweats, abdominal pain, nausea, SOB or change in bowel
+and bladder habits. On exam he has multiple well-healed surgical
+incisions excepting the medial RLQ oblique incision which has a 
+1
+cm draining superficial dehiscence in the middle of an otherwise
+well-healing scar. There is erythema the length of the incision
+and palpable induration. Purulent fluid is readily expressed,
+particularly from the medial pole of the wound. WBC is 9.5, Cr
+1.9 (last 1.6 on ___, LFTs are mildly elevated consistent with
+the last measured values on ___. 
+
+ 
+
+###RESPONSE: ETOH cirrhosis {Alcoholic cirrhosis}, liver {Transplanted liver present}, kidney transplant {Transplanted kidney present}, biliary stricture {Biliary stricture}, chronic rejection {Chronic graft rejection}, transplant {Transplantation}, PNA {Pneumonia}, erythema {Erythema}, purulent drainage {Purulent discharge}, surgical site infection {Surgical site infection}, erythema {Erythema}, drainage {Discharge}, fevers {Fever}, chills {Chill}, rigors {Rigor}, sweats {Sweating}, abdominal pain {Abdominal pain}, nausea {Nausea}, SOB {Dyspnea}, change in bowel {Altered bowel function}, bladder habits {Alteration in patterns of urinary elimination}, surgical
+incisions {Surgical incision wound}, RLQ {Structure of right lower quadrant of abdomen}, incision {Abdomen incision}, draining {Wound discharge}, dehiscence {Dehiscence}, healing scar {Healing scar}, erythema {Erythema}, incision {Surgical incision wound}, induration {Induration}, Purulent fluid {Purulent discharge}, wound {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: Past Medical History:
+___ gunshot wounds in ___ status post exploratory
+laparotomy and colostomy.
+___ colostomy was reversed.  
+___, he had a history of small-bowel obstruction with
+multiple surgeries that retrieved most of his small bowel.  
+___, laparotomy again had multiple surgeries again for 
+small
+bowel obstruction.
+___, he had a right knee arthroscopy.
+___, diagnosis of cirrhosis and bleeding varices.  
+___, he had hepatorenal syndrome and liver failure and he
+had his combined liver and kidney transplant at ___.
+H/o cholangitis, multiple ERCP with plastic/metal stents.
+___ cystoscopy to remove a stent that was placed that was
+causing urosepsis (this resulted in a lawsuit against ___).  
+___, he underwent a lysis of adhesions at ___.
+___ cholangitis/ s/p ERCP and stent placement.
+___. Hepaticojejunostomy with Roux-en-Y.
+___  PTC and liver biopsy with chronic rejection.
+___ Orthotropic Deceased Donor Liver Transplant
+Hepatic encephalopathy
+Gout
+Depression
+Insomnia 
+ 
+
+###RESPONSE: gunshot wounds {Gunshot wound}, exploratory
+laparotomy {Exploratory laparotomy}, colostomy {Colostomy}, colostomy {Colostomy}, small-bowel obstruction {Small bowel obstruction}, surgeries {Surgical procedure}, small bowel {Structure of small intestine}, laparotomy {Laparotomy}, surgeries {Surgical procedure}, small
+bowel obstruction {Small bowel obstruction}, knee arthroscopy {Arthroscopy of knee joint}, cirrhosis {Cirrhosis of liver}, bleeding varices {Bleeding varices}, hepatorenal syndrome {Hepatorenal syndrome}, liver failure {Hepatic failure}, liver {Transplanted liver present}, kidney transplant {Transplanted kidney present}, cholangitis {Cholangitis}, ERCP {Endoscopic retrograde cholangiopancreatography}, stents {Placement of stent}, cystoscopy {Transurethral cystoscopy}, stent {Removal of stent}, lysis of adhesions {Lysis of adhesions}, cholangitis {Cholangitis}, ERCP {Endoscopic retrograde cholangiopancreatography}, stent placement {Placement of stent}, liver biopsy {Biopsy of liver}, chronic rejection {Chronic rejection of liver transplant}, Orthotropic Deceased Donor Liver Transplant {Orthotopic transplantation of whole liver}, Hepatic encephalopathy {Hepatic encephalopathy}, Gout {Inflammatory disorder due to increased blood urate level}, Depression {Depressive disorder}, Insomnia {Insomnia}"
+"###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 - dementia (___)
+Father - diabetes/prostate cancer (___)
+2 Children, 3 Grandchildren all healthy
+ 
+
+###RESPONSE: dementia {Dementia}, diabetes {Diabetes mellitus}, prostate cancer {Carcinoma of prostate}"
+"###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:
+VS:  97.3  83  123/81  14  100%RA
+GEN: NAD, well-nourished, appropriately groomed.
+NEURO: AOx3, CN II-XII grossly intact
+HEENT: Sclerae anicteric, trachea midline, no JVD
+CV: RRR no MRG, 2+ peripheral pulses bilaterally  
+RESP: CTAB no WRC, no respiratory distress
+GI: Extensive abdominal scarring from previous surgical
+incisions. Medial RLQ oblique incision with a 1 cm draining
+superficial dehiscence in the middle of an otherwise 
+well-healing
+scar. Erythema the length of the incision with palpable
+induration. Purulent fluid readily expressed, particularly from
+the medial pole of the wound. Abdomen otherwise soft, non-tender
+and non-distended. No rebound tenderness or guarding. Dull to
+percussion. Bowel sounds normoactive. Rectal exam deferred
+EXT: WWP no CCE
+
+LAB VALUES:
+
+Lactate: 5.5
+
+139  111  35 
+-------------< 138 
+5.5  16  1.9   
+
+ALT: 57 AP: 231 Tbili: 2.2 Alb: 3.7 
+AST: 25 Lip: 19     
+
+9.5 ___ > 10.1 / 31.2 < 205 ___ 
+ 
+N:83.1 L:9.0 M:6.7 E:0.2 Bas:0.2 ___: 0.8 Absneut: 7.88
+Abslymp: 0.85 Absmono: 0.64 Abseos: 0.02 Absbaso: 0.02  
+
+___: 12.2  PTT: 24.7  INR: 1.1  
+
+IMAGING/STUDIES:
+
+N/A
+
+ 
+
+###RESPONSE: VS {Vital signs finding}, RA {Breathing room air}, GEN {General examination of patient}, NAD {No abnormality detected}, well-nourished {Well nourished}, NEURO {Neurological examination}, AOx3 {Oriented to person, time and place}, CN II {Optic nerve structure}, XII {Hypoglossal nerve structure}, grossly intact {Normal nervous system function}, HEENT {Physical examination procedure}, Sclerae anicteric {White sclera}, trachea {Tracheal structure}, JVD {Jugular venous engorgement}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, no MRG {Heart sounds normal}, 2+ peripheral pulses {Peripheral pulses normal}, RESP {Examination of respiratory system}, CTAB {Normal breath sounds}, distress {Distress}, GI {Examination of digestive system}, abdominal scarring {Abdominal skin scar}, surgical
+incisions {Surgical incision wound}, RLQ {Structure of right lower quadrant of abdomen}, incision {Abdomen incision}, draining {Wound discharge}, dehiscence {Dehiscence}, healing
+scar {Healing scar}, Erythema {Erythema}, incision {Surgical incision wound}, induration {Induration}, Purulent fluid {Purulent discharge}, wound {Wound}, Abdomen {Examination of abdomen}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, rebound {Rebound tenderness}, tenderness {Tenderness}, guarding {Abdominal guarding}, percussion {Percussion}, Bowel sounds {Normal bowel sounds}, Rectal exam {Rectal examination}, EXT {Examination of limb}, WWP {Normal tissue perfusion}"
+"###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:
+___ 11:57AM BLOOD WBC-9.5# RBC-3.24* Hgb-10.1* Hct-31.2* 
+MCV-96 MCH-31.2 MCHC-32.4 RDW-17.0* RDWSD-58.5* Plt ___
+___ 03:55AM BLOOD WBC-5.3 RBC-2.87* Hgb-9.0* Hct-26.8* 
+MCV-93 MCH-31.4 MCHC-33.6 RDW-16.8* RDWSD-56.2* Plt ___
+___ 11:26AM BLOOD WBC-6.0# RBC-3.53* Hgb-10.9* Hct-33.4* 
+MCV-95 MCH-30.9 MCHC-32.6 RDW-18.7* RDWSD-63.1* Plt ___
+___ 11:57AM BLOOD Glucose-138* UreaN-35* Creat-1.9* Na-139 
+K-5.5* Cl-111* HCO3-16* AnGap-18
+___ 03:55AM BLOOD Glucose-101* UreaN-32* Creat-1.6* Na-137 
+K-5.1 Cl-110* HCO3-15* AnGap-17
+___ 04:40AM BLOOD Glucose-112* UreaN-33* Creat-1.7* Na-136 
+K-5.1 Cl-109* HCO3-15* AnGap-17
+___ 11:26AM BLOOD Glucose-111* UreaN-43* Creat-1.8*# Na-139 
+K-4.8 Cl-112* HCO3-17* AnGap-15
+___ 11:26AM BLOOD ALT-34 AST-13 AlkPhos-185* TotBili-1.7*
+___ 03:55AM BLOOD tacroFK-12.6
+___ 04:20AM BLOOD tacroFK-11.6
+___ 04:40AM BLOOD tacroFK-8.1
+
+ 
+ 
+___ 11:57 am BLOOD CULTURE
+
+   Blood Culture, Routine (Pending): 
+
+ 
+ 
+___ 12:25 pm SWAB
+
+                            **FINAL REPORT ___
+
+   GRAM STAIN (Final ___: 
+      1+    (<1 per 1000X FIELD):   POLYMORPHONUCLEAR 
+LEUKOCYTES. 
+      2+   ___ per 1000X FIELD):   GRAM POSITIVE ROD(S). 
+
+   WOUND CULTURE (Final ___: 
+      LACTOBACILLUS SPECIES.    MODERATE GROWTH. 
+      ENTEROCOCCUS SP..    SPARSE GROWTH. 
+      MIXED BACTERIAL FLORA. 
+         This culture contains mixed bacterial types (>=3) so an
+         abbreviated workup is performed. Any growth of 
+P.aeruginosa,
+         S.aureus and beta hemolytic streptococci will be 
+reported. IF
+         THESE BACTERIA ARE NOT REPORTED, THEY ARE NOT PRESENT 
+in this
+         culture. 
+         Work-up of organism(s) listed discontinued (excepted 
+screened
+         organisms) due to the presence of mixed bacterial flora 
+detected
+         after further incubation. 
+
+                              SENSITIVITIES: MIC expressed in 
+MCG/ML
+                      
+_________________________________________________________
+                             ENTEROCOCCUS SP.
+                             |   
+AMPICILLIN------------  =>32 R
+LINEZOLID-------------     2 S
+PENICILLIN G----------  =>64 R
+VANCOMYCIN------------  =>32 R
+
+   ANAEROBIC CULTURE (Final ___:    NO ANAEROBES ISOLATED. 
+
+
+ 
+ 
+
+ 
+
+###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}, 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}, 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}, 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}, 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}, 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}, CULTURE {Blood culture}, Blood Culture {Blood culture}, GRAM STAIN {Gram stain method}, CULTURE {Microbial culture}, culture {Microbial culture}, culture {Microbial culture}, CULTURE {Microbial culture}"
+"###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:
+___ PMH EtOH cirrhosis, s/p combo liver/kidney trx (___) 
+c/bbiliary strict and chronic rejection requiring 
+___, recently hospitalized for PNA, was 
+readmitted for incision wound infection. Wound was I&D'd in the 
+ED and he was admitted to transplant surgery where he was 
+started on broad spectrum antibiotics pending blood and 
+incision/wound cultures. The wound was packed with Iodiform. 
+
+Wound culture initially isolated 2+ GPRs. He was afebrile and 
+would improved. Final culture data was unable until after 
+patient discharged on Augmentin to complete a weeks course. 
+Wound measured 2cm x 1cm. Normal saline damp to dry dressings 
+were to be done bid. Blood cultures drawn were unfinalized, but 
+negative to date. Of note, after patient was discharged, his 
+wound culture was finalized as VRE. The plan was to switch to 
+Linezolid for 7 days. His outpatient coordinator was notified 
+and was to call in the Linezolid to pharmacy and call the 
+patient. 
+
+While in patient, nutrition recommended tube feeds for poor po 
+intake. A post pyloric feeding tube was placed and tube feeds 
+were started (Nepro). ___ provided teaching to the patient and 
+his wife on ___ and supplies were delivered to the patient. 
+
+Vital signs remained stable, LFTs improved some more. At time of 
+discharge to home, his immunosuppression was set as tacrolimus 
+3mg twice daily as his tacrolimus level was not back. Tacrolimus 
+level was inaccurately reported and it was felt that the level 
+reported was his roommate's and vice versa. So, his dose was 
+increased to 3.5mg twice daily for a presumed level of 6.9 which 
+was on the low side and was more consistent with the prior day 
+of 8.1. Also, fluconazole was renally dosed and decreased to 
+200mg daily to start ___. Next lab draw was set for ___. 
+
+___ services were arranged in addition to ___. He was 
+discharged to home appearing alert and in NAD. 
+
+ 
+
+###RESPONSE: EtOH cirrhosis {Alcoholic cirrhosis}, liver {Transplanted liver present}, kidney {Transplanted kidney present}, PNA {Pneumonia}, incision wound infection {Postoperative wound infection}, Wound {Wound}, I&D {Incision AND drainage}, antibiotics {Antibiotic therapy}, incision/wound cultures {Wound microscopy, culture and sensitivities}, wound {Wound}, Wound culture {Wound microscopy, culture and sensitivities}, improved {Patient's condition improved}, culture {Microbial culture}, Wound {Wound}, Blood cultures {Blood culture}, wound culture {Wound microscopy, culture and sensitivities}, poor po 
+intake {Decrease in appetite}, post pyloric feeding {Insertion of feeding tube into small intestine}, teaching {Patient education}, Vital signs {Vital signs finding}, stable {Normal vital signs}, improved {Patient's condition improved}, immunosuppression {Immunosuppression}, alert {Mentally alert}, NAD {No abnormality detected}"
+"###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. NPH 10 Units Breakfast
+Insulin SC Sliding Scale using HUM Insulin
+2. Sodium Bicarbonate 650 mg PO TID 
+3. Acetaminophen 650 mg PO Q8H:PRN Pain - Mild 
+4. Omeprazole 40 mg PO DAILY 
+5. PredniSONE 12.5 mg PO DAILY 
+6. Sulfameth/Trimethoprim DS 1 TAB PO 3X/WEEK (___) 
+7. Tacrolimus 3.5 mg PO Q12H 
+8. ValGANCIclovir 450 mg PO EVERY OTHER DAY 
+9. Allopurinol ___ mg PO DAILY 
+10. amLODIPine 10 mg PO DAILY 
+11. Cyanocobalamin 1000 mcg PO EVERY 4  WEEKS (___) 
+12. Docusate Sodium 100 mg PO BID 
+13. Escitalopram Oxalate 15 mg PO DAILY 
+14. Fluconazole 400 mg PO Q24H 
+15. Multivitamins 1 TAB PO DAILY 
+16. Mycophenolate Sodium ___ 720 mg PO BID 
+17. Senna 8.6 mg PO BID:PRN constipation 
+18. TraMADol 50 mg PO Q6H:PRN Pain - Moderate 
+19. TraZODone 25 mg PO QHS:PRN insomnia 
+
+ 
+Discharge Medications:
+1.  Amoxicillin-Clavulanic Acid ___ mg PO Q12H 
+End date ___ 
+RX *amoxicillin-pot clavulanate 875 mg-125 mg 1 tablet(s) by 
+mouth twice a day Disp #*9 Tablet Refills:*0 
+2.  Fluconazole 200 mg PO Q24H  
+3.  NPH 10 Units Breakfast
+Insulin SC Sliding Scale using REG Insulin 
+4.  Omeprazole 20 mg PO DAILY  
+5.  PredniSONE 10 mg PO DAILY Duration: 7 Days 
+follow taper  
+6.  Sulfameth/Trimethoprim DS 1 TAB PO EVERY OTHER DAY  
+7.  Tacrolimus 3.5 mg PO Q12H  (changed to 3.5 twice daily from 
+3mg twice daily on ___ for level of 6.9
+8.  Acetaminophen 650 mg PO Q8H:PRN Pain - Mild 
+Maximum 6 of the 325 mg tablets daily  
+9.  Allopurinol ___ mg PO DAILY  
+10.  amLODIPine 10 mg PO DAILY  
+11.  Cyanocobalamin 1000 mcg PO EVERY 4  WEEKS (___)  
+12.  Docusate Sodium 100 mg PO BID 
+Hold for loose bowel movements or more than 2 bowel movements 
+daily  
+13.  Escitalopram Oxalate 15 mg PO DAILY  
+14.  Multivitamins 1 TAB PO DAILY  
+15.  Mycophenolate Sodium ___ 720 mg PO BID  
+16.  Senna 8.6 mg PO BID:PRN constipation 
+Hold for loose bowel movements or more than 2 bowel movements 
+daily  
+17.  Sodium Bicarbonate 650 mg PO TID  
+18.  TraMADol 50 mg PO Q4H:PRN Pain - Moderate  
+19.  TraZODone 25 mg PO HS:PRN insomnia  
+20.  ValGANCIclovir 450 mg PO EVERY OTHER DAY  
+21.Tube Feed Orders
+Tubefeeding: Nepro or Equivalent
+ Full strength;  Goal rate: 50 ml/hr
+ Residual Check: q4h Hold feeding for residual >= : 200 ml
+Flush w/ 50 ml water q6h
+Dispense 1 month supply;   Refill: 5
+
+ 
+
+###RESPONSE: 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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Severe malnutrition (decreased grip strength)
+liver transplant
+transplant incision abscess
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, Severe malnutrition {Nutritional marasmus}, liver transplant {Transplanted liver present}, transplant incision abscess {Postoperative wound abscess}, Mental Status {Neurological mental status determination}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, 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:
+Please call the transplant clinic at ___ for fever > 
+101, chills, nausea, vomiting, diarrhea, constipation, inability 
+to tolerate food, fluids or medications, feeding tube clogs, 
+yellowing of skin or eyes, increased abdominal pain, incisional 
+redness, drainage or bleeding, dizziness or weakness, decreased 
+urine output or dark, cloudy urine, swelling of abdomen or 
+ankles, or any other concerning symptoms.
+
+You will have labwork drawn every ___ and ___ as 
+arranged by the transplant clinic, with results to the 
+transplant clinic (Fax ___ . CBC, Chem 10, AST, ALT, 
+Alk Phos, T Bili, Trough Tacro level. 
+
+**On the days you have your labs drawn, do not take your 
+Tacrolimus until your labs are drawn. Bring your Tacrolimus with 
+you so you may take your medication as soon as your labwork has 
+been drawn.
+
+Please note that the Fluconazole dose has been decreased to 
+200mg daily. 
+
+You have been prescribed an antibiotic (augmentin) for your 
+abdominal incision infection
+
+Follow your medication card, keep it updated with any dosage 
+changes, and always bring your card with you to any clinic or 
+hospital visits.
+
+You may shower. Allow the water to run over your incision and 
+pat area dry. No rubbing, no lotions or powder near the 
+incision. 
+
+Continue NS damp to dry dressing to the incision open area. 
+Monitor for increased redness, drainage, foul odor or other 
+concerns.
+Complete Augmentin course as prescribed.
+
+No tub baths or swimming
+No driving if taking narcotic pain medications
+
+Avoid direct sun exposure. Wear protective clothing and a hat, 
+and always wear sunscreen with SPF 30 or higher when you go 
+outdoors.
+
+Drink enough fluids to keep your urine light in color. 
+You have had a feeding tube placed and have started tube feeds 
+to help with nutrition. Please continue the tube feeds as 
+ordered in addition to flushes. Monitor for clogging of the tube 
+or any increase in diarrhea or blood sugars that are hard to 
+manage.
+
+Check your blood sugars and blood pressure at home. Report 
+consistently elevated values to the transplant clinic
+
+Do not increase, decrease, stop or start medications without 
+consultation with the transplant clinic at ___. There 
+are significant drug interactions with anti-rejection 
+medications which must be considered in medication management 
+following transplant
+
+Refer to transplant binder, and there is always someone on call 
+at the transplant clinic with any questions that may arise
+
+ 
+
+###RESPONSE: clinic {Outpatient care management}, fever {Fever}, chills {Chill}, nausea {Nausea}, vomiting {Vomiting}, diarrhea {Diarrhea}, constipation {Constipation}, fluids {Tolerating oral fluid}, feeding tube clogs {Blocked endotracheal tube}, yellowing of skin {Yellow skin}, eyes {Scleral icterus}, abdominal pain {Abdominal pain}, redness {Redness of skin over lesion}, drainage {Discharge}, bleeding {Bleeding}, dizziness {Dizziness}, weakness {Asthenia}, decreased 
+urine output {Decreased urine output}, cloudy urine {Cloudy urine}, swelling of abdomen {Swollen abdomen}, ankles {Ankle region structure}, CBC {Complete blood count}, antibiotic {Antibiotic therapy}, abdominal incision {Abdomen incision}, infection {Local infection of wound}, incision {Surgical incision wound}, incision {Surgical incision wound}, dressing {Application of dressing}, incision {Surgical incision wound}, redness {Redness of skin over lesion}, drainage {Discharge}, odor {Wound odor}, taking narcotic pain medications {Narcotics education}, diarrhea {Diarrhea}, blood sugars {Glucose measurement, blood}, blood sugars {Glucose measurement, blood}, blood pressure {Blood pressure monitoring}, drug interactions {Drug interaction}, transplant {Transplantation}"
+"###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: CARDIOTHORACIC
+ 
+
+###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:
+Fatigue, dyspnea on exertion and lightheadedness.
+ 
+Major Surgical or Invasive Procedure:
+___ - aortic valve replacement, coronary artery bypass 
+grafts x2(LIMA>LAD,SVG>RCA) 
+___ - Left and right heart catheterization, coronary 
+angiogram left ventriculogram
+
+ 
+
+###RESPONSE: No Known Allergies to Drugs {Non-allergic hypersensitivity to drug or medicament}, Fatigue {Fatigue}, dyspnea on exertion {Dyspnea on exertion}, lightheadedness {Lightheadedness}, aortic valve replacement {Replacement of aortic valve}, coronary artery bypass 
+grafts {Coronary artery bypass grafting}, LIMA {Structure of left internal thoracic artery}, LAD {Structure of anterior descending branch of left coronary artery}, SVG {Aortocoronary artery bypass graft with saphenous vein graft}, RCA {Right coronary artery structure}, Left {Catheterization of left heart}, right heart catheterization {Catheterization of right heart}, coronary 
+angiogram {Angiography of coronary artery}, left ventriculogram {Left ventriculogram}"
+"###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:
+This ___ year old white male with known aortic stenosis is 
+followed with serial echocardiograms. Most recently these 
+revealed an aortic valve area of 0.7cm2, a bicuspid valve and 
+LVEF of 30%. She was referred for surgical evaluation after 
+recent new onset heart failure.
+
+ 
+
+###RESPONSE: aortic stenosis {Aortic valve stenosis}, echocardiograms {Echocardiography}, aortic valve {Aortic valve structure}, surgical {Surgical procedure}, evaluation {Evaluation procedure}, heart failure {Heart failure}"
+"###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
+Noninsulin dependent diabetes mellitus
+Aortic Stenosis/Aortic Insufficiency
+Mitral Regurgitation
+Gastroesophageal Reflux Disease
+degenerative joint disease
+tonsillectomy
+
+ 
+
+###RESPONSE: Hypertension {Hypertensive disorder, systemic arterial}, Noninsulin dependent diabetes mellitus {Diabetes mellitus type 2}, Aortic Stenosis {Aortic valve stenosis}, Aortic Insufficiency {Aortic valve regurgitation}, Mitral Regurgitation {Mitral valve regurgitation}, Gastroesophageal Reflux Disease {Gastroesophageal reflux disease}, degenerative joint disease {Osteoarthritis}, tonsillectomy {Tonsillectomy}"
+"###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 died of MI at ___; father died of CVA at ___
+
+ 
+
+###RESPONSE: died {Dead}, MI {Myocardial infarction}, died {Dead}, CVA {Cerebrovascular accident}"
+"###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:
+
+Pulse:91 Resp: 20     O2 sat: 100% RA
+B/P  Right: 108/63   Left: 104/65
+Height: 68""   Weight: 175 lbs
+
+General:NAD; slow to process and answer questions
+Skin: Dry [x] intact [x]
+HEENT: PERRLA [x] EOMI [x]anicteric sclera;OP unremarkable;teeth
+in poor repair
+Neck:  Supple [x] Full ROM [x]no JVD
+Chest: Lungs clear bilaterally [x]
+Heart: RRR [x]  Irregular []  Murmur ___ SEm radiates throughout
+precordium to carotids
+Abdomen: Soft [x] non-distended [x] non-tender [x]  bowel sounds
++ [x]
+no HSM/CVA tenderness
+Extremities: Warm [x], well-perfused [x]  Edema - none
+Varicosities: None [x]chronic mild venous stasis brawniness 
+above
+ankles bil.
+Neuro: Grossly intact;MAE ___ strengths;nonfocal exam; has mild
+cognitive deficits
+Pulses:
+Femoral      Right: 2+  Left: 2+
+DP           Right: NP  Left: NP
+___           Right: 1+  Left: 1+
+Radial       Right: 2+  Left: 2+
+
+Carotid: murmur radiates to both carotids
+
+ 
+
+###RESPONSE: Pulse {Finding of pulse rate}, Resp {Examination of respiratory system}, O2 sat {Oxygen saturation measurement}, RA {Breathing room air}, B/P {Blood pressure finding}, Right {Right upper arm structure}, Left {Left upper arm structure}, Height {Height / growth finding}, Weight {Weight finding}, General {General examination of patient}, NAD {No abnormality detected}, Skin {Examination of skin}, Dry {Xeroderma}, intact {Intact skin}, HEENT {Physical examination procedure}, PERRLA {Pupils equal, react to light and accommodation}, EOMI {Normal ocular motility}, anicteric sclera {White sclera}, unremarkable {No abnormality detected}, teeth {Structure of dentition}, repair {Surgical repair}, Neck {Physical examination procedure}, Supple {Normal movement of neck}, Full ROM {Normal movement of neck}, JVD {Jugular venous engorgement}, Chest {Examination of respiratory system}, Lungs {Examination of respiratory system}, Heart {Cardiovascular physical examination}, RRR {Normal heart rate}, Irregular {Irregular heart beat}, Murmur {Murmur}, precordium {Structure of precordium}, carotids {Carotid artery structure}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, non-distended {Normal abdominal contour}, non-tender {Abdominal tenderness}, bowel sounds {Normal bowel sounds}, HSM {Hepatosplenomegaly}, CV {Cardiovascular physical examination}, tenderness {Tenderness}, Extremities {Examination of limb}, Warm {Warm skin}, well-perfused {Normal tissue perfusion}, Edema {Edema}, Varicosities {Venous varices}, chronic {Chronic disease}, mild {Symptom mild}, venous stasis {Venous stasis}, ankles {Ankle region structure}, Neuro {Neurological examination}, Grossly intact {Normal nervous system function}, MAE {Does move all four limbs}, mild {Symptom mild}, cognitive deficits {Impaired cognition}, Femoral {Structure of femoral artery}, Right: 2 {Pulse present in right femoral artery}, Left: 2 {Pulse present in left femoral artery}, DP {Structure of dorsalis pedis artery}, Right: NP {Absence of pulse in right dorsalis pedis artery}, Left: NP {Absence of pulse in left dorsalis pedis artery}, Radial {Structure of radial artery}, Right {Structure of right radial artery}, 2+ {Normal radial pulse}, Left {Structure of left radial artery}, 2+ {Normal radial pulse}, Carotid {Carotid artery structure}, murmur {Murmur}, carotids {Carotid artery 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: Pertinent Results:
+___ ECHO
+PREBYPASS 
+No atrial septal defect is seen by 2D or color Doppler. There is 
+mild symmetric left ventricular hypertrophy. The left 
+ventricular cavity is moderately dilated. There is severe global 
+left ventricular hypokinesis (LVEF = ___ %). The right 
+ventricular cavity is mildly dilated with moderate impairment 
+with focal hypokinesis of the apical free wall. The ascending 
+aorta is moderately dilated. The descending thoracic aorta is 
+mildly dilated. There are simple atheroma in the descending 
+thoracic aorta. There are three aortic valve leaflets. The 
+aortic valve leaflets are moderately thickened. There is severe 
+aortic valve stenosis (valve area 0.8-1.0cm2). Moderate to 
+severe (3+) aortic regurgitation is seen. The mitral valve 
+leaflets are mildly thickened. Mild (1+) mitral regurgitation is 
+seen. 
+POSTBYPASS
+The patient is receiving dobutamine at 7ucg/kg/min.
+RV systolic function is improved. There is now mild RV 
+hypokinesis with minimal focality. LV systolic function is 
+marginally improved, LVEF ~25%. There is a well seated, well 
+fumctioning bioprosthesis in the aortic position. There is a 
+mild perivalvular leak. TR is now mild (1+). The remaining study 
+is otherwise unchanged from prebypass. 
+ 
+___ 06:00AM BLOOD WBC-10.0 RBC-3.42* Hgb-8.7* Hct-26.8* 
+MCV-78* MCH-25.3* MCHC-32.4 RDW-16.0* Plt ___
+___ 07:00AM BLOOD WBC-16.0* RBC-3.71* Hgb-9.1* Hct-29.8* 
+MCV-80* MCH-24.6* MCHC-30.6* RDW-15.6* Plt ___
+___ 06:00AM BLOOD Glucose-166* UreaN-26* Creat-1.1 Na-139 
+K-3.5 Cl-98 HCO3-33* AnGap-12
+___ 06:45PM BLOOD UreaN-31* Creat-1.1 K-3.7
+___ 05:41PM BLOOD Type-ART pO2-72* pCO2-45 pH-7.37 
+calTCO2-27 Base XS-0
+___ 12:30PM BLOOD %HbA1c-7.6*
+ 
+
+###RESPONSE: ECHO {Echocardiography}, atrial septal defect {Atrial septal defect}, color Doppler {Color Doppler ultrasound}, mild symmetric left ventricular hypertrophy {Mild left ventricular hypertrophy}, left 
+ventricular cavity is moderately dilated {Dilatation of left cardiac ventricle}, left ventricular {Left cardiac ventricular structure}, hypokinesis {Behavior showing reduced motor activity}, right 
+ventricular cavity is mildly dilated {Dilatation of right cardiac ventricle}, impairment {Impairment}, hypokinesis {Behavior showing reduced motor activity}, apical {Structure of apex of heart}, wall {Cardiac wall structure}, ascending 
+aorta {Ascending aorta structure}, dilated {Dilatation}, descending thoracic aorta {Structure of descending thoracic aorta}, dilated {Dilatation}, atheroma {Atheroma}, descending 
+thoracic aorta {Structure of descending thoracic aorta}, aortic valve leaflets {Structure of cardiac valve leaflet}, aortic valve leaflets {Structure of cardiac valve leaflet}, thickened {Increased thickness}, severe 
+aortic valve stenosis {Severe stenosis of aortic valve}, aortic regurgitation {Aortic valve regurgitation}, mitral valve 
+leaflets are mildly thickened {Thickened mitral leaflet}, Mild (1+) mitral regurgitation {Mild mitral valve regurgitation}, RV {Right cardiac ventricular structure}, improved {Patient's condition improved}, RV 
+hypokinesis {Hypokinetic right ventricular wall}, LV {Left cardiac ventricular structure}, improved {Patient's condition improved}, aortic {Aortic structure}, perivalvular leak {Prosthetic cardiac paravalvular leak}, 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}, 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}, 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}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, K {Blood potassium measurement}, pH {pH 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: Brief Hospital Course:
+Mr. ___ was admitted to the ___ on ___ for a cardiac 
+catheterization in anticipation of his aortic valve surgery. His 
+cardiac catheterization revealed three vessel coronary artery 
+disease. Mr. ___ was worked-up in the usual preoperative 
+manner and was ready for surgery. 
+
+On ___ he was taken to the Operating Room where he 
+underwent coronary artery bypass grafting to two vessels and an 
+aortic valve replacement using a tissue prosthesis. (Please see 
+operative note for details.) He weaned from bypass on 
+Dobutamine,Propofol and Neosynephrine in stable condition. 
+Postoperatively he was taken to the intensive care unit for 
+monitoring. 
+
+Over the next ___ hours he had awoke neurologically intact and 
+was extubated. Pressors were weaned off and he remained stable. 
+Beta blockade and aspirin were resumed. On postoperative day 
+one, he was transferred to the step down unit for further 
+recovery. He was gently diuresed towards his preoperative 
+weight. The physical therapy service was consulted for 
+assistance with his postoperative strength and mobility. 
+Oxygenation remained low and a CXR revealed what appeared to be 
+a large left effusion. A left lung thoracentesis was performed 
+on ___ yielding 500 mL of serosanguinous fluid.  A repeat CXR 
+demonstrated an elevated left diaphragm with atelectasis and 
+resolution of the effusion.  His oxygenation improved and he 
+felt better.
+
+He was discharged to a rehabilitation facility for further 
+recovery prior to going home.  He will continue on diuretics for 
+a week as he remained above his preoperative weight.  
+Arrangements were made for follow up with his cardiology, 
+medical and surgical providers.
+ 
+
+###RESPONSE: cardiac 
+catheterization {Cardiac catheterization}, aortic valve surgery {Aortic valve and adjacent structure operations}, cardiac catheterization {Cardiac catheterization}, three vessel coronary artery 
+disease {Triple vessel disease of the heart}, surgery {Surgical procedure}, coronary artery bypass grafting to two vessels {Coronary artery bypass grafts x 2}, aortic valve replacement {Replacement of aortic valve}, tissue {Body tissue structure}, operative {Surgical procedure}, stable condition {Patient's condition stable}, taken to the intensive care unit {Patient transfer to intensive care unit}, monitoring {Monitoring procedure}, neurologically intact {Normal nervous system function}, extubated {Removal of endotracheal tube}, Pressors {Hypotensive therapy}, stable {Patient's condition stable}, aspirin {Administration of aspirin}, postoperative {Postoperative state}, diuresed {Diuretic therapy}, weight {Weight finding}, physical therapy {Physical therapy assessment}, postoperative {Postoperative state}, CXR {Plain chest X-ray}, left {Left lung structure}, effusion {Pleural effusion}, left lung {Left lung structure}, thoracentesis {Thoracentesis}, CXR {Plain chest X-ray}, elevated {Elevation}, left diaphragm {Structure of left dome of diaphragm}, atelectasis {Atelectasis}, effusion {Pleural effusion}, improved {Patient's condition improved}, rehabilitation {Rehabilitation therapy}, diuretics {Diuretic therapy}, weight {Weight finding}, cardiology {Cardiology service}, 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: Medications on Admission:
+Furosemide 20mg daily, citalopram 20mg daily, glipizide 5mg 
+daily, metformin 1000mg daily, omeprazole 20mg daily, 
+simvastatin 80mg daily, diphenoxylate-atropine 25prn-prn  
+
+ 
+Discharge Medications:
+1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 
+times a day).  
+2. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) 
+Tablet, Delayed Release (E.C.) PO DAILY (Daily).  
+3. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: Two (2) 
+Capsule, Delayed Release(E.C.) PO DAILY (Daily).  
+4. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4H (every 
+4 hours) as needed for pain.  
+5. Oxycodone-Acetaminophen ___ mg Tablet Sig: ___ Tablets PO 
+Q4H (every 4 hours) as needed for pain.  
+6. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) 
+ML PO HS (at bedtime) as needed for constipation.  
+7. Bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal 
+DAILY (Daily) as needed for constipation.  
+8. Citalopram 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 
+ 
+9. Simvastatin 40 mg Tablet Sig: Two (2) Tablet PO DAILY 
+(Daily).  
+10. Ipratropium-Albuterol ___ mcg/Actuation Aerosol Sig: Two 
+(2) Puff Inhalation Q4H (every 4 hours).  
+11. Metformin 1,000 mg Tablet Sig: One (1) Tablet PO twice a 
+day.  
+12. Glipizide 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+
+13. Carvedilol 6.25 mg Tablet Sig: One (1) Tablet PO BID (2 
+times a day).  
+14. Lasix 40 mg Tablet Sig: One (1) Tablet PO once a day for 7 
+days.  
+15. Potassium Chloride 20 mEq Tab Sust.Rel. Particle/Crystal 
+Sig: One (1) Tab Sust.Rel. Particle/Crystal PO once a day for 7 
+days.  
+
+ 
+
+###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:
+coronary aretery disease
+s/p coronary artery bypass
+acute systolic heart failure
+Hypertension
+Non insulin dependent Diabetes Mellitus
+Aortic Stenosis/Aortic Insufficiency
+Mitral Regurgitation
+Gastroesophageal Reflux Disease
+degenerative joint disease
+
+ 
+Discharge Condition:
+Good
+
+ 
+
+###RESPONSE: coronary aretery disease {Coronary arteriosclerosis}, coronary artery bypass {Coronary artery bypass grafting}, acute systolic heart failure {Acute systolic heart failure}, Hypertension {Hypertensive disorder, systemic arterial}, Non insulin dependent Diabetes Mellitus {Diabetes mellitus type 2}, Aortic Stenosis {Aortic valve stenosis}, Aortic Insufficiency {Aortic valve regurgitation}, Mitral Regurgitation {Mitral valve regurgitation}, Gastroesophageal Reflux Disease {Gastroesophageal reflux disease}, degenerative joint disease {Osteoarthritis}"
+"###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:
+Monitor wounds for signs of infection. These include redness, 
+drainage or increased pain.  
+Report any fever greater then 100.5. 
+Report any weight gain of 2 pounds in 24 hours or 5 pounds in 1 
+week. 
+No lotions, creams or powders to incision. 
+Shower daily,gently pat the wound dry.
+No bathing or swimming for 1 month. 
+Take all medications as directed. 
+No driving for 1 month or while taking narcotics.. 
+.
+ 
+
+###RESPONSE: Monitor {Monitoring for signs and symptoms of infection}, wounds {Wound}, signs of infection {Monitoring for signs and symptoms of infection}, redness {Redness of skin over lesion}, drainage {Wound discharge}, increased pain {Increased pain}, fever {Fever}, weight gain {Weight gain}, incision {Surgical incision wound}, wound {Wound}, medications {Patient medication education}, while taking narcotics {Narcotherapy}"
+"###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:
+___
+ 
+Major Surgical or Invasive Procedure:
+- Exploratory laparotomy, resection of hepatic flexure, and 
+right colostomy ___ (___)
+
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, Exploratory laparotomy {Exploratory laparotomy}, resection {Excision}, hepatic flexure {Structure of right colic flexure}, colostomy {Colostomy}"
+"###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:
+___ presenting to ___ as transferred from OSH s/p MVC. On 
+arrival the patient had AMS and could not provide any history. 
+Per EMS and OSH records the patient was driving a truck while 
+shooting up heroin and struck a tree. At OSH, underwent imaging 
+that showed non-displaced sacral fracture, L5 transverse process 
+fracture and abdominal free air. He was transferred to ___ for 
+trauma evaluation, and taken to the OR emergently for Ex-lap. 
+Postoperatively, he was transferred to the trauma ICU for close 
+monitoring.
+ 
+
+###RESPONSE: AMS {Altered mental status}, imaging {Imaging}, non-displaced {Undisplaced fracture}, sacral fracture {Fracture of sacrum}, transverse process 
+fracture {Closed fracture lumbar vertebra, transverse process}, abdominal free air {Pneumoperitoneum}, Ex-lap {Exploratory laparotomy}, Postoperatively {Postoperative state}, monitoring {Monitoring 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: 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:
+Non contributory
+ 
+
+###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:
+Admission Physical Exam
+VS - T: 97.8 HR: 106 BP: 132/79 RR: 20 100% on PSV
+General: Intubated and sedated
+HEENT: PERRL, NCAT
+Neck: Ecchymosis over left neck, supple
+CV: Mild tachycardia, regular rhythm
+Lungs: CTAB
+Abdomen: Soft, colostomy pink without any output
+GU: Foley in place
+Ext: Warm, well perfused
+Neuro: Moving all extremities, localizes pain
+Skin: No rash
+ 
+
+###RESPONSE: Physical Exam {Physical examination procedure}, VS {Vital signs finding}, HR {Finding of heart rate}, BP {Blood pressure finding}, RR {Finding of rate of respiration}, General {General examination of patient}, Intubated {Intubation}, sedated {Sedated}, HEENT {Physical examination procedure}, PERRL {Pupils equal and reacting to light}, NC {Normal head}, Neck {Physical examination procedure}, Ecchymosis {Ecchymosis}, supple {Normal movement of neck}, CV {Cardiovascular physical examination}, tachycardia {Tachycardia}, regular rhythm {Normal sinus rhythm}, Lungs {Examination of respiratory system}, CTAB {Normal breath sounds}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, colostomy {Colostomy present}, pink {Pink skin}, GU {Examination of genitourinary system}, Ext {Examination of limb}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, Neuro {Neurological examination}, all extremities {All extremities}, pain {Pain}, Skin {Examination of skin}, rash {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:
+___ 06:15PM   GLUCOSE-131* UREA N-27* CREAT-1.2 SODIUM-145 
+POTASSIUM-3.5 CHLORIDE-107 TOTAL CO2-24 ANION GAP-18
+___ 06:15PM   CALCIUM-8.1* PHOSPHATE-4.4 MAGNESIUM-1.5*
+___ 06:15PM   WBC-2.8*# RBC-3.11*# HGB-9.6*# HCT-30.0*# 
+MCV-97# MCH-30.9 MCHC-32.0 RDW-12.9 RDWSD-45.3
+___ 06:15PM   PLT SMR-LOW PLT COUNT-87*#
+___ 06:15PM   ___ PTT-43.4* ___
+___ 01:21PM   COMMENTS-GREEN TOP
+___ 01:21PM   LACTATE-2.9*
+___ 01:06PM URINE  HOURS-RANDOM
+___ 01:06PM URINE  UCG-NEGATIVE
+___ 01:06PM URINE  bnzodzpn-POS barbitrt-NEG opiates-POS 
+cocaine-POS amphetmn-POS oxycodn-NEG mthdone-NEG
+___ 01:06PM URINE  COLOR-Amber APPEAR-Clear SP ___
+___ 01:06PM URINE  BLOOD-LG NITRITE-NEG PROTEIN-100 
+GLUCOSE-NEG KETONE-40 BILIRUBIN-SM UROBILNGN-4* PH-6.5 LEUK-NEG
+___ 01:06PM URINE  RBC-126* WBC-3 BACTERIA-NONE YEAST-NONE 
+EPI-0
+___ 01:06PM URINE  HYALINE-19*
+___ 01:06PM URINE  CA OXAL-MOD
+___ 01:06PM URINE  MUCOUS-RARE
+___ 01:00PM   GLUCOSE-129* UREA N-27* CREAT-1.1 SODIUM-142 
+POTASSIUM-3.7 CHLORIDE-104 TOTAL CO2-20* ANION GAP-22*
+___ 01:00PM   estGFR-Using this
+___ 01:00PM   ALT(SGPT)-61* AST(SGOT)-81* CK(CPK)-918* ALK 
+PHOS-122 TOT BILI-1.2
+___ 01:00PM   LIPASE-13
+___ 01:00PM   ALBUMIN-4.2
+___ 01:00PM   ASA-NEG ETHANOL-NEG ACETMNPHN-NEG 
+bnzodzpn-NEG barbitrt-NEG tricyclic-NEG
+___ 01:00PM   WBC-8.2 RBC-5.96 HGB-18.3* HCT-53.9* MCV-90 
+MCH-30.7 MCHC-34.0 RDW-12.7 RDWSD-41.2
+___ 01:00PM   NEUTS-84* BANDS-5 LYMPHS-7* MONOS-4* EOS-0 
+BASOS-0 ___ MYELOS-0 AbsNeut-7.30* AbsLymp-0.57* 
+AbsMono-0.33 AbsEos-0.00* AbsBaso-0.00*
+___ 01:00PM   HYPOCHROM-NORMAL ANISOCYT-NORMAL 
+POIKILOCY-NORMAL MACROCYT-NORMAL MICROCYT-NORMAL 
+POLYCHROM-NORMAL
+___ 01:00PM   PLT SMR-NORMAL PLT COUNT-207
+___ 01:00PM   ___ PTT-32.4 ___
+ 
+
+###RESPONSE: GLUCOSE {Glucose measurement, blood}, UREA N {Blood urea nitrogen measurement}, 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}, CALCIUM {Blood calcium measurement}, PHOSPHATE {Phosphate, total measurement}, MAGNESIUM {Blood magnesium 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, RDWSD {Red cell distribution width determination}, PLT {Platelet count}, PLT COUNT {Platelet count}, PTT {Partial thromboplastin time, activated}, URINE {Urinalysis}, URINE {Urinalysis}, UCG-NEGATIVE {Urine chorionic gonadotrophin measurement}, URINE {Urinalysis}, URINE {Urinalysis}, COLOR {Color finding}, PROTEIN {Measurement of protein in urine}, GLUCOSE {Glucose measurement, urine}, KETONE {Urinalysis, acetone or ketone bodies measurement}, BILIRUBIN {Bilirubin measurement, urine}, PH {pH measurement}, URINE {Urinalysis}, RBC {Red blood cell count}, WBC {White blood cell count}, AST {Aspartate aminotransferase measurement}, URINE {Urinalysis}, URINE {Urinalysis}, URINE {Urinalysis}, GLUCOSE {Glucose measurement, blood}, UREA N {Blood urea nitrogen measurement}, 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}, CK(CPK {Creatine kinase measurement}, PHOS {Phosphate, total measurement}, TOT BILI {Bilirubin, total measurement}, LIPASE {Triacylglycerol lipase measurement}, ALBUMIN {Albumin measurement}, ETHANOL {Blood ethanol 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}, 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}, EOS {Eosinophil count}, BASOS {Basophil count}, PLT {Platelet count}, PLT COUNT {Platelet count}, PTT {Partial thromboplastin time, activated}"
+"###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:
+___ presenting to ___ as transferred from OSH s/p MVC. On 
+arrival the patient had AMS and could not provide any history. 
+Per EMS and OSH records the patient was driving a truck while 
+shooting up heroin and struck a tree. At OSH, underwent imaging 
+that showed non-displaced sacral fracture, L5 transverse process 
+fracture and abdominal free air secondary to an ascending colon 
+perforation. He was transferred to ___ for trauma evaluation, 
+and taken to the OR emergently for Ex-lap. Postoperatively, he 
+was transferred to the trauma ICU for close monitoring. His ICU 
+course is summarized below with transitional issues consistent 
+of  a) postoperative fevers, seconadry to a feculent peritonitis 
+and GNRs bacteremia treated with Zosyn. b) intermittent 
+agitation secondary to withdrawal symptims in setting of chronic 
+heroin use.  Per APS and psychiatry, he was started on methadone 
+10TID, Haldol 2.5 q2H prn for agitation, added a basal rate of 
+.05 to dPCA, in addition to resumed his home psychiatric meds. 
+The patient was extubated onPD#1,  advanced diet to clears, and 
+transferred to the surgical ward for further management. His 
+hospital course is summarized below
+ 
+
+###RESPONSE: AMS {Altered mental status}, imaging {Imaging}, non-displaced {Undisplaced fracture}, sacral fracture {Fracture of sacrum}, transverse process 
+fracture {Closed fracture lumbar vertebra, transverse process}, abdominal free air {Pneumoperitoneum}, ascending colon 
+perforation {Traumatic perforation of ascending colon}, trauma {Traumatic injury}, evaluation {Evaluation procedure}, Ex-lap {Exploratory laparotomy}, Postoperatively {Postoperative state}, monitoring {Monitoring procedure}, postoperative fevers {Postoperative fever}, feculent peritonitis {Fecal peritonitis}, GNRs bacteremia {Bacteremia caused by Gram-negative bacteria}, agitation {Feeling agitated}, withdrawal symptims {Withdrawal symptom}, chronic 
+heroin use {Chronic drug abuse}, agitation {Feeling agitated}, extubated {Removal of endotracheal tube}"
+"###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. BuPROPion Dose is Unknown  PO BID 
+2. Lorazepam Dose is Unknown  PO QHS 
+3. Gabapentin 300 mg PO TID 
+4. MethylPHENIDATE (Ritalin) 20 mg PO DAILY 
+5. QUEtiapine Fumarate 25 mg PO Frequency is Unknown 
+6. Venlafaxine XR 225 mg PO Frequency is Unknown 
+
+ 
+Discharge Medications:
+1. Venlafaxine XR 225 mg PO DAILY 
+2. QUEtiapine Fumarate 25 mg PO QHS 
+3. Gabapentin 400 mg PO TID 
+4. OxycoDONE (Immediate Release)  ___ mg PO Q4H:PRN pain 
+___ will receive a 1 week supply. Please call the Surgery Clinic 
+to make an appointment for refills 
+5. MethylPHENIDATE (Ritalin) 20 mg PO DAILY 
+6. Morphine SR (MS ___ 60 mg PO Q12H 
+Taper:
+60mg BID x 3 days
+45mg BID x 3 days
+30mg BID x 3 days
+15mg BID x 3 days
+15mg QD x 3 days 
+7. Wheelchair
+Wheelchair
+
+ 
+
+###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:
+Traumatic injury, colonic perforation, scapular fracture, sacral 
+fracture, L5 transverse process fracture
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Out of Bed with assistance to chair or 
+wheelchair.
+
+ 
+
+###RESPONSE: Traumatic injury {Traumatic injury}, colonic perforation {Perforation of colon}, scapular fracture {Fracture of scapula}, sacral 
+fracture {Fracture of sacrum}, transverse process fracture {Closed fracture lumbar vertebra, transverse process}, 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}, Out of Bed with assistance {Difficulty getting off a bed}"
+"###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. ___,
+
+___ were admitted to ___ and 
+underwent an exploratory laparotomy, resection of
+hepatic flexure, and right colostomy. ___ are recovering well 
+and are now ready for discharge. Please follow the instructions 
+below to continue your recovery:
+
+Monitoring Ostomy output/ Prevention of Dehydration:
+*Keep well hydrated.
+*Replace fluid loss from ostomy daily.
+*Avoid only drinking plain water. Include Gatorade and/or other 
+vitamin drinks to replace fluid.
+*Try to maintain ostomy output between 1000mL to 1500mL per day. 
+
+*If Ostomy output >1 liter, take 4mg of Imodium, repeat 2mg with 
+each episode of loose stool. Do not exceed 16mg/24 hours.
+
+OSTOMY DISCHARGE INSTRUCTIONS:
+
+Patient D/C instructions:
+ 
+___ have a new colostomy. The most common complication from a 
+new colostomy placement is dehydration. The output from the 
+stoma is stool from the small intestine and the water content is 
+very high. The stool is no longer passing through the large 
+intestine which is where the water from the stool is reabsorbed 
+into the body and the stool becomes formed. ___ must measure 
+your colostomy output for the next few weeks. The output from 
+the stoma should not be more than 1200cc or less than 500cc. If 
+___ find that your output has become too much or too little, 
+please call the office for advice. The office nurse or nurse 
+practitioner can recommend medications to increase or slow the 
+colostomy output. Keep yourself well hydrated, if ___ notice 
+your colostomy output increasing, take in more electrolyte drink 
+such as Gatorade. Please monitor yourself for signs and symptoms 
+of dehydration including: dizziness (especially upon standing), 
+weakness, dry mouth, headache, or fatigue. If ___ notice these 
+symptoms please call the office or return to the emergency room 
+for evaluation if these symptoms are severe. ___ may eat a 
+regular diet with your new colostomy. However it is a good idea 
+to avoid fatty or spicy foods and follow diet suggestions made 
+to ___ by the ostomy nurses.
+ 
+Please monitor the appearance of the ostomy and stoma and care 
+for it as instructed by the wound/ostomy nurses. ___ stoma 
+(intestine that protrudes outside of your abdomen) should be 
+beefy red or pink, it may ooze small amounts of blood at times 
+when touched and this should subside with time. The skin around 
+the ostomy site should be kept clean and intact. Monitor the 
+skin around the stoma for bulging or signs of infection listed 
+above. Please care for the ostomy as ___ have been instructed by 
+the wound/ostomy nurses. ___ will be able to make an appointment 
+with the ostomy nurse in the clinic 7 days after surgery. ___ 
+will have a visiting nurse at home for the next few weeks 
+helping to monitor your ostomy until ___ are comfortable caring 
+for it on your own. 
+ 
+ 
+Currently your colostomy is allowing the surgery in your large 
+intestine to heal, which does take some time. ___ will come back 
+to the hospital for reversal of this colostomy when decided by 
+Dr. ___ will follow-up in the clinic, and the 
+surgeon will decide when will be the best time for your second 
+surgery. Until this time there is healthy intestine that is 
+still functioning as it normally would and it will produce mucus 
+and some may leak or ___ may feel as though ___ need to have a 
+bowel movement and ___ may sit on the toilet and empty this 
+mucus, it is normal. 
+ 
+ 
+Rehab D/C instructions:
+ 
+To the Rehab:
+Thank ___ for participating in the care of this patient.  This 
+patient has had multiple teaching sessions with both the 
+Wound/Ostomy nurses and with the staff nurses and should have a 
+good idea of how to care for their own ostomy.  They have also 
+been given several items that will assist them in their own 
+care, such as instruction sheets, ostomy supplies, and ostomy 
+output measuring tools.  However, we would like to stress a few 
+important points to assist ___ in the care of this patient.
+
+Bowel Function:  
+Ø  It is important to encourage the patient to monitor their 
+bowel function closely every day.  The patient should continue 
+to record their colostomy output (as much as physically 
+possible) and the amount of fluid they have taken in, just as 
+they were taught in the hospital.  A urinal or “hat” should be 
+used to record their ostomy output daily.  
+o   The patient has been taught to use a daily measurement chart 
+to record their I&O’s.  This chart should be continued to be 
+used at least until their follow-up appointment. If their ostomy 
+output is less than 500 ml or greater than 1200 ml of liquid 
+stool in a day, it is very important to call the doctor’s office 
+with this information. 
+o   Continue to reinforce to the patient that the major risk 
+with an colostomy is dehydration related to fluid loses. Daily 
+fluid intake is ___ glasses of fluids, including electrolyte 
+enhanced beverages.  In the hot weather, encourage them to take 
+in increased amounts of fluid and closely measure 
+their colostomy output.  
+o   Watch for signs and symptoms of dehydration including: dry 
+mouth or tongue, decrease in urination, urine darker in color, 
+dizzy when he/she stands, cramps in his/her abdomen or legs, 
+dizziness, increased thirst, or weakness. 
+Stoma Care:
+Ø  It is also important to monitor the appearance of the stoma. 
+The tissue of the stoma should be moist, pink or red in color. 
+o   If the stoma has color changes from pink / red to dark 
+purplish /blue in color, becomes swollen, or a large amount of 
+continuous bleeding into the pouch, and or at the Mucocutaneous 
+Junction (Stomal Incision). this is not normal. Call the 
+patient’s doctor’s office for assistance.  
+ If ___ or the patient has any questions regarding the care of 
+the patient’s ostomy, please refer to the instructions provided 
+to the patient by the wound/ostomy nurses. 
+___ the patient develops the following bowel symptoms please call 
+the surgeon’s office or go to the nearest emergency room if 
+severe: increasing abdominal distension and cramps, nausea, 
+vomiting, inability to tolerate food or liquids, decrease 
+in ostomy output, or have no output from ostomy for ___ hours
+
+Please call the Acute Care Surgery Clinic if ___ develop fevers, 
+chills, nausea, vomiting, decreased or no ostomy output, or 
+other concerns. The phone number is ___.
+
+ 
+
+###RESPONSE: exploratory laparotomy {Exploratory laparotomy}, resection {Excision}, hepatic flexure {Structure of right colic flexure}, colostomy {Colostomy}, ready for discharge {Ready for discharge}, loose stool {Loose stool}, colostomy {Colostomy}, colostomy {Colostomy}, placement {Implantation procedure}, dehydration {Dehydration}, stoma {Stoma}, stool {Stool finding}, small intestine {Structure of small intestine}, large 
+intestine {Structure of large intestine}, measure 
+your colostomy output {Monitoring of stoma output}, stoma {Stoma}, colostomy {Colostomy}, colostomy output increasing {High output stoma}, monitor yourself for signs and symptoms 
+of dehydration {Dehydration monitoring}, dizziness {Dizziness}, standing {Orthostatic body position}, weakness {Asthenia}, dry mouth {Xerostomia}, headache {Headache}, fatigue {Fatigue}, evaluation {Evaluation procedure}, regular diet {Normal diet}, colostomy {Colostomy}, stoma {Stoma}, stoma {Stoma}, intestine {Intestinal structure}, abdomen {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, Monitor {Monitoring for signs and symptoms of infection}, skin {Examination of skin}, stoma {Stoma}, bulging {Bulging}, signs of infection {Monitoring for signs and symptoms of infection}, colostomy {Colostomy}, surgery {Surgical procedure}, large 
+intestine {Structure of large intestine}, colostomy {Colostomy}, intestine {Intestinal structure}, teaching {Patient education}, record their colostomy output {Monitoring of stoma output}, liquid 
+stool {Liquid stool}, colostomy {Colostomy}, dehydration {Dehydration}, measure 
+their colostomy output {Monitoring of stoma output}, signs {Sign}, dehydration {Dehydration}, dry 
+mouth {Xerostomia}, tongue {Tongue structure}, decrease in urination {Decreased urine output}, urine darker in color {Urine: dark/concentrated}, dizzy {Dizziness}, stands {Orthostatic body position}, cramps {Cramp}, abdomen {Stomach cramps}, legs {Cramp in lower limb}, dizziness {Dizziness}, increased thirst {Increased thirst}, weakness {Asthenia}, stoma {Stoma}, tissue {Body tissue structure}, stoma {Stoma}, stoma {Stoma}, swollen {Swelling}, bleeding {Bleeding}, Mucocutaneous 
+Junction {Structure of mucocutaneous junction}, Incision {Surgical incision wound}, abdominal distension {Swollen abdomen}, cramps {Cramp}, nausea, 
+vomiting {Nausea and vomiting}, inability to tolerate food or liquids {Nausea and vomiting}, fevers {Fever}, chills {Chill}, nausea, vomiting {Nausea and vomiting}"
+"###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: UROLOGY
+ 
+
+###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: 
+ciprofloxacin
+ 
+Attending: ___.
+ 
+Chief Complaint:
+SCROTAL/PERINEAL ABSCESS
+ 
+Major Surgical or Invasive Procedure:
+1. Exam under anesthesia.
+2. Debridement of scrotal and perineal abscess.
+
+ 
+
+###RESPONSE: ciprofloxacin {Allergy to ciprofloxacin}, SCROTAL {Abscess of scrotum}, PERINEAL {Perineal structure}, ABSCESS {Abscess}, Exam under anesthesia {Physical examination under general anesthesia}, Debridement {Debridement}, scrotal {Abscess of scrotum}, perineal {Perineal structure}, abscess {Abscess}"
+"###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:
+___ h/o afib on Coumadin, MI s/p stent, CHF (LVEF ___,
+HLD, HTN, solitary kidney (donated), Crohn's, BPH managed with
+chronic indwelling foley; transferred from ___ with 
+right
+scrotal abscess.  
+
+Patient presented to his see his urologist (___)
+at ___ yesterday for a poorly draining foley.  Following
+the catheter change, there was reportedly drainage of purulent
+material and as such he was transferred to their ED for further
+evaluation.  He was admitted to the medicine service there for
+treatment of his infection.  On admission, ___ 24, febrile to
+102. UA data not available in outside records, though started on
+ceftriaxone/flagyl for empiric treatment. 
+
+When found to have right scrotal fluctuance, there was an
+ultrasound performed that showed right scrotal abscess with
+concern for fluid and gas extending into the perineum.  Due to
+concern for Fournier's gangrene, he was transferred to ___ for
+further assessment.
+ 
+
+###RESPONSE: afib {Atrial fibrillation}, MI {Myocardial infarction}, s/p stent {Placement of stent in coronary artery}, CHF {Congestive heart failure}, HLD {Hyperlipidemia}, HTN {Hypertensive disorder, systemic arterial}, Crohn's {Crohn's disease}, BPH {Benign prostatic hyperplasia}, foley {Catheterization of urinary bladder}, scrotal abscess {Abscess of scrotum}, see his urologist {Seen by urologist}, poorly draining foley {Decreased urine output}, catheter change {Replacement of indwelling catheter of urinary bladder}, drainage of purulent
+material {Purulent discharge}, evaluation {Evaluation procedure}, infection {Infectious disease}, febrile {Fever}, UA {Urinalysis}, scrotal {Scrotal structure}, fluctuance {Fluctuant}, ultrasound {Ultrasonography}, scrotal abscess {Abscess of scrotum}, perineum {Perineal structure}, Fournier's gangrene {Fournier's gangrene}, assessment {Evaluation 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: Past Medical History:
+Afib on coumadin                                                 
+
+MI s/p stent ___ ago
+HLD
+HTN
+Single kidney 
+Crohn's disease
+Anal fissure
+
+L donor nephrectomy
+Hernia repair  
+ 
+
+###RESPONSE: Afib {Atrial fibrillation}, MI {Myocardial infarction}, s/p stent {Placement of stent in coronary artery}, HLD {Hyperlipidemia}, HTN {Hypertensive disorder, systemic arterial}, kidney {Kidney structure}, Crohn's disease {Crohn's disease}, Anal fissure {Anal fissure}, L {Left kidney structure}, donor nephrectomy {Donor nephrectomy}, Hernia repair {Hernia repair}"
+"###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:
+Son- DM and renal failure                          
+ 
+
+###RESPONSE: DM {Diabetes mellitus}, renal failure {Renal failure syndrome}"
+"###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:
+WdWn male, NAD, AVSS
+Interactive, cooperative
+Abdomen soft, Nt/Nd
+Perineal incision packed w/ ___ plain nugauze. Edges pink, 
+clean, w/out evidence infection, necrosis.
+Perineal ___ drain in place; ___ wick removed. Hemiscrotum 
+Incision c/d/i w/out evidence hematoma or infection
+Lower extremities w/out edema or pitting and no report of calf 
+pain
+Foley catheter in place; secured to medial thigh
+
+ 
+
+###RESPONSE: Physical Exam {Physical examination procedure}, WdWn {Well nourished}, NAD {No abnormality detected}, AVSS {Vital signs finding}, Interactive {Does communicate}, cooperative {Cooperative mental state}, soft {Abdomen soft}, Nt {Abdominal tenderness}, Nd {Swollen abdomen}, Perineal incision {Incision of perineum}, packed w/ ___ plain nugauze {Application of gauze swab}, infection {Local infection of wound}, necrosis {Necrosis}, Perineal {Perineal structure}, drain in place {Insertion of drain}, Incision {Incision}, hematoma {Hematoma}, infection {Infectious disease}, Lower extremities {Lower limb structure}, edema {Edema}, pitting {Pitting edema}, pain {Pain}, Foley {Catheterization of urinary bladder}, medial thigh {Structure of medial surface of thigh}"
+"###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:
+___ 07:10AM BLOOD WBC-12.3* RBC-3.33* Hgb-8.3* Hct-26.2* 
+MCV-79* MCH-24.9* MCHC-31.7* RDW-17.6* RDWSD-50.4* Plt ___
+___ 06:58AM BLOOD WBC-9.9 RBC-3.12* Hgb-8.0* Hct-25.0* 
+MCV-80* MCH-25.6* MCHC-32.0 RDW-18.0* RDWSD-53.3* Plt ___
+___ 06:30PM BLOOD WBC-12.7* RBC-3.34* Hgb-8.3*# Hct-27.0*# 
+MCV-81* MCH-24.9* MCHC-30.7* RDW-18.0* RDWSD-53.1* Plt ___
+___ 06:30PM BLOOD Neuts-74.2* Lymphs-15.5* Monos-6.7 
+Eos-3.0 Baso-0.2 Im ___ AbsNeut-9.45* AbsLymp-1.97 
+AbsMono-0.85* AbsEos-0.38 AbsBaso-0.03
+___ 07:10AM BLOOD Glucose-100 UreaN-12 Creat-1.0 Na-135 
+K-4.3 Cl-99 HCO3-29 AnGap-11
+___ 06:58AM BLOOD Glucose-75 UreaN-12 Creat-0.8 Na-136 
+K-4.0 Cl-105 HCO3-24 AnGap-11
+___ 06:30PM BLOOD Glucose-89 UreaN-15 Creat-0.8 Na-135 
+K-4.1 Cl-105 HCO3-25 AnGap-9
+___ 07:10AM BLOOD Phos-3.9 Mg-1.6
+___ 06:40PM BLOOD Lactate-0.8
+
+___ 05:18PM URINE Color-Straw Appear-Clear Sp ___
+___ 06:40PM URINE Color-Straw Appear-Clear Sp ___
+___ 05:18PM URINE Blood-NEG Nitrite-NEG Protein-NEG 
+Glucose-NEG Ketone-NEG Bilirub-NEG Urobiln-NEG pH-6.0 Leuks-MOD
+___ 06:40PM URINE Blood-TR Nitrite-NEG Protein-NEG 
+Glucose-NEG Ketone-NEG Bilirub-NEG Urobiln-NEG pH-6.0 Leuks-LG
+___ 05:18PM URINE RBC-2 WBC-16* Bacteri-FEW Yeast-NONE 
+Epi-0
+___ 06:40PM URINE RBC-5* WBC-50* Bacteri-FEW Yeast-NONE 
+Epi-0
+
+___ BLOOD CULTURE Blood Culture, Routine-PENDING 
+INPATIENT 
+___ URINE URINE CULTURE-FINAL INPATIENT 
+___ BLOOD CULTURE Blood Culture, Routine-PENDING 
+INPATIENT 
+___ SWAB GRAM STAIN-FINAL; WOUND CULTURE-FINAL; 
+ANAEROBIC CULTURE-FINAL {BACTEROIDES FRAGILIS GROUP}; FUNGAL 
+CULTURE-PRELIMINARY EMERGENCY WARD 
+___ URINE URINE CULTURE-FINAL EMERGENCY WARD 
+___ BLOOD CULTURE Blood Culture, Routine-PENDING 
+EMERGENCY WARD 
+___ BLOOD CULTURE Blood Culture, Routine-PENDING 
+EMERGENCY WARD 
+___ 10:30 pm SWAB      PERINEAL SWAB. 
+
+   GRAM STAIN (Final ___: 
+      4+   (>10 per 1000X FIELD):   POLYMORPHONUCLEAR 
+LEUKOCYTES. 
+      NO MICROORGANISMS SEEN. 
+
+   WOUND CULTURE (Final ___:    NO GROWTH. 
+
+   ANAEROBIC CULTURE (Final ___: 
+      BACTEROIDES FRAGILIS GROUP.    SPARSE GROWTH. 
+         BETA LACTAMASE POSITIVE. 
+
+   FUNGAL CULTURE (Preliminary): 
+      NO FUNGUS ISOLATED. 
+      A swab is not the optimal specimen for recovery of 
+mycobacteria or
+      filamentous fungi.  A negative result should be 
+interpreted with
+      caution.  Whenever possible tissue biopsy or aspirated 
+fluid should
+      be submitted. 
+
+ 
+
+###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}, 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}, 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}, 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}, 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}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, URINE Color-Straw {Normal urine color}, URINE Color-Straw {Normal urine color}, URINE Blood {Blood in urine}, Protein {Measurement of protein in urine}, Ketone {Urinalysis, acetone or ketone bodies measurement}, pH {pH measurement}, URINE Blood {Blood in urine}, Protein {Measurement of protein in urine}, Ketone {Urinalysis, acetone or ketone bodies measurement}, pH {pH measurement}, RBC {Red blood cell count}, WBC {White blood cell count}, RBC {Red blood cell count}, WBC {White blood cell count}, CULTURE {Blood culture}, Blood Culture {Blood culture}, URINE {Urine culture}, URINE CULTURE {Urine culture}, CULTURE {Blood culture}, Blood Culture {Blood culture}, GRAM STAIN {Gram stain method}, WOUND {Wound}, CULTURE {Microbial culture}, CULTURE {Microbial culture}, CULTURE {Microbial culture}, URINE {Urine culture}, URINE CULTURE {Urine culture}, CULTURE {Blood culture}, Blood Culture {Blood culture}, CULTURE {Blood culture}, Blood Culture {Blood culture}, PERINEAL {Perineal structure}, GRAM STAIN {Gram stain method}, WOUND {Wound}, CULTURE {Microbial culture}, CULTURE {Microbial culture}, CULTURE {Microbial culture}, FUNGUS ISOLATED {Sample fungus isolated}, tissue {Body tissue structure}, biopsy {Biopsy}"
+"###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 patient was admitted to the urology service following 
+debridement of scrotal and perineal abscess.  See operative 
+report for full details.  The patient tolerated the procedure 
+well and recovered in the PACU before transfer to the surgical 
+floor.  He was admitted on zosyn/clindamycin for antibiotic 
+therapy, with BID packing changes of anterior and posterior 
+perineal wounds.  On POD1, he was attempted to be narrowed to 
+unasyn, though spiked a fever to ___ and was again re-broadened 
+to zosyn/clindamycin.  On POD2, he was narrowed to Bactrim 
+empirically for better MRSA coverage and remained afebrile 
+through the time of discharge.
+
+With respect to anticoagulation, the patient was seen by the 
+cardiology service, and the decision was made to restart the 
+patient's ASA and Plavix immediately postoperatively, as he 
+remained on it to the time of surgery and experienced no 
+bleeding complications.  He did, however, remain off of his 
+Coumadin for the duration of his hospital stay, and was 
+instructed to restart at home dose 2d after discharge.
+
+His foley catheter remained in place for the duration of his 
+stay.  His diet was advanced as tolerated following surgery.  At 
+discharge, patient's pain was well controlled with oral pain 
+medications, tolerating regular diet, ambulating without 
+assistance, and voiding without difficulty. Incision at 
+discharge without erythema or hematoma.  He will follow-up with 
+his home urologist, ___ at ___, as 
+directed and complete a course of Bactrim.  He will also follow 
+up with general surgery for perineal ___ removal.   ___ was 
+set up to assist with packing changes and drain care.
+
+ 
+
+###RESPONSE: debridement {Debridement}, scrotal {Abscess of scrotum}, perineal {Perineal structure}, abscess {Abscess}, operative {Surgical procedure}, procedure {Procedure}, PACU {Postanesthesia care}, surgical {Surgical procedure}, antibiotic 
+therapy {Antibiotic therapy}, packing changes {Change of dressing}, perineal {Perineal structure}, wounds {Wound}, fever {Fever}, MRSA {Methicillin resistant Staphylococcus aureus infection}, afebrile {Fever}, anticoagulation {Anticoagulant therapy}, cardiology service {Cardiology service}, surgery {Surgical procedure}, bleeding {Bleeding}, foley {Catheterization of urinary bladder}, diet {Dietary finding}, surgery {Surgical procedure}, pain was well controlled {Demonstrates adequate pain control}, oral {Administration of drug or medicament via oral route}, pain 
+medications {Administration of analgesic}, regular diet {Normal diet}, ambulating without 
+assistance {Independent walking}, voiding without difficulty {Normal micturition}, Incision {Incision}, erythema {Erythema}, hematoma {Hematoma}, follow-up {Follow-up status}, follow 
+up {Follow-up status}, surgery {Surgical procedure}, perineal {Perineal structure}, removal {Removal}, packing changes {Change of dressing}, drain care {Drainage tube care management}"
+"###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 may be inaccurate and requires 
+futher investigation.
+1. Metoprolol Tartrate 25 mg PO BID 
+2. Simvastatin 80 mg PO QPM 
+3. Clopidogrel 75 mg PO DAILY 
+4. Aspirin 325 mg PO DAILY 
+5. Warfarin 5 mg PO DAILY16 
+6. Feosol (ferrous sulfate;<br>iron, carbonyl) 325 mg (65 mg 
+iron) oral BID 
+
+ 
+Discharge Medications:
+1. Aspirin 325 mg PO DAILY 
+2. Clopidogrel 75 mg PO DAILY 
+3. Metoprolol Tartrate 25 mg PO BID 
+4. Simvastatin 80 mg PO QPM 
+5. Sulfameth/Trimethoprim DS 1 TAB PO BID 
+RX *sulfamethoxazole-trimethoprim [Bactrim DS] 800 mg-160 mg ONE 
+tablet(s) by mouth twice a day Disp #*20 Tablet Refills:*0
+6. Scopolamine Patch 1 PTCH TD ONCE Duration: 72 Hours 
+7. OxycoDONE (Immediate Release)  ___ mg PO Q4H:PRN Pain  
+RX *oxycodone 5 mg ___ tablet(s) by mouth Q4hrs Disp #*35 Tablet 
+Refills:*0
+8. Docusate Sodium 100 mg PO BID 
+RX *docusate sodium [Colace] 100 mg ONE capsule(s) by mouth 
+twice a day Disp #*60 Capsule Refills:*0
+9. Acetaminophen 650 mg PO TID 
+10. Nitroglycerin SL 0.4 mg SL Q5MIN:PRN chest pain Duration: 3 
+Doses 
+ONE Tablet(s) sublingually as instructed for chest pain x three 
+PRN 
+11. Feosol (ferrous sulfate;<br>iron, carbonyl) 325 mg (65 mg 
+iron) oral BID 
+12. Warfarin 5 mg PO DAILY16 
+resume on ___.  
+13. MESALAMINE
+You may resume your mesalamine unless otherwise explicitly 
+advised.
+
+ 
+
+###RESPONSE: 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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+PREOPERATIVE DIAGNOSES:
+1. Scrotal abscess.
+2. Perineal abscess.
+
+POSTOPERATIVE DIAGNOSES:
+1. Scrotal abscess.
+2. Perineal abscess.
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, Scrotal abscess {Abscess of scrotum}, Perineal {Perineal structure}, abscess {Abscess}, Scrotal abscess {Abscess of scrotum}, Perineal {Perineal structure}, abscess {Abscess}, Mental Status {Mental state finding}, Level of Consciousness {Finding of level of consciousness}, Alert {Mentally alert}, interactive {Does communicate}, 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 will be discharged home with ___ services for wound care 
+and packing changes. 
+
+-Please also reference the instructions provided by nursing on 
+Foley care/hygiene.  
+
+For your safety and the safety of others; PLEASE DO NOT drive, 
+operate dangerous machinery, or consume alcohol while taking 
+narcotic pain medications and while you have the 
+drain/foley/scrotal packing.
+
+-Your FOLEY should be secured to the catheter secure on your 
+thigh at ALL times.
+
+-Follow up with UROLOGY for wound check and post-op evaluation 
+as directed.  Surgery service will arrange outpatient follow-up 
+for the ___ drain removal. 
+
+-ALWAYS call to inform, review and discuss any medication 
+changes and your post-operative course with your primary care 
+doctor.
+
+-___ scrotum/phallus supported/elevated. Use a 
+jock-supporter/strap or jockey-type briefs or tight, 
+tighty-whities to facilitate this; Subsequently you may 
+transition to loose fitting briefs or boxer-briefs for 
+support--they should be cotton and/or breathable.
+
+-Do NOT use penis for intercourse/sex until explicitly advised 
+by your urologist that is may be ok to do so.
+
+-You may want to coordinate your showers with your ___ provider 
+and the planned dressing changes.
+
+-You may shower, but do NOT bathe, swim or otherwise immerse 
+your incision.
+
+-Tylenol should be your first line pain medication, a narcotic 
+pain medication has been prescribed for breakthough pain >4. 
+Replace Tylenol with narcotic pain medication. Max daily Tylenol 
+dose is from 3gm to 4gm depending on your kidney function, note 
+that narcotic pain medication also contains Tylenol 
+(acetaminophen)
+
+-Colace has been prescribed to avoid post-surgical constipation 
+and constipation related to narcotic pain medication, 
+discontinue if loose stool or diarrhea develops. Colace is a 
+stool ""softener""- it is NOT a laxative
+
+-Resume your home medications, except as noted.
+
+-DO NOT RESUME medications like VIAGRA, LEVITRA or CIALIS.
+
+-If you have fevers > 101.5 F, vomiting, or increased redness, 
+swelling, or discharge from your incision, call your doctor or 
+go to the nearest emergency room.
+ 
+
+###RESPONSE: wound care {Wound care}, packing changes {Change of dressing}, instructions provided by nursing {Nursing care education, guidance, counseling}, Foley care/hygiene {Urinary catheter care education}, while taking 
+narcotic pain medications {Narcotics education}, foley {Catheterization of urinary bladder}, scrotal {Scrotal structure}, packing {Packing of wound}, FOLEY {Catheterization of urinary bladder}, thigh {Thigh structure}, Follow up {Follow-up status}, wound check {Wound assessment}, post-op {Postoperative state}, evaluation {Evaluation procedure}, Surgery service {Surgical follow-up}, outpatient follow-up  {Outpatient care management}, drain removal {Removal of drain}, medication 
+changes  {Change of medication}, post-operative course {Postoperative state}, scrotum {Scrotal structure}, phallus supported {Fitting of external prosthetic device on penis}, elevated {Elevation}, supporter {Support}, support {Support}, penis {Penile structure}, intercourse/sex until explicitly advised {Recommendation to limit sexual activity}, dressing changes {Change of dressing}, incision {Incision}, pain medication {Administration of analgesic}, pain medication {Administration of analgesic}, breakthough pain {Breakthrough pain}, pain medication {Administration of analgesic}, kidney {Kidney structure}, pain medication {Administration of analgesic}, post-surgical {Postoperative state}, constipation {Constipation}, constipation {Constipation}, pain medication {Administration of analgesic}, loose stool {Loose stool}, diarrhea {Diarrhea}, fever {Fever}, vomiting {Vomiting}, redness {Redness of skin over lesion}, swelling {Swelling}, incision {Incision}"
+"###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: NEUROLOGY
+ 
+
+###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: 
+Penicillins / Morphine / adhesive tape / Iodine-Iodine 
+Containing
+ 
+Attending: ___
+ 
+Chief Complaint:
+Headache
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: Penicillins {Allergy to penicillin}, Morphine {Allergy to morphine}, adhesive tape {Allergy to adhesive agent}, Iodine-Iodine {Allergy to iodine compound}, Headache {Headache}"
+"###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:
+Patient is a ___ yo woman with PMHx sig. for CVA, CAD s/p 
+multiple PCIs, DM, and HTN who presented to ___ 
+___ for a severe headache, blurry vision, and concern 
+for increased gait instability.  Her headache started 4 AM this 
+morning, waking her up from sleep.  The headache starts in the 
+back and goes all over her head, described as a ""very bad"" pain, 
+rating ___.  Her headache is triggered wtih getting up, 
+relieved by sitting down.  Her headaches ia also associated with 
+nausea and dry heaves, no vomiting.  When she got out of bed, 
+she leaned forward, falling into the door.  She was lightheaded 
+and leaning to right and left.  Of note, pt had previously been 
+on coumadin for ___ years; this was discontinued 3 months ago.
+
+At OSH, she was hypertensive to sbp 200, which resolved on its 
+own.  She had a neg head CT scan and was transferred for neuro 
+eval and MRI. 
+
+In the ED, initial VS were: 98.4 76 146/99 18 95% RA.  Labs were 
+notable for ESR 16.  She had an LP.  MRI head showed ""No 
+evidence of acute infarct. Tiny DWI signal intensity at the 
+right frontal lobe (10:18) is likely T2 shinethrough. Chronic 
+microvascular ischemic changes seen in the paraventricular white 
+matter. no aneurysm or dissection seen. No evidence of 
+hemorrhage.""  The patient received percocet. Vitals prior to 
+transfer to the floor were:  98.4 76 146/99 18 95% RA.  
+
+Currently, she feels that her gait is back to baseline.
+ 
+Review of Systems:  
+(+) Per HPI plus:  night sweats, rhinorrhea, postnasal drip 
+cough, chronic joint pains, residual weakness in L leg and arm 
+and tingling in L leg from stroke 
+(-) Denies fever, chills, night sweats, recent weight loss or 
+gain. Denies sinus tenderness, or congestion. Denies chest pain 
+or tightness, palpitations. Denies  shortness of breath Denies 
+nausea, vomiting, diarrhea, constipation,  or abdominal pain. No 
+dysuria, urinary frequency. Denies rashes. All other review of 
+systems negative.  
+
+ 
+
+###RESPONSE: CVA {Cerebrovascular accident}, CAD {Coronary arteriosclerosis}, PCIs {Percutaneous coronary intervention}, DM {Diabetes mellitus}, HTN {Hypertensive disorder, systemic arterial}, headache {Headache}, blurry vision {Blurring of visual image}, gait instability {Unsteady when walking}, headache {Headache}, headache {Headache}, head {Head structure}, pain {Pain}, headache {Headache}, sitting {Sitting position}, headaches {Headache}, nausea {Nausea}, dry heaves {Retching}, vomiting {Vomiting}, lightheaded {Lightheadedness}, hypertensive {Hypertensive disorder, systemic arterial}, resolved {Problem resolved}, head CT {Computed tomography of head}, MRI {Magnetic resonance imaging}, VS {Vital signs finding}, Labs {Laboratory test}, LP {Lumbar puncture}, MRI head {Magnetic resonance imaging of head}, acute infarct {Acute infarct}, right frontal lobe {Right frontal lobe structure}, microvascular {Structure of small blood vessel (organ)}, ischemic changes {Ischemia}, white 
+matter {Cerebral white matter structure}, aneurysm {Aneurysm}, dissection {Dissecting hemorrhage}, hemorrhage {Hemorrhage}, Vitals {Vital signs finding}, baseline {Baseline state}, Review of Systems {Review of systems}, night sweats {Night sweats}, rhinorrhea {Nasal discharge}, postnasal drip {Posterior rhinorrhea}, cough {Cough}, joint pains {Joint pain}, weakness {Asthenia}, L leg {Structure of left lower limb}, arm {Left upper arm structure}, tingling {Pins and needles}, L leg {Structure of left lower limb}, stroke {Cerebrovascular accident}, fever {Fever}, chills {Chill}, night sweats {Night sweats}, recent weight loss {Recent weight loss}, gain {Recent weight gain}, sinus tenderness {Tenderness over frontal sinus}, congestion {Nasal congestion}, chest pain {Chest pain}, tightness {Tight chest}, palpitations {Palpitations}, shortness of breath {Dyspnea}, nausea, vomiting, diarrhea {Nausea, vomiting and diarrhea}, constipation {Constipation}, abdominal pain {Abdominal pain}, dysuria {Dysuria}, urinary frequency {Increased frequency of urination}, rashes {Eruption of skin}, review of 
+systems {Review of systems}, negative {No abnormality detected}"
+"###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:
+CVA in ___, residual weakness in L leg and arm and tingling in 
+L leg
+CAD s/p multiple PCIs
+DM2
+HTN
+h/o breast cancer, s/p lumpectomy in ___
+ 
+
+###RESPONSE: CVA {Cerebrovascular accident}, weakness {Asthenia}, L leg {Structure of left lower limb}, arm {Left upper arm structure}, tingling {Pins and needles}, L leg {Structure of left lower limb}, CAD {Coronary arteriosclerosis}, PCIs {Percutaneous coronary intervention}, DM2 {Diabetes mellitus type 2}, HTN {Hypertensive disorder, systemic arterial}, breast cancer {Malignant neoplasm of breast}, lumpectomy {Excision of mass}"
+"###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:
+Two sons have had CABG.
+ 
+
+###RESPONSE: CABG {Coronary artery bypass grafting}"
+"###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:
+Vitals:  147/67, 70, 98RA
+Gen: NAD, AOX3  
+HEENT: PERRL, EOMI, MMM, sclera anicteric, not injected  
+Neck: no LAD, no JVD  
+Cardiovascular: RRR normal s1, s2, no murmurs appreciated  
+Respiratory: bibasilar crackles, no wheezing  
+Abd: normoactive bowel sounds, soft, non-tender, non distended 
+Extremities: No edema, 2+ DP pulses  
+Neurological: CN II-XII intact, normal attention, sensation 
+normal, babinski down-going bilaterally, MS ___ in BUEs and BLEs 
+though slightly weaker on LLE, ataxic gait leaning to both 
+sides, unable to perform Romberg as unstead with eyes open  
+Integument: Warm, moist, no rash or ulceration  
+Psychiatric: appropriate, pleasant, not anxious
+ 
+
+###RESPONSE: Vitals {Vital signs finding}, RA {Breathing room air}, Gen {General examination of patient}, NAD {No abnormality detected}, AOX3 {Oriented to person, time and place}, HEENT {Physical examination procedure}, PERRL {Pupils equal and reacting to light}, EOMI {Normal ocular motility}, MMM {Moist oral mucosa}, sclera anicteric {White sclera}, Neck {Physical examination procedure}, LAD {Lymphadenopathy}, JVD {Jugular venous engorgement}, Cardiovascular {Cardiovascular physical examination}, RRR {Normal heart rate}, normal s1, s2 {Heart sounds normal}, murmurs {Murmur}, Respiratory {Examination of respiratory system}, bibasilar {Structure of base of lung}, crackles {Respiratory crackles}, wheezing {Wheezing}, Abd {Examination of abdomen}, normoactive bowel sounds {Normal bowel sounds}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, distended {Swollen abdomen}, Extremities {Examination of limb}, edema {Edema}, DP {Structure of dorsalis pedis artery}, Neurologic {Neurological examination}, CN II-XII intact {Normal central nervous system}, sensation 
+normal {Normal sensation}, babinski down-going {Plantar reflex normal}, LLE {Structure of left lower limb}, ataxic gait {Ataxic gait}, Romberg {Romberg sign}, Integument {Examination of skin}, Warm {Warm skin}, rash {Eruption of skin}, ulceration {Ulcer}, anxious {Anxiety}"
+"###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:
+___ 08:24PM   WBC-8.6 RBC-4.09* HGB-13.6 HCT-38.8 MCV-95 
+MCH-33.2* MCHC-34.9 RDW-13.5
+___ 08:24PM   NEUTS-52.4 ___ MONOS-5.4 EOS-3.8 
+BASOS-1.3
+___ 08:24PM   GLUCOSE-89 UREA N-22* CREAT-1.3* SODIUM-141 
+POTASSIUM-3.9 CHLORIDE-103 TOTAL CO2-25 ANION GAP-17
+___ 08:24PM   ___ PTT-22.6 ___
+
+Discharge Labs
+___ 06:50AM BLOOD WBC-10.6 RBC-3.70* Hgb-12.2 Hct-35.9* 
+MCV-97 MCH-33.0* MCHC-34.1 RDW-14.0 Plt ___
+___ 07:14AM BLOOD ___ PTT-95.9* ___
+___ 08:24PM BLOOD ESR-16
+___ 06:50AM BLOOD Glucose-87 UreaN-27* Creat-1.5* Na-147* 
+K-4.1 Cl-113* HCO3-25 AnGap-13
+___ 06:50AM BLOOD Calcium-8.7 Phos-2.7 Mg-2.2
+___ 08:24PM BLOOD CRP-1.3
+
+___ 10:46AM URINE Color-Yellow Appear-Hazy Sp ___
+___ 10:46AM URINE Blood-SM Nitrite-NEG Protein-150 
+Glucose-NEG Ketone-NEG Bilirub-NEG Urobiln-NEG pH-7.0 Leuks-MOD
+___ 10:46AM URINE ___ Bacteri-MANY 
+Yeast-NONE ___
+
+MRI ___
+IMPRESSION:
+1. Punctate acute infarcts in the right hemisphere, which could 
+be along ACA/MCA and MCA/PCA watershed territories or be within 
+the MCA territory.
+2. Chronic infarct of the superior right frontal lobe, MCA 
+territory.
+3. Multifocal high-grade stenoses involving the right MCA M2 
+divisions. Other milder probably atherosclerotic disease as 
+described above.
+4. Findings compatible with underlying chronic small vessel 
+ischemic disease.
+
+CTA ___
+IMPRESSION: Mild stenoses of the superior and inferior M2 
+divisions of the right MCA, improved compared to recent MRA. 
+This could be due to improvement in vasospasm or technical 
+differences in evaluation of stable atherosclerotic 
+irregularity.
+
+Carotid Doppler ___
+Right ICA stenosis <40%.
+Left ICA stenosis 60-69%.
+
+Echocardiogram ___
+The left atrium is normal in size. No atrial septal defect or 
+patent foramen ovale is seen by 2D, color Doppler or saline 
+contrast with maneuvers. Left ventricular wall thickness, cavity 
+size and regional/global systolic function are normal (LVEF 
+>55%). Tissue Doppler imaging suggests an increased left 
+ventricular filling pressure (PCWP>18mmHg). There is an abnormal 
+systolic flow contour at rest, but no left ventricular outflow 
+obstruction. There is no ventricular septal defect. Right 
+ventricular chamber size and free wall motion are normal. The 
+diameters of aorta at the sinus, ascending and arch levels are 
+normal. The aortic valve leaflets (3) are mildly thickened but 
+aortic stenosis is not present. No aortic regurgitation is seen. 
+The mitral valve leaflets are mildly thickened. The pulmonary 
+artery systolic pressure could not be determined. There is no 
+pericardial effusion. 
+IMPRESSION: No cardiac source of embolism seen. Normal global 
+and regional biventricular systolic function. Calcified aortic 
+and mitral valves without significant stenosis or regurgitation. 
+Negative bubble study. 
+
+EKG ___
+Sinus rhythm. Normal tracing. Compared to the previous tracing 
+of ___
+ventricular ectopy and left atrial abnormality are no longer 
+seen.
+___
+___ yo woman with PMHx sig. for CVA, CAD s/p multiple PCIs, DM, 
+and HTN who presented to ___ for a 
+severe headache, blurry vision, and concern for increased gait 
+instability.
+
+She was transferred to ___ for further neurologic evaluation 
+and MRI given concern for severe headache or neck pain ___ 
+radiating to bioccipital and bitemporal areas, with hypertension 
+to 200 mmHg and vomiting at ___. along with history of a 
+prior stroke, despite normal CT there. 
+
+MRI revealed punctate infarcts of the right hemisphere within 
+MCA or distal MCA watersheds. Therefore, Mrs. ___ was 
+admitted to Neurology for further workup.
+
+Headache improved and no new neurologic deficits were noted - 
+gait instability at baseline per patient. 
+
+CTA was reassuring with respect to intracranial MCA stenosis, 
+despite such on MRA. Carotid ultrasound revealed less than 40% R 
+internal carotid stenosis. There was no known history of atrial 
+fibrillation and echo demonstrated no thrombi or atrial septal 
+defect. 
+
+Headache may have related to underlying vasospasm, explaining 
+improved MCA territory stenosis from MRA to CTA. Headache may 
+have also related to uncontrolled hypertension. GIven that no 
+embolic source was found, this was seen as the most likely 
+explanation. Verapamil was started and initial heparin IV 
+therapy was stopped. On final assessment probable migraine with 
+vasospasm was thought most likely. Aspirin and simvastatin are 
+to continued. She is discharged for follow-up with Dr. ___ 
+in clinic. 
+ 
+
+###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}, PTT {Partial thromboplastin time, activated}, 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}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Protein {Measurement of protein in urine}, Ketone {Urinalysis, acetone or ketone bodies measurement}, pH {pH measurement}, MRI {Magnetic resonance imaging of head}, acute infarcts {Acute infarct}, right hemisphere {Right cerebral hemisphere structure}, ACA {Structure of anterior cerebral artery}, MCA {Structure of middle cerebral artery}, MCA {Structure of middle cerebral artery}, PCA {Structure of posterior cerebral artery}, MCA {Structure of middle cerebral artery}, infarct {Infarct}, right frontal lobe {Right frontal lobe structure}, MCA {Structure of middle cerebral artery}, stenoses {Stenosis}, M2 
+divisions {Structure of middle cerebral artery M2 segment}, atherosclerotic disease {Atherosclerosis}, small vessel {Structure of small blood vessel (organ)}, ischemic disease {Ischemia}, CTA {Computed tomography angiography with contrast}, stenoses {Stenosis}, M2 
+divisions {Structure of middle cerebral artery M2 segment}, right MCA {Structure of right middle cerebral artery}, improved {Patient's condition improved}, MRA {Magnetic resonance angiography of vascular structure of head}, vasospasm {Vasospasm}, atherosclerotic {Atherosclerosis}, Carotid {Carotid artery structure}, Doppler {Doppler ultrasound}, ICA stenosis {Internal carotid artery stenosis}, ICA stenosis {Internal carotid artery stenosis}, Echocardiogram {Echocardiography}, left atrium {Left atrial structure}, normal in size {Normal size}, atrial septal defect {Atrial septal defect}, patent foramen ovale {Patent foramen ovale}, color Doppler {Color Doppler ultrasound}, Left ventricular wall {Left cardiac ventricular structure}, thickness {Normal thickness}, cavity {Structure of cavity of left cardiac ventricle}, size {Normal size}, regional/global systolic function are normal {Normal left ventricular systolic function and wall motion}, Tissue Doppler imaging {Doppler ultrasonography of heart tissue}, left 
+ventricular {Left cardiac ventricular structure}, left ventricular outflow 
+obstruction {Left ventricular outflow tract obstruction}, ventricular septal defect {Ventricular septal defect}, Right 
+ventricular chamber {Right cardiac ventricular structure}, size {Normal size}, wall motion are normal {Finding of right ventricular wall motion}, aorta at the sinus, {Structure of sinus of Valsalva}, arch {Aortic arch structure}, aortic valve leaflets {Structure of cardiac valve leaflet}, mildly thickened {Increased thickness}, aortic stenosis {Aortic valve stenosis}, aortic regurgitation {Aortic valve regurgitation}, mitral valve leaflets {Structure of leaflet of mitral valve}, pulmonary 
+artery {Pulmonary artery structure}, pericardial effusion {Pericardial effusion}, embolism {Embolism}, Normal global 
+and regional biventricular systolic function {Normal left ventricular systolic function and wall motion}, Calcified {Pathologic calcification, calcified structure}, aortic {Aortic valve structure}, mitral valves {Mitral valve structure}, stenosis {Stenosis}, regurgitation {Mitral valve regurgitation}, EKG {Electrocardiographic procedure}, Sinus rhythm {Sinus rhythm}, ventricular ectopy {Ventricular premature complex}, left atrial abnormality {Left atrial abnormality}, CVA {Cerebrovascular accident}, CAD {Coronary arteriosclerosis}, PCIs {Percutaneous coronary intervention}, DM {Diabetes mellitus}, HTN {Hypertensive disorder, systemic arterial}, headache {Headache}, blurry vision {Blurring of visual image}, gait 
+instability {Unsteady when walking}, neurologic evaluation {Neurological examination}, MRI {Magnetic resonance imaging}, headache {Headache}, neck pain {Neck pain}, radiating {Radiating pain}, bioccipital {Occipital region structure}, bitemporal {Structure of temporal region}, hypertension {Hypertensive disorder, systemic arterial}, vomiting {Vomiting}, stroke {Cerebrovascular accident}, MRI {Magnetic resonance imaging}, infarcts {Infarct}, right hemisphere {Right cerebral hemisphere structure}, MCA {Structure of middle cerebral artery}, MCA {Structure of middle cerebral artery}, watersheds {Watershed infarct}, Headache {Headache}, improved {Patient's condition improved}, neurologic deficits {Neurological deficit}, gait instability {Unsteady when walking}, CTA {Computed tomography angiography with contrast}, intracranial {Intracranial structure}, MCA {Structure of middle cerebral artery}, stenosis {Stenosis}, Carotid ultrasound {Ultrasonography of carotid artery}, carotid stenosis {Carotid artery stenosis}, atrial 
+fibrillation {Atrial fibrillation}, echo {Echocardiography}, thrombi {Thrombus}, atrial septal 
+defect {Atrial septal defect}, Headache {Headache}, vasospasm {Vasospasm}, improved {Patient's condition improved}, MCA {Structure of middle cerebral artery}, stenosis {Stenosis}, MRA {Magnetic resonance angiography of vascular structure of head}, CTA {Computed tomography angiography with contrast}, Headache {Headache}, hypertension {Hypertensive disorder, systemic arterial}, heparin IV 
+therapy {Heparin therapy}, migraine {Migraine}, vasospasm {Vasospasm}"
+"###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:
+Metformin 500 mg bid
+Isosorbide mono 20 mg daily
+Metoprolol 100 mg TID
+Simvastatin 40 mg daily
+Lisinopril 40 mg daily
+Furosemide 40 mg daily
+Caltrate 600 + D
+Asa 81 mg daily
+ 
+Discharge Medications:
+1. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable 
+PO DAILY (Daily).
+Disp:*50 Tablet, Chewable(s)* Refills:*2*
+2. simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).
+Disp:*40 Tablet(s)* Refills:*2*
+3. verapamil 240 mg Cap,24 hr Sust Release Pellets Sig: One (1) 
+Cap,24 hr Sust Release Pellets PO once a day.
+Disp:*30 Cap,24 hr Sust Release Pellets(s)* Refills:*2*
+4. metoprolol tartrate 100 mg Tablet Sig: One (1) Tablet PO 
+three times a day.  
+5. sulfamethoxazole-trimethoprim 800-160 mg Tablet Sig: One (1) 
+Tablet PO BID (2 times a day) for 2 days.
+Disp:*4 Tablet(s)* Refills:*0*
+6. Lasix 40 mg Tablet Sig: One (1) Tablet PO once a day.
+Disp:*30 Tablet(s)* Refills:*2*
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Acute:
+-Punctate acute infarcts in the right hemisphere, which could be 
+along ACA/MCA and MCA/PCA watershed territories or be within the 
+MCA territory. 
+-Vasospasm 
+  
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, acute infarcts {Acute infarct}, right hemisphere {Right cerebral hemisphere structure}, ACA {Structure of anterior cerebral artery}, MCA {Structure of middle cerebral artery}, MCA {Structure of middle cerebral artery}, PCA {Structure of posterior cerebral artery}, MCA {Structure of middle cerebral artery}, Vasospasm {Vasospasm}, 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 to the hospital with unusual headache. Your 
+brain MRI showed a very small infarct in the frontal and 
+parietal areas; called ""watershed infarct"" that was likely due 
+to vasoconstriction. You will need to be on a medication called 
+verapamil to prevent further strokes.
+ 
+
+###RESPONSE: headache {Headache}, brain MRI {Magnetic resonance imaging of brain}, infarct {Infarct}, frontal {Frontal region structure}, parietal areas {Parietal region structure}, watershed infarct {Watershed infarct}, strokes {Cerebrovascular accident}"
+"###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: 
+Patient recorded as having No Known Allergies to Drugs
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Patient admitted for weight reduction surgery.
+ 
+Major Surgical or Invasive Procedure:
+Status Post Laparoscopic Gastric Band
+
+ 
+
+###RESPONSE: surgery {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:
+___ has class III  morbid obesity with weight of 288.4 lbs
+as of ___ (his initial screen weight on ___ was 285.9
+lbs), height of 61 inches and BMI of 54.7. His previous weight
+loss efforts have included 7 months of Weight Watchers in ___
+losing 25 lbs that he maintained for 2 months and 5 months of
+Slim-Fast in ___ without any results. He has not taken
+prescription weight loss medications or used over-the-counter 
+appetite suppressants/herbal supplements. He does not remember
+his weight at age ___ or his lowest adult weight but he weighed
+232 lbs on ___ and 289 lbs on ___, his highest adult
+weight.
+ 
+
+###RESPONSE: morbid obesity {Morbid obesity}, weight
+loss {Weight loss}, prescription {Prescription}, weight loss {Weight loss}"
+"###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:
+hypothyroidism with h/o Graves'  
+disease s/p ablation, severe sleep disordered breathing with  
+recommendation for CPAP by recent sleep study, fatty liver by  
+ultrasound, hyperlipidemia, neurofibromatosis, testicular  
+torsion, colitis likely diverticular disease hospitalized x 2 
+and  
+lower back and knee pain  
+
+ 
+
+###RESPONSE: hypothyroidism {Hypothyroidism}, Graves'  
+disease {Graves' disease}, ablation {Destructive procedure}, sleep study {Sleep studies}, fatty liver {Steatosis of liver}, ultrasound {Ultrasonography}, hyperlipidemia {Hyperlipidemia}, neurofibromatosis {Neurofibromatosis}, testicular  
+torsion {Torsion of testis}, colitis {Colitis}, diverticular disease {Diverticular disease}, lower back {Low back pain}, knee pain {Pain of knee 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:
+Family history is noted for mother living with heart
+disease, thyroid disease and obesity; grandparent deceased of
+heart disease.
+ 
+
+###RESPONSE: heart
+disease {Heart disease}, thyroid disease {Disorder of thyroid gland}, obesity {Obesity}, heart disease {Heart 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:
+His blood pressure was 127/82, pulse 94, respirations 16 and O2
+saturation 94% on room air. On physical examination ___ 
+was
+casually dressed and in no distress. His skin was warm, dry, no
+rashes, + neurofibromas on face (small), trunk/abdomen medium
+size with ___ spots on abdomen (large at RMQ, smaller
+area LLQ); tattoos bilateral lower extremities with lesion right
+anterior mid-shin. Anicteric sclerae, conjunctiva clear, pupils
+were equal round and reactive to light, fundi difficult to
+visualize, mucous membranes were moist, tongue pink and
+oropharynx was without exudates or hyperemia. Trachea was in the
+midline and the neck was supple without adenopathy, thyromegaly
+or carotid bruits. Chest was symmetric and the lungs were clear
+to auscultation, no wheezes, air movement was fair to good.
+Cardiac exam was regular rate and rhythm, normal S1 and S2, no
+murmurs, rubs or gallops. The abdomen was obese but soft and
+non-tender, non-distended, + bowel sounds, no masses or hernias,
+there was small healed incision scar umbilicus. There was no
+spinal tenderness or flank pain. There was no edema of the lower
+extremities, no venous stasis or clubbing, perfusion was good.
+There was no evidence of joint swelling or inflammation of the
+joints. There were no focal neurological deficits and his gait
+was normal.  
+ 
+
+###RESPONSE: blood pressure {Blood pressure finding}, pulse {Normal pulse}, O2
+sat {Oxygen saturation measurement}, on room air {Breathing room air}, physical examination {Physical examination procedure}, distress {Distress}, skin {Examination of skin}, warm {Warm skin}, rashes {Eruption of skin}, neurofibromas on face {Neurofibroma of face}, trunk {Trunk structure}, abdomen {Skin structure of anterior abdominal wall}, abdomen {Skin structure of anterior abdominal wall}, tattoos {Tattoo of skin}, lower extremities {Lower limb structure}, lesion {Lesion}, shin {Shin structure}, Anicteric {White sclera}, conjunctiva {Conjunctival structure}, pupils {Pupil finding}, mucous membranes were moist {Moist oral mucosa}, oropharynx {Oropharyngeal structure}, exudates {Exudate}, hyperemia {Hyperemia}, Trachea {Tracheal structure}, neck {Neck structure}, supple {Normal movement of neck}, adenopathy {Lymphadenopathy}, thyromegaly {Goiter}, carotid bruits {Carotid bruit}, Chest {Examination of respiratory system}, lungs were clear
+to auscultation {Normal breath sounds}, wheezes {Wheezing}, Cardiac {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<}, murmurs {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, abdomen {Examination of abdomen}, obese {Obese}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, bowel sounds {Normal bowel sounds}, hernias {Herniated structure}, incision {Incision}, scar {Scar}, umbilicus {Umbilical structure}, tenderness {Tenderness}, pain {Pain}, edema {Edema}, lower
+extremities {Lower limb structure}, venous stasis {Venous stasis}, clubbing {Clubbing}, perfusion {Perfusion}, joint swelling {Joint swelling}, joints {Joint structure}, neurological deficits {Neurological deficit}, gait {Gait normal}"
+"###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:
+___ 12:36PM BLOOD Hct-43.9
+___ 07:05AM BLOOD WBC-6.0 RBC-4.53* Hgb-12.1* Hct-37.3* 
+MCV-82 MCH-26.7* MCHC-32.5 RDW-13.7 Plt ___
+___ 07:05AM BLOOD Plt ___
+ 
+
+###RESPONSE: Hct {Hematocrit determination}, 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}"
+"###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:
+Patient admitted and underwent a laparoscopic gastric band. He 
+tolerated this procedure very well. Postoperative course was 
+complicated by urinary retention. Urology was consulted as 
+reinsertion of foley catheter was difficult. He will go home 
+with a foley catheter and appointment has been made for him with 
+urology to discontinue catheter in one week.
+
+Pain is well controlled on roxicet. Slowly progressed to 
+bariatric stage 3 with good tolerance. Discharge instructions 
+reviewed and discussed.
+
+Will follow up with Dr. ___ in 2 weeks.
+ 
+
+###RESPONSE: laparoscopic gastric band. {Laparoscopic adjustable gastric banding}, procedure {Procedure}, urinary retention {Retention of urine}, foley {Catheterization of urinary bladder}, foley {Catheterization of urinary bladder}, Pain is well controlled {Demonstrates adequate pain control}, Discharge instructions {Final inpatient visit with instructions at discharge}, follow up {Follow-up arranged}"
+"###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:
+Levothyroxine 300 mcg daily for  
+hypothyroid; Citalopram 20 mg daily for depression (not taking); 
+ 
+Simvastatin 40 mg daily for hyperlipidemia; Ibuprofen 800 mg  
+three times daily with meals as needed for back, knee pain;  
+Betamethasone 0.05% lotion to affected skin at bedtime;  
+multivitamins with minerals daily and vitamin D  
+
+ 
+Discharge Medications:
+1. Levothyroxine 100 mcg Tablet Sig: Three (3) Tablet PO DAILY 
+(Daily).  
+2. Citalopram 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 
+ 
+3. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+4. Oxycodone-Acetaminophen ___ mg/5 mL Solution Sig: ___ MLs 
+PO Q4H (every 4 hours) as needed for pain.
+Disp:*500 ML(s)* Refills:*0*
+5. Colace 50 mg/5 mL Liquid Sig: Ten (10) ml PO twice a day as 
+needed for constipation.
+Disp:*500 ml* Refills:*0*
+6. Multivitamin     Tablet Sig: One (1) Tablet PO once a day.  
+
+ 
+
+###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 Diagnosis: obesity
+
+ 
+Discharge Condition:
+Mental Status:Clear and coherent
+Level of Consciousness:Alert and interactive
+Activity Status:Ambulatory - Independent
+
+ 
+
+###RESPONSE: obesity {Obesity}, Mental Status {Neurological mental status determination}, 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:
+
+###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: Please call your surgeon or return to 
+the emergency department if you develop a fever greater than 
+101.5, chest pain, shortness of breath, severe abdominal pain, 
+pain unrelieved by your pain medication, severe nausea or 
+vomiting, severe abdominal bloating, inability to eat or drink, 
+foul smelling or colorful drainage from your incisions, redness 
+or swelling around your incisions, or any other symptoms which 
+are concerning to you.
+
+Diet: Stay on Stage III diet until your follow up appointment. 
+Do not self advance
+diet, do not drink out of a straw or chew gum.
+
+Medication Instructions:
+Resume your home medications, CRUSH ALL PILLS.
+You will be starting some new medications:
+1.  You are being discharged on medications to treat the pain 
+from your operation. These medications will make you drowsy and 
+impair your ability to drive a motor vehicle or operate 
+machinery safely. You MUST refrain from such activities while 
+taking these medications.
+2. You should begin taking a chewable complete multivitamin with 
+minerals once a day. No gummy vitamins.
+3. You should take a stool softener, Colace, twice daily for 
+constipation as needed, or until you resume a normal bowel 
+pattern.
+4. You must not use NSAIDS (non-steroidal anti-inflammatory 
+drugs) Examples are Ibuprofen, Motrin, Aleve, Nuprin and 
+Naproxen. These agents will cause bleeding and ulcers in your 
+digestive system.
+
+Activity:
+No heavy lifting of items ___ pounds for 6 weeks. You may 
+resume moderate
+exercise at your discretion, no abdominal exercises.
+
+Wound Care:
+You may shower, no tub baths or swimming. 
+If there is clear drainage from your incisions, cover with 
+clean, dry gauze. 
+Your steri-strips will fall off on their own. Please remove any 
+remaining strips ___ days after surgery.
+Please call the doctor if you have increased pain, swelling, 
+redness, or drainage from the incision sites. 
+
+ 
+
+###RESPONSE: Discharge Instructions {Final inpatient visit with instructions at discharge}, fever {Fever}, chest pain {Chest pain}, shortness of breath {Dyspnea}, abdominal pain {Abdominal pain}, pain {Pain}, pain medication {Administration of analgesic}, nausea {Nausea}, vomiting {Vomiting}, abdominal bloating {Abdominal bloating}, drainage {Discharge}, incisions {Incision}, redness {Redness of skin over lesion}, swelling {Swelling}, incisions {Incision}, Diet {Dietary finding}, diet {Dietary finding}, diet {Dietary finding}, pain {Pain}, operation {Surgical procedure}, drowsy {Drowsy}, impair your ability to drive a motor vehicle or operate 
+machinery safely {Patient should not drive or operate machinery}, take a stool softener {Administration of laxative}, constipation {Constipation}, a normal bowel 
+pattern {Normal bowel habits}, bleeding {Bleeding}, ulcers {Ulcer}, digestive system {Structure of digestive system}, exercise {Exercises}, abdominal exercises {Abdominal exercises}, drainage {Discharge}, incisions {Incision}, cover with 
+clean, dry gauze {Application of dressing}, surgery {Surgical procedure}, increased pain {Increased pain}, swelling {Swelling}, redness {Redness of skin over lesion}, drainage {Discharge}, incision {Incision}"
+"###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: 
+Sulfa (Sulfonamide Antibiotics) / Codeine / Azithromycin / 
+Tequin / Keflex / Penicillins
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Chest pain
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: Sulfonamide Antibiotics {Allergy to sulfonamide antibiotic}, Codeine {Allergy to codeine}, Azithromycin {Allergy to azithromycin}, Keflex {Allergy to cefalexin}, Penicillins {Allergy to penicillin}, Chest pain {Chest 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 man with long hx of GERD who presented to the ED after 
+experiencing intermittant chest pain associated with dizziness 
+over the preceding two days.  He was unsure if this was GERD 
+associted pain or not, and felt recent initiation of SSRI may 
+have contributed, but symptoms persisted, so he called ___ at 
+the recommendation of an RN from his PCP's office.   He was 
+given ASA (4 baby asa) by EMS and he reported immediate relief 
+of his chest pain.  
+
+In the ED, found to have VSS.  ECG with ? old inferior infarct.  
+No ischemic changes.  Trop flat times two.  Had planned obs and 
+stress test, but not able to do on ___, so admitted. 
+
+ROS: at current: denies dizziness, sob, nausea, cp.  Denies 
+recent blood in stool or tarry stools.  All other systems 
+reviewed and negative. 
+ 
+
+###RESPONSE: GERD {Gastroesophageal reflux disease}, chest pain {Chest pain}, dizziness {Dizziness}, GERD {Gastroesophageal reflux disease}, pain {Pain}, PCP {Primary care management}, relief {Feeling relief}, chest pain {Chest pain}, VSS {Vital signs finding}, ECG {Electrocardiographic procedure}, old inferior infarct {Old inferior myocardial infarction}, No ischemic changes {Electrocardiogram: no myocardial ischemia}, stress test {Electrocardiogram with exercise test}, dizziness {Dizziness}, sob {Dyspnea}, nausea {Nausea}, blood in stool {Hematochezia}, tarry stools {Melena}"
+"###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:
+HTN
+GERD
+HCL
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, GERD {Gastroesophageal reflux 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: 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:
+Cancer - lung and liver.  No hx. CAD in parents or siblings.
+ 
+
+###RESPONSE: Cancer {Malignant neoplasm}, lung {Malignant tumor of lung}, liver {Malignant neoplasm of liver}, CAD {Coronary arteriosclerosis}"
+"###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:
+AF and VSS. BP 156/98.  
+NAD
+Alert, oriented
+Independently ambulatory
+No JVD
+RRR no MRG
+CTA througout
+Soft, nt, nd, bs present
+No edema
+Distal pulses 2+
+No rash
+ 
+
+###RESPONSE: AF {Atrial fibrillation}, VSS {Vital signs finding}, BP {Blood pressure finding}, NAD {No abnormality detected}, Alert {Mentally alert}, oriented {Orientated}, Independently ambulatory {Independent walking}, JVD {Jugular venous engorgement}, RRR {Normal heart rate}, no MRG {Heart sounds normal}, CTA {Normal breath sounds}, Soft {Abdomen soft}, nt {Abdominal tenderness}, nd {Swollen abdomen}, bs present {Normal bowel sounds}, edema {Edema}, Distal pulses 2+ {Peripheral pulse present}, rash {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:
+___ 03:00PM   PLT COUNT-197
+___ 03:00PM   NEUTS-64.3 ___ MONOS-9.4 EOS-1.6 
+BASOS-0.5
+___ 03:00PM   WBC-6.7 RBC-4.69 HGB-14.0 HCT-39.4* MCV-84 
+MCH-30.0 MCHC-35.6* RDW-13.6
+___ 03:00PM   D-DIMER-<150
+___ 03:00PM   cTropnT-<0.01
+___ 03:00PM   estGFR-Using this
+___ 03:00PM   GLUCOSE-92 UREA N-20 CREAT-0.9 SODIUM-142 
+POTASSIUM-3.5 CHLORIDE-103 TOTAL CO2-26 ANION GAP-17
+___ 09:15PM   cTropnT-<0.01
+
+ECG: NSR.  S1Q3T3 (old).  No acute ischemic changes.
+
+___ ___ M  ___  ___ 
+ 
+Cardiology Report Stress Study Date of ___   
+ 
+  
+EXERCISE RESULTS 
+
+ 
+*** Not Signed Out *** 
+RESTING DATA 
+EKG:  SINUS, ERWP, NSSTTW   
+HEART RATE:  75 BLOOD PRESSURE:  144/70 
+  
+PROTOCOL GERVINO - TREADMILL 
+STAGE TIME SPEED ELEVATION HEART BLOOD RPP 
+  (MIN) (MPH) (%) RATE PRESSURE   
+1 ___ 1.0 5 82 148/74 ___ 
+2 ___ 1.6 6 79 150/70 ___ 
+3 ___ 2.2 7 86 156/60 ___ 2.8 8 94 156/60 ___ 
+  
+TOTAL EXERCISE TIME:  12 % MAX HRT RATE ACHIEVED:  66 
+ 
+SYMPTOMS: NONE   
+ST DEPRESSION: NONE 
+ 
+  
+INTERPRETATION: ___ yo man with h/o HTN and ECG with questionable 
+old 
+IMI was referred to evaluate an atypical chest discomfort and 
+lightheadedness. The patient completed 12 minutes of a Gervino 
+protocol 
+representing an average exercise tolerance for his age; ~ 6.2 
+METS. The 
+exercise test was stopped at the patient's request secondary to 
+fatigue. 
+No chest, back, neck or arm discomforts were reported. No 
+significant ST 
+segment changes were noted. The rhythm was sinus with rare 
+isolated APDs 
+and VPDs noted. In the absence of beta blocker therapy, the 
+heart rate 
+response to exercise was blunted. In addition, a blunted blood 
+pressure 
+response to exercise was noted. 
+  
+IMPRESSION: Average exercise tolerance. No anginal symptoms or 
+ischemic 
+ST segment changes. Blunted hemodynamic response to exercise 
+(see 
+above). 
+ 
+
+ 
+
+###RESPONSE: NEUTS {Neutrophil count}, MONOS {Monocyte count}, EOS {Eosinophil count}, 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}, cTropnT {Troponin T cardiac measurement}, 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}, cTropnT {Troponin T cardiac measurement}, ECG {Electrocardiographic procedure}, NSR {Normal sinus rhythm}, No acute ischemic {Electrocardiogram: no myocardial ischemia}, Cardiology {Cardiology service}, Stress Study {Electrocardiogram with exercise test}, EXERCISE {Electrocardiogram with exercise test}, EKG {Electrocardiographic procedure}, SINUS {Sinus rhythm}, HEART RATE {Finding of heart rate}, ELEVATION {Elevation}, HEART {Finding of heart rate}, PRESSURE {Blood pressure finding}, EXERCISE {Electrocardiogram with exercise test}, ST DEPRESSION {ST segment depression}, HTN {Hypertensive disorder, systemic arterial}, ECG {Electrocardiographic procedure}, old 
+IMI {Old inferior myocardial infarction}, chest discomfort {Chest discomfort}, lightheadedness {Lightheadedness}, exercise tolerance {Exercise tolerance finding}, exercise test {Electrocardiogram with exercise test}, fatigue {Fatigue}, chest {Thoracic structure}, back {Structure of back of trunk}, neck {Neck structure}, arm {Upper limb structure}, discomforts {Discomfort}, ST 
+segment changes {Electrocardiographic ST segment changes}, rhythm {Normal sinus rhythm}, sinus {Sinus rhythm}, therapy {Therapy}, heart rate {Finding of heart rate}, exercise {Electrocardiogram with exercise test}, blood 
+pressure {Blood pressure monitoring}, exercise {Electrocardiogram with exercise test}, exercise tolerance {Exercise tolerance finding}, anginal symptoms {Angina}, ischemic {Ischemia}, ST segment changes {Electrocardiographic ST segment changes}, hemodynamic {Hemodynamic monitoring}, exercise {Exercises}"
+"###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:
+Impression:
+
+Chest pain, intermittant, associated with lightheadeness, not 
+associated with activity, concerning for anginal pain; could be 
+due to gastritis or a side effect of new SSRI administration in 
+the past 10 days.  Fact that pt. reports that sysptoms 
+alleviated immediatley by the administration of asa by EMS 
+personnel unusual - no EMS documentation in pt. record.  I 
+remain concerned that this was more likely ntg administration 
+concurrently that may have resolved pain. 
+
+Stable and chronic issues include: HTN, HCL.
+
+Hospital course: 
+
+Troponin T negative times three.  Exercise stress test (non 
+imaging) was performed, result above.  Pt. had no symptoms of 
+chest pain or dizziness during this episode.  On further review, 
+pt. reported that chest pain and dizziness are most notable when 
+taking celexa - especially if he takes it on an empty stomach.  
+He also states that his chest pain is most consistent with his 
+acid reflux - and that this and dizziness are alleviated by 
+eating.  
+
+He endorses lonliness.  I have suggested that he continue to 
+take the SSRI, as the side effects of dizziness and GI upset 
+often resolve with continued administration of this medication.  
+He agrees with this. 
+
+ 
+
+###RESPONSE: Chest pain {Chest pain}, lightheadeness {Lightheadedness}, anginal pain {Angina}, gastritis {Gastritis}, side effect {Medication side effects present}, resolved {Problem resolved}, pain {Pain}, Stable {Patient's condition stable}, chronic issues {Chronic disease}, HTN {Hypertensive disorder, systemic arterial}, Troponin T {Troponin T measurement}, Exercise stress test {Electrocardiogram with exercise test}, imaging {Imaging}, chest pain {Chest pain}, dizziness {Dizziness}, chest pain {Chest pain}, dizziness {Dizziness}, stomach {Stomach structure}, chest pain {Chest pain}, acid reflux {Acid reflux}, dizziness {Dizziness}, lonliness {Feeling lonely}, side effects {Medication side effects present}, dizziness {Dizziness}, GI upset {Gastrointestinal irritation}, administration of this medication {Administration of drug or medicament}"
+"###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:
+ citalopram 
+10 mg Tablet 
+1 Tablet(s) by mouth once a day  ___
+New ___,
+ ___ 30 Tablet 3 (Three) ___ Care)  
+  gemfibrozil 
+600 mg Tablet 
+1 Tablet(s) by mouth once a day (Prescribed by Other Provider; 
+Dose adjustment - no new Rx)  ___
+Recorded Only ___,
+ ___        
+  hydrochlorothiazide 
+12.5 mg Capsule 
+1 Capsule(s) by mouth daily  ___
+Renewed ___,
+ ___ 90 Capsule 3 (Three) ___ Care)  
+  omeprazole 
+40 mg Capsule, Delayed Release(E.C.) 
+1 Capsule(s) by mouth once a day (Prescribed by Other Provider: 
+___  ___
+Recorded Only ___,
+ ___        
+  ranitidine HCl 
+150 mg Tablet 
+1 Tablet(s) by mouth at bedtime (Prescribed by Other Provider)  
+___
+Recorded Only ___,
+ ___        
+  terazosin 
+2 mg Capsule 
+1 Capsule(s) by mouth at bedtime (Prescribed by Other Provider: 
+___  ___
+Recorded Only ___,
+ ___        
+  * OTCs *             
+  acetaminophen [Tylenol Extra Strength] 
+500 mg Tablet 
+2 Tablet(s) by mouth q4hr as needed for pain (___)  ___
+Recorded Only ___,
+ ___        
+  carboxymethylcellulose sodium [Lubricant Eye Drops] 
+0.5 % Drops 
+1 gtt ___ four times a day as needed for dry eyes (Prescribed by 
+Other Provider: ___  ___
+Recorded Only ___,
+ ___        
+  cholecalciferol (vitamin D3) 
+1,000 unit Tablet 
+1 Tablet(s) by mouth once a day (___)  ___
+Recorded Only ___,
+ ___        
+  glucosamine-chondroitin 
+500 mg-400 mg Capsule 
+3 Capsule(s) by mouth once a day (___)  ___
+Recorded Only ___,
+ ___        
+  guar gum [Benefiber (guar gum)] 
+1 gram Tablet 
+1 Tablet(s) by mouth once a day (___)  ___
+Recorded Only ___,
+ ___        
+  multivitamin-minerals-lutein [Centrum Silver] 
+Tablet 
+1 Tablet(s) by mouth once a day (___)  ___
+Recorded Only ___,
+ ___        
+  saw ___ 
+500 mg Capsule 
+1 Capsule(s) by mouth once a day (___)  ___
+Recorded Only ___,
+ ___        
+  ___ by Drug Class            
+
+ 
+Discharge Medications:
+1. citalopram 20 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily).  
+2. gemfibrozil 600 mg Tablet Sig: One (1) Tablet PO BID (2 times 
+a day).  
+3. hydrochlorothiazide 12.5 mg Capsule Sig: One (1) Capsule PO 
+DAILY (Daily).  
+4. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: Two (2) 
+Capsule, Delayed Release(E.C.) PO DAILY (Daily).  
+5. ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO HS (at 
+bedtime).  
+6. terazosin 1 mg Capsule Sig: Two (2) Capsule PO HS (at 
+bedtime).  
+7. acetaminophen 500 mg Tablet Sig: Two (2) Tablet PO Q6H (every 
+6 hours) as needed for pain.  
+8. polyvinyl alcohol-povidone 1.4-0.6 % Dropperette Sig: ___ 
+Drops Ophthalmic PRN (as needed) as needed for dry eyes.  
+9. cholecalciferol (vitamin D3) 1,000 unit Tablet Sig: One (1) 
+Tablet PO DAILY (Daily).  
+10. multivitamin     Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+11. Benefiber (guar gum)  Oral
+12. saw ___  Oral
+13. Centrum Silver  Oral
+14. hydrocortisone 1 % Cream Sig: One (1) application Topical 
+twice a day for 1 weeks: to rash.
+Disp:*1 tube* Refills:*0*
+
+ 
+
+###RESPONSE: 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:
+acid reflux
+dizziness (occasionally) likely related to side effect of celexa
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent
+
+ 
+
+###RESPONSE: acid reflux {Acid reflux}, dizziness {Dizziness}, side effect {Medication side effects present}, 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:
+See below
+ 
+
+###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: NEUROLOGY
+ 
+
+###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:
+Seizures, confusion
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: No Known Allergies {Allergic disposition}, Adverse Drug Reactions {Propensity to adverse reactions to drug}, Seizures {Seizure}, confusion {Clouded consciousness}"
+"###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 ___ year old ___ woman with a PMHx of 
+TIIDM, pituitary mass s/p resection ___, and hyperlipidemia who 
+presents as a direct admission to the EMU due to her history of 
+seizures, recent lapses in memory, and fatigue for better 
+characterization of her seizures and medication adjustment. She 
+is followed outpatient by Dr. ___. The HPI is 
+obtained from previous notes and from interview with patient 
+through an interpreter.
+
+In brief, Ms. ___ initially presented to the Access Neurology 
+clinic in ___ with five episodes of loss of 
+consciousness which were thought to be seizures. These episodes 
+were not well characterized, but per her son-in-law, occurred 
+while at work in a ___ restaurant, while she was sleeping at 
+home, and at ___, when she was found at the store with no 
+shoes and no recollection of how she got to the store. The 
+patient does not recall these episodes, but states that her 
+husband described the final two episodes as foaming at the mouth 
+and jerking of her hands. She was started initially by her PCP 
+on ___ 750 BID. 
+
+After self-discontinuing this medication due to GI side effects 
+attributed to it, she experienced one more episode in ___. She has not had any episodes with jerking of her 
+extremities or loss of awareness, such as the ___ 
+incident since re-starting her Keppra after this. She does 
+however complain of light-headedness, fatigue, and brief memory 
+lapses. She characterizes the memory lapses as being in a room 
+and forgetting why she is there, or holding an object in her 
+hands such as plates and forgetting why she is holding them and 
+what she is doing with them. This happens ___ times per day and 
+did not occur prior to her first seizure. She denies vertigo, 
+poor sleep, ___, jamais ___, paresthesias. However she does 
+endorse a rising sense of fear in her abdomen that is sometimes 
+associated with these episodes. 
+
+Routine EEG in ___ showed an electrographic seizure from 
+the right temporal region as well as periodic discharges. MRI 
+from ___ is reviewed in detail below, but in brief 
+showed no evidence of hemorrhage, edema, mass, mass effect and 
+showed a nonspecific right temporal superficial soft tissue 
+density which was previously noted on head CT. 
+
+Given these new episodes of memory lapse, continued seizure 
+activity on EEG despite levetiracetam, and possible toxicity 
+from levetiracetam resulting in fatigue and dizziness, Ms. ___ 
+is admitted for EEG monitoring and medication adjustment. 
+
+Her further is also notable for a history of a resection of 
+pituitary mass in ___. She reports having double vision prior 
+to discovery of the mass. It also appears that she received 
+radiation therapy post-operatively. It is unclear at this time 
+what evaluation or monitoring has been done from an 
+endocrinologic perspective since her arrival to the ___. 
+Furthermore, she has been incidentally found to have a right 
+frontotemporal nonspecific superficial soft tissue density on 
+imaging, the etiology of which is unclear but could be related 
+to her surgery. 
+
+On neuro ROS, she endorses having headache ___ times per week 
+with associated visual phenomenon of seeing ""shadows"" in her 
+vision. The headache is most prominent across the front of her 
+forehead and extends to her temples bilaterally. While she 
+endorses having had diplopia prior to her pituitary surgery, she 
+currently denies diplopia. She additionally denies dysarthria, 
+dysphagia, difficulties producing or comprehending speech.
+
+On general review of systems, the pt denies chest pain, SOB. She 
+endorses dry mouth.
+ 
+
+###RESPONSE: TIIDM {Diabetes mellitus type 2}, pituitary mass {Mass of pituitary}, resection {Excision}, hyperlipidemia {Hyperlipidemia}, seizures {Seizure}, lapses in memory {Memory lapses}, fatigue {Fatigue}, seizures {Seizure}, medication adjustment {Change of medication}, loss of 
+consciousness {Loss of consciousness}, seizures {Seizure}, sleeping {Asleep}, mouth {Mouth region structure}, jerking {Spasmodic movement}, hands {Hand structure}, PCP {Primary care management}, GI side effects {Gastrointestinal tract drug side effect}, jerking {Spasmodic movement}, extremities {All extremities}, light-headedness {Lightheadedness}, fatigue {Fatigue}, memory 
+lapses {Memory lapses}, memory lapses {Memory lapses}, hands {Hand structure}, seizure {Seizure}, vertigo {Vertigo}, poor sleep {Difficulty sleeping}, paresthesias {Paresthesia}, fear {Fear}, abdomen {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, EEG {Electroencephalogram}, electrographic seizure {Electroencephalogram abnormality with seizure}, right temporal region {Right temporal lobe structure}, MRI {Magnetic resonance imaging}, no evidence {No abnormality detected}, hemorrhage {Hemorrhage}, edema {Edema}, mass {Mass of body structure}, right temporal {Right temporal lobe structure}, soft tissue {Structure of soft tissue}, density {Density outside reference range}, head CT {Computed tomography of head}, memory lapse {Memory lapses}, seizure {Seizure}, EEG {Electroencephalogram}, toxicity {Poisoning}, fatigue {Fatigue}, dizziness {Dizziness}, EEG monitoring {Continuous processed electroencephalogram}, medication adjustment {Review of medication}, resection of 
+pituitary mass {Operation on lesion of pituitary gland}, double vision {Diplopia}, mass {Mass of body structure}, radiation therapy {Radiation oncology AND/OR radiotherapy}, post-operatively {Postoperative state}, evaluation {Evaluation procedure}, monitoring {Monitoring procedure}, right 
+frontotemporal {Right temporal and frontal lobes (combined site)}, soft tissue {Structure of soft tissue}, density {Density outside reference range}, imaging {Imaging}, surgery {Surgical procedure}, ROS {Review of systems}, headache {Headache}, visual {Visual hallucinations}, vision {Visual disturbance}, headache is most prominent across the front of her 
+forehead {Frontal headache}, extends to her temples bilaterally {Temporal headache}, diplopia {Diplopia}, pituitary surgery {Operation on pituitary gland}, diplopia {Diplopia}, dysarthria {Dysarthria}, dysphagia {Dysphagia}, difficulties producing or comprehending speech {Difficulty comprehending speech}, general {General examination of patient}, review of systems {Review of systems}, chest pain {Chest pain}, SOB {Dyspnea}, dry mouth {Mucous membrane dryness}"
+"###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:
+1. Diabetes Type II
+2. Pituitary Mass s/p resection in ___ in ___
+3. Vitamin D deficiency
+4. Hyperlipidemia
+ 
+
+###RESPONSE: Diabetes Type II {Diabetes mellitus type 2}, Pituitary Mass {Mass of pituitary}, resection {Excision}, Vitamin D deficiency {Vitamin D deficiency}, Hyperlipidemia {Hyperlipidemia}"
+"###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:
+No known family history of seizure disorder. 
+ 
+
+###RESPONSE: seizure disorder {Seizure 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: Physical Exam:
+ON ADMISSION
+===========
+Vitals: 98.3 119/78 58 18 94RA 
+General: awake, cooperative, NAD.
+HEENT: Dry mouth. NC/AT, no scleral icterus noted.
+Neck: supple, no nuchal rigidity
+Pulmonary: breathing comfortably on room air
+Cardiac: RRR
+Abdomen: soft, NT/ND
+Extremities: warm, well perfused
+Skin: no rashes or lesions noted
+
+Neurologic:
+
+-Mental Status: Alert, oriented to self, hospital, and date. 
+Able
+to relate history through interpreter. Attentive, able to name
+___ backward without difficulty. Language appears to be fluent
+per interpreter. Able to follow both midline and appendicular
+commands. There was no evidence of apraxia or neglect.
+
+-Cranial Nerves:
+II, III, IV, VI:  PERRL 3 to 2mm and brisk. EOMI. Left gaze
+fatigable nystagmus. Normal saccades. VFF to confrontation.
+V: Facial sensation intact to light touch.
+VII: No facial droop, facial musculature symmetric.
+VIII: Hearing intact to finger-rub bilaterally.
+IX, X: Palate elevates symmetrically.
+XI: ___ strength in trapezii and SCM bilaterally.
+XII: Tongue protrudes in midline.
+
+-Motor: Normal bulk, tone throughout. No pronator drift
+bilaterally.
+No adventitious movements, such as tremor, noted. No asterixis
+noted.
+  Delt Bic Tri WrE FFl FE IO IP Quad Ham TA ___
+L  5    ___   ___  5   5    5  5     5     5   5
+R  5    ___   ___  5   5    5  5     5     5   5
+
+-Sensory: No deficits to light touch. No extinction to DSS.
+
+-Coordination: No intention tremor. No dysmetria on FNF
+
+-Gait: Deferred
+
+ON DISCHARGE
+============
+Vitals: 97.6 115/77 65 16 94% RA
+General: awake, cooperative, NAD.
+HEENT: Dry mouth. NC/AT, no scleral icterus noted.
+Neck: supple, no nuchal rigidity
+Pulmonary: breathing comfortably on room air
+Cardiac: RRR
+Abdomen: soft, NT/ND
+Extremities: warm, well perfused
+Skin: no rashes or lesions noted
+
+Neurologic:
+
+-Mental Status: Alert, oriented to self, hospital, and date. 
+Able to relate history through interpreter. Attentive, able to 
+name ___ backward without difficulty. Language appears to be 
+fluent per interpreter. Able to follow both midline and 
+appendicular commands. There was no evidence of apraxia or 
+neglect.
+
+-Cranial Nerves:
+II, III, IV, VI:  PERRL 3 to 2mm and brisk. EOMI. No nystagmus. 
+Normal saccades. VFF to confrontation.
+V: Facial sensation intact to light touch.
+VII: No facial droop, facial musculature symmetric.
+VIII: Hearing intact to finger-rub bilaterally.
+IX, X: Palate elevates symmetrically.
+XI: ___ strength in trapezii and SCM bilaterally.
+XII: Tongue protrudes in midline.
+
+-Motor: Normal bulk, tone throughout. Slight right sided 
+pronator drift.
+No adventitious movements, such as tremor, noted. No asterixis 
+noted.
+  Delt Bic Tri WrE FFl FE IO IP Quad Ham TA ___
+L  5    ___   ___  5   5    5  5     5     5   5
+R  5    ___   ___  5   5    5  5     5     5   5
+
+-Sensory: No deficits to light touch. No extinction to DSS.
+
+-Coordination: No intention tremor. No dysmetria on FNF.
+ 
+
+###RESPONSE: Vitals {Vital signs finding}, RA {Breathing room air}, General {General examination of patient}, awake {Awake}, cooperative {Cooperative mental state}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, Dry mouth {Mucous membrane dryness}, NC {Normal head}, scleral icterus {Scleral icterus}, Neck {Physical examination procedure}, supple {Normal movement of neck}, nuchal rigidity {Nuchal rigidity}, Pulm {Examination of respiratory system}, breathing comfortably {Breathing easily}, on room air {Breathing room air}, Cardiac {Cardiovascular physical examination}, RRR {Normal heart rate}, Abdomen {Examination of abdomen}, soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, Extremities {Examination of limb}, warm {Warm skin}, well perfused {Normal tissue perfusion}, Skin {Examination of skin}, rashes {Eruption of skin}, lesions {Lesion}, Mental Status {Neurological mental status determination}, Alert {Mentally alert}, oriented {Oriented to person}, Attentive {Well controlled integrated attention}, fluent {Does speak fluently}, no evidence {No abnormality detected}, apraxia {Apraxia}, neglect {Neglect of part of body}, PERRL {Pupils equal and reacting to light}, brisk {Brisk pupil movement}, EOMI {Normal ocular motility}, nystagmus {Nystagmus}, Normal saccades {Normal ocular motility}, VFF to confrontation {Normal visual field}, Facial {Face structure}, sensation intact to light touch {Light touch sensation present}, facial droop {Weakness of face muscles}, facial musculature symmetric {Facial symmetry}, Hearing intact {Hearing normal}, Palate elevates {Able to elevate soft palate}, trapezii {Structure of trapezius muscle}, SCM {Structure of sternocleidomastoid muscle}, Tongue protrudes {Able to protrude tongue}, Motor {Motor testing}, Normal bulk, tone {Normal tone in skeletal muscle}, pronator drift {Downward drift of outstretched supinated arm}, adventitious movements {Involuntary movement}, tremor {Tremor}, asterixis {Asterixis}, Sensory {Sensory testing}, No deficits to light touch {Normal light touch sensation}, intention tremor {Intention tremor}, dysmetria {Dysmetria}, FNF {Finger-to-nose test}, Vitals {Vital signs finding}, General {General examination of patient}, awake {Awake}, cooperative {Cooperative mental state}, NAD {Distress}, HEENT {General examination of patient}, Dry mouth {Mucous membrane dryness}, scleral icterus {Scleral icterus}, supple {Normal movement of neck}, nuchal rigidity {Nuchal rigidity}, Pulmonary {Examination of respiratory system}, breathing comfortably on room air {Breathing room air}, Cardiac {Cardiovascular physical examination}, RRR {Normal heart rate}, Abdomen {Examination of abdomen}, soft {Abdomen soft}, Extremities {Examination of limb}, warm {Warm skin}, well perfused {Normal tissue perfusion}, Skin {Examination of skin}, rashes {Eruption of skin}, lesions {Skin lesion}, Neurologic {Neurological examination}, Mental Status {Neurological mental status determination}, Alert {Mentally alert}, oriented {Oriented to person}, Attentive {Well controlled integrated attention}, fluent {Does speak fluently}, per interpreter {Interpreter present}, no evidence {No abnormality detected}, apraxia {Apraxia}, neglect {Neglect of part of body}, Cranial Nerves {Examination of cranial nerve}, PERRL {Pupils equal and reacting to light}, brisk {Brisk pupil movement}, EOMI {Normal ocular motility}, nystagmus {Nystagmus}, Normal saccades {Normal ocular motility}, VFF to confrontation {Normal visual field}, Facial {Face structure}, sensation intact to light touch {Light touch sensation present}, facial droop {Weakness of face muscles}, facial musculature symmetric {Facial symmetry}, Hearing intact {Hearing normal}, Palate elevates {Able to elevate soft palate}, trapezii {Structure of trapezius muscle}, SCM {Structure of sternocleidomastoid muscle}, Tongue protrudes in midline {Able to protrude tongue fully}, Motor {Motor testing}, Normal bulk, tone {Normal tone in skeletal muscle}, right sided {Structure of right half of body}, pronator drift {Downward drift of outstretched supinated arm}, adventitious movements {Involuntary movement}, tremor {Tremor}, asterixis {Asterixis}, Sensory {Sensory testing}, No deficits to light touch {Normal light touch sensation}, intention tremor {Intention tremor}, dysmetria {Dysmetria}, FNF {Finger-to-nose 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: Pertinent Results:
+___ 08:35AM BLOOD WBC-5.5 RBC-4.63 Hgb-13.6 Hct-40.5 MCV-88 
+MCH-29.4 MCHC-33.6 RDW-12.7 RDWSD-40.2 Plt ___
+___ 08:35AM BLOOD Glucose-311* UreaN-13 Creat-1.0 Na-140 
+K-3.7 Cl-98 HCO3-22 AnGap-20*
+___ 08:35AM BLOOD ALT-31 AST-25 LD(LDH)-179 AlkPhos-77 
+TotBili-0.7
+___ 08:35AM BLOOD Albumin-4.4 Calcium-9.2 Phos-3.8 Mg-2.2
+___ 08:35AM BLOOD FSH-4.8 LH-2.2 Prolact-2.9* TSH-1.0
+___ 12:01PM URINE Color-Straw Appear-Clear Sp ___
+___ 12:01PM URINE Blood-NEG Nitrite-NEG Protein-NEG 
+Glucose-1000* Ketone-NEG Bilirub-NEG Urobiln-NEG pH-7.0 
+Leuks-MOD*
+___ 12:01PM URINE RBC-1 WBC-19* Bacteri-NONE Yeast-NONE 
+Epi-1
+ 
+
+###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}, 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}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, Albumin {Albumin measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, TSH {Thyroid stimulating hormone measurement}, URINE Color-Straw {Normal urine color}, Protein {Measurement of protein in urine}, Ketone {Urinalysis, acetone or ketone bodies measurement}, pH {pH measurement}, RBC {Red blood cell count}, WBC {White blood cell count}"
+"###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:
+Ms. ___ is a ___ ___ speaking only woman with a past 
+medical history significant for a pituitary mass resected in 
+___ in ___ that she was told was benign; type 2 diabetes; 
+hyperlipidemia who started having episodes of memory lapses over 
+the last one to ___ years. For example, she would be performing 
+activity such as doing the dishes and then suddenly not remember 
+why she had dishes in her hands. She was evaluated by Dr. 
+___ in ___ ___ Department and an EEG was obtained on 
+___, which revealed one electrographic seizure with a 
+right temporal onset and without clear clinical correlate and 
+temporal intermittent rhythmic delta activity as well as 
+frequent left anterior temporal epileptiform discharges 
+occurring in 1 Hz periodic runs as well as intermittent focal 
+slowing of the left frontotemporal region indicative of focal 
+cerebral dysfunction. Her Keppra was continued at that time at 
+750 mg b.i.d. She has continued to have episodes of 
+forgetfulness and has subsequently been let go from her job. She 
+was admitted to the EMU for cvEEG in order to evaluate for any 
+evidence of subclinical seizures as well as her medication 
+optimization. In addition to her home dose of lamotrigine 1500 
+mg daily, she was started on lacosamide 50 mg twice daily, which 
+was subsequently increased to 150 mg twice daily, or 300 mg 
+daily dose. One seizure was detected at 1738 on ___ with ___ Hz 
+rhythmic discharges that rapidly lateralized over the left 
+temporal region with no obvious clinical correlate. This lasted 
+approximately 10 seconds. She also had frequent independent 
+right and left mesiotemporal epileptiform discharges admixed 
+with sharp bursts of rhythmic theta but no other seizures. 
+
+TRANSITIONAL ISSUES:
+-Consider wean from Keppra, given her report of increased 
+fatigue since starting Keppra. 
+-FSH, LH, TSH, and prolactin were all measured for further 
+evaluation of her endocrine status after resection of pituitary 
+mass. All levels were lower than reference ranges. 
+ 
+
+###RESPONSE: pituitary mass {Mass of pituitary}, type 2 diabetes {Diabetes mellitus type 2}, hyperlipidemia {Hyperlipidemia}, memory lapses {Memory lapses}, evaluated {Evaluation procedure}, EEG {Electroencephalogram}, electrographic seizure {Electroencephalogram abnormality with seizure}, right temporal {Right temporal lobe structure}, temporal {Right temporal lobe structure}, intermittent rhythmic delta activity {Focal episodic delta activity}, left {Structure of left half of head}, temporal epileptiform discharges {Periodic lateralized epileptiform discharges}, left frontotemporal region {Left temporal and frontal lobes (combined site)}, evaluate {Evaluation procedure}, seizures {Seizure}, medication 
+optimization {Review of medication}, increased {Increasing dosage of medication}, seizure {Seizure}, left 
+temporal region {Left temporal lobe structure}, right {Right temporal lobe structure}, left mesiotemporal {Left temporal lobe structure}, epileptiform discharges {Periodic lateralized epileptiform discharges}, sharp bursts {Focal sharp waves}, seizures {Seizure}, fatigue {Fatigue}, FSH {Follicle stimulating hormone measurement}, LH {Luteinizing hormone measurement}, TSH {Thyroid stimulating hormone measurement}, evaluation {Evaluation procedure}, resection of pituitary 
+mass {Excision of lesion of pituitary gland}"
+"###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. LevETIRAcetam 750 mg PO BID 
+2. Aspirin 81 mg PO DAILY 
+3. MetFORMIN XR (Glucophage XR) 500 mg PO DAILY 
+4. Simvastatin 20 mg PO QPM 
+5. Mirtazapine 15 mg PO QHS 
+6. Vitamin D ___ UNIT PO 1X/WEEK (___) 
+
+ 
+Discharge Medications:
+1.  LACOSamide 100 mg PO BID 
+RX *lacosamide [Vimpat] 150 mg 1 tablet(s) by mouth twice a day 
+Disp #*60 Tablet Refills:*0 
+2.  Aspirin 81 mg PO DAILY  
+3.  LevETIRAcetam 750 mg PO BID  
+4.  MetFORMIN XR (Glucophage XR) 500 mg PO DAILY  
+5.  Mirtazapine 15 mg PO QHS  
+6.  Simvastatin 20 mg PO QPM  
+7.  Vitamin D ___ UNIT PO 1X/WEEK (___)  
+
+ 
+
+###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:
+Epilepsy.  Intractable temporal lobe epilepsy.
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Epilepsy {Epilepsy}, temporal lobe epilepsy {Temporal lobe epilepsy}, 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:
+Dear Ms ___,
+
+It was a pleasure taking care of you at ___ 
+___.
+
+You were in the hospital so we could monitor you for seizures. 
+We also wanted to see if your episodes of confusion were due to 
+seizures.
+
+You had one seizure while at ___. You did not have any 
+episodes of confusion. We added a new medication called 
+Lacosamide to help prevent seizures.
+
+When you leave the hospital, it will be very important to take 
+BOTH seizure medications. You will follow up with Dr ___ to 
+discuss possibly stopping your Keppra.
+
+Best wishes,
+Your ___ team
+ 
+
+###RESPONSE: seizures {Seizure}, confusion {Clouded consciousness}, seizures {Seizure}, seizure {Seizure}, confusion {Clouded consciousness}, new medication {New medication commenced}, seizures {Seizure}, seizure {Seizure}, medications {Administration of drug or medicament}"
+"###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:
+s/p fall
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: No Known Allergies {Allergic disposition}, Adverse Drug Reactions {Propensity to adverse reactions to drug}, fall {Falls}"
+"###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:
+___ is transferred here for left-sided rib fractures, 8,9 and 
+10.
+No associated hemothorax or pneumothorax. On CT. He fell
+yesterday while in the shower. Reports he was getting out when 
+he
+slipped and he grabbed onto the shower curtain to slow his fall
+down. He landed on his left chest. He reports abdominal
+discomfort as well. Reports mild left elbow discomfort. He 
+denies
+head strike. He takes aspirin. His initial history of
+hypertension, hyperlipidemia. Sent here for trauma eval. His 
+pain
+is controlled currently received oxycodone Toradol the outside
+hospital.
+
+ 
+
+###RESPONSE: left-sided {Bone structure of left rib}, rib fractures {Fracture of multiple ribs}, hemothorax {Hemothorax}, pneumothorax {Pneumothorax}, fell {Falls}, fall {Falls}, left chest {Structure of left half of chest wall}, abdominal
+discomfort {Abdominal discomfort}, mild {Symptom mild}, left elbow {Left elbow region structure}, discomfort {Discomfort}, head strike {Injury of head}, aspirin {Administration of aspirin}, hypertension {Hypertensive disorder, systemic arterial}, hyperlipidemia {Hyperlipidemia}, trauma {Traumatic injury}, eval {Evaluation procedure}, pain
+is controlled {Pain control}"
+"###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:
+noncontributory
+ 
+
+###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:
+Admission Physical:
+98.3 81 116/90 20 96% 2L NC
+General: comfortable, NAD on o2
+___: RRR, no chest wall deformities
+Pulm: clear bilaterally, adequate inspiratory effort, tender 
+left
+side
+abdomen: soft, NT
+Ext: no deformities or abrasions, moves all extremities not
+tender to palpation
+
+Discharge Physical:
+VS: 97.8, 121/73, 72, 18, 92 RA
+Gen: A&O x3, sitting up at edge of bed, NARD, speaking and 
+breathing comfortably
+CV: HRR
+Pulm: LS ctab. TTP over left rib cage
+Abd: Soft, NT/ND
+Ext: No edema
+ 
+
+###RESPONSE: NC {Normal head}, General {General examination of patient}, comfortable {Comfortable appearance}, NAD {No abnormality detected}, o2 {Oxygen therapy}, RRR {Normal heart rate}, chest wall deformities {Deformity of chest wall}, Pulm {Examination of respiratory system}, clear {Normal breath sounds}, tender {Abdominal tenderness}, left
+side {Structure of left half of chest wall}, abdomen {Examination of abdomen}, soft {Abdomen soft}, NT {Abdominal tenderness}, deformities {Deformity}, abrasions {Abrasion}, all extremities {All extremities}, tender {Abdominal tenderness}, palpation {Palpation}, RA {Breathing room air}, O x3 {Oriented to person, time and place}, sitting {Sitting position}, NARD {Respiratory distress}, breathing comfortably {Breathing easily}, HRR {Normal heart rate}, Pulm {Examination of respiratory system}, ctab {Normal breath sounds}, TTP {Chest wall tenderness}, left {Structure of left half of chest wall}, rib cage {Thoracic cage structure}, Abd {Examination of abdomen}, Soft {Abdomen soft}, NT {Abdominal tenderness}, Ext {Examination of limb}, 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:
+___ 05:30AM BLOOD WBC-7.8 RBC-4.20* Hgb-12.7* Hct-37.8* 
+MCV-90 MCH-30.2 MCHC-33.6 RDW-13.2 RDWSD-43.2 Plt ___
+___ 03:02PM BLOOD WBC-10.3* RBC-4.49* Hgb-13.4* Hct-40.8 
+MCV-91 MCH-29.8 MCHC-32.8 RDW-13.2 RDWSD-43.8 Plt ___
+___ 05:30AM BLOOD Glucose-98 UreaN-12 Creat-1.0 Na-146 
+K-3.7 Cl-108 HCO3-23 AnGap-15
+___ 03:02PM BLOOD Glucose-102* UreaN-19 Creat-1.0 Na-145 
+K-3.8 Cl-109* HCO3-21* AnGap-15
+___ 05:30AM BLOOD Calcium-7.8* Phos-2.4* Mg-2.2
+
+Imaging: 
+CT C spine:
+1. No evidence of fracture or malalignment.
+2. Moderate cervical spondylosis.
+CT head
+Minimal subgaleal hematoma along the posterior vertex. 
+Otherwise,
+no evidence
+of an acute intracranial abnormality.
+CT A/P: 
+1. Acute lateral left eighth and ninth rib fractures are
+unchanged. No
+associated pleural effusion or pneumothorax visualized.
+2. No other acute traumatic abnormality in the abdomen or 
+pelvis.
+Normal
+spleen.
+3. Chronic appearing right diaphragmatic hernia containing a
+portion of the
+liver.
+4. Severe calcified coronary atherosclerosis.
+5. 2 cm right common iliac artery aneurysm.
+6. Diverticulosis without diverticulitis
+ 
+
+###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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, RDWSD {Red cell distribution width determination}, Plt {Platelet count}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, RDWSD {Red cell distribution width determination}, Plt {Platelet count}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium 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}, No evidence {No abnormality detected}, fracture {Fracture}, malalignment {Misalignment}, cervical spondylosis {Cervical spondylosis}, CT head {Computed tomography of head}, subgaleal hematoma {Epicranial subaponeurotic hematoma}, vertex {Vertex structure}, no evidence {No abnormality detected}, intracranial {Intracranial structure}, abnormality {No abnormality detected}, CT A/P {Computed tomography of abdomen and pelvis}, left {Bone structure of left rib}, eighth {Bone structure of eighth rib}, ninth {Bone structure of ninth rib}, rib fractures {Fracture of two ribs}, pleural effusion {Pleural effusion}, pneumothorax {Pneumothorax}, traumatic {Traumatic injury}, abnormality {No abnormality detected}, abdomen {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, pelvis {Structure of pelvis}, Normal {No abnormality detected}, spleen {Splenic structure}, Chronic {Chronic disease}, right {Structure of right half of body}, diaphragmatic hernia {Diaphragmatic hernia}, liver {Liver structure}, calcified {Pathologic calcification, calcified structure}, coronary atherosclerosis {Atherosclerosis of coronary artery}, right common iliac artery aneurysm {Aneurysm of right common iliac artery}, Diverticulosis {Diverticulosis of colon}, diverticulitis {Diverticulitis}"
+"###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:
+___ Y/o M with h/o HTN presents to the ED as a transfer from 
+___ with a left rib fracture s/p fall. The patient's lab 
+work was unremarkable.
+His CT Head showed a minimal subgaleal hematoma along the 
+posterior vertex
+but was otherwise unremarkable. His CT C-spine showed no 
+evidence of
+fracture or malalignment. The patient's CT chest was notable for 
+acute lateral
+left eighth and ninth rib fractures without an associated 
+pleural effusion or
+pneumothorax visualized. trauma surgery was consulted and will 
+admit for
+further pain management and monitoring in setting of multiple 
+rib fractures with
+hypoxia.
+
+By HD2, pain was well controlled. The patient was ambulating 
+independently in room and halls therefore ___ did not evaluate 
+him. Oxygen was successfully weaned off and the patient had an 
+oxygen saturation of 93-94% on room air at the time of 
+discharge. 
+During this hospitalization, the patient ambulated early and 
+frequently, was adherent with respiratory toilet and incentive 
+spirometry, and actively participated in the plan of care. The 
+patient received subcutaneous heparin and venodyne boots were 
+used during this stay.
+
+At the time of discharge, 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: HTN {Hypertensive disorder, systemic arterial}, left {Bone structure of left rib}, rib fracture {Fracture of rib}, fall {Falls}, lab 
+work {Laboratory test}, unremarkable {No abnormality detected}, CT Head {Computed tomography of head}, subgaleal hematoma {Epicranial subaponeurotic hematoma}, vertex {Vertex structure}, unremarkable {No abnormality detected}, CT C-spine {Computed tomography of cervical spine}, no 
+evidence {No abnormality detected}, fracture {Fracture}, malalignment {Misalignment}, CT chest {Computed tomography of chest}, left {Bone structure of left rib}, eighth {Bone structure of eighth rib}, ninth {Bone structure of ninth rib}, rib fractures {Fracture of two ribs}, pleural effusion {Pleural effusion}, pneumothorax {Pneumothorax}, trauma {Traumatic injury}, pain management {Pain management}, monitoring {Monitoring procedure}, multiple 
+rib fractures {Fracture of multiple ribs}, hypoxia {Hypoxia}, pain was well controlled {Demonstrates adequate pain control}, ambulating 
+independently {Independent walking}, evaluate {Evaluation procedure}, oxygen saturation {Finding of oxygen saturation}, on room air {Breathing room air}, respiratory toilet {Airway toilet}, incentive 
+spirometry {Incentive spirometry}, subcutaneous heparin {Subcutaneous injection of heparin}, afebrile {Temperature normal}, stable vital signs {Normal vital signs}, tolerating a regular 
+diet {Tolerating normal diet}, ambulating {Fully mobile}, voiding without assistance {Continence independent}, pain was well 
+controlled {Demonstrates adequate pain control}, teaching {Patient education}, follow-up {Follow-up encounter}, instructions {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:
+none
+ 
+Discharge Medications:
+1.  Acetaminophen 650 mg PO Q6H 
+RX *acetaminophen 325 mg 2 tablet(s) by mouth every six (6) 
+hours Disp #*30 Tablet Refills:*0 
+2.  Docusate Sodium 100 mg PO BID  
+3.  Ibuprofen 600 mg PO Q8H:PRN Pain - Mild 
+RX *ibuprofen 600 mg 1 tablet(s) by mouth every eight (8) hours 
+Disp #*20 Tablet Refills:*0 
+4.  Lidocaine 5% Patch 1 PTCH TD QAM L rib fx's  
+5.  OxyCODONE (Immediate Release) ___ mg PO Q4H:PRN Pain - 
+Moderate 
+RX *oxycodone 5 mg 1 tablet(s) by mouth every four (4) hours 
+Disp #*10 Tablet Refills:*0 
+6.  Polyethylene Glycol 17 g PO DAILY  
+
+ 
+
+###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:
+Acute lateral left eighth and ninth rib fractures 
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: left {Bone structure of left rib}, eighth {Bone structure of eighth rib}, ninth {Bone structure of ninth rib}, rib fractures {Fracture of two ribs}, 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:
+* Your injury caused 2 left sided rib fractures which can cause 
+severe pain and subsequently cause you to take shallow breaths 
+because of the pain.
+ 
+* You should take your pain medication as directed to stay ahead 
+of the pain otherwise you won't be able to take deep breaths. If 
+the pain medication is too sedating take half the dose and 
+notify your physician.
+ 
+* Pneumonia is a complication of rib fractures.  In order to 
+decrease your risk you must use your incentive spirometer 4 
+times every hour while awake.  This will help expand the small 
+airways in your lungs and assist in coughing up secretions that 
+pool in the lungs.
+ 
+* You will be more comfortable if you use a cough pillow to hold 
+against your chest and guard your rib cage while coughing and 
+deep breathing.
+ 
+* Symptomatic relief with ice packs or heating pads for short 
+periods may ease the pain.
+ 
+* Narcotic pain medication can cause constipation therefore you 
+should take a stool softener twice daily and increase your fluid 
+and fiber intake if possible.
+ 
+* Do NOT smoke
+ 
+* If your doctor allows, non-steroidal ___ drugs 
+are very effective in controlling pain ( ie, Ibuprofen, Motrin, 
+Advil, Aleve, Naprosyn) but they have their own set of side 
+effects so make sure your doctor approves.
+ 
+* Return to the Emergency Room right away for any acute 
+shortness of breath, increased pain or crackling sensation 
+around your ribs (crepitus).
+
+ 
+
+###RESPONSE: injury {Traumatic or non-traumatic injury}, left sided {Bone structure of left rib}, rib fractures {Fracture of two ribs}, severe pain {Severe pain}, cause you to take shallow breaths {Respiratory health self management education}, pain {Pain}, pain medication {Administration of analgesic}, pain {Pain}, able to take deep breaths {Able to take deep breaths}, pain medication {Administration of analgesic}, notify {Informing doctor}, Pneumonia {Pneumonia}, rib fractures {Fracture of multiple ribs}, decrease your risk {Preventive procedure}, use your incentive spirometer {Incentive spirometry}, awake {Awake}, airways {Airway structure}, lungs {Lung structure}, in coughing up secretions {Encouragement of deep breathing and coughing exercises}, lungs {Lung structure}, comfortable {Comfortable appearance}, chest {Thoracic structure}, rib cage {Thoracic cage structure}, coughing and 
+deep breathing {Deep breathing and coughing exercises}, relief {Pain relief}, ice packs {Application of ice}, heating pads {Heat therapy}, pain {Pain}, Narcotic pain medication can cause {Narcotics education}, constipation {Constipation}, take a stool softener {Administration of laxative}, increase your fluid {Fluid intake encouragement}, fiber intake {High fiber diet education}, Do NOT smoke {Smoking cessation education}, non-steroidal ___ drugs {Non-steroidal anti-inflammatory agent therapy}, controlling pain {Pain control}, side 
+effects {Medication side effects present}, Return to the Emergency Room {Emergency treatment management}, shortness of breath {Dyspnea}, increased pain {Increased pain}, crackling {Respiratory crackles}, sensation {Sensation of movement}, ribs {Bone structure of rib}, crepitus {Bone crepitus}"
+"###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: 
+Patient recorded as having No Known Allergies to Drugs
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Positive blood cultures 
+ 
+Major Surgical or Invasive Procedure:
+___: ___ removal
+
+ 
+
+###RESPONSE: No Known Allergies to Drugs {Non-allergic hypersensitivity to drug or medicament}, Positive blood cultures {Organism isolated in blood by culture}, removal {Removal}"
+"###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 ___ yo woman with ALL, now DAY ___ s/p 
+allogeneic stem cell transplant, who is admitted for evaluation 
+of a positive blood culture. pt was last admitted on ___ 
+with similar issues. she was noted to have coag -ve staph and 
+was started on 1g of vanco daily. her subsequently cultures came 
+back negative. she was discharged home with a course of vanco 
+which she finished ___. she was seen in clinic yesterday 
+without complaints of fever, chill or rigor. she did however 
+have surveillance cultures drawn from her line which today grew 
+GPC. she was called to come into the ed where she was noted to 
+be afebrile and hemodynamically stable. no clear source of 
+infection noted. line site appears intact. pt was started on 
+vancomycin and admitted for further care. 
+ 
+
+###RESPONSE: ALL {Precursor cell lymphoblastic leukemia}, allogeneic stem cell transplant {Allogeneic peripheral blood stem cell transplant}, evaluation {Evaluation procedure}, positive blood culture {Organism isolated in blood by culture}, cultures {Microbial culture}, vanco {Antibiotic therapy}, seen in clinic {Seen in clinic}, fever {Fever}, chill {Chill}, rigor {Rigor}, surveillance cultures {Surveillance culture}, hemodynamically stable {Hemodynamically stable}, infection {Infectious disease}, intact {No abnormality detected}, vancomycin {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:
+Acute lymphocytic leukemia
+The patient initially presented in ___ to an OSH with vague LUQ 
+discomfort. Initial abdominal imaging demonstrated gallstones. 
+In ___, she presented with chest pain radiating to her left 
+arm, shortness of breath, and weakness with WBC 123, Hct 19.6, 
+and Plt 23. Acute MI was ruled out. Abdominal US demonstrated 
+splenomegaly. She was transferred to ___ for further 
+evaluation and treatment of leukemia. She was started on 
+hydroxyurea and dexamethasone with allopurinol and bicarbonate 
+prophylaxis. Bone marrow biopsy and peripheral smear were 
+consistent with ALL with 9;22 translocation. Initial evaluation 
+with echocardiogram and LP were unremarkable. After two cycles 
+of Hyper CVAD, parts A and B, she underwent a matched unrelated 
+allogeneic stem cell transplantation wtih cyclophosphamide and 
+ATG conditioning on the XOMA trial on ___.
+
+ADDITIONAL MEDICAL HISTORY:  
+1. HTN  
+
+ 
+
+###RESPONSE: Acute lymphocytic leukemia {Precursor cell lymphoblastic leukemia}, LUQ {Structure of left upper quadrant of abdomen}, discomfort {Discomfort}, abdominal imaging {Imaging of abdomen}, gallstones {Gallbladder calculus}, chest pain {Chest pain}, radiating to her left 
+arm {Pain radiating to left arm}, shortness of breath {Dyspnea}, weakness {Asthenia}, WBC {White blood cell count}, Hct {Hematocrit determination}, Acute MI {Acute myocardial infarction}, Abdominal US {Ultrasonography of abdomen}, splenomegaly {Splenomegaly}, evaluation {Evaluation procedure}, leukemia {Leukemia}, prophylaxis {Administration of prophylactic drug or medicament}, Bone marrow biopsy {Bone marrow sampling}, ALL {Precursor cell lymphoblastic leukemia}, evaluation {Evaluation procedure}, echocardiogram {Echocardiography}, LP {Lumbar puncture}, unremarkable {No abnormality detected}, matched {Major crossmatch}, unrelated {Unrelated}, allogeneic stem cell transplantation {Allogeneic peripheral blood stem cell transplant}, HTN {Hypertensive disorder, systemic arterial}"
+"###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:
+Mom - HTN, hypercholesterolemia
+Dad - MI at ___ y.o., deceased at ___ y.o. from cardiac disease
+Sister - healthy
+___ any oncologic history, including leukemias or lymphomas.
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, hypercholesterolemia {Hypercholesterolemia}, MI {Myocardial infarction}, deceased {Dead}, cardiac disease {Heart disease}, leukemias {Leukemia}, lymphomas {Malignant lymphoma}"
+"###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:
+VITALS: 96.9, 82, 154/76, 16, 99% on ra  
+GEN: NAD, A&Ox3  
+HEENT: Clear OP, MMM.  
+NECK: Supple, No LAD, No JVD. Bilateral new lines  
+CV: RR, NL rate. NL S1, S2.  
+LUNGS: CTA, BS ___, No W/R/C  
+ABD: Soft, NT, ND. NL BS. No HSM  
+EXT: No edema. 2+ DP pulses ___  
+SKIN: No lesions  
+NEURO: A&Ox3. Appropriate. CN ___ intact.  
+
+ 
+
+###RESPONSE: VITALS {Vital signs finding}, ra {Breathing room air}, GEN {General examination of patient}, NAD {No abnormality detected}, Ox3 {Oriented to person, time and place}, HEENT {Physical examination procedure}, Clear OP {Pharynx normal}, MMM {Moist oral mucosa}, NECK {Physical examination procedure}, Supple {Normal movement of neck}, LAD {Lymphadenopathy}, JVD {Jugular venous engorgement}, CV {Cardiovascular physical examination}, RR {Finding of rate of respiration}, NL rate {Normal heart rate}, S2 {Normal second heart sound, S>2<}, LUNGS {Examination of respiratory system}, CTA {Normal breath sounds}, ABD {Examination of abdomen}, Soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, NL BS {Normal bowel sounds}, HSM {Hepatosplenomegaly}, EXT {Examination of limb}, edema {Edema}, 2+ DP pulses {All pulses present in bilateral lower limbs}, SKIN {Examination of skin}, lesions {Lesion}, NEURO {Neurological examination}, Ox3 {Oriented to person, time and place}, CN {Cranial nerve structure}, intact {Normal sensation}"
+"###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:
+___ 12:05AM URINE  BLOOD-NEG NITRITE-NEG PROTEIN-NEG 
+GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 
+LEUK-NEG
+___ 12:40AM   WBC-8.1 RBC-2.77* HGB-8.7* HCT-25.1* MCV-91 
+MCH-31.3 MCHC-34.5 RDW-18.3*
+___ 12:40AM   ALBUMIN-4.2 CALCIUM-9.4 MAGNESIUM-2.2
+___ 12:40AM   LIPASE-32
+___ 12:40AM   ALT(SGPT)-27 AST(SGOT)-65* ALK PHOS-121* TOT 
+BILI-0.3
+___ 12:40AM   GLUCOSE-98 UREA N-40* CREAT-1.9* SODIUM-134 
+POTASSIUM-6.3* CHLORIDE-105 TOTAL CO2-17* ANION GAP-18
+___ 05:50AM   GLUCOSE-79 UREA N-36* CREAT-1.9* SODIUM-134 
+POTASSIUM-4.6 CHLORIDE-104 TOTAL CO2-19* ANION GAP-16
+___ 05:50AM   ALBUMIN-4.1 CALCIUM-9.7 MAGNESIUM-2.0
+___ 05:50AM   WBC-7.5 RBC-2.76* HGB-8.7* HCT-24.6* MCV-89 
+MCH-31.6 MCHC-35.4* RDW-18.1*
+
+___ 1:50 pm BLOOD CULTURE     Site: ___
+Blood Culture, Routine (Preliminary): 
+STAPHYLOCOCCUS, COAGULASE NEGATIVE.    ISOLATED FROM ONE SET 
+ONLY. 
+SENSITIVITIES PERFORMED ON REQUEST.. 
+
+Blood cx ___ and ___ NGTD
+
+___ CATHETER TIP-IV Source: tunneled catheter. WOUND 
+CULTURE: No significant growth. 
+
+___ 09:00AM BLOOD Cyclspr-171
+
+___
+TTE: The left atrium is normal in size. No atrial septal defect 
+is seen by 2D or color Doppler. Left ventricular wall thickness, 
+cavity size and regional/global systolic function are normal 
+(LVEF 70%). There is no ventricular septal defect. Right 
+ventricular chamber size and free wall motion are normal. The 
+aortic valve leaflets (3) appear structurally normal with good 
+leaflet excursion and no aortic regurgitation. No masses or 
+vegetations are seen on the aortic valve. The mitral valve 
+appears structurally normal with trivial mitral regurgitation. 
+There is no mitral valve prolapse. No mass or vegetation is seen 
+on the mitral valve. The estimated pulmonary artery systolic 
+pressure is normal. No vegetation/mass is seen on the pulmonic 
+valve. There is no pericardial effusion. 
+Compared with the findings of the prior study (images reviewed) 
+of ___, the findings are similar.
+
+IMPRESSION: no obvious vegetations
+
+ 
+
+###RESPONSE: PROTEIN {Measurement of protein in urine}, KETONE {Urinalysis, acetone or ketone bodies measurement}, BILIRUBIN {Bilirubin measurement, urine}, PH {pH 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}, ALBUMIN {Albumin measurement}, CALCIUM {Blood calcium measurement}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, PHOS {Phosphate, total measurement}, TOT 
+BILI {Bilirubin, total measurement}, 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}, 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}, ALBUMIN {Albumin measurement}, CALCIUM {Blood calcium 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}, CULTURE {Blood culture}, Blood Culture {Blood culture}, SENSITIVITIES {Antimicrobial susceptibility test}, Blood cx {Blood culture}, CULTURE {Microbial culture}, TTE {Transthoracic echocardiography}, left atrium {Left atrial structure}, normal in size {Normal size}, atrial septal defect {Atrial septal defect}, color Doppler {Color Doppler ultrasound}, Left ventricular wall {Left cardiac ventricular structure}, thickness {Normal thickness}, cavity {Structure of cavity of left cardiac ventricle}, regional/global systolic function are normal {Normal left ventricular systolic function and wall motion}, ventricular septal defect {Ventricular septal defect}, Right 
+ventricular chamber {Right cardiac ventricular structure}, wall motion are normal {Normal ventricular wall motion}, aortic valve {Aortic valve structure}, leaflets {Structure of cardiac valve leaflet}, structurally normal {Aortic valve normal}, leaflet {Structure of cardiac valve leaflet}, aortic regurgitation {Aortic valve regurgitation}, mass {Mass}, vegetations {Vegetation}, aortic valve {Aortic valve structure}, mitral valve 
+appears structurally normal {Mitral valve normal}, mitral regurgitation {Mitral valve regurgitation}, mitral valve prolapse {Mitral valve prolapse}, mass {Mass}, vegetation {Vegetation}, mitral valve {Mitral valve structure}, pulmonary artery {Pulmonary artery structure}, systolic 
+pressure is normal {Normal systolic arterial pressure}, vegetation {Vegetation}, mass {Mass}, pulmonic 
+valve {Pulmonary valve structure}, pericardial effusion {Pericardial effusion}, vegetations {Vegetation}"
+"###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:
+___ woman DAY ___ s/p MUD allo SCT for ALL, recent admission 
+for coag negative staph positive blood cultures for which she 
+was completed a course of vancomycin now with repeat coag 
+negative staph positive blood cultures on surveillance cultures. 
+  
+1. Coagulase negative Staph bacteremia: Patient has had repeat 
+positive blood cultures but has been asymptomatic without 
+fevers. The most likely source is her ___ catheter which was 
+removed on ___. Repeat blood cultures were drawn and are no 
+growth to date. She was started on and discharged on a course of 
+vancomycin 1g IV q 48 hours. Level will be checked in clinic 
+prior to dose administration. If ___ remain negative, she 
+will obtain PICC line as outpatient. TTE was done which did not 
+show any eveidence of endocarditis and no vegetations.  
+
+2. Renal dysfunction: Patient has had fluctuating renal function 
+and has been seen by renal who recommended stopping her calcium 
+channel blocker. renal function during hospital stay at recent 
+baseline and improved slightly with IV fluids. She is planned to 
+receive IVF as outpt when she receives her vanco. 
+
+3. Anemia: HCT slightly decreased fom baseline. She was ordered 
+for transfusion if 1 unit PRBC at follow up on ___ in clinic.   
+
+
+4. Nausea: Continued on Prednisone 2.5 mg PO daily for ? GVH.  
+
+5. ALL s/p allo BMT: Cyclosporine level checked and was 171. 
+Continued on home doses. Continued on Acyclovir, Fluconazole.   
+  
+6. Hypertension: Patient hypertensive with SBP 150s-170s, HR 
+___ during admission. Metoprolol titrated up from 37.5 PO 
+BID to 50 PO BID. ___ require further titration as outpatient. 
+ 
+
+ 
+
+###RESPONSE: MUD {Allogeneic unrelated bone marrow transplant}, allo SCT {Allogeneic peripheral blood stem cell transplant}, ALL {Precursor cell lymphoblastic leukemia}, positive blood cultures {Organism isolated in blood by culture}, vancomycin {Antibiotic therapy}, positive blood cultures {Organism isolated in blood by culture}, surveillance cultures {Surveillance culture}, bacteremia {Bacteremia}, positive blood cultures {Organism isolated in blood by culture}, asymptomatic {Asymptomatic}, fevers {Fever}, catheter which was 
+removed {Removal of catheter}, blood cultures {Blood culture}, vancomycin {Antibiotic therapy}, IV {Administration of drug or medicament via intravenous route}, clinic {Outpatient care management}, obtain PICC line {Insertion of peripherally inserted central catheter}, TTE {Transthoracic echocardiography}, endocarditis {Endocarditis}, vegetations {Vegetation}, Renal dysfunction {Renal impairment}, renal function {Finding of renal function}, renal function {Finding of renal function}, baseline {Baseline state}, improved {Patient's condition improved}, IV fluids {Administration of intravenous fluids}, IVF {Administration of intravenous fluids}, outpt {Outpatient care management}, vanco {Antibiotic therapy}, Anemia {Anemia}, HCT slightly decreased {Hematocrit below reference range}, baseline {Baseline state}, transfusion if 1 unit PRBC {Transfusion of packed red blood cells}, follow up {Follow-up arranged}, clinic {Outpatient care management}, Nausea {Nausea}, ALL {Precursor cell lymphoblastic leukemia}, allo BMT {Allogeneic bone marrow transplantation}, Hypertension {Hypertensive disorder, systemic arterial}, hypertensive {Hypertensive disorder, systemic arterial}, HR {Finding of heart rate}"
+"###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:
+Famotidine 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+Prednisone 2.5 mg PO DAILY (Daily).  
+Lorazepam 1 mg Tablet Sig: ___ Tablets PO every six (6) hours as 
+needed.  
+Metoprolol Tartrate 25 mg Tablet Sig: 1.5 Tablets PO BID (2 
+times a day).  
+Ursodiol 300 mg Capsule Sig: One (1) Capsule PO BID (2 times a 
+day).  
+Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 
+times a day) as needed.  
+Multivitamin Capsule Sig: One (1) Capsule PO once a day.  
+Senna 8.6 mg Tablet Sig: One (1) Tablet PO twice a day as needed 
+for constipation.  
+Cyclosporine Modified 25 mg Capsule Sig: Four (4) Capsule PO qam 
+at 10am.  
+Cyclosporine 25 mg Capsule Sig: Five (5) Capsule PO QPM  
+(once a day (in the evening)): Please take at 10pm.  
+Fluconazole 200 mg Tablet Sig: One (1) Tablet PO Q24H (every  
+24 hours).  
+
+ 
+Discharge Medications:
+1. Ursodiol 300 mg Capsule Sig: One (1) Capsule PO BID (2 times 
+a day).  
+2. Cyclosporine Modified 25 mg Capsule Sig: Four (4) Capsule PO 
+qam.  
+3. Neoral 25 mg Capsule Sig: Five (5) Capsule PO qpm.  
+4. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a 
+day) as needed.  
+5. Multivitamin     Tablet Sig: One (1) Tablet PO DAILY (Daily). 
+ 
+6. Lorazepam 1 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 
+hours) as needed.  
+7. Famotidine 20 mg Tablet Sig: One (1) Tablet PO Q24H (every 24 
+hours).  
+8. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+
+9. Prednisone 2.5 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+10. Metoprolol Tartrate 25 mg Tablet Sig: Two (2) Tablet PO 
+twice a day.
+Disp:*120 Tablet(s)* Refills:*2*
+11. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID 
+(2 times a day) as needed.  
+12. Fluconazole 200 mg Tablet Sig: One (1) Tablet PO Q24H (every 
+24 hours).  
+13. Acyclovir 200 mg Capsule Sig: One (1) Capsule PO twice a 
+day.  
+14. Vancomycin in Normal Saline 1 gram/250 mL Solution Sig: One 
+(1) gram Intravenous q48 hours.  
+
+ 
+
+###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 Diagnosis
+1. Bacteremia
+2. ALL s/p allo SCT
+Secondary Diagnosis
+1. HTN
+
+ 
+Discharge Condition:
+Hemodynamically stable, afebrile, repeat blood cultures negative 
+to date
+
+ 
+
+###RESPONSE: Bacteremia {Bacteremia}, ALL {Precursor cell lymphoblastic leukemia}, allo SCT {Allogeneic peripheral blood stem cell transplant}, HTN {Hypertensive disorder, systemic arterial}, Hemodynamically stable {Hemodynamically stable}, blood cultures {Blood culture}"
+"###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 to the hospital because you had a positive 
+blood culture.  This may have been an infection from your 
+___ line which was removed while you were in the hospital. 
+To treat this infection, we started you on an antibiotic called 
+Vancomycin which will need to be continued. You will receive 
+this Antibiotic in clinic on ___ and ___. At 
+that time, if your repeat cultures have been negative, we will 
+most likely place a PICC line so you can get this antibiotic at 
+home. You will also need to have the vanocmycin level drawn in 
+clinic. In clinic, you will also receive blood for low blood 
+counts as well as IV fluids if you are dehydrated. We also did 
+an ultrasound of your heart to look for a source of your 
+infections but this report was not available yet at the time of 
+discharge. 
+
+We made the following changes to your medications. 
+1. We added Vancomycin 1 gram IV every 48 hours which you will 
+receive in clinic. 
+2. We increased your Metoprolol to 50mg twice a day
+
+Please call your primary oncologist or the heme/onc or ___ 
+fellow on call if you develop fever >100.4, chills, nausea, 
+vomiting or are unable to take in enough food or liquid. 
+
+ 
+
+###RESPONSE: positive 
+blood culture {Organism isolated in blood by culture}, infection {Infectious disease}, line which was removed {Removal of catheter}, infection {Infectious disease}, antibiotic {Antibiotic therapy}, Vancomycin {Antibiotic therapy}, Antibiotic {Antibiotic therapy}, clinic {Outpatient care management}, cultures {Microbial culture}, place a PICC line {Insertion of peripherally inserted central catheter}, antibiotic {Antibiotic therapy}, vanocmycin level {Vancomycin measurement}, clinic {Outpatient care management}, clinic {Outpatient care management}, receive blood {Transfusion of blood product}, low blood 
+counts {Red blood cell count below reference range}, IV fluids {Administration of intravenous fluids}, dehydrated {Dehydration}, ultrasound of your heart {Echocardiography}, infections {Infectious disease}, changes to your medications {Change of medication}, Vancomycin {Antibiotic therapy}, IV {Administration of drug or medicament via intravenous route}, clinic {Outpatient care management}, call {Informing doctor}, fever {Fever}, chills {Chill}, nausea, 
+vomiting {Nausea and vomiting}, unable to take in enough food {Eating problem}, liquid {Problem with drinking 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: 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: 
+Patient recorded as having No Known Allergies to Drugs
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Nausea, vomiting, abdominal pain
+ 
+Major Surgical or Invasive Procedure:
+Femoral line
+Dialysis
+
+ 
+
+###RESPONSE: Nausea, vomiting {Nausea and vomiting}, abdominal pain {Abdominal pain}, 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: History of Present Illness:
+___ year-old man very well known to ___ physicians with 
+frequent admissions for gastroparesis, malignant hypertension, 
+hyperglycemia, recently discharged on ___ and now presents 
+with nausea, vomitting, and abdominal pain which are typical 
+features of the gastroparetic syndrome. He states that his pain 
+began at 0300 on day of admission and was associated with nausea 
+and vomiting. Was uncontrolled by home medications. He pain is 
+now rated at ___. When questioned about his clonidine patch, he 
+states that he removed it on ___ due to low blood pressure. 
+In ED, vitals: T 100.2, SBP in the 180s, HR 116. He was given 
+labetalol in the ED. Initially had lactate level of 2.6 which 
+decreased to 1.8 prior to admission. Blood cultures were drawn 
+and nephrology has been made aware of his prescence.
+ 
+
+###RESPONSE: gastroparesis {Gastroparesis}, malignant hypertension {Malignant hypertension}, hyperglycemia {Hyperglycemia}, nausea {Nausea}, vomitting {Vomiting}, abdominal pain {Abdominal pain}, gastroparetic syndrome {Gastroparesis}, pain {Abdominal pain}, nausea 
+and vomiting {Nausea and vomiting}, pain {Pain}, low blood pressure {Low blood pressure}, vitals {Vital signs finding}, T {Body temperature finding}, HR {Finding of heart rate}, lactate level {Lactic acid measurement}, Blood cultures {Blood culture}"
+"###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:
+# Diabetes Mellitus Type I  
+- Gastroparesis with chronic hospitalizations  
+- ESRD on HD since ___  
+- Autonomic dysfunction, frequent HTN emergency & orthostatic  
+hypotension  
+- Peripheral neuropathy  
+# Coronary artery disease  
+- STEMI ___ in setting of cocaine, s/p BMS to LAD  
+# Aortic valve endocarditis (___) and ___  
+- In the context of coag neg staph bacteremia ___ and  
+___ and positive intravenous catheter tip ___ had 
+ 
+his HD catheter changed over a wire. known MRSE bacteremia for  
+which he completed a course of vancomycin for possible  
+endocarditis on ___.  
+MSSA Bacteremia: had an episode of MSSA endocardititis on ___ 
+admission, treated w/ nafcillin (___nded on  
+# Hypertension  
+# History of line sepsis with coag negative staph and priors  
+with klebsiella and enterobacteremia  
+# Esophageal ulceration: H pylori neg, active esophagitis seen  
+on EGD ___, h/o ___ tear  
+# History of substance abuse (cocaine, marijuana, alcohol)  
+# History of thrombosed AV fistula in LUE ___, gore-tex in  
+place  
+# Fungemia completed caspofungin IV on ___  
+# GI bleed associated with hypotension-colonscopy showed  
+friable and inflammed ascending and transverse colon,suggestive  
+
+either of ischemia or infection ___  
+
+ 
+
+###RESPONSE: Diabetes Mellitus Type I {Diabetes mellitus type 1}, Gastroparesis {Gastroparesis}, ESRD on HD {End stage renal failure on dialysis}, HTN emergency {Hypertensive emergency}, orthostatic  
+hypotension {Orthostatic hypotension}, Peripheral neuropathy {Peripheral nerve disease}, Coronary artery disease {Coronary arteriosclerosis}, STEMI {Acute ST segment elevation myocardial infarction}, LAD {Structure of anterior descending branch of left coronary artery}, Aortic valve {Aortic valve structure}, endocarditis {Endocarditis}, bacteremia {Bacteremia}, bacteremia {Bacteremia}, endocarditis {Endocarditis}, MSSA {Infection caused by methicillin susceptible Staphylococcus aureus}, Bacteremia {Bacteremia}, MSSA {Infection caused by methicillin susceptible Staphylococcus aureus}, endocardititis {Endocarditis}, Hypertension {Hypertensive disorder, systemic arterial}, line sepsis {Line sepsis associated with dialysis catheter}, Esophageal ulceration {Ulcer of esophagus}, esophagitis {Esophagitis}, EGD {Esophagogastroduodenoscopy}, substance abuse {Substance abuse}, cocaine {Cocaine abuse}, marijuana {Marijuana user}, alcohol {Alcohol abuse}, thrombosed AV fistula {Arteriovenous fistula thrombosis}, LUE {Structure of left upper limb}, Fungemia {Fungemia}, GI bleed {Gastrointestinal hemorrhage}, hypotension {Low blood pressure}, colonscopy {Colonoscopy}, ascending {Ascending colon structure}, transverse colon {Transverse colon structure}, ischemia {Ischemia}, infection {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: 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 deceased of ESRD and DM. Mother aged ___ with 
+hypertension. Two sisters, one with diabetes. Six brothers, one 
+with diabetes. There is no family history of premature coronary 
+artery disease or sudden death. 
+ 
+
+###RESPONSE: deceased {Dead}, ESRD {End-stage renal disease}, DM {Diabetes mellitus}, hypertension {Hypertensive disorder, systemic arterial}, diabetes {Diabetes mellitus}, diabetes {Diabetes mellitus}, coronary 
+artery disease {Coronary arteriosclerosis}, sudden death {Dead - sudden death}"
+"###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:
+VITALS: 98.2 ___ 28 98% RA
+GEN: Appears uncomfortable and is writhing in bed
+HEENT: Proptosis, EOMI, PERRL
+PULM: Sparse crackles bibasilar at posterior fields
+CARD: Tachycardic, nl S1, nl S2, III/VI SEM heard best at LUSB
+ABD: BS+, tender, mildly distended, tympanitic
+EXT: No lower extremity edema, femoral CVC
+NEURO: AOx3, Non-Focal
+ 
+
+###RESPONSE: VITALS {Vital signs finding}, RA {Breathing room air}, GEN {General examination of patient}, HEENT {Physical examination procedure}, Proptosis {Exophthalmos}, EOMI {Normal ocular motility}, PERRL {Pupils equal and reacting to light}, PULM {Examination of respiratory system}, crackles {Respiratory crackles}, bibasilar {Structure of base of lung}, CARD {Cardiovascular physical examination}, Tachycardic {Tachycardia}, nl S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, III {Third heart sound}, SEM {Ejection murmur}, LUSB {Structure of upper parasternal region}, ABD {Examination of abdomen}, BS+ {Normal bowel sounds}, tender {Abdominal tenderness}, distended {Swollen abdomen}, tympanitic {Abdomen tympanitic}, edema {Edema}, femoral {Structure of femoral artery}, CV {Cardiovascular physical examination}, NEURO {Neurological examination}, AOx3 {Oriented to person, time and place}"
+"###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:
+___ CXR AP CHEST: 
+Bilateral pulmonary vascular congestion is mild. There is no 
+pleural effusion. No definite evidence of pneumonia is 
+identified. Mild cardiomegaly is unchanged.
+IMPRESSION: Mild pulmonary vascular congestion.
+<br>
+___ Blood cultures x 2 showed no growth to date at 
+discharge.
+ 
+
+###RESPONSE: CXR {Plain chest X-ray}, pulmonary vascular {Structure of pulmonary blood vessel}, congestion {Congestion}, pleural effusion {Pleural effusion}, pneumonia {Pneumonia}, cardiomegaly {Cardiomegaly}, pulmonary vascular {Structure of pulmonary blood vessel}, congestion {Congestion}, Blood cultures {Blood culture}"
+"###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:
+## Gastroparesis:
+Nausea, vomiting, and abdominal pain all likely related to 
+extensive history of gastroparesis. Has inpatient regimen that 
+usually works for him. And during the hospitalization he was 
+initially NPO and was receiving Dilaudid ___ mg IV Q4H PRN pain, 
+Lorazepam ___ mg IV Q4H PRN nausea, metoclopramide 10 mg PO QID, 
+ondansetron 4 mg IV Q8H PRN nausea. After several days of 
+limited PO intake, the patient was able to eat and keep solid 
+food down reliably and was discharged with improved 
+symptomatology.
+<br>
+## Labile Blood Pressure:
+In emergency department, BP was 180s systolic and responded to 
+labetalol. Originally 190 systolic on transfer to floor. He was 
+stabilized s/p application of clonidine patch at admission and 
+blood pressures remained stable throughout the rest of the 
+admission. He was discharged on a clonidine patch 0.3 mg/24 hr 
+(change every ___, and labetalol dose of 200 mg PO BID.
+<br>
+## Fever:
+Low grade fever in ED. Afebrile through remainder of 
+hospitalization. At discharge his blood cultures drawn on 
+___ showed no growth. 
+<br>
+## Type 1 DM, Uncontrolled with Complications:
+Patient was put on home regimen of glargine 4 U at bedtime or 2 
+U if NPO. He was monitored using fingersticks QID with regular 
+insulin sliding scale. He triggered need for SSI only once 
+during his stay.
+<br>
+## ESRD, Anemia of Chronic Kidney Disease:
+Nephrology was made aware of patient admission and they followed 
+and dialyzed ___ as per his normal HD schedule ___.
+<br>
+## ? of Opioid addiction: 
+Could explain abdominal complaints and likely confounds the 
+gastroparesis picture. Clonidine should help with abdominal 
+cramping related to opiate withdrawal if this is the case. 
+Although this has been addressed at prior hospitalizations by 
+means of pain service consults, the patient has failed to 
+follow-up as an outpatient. He was discharged on a limited 
+supply of oral dilaudid.
+<br>
+## CAD s/p MI:
+No acute issues during this hospitalization. We continued 
+patient's home doses of simvastatin 40 mg daily, aspirin 325mg 
+daily and plavix 75mg daily.
+<br>
+## Chronic diastolic heart failure with EF 45%:
+Appeared stable during this admission.
+<br>
+Overall, patient was stable upon discharge.
+
+ 
+
+###RESPONSE: Gastroparesis {Gastroparesis}, Nausea, vomiting {Nausea and vomiting}, abdominal pain {Abdominal pain}, gastroparesis {Gastroparesis}, NPO {Nil by mouth}, pain {Pain}, nausea {Nausea}, nausea {Nausea}, able to eat {Able to eat}, improved {Patient's condition improved}, BP {Blood pressure finding}, blood pressures remained stable {Stable blood pressure}, Low grade fever {Low grade pyrexia}, Afebrile {Fever}, blood cultures  {Blood culture}, NPO {Nil by mouth}, insulin sliding scale {Sliding scale insulin regime}, SSI {Sliding scale insulin regime}, HD {Hemodialysis}, Opioid addiction {Opioid abuse}, gastroparesis {Gastroparesis}, abdominal 
+cramping {Stomach cramps}, opiate withdrawal {Opioid withdrawal syndrome}, stable {Patient's condition stable}, stable {Patient's condition stable}"
+"###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:
+1. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+2. Clonidine 0.3 mg/24 hr Patch Weekly Sig: One (1) Patch Weekly 
+Transdermal QSAT (every ___.  
+3. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+4. Gabapentin 300 mg Capsule Sig: One (1) Capsule PO QHD (each 
+hemodialysis).  
+5. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One 
+(1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours).  
+6. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+7. Labetalol 200 mg Tablet Sig: One (1) Tablet PO TID (3 times a 
+day).  
+8. Hydromorphone 2 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 
+hours): For ___, please take every 4 hours. On ___, please 
+take every 6 hours. On ___, please take every 8 hours. On ___ 
+and ___, please take every 12 hours.  Disp:*20 Tablet(s)* 
+Refills:*0*
+9. Metoclopramide 10 mg Tablet Sig: One (1) Tablet PO four times 
+a day. Disp:*120 Tablet(s)* Refills:*2*
+10. Lanthanum 500 mg Tablet, Chewable Sig: Two (2) Tablet, 
+Chewable PO TID W/MEALS (3 TIMES A DAY WITH MEALS).  
+11. Ondansetron 4 mg Tablet, Rapid Dissolve Sig: One (1) Tablet, 
+Rapid Dissolve PO Q8H (every 8 hours) as needed for nausea. 
+Disp:*30 Tablet, Rapid Dissolve(s)* Refills:*0*
+12. Cefazolin 10 gram Recon Soln Sig: One (1) Recon Soln 
+Injection QSAT (every ___ for 1 weeks.  
+13. Cefazolin 10 gram Recon Soln Sig: One (1) Recon Soln 
+Injection QHD (each hemodialysis) for 1 weeks.  
+14. Insulin Regular Human 100 unit/mL Cartridge Sig: Twelve (12) 
+units Injection once a day: Please continue your previous 
+outpatient insulin regimen.
+ 
+Discharge Medications:
+1. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+2. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+3. Gabapentin 300 mg Capsule Sig: One (1) Capsule PO QHD (each 
+hemodialysis).  
+4. Labetalol 200 mg Tablet Sig: One (1) Tablet PO BID (2 times a 
+day).  
+5. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+6. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One 
+(1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours).  
+7. Metoclopramide 10 mg Tablet Sig: One (1) Tablet PO QIDACHS (4 
+times a day (before meals and at bedtime)).  
+8. Lanthanum 500 mg Tablet, Chewable Sig: Two (2) Tablet, 
+Chewable PO TID W/MEALS (3 TIMES A DAY WITH MEALS).  
+9. Clonidine 0.3 mg/24 hr Patch Weekly Sig: One (1) Patch Weekly 
+Transdermal QWED (every ___.  
+10. Ondansetron 4 mg Tablet, Rapid Dissolve Sig: One (1) Tablet, 
+Rapid Dissolve PO q8hrs:prn.  
+11. Lantus 100 unit/mL Solution Sig: Four (4) units Subcutaneous 
+qpm.  
+12. Dilaudid 2 mg Tablet Sig: One (1) Tablet PO q4hrs:prn as 
+needed for pain: do not take while driving. 
+only take as instructed.
+Disp:*10 Tablet(s)* 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:
+gastroparesis. 
+hypertension
+diabetes
+autonomic dysfunction
+coronary artery disease
+end stage renal disease
+
+ 
+Discharge Condition:
+abdominal pain improved. able to tolerate a normal diet
+
+ 
+
+###RESPONSE: gastroparesis {Gastroparesis}, hypertension {Hypertensive disorder, systemic arterial}, diabetes {Diabetes mellitus}, coronary artery disease {Coronary arteriosclerosis}, end stage renal disease {End-stage renal disease}, abdominal pain {Abdominal pain}, improved {Patient's condition improved}, normal diet {Normal diet}"
+"###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 for abdominal pain due to your gastroparesis. 
+Your pain improved with pain medication, anti nausea medications 
+and bowel rest. You were able to tolerate a normal diet. 
+.
+Please continue to take your medications as prescribed.
+. 
+Please seek medical attention if you have worsening abdominal 
+pain and are not able to tolerate your diet or if you have other 
+worrisome medical symptoms.
+ 
+
+###RESPONSE: abdominal pain {Abdominal pain}, gastroparesis {Gastroparesis}, pain improved {Sensation of pain reduced}, pain medication {Administration of analgesic}, nausea {Nausea}, bowel rest {Nil by mouth}, normal diet {Normal diet}, worsening {Increased pain}, abdominal 
+pain {Abdominal 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: 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: 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: 
+Sulfa (Sulfonamide Antibiotics) / Lasix / fried clams
+ 
+Attending: ___.
+ 
+Chief Complaint:
+LUE numbness, tingling
+
+ 
+Major Surgical or Invasive Procedure:
+Banding left upper arm AV graft
+ 
+
+###RESPONSE: LUE {Structure of left upper limb}, numbness, tingling {Numbness and tingling sensation of skin}, Banding {Banding of arteriovenous fistula}, left upper arm {Left upper arm structure}, AV graft {Arteriovenous graft}"
+"###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:
+___ F ESRD on HD, s/p left upper arm AV graft in late ___, 
+presents to ED with pain in her left hand distal to her fistula. 
+Pt reports pain happens while she undergoes HD. Today it was 
+also associated with numbness and tingling. She has experienced 
+similar pain after HD before and is being considered for 
+banding. 
+
+ 
+
+###RESPONSE: ESRD {End-stage renal disease}, HD {Hemodialysis}, left upper arm {Left upper arm structure}, AV graft {Arteriovenous graft}, pain {Pain in scrotum}, left hand {Structure of left hand}, pain {Pain}, HD {Hemodialysis}, numbness and tingling {Numbness and tingling sensation of skin}, pain {Pain}, HD {Hemodialysis}, banding {Banding}"
+"###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:
+1) ESRD secondary to hypertensive nephropathy, started HD ___  
+
+2) Renal artery stenosis s/p bilateral renal artery stents  
+3) HTN  
+4) HLD  
+5) Hypothyroidism 
+
+PSH: left AV graft placement ___, b/l renal artery stents  
+
+ 
+
+###RESPONSE: ESRD secondary to hypertensive nephropathy {End stage renal disease due to hypertension}, HD {Hemodialysis}, Renal artery stenosis {Renal artery stenosis}, HTN {Hypertensive disorder, systemic arterial}, HLD {Hyperlipidemia}, Hypothyroidism {Hypothyroidism}, AV graft placement {Arteriovenous fistulization}, renal artery stents {Insertion of stent into arteriovenous fistula}"
+"###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:
+No family history of kidney disease. Mother with HTN.
+ 
+
+###RESPONSE: kidney disease {Kidney disease}, HTN {Hypertensive disorder, systemic arterial}"
+"###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 discharge:
+
+Vitals- 
+
+GEN: A&O, NAD
+HEENT: No scleral icterus, mucus membranes moist
+CV: RRR, No M/G/R
+PULM: Clear to auscultation b/l, No W/R/R
+ABD: Soft, nondistended, nontender, no rebound or guarding,
+normoactive bowel sounds, no palpable masses
+Ext: LUE w/o edema, palpable thrill in graft and distal radial 
+pulse, extremity slightly cooler than RUE (unchanged), Nail beds 
+slightly cyanotic compared to RUE (unchanged), capillary refill 
+slightly slower than RUE (unchanged)
+ No ___ edema, ___ warm and well perfused
+
+ 
+
+###RESPONSE: Vitals {Vital signs finding}, GEN {General examination of patient}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, scleral icterus {Scleral icterus}, mucus membranes moist {Moist oral mucosa}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, M {Heart murmur}, G {Gallop rhythm}, R {Pericardial friction rub}, PULM {Examination of respiratory system}, Clear to auscultation b/l {Normal breath sounds}, W {Wheezing}, R {Respiratory crackles}, R {Wheeze - rhonchi}, ABD {Examination of abdomen}, Soft {Abdomen soft}, nondistended {Normal abdominal contour}, nontender {Abdominal tenderness}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, normoactive bowel sounds {Normal bowel sounds}, Ext {Examination of limb}, LUE {Structure of left upper limb}, edema {Edema}, thrill {Thrill}, graft {Arteriovenous graft}, radial {Structure of radial artery}, pulse {Normal pulse}, extremity {Limb structure}, RUE {Structure of right upper limb}, RUE {Structure of right upper limb}, capillary refill {Capillary refill}, RUE {Structure of right upper limb}, edema {Edema}, warm {Warm skin}, well perfused {Normal tissue perfusion}"
+"###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:
+___ 04:25PM   PLT COUNT-182
+___ 04:25PM   NEUTS-82.0* LYMPHS-9.9* MONOS-3.3 EOS-3.6 
+BASOS-1.2
+___ 04:25PM   WBC-10.9 RBC-3.73*# HGB-11.5* HCT-37.2# 
+MCV-100* MCH-30.7 MCHC-30.9* RDW-15.7*
+___ 04:25PM   CALCIUM-9.5 PHOSPHATE-3.5 MAGNESIUM-2.0
+___ 04:25PM   estGFR-Using this
+___ 04:25PM   GLUCOSE-103* UREA N-25* CREAT-2.6* SODIUM-140 
+POTASSIUM-4.3 CHLORIDE-99 TOTAL CO2-29 ANION GAP-16
+ 
+
+###RESPONSE: NEUTS {Neutrophil count}, LYMPHS {Lymphocyte count}, MONOS {Monocyte count}, EOS {Eosinophil count}, 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}, CALCIUM {Blood calcium measurement}, 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}"
+"###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:
+Mrs. ___ was admitted to the ___ Surgery service on 
+___ for banding of her left upper arm AV graft. There were 
+no complications and the patient tolerated the procedure well. 
+After the procedure there was a palpable radial pulse and thrill 
+over the graft. The patient reported resolution of her pain and 
+tingling symptoms that she had prior to the procedure. On the 
+morning of POD 1, she noticed a ""heavy feeling"" and coolness of 
+her left middle finger. There was no pain or tenderness. After 
+examination it was determined that she can go home with close 
+follow up within one week to determine if the graft needs to be 
+compeltely ligated or not and to call if her symptoms return and 
+get worse. She was discharged back to her skilled nursing 
+facility after a session of HD in the morning of POD 1 and when 
+she was feeling well and tolerating regular diet.
+Her asprin and plavix were restarted on POD 1.
+
+ 
+
+###RESPONSE: banding {Banding}, left upper arm {Left upper arm structure}, AV graft {Arteriovenous graft}, procedure {Procedure}, procedure {Procedure}, palpable radial pulse {Radial pulse present}, thrill {Thrill}, graft {Arteriovenous graft}, pain {Pain}, tingling {Pins and needles}, procedure {Procedure}, heavy feeling {Heavy feeling}, coolness {Cool skin}, left middle finger {Structure of left middle finger}, pain {Pain}, tenderness {Tenderness}, graft {Structure of transplant}, HD {Hemodialysis}, regular diet {Normal diet}"
+"###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:
+aricept 5 HS, mirtazapine 7.5 HS, levothyroxine 50', calcitriol 
+0.25', captopril 12.5''', amlodipine 5', simvastatin 10', plavix 
+75', asa 81', oxycodone 2.5 Q6H PRN, colace 100'', Vit D3 800', 
+Vit B12 1000'   
+
+ 
+Discharge Medications:
+1. levothyroxine 50 mcg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+2. captopril 12.5 mg Tablet Sig: One (1) Tablet PO TID (3 times 
+a day).  
+3. amlodipine 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+
+4. simvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+5. donepezil 5 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 
+ 
+6. mirtazapine 15 mg Tablet Sig: 0.5 Tablet PO HS (at bedtime).  
+
+7. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 
+times a day).  
+8. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 
+6 hours) as needed for pain: no more than 2000mg per day.  
+9. oxycodone 5 mg Tablet Sig: 0.5 Tablet PO every ___ hours as 
+needed for pain.
+Disp:*20 Tablet(s)* Refills:*0*
+10. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable 
+PO once a day.  
+11. Plavix 75 mg Tablet Sig: One (1) Tablet PO once a day.  
+12. calcitriol 0.25 mcg Capsule Sig: One (1) Capsule PO once a 
+day.  
+13. Vitamin D-3 400 unit Tablet Sig: Two (2) Tablet PO once a 
+day.  
+14. Vitamin B-12 1,000 mcg Tablet Sig: One (1) Tablet PO once a 
+day.  
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+steal syndrome 
+esrd on hemodialysis
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, steal syndrome {Arterial steal syndrome}, esrd on hemodialysis {End stage renal failure on dialysis}, 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:
+You were admitted to the hospital for banding of your left arm 
+fistula because it was causing you some discomfort. Please call 
+Dr. ___ office ___ if you have any of the 
+warning signs listed. ___, ___ may be 
+contacted
+Resume your usual hemodialysis schedule via the tunnelled 
+dialysis line 
+****
+___  ___ will be resumed
+
+ 
+
+###RESPONSE: banding {Banding}, left arm {Left upper arm structure}, fistula {Arteriovenous fistula}, discomfort {Discomfort}, signs {Sign}, hemodialysis {Hemodialysis}"
+"###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: 
+tramadol / Compazine
+ 
+Attending: ___
+ 
+Chief Complaint:
+Trauma
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: tramadol {Allergy to tramadol}, Compazine {Allergy to prochlorperazine}, Trauma {Traumatic injury}"
+"###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 ___ yo M w/ h/o Hep C and IVDU who presented to 
+the ED with multiple blast injuries in the face and chest.  Of 
+note, patient reports that he was blown off by the lid of a 
+highly pressurized natural gas tank in his pickup truck and 
+sustained multiple injuries from the blast, including the R side 
+of his
+face, rib cage, and L leg.  He denies loss of consciousness at 
+the scene, but reports severe R-sided chest pain and blurry 
+vision in the right eye, as well as numbness in the posterior 
+aspect of the arm around the elbow.  
+
+ 
+
+###RESPONSE: Hep C {Viral hepatitis type C}, IVDU {Intravenous drug user}, blast injuries {Blast injury}, face {Injury of face}, chest {Chest injury}, multiple injuries {Multiple injuries}, R side 
+of his
+face {Structure of right half of face}, rib cage {Thoracic cage structure}, L leg {Structure of left lower limb}, loss of consciousness {Loss of consciousness}, R-sided chest pain {Right sided chest pain}, blurry 
+vision {Blurring of visual image}, right eye {Right eye structure}, numbness {Numbness}, posterior 
+aspect of the arm {Structure of posterior surface of upper arm}, elbow {Right elbow region 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: Past Medical History:
+Hep C 
+Overactive bladder 
+
+Past surgical History: 
+Splenectomy (in his ___ 
+Hernia repair ___ years old)
+ 
+
+###RESPONSE: Hep C {Viral hepatitis type C}, Overactive bladder {Overactive bladder}, Splenectomy {Splenectomy}, Hernia repair {Hernia repair}"
+"###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:
+Non contributory
+ 
+
+###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:
+Physical exam on Admission:
+BP 155/108  HR 76   RR 20   O2 sat 95% on RA 
+GEN: Alert, awake, lying uncomfortably in pain.
+HEENT: Multiple small lacerations on the R side of the face 
+around the eye.  Full ROM in the neck. No C spine tenderness. 
+PULM: Pain to palpation of R chest wall.  Inspiratory effort 
+limited by pain.
+ABD: Soft, NTND.  No signs of laceration, hematoma, or trauma in 
+the abdomen.    
+MSK: No paraspinal tenderness. 2-3 cm laceration in the L 
+anterior shin. Full ROM in L ankle. Tenderness in the posterior 
+R arm with diffuse patchy ecchymosis. 
+
+Physical exam on Discharge:
+97.3, BP 119/78  HR 63   RR 18   O2 sat 98% on RA 
+GEN: Alert and oriented x3
+HEENT: Multiple small lacerations on the R side of the face 
+around the eye.  Full ROM in the neck. No C spine tenderness. 
+Cardio: RRR
+PULM: Pain to palpation of R chest wall.  Clear bilateral air 
+entry
+ABD: Soft, NTND.  No signs of laceration, hematoma, or trauma is 
+the abdomen.    
+Extremities: WWP, CCE
+ 
+
+###RESPONSE: BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, O2 sat {Oxygen saturation measurement}, RA {Breathing room air}, GEN {General examination of patient}, Alert {Mentally alert}, awake {Awake}, lying {Lying in bed}, pain {Pain}, HEENT {Physical examination procedure}, small lacerations on the R side of the face {Superficial laceration of face}, Full ROM {Normal movement of neck}, neck {Neck structure}, tenderness {Tenderness}, PULM {Examination of respiratory system}, Pain {Pain}, palpation {Palpation}, R chest wall {Structure of right half of chest wall}, pain {Pain}, ABD {Examination of abdomen}, Soft {Abdomen soft}, ND {Swollen abdomen}, laceration {Laceration}, hematoma {Hematoma}, trauma in 
+the abdomen {Injury of abdomen}, MSK {Musculoskeletal system physical examination}, paraspinal {Structure of paravertebral region}, tenderness {Tenderness}, laceration in the L 
+anterior shin {Laceration of shin}, Full ROM {Range of joint movement normal}, L ankle {Structure of left ankle}, Tenderness {Tenderness}, posterior 
+R arm {Structure of soft tissue of right upper arm}, ecchymosis {Ecchymosis}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, O2 sat {Oxygen saturation measurement}, RA {Breathing room air}, GEN {General examination of patient}, Alert {Mentally alert}, oriented x3 {Oriented to person, time and place}, small lacerations on the R side of the face {Superficial laceration of face}, Full ROM {Normal movement of neck}, neck {Neck structure}, C spine tenderness {Cervical spine tender}, Cardio {Cardiovascular physical examination}, RRR {Normal heart rate}, PULM {Examination of respiratory system}, Pain to palpation {Chest wall tenderness}, R chest wall {Structure of right half of chest wall}, Clear bilateral air 
+entry {Normal breath sounds}, ABD {Examination of abdomen}, Soft {Abdomen soft}, NTND {Abdominal tenderness}, laceration {Laceration}, hematoma {Hematoma}, trauma is 
+the abdomen {Injury of abdomen}, Extremities {Examination of limb}, WWP {Normal tissue perfusion}"
+"###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:
+Imaging Results: 
+___ HEAD W/O CONTRAST 
+IMPRESSION:  No acute hemorrhage or acute fracture.  Right 
+periorbital soft tissue swelling 
+with numerous superficial radiodense foci likely representing 
+foreign bodies 
+versus skin debris.  Please correlate clinically. 
+
+___ CT CHEST/ABD/PELVIS W/  
+IMPRESSION: 
+1. Right-sided rib fractures involving the eighth and ninth ribs 
+which appear comminuted displaced as well as fractured right 
+tenth rib at the  costovertebral junction.  Associated tiny 
+right pneumothorax, right hemothorax 
+and soft tissue gas in the right posterior chest wall. 
+2. Scarring and nodular pleural thickening in the right lung 
+with associated  volume loss likely reflect chronic insult, 
+please correlate clinically. 
+3. Subtle peribronchovascular ground-glass opacities in the 
+right lower lobe  may reflect trace aspiration or bronchiolitis. 
+
+4. Moderate emphysema. 
+
+___ CT C-SPINE W/O CONTRAST
+IMPRESSION: 
+ 1. No fracture or malalignment within the cervical spine. 
+2. Aerosolized fluid within the upper esophagus which appears 
+patulous, may predispose to aspiration. 
+
+___ CHEST (PA & LAT)
+IMPRESSION:  Known tiny right pneumothorax is not conspicuous on 
+radiograph. 
+  
+
+___ CT ORBITS, SELLA & IAC 
+IMPRESSION: 
+1. The right globe is intact without evidence of hemorrhage or 
+retained  foreign body. 
+2. Soft tissue swelling involving the right periorbital region. 
+3. Multiple punctate hyperdense foci along the skin and 
+subcutaneous tissues  overlying the right cheek, right 
+periorbital region and right nasal bone, likely retained foreign 
+bodies. 
+
+___ CHEST (PORTABLE AP) 
+IMPRESSION:  Compared to the examination from 1 day prior, there 
+is likely an unchanged tiny right apical pneumothorax.  
+Loculated right-sided lateral pleural effusion appears slightly 
+increased.  Streaky opacities at the right lung base are likely 
+atelectatic.  No new consolidation is seen there is no 
+left-sided effusion pneumothorax.  Cardiomediastinal silhouette 
+is unchanged. 
+
+___ CHEST (PA & LAT) 
+IMPRESSION:  Comparison to ___.  The appearance of 
+the right loculated pleural 
+effusion is stable.  However, on today's image, no pneumothorax 
+is appreciated.  Areas of scarring throughout the right lung are 
+unchanged.  No change in appearance of the normal cardiac 
+silhouette and of the normal left lung. 
+
+Laboratory Results:
+
+___ 10:30AM BLOOD WBC-12.1* RBC-4.72 Hgb-14.9 Hct-43.6 
+MCV-92 MCH-31.6 MCHC-34.2 RDW-14.8 RDWSD-50.0* Plt ___
+___ 07:30PM BLOOD WBC-11.7* RBC-4.24* Hgb-13.1* Hct-39.0* 
+MCV-92 MCH-30.9 MCHC-33.6 RDW-14.9 RDWSD-50.0* Plt ___
+___ 06:20PM BLOOD WBC-20.0* RBC-4.69 Hgb-14.8 Hct-43.8 
+MCV-93 MCH-31.6 MCHC-33.8 RDW-14.6 RDWSD-50.1* Plt ___
+___ 06:20PM BLOOD Neuts-54.3 ___ Monos-6.4 Eos-2.1 
+Baso-0.6 Im ___ AbsNeut-10.84* AbsLymp-7.11* AbsMono-1.29* 
+AbsEos-0.43 AbsBaso-0.13*
+___ 10:30AM BLOOD Plt ___
+___ 07:30PM BLOOD Plt ___
+___ 06:20PM BLOOD Plt Smr-HIGH* Plt ___
+___ 06:20PM BLOOD ___ PTT-26.8 ___
+___ 10:30AM BLOOD Glucose-99 UreaN-9 Creat-0.8 Na-138 K-4.8 
+Cl-98 HCO3-27 AnGap-13
+___ 07:30PM BLOOD Glucose-88 UreaN-8 Creat-0.8 Na-138 K-4.5 
+Cl-100 HCO3-27 AnGap-11
+___ 06:20PM BLOOD Glucose-96 UreaN-13 Creat-1.2 Na-143 
+K-4.8 Cl-101 HCO3-29 AnGap-13
+___ 06:20PM BLOOD ALT-34 AST-57* CK(CPK)-247 AlkPhos-102 
+TotBili-0.2
+___ 10:30AM BLOOD Calcium-9.4 Phos-3.4 Mg-2.1
+___ 07:30PM BLOOD Calcium-8.6 Phos-3.8 Mg-1.9
+___ 06:20PM BLOOD Albumin-4.1
+ 
+
+###RESPONSE: HEAD {Imaging of head}, AST {Aspartate aminotransferase measurement}, acute hemorrhage {Acute hemorrhage}, fracture {Fracture}, Right 
+periorbital soft tissue swelling {Periorbital edema of right eye}, foreign bodies {Foreign body}, Right-sided {Bone structure of right rib}, rib fractures {Bone structure of right rib}, eighth {Bone structure of eighth rib}, ninth ribs {Bone structure of ninth rib}, comminuted displaced {Fracture, closed, comminuted, with displacement}, right {Bone structure of right rib}, tenth rib {Bone structure of tenth rib}, costovertebral junction {Costovertebral joint structure}, pneumothorax {Pneumothorax}, right {Right pleura structure}, hemothorax {Hemothorax}, soft tissue {Structure of soft tissue}, right posterior chest wall. {Structure of right half of posterior chest wall}, Scarring {Pleural scarring}, nodular {Nodule of lung}, pleural thickening {Thickening of pleura}, right lung {Right lung structure}, chronic {Chronic disease}, ground-glass opacities {Ground glass lung opacity}, right lower lobe {Structure of lower lobe of right lung}, aspiration {Aspiration pneumonia}, bronchiolitis {Bronchiolitis}, emphysema {Emphysema}, AST {Aspartate aminotransferase measurement}, fracture {Fracture}, malalignment {Misalignment}, cervical spine {Structure of cervical vertebral column}, fluid {Accumulation of fluid}, upper esophagus {Cervical esophagus structure}, aspiration {Aspiration pneumonia}, CHEST (PA & LAT {Plain chest X-ray}, pneumothorax {Pneumothorax}, radiograph {Plain chest X-ray}, SELLA {Computed tomography of pituitary fossa}, IAC {Structure of internal acoustic meatus of temporal bone}, right globe {Structure of right orbit proper}, intact {No abnormality detected}, hemorrhage {Hemorrhage}, retained  foreign body {Retained foreign body}, Soft tissue swelling {Soft tissue swelling}, right periorbital region {Structure of periorbital region of left eye}, skin and 
+subcutaneous tissues {Skin and/or subcutaneous tissue structure}, right cheek {Structure of skin of right cheek}, right nasal bone {Bone tissue structure of nasal bone}, retained foreign 
+bodies {Retained foreign body}, CHEST (PORTABLE AP {Plain x-ray of chest anteroposterior view}, right apical {Structure of apex of right lung}, pneumothorax {Pneumothorax}, right-sided {Right pleura structure}, pleural effusion {Pleural effusion}, opacities {Abnormally opaque structure}, right lung base {Structure of base of right lung}, atelectatic {Atelectasis}, consolidation {Consolidation}, left-sided {Left pleura structure}, effusion {Pleural effusion}, pneumothorax {Pneumothorax}, Cardiomediastinal {Mediastinal structure}, CHEST (PA & LAT {Plain chest X-ray}, right {Right pleura structure}, loculated pleural 
+effusion {Loculated pleural effusion}, stable {Patient's condition stable}, pneumothorax {Pneumothorax}, scarring {Pleural scarring}, right lung {Right lung structure}, normal {Normal size}, cardiac {Heart structure}, normal {Normal size}, left lung {Left lung structure}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, RDWSD {Red cell distribution width determination}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, RDWSD {Red cell distribution width determination}, 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}, 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}, Monos {Monocyte count}, Eos {Eosinophil count}, Baso {Basophil count}, PTT {Partial thromboplastin time, activated}, BLOOD Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, BLOOD Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, BLOOD 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}, CK(CPK {Creatine kinase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Albumin {Albumin 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: Brief Hospital Course:
+The patient presented to Emergency Department on ___. The 
+trauma general surgery team evaluated the patient and performed 
+a primary and a secondary survey. He was found to have rib 
+fractures and periorbital swelling. Ophthalmology evaluated the 
+patient and recommended  - Dedicated CT orbits will better 
+characterize superficial shrapnel burden however there is no 
+clinical evidence of intraocular FB or clinically significant 
+intraorbital FB- Artificial tears to right eye QID, more as 
+needed for irritation - GenTeal gel QHS to right eye  - can 
+apply erythromycin ophthalmic ointment to lids if irritated- 
+Follow up in ophthalmology clinic 2 weeks, sooner PRN. The 
+recommendations were following. The patient was then admitted to 
+the Acute Care Surgery Unit for further management of the 
+overall injuries. 
+
+During the hospital course review of systems had as follow:
+
+Neuro: The patient was alert and oriented throughout 
+hospitalization and pain was well controlled.
+
+CV: The patient remained stable from a cardiovascular 
+standpoint; vital signs were routinely monitored.
+Pulmonary: The patient remained stable from a pulmonary 
+standpoint; vital signs were routinely monitored. Good pulmonary 
+toilet, early ambulation and incentive spirometry were 
+encouraged throughout hospitalization. 
+
+GI/GU/FEN: The patient was tolerating a regular diet. Patient's 
+intake and output were closely monitored
+
+ID: The patient's fever curves were closely watched for signs of 
+infection, of which there were none.
+
+HEME: The patient's blood counts were closely watched for signs 
+of bleeding, of which there were none.
+
+Prophylaxis: The patient received subcutaneous heparin and ___ 
+dyne boots were used during this stay and was encouraged to get 
+up and ambulate as early as possible.
+
+At the time of discharge, the patient was doing well, afebrile 
+and hemodynamically stable.  The patient was tolerating a diet, 
+ambulating, voiding without assistance, and pain was well 
+controlled.  The patient received discharge teaching and 
+follow-up instructions with understanding verbalized and 
+agreement with the discharge plan.
+ 
+
+###RESPONSE: rib 
+fractures {Fracture of multiple ribs}, periorbital swelling {Periorbital edema}, CT orbits {Computed tomography of orbit}, right eye {Right eye structure}, right eye {Right eye structure}, Neuro {Neurological examination}, alert {Mentally alert}, oriented {Orientated}, pain was well controlled {Demonstrates adequate pain control}, CV {Cardiovascular physical examination}, stable {Patient's condition stable}, cardiovascular {Cardiovascular physical examination}, vital signs were routinely monitored {Monitoring of blood pressure, temperature, pulse rate and respiratory rate}, Pulmonary {Examination of respiratory system}, stable {Patient's condition stable}, pulmonary {Respiratory assessment}, vital signs were routinely monitored {Monitoring of blood pressure, temperature, pulse rate and respiratory rate}, pulmonary 
+toilet {Airway toilet}, incentive spirometry {Incentive spirometry}, GI {Gastrointestinal investigation}, GU {Examination of genitourinary system}, tolerating a regular diet {Tolerating normal diet}, intake and output {Measuring intake and output}, monitored {Monitoring procedure}, fever {Fever}, watched for signs of 
+infection {Monitoring for signs and symptoms of infection}, HEME {Hematology test}, blood counts {Blood test}, signs {Sign}, bleeding {Bleeding}, Prophylaxis {Preventive procedure}, subcutaneous heparin {Subcutaneous injection of heparin}, ambulate {Ambulation training}, afebrile {Temperature normal}, hemodynamically stable {Hemodynamically stable}, tolerating a diet {Tolerating diet}, ambulating {Fully mobile}, voiding without assistance {Continence independent}, pain was well 
+controlled {Demonstrates adequate pain control}, teaching {Patient education}"
+"###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:
+Methadone per patient 102 mg
+ 
+Discharge Medications:
+1.  Acetaminophen ___ mg PO Q6H:PRN Pain - Mild  
+2.  Artificial Tears ___ DROP BOTH EYES Q6H dryness  
+3.  Erythromycin 0.5% Ophth Oint 0.5 in RIGHT EYE QID 
+RX *erythromycin 5 mg/gram (0.5 %) 0.5 (One half) on lid every 
+four (4) hours Disp #*3.5 Gram Gram Refills:*0 
+4.  OxyCODONE (Immediate Release) 5 mg PO Q6H:PRN Pain - Severe 
+RX *oxycodone 5 mg 1 tablet(s) by mouth every six (6) hours Disp 
+#*10 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:
+Right sided ___ ribs fractures 
+Right ___ swelling 
+Left shin laceration
+Right pneumothorax and hemothorax
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Right sided {Bone structure of right rib}, ribs fractures {Fracture of multiple ribs}, Right {Structure of right orbital region}, swelling {Orbital swelling}, Left {Structure of shin of left lower leg}, shin laceration {Laceration of shin}, Right pneumothorax {Right pneumothorax}, hemothorax {Hemothorax}, 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:
+Dear Mr. ___,
+
+You were admitted to ___ falling a trauma. You were found to 
+have rib fractures and ___ swelling. You have recovered 
+well and are now ready for discharge. 
+
+* Your injury caused right sided ___ rib fractures which 
+can cause severe pain and subsequently cause you to take shallow 
+breaths because of the pain.
+ 
+* You should take your pain medication as directed to stay ahead 
+of the pain otherwise you won't be able to take deep breaths. If 
+the pain medication is too sedating take half the dose and 
+notify your physician.
+ 
+* Pneumonia is a complication of rib fractures.  In order to 
+decrease your risk you must use your incentive spirometer 4 
+times every hour while awake.  This will help expand the small 
+airways in your lungs and assist in coughing up secretions that 
+pool in the lungs.
+ 
+* You will be more comfortable if you use a cough pillow to hold 
+against your chest and guard your rib cage while coughing and 
+deep breathing.
+ 
+* Symptomatic relief with ice packs or heating pads for short 
+periods may ease the pain.
+ 
+* Narcotic pain medication can cause constipation therefore you 
+should take a stool softener twice daily and increase your fluid 
+and fiber intake if possible.
+ 
+* Do NOT smoke
+ 
+* If your doctor allows, non-steroidal ___ drugs 
+are very effective in controlling pain ( ie, Ibuprofen, Motrin, 
+Advil, Aleve, Naprosyn) but they have their own set of side 
+effects so make sure your doctor approves.
+ 
+* Return to the Emergency Room right away for any acute 
+shortness of breath, increased pain or crackling sensation 
+around your ribs (crepitus).
+
+You were also found to have a right sided ___ swelling. 
+If you have any worsening symptoms or change in vision please 
+return to your closest emergency department.
+
+ 
+
+###RESPONSE: trauma {Traumatic injury}, rib fractures {Fracture of multiple ribs}, swelling {Swelling}, ready for discharge {Ready for discharge}, injury {Traumatic injury}, right sided {Bone structure of right rib}, rib fractures {Fracture of multiple ribs}, severe pain {Severe pain}, pain {Pain}, pain medication {Administration of analgesic}, pain {Pain}, able to take deep breaths {Able to take deep breaths}, pain medication {Administration of analgesic}, Pneumonia {Pneumonia}, rib fractures {Fracture of multiple ribs}, use your incentive spirometer {Incentive spirometry}, airways {Airway structure}, lungs {Lung structure}, coughing up secretions {Encouragement of deep breathing and coughing exercises}, lungs {Lung structure}, chest {Thoracic structure}, rib cage {Thoracic cage structure}, coughing and 
+deep breathing {Deep breathing and coughing exercises}, relief {Pain relief}, ice packs {Application of ice}, heating pads {Heat therapy}, pain {Pain}, constipation {Constipation}, take a stool softener {Administration of laxative}, increase your fluid {Fluid intake encouragement}, fiber intake {High fiber diet education}, Do NOT smoke {Smoking cessation education}, controlling pain {Pain control}, shortness of breath {Dyspnea}, increased pain {Increased pain}, crackling sensation {Subcutaneous emphysema}, ribs {Bone structure of rib}, crepitus {Bone crepitus}, right sided {Structure of right orbital region}, swelling {Periorbital edema}, change in vision {Visual disturbance}"
+"###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: 
+Ace Inhibitors
+ 
+Attending: ___.
+ 
+Chief Complaint:
+tongue swelling
+ 
+Major Surgical or Invasive Procedure:
+Intubation
+
+ 
+
+###RESPONSE: Ace Inhibitors {Allergy to acetylcholinesterase inhibitor}, tongue swelling {Tongue swelling}, Intubation {Intubation}"
+"###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:
+___ yo male with history of ESRD s/p living unrelated kidney 
+transplant in ___ presented to the ER in the middle of the 
+night with tongue swelling. Per report, the pt noted he woke up 
+from his sleep at 3 Am and felt that his mouth had been forced 
+open.  
+In the ER he was statting 93% on RA and could barely speak. He 
+received 125 mg IV solumedrol, 50 mg IV benadryl, 20 mg IV 
+pepcid and 0.3 cc of 1:1000 epinephrine sc, but his symptoms 
+only got worse. He was thought to have angioedema and 
+fiberoptically intubated by anesthesia.  
+.  
+Upon arrival to the floor the pt was intubated and sedated. 
+Additional history obtained from his mother who lives with him. 
+She did not know his medication list, but stated this had never 
+happened to the pt before and she did not think there had been 
+any recent medication changes. Only notable thing was that pt 
+ate ""hot sauce"" last night which was different for him.  
+.
+Medications brought in by family following admission, includes 
+(recently added) benazepril.  
+ 
+
+###RESPONSE: ESRD {End-stage renal disease}, kidney 
+transplant {Transplant of kidney}, tongue swelling {Tongue swelling}, mouth {Mouth region structure}, RA {Breathing room air}, angioedema {Angioedema}, intubated {Intubation}, anesthesia {Under anesthesia}, sedated {Sedated}, medication changes {Change of medication}"
+"###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:
+HTN  
+ESRD s/p living unrelated kidney transplant in ___  
+sleep apnea on CPAP  
+DM2  
+H./o colon cancer s/p right colectomy by Dr. ___ ___. 
+No chemotherapy.  
+History of bilateral lower extremity edema.  
+s/p L AV fistula  
+hypercholesterolemia  
+admission for ___ cellulitis ion ___  
+h/o GIB  
+
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, ESRD {End-stage renal disease}, kidney transplant {Transplant of kidney}, sleep apnea {Sleep apnea}, on CPAP {Dependence on continuous positive airway pressure ventilation}, DM2 {Diabetes mellitus type 2}, colon cancer {Malignant neoplasm of colon}, right colectomy {Right colectomy}, chemotherapy {Chemotherapy}, bilateral lower extremity edema {Edema of bilateral lower limbs}, AV fistula {Arteriovenous fistula}, hypercholesterolemia {Hypercholesterolemia}, cellulitis {Cellulitis}, GIB {Gastrointestinal hemorrhage}"
+"###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:
+unknown
+ 
+
+###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:
+VS: T: 06.9 HR: 71 BP: 120/79 RR: 14 O2 Sat: 100% on vent  
+AC: 600x14 FIO2 1 PEEP 5  
+GEN: intubated, moving around, couging  
+HEENT: intubated, edematous tongue  
+Neck: supple  
+Cardio: RRR, nl S1 S2, no m/r/g  
+Pulm: CTAB ant, no w/r/r,no stridor  
+Abd: soft, NT, ND, + BS  
+Ext: no edema, 2+ DP pulses  
+Neuro: sedated, moving around, grimacing and coughing, moving 
+upper and lower ext; PERRL  
+Skin: no rashes or hives  
+
+ 
+
+###RESPONSE: VS {Vital signs finding}, HR {Finding of heart rate}, BP {Blood pressure finding}, RR {Finding of rate of respiration}, GEN {General examination of patient}, couging {Cough}, HEENT {Physical examination procedure}, edema {Edema}, Neck {Physical examination procedure}, supple {Normal movement of neck}, Cardio {Cardiovascular physical examination}, RRR {Normal heart rate}, S2 {Normal second heart sound, S>2<}, no m/r/g {Heart sounds normal}, Pulm {Examination of respiratory system}, CTAB {Normal breath sounds}, no w/r/r {Normal breath sounds}, stridor {Stridor}, Abd {Examination of abdomen}, soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, + BS {Normal bowel sounds}, Ext {Examination of limb}, edema {Edema}, 2+ DP pulses {All pulses present in bilateral lower limbs}, Neuro {Neurological examination}, sedated {Sedated}, coughing {Cough}, upper {Examination of lower limb}, lower ext {Lower limb structure}, PERRL {Pupils equal and reacting to light}, Skin {Examination of skin}, rashes {Eruption of skin}, hives {Wheal}"
+"###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:
+___ 06:15AM BLOOD WBC-4.9 RBC-3.86* Hgb-13.3* Hct-39.0* 
+MCV-101* MCH-34.3* MCHC-34.0 RDW-14.9 Plt Ct-58*
+___ 06:14AM BLOOD WBC-7.1# RBC-4.06* Hgb-14.0 Hct-40.2 
+MCV-99* MCH-34.4* MCHC-34.8 RDW-15.4 Plt Ct-67*
+___ 12:27AM BLOOD WBC-3.4* RBC-4.20* Hgb-14.9 Hct-41.9 
+MCV-100* MCH-35.4* MCHC-35.5* RDW-14.6 Plt Ct-64*
+___ 05:04AM BLOOD WBC-3.6* RBC-4.07* Hgb-14.4 Hct-41.0 
+MCV-101* MCH-35.4* MCHC-35.1* RDW-14.7 Plt Ct-78*
+___ 06:15AM BLOOD Glucose-223* UreaN-48* Creat-2.2* Na-141 
+K-3.5 Cl-101 HCO3-29 AnGap-15
+___ 06:14AM BLOOD Glucose-267* UreaN-38* Creat-2.0* Na-143 
+K-4.3 Cl-102 HCO3-29 AnGap-16
+___ 12:27AM BLOOD Glucose-268* UreaN-35* Creat-1.9* Na-139 
+K-4.1 Cl-103 HCO3-24 AnGap-16
+___ 06:15AM BLOOD tacroFK-10.4
+___ 08:55AM BLOOD Type-ART FiO2-100 pO2-443* pCO2-40 
+pH-7.43 calTCO2-27 Base XS-2 AADO2-252 REQ O2-48 
+Intubat-INTUBATED
+ 
+
+###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}, 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}, 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}, 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}, 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}, 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}, 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}"
+"###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:
+# Angioedema: Initially unclear precipitant for angioedema, 
+however, after family brought in meds following admission, an 
+ACE inhibitor was among them (had not previously been known to 
+be on ACE) and most likely due to this. No family or personal 
+history of angioedema.  No rash or hypotension.  IV steroids 
+(with transition to PO taper) started along with benadryl and 
+pepcid.  He was extubated easily on ___ following resolution 
+of the swelling.  ACE inhibitor was added to his allergy list.  
+He was discharged on a prednisone taper.
+
+# ESRD s/p txplnt in ___: Pt with unrelated living donor 
+txplnt.  Azathioprine and prograf were continued.  The renal 
+transplant team followed him during admission.
+  
+# HTN: Rrestarted home regimen with exception of ACE inhibitor.
+ 
+# DM: SSI and qid ___. 
+
+# Sleep apnea: not using CPAP regularly at home.
+
+ 
+
+###RESPONSE: Angioedema {Angioedema}, angioedema {Angioedema}, angioedema {Angioedema}, rash {Eruption of skin}, hypotension {Low blood pressure}, steroids {Steroid therapy}, extubated {Removal of endotracheal tube}, swelling {Swelling}, allergy {Allergic disposition}, ESRD {End-stage renal disease}, txplnt {Transplant of kidney}, renal 
+transplant {Transplant of kidney}, HTN {Hypertensive disorder, systemic arterial}, regimen {Therapeutic regimen}, DM {Diabetes mellitus}, SSI {Sliding scale insulin regime}, Sleep apnea {Sleep apnea}, CPAP {Continuous positive airway pressure ventilation treatment}"
+"###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:
+(meds brought in by family)
+Benazepril-HCTZ 1 tablet PO QD  
+Bactrim SS PO QD  
+Vitamin D 1.25 MG PO QD  
+HCTZ 25 mg PO QD  
+Azathioprine 100 mg PO QD  
+Prograf 3 mg PO BID (vs. 1 mg PO BID - unclear)
+Amlodipine 10 mg PO QD  
+Carvedilol 25 mg PO BID  
+Lipitor 80 mg PO QD  
+Aspirin 81 mg PO QD  
+
+ 
+Discharge Medications:
+1. Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+2. Trimethoprim-Sulfamethoxazole 80-400 mg Tablet Sig: One (1) 
+Tablet PO DAILY (Daily).  
+3. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: One (1) 
+Tablet PO DAILY (Daily).  
+4. Carvedilol 25 mg Tablet Sig: One (1) Tablet PO twice a day.  
+5. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) 
+Tablet, Delayed Release (E.C.) PO once a day.  
+6. Azathioprine 100 mg Tablet Sig: One (1) Tablet PO once a day. 
+ 
+7. Tacrolimus 1 mg Capsule Sig: One (1) Capsule PO Q12H (every 
+12 hours).  
+8. Amlodipine 10 mg Tablet Sig: One (1) Tablet PO once a day.  
+9. Hydrochlorothiazide 25 mg Tablet Sig: One (1) Tablet PO once 
+a day.  
+10. Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+11. Trimethoprim-Sulfamethoxazole 80-400 mg Tablet Sig: One (1) 
+Tablet PO DAILY (Daily).  
+12. Prednisone 10 mg Tablet Sig: as below Tablet PO Daily () for 
+3 days: Take 3 tablets for one day (30mg), followed by 2 tablets 
+for one day (20mg) and 1 tablet for one day (10mg).
+Disp:*6 Tablet(s)* 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:
+Primary:
+Angioedema likely secondary to ACE-I
+Secondary:
+ESRD s/p living transplant on chronic immunosupression
+Type II Diabetes
+Hypertension
+
+ 
+Discharge Condition:
+Stable with decreased tongue swelling
+
+ 
+
+###RESPONSE: Angioedema {Angioedema}, ESRD {End-stage renal disease}, transplant {Transplant of kidney}, immunosupression {Immunosuppression}, Type II Diabetes {Diabetes mellitus type 2}, Hypertension {Hypertensive disorder, systemic arterial}, Stable {Patient's condition stable}, tongue swelling {Tongue swelling}"
+"###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 to the hospital with a likely allergic 
+reaction to a medication you were taking, benzapril.
+
+While you were in the hospital, you required intubation to help 
+you breath because of your swollen tongue.  We treated you with 
+steroids and your tongue swelling improved.
+
+If you develop any shortness of breath, chest pain, swelling, 
+rash or any other concerning symptoms, you should call your 
+doctor or come to the emergency room.
+ 
+
+###RESPONSE: allergic 
+reaction {Allergic reaction}, intubation {Intubation}, swollen tongue {Tongue swelling}, steroids {Steroid therapy}, tongue swelling {Tongue swelling}, improved {Patient's condition improved}, shortness of breath {Dyspnea}, chest pain {Chest pain}, swelling {Swelling}, rash {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: 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:
+Transaminitis
+ 
+Major Surgical or Invasive Procedure:
+Diagnostic LHC ___
+LHC w/ LAD PCI ___
+
+ 
+
+###RESPONSE: codeine {Allergy to codeine}, Transaminitis {Aspartate transaminase level above reference range}, LHC {Catheterization of left heart}, LHC {Catheterization of left heart}, LAD {Structure of anterior descending branch of left coronary artery}, PCI {Percutaneous coronary intervention}"
+"###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 ___ female
+with history of alcoholic cirrhosis decompensated by grade I
+varices and two recent hospitalizations for hepatic
+encephalopathy, alcohol use disorder in remission, and
+non-obstructive coronary artery disease referred directly from
+___ clinic for incidental cholestatic injury, rising MELD
+and imminent transplant candidacy in that regard, and serial lab
+monitoring.
+
+Patient was first hospitalized from ___ for hepatic
+encephalopathy secondary to lactulose non-adherence and
+pan-sensitive E. coli UTI. She incidentally developed acute on
+chronic anemia, prompting endoscopy, which revealed one cord of
+grade I varices and portal hypertensive gastropathy without
+stigmata of bleeding. She was likewise hospitalized from ___
+for hepatic encephalopathy secondary to dehydration. Her
+mentation promptly resolved with hydration and was discharged on
+rifaximin. 
+
+She explains, ""I felt really good [after discharge]"" for an
+estimated 1.5 to 2 weeks, when ""things [then] went downhill,""
+meaning ""no energy"" and jaundice. She is not sleeping well due 
+to
+intense pruritus and is napping during the day. Her daughter
+adds, ""It doesn't take much to get her exhausted [now]...like 
+one
+errand."" She endorses anorexia and dysgeusia in recent days, and
+estimates a 5-pound weight loss since last hospitalization. She
+has not been confused and is taking her lactulose, noting ___
+bowel movements some days and ___ on others. She has vague,
+occasional ""crampy"" abdominal pain, which is not particularly
+bothersome.
+
+She recently completed a course of amoxicillin for a dental
+procedure, but denies other new medications or over-the-counter
+protein supplements or vitamins. Her colestipol was recently
+intensified, but she thinks her fatigue and jaundice pre-dated
+this. She continues to abstain from alcohol. Her routine
+surveillance labs on ___ revealed worsening hyperbilirubinemia
+(i.e., total bilirubin 11 to 23.4, then 21.7 today), prompting
+expedited follow-up today. She underwent MRCP and was then
+admitted directly for serial lab monitoring. 
+
+ 
+
+###RESPONSE: alcoholic cirrhosis {Alcoholic cirrhosis}, varices {Esophageal varices}, hepatic
+encephalopathy {Hepatic encephalopathy}, alcohol use {Current drinker of alcohol}, disorder in remission {Disorder in remission}, coronary artery disease {Coronary arteriosclerosis}, cholestatic injury {Injury of biliary tree}, monitoring {Monitoring procedure}, hepatic
+encephalopathy {Hepatic encephalopathy}, E. coli UTI {Urinary tract infection caused by Escherichia coli}, chronic anemia {Chronic anemia}, endoscopy {Endoscopy}, varices {Esophageal varices}, portal hypertensive gastropathy {Portal hypertensive gastropathy}, bleeding {Bleeding}, hepatic encephalopathy {Hepatic encephalopathy}, dehydration {Dehydration}, resolved {Problem resolved}, hydration {Administration of fluid therapy}, felt really good {Patient feels well}, jaundice {Jaundice}, sleeping {Asleep}, pruritus {Itching of skin}, anorexia {Loss of appetite}, dysgeusia {Taste sense altered}, weight loss {Weight loss}, confused {Clouded consciousness}, crampy {Stomach cramps}, abdominal pain {Abdominal pain}, dental
+procedure {Dental surgical procedure}, fatigue {Fatigue}, jaundice {Jaundice}, abstain from alcohol {Does abstain from drinking}, hyperbilirubinemia {Hyperbilirubinemia}, total bilirubin {Bilirubin, total measurement}, MRCP {Magnetic resonance cholangiopancreatography}"
+"###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:
+Alcoholic Cirrhosis c/b ascites, esophageal varices
+Colonic adenoma 
+Essential hypertension
+Melanocytic nevus
+Low back pain
+GERD
+Anemia 
+Cholecystectomy
+
+ 
+
+###RESPONSE: Alcoholic Cirrhosis {Alcoholic cirrhosis}, ascites {Ascites}, esophageal varices {Esophageal varices}, Colonic {Colon structure}, adenoma {Adenoma}, Essential hypertension {Essential hypertension}, Melanocytic nevus {Pigmented nevus}, Low back pain {Low back pain}, GERD {Gastroesophageal reflux disease}, Anemia {Anemia}, Cholecystectomy {Cholecystectomy}"
+"###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: ___ kidney disease, deceased
+Father: ___, deceased
+Brother: CAD with stent
+ 
+
+###RESPONSE: kidney disease {Kidney disease}, deceased {Dead}, deceased {Dead}, CAD {Coronary arteriosclerosis}, stent {Insertion of arterial stent}"
+"###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 EXAM:
+VITALS: T 98.3, HR 78, BP 133/71. RR 17, O2 100% RA  
+GENERAL: no apparent distress, jaundiced, thin 
+HEENT: temporal wasting, scleral icterus, oropharynx clear, 
+moist
+mucous membranes  
+NECK: supple, JVP 8 cm, no cervical lymphadenopathy 
+HEART: RRR, S1/S2, III/VI systolic murmur heard across the
+precordium
+PULM: unlabored, CTAB  
+ABDOMEN: surgical scar, soft, minor distention, non-tender,
+palpable liver edge 
+EXTREMITIES: warm, well perfused, without edema, intrinsic hand
+muscle wasting 
+NERUO: no asterxis, non-focal
+SKIN: no rash or lesion
+
+DISCHARGE EXAM:
+VITALS: T 98.4 BP 115/55 HR 78 RR 18  O2 Sat 99% on RA
+Wt: 141.1 lb/61 kg  
+GENERAL: NAD, months backward w 1 error.
+HEENT: AT/NC, anicteric sclera, MMM
+CV: RRR, S1/S2, no murmurs, gallops, or rubs
+PULM: CTAB, no wheezes, rales, rhonchi, breathing comfortably
+without use of accessory muscles
+GI: abdomen soft, moderately distended, without fluid
+wave, nontender in all quadrants, no rebound/guarding
+EXTREMITIES: no cyanosis, clubbing, or edema
+NEURO: Alert, moving all 4 extremities with purpose, face
+symmetric
+DERM: Warm and well perfused, mildly jaundiced (stable this
+admission), no excoriations or lesions, no rashes
+
+ 
+
+###RESPONSE: T {Body temperature finding}, HR {Finding of heart rate}, BP {Blood pressure finding}, RR {Finding of rate of respiration}, RA {Breathing room air}, GENERAL {General examination of patient}, distress {Distress}, jaundiced {Jaundice}, HEENT {Physical examination procedure}, temporal {Structure of temporal region}, scleral icterus {Scleral icterus}, oropharynx clear {Pharynx normal}, moist
+mucous membranes {Moist oral mucosa}, NECK {Physical examination procedure}, supple {Normal movement of neck}, JVP {Finding of jugular venous pressure}, cervical lymphadenopathy {Cervical lymphadenopathy}, HEART {Cardiovascular physical examination}, RRR {Normal heart rate}, S2 {Normal second heart sound, S>2<}, murmur {Murmur}, precordium {Structure of precordium}, PULM {Examination of respiratory system}, unlabored {Breathing easily}, CTAB {Normal breath sounds}, ABDOMEN {Examination of abdomen}, surgical scar {Surgical scar}, soft {Abdomen soft}, distention {Swollen abdomen}, ,
+palpable liver edge {Liver edge palpable}, EXTREMITIES {Examination of limb}, warm {Warm skin}, well perfused {Normal tissue perfusion}, edema {Edema}, hand {Hand structure}, muscle wasting {Muscle atrophy}, NERUO {Neurological examination}, asterxis {Asterixis}, SKIN {Examination of skin}, rash {Eruption of skin}, lesion {Skin lesion}, T {Body temperature finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, O2 Sat {Oxygen saturation measurement}, RA {Breathing room air}, GENERAL {General examination of patient}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, NC {Normal head}, anicteric sclera {White sclera}, MMM {Moist oral mucosa}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, murmurs {Heart murmur}, gallops {Gallop rhythm}, rubs {Pericardial friction rub}, PULM {Examination of respiratory system}, CTAB {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, rhonchi {Wheeze - rhonchi}, breathing comfortably {Breathing easily}, accessory muscles {Accessory skeletal muscle}, GI {Examination of digestive system}, abdomen soft {Abdomen soft}, distended {Swollen abdomen}, fluid {Effusion}, tender {Abdominal tenderness}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, EXTREMITIES {Examination of limb}, cyanosis {Cyanosis}, clubbing {Clubbing}, edema {Edema}, NEURO {Neurological examination}, Alert {Mentally alert}, moving all 4 extremities {Does move all four limbs}, face
+symmetric {Facial symmetry}, DERM {Examination of skin}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, jaundiced {Jaundice}, excoriations {Excoriation}, lesions {Skin lesion}, 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:
+ADMISSION LABS:
+===============
+___ 01:50PM   GLUCOSE-113*
+___ 01:50PM   UREA N-32* CREAT-1.2* SODIUM-131* 
+POTASSIUM-5.2 CHLORIDE-95* TOTAL CO2-21* ANION GAP-15
+___ 01:50PM   ALT(SGPT)-36 AST(SGOT)-83* ALK PHOS-178* TOT 
+BILI-21.7*
+___ 01:50PM   ALBUMIN-3.7
+___ 01:50PM   HBsAg-NEG HAV Ab-NEG
+___ 01:50PM   ASA-NEG ACETMNPHN-NEG
+___ 01:50PM   WBC-5.8 RBC-2.96* HGB-9.0* HCT-25.4* MCV-86 
+MCH-30.4 MCHC-35.4 RDW-27.5* RDWSD-84.0*
+___ 01:50PM   NEUTS-75.2* LYMPHS-13.8* MONOS-9.3 EOS-0.9* 
+BASOS-0.3 IM ___ AbsNeut-4.34 AbsLymp-0.80* AbsMono-0.54 
+AbsEos-0.05 AbsBaso-0.02
+___ 01:50PM   PLT COUNT-129*
+___ 01:50PM   ___
+___ 10:32AM   CREAT-1.3* SODIUM-129*
+___ 10:32AM   estGFR-Using this
+___ 10:32AM   ALT(SGPT)-31 AST(SGOT)-72* ALK PHOS-158* TOT 
+BILI-23.4*
+___ 10:32AM   ALBUMIN-3.6
+___ 10:32AM   ___
+
+DISCHARGE LABS:
+=================
+___ 07:50AM BLOOD WBC-4.5 RBC-2.46* Hgb-7.6* Hct-22.0* 
+MCV-89 MCH-30.9 MCHC-34.5 RDW-24.3* RDWSD-78.9* Plt Ct-65*
+___ 07:50AM BLOOD ___ PTT-35.5 ___
+___ 07:50AM BLOOD Glucose-136* UreaN-38* Creat-1.2* Na-132* 
+K-4.4 Cl-99 HCO3-20* AnGap-13
+___ 07:50AM BLOOD ALT-65* AST-139* AlkPhos-279* 
+TotBili-11.5*
+___ 07:50AM BLOOD Calcium-8.3* Phos-2.9 Mg-2.___ yo F with hx alcoholic cirrhosis c/b grade I varices, 
+malnutrition, and two recent hospitalizations for hepatic 
+encephalopathy referred directly from ___ clinic with 
+elevated bilirubin for expedited liver transplant work-up found 
+to have non-obstructive CAD in LAD, and on ___ had rotational 
+athrectomy and 2 drug-eluting stents placed, and resolving 
+transaminitis.
+
+ACUTE ISSUES
+#) Alcoholic cirrhosis, Child B/MELD ___ on admission, 26 on 
+___
+Patient initially presented from clinic with worsening 
+cholestasis of uncertain etiology. MRCP was negative for 
+cholangitis among other obstructive pathologies and infectious 
+work up has been negative. She recently had 3 teeth extracted, 
+so transient bacteremia may have contributed. No new medications 
+other than amoxicillin for dental prophylaxis and recent 
+intensification of colestipol. Now that patient is on aspirin 
+and Plavix, further evaluation of liver transplant will not 
+occur for 3 mo. 
+*Volume: She was hypervolemic, with increasing ascites based on 
+visual exam and weights. Continued Lasix and spironolactone as 
+tolerated by kidney.
+She received albumin. 
+*Infection: patient had ascites, but no fever, leukocytosis; 
+paracentesis was not performed as no strong clinical indication, 
+and currently on dual antiplatelet therapy
+*Bleeding: history of grade I varices. There was concern for 
+hemorrhage and CBC and coagulation parameters were at or above
+baseline.
+*Coagulopathy: INR 1.6; Platelets 65, up from 61 ___.
+*Encephalopathy: history of hepatic encephalopathy, though was
+entirely appropriate and oriented here. She was continued on 
+lactulose and rifaximin. 
+*Nutrition: nutrition evaluation for history of malnutrition.
+previously Started on Zinc Sulfate. She continued her home 
+dicyclomine. Her home ___ was held. 
+
+#) Coronary artery disease, non-obstructive: by CT coronary
+(CAD-RADS ___. Unremarkable nuclear exercise tolerance test. 
+Grade II diastolic dysfunction without focal wall motion 
+abnormality. Diagnostic
+catheterization ___ showed severe proximal LAD stenosis (80%) 
+and mild LCx disease. Per Cardiology recommendation and 
+agreement of Liver transplant
+team, was started on Plavix and aspirin. On ___, she underwent 
+rotational athrectomy and had 2 drug eluting stents placed ___ 
+for a single vessel mid-LAD epicardial CAD. This procedure will 
+temporarily preclude her status 
+for liver transplant due the necessity of Plavix for the next 3
+months. EF 73%n (___). She was started on atorvastatin. 
+
+___
+Cr increased from 0.9-1.0 baseline to 1.2. Given severe 
+cirrhosis, hepatorenal disease was considered. She received 25 g 
+albumin x1 with improvement. 
+
+#Anemia
+Hgb stable. No evidence of acute bleeding
+
+#Hyponatremia
+Improving on discharge. Likely hypervolemic hyponatremia in 
+context of
+decompensated cirrhosis.
+
+CHRONIC ISSUES:
+===============
+#GERD: pantoprazole changed to omeprazole 40 mg daily because of 
+better side effect profile with dual antiplatelet therapy 
+
+TRANSTIONAL ISSUES
+==================
+[] Pt will require 3mo aspirin+plavix following ___ cardiac 
+cath with placement of two drug-eluting stents in LAD.
+[] Please check labs on ___. 
+[] Will f/u ___ with Liver and ___ with Cards.
+
+CODE: Full
+CONTACT: Health care proxy chosen: Yes 
+Name of health care proxy: ___ 
+___: daughter 
+Phone number: ___ 
+___ on date: ___ 
+ 
+
+###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}, ALBUMIN {Albumin 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}, RDWSD {Red cell distribution width determination}, NEUTS {Neutrophil count}, LYMPHS {Lymphocyte count}, MONOS {Monocyte count}, EOS {Eosinophil count}, CREAT {Creatinine measurement}, SODIUM {Sodium measurement}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, PHOS {Phosphate, total measurement}, ALBUMIN {Albumin 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}, 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}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, alcoholic cirrhosis {Alcoholic cirrhosis}, varices {Esophageal varices}, malnutrition {Nutritional disorder}, hepatic 
+encephalopathy {Hepatic encephalopathy}, elevated bilirubin {Bilirubin level above reference range}, liver transplant {Transplantation of liver}, work-up {Evaluation procedure}, CAD {Coronary arteriosclerosis}, LAD {Structure of anterior descending branch of left coronary artery}, rotational 
+athrectomy {Atherectomy by rotary cutter}, drug-eluting stents placed {Endovascular insertion of drug eluting stent}, transaminitis {Aspartate transaminase level above reference range}, Alcoholic cirrhosis {Alcoholic cirrhosis}, cholestasis {Cholestasis}, MRCP {Magnetic resonance cholangiopancreatography}, cholangitis {Cholangitis}, infectious {Infectious disease}, work up {Evaluation procedure}, teeth extracted {Tooth extraction}, bacteremia {Bacteremia}, prophylaxis {Preventive procedure}, aspirin {Administration of aspirin}, evaluation {Evaluation procedure}, liver transplant {Transplantation of liver}, hypervolemic {Hypervolemia}, ascites {Ascites}, visual exam {Inspection}, weights {Weight finding}, kidney {Kidney structure}, received albumin {Administration of albumin}, Infection {Infectious disease}, ascites {Ascites}, fever {Fever}, leukocytosis {Leukocytosis}, paracentesis {Abdominal paracentesis}, antiplatelet therapy {Platelet aggregation inhibitor therapy}, Bleeding {Bleeding}, varices {Esophageal varices}, hemorrhage {Hemorrhage}, CBC {Complete blood count}, coagulation {Blood coagulation panel}, baseline {Baseline state}, Coagulopathy {Blood coagulation disorder}, Platelets {Finding of platelet count}, Encephalopathy {Disorder of brain}, hepatic encephalopathy {Hepatic encephalopathy}, oriented {Orientated}, Nutrition {Nutritional finding}, nutrition {Nutritional finding}, evaluation {Evaluation procedure}, malnutrition {Nutritional disorder}, Coronary artery disease {Coronary arteriosclerosis}, CT coronary {Computed tomography angiography of coronary artery with contrast}, CAD {Coronary arteriosclerosis}, RADS {Reactive airway disease}, exercise tolerance test {Exercise tolerance test}, diastolic dysfunction {Diastolic dysfunction}, focal wall motion 
+abnormality {Left ventricular wall motion abnormality}, catheterization {Cardiac catheterization}, proximal LAD stenosis {Stenosis of proximal portion of anterior descending branch of left coronary artery}, LCx {Structure of circumflex branch of left coronary artery}, disease {Disease}, Cardiology {Cardiology service}, Liver transplant {Transplantation of liver}, aspirin {Administration of aspirin}, rotational athrectomy {Atherectomy by rotary cutter}, drug eluting stents placed {Endovascular insertion of drug eluting stent}, single vessel {Single coronary vessel disease}, mid-LAD {Structure of mid portion of anterior descending branch of left coronary artery}, CAD {Coronary arteriosclerosis}, liver transplant {Transplantation of liver}, hepatorenal disease {Hepatorenal syndrome}, albumin {Administration of albumin}, improvement {Patient's condition improved}, Anemia {Anemia}, Hgb {Measurement of total hemoglobin concentration}, stable {Patient's condition stable}, acute bleeding {Acute hemorrhage}, Hyponatremia {Hyponatremia}, hypervolemic {Hypervolemia}, hyponatremia {Hyponatremia}, decompensated cirrhosis {Decompensated cirrhosis of liver}, GERD {Gastroesophageal reflux disease}, antiplatelet therapy {Platelet aggregation inhibitor therapy}, aspirin {Administration of aspirin}, cardiac 
+cath {Cardiac catheterization}, placement {Implantation procedure}, drug-eluting stents {Endovascular insertion of drug eluting stent}"
+"###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. Ondansetron 4 mg PO DAILY:PRN nausea 
+2. Lactulose 30 mL PO TID 
+3. DICYCLOMine 10 mg PO BID:PRN abdominal pain 
+4. colestipol 4 mg oral BID 
+5. DiphenhydrAMINE 25 mg PO QHS 
+6. Ferrous Sulfate 325 mg PO DAILY 
+7. Furosemide 20 mg PO DAILY 
+8. Spironolactone 25 mg PO BID 
+9. Multivitamins 1 TAB PO DAILY 
+10. Omeprazole 20 mg PO DAILY 
+11. Rifaximin 550 mg PO BID 
+12. Viactiv (calcium-vitamin D3-vitamin K) 500-500-40 
+mg-unit-mcg oral DAILY 
+
+ 
+Discharge Medications:
+1.  Aspirin 81 mg PO DAILY 
+RX *aspirin [Adult Aspirin Regimen] 81 mg 1 tablet(s) by mouth 
+daily Disp #*30 Tablet Refills:*0 
+2.  Atorvastatin 40 mg PO QPM 
+RX *atorvastatin 40 mg 1 tablet(s) by mouth Nightly Disp #*30 
+Tablet Refills:*0 
+3.  Clopidogrel 75 mg PO DAILY 
+RX *clopidogrel 75 mg 1 tablet(s) by mouth daily Disp #*30 
+Tablet Refills:*0 
+4.  HydrOXYzine 25 mg PO QHS:PRN itching, sleeping 
+RX *hydroxyzine HCl 25 mg 1 tab by mouth at bedtime Disp #*30 
+Tablet Refills:*0 
+5.  Zinc Sulfate 220 mg PO DAILY 
+RX *zinc sulfate 220 mg (50 mg zinc) 1 capsule(s) by mouth daily 
+Disp #*30 Capsule Refills:*0 
+6.  DICYCLOMine 10 mg PO BID:PRN abdominal pain  
+7.  DiphenhydrAMINE 25 mg PO QHS  
+8.  Ferrous Sulfate 325 mg PO DAILY  
+9.  Furosemide 20 mg PO DAILY  
+10.  Lactulose 30 mL PO TID  
+11.  Multivitamins 1 TAB PO DAILY  
+12.  Omeprazole 20 mg PO DAILY  
+13.  Ondansetron 4 mg PO DAILY:PRN nausea  
+14.  Rifaximin 550 mg PO BID  
+15.  Spironolactone 25 mg PO BID  
+16.  Viactiv (calcium-vitamin D3-vitamin K) 500-500-40 
+mg-unit-mcg oral DAILY  
+17. HELD- colestipol 4 mg oral BID  This medication was held. Do 
+not restart colestipol until cleared by your doctors. 
+
+ 
+
+###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:
+Cirrhosis with portal hypertension
+Decompensated liver failure with ascites, jaundice and 
+coagulopathy
+Coronary artery disease
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Cirrhosis {Cirrhosis of liver}, portal hypertension {Portal hypertension}, liver failure {Hepatic failure}, ascites {Ascites}, jaundice {Jaundice}, coagulopathy {Blood coagulation disorder}, Coronary artery disease {Coronary arteriosclerosis}, Mental Status {Neurological mental status determination}, 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. ___,
+
+You were admitted to ___ with abnormal liver tests. We think 
+this may have been related to your recent dental surgery. Your 
+numbers improved without intervention. While here, you had a 
+catheterization of your heart which showed one of your heart 
+vessels was partially blocked. You had two stents put in to keep 
+it open. Your liver tests were improving and you continued to be 
+well on discharge. Please get your labs drawn before your 
+appointment with Dr. ___ see him ___. It was a pleasure 
+being involved in your care. 
+
+Wishing you the best, 
+
+Your ___ Team 
+ 
+
+###RESPONSE: abnormal liver tests {Liver function tests outside reference range}, dental surgery {Dental surgical procedure}, improved {Patient's condition improved}, catheterization of your heart {Cardiac catheterization}, heart 
+vessels {Coronary artery structure}, stents {Insertion of arterial stent}, liver tests {Hepatic function panel}"
+"###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: 
+Iodine Containing Agents Classifier / Spironolactone / Asacol
+ 
+Attending: ___
+ 
+Chief Complaint:
+Fevers, tremors, chills. 
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: Iodine {Allergy to iodine compound}, Spironolactone {Allergy to spironolactone}, Fevers {Fever}, tremors {Tremor}, 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: History of Present Illness:
+patient is a ___ man with history of atrial fibrillation 
+on coumadin and ulcerative colitis s/p recent admission for 
+lower GIB (on prednisone taper) who presents from home with 
+fevers and chills.
+.
+On initial evaluation in the ED, his vitals were T 101, HR 84, 
+BP 146/112, RR 16, sat 96% ___. Labs notable for white count of 
+1.3 (69% polys, 14% lymphs, no bands) - down from recent 1.3 - 
+with hct 33 (stable at baseline), lactate 3.0, normal LFTs, INR 
+2.4 (on coumadin). Creatinine was 1.3 (at baseline). CXR showed 
+no acute cardiopulmonary process. UA was normal. Blood and urine 
+cultures were drawn and patient given vancomycin 1g and Zosyn in 
+addition to 500 mg Tylenol. GI was contacted in the ED and 
+advised admit to medicine, can consult if needed. Patient was 
+then admitted for further work-up.
+.
+Of note, patient was recently admitted ___ for diarrhea 
+that was felt to be secondary to UC. Patient underwent 
+colonoscopy on ___ that showed luminal narrowing at the sigmoid 
+with mild colitis; biopsies showed active colitis with no 
+evidence of malignancy. He was started on prednisone 40 mg daily 
+and asacol 800 mg tid with marked improvement in his symptoms. 
+Infectious GI workup was negative; biopsy for CMV was negative. 
+Patient was discharged with a slow prednisone taper and 
+increased dose of Asacol to 1600 mg tid. Omeprazole was also 
+added during that admission. Hydrochlorothiazide, lisinopril, 
+and colchicine were all stopped. 
+ 
+
+###RESPONSE: atrial fibrillation {Atrial fibrillation}, ulcerative colitis {Ulcerative colitis}, lower GIB {Lower gastrointestinal hemorrhage}, fevers {Fever}, chills {Chill}, evaluation {Evaluation procedure}, vitals {Vital signs finding}, T {Body temperature finding}, HR {Finding of heart rate}, BP {Blood pressure finding}, RR {Finding of rate of respiration}, sat {Finding of oxygen saturation}, Labs {Laboratory test}, lactate {Lactic acid measurement}, normal LFTs {Liver function tests within reference range}, CXR {Plain chest X-ray}, UA {Urinalysis}, normal {No abnormality detected}, urine 
+cultures {Urine culture}, diarrhea {Diarrhea}, UC {Ulcerative colitis}, colonoscopy {Colonoscopy}, narrowing {Narrowing}, sigmoid {Sigmoid colon structure}, colitis {Colitis}, biopsies {Biopsy}, colitis {Colitis}, no 
+evidence of malignancy {No evidence of malignant neoplasm}, Infectious GI {Infection of gastrointestinal tract}, biopsy {Biopsy}, CMV {Cytomegalovirus infection}"
+"###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:
+1. Atrial fibrillation
+2. Hypertension 
+3. Peripheral vascular disease
+4. Chronic renal insufficiency: Baseline Cr=1.3-1.6
+5. Impaired fasting glucose 
+6. Chronic lower extremity edema 
+7. h/o prostate cancer
+8. Hyperlipidemia 
+9. Gout
+10. Erectile dysfunction
+11. OSA 
+12. History of melanoma
+13. Restless leg syndrome
+14. Osteoarthritis
+15. h/o tremor
+ 
+
+###RESPONSE: Atrial fibrillation {Atrial fibrillation}, Hypertension {Hypertensive disorder, systemic arterial}, Peripheral vascular disease {Peripheral vascular disease}, Chronic renal insufficiency {Chronic renal insufficiency}, Impaired fasting glucose {Impaired fasting glycemia}, Chronic {Chronic edema}, lower extremity edema {Edema of lower extremity}, prostate cancer {Carcinoma of prostate}, Hyperlipidemia {Hyperlipidemia}, Gout {Inflammatory disorder due to increased blood urate level}, Erectile dysfunction {Erectile dysfunction}, OSA {Obstructive sleep apnea syndrome}, melanoma {Malignant melanoma of skin}, Restless leg syndrome {Restless legs}, Osteoarthritis {Osteoarthritis}, tremor {Tremor}"
+"###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:
+Brother - died of stomach cancer.  
+Father - ___ Disease 
+Mother - ___ Disease.
+ 
+
+###RESPONSE: died {Dead}, 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:
+Vitals: 97 86 110/70 18 97RA
+General: Pleasant, laughing, elderly man in NAD
+HEENT: MMM
+Neck: Supple
+Lungs: CTAB, no WRR
+Heart: RRR, no RMG, no JVD
+Abdomen: Soft, NTND, +BS
+Extremities: No edema 
+ 
+
+###RESPONSE: Vitals {Vital signs finding}, RA {Breathing room air}, General {General examination of patient}, laughing {Laughing}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, MMM {Moist oral mucosa}, Neck {Physical examination procedure}, Supple {Normal movement of neck}, Lungs {Examination of respiratory system}, CTAB {Normal breath sounds}, WRR {Finding of rate of respiration}, Heart {Cardiovascular physical examination}, RRR {Normal heart rate}, no RMG {Heart sounds normal}, JVD {Jugular venous engorgement}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, ND {Swollen abdomen}, +BS {Normal bowel sounds}, Extremities {Examination of limb}, 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:
+___ 08:55AM BLOOD WBC-1.3*# RBC-3.64* Hgb-10.7* Hct-33.0* 
+MCV-91 MCH-29.4 MCHC-32.4 RDW-15.0 Plt ___
+___ 08:55AM BLOOD Neuts-69.4 Lymphs-14.8* Monos-4.2 
+Eos-10.9* Baso-0.8
+___ 08:55AM BLOOD ___ PTT-33.7 ___
+___ 08:55AM BLOOD Glucose-234* UreaN-35* Creat-1.3* Na-137 
+K-4.2 Cl-99 HCO3-26 AnGap-16
+___ 08:55AM BLOOD ALT-39 AST-25 LD(LDH)-225 AlkPhos-70 
+Amylase-31 TotBili-0.4
+___ 06:50AM BLOOD Calcium-7.9* Phos-1.9* Mg-1.6
+___ 11:15AM BLOOD %HbA1c-7.2* eAG-160*
+___ 09:05AM BLOOD Lactate-3.0* K-4.1
+___ 08:05PM BLOOD Lactate-3.5*
+___ 10:05AM BLOOD Lactate-2.5*
+___ 07:15AM BLOOD Lactate-1.8
+
+___   Radiology ABDOMEN (SUPINE & ERECT  There are 
+multiple segments of dilated small bowel. Air is seen within the
+colon. No ___ colon identified. No pathologically dilated 
+bowel. Findings
+concerning for small-bowel obstruction, however. Surgical clips 
+are
+identified in the pelvis.  
+   
+___   Radiology CHEST (PA & LAT)  PA AND LATERAL CHEST 
+RADIOGRAPHS: The cardiomediastinal silhouette is stable.
+There is stable mild hilar prominence. The lungs are well 
+expanded and clear.
+The pleural surfaces are smooth without pleural effusions or 
+pneumothorax.
+IMPRESSION: No acute cardiopulmonary abnormality.
+ 
+
+###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}, Baso {Basophil 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}, 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}, eAG {Glucose measurement estimated from glycated hemoglobin}, K {Blood potassium measurement}, ABDOMEN {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, small bowel {Structure of small intestine}, colon {Colon structure}, colon {Colon structure}, dilated 
+bowel {Dilatation of intestine}, small-bowel obstruction {Small bowel obstruction}, pelvis {Structure of pelvis}, CHEST (PA & LAT) {Diagnostic radiography of chest, combined posteroanterior and lateral}, PA AND LATERAL CHEST 
+RADIOGRAPHS {Diagnostic radiography of chest, combined posteroanterior and lateral}, stable {Patient's condition stable}, stable {Patient's condition stable}, hilar {Structure of hilum of lung}, lungs {Lung structure}, pleural surfaces {Pleural membrane structure}, pleural effusions {Pleural effusion}, pneumothorax {Pneumothorax}"
+"###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:
+ASSESSMENT AND PLAN: ___ man with recent diagnosis of 
+ulcerative colitis presenting with fevers and rigors.
+.
+# Fevers, chills, near neutropenia. Patient initially with ___ 
+SIRS criteria positive with leukopenia and fever, however no 
+clear source for infection as pt without symptoms. Suspected GI 
+source as a possible cause, possibly a superimposed infectious 
+colitis on top of patient's ulcerative colitis. Emperic 
+vancomycin and zosyn was started given the patient was 
+borderline neutrapenic (ANC of 897 initially), however abx were 
+dc'd as pts neutropenia improved with cessation of asacol and pt 
+was without abd pain or focal sxs to suggest a source. Urine and 
+stool cxs were negative, blood cxs still pending on discharge 
+and will need to be followed up on dc.
+.
+# Neutropenia. Probably secondary to Asacol. Resolved after 
+DC'ing asachol. 
+.
+# Ulcerative colitis. Continued prednidone, pt dc'd on 35 mg q 
+day with instructions to decrease to 30 mg in one week and 
+continue until told to stop by GI. DC'd mesalamine. Continued 
+omeprazole for gastric protection.  He was also dc'd on humalog 
+sliding scale given elevated sugars while in house.  He will 
+receive teaching by ___ and can be weaned off insulin as an 
+outpt as prednisone is weaned.
+.
+# Atrial fibrillation. Patient with CHADs score of 2. Continued 
+coumadin while inpt, however held on discharged for 
+supratherapeutic INR.  He will f/u in ___ clinic two 
+days post discharge.
+
+# Hypertension. Held Lasix in the setting of acute infection. 
+Was restarted on ___ home dose, may need to be uptitrated in the 
+outpt setting.
+.
+# Gout. During his previous admission, patient suffered an acute 
+flare of gout in his left finger and bilateral toes. His 
+symptoms improved with prednisone. No sx of gout this admission. 
+Continued febuxostat.
+
+# CKD baseline creatinine 1.1-1.3 probably HTN induced. Remained 
+at baseline.
+ 
+
+###RESPONSE: ulcerative colitis {Ulcerative colitis}, fevers {Fever}, rigors {Rigor}, Fevers {Fever}, chills {Chill}, neutropenia {Neutropenia}, SIRS {Systemic inflammatory response syndrome}, leukopenia {Leukopenia}, fever {Fever}, infectious 
+colitis {Infectious colitis}, ulcerative colitis {Ulcerative colitis}, neutrapenic {Neutropenia}, neutropenia {Neutropenia}, improved {Patient's condition improved}, abd pain {Abdominal pain}, Urine {Urine culture}, Neutropenia {Neutropenia}, Ulcerative colitis {Ulcerative colitis}, sliding scale {Sliding scale insulin regime}, elevated sugars {Glucose level above reference range}, Atrial fibrillation {Atrial fibrillation}, Hypertension {Hypertensive disorder, systemic arterial}, acute infection {Acute infectious disease}, Gout {Inflammatory disorder due to increased blood urate level}, acute 
+flare of gout {Acute gout}, left finger {Structure of all fingers of left hand}, toes {Structure of all toes}, improved {Patient's condition improved}, gout {Inflammatory disorder due to increased blood urate level}, CKD {Chronic kidney disease}, creatinine {Serum creatinine within reference range}, HTN {Hypertensive disorder, systemic arterial}"
+"###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:
+- atenolol 25 mg daily
+- febuxostat 80 mg daily
+- clobetasol 0.05% ointment topical daily prn
+- furosemide 40 mg daily
+- omeprazole 40 mg daily
+- warfarin 2.5-5.0 mg daily as directed
+- lovastatin 40 mg daily at bedtime
+- prednisone taper (current dose should be 10 mg daily)
+- mesalamine 1600 mg tid 
+ 
+Discharge Medications:
+1. Lovastatin 40 mg Tablet Sig: One (1) Tablet PO once a day.  
+2. Prednisone 10 mg Tablet Sig: 3.5 Tablets PO DAILY (Daily): 
+decrease your dose to 30 mg/day in 7 days, continue at that dose 
+until you are told to change/stop by your doctor.
+Disp:*30 Tablet(s)* Refills:*2*
+3. Atenolol 25 mg Tablet Sig: One (1) Tablet PO once a day.  
+4. Lasix 40 mg Tablet Sig: ___ Tablet PO once a day.  
+5. Febuxostat 40 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 
+ 
+6. Clobetasol 0.05 % Ointment Sig: One (1)  Topical once a day.  
+
+7. Omeprazole 40 mg Capsule, Delayed Release(E.C.) Sig: One (1) 
+Capsule, Delayed Release(E.C.) PO once a day.  
+8. Insulin Lispro 100 unit/mL Solution Sig: One (1)  
+Subcutaneous ASDIR (AS DIRECTED): per sliding scale  until your 
+doctor tells you to stop.
+Disp:*100 units* Refills:*2*
+9. Outpatient Lab Work
+Please go to coagulation clinic on ___ to have your INR 
+checked
+10. Lancets     Misc Sig: One (1)  Miscellaneous four times a 
+day.
+Disp:*120 * Refills:*2*
+11. Syringe (Disposable)     Syringe Sig: One (1) 0.5 cc syringe 
+Miscellaneous four times a day: 0.5 cc syringe.
+Disp:*120 syringes* Refills:*2*
+12. test strip  Sig: One (1) strip  four times a day: Please 
+provide 120 test strips, 2 refills.
+Disp:*120 * Refills:*2*
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+1) Fever
+2) Ulcerative colitis 
+3) Diarrhea 
+4) Neutropenia
+5) Steroid-induced hyperglycemia
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, Fever {Fever}, Ulcerative colitis {Ulcerative colitis}, Diarrhea {Diarrhea}, Neutropenia {Neutropenia}, Steroid-induced hyperglycemia {Steroid-induced hyperglycemia}, 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:
+It was a pleasure to take care of you here at ___. You were 
+admitted for fevers and chills. Fortunately a complete 
+infectious work up was negative. You remained without a fever. 
+You were started on antiobiotics but these were discontinued as 
+you continued to improve and had no source of infection. Your 
+fevers and chills were thought to be most likely secondary to a 
+viral syndrome or your ulcerative colitis. 
+.
+We have made the following changes to your medications: 
+-STOP taking mesalamine as it lowered your white cell count
+-CONTINUE taking prednisone.  You should continue taking 35 mg 
+for 7 days, then decrease your dose by 5 mg and continue taking 
+30 mg until your doctor tells you to stop.
+-STOP taking warfarin until you are told to start by 
+anticoagulation clinc (you should have your INR drawn on ___
+-decrease your furosemide (lasix) to 20 daily
+-start taking insulin per sliding scale instructions four times 
+a day
+.
+Please call your doctor or return to the hospital if your 
+symptoms worsen or if you develop new symptoms including chest 
+pain or shortness of breath. 
+ 
+
+###RESPONSE: fevers {Fever}, chills {Chill}, infectious {Infectious disease}, fever {Fever}, antiobiotics {Antibiotic therapy}, infection {Infectious disease}, fevers {Fever}, chills {Chill}, viral syndrome {Nonspecific syndrome suggestive of viral illness}, ulcerative colitis {Ulcerative colitis}, changes to your medications {Change of medication}, cell count {Cell count}, lasix {Diuretic therapy}, sliding scale {Sliding scale insulin regime}, chest 
+pain {Chest pain}, shortness of breath {Dyspnea}"
+"###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: 
+Fragmin / levofloxacin
+ 
+Attending: ___.
+ 
+Chief Complaint:
+fever, cough, pleuritic pain
+ 
+Major Surgical or Invasive Procedure:
+none
+ 
+
+###RESPONSE: Fragmin {Allergy to dalteparin}, levofloxacin {Allergy to levofloxacin}, fever {Fever}, cough {Cough}, pleuritic pain {Pleuritic 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:
+Mr. ___ is a ___ history of HIV (""Good CD4 count"", VL 
+undetecable) who presents with 2 days of fevers, shourtness of 
+beath, yellow productive cough, pleuritic chest pain on his 
+right side. He reports fever of 104 on ___ and then onset of 
+cough productive of yellow/greenish sputum, shortness of breath 
+and pleuritic chest pain.  Decrease appetite with poor po 
+intake. No recent travel outside the the country; no sick 
+contact; no unprotected sexual intercourse. 
+
+In the ED, initial vitals were: 101 96 126/63 22 96% RA 
+- Labs were significant for WBC 24k with left shift.  Chem 10 
+remarkable for Na 131, BUN/Cr ___.  Flu negative. CXR 
+revealed multifocal pneumonia. Patient received vancomycin and 
+levofloxacin, albuterol/ipratropium nebs and admitted for 
+further care. 
+
+On the floor, the patient is complaining of ongoing right sided 
+pleuritic chest pain. He is comfortable on room air. 
+
+Of note, Mr. ___ endorses a history of previous pneumonias that 
+have required hospitalization but never intubation. He has been 
+treated with levofloxavin several times but recently noted the 
+developement of a rash. 
+
+REVIEW OF SYSTEMS:
+(+) Per HPI  
+(-) Denies headache, sinus tenderness, rhinorrhea or congestion. 
+ Denies nausea, vomiting, diarrhea, constipation or abdominal 
+pain. No recent change in bowel or bladder habits. No dysuria. 
+Denies arthralgias or myalgias. 
+
+ 
+
+###RESPONSE: HIV {Human immunodeficiency virus infection}, Good {Patient's condition satisfactory}, VL {Viral load}, undetecable {No abnormality detected}, fevers {Fever}, shourtness of 
+beath {Dyspnea}, yellow productive cough {Productive cough-yellow sputum}, pleuritic chest pain {Pleuritic pain}, right {Skin structure of right half of chest}, fever {Fever}, cough productive of yellow {Productive cough-yellow sputum}, greenish sputum {Productive cough -green sputum}, shortness of breath {Dyspnea}, pleuritic chest pain {Pleuritic pain}, Decrease appetite {Decrease in appetite}, poor po 
+intake {Inadequate oral food intake for physiological needs}, travel outside the the country {Travel abroad}, unprotected sexual intercourse {Unprotected sexual intercourse}, vitals {Vital signs finding}, RA {Breathing room air}, WBC {White blood cell count}, left shift {Left shifted white blood cells}, Flu {Influenza}, negative {No abnormality detected}, CXR {Plain chest X-ray}, pneumonia {Pneumonia}, vancomycin {Antibiotic therapy}, levofloxacin {Antibiotic therapy}, right sided {Right pleura structure}, pleuritic chest pain {Pleuritic pain}, on room air {Breathing room air}, pneumonias {Pneumonia}, intubation {Insertion of endotracheal tube}, levofloxavin {Antibiotic therapy}, rash {Eruption of skin}, headache {Headache}, sinus tenderness {Tenderness over frontal sinus}, rhinorrhea {Nasal discharge}, congestion {Nasal congestion}, nausea, vomiting, diarrhea {Nausea, vomiting and diarrhea}, constipation {Constipation}, abdominal 
+pain {Abdominal pain}, change in bowel {Altered bowel function}, bladder habits {Alteration in patterns of urinary elimination}, dysuria {Dysuria}, arthralgias {Joint pain}, myalgias {Muscle 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: Past Medical History:
+- HIV with undetectable viral load and CD4 of 395 as of ___.
+- Depression
+- HSV
+- recurrent pneumonias
+- Positive PPD s/p INH therapy
+
+ 
+
+###RESPONSE: HIV {Human immunodeficiency virus infection}, undetectable {No abnormality detected}, viral load {Viral load}, Depression {Depressive disorder}, recurrent pneumonias {Recurrent pneumonia}, Positive PPD {Mantoux: positive}, INH therapy {Tuberculosis management program}"
+"###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:
+No family history of allergies to medications. Otherwise 
+non-contributory
+ 
+
+###RESPONSE: allergies to medications {Non-allergic hypersensitivity to drug or medicament}"
+"###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:
+=============================
+Vitals: 98.1  168/75  76  97%RA
+General: Alert, oriented, no acute distress
+HEENT: Sclera anicteric, dry mucous mebranes, no tonsilla 
+exudates
+Neck: Supple, JVP not elevated, no LAD
+CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs
+Lungs: Unlabored breathing, rhonchi left lower and right lower 
+lobes with positive egophony, no wheezing 
+Abdomen: Soft, non-tender, non-distended
+Ext: Warm, well perfused
+Skin: no rashes
+
+DISCHARGE PHYSICAL EXAM: 
+============================
+Vitals: 98.7 ___ 66-70 18 97RA ___ 
+IO - MN: 895/500
+General: Alert, oriented, no acute distress, speaking in full 
+sentences
+HEENT: Sclera anicteric, dry mucous mebranes, no tonsilla 
+exudates
+Neck: Supple, JVP not elevated, no LAD
+CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs
+Lungs: Unlabored breathing, rhonchi left lower and right lower 
+lobes with positive egophony, no wheezing 
+Abdomen: Soft, non-tender, non-distended
+Ext: Warm, well perfused
+Skin: No rashes complete resolution of pruritic erythematous 
+papules over arms, neck and legs. 
+
+ 
+
+###RESPONSE: PHYSICAL EXAM {Physical examination procedure}, Vitals {Vital signs finding}, RA {Breathing room air}, General {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, distress {Distress}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, dry mucous mebranes {Mucous membrane dryness}, tonsilla 
+exudates {Exudate on tonsils}, Neck {Physical examination procedure}, Supple {Normal movement of neck}, JVP not elevated {Normal jugular venous pressure}, 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<}, murmurs {Murmur}, rubs {Pericardial friction rub}, Lungs {Examination of respiratory system}, labored breathing {Labored breathing}, rhonchi {Wheeze - rhonchi}, left lower {Structure of lower lobe of left lung}, right lower 
+lobes {Structure of lower lobe of right lung}, egophony {Egophony}, wheezing {Wheezing}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, non-tender {Abdominal tenderness}, Ext {Examination of limb}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, Skin {Examination of skin}, rashes {Eruption of skin}, PHYSICAL EXAM {Physical examination procedure}, Vitals {Vital signs finding}, RA {Breathing room air}, IO {Measuring intake and output}, General {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, distress {Distress}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, dry mucous mebranes {Mucous membrane dryness}, tonsilla 
+exudates {Exudate on tonsils}, Neck {Physical examination procedure}, Supple {Normal movement of neck}, JVP not elevated {Normal jugular venous pressure}, 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<}, murmurs {Murmur}, rubs {Pericardial friction rub}, Lungs {Examination of respiratory system}, labored breathing {Labored breathing}, rhonchi {Wheeze - rhonchi}, left lower {Structure of lower lobe of left lung}, right lower 
+lobes {Structure of lower lobe of right lung}, egophony {Egophony}, wheezing {Wheezing}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, non-tender {Abdominal tenderness}, Ext {Examination of limb}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, Skin {Examination of skin}, rashes {Eruption of skin}, resolution {Problem resolved}, pruritic {Pruritic disorder of skin}, erythema {Erythema}, papules {Papule of skin}, arms {Upper limb structure}, neck {Neck structure}, legs {Lower limb 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: Pertinent Results:
+ADMISSION LABS: 
+======================
+___ 08:45PM BLOOD WBC-24.8*# RBC-4.50* Hgb-13.7* Hct-39.1* 
+MCV-87 MCH-30.4 MCHC-34.9 RDW-13.7 Plt ___
+___ 08:45PM BLOOD Neuts-83.5* Lymphs-11.1* Monos-4.7 
+Eos-0.6 Baso-0.1
+___ 08:45PM BLOOD Glucose-133* UreaN-19 Creat-0.9 Na-131* 
+K-4.2 Cl-96 HCO3-21* AnGap-18
+___ 05:10AM BLOOD Calcium-8.5 Phos-2.5* Mg-1.7
+___ 08:52PM BLOOD Lactate-1.6
+
+IMAGING: 
+======================
+CXR ___: Multifocal  pneumonia,  right  greater  than  left.
+
+MICRO: 
+======================
+__________________________________________________________
+___ 5:27 am SPUTUM      Source: Expectorated. 
+
+   GRAM STAIN (Final ___: 
+      <10 PMNs and >10 epithelial cells/100X field. 
+      Gram stain indicates extensive contamination with upper 
+respiratory
+      secretions. Bacterial culture results are invalid. 
+      PLEASE SUBMIT ANOTHER SPECIMEN. 
+
+   RESPIRATORY CULTURE (Final ___: 
+      TEST CANCELLED, PATIENT CREDITED. 
+
+   LEGIONELLA CULTURE (Preliminary): 
+__________________________________________________________
+___ 4:57 am URINE      Source: ___. 
+
+                            **FINAL REPORT ___
+
+   Legionella Urinary Antigen  (Final ___: 
+      NEGATIVE FOR LEGIONELLA SEROGROUP 1 ANTIGEN. 
+           (Reference Range-Negative). 
+      Performed by Immunochromogenic assay. 
+      A negative result does not rule out infection due to other 
+L.
+      pneumophila serogroups or other Legionella species. 
+Furthermore, in
+      infected patients the excretion of antigen in urine ___ 
+vary. 
+__________________________________________________________
+___ 8:45 pm BLOOD CULTURE
+
+   Blood Culture, Routine (Pending): 
+__________________________________________________________
+___ 9:34 pm BLOOD CULTURE
+
+   Blood Culture, Routine (Pending): 
+
+DISCHARGE LABS: 
+======================
+___ 05:50AM BLOOD WBC-7.6# RBC-3.70* Hgb-11.2* Hct-33.1* 
+MCV-89 MCH-30.2 MCHC-33.8 RDW-13.7 Plt ___
+___ 05:50AM BLOOD Neuts-62.4 ___ Monos-5.9 Eos-1.0 
+Baso-0.3
+___ 05:50AM BLOOD ___ PTT-28.1 ___
+___ 05:50AM BLOOD Glucose-91 UreaN-11 Creat-0.5 Na-139 
+K-3.9 Cl-107 HCO3-22 AnGap-14
+___ 05:50AM BLOOD ALT-20 AST-23 LD(LDH)-129 AlkPhos-69 
+TotBili-0.2
+___ 05:50AM BLOOD Calcium-8.2* Phos-2.7 Mg-1.___ history of HIV (CD4 395, VL undetecable) who presents with 2 
+days of fevers, shortness of beath, yellow productive cough, 
+pleuritic chest pain with CXR showing multifocal pneumonia. 
+
+# Multifocal Community Acquired Pneumonia: Most likely from 
+non-opportunistic organisms such as strep pneumonia or 
+atypicals. Per patient he has been very compliant with his HIV 
+med and last CD4 count was 395 and VL undetectable therefore 
+making opportunistic infection such as PCP less likely. He is 
+currently hemodynamically stable with normal lactate and normal. 
+Creatinine suggesting good organ perfusion. He recieved 
+levofloxacin and subsequently developed a rash, which has also 
+been documented before so we will transition to alternate 
+antibiotic regimen for CAP.
+- Will treat for 8 day course of Augmentin + Azithromycin
+- Urine strep Ag pending at time of discharge.
+
+# Rash: Resolved. Mr. ___ developed a pruritic rash over arms, 
+neck and leg after administration of vancomycin and levofloxacin 
+in the ED. He improved with benadryl. He has a previous history 
+of rash documented at ___ that occurred after 
+administration of levofloxacin and fragmin. He tolerated 
+levofloxacin subsequently without rash so this medication was 
+continued at that time. The recurrence of this rash with 
+levofloxacin is concerning for a true allergy. As such we will 
+avoid this medication and transition to alternate treatment as 
+above.
+- levofloxacin allergy recorded at ___ and ___ 
+___
+
+# Hyponatremia: Sodium 131 on admission. This has been seen on 
+prior hospitalization. Likely hypovolemic hyponatremia as 
+improved with aggressive IV fluids. Sodium on discharge 136.
+# HIV: continue Stribild
+# Depression: continue Zoloft
+
+TRANSITIONAL:
+- complete 8 day course of augmentin and azithromycin
+- Per previous records, CT scan in ___ showed RUL nodule that 
+was most likely infectious in etiology. It was recommended that 
+followup CT be obtained when infectious symptoms had resolved.
+
+# CODE STATUS: Full Code 
+# CONTACT: Landlord ___ 
+
+ 
+
+###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}, 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}, IMAGING {Imaging}, CXR {Plain chest X-ray}, pneumonia {Pneumonia}, right {Right lung structure}, left {Left pleura structure}, SPUTUM {Microbial culture of sputum}, Expectorated {Does expectorate}, GRAM STAIN {Gram stain method}, cells {Cell structure}, Gram stain {Gram stain method}, upper 
+respiratory {Upper respiratory tract structure}, Bacterial culture {Bacterial culture}, RESPIRATORY {Structure of respiratory system}, CULTURE {Microbial culture}, LEGIONELLA {Legionella infection}, CULTURE {Microbial culture}, URINE {Evaluation of urine specimen}, Legionella {Legionella antigen assay}, Urinary {Evaluation of urine specimen}, NEGATIVE FOR LEGIONELLA SEROGROUP 1 ANTIGEN {Legionella pneumophila serogroup 1 antigen not detected}, Negative {No abnormality detected}, negative {No abnormality detected}, infection {Infectious disease}, urine {Evaluation of urine specimen}, CULTURE {Blood culture}, Blood Culture {Blood culture}, CULTURE {Blood culture}, Blood Culture {Blood culture}, 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}, 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}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, LDH {Serum lactate dehydrogenase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, HIV {Human immunodeficiency virus infection}, fevers {Fever}, shortness of beath {Dyspnea}, yellow productive cough {Productive cough-yellow sputum}, pleuritic chest pain {Pleuritic pain}, CXR {Plain chest X-ray}, pneumonia {Pneumonia}, Community Acquired Pneumonia {Community acquired pneumonia}, pneumonia {Pneumonia}, atypicals {Atypical pneumonia}, very compliant {Drug compliance good}, HIV {Human immunodeficiency virus infection}, med {Administration of drug or medicament}, VL {Viral load}, undetectable {No abnormality detected}, infection {Infectious disease}, PCP {Primary care management}, stable {Patient's condition stable}, normal {No abnormality detected}, lactate {Lactic acid measurement}, normal {No abnormality detected}, Creatinine {Creatinine measurement}, good organ perfusion {Normal organ or tissue vascular perfusion}, levofloxacin {Antibiotic therapy}, rash {Eruption of skin}, antibiotic {Antibiotic therapy}, regimen {Therapeutic regimen}, CAP {Community acquired pneumonia}, Urine {Evaluation of urine specimen}, Rash {Eruption of skin}, Resolved {Problem resolved}, pruritic rash {Pruritic rash}, arms {Upper limb structure}, neck {Cervical region back structure}, leg {Lower limb structure}, vancomycin {Antibiotic therapy}, levofloxacin {Antibiotic therapy}, improved {Patient's condition improved}, rash {Eruption of skin}, levofloxacin {Antibiotic therapy}, levofloxacin {Antibiotic therapy}, rash {Eruption of skin}, medication {Antibiotic therapy}, recurrence {Recurrent disease}, rash {Eruption of skin}, levofloxacin {Allergy to levofloxacin}, allergy {Allergic disposition}, medication {Antibiotic therapy}, levofloxacin allergy {Allergy to levofloxacin}, Hyponatremia {Hyponatremia}, hypovolemic {Hypovolemia}, hyponatremia {Hyponatremia}, improved {Patient's condition improved}, IV fluids {Administration of intravenous fluids}, HIV {Human immunodeficiency virus infection}, Depression {Depressive disorder}, augmentin {Antibiotic therapy}, azithromycin {Antibiotic therapy}, CT scan {Computed tomography of abdomen}, RUL {Structure of upper lobe of right lung}, nodule {Nodule of lung}, infectious {Infectious disease}, infectious {Infectious disease}, 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: Medications on Admission:
+The Preadmission Medication list is accurate and complete.
+1. Stribild 1 TAB PO DAILY 
+2. Sertraline 25 mg PO DAILY 
+
+ 
+Discharge Medications:
+1. Sertraline 25 mg PO DAILY 
+2. Stribild 1 TAB PO DAILY 
+3. Acetaminophen 1000 mg PO Q8H:PRN pain 
+RX *acetaminophen 500 mg 2 tablet(s) by mouth every 8 hours Disp 
+#*30 Tablet Refills:*0
+4. Amoxicillin-Clavulanic Acid ___ mg PO Q12H 
+RX *amoxicillin-pot clavulanate 875 mg-125 mg 1 tablet(s) by 
+mouth every 12 hours Disp #*13 Tablet Refills:*0
+5. Azithromycin 250 mg PO Q24H Duration: 4 Doses 
+RX *azithromycin 250 mg 1 tablet(s) by mouth daily Disp #*4 
+Tablet Refills:*0
+
+ 
+
+###RESPONSE: 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: Community Acquired Pneumonia
+SECONDARY: HIV (well controlled), Depression
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Community Acquired Pneumonia {Community acquired pneumonia}, HIV {Human immunodeficiency virus infection}, well controlled {Disease condition determination, well controlled}, Depression {Depressive disorder}, Mental Status {Neurological mental status determination}, Clear {No abnormality detected}, 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:
+Dear Mr. ___, 
+
+It was a pleasure meeting and taking care of you. You were 
+admitted with fever, cough and shortness of breath. You were 
+found to have a pneumonia on a chest radiograph. You were 
+initially treated with an antibiotic called levofloxacin, but 
+developed a rash to this medication. We believe you are allergic 
+to this medication as you have had a rash with it before. 
+Instead of this medication, you should take medications called 
+augmentin (a seven day course) and azithromycin (a four day 
+course) to complete 8 total days of antibiotics. You should also 
+followup with Dr. ___ as an outpatient. 
+
+We wish you the best, 
+
+Your ___ team  
+ 
+
+###RESPONSE: fever {Fever}, cough {Cough}, shortness of breath {Dyspnea}, pneumonia {Pneumonia}, chest radiograph {Plain chest X-ray}, antibiotic {Antibiotic therapy}, rash {Eruption of skin}, medication {Antibiotic therapy}, allergic 
+to this medication {Allergy to levofloxacin}, rash {Eruption of skin}, antibiotics {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: 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:
+syncopal episode with LOC, 2nd degree AV Block
+chronic atrial fibrillation with slow ventricular rate
+ 
+Major Surgical or Invasive Procedure:
+insertion of single chamber pacemaker
+
+ 
+
+###RESPONSE: No Known Allergies {Allergic disposition}, Adverse Drug Reactions {Propensity to adverse reactions to drug}, syncopal {Syncope}, LOC {Loss of consciousness}, AV Block {Atrioventricular block}, chronic atrial fibrillation {Chronic atrial fibrillation}, slow ventricular rate {Bradycardia}, insertion of single chamber pacemaker {Insertion of single chamber cardiac pacemaker pulse generator}"
+"###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:
+This is a ___ old male with a PMH significant for afib on 
+warfarin, HTN, hyperlipidemia and insulin dependent DM who 
+presented to the ED ___ after a fall with LOC. He awoke and 
+went to the bathroom, on his way back to the bed he
+blacked out and awoke on the floor. His wife heard the fall and 
+found him awake and alert on the floor. He does not remember 
+falling. He denies any lightheadedness, dizziness, 
+nausea,flushing, palpitations, or sudden weakness prior to the 
+fall. His wife did not note any jerking of his extremities and 
+there was no bowel or bladder incontinence, and he was not 
+confused
+immediately afterwards. He has never had any past episodes of 
+loss of consciousness. He normally walks for exercise and does 
+not note any chest pain, SOB, or lightheadedness with walking 1 
+mile. He reports remote transient episodes of lightheadedness 
+but no syncope and was thereafter diagnosed with atrial 
+fibrillation and started on Coumadin after that.
+
+ 
+
+###RESPONSE: afib {Atrial fibrillation}, on 
+warfarin {Warfarin therapy}, HTN {Hypertensive disorder, systemic arterial}, hyperlipidemia {Hyperlipidemia}, insulin dependent DM {Diabetes mellitus type 1}, fall {Falls}, LOC {Loss of consciousness}, blacked out {Syncope}, fall {Falls}, awake {Awake}, alert {Mentally alert}, lightheadedness {Lightheadedness}, dizziness {Dizziness}, nausea {Nausea}, flushing {Flushing}, palpitations {Palpitations}, weakness {Asthenia}, fall {Falls}, jerking {Spasmodic movement}, extremities {All extremities}, bowel {Incontinence of feces}, bladder incontinence {Urinary incontinence}, not 
+confused {Not confused}, loss of consciousness {Loss of consciousness}, exercise {Exercises}, chest pain {Chest pain}, SOB {Dyspnea}, lightheadedness {Lightheadedness}, lightheadedness {Lightheadedness}, syncope {Syncope}, atrial 
+fibrillation {Atrial fibrillation}, Coumadin {Anticoagulant 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:
+1. Diabetes: ___, his hemoglobin A1c was 7.8. Follows with 
+___.  
+2. Hypercholesterolemia: ___ total cholesterol of 173, HDL 
+46, LDL 114, triglycerides 63.  
+3. Hypertension:  
+4. Atrial fibrillation: dx ___. He underwent Holter monitor and 
+a stress test. On coumadin.  
+5. Erectile dysfunction: takes Viagra prn - has not taken this 
+in over one month  
+6. Cervical spondylosis  
+ 
+
+###RESPONSE: Diabetes {Diabetes mellitus}, hemoglobin {Hemoglobin finding}, Hypercholesterolemia {Hypercholesterolemia}, LDL {Low density lipoprotein cholesterol measurement}, Hypertension {Hypertensive disorder, systemic arterial}, Atrial fibrillation {Atrial fibrillation}, stress test {Electrocardiogram with exercise test}, coumadin {Anticoagulant therapy}, Erectile dysfunction {Erectile dysfunction}, Cervical spondylosis {Cervical spondylosis}"
+"###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 with alcoholism and DM. Mother is healthy at  
+age ___. Grandfather with diabetes in his ___.  
+ 
+
+###RESPONSE: alcoholism {Alcoholism}, DM {Diabetes mellitus}, diabetes {Diabetes mellitus}"
+"###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 ___:
+*Pertinent exam findings:
+VS: 97.6  158/90  59  18  98% RA
+Gen: A&OX3, NAD
+Neuro: Grossly intact. Swelling and erythema around L eye. 
+Neck/JVD: JVP normal
+CV: RR, nl S1, S2. No murmurs. 
+Chest: CTAB
+ABD: soft NT, ND
+Extr: No edema. WWP
+
+On Discharge:
+VS T 98.3 HR 56 RR 20 BP 116/65 98% RA
+Gen: A&Ox3, NAD
+Neuro: Grossly intact, no focal deficits, thoughts linear. 
+Improved edema and erythema about the left orbit. Steri-strips 
+intact. Moves all extremities w/o difficulty. L arm in sling.
+CV: RRR, S1, S2, no m/r/g
+Chest: CTAB
+ABD: soft, NT, obese +BS
+Extr: Mild effusion noted about left knee, small 1 cm abrasion, 
+cutaneous skin loss, no erythema or excess warmth, no drainage. 
++DP b/l
+
+ 
+
+###RESPONSE: VS {Vital signs finding}, RA {Breathing room air}, Gen {General examination of patient}, A {Mentally alert}, OX3 {Oriented to person, time and place}, NAD {No abnormality detected}, Neuro {Neurological examination}, Grossly intact {Normal nervous system function}, Swelling {Swelling of structure of eye}, erythema {Erythema}, L eye {Left eye structure}, JVD {Jugular venous engorgement}, JVP normal {Normal jugular venous pressure}, CV {Cardiovascular physical examination}, RR {Finding of rate of respiration}, nl S1, S2 {Heart sounds normal}, murmurs {Heart murmur}, Chest {Examination of respiratory system}, CTAB {Normal breath sounds}, ABD {Examination of abdomen}, soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, Extr {Examination of limb}, edema {Edema}, WWP {Normal tissue perfusion}, VS {Vital signs finding}, T {Body temperature finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, BP {Blood pressure finding}, RA {Breathing room air}, Gen {General examination of patient}, A {Mentally alert}, Ox3 {Oriented to person, time and place}, NAD {No abnormality detected}, Neuro {Neurological examination}, Grossly intact {Normal nervous system function}, no focal deficits {Normal nervous system function}, Improved {Patient's condition improved}, edema {Edema}, erythema {Erythema}, left orbit {Structure of left orbital region}, Steri-strips 
+intact {Application of adhesive skin closure}, Moves all extremities {Does move all four limbs}, L arm {Left upper arm structure}, in sling {Application of sling}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, S1, S2 {Heart sounds normal}, no m/r/g {Heart sounds normal}, Chest {Examination of respiratory system}, CTAB {Normal breath sounds}, ABD {Examination of abdomen}, soft {Abdomen soft}, NT {Abdominal tenderness}, obese {Obese abdomen}, +BS {Normal bowel sounds}, Extr {Examination of limb}, Mild {Symptom mild}, effusion {Effusion of joint of left knee}, left knee {Structure of left knee region}, abrasion {Dermabrasion}, cutaneous skin {Skin structure}, erythema {Erythema}, warmth {Joint warm}, drainage {Wound discharge}, +DP b/l {Dorsalis pulse present}"
+"###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:
+___ 05:35AM BLOOD WBC-6.6 RBC-5.32 Hgb-11.7* Hct-38.1* 
+MCV-72* MCH-22.0* MCHC-30.7* RDW-16.5* RDWSD-41.8 Plt ___
+___ 12:00PM BLOOD WBC-7.8 RBC-5.67 Hgb-12.5* Hct-41.1 
+MCV-73* MCH-22.0* MCHC-30.4* RDW-16.8* RDWSD-42.5 Plt ___
+___ 12:00PM BLOOD Neuts-75.7* Lymphs-15.3* Monos-7.3 
+Eos-0.8* Baso-0.5 Im ___ AbsNeut-5.91 AbsLymp-1.19* 
+AbsMono-0.57 AbsEos-0.06 AbsBaso-0.04
+___ 05:35AM BLOOD Plt ___
+___ 05:35AM BLOOD ___
+___ 12:00PM BLOOD ___ PTT-40.6* ___
+___ 05:35AM BLOOD Glucose-219* UreaN-19 Creat-0.9 Na-138 
+K-4.3 Cl-104 HCO3-26 AnGap-12
+___ 12:00PM BLOOD Glucose-255* UreaN-14 Creat-0.9 Na-134 
+K-4.5 Cl-98 HCO3-25 AnGap-16
+___ 05:35AM BLOOD ALT-12 AST-17 LD(LDH)-170 AlkPhos-76 
+TotBili-0.5
+___ 05:35AM BLOOD Albumin-3.6 Calcium-8.4 Phos-3.6 Mg-2.0
+
+DISCHARGE LABS:
+
+ECHO ___:
+The left atrial volume index is moderately increased. No left 
+atrial mass/thrombus seen (best excluded by transesophageal 
+echocardiography). Mild symmetric left ventricular hypertrophy 
+with normal cavity size, and regional/global systolic function 
+(biplane LVEF = 66 %). There is no left ventricular outflow 
+obstruction at rest or with Valsalva. There is no ventricular 
+septal defect. Right ventricular chamber size and free wall 
+motion are normal. Right ventricular chamber size is normal with 
+normal free wall contractility. The ascending aorta and aortic 
+arch are mildly dilated. The aortic valve leaflets (3) appear 
+structurally normal with good leaflet excursion and no aortic 
+stenosis or aortic regurgitation. The mitral valve leaflets are 
+structurally normal. No mitral regurgitation is seen. Trivial 
+mitral regurgitation is seen. The pulmonary artery systolic 
+pressure could not be determined. There is an anterior space 
+which most likely represents a prominent fat pad. 
+
+ IMPRESSION: Mild symmetric left ventricular hypertrophy with 
+preserved regional and global biventricular systolic function. 
+Mildly dilated ascending aorta. Left atrial dilation. No 
+structural cardiac cause of syncope identified. 
+ These findings are c/w hypertensive heart.
+
+ CLINICAL IMPLICATIONS: 
+ The patient has a mildly dilated ascending aorta. Based on ___ 
+ACCF/AHA Thoracic Aortic Guidelines, a follow-up echocardiogram 
+is suggested in ___ years
+
+CXR PA & LATERAL ___:
+COMPARISON:  Chest radiograph ___, CT trachea ___ 
+  
+FINDINGS:  
+  
+Low lung volumes are present.  Heart size appears mildly 
+enlarged.  
+Mediastinal and hilar contours are grossly unchanged.  Crowding 
+of 
+bronchovascular structures is present without overt pulmonary 
+edema.  Patchy opacities in the lung bases may reflect areas of 
+atelectasis, though infection is difficult to exclude in the 
+correct clinical setting.  No pleural effusion or pneumothorax 
+is present.  Mild multilevel degenerative changes are noted in 
+the thoracic spine. 
+  
+IMPRESSION:  
+  
+Low lung volumes with patchy bibasilar airspace opacities most 
+likely 
+reflective of atelectasis.  Infection cannot be excluded in the 
+correct 
+clinical setting. 
+
+KNEE XRAY (3 views) ___:
+COMPARISON:  ___ left knee radiographs 
+  
+FINDINGS:  
+  
+No acute fracture or dislocation is identified.  Mild 
+tricompartmental 
+degenerative changes with osteophytic spurring are demonstrated, 
+most 
+pronounced in the patellofemoral and lateral compartments of the 
+knee.  A 
+moderate size joint effusion is present.  Vascular 
+calcifications are seen 
+diffusely.  No concerning lytic or sclerotic osseous 
+abnormalities is 
+identified.  There are no radiopaque foreign bodies. 
+  
+IMPRESSION:  
+  
+No acute fracture or dislocation.  Moderate size joint effusion. 
+
+  
+
+CT HEAD w/o CONTRAST ___:
+FINDINGS:  
+  
+There is no evidence of acute infarction, hemorrhage, edema, or 
+mass.  There is mild prominence of the ventricles and sulci 
+suggestive of involutional changes. Scattered subcortical and 
+periventricular white matter hypodensities are nonspecific, 
+however likely represent the sequela of chronic small vessel 
+ischemic disease. 
+  
+There is soft tissue swelling overlying the left orbit, but the 
+globe appears intact.  No retrobulbar hematoma is seen.  There 
+is no evidence of fracture. There is partial opacification of 
+the right mastoid air cells suggestive of mild ongoing 
+inflammation.  The visualized portion of the paranasal 
+sinuses,left mastoid air cells, and middle ear cavities are 
+clear. 
+  
+IMPRESSION:  
+  
+Left periorbital soft tissue swelling without fracture.  No 
+acute intracranial process. 
+
+ 
+
+###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}, 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}, 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}, 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}, LDH {Lactate dehydrogenase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, Albumin {Albumin measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, left atrial {Left atrial structure}, volume {Cardiac chamber structure}, left 
+atrial {Left atrial structure}, mass {Mass}, thrombus {Thrombus}, transesophageal 
+echocardiography {Transesophageal echocardiography}, Mild symmetric left ventricular hypertrophy {Mild left ventricular hypertrophy}, normal cavity {Normal size cardiac chamber}, regional/global systolic function {Normal left ventricular systolic function and wall motion}, left ventricular outflow 
+obstruction {Left ventricular outflow tract obstruction}, Valsalva {Structure of left sinus of Valsalva}, ventricular 
+septal defect {Ventricular septal defect}, Right ventricular chamber {Right cardiac ventricular structure}, wall 
+motion are normal {Normal ventricular wall motion}, Right ventricular chamber {Right cardiac ventricular structure}, size is normal {Normal size}, wall {Cardiac wall structure}, ascending aorta {Ascending aorta structure}, aortic 
+arch {Aortic arch structure}, dilated {Dilatation}, aortic valve leaflets {Structure of cardiac valve leaflet}, structurally normal {Aortic valve normal}, leaflet {Structure of cardiac valve leaflet}, aortic 
+stenosis {Aortic valve stenosis}, aortic regurgitation {Aortic valve regurgitation}, mitral valve leaflets {Structure of leaflet of mitral valve}, structurally normal {Mitral valve normal}, mitral regurgitation {Mitral valve regurgitation}, Trivial 
+mitral regurgitation {Mild mitral valve regurgitation}, pulmonary artery {Pulmonary artery structure}, fat pad {Structure of normal fat pad}, Mild symmetric left ventricular hypertrophy {Mild left ventricular hypertrophy}, preserved regional and global biventricular systolic function {Normal cardiac function}, dilated ascending aorta {Ascending aorta dilatation}, Left atrial dilation {Left atrial dilatation}, cardiac {Heart structure}, syncope {Syncope}, hypertensive heart {Hypertensive heart disease}, dilated ascending aorta {Ascending aorta dilatation}, Thoracic Aortic {Thoracic aorta structure}, follow-up {Follow-up consultation}, echocardiogram {Echocardiography}, Chest radiograph {Plain chest X-ray}, trachea {Tracheal structure}, lung volumes {Finding of respiratory volume}, Heart {Heart structure}, enlarged {Enlargement}, Mediastinal {Mediastinal structure}, hilar {Structure of hilum of lung}, pulmonary 
+edema {Pulmonary edema}, opacities {Abnormally opaque structure}, lung bases {Structure of base of lung}, atelectasis {Atelectasis}, infection {Infectious disease}, pleural effusion {Pleural effusion}, pneumothorax {Pneumothorax}, Mild {Symptom mild}, degenerative changes {Degeneration of intervertebral disc}, thoracic spine {Structure of thoracic vertebral column}, lung volumes {Finding of respiratory volume}, bibasilar {Structure of base of lung}, opacities {Abnormally opaque structure}, atelectasis {Atelectasis}, Infection {Infectious disease}, left knee {Structure of left knee region}, radiographs {Plain radiography}, fracture {Fracture}, dislocation {Dislocation}, Mild {Symptom mild}, degenerative changes {Degenerative abnormality}, osteophytic {Osteophyte}, patellofemoral {Structure of left patellofemoral joint}, lateral compartments of the 
+knee {Structure of lateral compartment of knee}, joint effusion {Effusion of joint of left knee}, Vascular 
+calcifications {Vascular calcification}, lytic {Lysis}, sclerotic {Sclerosis}, osseous {Bone structure}, abnormalities {No abnormality detected}, foreign bodies {Foreign body}, fracture {Fracture}, dislocation {Dislocation}, joint effusion {Effusion of joint of left knee}, no evidence {No abnormality detected}, infarction {Infarct}, hemorrhage {Hemorrhage}, edema {Edema}, mass {Mass}, mild {Symptom mild}, ventricles {Brain ventricle structure}, sulci {Structure of sulcus of brain}, involutional changes {Involution}, periventricular white matter {Structure of periventricular white matter}, chronic {Chronic disease}, small vessel {Structure of small blood vessel (organ)}, ischemic disease {Ischemia}, soft tissue swelling {Soft tissue swelling}, left orbit {Structure of left orbit proper}, globe {Structure of eye proper}, intact {No abnormality detected}, retrobulbar hematoma {Retrobulbar hematoma}, no evidence {No abnormality detected}, fracture {Fracture}, right {Structure of right mastoid bone}, mastoid air cells {Structure of mastoid cell}, mild {Symptom mild}, inflammation {Mild inflammation}, paranasal 
+sinuses {Nasal sinus structure}, left {Structure of left mastoid bone}, mastoid air cells {Structure of mastoid cell}, middle ear cavities {Middle ear structure}, are 
+clear {No abnormality detected}, Left periorbital {Structure of periorbital region of left eye}, soft tissue swelling {Soft tissue swelling}, fracture {Fracture}, intracranial {Intracranial 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:
+The ___ hospital course was remarkable in relation to his 
+slow atrial fibrillation and second degree AV Block. He had 
+multiple pauses on telemetry 20 seconds or more and was 
+recommended for pacemaker insertion. He initially declined  the 
+procedure but after further consideration and discussion with 
+Dr. ___ the risks therein, proceeded with implantation. 
+ He remained therapeutic with his Coumadin and will continue to 
+be followed with his PCP at discharge. He was placed on IV 
+antibiotics and will transition to PO antibiotics at discharge. 
+He had multiple studies and exams performed while here and his 
+CT was negative for acute changes. His left eye remained stable 
+and swelling and ecchymosis was gradually and noticeably 
+improving.  He continued to complain of left knee pain. He 
+reported hitting the tibial tuberosity which remained tender to 
+palpation but without erythema or excess warmth.  Knee xrays 
+showed only chronic changes in relation to osteoarthritis 
+(tri-compartmental and prominent about the patello-femoral 
+compartment).  He has baseline numbness of his bilateral hands 
+related to his canal narrowing as seen on MRI in ___.  
+Surgery was discussed but he has foregone this for now, 
+preferring to wait and observe for worsening symptoms. He was 
+counseled to reconsider this decision and to avoid delay of any 
+worsening symptoms, increasing numbness, strength and 
+coordination. Physical Therapy was consulted and felt continued 
+home therapy was appropriate to help with falls prevention, gait 
+training, conditioning and safety, especially in light of his 
+weight bearing restrictions on the left upper extremity 
+following his pacemaker. 
+
+His device was interrogated on the day of discharge and a CXR 
+was completed confirming proper placement of the device and 
+leads. He was seen by Physical Therapy given his recent syncopal 
+episode and underlying musculoskeletal symptoms and deemed 
+appropriate for discharge on ___.  He will follow up with 
+Device Clinic in one week, has been recommended to have his INR 
+checked on ___ which is followed through the ___ 
+___ clinic, and continue follow up with his PCP, ___. 
+___.  Additionally, given his chronic atrial fibrillation he has 
+been recommended to have follow up with ___ Cardiology as 
+well, for a first available appointment. This has been requested 
+through Care Connections to the Cardiology team and he will be 
+contacted with an appointment at home when known.
+ 
+
+###RESPONSE: atrial fibrillation {Atrial fibrillation}, AV Block {Atrioventricular block}, telemetry {Cardiac telemetry}, pacemaker insertion {Implantation of cardiac pacemaker}, procedure {Surgical procedure}, discussion {Discussion}, Coumadin {Anticoagulant therapy}, PCP {Primary care management}, IV 
+antibiotics {Intravenous antibiotic therapy}, PO antibiotics {Oral antibiotic therapy}, exams {Physical examination procedure}, CT {Computed tomography}, left eye {Left eye structure}, stable {Patient's condition stable}, swelling {Swelling of structure of eye}, ecchymosis {Ecchymosis}, left knee {Structure of left knee region}, pain {Pain of knee region}, tibial tuberosity {Structure of tibial tuberosity}, tender to 
+palpation {Tenderness}, erythema {Erythema}, warmth {Joint warm}, Knee xrays {Radiologic examination of knee}, chronic {Chronic disease}, osteoarthritis {Osteoarthritis}, patello-femoral 
+compartment {Structure of patellofemoral joint}, baseline {Baseline state}, numbness {Numbness of hand}, hands {Hand structure}, canal {Spinal canal structure}, narrowing {Narrowing}, MRI {Magnetic resonance imaging}, Surgery {Surgical procedure}, numbness {Numbness}, coordination {Finding related to coordination / incoordination}, Physical Therapy {Physical therapy assessment}, therapy {Therapy}, falls prevention {Fall prevention}, gait 
+training {Gait training procedure}, weight bearing {Weight-bearing}, left upper extremity {Structure of left upper limb}, pacemaker {Implantation of cardiac pacemaker}, CXR {Plain chest X-ray}, placement of the device {Implantation of cardiac pacemaker}, Physical Therapy {Physical therapy assessment}, syncopal {Syncope}, musculoskeletal {Musculoskeletal system physical examination}, Clinic {Outpatient care management}, clinic {Outpatient care management}, PCP {Primary care management}, chronic atrial fibrillation {Chronic atrial fibrillation}, Cardiology {Cardiology 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: Medications on Admission:
+The Preadmission Medication list is accurate and complete.
+1. Quinapril 40 mg PO DAILY 
+2. Timolol Maleate 0.5% 1 DROP BOTH EYES BID 
+3. MetFORMIN (Glucophage) 1000 mg PO DAILY 
+4. Warfarin 2 mg PO 1X/WEEK (___) 
+5. Simvastatin 40 mg PO QPM 
+6. liraglutide 1.2 mg subcutaneous DAILY 
+7. 70/30 24 Units Breakfast
+70/30 24 Units Bedtime
+8. Tamsulosin 0.8 mg PO QHS 
+9. Alphagan P (brimonidine) 0.1 % ophthalmic 1 drop both eyes 
+twice daily  
+10. Warfarin 5 mg PO 6X/WEEK (___) 
+
+ 
+Discharge Medications:
+1.  Cephalexin 500 mg PO Q8H Duration: 3 Days 
+Take all of this medication as prescribed  
+2.  70/30 24 Units Breakfast
+70/30 24 Units Bedtime
+Insulin SC Sliding Scale using HUM Insulin 
+3.  Simvastatin 80 mg PO QPM  
+4.  Alphagan P (brimonidine) 0.1 % ophthalmic 1 drop both eyes 
+twice daily   
+5.  liraglutide 1.2 mg subcutaneous DAILY  
+6.  MetFORMIN (Glucophage) 1000 mg PO DAILY 
+Resume ___  
+7.  Quinapril 40 mg PO DAILY  
+8.  Tamsulosin 0.8 mg PO QHS  
+9.  Timolol Maleate 0.5% 1 DROP BOTH EYES BID  
+10.  Warfarin 5 mg PO 6X/WEEK (___)  
+11.  Warfarin 2 mg PO 1X/WEEK (___)  
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+syncope with loss of consciousness
+atrial fibrillation with slow ventricular response
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, syncope {Syncope}, loss of consciousness {Loss of consciousness}, atrial fibrillation {Atrial fibrillation}, slow ventricular response {Slow ventricular response}, Mental Status {Neurological mental status determination}, Clear {No abnormality detected}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, interactive {Does communicate}, 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:
+You were admitted to the hospital following a visit to the ED 
+after a syncopal episode with a loss of consciousness. You were 
+monitored on telemetry and were found to have a slow atrial 
+fibrillation rate response with multiple pauses and referred for 
+pacemaker implant as this could result in complete heart block. 
+A single chamber pacemaker was placed on ___.  You were 
+continued on all of your current medications, including your 
+Coumadin. You will need to follow up in Device Clinic in one 
+week (appt. information noted below). You were placed on IV 
+antibiotics while here and will continue oral antibiotics for 
+three days to prevent surgical site infection. It is important 
+to take all of this medication as prescribed. Your Coumadin 
+should continue to be followed as per your chronic schedule. You 
+will need to follow up with your PCP as well within 30 days 
+(appointment information included below). Your next INR should 
+be drawn as per the ___ clinic, we are 
+recommending a draw on ___.  Your INR at discharge on 
+___ was 1.9 and you will take your chronic dosing which is 5 mg 
+for 6 days a week with 2 mg on ___.  
+
+You had hit your head during your syncopal episode as well as 
+your eye and sustained an injury to your left orbit but no 
+fracture or hematoma.  You had resultant bruising from this 
+injury but remained otherwise stable.  A CT of your head was 
+performed and there was no internal hemorrhage. (results of CT 
+are below). Additionally you complained of left knee pain and 
+radiographs were done which showed no acute fracture. You do 
+have chronic osteoarthritis most pronounced about the knee cap 
+(patello-femoral area) which is chronic. You were seen by 
+Physical Therapy for evaluation prior to discharge to home. You 
+should follow up with your PCP and obtain referral to an 
+orthopedic physician for further workup and care for your 
+osteoarthritis of the knee. We recommend the use of ice, 20 
+minutes at a time per hour up to 5 times daily, along with 
+Tylenol for pain.
+
+You were seen by Physical Therapy and evaluated for safe 
+discharge to home. Based upon their recommendations, they are 
+recommending home physical therapy to work on gait training, use 
+of assistive device (cane) and strengthening and falls 
+prevention. Services have been requested on your behalf prior to 
+your discharge from the hospital from ___ Services.
+
+  You also reported continuing numbness of bilateral hands and 
+reported you had prior to admission and an MRI was performed in 
+___ which was reviewed showing cervical spondylosis and 
+canal narrowing and have not pursued surgical consultation. It 
+is recommended that you continue follow up with your PCP and 
+obtain surgical referral if your decision changes in that regard 
+or if your symptoms worsen. This is critical as your MRI does 
+canal narrowing.
+ 
+
+###RESPONSE: Discharge Instructions {Final inpatient visit with instructions at discharge}, syncopal {Syncope}, loss of consciousness {Loss of consciousness}, monitored {Monitoring procedure}, telemetry {Cardiac telemetry}, atrial 
+fibrillation {Atrial fibrillation}, pacemaker implant {Implantation of cardiac pacemaker}, complete heart block {Complete atrioventricular block}, single chamber pacemaker was placed {Insertion of single chamber cardiac pacemaker pulse generator}, medications {Prescription of drug}, Coumadin {Anticoagulant therapy}, Clinic {Outpatient care management}, IV 
+antibiotics {Intravenous antibiotic therapy}, oral antibiotics {Oral antibiotic therapy}, surgical site infection {Surgical site infection}, take all of this medication {Patient medication education}, Coumadin {Anticoagulant therapy}, PCP {Primary care management}, t INR should 
+be drawn {Monitoring of international normalized ratio}, will take your chronic dosing {Patient medication education}, syncopal {Syncope}, eye {Structure of eye proper}, injury {Traumatic or non-traumatic injury}, left orbit {Structure of left orbital region}, fracture {Fracture}, hematoma {Hematoma}, bruising {Contusion}, injury {Traumatic or non-traumatic injury}, stable {Patient's condition stable}, CT of your head {Computed tomography of head}, internal hemorrhage {Intracranial hemorrhage}, CT {Computed tomography of head}, left knee {Structure of left knee region}, pain {Pain of knee region}, radiographs {Plain radiography}, fracture {Fracture}, chronic osteoarthritis {Chronic osteoarthritis}, knee cap {Bone structure of patella}, patello-femoral {Structure of patellofemoral joint}, chronic {Chronic disease}, Physical Therapy for evaluation {Physical therapy assessment}, PCP {Primary care management}, referral to an 
+orthopedic physician {Referral to orthopedic service}, workup {Evaluation procedure}, osteoarthritis of the knee {Osteoarthritis of knee}, ice {Application of ice}, pain {Pain of knee region}, Physical Therapy and evaluated {Physical therapy assessment}, physical therapy {Physical therapy education}, gait training {Gait training procedure}, use 
+of assistive device (cane) {Use of cane education}, strengthening {Provision of advice about muscle strengthening exercise}, falls 
+prevention {Education about fall prevention}, numbness of bilateral hands {Numbness of hand}, MRI {Magnetic resonance imaging of head}, cervical spondylosis {Cervical spondylosis}, canal {Spinal canal structure}, narrowing {Narrowing}, surgical {Surgical procedure}, consultation {Consultation}, PCP {Primary care management}, surgical {Surgical procedure}, referral {Patient referral}, MRI {Magnetic resonance imaging}, canal {Spinal canal structure}, narrowing {Narrowing}"
+"###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: OBSTETRICS/GYNECOLOGY
+ 
+
+###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:
+elevated blood pressures with a headache and visual changes on 
+postpartum day 9.
+ 
+Major Surgical or Invasive Procedure:
+none
+
+ 
+
+###RESPONSE: elevated blood pressures {Finding of increased blood pressure}, headache {Headache}, visual changes {Visual disturbance}"
+"###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 ___ yo Gravida 1 Para ___ s/p low 
+transverse c-section ___ for non-reassuring fetal heart 
+tracing after induction of labor for elevated BPs. She presented 
+to the ED with headache and visual changes. She reported that 
+she had intermittent elevated BPs at the end of her pregnancy, 
+but never required any antihypertensive medications. She had no 
+laboratory abnormalities. Her postop/postpartum course was 
+benign. She noticed a headache starting approx 4 days prior to 
+presentantion, with intermittent periods of more intense pain 
+located in the occipital region with occasional pulsations. It 
+was always responsive to extra-strength tylenol and motrin. She 
+attributed headache to fatigue and recent surgery until today 
+when she noticed floaters in her left visual field that lasted 
+for approx 10 mins. She called her ob who asked her to come to 
+the ED.
+
+ 
+
+###RESPONSE: Gravida 1 {Primigravida}, Para {Parity finding}, low 
+transverse c-section {Emergency lower segment cesarean section}, fetal heart 
+tracing {Finding of fetal heart rate}, induction of labor {Induction of labor}, elevated BPs {Finding of increased blood pressure}, headache {Headache}, visual changes {Visual disturbance}, elevated BPs {Finding of increased blood pressure}, pregnancy {Pregnancy}, headache {Headache}, pain {Pain}, occipital region {Occipital region structure}, headache {Headache}, fatigue {Fatigue}, surgery {Surgical procedure}, floaters in her left visual field {Floaters in visual field}"
+"###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:
+ObHx: LTCS x 1 as above, ___ ___
+MedHx: Hiatal hernia
+SurgHx: LTCS
+
+ 
+
+###RESPONSE: Hiatal hernia {Hiatal hernia}"
+"###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:
+NC
+ 
+
+###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:
+In ED:
+BP  173/78 --> 10mg IV hydralazine --> 137/64
+O2 sat 100% RA
+
+Caucasian woman in NAD, breastfeeding on approach
+RRR, nl S1/S2
+CTAB
+Abd soft, nondistended. Mild tenderness to palpation. Incision
+clean, dry, intact with steri strips.
+Ext no edema/tenderness
+
+ 
+
+###RESPONSE: BP {Blood pressure finding}, O2 sat {Oxygen saturation measurement}, RA {Breathing room air}, NAD {No abnormality detected}, RRR {Normal heart rate}, S2 {Normal second heart sound, S>2<}, CTAB {Normal breath sounds}, Abd {Examination of abdomen}, soft {Abdomen soft}, nondistended {Normal abdominal contour}, tenderness {Tenderness}, palpation {Palpation}, Incision {Surgical incision wound}, clean, dry, intact {Wound healing well}, edema {Edema}, tenderness {Tenderness}"
+"###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:
+___ 01:15PM URINE  BLOOD-MOD NITRITE-NEG PROTEIN-NEG 
+GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-6.5 
+LEUK-NEG
+___ 12:08PM   ALT(SGPT)-25 AST(SGOT)-23 LD(LDH)-267* 
+CK(CPK)-63 ALK PHOS-104 TOT BILI-0.3
+___ 12:08PM   WBC-6.6# RBC-3.72* HGB-11.7* HCT-34.1* MCV-92 
+MCH-31.4 MCHC-34.3 RDW-12.9
+ 
+
+###RESPONSE: PROTEIN {Measurement of protein in urine}, KETONE {Urinalysis, acetone or ketone bodies measurement}, BILIRUBIN {Bilirubin measurement, urine}, PH {pH measurement}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, PHOS {Phosphate, total measurement}, TOT BILI {Bilirubin, 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}"
+"###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:
+Upon arrival to the ED, Ms ___ vital signs were 
+T 98.4  HR 64  BP 158/89  RR 14  O2 100%RA. She received a bolus 
+of 4g of magnesium and 10mg of IV hydralazine. She then reported 
+no visual changes and a very mild headache and denied RUQ pain. 
+Abdominal/incisional pain well controlled with Tylenol and 
+Motrin. No other associated symptoms. A head CT showed no 
+intracranial process. Her U/A was negative for protein, mod 
+blood, rare bacteria. Her pre-Eclampsia labs were negative 
+except Uric Acid which was 5.9. 
+
+She was readmitted to Labor and Delivery and continued on a 
+magnesium drip for 12 hours given concern for Pre-eclampsia. Her 
+blood pressures were well controlled in the 120s/70s without 
+additional antihypertensives. Repeat Pre-eclampsia labs were 
+negative and she was transferred to the postpartum floor after 
+12 hours of Magnesium. She was monitored for an additional day 
+on the postpartum floor to ensure that her blood pressures were 
+well controlled and that she remained free of pre-eclampsia 
+symtoms.
+
+She was discharged home on hospital day 2 with no 
+antihypertensive medications and a plan for close blood pressure 
+monitoring and an outpatient.
+
+ 
+
+###RESPONSE: vital signs {Vital signs finding}, visual changes {Visual disturbance}, headache {Headache}, RUQ pain {Right upper quadrant pain}, pain well controlled {Demonstrates adequate pain control}, head CT {Computed tomography of head}, intracranial {Intracranial structure}, pre-Eclampsia {Pre-eclampsia}, Pre-eclampsia {Pre-eclampsia}, blood pressures {Finding of increased blood pressure}, Pre-eclampsia {Pre-eclampsia}, blood pressures {Finding of increased blood pressure}, pre-eclampsia {Pre-eclampsia}, blood pressure 
+monitoring {Blood pressure monitoring}"
+"###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:
+Tylenol, Motrin
+ 
+Discharge Medications:
+Tylenol, Motrin
+ 
+
+###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:
+Postpartum Preeclampsia
+
+ 
+Discharge Condition:
+Mental Status:Clear and coherent
+Level of Consciousness:Alert and interactive
+Activity Status:Ambulatory - Independent
+
+ 
+
+###RESPONSE: Postpartum Preeclampsia {Pre-eclampsia in puerperium}, Mental Status {Neurological mental status determination}, 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:
+Call for blood pressures >150 (top number) or >100 (bottom 
+number)
+Call for Headaches, visual changes or right sided upper 
+abdominal pain
+Call with any questions
+ 
+
+###RESPONSE: blood pressures {Finding of increased blood pressure}, Headaches {Headache}, visual changes {Visual disturbance}, right sided upper 
+abdominal pain {Right upper quadrant 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: 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: 
+Patient recorded as having No Known Allergies to Drugs
+ 
+Attending: ___
+ 
+___ Complaint:
+shortness of breath
+ 
+Major Surgical or Invasive Procedure:
+Pulmonary vein isolation abaltion
+
+ 
+
+###RESPONSE: shortness of breath {Dyspnea}, Pulmonary vein {Structure of vein of pulmonary circulation}, abaltion {Destructive 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:
+Patient is a ___ male with a history of DM, HL, CM, CAD 
+s/p PCIs and atrial fibrillation. In ___ he was 
+referred back to the ___ cath lab because of symptoms of 
+shortness of breath and congestive heart failure. Cardiac 
+catheterization on ___ did not reveal any significant  
+obstructive CAD. RVEDP was noted at 33 mmHG with a mean wedge of 
+ 
+32 mmHG. There was severe pulmonary artery hypertension. He was  
+
+diuresed at that time. Stress testing in ___ had 
+revealed a predominantly fixed inferior apical defect with an 
+LVEF of 46% and somewhat dilated LV chamber.  
+
+The patient presented for Afib ablation today. Patient underwent 
+PVI with additional lines and failed cardioversion. He was given 
+1mg ibutilide and developed QT prolongation to 800ms which 
+transitioned to vfib. He was shocked and rhythm became sinus and 
+then slow afib. He was admitted to the CCU for close monitoring. 
+ 
+
+On review of systems, he denies SOB, CP, ___ pain, 
+numbness/tingling, lightheadedness. Reports had been in USOH 
+prior to this elective procedure.  
+
+ 
+
+###RESPONSE: DM {Diabetes mellitus}, HL {Hyperlipidemia}, CAD {Coronary arteriosclerosis}, PCIs {Percutaneous coronary intervention}, atrial fibrillation {Atrial fibrillation}, shortness of breath {Dyspnea}, congestive heart failure {Congestive heart failure}, Cardiac 
+catheterization {Cardiac catheterization}, CAD {Coronary arteriosclerosis}, pulmonary artery hypertension {Pulmonary hypertensive arterial disease}, diuresed {Diuretic therapy}, Stress {Electrocardiogram with exercise test}, inferior {Structure of myocardium of diaphragmatic region}, apical {Structure of apex of heart}, dilated LV chamber {Dilatation of left cardiac ventricle}, Afib {Atrial fibrillation}, ablation {Destructive procedure}, cardioversion {Cardioversion}, QT prolongation {Prolonged QT interval}, vfib {Ventricular fibrillation}, rhythm became sinus {Sinus rhythm}, afib {Atrial fibrillation}, monitoring {Monitoring procedure}, review of systems {Review of systems}, SOB {Dyspnea}, CP {Chest pain}, pain {Pain}, numbness/tingling {Numbness and tingling sensation of skin}, lightheadedness {Lightheadedness}, procedure {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: Past Medical History:
+CAD, s/p LAD stenting and diagonal PTCA/stenting to LAD and D1  
+Hyperlipidemia  
+Diabetes  
+Cardiomyopathy  
+? GERD  
+Removal of colon polyps  
+___- Surgical repair of an AV fistula in the left posterior  
+thigh/buttock  
+Atrial fibrillation (now chronic), s/p multiple prior  
+cardioversions  
+___- Right hip replacement  
+Arthritis of spine  
+Congestive heart failure  
+
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}, LAD stenting {Stent in anterior descending branch of left coronary artery}, PTCA {Percutaneous transluminal coronary angioplasty}, stenting {Insertion of arterial stent}, LAD {Structure of anterior descending branch of left coronary artery}, Hyperlipidemia {Hyperlipidemia}, Diabetes {Diabetes mellitus}, Cardiomyopathy {Cardiomyopathy}, GERD {Gastroesophageal reflux disease}, Removal of colon polyps {Colonic polypectomy}, Surgical repair of an AV fistula {Repair of arteriovenous fistula}, left {Structure of left thigh}, posterior {Structure of posterior surface of thigh}, thigh {Thigh structure}, buttock {Structure of left buttock}, Atrial fibrillation {Atrial fibrillation}, chronic {Chronic atrial fibrillation}, cardioversions {Cardioversion}, Right hip replacement {Prosthetic arthroplasty of right hip}, Arthritis of spine {Arthritis of spine}, Congestive heart failure {Congestive heart failure}"
+"###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:
+(-) FHx CAD 
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}"
+"###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: Middle aged man, flat in bed. NAD  
+HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were 
+pink, no pallor or cyanosis of the oral mucosa. No xanthalesma.  
+
+NECK: Unable to appreciate JVP, thick neck.  
+CARDIAC: Irregularly irregular, no MRG. Nl S1, S2.  
+LUNGS: No chest wall deformities, scoliosis or kyphosis. Resp 
+were unlabored, no accessory muscle use. CTAB, no crackles, 
+wheezes or rhonchi.  
+ABDOMEN: Soft, NTND. No HSM or tenderness. Abd aorta not 
+enlarged by palpation. No abdominial bruits.  
+EXTREMITIES: B/l femoral vein sheaths in place. No palpable 
+hematoma. Sl ooze. Sensation intact distally.  
+SKIN: No stasis dermatitis, ulcers, scars, or xanthomas.  
+PULSES:  
+Right: DP 2+ ___ 2+  
+Left: DP 2+ ___ 2+  
+
+ 
+
+###RESPONSE: GENERAL {General examination of patient}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, NC {Normal head}, Sclera anicteric {White sclera}, PERRL {Pupils equal and reacting to light}, EOMI {Normal ocular motility}, Conjunctiva {Conjunctival structure}, pallor {Pallor of skin of face}, cyanosis {Cyanosis}, oral mucosa {Oral mucous membrane structure}, xanthalesma {Xanthelasma}, NECK {Physical examination procedure}, JVP {Finding of jugular venous pressure}, neck {Neck structure}, CARDIAC {Cardiovascular physical examination}, Irregularly irregular {Heart irregularly irregular}, no MRG {Heart sounds normal}, S2 {Normal second heart sound, S>2<}, LUNGS {Examination of respiratory system}, chest wall deformities {Deformity of chest wall}, scoliosis {Scoliosis deformity of spine}, kyphosis {Kyphosis deformity of spine}, Resp {Examination of respiratory system}, accessory muscle {Accessory skeletal muscle}, CTAB {Normal breath sounds}, crackles {Respiratory crackles}, wheezes {Wheezing}, rhonchi {Wheeze - rhonchi}, ABDOMEN {Examination of abdomen}, Soft {Abdomen soft}, ND {Swollen abdomen}, HSM {Hepatosplenomegaly}, tenderness {Tenderness}, Abd {Examination of abdomen}, palpation {Palpation}, abdominial bruits {Abdominal bruit}, EXTREMITIES {Examination of limb}, B/l femoral vein sheaths {Bilateral femoral canals}, hematoma {Hematoma}, Sensation intact {Normal sensation}, SKIN {Examination of skin}, stasis dermatitis {Stasis dermatitis}, ulcers {Ulcer}, scars {Scar}, xanthomas {Xanthomatosis}, Right: DP 2+ {Normal pulse in right dorsalis pedis artery}, Left: DP 2+ {Normal pulse in left dorsalis pedis artery}"
+"###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-
+
+___ 07:05AM BLOOD WBC-11.1* RBC-5.12 Hgb-14.6 Hct-41.4 
+MCV-81* MCH-28.6 MCHC-35.3* RDW-16.0* Plt ___
+___ 03:19PM BLOOD WBC-12.7* RBC-4.45* Hgb-12.5* Hct-35.6* 
+MCV-80* MCH-28.1 MCHC-35.1* RDW-16.2* Plt ___
+___ 09:42PM BLOOD Hct-39.2*
+___ 03:51AM BLOOD Hct-35.9*
+___ 07:05AM BLOOD Neuts-73.0* Lymphs-17.9* Monos-4.8 
+Eos-3.5 Baso-0.8
+___ 07:05AM BLOOD ___
+___ 03:51AM BLOOD ___
+___ 07:05AM BLOOD Glucose-231* UreaN-50* Creat-1.4* Na-130* 
+K-6.6* Cl-87* HCO3-33* AnGap-17
+___ 03:51AM BLOOD Glucose-254* UreaN-36* Creat-1.1 Na-129* 
+K-3.7 Cl-91* HCO3-31 AnGap-11
+___ 03:19PM BLOOD Calcium-8.5 Phos-3.6 Mg-2.0
+___ 03:51AM BLOOD Calcium-8.2* Phos-2.6* Mg-1.___ yo m with CAD and chronic afib admitted for cardioversion. 
+
+# Atrial fibrillation: (see HPI for more details) Went for PVI 
+with ablation, was unsuccessful. He was given 1mg ibutilide and 
+developed QT prolongation to 800ms which transitioned to vfib. 
+He was shocked and rhythm became sinus and then slow afib. At 
+discharge he was still in slow afib. He was started on amio 
+400mg BID x 1 week, 400mg Qday x 1 week, then 200mg. Also on CCB 
+and dig home doses. Restarted on coumadin at discharge, but 
+subtheraputic. Was started on lovenox bridge with 60mg BID. Will 
+have INR checked in 2 days. Plan for out pt f/u with MRI to 
+evaluate pulmonary veins and then out pt cardioversion with Dr. 
+___. Will also have follow up with his regular 
+cardiologist and PCP. 
+
+# Coronary artery disease: Had known CAD, s/p PCI x ___, cath 
+in ___ revealed no flow limiting disease. Was stable during 
+admission.   
+-Continue ASA, statin, BB, ACEI  
+-Cardiac diet  
+
+# chronic systolic HF: Last EF based on MR was 45% with mildly 
+increased cavity size and mild global hypokinesis. Was stable 
+during admission. Continued on home lasix, metazolone, 
+spironolactone.  
+  
+# Hypotension: Pt has HTN at baseline. Post-procedure SBPs in 
+___. Given one 500cc bolus of NS. HR in 60-70s at time. Pulsus 
+10mmHg. Asymptomatic. Potentially vagal rxn. Hcts were stable 
+and blood pressure improved before discharge, home meds were 
+restarted.
+
+# DM- was on sliding scale insulin, was restarted on Lantus, but 
+the dose was increased to 24units in the morning. Glyburide was 
+stopped due to possiblly causing arrythmias.  Instead he was 
+started on Metformin 500mg BID.
+
+ 
+
+###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}, 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}, Hct {Hematocrit determination}, Hct {Hematocrit 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}, 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}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, CAD {Coronary arteriosclerosis}, chronic {Chronic disease}, cardioversion {Cardioversion}, Atrial fibrillation {Atrial fibrillation}, ablation {Destructive procedure}, QT prolongation {Prolonged QT interval}, vfib {Ventricular fibrillation}, rhythm became sinus {Normal sinus rhythm}, afib {Atrial fibrillation}, afib {Atrial fibrillation}, Restarted {Restart of medication}, coumadin {Anticoagulant therapy}, INR {Calculation of international normalized ratio}, MRI {Magnetic resonance imaging}, pulmonary veins {Structure of vein of pulmonary circulation}, cardioversion {Cardioversion}, PCP {Primary care management}, disease {Disease}, CAD {Coronary arteriosclerosis}, PCI {Percutaneous coronary intervention}, cath {Cardiac catheterization}, disease {Disease}, stable {Patient's condition stable}, Cardiac diet {Postoperative progressive diet}, chronic {Chronic disease}, cavity {Structure of cavity of left cardiac ventricle}, mild global hypokinesis {Mild hypokinesis of cardiac wall}, stable {Patient's condition stable}, lasix {Diuretic therapy}, Hypotension {Low blood pressure}, HTN {Hypertensive disorder, systemic arterial}, baseline {Baseline state}, procedure {Procedure}, Asymptomatic {Asymptomatic}, Hct {Hematocrit determination}, stable {Patient's condition stable}, improved {Patient's condition improved}, restarted {Restart of medication}, DM {Diabetes mellitus}, sliding scale insulin {Sliding scale insulin regime}, restarted {Restart of medication}, arrythmias {Cardiac arrhythmia}"
+"###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:
+Carvedilol 12.5mg twice a day  
+Digoxin .125mg daily every afternoon  
+Diltiazem 120mg daily every morning  
+Furosemide 80mg daily  
+Glyburide 5mg two tablets twice a day  
+Lantus insulin 20 units every morning  
+Lisinopril daily (unknown dosing)  
+Metolazone 2.5mg daily  
+KCL daily (unknown dosing)  
+Spironolactone 25mg daily every morning  
+Coumadin 4mg alternating with 5mg, last dose ___  
+Vitamin C 500mg daily  
+Aspirin 325mg daily  
+Vitamin B complex one daily  
+MVI  
+
+ 
+Discharge Medications:
+1. Enoxaparin 60 mg/0.6 mL Syringe Sig: One (1)  Subcutaneous 
+BID (2 times a day) for 7 days: take until instructed to stop by 
+your INR clnic.
+Disp:*14 syninges* Refills:*1*
+2. Amiodarone 200 mg Tablet Sig: Two (2) Tablet PO BID (2 times 
+a day): 2 pills twice a day for 7 days, then two pills once a 
+day for 3 weeks, then continue on one pill once a week.
+Disp:*70 Tablet(s)* Refills:*2*
+3. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4H (every 
+4 hours) as needed for fever, pain.  
+4. Digoxin 125 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+
+5. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+6. Lisinopril 5 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily).  
+7. Multivitamin     Tablet Sig: One (1) Tablet PO DAILY (Daily). 
+ 
+8. B-Complex with Vitamin C     Tablet Sig: One (1) Cap PO DAILY 
+(Daily).  
+9. Carvedilol 12.5 mg Tablet Sig: One (1) Tablet PO BID (2 times 
+a day). Tablet(s) 
+10. Ascorbic Acid ___ mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+11. Spironolactone 25 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+12. Insulin Glargine 100 unit/mL Solution Sig: ___ (24) 
+units Subcutaneous once a day: in the morning.  
+13. Diltiazem HCl 120 mg Capsule, Sustained Release Sig: One (1) 
+Capsule, Sustained Release PO DAILY (Daily).  
+14. Furosemide 80 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+15. Coumadin 2 mg Tablet Sig: Two (2) Tablet PO once a day: 
+alternate 2 pills with 2.5 pills.
+Disp:*75 Tablet(s)* Refills:*2*
+16. Metolazone 2.5 mg Tablet Sig: One (1) Tablet PO once a day.  
+
+17. Outpatient Lab Work
+please check on ___ INR, 
+please fax result to PCP,
+goal INR ___. Metformin 500 mg Tablet Sig: One (1) Tablet PO twice a day.
+Disp:*60 Tablet(s)* Refills:*2*
+
+ 
+
+###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:
+Atrial fibrillation, s/p ablation
+CAD, s/p LAD stent and diagonal PTCA/stenting
+Diabetes
+GERD
+Cardiomyopathy
+Congestive heart failure, systolic, chronic
+
+ 
+Discharge Condition:
+Hemodynamically stable, afebrile
+
+ 
+
+###RESPONSE: Atrial fibrillation {Atrial fibrillation}, ablation {Destructive procedure}, CAD {Coronary arteriosclerosis}, LAD stent {Stent in anterior descending branch of left coronary artery}, PTCA {Percutaneous transluminal coronary angioplasty}, stenting {Insertion of arterial stent}, Diabetes {Diabetes mellitus}, GERD {Gastroesophageal reflux disease}, Cardiomyopathy {Cardiomyopathy}, Congestive heart failure, systolic, chronic {Chronic systolic heart failure}, Hemodynamically stable {Hemodynamically stable}, afebrile {Temperature normal}"
+"###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 to ___ for a cardioversion. You had the 
+cardioversion, but the cardiologist was not able to albate the 
+cause of your a fib. Your heart rate became more irregular 
+during the procedure and you had to be shocked. You were started 
+on a medication called amiodarone for your afib and you will see 
+Dr. ___ in one ___ weeks to have a cardioversion after 
+your MRI. You will have a cardiac MRI to evaluate your heart's 
+blood vessels, call ___ to schedule.
+
+If you have chest pain, shortnes of breath, groin pain or 
+swelling or other concerning symptoms please seek medical 
+attention. 
+
+Please follow activiy, wound, and medication guidelines as 
+discussed.
+
+Your new medication amiodarone will be 400mg twice a day for a 
+week (starting on ___, then 400mg once a day until your 
+appointment with ___ in 1 month. Then he will adjust the 
+dose. 
+
+Your insulin was increased to 24units in the morning and your 
+glyburide was changed to metformin.
+
+You are also being sent home on a heart monitor, please follow 
+the instructions provided.
+
+You were started on Lovenox injections to thin your blood as 
+your coumadin levele are increased. Please take Coumadin as 
+ordered and get INR on ___ with ___ further 
+Coumadin dose. Take your lovenox until instructed to stop.
+ 
+
+###RESPONSE: cardioversion {Cardioversion}, cardioversion {Cardioversion}, a fib {Atrial fibrillation}, heart rate {Finding of heart rate}, irregular {Irregular heart beat}, procedure {Procedure}, medication {Administration of drug or medicament}, afib {Atrial fibrillation}, cardioversion {Cardioversion}, MRI {Magnetic resonance imaging}, cardiac MRI {Magnetic resonance imaging of heart}, heart {Heart structure}, blood vessels {Blood vessel structure}, chest pain {Chest pain}, shortnes of breath {Dyspnea}, groin pain {Inguinal pain}, swelling {Swelling}, seek medical 
+attention {Recommendation to seek attention}, activiy {Functional activity education}, wound {Wound}, medication {Patient medication education}, medication {Patient medication education}, heart monitor {Cardiac monitoring}, instructions {Recommendation to}, injections {Injection}, coumadin {Anticoagulant therapy}, Coumadin {Anticoagulant therapy}, INR {Calculation of international normalized ratio}, Coumadin {Anticoagulant 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: 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: CARDIOTHORACIC
+ 
+
+###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:
+Chest pain
+ 
+Major Surgical or Invasive Procedure:
+___ CABG x2(LIMA-LAD,SVG-OM) 
+
+ 
+
+###RESPONSE: No Known Allergies {Allergic disposition}, Adverse Drug Reactions {Propensity to adverse reactions to drug}, Chest pain {Chest pain}, CABG x2 {Coronary artery bypass grafts x 2}, LIMA {Structure of left internal thoracic artery}, LAD {Structure of anterior descending branch of left coronary artery}, SVG {Aortocoronary artery bypass graft with saphenous vein graft}"
+"###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 with hyperlipidemia and GERD/hiatal hernia 
+reports about one year of feeling fatigued/low energy. He has 
+also experienced intermittent episodes of chest burning that is 
+felt across the entire chest, occurring   with exertion, 
+resolving with rest. These episodes are unpredictable and do not
+consistently occur, happening about ___ times per month. He also 
+feels slightly more short of breath with exercise as compared to 
+prior years. A stress echo in ___ showed possible ischemia 
+involving the distal inferoseptum and possibly distal inferior 
+wall. He has been treated with imdur, aspirin and a statin and 
+is now being referred for coronary angiography.
+
+ 
+
+###RESPONSE: hyperlipidemia {Hyperlipidemia}, GERD {Gastroesophageal reflux disease}, hiatal hernia {Hiatal hernia}, fatigued {Fatigue}, chest burning {Burning chest pain}, chest {Thoracic structure}, exertion {Chest pain on exertion}, short of breath with exercise {Dyspnea on exertion}, stress echo {Stress echocardiography}, ischemia {Ischemia}, inferior 
+wall {Structure of myocardium of diaphragmatic region}, aspirin {Administration of aspirin}, coronary angiography {Angiography of coronary artery}"
+"###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:
+1. Hypercholesterolemia
+2. GERD, hiatal hernia
+3. H. Pylori s/p treatment
+4. Asthma as a child
+5. Insomnia
+6. Prior bone fractures
+
+ 
+
+###RESPONSE: Hypercholesterolemia {Hypercholesterolemia}, GERD {Gastroesophageal reflux disease}, hiatal hernia {Hiatal hernia}, H. Pylori {Infection caused by Helicobacter pylori}, Asthma {Asthma}, Insomnia {Insomnia}, fractures {Fracture}"
+"###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:
+Half-brother has had PCI in his ___, s/p AVR and CABG in his 
+___. Grandfather was thought to have had a heart attack in his 
+___.
+
+ 
+
+###RESPONSE: PCI {Percutaneous coronary intervention}, AVR {Replacement of aortic valve}, CABG {Coronary artery bypass grafting}, heart attack {Myocardial infarction}"
+"###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:
+Discharge PE:
+Physical Exam
+
+Pulse:73 Resp:20  O2 sat:93/RA
+B/P: 101/65
+Height:6'1""     Weight:95.3 kg preop, 99.1kg postop
+
+General:NAD
+Skin: Dry [x] intact [x]
+HEENT: PERRLA [x] EOMI [x]
+Neck:  Supple [x] Full ROM [x]
+Chest: Lungs clear bilaterally [x]
+Sternum: stable, healing well, C/D/I
+Heart: RRR [x]  Irregular []  Murmur [] grade ______
+Abdomen: Soft [x] non-distended [x] non-tender [x]  bowel sounds 
++
+[x]
+Extremities: Warm [x], well-perfused [x]  Edema: 1+BLE [x], LLE 
+healing well
+Varicosities: None [x]
+Neuro: Grossly intact [x]
+Pulses:
+DP           Right: 2+   Left:2+
+___           Right: 2+   Left:2+
+Radial       Right: 2+   Left:2+
+
+ 
+
+###RESPONSE: Physical Exam {Physical examination procedure}, Resp {Examination of respiratory system}, O2 sat {Oxygen saturation measurement}, RA {Breathing room air}, General {General examination of patient}, NAD {No abnormality detected}, Skin {Examination of skin}, HEENT {Physical examination procedure}, PERRLA {Pupils equal, react to light and accommodation}, EOMI {Normal ocular motility}, Neck {Physical examination procedure}, Supple {Normal movement of neck}, Full ROM {Normal range of cervical spine movement}, Chest {Examination of respiratory system}, Lungs {Examination of respiratory system}, Sternum {Bone structure of sternum}, stable {Patient's condition stable}, healing well {Wound healing well}, Heart {Cardiovascular physical examination}, RRR {Normal heart rate}, Irregular {Irregular heart beat}, Murmur {Murmur}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, non-distended {Normal abdominal contour}, non-tender {Abdominal tenderness}, bowel sounds 
++ {Normal bowel sounds}, Extremities {Examination of limb}, Warm {Warm skin}, well-perfused {Normal tissue perfusion}, Edema {Edema}, BLE {Edema of bilateral lower legs}, LLE {Structure of left lower limb}, healing well {Wound healing well}, Varicosities {Venous varices}, Neuro {Neurological examination}, Grossly intact {Normal nervous system function}, DP {Structure of dorsalis pedis artery}, Radial {Structure of radial artery}"
+"###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:
+___ ECHO
+PRE BYPASS The left atrium is dilated. No spontaneous echo 
+contrast or thrombus is seen in the body of the left atrium/left 
+atrial appendage or the body of the right atrium/right atrial 
+appendage. No atrial septal defect is seen by 2D or color 
+Doppler. Regional left ventricular wall motion is normal. 
+Overall left ventricular systolic function is normal (LVEF>55%). 
+The right ventricle displays normal free wall contractility. The 
+aortic root is mildly dilated at the sinus level. The ascending 
+aorta is mildly dilated. There are simple atheroma in the aortic 
+arch. The descending thoracic aorta is mildly dilated. There are 
+simple atheroma in the descending thoracic aorta. The aortic 
+valve leaflets (3) are mildly thickened but aortic stenosis is 
+not present. Trace aortic regurgitation is seen. The mitral 
+valve leaflets are mildly thickened. Mild (1+) mitral 
+regurgitation is seen. There is no pericardial effusion. Dr. 
+___ was notified in person of the results in the 
+operating room at the time of the study. 
+
+POST BYPASS There is normal biventricular systolic function. 
+Valvular function is unchanged from the pre-bypass exam. The 
+thoracic aorta is intact after decannulation
+
+CXR ___:
+IMPRESSION:   
+As compared to the previous radiograph, there is unchanged 
+evidence of minimal bilateral atelectatic changes at the lung 
+bases. No new parenchymal opacities. The lateral radiograph 
+reveals a minimal right pleural effusion.  No other relevant 
+change.  Normal alignment of sternal wires. Unchanged position 
+of the right internal jugular vein catheter. 
+
+LABS:
+___ 04:14AM BLOOD WBC-7.1 RBC-3.86* Hgb-11.8* Hct-36.0* 
+MCV-93 MCH-30.6 MCHC-32.8 RDW-11.9 Plt ___
+___ 03:35AM BLOOD WBC-9.3 RBC-4.12* Hgb-12.7* Hct-38.6* 
+MCV-94 MCH-30.7 MCHC-32.8 RDW-12.2 Plt ___
+___ 02:20AM BLOOD ___ PTT-25.5 ___
+___ 04:14AM BLOOD Glucose-104* UreaN-14 Creat-0.9 Na-137 
+K-4.6 Cl-101 HCO3-32 AnGap-9
+___ 03:35AM BLOOD Glucose-110* UreaN-15 Creat-1.0 Na-138 
+K-4.1 Cl-102 HCO3-32 AnGap-8
+___ 03:35AM BLOOD Mg-2.1
+ 
+
+###RESPONSE: ECHO {Echocardiography}, BYPASS {Construction of shunt}, left atrium {Left atrial structure}, dilated {Dilatation}, echo {Echocardiography}, thrombus {Thrombus}, left atrium {Left atrial structure}, left 
+atrial appendage {Entire left auricular appendage}, right atrium {Right atrial structure}, right atrial 
+appendage {Structure of right auricular appendage}, atrial septal defect {Atrial septal defect}, color 
+Doppler {Color Doppler ultrasound}, left ventricular {Left cardiac ventricular structure}, wall {Cardiac wall structure}, left ventricular systolic function is normal {Normal left ventricular systolic function and wall motion}, right ventricle {Right cardiac ventricular structure}, wall {Cardiac wall structure}, aortic root is mildly dilated {Aortic root dilatation}, sinus {Structure of sinus of Valsalva}, ascending 
+aorta {Ascending aorta structure}, dilated {Dilatation}, atheroma {Atheroma}, aortic 
+arch {Aortic arch structure}, descending thoracic aorta {Structure of descending thoracic aorta}, dilated {Dilatation}, atheroma {Atheroma}, descending thoracic aorta {Structure of descending thoracic aorta}, aortic 
+valve leaflets {Structure of cardiac valve leaflet}, mildly thickened {Increased thickness}, aortic stenosis {Aortic valve stenosis}, aortic regurgitation {Aortic valve regurgitation}, mitral 
+valve leaflets are mildly thickened {Thickened mitral leaflet}, Mild (1+) mitral 
+regurgitation {Mild mitral valve regurgitation}, pericardial effusion {Pericardial effusion}, BYPASS {Construction of shunt}, biventricular {Cardiac ventricular structure}, Valvular {Structure of heart valve tissue}, bypass {Construction of shunt}, exam {Physical examination procedure}, thoracic aorta {Thoracic aorta structure}, decannulation {Vascular cannula removal}, radiograph {Plain radiography}, atelectatic {Atelectasis}, lung 
+bases {Structure of base of lung}, opacities {Abnormally opaque structure}, radiograph {Plain radiography}, right {Structure of right pleural cavity}, pleural effusion {Pleural effusion}, sternal {Bone structure of sternum}, Unchanged position {Intravenous catheter in situ}, right internal jugular vein {Structure of right internal jugular vein}, 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}, 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}, BLOOD 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}, BLOOD 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}, 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: Brief Hospital Course:
+Mr. ___ was admitted to the ___ on ___ for surgical 
+management of his coronary artery disease. He was taken to the 
+operating room on the same day where he underwent coronary 
+artery bypass grafting to two vessels. Please see the operative 
+note for details. Postoperatively he was taken to the intensive 
+care unit for monitoring. Over the next several hours, he awoke 
+neurologically intact and was extubated. On postoperative day 
+one, he was transferred to the step down unit for further 
+recovery. His epicardial wires and chest tubes were removed per 
+protocol. He was gently diuresed towards his preoperative 
+weight. The physical therapy service was consulted for 
+assistance in his postoperative strength and recovery. He 
+continued to make steady progress and was discharged home on 
+postoperative day four.
+ 
+
+###RESPONSE: coronary artery disease {Coronary arteriosclerosis}, coronary 
+artery bypass grafting to two vessels {Coronary artery bypass grafts x 2}, operative {Surgical procedure}, was taken to the intensive 
+care unit {Patient transfer to intensive care unit}, monitoring {Monitoring response to treatment}, neurologically intact {Normal nervous system function}, extubated {Removal of endotracheal tube}, chest tubes were removed {Intercostal drain removal}, diuresed {Diuretic 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. ClonazePAM 1 mg PO DAILY 
+2. Isosorbide Mononitrate (Extended Release) 60 mg PO BID 
+3. Lansoprazole Oral Disintegrating Tab 15 mg PO DAILY 
+4. Lorazepam 1 mg PO DAILY 
+5. Simvastatin 40 mg PO DAILY 
+6. Aspirin 325 mg PO DAILY 
+
+ 
+Discharge Medications:
+1. Aspirin EC 81 mg PO DAILY 
+2. Lansoprazole Oral Disintegrating Tab 15 mg PO DAILY 
+3. Simvastatin 40 mg PO DAILY 
+4. Docusate Sodium 100 mg PO BID 
+RX *docusate sodium [Colace] 100 mg 1 capsule(s) by mouth twice 
+a day Disp #*60 Capsule Refills:*0
+5. HYDROmorphone (Dilaudid) ___ mg PO Q3H:PRN pain 
+RX *hydromorphone [Dilaudid] 2 mg ___ tablet(s) by mouth every 3 
+hours as needed Disp #*50 Tablet Refills:*0
+6. Lorazepam 1 mg PO DAILY 
+7. Furosemide 20 mg PO DAILY Duration: 7 Days 
+RX *furosemide 20 mg 1 tablet(s) by mouth daily Disp #*7 Tablet 
+Refills:*0
+8. Metoprolol Tartrate 12.5 mg PO BID 
+RX *metoprolol tartrate 25 mg 0.5 (One half) tablet(s) by mouth 
+twice a day Disp #*30 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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+1. Hypercholesterolemia
+2. GERD, hiatal hernia
+3. H. Pylori s/p treatment
+4. Asthma as a child
+5. Insomnia
+6. Prior bone fractures
+
+ 
+Discharge Condition:
+Alert and oriented x3 nonfocal 
+Ambulating with steady gait
+Incisional pain managed with oral analgesics
+Incisions: 
+Sternal - healing well, no erythema or drainage 
+Leg Right/Left - healing well, no erythema or drainage. Edema 1+
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, Hypercholesterolemia {Hypercholesterolemia}, GERD {Gastroesophageal reflux disease}, hiatal hernia {Hiatal hernia}, H. Pylori {Infection caused by Helicobacter pylori}, Asthma {Asthma}, Insomnia {Insomnia}, fractures {Fracture}, Alert {Mentally alert}, oriented x3 {Oriented to person, time and place}, Ambulating {Fully mobile}, steady gait {Gait normal}, Incisional {Surgical incision wound}, pain {Wound pain}, oral analgesics {Administration of analgesic}, Incisions {Surgical incision wound}, Sternal {Wound of structure of sternal region}, healing well {Wound healing well}, erythema {Erythema}, drainage {Discharge}, Leg Right {Structure of right lower limb}, Left {Structure of left lower limb}, healing well {Wound healing well}, erythema {Erythema}, drainage {Discharge}, 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: Discharge Instructions:
+1) Please shower daily including washing incisions gently with 
+mild soap, no baths or swimming until cleared by surgeon. Look 
+at your incisions daily for redness or drainage.
+2) Please NO lotions, cream, powder, or ointments to incisions. 
+3) Each morning you should weigh yourself and then in the 
+evening take your temperature, these should be written down on 
+the chart provided.
+4) No driving for approximately one month and while taking 
+narcotics. Driving will be discussed at follow up appointment 
+with surgeon when you will likely be cleared to drive. 
+5) No lifting more than 10 pounds for 10 weeks
+6) Please call with any questions or concerns ___
+
+*Females: Please wear bra to reduce pulling on incision, avoid 
+rubbing on lower edge
+**Please call cardiac surgery office with any questions or 
+concerns ___. Answering service will contact on call 
+person during off hours**
+
+ 
+
+###RESPONSE: incisions {Surgical incision wound}, incisions {Surgical incision wound}, redness {Redness of skin over lesion}, drainage {Discharge}, incisions {Surgical incision wound}, incision {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: 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: 
+Patient recorded as having No Known Allergies to Drugs
+ 
+Attending: ___.
+ 
+Chief Complaint:
+wound dehiscence
+ 
+Major Surgical or Invasive Procedure:
+none
+
+ 
+
+###RESPONSE: No Known Allergies to Drugs {Non-allergic hypersensitivity to drug or medicament}, wound dehiscence {Wound dehiscence}"
+"###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:
+___ M s/p splenectomy readmitted for wound dehiscence
+ 
+
+###RESPONSE: splenectomy {Splenectomy}, wound dehiscence {Wound dehiscence}"
+"###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:
+DM 
+HTN
+ 
+
+###RESPONSE: DM {Diabetes mellitus}, HTN {Hypertensive disorder, systemic arterial}"
+"###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:
+sister with ITP 
+ 
+
+###RESPONSE: ITP {Chronic idiopathic thrombocytopenic purpura}"
+"###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:
+Gen: NAD
+Abd: S/NT/ND, wound dehiscence at laterally edge of wound with 
+dehiscence of anterior but not posterior sheath, no erythema, no 
+signs of infection
+Ext: WNL
+
+ 
+
+###RESPONSE: Gen {General examination of patient}, NAD {No abnormality detected}, Abd {Examination of abdomen}, NT {Abdominal tenderness}, ND {Swollen abdomen}, wound dehiscence {Wound dehiscence}, wound {Gunshot wound}, dehiscence {Dehiscence}, erythema {Erythema}, Ext {Examination of limb}, WNL {No abnormality detected}"
+"###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:
+___ 04:00PM   WBC-19.8* RBC-3.60* HGB-10.1* HCT-32.4* 
+MCV-90 MCH-28.1 MCHC-31.2 RDW-15.8*
+___ 04:00PM   PLT COUNT-359
+ 
+
+###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}"
+"###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 was admitted, and a vac dressing was placed on the 
+wound. VAC therapy was continued with good results, but the 
+patient was kept in house until the first scheduled change of 
+the VAC dressing. This was performed without difficulty and the 
+patient is now discharged home with ___ for VAC changes. 
+ 
+
+###RESPONSE: wound {Wound}, VAC therapy {Vacuum assisted skin closure}"
+"###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:
+lasix 80am/40pm, metformin 500''', humalog ssi, NPH 56/50, 
+dexamethasone 8'', claritin prn  
+
+ 
+Discharge Medications:
+1. Metformin 500 mg Tablet Sig: One (1) Tablet PO TID (3 times a 
+day).  
+2. Furosemide 40 mg Tablet Sig: Two (2) Tablet PO QAM (once a 
+day (in the morning)).  
+3. Furosemide 40 mg Tablet Sig: One (1) Tablet PO QPM (once a 
+day (in the evening)).  
+4. Ascorbic Acid ___ mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+5. Acetaminophen 500 mg Tablet Sig: ___ Tablets PO Q6H (every 6 
+hours) as needed.  
+6. Dexamethasone 4 mg Tablet Sig: Two (2) Tablet PO Q12H (every 
+12 hours).  
+7. Medication
+Please resume all other home medications as before.
+
+ 
+
+###RESPONSE: lasix {Diuretic 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: Discharge Disposition:
+Home With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+wound dehiscence
+
+ 
+Discharge Condition:
+Good
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, wound dehiscence {Wound dehiscence}"
+"###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 for placement of a VAC dressing on your wound. 
+Please call Dr. ___ or return to the E.R. for any of 
+the following:
+*new nausea/vomiting
+*inability to eat
+*fever > 101.4
+*chest pain
+*shortness of breath
+*inability to have bowel movements or pass gas
+*new redness around wound
+*any other questions or concerns
+ 
+
+###RESPONSE: placement {Application of dressing}, wound {Wound}, nausea/vomiting {Nausea and vomiting}, fever {Fever}, chest pain {Chest pain}, shortness of breath {Dyspnea}, inability to have bowel movements {Does not defecate}, pass gas {Unable to break wind}, redness {Redness of skin over lesion}, wound {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:   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: 
+Penicillins
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Dyspnea 
+ 
+Major Surgical or Invasive Procedure:
+None
+ 
+
+###RESPONSE: Penicillins {Allergy to penicillin}, Dyspnea {Dyspnea}"
+"###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 PMH of AVR + single vessel CABG (___), pAF s/p 
+cardioversion, on sotalol, HTN, HLD p/w 1 day of worsening 
+dyspnea in the setting of gradual worsening over the past few 
+weeks. Her symptoms started around ___ and were associated 
+with diaphoresis, nausea, and pallor. She denied any chest 
+pain/pressure.  She presented to ___ where her EKG showed 
+sinus rhythm and she was given ASA 300mg rectally.  Her initial 
+TropT was elevated at 0.15.  She had a CXR which showed 
+pulmonary vascular congestion without frank pulmonary edema.  
+Her lungs were noted to have diffuse wheezes which were felt to 
+be most likely ___ pulmonary edema.  She was placed on BiPAP for 
+increased work of breathing and was transferred to ___ for 
+further management and potential ICU level of care.
+
+On arrival to the ___ ED, her EKG was unchanged from her prior 
+one at ___.  Her labs were notable for a WBC of 17 and Cr 
+rising from 1.3 to 1.4.  Her CKMB was normal at 6, and her 
+initial Troponin was 0.21 which declined to 0.16.  She was 
+initially on CPAP due to increased work of breathing with her 
+two VBGs being 7.37/48 and 7.4/42.  ___ was weaned to 5LNC 
+after being given 20mg of IV lasix.  She made 700cc of UOP over 
+the next 6 hours but developed increased WOB and was re-trialed 
+on BiPAP.  She was redosed with 20mg of IV lasix.  She was 
+hemodynamically stable throughout.  She is transferred to the 
+CCU for further management.     
+
+REVIEW OF SYSTEMS:  
+Cardiac review of systems is notable for absence of chest pain, 
+dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, 
+ankle edema, palpitations, syncope or presyncope.  
+
+Denies any prior history of stroke, TIA, deep venous thrombosis, 
+pulmonary embolism, bleeding at the time of surgery, myalgias, 
+joint pains, cough, hemoptysis, black stools or red stools. 
+Denies recent fevers, chills or rigors. 
+Denies exertional buttock or calf pain. All of the other review 
+of systems were negative.  
+ 
+
+###RESPONSE: AVR {Replacement of aortic valve}, single vessel {Single coronary vessel disease}, CABG {Coronary artery bypass grafting}, pAF {Paroxysmal atrial fibrillation}, cardioversion {Cardioversion}, HTN {Hypertensive disorder, systemic arterial}, HLD {Hyperlipidemia}, dyspnea {Dyspnea}, diaphoresis {Excessive sweating}, nausea {Nausea}, pallor {Pallor of skin of face}, chest 
+pain {Chest pain}, pressure {Tight chest}, EKG {Electrocardiographic procedure}, sinus rhythm {Sinus rhythm}, TropT was elevated {Troponin I above reference range}, CXR {Plain chest X-ray}, pulmonary vascular {Structure of pulmonary blood vessel}, congestion {Congestion}, pulmonary edema {Pulmonary edema}, lungs {Lung structure}, wheezes {Wheezing}, pulmonary edema {Pulmonary edema}, BiPAP {Bilevel positive airway pressure titration}, EKG {Electrocardiographic procedure}, WBC {White blood cell count}, Troponin {Troponin measurement}, on CPAP {Dependence on continuous positive airway pressure ventilation}, IV {Administration of drug or medicament via intravenous route}, lasix {Diuretic therapy}, BiPAP {Bilevel positive airway pressure titration}, IV {Administration of drug or medicament via intravenous route}, lasix {Diuretic therapy}, hemodynamically stable {Hemodynamically stable}, REVIEW OF SYSTEMS {Review of systems}, Cardiac {Heart disease}, review of systems {Review of systems}, chest pain {Chest pain}, dyspnea on exertion {Dyspnea on exertion}, paroxysmal nocturnal dyspnea {Paroxysmal nocturnal dyspnea}, orthopnea {Orthopnea}, ankle edema {Ankle edema}, palpitations {Palpitations}, syncope {Syncope}, presyncope {Near syncope}, stroke {Cerebrovascular accident}, TIA {Transient ischemic attack}, deep venous thrombosis {Deep venous thrombosis}, pulmonary embolism {Pulmonary embolism}, bleeding {Bleeding}, myalgias {Muscle pain}, joint pains {Joint pain}, cough {Cough}, hemoptysis {Hemoptysis}, black stools {Dark stools}, red stools {Red stools}, fevers {Fever}, chills {Chill}, rigors {Rigor}, buttock {Pain in buttock}, calf pain {Pain in calf}, review 
+of systems {Review of systems}"
+"###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:
+(+) HTN (+) HLD (-) DM
+b/l cataracts s/p surgery
+s/p cholecystectomy, hysterectomy
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, HLD {Hyperlipidemia}, DM {Diabetes mellitus}, cataracts {Cataract}, cholecystectomy {Cholecystectomy}, hysterectomy {Hysterectomy}"
+"###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 died of suspected MI @ ___. Mother died @ ___.
+ 
+
+###RESPONSE: died {Dead}, MI {Myocardial infarction}, died {Dead}"
+"###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 EXAM:
+Gen: Elderly woman with increased work of breathing, saturating 
+well on BiPAP
+HEENT: NCAT EOMI MMM 
+NECK: +JVP to mid neck
+CV: S1/S2, RRR ___ systolic murmur heard best at ___ IS MCL with 
+radiation to axilla
+LUNGS: expiratory wheezing, bibasilar crackles
+ABD: +BS soft NT/ND
+EXT: no c/c/e
+PULSES: 2+ pulses b/l
+SKIN: warm and dry
+NEURO: AAOx1-2
+
+DISCHARGE EXAM:
+Gen: No spontaneous respirations or chest wall movement noted
+HEENT: Pupils fixed and dilated. Absent corneal reflexes.
+CV: No heart sound appreciable on auscultation.
+Lungs: No breath sounds on auscultation.
+
+Patient pronounced dead at 16:51PM on ___.
+ 
+
+###RESPONSE: Gen {General examination of patient}, BiPAP {Bilevel positive airway pressure titration}, HEENT {Physical examination procedure}, NC {Normal head}, EOMI {Normal ocular motility}, MMM {Moist oral mucosa}, NECK {Physical examination procedure}, JVP {Finding of jugular venous pressure}, neck {Neck structure}, CV {Cardiovascular physical examination}, S2 {Normal second heart sound, S>2<}, RRR {Normal heart rate}, murmur {Murmur}, axilla {Axillary region structure}, LUNGS {Examination of respiratory system}, wheezing {Wheezing}, bibasilar {Structure of base of lung}, crackles {Respiratory crackles}, ABD {Examination of abdomen}, BS {Normal bowel sounds}, soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, PULSES {Normal pulse}, 2+ pulses {Peripheral pulses normal}, SKIN {Examination of skin}, warm {Warm skin}, dry {Xeroderma}, NEURO {Neurological examination}, Gen {General examination of patient}, spontaneous respirations {Spontaneous respiration}, chest wall {Chest wall structure}, Pupils fixed {Fixed dilatation of pupil}, dilated {Dilated pupil}, Absent corneal reflexes {Corneal reflex absent}, CV {Cardiovascular physical examination}, No heart sound {Heart sound inaudible}, auscultation {Auscultation}, Lungs {Lung structure}, No breath sounds {Absent breath sounds}, auscultation {Auscultation}, Patient pronounced dead {Patient status determination, deceased}"
+"###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:
+___ 04:10AM BLOOD WBC-17.5* RBC-3.91* Hgb-12.8 Hct-35.6* 
+MCV-91 MCH-32.6* MCHC-35.8* RDW-13.6 Plt ___
+___ 04:10AM BLOOD Neuts-84.5* Lymphs-8.2* Monos-6.4 Eos-0.7 
+Baso-0.2
+___ 04:29AM BLOOD ___ PTT-25.0 ___
+___ 04:29AM BLOOD Glucose-125* UreaN-38* Creat-1.3* Na-141 
+K-4.9 Cl-104 HCO3-22 AnGap-20
+___ 04:29AM BLOOD CK-MB-6
+___ 04:29AM BLOOD cTropnT-0.21*
+___ 04:29AM BLOOD Calcium-9.7 Phos-4.0 Mg-2.0
+___ 04:38AM BLOOD ___ pO2-48* pCO2-48* pH-7.37 
+calTCO2-29 Base XS-1
+___ 04:38AM BLOOD O2 Sat-81
+
+PERTINENT LABS:
+___ 09:07AM BLOOD WBC-16.4* RBC-3.91* Hgb-12.0 Hct-37.5 
+MCV-96 MCH-30.8 MCHC-32.0 RDW-14.2 Plt ___
+___ 09:07AM BLOOD ___ PTT-21.2* ___
+___ 09:07AM BLOOD Glucose-120* UreaN-128* Creat-5.0*# 
+Na-139 K-6.1* Cl-104 HCO3-17* AnGap-24*
+___ 11:40AM BLOOD cTropnT-0.16* ___
+___ 09:07AM BLOOD Calcium-8.6 Phos-11.4*# Mg-2.4
+___ 11:40PM BLOOD Lactate-2.2*
+___ 03:30PM BLOOD Lactate-1.9
+
+DISCHARGE LABS:   NONE, PATIENT MADE CMO AND EXPIRED
+
+MICRO:
+___ BLOOD CULTURE:  PENDING
+___ URINE CULTURE:   NO GROWTH.
+
+IMAGING: 
+___  ECG
+Normal sinus rhythm. Left ventricular hypertrophy. 
+Intraventricular 
+conduction delay. No previous tracing available for comparison.  
+
+
+___  CHEST (PORTABLE AP)
+FINDINGS:  The patient is rotated to the left. The patient is 
+status post median sternotomy. There is moderate pulmonary 
+edema. More confluent opacity at the right lung base may relate 
+to vascular congestion however a consolidation due to pneumonia 
+is not excluded. No large pleural effusion is seen. There is no 
+evidence of pneumothorax. The cardiac silhouette is enlarged. 
+The aorta is calcified and tortuous. 
+
+___  Portable TTE 
+Conclusions   
+The left atrium is mildly dilated. No atrial septal defect is 
+seen by 2D or color Doppler. There is mild symmetric left 
+ventricular hypertrophy with normal cavity size and 
+regional/global systolic function (LVEF>55%). Diastolic function 
+could not be assessed. There is a mild resting left ventricular 
+outflow tract obstruction. The right ventricular free wall is 
+hypertrophied. The right ventricular cavity is mildly dilated 
+with mild global free wall hypokinesis. A bioprosthetic aortic 
+valve prosthesis is present. The transaortic gradient is higher 
+than expected for this type of prosthesis. A paravalvular aortic 
+valve leak is probably present. Mild (1+) aortic regurgitation 
+is seen. The mitral valve leaflets are mildly thickened. There 
+is mild functional mitral stenosis (mean gradient 7 mmHg) due to 
+mitral annular calcification. Mild (1+) mitral regurgitation is 
+seen. [Due to acoustic shadowing, the severity of mitral 
+regurgitation may be significantly UNDERestimated.] The 
+tricuspid valve leaflets are mildly thickened. Moderate [2+] 
+tricuspid regurgitation is seen. The tricuspid regurgitation jet 
+is eccentric and may be underestimated. [Due to acoustic 
+shadowing, the severity of tricuspid regurgitation may be 
+significantly UNDERestimated.] There is moderate pulmonary 
+artery systolic hypertension. There is no pericardial effusion. 
+
+IMPRESSION: Mild symmetric left ventricular hypertrophy with 
+near-hyperdynamic left ventricular systolic function. The right 
+ventricle is dilated and hypokinetic with moderate tricuspid 
+regurgitation and moderate pulmonary hypertension. Bioprosthetic 
+AVR with high gradients - likely a combination of a relatively 
+small valve and hyperdynamic function. The leaflets as seen on 
+images #21 and #22 seem to move well although there is 
+significant calcification seen at ___ o'clock on the short axis 
+views. It is not clear if this is outside the valve or not. At 
+least mild mitral regurgitation. Mild calcific mitral stenosis. 
+Biatrial dilation.   
+
+___  CHEST (PORTABLE AP)
+IMPRESSION:  Interval worsening of pulmonary edema, without 
+effusions. 
+
+___  BILAT LOWER EXT VEINS
+IMPRESSION: No evidence of deep venous thrombosis in the right 
+or left lower extremity veins. 
+
+___  ECG
+Sinus rhythm. Prolonged Q-T interval. Left ventricular 
+hypertrophy. No major change from the previous tracing. 
+
+ 
+
+###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}, cTropnT {Troponin T cardiac measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, pH {pH 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}, PTT {Partial thromboplastin time, activated}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, cTropnT {Troponin T cardiac measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, ECG {Electrocardiographic procedure}, Normal sinus rhythm {Normal sinus rhythm}, Left ventricular hypertrophy {Left ventricular hypertrophy}, CHEST (PORTABLE AP {Plain x-ray of chest anteroposterior view}, median sternotomy {Median sternotomy}, pulmonary 
+edema {Pulmonary edema}, opacity {Abnormally opaque structure}, right lung base {Structure of base of right lung}, vascular {Blood vessel structure}, congestion {Congestion}, consolidation {Consolidation}, pneumonia {Pneumonia}, pleural effusion {Pleural effusion}, pneumothorax {Pneumothorax}, cardiac {Heart structure}, enlarged {Enlargement}, aorta {Aortic structure}, calcified {Pathologic calcification, calcified structure}, TTE {Transthoracic echocardiography}, left atrium {Left atrial structure}, dilated {Dilatation}, atrial septal defect {Atrial septal defect}, color Doppler {Color Doppler ultrasound}, mild symmetric left 
+ventricular hypertrophy {Mild left ventricular hypertrophy}, normal cavity {Normal size cardiac chamber}, regional/global systolic function {Normal left ventricular systolic function and wall motion}, left ventricular 
+outflow tract obstruction {Left ventricular outflow tract obstruction}, right ventricular {Right cardiac ventricular structure}, wall {Cardiac wall structure}, right ventricular cavity is mildly dilated {Dilatation of right cardiac ventricle}, wall {Cardiac wall structure}, hypokinesis {Behavior showing reduced motor activity}, aortic 
+valve {Aortic valve structure}, aortic 
+valve leak {Aortic valve regurgitation}, Mild (1+) aortic regurgitation {Mild mitral valve regurgitation}, mitral valve leaflets are mildly thickened {Thickened mitral leaflet}, mild functional mitral stenosis {Mild mitral valve stenosis}, mitral annular calcification {Mitral valve annular calcification}, Mild (1+) mitral regurgitation {Mild mitral valve regurgitation}, mitral 
+regurgitation {Mitral valve regurgitation}, tricuspid valve leaflets are mildly thickened {Tricuspid leaflet thickened}, Moderate [2+] 
+tricuspid regurgitation {Moderate tricuspid valve regurgitation}, tricuspid regurgitation {Tricuspid valve regurgitation}, tricuspid regurgitation {Tricuspid valve regurgitation}, pulmonary 
+artery systolic hypertension {Pulmonary hypertensive arterial disease}, pericardial effusion {Pericardial effusion}, Mild symmetric left ventricular hypertrophy {Mild left ventricular hypertrophy}, right 
+ventricle is dilated {Dilatation of right cardiac ventricle}, hypokinetic {Hypokinetic right ventricular wall}, moderate tricuspid 
+regurgitation {Moderate tricuspid valve regurgitation}, moderate pulmonary hypertension {Moderate pulmonary hypertension}, Bioprosthetic 
+AVR {Repair of aortic valve with tissue graft}, leaflets {Structure of cardiac valve leaflet}, calcification {Pathologic calcification, calcified structure}, mild mitral regurgitation {Mild mitral valve regurgitation}, Mild calcific mitral stenosis {Mild mitral valve regurgitation}, Biatrial dilation {Atrial dilatation}, CHEST (PORTABLE AP {Plain x-ray of chest anteroposterior view}, pulmonary edema {Pulmonary edema}, effusions {Pleural effusion}, LOWER EXT VEINS {Structure of vein of lower limb}, deep venous thrombosis {Deep venous thrombosis}, right {Structure of vein of right lower limb}, left lower extremity veins {Structure of vein of left lower limb}, ECG {Electrocardiographic procedure}, Sinus rhythm {Sinus rhythm}, Prolonged Q-T interval {Prolonged QT interval}, Left ventricular 
+hypertrophy {Left ventricular hypertrophy}"
+"###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:
+___ y/o F w/ hx of AVR, CABG in ___, PAF on sotalol, HTN, HLD w/ 
+recent echo showing preserved ejection fraction with acute on 
+subacute worsening dyspnea in the setting of leukocytosis and 
+CXR findings c/w PNA, found to have volume overload on exam with 
+increased work of breathing initially requiring BiPAP but later 
+made comfort care only after unsuccessful attempts at diuresis 
+and development of acute renal failure.
+
+ACTIVE ISSUES:
+#ACUTE DECOMPENSATED DIASTOLIC HEART FAILURE: LVEF >55%, mild 
+symmetric LVH, MAC, +MR. ___ consistent with heart 
+failure exacerbation in the setting of PNA. She initially 
+responded to IV lasix boluses but quickly developed acute renal 
+failure and persistent oxygen requirement. PE was considered in 
+the differential given +D-dimer and increased WOB but LENIs were 
+negative for DVT and symptomatology was not consistent. Patient 
+and family was approached regarding elective intubation and 
+right heart cath but declined as this was felt to be too 
+invasive. After a meeting with the patient and her family 
+(including HCP), patient was made DNR/DNI. Medical team and 
+family agreed to try high dose IV Lasix and if this was 
+unsuccessful, patient would be made comfort care only. 
+Unfortunately, high dose IV diuresis was unsuccessful and 
+patient was made comfort care only on ___. Palliative care was 
+consulted to assist with comfort measures. Patient expired on 
+___ at 16:51PM with family at bedside.
+
+#PNA: Patient presented with leukocytosis characterized by a 
+left shift. This in combination with her CXR which was 
+suggestive of a RLL opacification, was concerning for PNA. This 
+PNA also likely contributed if not caused her CHF exacerbation. 
+She was treated with CTX and azithromycin. Antibiotics were 
+withdrawn once patient was made comfort care only.
+
+CHRONIC ISSUES:
+#Atrial fibrillation: Patient remained in atrial fibrillation 
+throughout admission. She was continued on her home sotalol on 
+admission but this was withdrawn once patient was made CMO.
+
+#HTN: Normotensive on admission. Home BP meds were held on 
+admission especially in the setting of diuresis. 
+
+#HLD: Stable, she was continued on her home pravastatin which 
+was discontinued once she was made CMO.
+
+TRANSITIONAL ISSUES:
+NONE
+ 
+
+###RESPONSE: AVR {Replacement of aortic valve}, CABG {Coronary artery bypass grafting}, PAF {Paroxysmal atrial fibrillation}, HTN {Hypertensive disorder, systemic arterial}, HLD {Hyperlipidemia}, echo {Echocardiography}, dyspnea {Dyspnea}, leukocytosis {Leukocytosis}, CXR {Plain chest X-ray}, PNA {Pneumonia}, volume overload {Hypervolemia}, BiPAP {Bilevel positive airway pressure titration}, comfort care {Comfort measures}, diuresis {Diuresis}, acute renal failure {Acute kidney injury}, DECOMPENSATED DIASTOLIC HEART FAILURE {Decompensated cardiac failure}, mild 
+symmetric LVH {Mild left ventricular hypertrophy}, MAC {Mitral valve annular calcification}, MR {Mitral valve regurgitation}, heart 
+failure {Heart failure}, PNA {Pneumonia}, IV {Administration of drug or medicament via intravenous route}, lasix {Diuretic therapy}, acute renal 
+failure {Acute kidney injury}, PE {Pulmonary embolism}, DVT {Deep venous thrombosis}, intubation {Intubation}, right heart cath {Catheterization of right heart}, DNR {Not for resuscitation}, IV {Administration of drug or medicament via intravenous route}, comfort care {Comfort measures}, IV {Administration of drug or medicament via intravenous route}, diuresis {Diuresis}, comfort care {Comfort measures}, Palliative care {Palliative care}, comfort measures {Comfort measures}, PNA {Pneumonia}, leukocytosis {Leukocytosis}, left shift {Left shifted white blood cells}, CXR {Plain chest X-ray}, RLL {Structure of lower lobe of right lung}, opacification {Abnormally opaque structure}, PNA {Pneumonia}, PNA {Pneumonia}, CHF exacerbation {Exacerbation of congestive heart failure}, Antibiotics {Antibiotic therapy}, comfort care {Comfort measures}, Atrial fibrillation {Atrial fibrillation}, atrial fibrillation {Atrial fibrillation}, HTN {Hypertensive disorder, systemic arterial}, Normotensive {Normal blood pressure}, diuresis {Diuresis}, HLD {Hyperlipidemia}"
+"###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 may be inaccurate and requires 
+futher investigation.
+1. Acetaminophen 650 mg PO Q8H:PRN pain 
+2. ALPRAZolam 0.5 mg PO QHS insomnia 
+3. Losartan Potassium 25 mg PO DAILY 
+4. Potassium Chloride 20 mEq PO DAILY 
+5. Pravastatin 40 mg PO QPM 
+6. Sotalol 80 mg PO BID 
+7. Triamterene-HCTZ (37.5/25) 1 CAP PO DAILY 
+8. Ipratropium-Albuterol Neb 1 NEB NEB Q6H:PRN wheezing 
+
+ 
+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:
+PATIENT EXPIRED
+ 
+Discharge Condition:
+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 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:   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: 
+No Known Allergies / Adverse Drug Reactions
+ 
+Attending: ___
+ 
+Chief Complaint:
+confusion, abnormal labs
+
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: No Known Allergies {Allergic disposition}, Adverse Drug Reactions {Propensity to adverse reactions to drug}, confusion {Clouded consciousness}"
+"###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:
+Patient is a ___ w/pmh chronic mild hypoNa likely ___ SIADH, 
+HTN, COPD and chronic etoh use disorder who presents with 
+confusion in the setting of worsening hypoNa. 
+
+History obtained from patient as well as her son and daughter 
+who were at bedside. Patient has a long history of chronic 
+asymptomatic hyponatremia (Na 130-132) thought to be due to 
+SIADH and chronic tea and toast potomania (""nibbles"" and drinks 
+about 2 gallons of wine a week). Na was as low as 129 in ___ 
+due to increased ETOH intake and very poor PO intake. After PCP 
+counseling and change in her diet (more salty soups), Na was 
+improved to low 130s. Per daughter in law, patient has been 
+increasing her ETOH intake recently with very little PO intake. 
+Family has noted increased confusion and forgetfulness over the 
+past 2 weeks. Denied any speech slurring, weakness, numbness, 
+recent falls.
+
+Patient was taken to urgent care today for above sxs and noted 
+to have Na 125 from baseline around 130. She was sent to ___ 
+ED for further eval. Of note yesterday patient was also taken to 
+___ UC yesterday for a rash on her face. She was given Keflex 
+and prednisone for possible shingles. She reports the rash was 
+initially itchy but never painful. Currently it feels well and 
+does not bother her. 
+
+In the ED, initial VS were: 98.9 88 123/54 16 96% RA 
+  
+ ED physical exam was recorded as:
+Awake and alert but forgetful at times, moving all ext, CN 
+II-XII
+CTAB, RRR and abd NTND soft
+Ext wwp, 2+ pulses
+No signs of trauma
+rash on right side of face
+
+ED labs were notable for: 
+Na 125
+WBC 10.6
+H/H 10.8/32.1
+Urine sodium 42, Uosm 241
+
+Imaging showed:
+CXR:   
+No acute cardiopulmonary process seen. 
+
+Transfer VS were: 90 126/62 18 97% RA 
+ 
+ When seen on the floor, she is alert and oriented times 3. She 
+is not sure why she is in the hospital. She denies any pain 
+anywhere, dysuria, abd pain, n/v, diarrhea, fever, chills. 
+Reports chronic cough. Requesting sleep aid and nicotine patch.
+  
+REVIEW OF SYSTEMS: 
+ A ten point ROS was conducted and was negative except as above 
+in the HPI.
+
+ 
+
+###RESPONSE: chronic {Chronic disease}, hypoNa {Hyponatremia}, SIADH {Syndrome of inappropriate vasopressin secretion}, HTN {Hypertensive disorder, systemic arterial}, COPD {Chronic obstructive lung disease}, chronic etoh use disorder {Persistent alcohol abuse}, confusion {Clouded consciousness}, worsening {Patient's condition worsened}, hypoNa {Hyponatremia}, chronic {Chronic disease}, asymptomatic {Asymptomatic}, hyponatremia {Hyponatremia}, SIADH {Syndrome of inappropriate vasopressin secretion}, chronic {Chronic disease}, potomania {Hypo-osmolality and or hyponatremia}, drinks {Current drinker of alcohol}, increased ETOH intake {Problem drinker}, poor PO intake {Decrease in appetite}, counseling {Counseling}, diet {Dietary regime}, improved {Patient's condition improved}, ETOH {Alcohol abuse}, confusion {Clouded consciousness}, forgetfulness {Forgetful}, slurring {Slurred speech}, weakness {Asthenia}, numbness {Numbness}, falls {Falls}, baseline {Baseline state}, eval {Evaluation procedure}, rash on her face {Eruption of skin of face}, shingles {Herpes zoster}, rash {Eruption of skin}, itchy {Itching}, painful {Pain}, feels well {Well in self}, Awake {Awake}, alert {Mentally alert}, forgetful {Forgetful}, CN 
+II-XII {Examination of cranial nerve}, CTAB {Normal breath sounds}, RRR {Normal heart rate}, NTND {Abdominal tenderness}, soft {Abdomen soft}, 2+ pulses {Peripheral pulses normal}, signs {Sign}, trauma {Traumatic injury}, rash {Eruption of skin}, right side of face {Structure of right half of face}, labs {Laboratory test}, CXR {Plain chest X-ray}, No acute {No abnormality detected}, alert {Mentally alert}, oriented times 3 {Oriented to person, time and place}, pain {Pain}, dysuria {Dysuria}, abd pain {Abdominal pain}, diarrhea {Diarrhea}, fever {Fever}, chills {Chill}, chronic cough {Chronic cough}, REVIEW OF SYSTEMS {Review of systems}, ROS {Review of systems}"
+"###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:
+Purpura [D69.2] 
+Alcohol dependence [F10.20] 
+Emphysematous COPD [J43.9] 
+Tobacco dependence [F17.200] 
+HYPERTENSION - ESSENTIAL, UNSPEC [I10] 
+Lisinopril
+H/O solitary pulmonary nodule [___] 
+Hyponatremia [___.1] c/w SIADH
+RLL consolidation of chest CT -resolved. ( ___
+B12 deficiency, borderline [E53.8] 
+Asymptomatic PVD (peripheral vascular disease) [___.9] 
+SCREENING FOR COLON CANCER [___.11] 
+LICHEN SCLEROSUS ET ATROPHICUS 
+
+ 
+
+###RESPONSE: Purpura {Purpuric disorder}, Alcohol dependence {Alcohol dependence}, Emphysematous COPD {Pulmonary emphysema}, Tobacco dependence {Tobacco dependence syndrome}, HYPERTENSION - ESSENTIAL {Essential hypertension}, solitary pulmonary nodule {Solitary nodule of lung}, Hyponatremia {Hyponatremia}, SIADH {Syndrome of inappropriate vasopressin secretion}, RLL {Structure of lower lobe of right lung}, consolidation {Lung consolidation}, chest CT {Computed tomography of chest}, resolved {Problem resolved}, Asymptomatic {Asymptomatic}, PVD (peripheral vascular disease {Peripheral vascular disease}, SCREENING FOR COLON CANCER {Screening for malignant neoplasm of colon}, LICHEN SCLEROSUS {Lichen sclerosus}"
+"###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:
+No family 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: Physical Exam:
+On Admission: 
+Gen: NAD, A&O x3, lying in bed
+Eyes: EOMI, sclerae anicteric  
+HEENT: MMM, OP clear. Erythematous patch on right facial and 
+cervical area, with no tenderness to palpation, no induration. 
+Small dry crusted areas on the overlying skin.
+Cardiovasc: RRR, no MRG, full pulses, no edema  
+Resp: normal effort, no accessory muscle use, lungs CTA ___.
+GI: soft, NT, ND, BS+
+MSK: No significant kyphosis. No palpable synovitis.
+Skin: No visible rash. No jaundice.
+Neuro: AAOx3. No facial droop.
+Psych: Full range of affect
+
+On Discharge:
+VS: 97.8 134/59 66 18 91% RA
+GEN: Well appearing in NAD, sitting up in bed
+HEENT/Neck: Anicteric sclera, MMM, OP clear, neck supple.  
+HEART: RRR no m/r/g
+LUNGS: CTAB no wheezes, rales, or crackles.  Symmetric expansion
+ABD: soft NT/ND +BS no rebound or guarding, dry cough throughout
+exam, which patient states is her ""smoker's cough.""
+EXT: warm well perfused, no pitting edema
+NEURO: alert and oriented x3.  Fluent speech.  CN II-XII intact. 
+
+No focal deficits on strength testing.
+ 
+
+###RESPONSE: Gen {General examination of patient}, NAD {No abnormality detected}, O x3 {Oriented to person, time and place}, lying in bed {Lying in bed}, EOMI {Normal ocular motility}, sclerae anicteric {White sclera}, HEENT {Physical examination procedure}, MMM {Moist oral mucosa}, OP clear {Pharynx normal}, Erythematous {Erythema}, facial and 
+cervical {Face and/or neck structure}, tenderness {Tenderness}, palpation {Palpation}, induration {Induration of skin}, crusted areas {Crust on skin}, RRR {Normal heart rate}, no MRG {Heart sounds normal}, pulses {Normal pulse}, edema {Edema}, Resp {Examination of respiratory system}, normal effort {Visible respiratory effort}, accessory muscle {Accessory skeletal muscle}, lungs {Lung structure}, CTA {Normal breath sounds}, GI {Examination of digestive system}, soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, MSK {Musculoskeletal system physical examination}, kyphosis {Kyphosis deformity of spine}, palpable {Palpation}, synovitis {Synovitis}, Skin {Examination of skin}, rash {Eruption of skin}, jaundice {Jaundice}, Neuro {Neurological examination}, Ox3 {Oriented to person, time and place}, facial droop {Weakness of face muscles}, Psych {Psychological assessment}, affect {Mood finding}, GEN {General examination of patient}, Well appearing {Well cared for appearance}, NAD {Distress}, HEENT {Physical examination procedure}, Neck {Physical examination procedure}, Anicteric sclera {White sclera}, MMM {Moist oral mucosa}, OP clear {Pharynx normal}, neck supple {Normal movement of neck}, HEART {Cardiovascular physical examination}, RRR {Normal heart rate}, no m/r/g {Heart sounds normal}, LUNGS {Examination of respiratory system}, CTAB {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, crackles {Respiratory crackles}, Symmetric expansion {Chest expansion normal}, ABD {Examination of abdomen}, soft {Abdomen soft}, +BS {Normal bowel sounds}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, dry cough {Dry cough}, exam {Examination of abdomen}, smoker's cough {Smokers' cough}, EXT {Examination of limb}, warm {Warm skin}, well perfused {Normal tissue perfusion}, pitting edema {Pitting edema}, NEURO {Neurological examination}, alert {Mentally alert}, oriented x3 {Oriented to person, time and place}, Fluent speech {Finding of fluency of speech}, CN II-XII intact {Normal central nervous system}, No focal deficits {Normal nervous system function}"
+"###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:
+On Admission:
+___ 05:20PM URINE  OSMOLAL-241
+___ 05:20PM URINE  HOURS-RANDOM CREAT-29 SODIUM-42
+___ 01:40PM   GLUCOSE-106* UREA N-14 CREAT-0.7 SODIUM-125* 
+POTASSIUM-4.7 CHLORIDE-89* TOTAL CO2-26 ANION GAP-15
+___ 01:40PM   CALCIUM-9.6 PHOSPHATE-3.8 MAGNESIUM-1.8
+___ 01:40PM   OSMOLAL-283
+___ 01:40PM   WBC-10.6* RBC-3.47* HGB-10.8* HCT-32.1* 
+MCV-93 MCH-31.1 MCHC-33.6 RDW-14.2 RDWSD-48.2*
+___ 01:40PM   NEUTS-74.4* LYMPHS-14.6* MONOS-9.4 EOS-0.4* 
+BASOS-0.4 IM ___ AbsNeut-7.90* AbsLymp-1.55 AbsMono-1.00* 
+AbsEos-0.04 AbsBaso-0.04
+___ 01:40PM   PLT COUNT-300
+
+CXR: No acute cardiopulmonary process seen.
+
+CT chest (___):
+1.  4 mm noncalcified pulmonary nodule is stable since ___.  
+Followup per ___ recommendations.
+2.  COPD.
+
+On Discharge:
+___ 06:50AM BLOOD WBC-5.7 RBC-3.14* Hgb-9.8* Hct-30.0* 
+MCV-96 MCH-31.2 MCHC-32.7 RDW-14.4 RDWSD-49.9* Plt ___
+___ 07:15AM BLOOD Glucose-91 UreaN-12 Creat-0.6 Na-129* 
+K-4.0 Cl-93* HCO3-26 AnGap-14
+___ 07:15AM BLOOD Mg-1.6
+___ 06:20AM BLOOD VitB12-548 Folate-2.9
+___ 01:40PM BLOOD Osmolal-283
+___ 06:20AM BLOOD TSH-2.9
+ 
+
+###RESPONSE: URINE  OSMOLAL {Osmolality measurement, urine}, URINE {Evaluation of urine specimen}, CREAT {Creatinine measurement}, SODIUM {Sodium measurement}, GLUCOSE {Glucose measurement, urine}, UREA N {Blood urea nitrogen measurement}, 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}, CALCIUM {Blood calcium measurement}, PHOSPHATE {Phosphate, total measurement}, MAGNESIUM {Blood magnesium 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}, 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}, EOS {Eosinophil count}, BASOS {Basophil count}, PLT COUNT {Platelet count}, CXR {Plain chest X-ray}, No acute {No abnormality detected}, pulmonary nodule {Nodule of lung}, stable {Symptom not changed}, COPD {Chronic obstructive lung disease}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, RDWSD {Red cell distribution width determination}, BLOOD 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}, Mg {Blood magnesium measurement}, TSH {Thyroid stimulating hormone 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: Brief Hospital Course:
+Patient is a ___ year old woman with history of mild chronic 
+hypoNa attributed to SIADH, HTN, COPD and etoh use disorder who 
+presents with confusion and worsening hypoNa. 
+
+#Acute metabolic encephalopathy:
+#Hyponatremia:
+Patient's confusion and forgetfulness is likely due to acute on 
+chronic hyponatremia ___ poor solute intake (""tea and toast"", or 
+""wine and toast"") as well as possible mild SIADH (elevated UNa 
+and UOsm). It is unclear why she would have SIADH, no 
+intrapulmonary process on CXR.  She has a lung nodule which has 
+been stable on serial imaging. DDx also includes toxic metabolic 
+encephalopathy from chronic alcohol use vs alcohol withdrawal 
+(although currently not exhibiting any signs). Unlikely to be 
+infection (given clear CXR and UA), head trauma (no recent 
+history of head strike) medication side effects (not on any 
+culprit meds).  Na improved to recent baseline with free water 
+restriction and salt tabs.  She was encouraged to increase her 
+solute intake.  TSH, B12, folate wnl. B1 pending on discharge.
+
+Given her encephalopathy, ___ and OT were consulted and found 
+significant deficits concerning for her safety.  Her MMSE was 
+___ suggestive of mild-moderate cognitive impairment.  Her 
+family echoed these concerns about safety at home and she is now 
+discharged to rehab. She should have cognitive neurology follow 
+up as an outpatient. 
+
+#Facial Rash: 
+Mild cellulitis vs dermatitis with faint erythema, induration.  
+Does not appear to be shingles given lack of a dermatomal 
+distribution and no vescicular lesions.  In the outpatient 
+setting was given Keflex and steroid.  Her Keflex should be 
+continued through ___ to complete a ___TOH use disorder
+#Fall safety risk: 
+Per daughter in law, patient has longstanding history of ETOH 
+use disorder (about 2 gallons a wine per week), with prior 
+history of falls (twice last year). She was able to ambulate 
+independently at home, however now needs help with paying bills. 
+Family is concerned about patient's ability to take care of 
+herself at home and have entertained the possibility of 
+placement.  See above for evaluation.  She did not trigger on 
+CIWA
+
+#HTN: Continued Lisinopril 40 mg PO and amLODIPine 10 mg PO 
+DAILY 
+
+Chronic issues: COPD stable
+- Continued ASA
+- Continued vitamin B12 and D
+
+# Code status: DNR/DNI (confirmed with pt/family)
+
+Transitional:
+- Patient will need to be scheduled for follow up with cognitive 
+neurology
+- Continue Keflex through ___
+
+ 
+
+###RESPONSE: chronic 
+hypoNa {Chronic hyponatremia}, SIADH {Syndrome of inappropriate vasopressin secretion}, HTN {Hypertensive disorder, systemic arterial}, COPD {Chronic obstructive lung disease}, etoh use disorder {Alcohol abuse}, confusion {Clouded consciousness}, hypoNa {Hyponatremia}, Hyponatremia {Hyponatremia}, confusion {Clouded consciousness}, forgetfulness {Forgetful}, chronic hyponatremia {Chronic hyponatremia}, mild {Symptom mild}, SIADH {Syndrome of inappropriate vasopressin secretion}, SIADH {Syndrome of inappropriate vasopressin secretion}, CXR {Plain chest X-ray}, lung nodule {Nodule of lung}, stable {Symptom not changed}, imaging {Imaging}, toxic metabolic 
+encephalopathy {Toxic metabolic encephalopathy}, chronic alcohol use {Persistent alcohol abuse}, alcohol withdrawal {Alcohol withdrawal syndrome}, signs {Sign}, infection {Infectious disease}, clear {No abnormality detected}, CXR {Plain chest X-ray}, head trauma {Injury of head}, head strike {Injury of head}, medication side effects {Medication side effects present}, improved {Patient's condition improved}, baseline {Baseline state}, water 
+restriction {Fluid restriction}, TSH {Thyroid stimulating hormone measurement}, B12 {B12/folate level}, encephalopathy {Disorder of brain}, concerning for her safety {Safeguarding concern}, MMSE {Assessment using mini-mental state examination}, moderate cognitive impairment {Moderate cognitive impairment}, concerns about safety {Safeguarding concern}, neurology follow 
+up {Follow-up neurological assessment}, Facial Rash {Eruption of skin of face}, Mild {Symptom mild}, cellulitis {Cellulitis}, dermatitis {Inflammatory dermatosis}, erythema {Erythema}, induration {Induration}, shingles {Herpes zoster}, vescicular lesions {Vesicular eruption}, steroid {Steroid therapy}, TOH use disorder {Alcohol abuse}, Fall safety risk {At increased risk for falls}, ETOH 
+use disorder {Alcohol abuse}, falls {Falls}, able to ambulate {Able to walk}, evaluation {Evaluation procedure}, HTN {Hypertensive disorder, systemic arterial}, Chronic issues {Chronic disease}, COPD {Chronic obstructive lung disease}, stable {Patient condition unchanged}, 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. Lisinopril 40 mg PO DAILY 
+2. amLODIPine 10 mg PO DAILY 
+3. Vitamin D 1000 UNIT PO DAILY 
+4. Cyanocobalamin 1000 mcg PO 3X/WEEK (___) 
+5. Aspirin 81 mg PO DAILY 
+
+ 
+Discharge Medications:
+1.  Cephalexin 500 mg PO Q6H  
+2.  Docusate Sodium 100 mg PO BID 
+do not take if you are having loose stools  
+3.  FoLIC Acid 1 mg PO DAILY  
+4.  Multivitamins 1 TAB PO DAILY  
+5.  Nicotine Patch 7 mg TD DAILY  
+6.  Polyethylene Glycol 17 g PO DAILY:PRN constipation  
+7.  Senna 8.6 mg PO BID:PRN constipation  
+8.  Sodium Chloride 1 gm PO BID  
+9.  Thiamine 100 mg PO DAILY  
+10.  TraZODone 25 mg PO QHS:PRN insomnia  
+11.  amLODIPine 10 mg PO DAILY  
+12.  Aspirin 81 mg PO DAILY  
+13.  Cyanocobalamin 1000 mcg PO 3X/WEEK (___)  
+14.  Lisinopril 40 mg PO DAILY  
+15.  Vitamin D 1000 UNIT PO DAILY  
+
+ 
+
+###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:
+Acute metabolic encephalopathy
+Hyponatremia, SIADH
+Mild cognitive impairment
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+
+ 
+
+###RESPONSE: metabolic encephalopathy {Metabolic encephalopathy}, Hyponatremia {Hyponatremia}, SIADH {Syndrome of inappropriate vasopressin secretion}, Mild cognitive impairment {Mild neurocognitive disorder}, 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 - requires assistance or aid {Finding of walking aid use}, walker {Uses zimmer frame}, cane {Uses single walking stick}"
+"###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 admitted with increased confusion at home and worsened 
+hyponatremia.  Improved with fluid restriction.  Found to have 
+cognitive impairment and safety concerns at home.  Rehab 
+recommended as well as follow up with a neurologist.  Please 
+encourage alcohol cessation, encourage salt intake, and water 
+restriction to 1.5-2L per day
+ 
+
+###RESPONSE: confusion {Clouded consciousness}, hyponatremia {Hyponatremia}, Improved {Patient's condition improved}, fluid restriction {Fluid restriction}, cognitive impairment {Impaired cognition}, safety concerns {Safeguarding concern}, follow up {Follow-up arranged}, alcohol {Current drinker of alcohol}, water 
+restriction {Fluid restriction}"
+"###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: 
+morphine / Dilaudid
+ 
+Attending: ___.
+ 
+Chief Complaint:
+L distal femur nonunion 
+ 
+Major Surgical or Invasive Procedure:
+L distal femur nonunion ORIF with plate ___, ___
+
+ 
+
+###RESPONSE: morphine {Allergy to morphine}, L distal femur {Bone structure of distal left femur}, L distal femur {Bone structure of distal left femur}, nonunion {Nonunion of fracture}, ORIF {Open reduction of fracture of femur with internal fixation}"
+"###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:
+This is a follow-up visit for ___ chief complaint is
+left distal femur fracture history ___ is here today for
+follow-up with regards to his distal femur fracture he recently
+had a CT scan and is here today to discuss the findings.
+
+Past medical history no changes since we last saw him.
+
+Review of systems no fevers or chills.
+
+ 
+
+###RESPONSE: distal femur fracture {Fracture of distal end of femur}, distal femur fracture {Fracture of distal end of femur}, CT scan {Computed tomography of left lower limb}, Review of systems {Review of systems}, 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: Past Medical History:
+HTN
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}"
+"###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:
+NC
+ 
+
+###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:
+On discharge 
+
+General: well-appearing, breathing comfortably
+CV: pink and well perfused
+Abd: soft, non-tender, non-distended
+
+LLE: Incision well approximated. Dressing clean and dry. Fires 
+FHL, ___, TA, GCS. SILT ___ n distributions. Toes WWP 
+distally.
+
+ 
+
+###RESPONSE: General {General examination of patient}, well-appearing {Well cared for appearance}, breathing comfortably {Breathing easily}, CV {Cardiovascular physical examination}, well perfused {Normal tissue perfusion}, Abd {Examination of abdomen}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, LLE {Structure of left lower limb}, Incision {Surgical incision wound}, Dressing {Application of dressing}, SILT {Light touch sensation present}, Toes {Structure of all toes}, WWP {Normal tissue perfusion}"
+"###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:
+___ 06:30AM BLOOD WBC-15.4* RBC-3.41* Hgb-9.8* Hct-30.6* 
+MCV-90 MCH-28.7 MCHC-32.0 RDW-13.5 RDWSD-44.4 Plt ___
+___ 06:30AM BLOOD Glucose-322* UreaN-11 Creat-1.0 Na-134* 
+K-4.0 Cl-96 HCO3-24 AnGap-14
+ 
+
+###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}"
+"###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 is well known to the service and has been undergoing 
+evaluation for left distal femur. He presented from home on 
+___ for scheduled left distal femur nonunion ORIF, which 
+the patient tolerated well. For full details of the procedure 
+please see the separately dictated operative report.
+
+After the procedure the patient was taken from the OR to the 
+PACU, but was hypotensive requiring temporary pressors while in 
+the PACU. He was weaned off pressors prior to arrival on floor 
+(POD0) and SBP remained at 100 with HR around 100. Home 
+Metoprolol was held given hypotensive on POD1 with SBP to ___. 
+He was treated with IVF and pressures normalized. Additionally, 
+___ Diabetes service was consulted for newly found 
+hyperglycemia.
+
+He was initially given IV fluids and IV pain medications, but 
+progressed to a regular diet and oral medications on POD1. The 
+patient was given ___ antibiotics per routine. He is 
+on Apixaban at home and was switched to Enoxaparin ___. He 
+was restarted on home Apixaban on POD1. The patient's other home 
+medications were also continued throughout this hospitalization. 
+His intraoperative cultures did not grow any bacteria. The 
+___ hospital course was otherwise unremarkable.
+
+At the time of discharge the patient's pain was well controlled 
+with oral medications, incisions were clean/dry/intact, and the 
+patient was voiding/moving bowels spontaneously. The patient is 
+weight bearing as tolerated in left lower extremity, and will be 
+discharged on home Apixaban for DVT prophylaxis. The patient 
+will follow up with Dr. ___ routine. A thorough 
+discussion was had with the patient regarding the diagnosis and 
+expected post-discharge course including reasons to call the 
+office or return to the hospital, and all questions were 
+answered. The patient was also given written instructions 
+concerning precautionary instructions and the appropriate 
+follow-up care. The patient expressed readiness for discharge.
+
+ 
+
+###RESPONSE: evaluation {Evaluation procedure}, left distal femur {Bone structure of distal left femur}, left distal femur {Bone structure of distal left femur}, nonunion {Nonunion of fracture}, ORIF {Open reduction of fracture of femur with internal fixation}, procedure {Surgical procedure}, procedure {Surgical procedure}, PACU {Postanesthesia care}, hypotensive {Low blood pressure}, pressors {Hypotensive therapy}, PACU {Postanesthesia care}, pressors {Hypotensive therapy}, hypotensive {Hypotensive therapy}, IVF {Administration of intravenous fluids}, pressures normalized {Normal blood pressure}, Diabetes service was consulted {Referral to diabetes service}, hyperglycemia {Hyperglycemia}, given IV fluids {Administration of intravenous fluids}, pain medications {Administration of analgesic}, regular diet {Normal diet}, oral medications {Administration of drug or medicament via oral route}, antibiotics {Antibiotic therapy}, cultures {Microbial culture}, unremarkable {No abnormality detected}, pain was well controlled {Demonstrates adequate pain control}, oral medications {Administration of drug or medicament via oral route}, incisions {Surgical incision wound}, clean/dry/intact {Wound healing well}, voiding {Micturition finding}, moving bowels {Finding of defecation}, weight bearing {Weight-bearing}, left lower extremity {Structure of left lower limb}, DVT prophylaxis {Prevention of deep vein thrombosis}, follow up {Follow-up arranged}, discussion {Discussion}, instructions {Education}, instructions {Education}, follow-up care {Postoperative procedure education}, readiness for discharge {Ready for discharge}"
+"###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:
+Apixaban 5 mg PO BID  
+Atorvastatin 40 mg PO QPM  
+Digoxin 0.125 mg PO DAILY  
+Gabapentin 300 mg PO TID  
+Metoprolol Succinate XL 100 mg PO DAILY Please HOLD for SBP < 
+100 or HR < 
+Pantoprazole 40 mg PO Q12H  
+
+ 
+Discharge Medications:
+1.  Acetaminophen 650 mg PO Q6H  
+2.  Bisacodyl 10 mg PO/PR DAILY:PRN Constipation  
+3.  Calcium Carbonate 500 mg PO BID  
+4.  Cepacol (Sore Throat Lozenge) 1 LOZ PO Q2H:PRN Cough/Sore 
+Throat  
+5.  Docusate Sodium 100 mg PO BID  
+6.  Milk of Magnesia 30 ml PO BID:PRN Constipation  
+7.  Multivitamins 1 TAB PO DAILY  
+8.  OxyCODONE (Immediate Release) ___ mg PO Q4H:PRN Pain 
+RX *oxycodone 5 mg ___ tablet(s) by mouth every four (4) hours 
+PRN Disp #*50 Tablet Refills:*0 
+9.  Senna 8.6 mg PO BID  
+10.  Vitamin D 400 UNIT PO DAILY  
+11.  Apixaban 5 mg PO BID  
+12.  Atorvastatin 40 mg PO QPM  
+13.  Digoxin 0.125 mg PO DAILY  
+14.  Gabapentin 300 mg PO TID  
+15.  Metoprolol Succinate XL 100 mg PO DAILY 
+Please HOLD for SBP < 100 or HR < 55.  
+16.  Pantoprazole 40 mg PO Q12H  
+
+ 
+
+###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:
+L distal femur nonunion 
+
+ 
+Discharge Condition:
+AVSS
+NAD
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+
+LLE: Incision well approximated. Dressing clean and dry. Fires 
+FHL, ___, TA, GCS. SILT ___ n distributions. Toes WWP 
+distally.
+
+ 
+
+###RESPONSE: nonunion {Nonunion of fracture}, AVSS {Normal vital signs}, NAD {No abnormality detected}, Mental Status {Neurological mental status determination}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, interactive {Does communicate}, Ambulatory - requires assistance or aid {Finding of walking aid use}, LLE {Structure of left lower limb}, Incision {Surgical incision wound}, well approximated {Wound healing well}, Dressing {Application of dressing}, SILT {Light touch sensation present}, Toes {Structure of all toes}, WWP {Normal tissue perfusion}"
+"###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:
+INSTRUCTIONS AFTER ORTHOPAEDIC SURGERY:
+- You were in the hospital for orthopedic surgery. It is normal 
+to feel tired or ""washed out"" after surgery, and this feeling 
+should improve over the first few days to week. 
+- Resume your regular activities as tolerated, but please follow 
+your weight bearing precautions strictly at all times.
+
+ACTIVITY AND WEIGHT BEARING:
+- Weight bearing as tolerated in left lower extremity 
+
+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.
+
+PAIN MEDICATIONS INSTRUCTIONS:
+1)  Take Tylenol ___ every 6 hours around the clock.
+2)  Add your prescribed narcotics as needed for increased pain. 
+Start weaning the narcotic medication once you get home. 
+
+This is an example on how to wean down:
+Take 1 tablet every 3 hours as needed x 1 day,
+then 1 tablet every 4 hours as needed x 1 day,
+then 1 tablet every 6 hours as needed x 1 day,
+then 1 tablet every 8 hours as needed x 2 days, 
+then 1 tablet every 12 hours as needed x 1 day,
+then 1 tablet every before bedtime as needed x 1 day.  
+Then continue with Tylenol for pain.
+
+3)  Do not stop the Tylenol until you are off of the narcotic 
+medication. 
+
+ANTICOAGULATION:
+- Please continue taking your home Eliquis
+
+WOUND CARE:
+- Your incision is covered with a dry dressing. Please change 
+the dressing daily. If there is no drainage, you may leave your 
+incision open to the air. If you are continuing to have 
+drainage, you may place a dry dressing over the incision as 
+needed.
+- You may shower. 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.
+
+THIS PATIENT IS EXPECTED TO REQUIRE <30 DAYS OF REHAB
+Physical Therapy:
+Activity:   Activity:  Activity as tolerated
+ Right lower extremity:  Full weight bearing
+ Left lower extremity:  Full weight bearing
+Encourage turn, cough and deep breathe q2h when awake
+
+Treatments Frequency:
+Any staples or superficial sutures you have are to remain in 
+place for at least 2 weeks postoperatively.  Incision may be 
+left open to air unless actively draining.  If draining, you may 
+apply a gauze dressing secured with paper tape.  You may shower 
+and allow water to run over the wound, but please refrain from 
+bathing for at least 4 weeks postoperatively.
+
+Call your surgeon's office with any questions.  
+ 
+
+###RESPONSE: INSTRUCTIONS {Education}, SURGERY {Surgical procedure}, surgery {Surgical procedure}, tired {Tired}, washed out {Exhaustion}, after surgery {Postoperative state}, weight bearing {Weight-bearing}, precautions {Safety precautions}, Weight bearing {Weight-bearing}, left lower extremity {Structure of left lower limb}, 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}, Add your prescribed narcotics as needed {Narcotics education}, increased pain {Increased pain}, Start weaning the narcotic medication once you get home {Narcotics education}, pain {Pain}, Do not stop the Tylenol until you are off of the narcotic 
+medication {Narcotics education}, incision {Surgical incision wound}, dressing {Application of dressing}, change 
+the dressing {Change of dressing}, drainage {Discharge}, incision {Surgical incision wound}, drainage {Discharge}, dressing {Application of dressing}, incision {Surgical incision wound}, Activity as tolerated {Education about increasing activity tolerance}, Right lower extremity {Structure of right lower limb}, Full weight bearing {Full weight-bearing gait training}, Left lower extremity {Structure of left lower limb}, Full weight bearing {Full weight-bearing gait training}, cough and deep breathe {Deep breathing and coughing exercises}, awake {Awake}, Incision {Surgical incision wound}, draining {Wound discharge}, draining {Wound discharge}, apply a gauze dressing {Application of dressing}, wound {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:   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: 
+Penicillins / Amoxicillin
+ 
+Attending: ___.
+ 
+Chief Complaint:
+COPD exacerbation
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: Penicillins {Allergy to penicillin}, Amoxicillin {Allergy to amoxicillin}, COPD exacerbation {Acute exacerbation of chronic obstructive airways 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: History of Present Illness:
+___ w/ COPD p/w shortness of breath. Her symptoms started ___ 
+when she felt congested and had a little cough and bad chills. 
+Then with progressive SOB, cough, yellow sputum, subjective 
+fever. She reports being febrile to 99 at home. Today at ___ O2 
+sat 92% and was sent in after 2 nebs. Feels as though a 
+bronchial infection is occurring, but not pneumonia (she has had 
+both in the past). This is similar to her prior COPD 
+exacerbations, of which she has ___ per year, however this is 
+her first hospitalization for COPD exacerbation. No sick 
+contacts. 
+
+In the ED, initial VS were 98.3 102 114/71 20 94%. Labs were 
+remarkable for UA with 45 WBCs/few bacteria, K 3.6, Cr 0.6, mWBC 
+8.4, HCT 41. CXR showed evidence of COPD and L apical nodule. 
+Received albuterol/ipratropium nebs, 50mg prednisone, 500mg 
+azithromycin and was transferred to medicine for further 
+management. Transfer VS were 99.0 95 ___ 94% RA.
+
+On arrival to the floor, patient reports that she is no longer 
+experiencing fever and chills. Not currently SOB although she 
+feels some chest tightness.  She has a slight sore throat 
+although this is improved from this AM. Patient is very 
+friendly, speaking in full sentences, not on supplemental 
+oxygen.
+
+ 
+
+###RESPONSE: COPD {Chronic obstructive lung disease}, shortness of breath {Dyspnea}, cough {Cough}, chills {Chill}, SOB {Dyspnea}, cough {Cough}, yellow sputum {Yellow sputum}, fever {Fever}, febrile {Fever}, O2 
+sat {Oxygen saturation measurement}, bronchial infection {Infectious disorder of bronchus}, pneumonia {Pneumonia}, COPD 
+exacerbations {Acute exacerbation of chronic obstructive airways disease}, COPD exacerbation {Acute exacerbation of chronic obstructive airways disease}, VS {Vital signs finding}, UA {Urinalysis}, CXR {Plain chest X-ray}, COPD {Chronic obstructive lung disease}, L apical {Structure of apex of left lung}, nodule {Nodule of lung}, VS {Vital signs finding}, RA {Breathing room air}, fever {Fever}, chills {Chill}, SOB {Dyspnea}, chest tightness {Tight chest}, sore throat {Sore throat}, improved {Patient's condition improved}"
+"###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:
+COPD
+MI
+Positive PPD
+Hyperlipidemia 
+Arthritis in bilateral hands 
+Coronary artery disease s/p angioplasty with stent 
+Bronchiectasis
+ 
+
+###RESPONSE: COPD {Chronic obstructive lung disease}, MI {Myocardial infarction}, Positive PPD {Mantoux: positive}, Hyperlipidemia {Hyperlipidemia}, Arthritis in bilateral hands {Arthritis of finger of bilateral hand}, Coronary artery disease {Coronary arteriosclerosis}, angioplasty {Angioplasty of blood vessel}, stent {Insertion of arterial stent}, Bronchiectasis {Bronchiectasis}"
+"###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:  Cancer 
+___ Grandmother:  ___ - Type II
+ 
+
+###RESPONSE: Cancer {Malignant neoplasm}"
+"###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 - 98.5  119/66  97  22  92% RA
+General: Patient is sitting comfortably in bed, friendly and 
+alert, no acute distress
+HEENT: MMM
+Neck: Supple, non-tender, no lymphadenopathy appreciated  
+CV: Clear s1 and s2, irregular rhythm, no murmurs
+Lungs: Lungs with decreased breath sounds bilaterally, regular 
+respiratory rate and effort
+Abdomen: Soft, non distended, nontender, bowel sounds present
+GU: Deferred 
+Ext: Warn and well perfused, no edema
+Neuro: Patient with tremor of hands and head
+Skin: No rashes 
+
+DISCHARGE PHYSICAL EXAM 
+VS - 97.9  118/79  91  18  98% RA
+General: Patient is sitting comfortably in bed, friendly and 
+alert, no acute distress
+HEENT: MMM
+Neck: Supple, non-tender, no lymphadenopathy appreciated  
+CV: Regular rate and rhythm, clear s1 and s2, no murmurs
+Lungs: Lungs with decreased breath sounds bilaterally, regular 
+respiratory rate and effort, prolonged expiratory phase 
+Abdomen: Soft, non distended, nontender, bowel sounds present
+GU: Deferred 
+Ext: Warn and well perfused, no edema
+Neuro: Patient with tremor of b/l hands and head
+Skin: No rashes 
+
+ 
+
+###RESPONSE: PHYSICAL EXAM {Physical examination procedure}, VS {Vital signs finding}, RA {Breathing room air}, General {General examination of patient}, sitting {Sitting position}, alert {Mentally alert}, distress {Distress}, HEENT {Physical examination procedure}, MMM {Moist oral mucosa}, Neck {Physical examination procedure}, Supple {Normal movement of neck}, non-tender {Abdominal tenderness}, lymphadenopathy {Lymphadenopathy}, CV {Cardiovascular physical examination}, Clear {Normal breath sounds}, s1 and s2 {Heart sounds normal}, irregular rhythm {Irregular heart beat}, murmurs {Murmur}, Lungs {Examination of respiratory system}, Lungs {Examination of respiratory system}, decreased breath sounds {Decreased breath sounds}, regular 
+respiratory rate {Respiratory rate normal}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, distended {Swollen abdomen}, nontender {Abdominal tenderness}, bowel sounds present {Normal bowel sounds}, GU {Examination of genitourinary system}, Ext {Examination of limb}, well perfused {Normal tissue perfusion}, edema {Edema}, Neuro {Neurological examination}, tremor {Tremor}, hands {Hand structure}, head {Head structure}, Skin {Examination of skin}, rashes {Eruption of skin}, PHYSICAL EXAM {Physical examination procedure}, VS {Vital signs finding}, RA {Breathing room air}, General {General examination of patient}, sitting {Sitting position}, alert {Mentally alert}, distress {Distress}, HEENT {Physical examination procedure}, MMM {Moist oral mucosa}, Neck {Physical examination procedure}, Supple {Normal movement of neck}, non-tender {Abdominal tenderness}, lymphadenopathy {Lymphadenopathy}, CV {Cardiovascular physical examination}, Regular rate and rhythm {Normal heart rate}, s1 and s2 {Heart sounds normal}, murmurs {Murmur}, Lungs {Examination of respiratory system}, Lungs {Examination of respiratory system}, decreased breath sounds {Decreased breath sounds}, regular 
+respiratory rate {Respiratory rate normal}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, distended {Swollen abdomen}, nontender {Abdominal tenderness}, bowel sounds present {Normal bowel sounds}, GU {Examination of genitourinary system}, Ext {Examination of limb}, well perfused {Normal tissue perfusion}, edema {Edema}, Neuro {Neurological examination}, tremor {Tremor}, hands {Hand structure}, head {Head structure}, 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:
+ADMISSION LABS:
+___ 02:36PM BLOOD WBC-8.4 RBC-4.53 Hgb-13.9 Hct-41.0 MCV-91 
+MCH-30.7 MCHC-33.9 RDW-12.2 Plt ___
+___ 02:36PM BLOOD Neuts-79.1* Lymphs-11.3* Monos-7.5 
+Eos-1.4 Baso-0.7
+___ 02:36PM BLOOD Plt ___
+___ 02:36PM BLOOD Glucose-159* UreaN-17 Creat-0.6 Na-142 
+K-3.6 Cl-100 HCO3-32 AnGap-14
+
+IMAGING:
+CXR ___
+PA and lateral views of the chest.  The lungs are hyperinflated. 
+ There is asymmetric left apical pulmonary opacity worrisome for 
+underlying nodule.  Surgical chain sutures seen in the right mid 
+lung.  There is also subtle increased opacity projecting over 
+the right breast shadow, anteriorly on the lateral view.  The 
+cardiomediastinal silhouette is within normal limits.  No acute 
+osseous abnormality is identified. 
+  
+IMPRESSION:   
+Findings compatible with COPD.  Subtle asymmetric right basilar 
+opacity potentially in the middle lobe which could represent 
+atelectasis or scarring however infection cannot be totally 
+excluded. 
+  
+Findings worrisome for left apical pulmonary nodule for which 
+dedicated nonurgent chest CT is suggested.  
+
+DISCHARGE LABS:
+___ 07:55AM BLOOD WBC-8.2 RBC-4.80 Hgb-14.7 Hct-43.1 MCV-90 
+MCH-30.6 MCHC-34.1 RDW-12.2 Plt ___
+___ 07:55AM BLOOD Plt ___
+___ 07:55AM BLOOD Glucose-113* UreaN-14 Creat-0.6 Na-144 
+K-4.0 Cl-101 HCO3-30 AnGap-17
+
+MICROBIOLOGY:
+___ URINE CULTURES: no growth (final)
+___ BLOOD CULTURES: no growth (final)
+
+ 
+
+###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}, 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}, CXR {Plain chest X-ray}, lungs {Lung structure}, hyperinflated {Chest over-expanded}, left apical pulmonary {Structure of apex of left lung}, opacity {Abnormally opaque structure}, nodule {Nodule}, lung {Lung structure}, opacity {Abnormally opaque structure}, right breast {Right breast structure}, shadow {Shadow}, lateral {Diagnostic radiography of chest, lateral}, osseous {Bone structure}, COPD {Chronic obstructive lung disease}, right basilar {Structure of base of right lung}, opacity {Abnormally opaque structure}, middle lobe {Structure of middle lobe of right lung}, atelectasis {Atelectasis}, scarring {Healing scar}, infection {Infectious disease}, left apical {Structure of apex of left lung}, pulmonary nodule {Nodule of lung}, chest CT {Computed tomography of chest}, 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}, 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}"
+"###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 woman with a history of COPD, bronchiectasis, CAD 
+s/p MI with stent, among other medical issues who presented with 
+shortness of breath and increased cough and sputum production 
+consistent with her prior COPD flares.
+
+ACTIVE DIAGNOSES:
+
+# COPD exacerbation: Patient presented with symptoms similar to 
+her prior COPD exacerbations. Cannot exclude infectious etiology 
+however white count non-elevated, CXR consistent w/COPD. 
+Throughout the admission the patient has not needed supplemental 
+O2. She was treated with steroids, azithromycin, and PRN nebs. 
+Azithromycin was transitioned to doxycycline prior to discharge. 
+She remained stable with no worsening of symptoms. At time of 
+discharge, she is able to ambulate safely with a O2 sat in mid 
+90's. As her symptoms were not progressing and she was 
+saturating well on room air, we discharged her to follow-up with 
+PCP for further care. Of note, she asked us to provide her with 
+home nebulizer machine. We did not feel that was necessary. We 
+provided her with prescription for MDI plus spacer and urged her 
+to speak with her PCP if she believes she would benefit from 
+home nebulizer machine. 
+
+# Nausea: Patient complained of some morning nausea, with no 
+clear etiology. She noted that she would feel better after 
+eating or having her morning coffee. She received IV zofran PRN 
+for the nausea. No emesis on this admission. It had resolved by 
+time of discharge.
+
+CHRONIC DIAGNOSES: 
+
+# CAD: Her home medications of metoprolol succinate and aspirin 
+162 daily were continued continued on this stay. She did not 
+have any chest pain or symptoms suggestive of cardiac origin for 
+her shortness of breath or nausea.
+
+# Lung nodule: Patient has known lung nodules which have been 
+documented on prior CT scan. Nodule found incidentally on CXR, 
+and per report of location seems that it may be consistent with 
+location of previously known nodules. We recommended that this 
+be followed up on an outpatient basis. Radiology recommended a 
+non-urgent CT, however they may not have been aware that pt 
+already has known lung lesions being followed by serial CTs. As 
+above, patient has a significant smoking history.
+
+# Tremor: Pt with resting tremor in b/l hands and head, she has 
+not noticed it before. Husband has noticed and says it is not 
+new. Patient was surprised when it was brought up, however it 
+may be exacerbated by nebs and not as prominent at baseline. 
+Most likely essential tremor, however we recommend outpatient 
+follow-up by PCP for further evaluation.  
+
+TRANSITIONAL ISSUES:
+
+# We recommend continued outpatient follow-up of lung lesions
+
+# Tremor is likely benign, however may need to be evaluated 
+further
+ 
+
+###RESPONSE: COPD {Chronic obstructive lung disease}, bronchiectasis {Bronchiectasis}, CAD {Coronary arteriosclerosis}, MI {Myocardial infarction}, stent {Insertion of arterial stent}, shortness of breath {Dyspnea}, cough {Cough}, sputum production {Productive cough}, COPD {Chronic obstructive lung disease}, COPD exacerbation {Acute exacerbation of chronic obstructive airways disease}, COPD exacerbations {Acute exacerbation of chronic obstructive airways disease}, infectious {Infectious disease}, CXR {Plain chest X-ray}, COPD {Chronic obstructive lung disease}, stable {Patient's condition stable}, able to ambulate {Able to walk}, O2 sat {Oxygen saturation measurement}, on room air {Breathing room air}, nebulizer {Nebulizer therapy}, nebulizer {Nebulizer therapy}, Nausea {Nausea}, IV {Administration of drug or medicament via intravenous route}, nausea {Nausea}, emesis {Vomiting}, CAD {Coronary arteriosclerosis}, medications {Prescription of drug}, chest pain {Chest pain}, cardiac {Heart structure}, shortness of breath {Dyspnea}, nausea {Nausea}, Lung nodule {Nodule of lung}, lung nodules {Nodule of lung}, CT scan {Computed tomography}, Nodule {Nodule}, CXR {Plain chest X-ray}, nodules {Nodule}, followed up on an outpatient basis {Outpatient care management}, CT {Computed tomography}, lung lesions {Lesion of lung}, CTs {Computed tomography}, smoking {Smoker}, Tremor {Tremor}, resting tremor {Resting tremor}, hands {Hand structure}, head {Head structure}, essential tremor {Essential tremor}, outpatient 
+follow-up {Outpatient care management}, evaluation {Evaluation procedure}, outpatient follow-up {Outpatient care management}, lung lesions {Lesion of lung}, Tremor {Tremor}"
+"###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. Lansoprazole Oral Disintegrating Tab 30 mg PO DAILY 
+2. Lorazepam 1 mg PO HS:PRN Insomnia 
+3. ipratropium-albuterol ___ mcg/actuation Inhalation 4 times 
+daily PRN SOB/wheezing 
+4. Metoprolol Succinate XL 25 mg PO DAILY 
+5. Atorvastatin 40 mg PO DAILY 
+6. Symbicort (budesonide-formoterol) 160-4.5 mcg/actuation 
+Inhalation 2 puffs twice daily 
+7. Aspirin 162 mg PO DAILY 
+8. Nitroglycerin SL 0.3 mg SL PRN chest pain 
+
+ 
+Discharge Medications:
+1. PredniSONE 40 mg PO DAILY Duration: 3 Days 
+RX *prednisone 20 mg 2 tablet(s) by mouth once a day Disp #*6 
+Tablet Refills:*0
+2. Aspirin 162 mg PO DAILY 
+3. Atorvastatin 40 mg PO DAILY 
+4. Lansoprazole Oral Disintegrating Tab 30 mg PO DAILY 
+5. Lorazepam 1 mg PO HS:PRN Insomnia 
+6. Metoprolol Succinate XL 25 mg PO DAILY 
+7. ipratropium-albuterol ___ mcg/actuation Inhalation 4 times 
+daily PRN SOB/wheezing 
+8. Nitroglycerin SL 0.3 mg SL PRN chest pain 
+9. Symbicort (budesonide-formoterol) 160-4.5 mcg/actuation 
+Inhalation 2 puffs twice daily 
+10. Doxycycline Hyclate 100 mg PO Q12H Duration: 3 Days 
+RX *doxycycline hyclate 100 mg 1 capsule(s) by mouth every 
+twelve (12) hours Disp #*6 Capsule 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:
+COPD exacerbation
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: COPD exacerbation {Acute exacerbation of chronic obstructive airways disease}, Mental Status {Neurological mental status determination}, 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 at ___. You were admitted 
+to the hospital for evaluation and management of your COPD 
+exacerbation, after you presented to your Primary Care Physician 
+with increased shortness of breath and productive cough.  While 
+here, you were given antibiotics, steroids, and nebulizer 
+treatments and monitored overnight. You have not needed any 
+supplemental oxygen, and are walking around without significant 
+shortness of breath. 
+
+As your oxygen levels have been adequate and your symptoms have 
+not worsened, you are being discharged to continue your recovery 
+at home. We are discharging you with 3 days of antibiotics and 
+steroids to continue at home. 
+
+Thank you for allowing us to participate in your care.
+ 
+
+###RESPONSE: COPD 
+exacerbation {Acute exacerbation of chronic obstructive airways disease}, shortness of breath {Dyspnea}, productive cough {Productive cough}, antibiotics {Antibiotic therapy}, steroids {Steroid therapy}, nebulizer 
+treatments {Nebulizer therapy}, shortness of breath {Dyspnea}, antibiotics {Antibiotic therapy}, steroids {Steroid 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: 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:
+Chest pain
+ 
+Major Surgical or Invasive Procedure:
+None
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, Chest pain {Chest 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:
+___ h/o HCV cirrhosis s/p OLT ___ who presents with chest 
+discomfort and ___. Patient states that yesterday (___) he 
+developed sharp pleuritic type chest pain that was worse with 
+deep inspiration. He has never had pain like this before. Pain 
+did not travel. It persisted for at least one day and prompted 
+him to present to outside hospital. There an EKG was negative 
+for acute ischemia and initial troponin was reported as 
+indeterminate near his baseline. Due to elevated creatinine, 
+patient was unable to undergo CTA and was transferred here. 
+Patient with history of liver transplant ___ years ago and 
+infected hardware in the left knee that has been removed several 
+months ago while he waits for a new knee repair. Currently 
+anticoagulated with Coumadin for history of PE and atrial 
+fibrillation. Patient states he does not remember what his prior 
+PE felt like. In the ED his CP resolved. On arrival to the floor 
+he complained only of right Knee pain for which he receives high 
+doses of narcotics at his rehab. He reports pain is ___ 
+currently compared to ___ yesterday, but he will not beable to 
+sleep with this level of pain.  
+
+In the ED, initial vitals were:  
+98.2 67 123/68 19 99% 2L Nasal Cannula  
+- Labs were significant for  
+CBC  
+5.5 9.7 199  
+28.6  
+N:70.5 L:22.1 M:7.1 E:0 Bas:0.___.0 PTT: 37.1 INR: 3.4  
+Trop-T: 0.13  
+Chem 7  
+131 94 72  
+------------<125  
+4.4 26 2.2  
+ALT: 25 AP: 129 Tbili: 0.8 Alb: 3.0  
+AST: 12  
+- Imaging revealed  
+OSH CXR was without consolidation  
+ECG was Afib with RBBB stable from ___  
+ 
+-The patient was given  
+0.5 mg IV dilaudid x 1  
+Vitals prior to transfer were:  
+97.8 66 136/68 18 98% RA  
+Upon arrival to the floor,  
+T 97.8 BP 92/50 p 61 R 18 98% On RA  
+
+REVIEW OF SYSTEMS:  
+(+) Per HPI Of not he has not urinated in 12 hours  
+(-) Chest paint resolved in ED Denies fever, chills, night 
+sweats, recent weight loss or gain. Denies headache, sinus 
+tenderness, rhinorrhea or congestion. Denies cough, shortness of 
+breath. Denies chest pain or tightness, palpitations. Denies 
+nausea, vomiting, diarrhea, constipation or abdominal pain. No 
+recent change in bowel habits. No dysuria. 
+ 
+
+###RESPONSE: HCV cirrhosis {Cirrhosis of liver due to chronic hepatitis C}, OLT {Orthotopic transplantation of whole liver}, chest 
+discomfort {Chest discomfort}, sharp {Sharp pain}, pleuritic {Pleuritic pain}, chest pain {Chest pain}, worse {Increased pain}, pain {Pain}, Pain 
+did not travel {Radiating chest pain}, EKG {Electrocardiographic procedure}, acute ischemia {Acute myocardial ischemia}, troponin {Troponin measurement}, baseline {Baseline state}, elevated creatinine {Serum creatinine above reference range}, CTA {Computed tomography angiography with contrast}, liver transplant {Transplantation of liver}, left knee {Structure of left knee region}, removed {Removal}, knee repair {Arthroplasty of knee}, anticoagulated with Coumadin {Anticoagulant therapy}, PE {Pulmonary embolism}, atrial 
+fibrillation {Atrial fibrillation}, PE {Pulmonary embolism}, resolved {Problem resolved}, right Knee {Structure of right knee region}, narcotics {Narcotherapy}, pain {Pain}, pain {Pain}, vitals {Vital signs finding}, Nasal Cannula {Oxygen administration by nasal cannula}, Labs {Laboratory test}, CBC {Complete blood count}, INR {Calculation of international normalized ratio}, Trop {Troponin measurement}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, Imaging {Imaging}, CXR {Plain chest X-ray}, consolidation {Consolidation}, ECG {Electrocardiographic procedure}, Afib {Atrial fibrillation}, RBBB {Electrocardiographic right bundle branch block}, stable {Patient's condition stable}, IV {Intravenous therapy}, RA {Breathing room air}, RA {Breathing room air}, REVIEW OF SYSTEMS {Review of systems}, urinated {Micturition finding}, Chest paint {Chest pain}, resolved {Problem resolved}, fever {Fever}, chills {Chill}, night 
+sweats {Night sweats}, recent weight loss {Recent weight loss}, gain {Recent weight gain}, headache {Headache}, sinus 
+tenderness {Tenderness over frontal sinus}, rhinorrhea {Nasal discharge}, congestion {Nasal congestion}, Denies cough {Does not cough}, shortness of 
+breath {Dyspnea}, chest pain {Chest pain}, tightness {Tight chest}, palpitations {Palpitations}, nausea, vomiting, diarrhea {Nausea, vomiting and diarrhea}, constipation {Constipation}, abdominal pain {Abdominal pain}, change in bowel habits {Altered bowel function}, dysuria {Dysuria}"
+"###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:
+1. Hep C Cirrhosis s/p transplant at ___ on ___  
+-- Discharged from ___, presented to ___ 8 weeks post op for  
+prolonged hosp stay complicated by encephalopathy (due to  
+cyclosporine and tacrolimus), transient ischemic attack,  
+neutropenia, thrombocytopenia, mild acute rejection, acute  
+kidney injury, hypertension (cyclosporine related), recurrent c.
+difficile infection, and lower extremity edema  
+-- ___: portal vein thrombus with found incidental PE. U/S  
+of ___ negative for DVT. No anticoag at that time d/t bleeding  
+risk.  
+-- ___: Pt admitted to OSH with left ___ DV (fem-pop).  
+Preceded by episode of imobility from hospitalization for  
+pneumonia. Pt started on coumadin since this time with INR goal 
+___.  
+-- ___: left DVT in the setting of seemingly on  
+therapeutic anticoagulation with coumadin  
+-- BM suppression posttransplant: ___ BM Aspirate dyspoiesis 
+with myeloid and erythroid lineages along with megakaryocytic 
+hyperplasia  
+-- Posttransplant skin cancer: scalp lesion/squamous cell  
+carcinoma, R distal dorsal arm/squamous cell carcinoma, L  
+chest/basal cell carcinoma (s/p MOHs)  
+-- pseudogout, knee aspiration, s/p steroid injection  
+-- ___ edema, started lasix ___  
+2. H/O Esophageal varices, PVT prior to transplant: Most recent 
+BI records with ___ EGD without varicies  
+3. AVNRT s/p ablation in ___  
+4. Atrial fibrillation: failed CV immed post-tx, on coumadin  
+5. Melanoma status post excision in 1980s  
+6. Septic meningitis in ___  
+7. Osteoarthritis in the knees status post arthroscopy and left 
+knee replacement c/b septic joint on abx in ___.  
+8. Aphthous stomatitis  
+9. Asthma  
+10. GERD  
+11. High tibial osteotomy  
+12. s/p bilaterally cataract extraction  
+13. s/p Appendectomy  
+14. C. diff several times (4x) in ___ prior to transplant  
+15. History of CMV viremia.  
+16. History of acute rejection of a liver transplant.  
+ 
+
+###RESPONSE: Hep C Cirrhosis {Cirrhosis of liver due to chronic hepatitis C}, transplant {Transplantation of liver}, post op {Postoperative state}, encephalopathy {Disorder of brain}, transient ischemic attack {Transient ischemic attack}, neutropenia {Neutropenia}, thrombocytopenia {Thrombocytopenic disorder}, mild acute rejection {Acute rejection of liver transplant}, acute  
+kidney injury {Acute kidney injury}, hypertension {Hypertensive disorder, systemic arterial}, recurrent c.
+difficile infection {Recurrent infection caused by Clostridioides difficile}, lower extremity edema {Edema of lower extremity}, portal vein thrombus {Portal vein thrombosis}, PE {Pulmonary embolism}, S {Ultrasonography}, negative {No pathologic diagnosis}, DVT {Deep venous thrombosis}, bleeding  
+risk {At increased risk of hemorrhage}, imobility {Musculoskeletal immobility}, pneumonia {Pneumonia}, INR {Calculation of international normalized ratio}, DVT {Deep venous thrombosis}, anticoagulation {Anticoagulant therapy}, BM suppression {Myelosuppression}, BM Aspirate {Bone marrow aspiration procedure}, dyspoiesis {Dyserythropoiesis}, megakaryocytic 
+hyperplasia {Megakaryocytic hyperplasia of bone marrow}, skin cancer {Malignant neoplasm of skin}, scalp lesion {Lesion of scalp}, squamous cell  
+carcinoma {Squamous cell carcinoma}, R {Right upper arm structure}, dorsal arm {Structure of posterior surface of upper arm}, squamous cell carcinoma {Squamous cell carcinoma of skin}, L  
+chest {Structure of left half of chest wall}, basal cell carcinoma {Basal cell carcinoma}, MOHs {Mohs surgery}, pseudogout {Chondrocalcinosis due to pyrophosphate crystals}, knee aspiration {Aspiration of knee joint}, steroid injection {Injection of steroid}, edema {Edema}, lasix {Diuretic therapy}, Esophageal varices {Esophageal varices}, PVT {Portal vein thrombosis}, transplant {Transplantation}, EGD {Esophagogastroduodenoscopy}, varicies {Venous varices}, AVNRT {Re-entrant atrioventricular node tachycardia}, ablation {Destructive procedure}, Atrial fibrillation {Atrial fibrillation}, failed CV {Heart failure}, Melanoma {Malignant melanoma of skin}, excision {Excision of melanoma}, Septic meningitis {Infective meningitis}, Osteoarthritis in the knees {Osteoarthritis of knee}, arthroscopy {Arthroscopy of knee joint}, left 
+knee replacement {Total replacement of left knee joint}, septic joint {Arthritis of knee}, Aphthous stomatitis {Aphthous ulcer of mouth}, Asthma {Asthma}, GERD {Gastroesophageal reflux disease}, tibial osteotomy {Osteotomy of tibia}, bilaterally cataract extraction {Extraction of cataract of bilateral eyes}, Appendectomy {Excision of appendix}, transplant {Transplant of kidney}, CMV viremia {Cytomegalovirus viremia}, acute rejection of a liver transplant {Acute rejection of liver transplant}"
+"###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:
+The patient's father had bilateral lower extremity amputations 
+but had no clots prior to the surgery. There is no history of 
+VTE in the family. There is no history of miscarriages in the 
+family either. 
+
+ 
+
+###RESPONSE: bilateral lower extremity amputations {Amputation of bilateral lower limbs}, clots {Blood clot}, surgery {Surgical procedure}, VTE {Thromboembolism of vein}, miscarriages {Miscarriage}"
+"###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 EXAM:  
+================
+Vitals: T 97.8 BP 92/50 p 61 R 18 98% On RA  
+General: Alert, oriented, mildly distraught regarding right knee 
+pain  
+HEENT: Sclera anicteric, dry oropharynx, EOMI  
+Neck: Supple  
+CV: Regular rate and rhythm, ___ SEM at apex  
+Lungs: Clear to auscultation bilaterally, no wheezes, rales, 
+rhonchi  
+Abdomen: obese, soft,  
+Ext: Cool, pitting edema to sacrum bilaterally, R knee non ttp 
+but tender to flexion/extension and varous/valgus stress  
+Neuro: A+Ox3 ___ motor exam limited ___ pain  
+
+DISCHARGE EXAM:
+================
+Vitals: T 97.5, HR 81, BP 179/95, RR 22, SaO2 99% RA
+General: Alert, oriented, NAD, chronically ill-appearing 
+HEENT: Sclera anicteric, oropharynx wnl, MMM, EOMI  
+Neck: Supple, no JVD 
+CV: Irregular rhythm, normal rate, no murmurs
+Lungs: Limited exam, clear to auscultation anteriorly
+Abdomen: +BS, obese, soft, nontender, nondistended  
+Ext: WWP, ___ pitting edema bilaterally, compression dressings 
+in place. L knee in brace.
+Neuro: Oriented to self, place, and year (not day or month), no 
+asterixis, ___ motor exam limited ___ pain, sensation to light 
+touch intact
+ 
+
+###RESPONSE: Vitals {Vital signs finding}, BP {Blood pressure finding}, RA {Breathing room air}, General {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, right knee {Structure of right knee region}, pain {Pain}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, oropharynx {Oropharyngeal structure}, EOMI {Normal ocular motility}, Neck {Physical examination procedure}, Supple {Normal movement of neck}, CV {Cardiovascular physical examination}, Regular rate and rhythm {Normal heart rate}, SEM {Ejection 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}, obese {Obese abdomen}, soft {Abdomen soft}, Ext {Examination of limb}, Cool {Cool skin}, edema {Edema}, sacrum {Structure of sacral vertebral column}, R knee {Structure of right knee region}, ttp {Tenderness}, tender {Abdominal tenderness}, flexion {Flexion test}, extension {Abnormal extension}, varous/valgus stress {Adduction test of knee}, Neuro {Neurological examination}, Ox3 {Oriented to person, time and place}, motor exam {Motor testing}, pain {Pain}, Vitals {Vital signs finding}, SaO2 {Finding of oxygen saturation}, RA {Breathing room air}, General {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, NAD {No abnormality detected}, ill-appearing {Looks ill}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, oropharynx {Oropharyngeal structure}, MMM {Moist oral mucosa}, EOMI {Normal ocular motility}, Neck {Physical examination procedure}, Supple {Normal movement of neck}, JVD {Jugular venous engorgement}, CV {Cardiovascular physical examination}, Irregular rhythm {Irregular heart beat}, normal rate {Normal heart rate}, murmurs {Heart murmur}, Lungs {Examination of respiratory system}, exam {Lung finding}, clear to auscultation {Normal breath sounds}, Abdomen {Examination of abdomen}, +BS {Normal bowel sounds}, obese {Obese abdomen}, soft {Abdomen soft}, nontender {Abdominal tenderness}, nondistended {Normal abdominal contour}, Ext {Examination of limb}, WWP {Normal tissue perfusion}, pitting edema {Pitting edema}, L knee {Structure of left knee region}, Neuro {Neurological examination}, Oriented to self, place, and year {Oriented to person, time and place}, asterixis {Asterixis}, motor exam {Motor testing}, pain {Pain}, sensation to light 
+touch intact {Light touch sensation present}"
+"###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:
+================
+___ 12:20AM BLOOD WBC-5.5 RBC-3.23* Hgb-9.7* Hct-28.6* 
+MCV-89 MCH-30.2 MCHC-34.1 RDW-16.3* Plt ___
+___ 12:20AM BLOOD Neuts-70.5* ___ Monos-7.1 Eos-0 
+Baso-0.2
+___ 12:20AM BLOOD ___ PTT-37.1* ___
+___ 12:20AM BLOOD Plt ___
+___ 12:20AM BLOOD Glucose-125* UreaN-72* Creat-2.2* Na-131* 
+K-4.4 Cl-94* HCO3-26 AnGap-15
+___ 12:20AM BLOOD ALT-25 AST-12 AlkPhos-129 TotBili-0.8
+___ 12:20AM BLOOD CK-MB-1 cTropnT-0.13*
+___ 05:40AM BLOOD CK-MB-1 cTropnT-0.14*
+___ 09:45AM BLOOD CK-MB-2 cTropnT-0.15*
+___ 12:20AM BLOOD Albumin-3.0*
+___ 05:40AM BLOOD Albumin-3.0* Calcium-9.1 Phos-4.1 Mg-1.6
+___ 05:40AM BLOOD Osmolal-300
+___ 05:40AM BLOOD Cyclspr-80*
+___ 02:46PM URINE Color-LtAmb Appear-SlHazy Sp ___
+___ 02:46PM URINE Blood-NEG Nitrite-NEG Protein-30 
+Glucose-NEG Ketone-NEG Bilirub-NEG Urobiln-2* pH-5.5 Leuks-NEG
+___ 02:46PM URINE RBC-2 WBC-1 Bacteri-FEW Yeast-NONE Epi-0
+___ 02:46PM URINE CastHy-8*
+___ 02:46PM URINE Mucous-OCC
+___ 02:46PM URINE Hours-RANDOM Creat-139 Na-15 K-63 Cl-<10
+___ 02:46PM URINE Osmolal-369
+
+OTHER PERTINENT LABS:
+======================
+___ 05:45AM BLOOD Cyclspr-157
+___ 08:00AM BLOOD Cyclspr-114
+___ 05:35AM BLOOD Cyclspr-140
+___ 08:55AM BLOOD Cyclspr-339
+___ 04:47AM BLOOD Cyclspr-77*
+___ 05:40AM BLOOD Cyclspr-86*
+___ 05:24AM BLOOD Cyclspr-81*
+___ 06:40AM BLOOD Cyclspr-82*
+
+DISCHARGE LABS:
+================
+___ 05:40AM BLOOD WBC-4.5 RBC-3.08* Hgb-9.1* Hct-27.4* 
+MCV-89 MCH-29.5 MCHC-33.1 RDW-15.6* Plt ___
+___ 05:40AM BLOOD ___ PTT-36.1 ___
+___ 05:40AM BLOOD Glucose-121* UreaN-57* Creat-2.1* Na-130* 
+K-4.3 Cl-91* HCO3-33* AnGap-10
+___ 05:40AM BLOOD ALT-12 AST-9 AlkPhos-133* TotBili-0.8
+___ 05:40AM BLOOD Calcium-9.7 Phos-3.9 Mg-1.7
+
+MICROBIOLOGY:
+==============
+___ 11:48 pm URINE      Source: Catheter. 
+
+**FINAL REPORT ___
+
+URINE CULTURE (Final ___: 
+PROTEUS MIRABILIS.    >100,000 ORGANISMS/ML.. 
+PRESUMPTIVE IDENTIFICATION. 
+
+SENSITIVITIES: MIC expressed in MCG/ML
+                      
+_________________________________________________________
+                             PROTEUS MIRABILIS
+                             |   
+AMPICILLIN------------  =>32 R
+AMPICILLIN/SULBACTAM--     8 S
+CEFAZOLIN-------------    16 R
+CEFEPIME--------------   <=1 S
+CEFTAZIDIME-----------   <=1 S
+CEFTRIAXONE-----------   <=1 S
+CIPROFLOXACIN---------   =>4 R
+GENTAMICIN------------   <=1 S
+MEROPENEM-------------<=0.25 S
+PIPERACILLIN/TAZO-----   <=4 S
+TOBRAMYCIN------------   <=1 S
+TRIMETHOPRIM/SULFA----  =>16 R
+
+___ 2:46 pm URINE      Source: Catheter. 
+
+URINE CULTURE (Final ___:    NO GROWTH. 
+Blood Culture, Routine (Final ___:    NO GROWTH. 
+
+IMAGING:
+=========
+TTE (___):
+The left atrium is elongated. The right atrium is moderately 
+dilated. No atrial septal defect is seen by 2D or color Doppler. 
+There is mild symmetric left ventricular hypertrophy with normal 
+cavity size and regional/global systolic function (LVEF>55%). 
+There is no ventricular septal defect. Right ventricular chamber 
+size and free wall motion are normal. The diameters of aorta at 
+the sinus, ascending and arch levels are normal. The aortic 
+valve leaflets (3) are mildly thickened but aortic stenosis is 
+not present. Mild (1+) aortic regurgitation is seen. The mitral 
+valve leaflets are mildly thickened. Mild (1+) mitral 
+regurgitation is seen. The tricuspid valve leaflets are mildly 
+thickened. There is mild pulmonary artery systolic hypertension. 
+There is a small pericardial effusion. There are no 
+echocardiographic signs of tamponade. 
+Compared with the prior study (images reviewed) of ___, 
+the degree of MR seen has decreased. AS is not appreciated.  
+
+CXR (___):
+There is a right-sided PICC line terminating in the mid SVC.  
+Patient rotation contributes to exaggeration of the cardiac 
+size, which is likely normal. Segmental atelectasis is noted, 
+particular in the right lung, although there does appear to be 
+new pulmonary edema superimposed on this. There may be small 
+tiny effusions. There is no pneumothorax. 
+
+Renal U/S (___):
+IMPRESSION:  
+1. No evidence of hydronephrosis. 
+2. Extremely limited Doppler evaluation due to technically 
+limited study, 
+demonstrating both kidneys to be vascularized.  No further 
+Dopp;er analysis could be obtained. 
+ 
+
+###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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, Neuts {Neutrophil count}, Monos {Monocyte count}, Eos {Eosinophil count}, Baso {Basophil 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}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, Albumin {Albumin measurement}, Albumin {Albumin measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Nitrite {Nitrite measurement}, Protein {Measurement of protein in urine}, Glucose {Glucose measurement, urine}, Ketone {Urinalysis, acetone or ketone bodies measurement}, pH {pH measurement}, URINE {Urinalysis}, RBC {Red blood cell count}, WBC {White blood cell count}, Bacteri {Bacteriuria}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, URINE {Urinalysis}, 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}, 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}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, URINE {Urine culture}, URINE CULTURE {Urine culture}, SENSITIVITIES {Antimicrobial susceptibility test}, URINE {Urine culture}, URINE CULTURE {Urine culture}, Blood Culture {Blood culture}, left atrium is elongated {Left atrial enlargement}, right atrium is moderately 
+dilated {Right atrial dilatation}, atrial septal defect {Atrial septal defect}, color Doppler {Color Doppler ultrasound}, mild symmetric left ventricular hypertrophy {Mild left ventricular hypertrophy}, normal 
+cavity {Normal size cardiac chamber}, regional/global systolic function {Normal left ventricular systolic function and wall motion}, ventricular septal defect {Ventricular septal defect}, Right ventricular chamber {Right cardiac ventricular structure}, size {Normal size}, wall motion are normal {Normal ventricular wall motion}, aorta at 
+the sinus {Structure of sinus of Valsalva}, ascending {Ascending aorta structure}, arch {Aortic arch structure}, normal {Normal appearance}, aortic 
+valve leaflets {Structure of cardiac valve leaflet}, mildly thickened {Increased thickness}, aortic stenosis {Aortic valve stenosis}, Mild (1+) aortic regurgitation {Mild mitral valve regurgitation}, mitral 
+valve leaflets are mildly thickened {Thickened mitral leaflet}, Mild (1+) mitral 
+regurgitation {Mild mitral valve regurgitation}, tricuspid valve leaflets {Structure of leaflet of tricuspid valve}, pulmonary artery systolic hypertension {Pulmonary hypertensive arterial disease}, pericardial effusion {Pericardial effusion}, echocardiographic {Echocardiography}, signs {Sign}, tamponade {Cardiac tamponade}, MR {Mitral valve regurgitation}, PICC line {Peripherally inserted central venous catheter in situ}, SVC {Superior vena cava structure}, cardiac {Heart structure}, normal {Normal appearance}, atelectasis {Atelectasis}, right lung {Right lung structure}, pulmonary edema {Pulmonary edema}, effusions {Pleural effusion}, pneumothorax {Pneumothorax}, No evidence {No abnormality detected}, hydronephrosis {Hydronephrosis}, evaluation {Evaluation procedure}, both kidneys {Both kidneys}"
+"###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:
+Mr. ___ is a ___ gentleman with HCV cirrhosis ___ years 
+s/p OLD and h/o DVT and PE (on Coumadin) who was transferred 
+from an OSH with chest pain, which resolved on admission, but 
+found to have supratherapeutic INR and ___.
+
+# Acute on chronic kidney disease:  Cr up to 2.2 on admission 
+from baseline of 1.4-1.5.  Cr rose to 2.7 after albumin/IVF 
+boluses.  Muddy brown casts were seen on urine sediment.  Per 
+renal, multiple hypotensive episodes and bradycardia likely 
+resulted in ATN.  Patient's creatinine slowly improved after 
+starting diuretics.  Cr on discharge was 2.1.  Kidney function 
+is expected to recover with time.
+
+# Anasarca:  Patient was grossly anasarcic after being volume 
+resuscitated with albumin for hypotension.  TTE was largely 
+unchanged.  Patient was diuresed with 40-80 mg IV Lasix/day and 
+his edema improved.  He was discharged on torsemide 40 mg po 
+daily.
+
+# Hepatitis C cirrhosis s/p OLT:  Transplanted in ___, on 
+cyclosporine 75 mg q12h.  MMF was stopped in clinic in 
+___ and LFTs remained normal.  HCV VL 342,000 IU/mL on 
+___.  Last biopsy was performed at previous admission 
+revealed Grade ___ inflammation, no acute cellular rejection, no 
+steatosis or ballooning, and stage ___ fibrosis.   Atovaquone 
+was continued for prophylaxis.  Cyclosporine was decreased to 50 
+mg q12h and levels were monitored.
+
+# Supratherapeutic INR:  Patient's Coumadin was held on 
+admission for supratherapeutic INR.  He received vitamin K for 
+INR 5.2 and INR then became subtherapeutic.  Warfarin was 
+restarted with a heparin gtt until INR became therapeutic.  INR 
+became supratherapeutic again and Coumadin dose was adjusted.  
+INR on discharge was 3.6.  He was discharged on Coumadin 1 mg 
+daily.
+
+# Hypertension:  Patient was initially hypotensive and losartan 
+and diuretics were held.  He received an albumin bolus with 
+improvement in his blood pressure.  He then became hypertensive 
+during the latter part of his hospitalization (SBP up to 
+170/180s).  Losartan continued to be held given ___.  Patient 
+was started on amlodipine 5 mg daily, which can be uptitrated as 
+needed.
+
+# Prior left knee infection s/p hardware removal in ___:  
+Patient has chronic pain related to his previous knee 
+infection/hardware removal.  He also has shallow venous stasis 
+ulcers on bilateral lower extremities.  Patient's orthopedic 
+surgeon plans to replace his knee hardware once his ulcers have 
+healed and his leg swelling has resolved.  Patient's pain was 
+well-controlled on home Oxycontin and po Dilaudid.  He became 
+confused after receiving IV Dilaudid, so this was avoided.   
+
+# Catheter-associated UTI:  Initial urine culture was negative.  
+Repeat urine culture after catheter was placed grew >100,000 
+Klebsiella sensitive to ceftriaxone.  Foley was exchanged and 
+patient completed a 7 day course of ceftriaxone.  Foley was 
+removed prior to discharge.
+
+# Chest Pain:  Patient had chest pain at OSH, which resolved on 
+admission here.  No ischemic changes on EKG and three sets of 
+cardiac enzymes were negative.  Considered PE, especially given 
+h/o prior PE, but patient had been therapeutic on Coumadin.  CTA 
+was deferred given ___.
+
+# Atrial fibrillation/pauses:  Not on agents for rate or rhythm 
+control.  During last admission (___), patient was 
+bradycardic at night with ___ second pauses seen on telemetry. 
+ Patient continued to have pauses with HR ___, though rates 
+improved to ___ without intervention.  It is unclear if these 
+pauses are contributing to hypotensive episodes.  Patient is 
+followed by Dr. ___ have further outpatient EP 
+evaluation if warranted. 
+ 
+# Hyponatremia:  Na persistently low (as low as 130s), which is 
+chronic per review of prior discharge summaries.  Hyponatremia 
+neither responded to nor worsened with albumin or diuretics.
+
+TRANSITIONAL ISSUES:
+=====================
+[ ] Please check labs (CBC, CMP, LFTs, cyclosporine level, INR, 
+and PTT) on ___. Send labs to the ___ at ___ 
+___.
+[ ] INR 3.6 on discharge. Please hold Coumadin on ___. 
+Restart Coumadin at 1 mg daily on ___. Recheck INR on 
+___. Goal INR 2.0-3.0
+[ ] Patient was started on torsemide 40 mg daily for leg edema. 
+This should be decreased/discontinued if kidney function 
+worsens.
+[ ] Losartan held given ___. Amlodipine 5 mg daily started for 
+hypertension. Uptitrate to 10 mg daily as needed for blood 
+pressure.
+[ ] Cyclosporine dose decreased from 75 mg q12h to 50 mg q12h.
+[ ] Patient is followed by Dr. ___. Consider further 
+evaluation of bradycardia/pauses if indicated (note: bradycardia 
+improved, pauses persisted)
+[ ] Patient will have follow-up scheduled with orthopedics and 
+neurology (for pre-op clearance, per ortho). Ortho plans to 
+replace his left knee after venous stasis ulcers have healed and 
+after lower extremity swelling has resolved.
+[ ] PICC kept in place given need for frequent lab draws. 
+# Code: Full (confirmed) 
+# Emergency contact/HCP: ___ (wife) ___
+ 
+
+###RESPONSE: HCV cirrhosis {Cirrhosis of liver due to chronic hepatitis C}, OLD {Orthotopic liver transplant}, DVT {Deep venous thrombosis}, PE {Pulmonary embolism}, chest pain {Chest pain}, resolved {Problem resolved}, INR {Calculation of international normalized ratio}, Acute on chronic kidney disease {Acute-on-chronic renal failure}, Cr {Finding of creatinine level}, baseline {Baseline state}, Cr {Finding of creatinine level}, albumin {Administration of albumin}, IVF {Administration of intravenous fluids}, casts {Cast}, hypotensive episodes {Hypotensive episode}, bradycardia {Bradycardia}, ATN {Acute tubular necrosis}, creatinine {Creatinine measurement}, improved {Patient's condition improved}, diuretics {Diuretic therapy},  Cr {Finding of creatinine level}, Kidney function {Renal function monitoring}, Anasarca {Anasarca}, anasarcic {Anasarca}, resuscitated {Resuscitation}, albumin {Administration of albumin}, hypotension {Low blood pressure}, TTE {Transthoracic echocardiography}, diuresed {Diuretic therapy}, edema {Edema}, improved {Patient's condition improved}, Hepatitis C cirrhosis {Cirrhosis of liver due to chronic hepatitis C}, OLT {Orthotopic transplantation of whole liver}, Transplanted {Transplantation of liver}, LFTs {Hepatic function panel}, HCV {Viral hepatitis type C}, VL {Viral load}, biopsy {Biopsy}, inflammation {Inflammatory disorder}, acute cellular rejection {Acute cellular graft rejection}, steatosis {Steatosis}, fibrosis {Fibrosis}, prophylaxis {Preventive procedure}, monitored {Monitoring procedure}, INR {Calculation of international normalized ratio}, INR {Calculation of international normalized ratio}, INR {Calculation of international normalized ratio}, INR {Calculation of international normalized ratio}, Warfarin {Warfarin therapy}, restarted {Restart of medication}, heparin {Heparin therapy}, INR {Calculation of international normalized ratio}, INR {Calculation of international normalized ratio}, INR {Calculation of international normalized ratio}, Hypertension {Hypertensive disorder, systemic arterial}, hypotensive {Low blood pressure}, diuretics {Diuretic therapy}, albumin {Administration of albumin}, improvement {Patient's condition improved}, blood pressure {Blood pressure finding}, hypertensive {Hypertensive disorder, systemic arterial}, SBP {Increased systolic arterial pressure}, left knee {Structure of left knee region}, infection {Infectious disease}, hardware removal {Removal of device}, chronic pain {Chronic pain}, knee {Structure of left knee region}, infection {Infectious disease}, hardware removal {Removal of device}, venous stasis 
+ulcers on bilateral lower extremities {Venous ulcer of lower limb}, knee {Structure of left knee region}, ulcers {Ulcer}, leg swelling {Leg swelling symptom}, resolved {Problem resolved}, pain was 
+well-controlled {Demonstrates adequate pain control}, confused {Clouded consciousness}, IV {Intravenous therapy}, Catheter-associated UTI {Urinary tract infection associated with catheter}, urine culture was negative {Urine culture - no growth}, urine culture {Urine culture}, catheter was placed {Catheterization}, Foley {Catheterization of urinary bladder}, exchanged {Replacement procedure}, Foley was 
+removed {Removal of urinary bladder catheter}, Chest Pain {Chest pain}, chest pain {Chest pain}, resolved {Problem resolved}, No ischemic changes {Electrocardiogram: no myocardial ischemia}, EKG {Electrocardiographic procedure}, cardiac enzymes were negative {Cardiac enzymes within reference range}, PE {Pulmonary embolism}, PE {Pulmonary embolism}, CTA {Computed tomography angiography with contrast}, Atrial fibrillation {Atrial fibrillation}, rate {Finding of heart rate}, rhythm {Normal sinus rhythm}, bradycardic {Bradycardia}, pauses {Heart block}, telemetry {Cardiac telemetry}, pauses {Heart block}, HR {Finding of heart rate}, rates {Finding of heart rate}, improved {Patient's condition improved}, hypotensive episodes {Hypotensive episode}, EP {Cardiac electrophysiology}, evaluation {Evaluation procedure}, Hyponatremia {Hyponatremia}, chronic {Chronic disease}, Hyponatremia {Hyponatremia}, worsened {Patient's condition worsened}, albumin {Administration of albumin}, diuretics {Diuretic therapy}, CBC {Complete blood count}, LFTs {Hepatic function panel}, INR {Calculation of international normalized ratio}, INR {Calculation of international normalized ratio}, hold {Recommendation to stop drug treatment}, Restart {Restart of medication}, INR {Calculation of international normalized ratio}, INR {Calculation of international normalized ratio}, leg edema {Edema of lower leg}, discontinued {Recommendation to stop drug treatment}, kidney function 
+worsens {Decreased renal function}, hypertension {Hypertensive disorder, systemic arterial}, evaluation {Evaluation procedure}, bradycardia {Bradycardia}, pauses {Heart block}, bradycardia {Bradycardia}, improved {Patient's condition improved}, pauses {Heart block}, follow-up {Follow-up arranged}, left knee {Structure of left knee region}, venous stasis ulcers {Venous ulcer of lower limb}, lower extremity swelling {Swelling of lower limb}, resolved {Problem resolved}, PICC {Peripherally inserted central venous catheter in situ}"
+"###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. Acetaminophen 650 mg PO Q6H:PRN pain 
+2. Atovaquone Suspension 1500 mg PO DAILY 
+3. Bisacodyl ___AILY:PRN constipation 
+4. CycloSPORINE (Neoral) MODIFIED 75 mg PO Q12H 
+5. Fluoxetine 20 mg PO DAILY 
+6. Gabapentin 200 mg PO TID 
+7. HYDROmorphone (Dilaudid) 4 mg PO Q6H:PRN pain 
+8. Losartan Potassium 25 mg PO DAILY 
+9. Omeprazole 40 mg PO BID 
+10. Ranitidine 75 mg PO BID:PRN heartburn 
+11. Senna 17.2 mg PO QHS 
+12. Vitamin D ___ UNIT PO DAILY 
+13. Warfarin 2.5 mg PO DAILY16 
+14. Lactulose 30 mL PO TID 
+15. Ondansetron 4 mg PO Q8H:PRN nausea 
+16. Acidophilus (L.acidoph & 
+___ acidophilus) 175 mg oral 
+BID  
+17. Ferrous Sulfate 325 mg PO DAILY 
+18. Polyethylene Glycol 17 g PO EVERY OTHER DAY 
+19. OxyCODONE SR (OxyconTIN) 10 mg PO Q12H 
+20. Furosemide 40 mg PO DAILY 
+
+ 
+Discharge Medications:
+1. Acetaminophen 650 mg PO Q6H:PRN pain 
+2. Atovaquone Suspension 1500 mg PO DAILY 
+3. Bisacodyl ___AILY:PRN constipation 
+4. CycloSPORINE (Neoral) MODIFIED 50 mg PO Q12H 
+5. Ferrous Sulfate 325 mg PO DAILY 
+6. Fluoxetine 20 mg PO DAILY 
+7. HYDROmorphone (Dilaudid) 4 mg PO Q6H:PRN pain 
+RX *hydromorphone 4 mg 1 tablet(s) by mouth q6h prn Disp #*10 
+Tablet Refills:*0
+8. Lactulose 30 mL PO QID 
+9. Omeprazole 40 mg PO BID 
+10. Ondansetron 4 mg PO Q8H:PRN nausea 
+11. Polyethylene Glycol 17 g PO EVERY OTHER DAY 
+12. Ranitidine 75 mg PO BID:PRN heartburn 
+13. Senna 17.2 mg PO QHS 
+14. Vitamin D ___ UNIT PO DAILY 
+15. Warfarin 1 mg PO DAILY16 
+16. Amlodipine 5 mg PO DAILY 
+17. Torsemide 40 mg PO DAILY 
+18. Lidocaine 5% Patch 1 PTCH TD QAM 
+19. Acidophilus (L.acidoph & 
+___ acidophilus) 175 mg oral 
+BID  
+20. OxyCONTIN (oxyCODONE) 10 mg oral Q12H 
+RX *oxycodone [OxyContin] 10 mg 1 tablet(s) by mouth every 
+twelve (12) hours Disp #*10 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:
+Extended Care
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+PRIMARY DIAGNOSIS:
+===================
+Acute on chronic kidney disease
+
+SECONDARY DIAGNOSES:
+=====================
+Hypertension
+Catheter-associated urinary tract infection
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Out of Bed with assistance to chair or 
+wheelchair.
+
+ 
+
+###RESPONSE: Acute on chronic kidney disease {Acute-on-chronic renal failure}, Hypertension {Hypertensive disorder, systemic arterial}, Catheter-associated urinary tract infection {Urinary tract infection associated with catheter}, Mental Status {Neurological mental status determination}, Clear {Normal state of mind}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, interactive {Does communicate}, Out of Bed with assistance {Difficulty getting off a bed}"
+"###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. ___,
+
+It was a pleasure caring for you during your stay at ___.  You 
+were admitted because your kidney function was abnormal.  This 
+was likely due to damage to your kidneys from intermittently 
+having low blood pressure.  Your kidney function slowly 
+recovered and will hopefully continue to improve.  You were 
+given medications to remove fluid from your legs.  After your 
+leg swelling resolves and your leg ulcers heal, the orthopedic 
+surgeons will replace your knee.  Your blood pressure became 
+high, so you were started on a new medication to help with this.
+
+It is very important that you continue to take your medications 
+as prescribed and keep your follow-up appointments.
+
+We wish you good health!
+
+Sincerely,
+Your ___ Team
+ 
+
+###RESPONSE: kidney function {Renal function monitoring}, damage {Damage}, kidneys {Kidney structure}, low blood pressure {Low blood pressure}, kidney function {Renal function monitoring}, medications {Patient medication education}, legs {Lower limb structure}, leg swelling {Leg swelling symptom}, resolves {Problem resolved}, leg ulcers {Ulcer of lower extremity}, replace your knee {Arthroplasty of knee}, blood pressure became 
+high {Hypertensive disorder, systemic arterial}, new medication {New medication commenced}, take your medications 
+as prescribed {Patient medication education}"
+"###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: 
+No Known Allergies / Adverse Drug Reactions
+ 
+Attending: ___.
+ 
+Chief Complaint:
+needs heparin bridge
+ 
+Major Surgical or Invasive Procedure:
+___ right premolar extraction
+
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, right {Structure of right half of lower jaw region}, premolar {Structure of premolar tooth}, extraction {Tooth extraction}"
+"###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 ___ ___ lady with AFib, MV 
+stenosis s/p mechanical MV replacement ___ on Warfarin (INR 
+goal 2.5-3.5), severe tricuspid regurgitation, chronic 
+right-sided heart failure (EF 50%), with congestive hepatopathy 
+and ascites, severe pulmonary hypertension, and CAD s/p CABG 
+___ who has had ongoing tooth pain and requires a dental 
+procedure so she is admitted for Heparin bridge in anticipation 
+of the procedure.
+
+She has been having tooth pain for weeks.  Pain is located in 
+right pre-molar. She denies fevers and has not been on any 
+antibiotics.  She went to the dentist as an outpatient who 
+stated that she will need dental extraction (right pre-molar 
+tooth) but was unable to perform this in the setting of 
+mechanical valve.  She told this with her HCA PCP ___ 
+___ who discussed with her Cardiologist (___) who 
+recommended IV heparin bridging prior to dental procedure.  She 
+is a direct admit to the Medicine floor.
+ 
+On arrival to the floor, she feels at her baseline with pain of 
+right pre-molar tooth.
+
+Review of sytems:  
+Denies fever, chills, night sweats, headache, vision changes, 
+rhinorrhea, congestion, sore throat, cough, chest pain, 
+abdominal pain, nausea, vomiting, diarrhea, constipation, BRBPR, 
+melena, hematochezia, dysuria, hematuria.  
+ 
+
+###RESPONSE: AFib {Atrial fibrillation}, MV 
+stenosis {Mitral valve stenosis}, mechanical MV replacement {Mechanical prosthetic mitral valve replacement}, severe tricuspid regurgitation {Severe tricuspid valve regurgitation}, chronic 
+right-sided heart failure {Chronic right-sided heart failure}, hepatopathy {Disorder of liver}, ascites {Ascites}, severe pulmonary hypertension {Severe pulmonary hypertension}, CAD {Coronary arteriosclerosis}, CABG {Coronary artery bypass grafting}, tooth pain {Toothache}, dental 
+procedure {Dental surgical procedure}, procedure {Procedure}, tooth {Structure of dentition}, pain {Pain}, Pain {Pain}, right {Structure of right half of lower jaw region}, pre-molar {Structure of premolar tooth}, fevers {Fever}, antibiotics {Antibiotic therapy}, dental extraction {Tooth extraction}, right {Structure of right half of lower jaw region}, pre-molar 
+tooth {Structure of premolar tooth}, dental procedure {Dental surgical procedure}, pain {Pain}, right {Structure of right half of lower jaw region}, pre-molar tooth {Structure of premolar tooth}, fever {Fever}, chills {Chill}, night sweats {Night sweats}, headache {Headache}, rhinorrhea {Nasal discharge}, congestion {Nasal congestion}, sore throat {Sore throat}, cough {Cough}, chest pain {Chest pain}, abdominal pain {Abdominal pain}, nausea, vomiting, diarrhea {Nausea, vomiting and diarrhea}, constipation {Constipation}, BRBPR {Hematochezia}, melena {Melena}, hematochezia {Hematochezia}, dysuria {Dysuria}, hematuria {Blood in urine}"
+"###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:
+1. CARDIAC RISK FACTORS: 
+      Diabetes
+2. CARDIAC HISTORY:  
+   1.) Severe right heart failure: As of ___, 
+well-compensated NYHA ___, secondary to rheumatic fever as a 
+child. Complicated by congestive hepatopathy and cirrhosis.
+   2.) Severe pulmonary hypertension
+   3.) ""Wide open,"" severe tricuspid regurgitation since MVR 
+___.
+Status post-mitral valve
+   4.) Mechanical mitral valve repair ___ (and ___ per Pt) for 
+
+mitral stenosis (from rheumatic fever), on warfarin chronically
+   5.) Preserved EF
+   6.) CAD s/p CABG ___
+   7.) Atrial fibrillation, on warfarin. Bilaterally enlarged 
+atria.
+-CABG: ___
+-PERCUTANEOUS CORONARY INTERVENTIONS:  
+-PACING/ICD:  
+OTHER PAST MEDICAL HISTORY:  
+1. Crystal-proven gout. 
+2. Osteoarthritis of the knees.
+3.  Osteoarthritis of the hands.
+4.  Right rotator tendinopathy, resolved.
+5.  Cirrhosis, secondary to chronic passive liver congestion: 
+with ascites
+6.  Diabetes mellitus: Insulin-dependent, type II, complicated 
+by neuropathy
+7.  Anxiety
+8.  Varicose veins (extensive).
+9.  GERD
+
+ 
+
+###RESPONSE: CARDIAC RISK FACTORS {Assessment for risk of cardiovascular disease}, Diabetes {Diabetes mellitus}, CARDIAC {Heart structure}, right heart failure {Right ventricular failure}, rheumatic fever {Rheumatic fever}, hepatopathy {Disorder of liver}, cirrhosis {Cirrhosis of liver}, Severe pulmonary hypertension {Severe pulmonary hypertension}, severe tricuspid regurgitation {Severe tricuspid valve regurgitation}, MVR {Replacement of mitral valve}, mitral valve {Mitral valve structure}, Mechanical mitral valve repair {Mechanical prosthetic mitral valve replacement}, mitral stenosis {Mitral valve stenosis}, rheumatic fever {Rheumatic fever}, CAD {Coronary arteriosclerosis}, CABG {Coronary artery bypass grafting}, Atrial fibrillation {Atrial fibrillation}, Bilaterally enlarged 
+atria {Bilateral enlargement of atria}, CABG {Coronary artery bypass grafting}, PERCUTANEOUS CORONARY INTERVENTIONS {Percutaneous coronary intervention}, gout {Inflammatory disorder due to increased blood urate level}, Osteoarthritis of the knees {Osteoarthritis of knee}, Osteoarthritis of the hands {Degenerative joint disease of hand}, Right rotator tendinopathy {Tendinitis of right rotator cuff}, Cirrhosis {Cirrhosis of liver}, liver congestion {Cardiac cirrhosis}, ascites {Ascites}, Diabetes mellitus {Diabetes mellitus type 2}, neuropathy {Neuropathy}, Anxiety {Anxiety}, Varicose veins {Venous varices}, GERD {Gastroesophageal reflux 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: 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:
+No family history of early MI, arrhythmia, cardiomyopathies, or 
+sudden cardiac death; otherwise non-contributory.  
+ 
+
+###RESPONSE: MI {Myocardial infarction}, arrhythmia {Cardiac arrhythmia}, cardiomyopathies {Cardiomyopathy}, sudden cardiac death {Sudden cardiac death}"
+"###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 EXAM
+Vitals - 98.2, 135/77, 68, 98%RA
+General- Alert, oriented, no acute distress  
+HEENT- Sclera anicteric, dentures of lower teeth on, pain of 
+right pre-molar, no erythema/exudate appreciated  
+Neck- supple, JVP not elevated, no LAD  
+Lungs- Clear to auscultation bilaterally, no wheezes, rales, 
+ronchi  
+CV- Irregular, diastolic murmur RUSB
+Abdomen- soft, non-tender, non-distended, bowel sounds present, 
+no rebound tenderness or guarding, no organomegaly  
+GU- no foley  
+___- significant vericose veins b/l ___, 2+ pulses, no clubbing, 
+cyanosis or edema
+Neuro- CNs2-12 intact, motor function grossly normal  
+
+DISCHARGE EXAM
+Vitals - 97.___.2 129/54(120s-130s/50s), 70, 98%RA
+GEN - Alert, oriented, no acute distress  
+HEENT - Right lower pre molar extracted, sutures observed, no 
+active signs of bleeding. Pain well controlled. No 
+erythema/exudate appreciated, no jaw pain, no difficulty 
+opening/closing mouth  
+NECK - supple, JVP elevated 5cm, no LAD  
+LUNGS - Clear to auscultation bilaterally, no wheezes, or 
+crackles  
+CV - Irregular, diastolic murmur RUSB/LSB
+ABD - unchanged. soft, non-tender, non-distended, bowel sounds 
+present, no rebound tenderness or guarding, no organomegaly  
+GU- no foley  
+___ - unchanged. significant vericose veins b/l ___, 2+ pulses, 
+no clubbing, cyanosis or edema
+Neuro- CNs2-12 intact, motor function grossly normal. lucid.  
+ambulating on own.
+ 
+
+###RESPONSE: Vitals {Vital signs finding}, RA {Breathing room air}, General {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, distress {Distress}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, teeth {Structure of dentition}, pain {Pain}, right {Structure of right half of lower jaw region}, pre-molar {Structure of premolar tooth}, erythema {Erythema}, exudate {Exudate}, supple {Normal movement of neck}, JVP not elevated {Normal jugular venous pressure}, LAD {Lymphadenopathy}, Lungs {Examination of respiratory system}, Clear to auscultation bilaterally {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, ronchi {Wheeze - rhonchi}, CV {Cardiovascular physical examination}, Irregular {Irregular heart beat}, murmur {Murmur}, Abdomen- soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, bowel sounds present {Normal bowel sounds}, rebound {Rebound tenderness}, tenderness {Tenderness}, guarding {Abdominal guarding}, organomegaly {Abdominal organomegaly}, GU {Examination of genitourinary system}, vericose veins {Venous varices}, 2+ pulses {Peripheral pulses normal}, clubbing {Clubbing}, cyanosis {Cyanosis}, edema {Edema}, Neuro {Neurological examination}, CNs2-12 intact {Normal nervous system function}, motor function grossly normal {Normal motor response to command}, Vitals {Vital signs finding}, RA {Breathing room air}, GEN {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, distress {Distress}, HEENT {Physical examination procedure}, Right lower {Structure of right half of lower jaw region}, signs {Sign}, bleeding {Bleeding}, Pain well controlled {Demonstrates adequate pain control}, erythema {Erythema}, exudate {Exudate}, pain {Pain}, closing mouth {Difficulty closing mouth}, supple {Normal movement of neck}, JVP {Finding of jugular venous pressure}, LAD {Lymphadenopathy}, LUNGS {Examination of respiratory system}, Clear to auscultation bilaterally {Normal breath sounds}, wheezes {Wheezing}, crackles {Respiratory crackles}, CV {Cardiovascular physical examination}, Irregular {Irregular heart beat}, murmur {Murmur}, ABD {Examination of abdomen}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, bowel sounds 
+present {Normal bowel sounds}, rebound {Rebound tenderness}, tenderness {Tenderness}, guarding {Abdominal guarding}, organomegaly {Abdominal organomegaly}, GU {Examination of genitourinary system}, vericose veins {Venous varices}, 2+ pulses {Peripheral pulses normal}, clubbing {Clubbing}, cyanosis {Cyanosis}, edema {Edema}, Neuro {Neurological examination}, CNs2-12 intact {Normal nervous system function}, motor function grossly normal {Normal motor response to command}, lucid {Lucid}"
+"###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
+___ 10:02PM BLOOD WBC-7.0 RBC-3.57* Hgb-11.4* Hct-33.4* 
+MCV-94# MCH-31.9 MCHC-34.0 RDW-14.8 Plt ___
+___ 11:47AM BLOOD ___
+___ 06:00AM BLOOD Glucose-153* UreaN-50* Creat-1.5* Na-133 
+K-4.2 Cl-91* HCO3-33* AnGap-13
+___ 06:00AM BLOOD Calcium-9.7 Phos-3.4 Mg-2.3
+
+DISCHARGE LABS
+___ 07:15AM BLOOD WBC-6.7 RBC-3.78* Hgb-12.0 Hct-34.8* 
+MCV-92 MCH-31.7 MCHC-34.4 RDW-14.6 Plt ___
+___ 07:15AM BLOOD ___ PTT-91.1* ___
+___ 06:48AM BLOOD Glucose-138* UreaN-46* Creat-1.4* Na-132* 
+K-4.4 Cl-88* HCO3-32 AnGap-16
+___ 06:48AM BLOOD Calcium-9.8 Phos-4.2 Mg-2.4
+
+INR TREND
+___ 11:47AM BLOOD ___
+___ 06:00AM BLOOD ___ PTT-150* ___
+___ 07:00AM BLOOD ___ PTT-61.8* ___
+___ 06:00AM BLOOD ___ PTT-58.5* ___
+___ 12:43AM BLOOD ___ PTT-77.4* ___
+___ 06:48AM BLOOD ___ PTT-90.5* ___
+___ 07:15AM BLOOD ___ PTT-91.1* ___
+
+___ (PANOREX FOR DENTAL) - unread
+
+Pathology ReportTissue: Tooth # 28.Procedure Date of ___
+Report not finalized.
+Assigned Pathologist ___.
+Please contact the pathology department, ___ ___
+PATHOLOGY # ___
+Tooth # 28.
+ 
+
+###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}, 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}, 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}, PTT {Partial thromboplastin time, activated}, PTT {Partial thromboplastin time, activated}, PTT {Partial thromboplastin time, activated}, PTT {Partial thromboplastin time, activated}, PTT {Partial thromboplastin time, activated}, PTT {Partial thromboplastin time, activated}, Tooth {Structure of dentition}, Tooth {Structure of dentition}"
+"###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:
+Sra. ___ is a ___ ___ lady with AFib, MV 
+stenosis s/p mechanical MV replacement ___ on Warfarin (INR 
+goal 2.5-3.5), severe tricuspid regurgitation, chronic 
+right-sided heart failure (EF 50%), with congestive hepatopathy 
+and ascites, severe pulmonary hypertension, and CAD s/p CABG 
+___ who had ongoing tooth pain as an outpatient.  She was 
+directly admitted to Medicine for Heparin bridge while her INR 
+was allowed to drift downwards in order to undergo tooth 
+extraction.  She underwent uncomplicated single extraction of 
+tooth #28 on ___ and then remained in house on a Heparin drip 
+until her INR was therapeutic again, and then she was discharged 
+home.
+
+## DENTAL INFECTION & PAIN: resolved s/p extraction.
+No signs or symptoms of severe infection.  OMFS performed 
+uncomplicated single extraction of tooth #28 on ___, with 
+pre-operative Unasyn.  No bleeding complications.  The procedure 
+was done in the OR but only under local anesthesia.  Sutures 
+will dissolve.  She will follow up with her dentist or OMFS, as 
+she prefers.
+
+## MECHANICAL MV REPLACEMENT: on Warfarin, goal INR 2.5-3.5.
+As soon as she was directly admitted to the Medicine floor, she 
+was placed on Heparin gtt and her Warfarin was held.  She was 
+therapeutic for the duration of her admission, except for 
+stopping the drip 6 hrs pre-procedure.  It was able to be 
+re-started immediately post-operatively, and she was restarted 
+on her Warfarin post-operatively as well.  Heparin gtt was 
+stopped and she was discharged when her INR was >2.5.  Home 
+Warfarin dose was not changed; she will f/u tomorrow at ___ 
+___ clinic for INR check.
+- 5mg given ___ mg given ___ (INR in am = 1.9)
+- 7.5 mg give ___ (INR in am = 2.3)
+- Discharged ___ (INR in am = 3.0), please take 5 mg at home
+
+## CHF: stable issue, euvolemic.
+Her tricuspid regurgitation is severe and moderate pulmonary 
+hypertension; she was euvolemic on exam.  She was continued on 
+her home meds (torsemide, metoprolol, hctz, spironolactone).
+
+## HYPONa: asymptomatic, stable.
+Na 133 on admission.  Euvolemic on exam. Baseline Na appears to 
+be 133-140.  She remains on HCTZ, Torsemide, Spironolactone 
+which could be contributing.  Na was stable at 132 on the day of 
+discharge.
+
+## DM 2: stable.
+She was continued on her home Lantus 60mg QHS.  She initially 
+declined the proposed sliding scale (she felt that she would 
+drop too low since she was NPO for the procedure) and was 
+subsequently hyperglycemic in the 200's-300's.  When her family 
+brought in her home sliding scale, it was entered and she 
+complied, with much better blood glucose control.  She did not 
+have any hypoglycemia during this admission.
+
+## GOUT/OA: stable.
+She was continued on Febuxostat and low-dose Prednisone.
+
+## TRANSITIONAL ISSUES
+Emergency Contact:   ______
+Studies/labs pending at discharge:  
+--Panorex was viewed/interpreted by ___ so no Radiology read 
+pending
+--Extracted tooth pathology
+ 
+
+###RESPONSE: AFib {Atrial fibrillation}, MV 
+stenosis {Mitral valve stenosis}, mechanical MV replacement {Mechanical prosthetic mitral valve replacement}, severe tricuspid regurgitation {Severe tricuspid valve regurgitation}, chronic 
+right-sided heart failure {Chronic right-sided heart failure}, congestive hepatopathy {Cardiac cirrhosis}, ascites {Ascites}, severe pulmonary hypertension {Severe pulmonary hypertension}, CAD {Coronary arteriosclerosis}, CABG {Coronary artery bypass grafting}, tooth pain {Toothache}, tooth 
+extraction {Tooth extraction}, single extraction of 
+tooth {Extraction of single tooth}, DENTAL INFECTION {Infection of tooth}, PAIN {Pain}, extraction {Tooth extraction}, signs {Sign}, infection {Infectious disease}, single extraction of tooth {Extraction of single tooth}, bleeding {Bleeding}, procedure {Procedure}, under local anesthesia {Under local anesthesia}, MECHANICAL MV REPLACEMENT {Mechanical prosthetic mitral valve replacement}, CHF {Congestive heart failure}, stable {Patient's condition stable}, tricuspid regurgitation {Tricuspid valve regurgitation}, moderate pulmonary 
+hypertension {Moderate pulmonary hypertension}, HYPONa {Hyponatremia}, asymptomatic {Asymptomatic}, Baseline {Baseline state}, DM 2 {Diabetes mellitus type 2}, stable {Patient's condition stable}, procedure {Procedure}, blood glucose {Glucose measurement, blood}, hypoglycemia {Hypoglycemia}, GOUT {Inflammatory disorder due to increased blood urate level}, OA {Osteoarthritis}, stable {Patient's condition stable}, Extracted tooth {Tooth extraction}"
+"###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:
+1. Febuxostat 80 mg PO DAILY 
+2. Gabapentin 600 mg PO TID 
+3. Hydrochlorothiazide 12.5 mg PO DAILY  
+4. Metoprolol Succinate XL 25 mg PO DAILY  
+5. Potassium Chloride 10 mEq PO BID  
+6. PredniSONE 5 mg PO DAILY 
+7. Spironolactone 50 mg PO DAILY  
+8. Torsemide 150 mg PO DAILY 
+9. Warfarin ___ mg PO DAILY (AS DIRECTED BY ___ 
+___ CLINIC) 
+10. Glargine 60 Units Bedtime
+Insulin SC Sliding Scale using HUMALOG Insulin
+ 
+Discharge Medications:
+1. Febuxostat 80 mg PO DAILY 
+2. Gabapentin 600 mg PO TID 
+3. Hydrochlorothiazide 12.5 mg PO DAILY  
+4. Metoprolol Succinate XL 25 mg PO DAILY  
+5. Potassium Chloride 10 mEq PO BID  
+6. PredniSONE 5 mg PO DAILY 
+7. Spironolactone 50 mg PO DAILY  
+8. Torsemide 150 mg PO DAILY 
+9. Warfarin ___ mg PO DAILY (AS DIRECTED BY ___ 
+___ CLINIC) 
+10. Glargine 60 Units Bedtime
+Insulin SC Sliding Scale using HUMALOG Insulin
+ 
+
+###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:
+- Tooth extraction
+- INR maintenance and Heparin Bridge
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Tooth extraction {Tooth extraction}, Mental Status {Neurological mental status determination}, 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. ___,
+
+Thank you for choosing ___.  You were 
+admitted for extraction of your right premolar tooth and 
+management of your Warfarin/INR during this procedure.  Your 
+Home INR(International Normalized Ratio) goal is 2.5 - 3.5 given 
+your mechanical mitral valve.  Your Warfarin was stopped the day 
+before the procedure, and Heparin was started to maintain 
+anticoagulation.  The oral and maxillofacial surgeons (___) 
+performed the extraction in an operating room while Heparin was 
+off.  The operation was successful and there was minimal 
+bleeding.  Sutures were left in the location of the former 
+tooth, and these sutures will dissolve on their own.  The ___ 
+team suggests you follow up with them, or your home Dentist.  
+The ___ phone number is ___ if you wish to follow up 
+with them.
+
+After the procedure your Heparin was continued and Warfarin was 
+restarted to reach your INR goal of 2.5.  On the day of 
+discharge your INR = 3.0. 
+
+POST PROCEDURE RECOMMENDATIONS:
+- Pain control with Tylenol
+- Soft diet
+- Maintain meticulous oral hygiene
+- Rinse your mouth with Over the counter product called 
+""Peridex"" twice/day
+- No straws, vigorous rinsing, spitting
+
+MEDICATIONS:
+WARFARIN:
+- 5mg given ___ mg given ___ (INR in am = 1.9)
+- 7.5 mg give ___ (INR in am = 2.3)
+- Discharged ___ (INR in am = 3.0), please take 5 mg at home
+
+Continue other medications normally
+ 
+
+###RESPONSE: extraction {Extraction}, premolar tooth {Structure of premolar tooth}, procedure {Procedure}, mechanical mitral valve {Metal mitral valve prosthesis in situ}, procedure {Procedure}, anticoagulation {Anticoagulant therapy}, extraction {Extraction}, bleeding {Bleeding}, tooth {Structure of dentition}, procedure {Procedure}, Pain control {Pain control}, Soft diet {Soft diet}, oral hygiene {Mouth care}"
+"###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: 
+Patient recorded as having No Known Allergies to Drugs
+ 
+Attending: ___
+ 
+Chief Complaint:
+Change in mental status and fever
+ 
+Major Surgical or Invasive Procedure:
+None
+ 
+
+###RESPONSE: Change in mental status {Altered mental status}, fever {Fever}"
+"###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:
+___ yo M with recent diagnosis of gastric CA s/p total 
+gastrectomy of the Roux-en-Y reconstruction and feeding 
+jejunostomy with known anastamosis site ulcer and h/o aspiration 
+admitted with change in mental status and fever. Patient has 
+been feeling poorly since he was discharged home from the 
+hospital about 3 weeks ago. The patient has been following up 
+closely with his PCP who added ___ fentanyl patch and zofran to 
+help with pain and nausea. The patient went home and had 2 very 
+good days. On the third day he was a bit out of it but stable 
+and then on the fourth day he fell out of his chair and was 
+disoriented. He presented to the ED ___ and was treated for a 
+change in MS felt likely ___ oversedation with opiates. A CXR 
+was sent which showed atelectasis but no infiltrate. He was 
+taken off the oxycodone and fentanyl patch and sent home. 
+ On the day of admission his wife noted his temp to be 102 and 
+thought his MS had not improved very much so she called his pcp. 
+In office temp was 96, patient was noted to have increased cough 
+and sputum.  His PCP sent him here for workup of mental status 
+change and fever. 
+ On presentation he did not complain of pain just a diffuse 
+malaise. He reports a cough and wretching with nausea that is 
+responsive to zofran. He does not report SOB, chest pain, 
+abdominal pain, or calf pain. He reports feeling hot off and on 
+at homebut normally temp runs ___ except for the one at ___ 
+yesterday. He reports feeling a bit dehydrated but not dizzy or 
+light-headed. N one at home is sick and he has not traveled 
+anywhere recently.
+
+ 
+
+###RESPONSE: gastric CA {Malignant tumor of stomach}, total 
+gastrectomy {Total gastrectomy}, Roux-en-Y reconstruction {Total gastrectomy and anastomosis of esophagus to transposed jejunum}, feeding 
+jejunostomy {Feeding enterostomy of jejunum}, anastamosis site ulcer {Ulcer of anastomosis}, aspiration {Pulmonary aspiration}, change in mental status {Altered mental status}, fever {Fever}, pain {Pain}, nausea {Nausea}, stable {Patient's condition stable}, disoriented {Disorientated}, MS {Altered mental status}, CXR {Plain chest X-ray}, atelectasis {Atelectasis}, infiltrate {Infiltration}, temp {Body temperature finding}, MS {Altered mental status}, improved {Patient's condition improved}, temp {Body temperature finding}, cough {Cough}, sputum {Sputum finding}, workup {Evaluation procedure}, mental status {Neurological mental status determination}, fever {Fever}, pain {Pain}, malaise {Malaise}, cough {Cough}, nausea {Nausea}, SOB {Dyspnea}, chest pain {Chest pain}, abdominal pain {Abdominal pain}, calf pain {Pain in calf}, temp {Body temperature finding}, dehydrated {Dehydration}, dizzy {Dizziness}"
+"###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:
+Per OMR:
+HTN
+Osteoarthritis of L knee and R shoulder - s/p TKR ___
+Tonsillectomy
+Appendectomy 
+Bilateral cataract excision.
+ 
+
+###RESPONSE: Osteoarthritis of L knee {Osteoarthritis of left knee joint}, R shoulder {Osteoarthritis of joint of right shoulder region}, TKR {Total knee replacement}, Tonsillectomy {Tonsillectomy}, Appendectomy {Excision of appendix}, Bilateral cataract excision {Extraction of cataract of bilateral eyes}"
+"###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:
+Family history is notable for a son who died of lung cancer.
+ 
+
+###RESPONSE: died {Dead}, lung cancer {Malignant tumor of lung}"
+"###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:
+VITALS: t 95.6 BP 141/61 HR 80 RR 16 O2sat 95% RA
+GEN: Cachectic elderly M in NAD
+HEENT: NC/AT No scleral icterus. MMM
+NECK: No JVD. No LAD
+LUNGS: Crackles ___ way up
+HEART: RRR S1/S2 No M/R/G
+ABD: Incision site without erythema, dehiscence, or discharge. 
+Well-healed. Feeding tube in place with dressing 
+clean/dry/intact and just replaced today by PCP. +BS. NT/ND. NO 
+HSM 
+EXTREM: No cyanosis, clubbing, edema
+NEURO: Alert. Oriented X 3. CN ___ in tact. 
+
+ 
+
+###RESPONSE: VITALS {Vital signs finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, O2sat {Oxygen saturation measurement}, RA {Breathing room air}, GEN {General examination of patient}, Cachectic {Cachexia}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, NC {Normal head}, scleral icterus {Scleral icterus}, MMM {Moist oral mucosa}, NECK {Physical examination procedure}, JVD {Jugular venous engorgement}, LAD {Lymphadenopathy}, LUNGS {Examination of respiratory system}, Crackles {Respiratory crackles}, HEART {Cardiovascular physical examination}, RRR {Normal heart rate}, S2 {Normal second heart sound, S>2<}, No M/R/G {Heart sounds normal}, ABD {Examination of abdomen}, Incision site {Surgical incision wound}, erythema {Erythema}, dehiscence {Dehiscence}, Well-healed {Wound healed}, +BS {Normal bowel sounds}, NT {Abdominal tenderness}, ND {Swollen abdomen}, HSM {Hepatosplenomegaly}, EXTREM {Examination of limb}, cyanosis {Cyanosis}, clubbing {Clubbing}, edema {Edema}, NEURO {Neurological examination}, Alert {Mentally alert}, Oriented X 3 {Oriented to person, time and place}, CN {Cranial nerve 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: Pertinent Results:
+___ 12:30PM   WBC-13.0* RBC-3.72* HGB-11.2* HCT-33.8* 
+MCV-91 MCH-30.2 MCHC-33.2 RDW-15.5
+___ 12:30PM   NEUTS-87.0* LYMPHS-6.2* MONOS-6.5 EOS-0.3 
+BASOS-0.1
+___ 12:30PM   PLT COUNT-268
+___ 12:30PM   UREA N-17 CREAT-0.7 SODIUM-135 POTASSIUM-4.4 
+CHLORIDE-93* TOTAL CO2-33* ANION GAP-13
+___ 03:35PM   ___ PTT-32.4 ___
+___ 03:35PM   ALBUMIN-3.4 CALCIUM-9.0 PHOSPHATE-3.2 
+MAGNESIUM-1.9
+___ 03:35PM   ALT(SGPT)-18 AST(SGOT)-19 LD(LDH)-166 ALK 
+PHOS-71 TOT BILI-0.___XR: Pneumonia in the superior segment of the left lower lobe. 
+Results 
+communicated with Dr. ___ at 2:20 p.m. 
+
+CT HEAD: No acute intracranial abnormality.
+
+Assessment/Plan:
+___ yo M with recent diagnosis of gastric CA s/p total 
+gastrectomy of the Roux-en-Y reconstruction and feeding 
+jejunostomy admitted with fever and inc cough productive of 
+yellow sputum ___ PNA.
+.
+#. PNA: Patient with likely aspiration PNA. Clindmycin 300mg Q8H 
+and then switched to levofloxacin which would cover both the PNA 
+and the UTI. Blood cultures were pending at time of discharge 
+and will be followed up by Dr. ___.
+.
+#. UTI: Urine culture showed E.Coli. Sensitivities are pending 
+at time of discharge. He will be treated with Levofloxacin for 5 
+days with your last dose on ___.
+.
+#. Aspiration: Speech and swallow saw him and said nectar thick 
+liquids and pureed foods are ok but no medications PO. Refused 
+video swallow to eval for silent aspiration as cause of PNA. 
+Will go home on nectar thick liquids and pureed foods and have 
+repeat swallow exam as outpatient when can tolerate barium.
+.
+#. Pain: Controlled with tylenol standing, fentanyl patch, and 
+dilaudid PRN for pain while in house. 
+.
+#.Nausea: Exacerbated by constipation and increased rate of tube 
+feedings. Responds well to Zofran and compazine. Will go home 
+with scripts for this. Tube feeding goal rate was decreased to 
+70mL/hour to help him tolerate this and still get sufficient 
+caloric intake daily.
+.
+#. Anemia: Patient was noted to have a low hematocrit. Iron 
+studies suggest anemia of chronic disease. Patient will follow 
+up with his pcp regarding treatment and monitoring of this.
+.
+#. HTN: Patient had HTN while admitted. Started on previous dose 
+of metoprolol 12.5mg BID with good effect. Will continue as 
+outpatient.
+.
+#. FEN:Nutrtion recommened replete with fiber at 70mL/hour for 
+24hours daily. He will follow up for further recommendations 
+with the nutrition clinic at ___ as an outpatient. 
+.
+#. Prophylaxis: SC Heparin and PNeumoboots
+.
+#. Communication: With patient and dtr
+.
+#. Dispo: Full Code .
+ 
+
+###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}, CREAT {Creatinine measurement}, SODIUM {Sodium measurement}, POTASSIUM {Potassium measurement}, TOTAL CO2 {Blood total carbon dioxide (calculated)}, ANION GAP {Anion gap measurement}, PTT {Partial thromboplastin time, activated}, ALBUMIN {Albumin measurement}, CALCIUM {Blood calcium measurement}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, TOT BILI {Bilirubin, total measurement}, Pneumonia {Pneumonia}, left lower lobe {Structure of lower lobe of left lung}, intracranial {Intracranial structure}, abnormality {No abnormality detected}, gastric CA {Malignant tumor of stomach}, total 
+gastrectomy {Total gastrectomy}, Roux-en-Y reconstruction {Total gastrectomy and anastomosis of esophagus to transposed jejunum}, feeding 
+jejunostomy {Feeding enterostomy of jejunum}, fever {Fever}, cough productive of 
+yellow sputum {Productive cough-yellow sputum}, PNA {Pneumonia}, PNA {Pneumonia}, aspiration PNA {Aspiration pneumonia}, PNA {Pneumonia}, UTI {Urinary tract infectious disease}, Blood cultures {Blood culture}, UTI {Urinary tract infectious disease}, Urine culture {Urine culture}, E.Coli {Infection caused by Escherichia coli}, Sensitivities {Antimicrobial susceptibility test}, Aspiration {Aspiration}, nectar thick 
+liquids {Dietary liquid consistency - nectar thick liquid}, video swallow {Videofluoroscopy swallow}, aspiration {Pulmonary aspiration}, PNA {Pneumonia}, nectar thick liquids {Dietary liquid consistency - nectar thick liquid}, swallow exam {Fiberoptic endoscopic evaluation of swallowing}, Pain {Pain}, pain {Pain}, Nausea {Nausea}, constipation {Constipation}, tube 
+feedings {Tube feeding of patient}, Tube feeding {Tube feeding of patient}, Anemia {Anemia}, low hematocrit {Hematocrit below reference range}, anemia of chronic disease {Anemia of chronic disorder}, HTN {Hypertensive disorder, systemic arterial}, HTN {Hypertensive disorder, systemic arterial}, FEN {Nutrition management}, 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:
+Alternagel 1 tsp QID
+Dilaudid-5 1 mg Q6H PRN
+Atenolol 25mg PGT daily
+Zofran 4mg Q6H
+Lorazepam 0.5mg Per NG BID
+
+ 
+Discharge Medications:
+1. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 
+times a day): Please take through the feeding tube.
+Disp:*30 Tablet(s)* Refills:*2*
+2. Hydromorphone 2 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 
+hours) as needed for pain: Please take through the feeding tube.
+Disp:*30 Tablet(s)* Refills:*0*
+3. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q 8H 
+(Every 8 Hours): Please take through the feeding tube.  
+4. Lidocaine HCl 4 % Solution Sig: ___ MLs Mucous membrane Q6H 
+(every 6 hours).
+Disp:*500 mL* Refills:*2*
+5. Fentanyl 12 mcg/hr Patch 72 hr Sig: One (1) Patch 72 hr 
+Transdermal Q72H (every 72 hours).
+Disp:*5 Patch 72 hr(s)* Refills:*2*
+6. Lactulose 10 gram/15 mL Syrup Sig: Sixty (60) ML PO Q4H 
+(every 4 hours): Please do not take if you are having diarrhea.
+___ mL* Refills:*2*
+7. Polyethylene Glycol 3350 100 % Powder Sig: Seventeen (17) g 
+PO DAILY (Daily) as needed: Please do not take if you are having 
+diarrhea.
+Disp:*500 grams* Refills:*0*
+8. Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO HS (at 
+bedtime) as needed for for sleep.  
+9. Prochlorperazine Edisylate 5 mg/5 mL Syrup Sig: Ten (10) mg 
+PO every six (6) hours as needed for nausea.
+Disp:*60 ml* Refills:*1*
+10. Benzonatate 100 mg Capsule Sig: One (1) Capsule PO TID (3 
+times a day) as needed for cough.  
+11. Ondansetron 4 mg Tablet, Rapid Dissolve Sig: One (1) Tablet, 
+Rapid Dissolve PO Q8H (every 8 hours) as needed for nausea.  
+12. Jevity Plus     Liquid Sig: Seventy (70) ml/hr PO once a 
+day: Please increase tube feedings to 70mL/hour continuously for 
+24hours daily.
+Disp:*30 cans* Refills:*2*
+13. Levofloxacin 750 mg Tablet Sig: One (1) Tablet PO Q24H 
+(every 24 hours): Last dose on ___.
+Disp:*5 Tablet(s)* 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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Aspiration PNA
+Constipation
+
+ 
+Discharge Condition:
+The patient was afebrile, normotensive, not tachycaric, and 
+having normal bowel movements when he was discharged.
+
+ 
+
+###RESPONSE: Aspiration PNA {Aspiration pneumonia}, Constipation {Constipation}, afebrile {Fever}, normotensive {Normal blood pressure}, tachycaric {Tachycardia}"
+"###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 have been admitted with pneumonia. you have been treated 
+with antibiotics for this infection. You should continue the 
+antibiotics at home as outlined below.
+ You have also had constipation leading to nausea while you were 
+here. You should go home on stool softeners and laxatives as 
+outlined below. For the nausea you should take the anti-nausea 
+medicines you have at home.
+ You were also started on a low dose patch for your pain. You 
+should continue this patch and take dilaudid for breakthrough 
+pain only.
+ You have been given a swallowing evaluation that shows that you 
+are stil having a little bit of difficult swallowing. You should 
+only eat nectar thick liquids and soft solids. Pills should be 
+taken through your feeding tube. 
+ You had high blood pressures while you were hospitalized. You 
+were re-started on your metoprolol and your blood pressures were 
+more controlled. You should continue this as an outpatient.
+
+Medication changes:
+CHANGE Fentanyl Patch 25mg every 72 hours to Fentanyl Patch 
+12.5mg every 72 hours
+START: Clindamycin 300mg through feeding tube every 6 hours. 
+Last dose on ___
+START: Compazine 5mg through feeding tube every 6 hours as 
+needed for nausea
+START: Lactulose 60mL through feeding tube four times daily
+START: Polyethylene glycol 17g through feeding tube daily.
+START: Benzonatate 100mg through feeding tube every 8 hours as 
+needed for cough.
+START: Metoprolol 12.5mg via the feeding tube 2 times daily.
+
+You should call your PCP or come back to the ED if you have 
+fevers, shortness of breath, chest pain, severe abdominal pain, 
+severe nausea/vomiting, bright red blood in your stools or 
+tarry-looking stools. 
+ 
+
+###RESPONSE: pneumonia {Pneumonia}, treated 
+with antibiotics {Antibiotic therapy}, antibiotics {Antibiotic therapy}, constipation {Constipation}, nausea {Nausea}, stool softeners {Administration of laxative}, nausea {Nausea}, pain {Pain}, breakthrough 
+pain {Breakthrough pain}, nectar thick liquids {Dietary liquid consistency - nectar thick liquid}, high blood pressures {Hypertensive disorder, systemic arterial}"
+"###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: 
+Lipitor / Simvastatin / Megestrol
+ 
+Attending: ___.
+ 
+Chief Complaint:
+abdominal distension
+ 
+Major Surgical or Invasive Procedure:
+Paracentesis
+
+ 
+
+###RESPONSE: Lipitor {Allergy to atorvastatin}, Simvastatin {Allergy to simvastatin}, Megestrol {Allergy to megestrol}, abdominal distension {Swollen abdomen}, Paracentesis {Centesis}"
+"###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 man with h/o gastric ca, s/p 
+gastrectomy in ___, s/p 4 cycles ECX, cycle 1 CapOx in ___, 
+now with diffuse omental caking and malignant ascites, who is 
+being admitted with worsening abdominal distension, with plan 
+for ___ guided paracentesis.  
+  
+The patient had a therapeutic paracentesis last week with some 
+improvement in abdominal fullness. However, he has noted 
+increasing abdominal fullness over the past few days, associated 
+with abdominal pain typically in the evenings. He was seen in 
+the ED yesterday and discharged home with plan for ___ 
+paracentesis today. Otherwise, the patient is feeling ok. His 
+wife notes that he has had increasing nausea, not relieved with 
+Zofran, but Ativan helped yesterday. He also has mild shortness 
+of breath with exertion, but is still able to make it up 3 
+flights of stairs to their apartment.
+    
+ROS: No fevers, chills, chest pain, cough, headache, dysuria. No 
+BM in a week, not taking in much PO; on TPN at home.
+ 
+
+###RESPONSE: gastric ca {Malignant tumor of stomach}, gastrectomy {Excision of stomach structure}, omental {Omentum structure}, malignant ascites {Malignant ascites}, abdominal distension {Swollen abdomen}, paracentesis {Centesis}, paracentesis {Centesis}, abdominal fullness {Abdominal distension symptom}, abdominal fullness {Abdominal distension symptom}, abdominal pain {Abdominal pain}, paracentesis {Centesis}, nausea {Nausea}, mild {Symptom mild}, shortness 
+of breath with exertion {Dyspnea on exertion}, fevers {Fever}, chills {Chill}, chest pain {Chest pain}, cough {Cough}, headache {Headache}, dysuria {Dysuria}, on TPN {Total parenteral nutrition}"
+"###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:
+- p/w dysphagia  
+- EGD demonstrated a mass in the cardia of the stomach and  
+biopsy was consistent with poorly differentiated adenocarcinoma  
+
+with focal signet ring features.  
+- by EUS, he was staged as T3 with no evidence of invasion into 
+the thoracic aorta pericardium or pleura  
+- PET CT scan demonstrated a focus of avidity in the region of a 
+gastroesophageal junction, likely corresponding to the known 
+carcinoma and no evidence of distant metastatic disease was 
+identified.  
+- ___, underwent total gastrectomy - Pathology from that 
+procedure revealed a 6 x 6 x 1.5cm adenocarcinoma, diffuse type, 
+poorly differentiated with invasion into the serosa/visceral 
+peritoneum.  
+- ___ lymph nodes were positive out of 18 examined lymph nodes. 
+The proximal margin was involved by invasive carcinoma and he 
+did have lymphatic invasion.  
+- diagnosed with stage IIIC gastric cancer.  
+- Started on ___ with adjuvant ECX - received 4 cycles - 
+last treatment given on ___.  
+- Metastatic disease noted in ___ and C1D1 
+Oxaliplatin/capecitabine started on ___
+  
+Other 
+###RESPONSE: dysphagia {Dysphagia}, EGD {Esophagogastroduodenoscopy}, mass {Mass}, cardia {Cardia structure}, stomach {Stomach structure}, biopsy {Biopsy}, adenocarcinoma {Adenocarcinoma}, no evidence of invasion {No tumor invasion}, thoracic aorta {Thoracic aorta structure}, pericardium {Pericardial structure}, pleura {Pleural membrane structure}, PET {Positron emission tomography}, CT scan {Computed tomography of abdomen}, gastroesophageal junction {Cardioesophageal junction structure}, carcinoma {Carcinoma}, metastatic disease {Metastatic malignant neoplasm}, total gastrectomy {Total gastrectomy}, procedure {Procedure}, adenocarcinoma, diffuse type {Carcinoma, diffuse type}, serosa {Serous membrane structure}, lymph nodes {Structure of lymph node}, lymph nodes {Structure of lymph node}, carcinoma {Carcinoma}, lymphatic {Structure of lymphatic vessel}, gastric cancer {Malignant tumor of stomach}, Metastatic disease {Metastatic malignant neoplasm}"
+"###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:  
+HLD  
+Chronic pruritis, unknown etiology  
+Tonsillectomy and Adenoidectomy  
+Hydrocele repair  
+Ex-lap ___  
+Open chole  
+Meniscus surgery in ___  
+Cataract surgery in ___  
+Removal of a large colonic polyp on ___
+ 
+
+###RESPONSE: HLD {Hyperlipidemia}, Chronic {Chronic disease}, Tonsillectomy and Adenoidectomy {Tonsillectomy and adenoidectomy}, Hydrocele repair {Repair of hydrocele}, Meniscus surgery {Operation on meniscus of the knee}, Cataract surgery {Cataract surgery}, Removal {Removal}, colonic polyp {Polyp 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: 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:
+His mother died at age ___ from a brain hemorrhage and then had a 
+kidney removed. Father had high blood pressure and died at ___ of 
+a stroke. Sister had cancer and died at ___. A sister had a 
+stroke and died at ___. He has another sister with no medical 
+problems and a brother had early stage lung cancer who is alive 
+at age ___.  
+ 
+
+###RESPONSE: died {Dead}, brain {Brain structure}, hemorrhage {Hemorrhage}, kidney {Kidney structure}, high blood pressure {Hypertensive disorder, systemic arterial}, died {Dead}, stroke {Cerebrovascular accident}, cancer {Malignant neoplasm}, died {Dead}, stroke {Cerebrovascular accident}, died {Dead}, problems {Problem}, lung cancer {Malignant tumor of lung}, 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:
+ADMISSION EXAM:
+VS: T 96.5 BP 118/78 HR 95 RR 18 O2sat 97%RA 
+GEN: AOx3, NAD, cachectic appearing  
+HEENT: MMM. no LAD. no JVD. neck supple. 
+Cards: RR S1/S2 normal. no murmurs/gallops/rubs.  
+Pulm: No dullness to percussion, CTAB no crackles or wheezes  
+Abd: BS+, soft, diffusely tender in abdomen, mildly distended 
+with +fluid wave, no rebound/guarding, no HSM 
+Extremities: wwp, no edema. DPs, PTs 2+.  
+Neuro: AOx3, no focal deficits 
+  
+DISCHARGE EXAM:
+Less fullness on abdominal exam, otherwise unchanged
+ 
+
+###RESPONSE: VS {Vital signs finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, RA {Breathing room air}, GEN {General examination of patient}, AOx3 {Oriented to person, time and place}, NAD {No abnormality detected}, cachectic {Cachexia}, HEENT {Physical examination procedure}, MMM {Moist oral mucosa}, LAD {Lymphadenopathy}, JVD {Jugular venous engorgement}, supple {Normal movement of neck}, RR {Finding of rate of respiration}, S2 {Normal second heart sound, S>2<}, murmurs {Murmur}, gallops {Gallop rhythm}, rubs {Pericardial friction rub}, Pulm {Examination of respiratory system}, dullness to percussion {Dullness to percussion over Traube's space}, CTAB {Normal breath sounds}, crackles {Respiratory crackles}, wheezes {Wheezing}, Abd {Examination of abdomen}, BS+ {Normal bowel sounds}, soft {Abdomen soft}, tender {Abdominal tenderness}, distended {Swollen abdomen}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, HSM {Hepatosplenomegaly}, Extremities {Examination of limb}, wwp {Normal tissue perfusion}, edema {Edema}, Neuro {Neurological examination}, AOx3 {Oriented to person, time and place}, no focal deficits {Normal nervous system function}, abdominal exam {Examination of abdomen}"
+"###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:
+___ 09:45AM BLOOD WBC-13.7* RBC-3.91* Hgb-11.6* Hct-33.1* 
+MCV-85 MCH-29.7 MCHC-35.1* RDW-15.2 Plt ___
+___ 09:45AM BLOOD Neuts-82.3* Lymphs-9.7* Monos-6.0 Eos-1.8 
+Baso-0.3
+___ 09:45AM BLOOD ___ PTT-25.7 ___
+___ 09:45AM BLOOD Glucose-177* UreaN-30* Creat-0.7 Na-132* 
+K-5.7* Cl-100 HCO3-24 AnGap-14
+___ 01:09PM BLOOD K-4.4
+  
+STUDIES:
+___ U/S guided paracentesis:
+1. Small volume ascites.  
+2. Given the patient's pressure symptoms, 1.1 liters of fluid 
+was drained via a right flank approach.  
+
+ 
+
+###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}, K {Blood potassium measurement}, U/S guided paracentesis {Puncture and aspiration of abdomen using ultrasonographic guidance}, ascites {Ascites}, fluid 
+was drained {Drainage of abdomen}, flank {Flank 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:
+Mr. ___ is a ___ year old man with h/o gastric ca, s/p 
+gastrectomy in ___, s/p 4 cycles ECX, cycle 1 CapOx in ___, 
+now with diffuse omental caking and malignant ascites, admitted 
+for U/S-guided therapeutic paracentesis for abdominal 
+distension.  
+    
+#. Abdominal distension: Initially thought to be due to 
+increasing ascites. However, only 1L removed from paracentesis 
+with little improvement in symptoms. Abdominal fullness likely 
+also related to constipation, as the patient did not have a 
+bowel movement for almost 10 days prior to admission. He was 
+given a dose of Lactulose, as well as an enema, and had a 
+successful bowel movement prior to discharge. He was started on 
+Lactulose, Colace, and Senna.
+ 
+
+ 
+
+###RESPONSE: gastric ca {Malignant tumor of stomach}, gastrectomy {Excision of stomach structure}, omental {Omentum structure}, malignant ascites {Malignant ascites}, U/S-guided therapeutic paracentesis {Puncture and aspiration of abdomen using ultrasonographic guidance}, abdominal 
+distension {Swollen abdomen}, Abdominal distension {Swollen abdomen}, ascites {Ascites}, paracentesis {Centesis}, Abdominal fullness {Abdominal distension symptom}, constipation {Constipation}, did not have a 
+bowel movement {Constipation}, enema {Giving patient an enema}, bowel movement {Does defecate}"
+"###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:
+Vitamin B12 1000mcg IM qmonth  
+Lidocaine-Prilocaine cream for port access  
+Lorazepam 0.5mg PO q6h prn  
+Zofran 8mg PO q8h prn  
+Oxycontin 10mg PO BID
+Oxycodone ___ PO q4-6h prn  
+Maalox ___ PO prn  
+Terbinafine 1% cream BID to rash  
+Lidoderm TD daily
+ 
+Discharge Medications:
+1. lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 
+hours) as needed for nausea, anxiety.
+Disp:*30 Tablet(s)* Refills:*0*
+2. lactulose 10 gram/15 mL Solution Sig: Fifteen (15) mL PO 
+three times a day as needed for constipation.
+Disp:*500 mL* Refills:*0*
+3. prochlorperazine maleate 10 mg Tablet Sig: One (1) Tablet PO 
+every six (6) hours as needed for nausea.
+Disp:*30 Tablet(s)* Refills:*0*
+4. insulin regular human 100 unit/mL Solution Sig: sliding scale 
+ Injection four times a day: ___ 151-200: 2units
+___ 201-250: 4units
+___ 251-300: 6units
+___ 301-350: 8units
+___ 351-400: 10units.  
+5. oxycodone 10 mg Tablet Extended Release 12 hr Sig: One (1) 
+Tablet Extended Release 12 hr PO Q12H (every 12 hours).  
+6. oxycodone 5 mg/5 mL Solution Sig: ___ mg PO Q6H (every 6 
+hours) as needed for pain.  
+7. alum-mag hydroxide-simeth 200-200-20 mg/5 mL Suspension Sig: 
+Fifteen (15) ML PO QID (4 times a day) as needed for 
+indigestion.  
+8. terbinafine 1 % Cream Sig: One (1) Appl Topical BID (2 times 
+a day).  
+9. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 
+times a day).  
+10. senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a 
+day) as needed for constipation.  
+11. lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: 
+One (1) Adhesive Patch, Medicated Topical DAILY (Daily).  
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Primary Diagnosis: Malignant ascites, constipation, nausea
+Secondary Diagnosis: Gastric cancer
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, Malignant ascites {Malignant ascites}, constipation {Constipation}, nausea {Nausea}, Gastric cancer {Malignant tumor of stomach}, Mental Status {Neurological mental status determination}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, interactive {Does communicate}, 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 the hospital for a therapeutic 
+paracentesis. You had a liter of fluid removed by the 
+radiologists. You were also found to be constipated - you should 
+take stool softeners and Lactulose as needed for constipation.
+  
+The following changes were made to your medications:
+#. START Lactulose as needed for constipation
+#. START Compazine as needed for nausea
+  
+It was a pleasure meeting you and taking part in your care.
+ 
+
+###RESPONSE: paracentesis {Centesis}, fluid removed {Drainage of abdomen}, constipated {Constipation}, take stool softeners {Administration of laxative}, constipation {Constipation}, constipation {Constipation}, nausea {Nausea}"
+"###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: NEUROSURGERY
+ 
+
+###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: 
+latex
+ 
+Attending: ___
+ 
+Chief Complaint:
+Traumatic brain injury
+
+ 
+Major Surgical or Invasive Procedure:
+___ - Left craniectomy and right EVD placement 
+___ - Right chest tube placement
+___ - Left chest tube placement
+___ - Right EVD removal
+___ - Right EVD placement
+___ - Tracheostomy
+___ - PEG tube placement
+___ - Intermaxillary fixation
+___ - Removal of chest tubes
+___ - Right EVD replacement
+___ - Left cranioplasty
+___ - Right EVD removal
+
+ 
+
+###RESPONSE: latex {Allergy to Hevea brasiliensis latex protein}, Traumatic brain injury {Traumatic brain injury}, Left {Structure of left half of head}, craniectomy {Craniectomy}, right {Right cerebral hemisphere structure}, EVD {External drainage procedure from ventricle of brain}, placement {Implantation procedure}, Right {Right thorax structure}, chest tube placement {Insertion of pleural tube drain}, Left {Left thorax structure}, chest tube placement {Insertion of pleural tube drain}, Right {Right cerebral hemisphere structure}, EVD {External drainage procedure from ventricle of brain}, removal {Removal}, Right {Right cerebral hemisphere structure}, EVD {External drainage procedure from ventricle of brain}, placement {Implantation procedure}, Tracheostomy {Exteriorization of trachea}, PEG tube placement {Percutaneous endoscopic insertion of gastrostomy tube}, Intermaxillary fixation {Intermaxillary fixation of mandible and maxilla}, Removal of chest tubes {Intercostal drain removal}, Right {Right cerebral hemisphere structure}, EVD {External drainage procedure from ventricle of brain}, replacement {Replacement procedure}, Left {Structure of left half of head}, cranioplasty {Repair of bone of skull}, Right {Right cerebral hemisphere structure}, EVD {External drainage procedure from ventricle of brain}, removal {Removal}"
+"###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:
+___ is a ___ year old male who presented to the 
+Emergency Department on ___ as a transfer from an outside 
+facility status post fall approximately 25 feet from a 
+scaffolding. CT of the head at the outside facility revealed 
+multiple areas of acute extra-axial, subarachnoid, 
+intraparenchymal, and intraventricular hemorrhage with cerebral 
+compression as well as multiple skull and facial fractures. 
+Patient was transferred to ___ 
+for further evaluation and management.  
+ 
+
+###RESPONSE: fall {Falls}, CT {Computed tomography}, head {Head structure}, extra-axial {Cerebral hemorrhage}, subarachnoid {Subarachnoid intracranial hemorrhage}, intraparenchymal {Intraparenchymal hemorrhage of brain}, intraventricular hemorrhage {Ventricular hemorrhage}, cerebral 
+compression {Compression of brain}, multiple skull {Multiple fractures of skull}, facial fractures {Fracture of multiple bones of face}"
+"###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:
+- asthma
+- opioid abuse
+ 
+
+###RESPONSE: asthma {Asthma}, opioid abuse {Opioid 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: 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:
+Noncontributory
+ 
+
+###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:
+On Admission:
+-------------
+General:
+
+___ Coma Scale At The Scene: 4
+
+___ Coma Scale Upon Neurosurgical Evaluation: 6T
+
+Airway: [x]Intubated [ ]Not intubated
+
+Eye Opening: 
+[x]1 Does not open eyes
+
+Verbal:
+[x]1 Makes no sounds
+
+Motor:
+___ Flexion/withdrawal to painful stimuli 
+
+
+###RESPONSE: General {General examination of patient}, Coma Scale At The Scene: 4 {Glasgow coma scale, 4}, Neuro {Neurological examination}, Airway {Airway structure}, Intubated {Intubation}, intubated {Intubation}, Eye Opening: {Finding of response to visual stimuli}, open eyes {Finding of response to visual stimuli}, Flexion {Flexion test}, withdrawal {Withdrawn}, 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: Physical Exam:
+
+General: Well nourished male. Intubated, sedated, unresponsive.
+Head, Eyes, Ears, Nose Throat: Open left temporal skull fracture 
+without obvious brain matter visible, however there is 
+disruption of the galea. 
+Extremities: Warm and well perfused.
+
+Neurologic:
+
+Mental Status: Intubated, sedated, unresponsive.
+Orientation: Unable to assess, patient intubated, sedated, 
+unresponsive.
+Language: Unable to assess, patient intubated, sedated, 
+unresponsive.
+
+If Intubated:
+[ ]Cough [ ]Gag [x]Over breathing the ventilator
+
+Cranial Nerves:
+I: Not tested.
+II: Right pupil 3mm and minimally reactive to light. Left pupil 
+5mm and nonreactive to light.
+III, IV, VI: Unable to assess, patient intubated, sedated, 
+unresponsive.
+V, VII: Unable to assess, patient intubated, sedated, 
+unresponsive.
+VIII: Unable to assess, patient intubated, sedated, 
+unresponsive.
+IX, X: Unable to assess, patient intubated, sedated, 
+unresponsive.
+XI: Unable to assess, patient intubated, sedated, unresponsive.
+XII: Unable to assess, patient intubated, sedated, unresponsive.
+
+Motor: Off sedation. Right upper extremity withdraws to noxious. 
+Minimal to no movement of the right lower extremity. Moves left 
+upper and lower extremities spontaneously.
+
+On Discharge:
+-------------
+General:
+
+Vital Signs: T 99.4F, HR 99, BP 143/63, RR 17, O2Sat 99% 
+tracheostomy mask
+
+Exam:
+
+Opens Eyes: [ ]Spontaneous [x]To voice - Right eye opens, left
+does not [ ]To noxious
+Orientation: [ ]Person [ ]Place [ ]Time [x]None
+Follows Commands: [ ]Simple [ ]Complex [x]None
+Pupils: Right pupil round, reactive to light. Left pupil round,
+nonreactive to light.
+
+Motor: Right upper extremity briskly withdraws to noxious. Right
+lower extremity moves spontaneously, briskly withdraws to
+noxious. Left upper and lower extremities move spontaneously and
+purposefully, grossly full strength.
+
+Surgical Incision: 
+[x]Clean, dry, intact 
+[x]Sutures 
+[x]Staples
+ 
+
+###RESPONSE: Physical Exam {Physical examination procedure}, General {General examination of patient}, Well nourished {Well nourished}, Intubated {Intubation}, sedated {Sedated}, unresponsive {Unresponsive}, Head {Head structure}, Eyes {Structure of eye proper}, Ears {Ear structure}, Nose {Nasal structure}, Throat {Structure of anterior portion of neck}, skull fracture {Fracture of skull}, brain {Brain structure}, disruption {Disruption}, galea {Structure of galea aponeurotica}, Extremities {Examination of limb}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, Mental Status {Neurological mental status determination}, Intubated {Intubation}, sedated {Sedated}, unresponsive {Unresponsive}, Orientation {Finding related to orientation}, intubated {Intubation}, sedated {Sedated}, unresponsive {Unresponsive}, intubated {Intubation}, sedated {Sedated}, unresponsive {Unresponsive}, Cough {Cough}, II {Optic nerve structure}, Right pupil {Structure of pupil of right eye}, reactive to light {Finding of pupil reaction to light}, Left pupil {Structure of pupil of left eye}, nonreactive to light {Finding of pupil reaction to light}, III {Oculomotor nerve structure}, IV {Trochlear nerve structure}, VI {Abducens nerve structure}, intubated {Intubation}, sedated {Sedated}, unresponsive {Unresponsive}, V {Trigeminal nerve structure}, VII {Facial nerve structure}, intubated {Intubation}, sedated {Sedated}, unresponsive {Unresponsive}, VIII {Vestibulocochlear nerve structure}, intubated {Intubation}, sedated {Sedated}, unresponsive {Unresponsive}, IX {Glossopharyngeal nerve structure}, X {Vagus nerve structure}, intubated {Intubation}, sedated {Sedated}, unresponsive {Unresponsive}, XI {Accessory nerve structure}, intubated {Intubation}, sedated {Sedated}, unresponsive {Unresponsive}, XII {Hypoglossal nerve structure}, intubated {Intubation}, sedated {Sedated}, unresponsive {Unresponsive}, Motor {Motor testing}, sedation {Administration of sedative}, Right upper extremity {Structure of right upper limb}, withdraws to noxious {Responds to pain}, right lower extremity {Structure of right lower limb}, Moves {Does move}, left 
+upper {Structure of left upper limb}, lower extremities {Lower limb structure}, Vital Signs {Vital signs finding}, T {Body temperature finding}, HR {Finding of heart rate}, BP {Blood pressure finding}, RR {Finding of rate of respiration}, O2Sat {Oxygen saturation measurement}, tracheostomy {Exteriorization of trachea}, Eyes {Ophthalmic examination and evaluation}, Right eye {Right eye structure}, left {Left eye structure}, Orientation {Finding related to orientation}, Place {Oriented to place}, Time {Oriented to time}, Pupils {Pupil finding}, Right {Structure of pupil of right eye}, pupil round {Pupil round}, reactive to light {Finding of pupil reaction to light}, Left {Structure of pupil of left eye}, pupil round {Pupil round}, nonreactive to light {Finding of pupil reaction to light}, Motor {Motor testing}, Right upper extremity {Structure of right upper limb}, withdraws to noxious {Responds to pain}, Right
+lower extremity {Structure of right lower limb}, moves {Does move}, withdraws to
+noxious {Responds to pain}, Left upper {Structure of left upper limb}, move {Does move}, Surgical Incision {Surgical incision wound}, Clean, dry, intact {Wound healing well}, Sutures {Removal of suture}"
+"###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:
+Please see OMR for relevant laboratory and imaging results.
+
+ 
+
+###RESPONSE: imaging {Imaging}"
+"###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 male with a traumatic brain injury. Patient's 
+injuries included multiple areas of acute extra-axial, 
+subarachnoid, intraparenchymal, and intraventricular hemorrhage 
+with cerebral compression, multiple skull and facial fractures, 
+left clavicular fracture, multiple rib fractures, pulmonary 
+contusion, and hemothorax.
+
+#Traumatic Brain Injury
+Patient was taken to the operating room on ___ for a left 
+craniectomy and right EVD placement. Please see operative report 
+by Dr. ___ further details. Patient was transferred 
+back to the Trauma Intensive Care Unit. The patient's neurologic 
+exam waxed and waned throughout his hospitalization. Patient had 
+a progressive return of spontaneous movement on the left side 
+without significant progression on the right. Right EVD placed 
+in the operating room was subsequently removed on ___. CT 
+of the head on ___ showed external hydrocephalus, and the 
+right EVD was replaced. CT of the head on ___ showed 
+improvement in the patient's external hydrocephalus. Patient 
+returned to the operating room on ___ for a left 
+cranioplasty. Please see operative report by Dr. ___ 
+further details. A subgaleal drain was left in place and 
+subsequently removed on postoperative day two. The right EVD was 
+raised over the course of several days after the left 
+cranioplasty, intracranial pressures remained within expected 
+limits. The right EVD was clamped on ___, and the patient's 
+intracranial pressures remained stable. CT of the head on 
+___ was stable and the right EVD was removed. The patient 
+was started on sodium tablets during this hospitalization for 
+management of sodium, which continue to be weaned as tolerated. 
+The patient was transferred to the floor on ___. On 
+___ the patient's neurologic exam was stable. He was 
+afebrile with stable vital signs, tolerating activity with 
+assistance, tolerating his continuous tube feedings, voiding 
+without difficulty, and his pain was well controlled on enteral 
+pain medications. Patient was discharged to ___ 
+___ on ___ in stable condition.
+
+#Multiple Skull and Facial Fractures
+Plastic Surgery was consulted, and the patient underwent 
+intermaxillary fixation.
+
+#Left Clavicular Fracture
+Left clavicular fracture was nonoperable.
+
+#Respiratory
+Patient had progressive hypoxia on admission and had bilateral 
+chest tubes placed on ___. All chest tubes were 
+subsequently removed. Patient underwent tracheostomy on ___ 
+due to prolonged intubation and was subsequently weaned to a 
+tracheostomy mask. The patient had multiple bronchoscopies 
+during this hospitalization and was treated for a ventilator 
+associated pneumonia with cefepime and vancomycin. The patient 
+was noted to be tachypneic to the high ___ and low ___. A CTA of 
+the chest showed no evidence of pulmonary embolism. A chest 
+x-ray was ordered, which showed bilateral pulmonary effusions, 
+which were stable compared to prior imaging. The patient's 
+respiratory status continued to improve throughout his 
+hospitalization.
+
+#Nutrition
+Patient underwent PEG tube placement on ___ due to 
+prolonged intubation. Nutrition was consulted for tube feeding 
+recommendations. The patient tolerated advancement of his 
+continuous tube feedings to goal. 
+
+#Right Upper Extremity Thomboses
+Patient was found to have a nonocclusive right brachial, basilic 
+thrombus as well as an occlusive right cephalic thrombus. 
+Vascular Surgery consulted for question of a superior vena cava 
+filter, however they recommended conservative treatment. 
+
+#Loose Stools
+Patient had an increase in diarrhea during this hospitalization 
+and was diagnosed with Clostridium difficile colitis. A rectal 
+tube was placed. Vancomycin was started and patient completed 
+the course on ___. Repeat stool sample was negative for 
+Clostridium difficile on ___. Patient continued to have 
+loose stools. Nutrition was consulted and recommended adding 
+banana flakes.
+
+#Buttock Rash
+Antifungal cream was started for a rash on the patient's 
+buttocks.
+
+#Elevated Phosphorus
+Nutrition was consulted and recommended adding Tums for elevated 
+phosphorus. 
+
+#Anemia
+Patient's hemoglobin and hematocrit were monitored closely. They 
+were both low, but remained stable. 
+
+#Elevated PTT
+The patient's PTT was consistently elevated and subcutaneous 
+heparin was held. 
+
+#Disposition
+Physical Therapy and Occupational Therapy were both consulted, 
+and both recommended discharge to rehabilitation.
+ 
+
+###RESPONSE: traumatic brain injury {Traumatic brain injury}, injuries {Traumatic or non-traumatic injury}, extra-axial {Cerebral hemorrhage}, subarachnoid {Subarachnoid intracranial hemorrhage}, intraparenchymal {Intraparenchymal hemorrhage of brain}, intraventricular hemorrhage {Ventricular hemorrhage}, cerebral compression {Compression of brain}, multiple skull {Multiple fractures of skull}, facial fractures {Fracture of multiple bones of face}, left clavicular {Bone structure of left clavicle}, fracture {Fracture}, multiple rib fractures {Fracture of multiple ribs}, pulmonary 
+contusion {Contusion of lung}, hemothorax {Hemothorax}, Traumatic Brain Injury {Traumatic brain injury}, left {Structure of left half of head}, craniectomy {Craniectomy}, right {Right cerebral hemisphere structure}, EVD {External drainage procedure from ventricle of brain}, placement {Implantation procedure}, Trauma {Traumatic injury}, neurologic 
+exam {Neurological examination}, left {Structure of left half of body}, right {Structure of right half of body}, Right {Right cerebral hemisphere structure}, EVD {External drainage procedure from ventricle of brain}, placed {Implantation procedure}, removed {Removal}, CT {Computed tomography}, head {Head structure}, external hydrocephalus {External hydrocephalus}, right {Right cerebral hemisphere structure}, EVD {External drainage procedure from ventricle of brain}, replaced {Replacement procedure}, CT {Computed tomography}, head {Head structure}, improvement {Patient's condition improved}, external hydrocephalus {External hydrocephalus}, left {Structure of left half of head}, cranioplasty {Repair of bone of skull}, removed {Removal}, right {Right cerebral hemisphere structure}, EVD {External drainage procedure from ventricle of brain}, left {Structure of left half of head}, cranioplasty {Repair of bone of skull}, intracranial pressures {Finding of intracranial pressure}, right {Right cerebral hemisphere structure}, EVD {External drainage procedure from ventricle of brain}, clamped {Application of clamp}, intracranial pressures {Finding of intracranial pressure}, stable {Patient's condition stable}, CT {Computed tomography}, head {Head structure}, stable {Patient's condition stable}, right {Right cerebral hemisphere structure}, EVD {External drainage procedure from ventricle of brain}, removed {Removal}, neurologic exam {Neurological examination}, stable {Normal vital signs}, afebrile {Fever}, stable vital signs {Normal vital signs}, activity {Finding of functional performance and activity}, tube feedings {Tube feeding of patient}, voiding 
+without difficulty {Normal micturition}, pain was well controlled {Demonstrates adequate pain control}, pain medications {Administration of analgesic}, stable condition {Patient's condition stable}, Multiple Skull {Multiple fractures of skull}, Facial Fractures {Fracture of multiple bones of face}, intermaxillary fixation {Intermaxillary fixation of mandible and maxilla}, Left Clavicular {Bone structure of left clavicle}, Fracture {Fracture}, Left clavicular {Bone structure of left clavicle}, fracture {Fracture}, Respiratory {Examination of respiratory system}, hypoxia {Hypoxia}, chest tubes placed {Insertion of pleural tube drain}, chest tubes {Insertion of pleural tube drain}, removed {Removal}, tracheostomy {Exteriorization of trachea}, intubation {Intubation}, tracheostomy {Exteriorization of trachea}, bronchoscopies {Bronchoscopy}, ventilator 
+associated pneumonia {Ventilator-acquired pneumonia}, tachypneic {Tachypnea}, CTA {Computed tomography angiography with contrast}, chest {Plain chest X-ray}, no evidence {No abnormality detected}, pulmonary embolism {Pulmonary embolism}, chest 
+x-ray {Plain chest X-ray}, bilateral pulmonary {Both lungs}, effusions {Pleural effusion}, stable {Patient's condition stable}, imaging {Imaging}, respiratory {Structure of respiratory system}, Nutrition {Nutritional finding}, PEG tube placement {Percutaneous endoscopic insertion of gastrostomy tube}, intubation {Intubation}, Nutrition {Nutritional finding}, tube feeding {Tube feeding of patient}, tube feedings {Tube feeding of patient}, Right Upper Extremity {Structure of right upper limb}, Thomboses {Thrombus}, nonocclusive {Partial obstruction}, right brachial {Structure of right brachial vein}, basilic {Structure of basilic vein}, thrombus {Thrombus}, occlusive {Complete obstruction}, right cephalic {Structure of right cephalic vein}, thrombus {Thrombus}, Vascular Surgery {Vascular surgery procedure}, superior vena cava {Superior vena cava structure}, Loose Stools {Loose stool}, diarrhea {Diarrhea}, Clostridium difficile colitis {Clostridium difficile colitis}, rectal 
+tube was placed {Insertion of tube into rectum}, stool sample {Collection of stool specimen}, loose stools {Loose stool}, Nutrition {Nutritional finding}, Buttock {Buttock structure}, Rash {Eruption of skin}, rash {Eruption of skin}, buttocks {Buttock structure}, Elevated Phosphorus {Increased phosphorus diet}, Nutrition {Nutritional finding}, elevated 
+phosphorus {Increased phosphorus diet}, Anemia {Anemia}, hemoglobin {Hemoglobin finding}, hematocrit {Hematocrit determination}, stable {Patient's condition stable}, Elevated PTT {Partial thromboplastin time increased}, PTT was consistently elevated {Partial thromboplastin time increased}, heparin {Heparin therapy}, Physical Therapy {Physical therapy procedure}, Occupational Therapy {Occupational therapy}, rehabilitation {Rehabilitation 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:
+This Preadmission Medication List may be inaccurate and requires 
+further investigation.
+1. buprenorphine-naloxone (8mg-2mg) one tablet sublingual twice 
+daily 
+ 
+Discharge Medications:
+1. Acetaminophen (Liquid) 325-650 mg PO Q6H:PRN Pain - Mild 
+Please do not take more than 3000mg in 24 hours.  
+2. Calcium Carbonate 500 mg PO QID  
+3. Famotidine 20 mg PO BID  
+4. Ketoconazole 2%  1 Appl TP BID Duration: 28 Doses  
+5. Labetalol 200 mg PO BID 
+Hold for HR < 55 or SBP < 90.  
+6. OxyCODONE (Immediate Release) ___ mg PO Q6H:PRN Pain - 
+Moderate  
+7. Ramelteon 8 mg PO QHS 
+Should be given 30 minutes before bedtime.  
+8. Sarna Lotion 1 Appl TP QID:PRN Dry skin  
+9. Sodium Chloride 1 gm PO BID 
+Goal normonatremia, wean as tolerated.  
+10. Tamsulosin 0.4 mg PO QHS  
+
+ 
+
+###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:
+- traumatic brain injury with multiple areas of acute 
+extra-axial, subarachnoid, intraparenchymal, and 
+intraventricular hemorrhage with cerebral compression
+- multiple skull and facial fractures
+- external hydrocephalus 
+- left clavicular fracture
+- multiple rib fractures
+- pulmonary contusion
+- hemothorax
+- nonocclusive right brachial, basilic thrombus
+- occlusive right cephalic thrombus
+- Clostridium difficile colitis 
+
+ 
+Discharge Condition:
+Mental Status: Confused, always.
+Level of Consciousness: Lethargic, but arousable.
+Activity Status: Out of bed with assistance to chair or 
+wheelchair.
+
+ 
+
+###RESPONSE: traumatic brain injury {Traumatic brain injury}, extra-axial {Cerebral hemorrhage}, subarachnoid {Subarachnoid intracranial hemorrhage}, intraparenchymal {Intraparenchymal hemorrhage of brain}, intraventricular hemorrhage {Ventricular hemorrhage}, cerebral compression {Compression of brain}, multiple skull {Multiple fractures of skull}, facial fractures {Fracture of multiple bones of face}, external hydrocephalus {External hydrocephalus}, left clavicular {Fracture of multiple bones of face}, fracture {Fracture}, multiple rib fractures {Fracture of multiple ribs}, pulmonary contusion {Contusion of lung}, hemothorax {Hemothorax}, nonocclusive {Partial obstruction}, right brachial {Structure of right brachial vein}, basilic {Structure of basilic vein}, thrombus {Thrombus}, occlusive {Complete obstruction}, right cephalic {Structure of right cephalic vein}, thrombus {Thrombus}, Clostridium difficile colitis {Clostridium difficile colitis}, Mental Status {Neurological mental status determination}, Confused {Clouded consciousness}, Level of Consciousness {Assessment of consciousness level}, Lethargic {Lethargy}, Activity Status {Physical functional dependency}, Out of bed with assistance {Difficulty getting off a bed}"
+"###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:
+Surgery:
+• You underwent a surgery called a craniectomy. A portion of 
+your skull was removed to allow your brain to swell. 
+• You also underwent surgery to have your skull bone (or an 
+artificial bone) placed back on. 
+• Please keep your sutures and staples along your incision dry 
+until they are removed.
+• It is best to keep your incision open to air but it is ok to 
+cover it when outside. 
+• Call your surgeon if there are any signs of infection like 
+fever, redness, or drainage. 
+
+Activity:
+• We recommend that you avoid heavy lifting, running, climbing, 
+or other strenuous exercise until your follow-up appointment.
+• You make take leisurely walks and slowly increase your 
+activity at your own pace once you are symptom free at rest. 
+___ try to do too much all at once.
+• No driving while taking any narcotic or sedating medication. 
+• If you experienced a seizure while admitted, you are NOT 
+allowed to drive by law. 
+• No contact sports until cleared by your neurosurgeon. You 
+should avoid contact sports for six months. 
+
+Medications:
+• Please do NOT take any blood thinning medication (aspirin, 
+Coumadin, ibuprofen, Plavix) until cleared by the neurosurgeon. 
+• You may use acetaminophen (Tylenol) for minor discomfort if 
+you are not otherwise restricted from taking this medication.
+
+What You ___ Experience:
+• You may have difficulty paying attention, concentrating, and 
+remembering new information.
+• Emotional and/or behavioral difficulties are common. 
+• Feeling more tired and restlessness, irritability, and mood 
+swings are also common.
+• You may also experience some postoperative swelling around 
+your face and eyes. This is normal after surgery and most 
+noticeable on the second and third day of surgery. You may apply 
+ice or a cool or warm washcloth to your eyes to help with the 
+swelling. The swelling will be its worst in the morning after 
+laying flat from sleeping but should decrease when up. 
+• You may experience soreness with chewing. This is normal from 
+the surgery and will improve with time. Softer foods may be 
+easier during this time. 
+• Constipation is common. Be sure to drink plenty of fluids and 
+eat a high fiber diet. If you are taking narcotics (prescription 
+pain medications), try an over the counter stool softener.
+
+Headaches:
+• Headache is one of the most common symptoms after a traumatic 
+brain injury. 
+• Most headaches are not dangerous but you should call your 
+doctor if the headache gets worse, if you have increased 
+sleepiness, if you develop arm or leg weakness, and/or if you 
+have nausea or vomiting with a headache. 
+• Mild pain medications may be helpful with these headaches but 
+avoid taking pain medications on a daily basis unless prescribed 
+by your doctor. 
+• There are other things that can be done to help with your 
+headaches, including avoiding caffeine, getting enough sleep, 
+daily exercise, relaxation/meditation, massage, acupuncture, and 
+ice or heat packs. 
+
+More Information About Traumatic Brain Injuries:
+• You were given information about headaches after a traumatic 
+brain injury and the impact that a traumatic brain injury can 
+have on your family.
+• If you would like to read more about other topics such as 
+fatigue, balance, cognitive problems, sleeping, seizures, 
+driving, emotional problems, depression, sexuality after a 
+traumatic brain injury, and/or return to school or work, please 
+ask our staff for this information or visit 
+___.
+
+When To Call Your Doctor At ___:
+• Severe pain, redness, swelling, or drainage from the incision 
+site. 
+• Fever greater than 101.5 degrees Fahrenheit
+• Nausea and/or vomiting
+• Extreme sleepiness and not being able to stay awake
+• Severe headaches not relieved by pain relievers
+• Seizures
+• Any new problems with your vision or ability to speak
+• Weakness or changes in sensation in your face, arms, or legs
+
+Call ___ And Go To The Nearest Emergency Department If You 
+Experience Any Of The Following:
+• Sudden numbness or weakness in the face, arms, or legs
+• Sudden confusion or trouble speaking or understanding
+• Sudden trouble walking, dizziness, or loss of balance or 
+coordination
+• Sudden severe headaches with no known reason
+ 
+
+###RESPONSE: Surgery {Surgical procedure}, surgery {Surgical procedure}, craniectomy {Craniectomy}, skull {Bone structure of cranium}, removed {Removal}, brain {Brain structure}, swell {Swelling}, surgery {Surgical procedure}, skull {Bone structure of cranium}, sutures {Removal of suture}, incision {Incision}, removed {Removal of dressing}, incision {Incision}, signs of infection {Monitoring for signs and symptoms of infection}, fever {Fever}, redness {Redness of skin over lesion}, drainage {Discharge}, lifting {Does lift}, running {Does run}, climbing {Does climb}, strenuous exercise {Physical activity target strenuous exercise}, walks {Does walk}, activity {Functional activity education}, seizure {Seizure}, tired {Tired}, restlessness {Restlessness}, irritability {Feeling irritable}, mood 
+swings {Mood swings}, swelling {Swelling}, face {Face structure}, eyes {Structure of eye proper}, after surgery {Postoperative state}, surgery {Surgical procedure}, eyes {Structure of eye proper}, swelling {Swelling}, swelling {Swelling}, sleeping {Asleep}, soreness {Soreness}, surgery {Surgical procedure}, Constipation {Constipation}, high fiber diet {High residue diet}, narcotics {Narcotherapy}, pain medications {Administration of analgesic}, stool softener {Administration of laxative}, Headache {Headache}, traumatic 
+brain injury {Traumatic brain injury}, headaches {Headache}, headache {Headache}, sleepiness {Drowsy}, arm {Monoparesis - arm}, leg weakness {Monoparesis of lower limb}, nausea {Nausea}, vomiting {Vomiting}, headache {Headache}, Mild {Symptom mild}, pain medications {Administration of analgesic}, headaches {Headache}, pain medications {Administration of analgesic}, headaches {Headache}, exercise {Exercises}, relaxation {Relaxation training therapy}, meditation {Transcendental meditation therapy}, massage {Massage physiotherapy}, acupuncture {Acupuncture}, ice {Cold pack treatment}, heat packs {Thermotherapy with hot packs}, headaches {Headache}, traumatic 
+brain injury {Traumatic brain injury}, traumatic brain injury {Traumatic brain injury}, fatigue {Fatigue}, cognitive problems {Impaired cognition}, sleeping {Asleep}, seizures {Seizure}, emotional problems {Emotional problems}, depression {Depressive disorder}, sexuality {Finding related to sexual state}, traumatic brain injury {Traumatic brain injury}, Severe pain {Severe pain}, redness {Redness of skin over lesion}, swelling {Swelling}, drainage {Discharge}, incision 
+site {Surgical incision wound}, Fever {Fever}, Nausea {Nausea}, vomiting {Vomiting}, sleepiness {Drowsy}, awake {Awake}, headaches {Headache}, pain relievers {Administration of analgesic}, Seizures {Seizure}, problems with your vision {Abnormal vision}, ability to speak {Difficulty using language}, Weakness {Asthenia}, changes in sensation {Altered sensation of skin}, face {Face structure}, arms {Upper limb structure}, legs {Lower limb structure}, numbness {Numbness}, weakness {Asthenia}, face {Face structure}, arms {Upper limb structure}, legs {Lower limb structure}, confusion {Clouded consciousness}, walking {Does walk}, dizziness {Dizziness}, loss of balance {Unable to balance}, coordination {Finding related to coordination / incoordination}, headaches {Headache}"
+"###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: 
+Gatifloxacin / Penicillins / Ciprofloxacin / Bactrim
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Nausea and vomiting
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: Gatifloxacin {Allergy to fluoroquinolone}, Penicillins {Allergy to penicillin}, Ciprofloxacin {Allergy to ciprofloxacin}, Bactrim {Allergy to sulfamethoxazole and/or trimethoprim}, Nausea and vomiting {Nausea and vomiting}"
+"###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 a history of diabetes (thought to be type I) and 
+chronic ___ erythema who presents with nausea vomiting without 
+abdominal pain for the past day. Pateint reports she began 
+vomiting this am and in total has had 4 episodes of non bloody 
+vomiting in addition to loose stools and dysuria. She denies 
+associated chest pain, fevers, chills or shortness of breath. 
+She has not been able to tolerate oral intake at home. She 
+additionally notes an associated HA with photophobia starting 
+this am. Of note the patient also has a history of frequent 
+UTIs. She has been checking blood sugars at home and states they 
+have been in the 150s throughout the day.  
+Initial VS in the ED:97.2 79 ___ 93% Exam notable for 
+bilateral ___ edema and eryhtema with chronic skin changes 
+consistent with venous stasis. Labs notable for BG of 455, AG of 
+16 and trop negative x 2. VBG was 7.42/34/70. UA showed ketones 
+of 10 in addition to > 182 WBC, 17 RBC, moderate bacteria and 
+moderate nitrites. Head CT was negative for acute process. 
+Patient was given vanco for cellulitis, ctx for UTI. She was 
+started on IVF (received 3 L total). She was given 8 units IB 
+insulin and BG fell to 25. She was therefore given D50 with 
+increase to 417. In terms of blood pressure control she was 
+given her home losartan 50 mg with improvment in BP to systolics 
+of 160. VS prior to transfer: 77 167/62 16 99%.  
+
+ 
+
+###RESPONSE: diabetes {Diabetes mellitus}, erythema {Erythema}, nausea vomiting {Nausea and vomiting}, abdominal pain {Abdominal pain}, vomiting {Vomiting}, bloody 
+vomiting {Hematemesis}, loose stools {Loose stool}, dysuria {Dysuria}, chest pain {Chest pain}, fevers {Fever}, chills {Chill}, shortness of breath {Dyspnea}, able to tolerate oral intake {Tolerating oral fluid}, HA {Headache}, photophobia {Photophobia}, frequent 
+UTIs {Recurrent urinary tract infection}, blood sugars {Glucose measurement, blood}, VS {Vital signs finding}, Exam {Physical examination procedure}, edema {Edema}, eryhtema {Erythema}, skin changes {Skin appearance abnormal}, venous stasis {Venous stasis}, Labs {Laboratory test}, UA {Urinalysis}, moderate bacteria {Bacteriuria}, Head CT {Computed tomography of head}, cellulitis {Cellulitis}, UTI {Urinary tract infectious disease}, IVF {Administration of intravenous fluids}, VS {Vital signs finding}"
+"###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:
+1. DM2: insulin-dependent may be Type 1  
+-followed by ___  
+-c/b recurrent ulcers, urosepsis  
+-Charcot deformity  
+2. s/p amputation of L ___ & ___ toe  
+3. chronic ulcer of R pretibia  
+4. hx of MRSA foot ___  
+5. HTN  
+6. PVD  
+7. hypercholesterolemia  
+8. Anemia, ? ACD, baseline low ___  
+9. Hematemesis in ___ thought to be ___ small ___, 
+EGD ulcer in GE junction  
+
+ 
+
+###RESPONSE: DM2 {Diabetes mellitus type 2}, Type 1 {Diabetes mellitus type 1}, ulcers {Ulcer}, urosepsis {Sepsis due to urinary tract infection}, Charcot deformity {Charcot's arthropathy}, amputation of L ___ & ___ toe {Amputated toe of left foot}, chronic ulcer of R pretibia {Chronic ulcer of skin of lower leg}, MRSA {Methicillin resistant Staphylococcus aureus infection}, foot {Structure of left foot}, HTN {Hypertensive disorder, systemic arterial}, PVD {Peripheral vascular disease}, hypercholesterolemia {Hypercholesterolemia}, Anemia {Anemia}, Hematemesis {Hematemesis}, EGD ulcer {Gastrointestinal ulcer}, GE junction {Cardioesophageal junction 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: 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 had DM2, died of diabetes related coma  
+Father has DM2, still alive  
+Several family members on paternal side with DM2  
+No FH of CAD, MI, or cancer.
+ 
+
+###RESPONSE: DM2 {Diabetes mellitus type 2}, died {Dead}, diabetes related coma {Coma due to diabetes mellitus}, DM2 {Diabetes mellitus type 2}, alive {Alive}, DM2 {Diabetes mellitus type 2}, CAD {Coronary arteriosclerosis}, MI {Myocardial infarction}, cancer {Malignant neoplasm 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: 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:  
+Vitals: T: 98.2 BP: 191/110 P: 89 R:20 O2: 96% RA  
+General: Alert, oriented, appears mildly uncomfortable  
+HEENT: Sclera anicteric, dry mucous membranes, oropharynx clear  
+
+Neck: supple, JVP not elevated, no LAD  
+Lungs: Clear to auscultation bilaterally  
+CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, 
+gallops  
+Abdomen: soft, non-tender, non-distended, bowel sounds present, 
+no rebound tenderness or guarding  
+Ext: Warm, erythma of the shins bilaterally, bilateral peeling 
+scaling, several toes amputated.  
+Neuro: CN II-XII, strength ___, sensation in tact to light touch 
+ 
+
+Discharge Physical Exam:
+T 97.6 BP 170/65 (150-194/65-91) HR 86 RR 20 O2 sat 98% FSG @ 
+0600 160 (61-267)
+GEN: Alert, oriented, no acute distress  
+HEENT: NCAT MMM EOMI sclera anicteric, OP clear, poor dentition  
+
+NECK: supple, no JVD, no LAD  
+PULM: Good aeration, CTAB no wheezes, rales, ronchi  
+CV: RRR normal S1/S2, no mrg  
+ABD: soft obese NT ND normoactive bowel sounds, no r/g, no 
+suprapubic tenderness, no CVA tenderness  
+EXT: Erythema in lower extremities bilaterally with peeling 
+skin, no purulent drainage. Left toes amputated. No edema, 
+thready DP pulses.
+NEURO: CNs2-12 intact, motor function grossly normal, sensation 
+grossly intact 
+
+ 
+
+###RESPONSE: Physical Exam {Physical examination procedure}, Vitals {Vital signs finding}, T {Body temperature finding}, BP {Blood pressure finding}, P {Finding of pulse rate}, R {Finding of rate of respiration}, O2 {Oxygen saturation measurement}, RA {Breathing room air}, General {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, dry mucous membranes {Mucous membrane dryness}, oropharynx clear {Pharynx normal}, Neck {Physical examination procedure}, supple {Normal movement of neck}, JVP not elevated {Normal jugular venous pressure}, LAD {Lymphadenopathy}, Lungs {Examination of respiratory system}, Clear to auscultation bilaterally {Normal breath sounds}, 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<}, murmurs {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, Abdomen {Examination of abdomen}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, bowel sounds present {Normal bowel sounds}, rebound {Rebound tenderness}, tenderness {Tenderness}, guarding {Abdominal guarding}, Ext {Examination of limb}, Warm {Warm skin}, erythma {Erythema}, shins {Shin structure}, peeling {Peeling of skin}, scaling {Scaly skin}, toes amputated {Amputation of toe}, Neuro {Neurological examination}, CN II-XII {Normal central nervous system}, sensation in tact to light touch {Normal sensation}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, O2 sat {Oxygen saturation measurement}, GEN {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, distress {Distress}, NCAT {Normal head}, MMM {Moist oral mucosa}, EOMI {Normal ocular motility}, sclera anicteric {White sclera}, OP clear {Pharynx normal}, poor dentition {Impaired dentition}, supple {Normal movement of neck}, JVD {Jugular venous engorgement}, LAD {Lymphadenopathy}, PULM {Examination of respiratory system}, CTAB {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, ronchi {Wheeze - rhonchi}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, normal S1/S2 {Heart sounds normal}, no mrg {Heart sounds normal}, ABD {Examination of abdomen}, soft {Abdomen soft}, obese {Obese}, NT {Abdominal tenderness}, ND {Normal abdominal contour}, normoactive bowel sounds {Normal bowel sounds}, suprapubic tenderness {Suprapubic pain}, CVA tenderness {Renal angle tenderness}, EXT {Examination of limb}, Erythema {Erythema}, lower extremities {Lower limb structure}, peeling 
+skin {Peeling of skin}, purulent drainage {Purulent discharge from wound}, Left toes amputated {Amputated toe of left foot}, edema {Edema}, DP pulses {Dorsalis pulse present}, NEURO {Neurological examination}, CNs2-12 intact {Normal nervous system function}, motor function grossly normal {Normal motor response to command}, sensation 
+grossly intact {Normal sensation}"
+"###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:
+___ 06:00PM BLOOD WBC-10.3 RBC-4.99# Hgb-15.5# Hct-47.3# 
+MCV-95 MCH-31.1 MCHC-32.9 RDW-13.6 Plt ___
+___ 06:00PM BLOOD Neuts-91.0* Lymphs-5.9* Monos-2.6 Eos-0.1 
+Baso-0.4
+___ 06:00PM BLOOD ___ PTT-22.7* ___
+___ 06:00PM BLOOD Glucose-445* UreaN-31* Creat-1.4* Na-136 
+K-4.9 Cl-99 HCO3-20* AnGap-22*
+___ 06:00PM BLOOD ALT-12 AST-25 AlkPhos-113* TotBili-0.6
+___ 06:00PM BLOOD Albumin-4.2
+___ 10:52PM BLOOD Osmolal-313*
+___ 06:14PM BLOOD pO2-70* pCO2-34* pH-7.42 calTCO2-23 Base 
+XS--1 Comment-GREEN TOP
+___ 06:14PM BLOOD Lactate-3.2*
+
+Discharge:
+___ 07:55AM BLOOD WBC-7.7# RBC-4.17* Hgb-12.8 Hct-39.6 
+MCV-95 MCH-30.7 MCHC-32.3 RDW-13.7 Plt ___
+___ 07:55AM BLOOD ___ PTT-26.7 ___
+___ 07:55AM BLOOD Glucose-168* UreaN-24* Creat-1.3* Na-138 
+K-4.7 Cl-107 HCO3-22 AnGap-14
+___ 07:55AM BLOOD Calcium-7.8* Phos-3.0 Mg-2.0
+___ 11:44AM BLOOD Lactate-2.4*
+___ 11:44AM BLOOD ___ pO2-90 pCO2-54* pH-7.27* 
+calTCO2-26 Base XS--2 Comment-GREEN TOP
+___ 10:52PM BLOOD CK-MB-5 cTropnT-<0.01
+___ 06:00PM BLOOD cTropnT-<0.01
+
+Microbiology:
+___ and ___ Blood Cultures: Pending
+___ Urine Culture: Negative
+___ Urinalysis: Large leukocytes, positive nitrite, >182 WBC, 
+17 RBC, moderate bacteria
+
+Imaging:
+___ CCR: Limited, with mild cardiomegaly and no definite signs 
+of 
+pneumonia or overt CHF. 
+___ CT Head: No acute intracranial process.  Sinus disease in 
+the right 
+sphenoid sinus. 
+
+ 
+
+###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}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, Albumin {Albumin measurement}, pH {pH 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}, 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}, pH {pH measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, Blood Cultures {Blood culture}, Urine Culture {Urine culture}, Urinalysis {Urinalysis}, Large leukocytes {Leukocytes in urine}, positive nitrite {Nitrite detected in urine}, moderate bacteria {Bacteriuria}, cardiomegaly {Cardiomegaly}, pneumonia {Pneumonia}, CHF {Congestive heart failure}, CT Head {Computed tomography of head}, intracranial {Intracranial structure}, Sinus disease {Disorder of nasal sinus}, right 
+sphenoid sinus {Right sphenoid sinus 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:
+Brief Course:
+___ yo female with hx of likely type I diabetes presents with 
+nausea and vomiting, found to have elevated blood glucose to 455 
+and anion gap in the setting of UTI. Patient's blood sugars were 
+controlled and her anion gap resolved with subcutaneous insulin 
+and IV fluids. She was treated for her UTI with IV ceftriaxone 
+and discharged on oral cefuroxime.
+ 
+Active Issues:
+# DKA: Patient presented with elevated blood glucose, increased 
+anion gap, and ketones in urine reflective of some degree of 
+DKA. UTI is most likely precipitant. Patient recieved 8 units of 
+IV insulin and was transitioned to subcutaneous insulin regimen 
+which was taylored per ___ recommendations. Her electrolytes 
+were monitored and repleated as necessary and her anion gap 
+closed. She received IV fluids and was able to tolerated po. 
+Patient's blood glucose stabilized and she was discharged on her 
+home insulin regimen.
+ 
+# Hypertensive emergency: Patient presented with elevated blood 
+pressures to 200 systolic. She had a headache on admission 
+concerning for some level of end organ ischemia, which resolved 
+with blood pressure control. Patient maintained good urine 
+output with stable creatinine. Head CT negative. Trop negative x 
+2, EKG without evidence of ischemic changes. Patient was 
+continued on her home antihypertensive medication and required 2 
+prn doses of 12.5 mg captopril.
+  
+# UTI: Patient with grossly positive UA and leukocytosis, 
+although urine culture was negative. Patient has history of UTI 
+with culture growing pan sensitive proteus and ecoli. She was 
+initially treated with IV ceftriaxone then transitioned to oral 
+cefuroxime for total 10 day course, given her multiple 
+medication allergies and history of frequent UTIs.
+
+# Lower extremity erythema: Per patient lower extremity edema 
+currently at baseline. No obvious signs of cellulitis. Likely 
+combination of venous stasis dermatitis and arterial 
+insufficiency. Patient will fo home with ___ for wound care and 
+dressing changes.
+  
+Inactive Issue: 
+# CKD: Creatinine was below baseline (1.5-1.8). 
+
+Transitional Issues:
+1. Code Status: FULL
+2. Communication: Patient
+3. Medication changes: 
+-START Cefuroxime for UTI
+4. Follow up: PCP
+5. Pending studies: Blood cultures
+ 
+
+###RESPONSE: type I diabetes {Diabetes mellitus type 1}, nausea and vomiting {Nausea and vomiting}, elevated blood glucose {Glucose level above reference range}, UTI {Urinary tract infectious disease}, blood sugars {Glucose measurement, blood}, subcutaneous insulin {Subcutaneous injection of insulin}, IV fluids {Administration of intravenous fluids}, UTI {Urinary tract infectious disease}, DKA {Ketoacidosis due to diabetes mellitus}, elevated blood glucose {Glucose level above reference range}, increased 
+anion gap {Increased anion gap}, ketones in urine {Ketonuria}, DKA {Ketoacidosis due to diabetes mellitus}, UTI {Urinary tract infectious disease}, subcutaneous insulin {Subcutaneous injection of insulin}, regimen {Therapeutic regimen}, electrolytes 
+were monitored {Electrolyte monitoring}, anion gap 
+closed {Reduced anion gap}, IV fluids {Administration of intravenous fluids}, able to tolerated po {Tolerating oral fluid}, blood glucose stabilized {Blood glucose within reference range}, insulin regimen {Insulin regime}, Hypertensive emergency {Hypertensive emergency}, elevated blood 
+pressures {Finding of increased blood pressure}, headache {Headache}, ischemia {Ischemia}, urine 
+output {Finding of measures of urine output}, stable creatinine {Creatinine clearance-glomerular filtration within reference range}, Head CT {Computed tomography of head}, Trop {Troponin measurement}, EKG {Electrocardiographic procedure}, without evidence of ischemic changes {Electrocardiogram: no myocardial ischemia}, antihypertensive medication {Antihypertensive therapy}, UTI {Urinary tract infectious disease}, UA {Urinalysis}, leukocytosis {Leukocytosis}, urine culture was negative {Urine culture - no growth}, UTI {Urinary tract infectious disease}, culture {Microbial culture}, medication allergies {Allergy to drug}, frequent UTIs {Recurrent urinary tract infection}, Lower extremity {Lower limb structure}, erythema {Erythema}, lower extremity edema {Edema of lower extremity}, cellulitis {Cellulitis}, venous stasis dermatitis {Stasis dermatitis of lower limb due to chronic peripheral venous hypertension}, arterial 
+insufficiency {Arterial insufficiency}, wound care {Wound care}, dressing changes {Change of dressing}, CKD {Chronic kidney disease}, Creatinine was below baseline {Creatine kinase below reference range}, UTI {Urinary tract infectious disease}, Blood cultures {Blood culture}"
+"###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:
+Preadmissions medications listed are incomplete and require 
+futher investigation.  Information was obtained from 
+PatientwebOMR.
+1. Vitamin D 50,000 UNIT PO MONTHLY 
+2. Nortriptyline 150 mg PO HS 
+3. Rosuvastatin Calcium 20 mg PO DAILY 
+4. Losartan Potassium 50 mg PO DAILY 
+5. Pantoprazole 40 mg PO Q24H 
+6. Hydrochlorothiazide 25 mg PO DAILY 
+7. Detemir 70 Units Bedtime
+
+ 
+Discharge Medications:
+1. Hydrochlorothiazide 25 mg PO DAILY 
+2. Losartan Potassium 50 mg PO DAILY 
+3. Nortriptyline 150 mg PO HS 
+4. Pantoprazole 40 mg PO Q24H 
+5. Rosuvastatin Calcium 20 mg PO DAILY 
+6. Vitamin D 50,000 UNIT PO MONTHLY 
+7. cefUROXime axetil *NF* 500 mg Oral BID Duration: 8 Days 
+RX *cefuroxime axetil 500 mg 1 tablet(s) by mouth twice a day 
+Disp #*16 Tablet Refills:*0
+8. Detemir 70 Units Bedtime
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Primary:  Diabetic ketoacidosis
+          UTI
+          Dehydration
+          CKD
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, Diabetic ketoacidosis {Ketoacidosis due to diabetes mellitus}, UTI {Urinary tract infectious disease}, Dehydration {Dehydration}, CKD {Chronic kidney disease}, 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 - requires assistance or aid {Finding of walking aid use}, walker {Uses zimmer frame}, cane {Uses single walking stick}"
+"###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 at ___. You were admitted 
+for nausea and vomiting, and your blood sugars were found to be 
+very high and you were in DKA. We were able to control your 
+blood sugar level with insulin and your nausea and vomiting 
+improved.
+
+You were also suspected to have a urinary tract infection which 
+we treating with antibiotics.
+
+Please make the following changes to your medications:
+START Cefuroxime for your UTI
+ 
+
+###RESPONSE: nausea and vomiting {Nausea and vomiting}, blood sugars {Glucose measurement, blood}, DKA {Ketoacidosis due to diabetes mellitus}, nausea and vomiting {Nausea and vomiting}, improved {Patient's condition improved}, urinary tract infection {Urinary tract infectious disease}, antibiotics {Antibiotic therapy}, UTI {Urinary tract 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: 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: CARDIOTHORACIC
+ 
+
+###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: 
+Enbrel / Methotrexate / Ampicillin
+ 
+Attending: ___
+ 
+Chief Complaint:
+chest and arm pain
+ 
+Major Surgical or Invasive Procedure:
+___ CABG x6(LIMA-LAD,SVG-OM2-D2-D1,SVG-OM1,SVG-PDA)
+
+ 
+
+###RESPONSE: Methotrexate {Allergy to methotrexate}, Ampicillin {Allergy to ampicillin}, chest {Chest pain}, arm pain {Pain in upper limb}, CABG {Coronary artery bypass grafting}, LIMA {Structure of left internal thoracic artery}, LAD {Structure of anterior descending branch of left coronary artery}, SVG {Aortocoronary artery bypass graft with saphenous vein graft}, OM2 {Structure of second obtuse marginal branch of circumflex branch of left coronary artery}, D2 {Structure of second diagonal branch of anterior descending branch of left coronary artery}, D1 {Structure of first diagonal branch of anterior descending branch of left coronary artery}, SVG {Aortocoronary artery bypass graft with saphenous vein graft}, OM1 {Structure of first obtuse marginal branch of circumflex branch of left coronary artery}, SVG {Aortocoronary artery bypass graft with saphenous vein graft}, PDA {Structure of posterior descending coronary artery}"
+"###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 female who presented to ___ yesterday 
+with substernal chest pain radiating to her left arm that woke 
+her from sleep. She reports these symptoms have been occurring 
+intermittently over the last one month. At
+___ she ruled out for MI per enzymes. Stress test 
+showed small LV apex ischemia and mild inferior wall basal 
+hypokinesis, EF 57%. She was transferred to ___ for cardiac 
+catheterization and further evaluation. She was found to have 
+three vessel disease upon cardiac catheterization and is now
+being referred to cardiac surgery for revascularization. 
+
+ 
+
+###RESPONSE: substernal chest pain {Retrosternal pain}, radiating to her left arm {Pain radiating to left arm}, MI {Myocardial infarction}, Stress test {Electrocardiogram with exercise test}, LV apex {Structure of apex of left ventricle}, ischemia {Ischemia}, inferior wall {Structure of myocardium of inferior surface of left ventricle}, hypokinesis {Behavior showing reduced motor activity}, cardiac 
+catheterization {Cardiac catheterization}, evaluation {Evaluation procedure}, three vessel disease {Triple vessel disease of the heart}, cardiac catheterization {Cardiac catheterization}, revascularization {Heart revascularization}"
+"###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
+Dyslipidemia
+Tobacco abuse (currently smoking 1 PPD)
+Peripheral artery disease
+Hypothyroid
+Anxiety
+Depression
+Osteoporosis
+Rheumatoid arthritis
+Psoriasis
+Lupus (remote)
+C-diff (___)
+Past Surgical History:
+Choleysectomy
+Bilateral Cataract
+
+ 
+
+###RESPONSE: Hypertension {Hypertensive disorder, systemic arterial}, Dyslipidemia {Dyslipidemia}, Tobacco abuse {Tobacco dependence syndrome}, smoking {Smoker}, Peripheral artery disease {Peripheral arterial disease}, Hypothyroid {Hypothyroidism}, Anxiety
+Depression {Mixed anxiety and depressive disorder}, Osteoporosis {Osteoporosis}, Rheumatoid arthritis {Rheumatoid arthritis}, Psoriasis {Psoriasis}, Lupus {Lupus erythematosus}, Choleysectomy {Cholecystectomy}, Bilateral Cataract {Bilateral cataracts}"
+"###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:
+Premature coronary artery disease- non contributory
+
+ 
+
+###RESPONSE: coronary artery disease {Coronary arteriosclerosis}"
+"###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:
+Pulse:67 Resp:18  O2 sat:99/RA
+B/P  Right:158/103    Left:155/88
+Height:5'5""     Weight:64.3 kgs
+
+General: NAD
+Skin: Dry [x] intact [x]
+HEENT: PERRLA [x] EOMI []
+Neck:  Supple [x] Full ROM [x] MMM
+Chest: Lungs clear bilaterally [x]
+Heart: RRR [x]  Irregular []  Murmur -none
+Abdomen: Soft [x] non-distended [x] non-tender [x] +BS [x]
+Extremities: Warm x[], well-perfused [x]  Edema none
+ rash bilat upper and lower legs, red/dry/puritic w/ecoriated
+ankles and feet
+Varicosities: None [x]
+Neuro: Grossly intact [x] A&O x3, MAE, nonfocal exam
+Pulses:
+Femoral      Right: 2+ Left: 2+
+DP           Right: dop  Left: dop
+___           Right: dop  Left: dop
+Radial       Right: cath  Left: 2+
+
+Carotid Bruit  none
+
+ 
+
+###RESPONSE: Pulse {Finding of pulse rate}, Resp {Examination of respiratory system}, O2 sat {Oxygen saturation measurement}, RA {Breathing room air}, B/P {Blood pressure finding}, Right {Right upper arm structure}, Left {Left upper arm structure}, Weight {Weight finding}, General {General examination of patient}, NAD {No abnormality detected}, Skin {Examination of skin}, Dry {Xeroderma}, intact {Intact skin}, HEENT {Physical examination procedure}, PERRLA {Pupils equal, react to light and accommodation}, EOMI {Normal ocular motility}, Neck {Physical examination procedure}, Supple {Normal movement of neck}, Full ROM {Normal range of cervical spine movement}, MMM {Moist oral mucosa}, Chest {Examination of respiratory system}, Lungs {Examination of respiratory system}, Heart {Cardiovascular physical examination}, RRR {Normal heart rate}, Irregular {Irregular heart beat}, Murmur {Heart murmur}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, non-distended {Normal abdominal contour}, non-tender {Abdominal tenderness}, +BS {Normal bowel sounds}, Extremities {Examination of limb}, Warm {Warm skin}, well-perfused {Normal tissue perfusion}, Edema {Edema}, rash {Eruption of skin}, upper {Upper limb structure}, lower legs {Lower limb structure}, dry {Xeroderma}, puritic {Pruritic disorder of skin}, ecoriated {Excoriation of skin}, ankles {Ankle region structure}, feet {Foot structure}, Varicosities {Venous varices}, Neuro {Neurological examination}, Grossly intact {Normal nervous system function}, A {Mentally alert}, O x3 {Oriented to person, time and place}, MAE {Does move all four limbs}, Femoral {Structure of femoral artery}, DP {Structure of dorsalis pedis artery}, Radial {Structure of radial artery}, Right {Structure of right radial artery}, cath {Cardiac catheterization}, Left: 2 {Normal radial pulse}, Carotid Bruit {Carotid bruit}"
+"###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:
+ECHO ___
+Prebypass:
+The left atrium is normal in size. No thrombus is seen in the 
+left atrial appendage. There is mild symmetric left ventricular 
+hypertrophy. There is mild global left ventricular systolic 
+dysfunction with estimated Ejection Fraction 50-55%. Right 
+ventricular chamber size and free wall motion are normal. There 
+are simple atheroma in the ascending aorta. There are complex 
+(>4mm) atheroma in the aortic arch, maximum dimension 0.8 cm. 
+There are simple atheroma in the descending thoracic aorta. The 
+aortic valve leaflets (3) appear structurally normal with good 
+leaflet excursion and no aortic stenosis or aortic 
+regurgitation. The mitral valve appears structurally normal with 
+trivial mitral regurgitation. There is no pericardial effusion. 
+Dr. ___ was notified in person of the results on 
+___ at 1400. 
+Postbypass:
+The patient is AV paced on epinephrine, phenylephrine, 
+norepinephrine & vasopressin infusions. There is moderate mitral 
+regurgitation. There is mild tricuspid regurgitation. The 
+remaining valves are unchanged. Biventricular function is 
+maintained on multiple agents. There is biatrial enlargement and 
+bowing of the interatrial septum L->R. The aorta is intact.
+Prior to chest closure, biventricular function remains intact on 
+only norepinephrine & vasopressin infusions. The tricuspid 
+regurgitation is trace to mild. The mitral regurgitation is now 
+mild to moderate.  
+
+___ 04:44AM BLOOD WBC-9.5 RBC-2.90* Hgb-8.8* Hct-25.3* 
+MCV-87 MCH-30.4 MCHC-34.7 RDW-13.2 Plt ___
+___ 04:29AM BLOOD WBC-10.6 RBC-2.97* Hgb-8.8* Hct-26.1* 
+MCV-88 MCH-29.7 MCHC-33.8 RDW-13.2 Plt ___
+___ 02:53PM BLOOD WBC-11.4* RBC-3.35* Hgb-9.8* Hct-29.4* 
+MCV-88 MCH-29.3 MCHC-33.4 RDW-13.2 Plt ___
+___ 04:44AM BLOOD Glucose-88 UreaN-16 Creat-0.7 Na-130* 
+K-4.2 Cl-95* HCO3-25 AnGap-14
+___ 04:29AM BLOOD Glucose-90 UreaN-14 Creat-0.6 Na-126* 
+K-4.6 Cl-95* HCO3-27 AnGap-9
+___ 02:53PM BLOOD Glucose-121* UreaN-10 Creat-0.6 Na-127* 
+K-4.4 Cl-94* HCO3-25 AnGap-12
+___ 10:58AM BLOOD Glucose-102* Na-129* K-3.9 Cl-96
+ 
+
+###RESPONSE: ECHO {Echocardiography}, left atrium {Left atrial structure}, normal in size {Normal size}, thrombus {Thrombus}, left atrial appendage {Structure of left auricular appendage}, mild symmetric left ventricular 
+hypertrophy {Mild left ventricular hypertrophy}, left ventricular systolic 
+dysfunction {Left ventricular systolic dysfunction}, Right 
+ventricular chamber {Right cardiac ventricular structure}, wall motion are normal {Normal ventricular wall motion}, atheroma {Atheroma}, ascending aorta {Ascending aorta structure}, atheroma {Atheroma}, aortic arch {Aortic arch structure}, atheroma {Atheroma}, descending thoracic aorta {Structure of descending thoracic aorta}, aortic valve leaflets {Structure of cardiac valve leaflet}, structurally normal {Aortic valve normal}, leaflet {Structure of cardiac valve leaflet}, aortic stenosis {Aortic valve stenosis}, aortic 
+regurgitation {Aortic valve regurgitation}, mitral valve appears structurally normal {Mitral valve normal}, trivial mitral regurgitation {Mild mitral valve regurgitation}, pericardial effusion {Pericardial effusion}, moderate mitral 
+regurgitation {Moderate mitral valve regurgitation}, mild tricuspid regurgitation {Mild tricuspid valve regurgitation}, Biventricular {Cardiac ventricular structure}, biatrial {Atrial structure}, enlargement {Enlargement}, interatrial septum {Interatrial septum structure}, aorta {Aortic structure}, chest {Thoracic structure}, closure {Reparative closure}, biventricular {Cardiac ventricular structure}, infusions {Infusion}, tricuspid 
+regurgitation is trace to mild {Mild tricuspid valve regurgitation}, mitral regurgitation is now 
+mild {Mild mitral valve regurgitation}, moderate {Moderate mitral valve regurgitation}, 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}, 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}, 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}, 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}, 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}, 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}, Glucose {Glucose measurement, blood}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}"
+"###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 was admitted to the hospital and brought to the 
+operating room on ___ where the patient underwent urgent 
+coronary artery bypass graft times six.  Left internal mammary 
+artery to left anterior descending artery and saphenous vein 
+grafts to posterior descending artery, obtuse marginal 1 and 2, 
+and diagonal 1 and 2, and Endoscopic harvesting of the long 
+saphenous vein.  See operative note for full deatils. Overall 
+the patient tolerated the procedure well and post-operatively 
+was transferred to the CVICU in stable condition for recovery 
+and invasive monitoring. Post-operative day one found the 
+patient extubated, alert and oriented and breathing comfortably. 
+Initially she had no underlying rhythm and remained DDD paced. 
+The electrophysiology service was consulted.  Lopressor was 
+initiated once the patient regained her rhythm and she was 
+tolerating beta blockers with a rate in the 80's.  The patient 
+was neurologically intact and hemodynamically stable on no 
+inotropic or vasopressor support. She was gently diuresed toward 
+the preoperative weight.  The patient was transferred to the 
+telemetry floor for further recovery.  Mediastinal chest tubes 
+were removed and the pleural chest tube stayed in an additional 
+day due to an air leak.  After the pleural chest tube was on 
+waterseal for greater than ___ hours with a small stable 
+left pneumothorax, pleural chest tube was pulled. Follow up 
+chest radiograph showed small stable left pneumothorax. Pacing 
+wires were discontinued without complication on post-operative 
+day four. The patient was evaluated by the physical therapy 
+service for assistance with strength and mobility.  By the time 
+of discharge on post-operative day six the patient was 
+ambulating freely, the wound was healing and pain was controlled 
+with oral analgesics.  The patient was discharged to ___ 
+Rehab in good condition with appropriate follow up instructions.
+ 
+
+###RESPONSE: coronary artery bypass graft {Coronary artery bypass grafting}, Left internal mammary 
+artery {Structure of left internal thoracic artery}, left anterior descending artery {Structure of anterior descending branch of left coronary artery}, saphenous vein 
+grafts {Arterial bypass using vein graft}, posterior descending artery {Structure of posterior descending branch of right coronary artery}, obtuse marginal 1 {Structure of first obtuse marginal branch of circumflex branch of left coronary artery}, 2 {Structure of second obtuse marginal branch of circumflex branch of left coronary artery}, diagonal 1 {Structure of first diagonal branch of anterior descending branch of left coronary artery}, 2 {Structure of second diagonal branch of anterior descending branch of left coronary artery}, long 
+saphenous vein {Great saphenous vein structure}, stable condition {Patient's condition stable}, Post-operative {Postoperative state}, extubated {Removal of endotracheal tube}, alert {Mentally alert}, oriented {Oriented to person}, breathing comfortably {Breathing easily}, neurologically intact {Normal nervous system function}, hemodynamically stable {Hemodynamically stable}, vasopressor support {Vasopressor therapy}, diuresed {Diuretic therapy}, telemetry {Cardiac telemetry}, Mediastinal chest tubes 
+were removed {Removal of tube from mediastinum}, left pneumothorax {Left pneumothorax}, pleural chest tube was pulled {Intercostal drain removal}, chest radiograph {Plain chest X-ray}, left pneumothorax {Left pneumothorax}, ambulating {Fully mobile}, wound was healing {Wound healing well}, pain was controlled 
+with oral analgesics {Demonstrates adequate pain control}, instructions {Education}"
+"###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:
+Preadmission medications listed are correct and complete.  
+Information was obtained from webOMR.
+1. Atenolol 150 mg PO DAILY 
+2. Enalapril Maleate 20 mg PO BID 
+3. Hydrochlorothiazide 25 mg PO DAILY 
+4. Levothyroxine Sodium 100 mcg PO DAILY 
+5. Rosuvastatin Calcium 20 mg PO DAILY 
+6. Diazepam 5 mg PO Q12H:PRN anxiety 
+7. Carbamazepine 400 mg PO DAILY 
+8. Nortriptyline 200 mg PO HS 
+9. Aspirin 81 mg PO DAILY 
+10. Calcium Carbonate 500 mg PO QID:PRN reflux 
+11. Fluocinonide 0.05% Cream 1 Appl TP BID:PRN prn 
+
+ 
+Discharge Medications:
+1. Albuterol-Ipratropium ___ PUFF IH Q6H 
+2. Aspirin 81 mg PO DAILY 
+3. Carbamazepine 400 mg PO DAILY 
+4. Enalapril Maleate 10 mg PO BID 
+Hold for sbp<100 
+5. Levothyroxine Sodium 100 mcg PO DAILY 
+6. Nortriptyline 200 mg PO HS 
+7. Rosuvastatin Calcium 20 mg PO DAILY 
+8. Clopidogrel 75 mg PO DAILY 
+poor grafts 
+9. Fluticasone Propionate 110mcg 2 PUFF IH BID 
+10. Metoprolol Tartrate 12.5 mg PO BID 
+Hold for HR < 55 or SBP < 90 and call medical provider. 
+11. Ranitidine 150 mg PO BID 
+12. TraMADOL (Ultram) 50 mg PO Q6H:PRN pain 
+RX *tramadol 50 mg one tablet(s) by mouth every six hours Disp 
+#*40 Tablet Refills:*0
+13. Calcium Carbonate 500 mg PO QID:PRN reflux 
+14. Fluocinonide 0.05% Cream 1 Appl TP BID:PRN prn 
+15. Insulin SC 
+      Sliding Scale
+
+Fingerstick QACHS
+Insulin SC Sliding Scale using REG Insulin
+16. Diazepam 5 mg PO Q12H:PRN anxiety 
+17. Furosemide 40 mg PO DAILY Duration: 1 Weeks 
+18. Potassium Chloride 40 mEq PO DAILY Duration: 1 Weeks 
+Hold for K >4.5 
+
+ 
+
+###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:
+coronary artery disease, Hypertension, Dyslipidemia, 
+Tobacco(currently 1 PPD), Peripheral artery disease, 
+Hypothyroid, Anxiety, Depression, Osteoporosis,  
+Rheumatoid arthritis, Psoriasis, Lupus(remote), ___, 
+Choleysectomy, Bilateral Cataract  
+
+ 
+Discharge Condition:
+Alert and oriented x3 nonfocal 
+Ambulating with steady gait 
+Incisional pain managed with Ultram
+Incisions: 
+Sternal - healing well, no erythema or drainage 
+Leg Left - healing well, no erythema or drainage. 
+Trace Edema bilaterally
+ 
+
+ 
+
+###RESPONSE: coronary artery disease {Coronary arteriosclerosis}, Hypertension {Hypertensive disorder, systemic arterial}, Dyslipidemia {Dyslipidemia}, Tobacco {Tobacco dependence syndrome}, Peripheral artery disease {Peripheral arterial disease}, Hypothyroid {Hypothyroidism}, Osteoporosis {Osteoporosis}, Rheumatoid arthritis {Rheumatoid arthritis}, Psoriasis {Psoriasis}, Lupus {Lupus erythematosus}, Choleysectomy {Cholecystectomy}, Bilateral Cataract {Bilateral cataracts}, Alert {Mentally alert}, oriented x3 {Oriented to person, time and place}, Ambulating {Fully mobile}, steady gait {Gait normal}, Incisional {Surgical incision wound}, pain {Pain}, Incisions {Surgical incision wound}, Sternal {Wound of structure of sternal region}, healing well {Wound healing well}, erythema {Erythema}, drainage {Wound discharge}, Leg Left {Structure of left lower leg}, healing well {Wound healing well}, erythema {Erythema}, drainage {Wound discharge}, 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: Discharge Instructions:
+Please shower daily including washing incisions gently with mild 
+soap, no baths or swimming until cleared by surgeon. Look at 
+your incisions daily for redness or drainage
+Please NO lotions, cream, powder, or ointments to incisions 
+Each morning you should weigh yourself and then in the evening 
+take your temperature, these should be written down on the chart 
+
+No driving for approximately one month and while taking 
+narcotics, will be discussed at follow up appointment with 
+surgeon when you will be able to drive 
+No lifting more than 10 pounds for 10 weeks
+Please call with any questions or concerns ___
+Females: Please wear bra to reduce pulling on incision, avoid 
+rubbing on lower edge
+**Please call cardiac surgery office with any questions or 
+concerns ___. Answering service will contact on call 
+person during off hours**
+
+ 
+
+###RESPONSE: incisions {Surgical incision wound}, incisions {Surgical incision wound}, redness {Redness of skin over lesion}, drainage {Wound discharge}, incisions {Surgical incision wound}, incision {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: 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: 
+Patient recorded as having No Known Allergies to Drugs
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Abdominal pain
+ 
+Major Surgical or Invasive Procedure:
+ERCP: single stone in CBD removed + sphincterotomy.
+
+ 
+
+###RESPONSE: No Known Allergies to Drugs {Non-allergic hypersensitivity to drug or medicament}, Abdominal pain {Abdominal pain}, ERCP {Endoscopic retrograde cholangiopancreatography}, stone in CBD {Common bile duct calculus}, removed + sphincterotomy {Endoscopic sphincterotomy of sphincter of Oddi and removal of calculus}"
+"###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:
+HPI:This is a ___ yo male who was transfered from ___ today where he was admitted on  ___ for abdominal
+discomfort, vomiting and substernal chest pain. The patient has 
+a
+history of ischemic cardiomyopathy (EF:20%), Coronary artery
+disease and atrial fibrillation. He spiked a fever on the day of
+admission, blood cultures were obtained and  yielded 
+pansensitive
+E.coli. Repeated liver funtion tests showed an increase of total
+bilirubin (2.7 > 5.4) LFT's ( AST 52>343, ALT 33> 269). A RUQ
+ultrasound  didn't yield any evicence of gallstones, no intra or
+extrahepatic dilation. HIDA scan was performed on ___ and
+showed non-opacification of the gallbladder, consitant with 
+acute
+cholecystitis. He was transferred to the ___ today for further
+evaluation and treatment.
+ 
+
+###RESPONSE: abdominal
+discomfort {Abdominal discomfort}, vomiting {Vomiting}, substernal chest pain {Retrosternal pain}, ischemic cardiomyopathy {Generalized ischemic myocardial dysfunction}, Coronary artery
+disease {Coronary arteriosclerosis}, atrial fibrillation {Atrial fibrillation}, fever {Fever}, blood cultures {Blood culture}, liver funtion tests {Hepatic function panel}, total
+bilirubin {Bilirubin, total measurement}, RUQ {Structure of right upper quadrant of abdomen}, ultrasound {Ultrasonography of abdomen}, gallstones {Gallbladder calculus}, intra {Intrahepatic biliary tract structure}, dilation {Dilatation}, HIDA scan {Radionuclide imaging of liver and/or biliary tract using radioactive isotope}, gallbladder {Gallbladder structure}, acute
+cholecystitis {Acute cholecystitis}, evaluation {Evaluation 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: Past Medical History:
+Cardiomyopathy with EF of 20%, Atrial fibrillation,
+hypertension, hyperlipidemia, h/o ventricular tachycardia, 
+status
+post ICD placement, CAD, compensated congested heart failure,
+status post aortobi-iliac stent graft placement in ___, h/o
+renal lesion, presumed cacinoma, treated conservatively in the
+past, h/o prostate cancer
+ 
+
+###RESPONSE: Cardiomyopathy {Cardiomyopathy}, Atrial fibrillation {Atrial fibrillation}, hypertension {Hypertensive disorder, systemic arterial}, hyperlipidemia {Hyperlipidemia}, ventricular tachycardia {Ventricular tachycardia}, ICD placement {Automatic defibrillator procedure}, CAD {Coronary arteriosclerosis}, congested heart failure {Congestive heart failure}, stent graft placement {Insertion of arterial stent}, renal {Kidney structure}, lesion {Lesion}, cacinoma {Carcinoma}, prostate cancer {Carcinoma of prostate}"
+"###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:
+Noncontributory
+ 
+
+###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:
+VS: 97.2 HR 81 BP 94/68 RR 18 Sat 100% RA 
+General: awake and alert
+HEENT: no cervical or supraclavicular adenopathy noted, 
+Skin:dry
+CV: regular rhythm, II/VI SEM
+Lungs: CTA bilaterally
+Abdomen: soft, +BS, non-tender, no rebound/guarding
+Extremities: warm,no edema
+ 
+
+###RESPONSE: Physical Exam {Physical examination procedure}, VS {Vital signs finding}, HR {Finding of heart rate}, BP {Blood pressure finding}, RR {Finding of rate of respiration}, RA {Breathing room air}, General {General examination of patient}, awake {Awake}, alert {Mentally alert}, HEENT {Physical examination procedure}, cervical {Cervical lymphadenopathy}, supraclavicular adenopathy {Supraclavicular lymphadenopathy}, Skin {Examination of skin}, dry {Xeroderma}, CV {Cardiovascular physical examination}, regular rhythm {Normal sinus rhythm}, SEM {Ejection murmur}, Lungs {Examination of respiratory system}, CTA {Normal breath sounds}, Abdomen {Examination of abdomen}, soft {Abdomen soft}, +BS {Normal bowel sounds}, non-tender {Abdominal tenderness}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, Extremities {Examination of limb}, warm {Warm skin}, 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:
+___ 04:40AM BLOOD WBC-6.2 RBC-4.20* Hgb-13.1* Hct-40.3 
+MCV-96 MCH-31.2 MCHC-32.5 RDW-13.7 Plt ___
+___ 06:35AM BLOOD ___ PTT-34.3 ___
+___ 06:50AM BLOOD Glucose-124* UreaN-35* Creat-1.6* Na-137 
+K-4.1 Cl-98 HCO3-27 AnGap-16
+___ 06:50AM BLOOD ALT-47* AST-23 AlkPhos-271* TotBili-2.7*
+___ 06:50AM BLOOD Calcium-9.3 Phos-3.7 Mg-2.5
+
+ERCP ___
+Impression: Cannulation of the biliary duct was successful and 
+deep with a sphincterotome using a free-hand technique. 
+Periampullary diverticulum. 
+A single 1 cm round stone that was causing partial obstruction 
+was seen at the middle third of the common bile duct.  A 
+successful biliary sphincterotomy was performed in the 12 
+o'clock position using a sphincterotome over an existing 
+guidewire.  A biliary balloon sphincteroplasty was performed. A 
+12mm balloon was introduced for dilation successfully.  The 
+stone was extracted successfully using a balloon catheter. 
+Occlusion cholangiogram revealed no residual filling defects. 
+The cystic duct was dilated and widely patent. Partial 
+pancreatogram was normal.   
+ 
+
+###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}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, ERCP {Endoscopic retrograde cholangiopancreatography}, Cannulation {Cannulation}, biliary duct {Bile duct structure}, Periampullary diverticulum {Diverticulum of peri-ampullary tissue of hepatopancreatic ampulla}, stone {Calculus}, partial obstruction {Partial obstruction}, common bile duct {Common bile duct structure}, biliary sphincterotomy {Endoscopic incision of sphincter of Oddi}, dilation {Dilatation}, stone was extracted {Extraction of calculus of biliary tract}, Occlusion {Complete obstruction}, cholangiogram {Cholangiogram}, filling defects {Filling defect}, cystic duct {Cystic duct structure}, dilated {Dilatation}, pancreatogram {Pancreatic contrast 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: Brief Hospital Course:
+The patient was admitted to the General Surgical Service for 
+evaluation and treatment. On ___ the patient underwent ERCP 
+and were able to extract a CBD stone and performed a 
+sphincterotomy and sphincteroplasty which went well without 
+complication (reader referred to the Operative Note for 
+details). The patient arrived on the floor NPO, on IV fluids and 
+antibiotics. The patient was hemodynamically stable.
+
+Neuro: The patient did not have any complaints of pain on 
+arrival to the floor.
+
+CV: The patient remained stable from a cardiovascular 
+standpoint; vital signs were routinely monitored.
+
+Pulmonary: The patient remained stable from a pulmonary 
+standpoint; vital signs were routinely monitored. Good pulmonary 
+toilet, early ambulation and incentive spirrometry were 
+encouraged throughout hospitalization.
+
+GI/GU/FEN: Post-operatively, the patient was made NPO with IV 
+fluids. Diet was advanced when appropriate, which was well 
+tolerated. Patient's intake and output were closely monitored, 
+and IV fluid was adjusted when necessary. 
+
+ID: The patient's white blood count and fever curves were 
+closely watched for signs of infection. He did have a urine 
+culture that showed enterococcus ___. ID was curbsided 
+and they did not recommend antibiotics for treatment. Repeat UA 
+x 2 was negative. They suspect that it is colinization of the 
+UT. He was also on Zosyn for the ERCP. 
+
+Endocrine: The patient's blood sugar was monitored throughout 
+his stay.
+
+Hematology: The patient's complete blood count was examined 
+routinely; no transfusions were required.
+
+Prophylaxis: The patient received subcutaneous heparin and 
+venodyne boots were used during this stay; was encouraged to get 
+up and ambulate as early as possible.
+
+At the time of discharge, 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 received discharge teaching and 
+follow-up instructions with understanding verbalized and 
+agreement with the discharge plan.
+
+ 
+
+###RESPONSE: General Surgical Service {Admission to surgical department}, evaluation {Evaluation procedure}, ERCP {Endoscopic retrograde cholangiopancreatography}, CBD {Common bile duct structure}, stone {Extraction of calculus of biliary tract}, sphincterotomy {Endoscopic incision of sphincter of Oddi}, Operative {Surgical procedure}, NPO {Nil by mouth}, IV fluid {Administration of intravenous fluids}, antibiotics {Antibiotic therapy}, hemodynamically stable {Hemodynamically stable}, Neuro {Neurological examination}, pain {Pain}, CV {Cardiovascular physical examination}, stable {Patient's condition stable}, cardiovascular {Cardiovascular physical examination}, vital signs were routinely monitored {Monitoring of blood pressure, temperature, pulse rate and respiratory rate}, Pulmonary {Examination of respiratory system}, stable {Patient's condition stable}, vital signs were routinely monitored {Monitoring of blood pressure, temperature, pulse rate and respiratory rate}, pulmonary 
+toilet {Airway toilet}, incentive spirrometry {Incentive spirometry}, GI {Examination of digestive system}, GU {Examination of genitourinary system}, NPO {Nil by mouth}, IV 
+fluids {Administration of intravenous fluids}, Diet {Dietary finding}, intake and output {Measuring intake and output}, IV fluid {Administration of intravenous fluids}, white blood count {White blood cell count}, fever {Fever}, signs of infection {Monitoring for signs and symptoms of infection}, urine 
+culture {Urine culture}, antibiotics {Antibiotic therapy}, UA {Urinalysis}, UT {Structure of urinary tract proper}, ERCP {Endoscopic retrograde cholangiopancreatography}, blood sugar {Glucose measurement, blood}, complete blood count {Complete blood count}, transfusions {Transfusion}, Prophylaxis {Preventive procedure}, afebrile {Fever}, 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}, follow-up {Follow-up arranged}, instructions {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:
+(updated per documented OSH record ___
+Coumadin 4mg PO daily (on hold)
+Coreg 12.5mg po BID
+Amiodarone 200mg PO BID
+Trazodone 50 mg po QHS
+Nitro-patch 0.4mg/Hr TD overnight only
+Lasix 80 mg po dialy
+Spironolactone 12.5mg PO daily
+Digoxin 0.125 po daily
+Zocor 20mg PO QHS
+Colace 100mg PO BID
+Milk of Magnesia prn
+Zofran prn
+Morphine 2 to 4 mg q3h prn
+
+ 
+Discharge Medications:
+1. Carvedilol 12.5 mg Tablet Sig: One (1) Tablet PO BID (2 times 
+a day).  
+2. Digoxin 125 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+
+3. Simvastatin 10 mg Tablet Sig: Two (2) Tablet PO HS (at 
+bedtime).  
+4. Amiodarone 200 mg Tablet Sig: One (1) Tablet PO BID (2 times 
+a day).  
+5. Furosemide 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 
+ 
+6. Spironolactone 25 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). 
+ 
+7. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 
+times a day).  
+8. Trazodone 50 mg Tablet Sig: One (1) Tablet PO HS (at bedtime) 
+as needed for insomnia.  
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Choledocholithiasis
+
+ 
+Discharge Condition:
+Mental Status:Clear and coherent
+Level of Consciousness:Alert and interactive
+Activity Status:Ambulatory - Independent
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, Choledocholithiasis {Gallbladder and bile duct calculi}, Mental Status {Neurological mental status determination}, 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:
+Please call your doctor or nurse practitioner or return to the 
+Emergency Department for any of the following:
+
+*You experience new chest pain, pressure, squeezing or 
+tightness.
+*New or worsening cough, shortness of breath, or wheeze.
+*If you are vomiting and cannot keep down fluids or your 
+medications.
+*You are getting dehydrated due to continued vomiting, diarrhea, 
+or other reasons. Signs of dehydration include dry mouth, rapid 
+heartbeat, or feeling dizzy or faint when standing.
+*You see blood or dark/black material when you vomit or have a 
+bowel movement.
+*You experience burning when you urinate, have blood in your 
+urine, or experience a discharge.
+*Your pain is not improving within ___ hours or is not gone 
+within 24 hours. Call or return immediately if your pain is 
+getting worse or changes location or moving to your chest or 
+back.
+*You have shaking chills, or fever greater than 101.5 degrees 
+Fahrenheit or 38 degrees Celsius.
+*Any change in your symptoms, or any new symptoms that concern 
+you.
+
+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.
+
+ 
+
+###RESPONSE: chest pain {Chest pain}, pressure {Tight chest}, squeezing {Squeezing chest pain}, tightness {Tight chest}, cough {Cough}, shortness of breath {Dyspnea}, wheeze {Wheezing}, vomiting {Vomiting}, medications {Medication education}, dehydrated {Dehydration}, vomiting {Vomiting}, diarrhea {Diarrhea}, Signs {Sign}, dehydration {Dehydration}, dry mouth {Xerostomia}, rapid 
+heartbeat {Tachycardia}, dizzy {Dizziness}, faint {Feeling faint}, standing {Orthostatic body position}, blood or dark/black material when you vomit {Vomit contains blood}, bowel movement {Hematochezia}, burning {Burning sensation}, urinate {Micturition finding}, blood in your 
+urine {Blood in urine}, discharge {Discharge}, pain {Pain}, pain {Pain}, chest {Thoracic structure}, back {Structure of back of trunk}, shaking {Tremor}, chills {Chill}, fever {Fever}, medications {Medication education}, medication {Medication education}, medications {Medication education}, Avoid lifting 
+weights {Functional activity education}, follow-up {Follow-up arranged}, activity 
+restrictions {Functional activity education}, while taking pain 
+medications {Patient medication education}, follow-up {Follow-up arranged}, PCP {Primary care management}"
+"###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:
+ulcerative colitis
+ 
+Major Surgical or Invasive Procedure:
+___ ileostomy takedown
+ 
+
+###RESPONSE: No Known Allergies {Allergic disposition}, Adverse Drug Reactions {Propensity to adverse reactions to drug}, ulcerative colitis {Ulcerative colitis}, ileostomy takedown {Closure of ileostomy}"
+"###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:
+A ___ man who previously underwent
+abdominal colectomy, laparoscopic proctectomy, and diverting
+loop ileostomy, J pouch on ___.  The pouch study was normal. 
+ Risks
+and benefits included, but not limited to, infection,
+bleeding, leak, need for more procedures were discussed.  The
+patient understood and agreed.
+ 
+
+###RESPONSE: colectomy {Excision of colon}, laparoscopic {Laparoscopic procedure}, proctectomy {Resection of rectum}, loop ileostomy {Creation of loop ileostomy}, J pouch {J pouch}, normal {No abnormality detected}, infection {Infectious disease}, bleeding {Bleeding}, leak {Anastomosis, leaking}, procedures {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: Past Medical History:
+PMH:
+Ulcerative Colitis
+
+PSH:
+Lap colectomy w/ end ileostomy (___)
+ 
+
+###RESPONSE: Ulcerative Colitis {Ulcerative colitis}, Lap colectomy w/ end ileostomy {Laparoscopic total colectomy and ileostomy}"
+"###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:
+M: CAD, HLD
+Maternal GM: RA
+DM in father's side of family
+
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}, HLD {Hyperlipidemia}, RA {Rheumatoid arthritis}, DM {Diabetes mellitus}"
+"###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:
+NAD
+CV: RRR
+Resp: nl breathing effort
+GI: inc c/d/i, ND, NT, soft
+ 
+
+###RESPONSE: NAD {No abnormality detected}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, Resp {Examination of respiratory system}, nl breathing {Normal respiratory function}, GI {Examination of digestive system}, ND {Swollen abdomen}, NT {Abdominal tenderness}, soft {Abdomen soft}"
+"###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: Brief Hospital Course Template:  
+Mr ___ presented to ___ holding at ___ on ___ for 
+a ileostomy takedown. He tolerated the procedure well without 
+complications (Please see operative note for further details). 
+After a brief and uneventful stay in the PACU, the patient was 
+transferred to the floor for further post-operative management.  
+
+On ___, the patient was discharged to home. At discharge, 
+he was tolerating a regular diet, passing flatus, stooling, 
+voiding, and ambulating independently. He will follow-up in the 
+clinic in ___ weeks. This information was communicated to the 
+patient directly prior to discharge.  
+Include in Brief Hospital Course for Every Patient and check of 
+boxes that apply:  
+Post-Surgical Complications During Inpatient Admission:  
+[x] None  
+Social Issues Causing a Delay in Discharge:  
+[x] No social factors contributing in delay of discharge.  
+
+ 
+
+###RESPONSE: ileostomy takedown {Closure of ileostomy}, procedure {Surgical procedure}, operative {Surgical procedure}, PACU {Postanesthesia care}, post-operative management {Postoperative care}, regular diet {Normal diet}, passing flatus {Passing flatus}, stooling {Able to defecate}, voiding {Normal micturition}, ambulating independently {Independent walking}, follow-up {Follow-up arranged}, clinic {Outpatient care management}, Post-Surgical Complications {Postoperative complication}, social factors {Social factor}"
+"###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:PRN pain 
+do not take more than 3000mg of Tylenol or drink alcohol  
+RX *acetaminophen 500 mg 2 tablet(s) by mouth every eight (8) 
+hours Disp #*50 Tablet Refills:*0
+2. OxycoDONE (Immediate Release)  ___ mg PO Q4H:PRN pain 
+do not drink alcohol or drive a car while taking 
+RX *oxycodone 5 mg ___ tablet(s) by mouth every four (4) hours 
+Disp #*30 Tablet Refills:*0
+3. Tamsulosin 0.4 mg PO QHS 
+please take for 5 more days at home 
+RX *tamsulosin 0.4 mg 1 capsule(s) by mouth at bedtime Disp #*5 
+Capsule 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:
+Ileostomy Takedown
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Ileostomy Takedown {Closure of ileostomy}, Mental Status {Neurological mental status determination}, Clear {No abnormality detected}, 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 to the hospital after an ileostomy takedown. 
+You have recovered from this procedure well and you are now 
+ready to return home. You have tolerated a regular diet, passing 
+ 
+gas and your pain is controlled with pain medications by mouth. 
+You may return home to finish your recovery.  
+ 
+Please monitor your bowel function closely. You may or may not 
+have had a bowel movement prior to your discharge which is 
+acceptable, however it is important that you have a bowel 
+movement in the next ___ days. After anesthesia it is not 
+uncommon for patient’s to have some decrease in bowel function 
+but your should not have prolonged constipation. Some loose 
+stool and passing of small amounts of dark, old appearing blood 
+are expected however, if you notice that you are passing bright 
+red blood with bowel your please seek medical attention. If you 
+are passing loose stool without improvement please call the 
+office or go to the emergency room if the symptoms are severe. 
+If you are taking narcotic pain medications there is a risk that 
+you will have some constipation. Please take an over the counter 
+stool softener such as Colace, and if the symptoms does not 
+improve call the office. It is also not uncommon after an 
+ileostomy takedown to have frequent loose stools until you are 
+taking more regular food however this should improve.  
+The muscles of the sphincters have not been used in quite some 
+time and you may experience urgency or small amounts of 
+incontinence however this should improve. If you do not show 
+improvement in these symptoms within ___ days please call the 
+office for advice. Occasionally, patients will need to take a 
+medication to slow their bowel movements as their bodies adjust 
+to the new normal without an ileostomy, you should consult with 
+our office for advice. If you have any of the following symptoms 
+please call the office for advice or go to the emergency room if 
+ 
+severe: increasing abdominal distension, increasing abdominal 
+pain, nausea, vomiting, inability to tolerate food or liquids, 
+prolonged loose stool, or constipation.  
+ 
+You have a small wound where the old ileostomy once was. This 
+should be covered with a dry sterile gauze dressing. The wound 
+no longer requires packing with gauze packing strip. Please  
+monitor the incision for signs and symptoms of infection 
+including: increasing redness at the incision, opening of the 
+incision, increased pain at the incision line, draining of 
+white/green/yellow/foul smelling drainage, or if you develop a 
+fever. Please call the office if you develop these symptoms or 
+go to the emergency room if the symptoms are severe. You may  
+shower, let the warm water run over the wound line and pat the 
+area dry with a towel, do not rub. Please apply a new gauze 
+dressing after showering.  
+ 
+No heavy lifting for at least 6 weeks after surgery unless 
+instructed otherwise by your surgical team. You may gradually 
+increase your activity as tolerated but clear heavy exercise 
+with your surgical team.
+ 
+You will be prescribed a small amount of the pain medication 
+oxycodone. Please take this medication exactly as prescribed. 
+You may take Tylenol as recommended for pain. Please do not take 
+more than 3000mg of Tylenol daily. Do not drink alcohol while 
+taking narcotic pain medication or Tylenol. Please do not drive 
+a car while taking narcotic pain medication.  
+ 
+Thank you for allowing us to participate in your care! Our hope 
+is that you will have a quick return to your life and usual 
+activities. Good luck! 
+ 
+
+ 
+
+###RESPONSE: ileostomy takedown {Closure of ileostomy}, recovered from this procedure well {Good recovery following surgery}, ready to return {Ready for discharge}, regular diet {Normal diet}, passing 
+ 
+gas {Passing flatus}, pain {Pain}, pain medications {Administration of analgesic}, by mouth {Administration of drug or medicament via oral route}, monitor your bowel function {Monitoring bowel motility}, bowel movement {Able to defecate}, bowel 
+movement {Able to defecate}, anesthesia {Administration of anesthesia}, decrease in bowel function {Altered bowel function}, constipation {Constipation}, loose 
+stool {Loose stool}, dark {Dark stools}, old appearing blood {Melena}, bright 
+red blood {Hematochezia}, bowel {Intestinal structure}, seek medical attention {Recommendation to seek attention}, loose stool {Loose stool}, improvement {Patient's condition improved}, emergency {Emergency treatment}, taking narcotic pain medications {Narcotics education}, constipation {Constipation}, take an over the counter 
+stool softener {Administration of laxative}, ileostomy takedown {Closure of ileostomy}, loose stools {Loose stool}, e regular food {Normal diet}, muscles of the sphincters {Structure of sphincter ani muscle}, urgency {Urgent desire for stool}, small {Symptom mild}, incontinence {Incontinence of feces}, improvement {Patient's condition improved}, medication {Administration of drug or medicament}, bowel movements {Altered bowel function}, ileostomy {Ileostomy - stoma}, emergency {Emergency treatment}, abdominal distension {Swollen abdomen}, abdominal 
+pain {Abdominal pain}, nausea, vomiting {Nausea and vomiting}, inability to tolerate food or liquids {Nausea and vomiting}, loose stool {Loose stool}, constipation {Constipation}, wound {Wound}, ileostomy {Ileostomy operation}, sterile gauze dressing {Application of dressing, sterile}, wound {Wound}, packing {Packing of wound}, packing {Packing of wound}, 
+monitor {Monitoring for signs and symptoms of infection}, incision {Surgical incision wound}, signs {Sign}, infection {Local infection of wound}, redness {Redness of skin over lesion}, incision {Surgical incision wound}, incision {Surgical incision wound}, increased pain {Increased pain}, incision {Surgical incision wound}, draining {Wound discharge}, drainage {Wound discharge}, fever {Fever}, emergency {Emergency treatment}, shower {Functional activity education}, wound {Wound}, dressing {Application of dressing}, No heavy lifting {Functional activity education}, after surgery {Postoperative state}, activity as tolerated {Education about increasing activity tolerance}, t clear heavy exercise {Functional activity education}, Please take this medication exactly as prescribed {Patient medication education}, pain {Pain}, do not take {Patient medication education}, Do not drink alcohol {Education about alcohol consumption}, while 
+taking narcotic pain medication {Narcotics education}, Please do not drive 
+a car {Patient medication education}, while taking narcotic pain medication {Narcotics education}, activities {Finding of functional performance and activity}"
+"###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:  ___            ___ No:   ___
+ 
+Admission Date:  ___              Discharge Date:   ___
+ 
+Date of Birth:  ___             Sex:   F
+ 
+Service: UROLOGY
+ 
+
+###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:
+Metastatic colon cancer to left ureter
+ 
+Major Surgical or Invasive Procedure:
+Left nephroureterectomy
+
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, Metastatic colon cancer {Metastatic carcinoma to colon}, left ureter {Metastatic malignant neoplasm to ureter}, Left {Left kidney structure}, nephroureterectomy {Nephroureterectomy}"
+"###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:
+Dear Doctors:
+
+I had the pleasure of seeing our mutual patient, Ms. ___, today at the ___ in
+followup.  I performed cystoscopy on her today after a urine
+cytology demonstrated malignant cells consistent with colon
+cancer.  I had previously counseled her and seen her regarding
+her positive PET scan, which demonstrated a potential tumor in
+the left ureter.  However, she has a history of a completely
+obstructed left upper tract.  Therefore, I did not expect to see
+a positive urine cytology if she was indeed completely 
+obstructed
+and the only disease was in her ureter.  I, therefore, brought
+her back for a cystoscopy to evaluate her bladder to make sure
+that there were no additional tumors in her bladder.
+
+I performed flexible cystoscopy today, which is dictated
+separately.  It turns out that she does have a tumor in her
+bladder, near her left ureteral orifice.  This was pedunculated
+in nature, and had appearance similar to transitional cell
+carcinoma, although I could not make a diagnosis visually.  I 
+did
+take a small biopsy of it for histologic diagnosis and 
+cauterized
+the biopsy defect.
+
+This is a surprising finding, but it is a good thing that we
+evaluated the bladder, for we were planning left
+nephroureterectomy, and this would have been an unexpected
+finding.  Depending on what the histology shows, this will have
+different implications for her prognosis and for the future
+treatment plan.
+
+For example, if this is colon cancer, then a left
+nephroureterectomy with a larger bladder cuff, encompassing this
+tumor could be a reasonable treatment, as there is no other
+obvious site of disease.  If this is TCC, then this is a
+different story and I would not be able to fully explain her
+elevated CEA.  She would likely still need removal of this
+bladder tumor as well as left kidney and ureter, but her
+prognosis would likely be different, and we would have to look
+for other sites of disease.  I will bring her back in two weeks
+for a revisit and discussion of the biopsy results, and we will
+have a conversation then about what this implies and what we can
+do for her going forward.  Dr. ___ was present in clinic
+today, so I did show him the results of the cystoscopy visually,
+and we are in agreement in regards to the plan going forward.
+
+Thank you very much again for allowing me to participate in her
+care, and please feel free to contact me with any questions or
+concerns that you may have.
+
+Sincerely,
+
+___ MD, ___
+ 
+
+###RESPONSE: cystoscopy {Transurethral cystoscopy}, urine
+cytology {Urine cytology}, malignant cells {Tumor cells, malignant}, colon
+cancer {Malignant neoplasm of colon}, PET scan {Positron emission tomography}, tumor {Tumor finding}, left ureter {Structure of left ureter}, obstructed {Obstruction}, upper tract {Structure of upper urinary system}, positive {Detected by cytology}, urine cytology {Urine cytology}, obstructed {Obstruction}, disease {Disease}, ureter {Ureteric structure}, cystoscopy {Transurethral cystoscopy}, bladder {Urinary bladder structure}, tumors in her bladder {Neoplasm of bladder}, flexible cystoscopy {Flexible cystoscopy}, tumor in her
+bladder {Neoplasm of bladder}, left ureteral orifice {Structure of left ureteral orifice}, transitional cell
+carcinoma {Transitional cell carcinoma}, biopsy {Biopsy}, biopsy {Biopsy}, bladder {Urinary bladder structure}, left {Left kidney structure}, nephroureterectomy {Nephroureterectomy}, colon cancer {Malignant neoplasm of colon}, left {Left kidney structure}, nephroureterectomy {Nephroureterectomy}, TCC {Transitional cell carcinoma of bladder}, elevated CEA {Carcinoembryonic antigen above reference range}, removal {Removal}, bladder tumor {Neoplasm of bladder}, left kidney {Laceration of left kidney}, ureter {Ureteric 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: Past Medical History:
+- Stage I (pT1 pN0 cM0) sigmoid colon adenocarcinoma in ___  
+- Stage IIA (pT3 pN0 cM0) rectosigmoid colon adenoCA ___  
+intact IHC for MLH1, MSH2, MSH6, and PMS2; microsatellite stable 
+(MSS) by PCR; KRAS wild-type, BRAF wild-type  
+-obesity  
+-asthma  
+- HTN  
+- lipomatosis  
+- depression  
+SurgHx:  
+___ surgical history, in addition to the two colectomies, by 
+her report includes a cesarean section and possible bilateral 
+salpingo-oophorectomies. She also states that she underwent a 
+benign breast biopsy in the 1980s. I could find no record of the 
+pelvic surgery or any breast surgery by operative note or 
+pathology.  
+ 
+
+###RESPONSE: sigmoid colon adenocarcinoma {Adenocarcinoma of sigmoid colon}, rectosigmoid colon {Rectosigmoid structure}, adenoCA {Malignant adenomatous neoplasm}, obesity {Obesity}, asthma {Asthma}, HTN {Hypertensive disorder, systemic arterial}, lipomatosis {Lipomatosis}, depression {Depressive disorder}, colectomies {Excision of colon}, cesarean section {Cesarean section}, bilateral 
+salpingo-oophorectomies {Excision of bilateral fallopian tubes and ovaries}, breast biopsy {Biopsy of breast}, pelvic {Structure of pelvis}, surgery {Surgical procedure}, breast {Breast structure}, surgery {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: 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:
+___ family history is significant for her father who had a 
+laryngeal cancer, but was a heavy smoker. She has two children 
+who are well. There are no other family members with colon 
+cancer, sarcoma or any other malignancy that she was aware of. 
+ 
+
+###RESPONSE: laryngeal cancer {Malignant tumor of larynx}, smoker {Smoker}, colon 
+cancer {Malignant neoplasm of colon}, sarcoma {Sarcoma}, malignancy {Malignant neoplasm}"
+"###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:
+NAD
+WWP
+No respiratory distress
+Abdomen S, appropriately TTP, ND, incision c/d/i with staples
+No focal deficits
+ 
+
+###RESPONSE: NAD {No abnormality detected}, WWP {Normal tissue perfusion}, distress {Distress}, Abdomen {Examination of abdomen}, TTP {Tenderness}, ND {Swollen abdomen}, incision {Surgical incision wound}, No focal deficits {Normal nervous system function}"
+"###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:
+___ 07:10AM BLOOD WBC-4.7 RBC-2.78* Hgb-8.3* Hct-24.8* 
+MCV-89 MCH-29.8 MCHC-33.4 RDW-13.0 Plt ___
+___ 07:10AM BLOOD Glucose-88 UreaN-11 Creat-1.5* Na-138 
+K-4.6 Cl-100 HCO3-29 AnGap-14
+___ 07:10AM BLOOD Calcium-8.8 Phos-5.0*# Mg-2.1
+ 
+
+###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}, 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}"
+"###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:
+Patient was admitted to Urology after undergoing laparoscopic 
+left nephrectomy, open distal ureterectomy, transurethral 
+resection of bladder cuff, retroperitoneal lymph node 
+dissection. The surgery was complicated by an iatrogenic 
+incision into the vagina, which was repaired. Please see 
+dictated operative note for details.
+The patient received perioperative antibiotic prophylaxis. The 
+patient was transferred to the floor from the PACU in stable 
+condition. On POD0-1, pain was well controlled on PCA, hydrated 
+for urine output >30cc/hour, and provided with pneumoboots and 
+incentive spirometry for prophylaxis. On POD1, the patient 
+ambulated, restarted on home medications, basic metabolic panel 
+and complete blood count were checked. The patient was a little 
+nauseated for the first couple days post-operatively and she was 
+kept on sips. A KUB was performed, which did not show any 
+evidence of an ileus. The patient was started on anti-emetics 
+and an aggressive bowel regimen. She started to have bowel 
+movements on POD4 and her diet was slowly advanced. She was also 
+transitioned from a PCA to oral analgesics. On POD6, JP 
+creatinine was sent and showed no evidence of a urine leak. Her 
+JP was subsequently removed. The patient was discharged in 
+stable condition, eating well, ambulating independently, and 
+with pain control on oral analgesics. On exam, incision was 
+clean, dry, and intact, with no evidence of hematoma collection 
+or infection. The patient will go home with a foley catheter for 
+another ___ weeks and she will follow-up in clinic for a void 
+trial.
+
+ 
+
+###RESPONSE: laparoscopic {Laparoscopic procedure}, left nephrectomy {Excision of left kidney}, ureterectomy {Ureter excision}, transurethral 
+resection of bladder {Transurethral bladder excision}, retroperitoneal lymph node 
+dissection {Excision of retroperitoneal lymph node group}, incision {Surgical incision wound}, vagina {Vaginal structure}, repaired {Surgical repair}, antibiotic prophylaxis {Administration of prophylactic antibiotic}, stable 
+condition {Patient's condition stable}, pain was well controlled {Demonstrates adequate pain control}, PCA {Patient controlled analgesia}, incentive spirometry {Incentive spirometry}, prophylaxis {Preventive procedure}, ambulated {Ambulation training}, restarted {Restart of medication}, complete blood count {Complete blood count}, nauseated {Nausea}, post-operatively {Postoperative state}, KUB {Radiography of kidney-ureter-bladder}, ileus {Intestinal obstruction co-occurrent and due to decreased peristalsis}, bowel regimen {Bowel care}, bowel 
+movements {Does defecate}, PCA {Patient controlled analgesia}, oral analgesics {Administration of analgesic}, creatinine {Creatinine measurement}, no evidence {No abnormality detected}, urine leak {Urinary incontinence}, stable condition {Patient's condition stable}, ambulating independently {Independent walking}, pain control on oral analgesics {Demonstrates adequate pain control with oral analgesics}, incision {Surgical incision wound}, clean, dry, and intact {Wound healing well}, no evidence {No abnormality detected}, hematoma {Hematoma}, infection {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: Medications on Admission:
+The Preadmission Medication list is accurate and complete.
+1. Ipratropium-Albuterol Inhalation Spray 2 INH IH Q6H:PRN 
+wheezing, SOB 
+2. Diltiazem Extended-Release 120 mg PO DAILY 
+3. Docusate Sodium 100 mg PO BID 
+4. Polyethylene Glycol 17 g PO DAILY:PRN constipation 
+5. Multivitamins 1 TAB PO DAILY 
+6. Acetaminophen w/Codeine 1 TAB PO Q4H:PRN pain 
+7. Fluticasone-Salmeterol Diskus (250/50)  1 INH IH BID 
+8. Ciprofloxacin HCl 500 mg PO Q12H 
+9. albuterol sulfate 90 mcg/actuation inhalation BID wheezing, 
+SOB 
+10. Vitamin D 50,000 UNIT PO DAILY 
+
+ 
+Discharge Medications:
+1. Diltiazem Extended-Release 120 mg PO DAILY 
+2. Docusate Sodium 100 mg PO BID 
+3. Fluticasone-Salmeterol Diskus (250/50)  1 INH IH BID 
+4. Acetaminophen 1000 mg PO Q6H 
+5. Enoxaparin Sodium 30 mg SC Q24H 
+Start: Today - ___, First Dose: Next Routine Administration 
+Time 
+6. OxycoDONE (Immediate Release)  2.5 mg PO Q4H:PRN pain 
+7. albuterol sulfate 90 mcg/actuation inhalation BID wheezing, 
+SOB 
+8. Ipratropium-Albuterol Inhalation Spray 2 INH IH Q6H:PRN 
+wheezing, SOB 
+9. Multivitamins 1 TAB PO DAILY 
+10. Polyethylene Glycol 17 g PO DAILY:PRN constipation 
+11. Vitamin D 50,000 UNIT PO DAILY 
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Metastatic colon cancer
+
+ 
+Discharge Condition:
+Alert and oriented
+Ambulating
+Stable
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, Metastatic colon cancer {Metastatic carcinoma to colon}, Alert {Mentally alert}, oriented {Orientated}, Ambulating {Fully mobile}, Stable {Patient's condition stable}"
+"###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:
+-Please also refer to the provided written instructions on 
+post-operative care, instructions and expectations made 
+available from Dr. ___.
+
+-Resume your pre-admission/home medications except as noted. 
+ALWAYS call to inform, review and discuss any medication changes 
+and your post-operative course with your primary care doctor.
+
+-___ reduce the strain/pressure on your abdomen and incision 
+sites; remember to “log roll” onto your side and then use your 
+hands to push yourself upright while taking advantage of the 
+momentum of putting your legs/feet to the ground.
+
+--There may be bandage strips called “steristrips” which have 
+been applied to reinforce wound closure.  Allow these bandage 
+strips to fall off on their own over time but PLEASE REMOVE ANY 
+REMAINING GAUZE DRESSINGS WITHIN 2 DAYS OF DISCHARGE. You may 
+get the steristrips wet.
+
+-Please AVOID aspirin or aspirin containing products and 
+supplements that may have “blood-thinning” effects (like Fish 
+Oil, Vitamin E, etc.) unless you have otherwise been advised.
+
+-IBUPROFEN (the ingredient of Advil, Motrin, etc.) may be taken 
+even though you may also be taking Tylenol/Acetaminophen. You 
+may alternate these medications for pain control.  For pain 
+control, try TYLENOL FIRST, then ibuprofen, and then take the 
+narcotic pain medication as prescribed if additional pain relief 
+is needed.
+
+-Ibuprofen should always be taken with food. Please discontinue 
+taking and notify your
+doctor should you develop blood in your stool (dark, tarry 
+stools)
+
+-Call your Urologist's office to schedule/confirm your follow-up 
+appointment in ___ weeks AND if you have any questions.
+
+-Do not eat constipating foods for ___ weeks, drink plenty of 
+fluids to keep hydrated
+
+-No vigorous physical activity or sports for 4 weeks or until 
+otherwise advised. Light household chores/activity and leisurely 
+walking/activity is OK and should be continued. Do NOT be a 
+“couch potato”
+
+-Tylenol should be your first-line pain medication. A narcotic 
+pain medication has been
+prescribed for breakthrough pain ___. REPLACE the Tylenol with 
+this narcotic pain medication if additional pain control is 
+needed..
+
+-Max daily Tylenol (acetaminophen) dose is 4 grams from ALL 
+sources, note that narcotic pain medication also contains 
+Tylenol
+
+-Do not lift anything heavier than a phone book (10 pounds) or 
+drive until you are seen by your Urologist in follow-up
+
+-You may shower normally but do NOT immerse your incisions or 
+bathe
+
+-Do not drive or drink alcohol while taking narcotics and do not 
+operate dangerous machinery
+
+-Colace has been prescribed to avoid post surgical constipation 
+and constipation related to narcotic pain medication. 
+Discontinue if loose stool or diarrhea develops. Colace is a
+stool-softener, NOT a laxative
+
+-If you have fevers > 101.5 F, vomiting, or increased redness, 
+swelling, or discharge from your incision, call your doctor or 
+go to the nearest emergency room.
+
+-Your Foley should be secured to the catheter secure on your 
+thigh at ALL times until your follow up with the surgeon.
+
+-Follow up in ___ weeks for wound check and Foley removal. DO 
+NOT 
+allow anyone that is outside of the urology team remove your 
+Foley for any reason.
+
+-Wear Large Foley bag for majority of time; the leg bag is only 
+for short-term when leaving the house, etc.
+
+ 
+
+###RESPONSE: strain {Muscle strain}, pressure {Pressure}, abdomen {Skin structure of anterior abdominal wall}, incision 
+sites {Surgical incision wound}, wound closure {Wound healed}, pain control {Pain control}, pain 
+control {Pain control}, narcotic {Narcotherapy}, pain relief {Pain relief}, blood in your stool {Hematochezia}, dark {Dark stools}, tarry 
+stools {Melena}, narcotic {Narcotherapy}, pain medication {Administration of analgesic}, breakthrough pain {Breakthrough pain}, narcotic {Narcotherapy}, pain medication {Administration of analgesic}, pain control {Pain control}, narcotic {Narcotherapy}, pain medication {Administration of analgesic}, constipation {Constipation}, constipation {Constipation}, narcotic {Narcotherapy}, pain medication {Administration of analgesic}, loose stool {Loose stool}, diarrhea {Diarrhea}, stool-softener {Administration of laxative}, fevers {Fever}, vomiting {Vomiting}, redness {Redness of skin over lesion}, swelling {Swelling}, incision {Surgical incision wound}, Foley {Urinary catheter in situ}, thigh {Thigh structure}, wound check {Wound assessment}, Foley removal {Removal of urinary bladder catheter}"
+"###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:
+ etoh withdrawal  
+
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: No Known Allergies {Allergic disposition}, Adverse Drug Reactions {Propensity to adverse reactions to drug}, etoh withdrawal {Alcohol withdrawal syndrome}"
+"###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, primarily ___ speaking (but conversational in 
+___ presents with HA and shaking after stopping drinking. 
+Pt reports drinking 1 large bottle of cognac daily x `1 week. He 
+attests to being sober for 3 months prior to this binge. Last 
+drink was ___ afternoon. The HA is frontal and intense but 
+similar to prior HA. no Vision or hearing changes. Pt also 
+reports N/V and diffuse abd pain starting today. No 
+hematemeisis. Pain is discribed as intense. He says it is 
+different than his typical pancreatitis pain, but he can not 
+discribe in what way. Pain improves with vomitting. No diarrhea 
+or constipation. Pt reports feeling tremulous. Subjective 
+fevers. Pt endorses h/o etoh withdrawal seizures. He endorses 
+depression but denies SI/HI now or ever.  
+.  
+In the ED, initial VS: 98.0, 78, 150/89, 17, 100%RA. Pt received 
+10mg PO valium and 4mg IV zofran in ED. CIWA of ___. Pt was 
+tachy in ED and diaphoretic. Also complained of belly discomfort 
+and vomitted. Labs and abd exam benign. MS oriented. VS prior to 
+transfer 125/78, 93, 17, 95% RA.  
+.  
+Upon arrival to the floor the pt was seen inducing vomitting 
+multiple times and complained of a headache. He complains of a 
+HA.  
+.  
+Pt was admitted ___ with etoh withdrawal and abd pain but 
+left AMA the same day.  
+.  
+ROS: Denies, chills, night sweats, vision changes, rhinorrhea, 
+congestion, sore throat, cough, shortness of breath, chest pain, 
+, diarrhea, constipation, BRBPR, melena, hematochezia, dysuria, 
+hematuria.  
+
+ 
+
+###RESPONSE: HA {Headache}, shaking {Tremor}, drinking {Current drinker of alcohol}, drinking {Current drinker of alcohol}, binge {Drinking binge}, drink {Drinking episode}, HA is frontal {Frontal headache}, HA {Headache}, Vision {Visual disturbance}, hearing changes {Hearing change}, N/V {Nausea and vomiting}, diffuse {Diffuse pain}, abd pain {Abdominal pain}, hematemeisis {Hematemesis}, Pain {Pain}, pancreatitis {Pancreatitis}, pain {Pain}, Pain {Pain}, vomitting {Vomiting}, diarrhea {Diarrhea}, constipation {Constipation}, fevers {Fever}, etoh withdrawal seizures {Alcohol withdrawal-induced convulsion}, depression {Depressive disorder}, SI/HI {Suicidal intent}, tachy {Tachycardia}, diaphoretic {Excessive sweating}, discomfort {Discomfort}, Labs {Laboratory test}, abd exam {Examination of abdomen}, oriented {Orientated}, inducing vomitting {Self-induced vomiting}, headache {Headache}, HA {Headache}, etoh withdrawal {Alcohol withdrawal syndrome}, abd pain {Abdominal pain}, ROS {Review of systems}, chills {Chill}, night sweats {Night sweats}, vision changes {Visual disturbance}, rhinorrhea {Nasal discharge}, congestion {Nasal congestion}, sore throat {Sore throat}, cough {Cough}, shortness of breath {Dyspnea}, chest pain {Chest pain}, diarrhea {Diarrhea}, constipation {Constipation}, BRBPR {Hematochezia}, melena {Melena}, hematochezia {Hematochezia}, dysuria {Dysuria}, hematuria {Blood in urine}"
+"###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:
+1.  Recurrent pancreatitis complicated by necrosis in ___ secondary to alcohol abuse.
+2.  Hypertension.
+3.  History of a seizure disorder; status post a motor vehicle 
+accident in ___ (negative magnetic resonance 
+imaging and electroencephalogram).
+4.  Status post left knee surgery.
+5.  History of alcohol abuse with episodes of withdrawal.
+
+ 
+
+###RESPONSE: Recurrent pancreatitis {Recurrent pancreatitis}, necrosis {Necrosis}, alcohol abuse {Alcohol abuse}, Hypertension {Hypertensive disorder, systemic arterial}, seizure disorder {Seizure disorder}, motor vehicle 
+accident {Motor vehicle accident victim}, negative {No abnormality detected}, magnetic resonance 
+imaging {Magnetic resonance imaging}, electroencephalogram {Electroencephalogram}, left knee {Structure of left knee region}, surgery {Surgical procedure}, alcohol abuse {Alcohol abuse}, withdrawal {Alcohol withdrawal syndrome}"
+"###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 kidney cancer
+ 
+
+###RESPONSE: kidney cancer {Malignant tumor of kidney}"
+"###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 - well-appearing man in NAD, comfortable, appropriate  
+HEENT - NC/AT, PERRLA, EOMI, sclerae erythematous, MMM, OP clear 
+ 
+NECK - supple, no JVD,  
+LUNGS - CTA bilat, no r/rh/wh, good air movement, resp unlabored 
+ 
+HEART - RRR, no MRG, nl S1-S2  
+ABDOMEN - soft/ND, mild epigastric tenderness. No rebound or 
+guarding. no masses or HSM,  
+EXTREMITIES - WWP, no c/c/e, 2+ DPs  
+SKIN - no rashes or lesions  
+LYMPH - no cervical LAD  
+NEURO - awake, A&Ox3, CNs II-XII grossly intact, not tremulous. 
+muscle strength ___ throughout, sensation grossly intact 
+throughout, DTRs 2+ and symmetric, cerebellar exam intact, 
+steady gait. Normal visual fields  
+ 
+
+ 
+
+###RESPONSE: GENERAL {General examination of patient}, well-appearing {Well cared for appearance}, NAD {No abnormality detected}, comfortable {Comfortable appearance}, HEENT {Physical examination procedure}, NC {Normal head}, PERRLA {Pupils equal, react to light and accommodation}, EOMI {Normal ocular motility}, sclerae {Scleral structure}, erythema {Erythema}, MMM {Moist oral mucosa}, OP clear {Pharynx normal}, NECK {Physical examination procedure}, supple {Normal movement of neck}, JVD {Jugular venous engorgement}, LUNGS {Examination of respiratory system}, CTA {Normal breath sounds}, rh/wh {Wheeze - rhonchi}, good air movement {Breath normal}, resp unlabored {Labored breathing}, HEART {Cardiovascular physical examination}, RRR {Normal heart rate}, no MRG {Heart sounds normal}, S2 {Normal second heart sound, S>2<}, ABDOMEN {Examination of abdomen}, soft {Abdomen soft}, ND {Swollen abdomen}, mild {Symptom mild}, tenderness {Tenderness}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, masses {Abdominal mass}, HSM {Hepatosplenomegaly}, EXTREMITIES {Examination of limb}, WWP {Normal tissue perfusion}, no c/c/e {No abnormality detected}, SKIN {Examination of skin}, rashes {Eruption of skin}, lesions {Lesion}, LYMPH {Lymphatic system physical examination}, LAD {Lymphadenopathy}, NEURO {Neurological examination}, awake {Awake}, Ox3 {Oriented to person, time and place}, grossly intact {Normal nervous system function}, tremulous {Tremor}, muscle strength {Muscle weakness}, sensation grossly intact {Normal sensation}, DTRs 2 {Normal tendon reflex}, steady gait {Gait normal}, Normal visual fields {Normal visual field}"
+"###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:
+___ 07:20AM BLOOD WBC-7.2 RBC-4.89 Hgb-14.6 Hct-40.8 MCV-83 
+MCH-29.8 MCHC-35.8* RDW-13.4 Plt ___
+___ 07:50PM BLOOD WBC-5.6 RBC-5.12 Hgb-15.7 Hct-42.4 MCV-83 
+MCH-30.6 MCHC-37.0* RDW-13.2 Plt ___
+___ 07:50PM BLOOD Neuts-50.4 Lymphs-42.3* Monos-5.1 Eos-1.0 
+Baso-1.2
+___ 07:20AM BLOOD Glucose-98 UreaN-9 Creat-0.9 Na-138 K-3.8 
+Cl-100 HCO3-24 AnGap-18
+___ 07:50PM BLOOD Glucose-125* UreaN-11 Creat-1.1 Na-135 
+K-3.5 Cl-94* HCO3-24 AnGap-21*
+___ 07:50PM BLOOD ALT-27 AST-30 AlkPhos-42 TotBili-0.9
+___ 07:20AM BLOOD Albumin-4.3 Mg-1.9
+___ 07:50PM BLOOD Lipase-31
+___ 07:50PM BLOOD ASA-NEG Acetmnp-NEG Bnzodzp-NEG 
+Barbitr-NEG Tricycl-NEG
+___ 08:09AM BLOOD Lactate-2.4*
+.
+
+ 
+
+###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}, 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}, Lymphs {Lymphocyte count}, Monos {Monocyte count}, Eos {Eosinophil count}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, 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}, Albumin {Albumin 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: Brief Hospital Course:
+HOSPITAL COURSE
+This is a ___ year old gentleman  with a history of multiple 
+admissions for alcohol withdrawal who presented with 
+tachycardia, vomitting, diaphoresis consistent with Etoh 
+withdrawal.  He was treated with diazepam overnight and left 
+against medical advice the following morning 
+.  
+ACTIVE ISSUES
+# ETOH WITHDRAWAL: History of chronic ETOH use complicated by 
+pancreatitis in the past with recent admission in ___ for 
+management of withdrawal symptoms.  The patient's CIWA scale was 
+24 on admission which improved significantly with 10mg diazepam. 
+He only scored positive on the CIWA scale twice. The patient 
+reports a history of withdrawal seizures however on 
+clarification appears to be more consistent with tremors. 
+History of prior seizure after motor vehicle accident ___ years 
+ago. No evidence of pancreatitis on lab work. Alchohol cessation 
+was discussed with the patient who wanted treatment only for 
+withdrawal not abstinence.  A social work consult was requested. 
+ He was given thiamine folate and a multivitamin intravenously.  
+At mid-day following admission the patient was dressed and found 
+at the elevators preparing to leave.  The danger of alcohol 
+withdrawal and risk of seizures and even death was discussed.  
+The patient understood the importance of seeking medical 
+attention if his withdrawal returned.
+.  
+# ELEVATED AG: AG 17 on admission improved to 14 the following 
+morning. Likely in setting of etoh and with ketones in UA.  
+Lactate only marginally elevated at 2.4.
+.  
+# HEADACHE: Headache per review of prior discharge summaries is 
+a typical withdrawal symptoms for this patient. Improved 
+headache with treatment of withdrawal symptoms overnight with 
+valium. 
+.  
+# N/V, ABDOMINAL PAIN: Abdominal pain in this patient concerning 
+for pancreatitis given multiple admissions in past for alcohol 
+induced pancreatitis.  No evidence of pancreatitis on admission. 
+ Patient report frequent emesis is causing abdominal pain.
+He tolerated a solid diet prior to leaving AMA.
+.  
+# HISTORY OF DEPRESSION: The patient has a history of depression 
+with psychiatric evaluations in the past for suicidal ideation.  
+He did not present expressing suicidal ideation however 
+completely off all psychiatric medications and more frequent 
+admissions for alcohol withdrawal. The patient did not stay long 
+enough to meet with social work. Prior to leaving, the 
+importance of following up with his psychiatrist was stressed.
+.
+TRANSITIONAL ISSUES:
+The patient left against medical advice. Follow-up with his 
+primary care physician and psychiatrist was urged.  He does not 
+take any medications regularly.
+ 
+
+###RESPONSE: alcohol withdrawal {Alcohol withdrawal syndrome}, tachycardia {Tachycardia}, vomitting {Vomiting}, diaphoresis {Excessive sweating}, Etoh 
+withdrawal {Alcohol withdrawal syndrome}, left 
+against medical advice {Left against medical advice}, ETOH WITHDRAWAL {Alcohol withdrawal syndrome}, ETOH {Alcohol abuse}, pancreatitis {Pancreatitis}, management of withdrawal symptoms {Management of withdrawal symptom}, CIWA scale {Assessment using alcohol withdrawal scale}, improved {Patient's condition improved}, CIWA scale {Assessment using alcohol withdrawal scale}, withdrawal seizures {Alcohol withdrawal-induced convulsion}, tremors {Tremor}, seizure {Seizure}, motor vehicle accident {Motor vehicle accident victim}, No evidence {No abnormality detected}, pancreatitis {Pancreatitis}, withdrawal {Alcohol withdrawal syndrome}, alcohol 
+withdrawal {Alcohol withdrawal syndrome}, seizures {Seizure}, death {Dead}, withdrawal {Alcohol withdrawal syndrome}, ELEVATED AG {Increased anion gap}, improved {Patient's condition improved}, etoh {Alcohol abuse}, Lactate {Lactic acid measurement}, HEADACHE {Headache}, Headache {Headache}, withdrawal symptoms {Withdrawal symptom}, Improved {Patient's condition improved}, headache {Headache}, withdrawal symptoms {Withdrawal symptom}, ABDOMINAL PAIN {Abdominal pain}, Abdominal pain {Abdominal pain}, pancreatitis {Pancreatitis}, alcohol 
+induced pancreatitis {Inflammation of pancreas caused by alcohol}, No evidence {No abnormality detected}, pancreatitis {Pancreatitis}, emesis {Vomiting}, abdominal pain {Abdominal pain}, solid diet {Normal diet}, leaving AMA {Patient self-discharge against medical advice}, DEPRESSION {Depressive disorder}, depression {Depressive disorder}, psychiatric evaluations {Evaluation of psychiatric state of patient}, suicidal ideation {Suicidal thoughts}, suicidal ideation {Suicidal thoughts}, psychiatric {Psychiatry procedure or service}, medications {Administration of drug or medicament}, alcohol withdrawal {Alcohol withdrawal syndrome}, social {Social therapy}, psychiatrist {Psychiatric follow-up}, left against medical advice {Left against medical advice}, primary care {Primary care management}, psychiatrist {Psychiatric follow-up}, medications {Patient medication education}"
+"###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:
+not regularly taking any medications  
+occasionally takes atenolol for HTN when he ""feels his BP is 
+bad"".  
+
+ 
+Discharge Medications:
+1. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 
+6 hours) as needed for pain/fever.  
+
+ 
+
+###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:
+Alcohol withdrawal
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Alcohol withdrawal {Alcohol withdrawal syndrome}, Mental Status {Neurological mental status determination}, Clear {Normal state of mind}, Alert {Mentally alert}, interactive {Does communicate}, 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 left the hospital against medical advice.  We discussed the 
+risks of leaving including further alcohol withdrawal leading to 
+possible seizures and even death.  You were aware of these risks 
+and decided to leave.  Please follow up with your primary care 
+physician and psychiatrist.  No changes were made to your 
+medications.
+ 
+
+###RESPONSE: alcohol withdrawal {Alcohol withdrawal syndrome}, seizures {Seizure}, death {Dead}, primary care {Primary care management}, psychiatrist {Psychiatric follow-up}, changes were made to your 
+medications {Change of medication}"
+"###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:
+Occluded suprapubic catheter, urinary tract infection
+ 
+Major Surgical or Invasive Procedure:
+Exchange of suprapubic catheter 
+
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, Occluded suprapubic catheter {Obstruction of suprapubic catheter}, urinary tract infection {Urinary tract infectious disease}, Exchange of suprapubic catheter {Change of cystostomy tube}"
+"###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 rectal cancer, stage IV with extensive pelvic nodal 
+involvement, receiving palliative CAPOX, s/p palliative 
+resection of his lower rectum and anus with diverting colostomy 
+and suprapubic tube for urethral injury who presented to ___ 
+with urinary retention since last night. The patient reports 
+that no urine has come through catheter since yesterday evening. 
+Suprapubic tube was just replaced on ___. Pt also having 
+decreased ostomy output since this AM. Normally empties ___ per 
+day. He also has significant abdominal discomfort.  
+- In the ED, initial VS were 9 98.6 117 149/69 99% RA.  
+- Exam was notable for purulent discharge surrounding SP tube, 
+extreme discomfort & abdominal tenderness.  
+- Labs were notable for lactate 2.6, cr 0.6, na 131, k 4.6, wbc 
+10.3, hct 40, plt 202, UA was grossly +ve.  
+- Imaging was notable for AXR which showed a non obstructive 
+bowel gas pattern.  
+- Consulted services included urology who recommended no need 
+for further studies if Cr, lytes WNL. At 21:00, ED flushed 
+foley, removed and manually drained bladder. Replaced with new 
+___ foley. Urine with purulent material draininage. Pt's pain 
+was much improved  
+with this.  
+- Patient was given IV ceftriaxone.  
+- Patient was admitted to OMED for management of complicated 
+UTI.  
+- VS prior to ED transfer were 2 98.1 72 120/65 20 100% RA.  
+On presentation to floor, patient was pain free, after having 
+catheter excahnged. no anusea, said emptied colostomy bag prior 
+to coming to ED. No fevers, chills, nausea or vomitting.
+ 
+
+###RESPONSE: rectal cancer {Malignant tumor of rectum}, stage IV {Clinical stage IV}, pelvic nodal {Pelvic lymphadenopathy}, CAPOX {Chemotherapy}, resection {Excision}, rectum {Rectum structure}, anus {Anal structure}, diverting colostomy {Construction of diverting colostomy}, suprapubic tube {Procedure involving suprapubic catheter}, urethral injury {Injury of urethra}, urinary retention {Retention of urine}, urine {Urinalysis}, Suprapubic tube {Procedure involving suprapubic catheter}, abdominal discomfort {Abdominal discomfort}, VS {Vital signs finding}, RA {Breathing room air}, Exam {Physical examination procedure}, purulent discharge {Purulent discharge}, SP tube {Procedure involving suprapubic catheter}, discomfort {Discomfort}, abdominal tenderness {Abdominal tenderness}, wbc {White blood cell count}, hct {Hematocrit determination}, UA {Urinalysis}, Imaging {Imaging}, AXR {Diagnostic radiography of abdomen}, obstructive {Obstruction}, bowel gas pattern {Finding of gastrointestinal tract gas}, foley, removed {Removal of urinary bladder catheter}, drained bladder {Drainage of bladder}, Replaced with new 
+___ foley {Replacement of urinary catheter}, Urine {Urinalysis}, purulent {Purulent}, draininage {Drainage procedure}, pain {Pain}, improved {Patient's condition improved}, IV {Administration of drug or medicament via intravenous route}, UTI {Urinary tract infectious disease}, VS {Vital signs finding}, RA {Breathing room air}, pain free {No present pain}, catheter excahnged {Replacement of catheter}, anusea {Nausea}, colostomy {Colostomy}, fevers {Fever}, chills {Chill}, nausea {Nausea}, vomitting {Vomiting}"
+"###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:
+Past medical history: hyperlipidemia, cataracts, lymphadenopathy 
+(supraclavicular, mediastinal, RP, pelvic sidewall, iliac, 
+cervical)
+
+Past oncologic history:
+Presumed rectal cancer stage IV
+- ___ Began having anal irritation and pain with blood
+streaked stools and changing bowel habits. 
+- ___ Presented to his PCP, who found inguinal adenopathy. 
+- ___ Evaluated in the Hematologic Malignancies Clinic by
+Dr. ___. 
+- ___ PET CT showed, ""Widespread FDG-avid cervical,
+supraclavicular, mediastinal, retroperitoneal, pelvic sidewall,
+iliac, and inguinal lymphadenopathy, consistent with lymphoma.""
+- ___iopsy revealed adenocarcinoma
+consistent with a colorectal or appendiceal origin, positive for
+CK7, CK20 and CDX-2.
+
+PSH: cataract surgery, excision of right groin node ___, 
+Dr ___
+ 
+
+###RESPONSE: hyperlipidemia {Hyperlipidemia}, cataracts {Cataract}, lymphadenopathy {Lymphadenopathy}, supraclavicular {Supraclavicular lymphadenopathy}, mediastinal {Mediastinal lymphadenopathy}, RP {Retroperitoneal lymphadenopathy}, pelvic sidewall {Pelvic lymphadenopathy}, iliac {Iliac lymphadenopathy}, cervical {Cervical lymphadenopathy}, rectal cancer {Malignant tumor of rectum}, stage IV {Clinical stage IV}, pain {Abdominal pain}, blood
+streaked stools {Hematochezia}, changing bowel habits {Altered bowel function}, adenopathy {Lymphadenopathy}, Hematologic Malignancies {Malignant tumor of lymphoid, hemopoietic AND/OR related tissue}, PET CT {Positron emission tomography}, FDG-avid {Positron emission tomography with computed tomography using fluorodeoxyglucose (18-F)}, cervical {Cervical lymphadenopathy}, supraclavicular {Supraclavicular lymphadenopathy}, mediastinal {Mediastinal lymphadenopathy}, retroperitoneal {Retroperitoneal lymphadenopathy}, pelvic {Pelvic lymphadenopathy}, iliac {Iliac lymphadenopathy}, inguinal lymphadenopathy {Inguinal lymphadenopathy}, lymphoma {Malignant lymphoma}, adenocarcinoma {Adenocarcinoma}, colorectal {Structure of colon and/or rectum}, appendiceal {Appendix structure}, cataract surgery {Cataract surgery}, excision {Excision}, right groin {Right inguinal region structure}, node {Inguinal lymph node 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: 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, healthy.
+Father, treated for colon cancer in the past.
+No other malignancies in the family which he is aware. 
+ 
+
+###RESPONSE: colon cancer {Malignant neoplasm of colon}, malignancies {Malignant neoplasm}"
+"###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:
+EXAM ON ADMISSION
+General: NAD  
+VITAL SIGNS: 98 132/70 85 18 98 ra  
+HEENT: MMM, no OP lesions, no cervical, supraclavicular, or  
+axillary adenopathy, no thyromegaly  
+CV: RR, NL S1S2 no S3S4 MRG  
+PULM: CTAB  
+ABD: BS+, soft, NTND, no masses or hepatosplenomegaly, colostomy 
+bag in palce with minimal formed brown stool, suprapubic 
+catheter in place, purulent material noted around site of entry  
+
+LIMBS: No edema, clubbing, tremors, or asterixis; no inguinal 
+adenopathy  
+SKIN: No rashes or skin breakdown  
+NEURO: Cranial nerves II-XII are within normal limits excluding  
+
+visual acuity which was not assessed, no nystagmus; strength is  
+
+___ of the proximal and distal upper and lower extremities  
+
+EXAM ON DISCHARGE
+
+ 
+
+###RESPONSE: General {General examination of patient}, NAD {No abnormality detected}, VITAL SIGNS {Vital signs finding}, HEENT {Physical examination procedure}, MMM {Moist oral mucosa}, OP {Oropharyngeal structure}, lesions {Lesion}, cervical {Cervical lymphadenopathy}, supraclavicular {Supraclavicular lymphadenopathy}, axillary {Axillary lymph node structure}, adenopathy {Lymphadenopathy}, thyromegaly {Goiter}, CV {Cardiovascular physical examination}, RR {Finding of rate of respiration}, S2 {Normal second heart sound, S>2<}, PULM {Examination of respiratory system}, CTAB {Normal breath sounds}, ABD {Examination of abdomen}, BS {Normal bowel sounds}, soft {Abdomen soft}, ND {Swollen abdomen}, masses {Abdominal mass}, hepatosplenomegaly {Hepatosplenomegaly}, colostomy {Colostomy}, stool {Stool finding}, suprapubic 
+catheter in place {Suprapubic urinary catheter in situ}, purulent {Purulent}, LIMBS {Examination of limb}, edema {Edema}, clubbing {Clubbing}, tremors {Tremor}, asterixis {Asterixis}, inguinal 
+adenopathy {Inguinal lymphadenopathy}, SKIN {Examination of skin}, rashes {Eruption of skin}, skin breakdown {Broken skin}, NEURO {Neurological examination}, Cranial nerves II {Optic nerve structure}, XII {Hypoglossal nerve structure}, visual acuity {Visual acuity finding}, nystagmus {Nystagmus}, upper {Upper limb structure}, lower extremities {Lower limb 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: Pertinent Results:
+ADMISSION LABS
+___ 09:20PM BLOOD WBC-10.3# RBC-4.14* Hgb-13.3* Hct-40.0 
+MCV-97 MCH-32.3* MCHC-33.4 RDW-20.1* Plt ___
+___ 09:20PM BLOOD Neuts-86.4* Lymphs-6.7* Monos-6.4 Eos-0.3 
+Baso-0.1
+___ 09:20PM BLOOD Glucose-136* UreaN-16 Creat-0.6 Na-131* 
+K-7.0* Cl-97 HCO3-25 AnGap-16
+___ 09:00PM URINE Color-Yellow Appear-Hazy Sp ___
+___ 09:00PM URINE Blood-MOD Nitrite-POS Protein-30 
+Glucose-NEG Ketone-NEG Bilirub-NEG Urobiln-NEG pH-7.5 Leuks-LG
+___ 09:00PM URINE RBC-117* WBC-132* Bacteri-MOD Yeast-NONE 
+Epi-0
+
+INTERVAL STUDIES
+___ KUB
+Nonobstructive bowel gas pattern
+
+DISCHARGE LABS
+ 
+
+###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}, 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}, URINE {Urinalysis}, Color {Color finding}, URINE Blood {Blood in urine}, Protein {Measurement of protein in urine}, Ketone {Urinalysis, acetone or ketone bodies measurement}, pH {pH measurement}, URINE {Urinalysis}, RBC {Red blood cell count}, WBC {White blood cell count}, Bacteri {Bacteriuria}, KUB {Radiography of kidney-ureter-bladder}, Nonobstructive {Obstruction}, bowel gas pattern {Finding of gastrointestinal tract gas}"
+"###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:
+___ is a ___ year old man with stage IV rectal cancer with 
+extensive pelvic nodal involvement, who is receiving palliative 
+CAPOX, admitted to ___ with UTI.  
+
+# Complicated UTI: patient presented with blocked suprapubic 
+catheter, which was exchanged and is now draining well. His pain 
+is better but found to have grossly positive UA consistent with 
+UTI. He was never febrile. No prior culture data at ___. 
+Creatinine stable at 0.5-0.6 range. Started on CTX, pending 
+culture data for tailored antibiotics. Urine culture was 
+polymicrobial, so he was switched to cefpodoxime to complete 10 
+days on discharge. 
+
+# Rectal Cancer: Patient stable on regimen of CAPOX. Currently 
+C6D8  
+- touch base with Dr. ___, as ___ need to continue 
+capecitabine 1500 mg PO Q12H until C6D14 (ordered by oncology 
+attending).
+  
+# CAD: stable - continued home ASA 81 mg.
+
+ 
+
+###RESPONSE: stage IV {Clinical stage IV}, rectal cancer {Malignant tumor of rectum}, pelvic nodal {Pelvic lymphadenopathy}, CAPOX {Chemotherapy}, UTI {Urinary tract infectious disease}, UTI {Urinary tract infectious disease}, blocked suprapubic 
+catheter {Obstruction of suprapubic catheter}, exchanged {Change of cystostomy tube}, pain {Abdominal pain}, UA {Urinalysis}, UTI {Urinary tract infectious disease}, febrile {Fever}, culture {Microbial culture}, Creatinine {Creatinine measurement}, CTX {Contraction of uterus during labor}, culture {Microbial culture}, antibiotics {Antibiotic therapy}, Urine culture {Urine culture}, Rectal Cancer {Malignant tumor of rectum}, stable {Patient's condition stable}, regimen {Therapeutic regimen}, CAPOX {Chemotherapy}, CAD {Coronary arteriosclerosis}, stable {Patient's condition stable}"
+"###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. Docusate Sodium 100 mg PO BID 
+3. Capecitabine 1500 mg PO Q12 
+
+ 
+Discharge Medications:
+1. Aspirin 81 mg PO DAILY 
+2. Docusate Sodium 100 mg PO BID 
+3. Cefpodoxime Proxetil 400 mg PO Q12H Duration: 9 Days 
+RX *cefpodoxime 200 mg 2 tablet(s) by mouth twice a day Disp 
+#*36 Tablet Refills:*0
+4. Capecitabine 1500 mg PO Q12 
+
+ 
+
+###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: occluded suprapubic catheter, UTI
+Secondary diagnoses: stage IV rectal cancer, hyperlipidemia,  
+cataracts, lymphadenopathy (supraclavicular, mediastinal, RP, 
+pelvic sidewall, iliac, cervical); pelvic lymphadenopathy 
+causing lower extremity swelling  
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: occluded suprapubic catheter {Obstruction of suprapubic catheter}, UTI {Urinary tract infectious disease}, stage IV {Clinical stage IV}, rectal cancer {Malignant tumor of rectum}, hyperlipidemia {Hyperlipidemia}, cataracts {Cataract}, lymphadenopathy {Lymphadenopathy}, supraclavicular {Supraclavicular lymphadenopathy}, mediastinal {Mediastinal lymphadenopathy}, RP {Retroperitoneal lymphadenopathy}, pelvic {Pelvic lymphadenopathy}, iliac {Iliac lymphadenopathy}, cervical {Cervical lymphadenopathy}, pelvic lymphadenopathy {Pelvic lymphadenopathy}, lower extremity swelling {Swelling of lower limb}, Mental Status {Neurological mental status determination}, 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:
+Dear Mr. ___, 
+
+You were admitted to the hospital for a clogged suprapubic 
+catheter and a urinary tract infection. Your catheter was 
+exchanged and you were treated for your urinary tract infection 
+with IV antibiotics while in house. Lab data returned and showed 
+which antibiotics your infection is susceptible to. We switched 
+you to oral antibiotics to complete at home. 
+
+We wish you a very speedy recovery! It was a pleasure caring for 
+you.
+- Your team at ___
+ 
+
+###RESPONSE: clogged suprapubic 
+catheter {Obstruction of suprapubic catheter}, urinary tract infection {Urinary tract infectious disease}, catheter was 
+exchanged {Change of cystostomy tube}, urinary tract infection {Urinary tract infectious disease}, IV antibiotics {Intravenous antibiotic therapy}, antibiotics {Antibiotic therapy}, infection {Infectious disease}, oral antibiotics {Oral 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: 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: NEUROSURGERY
+ 
+
+###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:
+pituitary adenoma
+ 
+Major Surgical or Invasive Procedure:
+___ Transphenoidal resection of tumor
+
+ 
+
+###RESPONSE: No Known Allergies {Allergic disposition}, Adverse Drug Reactions {Propensity to adverse reactions to drug}, pituitary adenoma {Pituitary adenoma}, Transphenoidal resection of tumor {Transsphenoidal total excision of neoplasm of pituitary gland}"
+"###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 male with a hitory of a prior 
+transphenoidal resection on ___ at ___ by Dr. ___. 
+His cystic pituitary mass was originally found incidentally in 
+___, after he had imaging for a complaint of tinnitus.  He now 
+presents for a re-resection of the pituitary lesion. The initial 
+pathology from ___ was adenoma. 
+ 
+
+###RESPONSE: transphenoidal resection {Transsphenoidal total excision of neoplasm of pituitary gland}, pituitary mass {Mass of pituitary}, tinnitus {Tinnitus}, resection of the pituitary lesion {Transsphenoidal total excision of neoplasm of pituitary gland}, pathology {Abnormal histology findings}, adenoma {Benign pituitary adenoma}"
+"###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:
+transsphenoidal resection ___, polyp s/p lap,
+and hypothyroidism
+ 
+
+###RESPONSE: transsphenoidal resection {Transsphenoidal total excision of neoplasm of pituitary gland}, polyp {Polyp}, hypothyroidism {Hypothyroidism}"
+"###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:
+NC
+ 
+
+###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:
+Exam on Admission
+Neural intact. Visual fields full.
+
+On Discharge:
+A&Ox3
+PERRL 
+visual fields intact
+No pronator drift
+No leaking from nose when sitting up and leaning forward
+Motor: ___ throughout
+
+ 
+
+###RESPONSE: Neural {Neurological examination}, Visual fields full {Normal visual field}, Ox3 {Oriented to person, time and place}, PERRL {Pupils equal and reacting to light}, visual fields intact {Normal visual field}, pronator drift {Downward drift of outstretched supinated arm}, leaking {Discharge}, nose {Nasal structure}, sitting {Sitting position}, Motor {Motor testing}"
+"###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:
+CT HEAD W/O CONTRAST ___ 
+Status post transsphenoidal resection of pituitary lesion with 
+expected 
+postoperative changes. No evidence of pneumocephalus or 
+intracranial 
+hemorrhage. 
+
+ 
+
+###RESPONSE: AST {Aspartate aminotransferase measurement}, Status post {Postoperative state}, transsphenoidal resection of pituitary lesion {Transsphenoidal total excision of neoplasm of pituitary gland}, postoperative {Postoperative state}, No evidence {No abnormality detected}, pneumocephalus {Pneumocephalus}, intracranial 
+hemorrhage {Intracranial hemorrhage}"
+"###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:
+Mr. ___ was taken to the operating room on the day of 
+admission on ___ and underwent a transphenoidal resection of a 
+pituitary lesion. He tolerated the procedure well and was 
+extubated in the operating room. He was transferred to the Neuro 
+ICU post-operatively. Nasal packing was left in place 
+post-operatively and he was started on antibiotics for the 
+duration of the packing placement. He underwent a post-operative 
+non-contrast head CT which showed post-operative changes. His 
+diet as advanced as tolerated. His visual fields, as well as 
+urine and serum labs were routinely monitored.
+On ___ Mr ___ remained in the PACU. He was completely 
+neurologically intact. Vitals remained stable and he was 
+ambulatory out of bed to chair. Transfer orders pending and  
+awaiting transfer to floor.
+
+On ___, patient had two hours of increase urine output, urine 
+specific gravity and serum Na which were normal. Endocrine 
+evaluated the patient who recommended starting him on 40mg QAM 
+and 20mg QPM hydrocortisone today and decreasing to 20mg QAM and 
+10mg QPM tomorrow. They were not concerned with his output and 
+recommended discharge home. On exam, no drainage from the nose 
+or salty taste at the back of the throat. He was ambulating and 
+eating appropriately. He was discharge home and will be contact 
+for further follow up with endocrinology.
+
+ 
+
+ 
+
+###RESPONSE: transphenoidal resection of a 
+pituitary lesion {Transsphenoidal total excision of neoplasm of pituitary gland}, procedure {Surgical procedure}, extubated {Removal of endotracheal tube}, Neuro {Neurology service}, ICU {Patient transfer to intensive care unit}, post-operatively {Postoperative state}, Nasal packing {Packing of nasal cavity and nasopharynx}, post-operatively {Postoperative state}, antibiotics {Antibiotic therapy}, packing {Packing of wound}, post-operative {Postoperative state}, non-contrast head CT {Computed tomography of head without contrast}, post-operative {Postoperative state}, diet {Dietary finding}, visual fields {Visual field study}, urine {Evaluation of urine specimen}, serum labs {Blood test}, monitored {Monitoring procedure}, PACU {Postanesthesia care}, neurologically intact {Normal nervous system function}, Vitals remained stable {Normal vital signs}, increase urine output {Increased urine output}, urine 
+specific gravity {Urine specific gravity within reference range}, serum Na which were normal {Serum sodium level within reference range}, drainage from the nose {Nasal discharge}, throat {Structure of anterior portion of neck}, ambulating {Fully mobile}, follow up {Follow-up arranged}"
+"###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:
+c
+abergoline,fluocinonide,levothyroxine,simvastatin,Cialis,aspirin 
+81, VITAMIN D2,multivitamin tablet
+
+ 
+Discharge Medications:
+1. Hydrocortisone 20 mg PO REFER TO OTHER INSTRUCTIONS 
+please take 40mg QAM on ___ and 20mg QPM on ___, then 20mg QAM 
+and 10mg QPM until follow up. 
+RX *hydrocortisone 20 mg 1 tablet(s) by mouth refer to other 
+instructions Disp #*60 Tablet Refills:*1
+2. Levothyroxine Sodium 50 mcg PO DAILY 
+3. Omeprazole 40 mg PO DAILY 
+RX *omeprazole 40 mg 1 capsule(s) by mouth DAILY Disp #*60 
+Capsule Refills:*1
+4. OxycoDONE (Immediate Release)  ___ mg PO Q6H:PRN pain 
+RX *oxycodone 5 mg ___ tablet(s) by mouth every six (6) hours 
+Disp #*50 Tablet Refills:*0
+5. Simvastatin 10 mg PO QPM 
+6. Vitamin D 1400 UNIT PO DAILY 
+7. Docusate Sodium 100 mg PO BID 
+RX *docusate sodium [Colace] 100 mg 1 capsule(s) by mouth twice 
+a day Disp #*60 Capsule Refills:*1
+
+ 
+
+###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:
+pituitary adenoma
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: pituitary adenoma {Pituitary adenoma}, Mental Status {Neurological mental status determination}, Clear {No abnormality detected}, 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:
+¨Take your pain medicine as prescribed.
+¨Exercise should be limited to walking; no lifting, straining, 
+or excessive bending.
+¨Increase your intake of fluids and fiber, as narcotic pain 
+medicine can cause constipation. We generally recommend taking 
+an over the counter stool softener, such as Docusate (Colace) 
+while taking narcotic pain medication.
+¨Unless directed by your doctor, do not take any 
+anti-inflammatory medicines such as Motrin, Aspirin, Advil, and 
+Ibuprofen etc. 
+¨Clearance to drive and return to work will be addressed at 
+your post-operative office visit.
+¨Continue Sinus Precautions for an additional two weeks.  This 
+means, no use of straws, forceful blowing of your nose, or use 
+of your incentive spirometer. 
+¨If you have been discharged on Prednisone, take it daily as 
+prescribed.  
+¨If you are required to take Prednisone, an oral steroid, make 
+sure you are taking a medication to protect your stomach 
+(Prilosec, Protonix, or Pepcid), as this medication can cause 
+stomach irritation.  Prednisone should also be taken with a 
+glass of milk or with a meal. 
+
+CALL YOUR DOCTOR IMMEDIATELY IF YOU EXPERIENCE ANY OF THE 
+FOLLOWING
+
+¨New onset of tremors or seizures.
+¨Any confusion or change in mental status. 
+¨Any numbness, tingling, weakness in your extremities.
+¨Pain or headache that is continually increasing, or not 
+relieved by pain medication.
+¨Any signs of infection at the wound site: redness, swelling, 
+tenderness, or drainage.
+¨It is normal for feel nasal fullness for a few days after 
+surgery, but if you begin to experience drainage or salty taste 
+at the back of your throat, that resembles a “dripping” 
+sensation, or persistent, clear fluid that drains from your nose 
+that was not present when you were sent home, please call. 
+¨Fever greater than or equal to 101° F.
+¨If you notice your urine output to be increasing, and/or 
+excessive, and you are unable to quench your thirst, please call 
+your endocrinologist. 
+
+ 
+
+###RESPONSE: Discharge Instructions {Final inpatient visit with instructions at discharge}, Take your pain medicine {Administration of analgesic}, Exercise {Exercises}, walking {Does walk}, Increase your intake of fluids {Fluid intake encouragement}, narcotic pain 
+medicine can cause {Narcotics education}, constipation {Constipation}, stool softener {Administration of laxative}, while taking narcotic pain medication {Narcotics education}, Aspirin {Administration of aspirin}, post-operative office visit {Postoperative follow-up visit}, Sinus {Nasal sinus structure}, Precautions {Safety precautions}, nose {Nasal structure}, oral {Administration of drug or medicament via oral route}, steroid {Steroid therapy}, medication {Prescription of drug}, stomach {Stomach structure}, s medication can cause {Medication education}, stomach {Stomach structure}, tremors {Tremor}, seizures {Seizure}, confusion {Clouded consciousness}, mental status {Mental state finding}, numbness, tingling {Numbness and tingling sensation of skin}, weakness {Asthenia}, extremities {All extremities}, Pain {Pain}, headache {Headache}, pain medication {Administration of analgesic}, signs of infection {Monitoring for signs and symptoms of infection}, wound {Wound}, redness {Redness of skin over lesion}, swelling {Swelling}, tenderness {Tenderness}, drainage {Discharge}, nasal {Nasal structure}, after 
+surgery {Postoperative state}, drainage {Nasal discharge}, throat {Structure of anterior portion of neck}, clear fluid that drains from your nose {Leakage of cerebrospinal fluid from nose following surgical procedure}, Fever {Fever}, urine output to be increasing {Increased urine output}"
+"###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: 
+Patient recorded as having No Known Allergies to Drugs
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Urinary Tract Infection
+ 
+Major Surgical or Invasive Procedure:
+None
+ 
+
+###RESPONSE: Urinary Tract Infection {Urinary tract 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: History of Present Illness:
+___ male with quadriplegia, recurrent prior UTIs, neurogenic 
+bladder, and sacral decubitus presents with abd and back pain 
+and persistent UTI symtpoms. In ___ had E. Coli UTI 
+treated to ___ with Cefpodoxime. Was again admitted 
+___ again for UTI symptoms without indication of 
+infection.  A CT showed a decompressed bladder, bladder wall 
+thickening and enhancement of unclear significance for which 
+urology follow-up was recommended. He received Ceftriaxone then 
+36hr Cefpodoxime. UCx (+) Enterococcus and another gram positive 
+bacteria so treated with Bactrim.  He was given a 7 day course.  
+On ___ he was empirically started on Ampicillin for another 
+presumed UTI (had fevers).  Oxycodone ws increased and pyridium 
+started ___ for complaints of bladder spasms, but this worsened 
+with pain in back and over all body and abd. He was given 1mg 
+Ativan and then sent in.
+
+On ___ he was seen by Dr. ___ in Urology, where a KUB was 
+done showing no renal calculi, though pneumatosis could not be 
+ruled out.  Prior CT mentioned, ""There are scattered foci of air 
+and soft tissue thickening in the anterior abdominal wall."" 
+
+There has been concern that some of his behavior is 
+stress/coping related, and I understand that the patient had a 
+psych consult completed last week, after which Seroquel and 
+Valium were increased and Wellbutrin was started.
+ 
+
+###RESPONSE: quadriplegia {Quadriplegia}, recurrent prior UTIs {Recurrent urinary tract infection}, neurogenic 
+bladder {Neurogenic bladder}, sacral decubitus {Chronic skin ulcer of sacrum}, abd {Abdominal pain}, back pain {Backache}, UTI {Urinary tract infectious disease}, E. Coli UTI {Urinary tract infection caused by Escherichia coli}, UTI {Urinary tract infectious disease}, infection {Infectious disease}, CT {Computed tomography}, bladder {Urinary bladder structure}, bladder wall {Structure of wall of urinary bladder}, thickening {Increased thickness}, UCx (+) Enterococcus and another gram positive {Urine culture - mixed growth}, Bactrim {Antibiotic therapy}, UTI {Urinary tract infectious disease}, fevers {Fever}, bladder spasms {Spasm of bladder}, worsened {Increased pain}, pain in back {Backache}, abd {Abdominal pain}, KUB {Radiography of kidney-ureter-bladder}, renal calculi {Kidney stone}, pneumatosis {Gas retention}, CT {Computed tomography}, soft tissue {Structure of soft tissue}, thickening {Increased thickness}, anterior abdominal wall {Anterior abdominal wall structure}, behavior {Behavior finding}, stress {Stress}, psych consult {Psychiatric procedure, interview AND/OR consultation}"
+"###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:
+- fall injury c/b cervical spine and rib fracture in ___, s/p 
+multiple spine surgeries (c1-c4, c5-c7, L3-L5)
+- complete quadriplegia s/p baclofen pump placement on ___ 
+at ___
+- neurogenic bladder s/p suprapubic indrwelling catheter 
+(catheter placed in ___ ___
+- multiple UTIs
+- neurogenic bowel
+- lower back stage II coccyx pressure ulcer
+- muscle spasms
+- type II diabetes
+- anxiety (pyschiatrist ___. Worc. MA ___
+- depression (pyschiatrist ___. Worc. MA ___
+- hypercholesterolemia
+- GERD
+- h/o DVT/PE s/p IVC filter placement
+- history of gastrostomy
+- history of tracheostomy
+- history of alcohol abuse
+- history of drug (marijuana and cocaine) abuse
+
+ 
+
+###RESPONSE: fall injury {Falling injury}, cervical spine {Structure of cervical vertebral column}, rib fracture {Fracture of rib}, spine surgeries {Operative procedure on spinal structure}, quadriplegia {Quadriplegia}, placement {Implantation procedure}, neurogenic bladder {Neurogenic bladder}, suprapubic indrwelling catheter {Suprapubic urinary catheter in situ}, placed {Implantation procedure}, UTIs {Recurrent urinary tract infection}, neurogenic bowel {Neurogenic bowel}, lower back {Lower back structure}, stage II coccyx pressure ulcer {Pressure injury of coccygeal region of back stage II}, muscle spasms {Spasm}, type II diabetes {Diabetes mellitus type 2}, anxiety {Anxiety}, depression {Depressive disorder}, hypercholesterolemia {Hypercholesterolemia}, GERD {Gastroesophageal reflux disease}, DVT {Deep venous thrombosis}, PE {Pulmonary embolism}, IVC filter placement {Insertion of inferior vena caval filter}, gastrostomy {Gastrostomy}, tracheostomy {Exteriorization of trachea}, alcohol abuse {Alcohol abuse}, drug {Drug abuse}, cocaine) abuse {Cocaine 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: 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:
+Noncontributory
+ 
+
+###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:
+T 99.5, BP 111/66, HR 20, RR 20, SpO2 97%
+In NAD.
+OP clear, poor dentition, no lesions, no ___, neck supple
+No JVD, no bruits
+___ - none
+LUNGS CTA bilat w/o rhonchi, rubs, wheezes
+COR - RRR no MRG nl S2, S2.  Normal PMI
+ABD - mild distended, nl active bowel signs, non-tender, LLQ 
+mass under scar consistent with history of baclofen pump placed 
+there.  No rebound/guarding
+EXT - no clubbing, cyanosis, edema
+SKIN - Stage II decubiti bilat upper medial gluteal area with 
+surrounding StageI erythema, Stage II midline skin breakdown 
+coccygeal
+NERUO - Minimal proximal LUEx strength, more strength and 
+sensation RUEXt.  Is paraplegic LExt.
+ 
+
+###RESPONSE: BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, NAD {No abnormality detected}, OP clear {Pharynx normal}, dentition {Structure of dentition}, lesions {Lesion}, supple {Normal movement of neck}, JVD {Jugular venous engorgement}, bruits {Bruit}, LUNGS {Examination of respiratory system}, CTA {Normal breath sounds}, rhonchi {Wheeze - rhonchi}, rubs {Pericardial friction rub}, wheezes {Wheezing}, COR {Cardiovascular physical examination}, RRR {Normal heart rate}, no MRG {Heart sounds normal}, S2 {Normal second heart sound, S>2<}, S2 {Normal second heart sound, S>2<}, Normal {No abnormality detected}, ABD {Examination of abdomen}, mild {Symptom mild}, distended {Swollen abdomen}, bowel {Intestinal structure}, non-tender {Abdominal tenderness}, LLQ 
+mass {Mass of left lower quadrant of abdomen}, scar {Scar}, placed {Implantation procedure}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, EXT {Examination of limb}, clubbing {Clubbing}, cyanosis {Cyanosis}, edema {Edema}, SKIN {Examination of skin}, Stage II decubiti {Pressure injury of sacral region of back stage II}, gluteal area {Buttock structure}, erythema {Erythema}, skin breakdown {Broken skin}, NERUO {Neurological examination}, LUEx {Structure of left upper limb}, sensation {Normal sensation}, RUEXt {Structure of right upper limb}, paraplegic {Paraplegia}"
+"###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:
+___ 12:55PM   WBC-7.8 RBC-4.05* HGB-11.9* HCT-36.6* MCV-90 
+MCH-29.4 MCHC-32.6 RDW-14.9
+___ 12:55PM   NEUTS-52.8 ___ MONOS-4.1 EOS-4.1* 
+BASOS-1.1
+___ 12:22PM   LACTATE-3.6* K+-3.9
+___ 12:10PM   GLUCOSE-249* UREA N-12 CREAT-0.4* SODIUM-138 
+POTASSIUM-4.4 CHLORIDE-100 TOTAL CO2-23 ANION GAP-19
+___ 12:10PM URINE  BLOOD-MOD NITRITE-NEG PROTEIN-25 
+GLUCOSE-250 KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 
+LEUK-MOD
+___ 12:10PM URINE  ___ BACTERIA-FEW 
+YEAST-MOD ___
+
+___ 12:00 am URINE     Site: CATHETER
+                            **FINAL REPORT ___
+   URINE CULTURE (Final ___: 
+      ENTEROCOCCUS SP..    >100,000 ORGANISMS/ML.. 
+                              SENSITIVITIES: MIC expressed in 
+MCG/ML
+_________________________________________________________
+                             ENTEROCOCCUS SP.
+                             |   
+AMPICILLIN------------   <=2 S
+NITROFURANTOIN--------    32 S
+TETRACYCLINE----------   <=1 S
+VANCOMYCIN------------     1 S
+
+___ 2:00 am URINE      Source: Catheter. 
+                            **FINAL REPORT ___
+   URINE CULTURE (Final ___: 
+      Culture workup discontinued. Further incubation showed 
+contamination
+      with mixed skin/genital flora. Clinical significance of 
+isolate(s)
+      uncertain. Interpret with caution. 
+      ESCHERICHIA COLI.    >100,000 ORGANISMS/ML.. 
+         ___. ___ (___) REQUESTED SUSCEPTIBILITY TEST FOR 
+CEFPODOXIME ON
+         ___. 
+         Cefpodoxime = SENSITIVE, sensitivity testing performed 
+by ___
+         ___. 
+                              SENSITIVITIES: MIC expressed in 
+MCG/ML
+_________________________________________________________
+                             ESCHERICHIA COLI
+                             |   
+AMIKACIN--------------  =>64 R
+AMPICILLIN------------  =>32 R
+AMPICILLIN/SULBACTAM--    16 I
+CEFAZOLIN-------------   <=4 S
+CEFEPIME--------------   <=1 S
+CEFTAZIDIME-----------   <=1 S
+CEFTRIAXONE-----------   <=1 S
+CIPROFLOXACIN---------   =>4 R
+GENTAMICIN------------  =>16 R
+MEROPENEM-------------<=0.25 S
+NITROFURANTOIN--------  <=16 S
+PIPERACILLIN/TAZO-----   <=4 S
+TOBRAMYCIN------------  =>16 R
+TRIMETHOPRIM/SULFA----  =>16 R
+
+CXR ___
+AP CHEST 6:33 P.M. ___ 
+  
+HISTORY: Quadriplegic fever. Question pneumonia. 
+  
+IMPRESSION: AP chest compared to ___. 
+  
+A roughly crescentic opacity in the right lower lung, beneath 
+the downward 
+displaced minor fissure is probably scarring or atelectasis 
+unchanged since at 
+least ___. Lungs otherwise clear. Heart size normal. No 
+pleural 
+effusion or evidence of central adenopathy. 
+  
+The study and the report were reviewed by the staff radiologist. 
+
+
+Time Taken Not Noted     Log-In Date/Time: ___ 2:05 pm
+      URINE     Site: NOT SPECIFIED
+
+                            **FINAL REPORT ___
+
+   URINE CULTURE (Final ___: 
+      YEAST.    10,000-100,000 ORGANISMS/ML.. 
+
+ 
+
+###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}, PROTEIN {Measurement of protein in urine}, KETONE {Urinalysis, acetone or ketone bodies measurement}, BILIRUBIN {Bilirubin measurement, urine}, PH {pH measurement}, URINE {Evaluation of urine specimen}, AST {Aspartate aminotransferase measurement}, URINE {Evaluation of urine specimen}, URINE CULTURE {Urine culture}, SENSITIVITIES {Antimicrobial susceptibility test}, URINE {Evaluation of urine specimen}, URINE CULTURE {Urine culture}, Culture {Microbial culture}, workup {Evaluation procedure}, sensitivity {Antimicrobial susceptibility test}, SENSITIVITIES {Antimicrobial susceptibility test}, CXR {Plain chest X-ray}, AP CHEST {Plain x-ray of chest anteroposterior view}, Quadriplegic {Quadriplegia}, fever {Fever}, pneumonia {Pneumonia}, AP chest {Plain x-ray of chest anteroposterior view}, opacity {Abnormally opaque structure}, right lower lung {Structure of base of right lung}, fissure {Fissure}, scarring {Scar}, atelectasis {Atelectasis}, Lungs {Lung structure}, clear {Normal breath sounds}, Heart {Heart structure}, normal {No abnormality detected}, pleural 
+effusion {Pleural effusion}, adenopathy {Lymphadenopathy}, URINE CULTURE {Urine culture}, AST {Aspartate aminotransferase 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: Brief Hospital Course:
+___ quadriplegic with recurrent UTIs, now with worsening 
+dysuria while on Ampicillin which was started ___ for fevers 
+for presumed UTI.  His UA is still positive nitrites and 
+leukocyte esterase.
+.
+# Presumed UTI:  Given Vancomycin to cover enterococcus which he 
+received in the ED.  He did not get anything for gram negative 
+coverage. Ceftriaxone 2gm daily added to based on prior 
+sensitivities.  UCX came back negative for bacteria, and showed 
+___ of yeast, likely contaminant -- this was not treated 
+here.  Will defer to PCP if he wants to treat this.  A CXR was 
+negative for obvious pneumonia.
+.
+# Suprapubic/Abdominal Pain: DDx includes bladder spasm, but 
+given recent KUB and Abd/pelvic CT reads referenced above, I 
+reviewed recent radiology films with radiology ___ on 
+call radiologist who indicated the CT showed mild enhancement of 
+bladder which could be consistent with UTI, and non-specific air 
+around stool in the bowel with constipation. Valium was recently 
+increased prior to admission, and he was started on Pyridium 
+(which he states never helps him). The latter is discontinue on 
+discharge.  Pt given Oxycodone prn for improved pain control and 
+continued on a bowel regimen as ordered.  His pain is LLQ and 
+vague.  I discussed with his PCP about having him see the 
+surgeons at ___ who put in his Baclofen pump at some point in 
+near future.
+.
+# Sacral Decubitus Ulcer: Stage II - present on admission.  
+___ wound RN to assess.  Continue treatments.
+.
+# DM2:  Normally on metformin, was continued.
+.
+#Depression/Anxiety:  continue Seroquel, Wellbutrin, Citalopram 
+and valium.
+.
+CODE:  FULL per patient
+.
+CONTACT:  HCP = ___ ___
+
+ 
+
+###RESPONSE: quadriplegic {Quadriplegia}, recurrent UTIs {Recurrent urinary tract infection}, dysuria {Dysuria}, Ampicillin {Antibiotic therapy}, fevers {Fever}, UTI {Urinary tract infectious disease}, UA {Urinalysis}, positive nitrites {Nitrite detected in urine}, UTI {Urinary tract infectious disease}, Vancomycin {Antibiotic therapy}, sensitivities {Antimicrobial susceptibility test}, UCX came back negative for bacteria {Urine culture - no growth}, PCP {Primary care management}, CXR {Plain chest X-ray}, negative {No abnormality detected}, pneumonia {Pneumonia}, Suprapubic {Suprapubic pain}, Abdominal Pain {Abdominal pain}, bladder spasm {Spasm of bladder}, KUB {Radiography of kidney-ureter-bladder}, Abd/pelvic CT {Computed tomography of abdomen and pelvis}, CT {Computed tomography}, bladder {Urinary bladder structure}, UTI {Urinary tract infectious disease}, bowel {Intestinal structure}, constipation {Constipation}, improved {Patient's condition improved}, pain control {Pain control}, bowel {Intestinal structure}, regimen {Therapeutic regimen}, pain {Pain}, LLQ {Structure of left lower quadrant of abdomen}, PCP {Primary care management}, Sacral Decubitus Ulcer: Stage II {Pressure injury of sacral region of back stage II}, wound {Wound}, DM2 {Diabetes mellitus type 2}, Depression {Depressive disorder}, Anxiety {Anxiety}"
+"###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:
+1. Alendronate 70 mg Tablet Sig: One (1) Tablet PO QTUES 
+2. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) 
+Tablet, PO EVERY OTHER DAY 
+3. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: Two (2) 
+Capsule, Delayed Release(E.C.) PO DAILY (Daily).  
+4. Multivitamin     Tablet Sig: One (1) Tablet PO DAILY (Daily). 
+
+5. Tizanidine 2 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily).  
+
+6. Ascorbic Acid ___ mg Tablet Sig: Two (2) Tablet PO DAILY 
+(Daily).  
+7. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 
+
+times a day).  
+8. Metformin 500 mg Tablet Sig: One (1) Tablet PO twice a day.  
+9. Midodrine 5 mg Tablet Sig: Two (2) Tablet PO BID 
+10. Baclofen 10 mg Tablet Sig: 2.5 Tablets PO TID 
+11. Zofran 4 mg Tablet Sig: One (1) Tablet PO once a day as 
+needed for nausea.  
+12. Baclofen  Intrathecal
+13. Metamucil Powder Sig: One (1) dose PO once a day as 
+needed for constipation.  
+14. Fragmin 5,000 unit/0.2 mL Syringe Sig: One (1) syringe 
+Subcutaneous once a day.  
+15. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID prn 
+constipation.  
+16. Miralax 17 gram/dose Powder Sig: One (1) dose PO once a day 
+as needed for constipation.  
+17. Acetaminophen 500 mg Tablet Sig: ___ Tablets PO Q6H prn 
+fever, pain.  
+18. Oxycodone 5 mg Tablet Sig: Five (5) Tablet PO q8h:PRN pain
+19. Buspirone 10 mg Tablet Sig: One (1) Tablet PO TID 
+20. Citalopram 20 mg Tablet Sig: Two (2) Tablet PO DAILY 
+21. Lorazepam 1 mg Tablet Sig: One (1) Tablet PO HS   
+22. Diazepam 2 mg Tablet Sig: One (1) Tablet PO Q8H prn spasms.  
+
+23. Quetiapine 25 mg Tablet Sig: Three (3) Tablet PO HS 
+24. Sodium Chloride 0.65 % Aerosol, Spray Sig: ___ Sprays Nasal
+BID  
+25. Phenazopyridine 100 mg Tablet Sig: One (1) Tablet PO TID prn 
+bladder pain
+26. Sulfamethoxazole-Trimethoprim 800-160 mg Tablet Sig: One (1) 
+
+Tablet PO BID (2 times a day) for 7 days.
+27. MagOx 400 mg Tablet Sig: One (1) Tablet PO twice a day.  
+28. Oxycodone 5 mg Tablet Sig: Two (2) Tablet PO at bedtime as 
+needed for pain.  
+29. Lorazepam 0.5 mg Tablet Sig: 0.5 Tablet PO q8h:PRN as needed 
+
+for anxiety.
+ 
+Discharge Medications:
+1. Acetaminophen 325 mg Tablet Sig: ___ Tablets PO Q6H (every 6 
+hours) as needed for fever.  
+2. Senna 8.6 mg Tablet Sig: ___ Tablets PO BID (2 times a day).  
+
+3. Polyethylene Glycol 3350 17 gram/dose Powder Sig: One (1)  PO 
+DAILY (Daily) as needed for constipation.  
+4. Fluticasone 50 mcg/Actuation Spray, Suspension Sig: One (1) 
+Spray Nasal DAILY (Daily).  
+5. Baclofen 10 mg Tablet Sig: 2.5 Tablets PO TID (3 times a 
+day).  
+6. Ondansetron 4 mg Tablet, Rapid Dissolve Sig: One (1) Tablet, 
+Rapid Dissolve PO DAILY (Daily) as needed for nausea.  
+7. Alendronate 70 mg Tablet Sig: One (1) Tablet PO QTUES (every 
+___.  
+8. Bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal 
+HS (at bedtime).  
+9. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) 
+Capsule, Delayed Release(E.C.) PO DAILY (Daily).  
+10. Multivitamin     Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+11. Tizanidine 2 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 
+ 
+12. Metformin 500 mg Tablet Sig: One (1) Tablet PO BID (2 times 
+a day).  
+13. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID 
+(2 times a day).  
+14. Magnesium Oxide 400 mg Tablet Sig: One (1) Tablet PO BID (2 
+times a day).  
+15. Buspirone 10 mg Tablet Sig: 1.5 Tablets PO TID (3 times a 
+day).  
+16. Diazepam 2 mg Tablet Sig: Two (2) Tablet PO HS (at bedtime) 
+as needed for insomnia.  
+17. Quetiapine 100 mg Tablet Sig: One (1) Tablet PO HS (at 
+bedtime).  
+18. Citalopram 20 mg Tablet Sig: Two (2) Tablet PO DAILY 
+(Daily).  
+19. Oxycodone 5 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 
+hours) as needed for pain.  
+20. Fragmin 5,000 unit/0.2 mL Syringe Sig: One (1) dose 
+Subcutaneous once a day.  
+
+ 
+
+###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:
+Abdominal Pain
+Stage II sacral debuitus
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Bedbound.
+ 
+
+###RESPONSE: Abdominal Pain {Abdominal pain}, Stage II sacral debuitus {Pressure injury of sacral region of back stage II}, Mental Status {Neurological mental status determination}, Clear {No abnormality detected}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, interactive {Does communicate}, Activity Status {Physical functional dependency}, Bedbound {Bed-ridden}"
+"###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 with complaints of abdominal pain.  You were 
+empirically given antibiotics for possible urinary tract 
+infection but do not have a urinary tract infection by culture.  
+You have discomfort in your lower left abdomen, you are 
+tolerating all of your medications and a normal diet.  I 
+recommend you follow-up with your PCP and discuss ___ possible 
+visit with the surgeons who put in the baclofen pump (in the 
+left abdomen).  Please exercise patience with your current 
+condition and work with your facility's staff to help you as 
+best as possible. 
+ 
+
+###RESPONSE: abdominal pain {Abdominal pain}, antibiotics {Antibiotic therapy}, urinary tract 
+infection {Urinary tract infectious disease}, urinary tract infection {Urinary tract infectious disease}, culture {Microbial culture}, discomfort {Discomfort}, lower left abdomen {Structure of left lower quadrant of abdomen}, medications {Patient medication education}, normal diet {Normal diet}, follow-up {Follow-up status}, PCP {Primary care management}, left abdomen {Structure of left side of abdomen}"
+"###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: 
+Penicillins
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Headache
+ 
+Major Surgical or Invasive Procedure:
+Imaging-guided LP - ___
+
+ 
+
+###RESPONSE: Penicillins {Allergy to penicillin}, Headache {Headache}, Imaging {Imaging}, LP {Lumbar puncture}"
+"###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 ___ female with PMH of hypertension,
+spinal stenosis, recent diagnosis of shingles, who presents with
+severe headache.
+
+Patient reports that the day of admission she woke up from sleep
+around 3AM with a headache, which she describes as ""intense"" and
+""all over"".  She states that this pain worsened throughout the
+day.  It was associated with nausea and vomiting -reports
+vomiting several times throughout the day, not able to keep
+anything down.  She states that bright lights made somewhat
+worse, but also that she does not normally like bright lights. 
+No phonophobia, though she does note continued ear pain.  
+Reports
+no fevers or chills.  Did have some shooting pains at the back 
+of
+her neck, but no neck soreness or stiffness.  No dizziness or
+lightheadedness, but not associated with falls.
+
+On review of records, patient first presented to her PCPs office
+on ___ with a rash on her face and neck.  She was diagnosed
+at that time with shingles, and started on a 10-day course of
+acyclovir.  She returned to urgent care on ___ with
+weakness on the left side of her face.  She was diagnosed with
+Bell's palsy secondary to her herpes zoster infection.  Was
+started on prednisone 60 mg daily for a week.  Of note, patient
+states that she was taking 60 mg 3 times a day rather than daily
+(3 tabs, 3 times a day).  She return to clinic on ___, the
+day of admission, with her headache as described above.  At this
+time she was sent to the emergency department.
+
+In the ED:
+
+Initial vital signs were notable for: T 36.5, HR 63, BP 157/95,
+RR 16, 98% RA 
+
+Exam notable for:
+Constitutional: Comfortable.
+Head/eyes: NCAT, PERRLA, EOMI.
+ENT/neck: neck supple, no rigidity or pain
+Neuro: Slowed speech, but fluent, left sided facial droop that
+has been ongoing for a week due to bell's palsy resulting from
+shingles. strength and sensation intact in bl UE and ___. ftn in
+tact. CN ___ otherwise intact with exception of CN VII on left
+side.
+
+Labs were notable for:
+
+- CBC: WBC 11.7, hgb 13.0, plt 288 
+
+- Lytes:
+
+140 / 98 / 20     AGap=16 
+-------------- 91 
+3.4 \ 26 \ 0.8 
+
+- LFTs: AST: 20 ALT: 19 AP: 81 Tbili: 0.5 Alb: 4.1 
+- lipase 24
+- lactate 1.8
+
+Studies performed include:
+- NCHCT with no evidence of acute intracranial hemorrhage.
+- LP was attempted, but unable to obtain CSF sample 
+
+Consults: ___ was consulted for an LP, which was not done at time
+of admission 
+
+Patient was given:  
+___ 17:21 IVF  NS 1000 mL
+___ 17:28 IV Metoclopramide 10 mg   
+___ 17:28 IV DiphenhydrAMINE 25 mg  
+___ 17:29 IV Acyclovir 600 mg 
+___ 20:16 IV Morphine Sulfate 4 mg 
+
+Vitals on transfer: T 98.5, HR 58, BP 158/82, RR 16, 96% RA 
+ 
+Upon arrival to the floor, patient recounts history as above. 
+She states that overall her headache is slightly better than it
+was initially.
+
+ 
+
+###RESPONSE: hypertension {Hypertensive disorder, systemic arterial}, spinal stenosis {Spinal stenosis}, shingles {Herpes zoster}, severe {Symptom severe}, headache {Headache}, headache {Headache}, pain {Pain}, nausea and vomiting {Nausea and vomiting}, vomiting {Vomiting}, worse {Increased pain}, phonophobia {Phonophobia}, ear pain {Pain of ear}, fevers {Fever}, chills {Chill}, shooting pains {Shooting pain}, back 
+of
+her neck {Cervical region back structure}, neck {Cervical region back structure}, soreness {Soreness}, stiffness {Stiffness}, dizziness {Dizziness}, lightheadedness {Lightheadedness}, falls {Falls}, rash {Eruption of skin}, face {Face structure}, neck {Neck structure}, shingles {Herpes zoster}, weakness {Weakness of face muscles}, left side of her face {Structure of left half of face}, Bell's palsy {Bell's palsy}, herpes zoster infection {Herpes zoster}, headache {Headache}, emergency {Emergency treatment management}, vital signs {Vital signs finding}, RA {Breathing room air}, Comfortable {Comfortable appearance}, Head/eyes {Physical examination procedure}, NCAT {Normal head}, PERRLA {Pupils equal, react to light and accommodation}, EOMI {Normal ocular motility}, ENT/neck {Physical examination procedure}, neck supple {Normal movement of neck}, rigidity {Nuchal rigidity}, pain {Pain}, Neuro {Neurological examination}, Slowed speech {Bradylalia}, fluent {Does speak fluently}, left sided facial {Structure of left half of face}, bell's palsy {Bell's palsy}, shingles {Herpes zoster}, sensation intact {Normal sensation}, UE {Upper limb structure}, CN {Cranial nerve structure}, CN VII on left
+side {Structure of left facial nerve}, CBC {Complete blood count}, WBC {White blood cell count}, LFTs {Hepatic function panel}, AST {Aspartate aminotransferase measurement}, ALT {Alanine aminotransferase measurement}, AP {Alkaline phosphatase measurement}, Tbili {Bilirubin, total measurement}, Alb {Albumin measurement}, lipase {Serum lipase measurement}, lactate {Lactic acid measurement}, NCHCT {Computed tomography of head without contrast}, no evidence {No abnormality detected}, intracranial hemorrhage {Intracranial hemorrhage}, LP {Lumbar puncture}, CSF {Cerebrospinal fluid collection}, LP {Lumbar puncture}, IVF {Administration of intravenous fluids}, Vitals {Vital signs finding}, RA {Breathing room air}, headache {Headache}"
+"###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 
+- melanoma
+- hyperlipidemia
+- Gastric ulcer 
+- Asthma 
+- Spinal stenosis, lumbar region, with neurogenic claudication 
+ 
+
+###RESPONSE: hypertension {Hypertensive disorder, systemic arterial}, melanoma {Malignant melanoma of skin}, hyperlipidemia {Hyperlipidemia}, Gastric ulcer {Gastric ulcer}, Asthma {Asthma}, Spinal stenosis, lumbar region {Spinal stenosis of lumbar region}, neurogenic claudication {Neurogenic claudication}"
+"###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:
+Brother ___ 
+Father ___ 
+Mother ___ CAD/PVD - Early (___); Gout; Hypertension 
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}, PVD {Peripheral vascular disease}, Gout {Inflammatory disorder due to increased blood urate level}, Hypertension {Hypertensive disorder, systemic arterial}"
+"###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:
+VITALS: T 98.4, HR 66, BP 171/90, RR 18, 93% RA 
+GENERAL: Alert and in no apparent distress
+EYES: Anicteric, pupils equally round
+ENT: Neck supple with negative brudzinski's and kernig's signs.
+Crusted over lesions on left side of face, including pinna of 
+ear
+and external canal. Very tender to light palpation
+CV: Heart regular, no murmur, no S3, no S4.  No JVD.
+RESP: Lungs clear to auscultation with good air movement
+bilaterally.  Breathing is non-labored
+GI: Abdomen soft, non-distended, non-tender to palpation.  Bowel
+sounds present.  No HSM
+GU: No suprapubic fullness or tenderness to palpation
+MSK: Neck supple, moves all extremities, strength grossly full
+and symmetric bilaterally in all limbs
+SKIN: Lesions over left side of face as noted above
+NEURO: Alert, oriented x3, PEERL, EOMI. Left-sided facial droop
+with decreased sensation to forehead and nearly no sensation in
+V2 and V3 distribution. Hearing grossly intact bilaterally.
+Palate raises symmetrically, shoulder shrug normal, tongue
+midline, strength ___ in upper and lower distal and proximal
+muscle groups.  
+PSYCH: pleasant, appropriate affect
+ 
+
+###RESPONSE: VITALS {Vital signs finding}, HR {Finding of heart rate}, BP {Blood pressure finding}, RR {Finding of rate of respiration}, RA {Breathing room air}, GENERAL {General examination of patient}, Alert {Mentally alert}, distress {Distress}, EYES {Ophthalmic examination and evaluation}, Anicteric {White sclera}, pupils equally round {Pupil size and shape normal}, ENT {Abdominal tenderness}, supple {Normal movement of neck}, negative {No abnormality detected}, brudzinski's {Brudzinski's sign}, kernig's signs {Kernig's sign}, lesions {Lesion}, left side of face {Structure of left half of face}, pinna of 
+ear {Pinna structure}, external canal {External auditory canal structure}, tender {Abdominal tenderness}, palpation {Palpation}, CV {Cardiovascular physical examination}, Heart {Cardiovascular physical examination}, murmur {Murmur}, no S3 {Third heart sound, S>3<, inaudible}, no S4 {Fourth heart sound, S>4<, inaudible}, JVD {Jugular venous engorgement}, RESP {Examination of respiratory system}, Lungs {Examination of respiratory system}, good air movement {Breath normal}, Breathing {Examination of respiratory system}, labored {Labored breathing}, GI {Examination of digestive system}, soft {Abdomen soft}, non-distended {Normal abdominal contour}, non-tender {Abdominal tenderness}, palpation {Palpation}, Bowel
+sounds present {Normal bowel sounds}, HSM {Hepatosplenomegaly}, GU {Examination of genitourinary system}, suprapubic {Hypogastric region structure}, tenderness {Tenderness}, palpation {Palpation}, MSK {Musculoskeletal system physical examination}, supple {Normal movement of neck}, all extremities {All extremities}, symmetric bilaterally in all limbs {Normal bilateral upper limbs and bilateral lower limbs}, SKIN {Examination of skin}, Lesions {Skin lesion}, left side of face {Structure of left half of face}, NEURO {Neurological examination}, Alert {Mentally alert}, oriented {Orientated}, PEERL {Pupils equal and reacting to light}, EOMI {Normal ocular motility}, Left-sided facial {Structure of left half of face}, decreased sensation {Hypesthesia}, forehead {Forehead structure}, no sensation {Absence of sensation}, V2 {Entire maxilla}, V3 {Lower jaw region structure}, grossly intact {Normal nervous system function}, Palate {Palatal structure}, shoulder {Structure of right shoulder region}, normal {No abnormality detected}, tongue {Tongue structure}, upper and lower distal {Structure of distal palatal tooth surfaces}, muscle {Skeletal and/or smooth muscle structure}, PSYCH {Psychiatry procedure or service}, affect {Mood finding}"
+"###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:
+___ 03:15PM BLOOD WBC-11.7* RBC-4.54 Hgb-13.0 Hct-41.5 
+MCV-91 MCH-28.6 MCHC-31.3* RDW-12.6 RDWSD-41.7 Plt ___
+___ 03:15PM BLOOD Glucose-91 UreaN-20 Creat-0.8 Na-140 
+K-3.4* Cl-98 HCO3-26 AnGap-16
+___ 07:18AM BLOOD Calcium-8.6 Phos-3.9 Mg-1.9
+
+LP RESULTS:
+Tube 1: ___ 03:15PM CEREBROSPINAL FLUID (CSF) TNC-19* 
+RBC-700* Polys-7 Bands-1 ___ Monos-4
+Tube 4: ___ 03:15PM CEREBROSPINAL FLUID (CSF) TNC-22* 
+RBC-174* Polys-6 Bands-3 ___ ___ 03:15PM CEREBROSPINAL FLUID (CSF) TotProt-36 Glucose-57
+
+RELEVANT IMAGING:
+___ NCHCT:
+There is no evidence of acute, large territorial infarction, 
+fracture, 
+hemorrhage,edema,or mass effect.  There is mild prominence of 
+the ventricles  and sulci suggestive of involutional changes.  
+Periventricular white-matter hypodensities are nonspecific, 
+likely sequela of chronic ischemic small vessel  disease. 
+  
+Hyperostosis frontalis interna is noted.  Partial opacification 
+of the 
+posterior ethmoid air cells.  Layering fluid within the 
+bilateral sphenoid 
+sinuses, left greater than right, with aerosolized component 
+within the left sphenoid sinus.  The mastoid air cells are 
+clear.  The visualized portion of the orbits are normal. 
+  
+IMPRESSION:  
+1. No evidence of acute intracranial hemorrhage. 
+2. Paranasal sinus disease. 
+
+___ CTA head/neck:
+FINDINGS:  
+  
+CT head shows no evidence of hemorrhage, or loss of gray-white 
+matter 
+differentiation. No midline shift or hydrocephalus seen.  
+Aerosolized 
+secretions and fluid level are seen in the sphenoid sinus. 
+  
+CT angiography of the neck shows normal appearance of the 
+carotid and 
+vertebral arteries without stenosis or occlusion or dissection. 
+  
+CT angiography of the head shows normal appearance of the 
+arteries of the 
+anterior and posterior circulation without stenosis or occlusion 
+or aneurysm 
+greater than 3 mm in size. 
+  
+IMPRESSION:  
+No significant abnormalities on CT of the head without contrast. 
+ No 
+significant abnormalities on CT angiography of the head and 
+neck.  Sphenoid sinus soft tissue changes. 
+
+DISCHARGE RESULTS:
+___ 06:50AM BLOOD WBC-7.4 RBC-3.83* Hgb-11.2 Hct-36.5 
+MCV-95 MCH-29.2 MCHC-30.7* RDW-12.4 RDWSD-42.9 Plt ___
+___ 07:00AM BLOOD Glucose-98 UreaN-13 Creat-1.0 Na-141 
+K-4.4 Cl-103 HCO3-28 AnGap-10
+___ 07:00AM BLOOD Calcium-9.0 Phos-4.3 Mg-2.___ woman with PMH of hypertension, spinal stenosis, 
+recent diagnosis of shingles with suspected Ramsay Hunt 
+syndrome, who presented with severe headache. CT head and CTA 
+head/neck showed no acute process. She underwent LP which showed 
+22 WBCs, primarily lymphs, without xanthochromia. ID was 
+consulted who felt this finding may represent VZV meningitis vs 
+meningeal irritation from VZV, and recommended 10-day course of 
+anti-viral therapy. She was treated initially with IV acyclovir, 
+transitioned to valacyclovir to complete course, last day ___. 
+She was also seen by neurology, who recommended initiation of 
+amitriptyline for headache management, and treatment of 
+neuropathic pain. Gabapentin was also uptitrated to 400mg TID. 
+Lisinopril was uptitrated to 20mg from 10mg daily.
+
+TRANSITIONAL ISSUES:
+-Valtrex to finish ___
+-Patient should receive shingles vaccine ___ weeks after 
+resolution of symptoms
+-Amitriptyline started for neuropathic pain and headache
+-Gabapentin increased to 400mg TID for neuropathic pain
+-Patient complaining of headaches brought on by chewing, thought 
+to be related to shingles. If no improvement at f/u, would check 
+ESR/CRP to evaluate for GCA
+-Please refer to ___ neurology for f/u, per patient preference
+-Lisinopril increased from 10mg to 20mg daily
+ 
+
+###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}, 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}, RBC {Red blood cell count}, Monos {Monocyte count}, RBC {Red blood cell count}, Glucose {Glucose measurement, blood}, NCHCT {Computed tomography of head without contrast}, no evidence {No abnormality detected}, infarction {Infarct}, fracture {Fracture}, hemorrhage {Hemorrhage}, edema {Edema}, mass {Mass}, ventricles {Brain ventricle structure}, sulci {Structure of sulcus of brain}, involutional changes {Involution}, Periventricular white-matter {Structure of periventricular white matter}, chronic ischemic {Chronic cerebral ischemia}, small vessel {Structure of small blood vessel (organ)}, Hyperostosis frontalis interna {Hyperostosis interna frontalis}, opacification {Abnormally opaque structure}, posterior ethmoid air cells {Structure of posterior cells of ethmoid sinus}, fluid {Accumulation of fluid}, sphenoid 
+sinuses {Sphenoid sinus structure}, left {Left sphenoid sinus structure}, right {Right sphenoid sinus structure}, left sphenoid sinus {Left sphenoid sinus structure}, mastoid air cells {Structure of mastoid cell}, are 
+clear {No abnormality detected}, orbits {Structure of orbit proper}, normal {No abnormality detected}, No evidence {No abnormality detected}, intracranial hemorrhage {Intracranial hemorrhage}, Paranasal sinus disease {Disorder of nasal sinus}, CT head {Computed tomography of head}, no evidence {No abnormality detected}, hemorrhage {Hemorrhage}, midline shift {Midline shift of brain}, hydrocephalus {Hydrocephalus}, fluid {Accumulation of fluid}, sphenoid sinus {Sphenoid sinus structure}, CT angiography of the neck {Computed tomography angiography of vascular structure of neck with contrast}, normal appearance {Normal appearance}, carotid {Carotid artery structure}, vertebral arteries {Structure of vertebral artery}, stenosis {Stenosis}, occlusion {Complete obstruction}, dissection {Dissection of artery}, CT angiography of the head {Computed tomography angiography of head with contrast}, normal appearance {Normal appearance}, arteries {Arterial structure}, circulation {Structure of cardiovascular system}, stenosis {Stenosis}, occlusion {Complete obstruction}, aneurysm {Aneurysm}, No significant abnormalities {No abnormality detected}, CT of the head without contrast {Computed tomography of head without contrast}, No 
+significant abnormalities {No abnormality detected}, CT angiography of the head and 
+neck {Computed tomography angiography of head and neck with contrast}, Sphenoid sinus {Sphenoid sinus structure}, soft tissue {Structure of soft tissue}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, RDWSD {Red cell distribution width determination}, BLOOD 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}, hypertension {Hypertensive disorder, systemic arterial}, spinal stenosis {Spinal stenosis}, shingles {Herpes zoster}, Ramsay Hunt 
+syndrome {Herpes zoster auricularis}, severe {Symptom severe}, headache {Headache}, CT head {Computed tomography of head}, CTA 
+head/neck {Computed tomography angiography of head and neck with contrast}, no acute {No abnormality detected}, LP {Lumbar puncture}, lymphs {Lymphocyte count}, VZV meningitis {Herpes zoster with meningitis}, meningeal irritation {Meningeal irritation}, anti-viral therapy {Antiviral therapy}, headache {Headache}, neuropathic pain {Neuropathic pain}, receive shingles vaccine {Administration of vaccine product containing only Human alphaherpesvirus 3 antigen for shingles}, neuropathic pain {Neuropathic pain}, headache {Headache}, neuropathic pain {Neuropathic pain}, headaches {Headache}, shingles {Herpes zoster}, no improvement {Patient condition unchanged}, ESR {Erythrocyte sedimentation rate measurement}, CRP {C-reactive protein 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: Medications on Admission:
+The Preadmission Medication list is accurate and complete.
+1. Lisinopril 10 mg PO DAILY 
+2. Omeprazole 20 mg PO BID 
+3. Ondansetron 8 mg PO Q8H:PRN Nausea/Vomiting - First Line 
+4. Pravastatin 40 mg PO DAILY 
+5. Vitamin D ___ UNIT PO DAILY 
+6. DICYCLOMine 20 mg PO TID 
+7. Polyethylene Glycol 17 g PO BID 
+8. TraZODone 50-100 mg PO QHS:PRN insomnia 
+9. Senna 17.2 mg PO QHS 
+10. Morphine SR (MS ___ 30 mg PO Q12H 
+11. Gabapentin 300 mg PO TID 
+
+ 
+Discharge Medications:
+1.  Amitriptyline 10 mg PO QHS 
+RX *amitriptyline 10 mg 1 tablet(s) by mouth at bedtime Disp 
+#*30 Tablet Refills:*0 
+2.  Artificial Tears 2 DROP BOTH EYES QID 
+RX *dextran 70-hypromellose (PF) [Artificial Tears (PF)] 0.1 
+%-0.3 % ___ drops ___ four times a day Disp #*1 Bottle Refills:*2 
+
+3.  Capsaicin 0.025% 1 Appl TP TID 
+RX *capsaicin 0.025 % Apply small amount to affected area three 
+times a day Refills:*1 
+4.  HydrOXYzine 25 mg PO QHS:PRN itchiness 
+This medication will make you drowsy. Do not drive or operate 
+machinery while using this medication. 
+RX *hydroxyzine HCl 25 mg 1 tab by mouth at bedtime Disp #*20 
+Tablet Refills:*0 
+5.  ValACYclovir 1000 mg PO TID Duration: 4 Days 
+RX *valacyclovir 1,000 mg 1 tab by mouth three times a day Disp 
+#*13 Tablet Refills:*0 
+6.  Gabapentin 400 mg PO TID 
+RX *gabapentin 400 mg 1 capsule(s) by mouth three times a day 
+Disp #*90 Capsule Refills:*0 
+7.  Lisinopril 20 mg PO DAILY 
+RX *lisinopril 20 mg 1 tablet(s) by mouth once a day Disp #*30 
+Tablet Refills:*0 
+8.  DICYCLOMine 20 mg PO TID  
+9.  Morphine SR (MS ___ 30 mg PO Q12H  
+10.  Omeprazole 20 mg PO BID  
+11.  Ondansetron 8 mg PO Q8H:PRN Nausea/Vomiting - First Line  
+12.  Polyethylene Glycol 17 g PO BID  
+13.  Pravastatin 40 mg PO DAILY  
+14.  Senna 17.2 mg PO QHS  
+15.  TraZODone 50-100 mg PO QHS:PRN insomnia  
+16.  Vitamin D ___ UNIT PO DAILY  
+
+ 
+
+###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:
+Shingles with meningeal irritation
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Shingles with meningeal irritation {Herpes zoster with meningitis}, 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:
+Dear Ms. ___,
+
+You came to the hospital with a headache. While you were here, 
+you had a lumbar puncture which showed irritation due to 
+shingles. You were started on anti-viral medication, as well as 
+medications to help your headache. You should continue the 
+anti-viral medication (valacyclovir, also called Valtrex) until 
+___. You should also use artificial tears as needed for dry 
+eyes, and use your eye patch at night until your eye is closing 
+completely.
+
+Please follow-up with your PCP as scheduled below. At this 
+visit, you may request a referral to neurology for further 
+follow-up.
+
+It was a pleasure participating in your care.
+
+Sincerely,
+Your ___ Team
+ 
+
+###RESPONSE: headache {Headache}, lumbar puncture {Lumbar puncture}, shingles {Herpes zoster}, anti-viral medication {Antiviral therapy}, medications {Patient medication education}, headache {Headache}, anti-viral medication {Antiviral therapy}, dry 
+eyes {Dry eyes}, eye {Structure of eye proper}, eye {Structure of eye proper}"
+"###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: 
+No Known Allergies / Adverse Drug Reactions
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Syncope
+Back pain
+ 
+Major Surgical or Invasive Procedure:
+Nil
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, Syncope {Syncope}, Back pain {Backache}"
+"###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:
+___ yo female with history of HL, hypothyroidism, anxiety and 
+depression who presented after syncopal episode. She reports 
+being in her USOH until she was walking up to the store this 
+morning as per her routine. All of a sudden she felt her ""eyes 
+went black"". She reports fainting and losing consciousness. She 
+denies any other prior symptoms including dizziness, LH, visual 
+changes, nausea, CP, SOB, or palpitations. She denies any 
+urinary or fecal incontinence during the episode. She fell into 
+a seated position, as if she ""plopped down"" and broke her fall 
+with her right wrist. She then felt pain in both her right wrist 
+and her left hip, and it was this pain that ""awoke her"". She 
+denies hitting her head during the fall. No recent positional 
+change prior to the syncopal event. She has previously 
+experienced this same syncopal episode.  
+.  
+After her fall, she reports marked left hip pain. She denies any 
+urinary or fecal incontinence since the fall. She denies 
+numbness, tingling, weakness, or radiating pain in her legs
+ 
+
+###RESPONSE: HL {Hyperlipidemia}, hypothyroidism {Hypothyroidism}, anxiety {Anxiety}, depression {Depressive disorder}, syncopal {Syncope}, yes 
+went black {Syncope}, fainting {Syncope}, losing consciousness {Decreased level of consciousness}, dizziness {Dizziness}, LH {Labile essential hypertension}, visual 
+changes {Sight deteriorating}, nausea {Nausea}, SOB {Dyspnea}, palpitations {Palpitations}, urinary {Urinary incontinence}, fecal incontinence {Incontinence of feces}, fell {Falls}, fall {Falls}, right wrist {Structure of right wrist region}, pain {Pain}, right wrist {Structure of right wrist region}, left hip {Left hip region structure}, pain {Pain}, fall {Falls}, syncopal {Syncope}, syncopal {Syncope}, fall {Falls}, left hip {Left hip region structure}, pain {Pain}, urinary {Urinary incontinence}, fecal incontinence {Incontinence of feces}, fall {Falls}, numbness, tingling {Numbness and tingling sensation of skin}, weakness {Asthenia}, radiating pain {Radiating pain}, legs {Lower limb 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: Past Medical History:
+Osteopenia  
+Hypothyroidism  
+Depression  
+Anxiety  
+HLD  
+Cataracts s/p repair  
+
+ 
+
+###RESPONSE: Osteopenia {Osteopenia}, Hypothyroidism {Hypothyroidism}, Depression {Depressive disorder}, Anxiety {Anxiety}, HLD {Hyperlipidemia}, Cataracts {Cataract}, repair {Cataract surgery}"
+"###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:faint spells, breast Ca in ___
+ 
+
+###RESPONSE: faint {Syncope}, breast Ca {Malignant neoplasm of breast}"
+"###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:
+VS - 97.7 66 117/64 14 96% on RA 73.8kg  
+GENERAL - Alert, interactive, well-appearing elderly female in 
+pain, laying still in bed, unable to sit  
+HEENT - PERRLA, EOMI, sclerae anicteric, MMM, OP clear  
+NECK - Supple, no JVD  
+HEART - PMI non-displaced, RRR, nl S1-S2, no MRG  
+LUNGS - CTAB, no r/rh/wh, good air movement  
+ABDOMEN - +BS, soft/NT/ND, no masses or HSM  
+EXTREMITIES - WWP, no c/c/e, 2+ peripheral pulses  
+BACK - tender over thoracic spine T4-T8, no paraspinal muscle 
+tenderness, no lumbosacral tenderness, pain over left SI joint 
+and into left groin  
+NEURO - awake, A&Ox3, CNs II-XII grossly intact, muscle strength 
+___ throughout, sensation grossly intact throughout  
+.  
+
+ 
+
+###RESPONSE: VS {Vital signs finding}, RA {Breathing room air}, GENERAL {General examination of patient}, Alert {Mentally alert}, interactive {Does communicate}, well-appearing {Well cared for appearance}, pain {Pain}, laying still in bed {Lying in bed}, unable to sit {Unable to sit}, HEENT {Physical examination procedure}, PERRLA {Pupils equal, react to light and accommodation}, EOMI {Normal ocular motility}, sclerae anicteric {White sclera}, MMM {Moist oral mucosa}, OP clear {Pharynx normal}, NECK {Physical examination procedure}, Supple {Normal movement of neck}, JVD {Jugular venous engorgement}, HEART {Cardiovascular physical examination}, displaced {Apex beat displaced}, RRR {Normal heart rate}, nl S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, no MRG {Heart sounds normal}, LUNGS {Examination of respiratory system}, CTAB {Normal breath sounds}, ABDOMEN {Examination of abdomen}, +BS {Normal bowel sounds}, soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, masses {Abdominal mass}, HSM {Hepatosplenomegaly}, EXTREMITIES {Examination of limb}, WWP {Normal tissue perfusion}, 2+ peripheral pulses {Peripheral pulses normal}, tender {Abdominal tenderness}, T4 {Bone structure of T4}, T8 {Bone structure of T8}, paraspinal {Structure of paravertebral region}, tenderness {Tenderness}, lumbosacral {Structure of lumbar and/or sacral region of back}, tenderness {Tenderness}, pain {Pain}, left SI joint {Structure of left sacroiliac joint}, left groin {Left inguinal region structure}, NEURO {Neurological examination}, awake {Awake}, Ox3 {Oriented to person, time and place}, grossly intact {Normal nervous system function}, muscle {Skeletal and/or smooth muscle structure}, sensation grossly intact {Normal sensation}"
+"###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:
+___ 07:30PM   cTropnT-<0.01
+___ 07:30PM   WBC-14.9* RBC-4.80 HGB-13.0 HCT-41.2 MCV-86 
+MCH-27.2 MCHC-31.6 RDW-13.___ yo female with history of osteopenia, HL, and hypothyroidism 
+admitted for syncope.  
+.  
+# Syncope: Although patient has had previous syncopal episodes 
+in the past, she has always had prior warning of feeling hot and 
+sweatty and had managed to sit down and prevent herself from 
+passing out.  This episode was different.  She had no prior 
+warning symptoms as before making this episode an unlikely 
+vasovagal.  There was no positional changes prior to fall making 
+orthostatic hypotension induced syncope unlikely.  She is also 
+not on any current anti-hypertensives such as thiazides.  She 
+was not exerting herself in terms of coughing/sneezing prior to 
+episode making effort syncope unlikely. However, she was walking 
+to the store and exerting herself minimally although she states 
+this walk has never troubled her before.  No faecal/urinary 
+incontinence or confusion post syncope also rules out a seizure. 
+Although she denies any chest pain/palpitations/SOB/headache, 
+and unremarkable cardiovascular exam, her recent ECG shows new 
+atrial enlargement and slight intraventricular delay.  This 
+warrants further cardiac workup to rule out transient arrhythmia 
+inducing syncopal episodes.  
+
+-ECG - no ST/T wave changes, troponin <0.01  
+-monitor on telemetry  
+-ECHO looking specifically at valvular function (evidence of 
+aortic stenosis) which came back normal
+-As per Dr. ___, patient going home with event 
+recorder
+-Out patient PCP and cardiology appointments  
+.  
+# Left hip pain: Xrays without evidence of fracture. Most likely 
+contusion of left hip/sacrum.  
+-tylenol standing  
+-patient has been taking ibuprofen PRN for back pain, so discuss 
+risks in terms of GI bleed and pre-renal failure
+-small dose of oxycodone prn further pain  
+-___ consult  
+  
+.  
+# Back pain: History of osteopenia on BMD in ___. Compression 
+fracture seen in lumbar spine L2 level but does not correlate to 
+current symptoms. Compression fracture in the thoracic spine 
+would not be an unreasonable explanation for her current 
+symptoms given the mechanism of her fall.  
+-thoracic spine films  
+-___ as outpatient 
+-Discuss commencement of Calcium and Vit D supplements as well 
+as bisphosphonates even though patient has declined these in the 
+past 
+.  
+# Leukocytosis: Most likely stress response. No signs or 
+symptoms of infection.  
+  
+.  
+# Hypothyroidism: continue levothyroxine  
+.  
+# HL: continue simvastatin  
+.  
+# Anxiety/depression: continue sertraline  
+.  
+
+ 
+
+###RESPONSE: cTropnT {Troponin T cardiac 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}, osteopenia {Osteopenia}, HL {Hyperlipidemia}, hypothyroidism {Hypothyroidism}, syncope {Syncope}, Syncope {Syncope}, syncopal {Syncope}, hot and 
+sweatty {Feels hot and sweaty}, passing out {Syncope}, vasovagal {Vasovagal syncope}, fall {Falls}, orthostatic hypotension {Orthostatic hypotension}, syncope {Syncope}, t anti-hypertensives {On treatment for hypertension}, coughing {Cough}, sneezing {Sneezing}, effort syncope {Effort syncope}, faecal {Incontinence of feces}, urinary 
+incontinence {Urinary incontinence}, confusion {Clouded consciousness}, syncope {Syncope}, seizure {Seizure}, chest pain {Chest pain}, palpitations {Palpitations}, SOB {Dyspnea}, headache {Headache}, unremarkable cardiovascular exam {Cardiovascular system normal}, ECG {Electrocardiographic procedure}, atrial {Atrial structure}, enlargement {Enlargement}, intraventricular delay {Non-specific intraventricular conduction delay}, r cardiac workup {Examination of heart}, arrhythmia {Cardiac arrhythmia}, syncopal {Syncope}, ECG {Electrocardiographic procedure}, no ST/T wave change {Electrocardiogram normal}, troponin {Troponin measurement}, telemetry  {Electroencephalogram telemetry}, ECHO {Echocardiography}, valvular {Structure of heart valve tissue}, aortic stenosis {Aortic valve stenosis}, PCP {Primary care management}, cardiology appointments {Cardiac care management}, Left hip {Left hip region structure}, pain {Pain in scrotum}, fracture {Fracture}, contusion of left hip {Contusion of left hip region}, sacrum {Structure of sacral vertebral column}, back pain {Backache}, GI bleed {Gastrointestinal hemorrhage}, pre-renal failure {Pre-renal acute kidney injury}, pain {Pain}, Back pain {Backache}, osteopenia {Osteopenia}, Compression 
+fracture seen in lumbar spine L2 level {Compression fracture of second lumbar vertebra}, thoracic spine {Structure of thoracic vertebral column}, fall {Falls}, thoracic spine {Structure of thoracic vertebral column}, Leukocytosis {Leukocytosis}, stress {Stress}, signs {Sign}, infection {Infectious disease}, Hypothyroidism {Hypothyroidism}, HL {Hyperlipidemia}, Anxiety/depression {Mixed anxiety and depressive 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: Medications on Admission:
+ sertraline 50 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+ levothyroxine 75 mcg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+ simvastatin 10 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily).  
+
+ oxybutynin chloride 5 mg Tablet Sig: One (1) Tablet PO BID (2 
+times a day).  
+
+ 
+Discharge Medications:
+1. acetaminophen 500 mg Tablet Sig: ___ Tablets PO every six (6) 
+hours.  
+2. sertraline 50 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 
+ 
+3. levothyroxine 75 mcg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+4. simvastatin 10 mg Tablet Sig: Two (2) Tablet PO DAILY 
+(Daily).  
+5. oxybutynin chloride 5 mg Tablet Sig: One (1) Tablet PO BID (2 
+times a day).  
+
+ 
+
+###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:
+-Syncope
+-Lumbar level 2 fracture
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Syncope {Syncope}, Lumbar level 2 fracture {Fracture of second lumbar vertebra}, Mental Status {Neurological mental status determination}, Clear {No abnormality detected}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, interactive {Does communicate}, 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 ___,
+
+___ were admitted to the ___ on the ___ after ___ 
+experienced a black out and subsequent back pain.  Hip x-rays 
+and back x-rays were done on ___.  Hip x-rays showed no hip 
+fracture but back x-ray revealed a fracture at the L2 level of 
+your spine.  Your previous diagnosis of osteopenia likely 
+contributed to this.
+
+Your black out episode sounds like it could have been like your 
+previous episodes.  However, in order to rule out a cardiac 
+cause, we took an image of your heart with an ""echo"" which was 
+normal.  We will still send ___ home with an event recorder 
+which ___ will have for two weeks.  The results of this can be 
+reviewed with Dr. ___ and with Dr. ___ as per your 
+appointments below.
+
+Your medications will continue as per your home regimen:
+Oxybutinin 5mg twice daily
+Simvastatin 20mg Once daily
+Levothyroxine 75mcg once daily
+Sertraline 50mg once daily
+As acetominophen helped your pain, ___ may take the 500mg 
+tablets ___ tablets upto 4 times per day, but don't take more 
+than 6 in a day
+Please ensure ___ attend your follow up appointments as 
+described below.
+
+It was a pleasure looking after ___ here at the ___.
+ 
+
+###RESPONSE: black out {Syncope}, back pain {Backache}, Hip x-rays {Radiography of hip}, back {Structure of back of trunk}, x-rays {Radiographic imaging procedure}, Hip x-rays {Radiography of hip}, hip 
+fracture {Fracture of proximal end of femur}, back {Structure of back of trunk}, x-ray {Radiographic imaging procedure}, fracture at the L2 level of 
+your spine {Fracture of second lumbar vertebra}, osteopenia {Osteopenia}, black out {Syncope}, cardiac {Heart structure}, image of your heart {Imaging of heart}, echo {Echocardiography}, normal {No abnormality detected}, 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: 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: 
+Bactrim
+ 
+Attending: ___.
+ 
+Chief Complaint:
+mouth pain, odynophagia, rash 
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: Bactrim {Allergy to sulfamethoxazole and/or trimethoprim}, mouth pain {Painful mouth}, odynophagia {Swallowing painful}, rash {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: History of Present Illness:
+___ year old male with history of recently diagnosed HIV/AIDS, 
+PCP pneumonia treated with 21 days of high dose bactrim, now 
+presenting with 4 days of diffuse maculopapular rash, mouth 
+pain, and fevers to 102.
+.
+Patient requested HIV test approximately one month ago after 
+learning that a prior partner was HIV positive. He then 
+developed shortness of breath and cough and presented to the 
+emergency department. CXR demonstrated multifocal infiltrates 
+and he was diagnosed with PCP pneumonia by bronchoscopy. At that 
+time his HIV antibody was positive, his CD4 count was 54 
+(___), and his HIV VL was 321,000. He was treated with 
+bactrim DS 2 tabs TID for 21 days, and with a prednisone taper.
+.
+Since this time, he has been started on atripla as an outpatient 
+on ___. Over the last week he noticed a rash on his chest 
+and arms that worsened. It was itchy but not painful. He also 
+noted steadily worsening oral pain and pain with swallowing. He 
+also had fevers to 102 with chills for the past two nights and 
+poor PO intake. He presented to outpatient clinic and was 
+treated with fluconazole for thrush, and with valtrex for oral 
+herpes.
+.
+He then presented to outpatient clinic, and was noted to have a 
+diffuse maculopapular rash and mucositis. he was referred to the 
+ED with concern for ___ syndrome. 
+ 
+
+###RESPONSE: HIV {Human immunodeficiency virus infection}, AIDS {Acquired immune deficiency syndrome}, PCP pneumonia {Pneumocystosis jirovecii pneumonia}, maculopapular rash {Maculopapular rash}, mouth 
+pain {Painful mouth}, fevers {Fever}, HIV {Human immunodeficiency virus infection}, HIV positive {Human immunodeficiency virus detected}, shortness of breath {Dyspnea}, cough {Cough}, CXR {Plain chest X-ray}, infiltrates {Infiltration}, PCP pneumonia {Pneumocystosis jirovecii pneumonia}, bronchoscopy {Bronchoscopy}, HIV antibody {Human immunodeficiency virus antibody test}, CD4 count {Absolute CD4 count procedure}, HIV VL {Human immunodeficiency virus viral load}, started {New medication added}, rash {Eruption of skin}, chest {Skin structure of chest}, arms {Upper limb structure}, itchy {Itching}, painful {Pain}, worsening {Increased pain}, oral pain {Painful mouth}, pain with swallowing {Swallowing painful}, fevers {Fever}, chills {Chill}, poor PO intake {Decrease in appetite}, thrush {Candidiasis}, oral 
+herpes {Oral herpes simplex infection}, maculopapular rash {Maculopapular rash}, mucositis {Inflammatory disease of mucous membrane}, referred to the 
+ED {Referral to accident and emergency service}, syndrome {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:
+Esophageal candidiasis
+HIV/AIDS
+Pneumocystis pneumonia
+Hypertension
+Vitamin D Deficiency
+Tinea Barbae
+Alcohol Abuse 
+ 
+
+###RESPONSE: Esophageal candidiasis {Candidiasis of the esophagus}, HIV {Human immunodeficiency virus infection}, AIDS {Acquired immune deficiency syndrome}, Pneumocystis pneumonia {Pneumocystosis jirovecii pneumonia}, Hypertension {Hypertensive disorder, systemic arterial}, Vitamin D Deficiency {Vitamin D deficiency}, Tinea Barbae {Tinea barbae}, Alcohol Abuse {Alcohol 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: 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:
+
+###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 with DM, HTN, father with DM, HTN and 
+pacemaker. 
+ 
+
+###RESPONSE: DM {Diabetes mellitus}, HTN {Hypertensive disorder, systemic arterial}, DM {Diabetes mellitus}, HTN {Hypertensive disorder, systemic arterial}, pacemaker {Implantation of cardiac pacemaker}"
+"###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:
+PHYSICAL EXAM:
+Vitals - T: 98.6 BP: 140/90 HR: 120 RR: 18 02 sat:98/RA
+GENERAL: Pleasant, well appearing in NAD
+HEENT: Normocephalic, atraumatic. No conjunctival pallor. No 
+scleral icterus. PERRLA/EOMI. Desquamation of mouth, lips, 
+oozing blood on lips, ginigivitis.
+SKIN: Diffuse maculopapular rash, with red papules over chest, 
+arms, face, scrotum and legs.
+CARDIAC: Regular rhythm, normal rate. Normal S1, S2. No murmurs, 
+rubs or gallops.
+LUNGS: CTAB, no wheezes, rales, rhonchi, good air movement 
+biaterally.
+ABDOMEN: NABS. Soft, NT, ND. No HSM
+EXTREMITIES: No edema or calf pain, 2+ dorsalis pedis/ posterior 
+tibial pulses.
+SKIN: No rashes/lesions, ecchymoses.
+NEURO: A&Ox3. Appropriate. CN ___ grossly intact. Preserved 
+sensation throughout. ___ strength throughout. ___ reflexes, 
+equal ___. Normal coordination. Gait assessment deferred
+PSYCH: Listens and responds to questions appropriately, pleasant 
+
+ 
+
+###RESPONSE: PHYSICAL EXAM {Physical examination procedure}, Vitals {Vital signs finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, 02 sat {Oxygen saturation measurement}, RA {Breathing room air}, GENERAL {General examination of patient}, well appearing {Well cared for appearance}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, Normocephalic {Normal head}, atraumatic {No injuries apparent}, conjunctival pallor {Pale conjunctiva}, scleral icterus {Scleral icterus}, PERRLA {Pupils equal, react to light and accommodation}, EOMI {Normal ocular motility}, Desquamation {Peeling of skin}, mouth {Mouth region structure}, lips {Lip structure}, oozing {Wound discharge}, ginigivitis {Gingivitis}, SKIN {Examination of skin}, rash {Eruption of skin}, papules {Papular eruption of chin}, over chest {Skin structure of chest}, arms {Upper limb structure}, face {Face structure}, scrotum {Scrotal structure}, legs {Lower limb structure}, CARDIAC {Cardiovascular physical examination}, Regular rhythm {Normal sinus rhythm}, normal rate {Normal heart rate}, S2 {Normal second heart sound, S>2<}, murmurs {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, LUNGS {Examination of respiratory system}, CTAB {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, rhonchi {Wheeze - rhonchi}, good air movement {Breath normal}, ABDOMEN {Examination of abdomen}, NABS {Normal bowel sounds}, Soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, HSM {Hepatosplenomegaly}, EXTREMITIES {Examination of limb}, edema {Edema}, pain {Pain}, 2+ dorsalis pedis {Dorsalis pulse present}, posterior 
+tibial pulses {Posterior tibial pulse present}, SKIN {Examination of skin}, rashes {Eruption of skin}, lesions {Lesion}, ecchymoses {Ecchymosis}, NEURO {Neurological examination}, Ox3 {Oriented to person, time and place}, Appropriate {Appropriate affect}, grossly intact {Normal nervous system function}, Preserved 
+sensation {Normal sensation}, reflexes {Normal reflex}, Normal coordination {Normal coordination}, Gait assessment {Gait evaluation}, PSYCH {Psychological assessment}"
+"###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:
+___ 11:50AM BLOOD WBC-5.7 RBC-3.94* Hgb-11.7* Hct-34.1* 
+MCV-87 MCH-29.7 MCHC-34.4 RDW-16.3* Plt ___
+___ 11:50AM BLOOD Neuts-63 Bands-2 Lymphs-12* Monos-19* 
+Eos-3 Baso-1 ___ Myelos-0
+___ 11:50AM BLOOD ___ PTT-29.7 ___
+___ 11:50AM BLOOD Glucose-107* UreaN-14 Creat-1.8* Na-126* 
+K-4.8 Cl-95* HCO3-20* AnGap-16
+___ 11:50AM BLOOD ALT-34 AST-32 LD(LDH)-273* AlkPhos-50 
+TotBili-0.3
+___ 05:56AM BLOOD Calcium-8.6 Phos-2.8 Mg-1.9
+___ 11:45AM BLOOD Lactate-1.2 K-5.1
+ 
+
+###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}, 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}, Baso {Basophil 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}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, LDH {Serum total lactate dehydrogenase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Lactate {Lactic acid measurement}, K {Blood potassium 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: Brief Hospital Course:
+# ___: Bactrim was considered the most 
+likely causal agent was held.  Dermatology was consulted on 
+admission.  Skin biopsies were taken and he was started on 
+prednisone 80mg PO daily, with a planned taper over 4 weeks.  
+His bactrim, fluconazole and valtrex were stopped.  Opthomology 
+was consulted and found no ocular involvement.  His muscositis 
+pain was managed with lidocaine mouthwash, dexamthasone 
+mouthwash and PO vicodin.  His rash and mucositis improved, 
+though he still had substantial painful desquamation of the 
+scrotuim on discharge.
+.
+# HIV/AIDS: Patient had recently been started on atripla.  This 
+medication was initially held due to concern for low serum 
+bicarbonate, but was restarted once this resolved.  He was 
+treated with inhaled pentamindine once for PCP ___.  CXR 
+demonstrated no evidence of pneumonia. 
+.
+# Hypertension/Tachycardia: On admission, patient was 
+tachycardic and hypertensive.  He was intially restarted on his 
+home amlodipine and given IVF as there was concern that he was 
+hypovolemic.  His amlodipine was stopped, and he was started on 
+metoprolol.  His dose was titrated up to 50mg PO bid.
+.
+# Hyponatremia/ ARF: On admission, serum sodium was 126 and 
+creatine was 1.8.  With aggresive fluid resusciation with normal 
+saline, these values returned the the normal range. 
+ 
+
+###RESPONSE: held {Recommendation to stop drug treatment}, Skin biopsies {Biopsy of skin}, started {New medication added}, stopped {Recommendation to stop drug treatment}, pain {Pain}, rash {Eruption of skin}, mucositis {Inflammatory disease of mucous membrane}, improved {Patient's condition improved}, painful {Pain}, desquamation {Peeling of skin}, scrotuim {Scrotal structure}, HIV {Human immunodeficiency virus infection}, AIDS {Acquired immune deficiency syndrome}, started {New medication added}, held {Recommendation to stop drug treatment}, restarted {Restart of medication}, resolved {Problem resolved}, PCP {Pneumocystosis jirovecii pneumonia}, CXR {Plain chest X-ray}, no evidence {No abnormality detected}, pneumonia {Pneumonia}, Hypertension {Hypertensive disorder, systemic arterial}, Tachycardia {Tachycardia}, tachycardic {Tachycardia}, hypertensive {Finding of increased blood pressure}, restarted {Restart of medication}, IVF {Administration of intravenous fluids}, hypovolemic {Hypovolemia}, stopped {Recommendation to stop drug treatment}, started {New medication added}, Hyponatremia {Hyponatremia}, ARF {Acute kidney injury}, serum sodium {Sodium measurement, serum}, creatine {Creatine measurement}, fluid resusciation {Resuscitation using intravenous 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: Medications on Admission:
+Vitamin D 50,000 units q weekly
+Nizoral 2% shampoo
+Azithromycin 1000 mg po weekly
+Atripla 1 po daily
+Norvasc 10 mg po daily
+Fluconazole 200 mg po daily x 10 days ___ day 1)
+Ambien ___ mg po qhs prn insonia
+Valtrex 1 gm po BID x 10 days for initial HSV outbreak ___ day 
+1)
+Ibuprofen 600 mg po QID with meals prn pain, fever
+Ammonium Lactate one application for dry skin 
+ 
+Discharge Medications:
+1. White Petrolatum-Mineral Oil 42.5-56.8 % Ointment Sig: One 
+(1) Appl Ophthalmic TID (3 times a day).  
+2. Hydrocodone-Acetaminophen ___ mg Tablet Sig: ___ Tablets PO 
+Q6H (every 6 hours) as needed for pain.
+Disp:*40 Tablet(s)* Refills:*0*
+3. Metoprolol Tartrate 25 mg Tablet Sig: Two (2) Tablet PO BID 
+(2 times a day).
+Disp:*qs Tablet(s)* Refills:*2*
+4. Zolpidem 5 mg Tablet Sig: ___ Tablets PO HS (at bedtime) as 
+needed for insomnia.  
+5. Acetaminophen 325 mg Tablet Sig: ___ Tablets PO Q6H (every 6 
+hours) as needed for pain/fever.  
+6. Lidocaine HCl 2 % Solution Sig: Ten (10) ML Mucous membrane 
+QID (4 times a day) as needed for mouth pain.
+Disp:*qs 100 ml* Refills:*5*
+7. Prednisone 10 mg Tablet Sig: Please see below Tablet PO once 
+a day: 60mg daily (6 pills) for ___
+then switch to 40 mg (4 pills) for 5 days, 20mg (2 pills) for 5 
+days, 10 mg (1 pills) for 5 days then stop.
+Disp:*60 Tablet(s)* Refills:*0*
+8. ATRIPLA ___ mg Tablet Sig: One (1) Tablet PO once a 
+day.  
+9. Dexamethasone 0.5 mg/5 mL Elixir Sig: ___ MLs PO BID (2 
+times a day).
+Disp:*qs ML(s)* Refills:*2*
+10. Azithromycin 600 mg Tablet Sig: Two (2) Tablet PO once a 
+week: As directed by Dr. ___.  
+11. Pentamidine 300 mg Recon Soln Sig: One (1) inhaler 
+Inhalation once a month: As directed by Dr. ___.  
+12. Maalox/Viscous Lidocaine 2%
+1 part maalox (aluminum hydroxide/magnesium hydroxide), 1 part 
+viscous lidocaine 2%.  Swish and swallow, four times daily as 
+needed for oral 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:
+___
+HIV/AIDS
+Hypertension
+Tachycardia
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: HIV {Human immunodeficiency virus infection}, AIDS {Acquired immune deficiency syndrome}, Hypertension {Hypertensive disorder, systemic arterial}, Tachycardia {Tachycardia}, 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 with ___ syndrome, a condition 
+which affects the skin and mucous membranes.  We think this was 
+caused by the antibiotic bactrim.  You were treated with 
+steroids and pain medications. You will continue to take 
+steroids (prednisone) for several weeks as we taper the dose 
+down from 80mg to zero. You will take 60mg for 5 days, 40mg for 
+5 days, 20 mg for 5 days, 10 mg for 5 days, and then stop taking 
+it all together.
+
+You should not take bactrim in the future. You can continue 
+taking atripla for your HIV infection, and will continue taking 
+weekly azithromax and monthly pentamidine to prevent you from 
+getting opportunistic infections, until your CD4 count raises or 
+your primary HIV doctor decides that you no longer need them. 
+These drugs should be safe and will not cause recurrence of your 
+___.
+
+While you were here, you also showed signs of elevated heart 
+rate and blood pressure. We saw that Dr. ___ 
+Cardiologist, had suggested you change from amlodipine (Norvasc) 
+to Metoprolol (Toprol), which will help keep your heart from 
+beating too fast and also help lower your blood pressure. We are 
+sending you home on a dose of 50mg Metoprolol twice daily, and 
+you should follow up with Dr. ___ to see if this is 
+appropriately controlling your heart rate and blood pressure.
+
+The last thing you were followed for while here was your 
+shortness of breath. Given your history of PCP, we performed two 
+xrays to make sure you didn't have ongoing pneumonia. Your lungs 
+are currently clear, but you should ensure that you continue 
+taking your monthly pentamadine.
+
+Please stop taking valtex and fluconazole.  Discuss all 
+medication changes with your primary care doctor, ___.
+ 
+
+###RESPONSE: syndrome {Disease}, skin {Skin structure}, mucous membranes {Mucous membrane structure}, antibiotic {Antibiotic therapy}, steroids {Steroid therapy}, pain medications {Administration of analgesic}, steroids {Steroid therapy}, stop taking {Recommendation to stop treatment}, continue 
+taking {Recommendation to continue with drug treatment}, HIV infection {Human immunodeficiency virus infection}, continue taking {Recommendation to continue with drug treatment}, prevent {Preventive procedure}, infections {Infectious disease}, CD4 count {Absolute CD4 count procedure}, HIV {Human immunodeficiency virus infection}, recurrence {Recurrent disease}, signs {Sign}, elevated heart 
+rate {Tachycardia}, blood pressure {Finding of increased blood pressure}, heart {Heart structure}, blood pressure {Finding of increased blood pressure}, heart rate {Cardiotachometry}, blood pressure {Blood pressure monitoring}, shortness of breath {Dyspnea}, PCP {Pneumocystosis jirovecii pneumonia}, pneumonia {Pneumonia}, lungs {Lung structure}, continue 
+taking {Recommendation to continue with drug treatment}, stop taking {Recommendation to stop treatment}, medication changes {Change of medication}, primary care {Primary care management}"
+"###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: NEUROLOGY
+ 
+
+###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:
+dizziness and worsening right sided weakness
+ 
+Major Surgical or Invasive Procedure:
+none
+
+ 
+
+###RESPONSE: No Known Allergies {Allergic disposition}, Adverse Drug Reactions {Propensity to adverse reactions to drug}, dizziness {Dizziness}, right sided weakness {Right hemiparesis}"
+"###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:
+___ Stroke Scale Score: 9
+
+NIHSS performed within 6 hours of presentation at: ___ at
+2325
+NIHSS Total: 9
+1a. Level of Consciousness: 0
+1b. LOC Question: 0
+1c. LOC Commands: 0 
+2.  Best gaze: 0
+3.  Visual fields: 0
+4.  Facial palsy: 2 (residual)
+5a. Motor arm, left: 0
+5b. Motor arm, right: 2 (residual)
+6a. Motor leg, left: 0
+6b. Motor leg, right: 1 (residual)
+7.  Limb Ataxia: 0
+8.  Sensory: 1 (residual?)
+9.  Language: 1 (residual?)
+10. Dysarthria: 1 (residual?)
+11. Extinction and Neglect: 1 (residual?)
+ 
+REASON FOR CONSULTATION: dizziness, intermittent right lower
+extremity weakness throughout day
+
+HPI: 
+
+___ is a ___ year old woman with history of
+hypertension, hyperlipidemia, prior stroke with residual right
+hemiparesis, localization-related epilepsy on Keppra and
+lamotrigine, hypothyroidism, and glaucoma who presented to ED
+from nursing home after new-onset dizziness this morning with
+subsequent acute-on-chronic right lower extremity weakness.
+History obtained by patient and as per chart review. 
+
+The patient reports that she was she had seen Dr. ___
+yesterday in clinic to establish new neurology clinic follow-up.
+No outside records were available for evaluation at that time 
+but
+her baseline exam prior to new symptom onset was documented.
+After her clinic appointment, she returned to her nursing home 
+in
+usual state of health. She woke up this morning and felt well. 
+At
+around 11AM, while urinating, she suddenly felt room-spinning
+dizziness that resolved but was followed by an atypical 
+sensation
+in her right lower extremity, described as heaviness and
+weakness. She notes that she has lived with her residual stroke
+deficits for ___ years and never felt anything like this in her
+right leg. She tried to get up from the commode but did not have
+the strength and as such called for help. Throughout the rest of
+the day, she notes that her right sided weakness and heaviness
+was intermittent. Her dizziness has since resolved. This 
+evening,
+she noted that she was again feeling weaker in her right lower
+extremity, requiring assistance to mobilize which is atypical 
+for
+her. She thus requested ED evaluation and was brought to ___.
+Since arrival at ___ (~ 15 minutes prior to my evaluation) she
+notes her symptoms have started to improve again. She now thinks
+she may be back at baseline, or close to it. 
+
+Per Dr. ___ initial clinic note on ___:
+"" Based on history, the patient suffered a stroke ___ years ago
+and was left with right hemiparesis. Since the stroke she has
+been on ASA 81 mg and had no recurrent events. She also suffers
+from seizures with mouth foaming, shaking and urinary
+incontinence, but no generalization. She is on Keppra for
+her seizures and she has not had a seizure for a long time."" His
+exam at the time was notable for ""mild aphasia and dysarthria
+with right facial droop and right hemiparesis."" He had no 
+outside
+records at that time and as primary reason for visit was to
+establish neurological care, he continued her on home dose of
+atorvastatin 60mg, aspirin 81 mg per his note, Keppra, and
+lamictal (for mood? is what is questioned in Dr. ___. 
+ 
+ROS: 
+Notable for above findings, otherwise noncontributory
+ 
+PMH:
+====
+HYPERTENSION                                                    
+HYPERLIPIDEMIA                                                  
+HYPOTHYROIDISM                                                  
+STROKE                                                          
+SEIZURE DISORDER                                                
+GLAUCOMA        
+                                                
+Surgical History  (Last Verified ___ by ___,
+MD):
+Surgical History updated, no known surgical history.            
+
+Medications:
+===========
+***NEEDS MEDICATION RECONCILLIATION***
+Keppra 500mg BID
+lamotrigine 200mg BID (for mood)
+Aspirin (either 81 or 325, unclear per chart review/med review 
+in
+OMR)
+metoprolol succinate 25mg ER qday
+levothyroxine 50ucg qday
+furosemide 20mg qday
+baclofen 10mg PRN muscle spasm (BID)
+atorvastin 60mg qPM
+
+
+###RESPONSE: Stroke {Cerebrovascular accident}, NIHSS performed {Assessment using National Institutes of Health stroke scale}, Level of Consciousness {Assessment of consciousness level}, Visual fields {Visual field study}, Facial palsy {Facial palsy}, Motor {Motor testing}, arm, left {Structure of left upper limb}, Motor {Motor testing}, arm, right {Structure of right upper limb}, Motor {Motor testing}, leg, left {Structure of left lower limb}, Motor {Motor testing}, leg, right {Structure of right lower limb}, Limb {All extremities}, Ataxia {Ataxia}, Sensory {Sensory testing}, Dysarthria {Dysarthria}, dizziness {Dizziness}, lower
+extremity weakness {Paresis of lower extremity}, hypertension {Hypertensive disorder, systemic arterial}, hyperlipidemia {Hyperlipidemia}, stroke {Cerebrovascular accident}, right
+hemiparesis {Right hemiparesis}, localization-related epilepsy {Focal epilepsy}, hypothyroidism {Hypothyroidism}, glaucoma {Glaucoma}, dizziness {Dizziness}, chronic {Chronic disease}, right lower extremity weakness {Paresis of right lower limb}, chart review {Chart evaluation by healthcare professional}, evaluation {Evaluation procedure}, baseline {Baseline state}, exam {Physical examination procedure}, dizziness {Dizziness}, resolved {Problem resolved}, atypical 
+sensation {Abnormal sensation}, right lower extremity {Structure of right lower limb}, heaviness {Sensation of heaviness in limbs}, weakness {Asthenia}, stroke {Cerebrovascular accident}, deficits {Neurological deficit}, right leg {Structure of right lower leg}, right sided weakness {Right hemiparesis}, heaviness {Sensation of heaviness in limbs}, dizziness {Dizziness}, resolved {Problem resolved}, feeling weaker {Asthenia}, right lower
+extremity {Structure of right lower limb}, assistance to mobilize {Difficulty mobilizing}, evaluation {Evaluation procedure}, evaluation {Evaluation procedure}, baseline {Baseline state}, stroke {Cerebrovascular accident}, right hemiparesis {Right hemiparesis}, stroke {Cerebrovascular accident}, seizures {Seizure}, mouth {Mouth region structure}, shaking {Tremor}, urinary
+incontinence {Urinary incontinence}, seizures {Seizure}, seizure {Seizure}, exam {Physical examination procedure}, mild {Symptom mild}, aphasia {Aphasia}, dysarthria {Dysarthria}, right facial droop {Weakness of right facial muscle}, right hemiparesis {Right hemiparesis}, neurological care {Care of neurological patient}, mood {Mood management}, HYPERTENSION {Hypertensive disorder, systemic arterial}, HYPERLIPIDEMIA {Hyperlipidemia}, HYPOTHYROIDISM {Hypothyroidism}, STROKE {Cerebrovascular accident}, SEIZURE DISORDER {Seizure disorder}, GLAUCOMA {Glaucoma}, 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: Allergies:
+=========
+no known drug allergies         
+
+SOCIAL HISTORY:
+Social History  (Last Verified ___ by ___, 
+MD):
+Lives with:         Group setting                               
+Tobacco use:        Never smoker                                
+Alcohol use:        Denies                                      
+Recreational drugs  Denies                                      
+(marijuana, heroin,                                             
+crack pills or                                                  
+other):                                                         
+
+- Modified Rankin Scale:
+[] 0: No symptoms
+[] 1: No significant disability - able to carry out all usual
+activities despite some symptoms
+[] 2: Slight disability: able to look after own affairs without
+assistance but unable to carry out all previous activities
+[] 3: Moderate disability: requires some help but able to walk
+unassisted
+[x] 4: Moderately severe disability: unable to attend to own
+bodily needs without assistance and unable to walk unassisted
+[] 5: Severe disability: requires constant nursing care and
+attention, bedridden, incontinent
+[] 6: Dead
+ 
+FAMILY HISTORY:
+notable for stroke and hypertension            
+
+PHYSICAL EXAMINATION: 
+Vitals: 
+T96.9, HR70-80s, RR16-24, BP140-180/70s 95 SaO2
+Orthostatics:
+137/81 supine with HR 78 --> standing HR 95; BP 161/92
+
+General: Awake, cooperative, NAD.
+HEENT: NC/AT, no scleral icterus noted, MMM, no lesions noted in
+oropharynx.
+Neck: Supple,  No nuchal rigidity.
+Pulmonary: Normal work of breathing.
+Cardiac: RRR, warm, well-perfused.
+Abdomen: Soft, non-distended.
+Extremities: trace pedal edema.
+
+Neurologic:
+-Mental Status: Alert and interactive with examiner. Oriented to
+self and to situation. Able to follow midline and appendicular
+commands. Has difficulty with two-step commands. Able to name
+high and low frequency objects with exception of wristwatch 
+clasp
+(refers to as band). Difficulty with ___ backwards and ___
+backwards, after multiple attempts with either task says
+___ Repetition intact.
+No neglect. 
+
+-Cranial Nerves: PERRL 3>2. No nystagmus. Right eye does not
+fully bury sclera on lateral gaze. Visual fields full to finger
+counting. ? prior left bells palsy?. Right NLFF with delayed
+activation. Facial musculature symmetric. Hearing intact to
+conversation. Tongue midline. Slight dysarthria with guttural
+sounds. 
+ 
+-Motor: Right hemibody is with increased tone and spasticity at
+baseline. No adventitious movements. 
+  Delt Bic Tri WrE FFl FE IO IP Quad Ham TA ___
+L  5    ___   ___  5   5    5  5     5     5
+R  3    ___   0  0  0  3   4    4  4     4     0
+ Per Dr. ___ ___
+""R  2    ___   0  0  0  2   -___     4     2""
+
+-Sensory: Diminished sensation to pinprick on right lower
+extremity compared to left. Extinguishes to light touch with DSS
+on right. Temperature, proprioception intact.
+
+-Reflexes:
+  Bi Tri ___ Pat Ach
+L  2  2    2    3   2
+R  2  3    2    3   3
+Plantar response was ? extensor on right, flexor on left. 
+
+-Coordination: No intention tremor. No dysmetria on FNF on left
+and no decreased augmentation of movements with heel tapping on
+right or left lower extremity.
+
+-Gait: Deferred in setting of acute illness, without baseline
+walker on hand
+
+LABORATORY DATA:
+___ 12:00AM BLOOD WBC: 4.4 RBC: 4.24 Hgb: 11.7 Hct: 38.5
+MCV: 91 MCH: 27.6 MCHC: 30.4* RDW: 15.2 RDWSD: 50.4* Plt Ct: 244 
+
+___ 12:10AM BLOOD ___: 11.8 PTT: 28.3 ___: 1.1 
+___ 12:00AM BLOOD Glucose: 82 UreaN: 9 Creat: 0.8 Na: 142 
+K:
+4.0 Cl: 104 HCO3: 28 AnGap: 10 
+___ 12:00AM BLOOD ALT: 18 AST: 28 AlkPhos: 90 TotBili: 0.5 
+___ 12:00AM BLOOD cTropnT: <0.01 
+___ 12:00AM BLOOD Albumin: 4.3 Calcium: 10.0 Phos: 2.7 Mg:
+2.1 
+___ 12:00AM BLOOD ASA: NEG Ethanol: NEG Acetmnp: 8* 
+Tricycl:
+NEG 
+___ 12:06AM BLOOD Glucose: 82 Lactate: 1.5 Creat: 0.7 Na:
+139 K: 4.7 Cl: 108 calHCO3: 29 
+___ 12:06AM BLOOD Hgb: 12.5 calcHCT: 38 
+___ 02:36AM URINE Blood: NEG Nitrite: NEG Protein: NEG
+Glucose: NEG Ketone: NEG Bilirub: NEG Urobiln: NEG pH: 6.5 
+Leuks:
+NEG 
+___ 02:36AM URINE bnzodzp: NEG barbitr: NEG opiates: NEG
+cocaine: NEG amphetm: NEG oxycodn: NEG mthdone: NEG 
+
+EKG: NSR
+
+IMAGING: 
+NCHCT: multiple areas of encephalomalacia, including left
+frontoparietal, left occipital, right frontal and right parietal
+lobe suggestive of chronic incarcts. Prominent ventricles. ?
+periventricular white matter hypodensity.
+
+CTA head and neck: no large vessel occlusion, no significant
+intracranial disease. 
+
+ASSESSMENT:
+
+THis is a ___ year old woman with HTN, hyperlipidemia, prior
+stroke with right hemiparesis, recently seen in stroke neurology
+clinic, who presents today for new onset dizziness and
+intermittent stuttering right lower extremity 
+weakness/heaviness.
+Exam is notable for mild aphasia, which I suspect is at her
+baseline as per Dr. ___ on ___. She is 
+slightly
+inattentive to ___, which his mental exam also suggests was the
+case two days prior. However, I do not some slightly more
+profound right hemibody weakness as compared to his exam, with 0
+in ___ (previously documented as 2). The patient also endorses
+loss of pinprick sensation in right lower extremity and
+extinguishes on the right with DSS. 
+
+The underlying etiology for her new symptoms remains unclear. I
+am reassured by the resolution since arrival to the ED but am
+concerned about the possibility of a stuttering lacune given the
+intermittent right lower extremity weakness vs flow-dependent
+perfusion states vs subclinical seizures vs stroke 
+recrudescence.
+No obvious infectious triggers on routine lab work in ED. Given
+new onset of waxing/waning symptoms with significant stroke risk
+factors, admission is warranted for expedited management.
+
+PLAN:
+- Admit to stroke neurology service under attending Dr. ___.
+
+# Neuro:
+- MRI head 
+- Check risk factors: fasting lipid panel and HBA1c  
+- Consider increasing/transitioning aspirin  
+- Allow BP to autoregulate as below
+- ___ consults
+ 
+# CV:  
+- R/o MI with cardiac enzymes 
+- Monitor cardiac telemetry  
+- Allow BP to autoregulate with goal SBP<180 (goal 140-180s)  
+- Hydralazine 10 mg IV q6h prn SBP > 180  
+- Hold home antihypertensives / halve dose of beta-blocker  
+- Trans-thoracic echo  
+ 
+# Pulmonary:
+- Monitor oximetry
+- Screening CXR
+ 
+# GI/Nutrition:
+- NPO until passes water swallowing screen
+- Cardiac heart healthy diet once passess
+- Bowel regimen with Senna, Colace 
+ 
+# Renal: 
+- Baseline Cr: 0.7
+- Continue to trend
+- mIVF @ 70cc/hr for 1L pending PO eval 
+ 
+# Endocrine:
+- TSH, A1c
+- Finger sticks QID
+- Insulin sliding scale  
+ 
+# Toxic/Metabolic:  
+- Check LFTs  
+- Check urine and serum toxin screens 
+ 
+# ID:  
+- Check UA  
+- Check CXR
+ 
+# Heme:
+- Baseline Hgb: 11.7
+
+# Psychiatric/Behavioral: 
+- No active issues
+  
+# Hospital Issues: 
+- DVT PPx: Pneumoboots, SQ heparin 
+- Precautions: Fall, Aspiration 
+- Restraints: none 
+- Health Care Proxy: unknown
+- Code Status:  full
+
+ 
+
+###RESPONSE: drug allergies {Allergy to drug}, Never smoker {Never smoked tobacco}, disability {Disability}, able to carry out all usual
+activities {Able to carry out daily routine}, disability {Disability}, disability {Disability}, able to walk {Able to walk}, disability {Disability}, unable to walk {Unable to walk}, disability {Disability}, requires constant nursing care {Nursing assistance required}, Dead {Dead}, stroke {Cerebrovascular accident}, hypertension {Hypertensive disorder, systemic arterial}, standing {Orthostatic body position}, Awake {Awake}, cooperative {Cooperative mental state}, scleral icterus {Scleral icterus}, MMM {Moist oral mucosa}, lesions noted in
+oropharynx {Lesion of oropharynx}, Supple {Normal movement of neck}, nuchal rigidity {Nuchal rigidity}, RRR {Normal heart rate}, warm {Warm skin}, well-perfused {Normal tissue perfusion}, Soft {Abdomen soft}, non-distended {Normal abdominal contour}, pedal edema {Edema of foot}, Mental Status {Neurological mental status determination}, Alert {Mentally alert}, interactive {Does communicate}, Oriented {Oriented to person}, Repetition {Verbal repetition}, PERRL {Pupils equal and reacting to light}, nystagmus {Nystagmus}, Right eye {Right eye structure}, sclera {Scleral structure}, Visual fields {Visual field study}, full to finger
+counting {Full to finger counting}, bells palsy {Bell's palsy}, Facial musculature symmetric {Facial symmetry}, Hearing intact {Hearing normal}, Tongue {Tongue structure}, dysarthria {Dysarthria}, increased tone {Increased muscle tone}, spasticity {Spasticity}, baseline {Baseline state}, adventitious movements {Involuntary movement}, Delt {Structure of deltoid muscle}, Bic {Biceps brachii muscle structure}, Tri {Triceps brachii muscle structure}, WrE {Structure of extensor of wrist joint}, FFl {Structure of flexor of interphalangeal joint of finger}, FE {Structure of extensor muscle of forearm}, IO {Structure of intrinsic muscle of hand}, IP {Structure of iliopsoas muscle}, Quad {Structure of quadriceps femoris muscle}, Ham {Posterior muscle of thigh structure}, TA {Tibialis anterior muscle structure}, Diminished sensation {Hypesthesia}, pinprick {Finding of pin prick discrimination}, right lower
+extremity {Structure of right lower limb}, left {Structure of left lower limb}, light touch {Light touch sensation present}, right {Structure of right lower limb}, proprioception intact {Normal joint position sense}, Plantar response was ? extensor on right {Extensor plantar response right}, flexor on left {Plantar response-L=flexor}, intention tremor {Intention tremor}, dysmetria {Dysmetria}, FNF {Finger-to-nose test}, heel {Heel structure}, right {Structure of right lower limb}, left lower extremity {Structure of left lower limb}, baseline {Baseline state}, walker {Uses zimmer frame}, NSR {Normal sinus rhythm}, NCHCT {Computed tomography of head without contrast}, encephalomalacia {Encephalomalacia}, left
+frontoparietal {Left frontal and parietal lobes (combined site)}, left occipital {Left occipital lobe structure}, right frontal {Right frontal lobe structure}, right parietal
+lobe {Right parietal lobe structure}, chronic {Chronic disease}, incarcts {Infarct}, ventricles {Brain ventricle structure}, periventricular white matter {Structure of periventricular white matter}, CTA head and neck {Computed tomography angiography of head and neck with contrast}, large vessel {Large blood vessel structure}, occlusion {Complete obstruction}, intracranial {Intracranial structure}, disease {Disease}, HTN {Hypertensive disorder, systemic arterial}, hyperlipidemia {Hyperlipidemia}, stroke {Cerebrovascular accident}, right hemiparesis {Right hemiparesis}, stroke {Cerebrovascular accident}, dizziness {Dizziness}, lower extremity 
+weakness {Paresis of lower extremity}, heaviness {Sensation of heaviness in limbs}, Exam {Physical examination procedure}, mild {Symptom mild}, aphasia {Aphasia}, baseline {Baseline state}, right hemibody weakness {Right hemiparesis}, exam {Physical examination procedure}, pinprick {Finding of pin prick discrimination}, sensation {Abnormal sensation}, right lower extremity {Structure of right lower limb}, lacune {Lacunar infarction}, right lower extremity weakness {Paresis of right lower limb}, perfusion {Perfusion}, seizures {Seizure}, stroke {Cerebrovascular accident}, infectious {Infectious disease}, significant stroke risk {At increased risk of cerebrovascular accident}, neurology service {Neurology service}, Neuro {Neurological examination}, MRI head {Magnetic resonance imaging of head}, fasting {Fasting}, lipid panel {Lipid panel}, MI {Myocardial infarction}, cardiac enzymes {Cardiac enzymes/isoenzymes measurement}, cardiac telemetry {Cardiac telemetry}, IV {Administration of drug or medicament via intravenous route}, Trans-thoracic echo {Transthoracic echocardiography}, oximetry {Oximetry}, CXR {Plain chest X-ray}, NPO {Nil by mouth}, healthy diet {Healthy diet}, regimen {Therapeutic regimen}, Baseline {Baseline state}, TSH {Thyroid stimulating hormone measurement}, Finger sticks {Finger-prick sampling}, Insulin sliding scale {Sliding scale insulin regime}, LFTs {Hepatic function panel}, urine {Urinalysis}, UA {Urinalysis}, CXR {Plain chest X-ray}, Baseline {Baseline state}, Hgb {Measurement of total hemoglobin concentration}, DVT {Deep venous thrombosis}, PPx {Preventive procedure}, Precautions {Safety precautions}, Fall {Falls}, Aspiration {Pulmonary aspiration}"
+"###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                                                  
+HYPOTHYROIDISM                                                  
+STROKE                                                          
+SEIZURE DISORDER                                                
+GLAUCOMA    
+ 
+
+###RESPONSE: HYPERTENSION {Hypertensive disorder, systemic arterial}, HYPERLIPIDEMIA {Hyperlipidemia}, HYPOTHYROIDISM {Hypothyroidism}, STROKE {Cerebrovascular accident}, SEIZURE DISORDER {Seizure disorder}, GLAUCOMA {Glaucoma}"
+"###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:
+notable for stroke and hypertension   
+ 
+
+###RESPONSE: stroke {Cerebrovascular accident}, hypertension {Hypertensive disorder, systemic arterial}"
+"###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:
+24 HR Data (last updated ___ @ 423)
+    Temp: 98.3 (Tm 98.4), BP: 113/71 (113-145/71-84), HR: 72
+(65-94), RR: 16 (___), O2 sat: 96% (96-98), O2 delivery: Ra   
+
+General: Awake, cooperative, NAD.
+HEENT: NC/AT, no scleral icterus noted, MMM, no lesions noted in
+oropharynx.
+Neck: Supple,  No nuchal rigidity.
+Pulmonary: Normal work of breathing.
+Cardiac: RRR, warm, well-perfused.
+Extremities: trace pedal edema.
+
+Neurologic:
+-Mental Status: Alert and interactive with examiner. Oriented to
+self and to situation. Able to follow midline and appendicular
+commands. Has difficulty with two-step commands. Repetition
+intact. 
+
+-Cranial Nerves: PERRL 3>2. No nystagmus. Right eye does not
+fully bury sclera on lateral gaze. Visual fields full to finger
+counting. Right NLFF with delayed activation. Facial musculature
+symmetric. Hearing intact to conversation. Tongue midline. 
+Slight
+dysarthria with guttural sounds. 
+ 
+-Motor: Right hemibody is with increased tone and spasticity at
+baseline. No adventitious movements. 
+  Delt Bic Tri WrE FFl FE IO IP Quad Ham TA ___
+L  5    ___   ___  5   5    5  5     5     5
+R  3    4   4-   0   0  0 0  3   4    4  4-    4     0
+ Per Dr. ___ ___
+""R  2    ___   0  0  0  2   -___     4     2""
+
+-Sensory: deferred
+
+-Reflexes: deferred
+Plantar response was extensor on right, flexor on left. 
+
+-Coordination: No intention tremor. No dysmetria on FNF on left
+and no decreased augmentation of movements with heel tapping on
+right or left lower extremity.
+
+-Gait: Deferred
+
+ 
+
+###RESPONSE: O2 sat {Oxygen saturation measurement}, General {General examination of patient}, Awake {Awake}, cooperative {Cooperative mental state}, HEENT {Physical examination procedure}, scleral icterus {Scleral icterus}, MMM {Moist oral mucosa}, lesions noted in
+oropharynx {Lesion of oropharynx}, Supple {Normal movement of neck}, nuchal rigidity {Nuchal rigidity}, Pulmonary {Examination of respiratory system}, Cardiac {Cardiovascular physical examination}, RRR {Normal heart rate}, warm {Warm skin}, well-perfused {Normal tissue perfusion}, Extremities {Examination of limb}, pedal edema {Edema of foot}, Neurologic {Neurological examination}, Mental Status {Neurological mental status determination}, Alert {Mentally alert}, interactive {Does communicate}, Oriented {Oriented to person}, Repetition {Verbal repetition}, Cranial Nerves {Examination of cranial nerve}, PERRL {Pupils equal and reacting to light}, nystagmus {Nystagmus}, Right eye {Right eye structure}, sclera {Scleral structure}, Visual fields {Visual field study}, full to finger
+counting {Full to finger counting}, Facial musculature
+symmetric {Facial symmetry}, Hearing intact {Hearing normal}, Tongue {Tongue structure}, dysarthria {Dysarthria}, Motor {Motor testing}, increased tone {Increased muscle tone}, spasticity {Spasticity}, baseline {Baseline state}, adventitious movements {Involuntary movement}, Delt {Structure of deltoid muscle}, Bic {Biceps brachii muscle structure}, Tri {Triceps brachii muscle structure}, WrE {Structure of extensor of wrist joint}, FFl {Structure of flexor of interphalangeal joint of finger}, FE {Structure of extensor muscle of forearm}, IO {Structure of intrinsic muscle of hand}, IP {Structure of iliopsoas muscle}, Quad {Structure of quadriceps femoris muscle}, Ham {Posterior muscle of thigh structure}, TA {Tibialis anterior muscle structure}, Sensory {Sensory testing}, Reflexes {Reflex studies}, Plantar response was extensor on right {Extensor plantar response right}, flexor on left {Plantar response-L=flexor}, intention tremor {Intention tremor}, dysmetria {Dysmetria}, FNF {Finger-to-nose test}, heel {Heel structure}, right {Structure of right lower limb}, left lower extremity {Structure of left lower limb}, Gait {Examination of gait}"
+"###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:
+___ 06:00AM   ALT(SGPT)-16 AST(SGOT)-22 LD(LDH)-236 
+CK(CPK)-134 ALK PHOS-83 TOT BILI-0.4
+___ 06:00AM   CK-MB-3 cTropnT-<0.01
+___ 06:00AM   ALBUMIN-3.9 CALCIUM-9.5 PHOSPHATE-2.6* 
+MAGNESIUM-2.1 CHOLEST-154
+___ 06:00AM   %HbA1c-5.3 eAG-105
+___ 06:00AM   TRIGLYCER-40 HDL CHOL-76 CHOL/HDL-2.0 
+LDL(CALC)-70
+___ 06:00AM   TSH-7.9*
+___ 06:00AM   T4-8.1
+___ 06:00AM   WBC-4.7 RBC-4.00 HGB-11.0* HCT-36.4 MCV-91 
+MCH-27.5 MCHC-30.2* RDW-15.2 RDWSD-50.2*
+___ 06:00AM   ___ PTT-28.2 ___
+___ 02:36AM URINE  bnzodzpn-NEG barbitrt-NEG opiates-NEG 
+cocaine-NEG amphetmn-NEG oxycodn-NEG mthdone-NEG
+___ 12:10AM   ___ PTT-28.3 ___
+___ 12:06AM   GLUCOSE-82 LACTATE-1.5 CREAT-0.7 NA+-139 
+K+-4.7 CL--108 TCO2-29
+___ 12:06AM   HGB-12.5 calcHCT-38
+___ 12:00AM   ASA-NEG ETHANOL-NEG ACETMNPHN-8* 
+tricyclic-NEG
+
+CT Head/ neck:
+1. Multifocal areas of encephalomalacia as described above, 
+largest in the 
+left frontoparietal lobe.  This limits sensitivity for acute 
+territorial 
+infarction.  Consider further evaluation with MRI. 
+2. Small chronic infarct left thalamus. 
+3. No evidence of acute intracranial hemorrhage. 
+4. Patent head and neck vasculature with no evidence of focal 
+stenosis, 
+occlusion, or aneurysm. 
+5. Right thyroid lobe nodule measuring 1.9 cm. 
+
+MR brain:
+1. Study is moderately degraded by motion. 
+2. Multiple bilateral supratentorial chronic infarcts, largest 
+in the left MCA territory, with evidence of probable chronic 
+blood products within right parieto-occipital infarct. 
+3. No acute infarct or extra-axial collection. 
+
+ 
+
+###RESPONSE: ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, PHOS {Phosphate, total measurement}, TOT BILI {Bilirubin, total measurement}, cTropnT {Troponin T cardiac measurement}, ALBUMIN {Albumin measurement}, CALCIUM {Blood calcium measurement}, CHOLEST {Cholesterol measurement}, eAG {Glucose measurement estimated from glycated hemoglobin}, TSH {Thyroid stimulating hormone 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}, RDWSD {Red cell distribution width determination}, PTT {Partial thromboplastin time, activated}, PTT {Partial thromboplastin time, activated}, GLUCOSE {Glucose measurement, blood}, CREAT {Creatinine measurement}, CL {Chloride measurement, blood}, HGB {Measurement of total hemoglobin concentration}, HCT {Hematocrit determination}, encephalomalacia {Encephalomalacia}, left frontoparietal lobe {Left frontal and parietal lobes (combined site)}, infarction {Cerebral infarction}, evaluation {Evaluation procedure}, MRI {Magnetic resonance imaging of head}, infarct left thalamus {Thalamic infarction}, No evidence {No abnormality detected}, intracranial hemorrhage {Intracranial hemorrhage}, no evidence {No abnormality detected}, stenosis {Stenosis of artery}, occlusion {Occlusion of artery}, aneurysm {Arterial aneurysm}, thyroid lobe nodule {Thyroid nodule}, supratentorial {Supratentorial brain structure}, infarcts {Cerebral infarction}, left MCA {Structure of left middle cerebral artery}, right parieto-occipital {Right parietal and occipital lobes (combined site)}, infarct {Right sided cerebral infarction}, acute infarct {Cerebral infarction}"
+"###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:
+Hospital Course:
+___ is a ___ year old woman with history of 
+hypertension, hyperlipidemia, prior stroke with residual right 
+hemiparesis, localization-related epilepsy on Keppra and 
+lamotrigine, hypothyroidism, and glaucoma who presented to ED
+from nursing home after new-onset dizziness with subsequent 
+acute-on-chronic right lower extremity weakness. Dizziness 
+resolved but reported right sided ""heaviness"" persisted more so 
+than her baseline deficit and thus was admitted to the stroke 
+service. Upon admission to stroke service, underlying etiology 
+for her new symptoms remained unclear. Cardiac origin ruled out 
+with EKG and telemetry. There was resolution since arrival to 
+the ED but concerning with possibility of a stuttering lacune 
+given the intermittent right lower extremity weakness vs 
+flow-dependent perfusion states vs subclinical seizures vs 
+stroke recrudescence. No obvious infectious triggers on routine 
+lab work in ED. Ultimately determined to have no stroke on MRI 
+but given risk factors and past stroke burden, diagnosis of 
+nonspecific sequela of cerebral infarction. 
+
+#Nonspecific Sequela of infarction: patient reportedly had 
+intermittent weakness and dizziness while at her facility. Upon 
+assessment in the ED, her symptoms had significantly improved 
+and she reported basically being back to baseline. NCHCT was 
+ordered and read as showing multiple areas of encephalomalacia, 
+including left frontoparietal, left occipital, right frontal and 
+right parietal lobe suggestive of chronic infarcts. Prominent 
+ventricles and periventricular white matter hypodensity. CTA 
+head and neck showed no large vessel occlusion, no significant 
+and no intracranial disease. She was admitted to the stroke 
+service and an MRI brain was ordered. MR brain read as: Multiple 
+bilateral supratentorial chronic infarcts, largest in the left 
+MCA territory, with evidence of probable chronic blood products 
+within right parieto-occipital infarct. No acute infarct or 
+extra-axial collection. Stroke risk factor labs sent. TTE was 
+done and found to have EF of 60, no cardiac origin of emboli 
+observed and no PFO. ___ recommended ___ rehab. She was 
+kept on ASA 325 mg. Atorvastatin 60mg kept on. 
+
+#HYPERTENSION
+She was initially taken off of her home BP meds and given BP 
+chance to autoregulate given concern for stroke. Once new 
+infarct ruled out on imaging, home BP meds added back. 
+Metoprolol 25mg PO daily 
+
+#HYPERLIPIDEMIA
+She will be sent home on atorvastatin 60mg. 
+
+#HYPOTHYROIDISM 
+Her TSH was found to be elevated at 7.9 and her home 
+levothyroxine was increased from 50 to 62mg qday. Her PCP ___ 
+need to continue trending TSH while outpatient. 
+ #SEIZURE DISORDER
+Initial concern that her symptoms potentially were related to 
+seizure however no further concern and home medications were not 
+changed. She arrived on lamotrigine 200mg BID and keppra 500 BID 
+which she remained on. 
+
+#GLAUCOMA 
+No issues while inpatient. 
+
+Transitional Issues:
+[ ] PCP: trend TSH. Levothyroxine increased from 50 to 62.5mcg 
+daily given TSH 7.9. 
+
+Core Measures:
+AHA/ASA Core Measures for Ischemic Stroke and Transient Ischemic 
+Attack 
+1. Dysphagia screening before any PO intake? (x) Yes, confirmed 
+done - () Not confirmed () No. If no, reason why: 
+2. DVT Prophylaxis administered? (x) Yes - () No. If no, why not 
+(I.e. bleeding risk, hemorrhage, etc.) 
+3. Antithrombotic therapy administered by end of hospital day 2? 
+(x) Yes - () No. If not, why not? (I.e. bleeding risk, 
+hemorrhage, etc.)
+4. LDL documented? (x) Yes (LDL =70 ) - () No 
+5. Intensive statin therapy administered? atorvastatin 60mg LDL 
+> 70) (x) Yes - () No
+6. Smoking cessation counseling given? () Yes - () No [reason 
+(x) non-smoker - () unable to participate] 
+7. Stroke education (personal modifiable risk factors, how to 
+activate EMS for stroke, stroke warning signs and symptoms, 
+prescribed medications, need for followup) given in written 
+form? (x) Yes - () No 
+8. Assessment for rehabilitation or rehab services considered? 
+(x) Yes - () No. If no, why not? (I.e. patient at baseline 
+functional status)
+9. Discharged on statin therapy? (x) Yes - () No [if LDL >70, 
+reason not given: 
+10. Discharged on antithrombotic therapy? ASA 325 
+11. Discharged on oral anticoagulation for patients with atrial 
+fibrillation/flutter? () Yes - (x) No - If no, why not (I.e. 
+bleeding risk, etc.) 
+
+ 
+
+###RESPONSE: hypertension {Hypertensive disorder, systemic arterial}, hyperlipidemia {Hyperlipidemia}, stroke {Cerebrovascular accident}, right 
+hemiparesis {Right hemiparesis}, localization-related epilepsy {Focal epilepsy}, hypothyroidism {Hypothyroidism}, glaucoma {Glaucoma}, dizziness {Dizziness}, right lower extremity weakness {Paresis of right lower limb}, Dizziness {Dizziness}, resolved {Problem resolved}, right sided {Structure of right half of body}, heaviness {Sensation of heaviness in limbs}, baseline {Baseline state}, deficit {Neurological deficit}, Cardiac {Heart disease}, EKG {Electrocardiographic procedure}, telemetry {Cardiac telemetry}, lacune {Lacunar infarction}, right lower extremity weakness {Paresis of right lower limb}, perfusion {Perfusion}, seizures {Seizure}, stroke {Cerebrovascular accident}, infectious {Infectious disease}, stroke {Cerebrovascular accident}, MRI {Magnetic resonance imaging of head}, risk factors and past stroke burden {At increased risk of cerebrovascular accident}, cerebral infarction {Cerebral infarction}, infarction {Cerebral infarction}, weakness {Asthenia}, dizziness {Dizziness}, assessment {Evaluation procedure}, improved {Patient's condition improved}, baseline {Baseline state}, NCHCT {Computed tomography of head without contrast}, encephalomalacia {Encephalomalacia}, left frontoparietal {Left frontal and parietal lobes (combined site)}, left occipital {Left occipital lobe structure}, right frontal {Right frontal lobe structure}, right parietal lobe {Right parietal lobe structure}, infarcts {Cerebral infarction}, ventricles {Brain ventricle structure}, periventricular white matter {Structure of periventricular white matter}, CTA 
+head and neck {Computed tomography angiography of head and neck with contrast}, large vessel {Large blood vessel structure}, occlusion {Occlusion of cerebral artery}, intracranial {Intracranial structure}, disease {Disease}, MRI brain {Magnetic resonance imaging of brain}, MR brain {Magnetic resonance imaging of brain}, supratentorial {Supratentorial brain structure}, infarcts {Cerebral infarction}, left 
+MCA {Structure of left middle cerebral artery}, right parieto-occipital {Right parietal and occipital lobes (combined site)}, infarct {Cerebral infarction}, acute infarct {Acute infarct}, Stroke {Cerebrovascular accident}, TTE {Transthoracic echocardiography}, cardiac {Heart structure}, emboli {Embolus}, HYPERTENSION {Hypertensive disorder, systemic arterial}, stroke {Cerebrovascular accident}, infarct {Cerebral infarction}, imaging {Imaging}, HYPERLIPIDEMIA {Hyperlipidemia}, HYPOTHYROIDISM {Hypothyroidism}, TSH was found to be elevated {Thyroid stimulating hormone level above reference range}, PCP {Primary care management}, SEIZURE DISORDER {Seizure disorder}, seizure {Seizure}, GLAUCOMA {Glaucoma}, PCP {Primary care management}, Ischemic Stroke {Ischemic stroke}, Transient Ischemic 
+Attack {Transient ischemic attack}, Dysphagia screening {Screening for dysphagia}, DVT Prophylaxis {Prevention of deep vein thrombosis}, bleeding risk {At increased risk of hemorrhage}, hemorrhage {Bleeding}, Antithrombotic therapy {Continuous infusion of antithrombotic}, bleeding risk {At increased risk of hemorrhage}, hemorrhage {Bleeding}, LDL {Low density lipoprotein cholesterol measurement}, statin therapy {Administration of prophylactic statin}, Smoking cessation counseling {Smoking cessation education}, non-smoker {Non-smoker}, Stroke education {Education about cerebrovascular accident}, stroke {Cerebrovascular accident}, stroke {Cerebrovascular accident}, warning signs and symptoms {Discussion about clinical red flag warning sign}, Assessment for rehabilitation {Assessment for rehabilitation}, baseline {Baseline state}, statin therapy {Administration of prophylactic statin}, oral {Administration of drug or medicament via oral route}, anticoagulation {Anticoagulant therapy}, atrial 
+fibrillation {Atrial fibrillation}, flutter {Atrial flutter}, bleeding risk {At increased risk of hemorrhage}"
+"###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. Levothyroxine Sodium 50 mcg PO DAILY 
+2. Aspirin 325 mg PO DAILY 
+3. Vitamin D ___ UNIT PO MONTHLY 
+4. Multivitamins W/minerals 1 TAB PO DAILY 
+5. Metoprolol Succinate XL 25 mg PO DAILY 
+6. LevETIRAcetam 500 mg PO BID 
+7. LamoTRIgine 200 mg PO BID 
+8. Furosemide 20 mg PO DAILY 
+9. Baclofen 15 mg PO QPM 
+10. Atorvastatin 60 mg PO QPM 
+
+ 
+Discharge Medications:
+1.  Aspirin 325 mg PO DAILY  
+2.  Atorvastatin 60 mg PO QPM  
+3.  Baclofen 15 mg PO QPM  
+4.  Furosemide 20 mg PO DAILY  
+5.  LamoTRIgine 200 mg PO BID  
+6.  LevETIRAcetam 500 mg PO BID  
+7.  Levothyroxine Sodium 50 mcg PO DAILY  
+8.  Metoprolol Succinate XL 25 mg PO DAILY  
+9.  Multivitamins W/minerals 1 TAB PO DAILY  
+10.  Vitamin D ___ UNIT PO MONTHLY  
+
+ 
+
+###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:
+Nonspecific Sequela of Infarction
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+
+ 
+
+###RESPONSE: Infarction {Cerebral infarction}, 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 - requires assistance or aid {Finding of walking aid use}, walker {Uses zimmer frame}, cane {Uses single walking stick}"
+"###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. ___,  
+You were hospitalized due to symptoms of dizziness and right 
+sided weakness resulting from what we believe to be nonspecific 
+sequela of cerebral infarction. You were not found to have a new 
+stroke on MRI, however you have a history of residual problems 
+from past stroke and your new symptoms seemed consistent with 
+stroke. We believe that your new symptoms are likely secondary 
+to your stroke risk factors and related to old stroke. We would 
+like you to continue your current home meds and to continue 
+following closely with outpatient neurology in order to best 
+prevent further strokes. A stroke is a condition where a blood 
+vessel providing oxygen and nutrients to the brain is blocked by 
+a clot. The brain is the part of your body that controls and 
+directs all the other parts of your body, so damage to the brain 
+from being deprived of its blood supply can result in a variety 
+of symptoms.  
+
+Stroke can have many different causes, so we assessed you for 
+medical conditions that might raise your risk of having stroke. 
+In order to prevent future strokes, we plan to modify those risk 
+factors. Your risk factors are: high blood pressure, high 
+cholesterol. 
+
+We are not changing your home medications. 
+ 
+Please take your other medications as prescribed.  
+
+Please follow up with Neurology and your primary care physician 
+as listed below.  
+If you experience any of the symptoms below, please seek 
+emergency medical attention by calling Emergency Medical 
+Services (dialing 911). In particular, since stroke can recur, 
+please pay attention to the sudden onset and persistence of 
+these symptoms:  
+ - Sudden partial or complete loss of vision  
+ - Sudden loss of the ability to speak words from your mouth  
+ - Sudden loss of the ability to understand others speaking to 
+you  
+ - Sudden weakness of one side of the body  
+ - Sudden drooping of one side of the face  
+ - Sudden loss of sensation of one side of the body  
+
+ Sincerely,  
+ Your ___ Neurology Team  
+
+ 
+
+###RESPONSE: dizziness {Dizziness}, right 
+sided weakness {Right hemiparesis}, cerebral infarction {Cerebral infarction}, stroke {Cerebrovascular accident}, MRI {Magnetic resonance imaging of head}, problems {Problem}, stroke {Cerebrovascular accident}, stroke {Cerebrovascular accident}, stroke {Cerebrovascular accident}, stroke {Cerebrovascular accident}, strokes {Cerebrovascular accident}, stroke {Cerebrovascular accident}, blood 
+vessel {Blood vessel structure}, brain {Brain structure}, clot {Blood clot}, brain {Brain structure}, damage {Damage}, brain {Brain structure}, Stroke {Cerebrovascular accident}, stroke {Cerebrovascular accident}, strokes {Cerebrovascular accident}, high blood pressure {Hypertensive disorder, systemic arterial}, high 
+cholesterol {Hypercholesterolemia}, follow up with Neurology {Follow-up neurological assessment}, stroke {Cerebrovascular accident}, loss of vision {Functional visual loss}, loss of the ability to speak {Follow-up neurological assessment}, mouth {Mouth region structure}, loss of the ability to understand {Abnormal ability to understand}, weakness of one side of the body {Hemiparesis}, drooping of one side of the face {Facial hemiparesis}, loss of sensation {Numbness}"
+"###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: CARDIOTHORACIC
+ 
+
+###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 / adhesive tape / Percocet
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Recurrent chest pain, fatigue
+ 
+Major Surgical or Invasive Procedure:
+Coronary Artery Bypass Grafting x 2 (left internal mammary 
+artery to the left anterior descending coronary artery; 
+saphenous vein graft to the obtuse marginal branch)
+ 
+
+###RESPONSE: Codeine {Allergy to codeine}, adhesive tape {Allergy to adhesive agent}, chest pain {Chest pain}, fatigue {Fatigue}, Coronary Artery Bypass Grafting x 2 {Coronary artery bypass grafts x 2}, left internal mammary 
+artery {Structure of left internal thoracic artery}, left anterior descending coronary artery {Structure of anterior descending branch of left coronary artery}, saphenous vein graft {Aortocoronary artery bypass of one coronary artery with saphenous vein graft}, obtuse marginal {Structure of obtuse marginal branch of circumflex branch of left coronary artery}"
+"###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:
+Mrs. ___ is a ___ year old female with multiple cardiac risk 
+factors who
+presented with recurrent chest pain concerning for angina. 
+Stress test was notable for mild anteroseptal ischemia. 
+Subsequent cardiac catheterization showed 60% left main lesion. 
+Of note, she has history of SVT. She reported
+occasional episodes of palpitations and diaphoresis sometimes 
+associated with chest pain. These episodes occurred several 
+times per week.  Based upon the above findings, she was referred 
+to Dr. ___ surgical revascularization.
+ 
+
+###RESPONSE: cardiac risk 
+factors {Assessment for risk of cardiovascular disease}, chest pain {Chest pain}, angina {Angina}, Stress test {Electrocardiogram with exercise test}, anteroseptal ischemia {Ischemia of myocardium of anteroseptal region}, cardiac catheterization {Cardiac catheterization}, left main {Left coronary artery structure}, lesion {Lesion}, SVT {Supraventricular tachycardia}, palpitations {Palpitations}, diaphoresis {Excessive sweating}, chest pain {Chest pain}, surgical {Surgical procedure}, revascularization {Heart revascularization}"
+"###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:
+1.  Hypertension
+2.  Dyslipidemia
+3.  Type II Diabetes Mellitus
+4.  History of SVT
+5.  Abdominal Aortic Aneurysm - incidental finding on cath
+
+Past Surgical History: 
+1.  s/p Open Cholecystectomy
+2.  s/p Appendectomy
+
+ 
+
+###RESPONSE: Hypertension {Hypertensive disorder, systemic arterial}, Dyslipidemia {Dyslipidemia}, Type II Diabetes Mellitus {Diabetes mellitus type 2}, SVT {Supraventricular tachycardia}, Abdominal Aortic Aneurysm {Abdominal aortic aneurysm}, cath {Cardiac catheterization}, Cholecystectomy {Cholecystectomy}, Appendectomy {Excision of appendix}"
+"###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 - died of myocardial infarction in his ___
+ 
+
+###RESPONSE: died {Dead}, myocardial infarction {Myocardial infarction}"
+"###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:
+HR: 77  BP: 133/77  RR: 16  O2 sat: 99% RA
+Height: 61 inches    Weight: 145 lbs
+
+General: Well-developed female in no acute distress
+Skin: Warm [X] Dry [X] Intact [X]
+HEENT: NCAT [X] PERRLA [X] EOMI [X]
+Neck: Supple [X] Full ROM [X] JVD []
+Chest: Lungs clear bilaterally [X]
+Heart: RRR [X], No murmur/rub/Gallop
+Abdomen: Soft [X] non-distended [X] non-tender [X] bowel sounds 
++ [X]
+Extremities: Warm [X], well-perfused [X] Edema -, Slight rash on 
+bilateral forearms. 
+Varicosities: None [X]
+Neuro: Grossly intact [X]
+Pulses:
+Femoral      Right: 2+  Left: 2+
+DP           Right: 2+  Left: 2+
+___           Right: 2+  Left: 2+
+Radial       Right: 2+  Left: 2+
+
+Discharge Exam:
+
+Carotid Bruit    Right: -   Left: -
+
+Discharge Exam:
+VS: T: 98.3  HR: 80-90's SR  BP: 98-111/60  Sats: 96% RA  
+WT: 65 Kg preop 65.7 Kg
+General: ___ year-old female in no apparent distress
+HEENT: normocephalic
+Card: RRR normal S1,S2 no murmur
+Resp: clear breath sounds throughout
+GI: benign
+Extr: warm no edema
+Wound: sternal and RLE clean dry intact no erythema. sternum 
+stable
+Neuro: awake, alert oriented. ambulating in halls
+ 
+
+###RESPONSE: HR {Finding of heart rate}, BP {Blood pressure finding}, RR {Finding of rate of respiration}, O2 sat {Oxygen saturation measurement}, RA {Breathing room air}, Height {Height / growth finding}, Weight {Weight finding}, General {General examination of patient}, distress {Distress}, Skin {Examination of skin}, Warm {Warm skin}, Intact {Intact skin}, HEENT {Physical examination procedure}, NC {Normal head}, PERRLA {Pupils equal, react to light and accommodation}, EOMI {Normal ocular motility}, Neck {Physical examination procedure}, Supple {Normal movement of neck}, Full ROM {Normal range of cervical spine movement}, JVD {Jugular venous engorgement}, Chest {Examination of respiratory system}, Lungs {Examination of respiratory system}, Heart {Cardiovascular physical examination}, RRR {Normal heart rate}, murmur {Murmur}, rub {Pleural friction rub}, Gallop {Gallop rhythm}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, non-distended {Normal abdominal contour}, non-tender {Abdominal tenderness}, bowel sounds {Normal bowel sounds}, Extremities {Examination of limb}, Warm {Warm skin}, well-perfused {Normal tissue perfusion}, Edema {Edema}, rash {Eruption of skin}, forearms {Forearm structure}, Varicosities {Venous varices}, Neuro {Neurological examination}, Grossly intact {Normal nervous system function}, Femoral {Structure of femoral artery}, Right: 2+ {Pulse present in right femoral artery}, Left: 2+ {Pulse present in left femoral artery}, DP {Structure of dorsalis pedis artery}, Right: 2 {Pulse present in right dorsalis pedis artery}, Left: 2+ {Pulse present in left dorsalis pedis artery}, Right: 2 {Normal pulse in right dorsalis pedis artery}, Left: 2 {Pulse present in left femoral artery}, Radial {Structure of radial artery}, Right {Structure of right radial artery}, Left {Structure of left radial artery}, Carotid Bruit {Carotid bruit}, Right {Structure of right carotid artery}, Left {Structure of left carotid artery}, VS {Vital signs finding}, RA {Breathing room air}, preop {Preoperative state}, General {General examination of patient}, distress {Distress}, HEENT {Physical examination procedure}, normocephalic {Normal head}, Card {Structure of cardiovascular system}, RRR {Normal heart rate}, normal S1,S2 {Heart sounds normal}, murmur {Murmur}, Resp {Examination of respiratory system}, clear breath sounds {Normal breath sounds}, GI {Examination of digestive system}, Extr {Examination of limb}, warm {Warm skin}, edema {Edema}, sternal {Sternal skin structure}, RLE {Skin structure of right lower limb}, clean dry intact {Wound healing well}, erythema {Erythema}, sternum {Sternal skin structure}, Neuro {Neurological examination}, awake {Awake}, alert {Mentally alert}, oriented {Orientated}, ambulating {Fully mobile}"
+"###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:
+Cardiac Catheterization
+Right dominant system.  Left main coronary artery with ostial 
+60% stenosis. Left anterior descending and left circumflex 
+arteries had no aniographically apparent coronary artery 
+disease. The right coronary artery had proximal 30% lesion. 
+Estimated LVEF was 60%. Abdominal aortogram showed distal 
+aneurysm.
+
+Labs:
+___ WBC-7.1 RBC-3.11* Hgb-9.5* Hct-27.8* MCV-90 MCH-30.5 
+MCHC-34.0 RDW-12.8 Plt ___
+___ WBC-7.6# RBC-3.29*# Hgb-10.2*# Hct-28.6*# MCV-87 
+MCH-30.9 MCHC-35.5* RDW-12.8 Plt ___
+
+___ Glucose-158* UreaN-12 Creat-0.6 Na-129* K-4.2 Cl-91* 
+HCO3-34
+___ Glucose-128* UreaN-11 Creat-0.5 Na-127* K-4.1 Cl-90* 
+HCO3-33
+___ Glucose-148* UreaN-10 Creat-0.6 Na-130* K-4.1 Cl-92* 
+HCO3-29 
+___ UreaN-9 Creat-0.4 Na-137 K-3.3 Cl-108 HCO3-23 
+
+___ Mg-1.9
+___ Hgb-8.7* calcHCT-26
+
+___ MRSA SCREEN (Final ___:    No MRSA isolated. 
+
+Chest X-Ray ___: There is evidence of bilateral basal 
+atelectasis, left more than right.  In addition, a minimal left 
+pleural 
+effusion cannot be excluded.  The sternal wires and the 
+postoperative clips are in unchanged position.  No overt 
+pulmonary edema.  No pneumothorax. 
+
+ 
+
+###RESPONSE: Cardiac Catheterization {Cardiac catheterization}, Right dominant system {Right dominant coronary system}, Left main coronary artery {Structure of left coronary artery main stem}, stenosis {Stenosis}, Left anterior descending {Structure of anterior descending branch of left coronary artery}, left circumflex 
+arteries {Structure of circumflex branch of left coronary artery}, disease {Disease}, right coronary artery had proximal {Structure of proximal portion of right coronary artery}, lesion {Lesion}, Abdominal aortogram {Abdominal aortogram}, aneurysm {Aneurysm}, 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}, MCH {Mean corpuscular hemoglobin determination}, RDW {Red cell distribution width determination}, 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}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, HCO3 {Blood bicarbonate measurement}, Mg {Blood magnesium measurement}, Hgb {Measurement of total hemoglobin concentration}, MRSA SCREEN {Multi-resistant staphylococcus aureus screening}, MRSA {Methicillin resistant Staphylococcus aureus infection}, Chest X-Ray {Plain chest X-ray}, atelectasis {Atelectasis}, left {Left lung structure}, right {Right lung structure}, left {Structure of left pleural cavity}, pleural 
+effusion {Pleural effusion}, sternal {Structure of sternal region}, pulmonary edema {Pulmonary edema}, pneumothorax {Pneumothorax}"
+"###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:
+She was admitted to ___ on ___ and was taken to the 
+operating room.  She underwent Coronary Artery Bypass Grafting x 
+2 (left internal mammary artery to the left anterior descending 
+coronary artery; saphenous vein graft to the obtuse marginal 
+branch).  She tolerated the procedure well and post-operatively 
+was transferred to the CVICU in stable condition for recovery 
+and invasive monitoring. 
+She weaned from sedation, awoke neurologically intact and was 
+extubated on POD 1.  She was weaned from inotropic and 
+vasopressor support. She remained hemodynamically stable and was 
+transferred to the telemetry floor for further recovery.  Chest 
+tubes and pacing wires were discontinued without complication.  
+
+Respiratory: aggressive pulmonary toilet and nebs she titrated 
+off oxygen.
+
+Cardiac: Beta-blockers were titrated for rate control Lopressor 
+50 mg tid.  She remained in sinus rhythm without ectopy.  Blood 
+pressure was initially high 130-140's her losartan 50 mg was 
+restarted but required titration down to 25 mg daily for SBP 
+98-111.  Aspirin and Statin were resumed.
+
+GI: benign PPI and bowel regime continued
+
+Renal: renal function within normal limits.  She was gently 
+diuresed to her preop weight of 65.7 Kg.
+
+Hyponatremia: Na+ 12. With free water restriction it slowly 
+trend ed up. Discharge Na 129. She was asymptomatic.
+
+Endocrine: IV insulin and sliding scale for good blood sugar 
+control.  Once taken PO medication her metformin and Glyburide 
+were resumed.
+
+Disposition: She was evaluated by the physical therapy service 
+for assistance with strength and mobility.  By the time of 
+discharge on POD 4 she was ambulating freely, the wound was 
+healing, and pain was controlled with oral analgesics.  She was 
+discharged home with ___ in good condition with appropriate 
+follow up instructions.
+ 
+
+###RESPONSE: Coronary Artery Bypass Grafting x 
+2 {Coronary artery bypass grafts x 2}, left internal mammary artery {Structure of left internal thoracic artery}, left anterior descending 
+coronary artery {Structure of anterior descending branch of left coronary artery}, saphenous vein graft {Aortocoronary artery bypass of one coronary artery with saphenous vein graft}, obtuse marginal {Structure of obtuse marginal branch of circumflex branch of left coronary artery}, procedure {Surgical procedure}, post-operatively {Postoperative state}, stable condition {Patient's condition stable}, monitoring {Monitoring procedure}, sedation {Administration of sedative}, neurologically intact {Normal nervous system function}, extubated {Removal of endotracheal tube}, vasopressor support {Vasopressor therapy}, hemodynamically stable {Hemodynamically stable}, telemetry {Cardiac telemetry}, Chest 
+tubes {Insertion of pleural tube drain}, pulmonary toilet {Airway toilet}, sinus rhythm {Sinus rhythm}, Blood 
+pressure {Blood pressure finding}, restarted {Restart of medication}, Aspirin {Administration of aspirin}, bowel {Intestinal structure}, renal function {Renal function monitoring}, diuresed {Diuretic therapy}, preop {Preoperative state}, weight {Weight finding}, Hyponatremia {Hyponatremia}, asymptomatic {Asymptomatic}, sliding scale {Sliding scale insulin regime}, blood sugar {Blood sugar management}, evaluated {Evaluation procedure}, physical therapy {Physical therapy assessment}, ambulating {Fully mobile}, wound was 
+healing {Wound healing well}, pain was controlled with oral analgesics {Demonstrates adequate pain control}, good {Patient's condition satisfactory}, instructions {Recommendation to}"
+"###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. Atenolol 50 mg PO DAILY 
+2. GlyBURIDE 5 mg PO BID 
+3. Hydrochlorothiazide 50 mg PO DAILY 
+4. Losartan Potassium 50 mg PO DAILY 
+5. MetFORMIN (Glucophage) 850 mg PO BID 
+6. Aspirin 162 mg PO DAILY 
+7. Calcium Carbonate 500 mg PO BID 
+8. Multivitamins 1 TAB PO DAILY 
+9. Fish Oil (Omega 3) 1000 mg PO BID 
+
+ 
+Discharge Medications:
+1. Aspirin EC 81 mg PO DAILY 
+2. Calcium Carbonate 500 mg PO BID:PRN indigestion 
+3. GlyBURIDE 5 mg PO BID 
+4. Losartan Potassium 25 mg PO DAILY 
+RX *losartan 25 mg 1 tablet(s) by mouth once a day Disp #*30 
+Tablet Refills:*0
+5. Fish Oil (Omega 3) 1000 mg PO BID 
+6. MetFORMIN (Glucophage) 850 mg PO BID 
+7. Multivitamins 1 TAB PO DAILY 
+8. Acetaminophen 650 mg PO Q6H:PRN pain, fever 
+9. HYDROmorphone (Dilaudid) 2 mg PO Q6H:PRN pain 
+RX *hydromorphone 2 mg 1 tablet(s) by mouth every six (6) hours 
+Disp #*50 Tablet Refills:*0
+10. Lovastatin *NF* 40 mg Oral daily Reason for Ordering: Wish 
+to maintain preadmission medication while hospitalized, as there 
+is no acceptable substitute drug product available on formulary.
+11. Metoprolol Tartrate 50 mg PO TID 
+RX *metoprolol tartrate 50 mg 1 tablet(s) by mouth every eight 
+(8) hours Disp #*90 Tablet Refills:*5
+12. Senna 2 TAB PO DAILY 
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+___ Diagnosis:
+Coronary Artery Disease
+Hypertension
+Hyperlipidemia
+Type II Diabetes Mellitus
+History of SVT
+
+ 
+Discharge Condition:
+Alert and oriented x3 nonfocal
+Ambulating, gait steady
+Sternal pain managed with oral analgesics
+Sternal Incision - healing well, no erythema or drainage
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, Coronary Artery Disease {Coronary arteriosclerosis}, Hypertension {Hypertensive disorder, systemic arterial}, Hyperlipidemia {Hyperlipidemia}, Type II Diabetes Mellitus {Diabetes mellitus type 2}, SVT {Supraventricular tachycardia}, Alert {Mentally alert}, oriented x3 {Oriented to person, time and place}, Ambulating {Fully mobile}, gait steady {Gait normal}, Sternal pain {Pain of sternum}, oral analgesics {Administration of analgesic}, Sternal Incision {Wound of structure of sternal region}, healing well {Wound healing well}, erythema {Erythema}, drainage {Wound discharge}"
+"###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:
+1. Please shower daily including washing incisions gently with 
+mild soap, no baths or swimming, and look at your incisions
+2). Please NO lotions, cream, powder, or ointments to incisions
+3). Each morning you should weigh yourself and then in the 
+evening take your temperature, these should be written down on 
+the chart
+4). No driving for approximately one month and while taking 
+narcotics, will be discussed at follow up appointment with 
+surgeon when you will be able to drive
+5). No lifting more than 10 pounds for 10 weeks
+6). Please wear a bra to reduce pulling on the sternal incision
+
+**Please call cardiac surgery office with any questions or 
+concerns ___. Answering service will contact on call 
+person during off hours**
+
+ 
+
+###RESPONSE: shower {Functional activity education}, incisions {Surgical incision wound}, incisions {Surgical incision wound}, incisions {Surgical incision wound}, temperature {Body temperature finding}, while taking 
+narcotics {Narcotherapy}, No lifting {Functional activity education}, sternal incision {Wound of structure of sternal 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: 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: 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: 
+atorvastatin
+ 
+Attending: ___.
+ 
+Chief Complaint:
+L ankle pain
+ 
+Major Surgical or Invasive Procedure:
+___ - ORIF L Ankle (___)
+ 
+
+###RESPONSE: atorvastatin {Allergy to atorvastatin}, ankle pain {Ankle pain}, ORIF {Open reduction of fracture with internal fixation}, L Ankle {Structure of left ankle}"
+"###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 F presenting s/p mechanical fall this evening. She 
+reports immediate pain of the left ankle after feeling it twist. 
+She was also unable to bear weight. Currently denies parathesias 
+or numbness. 
+ 
+
+###RESPONSE: fall {Falls}, pain {Pain}, left ankle {Structure of left ankle}, unable to bear weight {Unable to weight-bear}, parathesias {Paresthesia}, numbness {Numbness}"
+"###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:
+PMH/PSH: 
+1.  Hypertension.
+2.  Hyperlipidemia.
+3.  Glucose intolerance.
+4.  Gastroesophageal reflux.
+5.  Allergic rhinitis.
+6.  Status post H. pylori infection - confirmed eradicated ___.
+7.  Breast biopsy bilateral in the ___ and ___.  The patient
+denies any cancer.
+8.  Bilateral oophorectomy and hysterectomy - ___.
+ 
+
+###RESPONSE: Hypertension {Hypertensive disorder, systemic arterial}, Hyperlipidemia {Hyperlipidemia}, Glucose intolerance {Impaired glucose tolerance}, Gastroesophageal reflux {Gastroesophageal reflux disease}, Allergic rhinitis {Allergic rhinitis}, H. pylori infection {Infection caused by Helicobacter pylori}, Breast biopsy {Biopsy of breast}, cancer {Malignant neoplasm of colon}, Bilateral oophorectomy {Excision of bilateral ovaries}, hysterectomy {Hysterectomy}"
+"###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:
+NC
+ 
+
+###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:
+VS: 99.1  103  148/72  18  98ra
+Gen: NAD, AAOx3
+LLE exam:
+SILT S/S/SP/DP/T
+fires ___
+WWP
+Splint in place
+ 
+
+###RESPONSE: Physical Exam {Physical examination procedure}, VS {Vital signs finding}, Gen {General examination of patient}, NAD {No abnormality detected}, Ox3 {Oriented to person, time and place}, LLE {Structure of left lower limb}, SILT {Light touch sensation present}, DP {Structure of dorsalis pedis artery}, WWP {Normal tissue perfusion}, Splint {Application of splint}"
+"###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:
+___ 07:10AM BLOOD WBC-7.0 RBC-4.03* Hgb-11.1* Hct-33.4* 
+MCV-83 MCH-27.6 MCHC-33.3 RDW-14.9 Plt ___
+
+ 
+
+###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}"
+"###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 L ankle fracture and was admitted to the orthopedic 
+surgery service.  The patient was taken to the operating room on 
+___ for ORIF L ankle, 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 rehab 
+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 touchdown weightbearing in the 
+left 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.
+ 
+Discharge Medications:
+1. Acetaminophen 1000 mg PO Q8H pain 
+RX *acetaminophen 500 mg 2 tablet(s) by mouth every 8 hours Disp 
+#*60 Tablet Refills:*2
+2. Amlodipine 2.5 mg PO DAILY 
+3. Calcium Carbonate 500 mg PO BID 
+4. Fluticasone Propionate NASAL 1 SPRY NU DAILY 
+5. Omeprazole 20 mg PO BID 
+6. OxycoDONE (Immediate Release)  ___ mg PO Q4H:PRN pain 
+RX *oxycodone 5 mg ___ tablet(s) by mouth every 4 hours Disp 
+#*61 Tablet Refills:*0
+7. Pravastatin 40 mg PO DAILY 
+8. Vitamin D 400 UNIT PO DAILY 
+9. Enoxaparin Sodium 40 mg SC DAILY Duration: 14 Days 
+RX *enoxaparin 40 mg/0.4 mL 40 mg SC daily Disp #*14 Syringe 
+Refills:*0
+10. Docusate Sodium 100 mg PO BID 
+RX *docusate sodium [Colace] 100 mg 1 capsule(s) by mouth twice 
+daily Disp #*30 Capsule Refills:*2
+11. Senna 1 TAB PO BID:PRN constipation 
+RX *sennosides [senna] 8.6 mg 1 tab by mouth twice daily Disp 
+#*30 Tablet Refills:*2
+
+ 
+
+###RESPONSE: emergency {Emergency treatment}, evaluated by the orthopedic surgery team {Orthopedic assessment}, L ankle {Structure of left ankle}, admitted to the orthopedic 
+surgery service {Admission by orthopedic surgeon}, ORIF {Open reduction of fracture with internal fixation}, L ankle {Structure of left ankle}, operative {Surgical procedure}, PACU {Postanesthesia care}, stable 
+condition {Patient's condition stable}, anesthesia {Administration of general anesthetic}, 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}, medications {Administration of drug or medicament}, unremarkable {No abnormality detected}, afebrile {Temperature normal}, stable 
+vital signs {Normal vital signs}, normal {No abnormality detected}, pain was well 
+controlled with oral medications {Demonstrates adequate pain control with oral analgesics}, incisions {Surgical incision wound}, clean/dry/intact {Wound healing well}, voiding {Normal micturition}, moving bowels {Finding of defecation}, weightbearing {Weight-bearing}, left lower extremity {Structure of left lower limb}, DVT 
+prophylaxis {Prevention of deep vein thrombosis}, follow up {Postoperative follow-up visit}, discussion {Patient education}"
+"###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:
+___
+ 
+___ Diagnosis:
+L bimalleolar ankle fracture
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+ 
+
+###RESPONSE: bimalleolar ankle fracture {Bimalleolar fracture of ankle}, 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 - requires assistance or aid {Finding of walking aid use}, walker {Uses zimmer frame}, cane {Uses single walking stick}"
+"###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:
+- Please be careful to keep your splint dry until your follow-up 
+appointment.  
+- 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.
+
+ACTIVITY AND WEIGHT BEARING:
+- Touchdown weightbearing left lower extremity
+Physical Therapy:
+Touchdown weightbearing in left lower extremity.
+Please keep splint on until your follow-up appointment.
+Treatment Frequency:
+Please keep splint on until your follow-up appointment. Please 
+keep your splint dry. You may elevate your foot for comfort as 
+you like. Any sutures/staples will be removed at your follow up 
+appointment.
+ 
+
+###RESPONSE: MEDICATIONS {Administration of drug or medicament}, medications {Administration of drug or medicament}, medications {Administration of drug or medicament}, Do not drink alcohol {Education about alcohol consumption}, while taking narcotic pain relievers {Narcotics education}, Narcotic pain relievers can cause {Narcotics education}, constipation {Constipation}, take a stool softener {Administration of laxative}, side effect {Medication side effects present}, ANTICOAGULATION {Anticoagulant therapy}, WOUND CARE {Wound care}, splint {Application of splint}, stitches {Removal of suture}, staples that need to be removed {Removal of staples}, ACTIVITY AND WEIGHT BEARING {Education about increasing activity tolerance}, weightbearing {Weight-bearing}, left lower extremity {Structure of left lower limb}, Physical Therapy {Physical therapy procedure}, weightbearing {Weight-bearing}, left lower extremity {Structure of left lower limb}, splint {Application of splint}, splint {Application of splint}, splint {Application of splint}, foot {Structure of left foot}, sutures {Removal of suture}, staples will be removed {Removal of staples}"
+"###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:
+volume overload 
+ 
+Major Surgical or Invasive Procedure:
+G-J Tube removed by interventional radiology ___
+
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, volume overload {Hypervolemia}, G-J Tube removed by interventional radiology {Removal of gastrojejunostomy tube using fluoroscopic guidance}"
+"###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 ___ with T1DM (c/b multiple toe
+amputations, gastroparesis & prior DKA), ESRD on HD (likely ___
+DM, no biopsy on file), bilateral ___ DVT s/p IVC filter ___
+and on warfarin, L non-occlusive jugular thrombus (___), R
+thalamic bleed in the setting of HTN emergency w/ residual L
+hemiparesis (___), & L hip fracture s/p fixation ___, and
+recent admission from ___ for MRSA bacteremia ___ PNA on
+vancomycin with HD sessions (scheduled course through ___, who
+presents from rehab with a 25-lb weight gain and worsening ___
+edema since discharge. The patient also had a new 2L O2
+requirement in the ED. 
+ 
+The patient is on a MWF HD session, and had not received his
+___ session. Per NP at his rehab facility, the patient had
+recently been becoming hypotensive while receiving HD at his
+facility, with a progressive volume overload and inability to
+increase UF. He has not been on diuretics, and was not started 
+on
+any at facility.
+
+ 
+
+###RESPONSE: T1DM {Diabetes mellitus type 1}, toe
+amputations {Amputated toe}, gastroparesis {Gastroparesis}, DKA {Ketoacidosis due to diabetes mellitus}, ESRD on HD {End stage renal failure on dialysis}, DM {Diabetes mellitus}, biopsy {Biopsy}, DVT {Deep venous thrombosis}, IVC filter {Inferior vena cava filter in situ}, on warfarin {Warfarin therapy}, L non-occlusive jugular {Structure of left jugular vein}, thrombus {Thrombus}, thalamic {Thalamic structure}, bleed {Bleeding}, HTN emergency {Hypertensive emergency}, L
+hemiparesis {Left hemiparesis}, hip fracture {Fracture of proximal end of femur}, fixation {Fixation}, MRSA bacteremia {Bacteremia caused by Methicillin resistant Staphylococcus aureus}, PNA {Pneumonia}, vancomycin {Antibiotic therapy}, HD {Hemodialysis}, weight gain {Weight gain}, worsening {Patient's condition worsened}, edema {Edema}, HD {Hemodialysis}, hypotensive {Low blood pressure}, HD {Hemodialysis}, volume overload {Hypervolemia}, diuretics {Diuretic 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:
+-type I DM (A1C 4.9 ___ w/ prior DKA
+-multiple amputations
+-gastroparesis
+-ESRD (likely ___ DM, no biopsy on file) on HD
+-bilateral ___ DVT s/p IVC filter ___
+-L non-occlusive jugular thrombus ___
+-R thalamic bleed in the setting of HTN emergency w/ residual L
+hemiparesis (___)
+-L hip fracture s/p fixation ___
+ 
+
+###RESPONSE: type I DM {Diabetes mellitus type 1}, DKA {Ketoacidosis due to diabetes mellitus}, amputations {Amputated toe}, gastroparesis {Gastroparesis}, ESRD {End-stage renal disease}, DM {Diabetes mellitus}, biopsy {Biopsy}, HD {Hemodialysis}, DVT {Deep venous thrombosis}, IVC filter ___ {Inferior vena cava filter in situ}, L non-occlusive jugular {Structure of left jugular vein}, thrombus {Thrombus}, thalamic {Thalamic structure}, bleed {Bleeding}, HTN emergency {Hypertensive emergency}, L
+hemiparesis {Left hemiparesis}, hip fracture {Fracture of proximal end of femur}, fixation {Fixation}"
+"###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:
+___ significant for stroke. 
+ 
+
+###RESPONSE: stroke {Cerebrovascular accident}"
+"###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: ___ Temp: 98.4 PO BP: 114/69 R Lying HR: 128 RR: 
+20
+O2 sat: 94% O2 delivery: RA 
+GENERAL: Patient lying in bed, NAD, interactive 
+HEAD: NC/AT, R pupil non-reactive (patient reports that it is a
+false eye). L pupil reactive. EOMI intact on left side. Oral
+mucosa w/o lesions, MMM. 
+NECK: Supple, no LAD, no thyromegaly. Elevated JVP. 
+CARDIAC: Tachycardic, irregular rhytm. No m/r/g. 
+RESPIRATORY: Speaking in full sentences. Decreased bibasilar
+breath rounds and mild crackles, L > R. 
+ABDOMEN: Unremarkable inspection, soft, NT, +BS. No palpable
+organomegaly. PEG tube in place, dressings c/d/I, no erythema or
+tenderness around site. 
+EXTREMITIES: Severe 2+ petting edema, L > R, in both UE and ___. 
+SKIN: Scattered ecchymoses across both arms b/l, no other 
+lesions
+or rashes. 
+NEUROLOGIC: ___ strength on left side; unable to lift L arm or L
+leg (baseline per patient). Normal strength on R side.  
+PSYCHIATRIC: Pleasant and cooperative. 
+
+DISCHARGE PHYSICAL EXAM
+========================
+Temp: 98.1 PO BP: 125/76 R Lying HR: 101 RR: 18 O2
+sat: 97% O2 delivery: Ra FSBG: 267 
+GENERAL: sitting up in bed, NAD, interactive 
+HEAD: NC/AT, R pupil non-reactive (false eye). L pupil reactive.
+EOMI intact on left side. Oral mucosa w/o lesions, MMM. 
+NECK: JVP normal
+CARDIAC: Tachycardic, irregular rhythm. No m/r/g. 
+RESPIRATORY: Nonlabored breathing, CATB.
+ABDOMEN: Unremarkable inspection, soft, NT. PEG tube in place,
+dressings c/d/I, no erythema or tenderness around site. 
+EXTREMITIES: 1+ pitting edema in left arm and leg, no edema R
+SKIN: Scattered ecchymoses across both arms b/l, no other 
+lesions
+or rashes. 
+NEUROLOGIC: ___ strength on left side; unable to lift L arm or L
+leg (baseline per patient). Normal strength on R side.  
+PSYCHIATRIC: Pleasant and cooperative.
+ 
+
+###RESPONSE: PHYSICAL EXAM {Physical examination procedure}, VS {Vital signs finding}, Temp {Body temperature finding}, BP {Blood pressure finding}, Lying {Lying in bed}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, O2 sat {Oxygen saturation measurement}, RA {Breathing room air}, GENERAL {General examination of patient}, lying in bed {Lying in bed}, NAD {No abnormality detected}, interactive {Does communicate}, HEAD {Physical examination procedure}, NC {Normal head}, R pupil {Structure of pupil of right eye}, non-reactive {No pupillary reaction to light}, false eye {Prosthetic eye in situ}, L pupil {Structure of pupil of left eye}, EOMI {Normal ocular motility}, left {Left eye structure}, Oral
+mucosa {Oral mucous membrane structure}, lesions {Lesion}, MMM {Moist oral mucosa}, NECK {Physical examination procedure}, Supple {Normal movement of neck}, LAD {Lymphadenopathy}, thyromegaly {Goiter}, JVP {Finding of jugular venous pressure}, CARDIAC {Cardiovascular physical examination}, Tachycardic {Tachycardia}, irregular rhytm {Irregular heart beat}, No m/r/g {Heart sounds normal}, RESP {Examination of respiratory system}, RA {Breathing room air}, bibasilar {Structure of base of lung}, mild {Symptom mild}, crackles {Respiratory crackles}, ABDOMEN {Examination of abdomen}, inspection {Inspection}, soft {Abdomen soft}, NT {Abdominal tenderness}, BS {Normal bowel sounds}, organomegaly {Abdominal organomegaly}, erythema {Erythema}, tenderness {Tenderness}, EXTREMITIES {Examination of limb}, edema {Edema}, UE {Upper limb structure}, SKIN {Examination of skin}, ecchymoses {Ecchymosis}, both arms {Both upper arms}, lesions {Lesion}, rashes {Eruption of skin}, NEURO {Neurological examination}, GI {Examination of digestive system}, unable to lift {Unable to lift}, L arm {Structure of left upper limb}, L
+leg {Structure of left lower limb}, baseline {Baseline state}, cooperative {Cooperative mental state}, PHYSICAL EXAM {Physical examination procedure}, Temp {Body temperature finding}, BP {Blood pressure finding}, Lying {Lying in bed}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, O2
+sat {Oxygen saturation measurement}, GENERAL {General examination of patient}, sitting {Sitting position}, NAD {No abnormality detected}, interactive {Does communicate}, HEAD {Physical examination procedure}, NC {Normal head}, R pupil {Structure of pupil of right eye}, non-reactive {No pupillary reaction to light}, (false eye) {Prosthetic eye in situ}, L pupil {Structure of pupil of left eye}, EOMI {Normal ocular motility}, left {Left eye structure}, Oral mucosa {Oral mucous membrane structure}, lesions {Lesion}, MMM {Moist oral mucosa}, NECK {Physical examination procedure}, JVP {Finding of jugular venous pressure}, CARDIAC {Cardiovascular physical examination}, Tachycardic {Tachycardia}, irregular rhythm {Irregular heart beat}, No m/r/g {Heart sounds normal}, RESP {Examination of respiratory system}, RA {Breathing room air}, CATB {Normal breath sounds}, ABDOMEN {Examination of abdomen}, inspection {Inspection}, soft {Abdomen soft}, NT {Abdominal tenderness}, erythema {Erythema}, tenderness {Tenderness}, EXTREMITIES {Examination of limb}, edema {Edema}, left arm {Structure of left upper limb}, leg {Structure of left lower limb}, edema {Edema}, SKIN {Examination of skin}, ecchymoses {Ecchymosis}, both arms {Both upper arms}, lesions {Lesion}, rashes {Eruption of skin}, NEURO {Neurological examination}, GI {Examination of digestive system}, unable to lift {Unable to lift}, L arm {Structure of left upper limb}, L
+leg {Structure of left lower limb}, baseline {Baseline state}, cooperative {Cooperative mental state}"
+"###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
+==============
+___ 10:15AM BLOOD WBC-15.4* RBC-2.27* Hgb-7.6* Hct-24.4* 
+MCV-108* MCH-33.5* MCHC-31.1* RDW-14.1 RDWSD-54.4* Plt ___
+___ 10:15AM BLOOD Neuts-63.3 Lymphs-4.4* Monos-5.6 
+Eos-25.0* Baso-1.1* Im ___ AbsNeut-9.72* AbsLymp-0.67* 
+AbsMono-0.86* AbsEos-3.84* AbsBaso-0.17*
+___ 10:15AM BLOOD ___ PTT-32.9 ___
+___ 07:52PM BLOOD ___ 03:50PM BLOOD Ret Aut-2.4* Abs Ret-0.05
+___ 10:15AM BLOOD Glucose-222* UreaN-107* Creat-3.8*# 
+Na-132* K-6.7* Cl-92* HCO3-26 AnGap-14
+___ 03:50PM BLOOD ALT-23 AST-18 LD(LDH)-178 AlkPhos-190* 
+TotBili-0.2 DirBili-<0.2 IndBili-0.2
+___ 10:15AM BLOOD ___
+___ 10:15AM BLOOD Calcium-9.8 Phos-3.8 Mg-1.8
+___ 03:50PM BLOOD calTIBC-165* Hapto-223* Ferritn-1616* 
+TRF-127*
+___ 03:50PM BLOOD TSH-1.5
+
+TROP TREND:
+___ 10:15AM BLOOD cTropnT-0.56*
+___ 07:52PM BLOOD cTropnT-0.61*
+___ 06:47AM BLOOD cTropnT-0.63*
+___ 05:25PM BLOOD CK-MB-3 cTropnT-0.72*
+___ 07:40AM BLOOD CK-MB-2 cTropnT-0.62*
+
+INR TREND:
+___ 05:08AM BLOOD ___ PTT-36.3 ___
+___ 06:14AM BLOOD ___ PTT-87.1* ___
+___ 07:00AM BLOOD ___ PTT-63.3* ___
+
+INTERVAL LABS
+==============
+___ 05:28AM BLOOD HBsAg-NEG HBsAb-POS HBcAb-NEG
+___ 05:28AM BLOOD HCV Ab-NEG
+___ 06:00PM BLOOD ___ pO2-187* pCO2-42 pH-7.39 
+calTCO2-26 Base XS-0 Comment-GREEN TOP 
+___ 06:00PM BLOOD Lactate-1.9
+
+DISCHARGE LABS
+==============
+___ 05:08AM BLOOD WBC-9.2 RBC-2.40* Hgb-7.8* Hct-25.7* 
+MCV-107* MCH-32.5* MCHC-30.4* RDW-14.6 RDWSD-57.0* Plt ___
+___ 05:08AM BLOOD Glucose-122* UreaN-44* Creat-3.0* Na-141 
+K-4.4 Cl-102 HCO3-26 AnGap-13
+___ 05:08AM BLOOD Calcium-8.9 Phos-4.4 Mg-1.8
+
+MICRO:
+=========
+___ 10:40 am BLOOD CULTURE      2 OF 2. 
+                            **FINAL REPORT ___
+   Blood Culture, Routine (Final ___:    NO GROWTH. 
+
+___ 6:00 pm STOOL     CONSISTENCY: NOT APPLICABLE
+      Source: Stool. 
+                            **FINAL REPORT ___
+   C. difficile PCR (Final ___: 
+      NEGATIVE. 
+           (Reference Range-Negative). 
+      The C. difficile PCR is highly sensitive for toxigenic 
+strains of C.
+      difficile and detects both C. difficile infection (CDI) 
+and
+      asymptomatic carriage. 
+      A negative C. diff PCR test indicates a low likelihood of 
+CDI or
+      carriage. 
+
+___ 7:15 pm MRSA SCREEN      Source: Nasal swab. 
+                            **FINAL REPORT ___
+   MRSA SCREEN (Final ___:    No MRSA isolated. 
+
+RADIOLOGY
+==========
+___ CXR
+IMPRESSION: Interval significant increase in left base 
+consolidation, worrisome for ongoing, worsened pneumonia.  
+Possible small left pleural effusion.  Equivocal new right base 
+opacity. Mild pulmonary vascular congestion without overt 
+pulmonary edema. 
+
+___ LOWER EXTREMITY US:
+IMPRESSION: 
+1. No evidence of acutedeep venous thrombosis in the left lower 
+extremity 
+veins.  A focal area of thickening along the posterior wall of 
+femoral vein could represent chronic changes from the previously 
+treated thrombus. 
+2. Nonspecific subcutaneous edema. 
+
+___:
+CONCLUSION:
+The left atrial volume index is normal. There is mild symmetric 
+left ventricular hypertrophy with a normal
+cavity size. There is normal regional and global left 
+ventricular systolic function. Quantitative biplane left
+ventricular ejection fraction is 58 %. Left ventricular cardiac 
+index is normal (>2.5 L/min/m2). There is
+no resting left ventricular outflow tract gradient. Mildly 
+dilated right ventricular cavity with normal free wall
+motion. The aortic sinus diameter is normal for gender with 
+normal ascending aorta diameter for gender. The
+aortic valve leaflets (3) appear structurally normal. There is 
+no aortic valve stenosis. There is no aortic
+regurgitation. The mitral valve leaflets are mildly thickened 
+with no mitral valve prolapse. There is mild [1+]
+mitral regurgitation. The pulmonic valve leaflets are normal. 
+The tricuspid valve leaflets appear structurally
+normal. There is mild [1+] tricuspid regurgitation. The 
+estimated pulmonary artery systolic pressure is
+normal. There is no pericardial effusion.
+IMPRESSION: Dilated right ventricle. Mild symmetric left 
+ventricular hypertrophy with normal
+cavity size and regional/global biventricular systolic function. 
+mild mitral and tricuspid
+regurgitation.
+Compared with the prior TTE (images not available for review) of 
+___ , the left ventricular systolic
+function appears to have improved.
+
+___ CTA CHEST 
+IMPRESSION: 
+1. No evidence of pulmonary embolism or aortic abnormality. 
+2. Multifocal pulmonary opacities in bilateral lungs have 
+progressed compared to ___ concerning for progression 
+of pneumonia. 
+3. Small to moderate bilateral pleural effusions. 
+
+___ G-J REMOVAL:
+IMPRESSION:  
+Technically successful gastrojejunostomy tube removal and T 
+fastener button removal.
+RECOMMENDATION(S):  Please re-consult interventional radiology 
+if there is 
+further need for enteral access in the future.  The gastrostomy 
+site may leak for the next few days while the site closes. 
+
+ 
+
+###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}, PTT {Partial thromboplastin time, activated}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, LDH {Serum lactate dehydrogenase level above reference range}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, TSH {Thyroid stimulating hormone measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, PTT {Partial thromboplastin time, activated}, PTT {Partial thromboplastin time, activated}, PTT {Partial thromboplastin time, activated}, HCV {Viral hepatitis type C}, pH {pH 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}, BLOOD 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}, BLOOD CULTURE {Blood culture}, Blood Culture {Blood culture}, CONSISTENCY {Finding of consistency of stool}, asymptomatic {Asymptomatic}, MRSA SCREEN {Multi-resistant staphylococcus aureus screening}, Nasal {Nasal structure}, MRSA SCREEN {Multi-resistant staphylococcus aureus screening}, MRSA {Methicillin resistant Staphylococcus aureus infection}, CXR {Plain chest X-ray}, left base 
+consolidation {Lung consolidation}, pneumonia {Pneumonia}, left {Left lung structure}, pleural effusion {Pleural effusion}, right base {Structure of base of right lung}, opacity {Abnormally opaque structure}, Mild {Symptom mild}, pulmonary vascular {Structure of pulmonary blood vessel}, congestion {Congestion}, pulmonary edema {Pulmonary edema}, No evidence {No abnormality detected}, acutedeep venous thrombosis {Acute deep venous thrombosis}, left lower 
+extremity 
+veins {Structure of vein of left lower limb}, thickening {Increased thickness}, femoral vein {Femoral vein structure}, chronic {Chronic disease}, thrombus {Thrombus}, subcutaneous {Subcutaneous tissue structure of lower extremity}, edema {Edema}, left atrial {Left atrial structure}, volume index is normal {Normal size cardiac chamber}, mild symmetric 
+left ventricular hypertrophy {Mild left ventricular hypertrophy}, normal
+cavity {Normal size cardiac chamber}, normal regional and global left 
+ventricular systolic function {Echocardiogram shows normal left ventricular function}, left
+ventricular {Left cardiac ventricular structure}, Left ventricular {Left cardiac ventricular structure}, cardiac 
+index is normal {Normal cardiac index}, left ventricular outflow tract {Structure of outflow tract of left ventricle}, dilated {Dilatation}, right ventricular cavity {Structure of cavity of right cardiac ventricle}, free wall
+motion {Normal ventricular wall motion}, aortic sinus {Structure of sinus of Valsalva}, ascending aorta {Ascending aorta structure}, aortic valve leaflets {Structure of cardiac valve leaflet}, structurally normal {Aortic valve normal}, aortic valve stenosis {Aortic valve stenosis}, aortic
+regurgitation {Aortic valve regurgitation}, mitral valve leaflets are mildly thickened {Thickened mitral leaflet}, mitral valve prolapse {Mitral valve prolapse}, mild [1+]
+mitral regurgitation {Mild mitral valve regurgitation}, pulmonic valve leaflets {Structure of cusp of pulmonic valve}, normal {No abnormality detected}, tricuspid valve leaflets appear structurally
+normal {Tricuspid valve normal}, mild [1+] tricuspid regurgitation {Mild tricuspid valve regurgitation}, pulmonary artery {Pulmonary artery structure}, systolic pressure is
+normal {Normal systolic arterial pressure}, pericardial effusion {Pericardial effusion}, Dilated {Dilatation}, right ventricle {Right cardiac ventricular structure}, Mild symmetric left 
+ventricular hypertrophy {Mild left ventricular hypertrophy}, normal
+cavity {Normal size cardiac chamber}, biventricular {Cardiac ventricular structure}, systolic function {Normal left ventricular systolic function and wall motion}, mild mitral {Mild mitral valve regurgitation}, tricuspid
+regurgitation {Tricuspid valve regurgitation}, TTE {Transthoracic echocardiography}, left ventricular systolic
+function {Normal left ventricular systolic function and wall motion}, improved {Patient's condition improved}, CTA CHEST {Computed tomography of chest}, No evidence {No abnormality detected}, pulmonary embolism {Pulmonary embolism}, aortic {Aortic structure}, abnormality {No abnormality detected}, pulmonary {Lung structure}, opacities {Abnormally opaque structure}, lungs {Lung structure}, pneumonia {Pneumonia}, bilateral pleural effusions {Bilateral pleural effusion}, l gastrojejunostomy tube removal {Removal of gastrojejunostomy tube using fluoroscopic guidance}, removal {Removal}, gastrostomy {Gastrostomy}, leak {Anastomosis, leaking}"
+"###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:
+SUMMARY STATEMENT
+=========================================================
+___ chronically-ill male with T1DM, ESRD on HD, bilateral ___ 
+DVT
+s/p IVC filter ___ and on warfarin, L non-occlusive jugular
+thrombus (___), R thalamic bleed in the setting of HTN
+emergency w/ residual L hemiparesis (___), and recent
+admission from ___ for MRSA bacteremia ___ PNA on 
+vancomycin
+with HD sessions (scheduled course through ___, who presents
+from rehab with a 25-lb weight gain and worsening ___ edema on 
+___.
+
+ACTIVE ISSUES
+=========================================================
+# Dysphagia, s/p G-J tube placement ___
+# Severe Protein Calorie Nutrition
+Patient noted to have high aspiration risk over course for last
+hospitalization, but decided to accept risks and trial pureed 
+solids with nectar-thick liquids during prior hospitalization. 
+Patient's G-J tube became clogged during admission. As patient 
+was maintaining good PO intake and eating food was important to 
+patient's GOC, the clogged G-J tube was pulled ___. On 
+discharge, patient was eating solid diet.
+
+# ESRD on HD, secondary to T1D 
+Pre-admission HD sessions at facility were reported to have been 
+limited by hypotension and tachycardia, and with an inability to 
+increase UF as a result. Here, patient received hemodialysis 
+through admission with ultrafiltration to remove excess volume. 
+Repeat Echo showed recovered EF at 58%. By ___ patient did 
+not appear volume overloaded on clinical exam. 
+
+# HF w recovered EF (EF 45% ___ 
+# Elevated troponins 
+Patient presented with volume overload and elevated proBNP, 
+consistent with HF exacerbation. Patient's discharge weight was 
+66.3kg, and reported dry weight is 63kg. Admission weight was 
+74.3kg. EKG w/o new ischemic changes, despite mild trop 
+elevation. Infectious workup negative, other than ongoing 
+aspiration. While here, a repeat Echo showed a recovered EF at 
+58%. His metoprolol was uptitrated for better rate control, and 
+his atorvastatin was continued. 
+
+# Pneumonia 
+# Recent MRSA Bacteremia 
+# Leukocytosis
+Patient had recent admission from ___ for MRSA bacteremia
+___ PNA, and has been dosed with vancomycin with HD sessions
+(scheduled course through ___. He presented with increased 
+leukocytosis, and CXR consistent with worsened bilateral 
+pneumonia, likely secondary to aspiration. He received a few 
+days of broad spectrum treatment, prior to return to his 
+original Vancomycin course. Vancomycin was transitioned to 
+linezolid ___, as vancomycin may have been contributing to 
+eosinophilia (3.84 on admission). All antibiotics were stopped 
+on day of discharge (___) as patient had completed course 
+for hospital associated pneumonia.
+
+# Anemia 
+Hgb notably below baseline; 7.6 on admission, from discharge Hgb 
+of 8.3. Had Hgb drop from 7.6 to 6.5 on ___. Anemia likely 
+multifactorial, including acute suppression iso infection, and 
+anemia of chronic disease from ESRD. Less likely GI bleed, as 
+patient has had no complaints of melena or BRBPR. Patient was 
+transfused for Hgb < 7 throughout admission. Hb was 7.8 at 
+discharge.
+
+# T1DM
+Patient has very brittle T1DM, and presented in DKA on recent 
+admission in ___. He is very sensitive to insulin and has had 
+hypoglycemic episodes in the past. He was continued on home 
+glargine 7U with Q6H insulin sliding scale for tube feeds on 
+admission. He was transitioned to glargine 8U and insulin lispro 
+2U with meals after he began to eat meals. He was discharge on 
+glargine 8U with lispro 2U at meals.
+
+# Hypoxia (resolved) 
+Had new 2L O2 requirement in ED, after satting in low ___ on RA.
+Most likely volume overload iso vs progression of pneumonia.
+Resolved by time of arrival to floor. 
+
+# Goals of Care 
+A family meeting was held in which patient's family expressed a 
+clear understanding that patient was seriously ill and that 
+DNR/DNI status was consistent with the patient's goals. He 
+himself confirmed these wishes to his providers as well. At end 
+of hospitalization, patient filled out MOLST with DNR/DNI 
+status. He would like to keep eating for comfort and understands 
+the risks of aspiration and death. 
+
+CHRONIC ISSUES
+=========================================================
+# Atrial Fibrillation and tachycardia
+Patient presented with HR in 120s. Patient's home metoprolol 
+dose was increased from 25mg q6h to 50 mg q6h.
+
+# History of VTE
+Complicated coagulation history. Patient had bilateral ___ DVT 
+s/p IVC 
+filter ___, L non-occlusive jugular thrombus (___), R 
+thalamic bleed in the setting of HTN emergency w/ residual L 
+hemiparesis (___). Patient was briefly subtherapeutic, and 
+therefore bridged with a heparin gtt until therapeutic again. 
+Patient was discharged on home dose of warfarin 2.5 mg with 
+therapeutic INR of 2.5 at discharge. 
+
+# GERD: 
+Home Pantoprazole 40 mg PO Q12H was continued.
+
+# Mood: 
+Home mirtazapine 15 mg PO QHS was continued. Sertraline 25 mg PO 
+DAILY were held while patient was receiving Linezolid due to 
+risk of serotonin syndrome. 
+
+TRANSITIONAL ISSUES
+=========================================================
+#MRSA bacteremia s/p treatment
+[ ] Surveillance blood cultures after HD on ___
+
+#Hypertension
+[ ] Uptitrate lisinopril as tolerated to goal SBP <130/80.
+
+#Atrial fibrillation:
+[ ] Uptitrated metoprolol to 50mg q6h while inpatient. If 
+requires further rate control, could add diltiazem or consider 
+amiodarone, with discussion with cardiologist.
+[ ] Can consolidate Metop tartrate into Metop Succinate 200mg 
+daily if tolerating well. 
+
+#Diabetes mellitus
+[ ] Insulin dose was increased to 8U glargine at baseline, 2U 
+short-acting with meals, and sliding scale. Please titrate as 
+needed.
+
+#Depression:
+[ ] Holding sertraline due to interaction w Linezolid (risk of 
+serotonin syndrome) until ___, then ok to restart.
+
+CODE: DNR/DNI
+CONTACT: ___ 
+Relationship: wife 
+Phone number: ___ 
+
+The total time spent today on discharge planning, counseling and 
+coordination of care today was greater than 30 minutes.
+ 
+
+###RESPONSE: T1DM {Diabetes mellitus type 1}, ESRD on HD {End stage renal failure on dialysis}, DVT {Deep venous thrombosis}, IVC filter {Inferior vena cava filter in situ}, on warfarin {Warfarin therapy}, L non-occlusive jugular {Structure of left jugular vein}, thrombus {Thrombus}, thalamic {Thalamic structure}, bleed {Bleeding}, HTN
+emergency {Hypertensive emergency}, L hemiparesis {Left hemiparesis}, MRSA bacteremia {Bacteremia caused by Methicillin resistant Staphylococcus aureus}, PNA {Pneumonia}, vancomycin {Antibiotic therapy}, HD {Hemodialysis}, weight gain {Weight gain}, edema {Edema}, Dysphagia {Dysphagia}, placement {Implantation procedure}, Severe Protein Calorie Nutrition {Severe protein-calorie malnutrition (Gomez: less than 60 percent of standard weight)}, aspiration risk {At increased risk for aspiration}, nectar-thick liquids {Dietary liquid consistency - nectar thick liquid}, good PO intake and eating food {Eating normal}, diet {Normal diet}, ESRD on HD {End stage renal failure on dialysis}, T1D {Diabetes mellitus type 1}, HD {Hemodialysis}, hypotension {Low blood pressure}, tachycardia {Tachycardia}, hemodialysis {Hemodialysis}, ultrafiltration {Ultrafiltration}, excess volume. {Hypervolemia}, Echo {Echocardiography}, volume overloaded {Hypervolemia}, exam {Physical examination procedure}, Elevated troponins {Troponin I above reference range}, volume overload {Hypervolemia}, HF exacerbation {Exacerbation of congestive heart failure}, weight {Weight finding}, weight {Weight finding}, weight {Weight finding}, EKG {Electrocardiographic procedure}, ischemic changes {Electrocardiographic myocardial ischemia}, Infectious {Infectious disease}, workup {Evaluation procedure}, aspiration {Aspiration pneumonia}, Echo {Echocardiography}, Pneumonia {Pneumonia}, MRSA Bacteremia {Bacteremia caused by Methicillin resistant Staphylococcus aureus}, Leukocytosis {Leukocytosis}, MRSA bacteremia {Bacteremia caused by Methicillin resistant Staphylococcus aureus}, PNA {Pneumonia}, vancomycin {Antibiotic therapy}, HD {Hemodialysis}, leukocytosis {Leukocytosis}, CXR {Plain chest X-ray}, bilateral 
+pneumonia {Bilateral pneumonia}, aspiration {Pulmonary aspiration}, Vancomycin {Antibiotic therapy}, Vancomycin {Antibiotic therapy}, vancomycin {Antibiotic therapy}, eosinophilia {Eosinophil count above reference range}, antibiotics {Antibiotic therapy}, hospital associated pneumonia {Nosocomial pneumonia}, Anemia {Anemia}, Hgb notably below baseline; {Hemoglobin below reference range}, Hgb {Measurement of total hemoglobin concentration}, Hgb {Measurement of total hemoglobin concentration}, Anemia {Anemia}, infection {Infectious disease}, anemia of chronic disease {Anemia of chronic disorder}, ESRD {End-stage renal disease}, GI bleed {Gastrointestinal hemorrhage}, no complaints {No complaints}, melena {Melena}, BRBPR {Hematochezia}, Hgb {Measurement of total hemoglobin concentration}, T1DM {Diabetes mellitus type 1}, T1DM {Diabetes mellitus type 1}, DKA {Ketoacidosis due to diabetes mellitus}, hypoglycemic {Hypoglycemia}, insulin sliding scale {Sliding scale insulin regime}, Hypoxia {Hypoxia}, resolved {Problem resolved}, satting {Finding of oxygen saturation}, RA {Breathing room air}, volume overload {Hypervolemia}, pneumonia {Pneumonia}, Resolved {Problem resolved}, meeting {Meetings}, DNR {Not for resuscitation}, DNR {Not for resuscitation}, aspiration {Pulmonary aspiration}, death {Dead}, Atrial Fibrillation {Atrial fibrillation}, tachycardia {Tachycardia}, HR {Finding of heart rate}, VTE {Thromboembolism of vein}, coagulation {Coagulation}, DVT {Deep venous thrombosis}, IVC 
+filter ___, {Inferior vena cava filter in situ}, thrombus {Thrombus}, thalamic {Thalamic structure}, bleed {Bleeding}, HTN emergency {Hypertensive emergency}, L 
+hemiparesis {Left hemiparesis}, heparin {Heparin therapy}, GERD {Gastroesophageal reflux disease}, serotonin syndrome {Serotonin syndrome}, MRSA bacteremia {Bacteremia caused by Methicillin resistant Staphylococcus aureus}, Surveillance blood cultures {Infection surveillance}, HD {Hemodialysis}, Hypertension {Hypertensive disorder, systemic arterial}, discussion {Discussion}, Diabetes mellitus {Diabetes mellitus}, baseline {Baseline state}, sliding scale {Sliding scale insulin regime}, serotonin syndrome {Serotonin syndrome}, DNR {Not for resuscitation}, discharge planning {Discharge planning}, counseling {Counseling}"
+"###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. Atorvastatin 40 mg PO QPM 
+2. Nephrocaps 1 CAP PO DAILY 
+3. Sertraline 25 mg PO DAILY 
+4. sevelamer CARBONATE 800 mg PO TID W/MEALS 
+5. Warfarin 2.5 mg PO DAILY16 
+6. Metoprolol Succinate XL 50 mg PO BID 
+7. Pantoprazole 40 mg PO Q12H 
+___  MD to order daily dose IV HD PROTOCOL 
+9. melatonin 6 mg oral QHS 
+10. Mirtazapine 15 mg PO QHS 
+11. Sucralfate 1 gm PO QID 
+12. Docusate Sodium 100 mg PO BID:PRN Constipation - First Line 
+13. ProMod Protein (protein supplement) 30 cc oral QID 
+14. Acetaminophen 650 mg PO Q6H:PRN Pain - Mild/Fever 
+15. Senna 17.2 mg PO BID:PRN Constipation - First Line 
+16. Glargine 7 Units Breakfast
+Insulin SC Sliding Scale using HUM Insulin
+17. Bisacodyl ___VERY OTHER DAY 
+
+ 
+Discharge Medications:
+1.  Lisinopril 2.5 mg PO DAILY  
+2.  Metoprolol Tartrate 50 mg PO Q6H  
+3.  Miconazole Powder 2% 1 Appl TP BID rash  
+4.  Ramelteon 8 mg PO QHS:PRN insomnia  
+5.  Sarna Lotion 1 Appl TP TID:PRN dry skin  
+6.  Glargine 8 Units Breakfast
+Humalog 2 Units Breakfast
+Humalog 2 Units Lunch
+Humalog 2 Units Dinner
+Insulin SC Sliding Scale using HUM Insulin 
+7.  Acetaminophen 650 mg PO Q6H:PRN Pain - Mild/Fever  
+8.  Atorvastatin 40 mg PO QPM  
+9.  Bisacodyl ___VERY OTHER DAY  
+10.  Docusate Sodium 100 mg PO BID:PRN Constipation - First Line 
+ 
+11.  melatonin 6 mg oral QHS  
+12.  Mirtazapine 15 mg PO QHS  
+13.  Nephrocaps 1 CAP PO DAILY  
+14.  Pantoprazole 40 mg PO Q12H  
+15.  ProMod Protein (protein supplement) 30 cc oral QID  
+16.  Senna 17.2 mg PO BID:PRN Constipation - First Line  
+17.  sevelamer CARBONATE 800 mg PO TID W/MEALS  
+18.  Sucralfate 1 gm PO QID  
+19.  Warfarin 2.5 mg PO DAILY16  
+20. HELD- Sertraline 25 mg PO DAILY  This medication was held. 
+Do not restart Sertraline until ___
+
+ 
+
+###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:
+End stage renal disease
+Pneumonia
+Heart failure with reduced ejection fraction
+Anemia
+Leukocytosis
+Type 1 Diabetes
+Dysphagia
+Hypoxia
+Atrial fibrillation
+Deep vein thrombosis
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Out of Bed with assistance to chair or 
+wheelchair.
+
+ 
+
+###RESPONSE: End stage renal disease {End-stage renal disease}, Pneumonia {Pneumonia}, Heart failure with reduced ejection fraction {Heart failure with reduced ejection fraction}, Anemia {Anemia}, Leukocytosis {Leukocytosis}, Type 1 Diabetes {Diabetes mellitus type 1}, Dysphagia {Dysphagia}, Hypoxia {Hypoxia}, Atrial fibrillation {Atrial fibrillation}, Deep vein thrombosis {Deep venous thrombosis}, 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}, Out of Bed with assistance {Difficulty getting off a bed}"
+"###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:
+======================  
+DISCHARGE INSTRUCTIONS  
+======================  
+Dear Mr. ___,
+It was a pleasure caring for you at ___ 
+___.
+
+WHY WAS I IN THE HOSPITAL?  
+- You came to the hospital from rehab because you had gained 25 
+pounds of fluid and developed swelling in your legs. 
+
+WHAT HAPPENED TO ME IN THE HOSPITAL?  
+- When you came to the hospital you were found to have symptoms 
+and signs on an infection in your lung, likely related to 
+swallowing food into your lungs. You underwent dialysis in the 
+hospital to remove fluid from your body. You also received 
+antibiotics to treat the infection in your lung. We removed your 
+feeding tube because you preferred to eat food, even with the 
+increased risk of infections in your lungs.
+
+WHAT SHOULD I DO AFTER I LEAVE THE HOSPITAL?
+- Continue to take all your medicines and keep your 
+appointments.
+
+We wish you the best!
+ 
+
+###RESPONSE: swelling {Swelling}, legs {Lower limb structure}, signs {Sign}, infection {Infectious disease}, lung {Metastatic malignant neoplasm to lung}, lungs {Lung structure}, dialysis {Dialysis procedure}, antibiotics {Antibiotic therapy}, infection {Infectious disease}, lung {Lung structure}, removed {Removal}, infections {Local infection of wound}, lungs {Examination of respiratory system}"
+"###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: 
+Vicodin
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Elevated creatinine
+.
+ 
+Major Surgical or Invasive Procedure:
+None
+.
+ 
+
+###RESPONSE: Elevated creatinine {Serum creatinine above reference range}"
+"###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:
+___ yo M hx etoh cirrhosis who presented yesterday to liver 
+clinic for second opinion. He was diagnosed with cirrhosis in 
+___, course complicated by variceal bleeding, ascites. On blood 
+work yesterday noted to have elevated Cr to 2.8, no prior 
+knowledge of renal insufficiency admitted today for further 
+evaluation.
+Pt has had a sore threat starting 5 d PTA associated with cough 
+productive of yellow sputum. No fever, chills, dyspnea. +Nausea 
+and vomiting about twice daily for 5 days, poor appetite. Urine 
+output unchanged. No abdominal pain, diarrhea. + sick contact, 
+wife had URI with sore throat and cough last week, now resolved.
+.
+ 
+
+###RESPONSE: etoh cirrhosis {Alcoholic cirrhosis}, liver {Disorder of liver}, cirrhosis {Cirrhosis of liver}, variceal bleeding {Bleeding esophageal varices}, ascites {Ascites}, elevated {Elevation}, Cr {Finding of creatinine level}, renal insufficiency {Renal insufficiency}, evaluation {Evaluation procedure}, sore {Soreness}, cough 
+productive of yellow sputum {Productive cough-yellow sputum}, fever {Fever}, chills {Chill}, dyspnea {Dyspnea}, Nausea 
+and vomiting {Nausea and vomiting}, poor appetite {Decrease in appetite}, Urine 
+output unchanged {Normal urinary stream}, diarrhea {Diarrhea}, sick {Illness}, URI {Upper respiratory infection}, sore throat {Sore throat}, cough {Cough}, 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: Past Medical History:
+Etoh cirrhosis, diagnosed in ___
+- hx variceal bleeding in ___, controlled with medications
+- hx ascites requiring periodic paracenteses
+Hx sepsis from dog bite in ___ c/b multiorgan failure
+L4-5 spinal fusion ___ at ___
+hx heart murmur, last echo at ___ 2 weeks ago
+HTN
+Hypercholesterolemia
+hx aortic aneurysm, stable for last ___ yrs
+.
+ 
+
+###RESPONSE: Etoh cirrhosis {Alcoholic cirrhosis}, variceal bleeding {Bleeding esophageal varices}, ascites {Ascites}, paracenteses {Abdominal paracentesis}, sepsis {Sepsis}, dog bite {Dog bite - wound}, multiorgan failure {Multiple organ failure}, spinal fusion {Spinal arthrodesis}, heart murmur {Heart murmur}, echo {Echocardiography}, HTN {Hypertensive disorder, systemic arterial}, Hypercholesterolemia {Hypercholesterolemia}, aortic aneurysm {Aortic aneurysm}, stable {Patient's condition stable}"
+"###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 CABG in ___, father and paternal grandmother with 
+leukemia, uncle with unknown liver problem. No hx pulmonary 
+disease, diabetes, stroke.
+.
+ 
+
+###RESPONSE: CABG {Coronary artery bypass grafting}, leukemia {Leukemia}, liver problem {Liver problem}, pulmonary 
+disease {Disorder of lung}, diabetes {Diabetes mellitus}, stroke {Cerebrovascular accident}"
+"###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:
+VS: T 972, BP 119/72, HR 66, RR 16, O2 sat 98% on RA
+Gen: pleasant male, ill appearing, no acute distress, AOx3, NAD
+HEENT: anicteric, MM dry, clear nasal discharge
+Neck: no JVD
+Resp: good air movement bilaterall, scaterred coarse ronchi 
+which improve with coughing, no wheezing
+CV: RRR, nl s1, s2, III/VI systolic murmur over apex, radiates 
+into abdomen
+Abd: +BS, soft, ND, NT, no HSM, + ascites, not tense
+Extr: warm, no edema, 2+ distal pulses
+Neuro: minimal asterixis, moves all exremities, no sensory 
+deficits
+.
+ 
+
+###RESPONSE: VS {Vital signs finding}, T {Body temperature finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, O2 sat {Oxygen saturation measurement}, RA {Breathing room air}, Gen {General examination of patient}, ill appearing {Looks ill}, distress {Distress}, AOx3 {Oriented to person, time and place}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, anicteric {White sclera}, MM dry {Mucous membrane dryness}, clear {Normal breath sounds}, nasal discharge {Nasal discharge}, Neck {Physical examination procedure}, JVD {Jugular venous engorgement}, Resp {Examination of respiratory system}, good {No abnormality detected}, ronchi {Wheeze - rhonchi}, coughing {Cough}, wheezing {Wheezing}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, nl s1, s2 {Heart sounds normal}, murmur {Murmur}, apex {Structure of apex of heart}, abdomen {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, Abd {Examination of abdomen}, BS {Normal bowel sounds}, soft {Abdomen soft}, ND {Swollen abdomen}, NT {Abdominal tenderness}, HSM {Hepatosplenomegaly}, ascites {Ascites}, tense {Shoulder stiff}, Extr {Examination of limb}, warm {Warm skin}, edema {Edema}, 2+ distal pulses {Peripheral pulses normal}, Neuro {Neurological examination}, asterixis {Asterixis}, moves all exremities {Does move all four limbs}, sensory 
+deficits {Sensory disability}"
+"###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:
+PERTINENT LABS:
+
+___ 04:20PM BLOOD WBC-8.1 RBC-4.06* Hgb-13.9* Hct-42.7 
+MCV-105* MCH-34.4* MCHC-32.7 RDW-13.4 Plt ___
+___ 05:10AM BLOOD WBC-7.5 RBC-3.32* Hgb-11.1* Hct-33.5* 
+MCV-101* MCH-33.6* MCHC-33.3 RDW-14.3 Plt ___
+___ 09:20PM BLOOD Neuts-77.3* Lymphs-11.1* Monos-7.5 
+Eos-3.9 Baso-0.3
+___ 04:20PM BLOOD ___ PTT-38.1* ___
+___ 04:20PM BLOOD UreaN-27* Creat-2.8* Na-134 K-5.6* Cl-102 
+HCO3-24 AnGap-14
+___ 04:20PM BLOOD ALT-37 AST-66* AlkPhos-227* TotBili-2.3*
+___ 04:20PM BLOOD TotProt-7.9 Albumin-2.9* Globuln-5.0*
+___ 05:45AM BLOOD Hapto-65
+___ 04:20PM BLOOD TSH-3.7
+___ 04:20PM BLOOD HBsAg-NEGATIVE HBsAb-NEGATIVE 
+HBcAb-NEGATIVE IgM HAV-NEGATIVE
+___:20PM BLOOD AFP-3.6
+___ 08:16PM URINE Color-Amber Appear-Hazy Sp ___
+___ 08:16PM URINE Blood-LG Nitrite-NEG Protein-TR 
+Glucose-NEG Ketone-NEG Bilirub-SM Urobiln-1 pH-5.0 Leuks-NEG
+___ 08:16PM URINE ___ Bacteri-FEW Yeast-NONE 
+___ 08:16PM URINE ___ 08:16PM URINE Eos-POSITIVE  
+___ 08:12AM URINE Hours-RANDOM UreaN-539 Creat-133 Na-35 
+TotProt-48 Prot/Cr-0.4*
+.
+MICRO DATA:
+URINE CX (___): negative
+.
+STUDIES:
+CXR (___): The suggestion of a small region of increased 
+radiopacity in the left mid lung at the level of the anterior 
+fourth rib, may correspond to a similar abnormality on the 
+lateral view projecting over the posterior aspect of the mid 
+thoracic spine. This could be a superimposition of normal 
+shadows or alternatively a very small focus of consolidation in 
+the left lung. Lungs are otherwise clear. There is no pleural 
+effusion or evidence of central adenopathy. Oblique chest views 
+might be helpful in determining whether the abnormality is real.
+.
+ABDOMINAL ULTRASOUND WITH DOPPLER (___): 
+1. Echogenic micronodular liver with no focal abnormalities 
+identified.
+2. Reverse flow in the right portal vein up into the left portal 
+vein. Patent umbilical vein.
+3. Single small gallstone with no signs of cholecystitis.
+4. Large amount of ascites.
+5. No hydronephrosis.
+.
+ 
+
+###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}, 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}, Baso {Basophil count}, PTT {Partial thromboplastin time, activated}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, AnGap {Anion gap measurement}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, Albumin {Albumin measurement}, TSH {Thyroid stimulating hormone measurement}, HBsAg-NEGATIVE {Hepatitis B surface antigen not detected}, NEGATIVE {No abnormality detected}, NEGATIVE {No abnormality detected}, NEGATIVE {No abnormality detected}, AFP {Alpha-1-Fetoprotein measurement}, URINE {Urine culture}, Color {Color finding}, URINE Blood {Urine blood test}, Ketone {Urinalysis, acetone or ketone bodies measurement}, pH {pH measurement}, URINE {Urine culture}, URINE {Urine culture}, URINE {Urine culture}, POSITIVE {Detected by cytology}, URINE {Urine culture}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, URINE CX {Urine culture}, negative {No abnormality detected}, CXR {Plain chest X-ray}, left {Left lung structure}, lung {Lung structure}, fourth rib {Bone structure of fourth rib}, lateral {Diagnostic radiography of chest, lateral}, thoracic spine {Structure of thoracic vertebral column}, superimposition {Superimposition}, normal {No abnormality detected}, shadows {Shadow}, consolidation {Consolidation}, left lung {Left lung structure}, Lungs {Lung structure}, clear {Normal breath sounds}, pleural 
+effusion {Pleural effusion}, adenopathy {Lymphadenopathy}, Oblique {Fracture, oblique}, chest {Plain chest X-ray}, abnormality {No abnormality detected}, ABDOMINAL ULTRASOUND {Ultrasonography of abdomen}, liver {Liver structure}, abnormalities {No abnormality detected}, right portal vein {Structure of right main branch of portal vein}, left portal 
+vein {Structure of left main branch of portal vein}, umbilical vein {Structure of umbilical vein}, gallstone {Gallbladder calculus}, signs {Sign}, cholecystitis {Cholecystitis}, ascites {Ascites}, hydronephrosis {Hydronephrosis}"
+"###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 man with EtOH cirrhosis admitted with elevated 
+creatinine.
+.
+# Acute renal failure - Creatinine was 3.1 on admission. No 
+known history of kidney disease and PCP records showed that his 
+creatinine had been 1.1 a few months ago. Diuretics were held. 
+He received albumin and a fluid challenge overnight when he was 
+admitted without any significant effect. Started midodrine and 
+octreotide as well as daily albumin in case hepatorenal was 
+playing a role. No new meds. No signs of obstruction and no 
+hydronephrosis on ultrasound. Renal was consulted. Urine 
+sediment with acanthocytes and possibly a couple red cell casts. 
+UA with small amount of hematuria ___ RBC, ___ RBC on 
+repeat). The renal team felt that his renal failure was likely 
+due to renal hypoperfusion (could even be HRS) from combination 
+of cirrhosis and aortic stenosis, with multiple recent large 
+volume paracenteses. ___ also have underlying IgA nephropathy 
+given proteinuria. Hep B/C serologies negative so not likely a 
+GN related to those. Creatinine remained stable and he was 
+discharged with the plan to follow-up with Renal as an 
+outpatient for biopsy and further evaluation.
+.
+# Cough - Association with sore throat, rhinorrhea, similar sick 
+contacts symptoms made a viral URI most likely. He remained 
+afebrile without leukocytosis. A very small opacity in left lung 
+was noted on CXR however given bacterial pneumonia was felt 
+unlikely, he was not treated with antibiotics.
+.
+# Alcoholic Cirrhosis - Complicated by varices and recurrent 
+ascites requiring large volume paracentesis. MELD 25. Most 
+recent paracentesis on ___ with 9L removed, did not receive 
+albumin. Diuretics were held as above for renal failure. 
+Continued nadolol, MVI, folate. Discontinued lactulose as 
+patient has no history of encephalopathy.
+.
+# HTN - Continued amlodipine.
+.
+# Hypercholesterolemia - Continued statin.
+.
+# Full code
+ 
+
+###RESPONSE: EtOH cirrhosis {Alcoholic cirrhosis}, elevated 
+creatinine {Serum creatinine above reference range}, Acute renal failure {Acute kidney injury}, Creatinine {Creatinine measurement}, creatinine {Creatinine measurement}, Diuretics {Diuretic therapy}, received albumin {Administration of albumin}, fluid {Administration of intravenous fluids}, albumin {Administration of albumin}, signs {Sign}, obstruction {Obstruction}, hydronephrosis {Hydronephrosis}, ultrasound {Ultrasonography}, Renal {Kidney structure}, Urine {Urine culture}, cell casts {Cellular casts}, hematuria {Blood in urine}, RBC {Red blood cell count}, RBC {Red blood cell count}, renal failure {Renal failure syndrome}, renal {Kidney structure}, HRS {Hepatorenal syndrome}, cirrhosis {Cirrhosis of liver}, aortic stenosis {Aortic valve stenosis}, paracenteses {Abdominal paracentesis}, IgA nephropathy {Immunoglobulin A nephropathy}, proteinuria {Proteinuria}, Hep B {Viral hepatitis type B}, negative {No abnormality detected}, Creatinine {Creatinine measurement}, stable {Patient's condition stable}, biopsy {Biopsy}, evaluation {Evaluation procedure}, Cough {Cough}, sore throat {Sore throat}, rhinorrhea {Nasal discharge}, sick {Illness}, viral {Viral disease}, URI {Upper respiratory infection}, afebrile {Fever}, leukocytosis {Leukocytosis}, opacity {Abnormally opaque structure}, left lung {Left lung structure}, CXR {Plain chest X-ray}, bacterial pneumonia {Bacterial pneumonia}, treated with antibiotics {Antibiotic therapy}, Alcoholic Cirrhosis {Alcoholic cirrhosis}, varices {Esophageal varices}, ascites {Ascites}, paracentesis {Abdominal paracentesis}, paracentesis {Centesis}, removed {Drainage of ascites}, albumin {Administration of albumin}, Diuretics {Diuretic therapy}, renal failure {Renal failure syndrome}, encephalopathy {Disorder of brain}, HTN {Hypertensive disorder, systemic arterial}, Hypercholesterolemia {Hypercholesterolemia}"
+"###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:
+Amlodipine 5mg daily
+Nadolol 80mg daily
+Protonix 40mg bid
+Folic acid 1mg daily
+Lipitor 20mg daily
+Lactulose 3tsp BID
+Spironolactone 50mg BID
+.
+
+###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: vicodin - itchy
+.
+ 
+Discharge Medications:
+1. Amlodipine 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+
+2. Nadolol 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+3. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One 
+(1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours).  
+4. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+
+5. Atorvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+6. Hexavitamin     Tablet Sig: One (1) Cap PO DAILY (Daily).  
+.
+ 
+
+###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: Acute renal failure
+.
+Secondary: EtOH cirrhosis, hypertension, hypercholesterolemia
+.
+ 
+Discharge Condition:
+Stable.
+.
+ 
+
+###RESPONSE: Acute renal failure {Acute kidney injury}, EtOH cirrhosis {Alcoholic cirrhosis}, hypertension {Hypertensive disorder, systemic arterial}, hypercholesterolemia {Hypercholesterolemia}, Stable {Patient's condition stable}"
+"###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 to the hospital for evaluation and treatment 
+of kidney failure. Several labs were sent to work up your kidney 
+failure; these were still pending at time of discharge. You will 
+need to have a biopsy of your kidney to help make a diagnosis. 
+.
+You will have to follow up with the nephrologists next week for 
+your biopsy. 
+.
+If you develop a tense swollen abdomen, confusion, fevers>101, 
+shortness of breath, chest pain, or other symptoms that are 
+concerning to you, you should return to the emergency room.
+.
+ 
+
+###RESPONSE: evaluation {Evaluation procedure}, kidney failure {Renal failure syndrome}, kidney 
+failure {Renal failure syndrome}, biopsy {Biopsy}, biopsy {Biopsy}, tense {Feeling tense}, swollen abdomen {Swollen abdomen}, confusion {Clouded consciousness}, fevers {Fever}, shortness of breath {Dyspnea}, chest pain {Chest pain}, return to the emergency room {Emergency treatment management}"
+"###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: 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: 
+Sulfa (Sulfonamide Antibiotics) / Ciprofloxacin / adhesive tape 
+/ Floxin / Neurontin / generic brand meds
+ 
+Attending: ___.
+ 
+Chief Complaint:
+left knee OA
+ 
+Major Surgical or Invasive Procedure:
+left knee replacement ___, ___
+
+ 
+
+###RESPONSE: Sulfonamide Antibiotics {Allergy to sulfonamide antibiotic}, Ciprofloxacin {Allergy to ciprofloxacin}, adhesive tape {Allergy to adhesive agent}, left knee OA {Osteoarthritis of left knee joint}, left knee replacement {Total replacement of left knee joint}"
+"###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 female with left knee OA s/p L TKR.
+ 
+
+###RESPONSE: left knee OA {Osteoarthritis of left knee joint}, L TKR {Total replacement of left knee joint}"
+"###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:
+BMI 31.68, thyroid dz, dyslipidemia, eczema
+Bursitis
+Low back pain                                                   
+Arthroscopy in ___ with Dr. ___ ___ 
+ 
+___ History:
+___
+
+###RESPONSE: thyroid dz {Disorder of thyroid gland}, dyslipidemia {Dyslipidemia}, eczema {Eczema}, Bursitis {Bursitis}, Low back pain {Low back pain}, Arthroscopy {Arthroscopy}"
+"###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:
+Non-contributory
+ 
+
+###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:
+Well appearing in no acute distress  
+ Afebrile with stable vital signs  
+ Pain well-controlled  
+ Respiratory: CTAB  
+ Cardiovascular: RRR  
+ Gastrointestinal: NT/ND  
+ Genitourinary: Voiding independently  
+ Neurologic: Intact with no focal deficits  
+ Psychiatric: Pleasant, A&O x3  
+ Musculoskeletal Lower Extremity:  
+ * Incision healing well with staples
+ * Thigh full but soft  
+ * No calf tenderness  
+ * ___ strength  
+ * SILT, NVI distally  
+ * Toes warm
+ 
+
+###RESPONSE: Physical Exam {Physical examination procedure}, Well appearing {Well cared for appearance}, distress {Distress}, Afebrile {Fever}, stable vital signs {Normal vital signs}, Pain {Pain}, Respiratory {Examination of respiratory system}, CTAB {Normal breath sounds}, Cardiovascular {Cardiovascular physical examination}, RRR {Normal heart rate}, Gastrointestinal {Examination of digestive system}, NT {Abdominal tenderness}, ND {Swollen abdomen}, Gen {General examination of patient}, Voiding independently {Normal micturition}, Neurologic {Neurological examination}, no focal deficits {Normal nervous system function}, O x3 {Oriented to person, time and place}, Musculoskeletal {Musculoskeletal system physical examination}, Lower Extremity {Lower limb structure}, Incision {Surgical incision wound}, healing well {Wound healing well}, Thigh {Thigh structure}, soft {Abdomen soft}, tenderness {Tenderness}, SILT {Light touch sensation present}, NVI distally {Normal peripheral neurovascular function}, Toes {Structure of all toes}, 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:
+___ 06:03AM BLOOD Hgb-8.4* Hct-26.6*
+___ 06:07AM BLOOD Hgb-9.5* Hct-29.3*
+___ 06:03AM BLOOD Creat-0.6
+___ 06:07AM BLOOD Creat-0.6
+ 
+
+###RESPONSE: Hgb {Measurement of total hemoglobin concentration}, Hct {Hematocrit determination}, Hgb {Measurement of total hemoglobin concentration}, Hct {Hematocrit determination}, Creat {Creatinine measurement}, Creat {Creatinine 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: Brief Hospital Course:
+The patient was admitted to the orthopedic surgery service and 
+was taken to the operating room for above described procedure. 
+Please see separately dictated operative report for details. The 
+surgery was uncomplicated and the patient tolerated the 
+procedure well. Patient received perioperative IV antibiotics.
+
+Postoperative course was remarkable for the following:
+POD #0 overnight, patient had high drain output and knee was 
+flexed with drain clamped for 4 hours with appropriate effect.
+POD #1, drain was discontinued. Dressing was changed per patient 
+request as she felt she was developing a rash. No rash noted.
+POD #2, patient complained of itchiness in morning.  A dose of 
+Benadryl was given and the itchiness resolved. Patient cleared 
+___ without further issues.
+
+Otherwise, pain was controlled with a combination of IV and oral 
+pain medications.  The patient received Aspirin 325 mg twice 
+daily for DVT prophylaxis starting on the morning of POD#1.  The 
+surgical dressing was changed on POD#2 and the surgical incision 
+was found to be clean and intact without erythema or abnormal 
+drainage. The patient was seen daily by physical therapy. Labs 
+were checked throughout the hospital course and repleted 
+accordingly. At the time of discharge the patient was tolerating 
+a regular diet and feeling well.  The patient was afebrile with 
+stable vital signs.  The patient's hematocrit was acceptable and 
+pain was adequately controlled on an oral regimen. The operative 
+extremity was neurovascularly intact and the wound was benign. 
+
+The patient's weight-bearing status is weight bearing as 
+tolerated on the operative extremity with no range of motion 
+restrictions.
+  
+Ms. ___ is discharged to home with services in stable 
+condition.
+ 
+
+###RESPONSE: admitted to the orthopedic surgery service {Admission by orthopedic surgeon}, procedure {Surgical procedure}, operative {Surgical procedure}, surgery {Surgical procedure}, procedure {Surgical procedure}, IV antibiotics {Intravenous antibiotic therapy}, Postoperative course {Postoperative state}, drain {Wound discharge}, knee {Structure of left knee region}, drain clamped {Clamping of drain}, drain was discontinued {Removal of drain}, Dressing was changed {Change of dressing}, rash {Eruption of skin}, rash {Eruption of skin}, itchiness {Itching}, itchiness {Itching}, pain was controlled {Demonstrates adequate pain control}, IV {Intravenous therapy}, oral {Administration of drug or medicament via oral route}, pain medications {Administration of analgesic}, Aspirin {Administration of aspirin}, DVT prophylaxis {Prevention of deep vein thrombosis}, surgical dressing was changed {Change of dressing}, surgical incision {Surgical incision wound}, intact {Intact skin}, erythema {Erythema}, drainage {Wound discharge}, physical therapy {Physical therapy procedure}, regular diet {Normal diet}, feeling well {Well in self}, afebrile {Fever}, stable vital signs {Normal vital signs}, hematocrit was acceptable {Stable hematocrit}, pain was adequately controlled {Demonstrates adequate pain control}, oral {Administration of drug or medicament via oral route}, regimen {Therapeutic regimen}, operative {Operative site}, extremity {All extremities}, neurovascularly intact {Normal peripheral neurovascular function}, wound {Wound}, weight-bearing {Weight-bearing}, weight bearing {Weight-bearing}, operative {Surgical procedure}, extremity {Limb structure}, stable 
+condition {Patient's condition stable}"
+"###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:
+1. BuPROPion (Sustained Release) 450 mg PO QHS 
+2. ClonazePAM 1 mg PO BID 
+3. Propranolol 20 mg PO BID 
+4. Atorvastatin 40 mg PO QPM 
+5. Ibuprofen 800 mg PO Q8H:PRN Pain - Mild 
+6. FLUoxetine 60 mg PO QHS 
+7. Levothyroxine Sodium 75-150 mcg PO DAILY 
+
+ 
+Discharge Medications:
+1.  Acetaminophen 1000 mg PO Q8H  
+2.  Aspirin EC 325 mg PO BID  
+3.  Docusate Sodium 100 mg PO BID  
+4.  OxyCODONE (Immediate Release) ___ mg PO Q4H:PRN Pain - 
+Moderate 
+5.  Pantoprazole 40 mg PO Q24H 
+Continue while on 4-week course of Aspirin 325 mg twice daily.  
+6.  Senna 8.6 mg PO BID  
+7.  Atorvastatin 40 mg PO QPM  
+8.  BuPROPion (Sustained Release) 450 mg PO QHS  
+9.  ClonazePAM 1 mg PO BID  
+10.  FLUoxetine 60 mg PO QHS  
+11.  Levothyroxine Sodium 75-150 mcg PO DAILY  
+12.  Propranolol 20 mg PO BID  
+13. HELD- Ibuprofen 800 mg PO Q8H:PRN Pain - Mild  This 
+medication was held. Do not restart Ibuprofen until you've been 
+cleared by your surgeon
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+left knee OA
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, left knee OA {Osteoarthritis of left knee joint}, Mental Status {Neurological mental status determination}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, interactive {Does communicate}, 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:
+1. Please return to the emergency department or notify your 
+physician if you experience any of the following: severe pain 
+not relieved by medication, increased swelling, decreased 
+sensation, difficulty with movement, fevers greater than 101.5, 
+shaking chills, increasing redness or drainage from the incision 
+site, chest pain, shortness of breath or any other concerns.
+
+2. Please follow up with your primary physician regarding this 
+admission and any new medications and refills. 
+
+3. Resume your home medications unless otherwise instructed.
+
+4. You have been given medications for pain control. Please do 
+not drive, operate heavy machinery, or drink alcohol while 
+taking these medications. As your pain decreases, take fewer 
+tablets and increase the time between doses. This medication can 
+cause constipation, so you should drink plenty of water daily 
+and take a stool softener (such as Colace) as needed to prevent 
+this side effect.  Call your surgeons office 3 days before you 
+are out of medication so that it can be refilled.  These 
+medications cannot be called into your pharmacy and must be 
+picked up in the clinic or mailed to your house.  Please allow 
+an extra 2 days if you would like your medication mailed to your 
+home.
+
+5. You may not drive a car until cleared to do so by your 
+surgeon.
+
+6. Please call your surgeon's office to schedule or confirm your 
+follow-up appointment.
+
+7. SWELLING: Ice the operative joint 20 minutes at a time, 
+especially after activity or physical therapy. Do not place ice 
+directly on the skin. You may wrap the knee with an ace bandage 
+for added compression. Please DO NOT take any non-steroidal 
+anti-inflammatory medications (NSAIDs such as Celebrex, 
+ibuprofen, Advil, Aleve, Motrin, naproxen etc) until cleared by 
+your physician.
+
+8. ANTICOAGULATION: Please continue your Aspirin 325 mg twice 
+daily for four (4) weeks to help prevent deep vein thrombosis 
+(blood clots).  Continue Pantoprazole daily while on Aspirin to 
+prevent GI upset (x 4 weeks). If you were taking Aspirin prior 
+to your surgery, take it at 325 mg twice daily until the end of 
+the 4 weeks, then you can go back to your normal dosing.
+ 
+9. WOUND CARE: Please keep your incision clean and dry. It is 
+okay to shower five days after surgery but no tub baths, 
+swimming, or submerging your incision until after your four (4) 
+week checkup. Please place a dry sterile dressing on the wound 
+each day if there is drainage, otherwise leave it open to air. 
+Check wound regularly for signs of infection such as redness or 
+thick yellow drainage. Staples will be removed at your follow-up 
+appointment in two weeks.
+
+10. ___ (once at home): Home ___, dressing changes as 
+instructed, wound checks.
+
+11. ACTIVITY: Weight bearing as tolerated on the operative 
+extremity. Mobilize.  ROM as tolerated. No strenuous exercise or 
+heavy lifting until follow up appointment.
+Physical Therapy:
+WBAT LLE
+ROMAT
+Wean assistive device as able (i.e. 2 crutches or walker)
+Mobilize frequently 
+Treatments Frequency:
+daily dressing changes as needed for drainage
+wound checks daily
+ice
+staple removal and replace with steri-strips at follow up visit 
+in clinic
+ 
+
+###RESPONSE: severe pain {Severe pain}, medication {Administration of drug or medicament}, swelling {Swelling}, decreased 
+sensation {Abnormal sensation}, difficulty with movement {Difficulty moving}, fevers {Fever}, shaking {Tremor}, chills {Chill}, redness {Redness of skin over lesion}, drainage {Discharge}, incision 
+site {Surgical incision wound}, chest pain {Chest pain}, shortness of breath {Dyspnea}, primary physician {Primary care management}, medications {Prescription of drug}, medications {Prescription of drug}, medications {Prescription of drug}, pain control {Pain control}, while 
+taking these medications {Patient medication education}, pain {Pain}, medication can 
+cause {Patient medication education}, constipation {Constipation}, take a stool softener {Administration of laxative}, side effect {Medication side effects present}, medication so that it can be refilled {Medication prefill education}, medications {Prescription of drug}, medication {Prescription of drug}, u may not drive {Functional activity education}, SWELLING {Swelling}, Ice {Application of ice}, operative joint {Operative site}, activity {Functional activity education}, physical therapy {Physical therapy procedure}, Do not place {Wound treatment education}, ice {Application of ice}, skin {Skin structure}, knee {Structure of left knee region}, compression {Compression}, DO NOT take {Patient medication education}, non-steroidal 
+anti-inflammatory medications {Non-steroidal anti-inflammatory agent therapy}, ANTICOAGULATION {Anticoagulant therapy}, Aspirin {Administration of aspirin}, prevent deep vein thrombosis {Prevention of deep vein thrombosis}, blood clots {Blood clot}, Aspirin {Administration of aspirin}, GI upset {Gastrointestinal irritation}, surgery {Surgical procedure}, WOUND CARE {Wound care}, incision {Surgical incision wound}, shower {Able to shower self}, after surgery {Postoperative state}, incision {Surgical incision wound}, place a dry sterile dressing {Application of dressing}, wound {Surgical incision wound}, drainage {Wound discharge}, wound {Surgical incision wound}, signs of infection {Monitoring for signs and symptoms of infection}, redness {Redness of skin over lesion}, drainage {Wound discharge}, Staples will be removed {Removal of staples}, dressing changes {Change of dressing}, wound checks {Wound assessment}, ACTIVITY {Functional activity education}, Weight bearing {Weight-bearing}, operative {Operative site}, extremity {Limb structure}, Mobilize {Mobilizing exercises}, ROM {Range of motion activity}, exercise {Exercises}, lifting {Does lift}, Physical Therapy {Physical therapy procedure}, LLE {Structure of left lower limb}, ROM {Range of motion activity}, Mobilize {Does mobilize}, Treatments Frequency {Wound treatment education}, dressing changes {Change of dressing}, drainage {Wound discharge}, wound checks {Wound assessment}, ice {Application of ice}, staple removal {Removal of staples}"
+"###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: CARDIOTHORACIC
+ 
+
+###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:
+Type A aortic dissection involving b/l carotids and severe
+neurologic deficits,
+ 
+Major Surgical or Invasive Procedure:
+none
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, Type A aortic dissection {Dissection of proximal aorta}, carotids {Carotid artery structure}, neurologic deficits {Neurological deficit}"
+"###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:
+___ found down at home approximately 2 hours prior to
+presentation, EMS called immediately by wife.  EMS noted unequal
+pulses in his upper extremities during transport.  Upon arrival,
+he was found to be minimally responsive with a GCS of 5, with a
+fixed and dilated right pupil and posturing movements of his 
+left
+arm.  He was intubated and underwent a CT of the head, which was
+negative, and then a CTA of the torso with dissection protocol. 
+This demonstrated an aortic dissection from the root into the
+abdomen with involvement of the brachiocephalic artery as well 
+as
+the left carotid.Cardiac surgery was consulted for possible 
+dissection repair.
+
+ 
+
+###RESPONSE: unequal
+pulses {Unequal pulse}, upper extremities {Upper limb structure}, GCS of 5 {Glasgow coma scale, 5}, fixed and dilated right pupil {Fixed dilatation of right pupil}, posturing movements {Abnormal posture}, left
+arm {Structure of left upper limb}, intubated {Intubation}, CT of the head {Computed tomography of head}, negative {No abnormality detected}, CTA {Computed tomography angiography of head with contrast}, torso {Trunk structure}, dissection protocol {Dissection procedure}, aortic dissection {Dissection of aorta}, abdomen {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, brachiocephalic artery {Structure of brachiocephalic artery}, left carotid {Structure of left carotid artery}, Cardiac surgery {Operation on heart}, dissection {Dissection of aorta}, repair {Surgical repair}"
+"###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:
+CAD, HTN, lipids, BPH
+
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}, HTN {Hypertensive disorder, systemic arterial}, BPH {Benign prostatic hyperplasia}"
+"###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:
+unknown
+ 
+
+###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:
+PE in ED:
+Pulse: Resp:intubated  O2 sat:100%
+B/P  ___  HR 44 (SR)
+
+ 
+
+###RESPONSE: Pulse {Finding of pulse rate}, Resp {Examination of respiratory system}, intubated {Intubation}, O2 sat {Oxygen saturation measurement}, B/P {Blood pressure finding}, HR {Finding of heart rate}"
+"###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:
+___ 06:01AM BLOOD WBC-10.7 RBC-4.89 Hgb-14.5 Hct-43.8 
+MCV-90 MCH-29.6 MCHC-33.0 RDW-13.7 Plt ___
+___ 06:01AM BLOOD ___ PTT-24.7* ___
+___ 06:01AM BLOOD Glucose-178* UreaN-18 Creat-1.0 Na-143 
+K-4.1 Cl-108 HCO3-21* AnGap-18
+    ___ ___ M  ___  ___ 
+ 
+Radiology Report CTA CHEST W&W/O C&RECONS, NON-CORONARY Study 
+Date of ___ 6:17 AM 
+ 
+  
+___   ___ 6:17 AM 
+CTA CHEST W&W/O C&RECONS, NON-; CTA ABD & PELVIS   Clip # 
+___   
+Reason: aortic dissection?  
+Contrast: OMNIPAQUE Amt: 80 
+ 
+
+ 
+UNDERLYING MEDICAL CONDITION: 
+   ___ with decreased pulse R hand, diaphoretic, fall, altered  
+REASON FOR THIS EXAMINATION: 
+   aortic dissection?  
+CONTRAINDICATIONS FOR IV CONTRAST: 
+   None. 
+
+ 
+ 
+Wet Read: SJBj SAT ___ 7:41 AM 
+Extensive type A aortic dissection extending from the aortic 
+root to the 
+distal abdominal aorta. Dissection extends up left 
+bracheocephalic and left 
+common carotid. RCC extension cannot be assessed. Diffuse large 
+bowel wall 
+thickening raises the possibility of ischemic bowel even though 
+the ___ 
+appears patent from the true lumen. 
+  
+
+ 
+Wet Read Audit # 1  
+Wet Read Audit # 2 SJBj SAT ___ 6:46 AM 
+Extensive type A aortic dissection extending from the aortic 
+root to the 
+distal abdominal aorta. Dissection extends up both carotids.  
+  
+Wet Read Audit # 3 SJBj SAT ___ 7:40 AM 
+Extensive type A aortic dissection extending from the aortic 
+root to the 
+distal abdominal aorta. Dissection extends up left 
+bracheocephalic and left 
+common carotid. RCC extension cannot be assessed.  
+  
+
+ 
+Final Report 
+INDICATION: ___ man with collapse, decreased right hand 
+pulse, 
+question dissection. 
+  
+COMPARISON: None. 
+  
+TECHNIQUE: MDCT data were acquired through the chest, abdomen 
+and pelvis 
+after the administration of 80 cc of IV contrast. Images were 
+displayed in 
+multiple planes. 
+  
+FINDINGS: The exam is limited by suboptimal contrast bolus 
+timing. 
+  
+There is an extensive type-A aortic dissection extending from 
+the aortic root, 
+to the descending and abdominal aorta, to the level of the 
+infrarenal 
+abdominal aorta. Evaluation for carotid extension is severely 
+limited by poor 
+contrast bolus timing and streak artifact through the neck. The 
+dissection at 
+least extends into the proximal left subclavian and into the 
+proximal right 
+brachiocephalic artery. Approximately 1.2 cm distal to the right 
+
+brachiocephalic origin, there is a 1.3 x 0.6 cm outpouching 
+(300b:18) which 
+may represent a pseudoaneurysm. Extension into the right common 
+carotid 
+cannot be assessed. The celiac, SMA and right and left renal 
+arteries 
+originate from the true lumen. The ___ from the true 
+lumen. 
+  
+There is no hemopericardium. There is fat stranding within the 
+mediastinum 
+without frank extravasation. Numerous chest wall collateral 
+vessels are 
+noted.  
+  
+CHEST: There is dependent atelectasis plus aspiration at both 
+lung bases.  
+The remainder of the lungs are clear. The airways are patent to 
+the 
+subsegmental level. An endotracheal tube ends in the upper 
+trachea.  
+  
+ABDOMEN: The liver parenchyma is homogeneous. The gallbladder is 
+thin-walled 
+and not distended. The pancreas, spleen, and adrenal glands are 
+unremarkable. 
+The kidneys enhance symmetrically. The stomach, small and large 
+bowel are of 
+normal caliber and appearance. 
+  
+PELVIS: Diffuse diverticulosis is seen throughout the colon. 
+There is a 
+right inguinal hernia (2:35) containing loops of small bowel 
+with mild 
+fecalization, but no wall thickening or adjacent stranding. 
+There is no free 
+pelvic fluid. There is no inguinal or pelvic adenopathy. The 
+appendix is 
+normal. 
+  
+BONE WINDOWS: There are moderate multilevel degenerative changes 
+throughout 
+the thoracolumbar spine. No concerning lytic or sclerotic 
+lesions. 
+  
+IMPRESSION: 
+  
+1. Extensive type-A dissection extending from the aortic root to 
+the 
+infrarenal abdominal aorta. The dissection extends into the 
+proximal left 
+subclavian and right brachiocephalic arteries. There is a small 
+thrombosed 
+pseudoaneurysm in the proximal right brachiocephalic artery. 
+Evaluation for 
+extension into the common carotid arteries is markedly limited 
+by poor 
+contrast bolus timing. Should further evaluation of the carotid 
+arteries be 
+necessary, neck CTA could be performed. 
+  
+2. Right inguinal hernia containing a loop of fecalized ileum 
+without 
+inflammation or wall thickening. 
+  
+3. Dependent atelectasis versus possible aspiration. 
+  
+4. Haziness of the mediastinal fat may be inflammatory although 
+hematoma is 
+not excluded. 
+  
+Findings were urgently conveyed to the ER physicians by Dr. ___ 
+___ 
+immediately after the completion of the scan by telephone on the 
+morning of 
+___ and discussed with ___ on the morning of 
+___ @ 
+9:55 am by Dr. ___. 
+  
+  
+  
+The study and the report were reviewed by the staff radiologist. 
+
+  
+___. ___ 
+___. ___ 
+___: SAT ___ 9:55 AM 
+ 
+  Imaging Lab 
+ 
+There is no report history available for viewing. 
+ 
+
+###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}, CORONARY {Atherosclerosis of coronary artery}, ABD {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, PELVIS {Structure of pelvis}, aortic dissection {Dissection of aorta}, pulse {Pulse finding}, R hand {Structure of right hand}, diaphoretic {Excessive sweating}, fall {Falls}, aortic dissection {Dissection of aorta}, AST {Aspartate aminotransferase measurement}, type A aortic dissection {Dissection of proximal aorta}, aortic 
+root {Supraaortic valve area structure}, abdominal aorta {Abdominal aorta structure}, Dissection {Dissection of artery}, left 
+bracheocephalic {Structure of left brachial artery}, left 
+common carotid {Left common carotid artery structure}, RCC {Renal cell carcinoma}, large 
+bowel wall {Structure of wall of large intestine}, thickening {Increased thickness}, ischemic bowel {Vascular insufficiency of intestine}, lumen {Structure of lumen of body system}, type A aortic dissection {Dissection of proximal aorta}, aortic 
+root {Supraaortic valve area structure}, abdominal aorta {Abdominal aorta structure}, Dissection {Dissection of artery}, carotids {Carotid artery structure}, type A aortic dissection {Dissection of proximal aorta}, aortic 
+root {Supraaortic valve area structure}, abdominal aorta {Abdominal aorta structure}, Dissection {Dissection of artery}, left 
+bracheocephalic {Structure of left brachial artery}, left 
+common carotid {Left common carotid artery structure}, RCC {Renal cell carcinoma}, collapse {Collapsing pulse}, right hand {Structure of right hand}, pulse {Pulse finding}, dissection {Dissection of artery}, chest, abdomen 
+and pelvis {Chest and/or abdomen and/or pelvis structure}, exam {Physical examination procedure}, type-A aortic dissection {Dissection of proximal aorta}, aortic root {Supraaortic valve area structure}, descending {Descending aorta structure}, abdominal aorta {Abdominal aorta structure}, infrarenal 
+abdominal aorta {Structure of infrarenal aorta}, Evaluation {Evaluation procedure}, carotid {Carotid artery structure}, artifact {Artifact}, neck {Neck structure}, dissection {Dissection of artery}, left subclavian {Structure of left subclavian artery}, right {Structure of right main branch of portal vein}, brachiocephalic artery {Structure of brachiocephalic artery}, right {Structure of right main branch of portal vein}, brachiocephalic {Structure of brachiocephalic artery}, pseudoaneurysm {Pseudoaneurysm}, right common 
+carotid {Right common carotid artery structure}, celiac {Structure of celiac artery}, SMA {Superior mesenteric artery structure}, right {Structure of right renal artery}, left renal 
+arteries {Structure of left renal artery}, lumen {Structure of lumen of body system}, lumen {Structure of lumen of body system}, hemopericardium {Hemopericardium}, fat {Structure of adipose tissue}, stranding {Density above reference range}, mediastinum {Mediastinal structure}, extravasation {Extravasation}, chest wall {Chest wall structure}, vessels {Blood vessel structure}, CHEST {Plain chest X-ray}, atelectasis {Atelectasis}, aspiration {Pulmonary aspiration}, both 
+lung {Both lungs}, bases {Structure of base of lung}, lungs are clear {Normal lung}, airways {Airway structure}, endotracheal tube {Insertion of endotracheal tube}, trachea {Tracheal structure}, ABDOMEN {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, liver parenchyma {Structure of parenchyma of liver}, gallbladder {Gallbladder structure}, distended {Swollen abdomen}, pancreas {Pancreatic structure}, spleen {Splenic structure}, adrenal glands {Bilateral adrenal glands}, unremarkable {No abnormality detected}, kidneys {Kidney structure}, stomach {Stomach structure}, small {Structure of small intestine}, large 
+bowel {Structure of large intestine}, normal {No abnormality detected}, PELVIS {Structure of pelvis}, diverticulosis {Diverticulosis of colon}, colon {Colon structure}, right inguinal hernia {Right inguinal hernia}, small bowel {Structure of small intestine}, wall {Colon wall structure}, thickening {Increased thickness}, pelvic {Structure of pelvis}, inguinal {Inguinal lymphadenopathy}, pelvic adenopathy {Pelvic lymphadenopathy}, appendix {Appendix structure}, normal {No abnormality detected}, BONE {Bone structure}, degenerative changes {Degeneration of spine}, thoracolumbar {Structure of thoracic and/or lumbar region of back}, spine {Structure of vertebral column}, lytic {Lysis}, sclerotic {Sclerosis}, lesions {Lesion}, type-A dissection {Dissection of proximal aorta}, aortic root {Supraaortic valve area structure}, infrarenal {Structure of infrarenal aorta}, abdominal aorta {Abdominal aorta structure}, dissection {Dissection of artery}, left 
+subclavian {Structure of left subclavian artery}, right {Structure of right main branch of portal vein}, brachiocephalic arteries {Structure of brachiocephalic artery}, thrombosed {Thrombus}, pseudoaneurysm {Pseudoaneurysm}, right {Structure of right main branch of portal vein}, brachiocephalic artery {Structure of brachiocephalic artery}, common carotid arteries {Common carotid artery structure}, evaluation {Evaluation procedure}, carotid 
+arteries {Carotid artery structure}, Right inguinal hernia {Right inguinal hernia}, ileum {Ileal structure}, inflammation {Inflammatory disorder}, wall {Colon wall structure}, thickening {Increased thickness}, atelectasis {Atelectasis}, aspiration {Pulmonary aspiration}, mediastinal fat {Structure of pericardial fat}, inflammatory {Inflammatory disorder}, hematoma {Hematoma}"
+"###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 presents with abdominal pain secondary to back pain 
+and rapidly deteriorating mental status with left hemi-neglect. 
+He was intubated for airway protection. CT of the head was 
+negative, CTA of the chest showing diffuse type A dissection. 
+Stat consult to cardiac surgery and vascular surgery was done.
+The family discussed with ___ risks of surgery. The 
+family were in agreement at having the pt extubated and allowing 
+him to die, knowing that it is what Mr. ___ would want; they 
+did not want to wait until his children, who live out of state, 
+arrive. Ms. ___ does not want an organ donation or
+an autopsy. ___ was taken off the ventilator and shortly 
+thereafter pronounced dead. The appropriate post mortem agencies 
+were contacted per hospital policy.
+ 
+
+###RESPONSE: abdominal pain {Abdominal pain}, back pain {Backache}, deteriorating {Patient's condition deteriorating}, mental status {Neurological mental status determination}, hemi-neglect {Hemi-neglect}, intubated {Intubation}, airway {Airway structure}, CT of the head {Computed tomography of head}, negative {No abnormality detected}, CTA of the chest {Computed tomography of chest}, type A dissection {Dissection of proximal aorta}, cardiac surgery {Operation on heart}, vascular surgery {Vascular surgery procedure}, surgery {Surgical procedure}, extubated {Removal of endotracheal tube}, autopsy {Autopsy examination}, dead {Dead}"
+"###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:
+Amlodipine 10'
+Isosorbinde mononitrate 100'
+Metoprolol 50''
+Nitroglycerin PRN
+Pravastatin 40'
+Tamsulosin 0.8'
+ASA 325'
+
+ 
+Discharge Medications:
+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: Discharge Disposition:
+Expired
+ 
+Discharge Diagnosis:
+Type A dissection
+ 
+Discharge Condition:
+expired
+ 
+                             ___ MD ___
+ 
+Completed by: ___
+
+###RESPONSE: Type A dissection {Dissection of proximal aorta}"
+"###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: 
+Penicillins
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Trauma activation from 5 foot fall 
+ 
+Major Surgical or Invasive Procedure:
+___ Exploratory laparotomy and splenectomy
+
+ 
+
+###RESPONSE: Penicillins {Allergy to penicillin}, Trauma {Traumatic injury}, fall {Falls}, Exploratory laparotomy {Exploratory laparotomy}, splenectomy {Splenectomy}"
+"###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:
+ACS is consulted to evaluate this ___ man status post
+witnessed 5 foot fall into ___ pit presenting with multiple PL
+Left sided rib fx, hemoperitoneum w/ liver, spleen, and left
+kidney lacerations. 
+
+Per documentation following his fall he was pulled out by
+bystanders and ambulatory on scene per EMS. At that time patient
+unable to complete full interview secondary to intoxication with
+ETOH, benzos.  Patient states he is drinking, may have used 
+drugs
+but he is not sure. Also endorses epigastric pain. States he has
+history of hepatitis C, no other medical problems.
+
+On evaluation, patient HDS. GCS 15. Abdomen soft, tender to
+palpation to LUQ. Non-peritoneal.
+
+ 
+
+###RESPONSE: fall {Falls}, Left sided {Bone structure of left rib}, rib fx {Fracture of rib}, hemoperitoneum {Nontraumatic hemoperitoneum}, liver {Laceration of liver}, spleen {Laceration of spleen}, left
+kidney lacerations {Laceration of left kidney}, fall {Falls}, intoxication with
+ETOH {Alcohol intoxication}, benzos {Benzodiazepine intoxication}, epigastric pain {Epigastric pain}, hepatitis C {Viral hepatitis type C}, evaluation {Evaluation procedure}, Abdomen soft {Abdomen soft}, tender to
+palpation to LUQ {Tenderness of left upper quadrant of abdomen}"
+"###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:
+PMH: 
+Hep C - untreated 
+Depression/anxiety
+History of polysubstance abuse
+Right PTX s/p gunshot wound to right chest ___ 
+
+PSH: 
+Right chest tube placement ___
+Laceration repair back, posterior leg s/p stabbing 
+
+ 
+
+###RESPONSE: Hep C {Viral hepatitis type C}, Depression {Depressive disorder}, anxiety {Anxiety}, polysubstance abuse {Polysubstance abuse}, Right PTX {Right pneumothorax}, gunshot wound {Gunshot wound}, right chest {Right thorax structure}, Right {Right thorax structure}, chest tube placement {Insertion of pleural tube drain}, Laceration {Laceration}, repair {Surgical repair}, back {Structure of posterior surface of lower leg}, posterior leg {Structure of posterior surface of lower leg}"
+"###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:
+FH: 
+No known family 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: Physical Exam:
+VS:  
+General : In no acute distress
+Cardio: Normal S1, S2
+Pulmonary: CTAB
+Abdomen: Soft, mildy distended, mild LUQ tenderness, midline 
+closed with staples 
+Extremities: no edema, no erythema
+
+ 
+
+###RESPONSE: VS {Vital signs finding}, General {General examination of patient}, distress {Distress}, Cardio {Cardiovascular physical examination}, S2 {Normal second heart sound, S>2<}, Pulm {Examination of respiratory system}, CTAB {Normal breath sounds}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, distended {Swollen abdomen}, mild {Symptom mild}, tenderness {Tenderness}, Extremities {Examination of limb}, edema {Edema}, erythema {Erythema}"
+"###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:
+___ 07:00AM BLOOD WBC-11.6* RBC-2.86* Hgb-8.5* Hct-25.9* 
+MCV-91 MCH-29.7 MCHC-32.8 RDW-13.9 RDWSD-45.4 Plt ___
+___ 06:56AM BLOOD WBC-10.7* RBC-2.74* Hgb-8.4* Hct-25.0* 
+MCV-91 MCH-30.7 MCHC-33.6 RDW-13.9 RDWSD-46.1 Plt ___
+___ 05:44PM BLOOD WBC-11.7* RBC-2.64* Hgb-8.0* Hct-24.2* 
+MCV-92 MCH-30.3 MCHC-33.1 RDW-14.0 RDWSD-46.5* Plt ___
+___ 06:50AM BLOOD WBC-12.9* RBC-2.23* Hgb-6.9* Hct-21.0* 
+MCV-94 MCH-30.9 MCHC-32.9 RDW-13.7 RDWSD-46.4* Plt ___
+___ 06:42AM BLOOD WBC-15.9* RBC-2.41* Hgb-7.4* Hct-22.8* 
+MCV-95 MCH-30.7 MCHC-32.5 RDW-14.1 RDWSD-47.8* Plt ___
+___ 01:59AM BLOOD WBC-15.8* RBC-2.45* Hgb-7.6* Hct-22.4* 
+MCV-91 MCH-31.0 MCHC-33.9 RDW-14.0 RDWSD-46.8* Plt ___
+___ 07:25AM BLOOD WBC-15.3* RBC-2.62* Hgb-8.1* Hct-23.7* 
+MCV-91 MCH-30.9 MCHC-34.2 RDW-14.1 RDWSD-46.1 Plt ___
+___ 12:05AM BLOOD WBC-14.5* RBC-2.70* Hgb-8.4* Hct-24.1* 
+MCV-89 MCH-31.1 MCHC-34.9 RDW-14.1 RDWSD-45.8 Plt ___
+___ 10:17PM BLOOD WBC-15.8* RBC-2.89* Hgb-9.0* Hct-26.1* 
+MCV-90 MCH-31.1 MCHC-34.5 RDW-14.3 RDWSD-47.0* Plt ___
+___ 03:22PM BLOOD WBC-12.4* RBC-2.99* Hgb-9.3* Hct-27.0* 
+MCV-90 MCH-31.1 MCHC-34.4 RDW-14.2 RDWSD-46.7* Plt ___
+___ 12:00PM BLOOD WBC-13.3* RBC-3.34* Hgb-10.5* Hct-30.1* 
+MCV-90 MCH-31.4 MCHC-34.9 RDW-14.2 RDWSD-46.5* Plt ___
+___ 05:09AM BLOOD WBC-12.6* RBC-2.45* Hgb-7.6* Hct-22.3* 
+MCV-91 MCH-31.0 MCHC-34.1 RDW-13.2 RDWSD-43.8 Plt Ct-78*
+___ 04:00AM BLOOD WBC-13.6* RBC-1.95* Hgb-6.1* Hct-18.2* 
+MCV-93 MCH-31.3 MCHC-33.5 RDW-13.3 RDWSD-45.2 Plt Ct-93*
+___ 07:43AM BLOOD WBC-9.2 RBC-2.52* Hgb-8.0* Hct-24.2* 
+MCV-96 MCH-31.7 MCHC-33.1 RDW-12.6 RDWSD-43.3 Plt ___
+___ 10:07AM BLOOD WBC-5.2 RBC-2.56* Hgb-8.1* Hct-25.0* 
+MCV-98 MCH-31.6 MCHC-32.4 RDW-12.8 RDWSD-45.1 Plt ___
+___ 04:08AM BLOOD WBC-4.9 RBC-2.48* Hgb-8.0* Hct-23.9* 
+MCV-96 MCH-32.3* MCHC-33.5 RDW-12.7 RDWSD-44.8 Plt ___
+___ 09:30PM BLOOD WBC-5.3 RBC-2.71* Hgb-8.5* Hct-26.6* 
+MCV-98 MCH-31.4 MCHC-32.0 RDW-12.9 RDWSD-45.8 Plt ___
+___ 04:20PM BLOOD WBC-5.7 RBC-2.71* Hgb-8.6* Hct-26.0* 
+MCV-96 MCH-31.7 MCHC-33.1 RDW-13.0 RDWSD-45.6 Plt ___
+___ 02:04PM BLOOD WBC-1.9* RBC-2.33* Hgb-7.4* Hct-22.6* 
+MCV-97 MCH-31.8 MCHC-32.7 RDW-13.1 RDWSD-46.7* Plt Ct-80*
+___ 05:45AM BLOOD WBC-7.6 RBC-2.98* Hgb-9.5* Hct-29.1* 
+MCV-98 MCH-31.9 MCHC-32.6 RDW-13.0 RDWSD-46.5* Plt ___
+___ 02:17AM BLOOD WBC-9.5 RBC-3.05* Hgb-9.8* Hct-29.6* 
+MCV-97 MCH-32.1* MCHC-33.1 RDW-12.9 RDWSD-46.0 Plt ___
+___ 10:05PM BLOOD WBC-12.9* RBC-3.48* Hgb-11.2* Hct-33.7* 
+MCV-97 MCH-32.2* MCHC-33.2 RDW-12.8 RDWSD-45.5 Plt ___
+___ 01:59AM BLOOD Neuts-78.8* Lymphs-11.8* Monos-8.2 
+Eos-0.1* Baso-0.1 NRBC-0.3* Im ___ AbsNeut-12.44* 
+AbsLymp-1.86 AbsMono-1.29* AbsEos-0.02* AbsBaso-0.02
+___ 04:00AM BLOOD Neuts-74.2* Lymphs-15.3* Monos-6.3 
+Eos-0.1* Baso-0.1 NRBC-0.2* Im ___ AbsNeut-10.11* 
+AbsLymp-2.09 AbsMono-0.86* AbsEos-0.02* AbsBaso-0.02
+___ 10:05PM BLOOD Neuts-66.6 ___ Monos-10.2 
+Eos-0.8* Baso-0.2 Im ___ AbsNeut-8.58* AbsLymp-2.81 
+AbsMono-1.32* AbsEos-0.10 AbsBaso-0.03
+___ 07:00AM BLOOD Plt ___
+___ 06:56AM BLOOD Plt ___
+___ 05:44PM BLOOD Plt ___
+___ 06:50AM BLOOD Plt ___
+___ 06:42AM BLOOD Plt ___
+___ 01:59AM BLOOD Plt ___
+___ 09:37AM BLOOD ___
+___ 07:25AM BLOOD Plt ___
+___ 07:25AM BLOOD ___ PTT-24.6* ___
+___ 12:05AM BLOOD Plt ___
+___ 10:17PM BLOOD Plt ___
+___ 03:22PM BLOOD Plt ___
+___ 12:00PM BLOOD Plt ___
+___ 05:09AM BLOOD Plt Ct-78*
+___ 05:09AM BLOOD ___ PTT-24.1* ___
+___ 04:00AM BLOOD Plt Ct-93*
+___ 03:49AM BLOOD ___ PTT-22.7* ___
+___ 07:43AM BLOOD Plt ___
+___ 10:07AM BLOOD Plt ___
+___ 04:08AM BLOOD Plt ___
+___ 04:08AM BLOOD ___ PTT-24.3* ___
+___ 09:30PM BLOOD Plt ___
+___ 08:13PM BLOOD Plt Ct-UNABLE TO 
+___ 04:20PM BLOOD Plt ___
+___ 02:04PM BLOOD Plt Smr-VERY LOW* Plt Ct-80*
+___ 05:45AM BLOOD Plt ___
+___ 05:45AM BLOOD ___ PTT-23.9* ___
+___ 10:05PM BLOOD Plt ___
+___ 10:05PM BLOOD ___ PTT-22.8* ___
+___ 03:49AM BLOOD ___ 04:00AM BLOOD Ret Aut-2.8* Abs Ret-0.05
+___ 07:00AM BLOOD Glucose-89 UreaN-7 Creat-0.6 Na-139 K-3.9 
+Cl-101 HCO3-25 AnGap-13
+___ 06:56AM BLOOD Glucose-92 UreaN-6 Creat-0.5 Na-137 K-3.8 
+Cl-97 HCO3-25 AnGap-15
+___ 06:50AM BLOOD Glucose-92 UreaN-7 Creat-0.6 Na-135 K-3.8 
+Cl-99 HCO3-25 AnGap-11
+___ 06:42AM BLOOD Glucose-99 UreaN-8 Creat-0.6 Na-137 K-4.2 
+Cl-100 HCO3-26 AnGap-11
+___ 01:59AM BLOOD Glucose-101* UreaN-8 Creat-0.6 Na-135 
+K-4.1 Cl-98 HCO3-26 AnGap-11
+___ 07:25AM BLOOD Glucose-108* UreaN-8 Creat-0.7 Na-137 
+K-4.6 Cl-101 HCO3-25 AnGap-11
+___ 07:25AM BLOOD Glucose-108* UreaN-8 Creat-0.7 Na-137 
+K-4.6 Cl-101 HCO3-25 AnGap-11
+___ 12:05AM BLOOD Glucose-120* UreaN-9 Creat-0.6 Na-135 
+K-4.3 Cl-102 HCO3-25 AnGap-8*
+___ 10:17PM BLOOD Glucose-117* UreaN-9 Creat-0.7 Na-135 
+K-4.5 Cl-102 HCO3-25 AnGap-8*
+___ 03:22PM BLOOD Glucose-128* UreaN-11 Creat-0.9 Na-136 
+K-4.3 Cl-101 HCO3-25 AnGap-10
+___ 05:09AM BLOOD Glucose-168* UreaN-12 Creat-0.9 Na-136 
+K-3.4* Cl-104 HCO3-22 AnGap-10
+___ 01:58AM BLOOD Glucose-269* UreaN-8 Creat-0.7 Na-131* 
+K-3.5 Cl-97 HCO3-14* AnGap-20*
+___ 04:08AM BLOOD Glucose-111* UreaN-10 Creat-0.7 Na-134* 
+K-3.9 Cl-99 HCO3-27 AnGap-8*
+___ 05:45AM BLOOD Glucose-111* UreaN-10 Creat-0.8 Na-139 
+K-4.5 Cl-104 HCO3-21* AnGap-14
+___ 10:05PM BLOOD Glucose-127* UreaN-10 Creat-1.0 Na-142 
+K-4.5 Cl-104 HCO3-21* AnGap-17
+___ 04:08AM BLOOD ALT-24 AST-39 LD(LDH)-238 AlkPhos-63 
+TotBili-0.6
+___ 10:05PM BLOOD ALT-31 AST-61* AlkPhos-66 TotBili-0.2
+___ 07:00AM BLOOD Calcium-8.7 Phos-3.9 Mg-2.0
+___ 06:56AM BLOOD Calcium-8.5 Phos-4.2 Mg-2.0
+___ 06:50AM BLOOD Calcium-8.5 Phos-3.7 Mg-2.0
+___ 06:42AM BLOOD Calcium-8.3* Phos-3.1 Mg-2.2
+___ 01:59AM BLOOD Calcium-8.2* Phos-2.7 Mg-2.2
+___ 07:25AM BLOOD Calcium-7.8* Phos-2.2* Mg-2.2
+___ 12:05AM BLOOD Calcium-7.7* Phos-2.6* Mg-1.7
+___ 10:17PM BLOOD Calcium-7.6* Phos-2.9 Mg-1.8
+___ 03:22PM BLOOD Calcium-7.4* Phos-3.2 Mg-1.8
+___ 05:09AM BLOOD Calcium-7.0* Phos-4.5 Mg-2.2
+___ 04:08AM BLOOD Albumin-3.6 Calcium-8.4 Phos-2.7 Mg-1.9
+___ 05:45AM BLOOD Calcium-8.7 Phos-4.2 Mg-1.8
+___ 10:05PM BLOOD Albumin-4.0 Calcium-8.8 Phos-4.5 Mg-2.0
+___ 10:05PM BLOOD ASA-NEG ___ Acetmnp-NEG 
+Tricycl-NEG
+___ 05:31AM BLOOD Type-ART pO2-170* pCO2-45 pH-7.32* 
+calTCO2-24 Base XS--3
+___ 04:00AM BLOOD Type-ART Rates-___/ Tidal V-600 PEEP-5 
+FiO2-50 pO2-210* pCO2-44 pH-7.29* calTCO2-22 Base XS--4 
+Intubat-INTUBATED Vent-CONTROLLED
+___ 05:31AM BLOOD Lactate-2.0
+___ 04:00AM BLOOD Glucose-272* Lactate-4.9* K-3.2* 
+calHCO3-22
+___ 02:10AM BLOOD Lactate-14.0*
+___ 10:14PM BLOOD Lactate-2.5*
+___ 09:00AM BLOOD Hgb-11.0* calcHCT-33
+___ 04:00AM BLOOD Hgb-5.2* calcHCT-16 O2 Sat-96
+___ 04:00AM BLOOD freeCa-1.09*
+ 
+
+###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}, 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}, 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}, 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}, 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}, 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}, 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}, 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}, 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}, 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}, 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}, 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}, 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}, 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}, 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}, 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}, 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}, 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}, 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}, 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}, 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}, 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}, Neuts {Neutrophil count}, Lymphs {Lymphocyte count}, Monos {Monocyte count}, Baso {Basophil count}, Neuts {Neutrophil count}, Monos {Monocyte count}, Baso {Basophil count}, PTT {Partial thromboplastin time, activated}, PTT {Partial thromboplastin time, activated}, PTT {Partial thromboplastin time, activated}, PTT {Partial thromboplastin time, activated}, PTT {Partial thromboplastin time, activated}, PTT {Partial thromboplastin time, activated}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, 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}, 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}, 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}, 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}, 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}, 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}, 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}, 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}, 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}, 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}, 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}, 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}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Albumin {Albumin measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Albumin {Albumin measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, pH {pH measurement}, pH {pH measurement}, Glucose {Glucose measurement, blood}, K {Blood potassium measurement}, Hgb {Measurement of total hemoglobin concentration}, HCT {Hematocrit determination}, Hgb {Measurement of total hemoglobin concentration}, HCT {Hematocrit determination}"
+"###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:
+Mr. ___ is a ___ male with Past Medical History 
+significant for untreated Hep C, EtOH substance use disorder, 
+polysubstance use disorder who presented to ___ s/p witnessed 
+fall 5' into pit at ___ station. He was found to have multiple 
+left rib fx (___), liver, spleen, & left kidney lacerations. 
+eFAST w/ positive fluid in RUQ, CT scan with fluid in pelvis. He 
+was admitted to the trauma surgery icu for close monitoring. He 
+underwent serial abdominal exams, Q6H CBC and Phenobarbital 
+loading for ETOH prophylaxis. His hematocrit remained relatively 
+stable and he was called out to the floor on HD 2. He was stable 
+on the floor until HD 4 when he acutely decompensated with 
+tachycardia to the 140s with SBP ___.  We gained access and took 
+him to the operating room emergently for an exploratory 
+laparotomy where he underwent a splenectomy. He received 5uprbc 
+total, 1 uffp. He was stabilized, extubated in the pacu and 
+transferred back to the floor for further management. 
+
+On 
+
+___ - discharged. Tolerating regular diet. Passing flatus 
+and having bowel movements. Patient received post splenectomy 
+vaccines on discharge with instruction to follow up with PCP for 
+continuous booster shots.  Midline abdominal Staples to be 
+removed in clinic. 
+___ Tolerating clears and some limited regular diet. 
+Ambulating independently . 
+___ Advanced diet to regular, H/H stable. ambulating with 
+RN. reassess needs.  
+ ___ 1 unit PRBCs for Hct 21. post tx Hct: 24.2 , 
+suppository, small liquid BM  
+ ___ blood cx, u cx pending, UA neg, walking with walker, 
+___ consult, oxy ___ q4hr  
+ ___ foley/JP DC  
+ ___ Temp 101.8 at ___. Resolved with Tylenol. CBC, CXR, 
+blood cx, UA sent stat  
+ ___ tachy 130s, SBP ___, 1L fluid, 2 uprbc, OR ex lap  
+ 
+
+ 
+
+###RESPONSE: Hep C {Viral hepatitis type C}, EtOH substance use disorder {Alcohol abuse}, polysubstance use disorder {Polysubstance abuse}, fall {Falls}, left {Bone structure of left rib}, rib fx {Fracture of rib}, liver {Laceration of liver}, spleen {Laceration of spleen}, left kidney lacerations {Laceration of left kidney}, eFAST {Focused assessment with ultrasonography for trauma}, RUQ {Structure of right upper quadrant of abdomen}, CT scan {Computed tomography}, pelvis {Structure of pelvis}, monitoring {Monitoring response to treatment}, abdominal exams {Examination of abdomen}, CBC {Complete blood count}, prophylaxis {Preventive procedure}, hematocrit remained relatively 
+stable {Stable hematocrit}, tachycardia {Tachycardia}, exploratory 
+laparotomy {Exploratory laparotomy}, splenectomy {Splenectomy}, extubated {Removal of endotracheal tube}, regular diet {Normal diet}, Passing flatus {Passing flatus}, splenectomy {Splenectomy}, vaccines {Administration of vaccine to produce active immunity}, Staples to be 
+removed {Removal of staples}, clinic {Outpatient care management}, regular diet {Normal diet}, Ambulating independently {Independent walking}, regular {Normal diet}, stable {Patient's condition stable}, ambulating {Fully mobile}, blood cx {Blood culture}, u cx {Urine culture}, UA {Urinalysis}, walking with walker {Does mobilize using walker}, Temp {Body temperature finding}, CBC {Complete blood count}, CXR {Plain chest X-ray}, blood cx {Blood culture}, UA {Urinalysis}, tachy {Tachycardia}, fluid {Administration of fluid 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. Methadone 80 mg PO DAILY 
+2. ProAir HPA - 2 puffs, every 4 hours as needed for wheezing 
+ 
+Discharge Medications:
+1.  Docusate Sodium 100 mg PO BID  
+2.  Docusate Sodium 100 mg PO BID  
+3.  HydrOXYzine 25 mg PO TID Anxiety  
+Take 1 capsule three times as needed for anxiety   
+4.  OxyCODONE (Immediate Release) 5 mg PO Q4H:PRN Pain - 
+Moderate  
+5.  ProAir HFA (albuterol sulfate) Other  inhalation Other 
+2 PUFFS , EVERY 4 HOURS AS NEEDED FOR WHEEZING 
+6.  Methadone 80 mg PO DAILY  
+
+ 
+
+###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:
+1. Nondisplaced fracture posterior left 12th rib,  
+2. Mildly displaced, comminuted fracture posterior left ___ & 
+11th ribs  
+3. Mildly displaced fracture posterolateral left 9th rib  
+4. Nondisplaced fracture anterolateral left 8th rib  
+5. Left kidney laceration (possible extension to renal pelvis & 
+collecting system)  
+6. Multiple splenic lacerations  
+7. Peripheral inferior liver laceration    
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+
+ 
+
+###RESPONSE: Nondisplaced fracture {Undisplaced fracture}, left {Bone structure of left rib}, 12th rib {Bone structure of twelfth rib}, displaced {Fracture with displacement}, comminuted fracture {Fracture, comminuted}, left {Bone structure of left rib}, 11th ribs {Bone structure of eleventh rib}, displaced fracture {Fracture with displacement}, left {Bone structure of left rib}, 9th rib {Bone structure of ninth rib}, Nondisplaced fracture {Undisplaced fracture}, left {Bone structure of left rib}, 8th rib {Bone structure of eighth rib}, Left kidney laceration {Laceration of left kidney}, renal pelvis {Renal pelvis structure}, splenic lacerations {Laceration of spleen}, liver laceration {Laceration of liver}, Mental Status {Neurological mental status determination}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, interactive {Does communicate}, 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 the Acute Care Surgery Service on ___ 
+after a fall sustaining left sided rib fractures, and injuries 
+to you spleen, liver, and left kidney. You had a large bleed 
+from your spleen and therefore you were taken to the operating 
+room and had it removed. Your spleen is important for your 
+immune system to function and therefore you were given vaccines 
+(Influenza. PCV13, Menactra, HIB) prior to leaving the hospital. 
+You should follow up with your primary care provider for ongoing 
+vaccines. 
+
+You are now doing better, tolerating a regular diet, having 
+bowel function (gas and bowel movements) and pain is better 
+controlled. 
+
+You are now ready to be discharged to home with the following 
+discharge instructions:
+
+Please call your doctor or nurse practitioner or return to the 
+Emergency Department for any of the following:
+*You experience new chest pain, pressure, squeezing or 
+tightness.
+*New or worsening cough, shortness of breath, or wheeze.
+*If you are vomiting and cannot keep down fluids or your 
+medications.
+*You are getting dehydrated due to continued vomiting, diarrhea, 
+or other reasons. Signs of dehydration include dry mouth, rapid 
+heartbeat, or feeling dizzy or faint when standing.
+*You see blood or dark/black material when you vomit or have a 
+bowel movement.
+*You experience burning when you urinate, have blood in your 
+urine, or experience a discharge.
+*Your pain in not improving within ___ hours or is not gone 
+within 24 hours. Call or return immediately if your pain is 
+getting worse or changes location or moving to your chest or 
+back.
+*You have shaking chills, or fever greater than 101.5 degrees 
+Fahrenheit or 38 degrees Celsius.
+*Any change in your symptoms, or any new symptoms that concern 
+you.
+
+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.
+
+Avoid driving or operating heavy machinery while taking pain 
+medications.
+
+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.
+*If you have steri-strips, they will fall off on their own. 
+Please remove any remaining strips ___ days after surgery.
+
+Liver/ Spleen lacerations:
+
+*AVOID contact sports and/or any activity that may cause injury 
+to your abdominal area for the next ___ weeks.
+ 
+*If you suddenly become dizzy, lightheaded, feeling as if you 
+are going to pass out go to the nearest Emergency Room as this 
+could be a sign that you are having internal bleeding from your 
+liver or spleen injury.
+ 
+*AVOID any blood thinners such as Motrin, Naprosyn, Indocin, 
+Aspirin, Coumadin or Plavix for at least ___ days unless 
+otherwise instructed by the MD/NP/PA.
+
+ 
+
+###RESPONSE: fall {Falls}, left sided {Bone structure of left rib}, rib fractures {Fracture of rib}, injuries {Traumatic or non-traumatic injury}, spleen {Splenic structure}, liver {Liver structure}, left kidney {Traumatic injury of left kidney}, bleed {Bleeding}, spleen {Splenic structure}, removed {Splenectomy}, spleen {Splenic structure}, immune system {Structure of immune system}, vaccines {Administration of vaccine to produce active immunity}, regular diet {Normal diet}, pain {Pain}, chest pain {Chest pain}, pressure {Tight chest}, squeezing {Squeezing chest pain}, tightness {Tight chest}, cough {Cough}, shortness of breath {Dyspnea}, wheeze {Wheezing}, vomiting {Vomiting}, cannot keep down fluids {Nausea and vomiting}, dehydrated {Dehydration}, vomiting {Vomiting}, diarrhea {Diarrhea}, Signs {Sign}, dehydration {Dehydration}, dry mouth {Xerostomia}, rapid 
+heartbeat {Tachycardia}, dizzy {Dizziness}, faint {Feeling faint}, standing {Orthostatic body position}, blood or dark/black material when you vomit {Vomit contains blood}, bowel movement {Hematochezia}, burning {Burning sensation}, urinate {Micturition finding}, blood in your 
+urine {Blood in urine}, discharge {Discharge}, pain {Pain}, pain {Pain}, chest {Thoracic structure}, back {Structure of back of trunk}, shaking {Tremor}, chills {Chill}, fever {Fever}, ambulate {Ambulation training}, increased pain {Increased pain}, swelling {Swelling}, redness {Redness of skin over lesion}, drainage {Discharge}, incision 
+site {Surgical incision wound}, surgical incisions {Surgical incision wound}, injury {Traumatic or non-traumatic injury}, abdominal {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, dizzy {Dizziness}, lightheaded {Lightheadedness}, feeling as if you 
+are going to pass out {Feeling faint}, sign {Sign}, bleeding {Bleeding}, liver {Injury of liver}, spleen injury {Injury of spleen}"
+"###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:
+abdominal pain
+ 
+Major Surgical or Invasive Procedure:
+___ - exploratory laparotomy, ileotomy, gallstone removal
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, abdominal pain {Abdominal pain}, exploratory laparotomy {Exploratory laparotomy}, ileotomy {Ileotomy}, gallstone removal {Cholelithotomy}"
+"###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 dementia transfered from OSH with a 3-day history of 
+nausea and vomiting. Per patient/family report, pt developed 
+nausea with a few episodes of nonbloody, nonbilious emesis three 
+days ago. He became progressively weaker in the setting of 
+almost no oral intake during this time.  The patient and family
+otherwise deny complaints of abdominal pain, fevers/chills, 
+diarrhea, or hematochezia. He cannot recall his last bowel 
+movement, but feels he has not passed stool or flatus in at 
+least 48 hours. He presented to ___ last evening 
+for evaluation, and CT imaging revealed findings consistent with
+gallstone ileus causing small bowel obstruction.  He was 
+transfered to ___ for further management.
+
+On arrival to ___, pt was found to be tachycardic (HR 115) 
+with mild hypotension (SBP 90), for which he was started on IVF 
+resuscitation. During placement of a nasogastric tube the pt 
+vomited, suffering a concomitant aspiration. He subsequently 
+developed respiratory distress and eventually required 
+intubation after failing noninvasive support.
+ 
+
+###RESPONSE: dementia {Dementia}, nausea and vomiting {Nausea and vomiting}, nausea {Nausea}, emesis {Vomiting}, no oral intake {Inadequate oral intake}, abdominal pain {Abdominal pain}, fevers {Fever}, chills {Chill}, diarrhea {Diarrhea}, hematochezia {Hematochezia}, bowel 
+movement {Altered bowel function}, not passed stool or flatus {Constipation}, evaluation {Evaluation procedure}, CT imaging {Computed tomography}, gallstone ileus {Gallstone ileus}, small bowel obstruction {Small bowel obstruction}, tachycardic {Tachycardia}, hypotension {Low blood pressure}, IVF 
+resuscitation {Resuscitation using intravenous fluid}, placement of a nasogastric tube {Insertion of nasogastric tube}, vomited {Vomiting}, aspiration {Pulmonary aspiration}, respiratory distress {Respiratory distress}, intubation {Insertion of endotracheal tube}"
+"###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:
+PMH: HTN, Dementia, HLD
+PSH: denies
+
+ 
+
+###RESPONSE: HTN {Hypertensive disorder, systemic arterial}, Dementia {Dementia}, HLD {Hyperlipidemia}"
+"###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:
+Admission Exam:
+Vitals: 98.9  110  105/68  18  95% facemask
+GEN: NAD. Alert w/ mild confusion.
+HEENT: No scleral icterus. Mucous membranes dry.
+CV: Reg rhythm but tachycardic.
+PULM: Clear to auscultation b/l
+ABD: Soft, nondistended, nontender to deep palpation.
+DRE: Normal tone. No gross blood. Heme-occult negative.
+Ext: ___ warm with palpable DP pulses and no edema.
+
+Physical examination upon discharge:  ___:
+
+Vital signs:  t=97.9, bp=135/80, hr=72, rr=20
+
+General:  Sitting comfortably in chair
+
+CV:  Ns1, s2, -3, -s4
+LUNGS:  Clear
+ABDOMEN:  soft, non-tender, midline incision with steri-strips
+EXT:  no pedal edema bil., + dp bil., no calf tenderness bil
+NEURO:  oriented to name, disoriented to time, place, 
+cooperative, follows commands
+
+ 
+
+###RESPONSE: Vitals {Vital signs finding}, GEN {General examination of patient}, NAD {No abnormality detected}, Alert {Mentally alert}, confusion {Clouded consciousness}, HEENT {Physical examination procedure}, scleral icterus {Scleral icterus}, Mucous membranes dry {Mucous membrane dryness}, CV {Cardiovascular physical examination}, Reg rhythm {Finding of regularity of heart rhythm}, tachycardic {Tachycardia}, PULM {Examination of respiratory system}, Clear to auscultation b/l {Normal breath sounds}, ABD {Examination of abdomen}, Soft {Abdomen soft}, nondistended {Normal abdominal contour}, nontender {Abdominal tenderness}, palpation {Palpation}, Heme-occult negative {Occult blood not detected in feces}, Ext {Examination of limb}, warm {Warm skin}, palpable DP pulses {Dorsalis pulse present}, edema {Edema}, Sitting {Sitting position}, Clear {Normal breath sounds}, soft {Abdomen soft}, midline incision {Midline incision}, pedal edema {Edema of foot}, calf tenderness {Pain in calf}, oriented to name {Oriented to person}, disoriented to time {Disorientated in time}, place {Disorientated in place}"
+"###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:
+___ 06:55AM BLOOD WBC-6.9 RBC-3.84* Hgb-11.8* Hct-37.3* 
+MCV-97 MCH-30.8 MCHC-31.7 RDW-12.9 Plt ___
+___ 06:55AM BLOOD Glucose-110* UreaN-20 Creat-0.9 Na-140 
+K-3.9 Cl-111* HCO3-22 AnGap-11
+___ 06:55AM BLOOD Calcium-8.5 Phos-2.7 Mg-2.0
+___ 01:55PM BLOOD WBC-7.2 RBC-3.83* Hgb-11.9* Hct-37.3* 
+MCV-98 MCH-31.1 MCHC-31.9 RDW-12.9 Plt ___
+___ 02:06AM BLOOD WBC-12.5* RBC-3.40* Hgb-10.5* Hct-32.3* 
+MCV-95 MCH-31.0 MCHC-32.6 RDW-13.2 Plt ___
+___ 07:15PM BLOOD WBC-6.0 RBC-4.26* Hgb-13.6* Hct-41.6 
+MCV-98 MCH-32.0 MCHC-32.7 RDW-13.3 Plt ___
+___ 09:21AM BLOOD WBC-5.0 RBC-4.57* Hgb-14.3 Hct-42.9 
+MCV-94 MCH-31.3 MCHC-33.4 RDW-12.9 Plt ___
+___ 01:20AM BLOOD WBC-5.4 RBC-5.06 Hgb-16.1 Hct-46.7 MCV-92 
+MCH-31.8 MCHC-34.5 RDW-12.8 Plt ___
+___ 01:57AM BLOOD Neuts-69 Bands-5 Lymphs-12* Monos-7 Eos-0 
+Baso-0 ___ Metas-5* Myelos-2*
+___ 01:55PM BLOOD Plt ___
+___ 02:16AM BLOOD Plt ___
+___ 12:34AM BLOOD ___ PTT-28.6 ___
+___ 01:20AM BLOOD ___ PTT-28.6 ___
+___ 01:55PM BLOOD Glucose-130* UreaN-21* Creat-1.0 Na-140 
+K-4.7 Cl-108 HCO3-19* AnGap-18
+___ 02:16AM BLOOD Glucose-116* UreaN-22* Creat-0.9 Na-140 
+K-3.6 Cl-108 HCO3-19* AnGap-17
+___ 01:54AM BLOOD Glucose-115* UreaN-25* Creat-1.0 Na-143 
+K-3.8 Cl-110* HCO3-25 AnGap-12
+___ 07:15PM BLOOD Glucose-142* UreaN-77* Creat-1.5* Na-137 
+K-3.7 Cl-106 HCO3-23 AnGap-12
+___ 09:21AM BLOOD Glucose-133* UreaN-91* Creat-1.8* Na-139 
+K-3.9 Cl-105 HCO3-23 AnGap-15
+___ 01:20AM BLOOD Glucose-162* UreaN-102* Creat-2.1* Na-134 
+K-3.6 Cl-97 HCO3-21* AnGap-20
+___ 06:04PM BLOOD CK(CPK)-25*
+___ 10:04PM BLOOD Lipase-49
+___ 01:08AM BLOOD CK-MB-1 cTropnT-0.40*
+___ 02:00AM BLOOD cTropnT-0.68*
+___ 06:04PM BLOOD CK-MB-1 cTropnT-0.78*
+___ 01:55PM BLOOD Calcium-8.6 Phos-2.8 Mg-2.1
+___ 02:16AM BLOOD Calcium-8.5 Phos-3.0 Mg-2.0
+___ 01:57AM BLOOD Triglyc-254*
+___ 10:04PM BLOOD Cortsol-28.3*
+___ 08:30AM BLOOD Vanco-20.3*
+___ 01:20AM BLOOD freeCa-1.09*
+___ 06:51PM BLOOD freeCa-1.17
+
+___:  EKG:  
+
+Sinus rhythm. A-V conduction delay. Inferior myocardial 
+infarction, age 
+indeterminate. No previous tracing available for comparison.
+
+___:  chest x-ray:
+
+  
+1. Enlarged aortic arch and extensively calcified aortic arch, 
+worrisome for aneurysmal dilatation. If warranted by clinical 
+situation, further evaluation could be performed with Chest CTA. 
+ 
+  
+2. Reticular pulmonary opacities, most compatible with chronic 
+lung disease. 
+  
+3. Bibasilar atelectasis
+
+___:  chest x-ray:
+
+ 
+FINDINGS: New right internal jugular line tip is at lower 
+SVC/cavoatrial 
+junction approximately 3.2 cm from the carina. Orogastric tube 
+courses below the diaphragm and ends into the body of the 
+stomach and is appropriately positioned. Since prior radiograph 
+acquired several hours apart, bibasilar atelectasis persists 
+with interval worsening on the right side and unchanged on the 
+left side. Small pleural effusion on the right side is similar. 
+Upper lungs are clear. There is no pneumothorax. Heart size, 
+mediastinal and hilar contours have stable appearance.
+
+___:  EKG:
+
+ Supraventricular rhythm at the upper limits of normal rate with 
+P-R interval 
+prolongation. Low amplitude P waves merged with the T wave. 
+Cannot rule out atrial tachycardia with 2:1 block. RSR' pattern 
+in leads V1-V2. Q waves in leads III and aVF - consider inferior 
+myocardial infarction. Since the previous tracing the rate is 
+faster. The P-R interval is longer with a difference in the P 
+wave which may be related to fusion with a T wave. 
+Clinical correlation is suggested.  
+TRACING #1
+
+___:  ECHO:
+
+ IMPRESSION: Mild symmetric left ventricular hypertrophy with 
+preserved global systolic function. The left ventricle is 
+compressed by a severely dilated and hypokinetic right 
+ventricle. The RV apical function is relatively preserved which 
+is a non-specific sign but could be due to pulmonary embolism. 
+Moderate tricuspid regurgitation and at least moderate pulmonary 
+hypertension.
+
+___:  EKG:
+
+Sinus bradycardia with sinus arrhythmia and P-R interval 
+prolongation. 
+Prolonged Q-T interval. Borderline low precordial QRS votlage. T 
+wave 
+inversions in leads VI-V4 and in the inferior leads. Slightly 
+delayed anterior R wave progression - cannot exclude prior 
+anteroseptal myocardial infarction. 
+Compared to the previous tracing of ___ T wave inversion is 
+more prominent in leads II and V3. RSR' pattern has resolved, 
+likely due to changes in electrode placement. Anterior R wave 
+progression has improved.An ongoing inferior and anterior 
+ischemic process cannot be excluded. Clinical correlation is 
+suggested 
+
+___:  chest x-xay:
+
+Moderate cardiomegaly is stable. Left lower lobe retrocardiac 
+consolidation and ill-defined opacities in the right mid and 
+lower lungs are stable, concerning for aspiration. There are no 
+new lung abnormalities, pneumothorax or enlarging pleural 
+effusions. Lines and tubes are in unchanged standard 
+position 
+
+___:  x-ray of the abdomen:
+
+IMPRESSION: Findings consistent with resolving small-bowel 
+obstruction from ___ with decreased gaseous distention of the 
+small bowel and progression of oral contrast into the proximal 
+colon.
+
+___:  cat scan of abdomen and chest:
+
+ Multifocal pneumonia/aspiration pneumonia within the right 
+upper, middle, 
+and lower lobes. 
+  
+2. Small bilateral pleural effusions with associated 
+atelectasis. 
+  
+3. Fusiform infrarenal abdominal aortic aneurysm as well as 
+aneurysmal 
+dilatation of the right common iliac artery and a saccular 
+aneurysm arising off the right internal iliac artery with 
+significant mural thrombus. 
+  
+4. Dilatation of loops of small bowel within the left abdomen 
+and pelvis.  
+The degree of small bowel dilatation overall has generally 
+decreased and this likely reflects a persistent ileus, although 
+a partial small bowel obstruction is not entirely excluded. 
+  
+5. Enlarged right hilar lymph node presumably reactive. 
+Following resolution of acute symptoms a follow-up Chest CT is 
+recommended. 
+  
+6. Emphysema. 
+  
+7. Pulmonary arterial hypertension. 
+  
+8. Probably duodenal lipoma
+
+___:  EKG:
+
+Sinus bradycardia. P-R interval prolongation. Borderline low 
+limb lead 
+voltage. Mild Q-T interval prolongation. Early R wave 
+progression. 
+RSR' pattern in lead V1. Borderline intraventricular conduction 
+delay.  
+ST-T wave abnormalities. Since the previous tracing of ___ 
+the Q-T interval is now shorter. Otherwise, unchanged.  
+TRACING #1 
+
+___:  EKG:
+
+Probable sinus rhythm with atrial premature beats. Since the 
+previous tracing the rate has increased. Atrial ectopy is new. 
+The QRS complex is narrower. ST-T wave abnormalities are less 
+prominent.
+
+___:  chest x-ray:
+
+FINDINGS: As compared to the previous radiograph, the known 
+multifocal 
+pneumonia, with a maximum manifestation at the right lung base, 
+is unchanged in extent and severity. Unchanged moderate 
+cardiomegaly without pulmonary edema. Unchanged monitoring and 
+support devices. No newly appeared focal parenchymal opacities.
+
+___:  chest x-ray:
+
+Compared to the prior radiograph, there has been no change. 
+Right sided 
+extensive opacities remain. Left-sided patchy opacities also 
+remain. Moderate cardiomegaly and areas of atelectasis 
+bilaterally is unchanged. Right-sided IJ terminates in the 
+mid-to-distal SVC.
+
+___:  chest x-ray:
+
+Rotated lordotic positioning. Allowing for this, the 
+cardiomediastinal 
+silhouette is likely stable. There are patchy opacities at the 
+right and left bases, similar, possibly minimally improved, 
+compared with ___ at 5:46 a.m. Doubt CHF. No gross 
+effusion.
+
+___ 5:01 pm SPUTUM      Source: Endotracheal. 
+
+                            **FINAL REPORT ___
+
+   GRAM STAIN (Final ___: 
+      >25 PMNs and <10 epithelial cells/100X field. 
+      NO MICROORGANISMS SEEN. 
+
+   RESPIRATORY CULTURE (Final ___: 
+      Commensal Respiratory Flora Absent. 
+      YEAST.    SPARSE GROWTH. 
+
+___ 12:29 am SPUTUM      Source: Endotracheal. 
+
+                            **FINAL REPORT ___
+
+   GRAM STAIN (Final ___: 
+      ___ PMNs and <10 epithelial cells/100X field. 
+      1+    (<1 per 1000X FIELD):   BUDDING YEAST. 
+
+   RESPIRATORY CULTURE (Final ___: 
+      Commensal Respiratory Flora Absent. 
+      YEAST.    SPARSE GROWTH. 
+
+___ 8:28 am MRSA SCREEN      Source: Nasal swab. 
+
+                            **FINAL REPORT ___
+
+   MRSA SCREEN (Final ___: 
+      POSITIVE FOR METHICILLIN RESISTANT STAPH AUREUS. 
+
+ 
+  
+ 
+ 
+  
+ 
+
+  
+
+ 
+  
+
+  
+
+  
+
+  
+ 
+  
+
+ 
+
+###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}, 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}, 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}, 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}, 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}, 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}, Lymphs {Lymphocyte count}, Monos {Monocyte count}, Eos {Eosinophil count}, PTT {Partial thromboplastin time, activated}, 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}, 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}, 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}, 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}, 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}, 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}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Triglyc {Triglycerides measurement}, EKG {Electrocardiographic procedure}, Sinus rhythm {Sinus rhythm}, A-V conduction delay {Atrioventricular block}, Inferior myocardial 
+infarction {Inferior myocardial infarction on electrocardiogram}, Enlarged aortic arch {Abnormality of aortic arch}, aortic arch {Aortic arch structure}, aneurysmal dilatation {Aneurysm}, evaluation {Evaluation procedure}, Chest CTA {Computed tomography angiography of chest with contrast}, pulmonary {Examination of respiratory system}, opacities {Abnormally opaque structure}, chronic 
+lung disease {Chronic lung disease}, Bibasilar {Structure of base of lung}, atelectasis {Atelectasis}, chest x-ray {Plain chest X-ray}, lower 
+SVC {Structure of low superior vena cava}, carina {Structure of carina of trachea}, diaphragm {Diaphragm structure}, stomach {Stomach structure}, radiograph {Plain radiography}, bibasilar {Structure of base of lung}, atelectasis {Atelectasis}, pleural effusion {Pleural effusion}, Upper lungs {Structure of upper zone of lung}, are clear {Normal lung}, pneumothorax {Pneumothorax}, Heart {Heart structure}, mediastinal {Mediastinal structure}, stable appearance {Patient's condition stable}, upper limits of normal rate {Measurement finding above reference range}, P-R interval 
+prolongation {Prolonged PR interval}, Low amplitude P waves {Flattened P wave}, atrial tachycardia {Atrial tachycardia}, 2:1 block {Electrocardiogram: partial atrioventricular block - 2:1}, RSR' pattern 
+in leads V1-V2 {rSr pattern in V1 and V2}, leads III {Lead III}, inferior 
+myocardial infarction {Inferior myocardial infarction on electrocardiogram}, P-R interval is longer {Prolonged PR interval}, Mild symmetric left ventricular hypertrophy {Mild left ventricular hypertrophy}, left ventricle {Left cardiac ventricular structure}, hypokinetic right 
+ventricle {Hypokinetic right ventricular wall}, RV apical {Structure of apex of right ventricle}, pulmonary embolism {Pulmonary embolism}, Moderate tricuspid regurgitation {Moderate tricuspid valve regurgitation}, moderate pulmonary 
+hypertension {Moderate pulmonary hypertension}, EKG {Electrocardiographic procedure}, Sinus bradycardia {Sinus bradycardia}, sinus arrhythmia {Nodal rhythm disorder}, P-R interval 
+prolongation {Prolonged PR interval}, Prolonged Q-T interval {Prolonged QT interval}, low precordial QRS votlage {Low QRS voltages in the precordial leads}, T 
+wave 
+inversions {Inverted T wave}, delayed anterior R wave progression {Electrocardiographic R wave abnormal}, anteroseptal myocardial infarction {Anteroseptal infarction on electrocardiogram}, T wave inversion {Inverted T wave}, leads II {Lead II}, RSR' pattern {rSr pattern in V1 and V2}, Anterior R wave 
+progression {Electrocardiographic R wave abnormal}, improved {Patient's condition improved}, anterior 
+ischemic {Electrocardiographic anterior ischemia}, cardiomegaly {Cardiomegaly}, stable {Patient's condition stable}, Left lower lobe {Structure of lower lobe of left lung}, consolidation {Lung consolidation}, opacities {Abnormally opaque structure}, lower lungs {Structure of lower lobe of lung}, stable {Patient's condition stable}, aspiration {Aspiration pneumonia}, lung abnormalities {Imaging of lung abnormal}, pneumothorax {Pneumothorax}, pleural 
+effusions {Pleural effusion}, small-bowel 
+obstruction {Small bowel obstruction}, gaseous distention {Abdominal distension, gaseous}, small bowel {Structure of small intestine}, progression of oral contrast {Diagnostic radiography with oral contrast}, proximal 
+colon {Ascending colon structure}, pneumonia {Pneumonia}, aspiration pneumonia {Aspiration pneumonia}, right 
+upper, middle, 
+and lower lobes {Right lung structure}, bilateral pleural effusions {Bilateral pleural effusion}, atelectasis {Atelectasis}, infrarenal abdominal aortic aneurysm {Aneurysm of infrarenal abdominal aorta}, aneurysmal 
+dilatation {Aneurysm}, right common iliac artery {Structure of right common iliac artery}, saccular 
+aneurysm {Saccular aneurysm}, right internal iliac artery {Structure of right internal iliac artery}, mural thrombus {Mural thrombus}, Dilatation {Dilatation}, small bowel {Structure of small intestine}, left abdomen {Structure of left side of abdomen}, pelvis {Structure of pelvis}, small bowel {Structure of small intestine}, partial small bowel obstruction {Partial obstruction of small bowel}, Enlarged right hilar lymph node {Localized enlarged lymph nodes}, Chest CT {Computed tomography of chest}, Emphysema {Emphysema}, Pulmonary arterial hypertension {Pulmonary hypertensive arterial disease}, duodenal {Duodenal structure}, lipoma {Lipoma}, EKG {Electrocardiographic procedure}, Sinus bradycardia {Sinus bradycardia}, P-R interval prolongation {Prolonged PR interval}, low 
+limb lead 
+voltage {Low QRS voltages in the limb leads}, Q-T interval prolongation {Prolonged QT interval}, R wave 
+progression {Electrocardiographic R wave abnormal}, RSR' pattern in lead V1 {rSr pattern in V1 and V2}, ST-T wave abnormalities {Nonspecific ST-T abnormality on electrocardiogram}, Q-T interval is now shorter {Shortened QT interval}, EKG {Electrocardiographic procedure}, sinus rhythm {Sinus rhythm}, atrial premature beats {Atrial premature complex}, Atrial ectopy {Premature atrial contraction}, ST-T wave abnormalities {Nonspecific ST-T abnormality on electrocardiogram}, chest x-ray {Plain chest X-ray}, radiograph {Plain radiography}, pneumonia {Pneumonia}, right lung base {Structure of base of right lung}, cardiomegaly {Cardiomegaly}, pulmonary edema {Pulmonary edema}, monitoring {Monitoring response to treatment}, opacities {Abnormally opaque structure}, chest x-ray {Plain chest X-ray}, radiograph {Plain radiography}, opacities {Abnormally opaque structure}, opacities {Abnormally opaque structure}, cardiomegaly {Cardiomegaly}, atelectasis {Atelectasis}, SVC {Superior vena cava structure}, chest x-ray {Plain chest X-ray}, Rotated lordotic {Lordosis deformity of spine}, stable {Patient's condition stable}, opacities {Abnormally opaque structure}, bases {Structure of base of lung}, improved {Patient's condition improved}, CHF {Congestive heart failure}, effusion {Pleural effusion}, RESPIRATORY CULTURE {Respiratory microbial culture}, RESPIRATORY CULTURE {Respiratory microbial culture}, MRSA SCREEN {Multi-resistant staphylococcus aureus screening}, MRSA SCREEN {Multi-resistant staphylococcus aureus screening}, POSITIVE FOR METHICILLIN RESISTANT STAPH AUREUS {Methicillin resistant Staphylococcus aureus detected}"
+"###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 ___ 
+___ with gallstone ileus. He had a gastric tube placed, but 
+was removed during transport.  He was hypoxic upon admission.  A 
+___ tube was replaced with subsequent vomitting.  He 
+was emergently intubated and taken to the operating room  on 
+___ for exploratory laparotomy, ileotomy and stone 
+extraction. He tolerated the procedure well and was transferred 
+to the intensive care unit for further care:
+
+Posoperatively, the patient was hypotensive and required fluid 
+boluses. A NICOM was placed that showed adequate cardiac output. 
+He was then started on intermittent levophed, vasopressin, and 
+dopamine.  As his hemodynamic status improved, the pressors were 
+weaned off by HD# 5. The patient was also noted to have a 
+troponin increase  to 0.8 and was intermittently bradycardic. He 
+underwent an Echocardiogaram which showed left ventricular 
+hypertrophy with an ejection fraction of >55%. He was seen by 
+Cardiology who atributed the changes to demand ischemia. On HD#4 
+the patient developed an arrythmia and there was concern for a 
+pulmonary embolism.  A CTA was performed which was negative for 
+a pulmonary embolism.  He otherwise had no cardiovascular 
+issues.
+
+During the hospital course, the patient required fluid 
+resuscitation and became fluid overloaded.  As a result of this, 
+he was difficult to ventilate and had to be paralyzed and 
+required several ventilatory mode changes. He was started on a 
+lasix drip to help decrease his overload.  This was discontinued 
+after 48 hours because of an increase in his creatinine. He 
+subsuequently auto-diuresised down to his dry weight. On HD #5, 
+he was started on tube feedings and gradually advanced to his 
+goal.   He was slowly weaned and extubated on POD#8. He was 
+maintained on a face mask throught POD #9 and weaned to nasal 
+cannula on POD #11.  He was placed on a 1 week course of zosyn 
+and vancomycin for his aspiration pneumonitis.   His oxygen 
+requirement slowly resolved.  He was evaluated by Speech and 
+Swallow to determine his ability to safely swallow without 
+aspiration.     
+
+On HD #5, the patient was started on tube feedings and slowly 
+advanced to goal.  He was evaluated by Speech and Swallow who 
+advanced him to a soft solid diet.  By POD 10 he was on a 
+regular diet and calorie counts were begun to measure the 
+magnitude of his oral intake.  He was tolerating a regular diet 
+upon discharge. 
+
+He was transferred to the surgical floor on HD #13.  His vital 
+signs have been stabie and he has been afebrile. His white blood 
+cell count has normalized and his hematocrit has been stable.  
+He was tolerating a regular diet.  He has been evaluated by 
+physical therapy and recommendations made for discharge to an 
+extended care facility where he can futhter regain his strength 
+and mobility.
+
+****Of note:  x-ray of the abdomen on ___ showed enlarged 
+right hilar lymph node and recommendation per radiology for a 
+repeat cat scan in the future.    
+
+ 
+
+###RESPONSE: gallstone ileus {Gallstone ileus}, hypoxic {Hypoxia}, vomitting {Vomiting}, intubated {Intubation}, exploratory laparotomy {Exploratory laparotomy}, ileotomy {Ileotomy}, stone 
+extraction {Bile duct stone removal}, hypotensive {Low blood pressure}, fluid 
+boluses {Intravenous injection}, NICOM was placed {Non-invasive cardiac output monitoring}, adequate cardiac output {Normal cardiac output}, improved {Patient's condition improved}, bradycardic {Bradycardia}, Echocardiogaram {Echocardiography}, left ventricular 
+hypertrophy {Left ventricular hypertrophy}, demand ischemia {Ischemia co-occurrent and due to increased oxygen demand}, arrythmia {Cardiac arrhythmia}, pulmonary embolism {Pulmonary embolism}, CTA {Computed tomography angiography with contrast}, pulmonary embolism {Pulmonary embolism}, fluid 
+resuscitation {Resuscitation using intravenous fluid}, fluid overloaded {Hypervolemia}, lasix {Diuretic therapy}, increase in his creatinine {Creatine kinase level above reference range}, tube feedings {Tube feeding of patient}, face mask {Oxygen administration by mask}, nasal 
+cannula {Oxygen administration by nasal cannula}, aspiration pneumonitis {Aspiration pneumonitis}, evaluated by Speech and 
+Swallow {Evaluation of oral stage deglutition and pharyngeal stage deglutition}, swallow {Does swallow}, aspiration {Pulmonary aspiration}, tube feedings {Tube feeding of patient}, evaluated by Speech and Swallow {Seen by speech and language therapy service}, soft solid diet {Soft diet}, regular diet {Normal diet}, measure the 
+magnitude of his oral intake {Nutritional monitoring}, tolerating a regular diet {Tolerating normal diet}, afebrile {Fever}, white blood 
+cell count {White blood cell count}, hematocrit {Hematocrit determination}, tolerating a regular diet {Tolerating normal diet}, evaluated by 
+physical therapy {Physical therapy management}, x-ray of the abdomen {Diagnostic radiography of abdomen}, enlarged 
+right hilar lymph node {Localized enlarged lymph nodes}, cat scan {Computed tomography}"
+"###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:
+Atorvastatin 20', Amlodipine 10', Losartan 100', Vitamin B12, 
+ASA (unknown dosage), Exelon patch 9.5mg/24hrs
+
+ 
+Discharge Medications:
+1. heparin (porcine) 5,000 unit/mL Solution Sig: 5000 (5000) 
+units Injection TID (3 times a day).  
+2. miconazole nitrate 2 % Powder Sig: One (1) Appl Topical BID 
+(2 times a day) as needed for fungal infection.  
+3. bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal 
+once a day as needed for constipation.  
+4. aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+5. albuterol sulfate 2.5 mg /3 mL (0.083 %) Solution for 
+Nebulization Sig: One (1) neb Inhalation Q6H (every 6 hours) as 
+needed for wheezing.  
+6. amlodipine 5 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily): 
+hold for systolic blood pressure <110, hr <60.  
+7. atorvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+8. losartan 50 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily).  
+9. quetiapine 25 mg Tablet Sig: Three (3) Tablet PO HS (at 
+bedtime).  
+10. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H 
+(every 6 hours) as needed for pain.  
+11. Colace 100 mg Capsule Sig: One (1) Capsule PO twice a day: 
+hold for loose stool.  
+12. white petrolatum-mineral oil 56.8-42.5 % Ointment Sig: One 
+(1) Appl Ophthalmic PRN (as needed) as needed for dry eyes.  
+13. Exelon 9.5 mg/24 hour Patch 24 hr Sig: One (1) patch 
+Transdermal daily ().  
+
+ 
+
+###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:
+aspiration
+gallstone ileus
+small bowel obstruction
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+
+ 
+
+###RESPONSE: aspiration {Pulmonary aspiration}, gallstone ileus {Gallstone ileus}, small bowel obstruction {Small bowel obstruction}, Mental Status {Neurological mental status determination}, Alert {Mentally alert}"
+"###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 to the hospital with nausea and vomitting.  
+You were found on cat scan to have a gallstone ileus and a small 
+bowel obstruction.  You had a tube placed into your stomach for 
+decompression and you subsequently vomitted with some fluid 
+entering your lungs and causing pneumonia.  You were taken to 
+the operating room where you had an exploratory laparotomy and 
+removal of the gallstone which was causing the obstruction.  You 
+were monitored in the intensive care unit after the surgery 
+where you required intravenous medication to support your blood 
+pressure.  You vital signs gradually improved and you were 
+transferred to the surgical floor.  You are now preparing for 
+discharge where you can regain your strength and mobility.   
+ 
+
+###RESPONSE: nausea {Nausea}, cat scan {Computed tomography}, gallstone ileus {Gallstone ileus}, small 
+bowel obstruction {Small bowel obstruction}, stomach {Stomach structure}, decompression {Decompression}, fluid 
+entering your lungs {Pulmonary aspiration}, pneumonia {Pneumonia}, exploratory laparotomy {Exploratory laparotomy}, removal of the gallstone {Removal of gallstones from intestine}, obstruction {Intestinal obstruction}, surgery {Surgical procedure}, improved {Patient's condition improved}"
+"###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:
+hypoxia
+ 
+Major Surgical or Invasive Procedure:
+Radiation Treatments
+
+ 
+
+###RESPONSE: No Known Allergies {Allergic disposition}, Adverse Drug Reactions {Propensity to adverse reactions to drug}, hypoxia {Hypoxia}, Radiation {Radiation oncology AND/OR radiotherapy}"
+"###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:
+___ M with history of SC lung cancer s/p RLL lobectomy ___, 
+recent hospitalization with low back pain found to have new 
+lesions in spine and hip, delerium, ARI improved with IVF, MSSA 
+bacteremia/PNA discharged on Nafcillin to be completed ___, 
+presents with sudden onset hypoxia this morning, with O2 sat 
+dropping to 81% at rehab and associated shortness of breath. He 
+was placed on 4L NC at that time. Notably patient also had some 
+urinary retention yesterday when at the hospital to have 
+radiation tattooing done, had a Foley placed yesterday, and he 
+has had gross hematuria since. He was taken to ___ 
+___ today where he was found to be anemic as well as to 
+have a UTI, and an elevated troponin to .4 in the setting of 
+atrial flutter/sinus tachycardia. Hct was also noted to drop 
+from ___. H receved asa 162 mg, oxycodone 5mg, zofran 4mg and 
+dilaudid 0.5 mg IV there.
+.
+Baseline sats at rehab have been ___ on 2L intermittently per 
+patient. Today sat to ___ on 2L. Notes show right leg swelling 
+U/S two days ago negative. 
+.
+Initial Vitals/Trigger: 97.6 114 179/95 19 97%6L. He denies 
+chest pain or abdominal pain, however he does endorse shortness 
+of breath which has somewhat resolved since he's been placed on 
+a nasal cannula at 4 L.
+.
+EKG showed atrial flutter. He was guiaic negative. Ceftriaxone 
+was given at 1245. Potassium was also give 1230 ___s 
+Oxycodone. CTA showed b/l subsegmental PEs.  CT head with old 
+lesions.
+.
+VS on transfer: afebrile 94 121/94 24 94% 2L.
+.
+On the floor, he denies ever having any shortness of breath, and 
+attributes his recent symptoms to anxiety which has resolved.  
+He denies any chest pain, and endorses a chronic cough which is 
+unchanged with occasional sputum production. His hematuria began 
+2 days ago, prior to that, he did not have dysuria.  He denies 
+any f/c/n/v/diarrhea.  Also has bilateral ___ edema which is new. 
+ Denies any new problems since transfer.
+ 
+
+###RESPONSE: SC lung cancer {Squamous cell carcinoma of lung}, RLL lobectomy {Lobectomy of lower lobe of right lung}, low back pain {Low back pain}, lesions {Lesion}, spine {Structure of vertebral column}, hip {Hip region structure}, delerium {Delirium}, improved {Patient's condition improved}, IVF {Administration of intravenous fluids}, MSSA {Infection caused by methicillin susceptible Staphylococcus aureus}, bacteremia {Bacteremia caused by Staphylococcus aureus}, PNA {Pneumonia caused by methicillin susceptible Staphylococcus aureus}, hypoxia {Hypoxia}, O2 sat 
+dropping to 81% {Oxygen saturation below reference range}, shortness of breath {Dyspnea}, NC {Oxygen administration by nasal cannula}, urinary retention {Retention of urine}, radiation {Radiation oncology AND/OR radiotherapy}, tattooing {Tattooing}, Foley placed {Catheterization of urinary bladder}, gross hematuria {Frank hematuria}, anemic {Anemia}, UTI {Urinary tract infectious disease}, elevated troponin {Troponin I above reference range}, atrial flutter {Atrial flutter}, sinus tachycardia {Sinus tachycardia}, IV {Intravenous therapy}, Baseline {Baseline state}, right leg swelling {Swelling of right lower limb}, U/S {Ultrasonography}, Vitals {Vital signs finding}, chest pain {Chest pain}, abdominal pain {Abdominal pain}, shortness 
+of breath {Dyspnea}, resolved {Problem resolved}, placed on 
+a nasal cannula {Oxygen administration by nasal cannula}, EKG {Electrocardiographic procedure}, atrial flutter {Atrial flutter}, CTA {Computed tomography angiography with contrast}, PEs {Pulmonary emphysema}, CT head {Computed tomography of head}, lesions {Lesion}, VS {Vital signs finding}, afebrile {Fever}, shortness of breath {Dyspnea}, anxiety {Anxiety}, chest pain {Chest pain}, chronic cough {Chronic cough}, sputum production {Productive cough}, hematuria {Blood in urine}, dysuria {Dysuria}, f/c {Fever with chills}, n/v {Nausea and vomiting}, diarrhea {Diarrhea}, edema {Edema}, problems {Problem}"
+"###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:
+-Squamous cell lung cancer: In remission for ___. s/p RLL 
+resection, no chemo, radiation. 
+-Head and neck cancer: Remote hx. Details unknown.
+-HTN
+-mild COPD 
+-mild carotid stenosis
+-Recent echo shows mild-moderate mitral valve stenosis/aortic 
+stenosis with preserved EF
+-hx of cardiac myxoma s/p resection with CVA
+
+ 
+
+###RESPONSE: Squamous cell lung cancer {Squamous cell carcinoma of lung}, In remission {Malignant neoplasm in full remission}, RLL 
+resection {Lobectomy of lower lobe of right lung}, chemo {Chemotherapy}, radiation {Radiation oncology AND/OR radiotherapy}, Head and neck {Structure of head and/or neck}, cancer {Malignant neoplasm}, HTN {Hypertensive disorder, systemic arterial}, COPD {Chronic obstructive lung disease}, carotid stenosis {Carotid artery stenosis}, echo {Echocardiography}, mild {Mild mitral valve stenosis}, moderate mitral valve stenosis {Moderate mitral valve stenosis}, aortic 
+stenosis {Aortic valve stenosis}, cardiac myxoma {Myxoma of heart}, resection {Resection of neoplasm of heart}, CVA {Cerebrovascular accident}"
+"###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:
+Daughter with breast cancer. Denies history of other cancers or
+heart disease.
+
+ 
+
+###RESPONSE: breast cancer {Malignant neoplasm of breast}, cancers {Malignant neoplasm}, heart disease {Heart 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:
+ON ADMISSION:
+Vitals: 98.9, 97, 111/59, 65-90s, 18, 94/4L 
+General: Alert, oriented, no acute distress, comfortable 
+appearing  
+HEENT: Sclera anicteric, MMM, oropharynx dry
+Neck: supple, JVP elevated to earlobe
+Lungs: b/l diffuse end expiratory high pitched wheeze loudest in 
+upper lobes
+CV: tachycardic rate and reg rhythm, normal S1 + S2, no murmurs, 
+rubs, gallops  
+Abdomen: soft, non-tender, non-distended, bowel sounds present, 
+no rebound tenderness or guarding, no organomegaly  
+GU: foley in place
+Ext: warm, well perfused, 2+ pulses, b/l ___ edema pitting in R 
+leg, greater than left
+Neuro: CNS in tact, sensation and strength in tact upper and 
+lower extremities, strength in left leg limited by left hip 
+pain.
+.
+ON DISCHARGE:
+Vitals: 96.5-97.6, 150-168/60-72, 76-83, ___, 94-97% 2L NC
+General: Alert, oriented, no acute distress  
+HEENT: Sclera anicteric, MMM, OP clear
+Neck: supple, JVP elevated to earlobe
+Lungs: b/l diffuse wheezing
+CV: tachycardic rate and reg rhythm, normal S1 + S2, ___ SEM 
+Abdomen: soft, non-tender, non-distended, bowel sounds (+) no 
+rebound or guarding, no HSM
+GU: foley
+Ext: warm, well perfused, 2+ pulses, b/l ___ edema pitting in R 
+leg, greater than left
+Neuro: CNS in tact, sensation and strength in tact upper and 
+lower extremities, strength in left leg limited by left hip 
+pain.
+ 
+
+###RESPONSE: Vitals {Vital signs finding}, General {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, distress {Distress}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, MMM {Moist oral mucosa}, oropharynx {Oropharyngeal structure}, Neck {Physical examination procedure}, supple {Normal movement of neck}, JVP {Finding of jugular venous pressure}, Lungs {Examination of respiratory system}, b/l {Lung structure}, expiratory high pitched wheeze {Expiratory wheezing}, upper lobes {Structure of upper lobe of lung}, CV {Cardiovascular physical examination}, tachycardic {Tachycardia}, reg rhythm {Finding of regularity of heart rhythm}, normal S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, murmurs {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, Abdomen {Examination of abdomen}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, bowel sounds present {Normal bowel sounds}, rebound {Rebound tenderness}, tenderness {Tenderness}, guarding {Abdominal guarding}, organomegaly {Abdominal organomegaly}, GU {Examination of genitourinary system}, foley in place {Urinary catheter in situ}, warm {Warm skin}, well perfused {Normal tissue perfusion}, 2+ pulses {Peripheral pulses normal}, edema {Edema}, R 
+leg {Structure of right lower leg}, left {Structure of left lower leg}, Neuro {Neurological examination}, CNS in tact {Normal central nervous system}, sensation {Normal sensation}, upper {Upper limb structure}, lower extremities {Lower limb structure}, left leg {Structure of left lower leg}, left {Left hip region structure}, pain {Pain}, Vitals {Vital signs finding}, 2L NC {Oxygen administration by nasal cannula}, General {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, distress {Distress}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, MMM {Moist oral mucosa}, OP clear {Pharynx normal}, Neck {Physical examination procedure}, supple {Normal movement of neck}, JVP elevated {Raised jugular venous pressure}, Lungs {Examination of respiratory system}, b/l {Lung structure}, wheezing {Wheezing}, CV {Cardiovascular physical examination}, tachycardic {Tachycardia}, reg rhythm {Finding of regularity of heart rhythm}, normal S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, SEM {Ejection murmur}, Abdomen {Examination of abdomen}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, bowel sounds (+) {Normal bowel sounds}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, HSM {Hepatosplenomegaly}, GU {Examination of genitourinary system}, Ext {Examination of limb}, warm {Warm skin}, well perfused {Normal tissue perfusion}, 2+ pulses {Peripheral pulses normal}, edema pitting {Pitting edema}, R 
+leg {Structure of right lower leg}, left {Structure of left lower leg}, Neuro {Neurological examination}, CNS in tact {Normal central nervous system}, sensation {Normal sensation}, upper {Upper limb structure}, lower extremities {Lower limb structure}, left leg {Structure of left lower leg}, left {Left hip region structure}, hip 
+pain {Hip 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: Pertinent Results:
+Admission Labs:
+___ 11:48AM BLOOD WBC-15.4* RBC-3.19* Hgb-9.4* Hct-27.1* 
+MCV-85 MCH-29.6 MCHC-34.8 RDW-15.1 Plt ___
+___ 11:48AM BLOOD Neuts-80.7* Lymphs-11.4* Monos-6.1 
+Eos-1.1 Baso-0.7
+___ 12:00PM BLOOD ___ PTT-25.0 ___
+___ 11:48AM BLOOD UreaN-22* Creat-1.5* Na-138 K-3.3 Cl-95* 
+HCO3-31 AnGap-15
+___ 11:48AM BLOOD ALT-14 AST-21 AlkPhos-97 TotBili-0.4
+___ 11:48AM BLOOD TotProt-6.9 Albumin-3.2* Globuln-3.7 
+Calcium-8.9
+___ 11:48AM BLOOD CEA-200*
+
+Discharge Labs:
+___ 07:05AM BLOOD WBC-8.8 RBC-3.31* Hgb-9.9* Hct-29.3* 
+MCV-89 MCH-29.8 MCHC-33.6 RDW-15.8* Plt ___
+___ 07:05AM BLOOD Glucose-147* UreaN-11 Creat-1.1 Na-135 
+K-4.2 Cl-96 HCO3-33* AnGap-10
+___ 07:05AM BLOOD ALT-19 AST-28 LD(LDH)-265* AlkPhos-80 
+TotBili-0.6
+___ 07:05AM BLOOD Albumin-3.0* Calcium-8.6 Phos-3.3 Mg-1.7
+
+Imaging:
+CT Chest:
+IMPRESSION: 
+1. Pulmonary emboli in the subsegmental branches of the left 
+lower lobe and 
+anterior left upper lobe with no evidence of right heart strain 
+or pulmonary 
+infarction. 
+2. New patchy consolidation in the dependent portion of the 
+right upper lobe 
+likely represents pneumonia or aspiration. Ground glass 
+opacities in a 
+bronchovascular distribution in the left upper lobe may 
+represent multifocal 
+pneumonia or significant aspiration event. 
+.
+CT Head:
+IMPRESSION:  
+1. No brain metastases identified.  
+2. There is no evidence of intra- or extra-axial hemorrhage; 
+however, subtle 
+subarachnoid hemorrhage cannot be excluded on this study due to 
+circulating 
+intravenous contrast. 
+.
+CXR:
+FINDINGS: As compared to the previous radiograph, the right PICC 
+line was 
+removed. Status post right lower lobe resection with subsequent 
+volume loss 
+of the right lung. Presence of a minimal right pleural effusion 
+cannot be 
+excluded. 
+  
+No newly appeared parenchymal opacities. No pulmonary edema. No 
+pneumonia.  
+Unchanged asymmetry of the tracheal course through the 
+mediastinum. 
+.
+___:
+IMPRESSION: Peroneal calf veins not visualized in either lower 
+extremities.  
+Otherwise, no DVT present 
+.
+CXR:
+Cardiomegaly and widened mediastinum are unchanged. Patient is 
+status post 
+right lower lobectomy. The lungs are grossly clear with the 
+surgical clips 
+projecting in the right medial upper hemithorax. Unchanged right 
+apical 
+pleural thickening and blunting of the right CP angle are likely 
+postoperative 
+changes. Aeration of the right lung has improved.
+ 
+
+###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}, Baso {Basophil count}, PTT {Partial thromboplastin time, activated}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, AnGap {Anion gap measurement}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, Albumin {Albumin 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}, BLOOD 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}, Albumin {Albumin measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Imaging {Imaging}, CT Chest {Computed tomography of chest}, Pulmonary emboli {Pulmonary embolism}, left 
+lower lobe {Structure of lower lobe of left lung}, anterior left upper lobe {Structure of anterior segment of upper division of left upper lobe of lung}, right heart {Structure of right side of heart}, pulmonary 
+infarction {Pulmonary infarction}, consolidation {Consolidation}, right upper lobe {Structure of bronchus of right upper lobe}, pneumonia {Pneumonia}, aspiration {Pulmonary aspiration}, Ground glass 
+opacities {Ground glass lung opacity}, left upper lobe {Structure of upper lobe of left lung}, pneumonia {Pneumonia}, aspiration {Pulmonary aspiration}, brain metastases {Metastatic malignant neoplasm to brain}, intra {Intracranial hemorrhage}, hemorrhage {Intracranial hemorrhage}, subarachnoid hemorrhage {Subarachnoid intracranial hemorrhage}, radiograph {Plain radiography}, right {Right atrial structure}, PICC 
+line was 
+removed {Removal of peripherally inserted central catheter}, right lower lobe resection {Lobectomy of lower lobe of right lung}, volume loss {Decreased size}, right lung {Right lung structure}, right {Right pleura structure}, pleural effusion {Pleural effusion}, opacities {Abnormally opaque structure}, pulmonary edema {Pulmonary edema}, pneumonia {Pneumonia}, mediastinum {Mediastinal structure}, Peroneal {Structure of peroneal vein}, lower 
+extremities {Lower limb structure}, DVT {Deep venous thrombosis}, CXR {Plain chest X-ray}, Cardiomegaly {Cardiomegaly}, widened mediastinum {Widened mediastinum}, status post {Postoperative state}, right lower lobectomy {Lobectomy of lower lobe of right lung}, lungs {Lung structure}, clear {No abnormality detected}, surgical {Surgical procedure}, right {Right thorax structure}, hemithorax {Structure of half of thorax lateral to midsagittal plane}, right 
+apical {Structure of apex of right lung}, pleural thickening {Thickening of pleura}, right {Structure of right common femoral artery}, CP angle {Structure of costophrenic angle}, postoperative {Postoperative state}, right lung {Right lung structure}, improved {Patient's condition improved}"
+"###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:
+___ M with history of SC lung cancer s/p RLL lobectomy ___, 
+recent hospitalization with low back pain found to have new 
+lesions in spine and hip, delerium, ARI improved with IVF, MSSA 
+bacteremia/PNA discharged on Nafcillin to be completed ___, 
+presented with sudden onset hypoxia found to have bilateral 
+subsegmental PEs, PNA and fluid overlead.
+.
+ACTIVE ISSUES:
+# HYPOXIA: Initial deterioration was likely ___ PE and 
+aspiration PNA. Patient was initially started heparin gtt then 
+bridged to lovenox and was initially placed on Vanco/Zosyn. As 
+patient became afebrile, he was placed on Augmentin and remained 
+afebrile. ***LAST DAY OF ANTIBIOTICS WILL BE ON ___ Hypoxic 
+continued despite adequate PE and PNA coverage; exam revealed 
+hypervolemic state. Patient was diursed with IV lasix 20mg. 
+Serum Bicarbonate started raising patient and diuresis 
+terminated. Patient was briefly off oxygen however then 
+restarted o2 at 2 liters. This remaining hypoxia was attributed 
+to PE. Patient will remain on lovenox indefinitely. 
+.
+# LOWER EXTREMITY WEAKNESS/HIP PAIN/URINARY RETENTION: Symptoms 
+were attributed bony metastasis. Patient started radiation 
+therapy and will compelte treatments on ___. Patient was 
+started on steroids to help with inflammation. Patient will 
+remain on this dose of steroids until ___ then he can began 
+taper (2mg Q12h for 3 days then 2mg Q24h then off). Outpatient 
+oncology will reassess him to see if further treatments are 
+necessary. Physical therapy saw patient and recommended 
+rehabilitation for strength training. Foley holiday was 
+attempted however patient continued to have retention of urine 
+upto 1L. Foley was then replaced resulting in hematuria, likely 
+___ trauma v. radiation cystitis. Hematocrit was stable and 
+patient was hemodynamically stable. 
+.
+# HYPERTENSION: Patient was markedly hypertensive during this 
+admission and amlodipine was started with better control of BP
+.
+# ELEVATED TROPONIN: Patient had initial troponin leak on 
+admission likely ___ tachycardia and PE; there was associated 
+EKG changes. No changes made to medications and no further 
+interventions were needed.
+.
+# ATRIAL FLUTTER: On initially presentation, patient was 
+elevated HR to 120s however with treatment of PE and continued 
+use of metoprolol, patient had HR returned to normal.
+.
+# CODE STATUS: DNR/DNI
+ 
+
+###RESPONSE: SC lung cancer {Squamous cell carcinoma of lung}, RLL lobectomy {Lobectomy of lower lobe of right lung}, low back pain {Low back pain}, lesions {Lesion}, spine {Structure of vertebral column}, hip {Hip region structure}, delerium {Delirium}, improved {Patient's condition improved}, IVF {Administration of intravenous fluids}, MSSA {Infection caused by methicillin susceptible Staphylococcus aureus}, bacteremia {Bacteremia caused by Staphylococcus aureus}, PNA {Pneumonia caused by methicillin susceptible Staphylococcus aureus}, hypoxia {Hypoxia}, PEs {Pulmonary emphysema}, PNA {Pneumonia}, fluid overlead {Hypervolemia}, HYPOXIA {Hypoxia}, PE {Pulmonary emphysema}, aspiration PNA {Aspiration pneumonia}, afebrile {Fever}, afebrile {Fever}, ANTIBIOTICS {Antibiotic therapy}, Hypoxic {Hypoxia}, PE {Pulmonary emphysema}, PNA {Pneumonia}, hypervolemic {Hypervolemia}, diursed {Diuresis}, IV {Intravenous therapy}, lasix {Diuretic therapy}, diuresis {Diuresis}, o2 {Oxygen therapy}, hypoxia {Hypoxia}, PE {Pulmonary emphysema}, LOWER EXTREMITY WEAKNESS {Paresis of lower extremity}, HIP PAIN {Hip pain}, URINARY RETENTION {Retention of urine}, bony metastasis {Metastatic malignant neoplasm to bone}, radiation 
+therapy {Radiation oncology AND/OR radiotherapy}, steroids {Steroid therapy}, inflammation {Inflammatory disorder}, Outpatient {Outpatient care management}, Physical therapy {Physical therapy procedure}, rehabilitation {Rehabilitation therapy}, strength training {Exercise promotion: strength training}, Foley {Catheterization of urinary bladder}, retention of urine {Retention of urine}, Foley {Catheterization of urinary bladder}, hematuria {Blood in urine}, trauma {Injury of urinary tract proper}, radiation cystitis {Irradiation cystitis}, Hematocrit was stable {Stable hematocrit}, hemodynamically stable {Hemodynamically stable}, HYPERTENSION {Hypertensive disorder, systemic arterial}, hypertensive {Hypertensive disorder, systemic arterial}, ELEVATED TROPONIN {Troponin I above reference range}, tachycardia {Tachycardia}, PE {Pulmonary emphysema}, EKG changes {Electrocardiogram abnormal}, medications {Administration of drug or medicament}, ATRIAL FLUTTER {Atrial flutter}, elevated HR {Tachycardia}, PE {Pulmonary emphysema}, 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:
+Medications:   per ___ form
+ Lasix 20mg daily, last ___
+ KCl 20meq daily, last ___
+ Asa 81 mg daily, last ___
+ Oxycontin 20mg BID, last 6am ___
+ Hydralazine 50 mg BID, last ___
+ Calcium carbonate 1250mg PO TID last ___
+ Oxycodone 5mg PO Q3H prn, last ___
+ Ativan 1mg PO Q8H prn last ___
+ lidoderm 5% patch topically to left hip last ___ at 7am
+ iron 325mg daily
+ metoprolol tartrate 25 mg Tab BID
+ colace 100mg BID prn 
+ senna 1 tabe BID prn
+ insulin humalog starting at 200 increase by 2 units every 50 up 
+to 400
+
+House regular Texture, Necture thick liquid
+
+hydrochlorothiazide 25 mg daily (stopped ___
+ nafcillin in D2.4W 2 gram/100 mL IV Piggy Back (stopped ___  
+ plan to change to Dicloxacillin 500 mg qid through ___
+
+ 
+Discharge Medications:
+1. furosemide 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 
+ 
+2. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable 
+PO DAILY (Daily).  
+3. hydralazine 50 mg Tablet Sig: One (1) Tablet PO BID (2 times 
+a day).  
+4. amoxicillin-pot clavulanate 875-125 mg Tablet Sig: One (1) 
+Tablet PO Q12H (every 12 hours): Last dose on ___.  
+5. oxycodone 20 mg Tablet Extended Release 12 hr Sig: One (1) 
+Tablet Extended Release 12 hr PO Q8H (every 8 hours).  
+6. lorazepam 0.5 mg Tablet Sig: ___ Tablets PO Q8H (every 8 
+hours) as needed for anxiety.  
+7. lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: 
+One (1) Adhesive Patch, Medicated Topical DAILY (Daily).  
+8. calcium carbonate 500 mg calcium (1,250 mg) Tablet Sig: One 
+(1) Tablet PO TID (3 times a day).  
+9. metoprolol tartrate 25 mg Tablet Sig: One (1) Tablet PO BID 
+(2 times a day).  
+10. enoxaparin 100 mg/mL Syringe Sig: One (1) syringe 
+Subcutaneous Q12H (every 12 hours).  
+11. polyethylene glycol 3350 17 gram/dose Powder Sig: One (1)  
+PO DAILY (Daily) as needed for constipation.  
+12. amlodipine 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 
+ 
+13. oxycodone 5 mg Tablet Sig: ___ Tablets PO Q3H (every 3 
+hours) as needed for pain.  
+14. dexamethasone 4 mg Tablet Sig: One (1) Tablet PO Q12H (every 
+12 hours).  
+15. insulin lispro 100 unit/mL Solution Sig: One (1) bottle 
+Subcutaneous QACHS: For ___ 150-200 give 2 units; if 201-250 give 
+4 units, if 251-300 give 6 units, for 301-350 give 8 units, if > 
+350 alert MD; At bed time, give 1 unit 201-250, give 2 units for 
+251-300, give 3 units for 301-350, alert MD for > 350.  
+16. guaifenesin 100 mg/5 mL Syrup Sig: ___ MLs PO Q6H (every 6 
+hours) as needed for cough.  
+
+ 
+
+###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:
+Pulmonary Emboli
+Aspiration Pneumonia
+Metastatic Lung Cancer
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Out of Bed with assistance to chair or 
+wheelchair.
+
+ 
+
+###RESPONSE: Pulmonary Emboli {Pulmonary embolism}, Aspiration Pneumonia {Aspiration pneumonia}, Metastatic {Metastatic malignant neoplasm}, Lung Cancer {Malignant tumor of lung}, Mental Status {Neurological mental status determination}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, interactive {Does communicate}, Activity Status {Physical functional dependency}, Out of Bed with assistance {Difficulty getting off a bed}"
+"###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 because you were having shortness of breath. 
+When you were admitted you were found to have blood clots in 
+your lungs. You were started on a blood thinning medication to 
+help stabilize the clots. You will remain this medication 
+indefinitely. You were also diagnosed pneumonia and placed on 
+antibiotics. You also have fluid in your lungs which we used 
+lasix to help remove the fluid. You however still require oxygen 
+which may be a result of your the lung clots.
+
+You began your radiation treatments while you were in the 
+hospital for your hip pain and urinary retention. You had 4 of 
+the 5 treatments and will return on ___ for your final 
+treatment. You will be followed by your oncologist to determine 
+if you need treatment. We are expecting you to start feeling 
+better in ___ weeks. In the mean time you will be going to an 
+excellent rehabilitation center to get stronger.
+
+You continue to have urinary retention likely from your cancer. 
+A catheter remains in your bladder to help drain the urine. 
+There is some blood in your urine from the catheter insertion 
+and should resolve within a few days.
+
+Please see the attached sheet for your medications. Please take 
+them as directed
+ 
+
+###RESPONSE: shortness of breath {Dyspnea}, blood clots {Blood clot}, lungs {Lung structure}, blood thinning medication {Administration of anticoagulant}, clots {Blood clot}, medication {Administration of drug or medicament}, pneumonia {Pneumonia}, antibiotics {Antibiotic therapy}, fluid in your lungs {Pleural effusion}, lasix {Diuretic therapy}, lung clots {Pulmonary embolism}, radiation {Radiation oncology AND/OR radiotherapy}, hip pain {Hip pain}, urinary retention {Retention of urine}, feeling 
+better {Well in self}, rehabilitation {Rehabilitation therapy}, urinary retention {Retention of urine}, cancer {Malignant neoplasm}, catheter remains in your bladder {Urinary catheter in situ}, blood in your urine {Blood in urine}, catheter insertion {Catheterization of urinary bladder}, medications {Administration of drug or medicament}"
+"###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: CARDIOTHORACIC
+ 
+
+###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 / Quinine
+ 
+Attending: ___
+ 
+Chief Complaint:
+non-small cell lung cancer
+ 
+Major Surgical or Invasive Procedure:
+video assisted cervical mediastinoscopy, flexible bronchoscopy
+
+ 
+
+###RESPONSE: Codeine {Allergy to codeine}, Quinine {Allergy to quinine}, non-small cell lung cancer {Non-small cell lung cancer}, cervical mediastinoscopy {Cervical mediastinoscopy}, flexible bronchoscopy {Flexible bronchoscopy}"
+"###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 ___ current ___ py smoker, hx Hep C & HCC s/p
+liver transplant ___, with 3cm RUL PET-avid nodule with
+pathology showing non-small cell carcinoma, here for follow-up.
+
+He has been asymptomatic since previous visit. No SOB, cough. No
+fevers, chills, nightsweats. He had EBUS which biopsied lesion
+showing non-small cell carcinoma. Lymph nodes were not biopsied. 
+
+PET negative for distant metastasis.
+ 
+
+###RESPONSE: smoker {Smoker}, Hep C {Viral hepatitis type C}, HCC {Liver cell carcinoma}, liver transplant {Transplantation of liver}, RUL {Structure of upper lobe of right lung}, PET {Positron emission tomography}, nodule {Nodule}, non-small cell carcinoma {Non-small cell carcinoma}, asymptomatic {Asymptomatic}, SOB {Dyspnea}, cough {Cough}, fevers {Fever}, chills {Chill}, nightsweats {Night sweats}, biopsied {Biopsy}, lesion {Lesion}, non-small cell carcinoma {Non-small cell carcinoma}, Lymph nodes {Structure of lymph node}, biopsied {Biopsy}, PET {Positron emission tomography}, distant metastasis {Distant metastasis present}"
+"###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:
+HEPATITIS C (genotype 1a, no sequelae of chronic liver disease 
+at this point, stage III fibrosis on biopsy; now s/p liver 
+transplant)                                                  
+HEPATOCELLULAR CARCINOMA (s/p RFA on ___ to segment VIa 
+lesion; now s/p liver transplant)                                
+     
+HYPERTENSION                                                     
+                                                   
+LUNG NODULE                                                     
+DIABETES MELLITUS                                                
+                                              
+H/O ALCOHOL ABUSE                                               
+H/O INTRAVENOUS DRUG ABUSE    
+ 
+
+###RESPONSE: HEPATITIS C {Viral hepatitis type C}, genotype {Genotype determination}, no sequelae {Sequelae of disorders}, chronic liver disease {Chronic liver disease}, fibrosis {Fibrosis of lung}, biopsy {Biopsy}, liver 
+transplant {Transplantation of liver}, HEPATOCELLULAR CARCINOMA {Hepatocellular carcinoma}, RFA {Radiofrequency ablation}, lesion {Lesion}, liver transplant {Transplantation of liver}, HYPERTENSION {Hypertensive disorder, systemic arterial}, LUNG NODULE {Nodule of lung}, DIABETES MELLITUS {Diabetes mellitus}, ALCOHOL ABUSE {Alcohol abuse}, DRUG ABUSE {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: 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:
+Positive for a mother with stomach cancer diagnosed at age of ___ 
+and father with diabetes and also alcoholic with diabetes and 
+coronary artery disease. 
+ 
+
+###RESPONSE: stomach cancer {Malignant tumor of stomach}, diabetes {Diabetes mellitus}, alcoholic {Problem drinker}, diabetes {Diabetes mellitus}, coronary artery disease {Coronary arteriosclerosis}"
+"###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:
+Gen: Awake, alert, NAD 
+CV: +RRR
+Chest: incisions and dressing over prior CT site c/d/i 
+Resp: Normal WOB, no distress on 2L NC; +CTAB, no wheezes or 
+crackles
+Abdomen: Soft, non-distended, non-TTP 
+Ext: Warm, well-perfused 
+
+ 
+
+###RESPONSE: Gen {General examination of patient}, Awake {Awake}, alert {Mentally alert}, NAD {No abnormality detected}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, Chest {Examination of respiratory system}, incisions {Surgical incision wound}, dressing {Application of dressing}, Resp {Examination of respiratory system}, WOB {Labored breathing}, distress {Distress}, NC {Normal head}, CTAB {Normal breath sounds}, wheezes {Wheezing}, crackles {Respiratory crackles}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, non-distended {Normal abdominal contour}, TTP {Tenderness}, Ext {Examination of limb}, Warm {Warm skin}, well-perfused {Normal tissue perfusion}"
+"###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:
+___ Liver Doppler US:
+IMPRESSION: 
+  
+1. Patent transplant hepatic vasculature with appropriate 
+waveforms. 
+2. Unremarkable appearance of the transplant liver with no 
+biliary dilatation. 
+3. Small left pleural effusion noted. 
+
+GRAM STAIN (Final ___: 
+      1+    (<1 per 1000X FIELD):   POLYMORPHONUCLEAR 
+LEUKOCYTES. 
+      4+   (>10 per 1000X FIELD):   GRAM NEGATIVE DIPLOCOCCI. 
+
+   RESPIRATORY CULTURE (Final ___: 
+      ~3000 CFU/mL Commensal Respiratory Flora. 
+      MORAXELLA CATARRHALIS.    >100,000 CFU/mL. 
+
+ 
+
+###RESPONSE: Liver {Liver structure}, Doppler US {Doppler ultrasonography}, transplant {Structure of transplant}, hepatic vasculature {Vascular structure of liver}, transplant {Structure of transplant}, liver {Liver structure}, biliary dilatation {Hypertrophy of bile duct}, left {Left lung structure}, pleural effusion {Pleural effusion}, GRAM STAIN {Gram stain method}, CULTURE {Microbial culture}"
+"###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:
+___ presented to ___ pre-op holding on ___ and 
+underwent video assisted right upper lobectomy and flexible 
+bronchoscopy (please see operative note for details). Patient 
+was extubated post procedure, however in the OR, he became 
+dyspneic, moving minimal air. He was reintubated given his 
+respiratory distress and transferred to the ICU (___). 
+The details of his/her course are as follows:
+
+Neuro: Given history of chronic pain on home suboxone, patient 
+was maintained on Tylenol and narcotics and the suboxone was 
+held. He was ultimately discharged with a supply of oxycodone 
+called to his pharmacy to last until his next appointment with 
+his PCP ___ ___. 
+
+CV: History of hypertension, continued on home lisinopril and 
+carvedilol. Remained hemodynamically stable, no active issues. 
+
+Pulm: Respiratory distress was likely secondary to lung 
+contusion when attempting to remove specimen, as well as post op 
+pain. He was extubated on POD1. He underwent bedside 
+bronchoscopies for clearing of mucous plugs, with BAL (___) 
+growing Moraxella. Both ___ drain and chest tube was put to 
+water seal on POD1. ___ drain was pulled on POD5, chest tube 
+was pulled on POD9, both with stable post pull films. His 
+progress was monitored with daily CXR. Encouraged IS, 
+ambulation. 
+
+FEN/GI: Transplant hepatology following, given his history of 
+___ s/p liver transplant. He was continued on home tacrolimus 
+dosing with monitoring of tacrolimus levels (goal ___ and LFTs. 
+Liver duplex was done due to persistently elevated LFTs per 
+hepatology recs, which showed no abnormalities. LFTs continued 
+to trend down. Follow up was set up with transplant hepatology 
+to recheck labs outpatient. Once extubated, diet was advanced as 
+tolerated. He tolerated a regular diet without nausea/vomiting 
+and was passing flatus and stool appropriately. 
+
+GU: He was able to void spontaneously without issue after foley 
+removal. Initial ___ with Cr 1.8 post op, which returned to his 
+baseline. History of CKD with baseline Cr 1.3-1.5.  
+
+Heme: H/H remained stable and he did not require any 
+transfusions. He was kept on prophylactic SQH while inpatient. 
+
+ID: He was treated with azithromycin x5 days for Moraxella 
+growing on BAL. 
+
+Dispo: He worked with physical therapy with a final 
+recommendation for discharge to home with home ___ services.  
+
+By day of discharge on ___, he was hemodynamically stable, 
+pain was well controlled on oral medications, he was tolerating 
+a regular diet without issue, and was ready for discharge.
+
+ 
+
+###RESPONSE: right upper lobectomy {Lobectomy of upper lobe of right lung}, flexible 
+bronchoscopy {Flexible bronchoscopy}, extubated {Removal of endotracheal tube}, procedure {Procedure}, dyspneic {Dyspnea}, moving minimal air {Difficulty breathing}, reintubated {Intubation}, respiratory distress {Respiratory distress}, Neuro {Neurology service}, chronic pain {Chronic pain}, CV {Cardiovascular physical examination}, hypertension {Hypertensive disorder, systemic arterial}, hemodynamically stable {Hemodynamically stable}, Pulm {Examination of respiratory system}, Respiratory distress {Respiratory distress}, lung {Metastatic malignant neoplasm to lung}, contusion {Contusion}, pain {Abdominal pain}, extubated {Removal of endotracheal tube}, bronchoscopies {Bronchoscopy}, CXR {Plain chest X-ray}, GI {Structure of digestive system}, Transplant {Transplantation}, liver transplant {Transplantation of liver}, LFTs {Hepatic function panel}, Liver {Liver structure}, elevated {Elevation}, LFTs {Hepatic function panel}, abnormalities {No abnormality detected}, LFTs {Hepatic function panel}, transplant {Transplantation}, extubated {Removal of endotracheal tube}, diet {Dietary finding}, regular diet {Normal diet}, nausea/vomiting {Nausea and vomiting}, passing flatus {Passing flatus}, GU {Examination of genitourinary system}, able to void {Normal micturition}, foley 
+removal {Removal of urinary bladder catheter}, CKD {Chronic kidney disease}, Heme {Hematology test}, H {Hemoglobin finding}, stable {Patient's condition stable}, transfusions {Transfusion}, ID {Infectious disease}, physical therapy {Physical therapy procedure}, hemodynamically stable {Hemodynamically stable}, pain was well controlled {Demonstrates adequate pain control}, oral medications {Administration of drug or medicament via oral route}, regular diet {Normal diet}, ready for discharge {Ready for discharge}"
+"###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 may be inaccurate and requires 
+further investigation.
+1. Lisinopril 5 mg PO DAILY 
+2. Nicotine Patch 21 mg/day TD DAILY 
+3. Nicotine Polacrilex 4 mg PO Q2H:PRN cigarette craving 
+4. CARVedilol 25 mg PO BID 
+5. Tacrolimus 1.5 mg PO QAM 
+6. docosahexanoic acid-epa 120-180 mg oral DAILY 
+7. Multivitamins 1 TAB PO DAILY 
+8. Buprenorphine-Naloxone Film (8mg-2mg) 1 FILM SL BID 
+9. sildenafil 25 mg oral DAILY:PRN ED 
+10. Calcium 500 + D (calcium carbonate-vitamin D3) 500 
+mg(1,250mg) -400 unit oral BID 
+11. Tacrolimus 1 mg PO QPM 
+12. Chantix Starting Month Box (varenicline) 0.5 mg (11)- 1 mg 
+(42) oral ASDIR 
+
+ 
+Discharge Medications:
+1.  OxyCODONE (Immediate Release) 15 mg PO Q6H:PRN Pain - Severe 
+
+  Reason for PRN duplicate override: Alternating agents for 
+similar severity
+RX *oxycodone 5 mg ___ tablet(s) by mouth every six (6) hours 
+Disp #*12 Tablet Refills:*0 
+2.  Buprenorphine-Naloxone Film (8mg-2mg) 1 FILM SL BID 
+Consider prescribing naloxone at discharge  
+3.  Calcium 500 + D (calcium carbonate-vitamin D3) 500 
+mg(1,250mg) -400 unit oral BID  
+4.  CARVedilol 25 mg PO BID  
+5.  Chantix Starting Month Box (varenicline) 0.5 mg (11)- 1 mg 
+(42) oral ASDIR  
+6.  docosahexanoic acid-epa 120-180 mg oral DAILY  
+7.  Lisinopril 5 mg PO DAILY  
+8.  Multivitamins 1 TAB PO DAILY  
+9.  Nicotine Patch 21 mg/day TD DAILY  
+10.  Nicotine Polacrilex 4 mg PO Q2H:PRN cigarette craving  
+11.  sildenafil 25 mg oral DAILY:PRN ED  
+12.  Tacrolimus 1.5 mg PO QAM  
+13.  Tacrolimus 1 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:
+right upper lobe non-small cell lung cancer
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: right upper lobe {Structure of upper lobe of right lung}, non-small cell lung cancer {Non-small cell lung cancer}, Mental Status {Neurological mental status determination}, 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:
+* You were admitted to the hospital for lung surgery and you've 
+recovered well. You are now ready for discharge.  
+
+* Continue to use your incentive spirometer 10 times an hour 
+while awake.
+
+* Check your incisions daily and report any increased redness or 
+drainage.   Cover the area with a gauze pad if it is draining.
+
+* Your chest tube dressing may be removed in 48 hours.  If it 
+starts to drain, cover it with a clean dry dressing and change 
+it  as needed to keep site clean and dry.
+
+* You may need pain medication once you are home but you can 
+wean it over the next week as the discomfort resolves.  Make 
+sure that you have regular bowel movements while on narcotic 
+pain medications as they are constipating which can cause more 
+problems.  Use a stool softener or gentle laxative to stay 
+regular.
+
+* No driving while taking narcotic pain medication.
+
+* Take Tylenol on a standing basis to avoid more opiod use.
+
+* Continue to stay well hydrated and eat well to heal your 
+incisions
+
+* Shower daily. Wash incision with mild soap & water, rinse, pat 
+dry
+ * No tub bathing, swimming or hot tubs until incision healed
+ * No lotions or creams to incision site
+
+* Walk ___ times a day and gradually increase your activity as 
+you can tolerate.
+
+Call Dr. ___ ___ if you experience:
+ -Fevers > 101 or chills
+ -Increased shortness of breath, chest pain or any other 
+symptoms that concern you.
+
+** If pathology specimens were sent at the time of surgery, the 
+reports will be reviewed with you in detail at your follow up 
+appointment. This will give both you and your doctor time to 
+understand the pathology, its implications and discuss options 
+going forward.**
+
+ 
+ 
+
+###RESPONSE: lung {Lung structure}, surgery {Surgical procedure}, ready for discharge {Ready for discharge}, incisions {Surgical incision wound}, redness {Redness of skin over lesion}, drainage {Discharge}, draining {Discharge}, removed {Removal of dressing}, drain {Discharge}, dressing {Application of dressing}, pain medication {Administration of analgesic}, discomfort {Discomfort}, pain medications {Administration of analgesic}, constipating {Constipation}, problems {Problem}, stool softener {Administration of laxative}, regular {Normal heart rate}, while taking narcotic pain medication {Narcotics education}, incision {Surgical incision wound}, incision {Surgical incision wound}, Fevers {Fever}, chills {Chill}, shortness of breath {Dyspnea}, chest pain {Chest 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: 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:
+fever
+ 
+Major Surgical or Invasive Procedure:
+none
+
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, fever {Fever}"
+"###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:
+HISTORY OF PRESENTING ILLNESS:
+Mr. ___ is a ___ male with asplenia,
+polycythemia ___, and secondary AML with CNS disease s/p allo
+SCT (D0 = ___ with relapsed disease s/p 3 cycles of
+decitabine/venetoclax and DLI on ___ currently on ___
+with recent admission for pneumonia who presents with fever.
+
+Patient was recently admitted ___ to ___ with right lower lobe
+pneumonia in the setting of neutropenia. He was treated with
+14-day course of meropenem and vancomycin. Infectious work-up,
+including bronchoscopy, was unrevealing. Hospitalization was
+complicated by transaminitis, presumed to be due to drug-induced
+liver injury, and persistent thrombocytopenia requiring several
+transfusions. He was also seen by dermatology for new nodules on
+his lower extremities and had a biopsy. Repeat chest imaging
+prior to discharge showed resolving right lower lobe pneumonia
+containing a fluid filled pneumatocele or early lung abscess. He
+was discharged to complete a further 14-day course of
+levofloxacin and metronidazole.
+
+He reports fever to ___ yesterday and 101.7 the morning of
+admission. He notes feeling more flushed. He also notes mild
+rhinorrhea over past few days which seems to be improving as 
+well
+as right ear discomfort. He also notes some right lung pain 
+which
+feels different and less intense then the pain he had prior to
+his last admission. The notes a mild cough, poor appetite, and
+chronic right foot neuropathy.
+
+On arrival to the ED, initial vitals were 98.3 86 113/85 20 98%
+RA. Exam was unremarkable. Labs were notable for WBC 6.9 (ANC
+100), H/H 7.7/24.0, Plt 12, INR 1.6, fibrinogen 761, Na 137, K
+4.1, BUN/Cr ___, ALP 266, LDH 317, and lactate 1.6. Influenza
+PCR was negative. CXR showed worsening right lower lobe
+consolidative opacity. Patient was given cefepime 2g IV and
+flagyl 500mg IV. Prior to transfer vitals were 99.2 100 122/70 
+16
+96% RA.
+
+On arrival to the floor, patient endorses the above history. He
+has no acute issues or concerns. He headache, vision changes,
+dizziness/lightheadedness, weakness/numbnesss, shortness of
+breath, hemoptysis, chest pain, palpitations, abdominal pain,
+nausea/vomiting, diarrhea, hematemesis, hematochezia/melena,
+dysuria, and hematuria.
+ 
+
+###RESPONSE: asplenia {Asplenia}, polycythemia {Erythrocytosis}, secondary {Metastatic malignant neoplasm}, AML {Acute myeloid leukemia}, CNS disease {Disorder of the central nervous system}, allo
+SCT {Allogeneic peripheral blood stem cell transplant}, relapsed {Relapsing acute myeloid leukemia}, disease {Disease}, pneumonia {Pneumonia}, fever {Fever}, right lower lobe
+pneumonia {Right lower zone pneumonia}, neutropenia {Neutropenia}, vancomycin {Antibiotic therapy}, Infectious {Infectious disease}, work-up {Evaluation procedure}, bronchoscopy {Bronchoscopy}, transaminitis {Aspartate transaminase level above reference range}, drug-induced
+liver injury {Drug-induced disorder of liver}, thrombocytopenia {Thrombocytopenic disorder}, transfusions {Transfusion}, nodules {Nodule}, lower extremities {Lower limb structure}, biopsy {Biopsy}, chest imaging {Chest imaging}, right lower lobe pneumonia {Right lower zone pneumonia}, fluid {Effusion}, pneumatocele {Air cyst}, lung abscess {Abscess of lung}, fever {Fever}, mild {Symptom mild}, rhinorrhea {Nasal discharge}, right ear {Right ear structure}, discomfort {Discomfort}, right lung {Right lung structure}, pain {Pain}, pain {Pain}, mild {Symptom mild}, cough {Cough}, poor appetite {Decrease in appetite}, chronic {Chronic disease}, right foot {Structure of right foot}, neuropathy {Neuropathy}, vitals {Vital signs finding}, RA {Breathing room air}, unremarkable {No abnormality detected}, WBC {White blood cell count}, H/H {Measurement of total hemoglobin concentration and hematocrit}, INR {Calculation of international normalized ratio}, LDH {Serum total lactate dehydrogenase measurement}, lactate {Lactic acid measurement}, Influenza
+PCR {Detection of Influenza A virus using polymerase chain reaction technique}, CXR {Plain chest X-ray}, right lower lobe {Structure of lower lobe of right lung}, consolidative {Lung consolidation}, opacity {Abnormally opaque structure}, vitals {Vital signs finding}, RA {Breathing room air}, headache {Headache}, vision changes {Visual disturbance}, dizziness {Dizziness}, lightheadedness {Lightheadedness}, weakness {Asthenia}, numbnesss {Numbness}, shortness of
+breath {Dyspnea}, hemoptysis {Hemoptysis}, chest pain {Chest pain}, palpitations {Palpitations}, abdominal pain {Abdominal pain}, nausea/vomiting, diarrhea {Nausea, vomiting and diarrhea}, hematemesis {Hematemesis}, hematochezia {Hematochezia}, melena {Melena}, dysuria {Dysuria}, hematuria {Blood in urine}"
+"###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:
+PAST ONCOLOGIC HISTORY:
+- ___: Initial BMBx, dx AML 
+- ___: Leukopheresis
+- ___: Induction Therapy 7+3 cytarabine + daunorubicin
+- ___: Hypercellular marrow with extensive fibrosis, 5%
+blasts
+- ___: IT Ara-C, TNC2 postive cytospin
+- ___: Triple therapy TNC 1, negative cytospin
+- ___: Triple therapy TNC 1 negative cytospin
+- ___: Triple therapy TNC 1 negative cytospin
+- ___: Triple therapy TNC 6 negative cytospin
+- ___: Admitted for URD ablative Allogeneic stem cell
+transplant with Fludarabine/Busulfan for conditioning regimen.
+Day 0 = ___. Enrolled into ___.
+- ___: BMBX D+24, PB Chimerism CD33 100 D, CD3 70%. BM JAK2
+1%
+- ___: BM Chimerism D87% (CD33 100 CD3 D68%)
+- ___: BM Chimerism D91% (DCD33 100 CD3 D68%)
+- ___ apheresis unsuccessful
+- ___: PB chimersims D93% (CD33 100, CD3 80%)
+- ___: RLE DVT started on LMWH
+- ___: PB chimersims D97% (CD33 99, CD3 97%)
+- ___: BMBX 8% blasts, Stoped tacrolimus
+- ___: C1D1 Dacogen/Venetoclax
+- ___: C2D1 Dacogen/Venetoclax
+- ___: DLI
+- ___: C3D1 Dacogen/Venetoclax
+
+Polycythemia ___ as described above
+-CAD status post PCI
+___ Splenectomy 
+ 
+
+###RESPONSE: BMBx {Bone marrow sampling}, AML {Acute myeloid leukemia}, Leukopheresis {Leukopheresis}, Therapy {Therapy}, fibrosis {Fibrosis}, Allogeneic stem cell
+transplant {Allogeneic peripheral blood stem cell transplant}, regimen {Therapeutic regimen}, BMBX {Bone marrow sampling}, Chimerism {Cellular mosaicism}, BM {Bone marrow structure}, BM {Bone marrow structure}, Chimerism {Cellular mosaicism}, BM {Bone marrow structure}, Chimerism {Cellular mosaicism}, apheresis {Apheresis}, RLE {Structure of right lower limb}, DVT {Deep venous thrombosis}, BMBX {Bone marrow sampling}, Polycythemia {Erythrocytosis}, CAD {Coronary arteriosclerosis}, status post {Postoperative state}, PCI {Percutaneous coronary intervention}, Splenectomy {Splenectomy}"
+"###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 with polycythemia ___.
+ 
+
+###RESPONSE: polycythemia {Erythrocytosis}"
+"###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: Temp 99.6, BP 118/69, HR 89, RR 18, O2 sat 97% RA.
+GENERAL: Pleasant man, in no distress, lying in bed comfortably.
+HEENT: Anicteric, PERLL, OP clear.
+CARDIAC: RRR, no murmurs.
+LUNG: Appears in no respiratory distress, right basilar rhonchi.
+ABD: Soft, non-tender, non-distended, positive bowel sounds,.
+EXT: Warm, well perfused, no lower extremity edema.
+NEURO: A&Ox3, good attention and linear thought, gross strength
+and sensation intact.
+SKIN: Multiple pink-to-violaceous firm papules on bilateral 
+lower
+extremities as well as several on bilateral upper extremities.
+
+DISCHARGE PHYSICAL EXAM:
+moderate distress apneic restless at times
+ 
+
+###RESPONSE: PHYSICAL EXAM {Physical examination procedure}, VS {Vital signs finding}, Temp {Body temperature finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, O2 sat {Oxygen saturation measurement}, RA {Breathing room air}, GENERAL {General examination of patient}, distress {Distress}, lying in bed {Lying in bed}, HEENT {Physical examination procedure}, Anicteric {White sclera}, PERLL {Pupils equal, react to light and accommodation}, OP clear {Pharynx normal}, CARDIAC {Cardiovascular physical examination}, RRR {Normal heart rate}, murmurs {Murmur}, LUNG {Examination of respiratory system}, distress {Distress}, right basilar {Structure of base of right lung}, rhonchi {Wheeze - rhonchi}, ABD {Examination of abdomen}, Soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, positive bowel sounds {Normal bowel sounds}, EXT {Examination of limb}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, edema {Edema}, NEURO {Neurological examination}, Ox3 {Oriented to person, time and place}, attention {Finding related to attentiveness}, sensation intact {Normal sensation}, SKIN {Examination of skin}, papules {Papule}, bilateral 
+lower
+extremities {Both lower extremities}, bilateral upper extremities {Both upper extremities}, moderate {Symptom moderate}, distress {Distress}, apneic {Apnea}, restless {Restlessness}"
+"###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:
+___ 05:55PM BLOOD WBC: 6.9 RBC: 2.46* Hgb: 7.7* Hct: 24.0*
+MCV: 98 MCH: 31.3 MCHC: 32.1 RDW: 16.6* RDWSD: 54.1* Plt Ct: 12*
+___ 05:55PM BLOOD Neuts: 1* Lymphs: ___ Monos: 9 Eos: 1 
+Baso:
+0 Blasts: 69* NRBC: 108.0* AbsNeut: 0.10* AbsLymp: 1.92 AbsMono:
+0.62 AbsEos: 0.07 AbsBaso: 0.00*
+___ 05:55PM BLOOD ___: 17.2* PTT: 30.2 ___: 1.6*
+___ 05:55PM BLOOD Fibrino: ___
+___ 05:55PM BLOOD Glucose: 104* UreaN: 14 Creat: 0.8 Na: 
+137
+K: 4.1 Cl: 99 HCO3: 26 AnGap: 12
+___ 05:55PM BLOOD ALT: 22 AST: 33 LD(LDH): 317* AlkPhos:
+266* TotBili: 0.8
+___ 05:55PM BLOOD Albumin: 3.4*
+___ 06:16PM BLOOD Lactate: 1.6
+
+DISCHARGE LABS
+none-CMO
+ 
+
+###RESPONSE: WBC {White blood cell count}, RBC {Red blood cell count}, Hct {Hematocrit determination}, BLOOD Glucose {Glucose measurement, blood}, TotBili {Bilirubin, total measurement}, Lactate {Lactic acid 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: Brief Hospital Course:
+Mr. ___ is a ___ male with asplenia, 
+polycythemia ___, and secondary AML with CNS disease s/p allo 
+SCT (D0 = ___ with relapsed disease s/p 3 cycles of 
+decitabine/venetoclax and DLI on ___ most recently on 
+Ivisidenib with recent admission for pneumonia who presented 
+with febrile neutropenia with persistent RLL pneumonia with 
+course c/b SVT with unfortunate overwhelming infection now 
+transitioned to comfort measures only and transition to home 
+hospice.
+
+ACUTE CONDITIONS
+==================== 
+
+#RIGHT LOWER LOBE PNEUMONIA: 
+#FEBRILE NEUTROPENIA (Fevers persist]: 
+Patient is status post recent prolonged admission with right 
+lobe pneumonia that was concerning for possible abscess as well 
+as viral or fungal etiology. BAL and induced sputum studies were 
+negative at the time. He recently completed prolonged course of
+antibiotics; however, he was re-admitted with febrile 
+neutropenia and persistent RLL pneumonia concerning of fungal 
+etiology on imaging vs. lung abscess formation per ID. Further 
+work up of PNA with urine legionella (neg), strep pneumo (neg), 
+MRSA (neg) and parvovirus (neg). Sinus CT ___ obtained for 
+continued sinus
+pressure showed a right obstructive sinusitis. He was started on 
+IV Vancomycin (D1 ___ and IV Ceftaz 2gm Q8 hours 
+(D1 ___. Beta glucan elevated at 424, could be 
+false elevation, galactomannan negative. Repeat BD glucan 
+negative, Asp galactomannan ___ PND. MRSA negative; 
+therefore, vancomycin
+was discontinued. Patient had continued fevers, which prompted 
+re-imaging on ___. Chest CT showed progression of pneumonia, 
+now involving majority of the right lower lobe with surrounding 
+ground-glass opacities. Given concern for fungal pneumonia, 
+patient was started on Ambisone. ID re-consulted ___, recs 
+biopsy and induced sputum. Per ID, would need biopsy of his RLL 
+consolidation but deferred in light of profound TCP and GOC.
+
+Unfortunately, patient developed worsening pulmonary symptoms 
+(increased WOB ___ and tachycardia) and his 
+antibiotics was escalated from ceftazidime to meropenem (D1: 
+___. He also developed new SVT which may have 
+exacerbated his pulmonary symptoms. He was given Solumedrol 50mg 
+IVPx1 and was continued daily through ___, d/c'd as has not 
+been efficacious for his pulmonary symptoms. Given ongoing high 
+fevers, added Linezolid (D1 ___. Chest CT showed 
+worsening PNA on ___, after discussing the results with 
+primary oncologist, patient decided to transition care from 
+aggressive treatment to focus on symptom management and comfort. 
+His antibiotics were discontinued on ___ and he was started 
+on Morphine IV/PO for dyspnea management. He was discharged home 
+on ___ and after multiple discussions, agreed to home with 
+hospice services.
+-per palliative recommendations will be discharged home with: 
+morphine ___ po suspension q2 prn, Ativan 0.5-1mg po q4 prn, 
+Tylenol ___ po prn.
+
+#RELAPSED AML: He is s/p allogeneic SCT (D0 = ___ with 
+relapsed disease s/p 3 cycles of decitabine/venetoclax and DLI 
+on ___. BMBx ___ consistent with persistent leukemia, 
+based on (+)IDH1 mutation. He was started on ivosidenib ___, 
+and venetoclax was stopped. Patient w/ lesions to extremities 
+that
+was concerning for leukemia cutis. Dermatology biopsied site on 
+___ result c/w leukemia cutis. Given persistent PNA despite 
+ABX and progressive disease, had GOC discussion with primary 
+oncologist on ___ and patient was made DNR/DNI, and on 
+___ as above with transition to CMO. 
+
+#DISCHARGE PLANNING: patient with difficult non compliance in 
+the past and patient was eager to leave the hospital ASAP ___ 
+AM. He initially was refusing home services, including hospice 
+care but after discussion with RN, SW, palliative team agreed to 
+go home with hospice services. Initially consulted ethics and 
+psychiatry with concern of patient leaving AMA however after 
+multiple discussions with ___ team patient agreed to resuming 
+hospice services and abiding by recommendations. Patient had 
+safety evaluation before discharge and appropriate to discharge 
+home with hospice. 
+
+d/c planning > 30 min
+
+ 
+
+###RESPONSE: asplenia {Asplenia}, polycythemia {Erythrocytosis}, secondary {Metastatic malignant neoplasm}, AML {Acute myeloid leukemia}, CNS disease {Disorder of the central nervous system}, allo 
+SCT {Allogeneic peripheral blood stem cell transplant}, relapsed {Relapsing acute myeloid leukemia}, disease {Disease}, pneumonia {Pneumonia}, febrile neutropenia {Febrile neutropenia}, RLL pneumonia {Right lower zone pneumonia}, SVT {Supraventricular tachycardia}, infection {Infectious disease}, comfort measures {Comfort measures}, RIGHT LOWER LOBE PNEUMONIA {Right lower zone pneumonia}, FEBRILE NEUTROPENIA {Febrile neutropenia}, Fevers {Fever}, status post {Postoperative state}, right 
+lobe pneumonia {Right lower zone pneumonia}, abscess {Abscess of lung}, viral {Viral disease}, fungal {Mycosis}, induced sputum {Collection of induced sputum}, antibiotics {Antibiotic therapy}, febrile 
+neutropenia {Febrile neutropenia}, RLL pneumonia {Right lower zone pneumonia}, fungal {Mycosis}, imaging {Imaging}, lung abscess {Abscess of lung}, PNA {Pneumonia}, urine {Evaluation of urine specimen}, legionella {Legionella infection}, MRSA {Methicillin resistant Staphylococcus aureus infection}, parvovirus {Parvovirus infection}, Sinus {Nasal sinus structure}, CT {Computed tomography}, sinus
+pressure {Sensation of nasal sinus pressure}, right {Right sphenoid sinus structure}, obstructive sinusitis {Obstructive sinusitis}, Vancomycin {Antibiotic therapy}, MRSA {Methicillin resistant Staphylococcus aureus infection}, vancomycin {Antibiotic therapy}, fevers {Fever}, imaging {Imaging}, Chest CT {Computed tomography of chest}, pneumonia {Pneumonia}, right lower lobe {Structure of lower lobe of right lung}, ground-glass opacities {Ground glass lung opacity}, fungal pneumonia {Fungal pneumonia}, biopsy {Biopsy}, induced sputum {Collection of induced sputum}, biopsy {Biopsy}, RLL {Structure of lower lobe of right lung}, consolidation {Consolidation}, TCP {Thrombocytopenic disorder}, worsening pulmonary symptoms {Decreased respiratory function}, WOB {Labored breathing}, tachycardia {Tachycardia}, antibiotics {Antibiotic therapy}, SVT {Supraventricular tachycardia}, exacerbated his pulmonary symptoms {Decreased respiratory function}, pulmonary {Structure of respiratory system}, fevers {Fever}, Chest CT {Computed tomography of chest}, PNA {Pneumonia}, symptom management {Symptom management}, antibiotics {Antibiotic therapy}, dyspnea {Dyspnea}, discussions {Discussion}, RELAPSED AML {Relapsing acute myeloid leukemia}, allogeneic SCT {Allogeneic peripheral blood stem cell transplant}, relapsed {Relapsing acute myeloid leukemia}, disease {Disease}, BMBx {Bone marrow sampling}, leukemia {Leukemia}, mutation {Genetic mutation}, lesions {Skin lesion}, extremities {All extremities}, leukemia cutis {Leukemic infiltration of skin}, Dermatology biopsied {Biopsy of skin}, leukemia cutis {Leukemic infiltration of skin}, PNA {Pneumonia}, ABX {Antibiotic therapy}, disease {Disease}, discussion {Discussion}, DNR {Not for resuscitation}, non compliance {Drug compliance poor}, hospice 
+care {Hospice care}, discussion {Discussion}, hospice services {Hospice care}, leaving AMA {Patient self-discharge against medical advice}, discussions {Discussion}, hospice services {Hospice care}, evaluation {Evaluation procedure}, hospice {Hospice care}, d/c planning {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:
+The Preadmission Medication list is accurate and complete.
+1. LevoFLOXacin 750 mg PO DAILY 
+2. Ursodiol 300 mg PO QAM 
+3. Ursodiol 600 mg PO QPM 
+4. Magnesium Oxide 800 mg PO DAILY 
+5. Vitamin D ___ UNIT PO DAILY 
+6. Isavuconazonium Sulfate 372 mg PO DAILY 
+7. Gabapentin 400 mg PO DAILY 
+8. Multivitamins W/minerals 1 TAB PO DAILY 
+9. FoLIC Acid 1 mg PO DAILY 
+10. Acyclovir 400 mg PO Q8H 
+11. Pentamidine-Inhalation 300 mg IH MONTHLY 
+12. Tibsovo (ivosidenib) 500 mg PO DAILY 
+
+ 
+Discharge Medications:
+1.  Acetaminophen 650 mg PO Q6H:PRN Pain - Mild/Fever  
+2.  LORazepam 0.5-1 mg PO Q4H:PRN anxiety 
+RX *lorazepam 0.5 mg ___ tabs by mouth every 4 hours as needed 
+Disp #*42 Tablet Refills:*0 
+3.  Morphine Sulfate (Oral Solution) 2 mg/mL ___ mg PO Q2H:PRN 
+pain/dyspnea 
+RX *morphine 10 mg/5 mL ___ ml by mouth every 2 hours as needed 
+Refills:*0 
+4.  Gabapentin 400 mg PO DAILY  
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Primary Diagnosis
+=============
+febrile neutropenia 
+AML
+Pneumonia
+Sinusitis
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: With Service {Home health aide service management}, febrile neutropenia {Febrile neutropenia}, AML {Acute myeloid leukemia}, Pneumonia {Pneumonia}, Sinusitis {Sinusitis}, Mental Status {Neurological mental status determination}, 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:
+Mr. ___, 
+
+You were admitted for fevers while your blood counts were low. 
+You were found to have persistent pneumonia which did not 
+improve with antibiotics. With worsening pneumonia, you 
+transitioned to comfort measures and supportive care. You are 
+not being discharge home. 
+
+Sincerely, 
+Your ___ team
+ 
+
+###RESPONSE: fevers {Fever}, blood counts {Blood test}, pneumonia {Pneumonia}, antibiotics {Antibiotic therapy}, pneumonia {Pneumonia}, comfort measures {Comfort measures}, supportive care {Support}"
+"###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: 
+Patient recorded as having No Known Allergies to Drugs
+ 
+Attending: ___.
+ 
+Chief Complaint:
+left ankle cellulitis
+ 
+Major Surgical or Invasive Procedure:
+none 
+
+ 
+
+###RESPONSE: No Known Allergies to Drugs {Non-allergic hypersensitivity to drug or medicament}, left ankle cellulitis {Cellulitis of left ankle}"
+"###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 female with HCV p/w 2 days of left ankle pain and redness 
+and also new low back/buttocks pain.  She recently attempted to 
+clip an ingrown toenail on her left foot although she reports no 
+toe pain or redness.  She denies fevers and chills although has 
+been having daily hot flashes.  Denies trauma to the ankle.  No 
+prior cellulitis or joint infections.
+.
+Ortho was consulted in ED in regards to question of a septic 
+joint.  No joint aspiration was performed as clinically felt to 
+be low chance of joint involvement.  She was given Vanco and 
+Cefazolin and pain control in ER.
+.
+Also got Cipro for + UA.
+ 
+
+###RESPONSE: HCV {Viral hepatitis type C}, left ankle {Structure of left ankle}, pain {Pain}, redness {Redness of skin over lesion}, low back {Low back pain}, buttocks pain {Pain in buttock}, ingrown toenail {Ingrowing toenail}, left foot {Structure of left foot}, toe pain {Pain in toe}, redness {Redness of skin over lesion}, fevers {Fever}, chills {Chill}, hot flashes {Menopausal flushing}, trauma {Traumatic injury}, ankle {Structure of left ankle}, cellulitis {Cellulitis}, joint infections {Infectious disorder of joint}, septic 
+joint {Arthritis of knee}, joint aspiration {Arthrocentesis}, joint {Joint structure}, pain control {Pain control}, ER {Emergency treatment}, + UA {Abnormal urinalysis}"
+"###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:
+HCV
+Hypertension  
+Hypothyroidism
+h/o pneumonia at ___ yrs and ___ yrs  
+MR/CHF - in the setting of pneumonia  
+Preeclampsia  
+Anxiety  
+h/o Kidney stones  
+s/p C-section  
+Chronic pain secondary to bilateral foot deformities.
+s/p removal of left breast cysts  
+left neck cyst removal  
+anemia
+ 
+
+###RESPONSE: HCV {Viral hepatitis type C}, Hypertension {Hypertensive disorder, systemic arterial}, Hypothyroidism {Hypothyroidism}, pneumonia {Pneumonia}, MR {Mitral valve regurgitation}, CHF {Congestive heart failure}, pneumonia {Pneumonia}, Preeclampsia {Pre-eclampsia}, Anxiety {Anxiety}, Kidney stones {Kidney stone}, C-section {Cesarean section}, Chronic pain {Chronic pain}, foot deformities {Deformity of foot}, removal {Removal}, left breast {Left breast structure}, cysts {Cyst}, left neck {Structure of left half of neck}, cyst {Cyst}, removal {Removal}, anemia {Anemia}"
+"###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 with hypothyroidism. Father with hypertension and 
+alcoholism. Grandfather with jaw cancer. No known family history 
+of liver disease. 
+ 
+
+###RESPONSE: hypothyroidism {Hypothyroidism}, hypertension {Hypertensive disorder, systemic arterial}, alcoholism {Alcoholism}, jaw {Structure of left half of neck}, cancer {Malignant neoplasm}, liver disease {Disorder of liver}"
+"###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:
+VS:  97.2   140/100    72   20 100%RA
+GEN: Well appearing, Comfortable, NAD
+HEENT: NCAT, PERRL, OP clear, no thrush
+NECK: Supple, no LAD
+CV: RRR, III/VI SM LSB
+LUNGS: CTABL
+ABD: Soft, NTND, no masses, no bruits
+EXT: No ___ edema, erythema and warmth present over left ankle 
+and anterior leg.  Slightly decreased ROM on active and passive 
+movement.  2+ ___ pulses.  Right knee without warmth or 
+swelling.  No palpable LNs in popliteal fossa.
+BACK: No midline tenderness.  Small, mobile, tender lymph nodes 
+palpable over bilateral iliac crests.
+ 
+
+###RESPONSE: VS {Vital signs finding}, RA {Breathing room air}, GEN {General examination of patient}, Well appearing {Well cared for appearance}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, NC {Normal head}, PERRL {Pupils equal and reacting to light}, OP clear {Pharynx normal}, thrush {Candidiasis}, NECK {Physical examination procedure}, Supple {Normal movement of neck}, LAD {Lymphadenopathy}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, SM {Systolic murmur}, LUNGS {Examination of respiratory system}, CTABL {Normal breath sounds}, ABD {Examination of abdomen}, Soft {Abdomen soft}, ND {Swollen abdomen}, masses {Abdominal mass}, EXT {Examination of limb}, edema {Edema}, erythema {Erythema}, warm {Warm skin}, left ankle {Structure of left ankle}, anterior leg {Skin structure of anterior surface of lower leg}, decreased ROM {Limitation of joint movement}, active {Active range of joint movement reduced}, passive 
+movement {Passive range of joint movement reduced}, 2+ ___ pulses {Lower limb pulse present}, Right knee {Structure of right knee region}, warm {Warm skin}, swelling {Joint swelling}, palpable {Finding by palpation}, LNs in popliteal fossa {Popliteal lymph node structure}, tenderness {Tenderness}, tender {Abdominal tenderness}, palpable {Finding by palpation}, iliac crests {Structure of iliac lymph node}"
+"###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:
+___ 08:50AM BLOOD WBC-9.6
+___ 10:00PM BLOOD WBC-7.1 RBC-4.00* Hgb-12.2 Hct-35.0* 
+MCV-88 MCH-30.6 MCHC-35.0 RDW-13.3 Plt ___
+___ 10:00PM BLOOD Neuts-54.5 ___ Monos-4.9 Eos-3.8 
+Baso-0.6
+___ 08:50AM BLOOD UreaN-13 Creat-0.9
+___ 10:00PM BLOOD Glucose-118* UreaN-18 Creat-0.9 Na-141 
+K-4.1 Cl-107 HCO3-28 AnGap-10
+___ 10:00PM BLOOD CRP-14.5*
+___ 10:10PM BLOOD Lactate-1.5
+___ 12:50AM URINE Color-Yellow Appear-Clear Sp ___
+___ 12:50AM URINE Blood-NEG Nitrite-NEG Protein-NEG 
+Glucose-NEG Ketone-TR Bilirub-NEG Urobiln-NEG pH-5.0 Leuks-SM
+___ 12:50AM URINE RBC-0 ___ Bacteri-NONE Yeast-NONE 
+___
+Blood and urine culture neg (urine culture was done after 
+antibiotics)
+ 
+
+###RESPONSE: WBC {White blood cell count}, 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}, Monos {Monocyte count}, Eos {Eosinophil count}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, 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}, URINE {Evaluation of urine specimen}, Color {Color finding}, Clear {Urine looks clear}, Protein {Measurement of protein in urine}, pH {pH measurement}, URINE {Evaluation of urine specimen}, RBC {Red blood cell count}, Blood {Blood culture}, urine culture {Urine culture}, urine culture {Urine culture}, antibiotics {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: Brief Hospital Course:
+Left ankle celluliis improved with vancomycin and pt was 
+discharged on keflex. Oxycodone controlled pain well. 
+Cipro was continued for UTI. 
+Patient is known to have intraabdominal lymphadenopathy in past 
+and has noted low back lymph nodes. She was advised to follow up 
+with PCP regarding further follow up. 
+Also she was concered of a breast mass and was advised to 
+discuss with PCP ___. mammogram/US. 
+ 
+
+###RESPONSE: Left ankle {Structure of left ankle}, celluliis {Cellulitis}, improved {Patient's condition improved}, vancomycin {Antibiotic therapy}, controlled pain {Demonstrates adequate pain control}, UTI {Urinary tract infectious disease}, intraabdominal lymphadenopathy {Disorder of intra-abdominal lymph nodes}, low back {Lower back structure}, lymph nodes {Structure of lymph node}, follow up {Follow-up arranged}, PCP {Primary care management}, follow up {Follow-up arranged}, breast mass {Breast lump}, PCP {Primary care management}, mammogram {Mammography}, US {Ultrasonography of bilateral breasts}"
+"###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:
+Clonazepam 1mg BID at 7PM and bedtime
+Clonazepam 2 mg BID prn
+Diltiazem 240mg daily
+HCTZ 25mg daily
+Synthroid ___ microgram daily x 6 days and then 100 microgram on 
+___ day
+Olmesartan 40 mg daily
+Darvon 65mg PRN
+Prilosec OTC
+Propanolol 40 mg TID
+ 
+Discharge Medications:
+1. Clonazepam 1 mg Tablet Sig: Two (2) Tablet PO twice a day as 
+needed for anxiety: Do not take with alcohol, do not drive or 
+use machinery while on this medicaton. Can make you drowsy. .  
+2. Clonazepam 1 mg Tablet Sig: One (1) Tablet PO DAILY AT 7PM 
+(): Do not take with alcohol, do not drive or use machinery 
+while on this medicaton. Can make you drowsy. .  
+3. Clonazepam 1 mg Tablet Sig: One (1) Tablet PO QHS (once a day 
+(at bedtime)) as needed: Do not take with alcohol, do not drive 
+or use machinery while on this medicaton. Can make you drowsy. . 
+ 
+4. Diltiazem HCl 120 mg Capsule, Sustained Release Sig: Two (2) 
+Capsule, Sustained Release PO DAILY (Daily).  
+5. Hydrochlorothiazide 12.5 mg Capsule Sig: Two (2) Capsule PO 
+DAILY (Daily).  
+6. Levothyroxine 100 mcg Tablet Sig: Two (2) Tablet PO 6X/WEEK 
+(___).  
+7. Levothyroxine 100 mcg Tablet Sig: One (1) Tablet PO 1X/WEEK 
+(___).  
+8. Olmesartan 20 mg Tablet Sig: Two (2) Tablet PO Daily () as 
+needed for HTN.  
+9. Propranolol 40 mg Tablet Sig: One (1) Tablet PO TID (3 times 
+a day).  
+10. Prilosec OTC 20 mg Tablet, Delayed Release (E.C.) Sig: One 
+(1) Tablet, Delayed Release (E.C.) PO once a day.  
+11. Oxycodone 5 mg Tablet Sig: ___ Tablets PO every eight (8) 
+hours as needed for pain: Do not take with alcohol, do not drive 
+or use machinery while on this medicaton. Can make you drowsy. .
+Disp:*10 Tablet(s)* Refills:*0*
+12. Cephalexin 500 mg Capsule Sig: One (1) Capsule PO Q6H (every 
+6 hours) for 7 days.
+Disp:*28 Capsule(s)* 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:
+Left leg/ankle cellulitis
+Urinary tract infection, bacterial likely
+Lymphadenopathy
+Concern for breast mass
+History of hypertension and anxiety
+Tobacco user
+
+ 
+Discharge Condition:
+stable 
+
+ 
+
+###RESPONSE: Left leg {Structure of left lower leg}, ankle {Structure of left ankle}, cellulitis {Cellulitis}, Urinary tract infection {Urinary tract infectious disease}, bacterial {Bacterial infectious disease}, Lymphadenopathy {Lymphadenopathy}, breast mass {Breast lump}, hypertension {Hypertensive disorder, systemic arterial}, anxiety {Anxiety}, Tobacco user {Tobacco user}, stable {Patient's condition stable}"
+"###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:
+Return to the hospital if you have new fevers, chills, worsening 
+ankle swelling or pain or any new symptoms of concern to you. 
+
+Take the antibiotocs as prescribed for cellulitis. 
+
+Keep your appointments. 
+
+Discuss your concern about breast mass and also enlarged lymph 
+nodes with your primary care doctor - Dr ___ you se him 
+this week. You will need further work up for it. Dr ___ 
+arrange for it in clinic. 
+
+Do not take oxycodone and drive or use machinery or cook. 
+
+ 
+
+###RESPONSE: Discharge Instructions {Final inpatient visit with instructions at discharge}, fevers {Fever}, chills {Chill}, ankle swelling {Swollen ankle}, pain {Abdominal pain}, antibiotocs {Ankle pain}, cellulitis {Cellulitis}, breast mass {Breast lump}, enlarged lymph 
+nodes {Lymphadenopathy}, work up {Evaluation procedure}, clinic {Outpatient care management}"
+"###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: 
+Penicillins / Aspirin / Sulfa (Sulfonamide Antibiotics) / Latex 
+/ banana / kiwi / peanut / clindamycin / salicylates
+ 
+Attending: ___.
+ 
+Chief Complaint:
+shortness of breath
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: Penicillins {Allergy to penicillin}, Aspirin {Allergy to aspirin}, Antibiotics {Antibiotic therapy}, peanut {Allergy to peanut}, shortness of breath {Dyspnea}"
+"###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 ___ history of
+asthma, PCOS, hypertension, G6PD, and PTSD, presenting with
+worsening shortness of breath with concern for asthma
+exacerbation.
+
+Of note, patient recently presented to ___ ___ with
+worsening shortness of breath and coughing. Patient stated this
+felt like her prior asthma exacerbations. Given documented
+minimal wheezing on exam and with normal O2 saturation, she was
+treated with duonebs as well as prednisone. She was discharged 
+on
+prednisone 50 mg daily x 5 days. 
+
+Patient states that she never felt better after being discharged
+from the ___. She completed her 5 day course of
+prednisone 50 mg daily ___. She has continued to have 
+worsening
+shortness of breath, was told by co-workers this morning that 
+she
+was gasping for air and he could hear her audibly wheezing.
+States she has been adherent to her home Advair inhalers, has
+been using her albuterol rescue inhaler every couple of minutes
+without relief. Today has noted new worsening productive cough
+with phlegm. Denies any fevers or chills. Denies any sore throat
+or rhinorrhea.
+
+In the ED, initial VS were: T 98.1 HR 106 BP 175/96 RR 24 O2
+100%RA
+
+On Exam:
+Gen: Moderate distress, unable to speak in full sentences, 
+severe
+cough
+CV: RRR, normal S1/S2
+Pulm: +accessory muscle use, diffuse end expiratory wheezing,
+diminished breath sounds R lung base, bibasilar crackles
+
+Labs notable for: 
+- WBC 8.1, Hb 11.7, PLT 280
+- Na 142, K 3.8, BUN 5, Cr 0.5
+- VBG 7.41/___
+- Flu: Negative
+- UA: Moderate leuks, negative nitrite, 2 WBC, few bacteria  
+
+Imaging showed:
+CXR ___:
+1. Slightly increased interstitial opacities in the right lower
+lung field may represent bronchovascular crowding secondary to
+decreased inspiratory effort however an early infectious or
+inflammatory process cannot be excluded, particularly in this
+patient with productive cough.
+
+Consults: None
+
+Patient received:
+___ 07:51 IH Albuterol 0.083% Neb Soln
+___ 07:51 IH Ipratropium Bromide Neb 1 NEB  
+___ 08:09 IH Albuterol 0.083% Neb Soln 1 NEB 
+___ 08:09 IH Ipratropium Bromide Neb 1 NEB  
+___ 08:09 PO Ondansetron ODT 4 mg 
+___ 09:51 IV Magnesium Sulfate  
+___ 09:51 IV MethylPREDNISolone Sodium Succ 125 mg 
+___ 09:53 IH Albuterol 0.083% Neb Soln 1 NEB 
+___ 09:53 IH Ipratropium Bromide Neb 1 NEB   
+___ 10:53 IV Magnesium Sulfate 2 gm 
+___ 11:09 IV Azithromycin  
+___ 13:10 IV Azithromycin 500 mg 
+___ 14:22 IV CefTRIAXone   
+___ 14:29 IV CefTRIAXone 2 g  
+___ 16:16 PO/NG Spironolactone 100 mg 
+___ 16:16 IVF  LR  
+___ 17:39 IVF  LR 1000 mL 
+___ 20:21 PO/NG Acetaminophen 1000 mg 
+___ 20:38 PO TraMADol 50 mg 
+
+Transfer VS were: T 98.9 HR 114, BP 158/89 RR 18 O2 100%RA
+
+On arrival to the floor, patient confirms the above
+history. States that at present she does not feel short of
+breath, however endorsing frequent coughing (with occasional
+brownish phlegm).
+
+ 
+
+###RESPONSE: asthma {Asthma}, PCOS {Polycystic ovary syndrome}, hypertension {Hypertensive disorder, systemic arterial}, G6PD {Glucose-6-phosphate dehydrogenase deficiency anemia}, PTSD {Posttraumatic stress disorder}, shortness of breath {Dyspnea}, asthma
+exacerbation {Exacerbation of asthma}, shortness of breath {Dyspnea}, coughing {Cough}, asthma exacerbations {Exacerbation of asthma}, wheezing {Wheezing}, normal O2 saturation {Oxygen saturation within reference range}, shortness of breath {Dyspnea}, gasping {Gasping for breath}, wheezing {Wheezing}, inhalers {Oxygen therapy}, inhaler {Oxygen therapy}, relief {Feeling relief}, productive cough {Productive cough}, fevers {Fever}, chills {Chill}, sore throat {Sore throat}, rhinorrhea {Nasal discharge}, VS {Vital signs finding}, RA {Breathing room air}, Gen {General examination of patient}, distress {Distress}, unable to speak {Unable to speak}, cough {Cough}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, normal S1 {Normal first heart sound, S>1<}, Pulm {Examination of respiratory system}, accessory muscle {Accessory skeletal muscle}, expiratory wheezing {Expiratory wheezing}, diminished breath sounds {Decreased breath sounds}, R lung base {Structure of base of right lung}, bibasilar {Structure of base of lung}, crackles {Respiratory crackles}, Flu {Influenza}, UA {Urinalysis}, CXR {Plain chest X-ray}, opacities {Abnormally opaque structure}, lung field {Structure of lung field}, infectious {Infectious disease}, inflammatory {Inflammatory disorder}, productive cough {Productive cough}, IV {Intravenous therapy}, IV {Intravenous therapy}, IV {Intravenous therapy}, IV {Intravenous therapy}, IV {Intravenous therapy}, IV {Intravenous therapy}, IV {Intravenous therapy}, IVF {Administration of intravenous fluids}, IVF {Administration of intravenous fluids}, VS {Vital signs finding}, RA {Breathing room air}, short of
+breath {Dyspnea}, coughing {Cough}, brownish phlegm {Brown sputum}"
+"###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:
+Asthma
+Obstructive sleep apnea
+PCOS (polycystic ovarian syndrome)       
+Psychosocial stressors, PTSD
+Iron deficiency anemia                              
+G6PD deficiency
+Headaches/Migraines
+Menorrhagia
+Atypical squamous cells of undetermined significance (ASCUS) on 
+___ smear of cervix
+h/o STD, Herpes simplex vulvovaginitis
+
+ 
+
+###RESPONSE: Asthma {Asthma}, Obstructive sleep apnea {Obstructive sleep apnea syndrome}, PCOS {Polycystic ovary syndrome}, polycystic ovarian syndrome {Polycystic ovary syndrome}, PTSD {Posttraumatic stress disorder}, Iron deficiency anemia {Iron deficiency anemia}, G6PD deficiency {Glucose-6-phosphate dehydrogenase deficiency anemia}, Headaches {Headache}, Migraines {Migraine}, Menorrhagia {Menorrhagia}, Atypical squamous cells of undetermined significance {Atypical squamous cells of undetermined significance}, smear of cervix {Cytopathology procedure, preparation of smear, genital source}, STD {Sexually transmitted infectious disease}, Herpes simplex {Herpes simplex}, vulvovaginitis {Vulvovaginitis}"
+"###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:
+- Sister w/ arrhythmia on rhythm control - unable to specify 
+further 
+- brother with cardiomyopathy
+- low potassium in family
+- Hypertension
+- Malignancy (sarcoma in mother, leukemia in father)
+- Depression
+- Obesity
+- T2DM
+- Keratoconus (multiple family members)
+ 
+
+###RESPONSE: arrhythmia {Cardiac arrhythmia}, cardiomyopathy {Cardiomyopathy}, low potassium {Hypokalemia}, Hypertension {Hypertensive disorder, systemic arterial}, Malignancy {Malignant neoplasm}, sarcoma {Sarcoma}, leukemia {Leukemia}, Depression {Depressive disorder}, Obesity {Obesity}, T2DM {Diabetes mellitus type 2}, Keratoconus {Keratoconus}"
+"###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 98.2 BP 166/98 HR 118 RR 18 O2 97%RA
+Gen: Intermittently coughing, however speaking in full sentences
+HEENT: NC/AT, PERRLA, EOMI
+Lungs: Decreased breath sounds throughout, however with good air
+movement. Diffuse expiratory wheezing throughout all lung 
+fields.
+CV: Tachycardic, regular rhythm, no murmurs, rubs, or gallops
+Abdomen: Soft, NT/ND.  Normoactive bowel sounds.  No evidence of
+organomegaly
+Neuro: CN II-XII intact. No focal neurological deficits.
+Extremities: 2+ peripheral pulses, no C/C/E
+
+DISCHARGE PHYSICAL EXAM:
+========================
+VS: ___ 0714 Temp: 98.2 PO BP: 130/88 HR: 91 RR: 20 O2 sat:
+98% O2 delivery: RA 
+Gen: Young F in NAD. Appears stated age. Intermittently coughing
+HEENT: NC/AT, EOMI
+Lungs: CTABL, no wheezes appreciated. Breathing comfortably on 
+RA
+without use of accessory muscles. 
+CV: RRR, no murmurs, rubs, or gallops
+Abdomen: Soft, NT/ND. NABS.  No evidence of organomegaly
+Neuro: No focal neurological deficits. A&Ox3. Moving all
+extremities.
+Extremities: warm and well-perfused, no 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}, Gen {General examination of patient}, coughing {Cough}, HEENT {Physical examination procedure}, NC {Normal head}, AT {No injuries apparent}, PERRLA {Pupils equal, react to light and accommodation}, EOMI {Normal ocular motility}, Lungs {Examination of respiratory system}, Decreased breath sounds {Decreased breath sounds}, wheezing {Wheezing}, lung 
+fields {Structure of lung field}, CV {Cardiovascular physical examination}, Tachycardic {Tachycardia}, regular rhythm {Normal sinus rhythm}, murmurs {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, Normoactive bowel sounds {Normal bowel sounds}, organomegaly {Abdominal organomegaly}, Neuro {Neurological examination}, CN II {Normal central nervous system}, XII intact {Normal central nervous system}, neurological deficits {Neurological deficit}, Extremities {Examination of limb}, 2+ peripheral pulses {Peripheral pulses normal}, O2 sat {Oxygen saturation measurement}, RA {Breathing room air}, Gen {General examination of patient}, NAD {No abnormality detected}, coughing {Cough}, HEENT {Physical examination procedure}, NC {Normal head}, AT {No injuries apparent}, EOMI {Normal ocular motility}, Lungs {Examination of respiratory system}, CTABL {Normal breath sounds}, wheezes {Wheezing}, Breathing comfortably {Normal respiratory function}, RA {Breathing room air}, accessory muscles {Accessory skeletal muscle}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, murmurs {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, NABS {Normal bowel sounds}, organomegaly {Abdominal organomegaly}, Neuro {Neurological examination}, neurological deficits {Neurological deficit}, all
+extremities {All extremities}, Extremities {All extremities}, 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:
+===============
+___ 08:08AM   HCG-<5
+___ 08:08AM   CALCIUM-9.5 PHOSPHATE-4.6* MAGNESIUM-1.7
+___ 08:08AM   GLUCOSE-107* UREA N-5* CREAT-0.5 SODIUM-142 
+POTASSIUM-3.8 CHLORIDE-104 TOTAL CO2-22 ANION GAP-16
+___ 09:07AM URINE  MUCOUS-FEW*
+___ 09:07AM URINE  RBC-1 WBC-2 BACTERIA-FEW* YEAST-NONE 
+EPI-2
+___ 09:07AM URINE  BLOOD-NEG NITRITE-NEG PROTEIN-NEG 
+GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-6.0 
+LEUK-MOD*
+___ 09:07AM URINE  COLOR-Straw APPEAR-Hazy* SP ___
+___ 09:07AM URINE  UCG-NEGATIVE
+___ 12:06PM   PLT COUNT-280
+___ 12:06PM   NEUTS-45.7 ___ MONOS-12.2 EOS-3.2 
+BASOS-0.4 IM ___ AbsNeut-3.72 AbsLymp-3.12 AbsMono-0.99* 
+AbsEos-0.26 AbsBaso-0.03
+___ 12:06PM   WBC-8.1 RBC-4.59 HGB-11.7 HCT-38.1 MCV-83 
+MCH-25.5* MCHC-30.7* RDW-13.5 RDWSD-40.3
+___ 02:13PM   ___ PO2-49* PCO2-39 PH-7.41 TOTAL CO2-26 
+BASE XS-0 COMMENTS-PERIPHERAL
+___ 02:25PM OTHER BODY FLUID  FluAPCR-NEGATIVE 
+FluBPCR-NEGATIVE
+
+MICROBIOLOGY:
+=============
+__________________________________________________________
+___ 7:57 am SPUTUM      Source: Expectorated. 
+
+                            **FINAL REPORT ___
+
+   GRAM STAIN (Final ___: 
+      ___ PMNs and >10 epithelial cells/100X field. 
+      Gram stain indicates extensive contamination with upper 
+respiratory
+      secretions. Bacterial culture results are invalid. 
+      PLEASE SUBMIT ANOTHER SPECIMEN. 
+
+   RESPIRATORY CULTURE (Final ___: 
+      TEST CANCELLED, PATIENT CREDITED. 
+__________________________________________________________
+___ 2:25 pm Rapid Respiratory Viral Screen & Culture
+      Source: Nasopharyngeal swab. 
+
+                            **FINAL REPORT ___
+
+   Respiratory Viral Culture (Final ___: 
+      No respiratory viruses isolated. 
+      Culture screened for Adenovirus, Influenza A & B, 
+Parainfluenza type
+      1,2 & 3, and Respiratory Syncytial Virus.. 
+      Detection of viruses other than those listed above will 
+only be
+      performed on specific request. Please call Virology at 
+___
+      within 1 week if additional testing is needed. 
+
+   Respiratory Viral Antigen Screen (Final ___: 
+      Negative for Respiratory Viral Antigen. 
+      Specimen screened for: Adeno, Parainfluenza 1, 2, 3, 
+Influenza A, B,
+      and RSV by immunofluorescence. 
+      Refer to respiratory viral culture and/or Influenza PCR 
+(results
+      listed under ""OTHER"" tab) for further information.. 
+__________________________________________________________
+___ 11:05 am BLOOD CULTURE      SET#2. 
+
+   Blood Culture, Routine (Pending):    No growth to date. 
+__________________________________________________________
+___ 11:02 am BLOOD CULTURE      SET#1. 
+
+   Blood Culture, Routine (Pending):    No growth to date. 
+__________________________________________________________
+___ 9:07 am URINE
+
+                            **FINAL REPORT ___
+
+   URINE CULTURE (Final ___: 
+      MIXED BACTERIAL FLORA ( >= 3 COLONY TYPES), CONSISTENT 
+WITH SKIN
+      AND/OR GENITAL CONTAMINATION. 
+
+IMAGING:
+========
+___ CXR
+FINDINGS:  
+When compared to most recent prior chest radiograph, there is 
+slightly 
+increased interstitial opacity projecting over the right lower 
+lung field 
+which appears more conspicuous .  This may represent crowding of 
+pulmonary 
+vasculature due to decreased inspiratory effort however an early 
+infectious or inflammatory process cannot be excluded.  There is 
+otherwise no other areas of focal consolidation.  There is no 
+pleural effusion or pneumothorax.  The cardiomediastinal 
+silhouette is within normal limits.  There is no acute osseous 
+abnormality or free intraperitoneal air under the diaphragm. 
+  
+IMPRESSION: 
+1. Slightly increased interstitial opacities in the right lower 
+lung field may represent bronchovascular crowding secondary to 
+decreased inspiratory effort however an early infectious or 
+inflammatory process cannot be excluded, particularly in this 
+patient with productive cough. 
+
+DISCHARGE LABS:
+===============
+(from day prior, no labs obtained on day of discharge)
+___ 06:50AM BLOOD WBC-15.1* RBC-4.91 Hgb-12.8 Hct-40.0 
+MCV-82 MCH-26.1 MCHC-32.0 RDW-13.2 RDWSD-38.9 Plt ___
+___ 06:50AM BLOOD Plt ___
+___ 06:50AM BLOOD Glucose-84 UreaN-10 Creat-0.6 Na-142 
+K-4.7 Cl-105 HCO3-25 AnGap-12
+___ 06:50AM BLOOD Calcium-9.5 Phos-4.6* Mg-2.___RIEF HOSPITAL SUMMARY:
+========================
+Ms. ___ is a ___ history of asthma, PCOS, hypertension, G6PD 
+deficiency, and PTSD, who recently presented to ___ 
+with worsening shortness of breath treated with prednisone 
+burst, now re-presenting with worsening shortness of breath and 
+wheezing, admitted with asthma exacerbation and community 
+acquired pneumonia. 
+
+TRANSITIONAL ISSUES:
+====================
+[ ] Patient hypertensive and with headaches while hospitalized. 
+Started on verapamil 120mg qd with some improvement in blood 
+pressure and headaches. Will require close-follow up, especially 
+once she completes the steroid taper as it was felt her steroids 
+contributed to her hypertension. 
+[ ] Patient discharged on steroid taper as follows: 50mg qd x2d, 
+40mg x2d, 30mg x2d, 20mg x2d, and 10mg x2d. PCP should reassess 
+respiratory symptoms and determine if a longer taper is 
+necessary.
+[ ] Pending tests: ___ Blood cultures x2- no growth to date.
+[ ] Patient was tachycardic during admission to 100-120s. Was 
+thought to be secondary to frequent albuterol use prior to 
+admission and ultimately improved during the majority of her 
+stay. Low risk for DVT/PE per Wells criteria and other vital 
+signs remained stable. Please follow up at next PCP ___.
+[ ] Patient had a significant headache during admission, with a 
+known history of migraines. She required IV ketorolac, PO 
+fioricet, and IV Compazine during admission. She was discharged 
+with PO Compazine and ibuprofen. Further headache management 
+should be considered in the outpatient setting. 
+
+ACUTE ISSUES:
+===============
+#Asthma exacerbation
+#?CAP 
+Patient has a history of asthma and has approximately 5 
+exacerbations per year with no prior intubations. She recently 
+presented to ___ on ___ with worsening dyspnea, s/p 
+inhalers and prednisone 50mg x5d completed ___ but without 
+subjective improvement. She presented to ___ ED with severe 
+dyspnea with diffuse wheezing on exam. She received 
+methylprednisolone 125mg x1 in the ED and then was started on 
+prednisone 60mg qd. There was question of new RLL infiltrate on 
+CXR on admission concerning for pneumonia, which could possibly 
+have been the trigger for her asthma exacerbation. She was 
+afebrile and without leukocytosis on admission but did have a 
+productive cough. Sputum culture was contaminated by upper 
+respiratory flora. Influenza PCR was negative. Respiratory viral 
+panel and culture were negative. She completed a 5-day course of 
+Ceftriaxone and azithromycin for empiric CAP treatment prior 
+discharge. There was some concern for PE in this young female 
+with wheezing and tachycardia but had low risk per Wells 
+criteria (see below), with ultimate improvement in her 
+tachycardia for the majority of her hospitalization. She was 
+continued on home Advair and received duonebs q6h. She was 
+switched from her home albuterol to levalbuterol nebs q2h:prn 
+given tachycardia, but was switched back to albuterol on 
+discharge. Patient was discharged on steroid taper for 10 days 
+(50mg qd x2d, 40 x2d, 30 x2d, 20 x2d, 10 x2d) and will follow up 
+with her PCP prior to the end of the taper to assess symptom 
+resolution. She also received guaifenison for cough. 
+
+#HTN 
+Patient hypertensive to 180s on admission. She is only on 
+spironolactone at home. She was previously hospitalized in ___ 
+for wide-ranging SBP to 180-190s, requiring nifedipine and was 
+started on labetalol at that time. Neuro workup at that time 
+with negative CTA/CTV. Subsequently had BP med overdose 
+requiring dopamine in MICU during prior hospitalization. During 
+hospitalization, her hypertension was felt to be related to 
+steroids. She was continued on home spironolactone and received 
+hydralazine prn. She was also started on verapamil 120mg qd for 
+both hypertension and headache. BPs were improved with addition 
+of verapamil and were 130-150s/70-90s on day of discharge. At 
+her PCP follow up, please evaluate her blood pressures (given 
+the prednisone will be tapering) and determine if Verapamil 
+should be continued.
+
+#Tachycardia 
+Patient tachycardia to the 90-120s on admission. EKG showed 
+sinus tachycardia. Differential included ___ albuterol (patient 
+endorsed using albuterol frequently prior to admission) vs PE. 
+There was lower suspicion for PE manifested as tachycardia and 
+wheezing given recent high frequency of albuterol nebs and low 
+risk per Wells criteria. Patient had no recent travel or 
+immobilization, no history of DVT/PE, and no known 
+hypercoagulable state. Her tachycardia improved during the 
+majority of her hospitalization.
+
+#Headache 
+Patient presented with right sided headache since ED, no focal 
+neurological deficits. Patient has history of migraines. No 
+improvement with APAP, tramadol or ibuprofen so patient received 
+ketorolac and Fioricet as well as IV Compazine as needed. 
+
+CHRONIC ISSUES:
+===============
+#Hypokalemia - Continued on home K supplementation 
+
+#PCOS - Continued on home spironolactone 100mg PO BID
+
+#OSA - History of CPAP previously non-adherent. 
+
+#CODE: Full (presumed)
+#CONTACT:
+Name of health care proxy: ___ 
+Relationship: sister 
+Phone number: ___ 
+
+ 
+___ on Admission:
+The Preadmission Medication list is accurate and complete.
+1. Vitamin D ___ UNIT PO 1X/WEEK (WE) 
+2. Albuterol Inhaler 1 PUFF IH Q6H:PRN Shortness of breath 
+3. Spironolactone 100 mg PO BID 
+4. Albuterol 0.083% Neb Soln 1 NEB IH Q4H:PRN wheeze 
+5. Fluticasone-Salmeterol Diskus (250/50)  1 INH IH BID 
+6. Vitamin D ___ UNIT PO DAILY 
+7. Potassium Chloride 20 mEq PO TID 
+8. Prenatal Vitamins 1 TAB PO DAILY 
+
+ 
+Discharge Medications:
+1.  Ibuprofen 600 mg PO Q6H:PRN Pain - Mild NOT relieved by 
+Acetaminophen 
+RX *ibuprofen 600 mg 1 tablet(s) by mouth four times a day Disp 
+#*12 Tablet Refills:*0 
+2.  PredniSONE 50 mg PO DAILY Duration: 2 Doses 
+Start: Tomorrow - ___, First Dose: First Routine 
+Administration Time 
+This is dose # 1 of 5 tapered doses
+RX *prednisone 10 mg 5 tablet(s) by mouth once a day Disp #*10 
+Tablet Refills:*0 
+3.  PredniSONE 40 mg PO DAILY Duration: 2 Doses 
+Start: After 50 mg DAILY tapered dose 
+This is dose # 2 of 5 tapered doses
+RX *prednisone 10 mg 4 tablet(s) by mouth once a day Disp #*8 
+Tablet Refills:*0 
+4.  PredniSONE 30 mg PO DAILY Duration: 2 Doses 
+Start: After 40 mg DAILY tapered dose 
+This is dose # 3 of 5 tapered doses
+RX *prednisone 10 mg 3 tablet(s) by mouth once a day Disp #*6 
+Tablet Refills:*0 
+5.  PredniSONE 20 mg PO DAILY Duration: 2 Doses 
+Start: After 30 mg DAILY tapered dose 
+This is dose # 4 of 5 tapered doses
+RX *prednisone 10 mg 2 tablet(s) by mouth once a day Disp #*4 
+Tablet Refills:*0 
+6.  PredniSONE 10 mg PO DAILY Duration: 2 Doses 
+Start: After 20 mg DAILY tapered dose 
+This is dose # 5 of 5 tapered doses
+RX *prednisone 10 mg 1 tablet(s) by mouth once a day Disp #*2 
+Tablet Refills:*0 
+7.  Prochlorperazine 10 mg PO Q6H:PRN nausea 
+RX *prochlorperazine maleate [Compazine] 10 mg 1 tablet(s) by 
+mouth four times a day Disp #*12 Tablet Refills:*0 
+8.  Verapamil SR 120 mg PO Q24H 
+RX *verapamil [Calan SR] 120 mg 1 tablet(s) by mouth once a day 
+Disp #*30 Tablet Refills:*0 
+9.  Albuterol 0.083% Neb Soln 1 NEB IH Q4H:PRN wheeze  
+10.  Albuterol Inhaler 1 PUFF IH Q6H:PRN Shortness of breath  
+11.  Fluticasone-Salmeterol Diskus (250/50)  1 INH IH BID  
+12.  Potassium Chloride 20 mEq PO TID  
+13.  Prenatal Vitamins 1 TAB PO DAILY  
+14.  Spironolactone 100 mg PO BID  
+15.  Vitamin D ___ UNIT PO DAILY  
+16.  Vitamin D ___ UNIT PO 1X/WEEK (WE)  
+
+ 
+
+###RESPONSE: CALCIUM {Blood calcium measurement}, 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}, URINE {Urine culture}, URINE {Urine culture}, RBC {Red blood cell count}, WBC {White blood cell count}, AST {Aspartate aminotransferase measurement}, PROTEIN {Measurement of protein in urine}, KETONE {Urinalysis, acetone or ketone bodies measurement}, BILIRUBIN {Bilirubin measurement, urine}, PH {pH measurement}, COLOR {Color finding}, URINE {Urine culture}, NEUTS {Neutrophil count}, MONOS {Monocyte count}, EOS {Eosinophil count}, 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}, RDWSD {Red cell distribution width determination}, PH {pH measurement}, TOTAL CO2 {Blood total carbon dioxide (calculated)}, SPUTUM {Sputum finding}, Expectorated {Does expectorate}, GRAM STAIN {Gram stain method}, cells {Cell structure}, Gram stain {Gram stain method}, respiratory {Examination of respiratory system}, Bacterial culture {Bacterial culture}, invalid {Invalidism}, RESPIRATORY {Examination of respiratory system}, CULTURE {Microbial culture}, Respiratory {Examination of respiratory system}, Culture {Microbial culture}, Respiratory {Examination of respiratory system}, Viral Culture {Viral culture}, respiratory {Examination of respiratory system}, Culture {Microbial culture}, Influenza {Influenza}, Parainfluenza {Parainfluenza}, Respiratory {Examination of respiratory system}, Detection of viruses {Detection of virus}, Respiratory {Examination of respiratory system}, Respiratory {Examination of respiratory system}, Parainfluenza {Parainfluenza}, Influenza {Influenza}, immunofluorescence {Fluorescent immunoassay}, respiratory {Examination of respiratory system}, viral culture {Viral culture}, Influenza {Influenza}, tab {Therapeutic abortion procedure}, BLOOD CULTURE {Blood culture}, Blood Culture {Blood culture}, BLOOD CULTURE {Blood culture}, Blood Culture {Blood culture}, URINE {Urine culture}, URINE CULTURE {Urine culture}, SKIN {Examination of skin}, CXR {Plain chest X-ray}, chest {Thoracic structure}, radiograph {Plain radiography}, opacity {Abnormally opaque structure}, lung field {Structure of lung field}, infectious {Infectious disease}, inflammatory {Inflammatory disorder}, consolidation {Consolidation}, pleural effusion {Pleural effusion}, pneumothorax {Pneumothorax}, osseous {Bony labyrinth structure}, diaphragm {Diaphragm structure}, opacities {Abnormally opaque structure}, lung field {Structure of lung field}, infectious {Infectious disease}, inflammatory {Inflammatory disorder}, productive cough {Productive cough}, 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}, asthma {Asthma}, PCOS {Polycystic ovary syndrome}, hypertension {Hypertensive disorder, systemic arterial}, G6PD 
+deficiency {Glucose-6-phosphate dehydrogenase deficiency anemia}, PTSD {Posttraumatic stress disorder}, shortness of breath {Dyspnea}, shortness of breath {Dyspnea}, wheezing {Wheezing}, asthma exacerbation {Exacerbation of asthma}, community 
+acquired pneumonia {Community acquired pneumonia}, hypertensive {Hypertensive disorder, systemic arterial}, headaches {Headache}, blood 
+pressure {Blood pressure finding}, headaches {Headache}, hypertension {Hypertensive disorder, systemic arterial}, PCP {Primary care management}, respiratory {Examination of respiratory system}, Blood cultures {Blood culture}, tachycardic {Tachycardia}, improved {Patient's condition improved}, DVT {Deep venous thrombosis}, PE {Pulmonary embolism}, vital 
+signs {Vital signs finding}, stable {Patient's condition stable}, PCP {Primary care management}, headache {Headache}, migraines {Migraine}, IV {Intravenous therapy}, IV {Intravenous therapy}, headache {Headache}, Asthma exacerbation {Exacerbation of asthma}, asthma {Asthma}, intubations {Intubation}, dyspnea {Dyspnea}, inhalers {Oxygen therapy}, dyspnea {Dyspnea}, wheezing {Wheezing}, infiltrate {Infiltration}, CXR {Plain chest X-ray}, pneumonia {Pneumonia}, asthma exacerbation {Exacerbation of asthma}, afebrile {Temperature normal}, leukocytosis {Leukocytosis}, productive cough {Productive cough}, Sputum culture {Microbial culture of sputum}, respiratory {Examination of respiratory system}, Influenza {Influenza}, Respiratory {Examination of respiratory system}, culture {Microbial culture}, PE {Pulmonary embolism}, wheezing {Wheezing}, tachycardia {Tachycardia}, tachycardia {Tachycardia}, tachycardia {Tachycardia}, PCP {Primary care management}, cough {Cough}, HTN {Hypertensive disorder, systemic arterial}, hypertensive {Hypertensive disorder, systemic arterial}, Neuro {Neurological examination}, CTA {Computed tomography angiography with contrast}, CTV {Computed tomography venography with contrast}, overdose {Overdose}, hypertension {Hypertensive disorder, systemic arterial}, hypertension {Hypertensive disorder, systemic arterial}, headache {Headache}, improved {Patient's condition improved}, PCP {Primary care management}, blood pressures {Blood pressure finding}, Tachycardia {Tachycardia}, tachycardia {Tachycardia}, sinus tachycardia {Sinus tachycardia}, PE {Pulmonary embolism}, suspicion {Suspicion}, PE {Pulmonary embolism}, tachycardia {Tachycardia}, wheezing {Wheezing}, frequency {Increased frequency of urination}, DVT {Deep venous thrombosis}, PE {Pulmonary embolism}, hypercoagulable state {Hypercoagulability state}, tachycardia {Tachycardia}, improved {Patient's condition improved}, Headache {Headache}, right sided headache {Unilateral headache on right side of head}, neurological deficits {Neurological deficit}, migraines {Migraine}, IV {Intravenous therapy}, Hypokalemia {Hypokalemia}, PCOS {Polycystic ovary syndrome}, OSA {Obstructive sleep apnea syndrome}, Inhaler {Oxygen therapy}, Shortness of breath {Dyspnea}, wheeze {Wheezing}, TAB {Therapeutic abortion 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: Discharge Disposition:
+Home
+ 
+Discharge Diagnosis:
+Primary Diagnosis:
+Asthma exacerbation
+Community acquired pneumonia
+
+Secondary Diagnosis:
+Hypertension
+Tachycardia
+Headache
+Hypokalemia
+Polycystic ovarian syndrome
+Obstructive sleep apnea
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Asthma exacerbation {Exacerbation of asthma}, Community acquired pneumonia {Community acquired pneumonia}, Hypertension {Hypertensive disorder, systemic arterial}, Tachycardia {Tachycardia}, Headache {Headache}, Hypokalemia {Hypokalemia}, Polycystic ovarian syndrome {Polycystic ovary syndrome}, Obstructive sleep apnea {Obstructive sleep apnea syndrome}, Mental Status {Neurological mental status determination}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, 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 to care for you at the ___ 
+___.  
+
+Why did you come to the hospital?  
+- You came to the hospital because you were having difficulty 
+breathing. 
+
+What did you receive in the hospital?  
+- You received steroids to treat an asthma exacerbation.
+- You received antibiotics to treat any infection in lungs. 
+- You received medications to treat your headache.
+- You were started on a new blood pressure medication because 
+your blood pressure was high.
+
+What should you do once you leave the hospital?  
+- You should take all of your medications as prescribed (see 
+below).
+- You should attend all of your scheduled outpatient 
+appointments.  
+
+We wish you the best!  
+Your ___ Care Team  
+
+ 
+
+###RESPONSE: difficulty 
+breathing {Difficulty breathing}, asthma {Asthma}, antibiotics {Antibiotic therapy}, infection {Infectious disease}, lungs {Lung structure}, headache {Headache}, blood pressure {Blood pressure finding}, blood pressure was high {Hypertensive disorder, systemic arterial}"
+"###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:
+Chest pain
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: Chest pain {Chest 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:
+___ with prior history of cocaine abuse presents from jail with 
+chest pain. He awoke from sleep at 1AM with sharp sub sternal 
+chest pain, ___ in intensity, non-radiating, worse with deep 
+inspiration. Pain has been constant. Never had this type of pain 
+before. No recent chest wall injuries or strenuous activities. 
+Went to ___ and had a concerning EKG with ?STE and 
+hyperacute T's that didn't meet criteria. Got ASA, had negative 
+trop @ 0230, negative d-dimer. Pain unrelieved with nitro, 
+morphine, dilaudid so patient transferred to ___ for further 
+eval.  
+ 
+In the ED intial vitals were: 97 58 100/69 16 100%  
+Labs were significant for WBC 12.1, Troponin <.01, Phos 1.4  
+Patient was given: Dilaudid IV and lorazepam  
+Vitals on transfer: 66 120/64 7 98%  
+
+On the floor patient reports improvement in chest pain, now 
+___. Denies fever, chills, cough, SOB, orthopnea.  
+
+ 
+
+###RESPONSE: cocaine abuse {Cocaine abuse}, chest pain {Chest pain}, chest pain {Chest pain}, radiating {Radiating pain}, Pain {Pain}, constant {Constant pain}, pain {Pain}, chest wall injuries {Injury of chest wall}, EKG {Electrocardiographic procedure}, Pain {Pain}, vitals {Vital signs finding}, Vitals {Vital signs finding}, chest pain {Chest pain}, fever {Fever}, chills {Chill}, cough {Cough}, SOB {Dyspnea}, orthopnea {Orthopnea}"
+"###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:
+MGF- CAD
+Father- cirrhosis
+Mother- lung cancer 
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}, lung cancer {Malignant tumor of lung}"
+"###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:
+VS: T=97.6 BP=107/62 HR=68 RR=18 O2 sat=99% RA  
+General: Well developed male in NAD 
+HEENT: EOMI, PERRL, sclera anicteric 
+Neck: JVP not elevated, supple, no LAD 
+CV: RRR, normal S1 and S2, no mrg. Chest wall is mildly tender 
+to palpation over left and right margins of sternum and xyphoid 
+process 
+Lungs: CTAB, no wheezes or rales 
+Abdomen: Soft, nontender, non-distended, no palpable 
+organomegaly 
+GU: No foley  
+Ext: Warm, well perfused, no edema, 2+ DP pulses 
+
+Discharge:
+General: Well developed male in NAD 
+HEENT: EOMI, PERRL, sclera anicteric 
+Neck: JVP not elevated, supple, no LAD 
+CV: RRR, normal S1 and S2, no mrg. Chest wall is mildly tender 
+to palpation over left and right margins of sternum and xyphoid 
+process 
+Lungs: CTAB, no wheezes or rales 
+Abdomen: Soft, nontender, non-distended, no palpable 
+organomegaly 
+GU: No foley  
+Ext: Warm, well perfused, no edema, 2+ DP pulses 
+
+ 
+
+###RESPONSE: VS {Vital signs finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, O2 sat {Oxygen saturation measurement}, RA {Breathing room air}, General {General examination of patient}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, EOMI {Normal ocular motility}, PERRL {Pupils equal and reacting to light}, sclera anicteric {White sclera}, Neck {Physical examination procedure}, JVP not elevated {Normal jugular venous pressure}, supple {Normal movement of neck}, 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<}, Chest {Examination of respiratory system}, tender {Abdominal tenderness}, palpation {Palpation}, sternum {Bone structure of sternum}, Lungs {Examination of respiratory system}, CTAB {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, nontender {Abdominal tenderness}, non-distended {Normal abdominal contour}, organomegaly {Abdominal organomegaly}, GU {Examination of genitourinary system}, foley {Catheterization of urinary bladder}, Ext {Examination of limb}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, edema {Edema}, 2+ DP pulses {All pulses present in bilateral lower limbs}, General {General examination of patient}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, EOMI {Normal ocular motility}, PERRL {Pupils equal and reacting to light}, sclera anicteric {White sclera}, Neck {Physical examination procedure}, JVP not elevated {Normal jugular venous pressure}, supple {Normal movement of neck}, LAD {Lymphadenopathy}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, normal S1 {Normal first heart sound, S>1<}, Chest wall is mildly tender {Chest wall tenderness}, sternum {Bone structure of sternum}, Lungs {Examination of respiratory system}, CTAB {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, organomegaly {Abdominal organomegaly}, GU {Examination of genitourinary system}, foley {Catheterization of urinary bladder}, Ext {Examination of limb}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, edema {Edema}, 2+ DP pulses {All pulses present in bilateral lower 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:
+___ 04:35AM BLOOD WBC-12.1* RBC-4.66 Hgb-14.3 Hct-42.7 
+MCV-92 MCH-30.6 MCHC-33.5 RDW-11.8 Plt ___
+___ 04:35AM BLOOD Neuts-86.0* Lymphs-9.9* Monos-3.3 Eos-0.2 
+Baso-0.5
+___ 04:35AM BLOOD Glucose-91 UreaN-17 Creat-0.9 Na-138 
+K-4.1 Cl-104 HCO3-22 AnGap-16
+___ 04:35AM BLOOD CK(CPK)-98
+___ 04:35AM BLOOD cTropnT-<0.01
+___ 04:35AM BLOOD CK-MB-2
+___ 04:35AM BLOOD Calcium-9.3 Phos-1.4* Mg-1.6
+
+Imaging: 
+Surface Echo ___:
+IMPRESSION: Normal biventricular regional/global systolic 
+function.  
+
+CTA ___:
+1.  No evidence of acute aortic syndrome. 
+2.  Heart size is top normal with a dilated right atrium.  No 
+pericardial 
+effusion.   
+3.  No focal consolidation.  Bilateral centrilobular nodules may 
+represent respiratory bronchiolitis in the setting of smoking 
+history.  Mild paraseptal emphysema. 
+
+Discharge:
+___:05PM BLOOD CK-MB-2 cTropnT-<0.___ with prior history of cocaine abuse presents from jail with 
+chest pain. 
+
+#Chest Pain: Most likely costochondtritis versus other 
+musculoskeletal pain. Pain is atypical for angina given lack of 
+association with exertion, lack of improvement with nitro and 
+reproducibility on exam albeit patient is at risk of CAD with 
+history of cocaine use. CTA is unrevealing for aortic dissection 
+or PE and troponin is negative x3 along with a normal surface 
+ECHO which are reassuring. ECG shows submillimeter ST elevations 
+that are concave up and may be normal variant. Patient was 
+started on daily aspirin daily 81mg and pain was improved with 
+tylenol and ibuprofen. Patient should continue to take ibuprofen 
+as needed for pain anti-inflammatory effect.
+
+#Hypophosphatemia: Patient was repleted with neutraphos.
+
+#Psych: Continue home seroquel  
+
+Transitional Issues:
+-Patient was ruled out for MI with negative trop x3. EKG showed 
+precordial J-point elevation which may be normal variant. 
+-Patient was started on aspirin 81 mg daily
+-Patient was advised to take ibuprofen for pain
+-Patient will need to establish PCP once released from jail
+-Full code
+ 
+
+###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}, 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}, cTropnT {Troponin T cardiac measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Imaging {Imaging}, regional/global systolic 
+function {Normal left ventricular systolic function and wall motion}, aortic {Aortic structure}, syndrome {Disease}, Heart {Heart structure}, dilated right atrium {Right atrial dilatation}, pericardial 
+effusion {Pericardial effusion}, consolidation {Consolidation}, nodules {Nodule}, bronchiolitis {Bronchiolitis}, smoking {Smoker}, paraseptal emphysema {Paraseptal emphysema}, cTropnT {Troponin T cardiac measurement}, cocaine abuse {Cocaine abuse}, chest pain {Chest pain}, Chest Pain {Chest pain}, costochondtritis {Costal chondritis}, musculoskeletal pain {Musculoskeletal pain}, Pain {Pain}, angina {Angina}, CAD {Coronary arteriosclerosis}, CTA {Computed tomography angiography with contrast}, aortic dissection {Dissection of aorta}, normal surface 
+ECHO {Electrocardiogram normal}, ECG {Electrocardiographic procedure}, ST elevations {ST segment elevation}, aspirin {Administration of aspirin}, pain {Pain}, improved {Patient's condition improved}, pain {Pain}, Hypophosphatemia {Hypophosphatemia}, Psych {Psychiatric procedure, interview AND/OR consultation}, MI {Myocardial infarction}, EKG {Electrocardiographic procedure}, aspirin {Administration of aspirin}, 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: Medications on Admission:
+The Preadmission Medication list is accurate and complete.
+1. QUEtiapine Fumarate Dose is Unknown  PO DAILY 
+
+ 
+Discharge Medications:
+1. QUEtiapine Fumarate 0 mg PO DAILY 
+2. Aspirin 81 mg PO DAILY 
+RX *aspirin 81 mg 1 tablet,delayed release (___) by mouth 
+once a day Disp #*30 Tablet Refills:*0
+3. Ibuprofen 600 mg PO Q8H:PRN pain 
+RX *ibuprofen 600 mg 1 tablet(s) by mouth every eight (8) hours 
+Disp #*30 Tablet Refills:*0
+4. Acetaminophen 650 mg PO Q6H:PRN pain 
+RX *acetaminophen 650 mg 1 tablet extended release(s) by mouth 
+every six (6) hours Disp #*30 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:
+Extended Care
+ 
+Discharge Diagnosis:
+Chest pain
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Chest pain {Chest pain}, Mental Status {Neurological mental status determination}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, 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 Mr. ___,
+
+You were admitted to ___ for chest pain. Based on your 
+physical examination, EKG, ultrasound of your heart and blood 
+tests we do not feel that your chest pain is related to a heart 
+attack. Your pain may be from inflammation of you muscles or 
+cartilage. Please take ibuprofen as needed for pain which will 
+help with the inflammation. Please establish a primary care 
+physician when you are released from jail. 
+ 
+
+###RESPONSE: chest pain {Chest pain}, physical examination {Physical examination procedure}, EKG {Electrocardiographic procedure}, ultrasound of your heart {Echocardiography}, blood 
+tests {Blood test}, chest pain {Chest pain}, heart 
+attack {Myocardial infarction}, pain {Pain}, inflammation {Inflammatory disorder}, muscles {Skeletal and/or smooth muscle structure}, pain {Pain}, inflammation {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: 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:
+Chest pain
+ 
+Major Surgical or Invasive Procedure:
+Cardiac catheterization (___)
+ 
+
+###RESPONSE: Chest pain {Chest pain}, 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:
+___ yo male history of CAD IMI in ___ and 3VD with stent to LAD 
+in ___, HTN, presenting with chest pain. Patient noitces for 
+the last 2 weeks or so he has been having chest discomfort with 
+minimal activity. Specifically having chest heaviness taking in 
+his garbage cans, pushing a golf cart, or talking short walks. 
+For the last 2 days, patient noticed with minimal exertion and 
+short walks, would have chest heaviness/discomfort that would 
+resolve after several minutes of rest. The day of presentation, 
+the patient went for a walk at 3 ___ had had right sided chest 
+pressure, which resolved with rest. He was home and doing 
+chores, and decided to go for a walk again and said after about 
+___ a mile the chest discomfort returned prompting him to go 
+to the hospital for further evaluation.
+
+He was seen at an outside hospital where a CTA of the chest was 
+performed it showed no evidence of pulmonary embolism. He was 
+sent here for further eval. He received an aspirin. Trop 0.02 at 
+OSH.  
+Initial VS in the ED: T 97.5 HR 68 BP 157/103 RR 16 satting 97% 
+on RA. Labs were all normal including tropinins, CMP, CBC. EKG 
+showed sinus rhythm Q waves inferiorly consistent with prior. 
+VSS at time of transfer.  
+ 
+CP feels different than his MI in the past, which was burning 
+pain.  This has felt more like pressure.
+
+Apparently gets nuclear studies as part of a research protocol 
+at ___ serially.
+
+On the floor, pt. in NAD.  
+
+Review of systems:  
+(+) Per HPI  
+(-) Denies fever, chills, night sweats, recent weight loss or 
+gain. Denies headache, sinus tenderness, rhinorrhea or 
+congestion. Denied cough, shortness of breath. Denied nausea, 
+vomiting, diarrhea, constipation or abdominal pain. No recent 
+change in bowel or bladder habits. No dysuria. Denied 
+arthralgias or myalgias.  
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}, IMI {Old inferior myocardial infarction}, 3VD {Triple vessel disease of the heart}, stent to LAD {Placement of stent in anterior descending branch of left coronary artery}, HTN {Hypertensive disorder, systemic arterial}, chest pain {Chest pain}, chest discomfort {Chest discomfort}, chest {Thoracic structure}, heaviness {Heavy feeling}, walks {Does walk}, exertion {Chest pain on exertion}, short walks, would have chest heaviness/discomfort {Chest pain on exertion}, resolve {Problem resolved}, walk {Does walk}, right sided {Right thorax structure}, chest {Thoracic structure}, resolved {Problem resolved}, walk {Does walk}, chest discomfort {Chest discomfort}, evaluation {Evaluation procedure}, CTA of the chest {Computed tomography angiography of chest with contrast}, no evidence {No abnormality detected}, pulmonary embolism {Pulmonary embolism}, aspirin {Administration of aspirin}, VS {Vital signs finding}, HR {Finding of heart rate}, BP {Blood pressure finding}, RR {Finding of rate of respiration}, satting {Finding of oxygen saturation}, RA {Breathing room air}, Labs {Laboratory test}, normal {No abnormality detected}, tropinins {Troponin measurement}, CBC {Complete blood count}, EKG {Electrocardiographic procedure}, sinus rhythm {Sinus rhythm}, VSS {Vital signs finding}, CP {Chest pain}, MI {Myocardial infarction}, burning 
+pain {Burning pain}, pressure {Pressure}, nuclear studies {Nuclear medicine diagnostic procedure on cardiovascular system}, Review of systems {Review of systems}, fever {Fever}, chills {Chill}, night sweats {Night sweats}, recent weight loss {Recent weight loss}, gain {Recent weight gain}, headache {Headache}, sinus tenderness {Tenderness over frontal sinus}, rhinorrhea {Nasal discharge}, congestion {Nasal congestion}, cough {Cough}, shortness of breath {Dyspnea}, nausea, 
+vomiting, diarrhea {Nausea, vomiting and diarrhea}, constipation {Constipation}, abdominal pain {Abdominal pain}, change in bowel {Altered bowel function}, bladder habits {Alteration in patterns of urinary elimination}, dysuria {Dysuria}, arthralgias {Joint pain}, myalgias {Muscle 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: Past Medical History:
+- CAD s/p IMI ___ when playing basketball, cath about one year  
+
+later showed 3VD, stent in ___ to LAD by Dr. ___.
+- Hypertension  
+- H/o hernia repair  
+- H/o pilonidal cysts  
+- Achilles tendon tear Left leg
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}, IMI {Old inferior myocardial infarction}, cath {Cardiac catheterization}, 3VD {Triple vessel disease of the heart}, stent {Insertion of arterial stent}, LAD {Structure of anterior descending branch of left coronary artery}, Hypertension {Hypertensive disorder, systemic arterial}, hernia repair {Hernia repair}, pilonidal cysts {Pilonidal cyst}, Achilles tendon tear Left leg {Rupture of left Achilles tendon}"
+"###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 died from MI, mother with valvular disorder in ___.  
+ 
+
+###RESPONSE: died {Dead}, MI {Myocardial infarction}, valvular disorder {Heart valve 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: Physical Exam:
+ADMISSION PHYSICAL EXAM
+Gen: well appearing, NAD, lying flat  
+Heent: OP clear, moist, anicteric  
+Neck: supple, JVP flat  
+Lungs: CTAB  
+___: nl S1 S2 PMI non displaced, RRR, no m/r/g  
+Abd: soft, NT/ND, BS+  
+Ext: warm, 1+ edema to ankles b/l  
+Neuro: A&O, appropriate, full strength, normal senstation  
+throughout  
+
+DISCHARGE PHYSICAL EXAM:
+Vitals: T 97.5 BP 131/74 HR 69 RR 18 SaO2 98% on RA
+Gen: well appearing, NAD, lying flat  
+Heent: OP clear, moist, anicteric  
+Neck: supple, JVP flat  
+Lungs: CTAB  
+___: nl S1 S2 PMI non displaced, RRR, no m/r/g  
+Abd: soft, NT/ND, BS+  
+Ext: warm, 1+ edema to ankles b/l  
+Neuro: A&O, appropriate, full strength, normal senstation  
+throughout  
+ 
+
+###RESPONSE: PHYSICAL EXAM {Physical examination procedure}, Gen {General examination of patient}, well appearing {Well cared for appearance}, NAD {No abnormality detected}, lying {Lying in bed}, Heent {Physical examination procedure}, OP clear {Pharynx normal}, moist {Moist oral mucosa}, anicteric {White sclera}, Neck {Physical examination procedure}, supple {Normal movement of neck}, JVP {Finding of jugular venous pressure}, Lungs {Examination of respiratory system}, CTAB {Normal breath sounds}, S2 {Normal second heart sound, S>2<}, displaced {Apex beat displaced}, RRR {Normal heart rate}, no m/r/g {Heart sounds normal}, Abd {Examination of abdomen}, soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, BS+ {Normal bowel sounds}, Ext {Examination of limb}, warm {Warm skin}, edema {Edema}, Neuro {Neurological examination}, normal senstation {Normal sensation}, Vitals {Vital signs finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, RA {Breathing room air}, Gen {General examination of patient}, well appearing {Well cared for appearance}, lying {Lying in bed}, Heent {Physical examination procedure}, OP clear {Pharynx normal}, moist {Moist oral mucosa}, anicteric {White sclera}, Neck {Physical examination procedure}, supple {Normal movement of neck}, JVP flat {Normal jugular venous pressure}, Lungs {Examination of respiratory system}, CTAB {Normal breath sounds}, nl S1 S2 {Heart sounds normal}, displaced {Apex beat displaced}, RRR {Normal heart rate}, no m/r/g {Heart sounds normal}, Abd {Examination of abdomen}, soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, BS+ {Normal bowel sounds}, Ext: {Examination of limb}, edema {Edema}, Neuro {Neurological examination}, normal senstation {Normal sensation}"
+"###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:
+___ 06:58AM BLOOD cTropnT-<0.01
+___ 02:00AM BLOOD cTropnT-<0.01
+___ 02:00AM BLOOD Glucose-104* UreaN-20 Creat-1.0 Na-141 
+K-4.1 Cl-106 HCO3-25 AnGap-14
+___ 06:58AM BLOOD Glucose-94 UreaN-17 Creat-0.9 Na-143 
+K-4.1 Cl-106 HCO3-28 AnGap-13
+___ 02:00AM BLOOD WBC-5.1 RBC-4.68 Hgb-14.7 Hct-41.3 MCV-88 
+MCH-31.4 MCHC-35.6* RDW-12.6 Plt ___
+___ 06:58AM BLOOD WBC-4.4 RBC-4.63 Hgb-14.4 Hct-41.2 MCV-89 
+MCH-31.1 MCHC-34.8 RDW-12.5 Plt ___
+
+CARDIAC CATH (___)
+- Final results pending at the time of discharge but verbal 
+signout and images reviewed, revealing existing known CAD plus a 
+lesion in the mLAD s/p DES.
+ 
+
+###RESPONSE: cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, 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}, 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}, 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}, 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}, CARDIAC CATH {Cardiac catheterization}, CAD {Coronary arteriosclerosis}, lesion {Lesion}, mLAD {Structure of mid portion of anterior descending branch of left coronary artery}, DES {Endovascular insertion of drug eluting stent}"
+"###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:
+___ yo male with CAD presenting with symptoms concerning for 
+unstable angina.
+ 
+#) UNSTABLE ANGINA: Known CAD with stent in past. Has stressed 
+himself with pain with minimal exertion.  No evidence of cardiac 
+enzyme leak.  TIMI risk = 4.  Started on heparin gtt.  Given 
+atorvastatin 80mg, metoprolol.  Cath revealed similar findings 
+as prior cath with known occluded RCA, but now mLAD lesion felt 
+to be culprit s/p DES.
+
+#) HYPERTENSION: Not optimally controlled. Consider increasing 
+losartan as outpatient.
+# Code: Full code
+# Communication: Patient/ Wife ___ ___   
+ 
+___ on Admission:
+The Preadmission Medication list is accurate and complete.
+1. Aspirin 325 mg PO DAILY 
+2. Clopidogrel 75 mg PO DAILY 
+3. Atorvastatin 80 mg PO DAILY 
+4. Metoprolol Succinate XL 25 mg PO DAILY 
+hold for SBP<100/ HR<60 
+5. Fish Oil (Omega 3) 2400 mg PO QHS 
+6. Vitamin D ___ UNIT PO DAILY 
+7. FoLIC Acid 1 mg PO DAILY 
+8. Losartan Potassium 50 mg PO DAILY 
+hold for SBP<100 or K+>5.5 
+
+ 
+Discharge Medications:
+1. Aspirin 325 mg PO DAILY 
+2. Atorvastatin 80 mg PO DAILY 
+3. Clopidogrel 75 mg PO DAILY 
+4. Fish Oil (Omega 3) 2400 mg PO QHS 
+5. FoLIC Acid 1 mg PO DAILY 
+6. Losartan Potassium 50 mg PO DAILY 
+7. Metoprolol Succinate XL 25 mg PO DAILY 
+8. Vitamin D ___ UNIT PO DAILY 
+
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}, unstable angina {Preinfarction syndrome}, UNSTABLE ANGINA {Preinfarction syndrome}, CAD {Coronary arteriosclerosis}, stent {Placement of stent in coronary artery}, pain with minimal exertion {Chest pain on exertion}, No evidence {No abnormality detected}, cardiac 
+enzyme leak {Cardiac enzyme or marker above reference range}, heparin {Heparin therapy}, Cath {Cardiac catheterization}, cath {Cardiac catheterization}, occluded RCA {Right coronary artery occlusion}, mLAD {Structure of mid portion of anterior descending branch of left coronary artery}, lesion {Lesion}, DES {Endovascular insertion of drug eluting stent}, HYPERTENSION {Hypertensive disorder, systemic arterial}, increasing {Prescription dose change}, Aspirin {Administration of aspirin}, SBP {Blood pressure monitoring}, HR {Cardiotachometry}, SBP {Blood pressure monitoring}"
+"###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:
+Unstable angina
+Coronary artery disease
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Unstable angina {Preinfarction syndrome}, Coronary artery disease {Coronary arteriosclerosis}, 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:
+Dear Mr. ___,
+   It was a pleasure taking care of you at ___.  You were 
+admitted for chest pain and were found to have a blockage in one 
+of your heart arteries.  A stent was placed in this artery, 
+relieving the blockage.  Please refrain from vigorous physical 
+activity for one week.  You must take your medications EVERY 
+DAY.
+ 
+
+###RESPONSE: chest pain {Chest pain}, blockage in one 
+of your heart arteries {Coronary occlusion}, stent was placed in this artery {Placement of stent in coronary artery}, blockage {Coronary occlusion}, refrain from vigorous physical 
+activity {Recommendation regarding functional activity}, must take your medications {Recommendation to continue with drug treatment}"
+"###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:
+Acute onset Nausea and vomiting 
+ 
+Major Surgical or Invasive Procedure:
+None
+ 
+
+###RESPONSE: No Known Allergies {Allergic disposition}, Adverse Drug Reactions {Propensity to adverse reactions to drug}, Nausea and vomiting {Nausea and vomiting}"
+"###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 panhypopituitarism presenting with acute onset nausea 
+vomiting and fever. 
+
+Patient had cough and congestion for approximately one week, 
+mild chills, but no recorded fevers.  Yesterday prior to 
+admission, he had sudden onset nausea, vomiting. He called his 
+PCP, who told him to increase his dose of PO prednisone, but he 
+was unable to tolerate PO.  He vomited a total of ___ times. At 
+9PM, he vomited, then ""blacked out"" for ___ minutes, not 
+responding to wife calling his name, woke up spontaneously and 
+felt ok.  No abnormal limb movements, tongue biting, or 
+incontinence.  Wife called ___ and he was brought to the 
+emergency department.  No preceeding chest pain or palpitations. 
+ This is his first syncopal episode.
+
+Of note, per recent discharge summary, patient has a history of 
+not consistently taking his medications, including his PO 
+prednisone, resulting in nausea/vomiting, and admission for IV 
+steroids.  It was emphasized at that time that he must take all 
+his medications as prescribed.
+In the ED, initial VS were: 101.3 82 159/64 18 96% 2L Nasal 
+Cannula  
+.  
+Labs were notable for a TSH of 0.25 and a Lactate of 2.2. He was 
+given 100 mg IV hydrocortisone, 1g of tylenol, zofran for his 
+vomiting, 1 L NS.  
+.  
+On arrival to the floor he is in no pain and resting 
+comfortably.  
+He is most concerned about dizziness he has been experienced, 
+which has been persistent since ___.  He 
+experiences lightheadedness, inability to walk, feels 
+disoriented ""loses himself in space"", and his legs feel weak.  
+Dizziness occurs ___ times daily, and experiences this sensation 
+for ___ minutes at a time.  He usually just rests and feels 
+better.  Never had a loss of consciousness or fall.  No abnormal 
+limb movements, no history of seizure, stroke, or MI.  Only 
+experiences dizziness when moving, never while lying still in 
+bed.
+
+Also complains of chest pressure lasting ___ minutes at night, 
+never occurs with activity, now happening ___ weekly.  Had this 
+complaint during last hospitalization, was recommended to get 
+outpatient nuclear stress.  No changes recently.
+.  
+REVIEW OF SYSTEMS:  
+(+)Per HPI
+Pertinent negatives:  abdominal pain, dysuria / polyuria, vision 
+changes, unilateral weakness, confusion or altered mental 
+status, abnormal limb movements
+ 
+
+###RESPONSE: panhypopituitarism {Panhypopituitarism}, nausea 
+vomiting {Nausea and vomiting}, fever {Fever}, cough {Cough}, congestion {Nasal congestion}, mild {Symptom mild}, chills {Chill}, fevers {Fever}, nausea, vomiting {Nausea and vomiting}, vomited {Vomiting}, vomited {Vomiting}, blacked out {Syncope}, not 
+responding to wife calling {No response to sound}, No abnormal limb movements {Able to move all four limbs}, tongue biting {Tongue biting}, incontinence {Incontinence}, chest pain {Chest pain}, palpitations {Palpitations}, syncopal {Syncope}, not consistently taking his medications {Drugs - partial non-compliance}, nausea/vomiting {Nausea and vomiting}, IV {Intravenous therapy}, steroids {Steroid therapy}, VS {Vital signs finding}, Nasal 
+Cannula {Oxygen administration by nasal cannula}, IV {Intravenous therapy}, vomiting {Vomiting}, dizziness {Dizziness}, lightheadedness {Lightheadedness}, inability to walk {Unable to walk}, disoriented ""loses himself in space"" {Spatial disorientation}, legs {Lower limb structure}, Dizziness {Dizziness}, loss of consciousness {Loss of consciousness}, fall {Falls}, No abnormal 
+limb movements {Able to move all four limbs}, seizure {Seizure}, stroke {Cerebrovascular accident}, MI {Myocardial infarction}, dizziness {Dizziness}, chest pressure {Tight chest}, abdominal pain {Abdominal pain}, dysuria {Dysuria}, polyuria {Polyuria}, vision 
+changes {Visual disturbance}, weakness {Asthenia}, confusion {Clouded consciousness}, altered mental 
+status {Altered mental status}, limb {Limb 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: Past Medical History:
+- DM2  
+- acromegaly s/p transsphenoidal resection and proton beam  
+irradiation in ___  
+- panhypopituitarism
+- Multiple hospitalizations for nausea, vomiting, dizziness, 
+most recently dc'ed ___ for n/v and was not taking PO 
+prednisone consistently; had n/v and headache with negative 
+neurologic workup ___
+- Thyroid nodules  
+- cholecystectomy  
+ 
+
+###RESPONSE: DM2 {Diabetes mellitus type 2}, acromegaly {Acromegaly}, proton beam  
+irradiation {External beam radiation therapy protons}, panhypopituitarism {Panhypopituitarism}, nausea, vomiting {Nausea and vomiting}, dizziness {Dizziness}, n/v {Nausea and vomiting}, n/v {Nausea and vomiting}, headache {Headache}, neurologic {Neurological examination}, Thyroid nodules {Thyroid nodule}, cholecystectomy {Cholecystectomy}"
+"###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:
+Negative for headache, migraine, stroke.
+ 
+
+###RESPONSE: headache {Headache}, migraine {Migraine}, stroke {Cerebrovascular accident}"
+"###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 - 98.2 117/52 64 18 98% 3L
+GENERAL - well-appearing man in NAD, comfortable, appropriate, 
+large set jaw  
+HEENT - NC/AT dry MM  
+NECK - supple  
+LUNGS - Bibasilar crackles, R > L
+HEART - RRR, no MRG, nl S1-S2  
+ABDOMEN - NABS, soft/NT/ND, no masses or HSM, no 
+rebound/guarding  
+EXTREMITIES - WWP, no c/c/e, 2+ peripheral pulses (radials, 
+DPs), +large hands and feet c/w acromegaly
+SKIN - no rashes or lesions  
+NEURO - A&O, answers questions appropriately, no nystagmus, gait 
+steady
+
+DISCHARGE PHYSICAL EXAM
+VS - Tm 98.7 Tc 98.4 BP 102/46 64 18 89% on RA -> 100% on RA 
+with deep breathing and coughing; ambulatory sats maintained at 
+99%, transiently dropped only as low as 95%
+GENERAL - well-appearing ___ man in NAD, comfortable, 
+appropriate, large set jaw  
+HEENT - NC/AT dry MM  
+NECK - supple  
+LUNGS - Bibasilar crackles, R > L
+HEART - RRR, no MRG, nl S1-S2  
+ABDOMEN - NABS, soft/NT/ND, no masses or HSM, no 
+rebound/guarding  
+EXTREMITIES - WWP, no c/c/e, 2+ peripheral pulses (radials, 
+DPs), +large hands and feet c/w acromegaly
+SKIN - no rashes or lesions  
+NEURO - A&O, answers questions appropriately, no nystagmus, gait 
+steady
+ 
+
+###RESPONSE: PHYSICAL EXAM {Physical examination procedure}, VS {Vital signs finding}, GENERAL {General examination of patient}, well-appearing {Well cared for appearance}, NAD {No abnormality detected}, jaw {Jaw region structure}, HEENT {Physical examination procedure}, NC/AT {Normal head}, dry MM {Mucous membrane dryness}, NECK {Physical examination procedure}, LUNGS {Examination of respiratory system}, Bibasilar {Structure of base of lung}, crackles {Respiratory crackles}, HEART {Cardiovascular physical examination}, RRR {Normal heart rate}, no MRG {Heart sounds normal}, S2 {Normal second heart sound, S>2<}, ABDOMEN {Examination of abdomen}, NABS {Normal bowel sounds}, soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, masses {Abdominal mass}, HSM {Hepatosplenomegaly}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, EXTREMITIES {Examination of limb}, WWP {Normal tissue perfusion}, 2+ peripheral pulses {Peripheral pulses normal}, radials {Structure of radial artery}, DPs {Structure of dorsalis pedis artery}, large hands {Large hand}, feet {Large, broad feet}, acromegaly {Acromegaly}, SKIN {Examination of skin}, rashes {Eruption of skin}, lesions {Lesion}, NEURO {Neurological examination}, nystagmus {Nystagmus}, gait 
+steady {Gait normal}, PHYSICAL EXAM {Physical examination procedure}, VS {Vital signs finding}, BP {Blood pressure finding}, RA {Breathing room air}, RA {Breathing room air}, deep breathing {Deep breathing}, coughing {Cough}, GENERAL {General examination of patient}, well-appearing {Well cared for appearance}, NAD {No abnormality detected}, jaw {Jaw region structure}, HEENT {Physical examination procedure}, NC/AT {Normal head}, dry MM {Mucous membrane dryness}, NECK {Physical examination procedure}, supple {Normal movement of neck}, LUNGS {Examination of respiratory system}, Bibasilar {Structure of base of lung}, crackles {Respiratory crackles}, HEART {Cardiovascular physical examination}, RRR {Normal heart rate}, no MRG {Heart sounds normal}, S2 {Normal second heart sound, S>2<}, ABDOMEN {Examination of abdomen}, NABS {Normal bowel sounds}, soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, masses {Abdominal mass}, HSM {Hepatosplenomegaly}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, EXTREMITIES {Examination of limb}, WWP {Normal tissue perfusion}, 2+ peripheral pulses {Peripheral pulses normal}, radials {Structure of radial artery}, DPs {Structure of dorsalis pedis artery}, large hands {Large hand}, feet {Large, broad feet}, acromegaly {Acromegaly}, SKIN {Examination of skin}, rashes {Eruption of skin}, lesions {Lesion}, NEURO {Neurological examination}, nystagmus {Nystagmus}, gait 
+steady {Gait normal}"
+"###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
+___ 01:10AM BLOOD WBC-6.4 RBC-3.79* Hgb-11.8* Hct-34.4* 
+MCV-91 MCH-31.2 MCHC-34.3 RDW-14.4 Plt ___
+___ 01:10AM BLOOD Neuts-84.4* Lymphs-9.0* Monos-5.5 Eos-1.0 
+Baso-0.1
+___ 09:00AM BLOOD ___ PTT-27.1 ___
+___ 03:35PM BLOOD UreaN-32* Creat-1.1 Na-141 K-5.3* Cl-102 
+HCO3-28 AnGap-16
+
+OTHER RELEVANT LABS
+___ 03:35PM BLOOD Albumin-4.1 Calcium-9.5 Cholest-127
+___ 03:35PM BLOOD Triglyc-153* HDL-47 CHOL/HD-2.7 
+LDLcalc-49
+___ 03:35PM BLOOD %HbA1c-8.1* eAG-186*
+___ 03:35PM BLOOD TSH-0.25*
+___ 03:35PM BLOOD Free T4-1.1
+
+DISCHARGE LABS
+___ 12:45PM BLOOD WBC-6.3 RBC-3.37* Hgb-10.4* Hct-31.2* 
+MCV-93 MCH-31.0 MCHC-33.5 RDW-14.4 Plt ___
+___ 06:40AM BLOOD Glucose-182* UreaN-30* Creat-0.8 Na-140 
+K-3.9 Cl-107 HCO3-25 AnGap-12
+___ 06:40AM BLOOD Calcium-7.8* Phos-3.3 Mg-1.8
+
+IMAGING
+CHEST X-RAY:  Peribronchial opacification at both lung bases is 
+most likely atelectasis, but on the right, there is also a small 
+right pleural effusion, raising concern for pneumonia.  Heart 
+size is top normal, exaggerated by exceedingly low lung volumes. 
+ There is no pulmonary edema.
+
+MICROBIOLOGY
+NEGATIVE:  Influenza A/B by ___ DIRECT INFLUENZA A ANTIGEN 
+TEST-FINAL; DIRECT INFLUENZA B ANTIGEN TEST-FINAL; Respiratory 
+Viral Culture-FINAL INPATIENT 
+___ URINE Legionella Urinary Antigen -FINAL 
+INPATIENT 
+___ URINE URINE CULTURE-FINAL INPATIENT 
+ 
+
+###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}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, AnGap {Anion gap measurement}, Albumin {Albumin measurement}, Calcium {Blood calcium measurement}, Cholest {Cholesterol measurement}, Triglyc {Triglycerides measurement}, HDL {High density lipoprotein measurement}, CHOL/HD {Cholesterol/High density lipoprotein ratio measurement}, eAG {Glucose measurement estimated from glycated hemoglobin}, TSH {Thyroid stimulating hormone measurement}, Free T4 {T4 free 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}, 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}, IMAGING {Imaging}, CHEST X-RAY {Plain chest X-ray}, lung bases {Structure of base of lung}, atelectasis {Atelectasis}, right {Right lung structure}, right pleural {Right pleura structure}, effusion {Pleural effusion}, pneumonia {Pneumonia}, Heart {Heart structure}, lung volumes {Finding of respiratory volume}, edema {Edema}, MICROBIOLOGY {Microbiology}, INFLUENZA B ANTIGEN TEST {Influenza B virus antigen assay}, Viral Culture {Viral culture}, URINE {Urine culture}, Urinary {Urinary system structure}, URINE {Urine culture}, URINE CULTURE {Urine culture}"
+"###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:
+___ YOM with panhypopituitaryism presented to ___ with fever, 
+sudden onset nausea/vomiting, syncope, and hypoxemia, found to 
+have possible pneumonia on CXR.  He most likely had a viral 
+illness and required stress-dose steroids, but was unable to 
+tolerate PO due to inractable nausea/vomiting.  He likely 
+experienced syncope from dehydration related to viral illness, 
+nausea, vomiting.
+
+# Panhypopituitarism, central adrenal insufficiency:  Patient 
+presented with nausea, vomiting, diarrhea; has been admitted 
+with similar presentations.  Nausea and vomiting improved with 1 
+dose IV steroids, and was able to tolerate oral steroids.  Home 
+prednisone was increased to 15mg daily.  Patient was instructed 
+to continue stress dose prednisone 15mg daily for duration of 
+pneumonia treatment, patient has appointment with outpatient 
+endocrinologist on ___, who was endocrinologist was updated 
+on hospitalization.
+
+# Fever, Hypoxemia, Healthcare associated pneumonia vs 
+aspiration:  Patient reported respiratory illness ongoing for 
+approximately 1 week.  Chest x-ray showed possible pneumonia.  
+His CURB-65 score was 2, moderate severity.  Alternatively, he 
+may have had aspiration event during vomiting / syncopal 
+episode.  He recently traveled to ___, but given Wells Score 
+of 0, suspicion for PE was low.  Started levofloxacin 750 mg 
+daily for HCAP (___).  He was successfully weaned off of 
+supplemental O2, and ambulatory sats remained in the high ___.  
+Influenza A/B and urine legionella were negative.  Other 
+infectious workup with pertinent negatives:  Urinalysis and 
+urine culture negative.  Blood cultures NGTD at the time this 
+note is written.
+
+# Syncope:  Likely vasovagal in setting of vomiting and 
+dehydration versus orthostatic hypotension in the setting of 
+inability to take PO steroids.  Family denies abnormal movements 
+to suggest seizure, awoke spontaneously with no residual 
+deficits.  EKG showed RBB but no significant change from prior.  
+Was monitored on telemetry overnight with no events recorded.
+
+# Dizziness: Adrenal insufficiency vs vertigo (associated with 
+movement and relieved with meclizine); orthostatics were normal, 
+negative workup on prior admissions.  
+
+# Anemia:  HCT has been mid 30's in past, most recently 31 
+___, with normal iron studies. Rectal exam done and was 
+found to be guaiac negative.  HCT was stable
+
+# Hypertension: Quinapril was held given low/normal blood 
+pressures during hospitalization, and possible contribution to 
+syncope.  PCP was informed and may restart if needed.
+
+# Chest pain:  Patient presented with atypical chest pain during 
+last admission, ruled out for MI seen by cardiology, recommended 
+outpatient stress test; History not consistent with cardiac 
+etiology, may be GI (esophageal irritation, acid reflux)
+Continued home aspirin 325mg, atorva 80mg, quinapril 10mg daily. 
+ Recommended outpatient stress test 
+
+# DM: Held oral diabetes meds and placed on insulin SS 
+
+# CONTACT: patient, son ___ ___ ___ 
+(daughter in law)  
+
+other transitional issues (per PACT):
+- Inconsistent with metformin and glimeperide; consider reducing 
+ regimen to single agent for compliance (perhaps XR version of 
+metformin which would be $4/month and provide better daily 
+coverage). Taking an ACEI (MA-) and an ASA.
+- Overdue for eye clinic f/up. 
+ 
+
+###RESPONSE: panhypopituitaryism {Panhypopituitarism}, fever {Fever}, nausea/vomiting {Nausea and vomiting}, syncope {Syncope}, hypoxemia {Hypoxemia}, pneumonia {Pneumonia}, CXR {Plain chest X-ray}, viral 
+illness {Viral disease}, steroids {Steroid therapy}, nausea/vomiting {Nausea and vomiting}, syncope {Syncope}, dehydration {Dehydration}, viral illness {Viral disease}, nausea, vomiting {Nausea and vomiting}, Panhypopituitarism {Panhypopituitarism}, adrenal insufficiency {Adrenal cortical hypofunction}, nausea, vomiting {Nausea and vomiting}, Nausea and vomiting {Nausea and vomiting}, improved {Patient's condition improved}, IV {Intravenous therapy}, steroids {Steroid therapy}, oral {Administration of drug or medicament via oral route}, steroids {Steroid therapy}, pneumonia {Pneumonia}, Fever {Fever}, Hypoxemia {Hypoxemia}, Healthcare associated pneumonia {Nosocomial pneumonia}, aspiration {Aspiration pneumonia}, ted respiratory illness {Disorder of respiratory system}, Chest x-ray {Plain chest X-ray}, pneumonia {Pneumonia}, aspiration {Aspiration into respiratory tract}, vomiting {Vomiting}, syncopal {Syncope}, PE {Pulmonary embolism}, HCAP {Nosocomial pneumonia}, infectious {Infectious disease}, workup {Evaluation procedure}, Urinalysis {Urinalysis}, urine culture {Urine culture}, Blood cultures {Blood culture}, Syncope {Syncope}, vasovagal {Vasovagal syncope}, vomiting {Vomiting}, dehydration {Dehydration}, orthostatic hypotension {Orthostatic hypotension}, abnormal movements {Abnormal movement}, seizure {Seizure}, EKG {Electrocardiographic procedure}, RBB {Right bundle branch block}, telemetry {Electroencephalogram telemetry}, Dizziness {Dizziness}, Adrenal insufficiency {Adrenal cortical hypofunction}, vertigo {Vertigo}, orthostatics {Orthostatic body position}, Anemia {Anemia}, Rectal exam {Rectal examination}, guaiac {Guaiac test for occult blood in feces specimen}, HCT was stable {Stable hematocrit}, Hypertension {Hypertensive disorder, systemic arterial}, normal blood 
+pressures {Normal blood pressure}, syncope {Syncope}, Chest pain {Chest pain}, atypical chest pain {Atypical chest pain}, MI {Myocardial infarction}, stress test {Electrocardiogram with exercise test}, cardiac {Heart structure}, GI {Structure of digestive system}, acid reflux {Acid reflux}, stress test {Electrocardiogram with exercise test}, DM {Diabetes mellitus}, diabetes {Diabetes mellitus}"
+"###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. Atorvastatin 80 mg PO DAILY 
+2. glimepiride *NF* 1 mg Oral daily 
+3. Levothyroxine Sodium 75 mcg PO DAILY 
+4. MetFORMIN (Glucophage) 1000 mg PO BID 
+5. PredniSONE 5 mg PO DAILY 
+6. Quinapril 10 mg PO DAILY 
+7. Aspirin 81 mg PO DAILY 
+8. Vitamin D 3000 UNIT PO DAILY 
+9. Docusate Sodium 100 mg PO DAILY 
+10. Senna 1 TAB PO BID:PRN constipation 
+
+ 
+Discharge Medications:
+1. Aspirin 81 mg PO DAILY 
+2. Atorvastatin 80 mg PO DAILY 
+3. Docusate Sodium 100 mg PO DAILY 
+4. Levothyroxine Sodium 75 mcg PO DAILY 
+5. PredniSONE 15 mg PO DAILY 
+RX *prednisone 5 mg 3 tablet(s) by mouth DAILY Disp #*15 Tablet 
+Refills:*0
+6. Senna 1 TAB PO BID:PRN constipation 
+7. Vitamin D 3000 UNIT PO DAILY 
+8. Calcium Carbonate 1500 mg PO DAILY 
+Do not take within 1 hour of taking levothyroxine 
+9. Levofloxacin 750 mg PO DAILY Duration: 7 Days 
+RX *levofloxacin 750 mg 1 tablet(s) by mouth DAILY Disp #*5 
+Tablet Refills:*0
+10. MetFORMIN (Glucophage) 1000 mg PO BID 
+
+ 
+
+###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:
+Community acquired pneumonia, panhypopituitarism
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Community acquired pneumonia {Community acquired pneumonia}, panhypopituitarism {Panhypopituitarism}, Mental Status {Neurological mental status determination}, 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 Mr. ___, 
+You were ___ to ___ for nausea, vomiting, and fever.  The 
+nausea, vomiting, and dizziness that you experience periodically 
+is most likely a result of low levels of steroids in your blood 
+because your pituitary gland, which controls release of 
+hormones, has been partially resected.  It is very important 
+that you take prednisone as prescribed every day to prevent 
+these symptoms.
+
+You had fevers and your chest x-ray showed evidence of 
+pneumonia, so we started you on an antibiotic called 
+levofloxacin.
+ 
+
+###RESPONSE: nausea, vomiting {Nausea and vomiting}, fever {Fever}, nausea, vomiting {Nausea and vomiting}, dizziness {Dizziness}, low levels of steroids {Abnormal steroid hormone}, pituitary gland {Pituitary structure}, fevers {Fever}, chest x-ray {Plain chest X-ray}, 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: 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: PSYCHIATRY
+ 
+
+###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:
+""What about my headaches?""
+
+ 
+Major Surgical or Invasive Procedure:
+None
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, headaches {Headache}"
+"###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:
+HISTORY OF PRESENT ILLNESS: Please see Dr. ___ Dr.
+___ consult note from ___ for further details of 
+the
+HPI, PPHx, PMHx, Substance Use Hx, SHx.
+ 
+Briefly, this is a ___ year old woman with history of chronic
+headaches and dyspepsia who originally came to the hospital on
+___ for sudden catatonic like symptoms in the setting of
+topiramate overuse for treatment of chronic headaches. She was
+transferred to neurology for workup of her catatonic features,
+her EEG showed diffuse slowing, and her symptoms improved
+significantly after a trial of lorazepam 2mg IM x 1. 
+
+She was revisited by psychiatry consult services who felt that
+she seemed to have new-onset psychotic processes, expressing
+paranoia and emotional lability.
+
+Upon arrival to the unit she stated she did not understand why
+she was on the psychiatric ward. She was concerned about her
+previous headaches and felt they were not adequately addressed
+but expressed she had not had a headache for the past 2 days. 
+She
+did not express any complaints, though stated she felt better
+when she sang, and sang church hymns through the remainder of 
+the
+interview.
+
+After speaking with her husband who came to visit, he states 
+that
+she is still, at times, not at her baseline. He stated she is
+sometimes confused and has difficulty concentrating. He does
+acknowledge that she is significantly improved from when she was
+first admitted.
+
+ 
+
+###RESPONSE: chronic
+headaches {Chronic headache disorder}, dyspepsia {Indigestion}, catatonic {Catatonia}, chronic headaches {Chronic headache disorder}, neurology {Neurological examination}, workup {Evaluation procedure}, catatonic {Catatonia}, EEG {Electroencephalogram}, improved {Patient's condition improved}, paranoia {Paranoid disorder}, emotional lability {Mood swings}, psychiatric {Psychiatry procedure or service}, headaches {Headache}, headache {Headache}, baseline {Baseline state}, confused {Clouded consciousness}, difficulty concentrating {Unable to concentrate}, improved {Patient's condition improved}"
+"###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:
+Headaches
+ 
+
+###RESPONSE: Headaches {Headache}"
+"###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:
+SAFETY:  The pt. was placed on 15 minute checks on admission and 
+
+remained here on that level of observation throughout.  She was 
+unit-restricted.  There were no acute safety issues during this 
+hospitalization.
+
+LEGAL: ___
+PSYCHIATRIC: 
+Catatonia had resolved before admission with ativan. On 
+admission, she endorsed depressed mood with neurovegetative 
+symptoms including reduced sleep, interest, energy, 
+concentration, and appetite. She exhibited transient psychotic 
+symptoms including a paranoid delusion that somebody was coming 
+to hurt her, and auditory hallucinations where she heard the 
+voice of her cousin and her brother. On admission, pt was 
+started on mirtazapine 7.5mg PO QHS, olanzapine 5mg PO BID, and 
+lorazepam 1mg PO BID with 1mg PO Q6H prn. On this regimen, she 
+improved significantly. Her mood improved, and her psychotic 
+symptoms resolved. Whereas on admission she was significantly 
+fixated on somatic symptoms, in which these complaints 
+represented the ___ her focus, by the time of discharge, 
+these complaints were only mentioned in passing. She has poor 
+insight, and she does not wish to take medications after 
+discharge, as she believes that taking medication will make her 
+dependent on them for further functioning.
+ 
+
+GENERAL MEDICAL CONDITIONS:
+
+PSYCHOSOCIAL:
+#) GROUPS/MILIEU: pt was visible on the unit but did not attend 
+many groups.
+
+#) COLLATERAL CONTACTS:
+Husband denied previous depression or psychosis.
+
+RISK ASSESSMENT:
+
+#) Chronic/Static Risk Factors:
+-mood disorder
+
+#) Modifiable Risk Factors:
+-mood disorder
+-psychosocial stressors
+-poor insight, doesn't believe medications have helped her
+
+#) Protective Factors:
+-married with children
+-gender
+-no past suicide attempts
+
+PROGNOSIS: Guarded
+Ms. ___ will need ___ follow-up with a 
+psychiatrist and therapist. If she adheres to her medications 
+and appointments, she will likely do well. However, as she does 
+not believe that medications are helping her, and she does not 
+want to take psychotropic medications long-term, non-compliance 
+is a significant risk.
+ 
+
+###RESPONSE: SAFETY {Safety case management}, level of observation {Levels of observation}, no acute {No abnormality detected}, PSYCHIATRIC {Psychiatry procedure or service}, Catatonia {Catatonia}, resolved {Problem resolved}, depressed mood {Depressed mood}, reduced sleep {Short-sleeper}, interest {Loss of interest}, energy {Lack of energy}, concentration {Unable to concentrate}, appetite {Decrease in appetite}, psychotic 
+symptoms {Psychotic symptom present}, paranoid delusion {Paranoid delusion}, auditory hallucinations {Auditory hallucinations}, regimen {Therapeutic regimen}, improved {Patient's condition improved}, mood improved {Improved mood}, psychotic 
+symptoms resolved {Psychotic symptom finding}, somatic symptoms {Somatic pain}, insight {Finding related to ability to comprehend}, does not wish to take medications {Non-compliance of drug therapy}, medication {Administration of drug or medicament}, MILIEU {Environmental intervention}, did not attend {Did not attend}, depression {Depressive disorder}, psychosis {Psychotic disorder}, mood disorder {Mood disorder}, mood disorder {Mood disorder}, insight {Finding related to ability to comprehend}, medications {Administration of drug or medicament}, married {Married}, suicide attempts {Suicidal intent}, PROGNOSIS {Determination of prognosis}, follow-up {Follow-up arranged}, psychiatrist {Psychiatric follow-up}, medications {Prescription of drug}, medications {Administration of drug or medicament}, psychotropic medications {On psychotropic medication}, non-compliance {Non-compliance of drug 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. OLANZapine 2.5 mg PO QHS 
+2. timolol maleate 5 mg oral BID 
+3. Omeprazole 20 mg PO BID 
+
+ 
+
+###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:
+MDD with psychotic features
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: MDD with psychotic features {Severe mood disorder with psychotic features}, Mental Status {Neurological mental status determination}, Clear {Normal state of mind}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, interactive {Does communicate}, 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:
+-please take your medications as prescribed
+-please follow-up with outpatient appointments
+ 
+                             ___ MD ___
+ 
+Completed by: ___
+
+###RESPONSE: take your medications as prescribed {Patient medication education}, follow-up {Follow-up arranged}"
+"###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: 
+Patient recorded as having No Known Allergies to Drugs
+ 
+Attending: ___.
+ 
+Chief Complaint:
+chest pain
+ 
+Major Surgical or Invasive Procedure:
+___ Cardiac catheterization
+
+ 
+
+###RESPONSE: No Known Allergies to Drugs {Non-allergic hypersensitivity to drug or medicament}, chest pain {Chest pain}, 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:
+Patient is a ___ year old male with history of coronary artery 
+disease status-post catherization in ___ with stent to OM1, 
+and hypertension who presents with chest pain.  
+.  
+Patient reports that he had a ""stabbing"" chest pain this 
+morning. He states he had ""a lot"" of chest pain, more than the 
+___ episodes per day he had been having previously. He states it 
+improved with nitroglycerin that he took at home. He also had 
+had a positive stress test about a week ago and an outpatient 
+catherization at ___ had been planned.  
+.  
+He initially presented to ___, where he 
+received nitropaste. Vitals there were 94/22, HR 94, RR 18, 97% 
+on RA, and no pain. Cardiac enzymes there were CK 170 and 
+Troponin 0.02 at 12:30 ___.  
+Upon arrival to ___, his blood pressure was 104/52, HR 52, RR 
+18, temperature 96.2, and respiratory rate of 18. He was given 
+325 mg of aspirin and tolerated it well--of note there is a 
+possible allergy to aspirin noted in his admission intake form.  
+
+.  
+Patient was resting comfortably in his bed without any 
+complaints when interviewed. He denied chest pain or shortness 
+of breath.  
+.  
+On review of systems, he denies any prior history of stroke, 
+TIA, deep venous thrombosis, pulmonary embolism, bleeding at the 
+time of surgery, myalgias, cough, hemoptysis, black stools or 
+red stools. He denies recent fevers, chills or rigors. No 
+exertional buttock or calf pain. All of the other review of 
+systems were negative except for pain in his right hand that 
+patient relates has continued to bother him since a fall earlier 
+in the year.  
+.  
+Cardiac review of systems is notable for chest pain as discussed 
+above, accompanied by lightheadedness this morning. No worsening 
+dypsnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, 
+ankle edema, palpitations, syncope or presyncope.  
+.  
+
+ 
+
+###RESPONSE: coronary artery 
+disease {Coronary arteriosclerosis}, stent {Insertion of arterial stent}, OM1 {Structure of first obtuse marginal branch of circumflex branch of left coronary artery}, hypertension {Hypertensive disorder, systemic arterial}, chest pain {Chest pain}, stabbing {Stabbing pain}, chest pain {Chest pain}, chest pain {Chest pain}, improved {Patient's condition improved}, stress test {Electrocardiogram with exercise test}, catherization {Cardiac catheterization}, Vitals {Vital signs finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, RA {Breathing room air}, pain {Chest pain}, Cardiac enzymes {Finding of cardiac enzyme levels}, Troponin {Troponin measurement}, blood pressure {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, temperature {Body temperature finding}, respiratory rate {Finding of rate of respiration}, allergy to aspirin {Allergy to aspirin}, chest pain {Chest pain}, shortness 
+of breath {Dyspnea}, review of systems {Review of systems}, stroke {Cerebrovascular accident}, TIA {Transient ischemic attack}, deep venous thrombosis {Deep venous thrombosis}, pulmonary embolism {Pulmonary embolism}, bleeding {Bleeding}, surgery {Surgical procedure}, myalgias {Muscle pain}, cough {Cough}, hemoptysis {Hemoptysis}, black stools {Dark stools}, red stools {Red stools}, fevers {Fever}, chills {Chill}, rigors {Rigor}, exertional {Pain provoked by exertion}, buttock {Pain in buttock}, calf pain {Pain in calf}, review of 
+systems {Review of systems}, negative {No abnormality detected}, pain {Hand pain}, right hand {Structure of right hand}, fall {Falls}, Cardiac {Structure of cardiovascular system}, review of systems {Review of systems}, chest pain {Chest pain}, lightheadedness {Lightheadedness}, dypsnea on exertion {Dyspnea on exertion}, paroxysmal nocturnal dyspnea {Paroxysmal nocturnal dyspnea}, orthopnea {Orthopnea}, ankle edema {Ankle edema}, palpitations {Palpitations}, syncope {Syncope}, presyncope {Near 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:
+- CAD s/p BMS to OM1  (see below)
+- HTN  
+- renal calculi s/p surgery  
+- hip replacement x 2 on right r/t injuries  
+- GSW to pelvis/femur WWII; left hip replacement r/t war 
+injuries (left leg is shorter than right)  
+- BPH  
+- pneumonia  
+- appendectomy  
+.  
+Cardiac Risk Factors: (-)Diabetes, (-)Dyslipidemia, 
+(+)Hypertension  
+.  
+Cardiac History:  
+Percutaneous coronary intervention, in ___ anatomy as 
+follows: BMS to the OM with rotational atherectomy. Had to have 
+___ cath 10 days after first as first attempt at stent placement 
+was unsuccessful.  
+
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}, OM1 {Structure of first obtuse marginal branch of circumflex branch of left coronary artery}, HTN {Hypertensive disorder, systemic arterial}, renal calculi {Kidney stone}, surgery {Surgical procedure}, hip replacement {Prosthetic arthroplasty of hip}, right {Structure of right knee region}, injuries {Traumatic or non-traumatic injury}, GSW {Gunshot wound}, pelvis {Structure of pelvis}, femur {Bone structure of femur}, left hip replacement {Total replacement of left hip joint}, war 
+injuries {War injury}, left leg {Structure of left lower leg}, shorter {Short leg}, right {Structure of right lower limb}, BPH {Benign prostatic hyperplasia}, pneumonia {Pneumonia}, appendectomy {Excision of appendix}, Cardiac Risk Factors {Assessment for risk of cardiovascular disease}, Diabetes {Diabetes mellitus}, Dyslipidemia {Dyslipidemia}, Hypertension {Hypertensive disorder, systemic arterial}, Cardiac {Structure of cardiovascular system}, Percutaneous coronary intervention {Percutaneous coronary intervention}, OM {Structure of obtuse marginal branch of circumflex branch of left coronary artery}, rotational atherectomy {Atherectomy by rotary cutter}, cath {Cardiac catheterization}, stent placement {Placement of stent}"
+"###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:
+There is no family history of premature coronary artery disease. 
+A brother died suddenly in sleep at age ___. 
+ 
+
+###RESPONSE: coronary artery disease {Coronary arteriosclerosis}, died {Dead}"
+"###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:
+VS: 97.7, 158/67, 56, 18, 97% on RA, 161 lbs.  
+GENERAL: Elderly male, sleeping, easily awaken, NAD. Oriented 
+x3. Mood, affect appropriate.  
+HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were 
+pink, no pallor or cyanosis of the oral mucosa. No xanthalesma.  
+
+NECK: Supple with JVP of 8 cm.  
+CARDIAC: PMI located in ___ intercostal space, midclavicular 
+line. Bradycardic, irregularly irregular, S1, S2. No m/r/g. No 
+thrills, lifts. No S3 or S4.  
+LUNGS: No chest wall deformities, scoliosis or kyphosis. Resp 
+were unlabored, no accessory muscle use. CTAB, no crackles, 
+wheezes or rhonchi. Transmitted noises from abdomen appreciated 
+at times. Fleshy nodule in middle of upper back.  
+ABDOMEN: Soft, NTND. No HSM or tenderness. Abd aorta not 
+enlarged by palpation. No abdominial bruits.  
+EXTREMITIES: No c/c/e. No femoral bruits.  
+SKIN: No stasis dermatitis, ulcers, scars, or xanthomas.  
+PULSES:  
+Bilateral: Carotid 2+ Very strong bilateral DP 2+ ___ 2+
+ 
+
+###RESPONSE: VS {Vital signs finding}, RA {Breathing room air}, GENERAL {General examination of patient}, sleeping {Asleep}, awake {Awake}, NAD {No abnormality detected}, Oriented 
+x3 {Oriented to person, time and place}, Mood {Level of mood - normal}, affect {Mood finding}, HEENT {Physical examination procedure}, NC {Normal head}, Sclera anicteric {White sclera}, PERRL {Pupils equal and reacting to light}, EOMI {Normal ocular motility}, Conjunctiva were 
+pink {Conjunctiva normal}, pallor {Pallor of skin of face}, cyanosis {Cyanosis}, oral mucosa {Oral mucous membrane structure}, xanthalesma {Xanthelasma}, NECK {Physical examination procedure}, Supple {Normal movement of neck}, JVP {Finding of jugular venous pressure}, CARDIAC {Cardiovascular physical examination}, intercostal space {Structure of intercostal space}, midclavicular 
+line {Midclavicular line}, Bradycardic {Bradycardia}, irregularly irregular {Heart irregularly irregular}, S2 {Normal second heart sound, S>2<}, thrills {Thrill}, No S3 {Third heart sound, S>3<, inaudible}, S4 {Fourth heart sound, S>4<, inaudible}, LUNGS {Examination of respiratory system}, chest wall deformities {Deformity of chest wall}, scoliosis {Scoliosis deformity of spine}, kyphosis {Kyphosis deformity of spine}, Resp {Examination of respiratory system}, accessory muscle {Accessory skeletal muscle}, CTAB {Normal breath sounds}, crackles {Respiratory crackles}, wheezes {Wheezing}, rhonchi {Wheeze - rhonchi}, Transmitted noises {Transmitted sounds}, abdomen {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, nodule {Nodule}, upper back {Upper back structure}, ABDOMEN {Examination of abdomen}, Soft {Abdomen soft}, ND {Swollen abdomen}, HSM {Hepatosplenomegaly}, tenderness {Tenderness}, Abd {Examination of abdomen}, enlarged {Enlargement}, palpation {Palpation}, abdominial bruits {Abdominal bruit}, EXTREMITIES {Examination of limb}, femoral bruits {Femoral bruit}, SKIN {Examination of skin}, stasis dermatitis {Stasis dermatitis}, ulcers {Ulcer}, scars {Scar}, xanthomas {Xanthomatosis}, PULSES {Pulse finding}, Carotid 2 {Normal carotid arterial pulse}, DP 2+ {Dorsalis pulse present}"
+"###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:
+___ Cardiac cath:
+COMMENTS:      
+1. Selective coronary angiography of this right dominant system 
+demonstrated no significant obstructive CAD. The LMCA had mild 
+disease. 
+The LCX/OM1 stents were patent. The LA and RCA had moderate 
+diffuse disease, unchanged from the prior catheterization in 
+___. 
+2. Limited resting hemodynamics demonstrated systemic arterial 
+hypertension (154/61). 
+  
+FINAL DIAGNOSIS:     
+1. No significant obstructive CAD. Patent OM stents. 
+
+ 
+
+###RESPONSE: Cardiac cath {Cardiac catheterization}, coronary angiography {Angiography of coronary artery}, right {Right coronary artery structure}, CAD {Coronary arteriosclerosis}, LMCA {Structure of left coronary artery main stem}, disease {Disease}, LCX {Stent in circumflex branch of left coronary artery}, OM1 {Structure of first obtuse marginal branch of circumflex branch of left coronary artery}, stents were patent {Coronary stent patent}, LA {Structure of circumflex branch of left coronary artery}, RCA {Right coronary artery structure}, disease {Disease}, catheterization {Cardiac catheterization}, hemodynamics {Hemodynamic monitoring}, systemic arterial 
+hypertension {Hypertensive disorder, systemic arterial}, CAD {Coronary arteriosclerosis}, OM {Structure of obtuse marginal branch of circumflex branch of left coronary artery}, stents {Coronary stent patent}"
+"###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:
+Patient is a ___ year old male with history of coronary artery 
+disease and hypertension who presents with chest pain in the 
+setting of a recent positive stress test.  
+.  
+# CORONARIES: Patient has known CAD, has prior BMS to OM1 in 
+___. His recurrent chest pain is concerning for stuttering 
+angina given his known disease and response to nitroglycerin. 
+Report of his out-patient stress test (reportedly positive per 
+patient) was not available for review at time of admission, but 
+plans were already being made for repeat catherization given 
+worsening symptoms in the setting of a good medical regimen. 
+Cardiac enzymes were negative times three and no ischemic 
+changes were seen on EKG. Cardiac catheterization was performed 
+which revealed no significant lesions or stenosis.  Pt remained 
+pain free throughout his hospitalization. He was instructed to 
+continue his home cardiac medications as previously directed and 
+follow up with his primary care physician within one week of 
+discharge.
+.  
+# RHYTHM: Pt has no history of arrhythmias. Sinus bradycardia 
+with 1st degree AV block is an old finding. Given pts known 
+bradycardia and new history of dizziness and fatigue, pt was 
+evaluated by the Electrophysiology team.  There was no 
+indication for pacemaker placement during this admission.  Pt 
+was discharged home with a holter monitor to observe the extent 
+of his bradycardia. Pt will follow up with his primary care 
+provider and cardiologist to determine the benefit of a 
+pacemaker in the future.  
+.
+# PUMP: No evidence of failure on history or exam.  
+.   
+# HTN: Continue home medications (mayzide, terazosin, diovan, 
+metoprolol in lieu of atenolol given advanced age and atenolol 
+is renally cleared)  
+.  
+# BPH: Continue terazosin.  
+.  
+# Anemia: Stable from one year ago. Will defer any desired 
+further work-up to outpatient providers.  
+.  
+# FEN: Precath hydration was provided.  
+.  
+# ACCESS: PIV's   
+.  
+# CODE: Full  
+.  
+# Contact: Daughter ___:  
+Phone: ___  
+
+ 
+
+###RESPONSE: coronary artery 
+disease {Coronary arteriosclerosis}, hypertension {Hypertensive disorder, systemic arterial}, chest pain {Chest pain}, stress test {Electrocardiogram with exercise test}, CAD {Coronary arteriosclerosis}, OM1 {Structure of first obtuse marginal branch of circumflex branch of left coronary artery}, chest pain {Chest pain}, angina {Angina}, stress test {Electrocardiogram with exercise test}, no ischemic 
+changes {Electrocardiogram: no myocardial ischemia}, EKG {Electrocardiographic procedure}, Cardiac catheterization {Cardiac catheterization}, lesions {Lesion}, stenosis {Stenosis}, pain {Chest pain}, arrhythmias {Cardiac arrhythmia}, Sinus bradycardia {Sinus bradycardia}, 1st degree AV block {First degree atrioventricular block}, bradycardia {Bradycardia}, dizziness {Dizziness}, fatigue {Fatigue}, evaluated {Evaluation procedure}, pacemaker placement {Implantation of cardiac pacemaker}, bradycardia {Bradycardia}, follow up {Follow-up arranged}, HTN {Hypertensive disorder, systemic arterial}, BPH {Benign prostatic hyperplasia}, Anemia {Anemia}, Stable {Patient's condition stable}, PIV {Peripheral intravenous catheter care}"
+"###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:
+Atenolol 25 mg daily  
+Plavix 75 mg daily  
+___ 12.5 mg daily  
+Omeprazole 40 mg daily  
+Zocor 20 mg daily  
+Terazosin 10 mg daily  
+Diovan 80 mg daily  
+Imdur 60 mg daily  
+ 
+Discharge Medications:
+1. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) 
+Tablet, Delayed Release (E.C.) PO once a day.
+Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2*
+2. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+3. Simvastatin 20 mg Tablet Sig: One (1) Tablet PO once a day.  
+4. Omeprazole 40 mg Capsule, Delayed Release(E.C.) Sig: One (1) 
+Capsule, Delayed Release(E.C.) PO once a day.  
+5. Terazosin 10 mg Capsule Sig: One (1) Capsule PO once a day.  
+6. Isosorbide Mononitrate 60 mg Tablet Sustained Release 24 hr 
+Sig: One (1) Tablet Sustained Release 24 hr PO DAILY (Daily).  
+7. Valsartan 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+
+8. Maxzide-25mg  Oral
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+___ Diagnosis:
+Primary
+1. Coronary artery disease
+2. Hypertension
+3. Bradycardia
+
+ 
+Discharge Condition:
+Hemodynamically stable, chest pain free
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, Coronary artery disease {Coronary arteriosclerosis}, Hypertension {Hypertensive disorder, systemic arterial}, Bradycardia {Bradycardia}, Hemodynamically stable {Hemodynamically stable}, chest pain {Chest 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: Discharge Instructions:
+You came into the hospital because of chest pain. You underwent 
+a repeat cardiac catheterization that showed no major new 
+blockages.
+.
+At the other hospital, you had evidence of an irregular heart 
+rhythm (atrial fibrillation or flutter) but your heart rhythm 
+here looked regular. You will need a heart monitor for 48 hours 
+following discharge from the hospital to see if the irregular 
+rhythm recurs.
+.
+We stopped your atenolol because it may be contributing to the 
+dizzy episodes you were having prior to coming into the 
+hospital. 
+Please take your medications as directed and keep your followup 
+appointments.
+.
+Call your doctor and seek medical attention if you develop:
+** worsening chest discomfort, shortness of breath, 
+lightheadedness or dizziness, bleeding, swelling, or pain at the 
+procedure site at your groin, or if you have any other symptoms 
+that worry you
+ 
+
+###RESPONSE: chest pain {Chest pain}, cardiac catheterization {Cardiac catheterization}, irregular heart 
+rhythm {Irregular heart beat}, atrial fibrillation {Atrial fibrillation}, flutter {Atrial flutter}, heart rhythm {Finding of heart rhythm}, regular {Normal sinus rhythm}, irregular 
+rhythm {Irregular heart beat}, dizzy {Dizziness}, chest discomfort {Chest discomfort}, shortness of breath {Dyspnea}, lightheadedness {Lightheadedness}, dizziness {Dizziness}, bleeding {Bleeding}, swelling {Swelling}, pain {Chest pain}, procedure {Procedure}, groin {Inguinal region 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: 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:
+abdominal pain, diarrhea
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, abdominal pain {Abdominal pain}, 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:
+Mr. ___ is a ___ yo M w/hx of DVT, hyponatremia, and chronic 
+pancreatic abnormalitiy of unknown etiology presenting with 
+lower abdominal pain and diarrhea. His symptoms began with 
+diarrhea on ___ happening twice a day, was nonbloody.  He 
+developed abdominal pain on ___, constant, 
+nonradiating, and in the lower central abdomen. His abdominal 
+pain progressed over three days to ___, and his diarrhea did 
+not improve.  His last bowel movement was yesterday and is 
+currently passing gas. He has been able to eat and drink, denies 
+any fevers, chills, vomiting, hematemesis, melena, hematochezia, 
+travel, sick contacts, food ingestion.  He finished triple 
+therapy for H. Pylori 1 month ago. He did endorse urinary 
+hesitancy, no dysuria. He has no history of alcohol use, did 
+smoke with 2.5 pack years.  
+
+On arrival to the ED, initial vitals were: T97.8 HR84 BP136/84 
+RR16 O296% ra. Exam notable for mild diffuse ttp, no 
+rebound/guarding. Labs notable for: ALT 87 AP 60 Tbili: 0.2 Na: 
+129 BUN/crea: ___ Lip: 171 WBC: 8.2. CT abdomen showed 
+pancreatitis of body and tail and likely distal splenic vein 
+thrombosis. In ED, patient received  Morphine 5 mg IV, 4mg 
+zofran, and 2L IV NS. Patient evaluated by ACS who recommended 
+admission to medicine for suspected pancreatitis. VS prior to 
+transfer: 98.3 76 116/72 14 100% RA. 
+
+Currently, he is feeling ___ abdominal pain, which he calls 
+comfortable.  It is in the center lower abdomen, nonradiating.  
+He denies any vomiting, fevers, chills, or SOB.
+
+Of note, he has had a 25 lb weight loss since ___ and has had 
+a poor appetite.  He has some chronic symptoms that began with 
+constipation.  Sometime in ___ he was admitted to the ___ 
+for hyponatremia and was found to have a chronic pancreatic 
+abnormality of unknown etiology s/p biopsy, colonoscopy, and 
+endoscopy.  He also had a DVT that he is on Lovenox for 
+currently.  He expresses some chronic lower abdominal pain that 
+sometimes involves testicular pain.
+ 
+ROS: per HPI, denies fever, chills, night sweats, vision 
+changes,  shortness of breath, chest pain, vomiting, BRBPR, 
+melena, hematochezia, dysuria, hematuria. Did endorse headache.
+
+ 
+
+###RESPONSE: DVT {Deep venous thrombosis}, hyponatremia {Hyponatremia}, chronic 
+pancreatic abnormalitiy {Disorder of pancreas}, lower abdominal pain {Lower abdominal pain}, diarrhea {Diarrhea}, diarrhea {Diarrhea}, abdominal pain {Abdominal pain}, constant {Constant pain}, nonradiating {Radiating pain}, lower central abdomen {Lower abdomen structure}, abdominal 
+pain {Abdominal pain}, diarrhea {Diarrhea}, passing gas {Passing flatus}, able to eat {Able to eat}, fevers {Fever}, chills {Chill}, vomiting {Vomiting}, hematemesis {Hematemesis}, melena {Melena}, hematochezia {Hematochezia}, travel {Travel abroad}, triple 
+therapy for H. Pylori {Triple therapy helicobacter pylori}, urinary 
+hesitancy {Delay when starting to pass urine}, dysuria {Dysuria}, alcohol use {Current drinker of alcohol}, did 
+smoke {Ex-smoker}, vitals {Vital signs finding}, diffuse {Diffuse pain}, ttp {Tenderness}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, ALT {Alanine aminotransferase above reference range}, WBC {White blood cell count}, CT abdomen {Computed tomography of abdomen}, pancreatitis {Pancreatitis}, splenic vein 
+thrombosis {Splenic vein thrombosis}, pancreatitis {Pancreatitis}, VS {Vital signs finding}, RA {Breathing room air}, abdominal pain {Abdominal pain}, lower abdomen {Lower abdomen structure}, nonradiating {Radiating pain}, vomiting {Vomiting}, fevers {Fever}, chills {Chill}, SOB {Dyspnea}, weight loss {Weight loss}, poor appetite {Decrease in appetite}, constipation {Constipation}, hyponatremia {Hyponatremia}, chronic pancreatic 
+abnormality {Disorder of pancreas}, biopsy {Biopsy}, colonoscopy {Colonoscopy}, endoscopy {Endoscopy}, DVT {Deep venous thrombosis}, lower abdominal pain {Lower abdominal pain}, testicular pain {Pain in testicle}, fever {Fever}, chills {Chill}, night sweats {Night sweats}, vision 
+changes {Visual disturbance}, shortness of breath {Dyspnea}, chest pain {Chest pain}, vomiting {Vomiting}, BRBPR {Hematochezia}, melena {Melena}, hematochezia {Hematochezia}, dysuria {Dysuria}, hematuria {Blood in urine}, headache {Headache}"
+"###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:
+pancreatic mass s/p biopsy, colonoscopy, and endoscopy, the most 
+recent endoscopy in ___
+H pylori gastritis s/p triple therapy 1 month ago 
+DVT in ___
+Diabetes Mellitus (reported by patient, on no therapy)
+
+ 
+
+###RESPONSE: pancreatic mass {Mass of pancreas}, biopsy {Biopsy}, colonoscopy {Colonoscopy}, endoscopy {Endoscopy}, endoscopy {Endoscopy}, H pylori gastritis {Gastritis caused by Helicobacter pylori}, triple therapy {Triple therapy helicobacter pylori}, DVT {Deep venous thrombosis}, Diabetes Mellitus {Diabetes mellitus}, 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: 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:
+Denies any family history of pancreatic or other GI disease, 
+cancer, or autoimmune disease
+
+ 
+
+###RESPONSE: pancreatic {Pancreatic structure}, GI disease {Disorder of gastrointestinal tract}, cancer {Malignant neoplasm}, autoimmune disease {Autoimmune 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:
+======================
+Admission Physical Exam
+======================
+VS - Temp 97.8F, BP 125/62, HR 106, R 18, O2-sat 98% RA  
+General: NAD, appears comfortable
+HEENT: normocephalic, no scleral icterus, OP clear. 
+Neck: supple, no cervical ___.
+CV:  regular rhymthm, tachycardic, nl S1 S2, no r/m/g 
+appreciated.
+Lungs: CTAB, no rales
+Abdomen: +BS.Soft,nondistended,tender to palpation in the 
+central lower abdomen and epigastric regions, worse in lower 
+abdomen. ___ and Grey-Turner's signs negative.  No fluid 
+wave. No hepatosplenomegaly. No rebound or guarding.
+GU: no Foley. No LAD,no testicular pain to palpation. No CVA 
+tenderness.
+Ext: WWP, +2 pulses. No pedal edema. 
+Neuro: A+Ox3, attentive. Memory intact. Motor and sensory 
+function grossly intact.
+Skin: no rashes. No spider angiomata.
+
+=====================
+Discharge Physical Exam
+=====================
+VS- 98.7 119/72 83 18 95RA
+General: NAD, appears comfortable
+HEENT: no scleral icterus 
+CV: regular rhythm, normal rate, S1 and S2 clear and of good 
+quality, no r/m/g appreciated.
+Lungs: CTAB bilaterally with good air movement. 
+Abdomen: +BS. Soft, non-tender, slightly distended. No rebound 
+or guarding.
+Extremities: Warm and well perfused with 2+ DP pulses, no 
+cyanosis, edema, or excoriations.
+Neuro: A+Ox3, attentive. 
+
+ 
+
+###RESPONSE: Physical Exam {Physical examination procedure}, VS {Vital signs finding}, Temp {Body temperature finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, O2-sat {Oxygen saturation measurement}, RA {Breathing room air}, General {General examination of patient}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, normocephalic {Normal head}, scleral icterus {Scleral icterus}, OP clear {Pharynx normal}, Neck {Physical examination procedure}, supple {Normal movement of neck}, cervical {Cervical lymphadenopathy}, CV {Cardiovascular physical examination}, regular rhymthm {Normal sinus rhythm}, tachycardic {Tachycardia}, S2 {Normal second heart sound, S>2<}, Lungs {Examination of respiratory system}, CTAB {Normal breath sounds}, rales {Respiratory crackles}, Abdomen {Examination of abdomen}, BS {Normal bowel sounds}, Soft {Abdomen soft}, nondistended {Normal abdominal contour}, tender {Abdominal tenderness}, palpation {Palpation}, lower abdomen {Lower abdomen structure}, epigastric regions {Epigastric region structure}, lower 
+abdomen {Lower abdomen structure}, Grey-Turner's signs {Grey Turner's sign}, hepatosplenomegaly {Hepatosplenomegaly}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, GU {Examination of genitourinary system}, Foley {Catheterization of urinary bladder}, LAD {Lymphadenopathy}, pain {Pain}, palpation {Palpation}, CV {Cardiovascular physical examination}, tenderness {Tenderness}, Ext {Examination of limb}, WWP {Normal tissue perfusion}, 2 pulses {Peripheral pulses normal}, edema {Edema}, Neuro {Neurological examination}, Ox3 {Oriented to person, time and place}, Memory intact {Memory function normal}, grossly intact {Normal nervous system function}, Skin {Examination of skin}, rashes {Eruption of skin}, spider angiomata {Spider telangiectasis of skin}, Physical Exam {Physical examination procedure}, VS {Vital signs finding}, RA {Breathing room air}, General {General examination of patient}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, scleral icterus {Scleral icterus}, CV {Cardiovascular physical examination}, regular rhythm {Normal sinus rhythm}, normal rate {Normal heart rate}, S2 {Normal second heart sound, S>2<}, Lungs {Examination of respiratory system}, CTAB {Normal breath sounds}, good air movement {Breath normal}, Abdomen {Examination of abdomen}, BS {Normal bowel sounds}, Soft {Abdomen soft}, non-tender {Abdominal tenderness}, distended {Swollen abdomen}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, Extremities {Examination of limb}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, 2+ DP pulses {All pulses present in bilateral lower limbs}, cyanosis {Cyanosis}, edema {Edema}, excoriations {Excoriation}, Neuro {Neurological examination}, A {Mentally alert}, Ox3 {Oriented to person, time and place}, attentive {Well controlled integrated attention}"
+"###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
+=============================
+___ 12:45AM BLOOD WBC-8.2 RBC-4.53* Hgb-12.4* Hct-40.2 
+MCV-89 MCH-27.4 MCHC-30.9* RDW-12.3 Plt ___
+___ 12:45AM BLOOD Neuts-59.0 ___ Monos-7.6 Eos-2.0 
+Baso-0.5
+___ 12:45AM BLOOD Plt ___
+___ 10:30AM BLOOD Glucose-110* UreaN-4* Creat-0.4* Na-134 
+K-4.1 Cl-99 HCO3-27 AnGap-12
+___ 12:45AM BLOOD Glucose-151* UreaN-6 Creat-0.6 Na-129* 
+K-4.5 Cl-97 HCO3-27 AnGap-10
+___ 12:45AM BLOOD ALT-87* AST-35 AlkPhos-60 TotBili-0.2
+___ 12:45AM BLOOD Lipase-171*
+___ 10:30AM BLOOD Calcium-8.8 Phos-3.8 Mg-1.8
+___ 12:45AM BLOOD Albumin-4.4 Calcium-8.9 Phos-4.3 Mg-2.0
+___ 12:45AM BLOOD Osmolal-266*
+___ 08:06PM BLOOD CA ___ -Test  
+================
+Imaging
+================
+CT Abd/Pelv w/Contrast ___: IMPRESSION:  
+ 
+1.  Pancreatitis most prominent in the body and tail of the 
+pancreas with
+areas of pancreatic parenchymal hypoenhancement in the body and 
+tail,
+concerning for edema or impending pancreatic necrosis, involving 
+less than ___ of the gland. The areas of hypodensity in the 
+pancreas are round and focal lesions cannot be excluded. No 
+peripancreatic fluid collection.  The splenic vein is attenuated 
+proximally and likely narrowed in the region adjacent to the 
+body and tail of the pancreas.
+ 
+2.  Multiple bilateral solid and ground glass nodules throughout 
+both lung
+bases most likely represents infection, however, further 
+characterization withdedicated chest CT could be considered on a 
+non-emergent basis to exclude the possibility of malignancy.
+
+==================
+Discharge Results
+==================   
+___ 07:15AM BLOOD Hct-38.3*
+___ 07:10AM BLOOD Na-132* K-3.9 Cl-97
+___ 07:10AM BLOOD ALT-149* AST-50* AlkPhos-87 TotBili-0.4
+ 
+
+###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}, Monos {Monocyte count}, Eos {Eosinophil 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}, 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}, Lipase {Serum lipase measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Albumin {Albumin measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Imaging {Imaging}, Pancreatitis {Pancreatitis}, pancreas {Pancreatic structure}, pancreatic parenchymal {Structure of parenchyma of pancreas}, edema {Edema}, pancreatic necrosis {Necrosis of pancreas}, pancreas {Pancreatic structure}, lesions {Lesion}, fluid collection {Accumulation of fluid}, splenic vein {Structure of splenic vein}, pancreas {Pancreatic structure}, ground glass {Ground glass lung opacity}, nodules {Nodule}, lung
+bases {Structure of base of lung}, infection {Infectious disease}, malignancy {Malignant neoplasm}, Hct {Hematocrit determination}, Na {Blood sodium measurement}, K {Blood potassium measurement}, Cl {Chloride measurement, blood}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total 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: Brief Hospital Course:
+Mr. ___ is a ___ yo M with hx of DVT, hyponatremia, and 
+pancreatic mass suggestive of malignancy presenting with 
+pancreatitis secondary to pancreatic mass.
+  
+# Pancreatitis: Patient was treated conservatively for 
+pancreatitis. Morphine IV administered for pain control, he 
+remained NPO and given intravenous fluids. Diet was advanced 
+slowly once pain resolved and prior to discharge was tolerating 
+food and fluids without pain. Started pancreatic enzymes for 
+diarrhea.  He remained hemodynamically stable throughout.
+   
+# Pancreatic mass: FNA biopsy at outside hospital suggests 
+adenocarcinoma versus neuroendocrine tumor. Records from ___ 
+including MRI showed pancreatic ductal mass and PET with uptake 
+in the lungs. Chest CT with nodules suggestive of metastatic 
+disease.  The oncology team was consulted, and additional biopsy 
+was recommended however can be completed in the outpatient 
+setting. ___ was consulted and will set patient up for biopsy 
+post discharge. 
+  
+# Hyponatremia: Secondary to SIADH given low sodium with 
+euvolemia, elevated urine sodium, and improvement of sodium with 
+fluid restriction. He has a history of SIADH and presented with 
+a sodium of 129 that improved over the course of his admission 
+with fluid restriction. He had no neurologic symptoms at any 
+point during his admission.
+   
+# Splenic vein thrombosis: Imaging findings were suggestive of 
+splenic vein thrombosis, which based on prior ___ imaging is 
+chronic.  He was maintained on his home Lovenox dose.
+     
+==================
+Transitions of Care
+==================
+- To undergo outpatient retroperitoneal lymph node biopsy for 
+final diagnosis of his pancreatic mass
+- Oncology outpatient eval to determine next treatment steps
+- Follow up with PCP regarding ___ enzyme titration to 
+help with diarrhea
+- Follow up with PCP regarding BPH
+- Monitor Hyponatremia
+- Code Status: Full code
+- Additional contact: Brother ___ ___
+ 
+
+###RESPONSE: DVT {Deep venous thrombosis}, hyponatremia {Hyponatremia}, pancreatic mass {Mass of pancreas}, malignancy {Malignant neoplasm}, pancreatitis {Pancreatitis}, pancreatic mass {Mass of pancreas}, Pancreatitis {Pancreatitis}, pancreatitis {Pancreatitis}, pain control {Pain control}, remained NPO {On nothing by mouth status}, intravenous fluids {Intravenous infusion}, pain resolved {No present pain}, tolerating 
+food {Tolerating normal diet}, fluids {Tolerating oral fluid}, without pain {No present pain}, diarrhea {Diarrhea}, hemodynamically stable {Hemodynamically stable}, Pancreatic mass {Mass of pancreas}, FNA biopsy {Fine needle biopsy}, adenocarcinoma {Adenocarcinoma}, neuroendocrine tumor {Neuroendocrine tumor}, MRI {Magnetic resonance imaging}, pancreatic ductal mass {Mass of pancreas}, PET {Positron emission tomography}, lungs {Metastatic malignant neoplasm to lung}, Chest CT {Computed tomography of chest}, nodules {Nodule}, metastatic 
+disease {Metastatic malignant neoplasm}, biopsy {Biopsy}, biopsy {Biopsy}, Hyponatremia {Hyponatremia}, SIADH {Syndrome of inappropriate vasopressin secretion}, euvolemia {Normal blood volume}, urine sodium {Sodium measurement, urine}, fluid restriction {Fluid restriction}, SIADH {Syndrome of inappropriate vasopressin secretion}, sodium {Sodium measurement}, improved {Patient's condition improved}, fluid restriction {Fluid restriction}, no neurologic symptoms {Normal nervous system function}, Splenic vein thrombosis {Splenic vein thrombosis}, Imaging findings {Imaging finding}, splenic vein thrombosis {Splenic vein thrombosis}, imaging {Imaging}, retroperitoneal lymph node {Structure of retroperitoneal lymph node}, biopsy {Biopsy}, pancreatic mass {Mass of pancreas}, outpatient eval {Outpatient procedure}, PCP {Primary care management}, diarrhea {Diarrhea}, PCP {Primary care management}, BPH {Benign prostatic hyperplasia}, Hyponatremia {Hyponatremia}"
+"###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. Enoxaparin Sodium 70 mg SC Q12H 
+Start: ___, First Dose: Next Routine Administration Time 
+
+ 
+Discharge Medications:
+1. Pancrelipase 5000 1 CAP PO TID W/MEALS 
+Please talk with your doctors about ___ the medicine to 
+help with diarrhea. 
+RX *lipase-protease-amylase [Pancrelipase 5000] 5,000 
+unit-17,000 unit-27,000 unit 1 capsule(s) by mouth three times a 
+day Disp #*90 Capsule Refills:*0
+2. Enoxaparin Sodium 70 mg SC Q12H 
+Start: ___, First Dose: First Routine Administration Time 
+3. Tamsulosin 0.4 mg PO HS 
+Follow up with your primary care doctor about this medication 
+and your symptoms. 
+RX *tamsulosin 0.4 mg 1 capsule(s) by mouth at bedtime Disp #*30 
+Capsule Refills:*0
+4. Benzonatate 100 mg PO TID:PRN Cough 
+RX *benzonatate 100 mg 1 capsule(s) by mouth three times a day 
+Disp #*90 Capsule 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:
+Active:
+- Pancreatitis
+- Pancreatic malignancy
+  
+Chronic:
+- Pancreatic cancer
+- Hyponatremia
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Pancreatitis {Pancreatitis}, Pancreatic malignancy {Malignant tumor of pancreas}, Pancreatic cancer {Malignant tumor of pancreas}, Hyponatremia {Hyponatremia}, Mental Status {Neurological mental status determination}, Clear {Normal state of mind}, Alert {Mentally alert}, interactive {Does communicate}, 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 hospital because of abdominal pain and 
+diarrhea caused by inflammation of your pancreas.  You received 
+fluids and pain medication and improved. You were tolerating 
+food and liquids by mouth at discharge.  You were given some 
+pancreatic enzymes to help with the diarrhea. 
+   
+We acquired records from the ___, which along with your 
+symptoms of weight loss are concerning for cancer. We scheduled 
+an outpatient biopsy of a lymph node for you. It is very 
+important that you have that procedure done and follow up with 
+the oncologists to continue your care. You were complaining of 
+some tenderness around your bladder and some difficulty 
+initiating urination, so you were starting on a medication to 
+help with that and should follow up with your primary care 
+doctor. Thank you for having us be a part of your care team.
+ 
+The Interventional Radiology team will be contacting you to 
+schedule an appointment for your biopsy. If you do not hear by 
+___ next week please call the floor ___
+ 
+
+###RESPONSE: abdominal pain {Abdominal pain}, diarrhea {Diarrhea}, inflammation of your pancreas {Pancreatitis}, pain medication {Administration of analgesic}, improved {Patient's condition improved}, tolerating 
+food {Tolerating diet}, liquids by mouth {Tolerating oral fluid}, diarrhea {Diarrhea}, weight loss {Weight loss}, cancer {Malignant neoplasm}, biopsy {Biopsy}, lymph node {Structure of lymph node}, tenderness {Tenderness}, bladder {Urinary bladder structure}, difficulty 
+initiating urination {Delay when starting to pass urine}, biopsy {Biopsy}"
+"###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: PLASTIC
+ 
+
+###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: 
+Compazine
+ 
+Attending: ___.
+ 
+Chief Complaint:
+abdominal wound 
+ 
+Major Surgical or Invasive Procedure:
+Abdominal wound exploration and removal of infected mesh.
+
+ 
+
+###RESPONSE: Compazine {Allergy to prochlorperazine}, abdominal wound {Wound of abdomen}, Abdominal wound exploration {Exploration of penetrating wound of abdomen}, removal of infected mesh {Removal of mesh from 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: History of Present Illness:
+___ is a ___ year old female with history of lower 
+abdominal desmoid tumor removal and reconstruction with mesh 
+with subsequent infection and resection of mesh and replacement, 
+eventually wound which required delayed primary closure. She 
+presented to clinic with a small wound in the middle ofher lower 
+abdominal incision site.  She is here today for abdominal wound 
+exploration.
+
+ 
+
+###RESPONSE: abdominal desmoid tumor removal {Excision of subfascial abdominal wall tumor}, reconstruction {Reconstruction procedure}, infection {Postoperative wound infection}, resection of mesh {Removal of mesh from wound}, replacement {Replacement procedure}, wound {Surgical incision wound}, closure {Reparative closure}, wound {Surgical incision wound}, abdominal incision {Abdomen incision}, abdominal wound 
+exploration {Exploration of penetrating wound of abdomen}"
+"###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:
+depression, chronic headaches, presyncope, type 2 diabetes
+mellitus, hyperlipidemia, obesity, chronic urinary tract 
+infections, and chronic back pain.  She has a longstanding
+microcytosis with a negative workup in the past.
+.
+PSH
+D&C, right first metatarsal bunion, cesarean section 
+with placenta previa, bilateral breast reduction, bilateral ORIF 
+
+of the hips for congenital dysplasia. 
+
+ 
+
+###RESPONSE: depression {Depressive disorder}, chronic headaches {Chronic headache disorder}, presyncope {Near syncope}, type 2 diabetes
+mellitus {Diabetes mellitus type 2}, hyperlipidemia {Hyperlipidemia}, obesity {Obesity}, chronic urinary tract 
+infections {Chronic urinary tract infection}, chronic back pain {Chronic back pain}, microcytosis {Microcytosis, red cells}, negative {No pathologic diagnosis}, workup {Evaluation procedure}, D&C {Dilation and curettage}, right first metatarsal {Structure of first metatarsal bone of right foot}, bunion {Swelling of first metatarsophalangeal joint of hallux}, cesarean section {Cesarean section}, placenta previa {Placenta previa}, bilateral breast reduction {Reduction plasty of bilateral breasts}, congenital dysplasia {Congenital hip dysplasia}"
+"###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:
+Non-contributory
+ 
+
+###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:
+Physical exam per PRS post operative note ___ 1844 Temp: 97.5 PO BP: 111/63 L Lying HR: 106 RR: 20 O2
+sat: 100% O2 delivery: RA 
+Gen: NAD, A&Ox3, lying on stretcher.
+HEENT: Normocephalic. 
+CV: RRR
+R: Breathing comfortably on room air. No wheezing.
+Abd: Lower abd with VAC in place, holding suction, trace SS
+output. No surrounding erythema. 
+Ext: WWP. 
+
+ 
+
+###RESPONSE: Temp {Body temperature finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, O2
+sat {Oxygen saturation measurement}, RA {Breathing room air}, Gen {General examination of patient}, NAD {No abnormality detected}, Ox3 {Oriented to person, time and place}, lying {Lying in bed}, HEENT {Physical examination procedure}, Normocephalic {Normal head}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, Breathing comfortably on room air {Breathing room air}, wheezing {Wheezing}, Abd {Examination of abdomen}, erythema {Erythema}, Ext {Examination of limb}, WWP {Normal tissue perfusion}"
+"###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:
+___ 10:20PM   GLUCOSE-210* UREA N-11 CREAT-0.7 SODIUM-139 
+POTASSIUM-4.2 CHLORIDE-101 TOTAL CO2-25 ANION GAP-13
+___ 10:20PM   estGFR-Using this
+___ 10:02PM URINE  HOURS-RANDOM
+___ 10:02PM URINE  UCG-NEGATIVE
+.
+IMAGING:
+Radiology Report CT ABD & PELVIS W & W/O CONTRAST, ADDL SECTIONS 
+Study Date of ___ 12:08 AM 
+IMPRESSION: 
+1. Interval decrease in size of the prior anterior abdominal 
+wall collections. 
+2. No fistula.  No hernia. 
+3. Cholelithiasis, but no features of cholecystitis. 
+4. Rest of the findings as described above. 
+
+ 
+
+###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}, CT ABD & PELVIS W {Computed tomography of abdomen and pelvis with contrast}, W/O CONTRAST {Computed tomography of abdomen and pelvis without contrast}, decrease in size {Decreased size}, anterior abdominal 
+wall {Anterior abdominal wall structure}, fistula {Fistula}, hernia {Hernia of abdominal cavity}, Cholelithiasis {Calculus in biliary tract}, cholecystitis {Cholecystitis}"
+"###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 was admitted to the plastic surgery service on 
+___ and had a abdominal wound exploration and removal of 
+mesh.  The patient tolerated the procedure well. 
+ .
+ Neuro: Post-operatively, the patient received IV pain 
+medications with good effect and adequate pain control. When 
+tolerating oral intake, the patient was transitioned to oral 
+pain medications. 
+ .
+ CV: The patient was stable from a cardiovascular standpoint; 
+vital signs were routinely monitored.
+ .
+ Pulmonary: The patient was stable from a pulmonary standpoint; 
+vital signs were routinely monitored.
+ .
+ GI/GU: Post-operatively, the patient was given IV fluids until 
+tolerating oral intake.  Her diet was advanced when appropriate, 
+which was tolerated well. She was also started on a bowel 
+regimen to encourage bowel movement. Intake and output were 
+closely monitored. 
+ .
+ ID: Post-operatively, the patient was started on IV cefazolin, 
+then switched to PO cefadroxil for discharge home. The patient's 
+temperature was closely watched for signs of infection. 
+ .
+ Prophylaxis: The patient received subcutaneous heparin during 
+this stay, and was encouraged to get up and ambulate as early as 
+possible. 
+ .
+ At the time of discharge on POD#2, the patient was doing well, 
+afebrile with stable vital signs, tolerating a regular diet, 
+ambulating, voiding without assistance, and pain was well 
+controlled.  She was discharged with wound vac in place.
+ 
+
+###RESPONSE: abdominal wound exploration {Exploration of penetrating wound of abdomen}, removal of 
+mesh {Removal of mesh from wound}, Neuro {Neurological assessment}, Post-operatively {Postoperative state}, IV {Intravenous therapy}, pain 
+medications {Administration of analgesic}, good effect {Good therapeutic response}, adequate pain control {Demonstrates adequate pain control}, tolerating oral intake {Tolerating diet}, oral {Administration of drug or medicament via oral route}, pain medications {Administration of analgesic}, stable {Patient's condition stable}, vital signs were routinely monitored {Monitoring of blood pressure, temperature, pulse rate and respiratory rate}, Pulmonary {Examination of respiratory system}, stable {Patient's condition stable}, vital signs were routinely monitored {Monitoring of blood pressure, temperature, pulse rate and respiratory rate}, Post-operatively {Postoperative state}, given IV fluids {Administration of intravenous fluids}, tolerating oral intake {Tolerating diet}, diet was advanced {Advance diet as tolerated}, bowel 
+regimen {Bowel care}, Intake and output {Measuring intake and output}, Post-operatively {Postoperative state}, temperature {Temperature taking}, watched for signs of infection {Monitoring for signs and symptoms of infection}, Prophylaxis {Preventive procedure}, subcutaneous heparin {Subcutaneous injection of heparin}, ambulate {Ambulation training}, afebrile {Temperature normal}, stable vital signs {Normal vital signs}, tolerating a regular diet {Tolerating normal diet}, ambulating {Fully mobile}, voiding without assistance {Normal micturition}, pain was well 
+controlled {Demonstrates adequate pain control}, wound vac {Vacuum assisted skin closure}"
+"###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. Albuterol Inhaler 2 PUFF IH Q4H:PRN SOB 
+2. Carbamazepine (Extended-Release) 100 mg PO QAM 
+3. Carbamazepine (Extended-Release) 200 mg PO QHS 
+4. cefaDROXil 500 mg oral BID 
+5. FLUoxetine 60 mg PO DAILY 
+6. Gabapentin 300 mg PO QHS 
+7. Gabapentin 100 mg PO BID 
+8. MetFORMIN (Glucophage) 850 mg PO BID 
+9. Omeprazole 20 mg PO DAILY 
+10. Ondansetron 8 mg PO DAILY:PRN nausea 
+11. OxyCODONE (Immediate Release) 5 mg PO Q4H:PRN Pain - 
+Moderate 
+12. Polyethylene Glycol 17 g PO DAILY:PRN Constipation - Second 
+Line 
+13. RisperiDONE 0.5 mg PO DAILY 
+14. Simvastatin 40 mg PO QPM 
+15. Acetaminophen 650 mg PO Q6H:PRN Pain - Mild 
+16. Aspirin 81 mg PO DAILY 
+17. Docusate Sodium 100 mg PO BID:PRN Constipation - First Line 
+18. Senna 8.6 mg PO BID:PRN Constipation - Second Line 
+
+ 
+Discharge Medications:
+1.  cefaDROXil 500 mg oral BID 
+RX *cefadroxil 500 mg 1 capsule(s) by mouth twice a day Disp 
+#*56 Capsule Refills:*2 
+2.  Ibuprofen 600 mg PO Q6H:PRN Pain - Mild 
+  Reason for PRN duplicate override: Alternating agents for 
+similar severity 
+3.  Simethicone 40-80 mg PO QID:PRN abdominal gas  
+4.  OxyCODONE (Immediate Release) ___ mg PO Q4H:PRN Pain - 
+Moderate 
+RX *oxycodone 5 mg ___ tablet(s) by mouth every four (4) hours 
+Disp #*50 Tablet Refills:*0 
+5.  Acetaminophen 650 mg PO Q6H:PRN Pain - Mild  
+6.  Albuterol Inhaler 2 PUFF IH Q4H:PRN SOB  
+7.  Aspirin 81 mg PO DAILY  
+8.  Carbamazepine (Extended-Release) 100 mg PO QAM  
+9.  Carbamazepine (Extended-Release) 200 mg PO QHS  
+10.  Docusate Sodium 100 mg PO BID:PRN Constipation - First Line 
+ 
+11.  FLUoxetine 60 mg PO DAILY  
+12.  Gabapentin 300 mg PO QHS  
+13.  Gabapentin 100 mg PO BID  
+14.  MetFORMIN (Glucophage) 850 mg PO BID  
+15.  Omeprazole 20 mg PO DAILY  
+16.  Ondansetron 8 mg PO DAILY:PRN nausea  
+17.  Polyethylene Glycol 17 g PO DAILY:PRN Constipation - Second 
+Line  
+18.  RisperiDONE 0.5 mg PO DAILY  
+19.  Senna 8.6 mg PO BID:PRN Constipation - Second Line  
+20.  Simvastatin 40 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 With Service
+ 
+Facility:
+___ 
+ 
+Discharge Diagnosis:
+1) Infected mesh
+2) Poor coping skills in setting of depression
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, depression {Depressive disorder}, 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:
+Personal Care:
+ 1. You will have a wound VAC dressing with a wound vac machine 
+in place for discharge home.  This will remain in place until 
+you come back on ___ for the OR.
+ 2. While VAC is in place, please clean around the VAC site and 
+monitor for air leaks of the VAC
+ 3. A written record of the daily output from the VAC drain 
+should be brought to every follow-up appointment. 
+ 4. You may shower daily with assistance as needed.  You should 
+do this with wound vac apparatus disconnected from you.  Once 
+you have showered you will need to reconnect your dressing to 
+the wound vac apparatus and make sure it is functioning 
+properly.
+ 5. No baths until after directed by your surgeon.
+ .
+ Activity:
+ 1. Avoid strenuous activity with wound vac in place.
+ .
+ Medications:
+ 1. Resume your regular medications unless instructed otherwise 
+and take any new meds as ordered .
+ 2. You may take your prescribed pain medication for moderate to 
+severe pain. You may switch to Tylenol or Extra Strength Tylenol 
+for mild pain as directed on the packaging. Please note that 
+Percocet and Vicodin have Tylenol as an active ingredient so do 
+not take these meds with additional Tylenol.
+ 3. Take prescription pain medications for pain not relieved by 
+tylenol.
+ 4. Take your antibiotic as prescribed if you are discharged on 
+one.
+ 5. Take Colace, 100 mg by mouth 2 times per day, while taking 
+the prescription pain medication. You may use a different 
+over-the-counter stool softener if you wish.
+ 6. Do not drive or operate heavy machinery while taking any 
+narcotic pain medication. You may have constipation when taking 
+narcotic pain medications (oxycodone, percocet, vicodin, 
+hydrocodone, dilaudid, etc.); you should continue drinking 
+fluids, you may take stool softeners, and should eat foods that 
+are high in fiber.
+ .
+ Call the office IMMEDIATELY if you have any of the following:
+ 1. Signs of infection: fever with chills, increased redness, 
+swelling, warmth or tenderness at the surgical site, or unusual 
+drainage from the incision(s).
+ 2. A large amount of bleeding from the incision(s) or drain(s).
+ 3. Fever greater than 101.5 oF
+ 4. Severe pain NOT relieved by your medication.
+ .
+ Return to the ER if: 
+ * If you are vomiting and cannot keep in fluids or your 
+medications. 
+ * If you have shaking chills, fever greater than 101.5 (F) 
+degrees or 38 (C) degrees, increased redness, swelling or 
+discharge from incision, chest pain, shortness of breath, or 
+anything else that is troubling you.
+ * Any serious change in your symptoms, or any new symptoms that 
+concern you.
+ 
+
+###RESPONSE: wound VAC {Vacuum assisted skin closure}, dressing {Application of dressing}, in place {Device in situ}, output from the VAC drain {Monitoring of fluid output from drain}, Signs of infection {Monitoring for signs and symptoms of infection}, fever with chills {Fever with chills}, redness {Redness of skin over lesion}, swelling {Swelling}, warmth {Warm skin}, tenderness {Tenderness}, surgical site {Operative site}, drainage {Wound discharge}, incision {Surgical incision wound}, bleeding {Bleeding}, incision {Surgical incision wound}, drain {Wound discharge}, Fever {Fever}, Severe pain {Severe pain}, vomiting {Vomiting}, cannot keep in fluids {Unable to drink}, shaking {Tremor}, chills {Chill}, fever {Fever}, redness {Redness of skin over lesion}, swelling {Swelling}, incision {Surgical incision wound}, chest pain {Chest pain}, shortness of breath {Dyspnea}"
+"###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: 
+morphine
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Dyspnea, cough
+ 
+Major Surgical or Invasive Procedure:
+Intubation ___
+Extubation ___
+
+ 
+
+###RESPONSE: morphine {Allergy to morphine}, Dyspnea {Dyspnea}, cough {Cough}, Intubation {Insertion of endotracheal tube}, Extubation {Removal of endotracheal tube}"
+"###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 ___ woman with a history of CHF (LVEF 70% in 
+___, on Bumex), Afib (on Abixiban), and HTN who presents with 
+worsening shortness of breath over the past week. Dyspnea has 
+been on exertion and at rest. Associated with PND and orthopnea. 
+Also associated with 1 month of increased bilateral lower 
+extremity swelling, R>L. Not associated with chest pain or 
+palpitations. During this time, she has had a non-productive 
+cough, as well as intermittent dysuria and increased urinary 
+frequency. She notes an odor to urine, but denies fevers, 
+chills, chest pain, abdominal pain, or pain in legs. No recent 
+sick contacts, no recent travel. No nasal congestion, cough, or 
+other URI symptoms preceding dyspnea. 
+  
+In the ED, initial vitals were: T 98.3 HR 110 BP 142/74 RR 24 
+SaO2 94% on nc  
+Exam: Rales at both lung bases. RLE edema > LLE (stable from 
+previous PCP ___ 
+Labs:  proBNP 7388, K 3.0, Cr 1.7, Mg 1.3, WBC 12.3, Hgb 11.2, 
+Plt 286, INR 1.4, lacate 1.7
+Imaging:  EKG: HR 130, AFib w RVR, Left axis, Normal QRS and 
+QTc, no STE. CXR: Mild pulmonary edema, worse in the interval. 
+Bedside U/S: mild pericardial effusion
+Consults:  Cardiology, Respiratory therapy
+Patient was given Nitro gtt for control of shortness of breath. 
+She developed AF + RVR, so was started on Esmolol gtt. She 
+became hypotensive to ___, so Esmolol gtt was stopped, and her 
+HR improved without further intervention. She also received 
+Aspirin, Lasix 80mg IVx1 & 40mg IVx2, K 40mg POx1, Mg 2gm IV.
+Decision was made to admit to CCU for CHF exacerbation with 
+pulmonary edema requiring BiPAP
+Vitals on transfer were:  HR 100 BP 113/56 RR 25 SaO2 98% ra
+
+On the floor, patient reports feeling well. She continues to be 
+a little short of breath, but the facemask is bothering her. She 
+denies current chest pain. Has been coughing and short of breath 
+for the past week. Cough is nonproductive. No current abdominal 
+pain or dysuria.  
+ 
+REVIEW OF SYSTEMS:  
+(+) per HPI  
+Cardiac review of systems is notable for absence of chest pain, 
+palpitations, syncope or presyncope.  
+Denies any prior history of stroke, TIA, deep venous thrombosis, 
+pulmonary embolism, bleeding at the time of surgery, myalgias, 
+joint pains, cough, hemoptysis, black stools or red stools. 
+Denies recent fevers, chills or rigors. Denies exertional 
+buttock or calf pain. All of the other review of systems were 
+negative.  
+
+ 
+
+###RESPONSE: CHF {Congestive heart failure}, Afib {Atrial fibrillation}, HTN {Hypertensive disorder, systemic arterial}, worsening {Patient's condition worsened}, shortness of breath {Dyspnea}, Dyspnea {Dyspnea}, exertion {Dyspnea on exertion}, at rest {Dyspnea at rest}, PND {Paroxysmal nocturnal dyspnea}, orthopnea {Orthopnea}, bilateral lower 
+extremity swelling {Swelling of bilateral lower limbs}, chest pain {Chest pain}, palpitations {Palpitations}, non-productive 
+cough {Dry cough}, dysuria {Dysuria}, urinary 
+frequency {Increased frequency of urination}, odor to urine {Abnormal urine odor}, fevers {Fever}, chills {Chill}, chest pain {Chest pain}, abdominal pain {Abdominal pain}, pain in legs {Pain in lower limb}, travel {Travel abroad}, nasal congestion {Nasal congestion}, cough {Cough}, URI {Upper respiratory infection}, dyspnea {Dyspnea}, vitals {Vital signs finding}, HR {Finding of heart rate}, BP {Blood pressure finding}, RR {Finding of rate of respiration}, SaO2 {Finding of oxygen saturation}, on nc {Oxygen administration by nasal cannula}, Exam {Physical examination procedure}, Rales {Respiratory crackles}, lung bases {Structure of base of lung}, RLE edema > LLE {Edema of bilateral lower limbs}, stable {Patient's condition stable}, PCP {Primary care management}, Labs {Laboratory test}, WBC {White blood cell count}, INR {Calculation of international normalized ratio}, Imaging {Imaging}, EKG {Electrocardiographic procedure}, HR {Finding of heart rate}, AFib w RVR {Atrial fibrillation with rapid ventricular response}, Left {Structure of left side of heart}, axis {Electrocardiographic axis finding}, Normal {No abnormality detected}, QRS {Finding of electrocardiogram QRS complex}, QTc {Finding of electrocardiogram QT interval}, STE {ST segment elevation}, CXR {Plain chest X-ray}, Mild {Symptom mild}, pulmonary edema {Pulmonary edema}, worse {Patient's condition worsened}, U/S {Ultrasonography}, mild {Symptom mild}, pericardial effusion {Pericardial effusion}, Cardiology {Cardiology service}, Respiratory therapy {Respiratory therapy}, shortness of breath {Dyspnea}, AF + RVR {Atrial fibrillation with rapid ventricular response}, hypotensive {Low blood pressure}, Esmolol gtt was stopped {Recommendation to stop drug treatment}, HR {Finding of heart rate}, improved {Patient's condition improved}, Aspirin {Administration of aspirin}, Lasix {Diuretic therapy}, IV {Intravenous therapy}, CHF exacerbation {Exacerbation of congestive heart failure}, pulmonary edema {Pulmonary edema}, BiPAP {Bilevel positive airway pressure titration}, Vitals {Vital signs finding}, HR {Finding of heart rate}, BP {Blood pressure finding}, RR {Finding of rate of respiration}, SaO2 {Finding of oxygen saturation}, ra {Breathing room air}, feeling well {Well in self}, short of breath {Dyspnea}, facemask {Oxygen administration by mask}, chest pain {Chest pain}, coughing {Cough}, short of breath {Dyspnea}, Cough is nonproductive {Dry cough}, abdominal 
+pain {Abdominal pain}, dysuria {Dysuria}, REVIEW OF SYSTEMS {Review of systems}, Cardiac {Cardiovascular physical examination}, review of systems {Review of systems}, chest pain {Chest pain}, palpitations {Palpitations}, syncope {Syncope}, presyncope {Near syncope}, stroke {Cerebrovascular accident}, TIA {Transient ischemic attack}, deep venous thrombosis {Deep venous thrombosis}, pulmonary embolism {Pulmonary embolism}, bleeding {Bleeding}, surgery {Surgical procedure}, myalgias {Muscle pain}, joint pains {Joint pain}, cough {Cough}, hemoptysis {Hemoptysis}, black stools {Dark stools}, red stools {Red stools}, fevers {Fever}, chills {Chill}, rigors {Rigor}, exertional {Pain provoked by exertion}, buttock {Pain in buttock}, calf pain {Pain in calf}, review of systems {Review of systems}, negative {No abnormality detected}"
+"###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
+peripheral vascular disease
+venous insufficiency
+peripheral neuropathy
+history of colon CA (no rad/chem)
+rosacea
+intertrigo
+L5-S1 radiculopathy
+
+PSH: 
+partial colectomy 93'
+R ___ angio; 
+PTA R SFA c stent x 2 at mid/distal SFA ___ (Zilver 
+stent)
+ 
+
+###RESPONSE: Hypertension {Hypertensive disorder, systemic arterial}, hyperlipidemia {Hyperlipidemia}, peripheral vascular disease {Peripheral vascular disease}, venous insufficiency {Vascular insufficiency}, peripheral neuropathy {Peripheral nerve disease}, colon CA {Malignant neoplasm of colon}, rad {Radiation oncology AND/OR radiotherapy}, chem {Chemotherapy}, rosacea {Rosacea}, intertrigo {Intertrigo}, L5-S1 {Structure of intervertebral disc of L5 and S1}, radiculopathy {Nerve root disorder}, partial colectomy {Partial resection of colon}, angio {Angiography}, PTA {Percutaneous transluminal angioplasty}, SFA {Structure of superficial femoral artery}, stent {Insertion of arterial stent}, SFA {Structure of superficial femoral artery}, stent {Insertion of arterial stent}"
+"###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:
+CAD in brother
+ 
+Physical ___:
+ADMISSION PHYSICAL EXAMINATION:  
+VS:  T 97.1 HR 113 BP 121/76 RR 25 SaO2 100% on facemask
+Gen:  elderly woman, labored breathing, nontoxic, NAD
+HEENT:  no scleral icterus, erythema and ecchymosis over nose 
+and mouth, mmm
+NECK:  +JVD (JVP 12cm)
+CV:  tachycardic, irregular rhythm, no m/r/g
+LUNGS:  on facemask, coughing, junky breath sounds with 
+bilateral wheezing and rhonchi; wheezing 
+ABD:  soft, NT/ND, +bs, no suprapubic tenderness
+EXT:  warm, 2+ edema in bilateral ___ to knees, venous stasis 
+changes R>L
+SKIN: erythema and ecchymosis over nose and mouth
+NEURO:  alert, moving all 4 extremities, no gross deficits
+
+DISCHARGE PHYSICAL EXAM:
+Discharge Weight: 72.9 kg
+VS: 97-98.6 90-110s/50-60s ___ RA
+Weight: 74.4 <--75.4 <--75.1 kg <-- 75.8 kg
+Tele: short asymptomatic sinus pauses while sleeping
+Gen:  elderly woman, NAD
+HEENT:  no scleral icterus, erythema and ecchymosis over nose 
+and mouth, mmm
+NECK:  no JVD
+CV:  regular rate, irregularly irregular rhythm, no m/r/g
+LUNGS:  wheezing and rhonchi have resolved 
+ABD:  soft, NT/ND, +bs, no ttp
+EXT:  warm, no edema, venous stasis changes R>L
+SKIN: erythema and ecchymosis over nose and mouth mostly 
+resolved
+NEURO:  alert, moving all 4 extremities, no gross deficits, 
+oriented to person, time, and place
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}, PHYSICAL EXAMINATION {Physical examination procedure}, VS {Vital signs finding}, HR {Finding of heart rate}, BP {Blood pressure finding}, RR {Finding of rate of respiration}, SaO2 {Finding of oxygen saturation}, facemask {Oxygen administration by mask}, Gen {General examination of patient}, labored breathing {Labored breathing}, HEENT {Physical examination procedure}, scleral icterus {Scleral icterus}, erythema {Erythema}, ecchymosis {Ecchymosis}, nose {Nasal structure}, mouth {Mouth region structure}, mmm {Moist oral mucosa}, NECK {Physical examination procedure}, JVD {Jugular venous engorgement}, JVP {Finding of jugular venous pressure}, CV {Cardiovascular physical examination}, tachycardic {Tachycardia}, irregular rhythm {Irregular heart beat}, no m/r/g {Heart sounds normal}, LUNGS {Examination of respiratory system}, facemask {Oxygen administration by mask}, coughing {Cough}, breath sounds {Finding of breath sounds}, wheezing {Wheezing}, rhonchi {Wheeze - rhonchi}, wheezing {Wheezing}, ABD {Examination of abdomen}, soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, +bs {Normal bowel sounds}, EXT {Examination of limb}, warm {Warm skin}, edema in bilateral ___ to knees {Edema of bilateral lower legs}, venous stasis {Venous stasis}, SKIN {Examination of skin}, erythema {Erythema}, ecchymosis {Ecchymosis}, nose {Nasal structure}, mouth {Mouth region structure}, NEURO {Neurological examination}, alert {Mentally alert}, moving all 4 extremities {Does move all four limbs}, deficits {Neurological deficit}, Weight {Weight finding}, VS {Vital signs finding}, RA {Breathing room air}, Weight {Weight finding}, Tele {Cardiac telemetry}, asymptomatic {Asymptomatic}, sinus pauses {Sinus arrest}, sleeping {Asleep}, Gen {General examination of patient}, HEENT {Physical examination procedure}, scleral icterus {Scleral icterus}, erythema {Erythema}, ecchymosis {Ecchymosis}, nose {Nasal structure}, mouth {Mouth region structure}, mmm {Moist oral mucosa}, NECK {Physical examination procedure}, JVD {Jugular venous engorgement}, CV {Cardiovascular physical examination}, regular rate {Normal heart rate}, irregularly irregular {Heart irregularly irregular}, rhythm {Irregular heart beat}, no m/r/g {Heart sounds normal}, LUNGS {Examination of respiratory system}, wheezing {Wheezing}, rhonchi {Wheeze - rhonchi}, ABD {Examination of abdomen}, soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, +bs {Normal bowel sounds}, EXT {Examination of limb}, warm {Warm skin}, edema {Edema}, venous stasis {Venous stasis}, SKIN {Examination of skin}, erythema {Erythema}, ecchymosis {Ecchymosis}, nose {Nasal structure}, mouth {Mouth region structure}, NEURO {Neurological examination}, alert {Mentally alert}, moving all 4 extremities {Does move all four limbs}, deficits {Neurological deficit}, oriented to person, time, and place {Oriented to person, time and place}"
+"###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:
+======================
+___ 01:40PM BLOOD WBC-12.3*# RBC-4.03 Hgb-11.2 Hct-35.9 
+MCV-89 MCH-27.8 MCHC-31.2* RDW-16.2* RDWSD-52.7* Plt ___
+___ 01:40PM BLOOD ___ PTT-33.7 ___
+___ 01:40PM BLOOD Glucose-132* UreaN-35* Creat-1.7* Na-140 
+K-3.0* Cl-93* HCO3-26 AnGap-24*
+___ 01:40PM BLOOD ALT-16 AST-22 AlkPhos-131* TotBili-1.0
+___ 01:40PM BLOOD proBNP-___*
+___ 01:40PM BLOOD cTropnT-<0.01
+___ 01:40PM BLOOD Albumin-4.1 Calcium-7.2* Phos-4.0 Mg-1.3*
+___ 03:29AM BLOOD Type-ART Temp-36.3 Rates-/29 pO2-152* 
+pCO2-120* pH-7.07* calTCO2-37* Base XS-0 Intubat-NOT INTUBA
+___ 02:14PM BLOOD Lactate-1.7
+___ 03:29AM BLOOD freeCa-0.93*
+
+OTHER PERTINENT LABS:
+======================
+___ 08:53PM BLOOD cTropnT-<0.01
+___ 01:40PM BLOOD cTropnT-<0.01
+___ 06:55AM BLOOD TSH-7.9*
+___ 06:55AM BLOOD Free T4-1.2
+
+MICRO:
+======================
+___ Blood culture: negative
+___ MRSA screen: negative
+___ Urine culture: KLEBSIELLA PNEUMONIAE.    >100,000 
+ORGANISMS/ML..
+___ Sputum culture: MORAXELLA CATARRHALIS.    MODERATE GROWTH. 
+
+
+IMAGING/STUDIES:
+======================
+CXR ___: Comparison to ___.  Decrease in extent 
+of a pre-existing left pleural effusion.  Unchanged appearance 
+of the right lung.  Moderate cardiomegaly.  Mild retrocardiac 
+atelectasis.  Unchanged fibrotic right upper lobe changes.  
+Right PICC line is constant. 
+
+ECHO ___: 
+The left atrium is moderately dilated. The estimated right 
+atrial pressure is at least 15 mmHg. There is mild symmetric 
+left ventricular hypertrophy with normal cavity size and 
+regional/global systolic function (LVEF>55%). There is mild 
+symmetric left ventricular hypertrophy. The left ventricular 
+cavity size is normal. Overall left ventricular systolic 
+function is normal (LVEF>55%). Doppler parameters are 
+indeterminate for left ventricular diastolic function. Right 
+ventricular chamber size and free wall motion are normal. The 
+aortic valve leaflets (3) appear structurally normal with good 
+leaflet excursion and no aortic stenosis or aortic 
+regurgitation. The mitral valve leaflets are moderately 
+thickened. Mild (1+) mitral regurgitation is seen. [Due to 
+acoustic shadowing, the severity of mitral regurgitation may be 
+significantly UNDERestimated.] There is moderate pulmonary 
+artery systolic hypertension. There is no pericardial effusion. 
+There is an anterior space which most likely represents a 
+prominent fat pad. 
+
+ Compared with the prior study (images reviewed) of ___, 
+pulmonary artery systolic pressure is higher and mild mitral 
+regurgitation is now appreciated. Other findings are similar.  
+
+DISCHARGE LABS:
+======================
+___ 07:14AM BLOOD WBC-6.4 RBC-3.48* Hgb-9.6* Hct-31.4* 
+MCV-90 MCH-27.6 MCHC-30.6* RDW-16.8* RDWSD-53.8* Plt ___
+___ 07:14AM BLOOD Glucose-107* UreaN-27* Creat-1.7* Na-144 
+K-3.7 Cl-104 HCO3-34* AnGap-10
+___ 07:14AM BLOOD Calcium-7.4* Phos-3.3 Mg-2.___RIEF SUMMARY STATEMENT:
+=========================
+___ woman with a history of CHF (LVEF 70% in ___, on Bumex), 
+Afib (on Apixiban), and HTN who presented with worsening 
+shortness of breath over the past week and cough found to have R 
+sided pneumonia and acute on chronic diastolic heart failure 
+exacerbation requiring BiPAP, complicated by hypercarbic 
+respiratory failure requiring intubation. Sputum culture grew 
+Moraxella and was treated with ceftriaxone (___) and 
+azithromycin (___). Patient was given steroids, d/c'ed 
+after 3 days due to worsening delirium. Delirium improved after 
+steroids were d/c'ed and with Seroquel.  Pt. with afib with RVR 
+during hospitalization.  Started on metoprolol and amiodarone 
+with improvement in rates.
+
+ACTIVE ISSUES: 
+=========================
+#) ACUTE DECOMPENSATED DIASTOLIC HEART FAILURE: LVEF 70% in 
+___. On admission, her exam was consistent with fluid overload, 
+with elevated JVP and 2+ pitting edema in both legs. LVEF 55-60% 
+on this admission. She was diuresed with 120 mg IV Lasix boluses 
+and Lasix gtt. Patient was transitioned to her home Bumex prior 
+to discharge. Of note, her Bumex had recently been increased as 
+an outpatient but she was not aware of this increase and had 
+continued at her previous dose, possibly leading to the present 
+admission.
+
+#) HYPOXIA/CAP: Patient presented with hypoxia, was likely due 
+to CHF exacerbation and community acquired pneumonia. Although 
+patient stated she had no history of asthma or COPD, she had 
+episodes of wheezing and was given standing ipratropium nebs 
+which improved wheezing and hypoxia. Patient was found to have R 
+lobe pneumonia on CXR and sputum culture grew Moraxella. She was 
+treated with 7 day course of Ceftriaxone. Due to worsening 
+hypercarbia and wheezing, she was treated with prednisone for 
+CAP, however prednisone was stopped after 3 days due to 
+worsening delirium. Patient had aggressive pulmonary toilet for 
+copious secretions and productive cough. Hypoxia had resolved 
+prior to discharge.
+
+#) ACUTE HYPERCARBIC RESPIRATORY FAILURE: Patient had episode of 
+agitation and altered mental status on first night of admission, 
+was found to have pCO2 120 and pH 7.07. She was intubated for 
+hypercarbic respiratory failure and treated with diuretics and 
+antibiotics for pneumonia. She was extubated the next day 
+(___). She had subsequent episodes of respiratory distress 
+that resolved with BiPAP.
+
+#) AFIB with RVR: At home patient took Apixiban 2.5mg BID and 
+Diltiazem 180mg BID.  On this admission, pt. with RVR.  HRs were 
+140s-150s during admission which was controlled with a diltiazem 
+gtt.  She was started back on her PO diltiazem and started on 
+metoprolol 100 XL.  She still had difficult to control rates.  
+As such, patient was started on amiodarone with improvement.  
+She eventually was transitioned back to PO medications and was 
+discharged on Metoprolol succinate 100 XL daily, Diltiazem 120 
+mg daily, and amiodarone. She was discharged on her home 
+apixaban for anticoagulation.
+
+#) ALTERED MENTAL STATUS: Patient had worsening delirium after 
+extubation most likely due to steroids, scopolamine, and ICU 
+hospitalization. The scopolamine patch and steroids were d/c'ed 
+and patient improved slowly. She was started on 50 mg Seroquel 
+at 4 pm and 10 pm daily for continued agitation and sundowning. 
+Mental status improved prior to discharge and she was AAOX3.  
+She was discontinued off of Seroquel with stable mental status 
+for over 72 hours.
+
+CHRONIC ISSUES:  
+=========================
+#) GERD: 
+- Continued home omeprazole 20 mg daily
+
+#) CHRONIC PAIN
+- Continued home Gabapentin 300mg qhs 
+
+TRANSITIONAL ISSUES:
+======================
+# Discharge Weight: 72.9kg (standing, day of discharge)
+# s/p CAP Course: Completed Ceftriaxone 7 days, Prednisone 3 
+days
+# Afib Outpatient Management:  Patient needs to follow up with 
+Dr. ___ Dr. ___ from cardiology.
+# Afib with RVR: Pt. with difficult to control ventricular rates 
+in the setting of her illness.  She was started on metoprolol 
+and amiodarone. Continued on dilt and apixaban.
+# Amio:  Would consider discontinuing amiodarone now that 
+patient is stable with rate-controlled Afib.  Otherwise, patient 
+needs safety monitoring if she remains on Amiodarone long term. 
+Please check PFTs and TFTs as an outpatient. On ___, 
+TSH:7.9 Free-T4:1.2.
+# Amiodarone Dosing: Given 400 BID for 1 week (to ___, 200 
+BID for 3 weeks (to ___, then 200 daily (Starting 
+___ 
+# Consider cardioversion as outpatient
+# Patient noticed to have painless lump underneath R mandible. 
+Please evaluate as outpatient.
+# Code: DNR/DNI
+# HCP:  ___ (pt's niece): ___
+
+ 
+
+###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}, 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}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, proBNP {N-terminal pro-brain natriuretic peptide measurement}, cTropnT {Troponin T cardiac measurement}, Albumin {Albumin measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, pH {pH measurement}, Lactate {Lactic acid measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac measurement}, TSH {Thyroid stimulating hormone measurement}, Free T4 {T4 free measurement}, Blood culture {Blood culture}, negative {No abnormality detected}, MRSA {Methicillin resistant Staphylococcus aureus infection}, negative {No abnormality detected}, Urine culture {Urine culture}, Sputum culture {Microbial culture of sputum}, CXR {Plain chest X-ray}, left {Left lung structure}, pleural effusion {Pleural effusion}, right lung {Right lung structure}, cardiomegaly {Cardiomegaly}, Mild {Symptom mild}, atelectasis {Atelectasis}, right upper lobe {Structure of upper lobe of right lung}, PICC line {Peripherally inserted central venous catheter in situ}, ECHO {Echocardiography}, left atrium is moderately dilated {Left atrial dilatation}, right 
+atrial {Right atrial structure}, pressure {Pressure}, mild symmetric 
+left ventricular hypertrophy {Mild left ventricular hypertrophy}, normal cavity {Normal size cardiac chamber}, regional/global systolic function {Normal left ventricular systolic function and wall motion}, mild 
+symmetric left ventricular hypertrophy {Mild left ventricular hypertrophy}, left ventricular 
+cavity {Structure of cavity of left cardiac ventricle}, size is normal {Normal size}, left ventricular systolic 
+function is normal {Normal left ventricular systolic function and wall motion}, left ventricular {Structure of myocardium of left ventricle}, Right 
+ventricular chamber {Right cardiac ventricular structure}, size {Normal size}, wall motion are normal {Finding of right ventricular wall motion}, aortic valve leaflets {Structure of cardiac valve leaflet}, structurally normal {Aortic valve normal}, good {No abnormality detected}, leaflet {Structure of cardiac valve leaflet}, aortic stenosis {Aortic valve stenosis}, aortic 
+regurgitation {Aortic valve regurgitation}, mitral valve leaflets {Structure of leaflet of mitral valve}, thickened {Increased thickness}, Mild (1+) mitral regurgitation {Mild mitral valve regurgitation}, mitral regurgitation {Mitral valve regurgitation}, pulmonary 
+artery systolic hypertension {Pulmonary hypertensive arterial disease}, pericardial effusion {Pericardial effusion}, fat pad {Structure of normal fat pad}, study {Evaluation procedure}, systolic pressure {Increased systolic arterial pressure}, mild mitral 
+regurgitation {Mild mitral valve regurgitation}, 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}, CHF {Congestive heart failure}, Afib {Atrial fibrillation}, HTN {Hypertensive disorder, systemic arterial}, worsening {Patient's condition worsened}, shortness of breath {Dyspnea}, cough {Cough}, R 
+sided {Right lung structure}, pneumonia {Pneumonia}, acute on chronic diastolic heart failure {Acute on chronic diastolic heart failure}, BiPAP {Bilevel positive airway pressure titration}, hypercarbic 
+respiratory failure {Hypercapnic respiratory failure}, intubation {Insertion of endotracheal tube}, Sputum culture {Microbial culture of sputum}, steroids {Steroid therapy}, worsening {Patient's condition worsened}, delirium {Delirium}, Delirium {Delirium}, improved {Patient's condition improved}, steroids {Steroid therapy}, afib with RVR {Atrial fibrillation with rapid ventricular response}, improvement {Patient's condition improved}, rates {Finding of heart rate}, DECOMPENSATED DIASTOLIC HEART FAILURE {Decompensated cardiac failure}, exam {Physical examination procedure}, fluid overload {Hypervolemia}, JVP {Finding of jugular venous pressure}, 2+ pitting edema {2+ pitting edema}, both legs {Both lower legs}, diuresed {Diuretic therapy}, IV {Intravenous therapy}, Lasix {Diuretic therapy}, Lasix {Diuretic therapy}, increased {Increasing dosage of medication}, HYPOXIA {Hypoxia}, CAP {Community acquired pneumonia}, hypoxia {Hypoxia}, CHF exacerbation {Exacerbation of congestive heart failure}, community acquired pneumonia {Community acquired pneumonia}, asthma {Asthma}, COPD {Chronic obstructive lung disease}, wheezing {Wheezing}, standing {Orthostatic body position}, improved {Patient's condition improved}, wheezing {Wheezing}, hypoxia {Hypoxia}, pneumonia {Pneumonia}, CXR {Plain chest X-ray}, sputum culture {Microbial culture of sputum}, worsening {Patient's condition worsened}, hypercarbia {Hypercapnia}, wheezing {Wheezing}, CAP {Community acquired pneumonia}, worsening {Patient's condition worsened}, delirium {Delirium}, pulmonary toilet {Airway toilet}, copious secretions {Copious sputum}, productive cough {Productive cough}, Hypoxia {Hypoxia}, resolved {Problem resolved}, HYPERCARBIC RESPIRATORY FAILURE {Hypercapnic respiratory failure}, agitation {Feeling agitated}, altered mental status {Altered mental status}, intubated {Insertion of endotracheal tube}, hypercarbic respiratory failure {Hypercapnic respiratory failure}, diuretics {Diuretic therapy}, antibiotics {Antibiotic therapy}, pneumonia {Pneumonia}, extubated {Removal of endotracheal tube}, respiratory distress {Respiratory distress}, resolved {Problem resolved}, BiPAP {Bilevel positive airway pressure titration}, AFIB with RVR {Atrial fibrillation with rapid ventricular response}, RVR {Atrial fibrillation with rapid ventricular response}, HRs {Finding of heart rate}, rates {Finding of heart rate}, improvement {Patient's condition improved}, PO medications {Administration of drug or medicament via oral route}, apixaban {Anticoagulant therapy}, anticoagulation {Anticoagulant therapy}, ALTERED MENTAL STATUS {Altered mental status}, worsening {Patient's condition worsened}, delirium {Delirium}, extubation {Removal of endotracheal tube}, steroids {Steroid therapy}, ICU {Admission to intensive care unit}, steroids {Steroid therapy}, improved {Patient's condition improved}, agitation {Feeling agitated}, sundowning {Sundowning}, Mental status {Altered mental status}, improved {Patient's condition improved}, OX3 {Oriented to person, time and place}, discontinued {Recommendation to stop drug treatment}, stable {Patient's condition stable}, mental status {Mental state finding}, GERD {Gastroesophageal reflux disease}, CHRONIC PAIN {Chronic pain}, Weight {Weight finding}, standing {Orthostatic body position}, CAP {Community acquired pneumonia}, Afib {Atrial fibrillation}, Outpatient {Outpatient care management}, follow up {Follow-up arranged}, cardiology {Cardiology service}, Afib with RVR {Atrial fibrillation with rapid ventricular response}, ventricular {Cardiac ventricular structure}, rates {Finding of heart rate}, stable {Patient's condition stable}, rate {Finding of heart rate}, Afib {Atrial fibrillation}, monitoring {Monitoring procedure}, PFTs {Measurement of respiratory function}, TFTs {Thyroid panel}, TSH {Thyroid stimulating hormone measurement}, Free-T4 {T4 free measurement}, cardioversion {Cardioversion}, lump {Mass}, mandible {Bone structure of mandible}, evaluate {Evaluation procedure}, 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. Bumetanide 2 mg PO QAM 
+2. bumetanide 1 mg oral QPM 
+3. Diltiazem Extended-Release 180 mg PO BID 
+4. Apixaban 2.5 mg PO BID 
+5. Gabapentin 300 mg PO QHS 
+6. Omeprazole 20 mg PO DAILY 
+7. Aspirin 81 mg PO DAILY 
+8. Cyanocobalamin 1000 mcg PO DAILY 
+9. miconazole nitrate unknown strength topical apply underneath 
+breasts and groin as needed for rash 
+
+ 
+Discharge Medications:
+1. Apixaban 2.5 mg PO BID 
+2. Aspirin 81 mg PO DAILY 
+3. Bumetanide 2 mg PO QAM 
+4. Bumetanide 1 mg ORAL QPM 
+5. Diltiazem Extended-Release 120 mg PO DAILY 
+6. Gabapentin 300 mg PO DAILY 
+7. Omeprazole 20 mg PO DAILY 
+8. Amiodarone 400 mg PO BID 
+9. Metoprolol Succinate XL 100 mg PO DAILY 
+10. Cyanocobalamin 1000 mcg PO DAILY 
+11. miconazole nitrate unknown  TOPICAL APPLY UNDERNEATH BREASTS 
+AND GROIN AS NEEDED FOR RASH 
+12. Docusate Sodium 100 mg PO BID 
+13. Polyethylene Glycol 17 g PO DAILY:PRN constipation 
+14. Senna 8.6 mg PO BID:PRN constipation 
+
+ 
+
+###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 DIAGNOSES
+===================
+Acute on chronic diastolic heart failure
+Community Acquired Pneumonia
+Hypercarbic respiratory failure
+Delirium
+
+SECONDARY DIAGNOSES
+=====================
+Hypertension
+Hyperlipidemia
+Intertrigo
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+
+ 
+
+###RESPONSE: Acute on chronic diastolic heart failure {Acute on chronic diastolic heart failure}, Community Acquired Pneumonia {Community acquired pneumonia}, Hypercarbic respiratory failure {Hypercapnic respiratory failure}, Delirium {Delirium}, Hypertension {Hypertensive disorder, systemic arterial}, Hyperlipidemia {Hyperlipidemia}, Intertrigo {Intertrigo}, Mental Status {Neurological mental status determination}, Clear {Normal state of mind}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, interactive {Does communicate}, Ambulatory - requires assistance or aid {Finding of walking aid use}, walker {Uses zimmer frame}, cane {Uses single walking stick}"
+"###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. ___,
+
+You were admitted to ___ 
+because you had shortness of breath and cough. You were having 
+trouble breathing so you were placed on BiPAP machine and sent 
+to the cardiac ICU. You were found to have a pneumonia and heart 
+failure exacerbation causing fluid to accumulate in your lungs. 
+You required a breathing tube and breathing machine for a short 
+time to help you breathe during the beginning of your 
+hospitalization. You were given medications to treat your 
+pneumonia and medications to help remove fluid from your lungs. 
+You were given steroids to help decrease inflammation in your 
+lungs, but this caused you to be agitated and confused in the 
+ICU. Your confusion improved off of the steroids. Your exercise 
+tolerance decreased from your baseline, so you are being 
+discharged to rehab before you go home.
+
+Sincerely,
+
+Your ___ Team
+ 
+
+###RESPONSE: shortness of breath {Dyspnea}, cough {Cough}, trouble breathing {Difficulty breathing}, BiPAP {Bilevel positive airway pressure titration}, cardiac ICU {Admission to cardiac intensive care unit}, pneumonia {Pneumonia}, heart 
+failure {Heart failure}, lungs {Lung structure}, breathing tube {Insertion of endotracheal tube}, breathing {Dual pressure spontaneous ventilation support}, medications {Prescription of drug}, pneumonia {Pneumonia}, medications {Prescription of drug}, lungs {Lung structure}, steroids {Steroid therapy}, inflammation {Inflammatory disorder}, lungs {Lung structure}, agitated {Feeling agitated}, confused {Clouded consciousness}, ICU {Admission to intensive care unit}, confusion {Clouded consciousness}, improved {Patient's condition improved}, steroids {Steroid therapy}, exercise 
+tolerance {Exercise tolerance finding}, baseline {Baseline state}"
+"###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: 
+Demerol / Zestril / adhesive tape / ondansetron / ondansetron 
+HCl
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Vomiting
+ 
+Major Surgical or Invasive Procedure:
+none
+
+ 
+
+###RESPONSE: adhesive tape {Allergy to adhesive agent}, Vomiting {Vomiting}"
+"###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:
+___ yo M with metastatic esophageal cancer presents with 
+refractory nausea and vomiting. History was obtained from the 
+patient's wife as the patient was too confused. According to his 
+wife, Mr. ___ has had mild nausea periodically until ___ 
+night, when he started vomiting coffee grounds every 2 hrs. On 
+___ morning the vomiting stopped, but he was still not able 
+to tolerate any solid foods. On ___ and ___ mornings he 
+vomited yellow, frothy emesis between ___, but had no further 
+vomiting. On ___ he was able to eat half an egg and some 
+chicken noodle soup, but that was it. Of note, mid last week he 
+also had some diarrhea, but that has resolved. Confusion began 
+today, previously he was not confused. His wife does note that 
+he has been very weak, with occasional tremors/""spasms"" in the 
+legs. He has not complained of a headache. He has been urinating 
+normally, and had a BM today or yesterday. His wife notes that 
+she is a ___, and would have been able to manage taking care 
+of him at home, but she was concerned that he might have an 
+aspiration pneumonia.
+
+His wife also reports that his pain (in neck, shoulders, right 
+hip/pelvis) has been well-controlled on methadone 20mg tid. He 
+has not required oxycodone for breakthrough in over a week. His 
+oncologist did increase his methadone to 25mg tid two weeks ago, 
+but he opted to return to the lower dose as he felt that the 
+higher dose was causing worsening nausea.
+
+Review of Systems:  
+(+) Per HPI  
+(-) Denies chills, night sweats. Denies blurry vision, diplopia, 
+loss of vision, photophobia. Denies headache, sinus tenderness, 
+rhinorrhea or congestion. Denies palpitations, lower extremity 
+edema. Denies shortness of breath. Denies melena, hematemesis, 
+hematochezia. Denies dysuria, stool or urine incontinence. 
+Denies arthralgias or myalgias. Denies rashes. All other systems 
+negative.  
+
+ 
+
+###RESPONSE: metastatic {Metastatic malignant neoplasm}, esophageal cancer {Malignant tumor of esophagus}, refractory nausea and vomiting {Intractable nausea and vomiting}, confused {Clouded consciousness}, nausea {Nausea}, vomiting coffee grounds {Coffee ground vomiting}, vomiting {Vomiting}, vomited {Vomiting}, emesis {Vomiting}, vomiting {Vomiting}, able to eat {Able to eat}, diarrhea {Diarrhea}, Confusion {Clouded consciousness}, not confused {Not confused}, weak {Asthenia}, tremors {Tremor}, spasms {Spasm}, legs {Lower limb structure}, headache {Headache}, aspiration pneumonia {Aspiration pneumonia}, pain {Pain}, neck {Cervical region back structure}, shoulders {Shoulder region structure}, right 
+hip {Right hip region structure}, pelvis {Structure of right half of pelvis}, nausea {Nausea}, chills {Chill}, night sweats {Night sweats}, blurry vision {Blurring of visual image}, diplopia {Diplopia}, loss of vision {Blindness AND/OR vision impairment level}, photophobia {Photophobia}, headache {Headache}, sinus {Nasal sinus structure}, tenderness {Tenderness}, rhinorrhea {Nasal discharge}, congestion {Nasal congestion}, palpitations {Palpitations}, lower extremity 
+edema {Edema of lower extremity}, shortness of breath {Dyspnea}, melena {Melena}, hematemesis {Hematemesis}, hematochezia {Hematochezia}, dysuria {Dysuria}, stool or urine incontinence {Double incontinence}, arthralgias {Joint pain}, myalgias {Muscle pain}, 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: Past Medical History:
+PAST ONCOLOGIC HISTORY:  
+- Stage IV metastatic poorly differentiated esophageal 
+adenocarcinoma diagnosed in ___  
+ 
+PAST MEDICAL HISTORY:  
+- dCHF  
+- CABG: ___ (LIMA to LAD) due to CCATH showing total occlusion  
+
+of the RCA and circumflex arteries and an 80% left main  
+stenosis.  
+- CAD: CCATH/PCI: ___ - PTCA and DES x2 of the LMCA 
+bifurcation (LAD and ramus), ___ - ___ 
+___, ___ - ___, ___ - ___ anastomotic site 
+of LIMA to LAD, ___, ___  
+- s/p St. ___ Aortic Valve Replacement ___ - on coumadin in 
+past 
+- ""Intractable angina"" on methadone  
+- Hypertension  
+- Dyslipidemia  
+- h/o defibrillation in ___  
+- Nephrolithiasis  
+- s/p lap cholecystectomy in ___  
+- Horner's syndrome - mild  
+
+ 
+
+###RESPONSE: Stage IV {Clinical stage IV}, metastatic {Metastatic malignant neoplasm}, esophageal 
+adenocarcinoma {Adenocarcinoma in situ of esophagus}, dCHF {Diastolic heart failure}, CABG {Coronary artery bypass grafting}, LIMA {Structure of left internal thoracic artery}, LAD {Structure of anterior descending branch of left coronary artery}, CCATH {Cardiac catheterization}, total occlusion {Complete obstruction}, RCA {Right coronary artery structure}, circumflex arteries {Structure of circumflex branch of left coronary artery}, left main {Left coronary artery structure}, stenosis {Stenosis}, CAD {Coronary arteriosclerosis}, CCATH {Cardiac catheterization}, PCI {Percutaneous coronary intervention}, PTCA {Percutaneous transluminal coronary angioplasty}, DES {Endovascular insertion of drug eluting stent}, LMCA {Left coronary artery structure}, bifurcation {Bifurcation}, LAD {Structure of anterior descending branch of left coronary artery}, LIMA {Structure of left internal thoracic artery}, LAD {Structure of anterior descending branch of left coronary artery}, Aortic Valve Replacement {Replacement of aortic valve}, Intractable angina {Refractory angina}, Hypertension {Hypertensive disorder, systemic arterial}, Dyslipidemia {Dyslipidemia}, Nephrolithiasis {Kidney stone}, cholecystectomy {Cholecystectomy}"
+"###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:
+Many family members with CAD.
+ 
+
+###RESPONSE: CAD {Disorder of coronary artery}"
+"###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
+VITALS: Afebrile, T 97.9, 140/90, ___, RR 20, 95% on room air 
+GENERAL: Middle aged man laying in bed, in NAD
+HEENT: NCAT, EOMI, PERRL, anicteric sclera, poor dentition, MMM  
+
+NECK: supple, no LAD  
+CARDIAC: RRR, S1 normal, mechanical S2, ___ systolic murmur hear 
+throughout precordium. 
+LUNG: Bilateral rales half-way up, no rhonchi, diminished breath 
+sounds at bases bilaterally
+ABDOMEN: Soft, generalized ttp, normoactive bowel sounds 
+throughout, no rebound/guarding, no hepatosplenomegaly  
+EXTREMITIES: WWP, no c/c/e, 2+ DP pulses bilaterally
+NEURO: CN II-XII intact, strength ___ in bilateral triceps, 
+biceps, deltoid, handgrip, and bilateral quads, ankle 
+flexion/extension, sensation intact. Oriented to ___ and ___, 
+not oriented to date. Having difficulty answering questions, not 
+sure how many days he has been vomiting 
+
+ 
+
+###RESPONSE: VITALS {Vital signs finding}, Afebrile {Temperature normal}, RR {Finding of rate of respiration}, on room air {Breathing room air}, GENERAL {General examination of patient}, laying in bed {Lying in bed}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, NC {Normal head}, EOMI {Normal ocular motility}, PERRL {Pupils equal and reacting to light}, anicteric sclera {White sclera}, dentition {Finding of dentition}, MMM {Moist oral mucosa}, NECK {Physical examination procedure}, supple {Normal movement of neck}, LAD {Lymphadenopathy}, CARDIAC {Cardiovascular physical examination}, RRR {Normal heart rate}, S1 normal {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, murmur {Murmur}, precordium {Structure of precordium}, LUNG {Examination of respiratory system}, rales {Respiratory crackles}, rhonchi {Wheeze - rhonchi}, diminished breath 
+sounds {Decreased breath sounds}, bases {Structure of base of lung}, ABDOMEN {Examination of abdomen}, Soft {Abdomen soft}, generalized ttp {Generalized abdominal tenderness}, normoactive bowel sounds {Normal bowel sounds}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, hepatosplenomegaly {Hepatosplenomegaly}, EXTREMITIES {Examination of limb}, WWP {Normal tissue perfusion}, 2+ DP pulses {All pulses present in bilateral lower limbs}, NEURO {Neurological examination}, CN II-XII intact {Normal central nervous system}, triceps {Triceps brachii muscle structure}, biceps {Biceps brachii muscle structure}, deltoid {Structure of deltoid muscle}, quads {Structure of quadriceps femoris muscle}, ankle {Ankle region structure}, sensation intact {Normal sensation}, Oriented {Orientated}, oriented {Orientated}, vomiting {Vomiting}"
+"###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:
+___ 12:25PM BLOOD WBC-15.7*# RBC-4.55*# Hgb-11.7*# 
+Hct-35.7*# MCV-78* MCH-25.6* MCHC-32.7 RDW-22.0* Plt ___
+___ 12:25PM BLOOD UreaN-21* Creat-1.3*
+ 
+
+###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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine 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: Brief Hospital Course:
+___ yo M with h/o metastatic esophageal cancer presented with 
+nausea, vomiting, dehydration, hypercalcemia (14), and failure 
+to thrive, and also with significant multifactorial 
+encephalopathy (likely toxic-metabolic encephalopathy).
+
+#Hypercalcemia: numerous ___, elev alk phos, malignancy 
+related (Not working up with PTH levels, etc). Likely 
+precipitated by dehydration. Provided IVF with NS and K 
+repletion >200cc/hr (despite sig CAD history has preserved EF on 
+last echo). Pt developed mild SOB with diffuse rales, so IVF 
+subsequently d/c'd. Calcium improved. No reaction to test dose 
+calcitonin and started calcitonin 250units SC (4mg/kg) q12h. 
+Received IV pamidronate 90mg on ___.
+
+# Acute multifactorial encephalopathy; likely multifactorial 
+toxic metabolic due to hypercalcemia, pain and progression of 
+malignancy. Treated with olanzapine.
+
+#Metastatic Esophageal Cancer with bone and lung ___: disease 
+progessing, he did not tolerate first round of chemo and does 
+not want further chemo or treatment. On admission focus was 
+sympom control and hospice care with plan to discharge to 
+nursing home. However on ___ pt became intolerant of all po 
+including fluids and medications. I had a conversation with his 
+wife on ___ regarding this change in condition and thus 
+prognosis. The decision was made to make the patient CMO. His 
+PCP, oncologist and cardiologist were made aware of this change. 
+He was made comfortable with morphine, olanzapine, scopolomine, 
+and glycopyroate and died peacefully with his wife at the 
+bedside on the morning of ___.
+
+ 
+
+###RESPONSE: metastatic {Metastatic malignant neoplasm}, esophageal cancer {Malignant tumor of esophagus}, nausea, vomiting {Nausea and vomiting}, dehydration {Dehydration}, hypercalcemia {Hypercalcemia}, failure 
+to thrive {Failure to thrive}, multifactorial 
+encephalopathy {Multifactorial encephalopathy}, toxic-metabolic encephalopathy {Toxic metabolic encephalopathy}, Hypercalcemia {Hypercalcemia}, elev alk phos {Alkaline phosphatase above reference range}, malignancy {Malignant neoplasm}, dehydration {Dehydration}, CAD {Disorder of coronary artery}, echo {Echocardiography}, SOB {Dyspnea}, rales {Respiratory crackles}, improved {Patient's condition improved}, IV {Intravenous therapy}, multifactorial encephalopathy {Multifactorial encephalopathy}, toxic metabolic {Toxic metabolic encephalopathy}, hypercalcemia {Hypercalcemia}, pain {Pain}, malignancy {Malignant neoplasm}, Metastatic {Metastatic malignant neoplasm}, Esophageal Cancer {Malignant tumor of esophagus}, bone {Bone structure}, lung {Metastatic malignant neoplasm to lung}, disease {Disease}, chemo {Chemotherapy}, chemo {Chemotherapy}, hospice care {Hospice care}, discharge to 
+nursing home {Discharge to nursing home}, prognosis {Determination of prognosis}, make the patient CMO {Comfort care only status}, died {Dead}"
+"###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. Prochlorperazine 10 mg PO Q6H:PRN nausea 
+2. Lorazepam 1 mg PO Q6H:PRN nausea 
+3. Metoprolol Succinate XL 50 mg PO DAILY 
+4. Polyethylene Glycol 17 g PO DAILY 
+5. Atorvastatin 80 mg PO DAILY 
+6. Torsemide 40 mg PO DAILY 
+7. Isosorbide Mononitrate (Extended Release) 120 mg PO DAILY 
+8. Methadone 20 mg PO TID 
+9. OxycoDONE (Immediate Release)  5 mg PO Q6H:PRN pain 
+10. Pantoprazole 40 mg PO Q12H 
+11. Citalopram 30 mg PO DAILY 
+12. FoLIC Acid 1 mg PO DAILY 
+13. Vitamin D Dose is Unknown  PO DAILY 
+
+ 
+Discharge Medications:
+none, pt deceased
+ 
+
+###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 with Service
+ 
+Discharge Diagnosis:
+metastatic esophageal cancer
+hypercalcemia of malignancy
+failure to thrive
+malnutrition, moderate
+cancer related pain
+bone metastasis
+
+ 
+Discharge Condition:
+deceased
+ 
+                             ___ MD ___
+ 
+Completed by: ___
+
+###RESPONSE: metastatic {Metastatic malignant neoplasm}, esophageal cancer {Malignant tumor of esophagus}, hypercalcemia of malignancy {Humoral hypercalcemia of malignancy}, failure to thrive {Failure to thrive}, malnutrition {Nutritional disorder}, cancer related pain {Chronic pain due to malignant neoplastic disease}, bone {Bone structure}, metastasis {Metastatic malignant neoplasm}, deceased {Dead}"
+"###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: 
+Spice Flavor / Children's Tylenol Plus / Bactrim
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Abscess
+ 
+Major Surgical or Invasive Procedure:
+Incision and drainage of abscess
+ 
+
+###RESPONSE: Abscess {Abscess}, Incision and drainage of abscess {Incision and drainage of abscess}"
+"###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:
+Patient is a ___ yo man with PMHx sig. for developmental delay 
+and history of MRSA abscesses who presents with an axillary 
+abscess.  The patient reports itchy rash under his arms 
+bilaterally for the past 2 weeks.  He was seen in the office on 
+___, given antifungal creams and antihistamines, which have not 
+helped.  A painful lump under his L arm worsened and several 
+small R pustules under the right arm.  He reports that the 
+redness and itching is spreading to his chest.  The patient 
+reports that he has felt febrile for one night, did not take 
+temperature.  No chills, nightsweats. 
+
+The patient is a ___ and has been outside recently, has 
+sunburn on left arm, but has redness on his chest which patient 
+reports is not sunburn. 
+
+In the ED, initial VS were: 98.2 86 134/88 15 98% RA. Exam was 
+notable for L axilla with single large abscess 2.5x3.5cm and 
+surrounding erythema. This was I&D'ed and packed.  Labs were 
+unremarkable. The patient received vancomycin, percocet. 
+ 
+Review of Systems:  
+(+) Per HPI  
+(-) Denies headache, sinus tenderness, rhinorrhea or congestion. 
+Denies chest pain or tightness, palpitations. Denies cough, 
+shortness of breath. Denies nausea, vomiting, diarrhea, 
+constipation, or abdominal pain. No dysuria, urinary frequency. 
+Denies arthralgias or myalgias. All other review of systems 
+negative. 
+ 
+
+###RESPONSE: developmental delay {Developmental delay}, MRSA {Methicillin resistant Staphylococcus aureus infection}, abscesses {Abscess}, axillary 
+abscess {Abscess of axilla}, itchy {Itching}, rash {Eruption of skin}, arms {Upper limb structure}, painful {Pain}, lump {Mass}, L arm {Left upper arm structure}, pustules {Pustule}, right arm {Right upper arm structure}, redness {Redness of skin over lesion}, itching {Itching}, chest {Thoracic structure}, febrile {Fever}, chills {Chill}, nightsweats {Night sweats}, sunburn {Solar erythema}, left arm {Left upper arm structure}, redness {Redness of skin over lesion}, chest {Thoracic structure}, sunburn {Solar erythema}, VS {Vital signs finding}, RA {Breathing room air}, Exam {Physical examination procedure}, L axilla {Structure of left axillary region}, abscess {Abscess}, erythema {Erythema}, I&D {Incision AND drainage}, unremarkable {No abnormality detected}, headache {Headache}, sinus {Nasal sinus structure}, tenderness {Tenderness}, rhinorrhea {Nasal discharge}, congestion {Nasal congestion}, chest pain {Chest pain}, tightness {Tight chest}, palpitations {Palpitations}, Denies cough {Does not cough}, shortness of breath {Dyspnea}, nausea, vomiting, diarrhea {Nausea, vomiting and diarrhea}, constipation {Constipation}, abdominal pain {Abdominal pain}, dysuria {Dysuria}, urinary frequency {Increased frequency of urination}, arthralgias {Joint pain}, myalgias {Muscle pain}, review of systems {Review of systems}"
+"###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:
+ANEMIA (ICD-285.9)      
+CONSTIPATION (ICD-564.0)      
+CALCULUS, KIDNEY (ICD-592.0)      
+CELLULITIS/ABSCESS - MRSA (ICD-682.9)      
+RETARDATION, MENTAL NOS (ICD-319)      
+CARPAL TUNNEL SYNDROME, BILATERAL (ICD-354.0)      
+
+ 
+
+###RESPONSE: ANEMIA {Anemia}, CONSTIPATION {Constipation}, CALCULUS {Calculus}, KIDNEY {Kidney structure}, CELLULITIS {Cellulitis}, ABSCESS {Abscess}, MRSA {Methicillin resistant Staphylococcus aureus infection}, RETARDATION, MENTAL {Intellectual disability}, CARPAL TUNNEL SYNDROME {Carpal tunnel syndrome}"
+"###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 with diabetes.
+ 
+
+###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:
+Vitals:  98.1, 121/66, 58, 14. 97RA, ___ pain in L axilla
+Gen: NAD, AOX3  
+HEENT: PER, EOMI, MMM, sclera anicteric, not injected  
+Neck: no LAD, no JVD  
+Cardiovascular: RRR normal s1, s2, no murmurs appreciated  
+Respiratory: Clear to auscultation bilaterally, no wheezes, 
+rales or rhonchi  
+Abd: normoactive bowel sounds, soft, non-tender, non distended  
+Extremities: No edema, 2+ DP pulses, R axilla erythematous with 
+scattered pustules, L axilla erythematous with I&D site  
+NEURO: PERRL, EOMI, face symmetric, no tongue deviation  
+Integument: Warm, moist; erythematous macular rash across chest
+Psychiatric: appropriate, pleasant, not anxious  
+
+ 
+
+###RESPONSE: Vitals {Vital signs finding}, RA {Breathing room air}, pain {Pain}, L axilla {Structure of left axillary region}, Gen {General examination of patient}, NAD {No abnormality detected}, AOX3 {Oriented to person, time and place}, HEENT {Physical examination procedure}, EOMI {Normal ocular motility}, MMM {Moist oral mucosa}, sclera anicteric {White sclera}, Neck {Physical examination procedure}, LAD {Lymphadenopathy}, JVD {Jugular venous engorgement}, Cardiovascular {Cardiovascular physical examination}, RRR {Normal heart rate}, normal s1, s2 {Heart sounds normal}, murmurs {Murmur}, Respiratory {Examination of respiratory system}, Clear to auscultation bilaterally {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, rhonchi {Wheeze - rhonchi}, Abd {Examination of abdomen}, normoactive bowel sounds {Normal bowel sounds}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, distended {Swollen abdomen}, Extremities {Examination of limb}, edema {Edema}, 2+ DP pulses {Dorsalis pulse present}, R axilla {Structure of right axillary region}, erythema {Erythema}, pustules {Pustule}, L axilla {Structure of left axillary region}, erythema {Erythema}, I&D {Incision AND drainage}, NEURO {Neurological examination}, PERRL {Pupils equal and reacting to light}, EOMI {Normal ocular motility}, face symmetric {Facial symmetry}, tongue {Tongue structure}, deviation {Displacement}, Integument {Structure of integumentary system}, Warm {Warm skin}, moist {Moist skin}, erythema {Erythema}, rash {Eruption of skin}, chest {Thoracic structure}, Psychiatric {Psychiatric symptom}, anxious {Anxiety}"
+"###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:
+___ 06:45PM   WBC-8.4 RBC-4.84 HGB-14.2 HCT-41.5 MCV-86 
+MCH-29.2 MCHC-34.2 RDW-13.6
+___ 06:45PM   NEUTS-55.7 ___ MONOS-4.0 EOS-4.1* 
+BASOS-1.8
+___ 06:45PM   PLT COUNT-368
+___ 06:45PM   GLUCOSE-111* UREA N-17 CREAT-0.9 SODIUM-140 
+POTASSIUM-4.5 CHLORIDE-104 TOTAL CO2-29 ANION GAP-12
+___ 06:45PM   ___ PTT-26.1 ___
+___ 06:52PM   LACTATE-1.___. Abscess, left axilla:  Patient has a history of MRSA skin 
+abscesses. This episode was treated with incision and drainage 
+followed by IV vancomycin then oral clindamicin. He has an 
+appointment with his PCP's office for the day after discharge.
+ 
+
+###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}, PTT {Partial thromboplastin time, activated}, Abscess {Abscess}, left axilla {Structure of left axillary region}, MRSA {Methicillin resistant Staphylococcus aureus infection}, skin 
+abscesses {Abscess of skin and/or subcutaneous tissue}, incision and drainage {Incision AND drainage}, IV {Administration of drug or medicament via intravenous route}, oral {Administration of drug or medicament via oral route}, PCP {Primary care management}"
+"###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:
+OMEPRAZOLE 20 MG CPDR (OMEPRAZOLE) 1 tab po every day      
+VYTONE CRE 1% (IODOQUINOL-HC) APPLY BID TO AFFECTED AREAS      
+CLOTRIM ANTIFUNGAL CREA 1 % (CLOTRIMAZOLE) apply to affected 
+area bid      
+DIPHENHYDRAMINE HCL 25 MG CAPS (DIPHENHYDRAMINE HCL) ___ tabs PO 
+Q4-6H PRN      
+LORATADINE 10 MG TABS (LORATADINE) 1 tab po every day as needed 
+for itch
+ 
+Discharge Medications:
+1. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) 
+Capsule, Delayed Release(E.C.) PO once a day.  
+2. loratadine 10 mg Tablet Sig: One (1) Tablet PO once a day as 
+needed for itching.  
+3. iodoquinol-HC ___ % Cream Sig: One (1)  Topical twice a day.  
+
+4. clotrimazole 1 % Cream Sig: One (1)  Topical twice a day.  
+5. clindamycin HCl 300 mg Capsule Sig: One (1) Capsule PO every 
+eight (8) hours for 6 days.
+Disp:*18 Capsule(s)* 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:
+1. Abscess
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+ 
+
+###RESPONSE: Abscess {Abscess}, Mental Status {Neurological mental status determination}, 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:
+You were admitted with an abscess in your left axilla (armpit). 
+Please continue taking the prescribed antibiotics and follow-up 
+with the ___ on tomorrow (___).
+ 
+
+###RESPONSE: abscess {Abscess}, left axilla {Structure of left axillary region}, armpit {Structure of axillary fossa}, antibiotics {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: 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: 
+Patient recorded as having No Known Allergies to Drugs
+ 
+Attending: ___.
+ 
+Chief Complaint:
+low BP
+ 
+Major Surgical or Invasive Procedure:
+none
+
+ 
+
+###RESPONSE: low BP {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: History of Present Illness:
+___ h/o Lupus, embolic strokes s/p recent stroke on coumadin, 
+metastatic colon cancer on chemotherapy s/p renal transplant on 
+PD admitted from clinic with hypotension. Patient presented to 
+___ today for INR check, but went to ___ clinic. She 
+noted that she was slightly dizzy with some blurred vision while 
+walking through the parking lot. In ___ clinic, they 
+checked her INR, and then decided to start her on cycle 1 of 
+erbitux. She was given benadryl as premedication.  
+.  
+Her blood pressure was then found to be low 70/40. The patient's 
+typically BP runs in SBP ___ and there is always difficulty 
+obtaining accurate BP's. Because of this the patient was kept in 
+clinic for gentle fluids with the goal of returning her SBP to 
+mid 80's. She was also given decadron in the chance that she was 
+having a reaction to erbitux. As her blood pressure did not 
+increase adequately, it was decided to admit her. In addition, 
+she was drowsy in clinic - ___ to Benadryl?, but was becoming 
+increasingly alert as the benadryl wore off.  
+.  
+The patient now states that her mental status is greatly 
+improved, at baseline, ""feels normal"". She also reports that she 
+has increased the amount of fluid she removes in PD in order to 
+dec peripheral edema. In addition, she missed her midodrine 
+doses today. She also notes that yesterday she had poor PO 
+intake secondary to the heat and mild nausea. Denies any 
+vomting, no chills, no fever, minimal diarrhea.  
+.  
+In ___, the patient was admitted with fever and hypotension. 
+She was found to have CDiff colitis in early ___, discharged 
+on vancomycin PO - which she has finished. Several days ago, she 
+was admitted to the neurology service for acute/subacute embolic 
+stroke. In the work up, she was found to have a filamentous 
+structure on the right atrial catheter c/w thrombus and was 
+started on anticoagulation.  
+.
+ 
+Clinic course:  
+# VS: 4:45pm BP 76/58 P ___  
+# Meds/IVF: 1.5L NS slowly, benadryl as premedication with 
+erbitux  
+.  
+ROS:  
+(+) mild nausea, mild diarrhea, DOE but at baseline, + 
+peripheral edema but dec over the past week, + leg weakness when 
+climbing stairs (at baseline)  
+(-) no abominal pain, no lupus symptoms, no rash, no worsening 
+joint swelling, no hematochezia, no melena 
+
+ 
+
+###RESPONSE: Lupus {Lupus erythematosus}, embolic strokes {Embolic stroke}, stroke {Cerebrovascular accident}, metastatic colon cancer {Metastatic carcinoma to colon}, chemotherapy {Chemotherapy}, renal transplant {Transplant of kidney}, PD {Peritoneal dialysis}, hypotension {Low blood pressure}, dizzy {Dizziness}, blurred vision {Blurring of visual image}, blood pressure {Blood pressure finding}, low {Low blood pressure}, BP {Blood pressure finding}, fluids {Administration of intravenous fluids}, drowsy {Drowsy}, alert {Mentally alert}, improved {Patient's condition improved}, baseline {Baseline state}, PD {Peritoneal dialysis}, peripheral edema {Peripheral edema}, poor PO 
+intake {Inadequate oral intake}, nausea {Nausea}, vomting {Vomiting}, chills {Chill}, fever {Fever}, diarrhea {Diarrhea}, fever {Fever}, hypotension {Low blood pressure}, CDiff colitis {Clostridium difficile colitis}, embolic 
+stroke {Embolic stroke}, right atrial {Right atrial structure}, thrombus {Thrombus}, anticoagulation {Anticoagulant therapy}, VS {Vital signs finding}, BP {Blood pressure finding}, nausea {Nausea}, diarrhea {Diarrhea}, DOE {Dyspnea on exertion}, peripheral edema {Peripheral edema}, leg weakness {Monoparesis of lower limb}, abominal pain {Abdominal pain}, lupus {Lupus erythematosus}, rash {Eruption of skin}, joint swelling {Joint swelling}, hematochezia {Hematochezia}, melena {Melena}"
+"###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:
+.  
+POncH  
+# Stage III metstatic colon adenocarcinoma (dx ___: LVI, 
+venous, perineural invasion; FDG-avid RUL, L adrenal gland mass 
+(___), brain mets  
+--s/p resection  
+--s/p irinotecan X2 doses dc'd ___ intractable diarrhea  
+--s/p capecitabine, oxaliplatin x3 cycles  
+--s/p fluorouracil, leucovorin, oxaliplatin (Folfox) ___  
+.  
+PMH  
+# ESRD s/p failed renal transplants x2 (___), on PD x3 
+daily, immunosuppressants d/c'd on ___ given increasing 
+creatinine and in setting of chemo treatment  
+# SLE on prednisone 5mg daily  
+# Hyperlipidemia  
+# Osteoporosis  
+# Mitral regurgitation  
+# Dyspepsia  
+# Seizure disorder s/p stroke (___)  
+
+ 
+
+###RESPONSE: Stage III {Carcinoma of colon, stage III}, metstatic colon {Metastatic carcinoma to colon}, adenocarcinoma {Adenocarcinoma}, LVI {Blood/lymphatic vessel invasion by tumor present (breast)}, venous {Venous (large vessel) invasion by tumor present}, perineural invasion {Perineural invasion by tumor present}, FDG-avid {Positron emission tomography with computed tomography using fluorodeoxyglucose (18-F)}, RUL {Structure of upper lobe of right lung}, L adrenal gland {Structure of left adrenal gland}, mass {Mass of adrenal gland}, brain mets {Metastatic malignant neoplasm to brain}, resection {Excision}, diarrhea {Diarrhea}, ESRD {End-stage renal disease}, failed renal transplants {Failed renal transplant}, PD {Peritoneal dialysis}, chemo {Chemotherapy}, SLE {Systemic lupus erythematosus}, Hyperlipidemia {Hyperlipidemia}, Osteoporosis {Osteoporosis}, Mitral regurgitation {Mitral valve regurgitation}, Dyspepsia {Indigestion}, Seizure disorder {Seizure disorder}, stroke {Cerebrovascular accident}"
+"###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:
+This is largely unknown to the patient. There are multiple 
+cancers in the family.
+
+ 
+
+###RESPONSE: multiple 
+cancers {Multiple malignancy}"
+"###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:
+VS: T 97.3, BP 95/78, HR 100, RR 20, O2sat 97 on RA  
+Gen: NAD  
+HEENT: NCAT, MMM, OP clear, neck supple, mildly dysarthric 
+speech, mild ___ flattening on the left  
+CV: RRR, S1S2, ___ murmur  
+Chest: coughing with deep inspiration, crackles ___ up on right 
+side posteriorly, no labored breathing  
+Abd: Soft, NT, distended, no rebound, no guarding; no TTP, NABS  
+
+Ext: 2+ pitting edema B  
+Neuro: AOx3, attention intact, strength ___ bilaterally, CN II- 
+XII intact  
+
+ 
+
+###RESPONSE: VS {Vital signs finding}, T {Body temperature finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, O2sat {Oxygen saturation measurement}, RA {Breathing room air}, Gen {General examination of patient}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, NC {Normal head}, MMM {Moist oral mucosa}, OP clear {Pharynx normal}, supple {Normal movement of neck}, dysarthric 
+speech {Dysarthria}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, S2 {Normal second heart sound, S>2<}, murmur {Murmur}, Chest {Examination of respiratory system}, coughing {Cough}, crackles {Respiratory crackles}, right 
+side {Right lung structure}, labored breathing {Labored breathing}, Abd {Examination of abdomen}, Soft {Abdomen soft}, NT {Abdominal tenderness}, distended {Swollen abdomen}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, TTP {Tenderness}, NABS {Normal bowel sounds}, Ext {Examination of limb}, edema {Edema}, Neuro {Neurological examination}, AOx3 {Oriented to person, time and place}, attention {Finding related to attentiveness}, CN II- 
+XII intact {Normal central nervous system}"
+"###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:
+___ 06:08PM BLOOD WBC-9.6 RBC-3.29* Hgb-10.6* Hct-32.4* 
+MCV-98 MCH-32.1* MCHC-32.7 RDW-17.7* Plt ___
+___ 05:15AM BLOOD WBC-9.7 RBC-3.23* Hgb-10.4* Hct-32.1* 
+MCV-99* MCH-32.1* MCHC-32.3 RDW-17.7* Plt ___
+
+___ 12:23PM BLOOD ___
+___ 11:56AM BLOOD ___
+___ 06:08PM BLOOD Glucose-145* UreaN-33* Creat-8.4* Na-134 
+K-4.1 Cl-100 HCO3-27 AnGap-11
+___ 05:15AM BLOOD Glucose-141* UreaN-36* Creat-8.3* Na-134 
+K-3.7 Cl-100 HCO3-28 AnGap-10
+___ 06:08PM BLOOD Calcium-7.4* Phos-3.4 Mg-2.0
+___ 05:15AM BLOOD Calcium-7.3* Phos-3.2 Mg-2.___y the time the patient reached the floor, her BP had returned 
+to normal and she was feeling well. She was observed overnight, 
+restarted on Midodrine and seen by the renal team. The renal 
+team recomended reducing the amount of fluid removed at each 
+session. She had no further episodes of low BP. In addition, her 
+INR was monitored. On the day of discharge, it was 3.6 and she 
+was instructed to hold her evening dose. These instructions were 
+also communicated to the ___ anti-coagulation nurses; they will 
+call her with further instructions.
+ 
+
+###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}, 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}, 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}, 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}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, low BP {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:
+1. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable 
+PO DAILY (Daily) for ___ days.  
+2. Prednisone 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+
+3. Trimethoprim-Sulfamethoxazole 80-400 mg Tablet Sig: One (1) 
+Tablet PO MWF (___).  
+4. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) 
+Tablet, Chewable PO QID (4 times a day).  
+5. Midodrine 2.5 mg Tablet Sig: One (1) Tablet PO TID (3 times a 
+
+day).  
+6. Potassium Chloride 20 mEq Packet Sig: Two (2) Packet PO DAILY 
+
+(Daily).  
+7. Ferrous Sulfate 325 mg (65 mg Iron) Tablet Sig: One (1) 
+Tablet PO DAILY (Daily).  
+8. Calcitriol 0.25 mcg Capsule Sig: One (1) Capsule PO DAILY 
+(Daily).  
+9. Warfarin 5 mg Tablet Sig: One (1) Tablet PO once a day.
+Disp:*30 Tablet(s)* Refills:*2*
+ 
+Discharge Medications:
+1. Midodrine 2.5 mg Tablet Sig: One (1) Tablet PO TID (3 times a 
+day).  
+2. Prednisone 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+
+3. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable 
+PO DAILY (Daily).  
+4. Trimethoprim-Sulfamethoxazole 160-800 mg Tablet Sig: One (1) 
+Tablet PO MWF (___).  
+5. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) 
+Tablet, Chewable PO QID (4 times a day).  
+6. Ferrous Sulfate 325 mg (65 mg Iron) Tablet Sig: One (1) 
+Tablet PO DAILY (Daily).  
+7. Calcitriol 0.25 mcg Capsule Sig: One (1) Capsule PO DAILY 
+(Daily).  
+8. Warfarin 2.5 mg Tablet Sig: Two (2) Tablet PO once a day: 
+take at 4pm at night.
+Disp:*30 Tablet(s)* Refills:*2*
+
+ 
+
+###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:
+Low Blood Pressure
+End Stage Renal Disease
+
+ 
+Discharge Condition:
+improved
+
+ 
+
+###RESPONSE: Low Blood Pressure {Low blood pressure}, End Stage Renal Disease {End-stage renal disease}, improved {Patient's condition improved}"
+"###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 for low blood pressure. You were given fluids 
+and restarted on Midodrine. Your blood pressure improved. The 
+renal team also recomended taking off less fluid with dialysis 
+to avoid low blood pressures.
+.
+You should continued taking coumadin. Your INR was elevated 
+today. You should NOT take any warfarin (coumadin) tonight. The 
+___ clinic will call you to adjust the dose. You 
+will need to have your INR checked on ___.
+.
+If you have dizziness, light-headedness, fevers or chills, you 
+should return to the emergency room.
+ 
+
+###RESPONSE: low blood pressure {Low blood pressure}, fluids {Administration of intravenous fluids}, blood pressure {Blood pressure finding}, improved {Patient's condition improved}, dialysis {Dialysis procedure}, low blood pressures {Low blood pressure}, dizziness {Dizziness}, light-headedness {Lightheadedness}, 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:   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: 
+Patient recorded as having No Known Allergies to Drugs
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Dizziness, Left arm weakness 
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: Dizziness {Dizziness}, Left arm {Structure of left upper limb}"
+"###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 left handed woman presenting with dizziness and left 
+arm weakness. The patient reports starting a new medication, 
+donepezil, about 1 week ago. Following this period in time she 
+noted the onset of vertigo while standing up, which would 
+resolve upon sitting down. She also noted, though not 
+concurrently, that her left arm ""felt weak."" Onset of this 
+sensation was slow over days. She reports difficulty reaching up 
+to touch her forehead. There was no associated pain. She reports 
+difficulty with handwriting because the pen jerks around the 
+page. She does not have any hand weakness however, in that she 
+has no difficulty in opening doorknobs or jars. The pt denied 
+headache, loss of vision, blurred vision, diplopia, dysarthria, 
+dysphagia. tinnitus or hearing difficulty. Denied difficulties 
+producing or comprehending speech. No parasthesias. No bowel or 
+bladder incontinence or retention. Denied difficulty with gait.  
+
+  
+In the emergency department, initial vitals: 13:54 0 97.9 72 
+128/95 18 98. Not orthostatic. No gait abnormality. EKG- new TWI 
+I, otherwise nonspecific change. CXR-atelectasis at RL base, no 
+pna or effusion, large dilated air filled viscous in upper 
+abdomen correlate clinically- no abd pain on exam. KUB given 
+findings on CXR- non specific bowel gas pattern, need f/u final 
+read. Cardiac enzymes- neg. WBC inc but U/A-neg and it appears 
+to be chronically elevated. CT Head-neg. Neuro consult- no acute 
+issue, no objective signs of weakness, symptoms may be related 
+to Aricept, can d/c medicatoin and then get in touch with PCP to 
+discuss--->per neuro added on Lithium level (mildly elevated). 
+200 cc NS and 8 mg of IV Zofran given. Admitted for syncope w/u. 
+ 
+  
+On arrival to the floor, she states she is feeling somewhat 
+depressed with suicidal ideation but no intent/plan. She feels 
+safe now that she is hospitalized. She states that occasionally 
+when she walks, she feels worried that she is going to fall but 
+has not fallen as of yet. She has a mildly productive cough that 
+has developed in the past 10 minutes.  
+  
+Review of systems:  
+(+) Per HPI  
+(-) Denies fever, chills, night sweats, recent weight loss or 
+gain. Denies headache, sinus tenderness, rhinorrhea or 
+congestion. Denied shortness of breath. Denied chest pain or 
+tightness, palpitations. Denied nausea, vomiting, diarrhea, 
+constipation or abdominal pain. No recent change in bowel or 
+bladder habits. No dysuria. Denied arthralgias or myalgias.  
+
+ 
+
+###RESPONSE: left handed {Left handed}, dizziness {Dizziness}, left 
+arm {Structure of left upper limb}, vertigo {Vertigo}, standing {Orthostatic body position}, resolve {Problem resolved}, sitting {Sitting position}, left arm {Structure of left upper limb}, weak {Asthenia}, difficulty reaching {Difficulty reaching}, forehead {Forehead structure}, pain {Pain}, hand {Hand structure}, weakness {Asthenia}, headache {Headache}, loss of vision {Functional visual loss}, blurred vision {Blurring of visual image}, diplopia {Diplopia}, dysarthria {Dysarthria}, dysphagia {Dysphagia}, tinnitus {Tinnitus}, hearing difficulty {Hearing difficulty}, difficulties 
+producing or comprehending speech {Difficulty comprehending speech}, parasthesias {Paresthesia}, bowel {Incontinence of feces}, bladder incontinence {Urinary incontinence}, retention {Retention of urine}, difficulty with gait {Abnormal gait}, vitals {Vital signs finding}, orthostatic {Orthostatic body position}, gait abnormality {Abnormal gait}, EKG {Electrocardiographic procedure}, TWI {Inverted T wave}, CXR {Plain chest X-ray}, atelectasis {Atelectasis}, RL base {Structure of base of right lung}, pna {Pneumonia}, effusion {Pleural effusion}, dilated {Dilatation}, upper 
+abdomen {Upper abdomen structure}, abd pain {Abdominal pain}, exam {Physical examination procedure}, KUB {Radiography of kidney-ureter-bladder}, CXR {Plain chest X-ray}, bowel gas pattern {Finding of gastrointestinal tract gas}, Cardiac enzymes {Finding of cardiac enzyme levels}, WBC {White blood cell count}, U/A-neg {Urinalysis = no abnormality}, CT Head {Computed tomography of head}, Neuro {Neurology service}, signs {Sign}, weakness {Asthenia}, Lithium level {Finding of lithium level}, syncope {Syncope}, depressed {Depressed mood}, suicidal ideation {Suicidal thoughts}, intent {Suicidal intent}, walks {Difficulty walking}, worried {Worried}, fall {Falls}, fallen {Falls}, productive cough {Productive cough}, fever {Fever}, chills {Chill}, night sweats {Night sweats}, recent weight loss {Recent weight loss}, gain {Recent weight gain}, headache {Headache}, sinus tenderness {Tenderness over frontal sinus}, rhinorrhea {Nasal discharge}, congestion {Nasal congestion}, shortness of breath {Dyspnea}, chest pain {Chest pain}, tightness {Tight chest}, palpitations {Palpitations}, nausea, vomiting, diarrhea {Nausea, vomiting and diarrhea}, constipation {Constipation}, abdominal pain {Abdominal pain}, change in bowel {Altered bowel function}, bladder habits {Alteration in patterns of urinary elimination}, dysuria {Dysuria}, arthralgias {Joint pain}, myalgias {Muscle 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: Past Medical History:
+COPD--Pt does not use 02 at home  
+Hypothryoid  
+Hyperlipidemia 
+RLS 
+
+PSYCHIATRIC HISTORY:  Per OMR, and patient interview:
+Diagnosedwith schizoaffective disorder ___ years ago after having
+her son. First hospitalization in ___ ___ after 
+SA
+by cutting wrists.  Several other SA, including OD, and
+self-stabbing.  Reports associated ___ with some of these SA, 
+but
+reports no auditory hallucinations in ___ years. Pt relates that
+last suicide attempt was ___ years ago, and that last psychiatric
+hospitalization was ___ years ago prior to recent ___ 
+admission
+in ___ (5 days). Has had over 10 psychiatric
+hospitalizations.  Has gone to day program at ___ over
+past ___ years.
+Psychiatrist: ___, MD at ___  ___
+Therapist: ___ at ___ 
+___
+
+ 
+
+###RESPONSE: COPD {Chronic obstructive lung disease}, Hypothryoid {Hypothyroidism}, Hyperlipidemia {Hyperlipidemia}, schizoaffective disorder {Schizoaffective disorder}, cutting wrists {Cutting own wrists}, self-stabbing {Stabbing self}, auditory hallucinations {Auditory hallucinations}, suicide attempt {Suicidal intent}"
+"###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:
+None known. 
+ 
+
+###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:
+VITAL SIGNS: T 96.7 BP 110/62 HR 61 RR 18 O2 94% on RA  
+GENERAL: Pleasant, depressed appearing.  
+HEENT: Normocephalic, atraumatic. No conjunctival pallor. No 
+scleral icterus. PERRLA/EOMI. MMM. OP clear. Neck Supple, No 
+LAD, No thyromegaly.  
+CARDIAC: Regular rhythm, normal rate. Normal S1, S2. No murmurs, 
+rubs or ___. JVP not elevated.  
+LUNGS: Occasional rhonchi that clear w/ coughing, good air 
+movement biaterally.  
+ABDOMEN: Distended but NABS. Soft, NT, ND. No HSM  
+EXTREMITIES: No edema or calf pain, 2+ dorsalis pedis/ posterior 
+tibial pulses.  
+SKIN: No rashes/lesions, ecchymoses.  
+NEURO: A&Ox3. Appropriate. CN ___ grossly intact. Preserved 
+sensation throughout. ___ strength throughout. Babinski 
+equivocal. Normal coordination. Gait assessment deferred  
+PSYCH: Endorses suicidal ideation but no plan, + more depressed 
+recently about concern that her memory is failing her  
+
+ 
+
+###RESPONSE: VITAL SIGNS {Vital signs finding}, T {Body temperature finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, O2 {Finding of oxygen saturation}, RA {Breathing room air}, GENERAL {General examination of patient}, depressed {Depressed mood}, HEENT {Physical examination procedure}, Normocephalic {Normal head}, atraumatic {No injuries apparent}, conjunctival pallor {Pale conjunctiva}, scleral icterus {Scleral icterus}, PERRLA {Pupils equal, react to light and accommodation}, EOMI {Normal ocular motility}, MMM {Moist oral mucosa}, OP clear {Pharynx normal}, Supple {Normal movement of neck}, LAD {Lymphadenopathy}, thyromegaly {Goiter}, CARDIAC {Cardiovascular physical examination}, Regular rhythm {Normal sinus rhythm}, normal rate {Normal heart rate}, Normal S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, murmurs {Murmur}, rubs {Pericardial friction rub}, JVP not elevated {Normal jugular venous pressure}, LUNGS {Examination of respiratory system}, rhonchi {Wheeze - rhonchi}, ABDOMEN {Examination of abdomen}, Distended {Swollen abdomen}, NABS {Normal bowel sounds}, Soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, HSM {Hepatosplenomegaly}, EXTREMITIES {Examination of limb}, edema {Edema}, pain {Pain}, 2+ dorsalis pedis {Dorsalis pulse present}, posterior 
+tibial pulses {Posterior tibial pulse present}, SKIN {Examination of skin}, rashes {Eruption of skin}, lesions {Lesion}, ecchymoses {Ecchymosis}, NEURO {Neurological examination}, Ox3 {Oriented to person, time and place}, Appropriate {Appropriate affect}, CN {Cranial nerve structure}, grossly intact {Normal nervous system function}, Preserved 
+sensation {Normal sensation}, Babinski {Flexor plantar response finding}, Normal coordination {Normal coordination}, Gait assessment {Gait evaluation}, PSYCH {Initial psychiatric evaluation}, suicidal ideation {Suicidal thoughts}, depressed {Depressed mood}, memory {Memory finding}"
+"###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:
+___ 03:00PM   PLT COUNT-386
+___ 03:00PM   NEUTS-83.1* LYMPHS-11.6* MONOS-3.6 EOS-1.4 
+BASOS-0.2
+___ 03:00PM   WBC-16.9* RBC-4.82 HGB-14.3 HCT-43.0 MCV-89 
+MCH-29.8 MCHC-33.3 RDW-13.4
+___ 03:00PM   LITHIUM-1.6*
+___ 03:00PM   CALCIUM-11.4* PHOSPHATE-3.0 MAGNESIUM-2.1
+___ 03:00PM   CK-MB-NotDone
+___ 03:00PM   cTropnT-<0.01
+___ 03:00PM   CK(CPK)-67
+___ 03:00PM   estGFR-Using this
+___ 03:00PM   GLUCOSE-98 UREA N-15 CREAT-1.0 SODIUM-136 
+POTASSIUM-3.4 CHLORIDE-103 TOTAL CO2-23 ANION GAP-13
+___ 03:31PM   ___ PTT-24.6 ___
+___ 06:00PM URINE  BLOOD-NEG NITRITE-NEG PROTEIN-NEG 
+GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-0.2 PH-7.0 
+LEUK-NEG
+___ 06:00PM URINE  COLOR-Straw APPEAR-Clear SP ___
+___ 09:18PM   CK-MB-NotDone
+___ 09:18PM   cTropnT-<0.01
+___ 09:18PM   CK(CPK)-45
+.
+CT Head (___):
+There is no hemorrhage, edema, mass effect, or acute 
+large vascular territory infarction. The gray-white matter 
+differentiation is preserved. There is mild asymmetric frontal 
+atrophy, but the ventricles and sulci are otherwise normal in 
+caliber and configuration. Basal cisterns are preserved. There 
+is no shift of normally midline structures. Calcifications are 
+seen involving the cavernous and supraclinoid internal carotid 
+arteries. The osseous structures demonstrate no fracture. There 
+are no suspicious lytic 
+or sclerotic lesions. The visualized paranasal sinuses and 
+mastoid air cells are normally pneumatized and clear. 
+.  
+IMPRESSION: No acute intracranial process. 
+
+ 
+
+###RESPONSE: PLT COUNT {Platelet count}, NEUTS {Neutrophil count}, LYMPHS {Lymphocyte count}, MONOS {Monocyte count}, EOS {Eosinophil count}, 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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, LITHIUM {Finding of lithium level}, CALCIUM {Blood calcium measurement}, PHOSPHATE {Phosphate, total measurement}, MAGNESIUM {Blood magnesium measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, CK(CPK {Creatine kinase measurement}, GLUCOSE {Glucose measurement, blood}, UREA N {Blood urea nitrogen measurement}, 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}, PTT {Partial thromboplastin time, activated}, URINE {Urinalysis}, PROTEIN {Measurement of protein in urine}, GLUCOSE {Glucose measurement, urine}, KETONE {Urinalysis, acetone or ketone bodies measurement}, BILIRUBIN {Bilirubin measurement, urine}, PH {pH measurement}, COLOR {Color finding}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, CK(CPK {Creatine kinase measurement}, hemorrhage {Hemorrhage}, edema {Edema}, mass {Mass}, vascular {Blood vessel structure}, infarction {Infarct}, white matter {Cerebral white matter structure}, frontal {Structure of cortex of frontal lobe}, atrophy {Atrophy}, ventricles {Brain ventricle structure}, sulci {Structure of sulcus of brain}, cisterns {Structure of subarachnoid cistern}, shift of normally midline structures {Midline shift of brain}, Calcifications {Pathologic calcification, calcified structure}, internal carotid 
+arteries {Internal carotid artery structure}, osseous structures {Bone structure}, fracture {Fracture}, lytic {Lysis}, sclerotic {Sclerosis}, lesions {Lesion}, paranasal sinuses {Nasal sinus structure}, mastoid air cells {Structure of mastoid cell}, intracranial {Intracranial 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:
+___ y/o female with a h/o schizoaffective disorder and 
+hypothyroidism who presented with dizziness and was found to be 
+hypercalcemic. The following issues were investigated during 
+this hospitalization:
+  
+1. Dizziness: Onset of symptoms correlates with initiation of 
+Aricept for short-term memory loss and this medication has been 
+associated with dizziness. Patient received IVF upon arrival for 
+hypercalcemia but was never found to be orthostatic. Aricept was 
+held while in house with improvement in symptoms. Head CT 
+unremarkable as was neuro exam. Patient was discharged with home 
+___. She will not continue on Aricept. 
+  
+2.  Hypercalcemia: Patient with history of elevated PTH since 
+___ with intermittently elevated calcium values. Calcium > 11 
+on admission, but responsive to IVF. Calcium and vitamin D 
+supplements discontinued but bisphosphonate continued. Endocrine 
+consulted given concern for Lithium-induced hyperparathyroidism. 
+24 hour urine calcium was low and consistent with 
+Lithium-induced disease and not likely necessitating surgical 
+intervention. Still, further work-up was deferred to the 
+outpatient setting. Lithium was decreased, but maintained as the 
+endocrinopathies are generally not reversed with stopping 
+Lithium and mood-stabilization remains of concern. She will f/u 
+her lithium levels with her outpatient psychiatrist Dr. ___. 
+She will also f/u as an outpatient with endocrinology.
+
+3. Diabetes Insipidus: Suggested by mildly elevated Na and 
+chloride, in the setting of endocrinopathies in a patient on 
+long-term Lithium. Patient was started on Amiloride at the 
+recommendation of the endocrinology consult, with improvement in 
+electrolyte derrangements. Patient was otherwise encouraged to 
+remain hydrated. She will be discharged on amiloride. 
+  
+4. Schizoaffective d/o: Psychiatry was consulted given concern 
+for suicidal ideations and depression as well as for guidance 
+for Lithium. Patient was initially on a ___, requiring 
+that she remain hospitalized with intention to be transferred to 
+a psychiatric facility. However, as her hospitalization 
+continued and her metabolic derrangements were corrected, her 
+mood improved. The section was eventually lifted and the patient 
+was restarted on Lithium at a lower dose with outpatient 
+follow-up with her psychiatrist. 
+  
+5. Dementia: Per patient's outpatient psychologist, 
+neuropsychological testing showed significant memory impairment 
+and MRI showed vascular disease, suggesting a possible etiology 
+of dementia. Patient had been started on Aricept as an 
+outpatient, but this was held given the complaint of 
+lightheadedness that started after initiation of medication. 
+
+6. Hypothyroidism: Patient was maintained on outpatient 
+Levothyroxine.
+
+7. Osteoporosis: Calcium and Vitamin D were held given elevated 
+calcium and PTh on presentation, though Alendronate was 
+continued. 
+
+8. Hyperlipidemia: Patient was maintained on outpatient statin. 
+
+9. Leukocytosis: Chronic problem of unclear etiology. No obvious 
+source of infection. ___ trended down during this 
+hospitalization and thus work-up was not pursued. 
+
+Full code
+
+She was discharged with outpatient endocrine and psychiatry 
+follow up.
+ 
+
+###RESPONSE: schizoaffective disorder {Schizoaffective disorder}, hypothyroidism {Hypothyroidism}, dizziness {Dizziness}, hypercalcemic {Hypercalcemia}, Dizziness {Dizziness}, short-term memory loss {Poor short-term memory}, dizziness {Dizziness}, IVF {Administration of intravenous fluids}, hypercalcemia {Hypercalcemia}, orthostatic {Orthostatic hypotension}, Head CT {Computed tomography of head}, unremarkable {No abnormality detected}, neuro exam {Normal nervous system function}, Hypercalcemia {Hypercalcemia}, calcium {Blood calcium measurement}, Calcium {Blood calcium measurement}, IVF {Administration of intravenous fluids}, Lithium-induced hyperparathyroidism {Hyperparathyroidism caused by lithium therapy}, urine calcium {Calcium measurement, urine}, surgical 
+intervention {Surgical procedure}, work-up {Evaluation procedure}, lithium levels {Finding of lithium level}, psychiatrist {Psychiatric follow-up}, Diabetes Insipidus {Diabetes insipidus}, Schizoaffective {Schizoaffective disorder}, suicidal ideations {Suicidal thoughts}, depression {Depressive disorder}, mood improved {Improved mood}, on Lithium {On lithium}, outpatient 
+follow-up {Outpatient care management}, psychiatrist {Psychiatric follow-up}, Dementia {Dementia}, neuropsychological testing {Neuropsychological testing}, memory impairment {Memory impairment}, MRI {Magnetic resonance imaging}, vascular disease {Disorder of blood vessel}, dementia {Dementia}, lightheadedness {Lightheadedness}, Hypothyroidism {Hypothyroidism}, Osteoporosis {Osteoporosis}, elevated 
+calcium {Hypercalcemia}, PTh {Hyperparathyroidism}, Hyperlipidemia {Hyperlipidemia}, Leukocytosis {Leukocytosis}, infection {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: Medications on Admission:
+Aricept 5mg QHS (started 1 week ago)  
+Simvastatin 40 mg daily  
+levothyroxine 0.125 mg daily  
+aspirin 81 mg daily  
+iron daily  
+alendronate 70 mg every week  
+vitamin D 400 units b.i.d.  
+calcium 400 mg b.i.d.  
+lithium 300 mg ___ mg once qhs  
+Risperdal 4 mg b.i.d.  
+Seroquel 50 mg daily  
+lorazepam 1 mg daily  
+cilostazol 100 mg b.i.d.  
+citalopram daily (dose unknown)  
+
+ 
+Discharge Medications:
+1. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+2. Levothyroxine 125 mcg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+3. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).  
+4. Risperidone 2 mg Tablet Sig: Two (2) Tablet PO BID (2 times a 
+day).  
+5. Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO BID (2 times a 
+day).  
+6. Cilostazol 100 mg Tablet Sig: One (1) Tablet PO BID (2 times 
+a day).  
+7. Alendronate 70 mg Tablet Sig: One (1) Tablet PO QSUN (every 
+___.  
+8. Quetiapine 100 mg Tablet Sig: One (1) Tablet PO QHS (once a 
+day (at bedtime)).  
+9. Amiloride 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
+Disp:*30 Tablet(s)* Refills:*2*
+10. Lithium Carbonate 300 mg Capsule Sig: One (1) Capsule PO QHS 
+(once a day (at bedtime)).
+Disp:*30 Capsule(s)* Refills:*2*
+11. Citalopram 20 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily).  
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Primary:
+Lightheadedness
+Hyperparathyroidism
+Nephrogenic Diabetes Inspidus
+
+Secondary: 
+Schizoaffective disorder
+
+ 
+Discharge Condition:
+Stable
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, Lightheadedness {Lightheadedness}, Hyperparathyroidism {Hyperparathyroidism}, Nephrogenic Diabetes Inspidus {Nephrogenic diabetes insipidus}, Schizoaffective disorder {Schizoaffective disorder}, Stable {Patient's condition stable}"
+"###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 seen and evaluated for left hand weakness and 
+lightheadedness, which was felt to be due to a new medication 
+you started - Aricept. This medication has been stopped. 
+Additionally, you were noted to have an elevated calcium, which 
+was due to a hormone problem called hyperparathyroidism. This 
+hormone problem is likely due to Lithium, which you take and 
+NEED to continue to take to control your mood. However, your 
+Lithium dose has been decreased. Since your walking was unsteady 
+but improved when you were discharged, you will have home ___ 
+care. 
+
+Take all of your medications as directed. Your Aricept, calcium 
+and vitamin D have been stopped and your Lithium has been 
+decreased. You were also started on a new medication, Amiloride, 
+to help control your sodium level. It is important to stay very 
+well hydrated.
+
+Keep all of your follow-up appointments. They are listed below. 
+Once you are discharged, you have an appointment with endocrine 
+at 3PM today. It is very important that you keep this 
+appointment. You will also need to follow up with your 
+psychiatrist, Dr. ___, for management of your 
+Lithium. The psychiatry team here will contact him and will make 
+an appointment for you. 
+
+Call your doctor or go to the ER for any of the following: chest 
+pain, shortness of breath, fevers/chills, 
+nausea/vomiting/diarrhea, worsened lightheadedness or falls, 
+sudden slurred speech or weakness, headaches, vision changes, 
+extreme fatigue, confusion or any other concerning symptoms. 
+ 
+
+###RESPONSE: left hand weakness {Weakness of left hand}, lightheadedness {Lightheadedness}, elevated calcium {Hypercalcemia}, hyperparathyroidism {Hyperparathyroidism}, mood {Mood swings}, r walking was unsteady {Unsteady when walking}, improved {Patient's condition improved}, sodium level {Finding of sodium level}, psychiatrist {Psychiatric follow-up}, chest 
+pain {Chest pain}, shortness of breath {Dyspnea}, fevers {Fever}, chills {Chill}, nausea/vomiting/diarrhea {Nausea, vomiting and diarrhea}, lightheadedness {Lightheadedness}, falls {Falls}, slurred speech {Slurred speech}, weakness {Asthenia}, headaches {Headache}, vision changes {Visual disturbance}, fatigue {Fatigue}, confusion {Clouded consciousness}"
+"###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: 
+vancomycin / Zosyn
+ 
+Attending: ___.
+ 
+Chief Complaint:
+fevers, lethargy
+ 
+Reason for MICU transfer:  concern for septic shock
+
+ 
+Major Surgical or Invasive Procedure:
+None
+ 
+
+###RESPONSE: vancomycin {Allergy to vancomycin}, fevers {Fever}, lethargy {Lethargy}, MICU transfer {Patient transfer to intensive care unit}, septic shock {Septic shock}"
+"###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 recent diagnosis of Graves' disease and longtime 
+diagnosis of Kawasaki's disease on warfarin, presenting to ED 
+with intermittent fevers and lethargy x 1 week and RLQ abdominal 
+pain x ___ days.  Initially developed fever up to 102 and mild 
+sore throat 1 week ago, was found to have normal WBC with left 
+shift and mildly elevated TSH at ___, and was discharged 
+home with presumptive diagnosis of viral infection.  However, 
+his fevers persisted as high as 102 with night sweats and 
+headaches, and was told by his endocrinologist Dr. ___ to 
+discontinue his methimazole (MMI). He then developed RLQ pain 
+and right groin pain especially on ambulation, and was sent to 
+ED following appointment with Dr. ___.
+
+In the ED, his initial vitals were 98.3 77 58/34 18 98%.  He was 
+given 4L fluids.  Bedside ultrasound showed no free fluid or 
+tamponade with normal IVC and mildly diminished cardiac 
+contractility.  Labs notable for WBC 12.8 with left shift, UA 
+with 93 WBC, CXR showed no pneumonia, two CT A/P were performed 
+that showed no appendicitis or bowel wall thickening but did 
+show right retroperitoneal stranding.  Surgery was consulted and 
+recommended admission to medicine.  Endocrinology was consulted 
+for concern of thyrotoxicosis or adrenal insufficiency, and 
+recommended discontinuation of steroids but further thyroid 
+studies.  He had a R IJ placed, was started on levophed, 
+vanc/zosyn, and hydrocortisone.
+
+In the MICU, his initial vitals were 101.4 117 108/70 35 93% 2L. 
+ He reported feeling more energy.
+
+ 
+
+###RESPONSE: Graves' disease {Graves' disease}, Kawasaki's disease {Acute febrile mucocutaneous lymph node syndrome}, intermittent fevers {Intermittent fever}, lethargy {Lethargy}, RLQ abdominal 
+pain {Right lower quadrant pain}, fever {Fever}, sore throat {Sore throat}, normal WBC {White blood cell count within reference range}, left 
+shift {Left shifted white blood cells}, elevated TSH {Thyroid stimulating hormone level above reference range}, viral infection {Viral disease}, fevers {Fever}, night sweats {Night sweats}, headaches {Headache}, RLQ pain {Right lower quadrant pain}, right groin pain {Right inguinal pain}, vitals {Vital signs finding}, fluids {Administration of fluid therapy}, ultrasound {Ultrasonography}, free fluid {Effusion}, tamponade {Cardiac tamponade}, IVC {Inferior vena cava structure}, cardiac {Heart structure}, left shift {Left shifted white blood cells}, UA {Urinalysis}, CXR {Plain chest X-ray}, pneumonia {Pneumonia}, CT A/P {Computed tomography of abdomen and pelvis}, appendicitis {Appendicitis}, bowel wall {Intestinal wall structure}, thickening {Increased thickness}, right {Structure of right half of body}, retroperitoneal {Retroperitoneal compartment structure}, Surgery was consulted {Medical consultation on hospital inpatient}, thyrotoxicosis {Thyrotoxicosis}, adrenal insufficiency {Adrenal cortical hypofunction}, steroids {Steroid therapy}, thyroid 
+studies {Examination of thyroid gland}, vitals {Vital signs finding}"
+"###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:
+- ___' disease based on clinical presentation (duration of
+symptoms, mild orbitopathy, lid lag, non tender mildly enlarged
+thyroid gland). No RAIU. No TSI or TBII testing. Had elevated 
+TPO
+ab 266 (reference range ___
+- Kawasaki disease s/p MI (suggestive though not completely 
+diagnosed on cardiac cath in ___ now on coumadin
+- asthma
+- hyperlipidemia
+- gout
+
+ 
+
+###RESPONSE: disease {Disease}, mild {Symptom mild}, orbitopathy {Thyroid eye disease}, lid lag {Lid lag}, tender {Tenderness of thyroid}, enlarged
+thyroid gland {Goiter}, RAIU {Radionuclide imaging of thyroid using iodine radioisotope}, TSI {Thyroid stimulating immunoglobulins measurement}, TBII {Thyrotropin binding inhibitory immunoglobulins measurement}, Kawasaki disease {Acute febrile mucocutaneous lymph node syndrome}, MI {Myocardial infarction}, cardiac cath {Cardiac catheterization}, asthma {Asthma}, hyperlipidemia {Hyperlipidemia}, gout {Inflammatory disorder due to increased blood urate level}"
+"###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:
+His father died at age ___ with asbestosis.  His mother is ___ and
+is in assisted living.  He has two brothers and a sister who are
+healthy.  His son age ___ was diagnosed as hypothyroid and his
+daughter, age ___, is healthy.
+
+ 
+
+###RESPONSE: died {Dead}, asbestosis {Asbestosis}, hypothyroid {Hypothyroidism}"
+"###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:
+Vitals:  101.4 117 108/70 35 93% 2L
+General: Alert, oriented, mild blanching erythema throughout 
+chest/trunk/extremities, no acute distress  
+HEENT: dry MM, OC/OP clear
+Neck: supple, no LAD, no JVP 
+CV: Tachycardic, regular rhythm, normal S1/S2, no m/r/g
+Lungs: Tachypneic, clear to auscultation bilaterally, no w/r/r
+Abdomen: soft, non-tender, mildly distended, hypoactive bowel 
+sounds, no organomegaly, no rebound or guarding  
+GU: foley in place
+Ext: Warm, well perfused, 2+ pulses, no c/c/e  
+Neuro: CN II-XII intact, ___ strength upper/lower extremities 
+ 
+DISCHARGE PHYSICAL EXAM:
+AVSS
+Lungs clear with very scant coarse sounds at right base
+Very Mild RLQ tenderness
+
+ 
+
+###RESPONSE: Physical Exam {Physical examination procedure}, PHYSICAL EXAM {Physical examination procedure}, Vitals {Vital signs finding}, General {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, erythema {Erythema}, chest {Thoracic structure}, trunk {Trunk structure}, extremities {Examination of limb}, distress {Distress}, HEENT {Physical examination procedure}, dry MM {Mucous membrane dryness}, OP clear {Pharynx normal}, Neck {Physical examination procedure}, supple {Normal movement of neck}, LAD {Lymphadenopathy}, JVP {Finding of jugular venous pressure}, CV {Cardiovascular physical examination}, Tachycardic {Tachycardia}, regular rhythm {Normal sinus rhythm}, normal S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, no m/r/g {Heart sounds normal}, Lungs {Examination of respiratory system}, Tachypneic {Tachypnea}, clear to auscultation bilaterally {Normal breath sounds}, no w/r/r {Normal breath sounds}, Abdomen {Examination of abdomen}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, distended {Swollen abdomen}, hypoactive bowel 
+sounds {Decreased bowel sounds}, organomegaly {Abdominal organomegaly}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, GU {Examination of genitourinary system}, foley in place {Urinary catheter in situ}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, 2+ pulses {Peripheral pulses normal}, Neuro {Neurological examination}, CN II-XII intact {Normal central nervous system}, upper {Upper limb structure}, lower extremities {Lower limb structure}, PHYSICAL EXAM {Physical examination procedure}, AVSS {Vital signs finding}, Lungs {Examination of respiratory system}, clear {Chest clear}, right base {Structure of base of right lung}, RLQ tenderness {Tenderness of right lower quadrant of abdomen}"
+"###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:
+___ 09:37AM BLOOD WBC-12.8*# RBC-3.78* Hgb-10.2*# 
+Hct-32.5*# MCV-86 MCH-26.9*# MCHC-31.4 RDW-16.4* Plt ___
+___ 09:37AM BLOOD Neuts-91* Bands-3 Lymphs-2* Monos-3 Eos-0 
+Baso-0 ___ Metas-1* Myelos-0
+___ 09:37AM BLOOD ___ PTT-35.4 ___
+___ 09:37AM BLOOD Glucose-105* UreaN-23* Creat-1.9*# Na-133 
+K-5.0 Cl-99 HCO3-22 AnGap-17
+___ 09:37AM BLOOD ALT-19 AST-20 AlkPhos-101 TotBili-0.8
+___ 09:37AM BLOOD Albumin-3.4* Calcium-8.8 Phos-2.1* Mg-2.2
+___ 02:42PM BLOOD T4-5.9 T3-84 calcTBG-0.75* TUptake-1.33* 
+T4Index-7.8
+___ 09:37AM BLOOD TSH-0.71
+___ 09:37AM BLOOD Cortsol-51.8*
+___ 09:53AM BLOOD Lactate-2.0
+___ 03:19AM BLOOD Lactate-1.3
+___ 02:34PM BLOOD O2 Sat-62
+___ 03:19AM BLOOD O2 Sat-87
+
+DISCHARGE LABS:
+___ 07:10AM BLOOD WBC-5.7 RBC-3.37* Hgb-9.0* Hct-28.6* 
+MCV-85 MCH-26.8* MCHC-31.6 RDW-17.6* Plt ___
+___ 07:10AM BLOOD ___
+___ 07:10AM BLOOD Glucose-84 UreaN-17 Creat-0.7 Na-141 
+K-3.9 Cl-105 HCO3-30 AnGap-10
+___ 08:20AM BLOOD Calcium-8.3* Phos-2.6* Mg-2.5
+
+___ ___ M  ___  ___BD & PELVIS W/O CONTRAST Study Date of 
+___ 4:12 ___ 
+ 
+  
+___   ___ 4:___BD & PELVIS W/O CONTRAST; -77 BY DIFFERENT PHYSICIAN   ___ 
+# ___   
+Reason: Eval retroperitoneal process as seen on previous CT 
+scan. PO 
+ 
+
+ 
+UNDERLYING MEDICAL CONDITION: 
+   History: ___ with fevers and RLQ tenderness  
+REASON FOR THIS EXAMINATION: 
+   Eval retroperitoneal process as seen on previous CT scan. PO 
+contrast already  
+   given 
+CONTRAINDICATIONS FOR IV CONTRAST: 
+    
+
+ 
+ 
+Wet Read: ___ ___ 7:03 ___ 
+  
+1. Minimal asymmetric right perinephric stranding. Please 
+correlate with 
+urinalysis.  
+  
+2. Normal appendix.  
+  
+3. Unchanged nonspecific right retroperitoneal stranding 
+extending along the 
+right iliac vessels.  
+  
+4. 5 mm left lower lobe pulmonary nodule should be followed in 
+___ months if 
+the patient is at high risk for lung malignancy.  
+  
+
+ 
+Final Report 
+HISTORY:  ___ male with fevers and right lower quadrant 
+tenderness.   
+  
+COMPARISON:  Same day CT of in ___.   
+  
+TECHNIQUE:  MDCT images were obtained from the lung bases to the 
+pubic 
+symphysis after administration of oral contrast.  IV contrast 
+was not 
+administered.  This examination was repeated since a CT 
+performed at 12:00 in 
+order to better visualize the appendix.  Axial images were 
+interpreted in 
+conjunction with coronal and sagittal reformats.   
+  
+FINDINGS: 
+  
+Coronary artery calcifications are similar to prior.  Bibasilar 
+atelectasis is 
+unchanged.  5 mm left lower lobe nodule should be followed as 
+previously 
+recommended.  No pleural or pericardial effusion.   
+  
+ABDOMEN:   
+  
+Evaluation of the intra-abdominal organs is limited by lack of 
+IV contrast 
+administration.  The unenhanced appearance of the liver, 
+gallbladder, intra 
+and extrahepatic bile ducts, pancreas, spleen, and adrenal 
+glands is normal.  
+There is minimal asymmetric right perinephric stranding and 
+thickening of 
+Gerota's fascia.  The ureters have a normal course and caliber. 
+No calculi are 
+seen within the kidneys or ureters, and no hydronephrosis is 
+present. 
+  
+The stomach is normal.  The small and large bowel have a normal 
+course and 
+calibur.  The appendix is not dilated and the base of the 
+appendix contains 
+oral contrast, though the remainder of the appendix does not 
+fill with oral 
+contrast. No stranding is noted about the appendiceal tip. 
+  
+Right retroperitoneal stranding extending from the right lateral 
+conal fascia 
+along the right iliac vessels is unchanged and nonspecific. No 
+focal fluid 
+collection is present.  No retroperitoneal or mesenteric 
+lymphadenopathy.  The 
+unenhanced appearance of the portal and intra-abdominal systemic 
+vasculature 
+is unremarkable.  No abdominal wall hernia, pneumoperitoneum, or 
+free 
+intraperitoneal fluid. 
+  
+PELVIS:  The bladder contains a Foley catheter.  The terminal 
+ureters are 
+normal.  The prostate gland is unremarkable.  No pelvic 
+side-wall or inguinal 
+lymphadenopathy. No free pelvic fluid or inguinal hernia. 
+  
+OSSEOUS STRUCTURES:  No focal lytic or sclerotic lesion 
+concerning for 
+malignancy.  Retrolisthesis of L5 on S1.  Mild multilevel 
+thoracolumbar spine 
+degenerative changes.   
+  
+CT Abd and Pelvis
+IMPRESSION: 
+  
+1.  Minimal asymmetric right perinephric stranding and 
+thickening of Gerota's 
+fascia, which can be seen with pyelonephritis. Clinical 
+correlation with 
+urinalysis recommended. 
+  
+2.  Unchanged right retroperitoneal stranding extending along 
+the right iliac 
+vessels, non-specific. Findings could relate to urinary tract 
+infection.   
+  
+3.  Normal appendix.   
+   
+4.  5 mm left lower lobe pulmonary nodule should be re-assessed 
+in 12 months 
+if there is low risk of lung malignancy or in ___ months there 
+is high risk. 
+ 
+
+ 
+
+###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}, 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}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, Albumin {Albumin measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, TSH {Thyroid stimulating hormone 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}, 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}, PELVIS W/O CONTRAST {Computed tomography of pelvis without contrast}, PELVIS W/O CONTRAST {Computed tomography of pelvis without contrast}, CT 
+scan {Computed tomography of abdomen}, fevers {Fever}, RLQ tenderness {Tenderness of right lower quadrant of abdomen}, CT scan {Computed tomography of abdomen}, IV {Intravenous therapy}, right {Structure of right half of body}, perinephric {Structure of perirenal region}, urinalysis {Urinalysis}, appendix {Appendix structure}, right {Structure of right half of body}, retroperitoneal {Retroperitoneal compartment structure}, right iliac vessels {Structure of right iliac vessel}, left lower lobe {Structure of lower lobe of left lung}, pulmonary nodule {Nodule of lung}, lung malignancy {Metastatic malignant neoplasm to lung}, fevers {Fever}, right lower quadrant 
+tenderness {Tenderness of right lower quadrant of abdomen}, lung bases {Structure of base of lung}, pubic 
+symphysis {Structure of epiphysis of pubis}, oral {Administration of drug or medicament via oral route}, IV {Intravenous therapy}, appendix {Appendix structure}, Coronary artery calcifications {Calcification of coronary artery}, Bibasilar {Structure of base of lung}, atelectasis {Atelectasis}, left lower lobe {Structure of lower lobe of left lung}, nodule {Nodule of lung}, pleural {Pleural effusion}, pericardial effusion {Pericardial effusion}, ABDOMEN {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, Evaluation {Evaluation procedure}, abdominal {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, IV {Intravenous therapy}, liver {Liver structure}, gallbladder {Gallbladder structure}, intra {Intrahepatic biliary tract structure}, extrahepatic bile ducts {Extrahepatic duct structure}, pancreas {Pancreatic structure}, spleen {Splenic structure}, adrenal 
+glands {Bilateral adrenal glands}, perinephric {Structure of perirenal region}, thickening {Increased thickness}, fascia {Structure of fascia}, ureters {Ureteric structure}, calculi {Calculus}, kidneys {Kidney structure}, ureters {Ureteric structure}, hydronephrosis {Hydronephrosis}, stomach {Stomach structure}, small {Structure of small intestine}, large bowel {Structure of large intestine}, appendix {Appendix structure}, dilated {Dilatation}, appendix {Appendix structure}, oral {Administration of drug or medicament via oral route}, appendix {Appendix structure}, oral {Administration of drug or medicament via oral route}, Right {Structure of right half of body}, retroperitoneal {Retroperitoneal compartment structure}, fascia {Structure of fascia}, right iliac vessels {Structure of right iliac vessel}, retroperitoneal {Retroperitoneal lymphadenopathy}, mesenteric 
+lymphadenopathy {Mesenteric lymphadenopathy}, abdominal {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, unremarkable {No abnormality detected}, abdominal wall {Structure of wall of abdominal proper segment of trunk}, hernia {Herniated structure}, pneumoperitoneum {Pneumoperitoneum}, PELVIS {Structure of pelvis}, bladder {Urinary bladder structure}, Foley catheter {Urinary catheter in situ}, ureters {Ureteric structure}, prostate gland {Prostatic structure}, unremarkable {No abnormality detected}, pelvic 
+side-wall {Pelvic lymphadenopathy}, inguinal 
+lymphadenopathy {Inguinal lymphadenopathy}, pelvic {Structure of pelvis}, inguinal hernia {Inguinal hernia}, OSSEOUS STRUCTURES {Bone structure}, lytic {Lysis}, sclerotic {Sclerosis}, lesion {Lesion}, malignancy {Malignant neoplasm}, Retrolisthesis {Retrolisthesis}, thoracolumbar {Structure of thoracic and/or lumbar region of back}, spine {Structure of vertebral column}, degenerative changes {Degeneration of spine}, CT Abd and Pelvis {Computed tomography of abdomen and pelvis}, right {Structure of right half of body}, perinephric {Structure of perirenal region}, thickening {Increased thickness}, fascia {Structure of fascia}, pyelonephritis {Pyelonephritis}, urinalysis {Urinalysis}, right {Structure of right half of body}, retroperitoneal {Retroperitoneal compartment structure}, right iliac 
+vessels {Structure of right iliac vessel}, urinary tract 
+infection {Urinary tract infectious disease}, appendix {Appendix structure}, left lower lobe {Structure of lower lobe of left lung}, pulmonary nodule {Nodule of lung}, lung malignancy {Metastatic malignant neoplasm to lung}"
+"###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 hyperthyroidism on methimazole, Kawasaki's on warfarin, 
+presenting with one week of intermittent fevers, lethargy, and 
+RLQ pain, found to be in septic shock of unclear etiology:
+
+# Septic shock ___ pyelonephritis: The patient meet SIRS 
+criteria with fever, leukocytosis, tachycardia, tachypnea, also 
+hypotensive with likely source urinary given concerning UA 
+(RBC-4, WBC-93, no epi's) and perinephric/retroperitoneal 
+stranding on CT.  The patient was bolus 6L of NS and started a 
+levophed gtt in the ED.  A central line was placed in the ED.  
+The CVP was resusitated to >12, and MAP remained >65 on 
+levophed.  His BP quickly improved and he was weaned from the 
+levophed gtt.  He was initially given vancomycin and zosyn in 
+the ED, which was narrowed to cefepime on arrival to the FICU.  
+He developed a morbilliform rash after recieving vancomycin and 
+zosyn in the ED.  He remained off pressors for over 48 hour and 
+was admitted to a medical floor bed.  After 3 days, his 
+antibiotics were narrowed to levofloxacin.  Blood and Urine 
+cultures had no growth to date at that time. The patient was 
+discharged on 7 day additional days of Levofloxacin for a full 
+14d treatment for pylenonephritis due to septic shock.
+
+# ___: Cr 1.9 in ED secondary to shock, which resolved to 
+baseline after fluid resusitation.
+
+# Hyperthyroidism: The patient was followed by endocrinology 
+will inpatient after a recent diagnosis of Grave's Disease.  He 
+was continued on his home propranolol, but the home dose of 
+methimazole was held.  The patient will need to follow up with 
+endocrinology with 1 week of discharge.
+
+# Kawasaki's disease: He was continued on his home coumadin and 
+quinapril.  An Echo was obtained that revealed a normal EF with 
+mild aortic valve stenosis. The patients INR on d/c was 3.7 
+given interaction with Coumadin. The patient will hold his 
+Coumadin for 2 nights and have his INR checked on ___ at 
+the ___. 
+
+# Alcohol use: He denies a history of withdrawal, DTs, or 
+seizures in previous hospitalizations.  e was initially started  
+on a CIWA, but was discontinued after not scoring for the 
+duration of his hospitalization.
+
+# HLD: continued ezetimibe, held lipitor per endocrinology.
+
+# Gout: well controlled, continued home allopurinol
+
+# Pulmonary Nodule: Please see above.
+ 
+
+###RESPONSE: hyperthyroidism {Hyperthyroidism}, Kawasaki's {Acute febrile mucocutaneous lymph node syndrome}, intermittent fevers {Intermittent fever}, lethargy {Lethargy}, septic shock {Septic shock}, Septic shock {Septic shock}, pyelonephritis {Pyelonephritis}, SIRS {Systemic inflammatory response syndrome}, fever {Fever}, leukocytosis {Leukocytosis}, tachycardia {Tachycardia}, tachypnea {Tachypnea}, hypotensive {Low blood pressure}, urinary {Urinary system structure}, UA {Urinalysis}, perinephric {Structure of perirenal region}, retroperitoneal {Retroperitoneal compartment structure}, CT {Computed tomography}, resusitated {Resuscitation}, BP {Blood pressure finding}, improved {Patient's condition improved}, vancomycin {Antibiotic therapy}, morbilliform rash {Morbilliform rash}, vancomycin {Antibiotic therapy}, pressors {Hypotensive therapy}, antibiotics {Antibiotic therapy}, Urine 
+cultures {Urine culture}, pylenonephritis {Pyelonephritis}, septic shock {Septic shock}, shock {Septic shock}, baseline {Baseline state}, fluid resusitation {Administration of fluid therapy}, Hyperthyroidism {Hyperthyroidism}, Grave's Disease {Graves' disease}, Kawasaki's disease {Acute febrile mucocutaneous lymph node syndrome}, Echo {Echocardiography}, mild aortic valve stenosis {Mild stenosis of aortic valve}, Alcohol use {Current drinker of alcohol}, withdrawal {Alcohol withdrawal syndrome}, DT {Alcohol withdrawal delirium}, seizures {Seizure}, HLD {Hyperlipidemia}, Gout {Inflammatory disorder due to increased blood urate level}, Pulmonary Nodule {Nodule of lung}"
+"###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. Ezetimibe 10 mg PO DAILY 
+2. Propranolol 10 mg PO BID 
+3. Quinapril 10 mg PO DAILY 
+4. Allopurinol ___ mg PO DAILY 
+5. Warfarin 2.5 mg PO 4X/WEEK (___) 
+6. Warfarin 2 mg PO 3X/WEEK (___) 
+
+ 
+Discharge Medications:
+1. Ezetimibe 10 mg PO DAILY 
+2. Propranolol 10 mg PO BID 
+3. Quinapril 10 mg PO DAILY 
+4. Warfarin 2.5 mg PO 4X/WEEK (___) 
+Do not take until instructed
+
+5. Warfarin 2 mg PO 3X/WEEK (___) 
+6. Levofloxacin 750 mg PO DAILY 
+RX *levofloxacin [Levaquin] 750 mg 1 tablet(s) by mouth Daily 
+Disp #*7 Tablet Refills:*0
+7. PredniSONE 40 mg PO DAILY 
+RX *prednisone 20 mg 2 tablet(s) by mouth daily Disp #*8 Tablet 
+Refills:*0
+8. Pulmicort Flexhaler *NF* (budesonide) 90 mcg/actuation 
+Inhalation BID 
+9. Allopurinol ___ mg PO DAILY 
+10. Methimazole 10 mg PO TID 
+Do not take this medication until instructed to do so by Dr. 
+___
+ 
+11. Simvastatin 40 mg PO DAILY 
+Please do not take this medication until instructed to do so by 
+your PCP. 
+
+ 
+
+###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 Diagnosis
+- Septic Shock secondary to pyelnonephritis
+- Graves Disease
+- Kawasaki Disease
+- Gerd
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+ 
+
+###RESPONSE: Septic Shock {Septic shock}, pyelnonephritis {Pyelonephritis}, Graves Disease {Graves' disease}, Kawasaki Disease {Acute febrile mucocutaneous lymph node syndrome}, Gerd {Gastroesophageal reflux disease}, Mental Status {Mental state finding}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, interactive {Does communicate}, 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 to ___ with low blood pressure and were 
+found to have sepsis. While the source of the infection is not 
+entirely clear, this was most likely due to a kidney infection. 
+You were also treated for an asthma exacerbation. Please note 
+the changes to your medications below.
+ 
+
+###RESPONSE: low blood pressure {Low blood pressure}, sepsis {Sepsis}, infection {Infectious disease}, kidney infection {Infectious disorder of kidney}, asthma exacerbation {Exacerbation of asthma}, changes to your medications {Medication education}"
+"###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:
+Abdominal pain 
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, Abdominal pain {Abdominal 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:
+___ w/LURT (___) with CKD stage IV
+of renal allograft, RAS s/p stenting, CAD s/p DES x4 ___, 
+___
+on aspirin/Plavix, HFpEF, atrial fibrillation s/p DVVC (___)
+on Eliquis, HTN, HLD, T2DM, aorto-iliac occlusive disease,
+bilateral carotid disease c/b recent CVA, OSA, and prostate
+cancer, with recent hospitalization for HF exacerbation and
+pericarditis, who presents with abdominal pain. 
+
+He states that he has had poor appetite and epigastric pain 
+since
+discharge on ___. He feels progressively weaker as a result. 
+The
+epigastric pain does not radiate. He denies fevers, nausea,
+vomiting, chest pain, diarrhea, difficulty breathing, hematuria,
+dysuria, lower extremity edema, back pain. 
+
+ 
+
+###RESPONSE: LURT {Transplant of kidney}, CKD stage IV {Chronic kidney disease stage 4}, renal allograft {Live donor renal transplant}, RAS {Renal artery stenosis}, stenting {Insertion of arterial stent}, CAD {Coronary arteriosclerosis}, DES {Endovascular insertion of drug eluting stent}, HFpEF {Heart failure with normal ejection fraction}, atrial fibrillation {Atrial fibrillation}, DVVC {Direct current cardioversion}, HTN {Hypertensive disorder, systemic arterial}, HLD {Hyperlipidemia}, T2DM {Diabetes mellitus type 2}, aorto-iliac occlusive disease {Occlusion of aortoiliac artery}, l carotid disease {Disorder of carotid artery}, CVA {Cerebrovascular accident}, OSA {Obstructive sleep apnea syndrome}, prostate
+cancer {Carcinoma of prostate}, HF exacerbation {Exacerbation of congestive heart failure}, pericarditis {Pericarditis}, abdominal pain {Abdominal pain}, poor appetite {Decrease in appetite}, epigastric pain {Epigastric pain}, epigastric pain {Epigastric pain}, radiate {Radiating pain}, fevers {Fever}, nausea,
+vomiting {Nausea and vomiting}, chest pain {Chest pain}, diarrhea {Diarrhea}, difficulty breathing {Difficulty breathing}, hematuria {Blood in urine}, dysuria {Dysuria}, lower extremity edema {Edema of lower extremity}, back pain {Backache}"
+"###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:
+
+###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: Past Medical History: 
+Cardiovascular Issues:
+1.  Coronary artery disease (s/p ___ 2 to proximal-LAD ___,
+s/p ___ 2 to mid-LAD ___.
+2.  Diastolic congestive heart failure.
+3.  Hypertension.
+4.  Dyslipidemia.
+5.  Claudication/Aorto iliac occlusive disease (ABI 0.88/0.76).
+6.  Morbid obesity.
+7. diabetes
+8 Obstructive sleep apnea
+9. C diff enterocolitis
+10 renal artery stenosis
+11. s/p kidney transplant with CKD stage IV transplanted kidney
+12. Klepbsiella UTI
+13. Prostate cancer
+14. Hyperparathyroidism
+ 
+
+###RESPONSE: Coronary artery disease {Coronary arteriosclerosis}, proximal-LAD {Structure of proximal portion of anterior descending branch of left coronary artery}, mid-LAD {Structure of mid portion of anterior descending branch of left coronary artery}, congestive heart failure {Congestive heart failure}, Hypertension {Hypertensive disorder, systemic arterial}, Dyslipidemia {Dyslipidemia}, Claudication {Intermittent claudication}, Aorto iliac occlusive disease {Occlusion of aortoiliac artery}, Morbid obesity {Morbid obesity}, diabetes {Diabetes mellitus}, Obstructive sleep apnea {Obstructive sleep apnea syndrome}, enterocolitis {Inflammation of small intestine and colon}, renal artery stenosis {Renal artery stenosis}, kidney transplant {Transplant of kidney}, CKD stage IV {Chronic kidney disease stage 4}, transplanted kidney {Structure of transplanted kidney}, UTI {Urinary tract infectious disease}, Prostate cancer {Carcinoma of prostate}, Hyperparathyroidism {Hyperparathyroidism}"
+"###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: ___, gout  
+Mother: ___, ESRD on hemodialysis
+Brothers: Lung cancer and CAD 
+His father died at age ___ of dementia.  His mother died at age 
+___
+of heart failure.  She also had a history of stroke and
+hypertension.  He has two brothers, two sisters, and no 
+children.
+One of his brothers had an MI in his late ___. There is no 
+family
+history notable for hyperlipidemia, diabetes,or sudden cardiac
+death.
+ 
+
+###RESPONSE: gout {Inflammatory disorder due to increased blood urate level}, ESRD on hemodialysis {End stage renal failure on dialysis}, Lung cancer {Malignant tumor of lung}, CAD {Coronary arteriosclerosis}, died {Dead}, dementia {Dementia}, died {Dead}, heart failure {Heart failure}, stroke {Cerebrovascular accident}, hypertension {Hypertensive disorder, systemic arterial}, MI {Myocardial infarction}, hyperlipidemia {Hyperlipidemia}, diabetes {Diabetes mellitus}, sudden cardiac
+death {Sudden cardiac death}"
+"###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 Exam:
+===============
+GENERAL: Alert and interactive. In no acute distress.
+HEENT: NCAT. PERRL, EOMI. Sclera anicteric and without 
+injection.
+MMM.
+NECK: No cervical lymphadenopathy. 
+CARDIAC: Regular rhythm, normal rate. Audible S1 and S2. No
+murmurs/rubs/gallops.
+LUNGS: Clear to auscultation bilaterally. No wheezes, rhonchi or
+rales. No increased work of breathing.
+BACK: No spinous process tenderness. No CVA tenderness.
+ABDOMEN: Soft, non distended, non-tender to deep palpation in 
+all
+four quadrants. 
+EXTREMITIES: No clubbing, cyanosis, or edema. Pulses DP/Radial 
+2+
+bilaterally.
+SKIN: Warm. No rash.
+NEUROLOGIC: ___ strength throughout. Normal sensation. AOx3.
+
+Discharge Exam:
+GENERAL: NAD 
+CARDIAC: Regular rhythm, normal rate. 
+LUNGS: Clear to auscultation bilaterally. No wheezes, rhonchi or
+rales. No increased work of breathing..
+ABDOMEN: Soft, non distended, non-tender to deep palpation in 
+all
+four quadrants. 
+EXTREMITIES: no edema bilateral lower extremity
+
+ 
+
+###RESPONSE: GENERAL {General examination of patient}, Alert {Mentally alert}, interactive {Does communicate}, distress {Distress}, HEENT {Physical examination procedure}, NC {Normal head}, PERRL {Pupils equal and reacting to light}, EOMI {Normal ocular motility}, Sclera anicteric {White sclera}, injection {Scleral injection}, MMM {Moist oral mucosa}, NECK {Physical examination procedure}, cervical lymphadenopathy {Cervical lymphadenopathy}, CARDIAC {Cardiovascular physical examination}, Regular rhythm {Normal sinus rhythm}, normal rate {Normal heart rate}, S2 {Normal second heart sound, S>2<}, murmurs {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, LUNGS {Examination of respiratory system}, Clear to auscultation bilaterally {Normal breath sounds}, wheezes {Wheezing}, rhonchi {Wheeze - rhonchi}, rales {Respiratory crackles}, increased work of breathing {Difficulty breathing}, BACK {Physical examination procedure}, spinous process {Structure of spinous process of vertebra}, tenderness {Tenderness}, CV {Cardiovascular physical examination}, tenderness {Tenderness}, ABDOMEN {Examination of abdomen}, Soft {Abdomen soft}, distended {Swollen abdomen}, non-tender {Abdominal tenderness}, palpation {Palpation}, EXTREMITIES {Examination of limb}, clubbing {Clubbing}, cyanosis {Cyanosis}, edema {Edema}, Pulses DP/Radial 
+2+ {Peripheral pulses normal}, SKIN {Examination of skin}, Warm {Warm skin}, rash {Eruption of skin}, NEURO {Neurological examination}, GI {Examination of digestive system}, Normal sensation {Normal sensation}, AOx3 {Oriented to person, time and place}, GENERAL {General examination of patient}, NAD {No abnormality detected}, CARDIAC {Cardiovascular physical examination}, Regular rhythm {Normal sinus rhythm}, normal rate {Normal heart rate}, LUNGS {Examination of respiratory system}, Clear to auscultation bilaterally {Normal breath sounds}, wheezes, rhonchi {Wheeze - rhonchi}, rales {Respiratory crackles}, increased work of breathing {Difficulty breathing}, ABDOMEN {Examination of abdomen}, Soft {Abdomen soft}, non distended {Swollen abdomen}, non-tender {Abdominal tenderness}, deep palpation {Deep palpation}, EXTREMITIES {Examination of limb}, edema bilateral lower extremity {Edema of bilateral lower 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:
+Labs:
+
+___ 08:20PM BLOOD WBC-16.8* RBC-4.34* Hgb-12.3* Hct-37.8* 
+MCV-87 MCH-28.3 MCHC-32.5 RDW-14.6 RDWSD-46.5* Plt ___
+___ 08:20PM BLOOD ___ PTT-27.1 ___
+___ 08:20PM BLOOD Glucose-167* UreaN-61* Creat-2.6* Na-138 
+K-3.4* Cl-95* HCO3-24 AnGap-19*
+___ 07:34AM BLOOD Glucose-147* UreaN-57* Creat-2.6* Na-144 
+K-4.1 Cl-104 HCO3-23 AnGap-17
+___ 02:58AM BLOOD CMV VL-NOT DETECT
+___ 08:29PM BLOOD Lactate-1.1
+
+Imaging:
+CT Abdomen/Peliv
+IMPRESSION: 
+1. Focal wall thickening with pericolonic stranding at the 
+hepatic flexure,  most consistent with focal 
+colits(infectious/inflammatory/ischemic) versus  diverticulitis. 
+ Recommend follow-up colonoscopy after acute symptoms subside. 
+2. Sigmoid colon diverticulosis with equivocal haziness of the 
+fat adjacent to  the proximal sigmoid colon could represent 
+additional site of 
+diverticulitis/focal colitis. 
+3. Small to moderate right and small left bilateral pleural 
+effusions with 
+overlying atelectasis.  Small pericardial effusion again seen. 
+4. Right lower quadrant transplant kidney with mild dilatation 
+of the renal  pelvis, increased compared to the prior CT from ___. 
+
+Renal Transplant US:
+Interval increase in intrarenal arterial resistive indices now 
+ranging from  0.89-1.0 with lack of diastolic flow seen in the 
+mid and lower pole intrarenal  arteries as well as main renal 
+artery. This is new compared to ___, however loss 
+of diastolic flow was also seen on a prior renal ultrasound  
+performed ___. 
+
+ 
+
+###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}, 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}, 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}, CT Abdomen/Peliv {Computed tomography of abdomen and pelvis}, thickening {Increased thickness}, pericolonic {Structure of paracolic region}, hepatic flexure {Structure of right colic flexure}, colits {Colitis}, infectious {Infectious disease}, inflammatory {Inflammatory disorder}, ischemic {Ischemia}, diverticulitis {Diverticulitis}, colonoscopy {Colonoscopy}, Sigmoid colon diverticulosis {Diverticulosis of sigmoid colon}, sigmoid colon {Sigmoid colon structure}, diverticulitis {Diverticulitis}, colitis {Colitis}, bilateral pleural 
+effusions {Bilateral pleural effusion}, atelectasis {Atelectasis}, pericardial effusion {Pericardial effusion}, Right lower quadrant {Structure of right lower quadrant of abdomen}, transplant kidney {Structure of transplanted kidney}, dilatation 
+of the renal  pelvis {Dilatation of renal pelvis}, arteries {Arterial structure}, renal 
+artery {Structure of renal artery}, renal ultrasound {Echography of kidney}"
+"###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:
+___ w/LURT (___) with CKD stage IV of renal allograft, RAS 
+s/p stenting, CAD s/p DES x4 (___) on aspirin/Plavix, 
+HFpEF, atrial fibrillation s/p DVVC (___) on Eliquis, HTN, 
+HLD, T2DM, aorto-iliac occlusive disease, bilateral carotid 
+disease c/b recent CVA, OSA, and prostate cancer, with recent
+hospitalization for CHF exacerbation and pericarditis, who 
+presents with abdominal pain with CT A/P concerning for 
+diverticulitis. 
+
+#Diverticulitis.
+#Abdominal pain. 
+Patient presented with new onset abdominal pain.  CT A/P 
+obtained in ED consistent with diverticulitis. The patient was 
+started on Unasyn while inpatient and had good response. He was 
+able to tolerate PO and was having normal non bloody BM at the 
+time of discharge. At time of discharge, abdominal pain had 
+resolved.
+He was discharged with Augmentin per renal dosing 500mg BID to 
+compete a 10 day course (___) In addition, given his history 
+of recurrent C diff, he was started on oral vancomycin for C 
+diff prophylaxis. He will continue oral vancomycin for a total 
+of 15 day course (___). The patient should have a colonoscopy 
+to evaluate for bowel pathology in the setting of 
+diverticulitis. 
+
+CHRONIC AND STABLE ISSUES
+=========================
+#ESRD s/p renal transplant
+#Immunosuppression. ESRD s/p living unrelated transplantation in
+___ c/b transplant glomerulopathy (biopsy proven in ___, 
+now
+with CKD IV. Per Renal Transplant notes, he has a had a gradual
+increase in SCr over the past year. Cr is currently at baseline
+2.3-2.6.
+- continue mycophenolate mofetil 250 mg PO BID
+- continue tacrolimus 1.5 mg PO Q12H, goal ___
+
+#Pericarditis
+#Pericardial effusion. Etiology of the effusion was thought to 
+be
+viral pericarditis likely due to recent upper respiratory
+infection given elevated CRP. A second TTE showed small to
+moderate (small ammount apically and more moderate at base)
+pericardial effusion with no overt evidence of tamponade. It was
+felt that the effusion was predominantly posterior and unlikely
+to be amenable to 
+pericardiocentesis, which was deferred.
+- continue ASA 325 TID (last ___ for 2 week course
+- continue colchicine 3 months (last ___
+
+#HFpEF, Stage C, NYHA class II. Recent hospitalization for HFpEF
+exacerbation due to withholding diuretic and possible bacterial
+pneumonia. Currently euvolemic on exam
+- continue torsemide 
+- continue coreg
+- continue amlodipine, hydralazine 
+
+#CAD
+#Troponinemia
+- continue high dose ASA as above, then will return to ASA 81 mg
+on ___
+- continue pravastatin 
+
+#HTN
+- continue hydralazine, amlodipine
+- continue coreg
+
+#Atrial Fibrillation: s/p DCCV
+- continue home carvedilol 
+- continue home apixaban 
+
+#T2DM
+- continue home glargine 24U QAM
+- continue ISS
+
+#Dyslipidemia
+#Claudication/aortoiliac occlusive disease.
+#Bilateral carotid artery disease (80-99% ___, 60-69% LICA)
+#Multiple CVA/embolic strokes. Strokes attributed to
+subtherapeutic 
+INR, switched to NOAC during inpatient admission ___. 
+- continue ASA, apixaban as above
+- continue Pravastatin as above
+
+#Gout
+- continue allopurinol 
+
+#BPH
+- continue tamsulosin
+
+#GERD
+- continue pantoprazole especially as he is on high dose ASA
+
+Transitional issues:
+
+Transitional Issues:
+====================
+Recommend follow-up colonoscopy after acute symptoms subside.
+
+ 
+
+###RESPONSE: LURT {Transplant of kidney}, CKD stage IV {Chronic kidney disease stage 4}, renal allograft {Live donor renal transplant}, RAS {Renal artery stenosis}, stenting {Insertion of arterial stent}, CAD {Coronary arteriosclerosis}, DES {Endovascular insertion of drug eluting stent}, HFpEF {Heart failure with normal ejection fraction}, atrial fibrillation {Atrial fibrillation}, DVVC {Direct current cardioversion}, HTN {Hypertensive disorder, systemic arterial}, HLD {Hyperlipidemia}, T2DM {Diabetes mellitus type 2}, aorto-iliac occlusive disease {Occlusion of aortoiliac artery}, carotid 
+disease {Disorder of carotid artery}, CVA {Cerebrovascular accident}, OSA {Obstructive sleep apnea syndrome}, prostate cancer {Carcinoma of prostate}, CHF exacerbation {Exacerbation of congestive heart failure}, pericarditis {Pericarditis}, abdominal pain {Abdominal pain}, CT A/P {Computed tomography of abdomen and pelvis}, diverticulitis {Diverticulitis}, Diverticulitis {Diverticulitis}, Abdominal pain {Abdominal pain}, abdominal pain {Abdominal pain}, CT A/P {Computed tomography of abdomen and pelvis}, diverticulitis {Diverticulitis}, bloody BM {Hematochezia}, abdominal pain {Abdominal pain}, oral {Administration of drug or medicament via oral route}, prophylaxis {Preventive procedure}, oral {Administration of drug or medicament via oral route}, colonoscopy {Colonoscopy}, bowel {Intestinal structure}, diverticulitis {Diverticulitis}, ESRD {End-stage renal disease}, renal transplant {Transplant of kidney}, ESRD {End-stage renal disease}, transplantation {Transplantation}, transplant glomerulopathy {Transplant glomerulopathy}, biopsy {Biopsy}, CKD IV {Chronic kidney disease stage 4}, baseline {Baseline state}, Pericarditis {Pericarditis}, Pericardial effusion {Pericardial effusion}, effusion {Pericardial effusion}, viral pericarditis {Viral pericarditis}, upper respiratory
+infection {Upper respiratory infection}, elevated CRP {C-reactive protein above reference range}, TTE {Transthoracic echocardiography}, pericardial effusion {Pericardial effusion}, tamponade {Cardiac tamponade}, effusion {Pericardial effusion}, pericardiocentesis {Pericardiocentesis}, HFpEF {Heart failure with normal ejection fraction}, HFpEF {Heart failure with normal ejection fraction}, diuretic {Diuretic therapy}, bacterial
+pneumonia {Bacterial pneumonia}, euvolemic {Normal blood volume}, CAD {Coronary arteriosclerosis}, HTN {Hypertensive disorder, systemic arterial}, Atrial Fibrillation {Atrial fibrillation}, DCCV {Direct current cardioversion}, T2DM {Diabetes mellitus type 2}, ISS {Sliding scale insulin regime}, Dyslipidemia {Dyslipidemia}, Claudication {Intermittent claudication}, aortoiliac occlusive disease {Aortoiliac atherosclerosis}, carotid artery disease {Disorder of carotid artery}, CVA {Cerebrovascular accident}, embolic strokes {Embolic stroke}, Strokes {Cerebrovascular accident}, Gout {Inflammatory disorder due to increased blood urate level}, BPH {Benign prostatic hyperplasia}, GERD {Gastroesophageal reflux disease}, 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: Medications on Admission:
+The Preadmission Medication list is accurate and complete.
+1. Acidophilus Probiotic (acidophilus-pectin, citrus) 100 
+million cell-10 mg oral DAILY 
+2. DICYCLOMine 10 mg PO DAILY:PRN abdominal pain 
+3. melatonin 10 mg oral QHS 
+4. Nitroglycerin SL 0.3 mg SL Q5MIN:PRN chest pain 
+5. Allopurinol ___ mg PO DAILY 
+6. amLODIPine 10 mg PO DAILY 
+7. Apixaban 2.5 mg PO BID 
+8. Aspirin 325 mg PO TID 
+9. Calcitriol 0.25 mcg PO DAILY 
+10. Carvedilol 25 mg PO BID 
+11. Multivitamins 1 TAB PO DAILY 
+12. Mycophenolate Mofetil 250 mg PO BID 
+13. Pantoprazole 40 mg PO Q24H 
+14. Pravastatin 40 mg PO QPM 
+15. Tacrolimus 1.5 mg PO Q12H 
+16. Torsemide 80 mg PO BID 
+17. Tamsulosin 0.4 mg PO QHS 
+18. Colchicine 0.3 mg PO DAILY Pericarditis  
+19. HydrALAZINE 25 mg PO TID 
+20. Calcium Carbonate 500 mg PO QID:PRN gas 
+21. Glargine 24 Units Breakfast
+
+ 
+Discharge Medications:
+1.  Amoxicillin-Clavulanic Acid ___ mg PO Q12H 
+RX *amoxicillin-pot clavulanate 500 mg-125 mg 1 tablet(s) by 
+mouth every twelve (12) hours Disp #*16 Tablet Refills:*0 
+2.  Vancomycin Oral Liquid ___ mg PO/NG BID 
+RX *vancomycin [Firvanq] 25 mg/mL 5 ml by mouth twice a day Disp 
+#*3900 Milliliter Milliliter Refills:*0 
+3.  Glargine 24 Units Breakfast 
+4.  Acidophilus Probiotic (acidophilus-pectin, citrus) 100 
+million cell-10 mg oral DAILY  
+5.  Allopurinol ___ mg PO DAILY  
+6.  amLODIPine 10 mg PO DAILY  
+7.  Apixaban 2.5 mg PO BID  
+8.  Aspirin 325 mg PO TID  
+9.  Calcitriol 0.25 mcg PO DAILY  
+10.  Calcium Carbonate 500 mg PO QID:PRN gas  
+11.  Carvedilol 25 mg PO BID  
+12.  Colchicine 0.3 mg PO DAILY Pericarditis   
+13.  DICYCLOMine 10 mg PO DAILY:PRN abdominal pain  
+14.  HydrALAZINE 25 mg PO TID  
+15.  melatonin 10 mg oral QHS  
+16.  Multivitamins 1 TAB PO DAILY  
+17.  Mycophenolate Mofetil 250 mg PO BID  
+18.  Nitroglycerin SL 0.3 mg SL Q5MIN:PRN chest pain  
+19.  Pantoprazole 40 mg PO Q24H  
+20.  Pravastatin 40 mg PO QPM  
+21.  Tacrolimus 1.5 mg PO Q12H  
+22.  Tamsulosin 0.4 mg PO QHS  
+23.  Torsemide 80 mg PO BID  
+
+ 
+
+###RESPONSE: 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:
+Diverticulitis
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Diverticulitis {Diverticulitis}, Mental Status {Neurological mental status determination}, 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:
+Dear Mr ___,  
+It was a pleasure caring for you at ___ 
+___.
+
+WHY WAS I IN THE HOSPITAL?  
+- You had abdominal pain from diverticulitis 
+
+WHAT HAPPENED TO ME IN THE HOSPITAL?  
+- We gave you antibiotics and you got better
+- We transitioned you to oral antibiotics
+
+WHAT SHOULD I DO AFTER I LEAVE THE HOSPITAL?
+- Please take all of the antibiotics as described below:
+- Augmentin 500mg BID until (___)
+- Vancomycin 125mg BID until (___)
+
+We wish you the ___!
+
+Sincerely,  
+Your ___ Team  
+
+ 
+
+###RESPONSE: abdominal pain {Abdominal pain}, diverticulitis {Diverticulitis}, antibiotics {Antibiotic therapy}, oral antibiotics {Oral 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: 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: 
+Penicillins / aspirin / seafood / Percocet / cats
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Syncope
+ 
+Major Surgical or Invasive Procedure:
+tPA via EKOS catheter x 2 (___)
+
+ 
+
+###RESPONSE: Penicillins {Allergy to penicillin}, aspirin {Allergy to aspirin}, seafood {Allergy to seafood}, cats {Allergy to Felis catus protein}, Syncope {Syncope}, tPA {Intravenous injection of tissue plasminogen activator}, catheter {Insertion of central venous catheter}"
+"###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 ___ year-old patient with a history of 
+retroperitoneal lipoma and abnormal uterine bleeding who is 
+transferred from an OSH due to massive pulmonary embolism. 
+
+Of note, Ms. ___ has been having prolonged and profuse uterine 
+bleeding for which she was started on norethindrone by her 
+gynecologist. One day prior to admission she developed left leg 
+swelling and pain which she did not make of too much. The day of 
+admission she developed sudden-onset dyspnea, palpitations and 
+she later lost consciousness only to regain it when EMS arrived. 
+
+
+She was taken to ___ where she had a CTA 
+Chest showing bilateral PEs and was started on a heparin gtt. In 
+the ED she underwent a second syncopal event after going to the 
+bathroom. On the day of transfer an echocardiogram was done 
+showing severe RV dilation and hypokinesis sparing the apex 
+leading to transfer to ___ for higher level of care. 
+
+On arrival to the MICU,  she had no additional complaints.
+
+ 
+
+###RESPONSE: retroperitoneal {Retroperitoneal compartment structure}, lipoma {Lipoma morphology}, abnormal uterine bleeding {Abnormal uterine bleeding}, pulmonary embolism {Pulmonary embolism}, uterine 
+bleeding {Abnormal uterine bleeding}, left leg 
+swelling {Localized swelling of left lower limb}, pain {Pain in left lower limb}, dyspnea {Dyspnea}, palpitations {Palpitations}, lost consciousness {Loss of consciousness}, CTA 
+Chest {Computed tomography angiography of chest with contrast}, PEs {Pulmonary embolism}, heparin {Heparin therapy}, syncopal {Syncope}, echocardiogram {Echocardiography}, RV dilation {Dilatation of right cardiac ventricle}, hypokinesis {Hyperkinetic right ventricular wall}, apex {Structure of apex of heart}, MICU {Patient transfer to intensive care unit}"
+"###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:
+Seasonal allergies                                              
+Retroperitoneal fatty mass                                      
+H/o anemia 
+C-section                                                       
+Umbilical hernia s/p repair 
+ 
+
+###RESPONSE: Seasonal allergies {Seasonal allergy}, Retroperitoneal fatty mass {Mass of retroperitoneal structure}, anemia {Anemia}, C-section {Cesarean section}, Umbilical hernia {Umbilical hernia}, repair {Repair of umbilical hernia}"
+"###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: ___   
+Father: ___ cancer   
+MGM: Hypertension 
+ 
+
+###RESPONSE: cancer {Malignant neoplasm}, Hypertension {Hypertensive disorder, systemic arterial}"
+"###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
+=======================
+Vitals: Please see Metavision
+GENERAL: Alert, oriented, no acute distress  
+HEENT: Sclera anicteric, MMM, oropharynx clear  
+NECK: supple, JVP 2cm above clavicle at 45 degrees, no LAD  
+LUNGS: Clear to auscultation bilaterally, no wheezes, rales, 
+rhonchi  
+CV: Regular rate and rhythm, loud S2, no murmurs, rubs, gallops  
+
+ABD: soft, non-tender, non-distended, bowel sounds present, no 
+rebound tenderness or guarding, no organomegaly  
+EXT: Warm, well perfused. L>R diameter of calves. Non-tender 
+calves.
+NEURO: AOx3, grossly non-focal
+
+Discharge Physical Exam
+=======================
+Vitals: T 98.6, BP 115/65, HR 81, RR 18, SpO2 100/RA
+General: Alert, oriented, no acute distress, lying comfortably. 
+Tearful talking about her kids and wanting to get home to them.
+HEENT: Sclera anicteric, MMM, oropharynx clear. Bandage over R 
+lower neck is clean and dry.
+Lungs: Faint bibasilar crackles  
+CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, 
+gallops  
+Abdomen: soft, non-tender, non-distended, bowel sounds present, 
+no rebound tenderness or guarding, no organomegaly  
+Ext: Warm, well perfused, 2+ pulses, trace edema in L leg up 
+into shin. No edema on R side. No erythema or increased warmth.  
+
+Skin: Without rashes or lesions - R neck bandaged from IJ line 
+as above 
+Neuro: moving all extremities  
+ 
+
+###RESPONSE: Physical Exam {Physical examination procedure}, Vitals {Vital signs finding}, GENERAL {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, no acute {No abnormality detected}, distress {Distress}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, MMM {Moist oral mucosa}, oropharynx clear {Pharynx normal}, NECK {Physical examination procedure}, supple {Normal movement of neck}, JVP {Finding of jugular venous pressure}, clavicle {Bone structure of clavicle}, LAD {Lymphadenopathy}, LUNGS {Examination of respiratory system}, Clear to auscultation bilaterally {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, rhonchi {Wheeze - rhonchi}, CV {Cardiovascular physical examination}, Regular rate and rhythm {Normal heart rate}, loud {Heart sounds exaggerated}, S2 {Normal second heart sound, S>2<}, murmurs {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, ABD {Examination of abdomen}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, bowel sounds present {Normal bowel sounds}, rebound {Rebound tenderness}, tenderness {Tenderness}, guarding {Abdominal guarding}, organomegaly {Abdominal organomegaly}, EXT {Examination of limb}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, calves {Structure of calf of leg}, tender {Abdominal tenderness}, calves {Structure of calf of leg}, NEURO {Neurological examination}, AOx3 {Oriented to person, time and place}, grossly non-focal {No abnormality detected}, Physical Exam {Physical examination procedure}, Vitals {Vital signs finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, SpO2 {Finding of oxygen saturation}, RA {Breathing room air}, General {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, no acute {No abnormality detected}, distress {Distress}, lying {Lying in bed}, Tearful {Crying associated with mood}, talking {Does speak}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, MMM {Moist oral mucosa}, oropharynx clear {Pharynx normal}, Bandage {Application of bandage}, neck {Structure of right half of neck}, Lungs {Examination of respiratory system}, bibasilar {Structure of base of lung}, crackles {Respiratory crackles}, 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<}, murmurs {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, Abdomen {Examination of abdomen}, soft {Abdomen soft}, non-tender {Abdominal tenderness}, non-distended {Normal abdominal contour}, bowel sounds present {Normal bowel sounds}, rebound {Rebound tenderness}, tenderness {Tenderness}, guarding {Abdominal guarding}, organomegaly {Abdominal organomegaly}, Ext {Examination of limb}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, 2+ pulses {Peripheral pulses normal}, edema {Edema}, L leg {Structure of left lower limb}, shin {Shin structure}, edema {Edema}, R side {Structure of right lower leg}, erythema {Erythema}, warm {Warm skin}, Skin {Examination of skin}, rashes {Eruption of skin}, lesions {Lesion}, R neck {Structure of right half of neck}, bandaged {Application of bandage}, IJ line {Catheterization of internal jugular vein}, Neuro {Neurological examination}, all extremities {All extremities}"
+"###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
+==============
+___ 02:37PM BLOOD WBC-8.2# RBC-3.94 Hgb-9.3* Hct-31.1* 
+MCV-79*# MCH-23.6*# MCHC-29.9* RDW-17.8* RDWSD-50.8* Plt ___
+___ 02:37PM BLOOD Neuts-62.9 ___ Monos-10.3 
+Eos-0.2* Baso-0.4 Im ___ AbsNeut-5.13 AbsLymp-2.12 
+AbsMono-0.84* AbsEos-0.02* AbsBaso-0.03
+___ 05:34PM BLOOD ___ PTT-49.9* ___
+___ 02:37PM BLOOD Glucose-82 UreaN-8 Creat-0.6 Na-140 K-3.4 
+Cl-114* HCO3-16* AnGap-13
+___ 02:37PM BLOOD ALT-9 AST-18 LD(LDH)-285* AlkPhos-61 
+TotBili-0.6
+___ 02:37PM BLOOD cTropnT-0.03* proBNP-1552*
+___ 02:37PM BLOOD Albumin-3.0* Calcium-6.8* Phos-2.2* 
+Mg-1.7
+___ 02:49PM BLOOD Lactate-1.6
+
+Discharge labs
+==============
+___ 08:55AM BLOOD WBC-6.2 RBC-3.81* Hgb-9.1* Hct-29.2* 
+MCV-77* MCH-23.9* MCHC-31.2* RDW-19.8* RDWSD-51.6* Plt ___
+___ 08:55AM BLOOD Plt ___
+___ 11:25AM BLOOD PTT-60.5*
+___ 08:55AM BLOOD ___ PTT-66.9* ___
+___ 08:55AM BLOOD Glucose-83 UreaN-8 Creat-0.7 Na-141 K-3.7 
+Cl-106 HCO3-24 AnGap-15
+___ 08:55AM BLOOD Calcium-8.6 Phos-4.0 Mg-2.1
+
+Imaging
+___ Pelvic US  
+1. Fibroid uterus, distorting the endometrium. 
+2. Blood in the endocervical canal. 
+3. Normal ovaries.  No free fluid. 
+
+___ EKOS placement
+RECOMMENDATION(S):  1. Infusion of 1.0 mg tPA through each the 
+EKOS 
+catheter. 
+2. Monitor fibrinogen and H&H at least Q6 
+3. Reassessment of patient in  12  hours status post catheter 
+directed 
+chemical thrombectomy with EKOS 
+
+___ TTE
+The left atrium is normal in size. Left ventricular wall 
+thickness, cavity size, and global systolic function are normal 
+(LVEF>55%). The right ventricular cavity is mildly dilated with 
+mild global free wall hypokinesis. The aortic valve leaflets (3) 
+appear structurally normal with good leaflet excursion and no 
+aortic stenosis. The mitral valve leaflets are structurally 
+normal. There is borderline pulmonary artery systolic 
+hypertension. There is no pericardial effusion. 
+IMPRESSION: Suboptimal image quality. Mild right ventricular 
+cavity dilation with free wall hypokinesis. Borderline pulmonary 
+artery systolic hypertension. Normal left ventricular cavity 
+size and global systolic function.  
+
+___ Pulmonary arteriogram
+Significant decrease in pulmonary embolic volume with 
+significant improvement 
+of peripheral pulmonary arterial flow 
+RECOMMENDATION(S):  Continue anticoagulation. 
+ 
+
+###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}, Monos {Monocyte count}, Baso {Basophil count}, PTT {Partial thromboplastin time, activated}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, LDH {Lactate dehydrogenase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, cTropnT {Troponin T cardiac measurement}, proBNP {N-terminal pro-brain natriuretic peptide measurement}, Albumin {Albumin measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Lactate {Lactic acid 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}, PTT {Partial thromboplastin time, activated}, PTT {Partial thromboplastin time, activated}, Glucose {Glucose measurement, blood}, UreaN {Blood urea nitrogen measurement}, Creat {Creatinine measurement}, Na {Blood sodium measurement}, K {Blood potassium measurement}, HCO3 {Blood bicarbonate measurement}, AnGap {Anion gap measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Imaging {Imaging}, Pelvic US {Pelvic echography}, Fibroid uterus {Uterine leiomyoma}, endometrium {Endometrial structure}, endocervical canal {Structure of cervical canal of uterus}, Normal ovaries {Normal ovary}, free fluid {Effusion}, placement {Insertion of central venous catheter}, Infusion {Infusion}, tPA {Intravenous injection of tissue plasminogen activator}, catheter {Insertion of central venous catheter}, fibrinogen {Fibrinogen measurement}, H&H {Measurement of total hemoglobin concentration and hematocrit}, status post {Postoperative state}, catheter {Insertion of central venous catheter}, thrombectomy {Removal of thrombus}, TTE {Transthoracic echocardiography}, left atrium {Left atrial structure}, normal in size {Normal size}, Left ventricular wall {Left cardiac ventricular structure}, thickness {Normal thickness}, cavity {Structure of cavity of left cardiac ventricle}, systolic function are normal {Normal left ventricular systolic function and wall motion}, right ventricular cavity {Structure of cavity of right cardiac ventricle}, free wall hypokinesis {Hypokinesis of cardiac wall}, aortic valve leaflets {Structure of cardiac valve leaflet}, structurally normal {Aortic valve normal}, good {No abnormality detected}, leaflet {Structure of cardiac valve leaflet}, aortic stenosis {Aortic valve stenosis}, mitral valve leaflets {Structure of leaflet of mitral valve}, structurally 
+normal {Mitral valve normal}, pulmonary artery systolic 
+hypertension {Pulmonary hypertensive arterial disease}, pericardial effusion {Pericardial effusion}, right ventricular 
+cavity {Structure of cavity of right cardiac ventricle}, free wall hypokinesis {Hypokinesis of cardiac wall}, pulmonary 
+artery systolic hypertension {Pulmonary hypertensive arterial disease}, left ventricular cavity {Structure of cavity of left cardiac ventricle}, systolic function {Normal left ventricular systolic function and wall motion}, Pulmonary arteriogram {Angiography of pulmonary arteries}, decrease {Decreased size}, pulmonary embolic {Pulmonary embolism}, improvement {Patient's condition improved}, l pulmonary arterial flow {Structure of artery of pulmonary circulation}, anticoagulation {Anticoagulant 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: Brief Hospital Course:
+Ms. ___ is a ___ year-old patient with a history of 
+retroperitoneal lipoma and abnormal uterine bleeding who is 
+transferred from an OSH due to massive pulmonary embolism. 
+
+#Massive Pulmonary Embolism: Pt was transferred from outside 
+hospital, where a CTA chest showed pulmonary embolism. Given 
+syncope x2 prior to admission, echocardiographic signs of RV 
+failure, elevated proBNP (1552) and troponin T (0.03), this PE 
+is classified as massive. Initially, patient was hemodynamically 
+stable at rest with labile hemodynamics on minimal exertion. Pt 
+received tPA via EKOS catheter x 2 on ___ for directed lysis 
+of clot. Pt is now hemodynamically stable. Pt on heparin gtt 
+during admission; warfarin initiated on ___ (received 5mg). 
+NOACs were considered, but due to insurance issues and patient 
+preference, warfarin was chosen. INR on discharge of 1.1; pt 
+will go home with lovenox for bridging until therapeutic on 
+warfarin.
+
+#Abnormal uterine bleeding: Has been ongoing for year but 
+slightly worse recently, for which she was started on 
+norethindrone. Pelvic ultrasound showed fibroid uterus with 
+blood in endocervical canal, normal ovaries, no free air. Gyn 
+saw patient, recommended hysterectomy. Pt not interested in 
+hysterectomy at this time, will f/u with gyn as an outpatient. 
+Bleeding is minimal at this time, and remained stable on heparin 
+gtt and with tPA.
+
+#Anemia: stable throughout admission. H/H of 9.1 and 29.2 on 
+discharge.
+
+TRANSITIONAL ISSUES:
+#ABNORMAL UTERINE BLEEDING: will follow-up at ___ resident 
+___ for gynecology 
+#HYPERCOAGULABILITY: should get hypercoagulability work-up as 
+outpatient. Mother also has history of PE.
+#ANTICOAGULATION: initiated on warfarin on ___ will be on 
+lovenox at home to bridge onto warfarin therapy. Will need close 
+follow-up of coagulation studies. INR should be checked on 
+___. Dr ___ manage her 
+Coumadin.bility work up as outpatient
+ 
+
+###RESPONSE: retroperitoneal {Retroperitoneal compartment structure}, lipoma {Lipoma}, abnormal uterine bleeding {Abnormal uterine bleeding}, pulmonary embolism {Pulmonary embolism}, Pulmonary Embolism {Pulmonary embolism}, CTA chest {Computed tomography angiography of chest with contrast}, pulmonary embolism {Pulmonary embolism}, syncope {Syncope}, echocardiographic {Echocardiography}, signs {Sign}, RV {Right cardiac ventricular structure}, elevated {Complement level above reference range}, troponin T {Troponin T measurement}, PE {Pulmonary embolism}, hemodynamically 
+stable {Hemodynamically stable}, hemodynamics {Hemodynamic monitoring}, tPA {Intravenous injection of tissue plasminogen activator}, catheter {Insertion of central venous catheter}, lysis {Lysis}, clot {Blood clot}, hemodynamically stable {Hemodynamically stable}, heparin {Heparin therapy}, INR {Calculation of international normalized ratio}, on 
+warfarin {Warfarin therapy}, Abnormal uterine bleeding {Abnormal uterine bleeding}, worse {Patient's condition worsened}, Pelvic ultrasound {Pelvic echography}, fibroid uterus with 
+blood {Abnormal uterine bleeding due to uterine fibroid}, endocervical canal {Structure of cervical canal of uterus}, normal ovaries {Normal ovary}, free air {Pneumoperitoneum}, hysterectomy {Hysterectomy}, not interested {Lack of interest}, hysterectomy {Hysterectomy}, Bleeding {Abnormal uterine bleeding}, minimal {Symptom mild}, stable {Patient's condition stable}, heparin {Heparin therapy}, tPA {Intravenous injection of tissue plasminogen activator}, Anemia {Anemia}, stable {Patient's condition stable}, ABNORMAL UTERINE BLEEDING {Abnormal uterine bleeding}, follow-up {Follow-up arranged}, HYPERCOAGULABILITY {Hypercoagulability state}, hypercoagulability {Hypercoagulability state}, work-up {Evaluation procedure}, ANTICOAGULATION {Anticoagulant therapy}, on warfarin {Warfarin therapy}, warfarin therapy {Warfarin therapy}, follow-up {Follow-up consultation}, coagulation {Coagulation}, studies {Monitoring procedure}, INR {Calculation of international normalized ratio}, checked {Monitoring procedure}, Coumadin {Anticoagulant therapy}, work up {Evaluation 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:
+The Preadmission Medication list is accurate and complete.
+1. norethindrone acetate 5 mg oral BID 
+
+ 
+Discharge Medications:
+1.  Enoxaparin Sodium 80 mg SC BID 
+Start: ___, First Dose: Next Routine Administration Time 
+RX *enoxaparin 80 mg/0.8 mL 80 mg SQ twice a day Disp #*60 
+Syringe Refills:*0 
+2.  Warfarin 5 mg PO DAILY16 
+RX *warfarin [Coumadin] 2.5 mg Two tablet(s) by mouth Once a day 
+Disp #*30 Tablet Refills:*0 
+3.  norethindrone acetate 5 mg oral BID  
+
+ 
+
+###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:
+ - Massive pulmonary embolism
+ - Abnormal uterine bleeding
+
+SECONDARY DIAGNOSES:
+ - Anemia
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: pulmonary embolism {Pulmonary embolism}, Abnormal uterine bleeding {Abnormal uterine bleeding}, Anemia {Anemia}, 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:
+Dear Ms ___,
+
+You were admitted to ___ from 
+___ to ___ for a massive pulmonary embolism (blood clot 
+in your lungs).
+
+WHAT HAPPENED WHILE YOU WERE IN THE HOSPITAL?
+=============================================
+ - You had an ultrasound of your heart, which showed that your 
+heart was being affected by the pulmonary embolism.
+ - You were seen by our gynecologists, who thought your uterine 
+bleeding was stable and that you were okay to receive blood 
+thinners for your blood clot.
+ - You had a pelvic ultrasound, which showed fibroids in your 
+uterus, which is likely the cause of your bleeding.
+ - You had catheters put into your neck that reached the spot in 
+your lungs where the blood clot was. A medicine called tPA was 
+put into the catheters that helped to break up the clot.
+ - You were on an IV drip of heparin (blood thinner).
+ - You were started on warfarin (Coumadin), which is a blood 
+thinner pill that you will continue to take once you leave the 
+hospital.
+
+WHAT WILL HAPPEN WHEN YOU LEAVE THE HOSPITAL?
+=============================================
+ - You will continue to take warfarin as prescribed. It is very 
+important that you take this every day to prevent your blood 
+clot from getting worse.
+ - You will have to inject yourself with enoxaparin (Lovenox) at 
+home until you determine with your primary care doctor that your 
+warfarin dose is appropriate. It is VERY important that you take 
+this every day to prevent your blood clot from getting worse, 
+until your primary care doctor tells you it is okay to stop.
+ - You should got to Dr. ___ office on ___ to get your 
+INR level drawn. 
+ - You will see Dr ___ care doctor) for routine 
+follow-up once you leave the hospital.
+ - You will see one of our cardiologists (who helped to take 
+care of your blood clot in the hospital) in the office for 
+follow-up of your blood clot.
+ - You will see a gynecologist in our clinic here for follow-up 
+of your bleeding and fibroids.
+
+If you have any further questions regarding your care here, 
+please do not hesitate to contact us. We wish you the ___ with 
+your health going forward.
+
+Your ___ Care Team
+ 
+
+###RESPONSE: pulmonary embolism {Pulmonary embolism}, blood clot {Blood clot}, lungs {Lung structure}, ultrasound of your heart {Echocardiography}, heart {Heart structure}, pulmonary embolism {Pulmonary embolism}, uterine 
+bleeding {Abnormal uterine bleeding}, stable {Patient's condition stable}, receive blood 
+thinners {Anticoagulant therapy}, blood clot {Blood clot}, pelvic ultrasound {Pelvic echography}, fibroids {Uterine leiomyoma}, uterus {Uterine structure}, bleeding {Abnormal uterine bleeding}, catheters {Insertion of central venous catheter}, neck {Neck structure}, lungs {Lung structure}, blood clot {Blood clot}, tPA {Intravenous injection of tissue plasminogen activator}, catheters {Insertion of central venous catheter}, clot {Blood clot}, IV {Intravenous therapy}, heparin {Heparin therapy}, blood thinner {Anticoagulant therapy}, on warfarin {Warfarin therapy}, Coumadin {Anticoagulant therapy}, blood 
+thinner {Anticoagulant therapy}, warfarin {Warfarin therapy}, blood 
+clot {Blood clot}, primary care {Primary care management}, blood clot {Blood clot}, primary care {Primary care management}, INR {Calculation of international normalized ratio}, follow-up {Follow-up consultation}, blood clot {Blood clot}, follow-up {Follow-up consultation}, blood clot {Blood clot}, clinic {Outpatient care management}, follow-up {Follow-up consultation}, bleeding {Abnormal uterine bleeding}, fibroids {Uterine leiomyoma}"
+"###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: OBSTETRICS/GYNECOLOGY
+ 
+
+###RESPONSE: OBSTETRICS {Obstetric procedure}, GYNECOLOGY {Operation on female genital organs}"
+"###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
+ 
+Attending: ___.
+ 
+Chief Complaint:
+endometrial cancer
+ 
+Major Surgical or Invasive Procedure:
+total laparoscopic hysterectomy, bilateral 
+salpingo-oophorectomy, pelvic lymph node dissection, cystoscopy
+
+ 
+
+###RESPONSE: endometrial cancer {Endometrial carcinoma}, laparoscopic hysterectomy {Laparoscopic hysterectomy}, bilateral 
+salpingo-oophorectomy {Excision of bilateral fallopian tubes and ovaries}, pelvic lymph node dissection {Pelvic lymphadenectomy}, cystoscopy {Transurethral cystoscopy}"
+"###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 a past medical
+history notable for chronic kidney disease, hypertension, and a
+history of PE and DVT in ___ who reports the onset of vaginal
+bleeding on ___.  She presented to the emergency room and
+underwent a CT of the abdomen and pelvis.  This showed
+diverticular disease without inflammation as well as uterine
+fibroids but no lymphadenopathy.   She was referred to Dr. 
+___ attempted an endometrial biopsy which was nondiagnostic.  
+She
+also had what appeared to be a cervical biopsy and ECC on
+___ which were both negative.  She then proceeded to the
+operating room on ___ for a hysteroscopy with ___ curettage.  Findings were notable for a lush endometrium
+with a polypoid lesion with abnormal vessels on the right 
+uterine
+sidewall and a larger lesion on the posterior uterine wall with
+abnormal vessels, both which were biopsied and removed.  Final
+pathology from this procedure showed an endometrial
+adenocarcinoma, endometrioid type, FIGO grade 1.  The specimen
+has been received here at ___ but has not yet been
+interpreted for second opinion.  The patient was referred to GYN
+oncology for further evaluation and treatment recommendations. 
+She presents today for consultation along with her 2 daughters.
+
+Since then she continues to have light vaginal bleeding.  She
+otherwise feels
+well and denies any pain or discomfort. She denies any
+early satiety, unintentional weight changes, nausea/vomiting,
+SOB/CP, increased abdominal girth, abdominal or pelvic pain,
+vaginal discharge, or change in her bowel or bladder habits.
+
+10 system Review of Systems negative except as noted above.
+ 
+
+###RESPONSE: chronic kidney disease {Chronic kidney disease}, hypertension {Hypertensive disorder, systemic arterial}, PE {Pulmonary embolism}, DVT {Deep venous thrombosis}, vaginal
+bleeding {Bleeding from vagina}, CT {Computed tomography}, abdomen {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, pelvis {Structure of pelvis}, diverticular disease {Diverticular disease}, inflammation {Inflammatory disorder}, uterine
+fibroids {Uterine leiomyoma}, lymphadenopathy {Lymphadenopathy}, endometrial biopsy {Endometrial biopsy}, cervical biopsy {Cervical biopsy}, ECC {Endocervical curettage}, hysteroscopy {Hysteroscopy}, curettage {Curettage}, endometrium {Endometrial structure}, lesion {Lesion}, vessels {Blood vessel finding}, right {Right hip region structure}, uterine {Uterine structure}, lesion {Lesion}, posterior uterine wall {Structure of posterior wall of uterus}, vessels {Blood vessel finding}, biopsied {Biopsy}, removed {Removal}, endometrial
+adenocarcinoma, endometrioid type {Endometrioid carcinoma of endometrium}, grade 1 {G1 grade}, GYN {Gynecologic examination}, vaginal bleeding {Bleeding from vagina}, feels
+well {Well in self}, pain {Abdominal pain}, discomfort {Discomfort}, early satiety {Early satiety}, weight changes {Weight change finding}, nausea {Nausea}, vomiting {Vomiting}, SOB {Dyspnea}, CP {Chest pain}, increased abdominal girth {Swollen abdomen}, abdominal {Abdominal pain}, pelvic {Pain in pelvis}, pain {Abdominal pain}, vaginal discharge {Vaginal discharge}, bowel {Intestinal structure}, bladder {Urinary bladder structure}, habits {Habit}, Review of Systems {Review of systems}"
+"###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:
+Health Maintenance:
+-Mammogram: ___ years ago
+-Colonoscopy: Never
+-Bone Mineral Density: Unsure 
+
+
+###RESPONSE: Mammogram {Mammography}, Colonoscopy {Colonoscopy}, Density {Abnormally opaque 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: Past Medical History: obesity, pernicious anemia, asthma,
+hypertension, anxiety disorder, hypothyroidism, personal history
+of a DVT and PE, chronic kidney disease, chronic venous stasis
+and lower extremity edema
+
+Past Surgical History: Open cholecystectomy, ___
+                                 
+Past OB History:  G7 P5
+7 vaginal deliveries without complications
+
+Past GYN History:
+Menopausal.  This is her first episode of postmenopausal
+bleeding.  She has never taken any hormone replacement therapy. 
+She denies any significant gynecologic problems in the past.
+
+ 
+
+###RESPONSE: obesity {Obesity}, pernicious anemia {Pernicious anemia}, asthma {Asthma}, hypertension {Hypertensive disorder, systemic arterial}, anxiety disorder {Anxiety disorder}, hypothyroidism {Hypothyroidism}, DVT {Deep venous thrombosis}, PE {Pulmonary embolism}, chronic kidney disease {Chronic kidney disease}, chronic {Chronic edema}, venous stasis {Venous stasis}, lower extremity edema {Edema of lower extremity}, cholecystectomy {Cholecystectomy}, vaginal deliveries {Vaginal delivery}, Menopausal {Menopause finding}, postmenopausal
+bleeding {Postmenopausal bleeding}, hormone replacement therapy {Hormone replacement therapy}, gynecologic problems {Female genital tract problem}"
+"###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:
+Denies family history of GYN cancer, breast cancer, colon cancer 
+                                            
+
+ 
+
+###RESPONSE: GYN {Female genital organ structure}, cancer {Malignant neoplasm}, breast cancer {Malignant neoplasm of breast}, colon cancer {Malignant neoplasm 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: Physical Exam:
+On day of discharge:
+Afebrile, vitals stable
+No acute distress
+CV: regular rate and rhythm
+Pulm: clear to auscultation bilaterally
+Abd: soft, appropriately tender, nondistended, incision 
+clean/dry/intact, no rebound/guarding
+___: nontender, nonedematous
+
+ 
+
+###RESPONSE: Afebrile {Fever}, vitals {Vital signs finding}, stable {Stable blood pressure}, distress {Distress}, CV {Cardiovascular physical examination}, regular rate and rhythm {Normal heart rate}, Pulm {Examination of respiratory system}, clear to auscultation bilaterally {Normal breath sounds}, Abd {Examination of abdomen}, soft {Abdomen soft}, tender {Abdominal tenderness}, nondistended {Normal abdominal contour}, incision {Abdomen incision}, clean/dry/intact {Wound healing well}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, nontender {Abdominal tenderness}, 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:
+___ 06:25AM BLOOD WBC-7.1 RBC-3.81* Hgb-10.7* Hct-32.5* 
+MCV-85 MCH-28.1 MCHC-32.9 RDW-14.5 RDWSD-44.9 Plt ___
+___ 06:25AM BLOOD Glucose-114* UreaN-13 Creat-0.9 Na-139 
+K-3.7 Cl-102 HCO3-27 AnGap-14
+___ 06:25AM BLOOD Calcium-8.4 Phos-2.9 Mg-2.0
+ 
+
+###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}, Calcium {Blood calcium measurement}, Phos {Phosphate, total 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: Brief Hospital Course:
+Ms. ___ was admitted to the gynecologic oncology service 
+after undergoing total laparoscopic hysterectomy, bilateral 
+slapping-oophorectomy, pelvic lymph node dissection, and 
+cystoscopy for endometrial cancer. Please see the operative 
+report for full details.  
+
+Her post-operative course is detailed as follows. Immediately 
+postoperatively, her pain was controlled with IV morphine and IV 
+toradol. Her diet was advanced without difficulty and she was 
+transitioned to PO ibuprofen, liquid Tylenol, and liquid 
+oxycodone. On post-operative day #1, her urine output was 
+adequate so her Foley catheter was removed and she voided 
+spontaneously. 
+
+She was continued on her home medications for hypothyroidism, 
+hypertension (hydrochlorothiazide restarted on post operative 
+day 1), and asthma.
+
+By post-operative day 1, she was tolerating a regular diet, 
+voiding spontaneously, ambulating independently, and pain was 
+controlled with oral medications. She was then discharged home 
+in stable condition with outpatient follow-up scheduled.  She 
+was also discharged on 28 days of Lovenox for a personal history 
+of deep venous thrombosis and pulmonary embolism.
+ 
+
+###RESPONSE: laparoscopic hysterectomy {Laparoscopic hysterectomy}, bilateral 
+slapping-oophorectomy {Excision of bilateral fallopian tubes and ovaries}, pelvic lymph node dissection {Pelvic lymphadenectomy}, cystoscopy {Transurethral cystoscopy}, endometrial cancer {Endometrial carcinoma}, post-operative course {Postoperative state}, pain {Pain}, IV {Intravenous therapy}, IV {Intravenous therapy}, diet {Dietary finding}, urine {Urine culture}, Foley cathete {Catheterization of urinary bladder}, medications {Administration of drug or medicament}, hypothyroidism {Hypothyroidism}, hypertension {Hypertensive disorder, systemic arterial}, asthma {Asthma}, regular diet {Normal diet}, voiding spontaneously {Normal micturition}, ambulating independently {Independent walking}, pain {Pain}, oral medications {Administration of drug or medicament via oral route}, stable condition {Patient's condition stable}, outpatient follow-up {Outpatient care management}, deep venous thrombosis {Deep venous thrombosis}, pulmonary embolism {Pulmonary embolism}"
+"###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:
+albuterol, brinzolamide-brimonidine (eye drops), clobetasol, 
+fluticasone-salmeterol, hydrochlorothiazide 12.5 daily, 
+latenoprost, levothyroxine 75 mcg daily, ativan, timolol, 
+tramadol, baby aspirin, vitamin D3, vitamin B12
+ 
+Discharge Medications:
+1.  Acetaminophen (Liquid) 650 mg PO Q6H:PRN Pain - Moderate 
+RX *acetaminophen 650 mg/20.3 mL 650 mg by mouth every 6 hours 
+Refills:*1 
+2.  Docusate Sodium 100 mg PO BID:PRN constipation 
+RX *docusate sodium [Colace] 100 mg 1 capsule(s) by mouth twice 
+per day Disp #*60 Capsule Refills:*1 
+3.  Enoxaparin Sodium 40 mg SC Q24H 
+Start: ___, First Dose: Next Routine Administration Time 
+RX *enoxaparin 40 mg/0.4 mL 40 mg IM daily Disp #*28 Syringe 
+Refills:*0 
+4.  Ibuprofen Suspension 400 mg PO Q8H:PRN Pain - Mild 
+RX *ibuprofen 100 mg/5 mL 20 ml by mouth every four (4) hours 
+Refills:*0 
+5.  OxycoDONE Liquid 2.5 mg PO Q4H:PRN Pain - Moderate 
+RX *oxycodone 5 mg/5 mL 2.5 mg by mouth every 4 hours Refills:*0 
+
+6.  Senna 8.6 mg PO BID:PRN constipation 
+RX *sennosides [senna] 8.8 mg/5 mL 5 ml by mouth twice a day 
+Refills:*0 
+7.  Albuterol Inhaler ___ PUFF IH Q6H:PRN wheezing  
+8.  Hydrochlorothiazide 12.5 mg PO DAILY  
+9.  Levothyroxine Sodium 75 mcg PO DAILY  
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+endometrial cancer
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, endometrial cancer {Endometrial carcinoma}, 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. ___,
+.
+You were admitted to the gynecologic oncology service after 
+undergoing the procedures listed below. You have recovered well 
+after your operation, and the team feels that you are safe to be 
+discharged home. Please follow these instructions: 
+. 
+Laparoscopic instructions:  
+* Take your medications as prescribed. We recommend you take 
+non-narcotics (i.e. Tylenol, ibuprofen) regularly for the first 
+few days post-operatively, and use the narcotic as needed. As 
+you start to feel better and need less medication, you should 
+decrease/stop the narcotic first.
+* Do not drive while taking narcotics.  
+* Do not combine narcotic and sedative medications or alcohol.  
+* Do not take more than 4000mg acetaminophen (tylenol) in 24 
+hrs.  
+* No strenuous activity until your post-op appointment.  
+* Nothing in the vagina (no tampons, no douching, no sex) for 8 
+weeks.
+* No heavy lifting of objects >10 lbs for 4 weeks.  
+* You may eat a regular diet.
+* It is safe to walk up stairs.  
+.
+Incision care:  
+* You may shower and allow soapy water to run over incision; no 
+scrubbing of incision. No bath tubs for 6 weeks.  
+* You should remove your port site dressings ___ days after your 
+surgery, if they have not already been removed in the hospital. 
+Leave your steri-strips on.  If they are still on after ___ 
+days from surgery, you may remove them.  
+* If you have staples, they will be removed at your follow-up 
+visit.  
+.
+To reach medical records to get the records from this 
+hospitalization sent to your doctor at home, call ___.  
+
+.
+Call your doctor at ___ for:  
+* fever > 100.4  
+* severe abdominal pain  
+* difficulty urinating  
+* vaginal bleeding requiring >1 pad/hr  
+* abnormal vaginal discharge  
+* redness or drainage from incision  
+* nausea/vomiting where you are unable to keep down fluids/food 
+or your medication  
+* chest pain or difficulty breathing 
+* onset of any concerning symptoms 
+
+ 
+
+###RESPONSE: medications {Administration of drug or medicament}, medication {Administration of drug or medicament}, decrease {Decreased size}, while taking narcotics {Narcotics education}, medications {Administration of drug or medicament}, vagina {Vaginal structure}, lifting {Does lift}, regular diet {Normal diet}, walk {Does walk}, Incision care {Incision care}, incision {Surgical incision wound}, incision {Surgical incision wound}, fever {Fever}, abdominal pain {Abdominal pain}, difficulty urinating {Difficulty passing urine}, vaginal bleeding {Bleeding from vagina}, pad {Pad}, abnormal vaginal discharge {Vaginal discharge problem}, redness {Redness of skin over lesion}, drainage {Discharge}, incision {Incision}, nausea {Nausea}, vomiting {Vomiting}, fluids {Tolerating oral fluid}, medication {Administration of drug or medicament}, chest pain {Chest pain}, difficulty breathing {Difficulty breathing}"
+"###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: 
+Codeine / Iodine / Morphine / Percocet / Percodan
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Left Facial Pain, Skin Infection and Fever
+ 
+Major Surgical or Invasive Procedure:
+none
+ 
+
+###RESPONSE: Codeine {Allergy to codeine}, Iodine {Allergy to iodine compound}, Morphine {Allergy to morphine}, Left Facial {Structure of left half of face}, Pain {Pain in face}, Skin Infection {Infection of skin and/or subcutaneous tissue}, Fever {Fever}"
+"###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 man with a history of squamous cell 
+carcinoma s/p Mohs to the L temporal area on ___. Since the 
+surgery, he has been having headaches, gradually worsening. He 
+has not been able to eat much since ___ due to the pain. It now 
+extends from his forehead down to his mandible on the L. He 
+initially took acetaminophen, which did not change his pain. He 
+then took 400 mg ibuprofen which seemed to help. On ___ he 
+developed fevers and chills. He came to the hospital.
+ 
+
+###RESPONSE: squamous cell 
+carcinoma {Squamous cell carcinoma}, Mohs {Mohs surgery}, L temporal {Left temporal lobe structure}, surgery {Surgical procedure}, headaches {Headache}, worsening {Increased pain}, has not been able to eat {Unable to eat}, pain {Pain}, forehead {Forehead structure}, mandible {Bone structure of mandible}, pain {Pain}, 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: Past Medical History:
+-dyslipidemia  
+-BPH  
+-numerous non-melanoma skin cancers  
+-actinic keratoses  
+-s/p splenectomy following MVA in ___ (? vaccinations)
+ 
+
+###RESPONSE: dyslipidemia {Dyslipidemia}, BPH {Benign prostatic hyperplasia}, melanoma {Malignant melanoma of skin}, skin cancers {Malignant neoplasm of skin}, actinic keratoses  {Actinic keratosis}, splenectomy {Splenectomy}, MVA {Motor vehicle accident victim}, vaccinations {Administration of vaccine to produce active immunity}"
+"###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 was a ___ and family had prolonged sun exposure. 
+There is a strong family history of actinic keratoses,  and skin 
+cancer. 
+ 
+
+###RESPONSE: actinic keratoses {Actinic keratosis}, skin 
+cancer {Malignant neoplasm 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: Physical Exam:
+VS: T 97, BP 118/70, RR 16, O2 98% on RA  
+Gen: appears comfortable, talkative and pleasant  
+HEENT: L temporal surgical wound healing, slight purulence when 
+pressed most pronounced at hairline, erythema is most pronounced 
+around the wound but extends down to his mandible. He is very 
+tender around the suture and mildly tender down the L lateral 
+aspect of his face.  
+Neck: supple  
+Cardiovascular: regular, no murmur  
+Respiratory: Clear to auscultation bilaterally, no wheezes, 
+rales or rhonchi  
+Abd: Soft, non-tender, non distended, no heptosplenomegally, 
+bowel sounds present, abdominal scar from splenectomy  
+Extremities: warm, no edema  
+Neurological: grossly intact  
+Skin: L temporal area described above. Otherwise, he has diffuse 
+actinic keratoses, most pronounced on his back and scalp.
+ 
+
+###RESPONSE: VS {Vital signs finding}, T {Body temperature finding}, BP {Blood pressure finding}, RR {Finding of rate of respiration}, O2 {Oxygen saturation measurement}, RA {Breathing room air}, Gen {General examination of patient}, HEENT {Physical examination procedure}, L temporal {Structure of left temporal bone}, surgical wound {Surgical wound}, healing {Wound healed}, purulence {Purulent discharge from wound}, erythema {Erythema}, wound {Wound}, mandible {Bone structure of mandible}, tender {Abdominal tenderness}, tender {Abdominal tenderness}, L lateral 
+aspect of his face {Structure of left half of face}, Neck {Physical examination procedure}, supple {Normal movement of neck}, Cardiovascular {Cardiovascular physical examination}, regular {Normal heart rate}, murmur {Murmur}, Respiratory {Examination of respiratory system}, Clear to auscultation bilaterally {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, rhonchi {Wheeze - rhonchi}, Abd {Examination of abdomen}, Soft {Abdomen soft}, non-tender {Abdominal tenderness}, distended {Swollen abdomen}, heptosplenomegally {Hepatosplenomegaly}, bowel sounds present {Normal bowel sounds}, abdominal scar {Abdominal skin scar}, splenectomy {Splenectomy}, Extremities {Examination of limb}, warm {Warm skin}, edema {Edema}, Neurologic {Neurological examination}, grossly intact {Normal nervous system function}, Skin {Examination of skin}, temporal {Structure of left temporal bone}, actinic keratoses {Actinic keratosis}, back {Structure of back of trunk}, scalp {Scalp 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: Pertinent Results:
+___ 06:30PM   WBC-24.4*# RBC-4.59* HGB-14.2 HCT-41.9 MCV-91 
+MCH-31.0 MCHC-33.9 RDW-13.5
+
+___ 07:27AM BLOOD WBC-17.5* RBC-4.22* Hgb-13.3* Hct-39.1* 
+MCV-93 MCH-31.4 MCHC-33.9 RDW-13.4 Plt ___ year-old man with a history of squamous cell carcinoma s/p 
+Mohs to the L temporal area on ___. Since the surgery, he has 
+been having headaches, gradually worsening. He has not been able 
+to eat much since ___ due to the pain. It now extends from his 
+forehead down to his mandible on the L.
+.
+In the ED, initial VS T 99.9, BP 144/87, HR 93, RR 16, O2 96% 
+RA. Exam was notable for infected-appearing wound on L temporal 
+area. Labs notable for leukocytosis. Dermatology saw him and 
+recommended IV MRSA coverage and observation overnight. He was 
+given 1g vancomycin and admitted.  
+.
+His elevated temperature resolved with administration of 2 doses 
+of IV vancomycin. WBC count on ED presentation was 24.4 and on 
+day of discharge was 17.5. Pain was also subjectively much 
+improved. Gram stain of wound revealed gram positive cocci in 
+pairs. Wound and blood culture and sensitity remain pending. 
+Dermatology was consulted and recommended follow-up appointment 
+in their surgery clinic on ___ at 2PM and 
+outpatient oral antibiotic therapy. Patient was prescribed 
+Bactrim DS PO x 14 days. 
+.
+His other medical problems were stable and no changes were made 
+to the medications other than adding Bactrim DS for his current 
+skin infection.
+
+ 
+
+###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}, 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}, squamous cell carcinoma {Squamous cell carcinoma}, Mohs {Mohs surgery}, L temporal {Left temporal lobe structure}, surgery {Surgical procedure}, headaches {Headache}, worsening {Increased pain}, has not been able 
+to eat {Unable to eat}, pain {Pain}, forehead {Forehead structure}, mandible {Bone structure of mandible}, VS {Vital signs finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, O2 {Oxygen saturation measurement}, infected-appearing wound {Local infection of wound}, L temporal {Left temporal lobe structure}, leukocytosis {Leukocytosis}, elevated temperature {Body temperature above reference range}, resolved {Problem resolved}, WBC {White blood cell count}, Pain {Pain}, improved {Patient's condition improved}, Gram stain {Gram stain method}, wound {Wound}, Wound {Wound}, blood culture {Blood culture}, oral antibiotic therapy {Oral antibiotic therapy}, stable {Patient's condition stable}, infection {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: Medications on Admission:
+simvastatin 5 mg daily  
+finasteride 5 mg dialy  
+ 
+Discharge Medications:
+1. Ibuprofen 400 mg Tablet Sig: Two (2) Tablet PO Q8H (every 8 
+hours) as needed for pain.
+Disp:*20 Tablet(s)* Refills:*0*
+2. Finasteride 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
+Disp:*30 Tablet(s)* Refills:*2*
+3. Simvastatin 10 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily).
+Disp:*30 Tablet(s)* Refills:*2*
+4. Bactrim DS 800-160 mg Tablet Sig: Two (2) Tablet PO twice a 
+day for 14 days.
+Disp:*56 Tablet(s)* 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:
+L Facial cellulitis
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: L Facial {Structure of left half of face}, cellulitis {Cellulitis}, 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 to ___ for 
+fever and a skin infection. You were started on IV vancomycin in 
+the ED and continued on admission. Your fever resolved and your 
+pain improved. In addition, your white blood cell count is 
+appropriately responding to the antibiotic therapy. Your 
+infection treatment with antibiotics will be continued as oral 
+Bactrim DS 2 pills twice daily for 14 days. You should continue 
+your home medications as written in this discharge document.
+.
+The Following CHANGES have been made:
+You were STARTED on BACTRIM DS 2 pills twice per day for 14 days 
+for the infection.
+.
+Please follow up with your dermatologist on ___ on ___ 
+at 2pm ___ ___ Center Dermatologic Surgery clinic .
+
+ 
+
+###RESPONSE: fever {Fever}, skin infection {Infection of skin and/or subcutaneous tissue}, fever {Fever}, resolved {Problem resolved}, pain improved {Sensation of pain reduced}, white blood cell count {White blood cell count}, antibiotic therapy {Antibiotic therapy}, infection {Infectious disease}, antibiotics {Antibiotic therapy}, infection {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: 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: 
+Chocolate Flavor / Atenolol
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Lethargy, speech difficulties, word-finding difficulties
+ 
+Major Surgical or Invasive Procedure:
+None
+ 
+
+###RESPONSE: Atenolol {Allergy to atenolol}, Lethargy {Lethargy}, speech difficulties {Has difficulty with speech}, word-finding difficulties {Word finding difficulty}"
+"###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 gentleman seen recently in the ED 
+for a fall returning with lethargy, slurred & repeated speech, 
+difficult with word finding. 4 days prior to admission, the 
+patient was out at the ___, was pushed from a standing 
+position and fell on his knees. Since that time he has had 
+considerable pain, and decreased mobility. The morning prior to 
+admission, he awoke with decreased appetite, had lethargy and 
+then later developed difficulty with word finding, right leg 
+weakness and slurred speech. He called into ___ and he was 
+referred to the ED for possible stroke work up.  
+.  
+In the ED, Initial VS: 102 67 140/67 18 96%RA. Patient received 
+Tylenol CTX, Azithro for CAP/retrocardiac opacity on CXR. Neuro 
+recommended infectious work up and will follow in consult. 
+Transfer VS: 98.0 63 116/40 16 98%RA.  
+.  
+On arrival to the floor, the patient is comfortable, and per 
+niece, back to baseline. He denies any discomfort or any recent 
+indications of illness: fevers, chills, cough, chest pain, 
+dyspnea, sputum, abdominal pain, nausea, vomiting, dysuria.  He 
+and his niece report cough and some malaise over last two days.
+.  
+Review of Systems:  
+(+) Per HPI  
+(-) Denies fever, chills, night sweats, recent weight loss or 
+gain. Denies headache, sinus tenderness, rhinorrhea or 
+congestion. Denies chest pain or tightness, palpitations. Denies 
+cough, shortness of breath, or wheezes. Denied nausea, vomiting, 
+diarrhea, constipation or abdominal pain. No recent change in 
+bowel or bladder habits. No dysuria. Denies arthralgias or 
+myalgias. Denies rashes or skin breakdown. No numbness/tingling 
+in extremities. No feelings of depression or anxiety. All other 
+review of systems negative.  
+
+ 
+
+###RESPONSE: fall {Elderly fall}, lethargy {Lethargy}, slurred {Slurred speech}, difficult with word finding {Word finding difficulty}, standing 
+position {Orthostatic body position}, fell {Elderly fall}, knees {Knee region structure}, pain {Pain}, decreased mobility {Reduced mobility}, decreased appetite {Decrease in appetite}, lethargy {Lethargy}, difficulty with word finding {Word finding difficulty}, right leg {Structure of right lower leg}, weakness {Monoparesis of lower limb}, slurred speech {Slurred speech}, stroke {Cerebrovascular accident}, RA {Breathing room air}, opacity {Abnormally opaque structure}, CXR {Plain chest X-ray}, RA {Breathing room air}, discomfort {Discomfort}, fevers {Fever}, chills {Chill}, cough {Cough}, chest pain {Chest pain}, dyspnea {Dyspnea}, sputum {No sputum}, abdominal pain {Abdominal pain}, nausea {Nausea}, vomiting {Vomiting}, dysuria {Dysuria}, cough {Cough}, malaise {Malaise}, fever {Fever}, chills {Chill}, night sweats {Night sweats}, recent weight loss {Recent weight loss}, gain {Recent weight gain}, headache {Headache}, tenderness {Tenderness}, rhinorrhea {Nasal discharge}, congestion {Nasal congestion}, chest pain {Chest pain}, tightness {Tight chest}, palpitations {Palpitations}, cough {Cough}, shortness of breath {Dyspnea}, wheezes {Wheezing}, nausea {Nausea}, vomiting {Vomiting}, diarrhea {Diarrhea}, constipation {Constipation}, abdominal pain {Abdominal pain}, change in 
+bowel {Altered bowel function}, bladder {Urinary bladder structure}, dysuria {Dysuria}, arthralgias {Joint pain}, myalgias {Muscle pain}, rashes {Eruption of skin}, skin breakdown {Broken skin}, No numbness/tingling {Numbness and tingling sensation of skin}, extremities {Limb structure}, depression {Depressive disorder}, anxiety {Anxiety}, review of systems {Review of systems}"
+"###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  
+- Prostate cancer  
+- Hypertension  
+- Hyperlipidemia  
+- Type two diabetes mellitus
+- Osteoporosis
+
+ 
+
+###RESPONSE: Atrial Fibrillation {Atrial fibrillation}, Prostate cancer {Carcinoma of prostate}, Hypertension {Hypertensive disorder, systemic arterial}, Hyperlipidemia {Hyperlipidemia}, Type two diabetes mellitus {Diabetes mellitus type 2}, Osteoporosis {Osteoporosis}"
+"###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:
+Non-contributory
+ 
+
+###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:
+(At time of admission)
+VS: 97.7 130/53 80 24 96% RA  
+GEN: Elderly gentleman, well appearing and comfortable  
+HEENT: No JVD, no LAD  
+CV: S1 & S2 regular without murmur  
+PULM: Bibasilar crackles, decreased LLL breath sounds  
+ABD: NTND  
+LIMBS: Bandaged knees, chronic stasis changes bilateral lower 
+extremities, no edema  
+NEURO: AAOx3, CN ii-xii grossly intact, gait deferred 
+
+ 
+
+###RESPONSE: VS {Vital signs finding}, RA {Breathing room air}, GEN {General examination of patient}, HEENT {Physical examination procedure}, JVD {Jugular venous engorgement}, LAD {Lymphadenopathy}, CV {Cardiovascular physical examination}, S2 {Normal second heart sound, S>2<}, murmur {Murmur}, PULM {Examination of respiratory system}, Bibasilar {Structure of base of lung}, crackles {Respiratory crackles}, ABD {Examination of abdomen}, ND {Swollen abdomen}, LIMBS {Examination of limb}, Bandaged {Application of bandage}, knees {Knee region structure}, stasis {Stasis}, lower 
+extremities {Lower limb structure}, edema {Edema}, NEURO {Neurological examination}, Ox3 {Oriented to person, time and place}, CN ii {Optic nerve structure}, xii {Hypoglossal nerve structure}, grossly intact {Normal nervous system function}"
+"###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:
+Chest X-ray 
+___
+FRONTAL AND LATERAL VIEWS OF THE CHEST: Lung volumes are low. 
+Streaky 
+opacity at the lung bases likely due to atelectasis. There is 
+stable 
+eventration of the right hemidiaphragm. Increased density in the 
+retrocardiac area and seen laterally at the left lung base are 
+concerning for infectious process. There is calcification of the 
+aortic knob, unchanged with a slightly tortuous aorta. Heart 
+size is mildly enlarged with prominent left atrium.  There is no 
+pleural effusion or pneumothorax. 
+  
+IMPRESSION: Increased patchy opacities at the left lung base 
+concerning for pneumonia/aspiration. 
+
+Head CT
+___
+FINDINGS: There is no acute intracranial hemorrhage, large areas 
+of edema, 
+large masses or mass effect. Periventricular white matter 
+hypodensities is 
+consistent with chronic small vessel ischemic changes. There is 
+preservation of normal gray-white matter differentiation. The 
+ventricles and sulci are normal in size and configuration given 
+the patient's age. 
+Soft tissues of the orbits and nasopharynx are within normal 
+limits. The 
+visualized paranasal sinuses and mastoid air cells are clear. No 
+fractures 
+are identified. 
+IMPRESSION: No acute intracranial process. No acute hemorrhage. 
+
+Laboratories on day of discharge:
+WBC 6.5, Hemoglobin 11.3, Hematocrit 33.5, Platelets 196, MCV 89
+INR 3.7
+Na 135, K 3.3, Cl 102, HCO3 25, BUN 52, Creatinine 1.5, Glucose 
+118
+Ca 8.4, Mg 2.3, P 3.1
+CK 308
+
+ 
+
+###RESPONSE: Chest X-ray {Plain chest X-ray}, CHEST {Thoracic structure}, Lung {Lung structure}, opacity {Abnormally opaque structure}, lung bases {Structure of base of lung}, atelectasis {Atelectasis}, stable {Patient's condition stable}, eventration {Eventration}, right hemidiaphragm {Structure of right hemidiaphragm}, left lung {Left lung structure}, infectious process {Infectious disease}, calcification of the 
+aortic knob {Aortic valve calcification}, aorta {Aortic structure}, Heart {Heart structure}, left atrium {Left atrial structure}, pleural effusion {Pleural effusion}, pneumothorax {Pneumothorax}, opacities {Abnormally opaque structure}, the left lung base {Structure of base of left lung}, pneumonia {Pneumonia}, aspiration {Aspiration pneumonia}, intracranial hemorrhage {Intracranial hemorrhage}, edema {Edema}, mass {Mass}, mass {Mass}, Periventricular white matter {Structure of periventricular white matter}, chronic {Chronic disease}, small vessel {Structure of small blood vessel (organ)}, ischemic {Ischemia}, ventricles {Brain ventricle structure}, Soft tissues of the orbits {Structure of soft tissues of orbit}, nasopharynx {Nasopharyngeal structure}, paranasal sinuses {Nasal sinus structure}, and mastoid air cells {Structure of mastoid cell}, fractures {Fracture}, intracranial {Intracranial structure}, acute hemorrhage {Acute hemorrhage}, Hematocrit {Hematocrit determination}, Platelets {Platelet}"
+"###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:
+#) Altered mental status: Initially concerning for stroke or 
+bleed given history of anticoagulation and recent fall (though 
+denied hitting head), however head CT did not demonstrate any 
+bleed. Neurology was consulted in the emergency room and 
+evaluated the patient. Based on his fever and chest x-ray 
+findings, it was felt that his symptoms represented metabolic 
+encephalopathy secondary to his febrile infection.
+His mental status improved during his admission, and his 
+neurologic examination remained non-focal.
+<br>
+#) Fever: Urine analysis not consistent with urinary tract 
+infection, with culture negative for 24 hours. Chest x-ray was 
+concerning for pneumonia at the left base. No other localizing 
+symptoms or findings on examination. Patient was given 
+ceftriaxone and azithromycin in the emergency room along with 
+acetaminophen. He remained afebrile after that time, without any 
+leukocytosis.
+- He should continue azithromycin for 2 more days, and 
+cefpodoxine 200 mg Q12 hours for 4 additional days.
+- Blood cultures were pending at time of discharge, but were 
+negative. Final cultures should be followed up from 
+rehabilitation.
+<br>
+#) Atrial fibrillation: Patient's INR was elevated at time of 
+admission, so his warfarin was held. He is not on any 
+rate-controlling agents at home and had good rate control (high 
+40's to 60's) during his admission.
+- His INR should be check day after discharge, and warfarin 
+resumed and adjusted accordingly.
+<br>
+#) Hypertension: His blood pressure medications were held 
+initially to monitor for any hypotension given altered mental 
+status and febrile state, they were resumed day of discharge 
+when his systolic pressure was 160 in the morning.
+<br>
+#) Hyperlipidemia: Continue pravastatin
+<br>
+#) Renal insufficiency: Baseline values in our system are 
+varied, 1.1-1.3 or 1.4. FeUrea was 36%, which was on the cut-off 
+for being consistent with pre-renal etiology. His function 
+remained stable slightly above baseline at 1.4-1.5 during 
+admission. He was encouarged to take PO's during his first day, 
+and his home medications werer re-started on day two. Given 
+small blood seen in urine analysis, CK was checked to evaluate 
+for rhabdomyolysis, which was 308.
+<br>
+#) Anemia: Patient had mild normocytic anemia during his stay. 
+Iron studies, B-12, and folate were pending at time of discharge 
+and may be followed up on an outpatient basis.
+<br>
+#) Diabetes Mellitus: Patient's blood sugars were mildly 
+elevated during his admission (100-120's), but he was not 
+treated, as wished to avoid hypoglycemia.
+<br>
+#) Osteoporosis: Continued vitamin D, calcium, and alendronate.
+<br>
+#) Status-post fall earlier in week: Patient was evaluated by 
+physical therapy, who felt a short stay at rehabilitation was 
+appropriate.
+
+ 
+
+###RESPONSE: Altered mental status {Altered mental status}, stroke {Cerebrovascular accident}, bleed {Bleeding}, anticoagulation {Anticoagulant therapy}, fall {Falls}, head {Head structure}, head CT {Computed tomography of head}, bleed {Hemorrhage}, fever {Fever}, chest x-ray {Plain chest X-ray}, metabolic 
+encephalopathy {Metabolic encephalopathy}, febrile {Fever}, infection {Infectious disease}, mental status {Mental state finding}, improved {Patient's condition improved}, neurologic examination {Neurological examination}, Fever {Fever}, Urine analysis {Urinalysis}, urinary tract 
+infection {Urinary tract infectious disease}, culture {Urine culture}, Chest x-ray {Plain chest X-ray}, pneumonia {Pneumonia}, left base {Structure of base of left lung}, leukocytosis {Leukocytosis}, Blood cultures {Blood culture}, cultures {Microbial culture}, rehabilitation {Rehabilitation therapy}, Atrial fibrillation {Atrial fibrillation}, Hypertension {Hypertensive disorder, systemic arterial}, hypotension {Low blood pressure}, altered mental 
+status {Altered mental status}, febrile {Fever}, Hyperlipidemia {Hyperlipidemia}, Renal insufficiency {Renal insufficiency}, Baseline {Baseline state}, rhabdomyolysis {Rhabdomyolysis}, Anemia {Anemia}, normocytic anemia {Normocytic anemia}, Diabetes Mellitus {Diabetes mellitus}, hypoglycemia {Hypoglycemia}, Osteoporosis {Osteoporosis}"
+"###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:
+Alendronate 70mg PO Q week  
+Pravastatin 20mg PO daily  
+Spironolactore-HCTZ 25mg-25mg PO daily  
+Warfarin 1.25mg PO Daily  
+Calcium/Vitamin D  
+Colace 100mg PO BID  
+
+ 
+Discharge Medications:
+1. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: Two (2) 
+Tablet PO DAILY (Daily).  
+2. Pravastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY 
+(Daily).  
+3. Azithromycin 250 mg Tablet Sig: One (1) Tablet PO Q24H (every 
+24 hours) for 2 days.
+Disp:*2 Tablet(s)* Refills:*0*
+4. Cefpodoxime 200 mg Tablet Sig: One (1) Tablet PO every twelve 
+(12) hours for 4 days.
+Disp:*8 Tablet(s)* Refills:*0*
+5. Alendronate 70 mg Tablet Sig: One (1) Tablet PO once a week.  
+
+6. Calcium Carbonate-Vit D3-Min 600-400 mg-unit Tablet Sig: One 
+(1) Tablet PO twice a day.  
+7. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 
+times a day).  
+8. Aldactazide ___ mg Tablet Sig: One (1) Tablet PO once a 
+day.  
+
+ 
+
+###RESPONSE: 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:
+Extended Care
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Primary diagnosis:
+- Pneumonia
+Secondary diagnoses:
+- Atrial fibrillation
+- Hypertension
+- Hyperlipidemia
+- History of prostate cancer
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+
+ 
+
+###RESPONSE: Pneumonia {Pneumonia}, Atrial fibrillation {Atrial fibrillation}, Hypertension {Hypertensive disorder, systemic arterial}, Hyperlipidemia {Hyperlipidemia}, prostate cancer {Carcinoma of prostate}, Mental Status {Mental state finding}, Level of Consciousness {Finding of level of consciousness}, 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:
+You were admitted for concern over word-finding difficulties and 
+changes in your speech. After evaluation, it was found that you 
+had a pneumonia, and it was likely that the fevers were 
+contributing to the changes in your mental status.
+
+We have made the following changes to your medications:
+- STARTED an antibiotic called Cefpodoxine 200 mg every 12 hours 
+for 4 days
+- STARTED an antibiotic called Azithromycin 250 mg daily for 2 
+days
+
+No other changes were made to your medications.
+ 
+
+###RESPONSE: word-finding difficulties {Word finding difficulty}, evaluation {Evaluation procedure}, pneumonia {Pneumonia}, fevers {Fever}, mental status {Mental state finding}, antibiotic {Antibiotic therapy}, antibiotic {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: 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: 
+No Known Allergies / Adverse Drug Reactions
+ 
+Attending: ___.
+ 
+Chief Complaint:
+R knee pain
+ 
+Major Surgical or Invasive Procedure:
+R patellar tendon rupture
+
+ 
+
+###RESPONSE: No Known Allergies {Allergic disposition}, Adverse Drug Reactions {Propensity to adverse reactions to drug}, knee pain {Pain of knee region}, R patellar tendon rupture {Traumatic rupture of right patellar tendon}"
+"###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:
+He was playing softball 1 hour prior to his presentation to the
+emergency department, he was jogging slowly, turning suddenly 
+and
+felt a pop.  He felt immediate pain in his knee and fell to the
+ground but did not hit his head or lose consciousness.
+
+He is unable to move his knee afterwards actively.
+ 
+
+###RESPONSE: emergency {Emergency treatment management}, pain in his knee {Pain of knee region}, fell {Falls}, head {Head structure}, lose consciousness {Loss of consciousness}, unable to move his knee {No knee movement}"
+"###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:
+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: Physical Exam:
+Gen:NAD
+RLE: dressing c/d/I
+knee immobilizer in place
+fires ___
+foot WWP
+ 
+
+###RESPONSE: Gen {General examination of patient}, NAD {No abnormality detected}, RLE {Structure of right lower limb}, dressing {Application of dressing}, knee immobilizer {Application of knee immobilizer}, in place {Device in situ}, foot {Foot structure}, WWP {Normal tissue perfusion}"
+"###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:
+___ 05:15AM BLOOD WBC-8.0 RBC-4.35* Hgb-13.2* Hct-39.5* 
+MCV-91 MCH-30.3 MCHC-33.4 RDW-12.7 RDWSD-41.5 Plt ___
+ 
+
+###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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, RDWSD {Red cell distribution width determination}"
+"###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 a R patellar tendon rupture and was admitted to the 
+orthopedic surgery service. The patient was taken to the 
+operating room on ___ for R patellar tendon repair, which 
+the patient tolerated well. For full details of the procedure 
+please see the separately dictated operative report. The patient 
+was taken from the OR to the PACU in stable condition and after 
+satisfactory 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 ___ 
+antibiotics and anticoagulation per routine. The patient's 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's pain was well controlled 
+with oral medications, incisions were clean/dry/intact, and the 
+patient was voiding/moving bowels spontaneously. The patient is 
+weight bearing as tolerated in the right lower extremity, and 
+will be discharged on aspirin for DVT prophylaxis. The patient 
+will follow up with Dr. ___ routine. A thorough 
+discussion was had with the patient regarding the diagnosis and 
+expected post-discharge course including reasons to call the 
+office or return to the hospital, and all questions were 
+answered. The patient was also given written instructions 
+concerning precautionary instructions and the appropriate 
+follow-up care. The patient expressed readiness for discharge.
+ 
+
+###RESPONSE: emergency {Emergency treatment management}, evaluated by the orthopedic surgery team {Orthopedic assessment}, patellar tendon rupture {Rupture of patellar tendon}, admitted to the 
+orthopedic surgery service {Admission by orthopedic surgeon}, patellar tendon repair {Repair of patellar tendon}, procedure {Procedure}, PACU {Postanesthesia care}, stable condition {Patient's condition stable}, anesthesia {Administration of general anesthetic}, 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}, pain was well controlled 
+with oral medications {Demonstrates adequate pain control with oral analgesics}, incisions {Incision}, clean/dry/intact {Wound healing well}, voiding {Normal micturition}, moving bowels spontaneously {Normal bowel habits}, weight bearing {Weight-bearing}, right lower extremity {Structure of right lower limb}, aspirin {Administration of aspirin}, DVT prophylaxis {Prevention of deep vein thrombosis}, follow up {Follow-up arranged}, discussion {Patient education}, call the 
+office {Recommendation regarding contacting someone}, instructions {Patient education}, instructions {Patient education}, follow-up care {Postoperative procedure education}, readiness for discharge {Ready for discharge}"
+"###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.  Aspirin 325 mg PO DAILY 
+RX *aspirin 325 mg 1 (One) tablet(s) by mouth once a day Disp 
+#*30 Tablet Refills:*0 
+3.  Docusate Sodium 100 mg PO BID  
+4.  OxyCODONE (Immediate Release) ___ mg PO Q4H:PRN Pain - 
+Moderate 
+RX *oxycodone 5 mg ___ capsule(s) by mouth every three to six 
+hours Disp #*25 Capsule Refills:*0 
+5.Outpatient Physical Therapy
+WBAT RLE in ___ brace locked in extension. Evaluate and 
+treat. 
+6.Crutches
+Diagnosis: right patellar tendon rupture
+Prognosis: good
+Length of need: 13 months
+
+ 
+
+###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 patellar tendon rupture
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: R patellar tendon rupture {Traumatic rupture of right patellar tendon}, 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:
+
+###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:
+
+INSTRUCTIONS AFTER ORTHOPAEDIC SURGERY:
+
+- You were in the hospital for orthopedic surgery. It is normal 
+to feel tired or ""washed out"" after surgery, and this feeling 
+should improve over the first few days to week. 
+- Resume your regular activities as tolerated, but please follow 
+your weight bearing precautions strictly at all times.
+
+ACTIVITY AND WEIGHT BEARING:
+- WBAT RLE locked in extension in ___ brace
+
+MEDICATIONS:
+  1)  Take Tylenol ___ every 6 hours around the clock. This is 
+an over the counter medication.
+  2)  Add  *** as needed for increased pain. Aim to wean off 
+this medication in 1 week or sooner.  This is an example on how 
+to wean down:
+Take 1 tablet every 3 hours as needed x 1 day,
+then 1 tablet every 4 hours as needed x 1 day,
+then 1 tablet every 6 hours as needed x 1 day,
+then 1 tablet every 8 hours as needed x 2 days, 
+then 1 tablet every 12 hours as needed x 1 day,
+then 1 tablet every before bedtime as needed x 1 day.  
+Then continue with Tylenol for pain.
+  3)  Do not stop the Tylenol until you are off of the narcotic 
+medication.
+  4)  Per state regulations, we are limited in the amount of 
+narcotics we can prescribe. If you require more, you must 
+contact the office to set up an appointment because we cannot 
+refill this type of pain medication over the phone. 
+  5)  Narcotic pain relievers can cause constipation, so you 
+should drink eight 8oz glasses of water daily and continue 
+following the bowel regimen as stated on your medication 
+prescription list. These meds (senna, colace, miralax) are over 
+the counter and may be obtained at any pharmacy.
+  6)  Do not drink alcohol, drive a motor vehicle, or operate 
+machinery while taking narcotic pain relievers.
+  7)  Please take all medications as prescribed by your 
+physicians at discharge.
+  8)  Continue all home medications unless specifically 
+instructed to stop by your surgeon.
+      
+ANTICOAGULATION:
+- Please take aspirin 81 mg daily for 4 weeks
+
+WOUND CARE:
+- You may shower. 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.
+- Incision may be left open to air unless actively draining. If 
+draining, you may apply a gauze dressing secured with paper 
+tape.
+- Splint must be left on until follow up appointment unless 
+otherwise instructed.
+- Do NOT get splint wet.
+
+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
+
+FOLLOW UP:
+Please follow up with your Orthopaedic Surgeon, Dr. ___. 
+You will have follow up with ___, NP in the 
+Orthopaedic Trauma Clinic 14 days post-operation for evaluation. 
+Call ___ to schedule appointment upon discharge.
+
+Please follow up with your primary care doctor regarding this 
+admission within ___ weeks and for any new medications/refills.
+
+Please follow up with your primary care doctor regarding this 
+admission within ___ weeks and for and any new 
+medications/refills.
+
+Physical Therapy:
+WBAT locked in extension
+Treatments Frequency:
+Any staples or superficial sutures you have are to remain in 
+place for at least 2 weeks postoperatively.  Incision may be 
+left open to air unless actively draining.  If draining, you may 
+apply a gauze dressing secured with paper tape.  You may shower 
+and allow water to run over the wound, but please refrain from 
+bathing for at least 4 weeks postoperatively.
+
+ 
+
+###RESPONSE: orthopedic surgery {Operation on musculoskeletal system}, tired {Tired}, washed out {Exhaustion}, after surgery {Postoperative state}, activities as tolerated {Education about increasing activity tolerance}, weight bearing {Weight-bearing}, precautions {Safety precautions}, WBAT {Weight-bearing gait training}, RLE {Structure of right lower limb}, increased pain {Increased pain}, medication {Administration of drug or medicament}, Tylenol {Administration of analgesic}, for pain {Pain relief}, Do not stop the Tylenol until you are off of the narcotic 
+medication {Narcotics education}, narcotics {Narcotherapy}, pain medication {Administration of analgesic}, Narcotic pain relievers can cause {Narcotics education}, constipation {Constipation}, bowel regimen {Bowel care}, medication 
+prescription {Prescription of drug}, meds {Administration of drug or medicament}, senna, colace {Administration of laxative}, Do not drink alcohol {Education about alcohol consumption}, drive a motor vehicle {Unable to drive a car}, while taking narcotic pain relievers {Narcotics education}, Please take all medications as prescribed {Patient medication education}, medications {Administration of drug or medicament}, may shower {Wound treatment education}, stitches {Removal of suture}, staples that need to be removed {Removal of staples}, Incision {Surgical incision wound}, draining {Wound discharge}, draining {Wound discharge}, apply a gauze dressing {Application of dressing}, Splint {Application of splint}, PCP {Primary care management}, return to the 
+emergency {Emergency treatment education}, Increasing pain {Increased pain}, pain medications {Administration of analgesic}, Increasing {Patient's condition worsened}, redness {Redness of skin over lesion}, swelling {Swelling}, drainage {Wound discharge}, incision {Surgical incision wound}, increasing {Patient's condition worsened}, numbness, tingling {Numbness and tingling sensation of skin}, loss of 
+sensation {Numbness}, Fever {Fever}, Shaking {Tremor}, chills {Chill}, Chest pain {Chest pain}, Shortness of breath {Dyspnea}, Nausea {Nausea}, vomiting {Vomiting}, inability to keep food {Unable to eat}, liquid {Unable to drink}, medications {Administration of drug or medicament}, post-operation {Postoperative state}, evaluation {Evaluation procedure}, primary care {Primary care management}, new medications {New medication commenced}, primary care {Primary care management}, new 
+medications {New medication commenced}, WBAT {Weight-bearing gait training}, staples {Closure by staple}, sutures {Closure by suture}, in 
+place {Device in situ}, postoperatively {Postoperative state}, Incision {Surgical incision wound}, draining {Wound discharge}, draining {Wound discharge}, apply a gauze dressing {Application of dressing}, may shower {Wound treatment education}, water to run over the wound {Irrigation of wound}, postoperatively {Postoperative state}"
+"###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
+ 
+Major Surgical or Invasive Procedure:
+___ cardioversion - ___
+
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, Dyspnea {Dyspnea}, cardioversion {Cardioversion}"
+"###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 AFib s/p DCCV ___ on apixaban, bicuspid aortic 
+valve with mild AS, hyperlipidemia, OSA on CPAP, sarcoidosis, 
+presents with dyspnea, AFib with RVR, acute CHF.  
+ ___ was recently admitted in ___ for AFib with RVR. ___ was 
+treated with IV diltiazem and transitioned to oral agents. ___ 
+was given Lasix 20 IV for mild volume overload. ___ had sinus 
+pauses on telemetry thought to be due to OSA. ___ was started on 
+apixaban for anticoagulation. On ___, ___ had elective ___ 
+with successful electrical cardioversion of atrial fibrillation 
+to sinus rhythm.  
+ ___ was seen by Dr. ___ on ___. The patient was noticed 
+to be in acute heart failure but the patient strongly preferred 
+outpatient treatment and so his torsemide dose was increased 
+from 40mg to 120mg. ___ had some success with this and lost 14 
+lbs. ___ uses 3 pillows at baseline and has recent PND. Over past 
+day, ___ developed increasing dyspnea on exertion. ___ presented 
+to ___ ED, BNP was ___, troponin negative, and ___ was 
+transferred here.  
+ In the ED, initial vital signs were: 98.3 100 ___ 95% RA  
+
+ - Labs were notable for: WBC stable. K 3.2. Mg 1.8. BUN/Cr 
+___. TnT neg. BNP 1317 (prior ___)  
+ - Imaging: OSH CXR R hilar adenopathy, mild R basilar 
+patchiness, no significant change from prior CXR ___  
+ - The patient was given:  
+ ___ 21:48 PO/NG Apixaban 5 mg  
+ ___ 23:57 IV Furosemide 80 mg  
+ - Consults: Atrius Cards- admit  
+ Upon arrival to the floor, patient has no complaints.  
+ ROS per HPI otherwise negative in 14-point review. 
+ 
+
+###RESPONSE: AFib {Atrial fibrillation}, DCCV {Direct current cardioversion}, bicuspid aortic 
+valve {Bicuspid aortic valve}, hyperlipidemia {Hyperlipidemia}, OSA {Obstructive sleep apnea syndrome}, sarcoidosis {Sarcoidosis}, dyspnea {Dyspnea}, AFib with RVR {Atrial fibrillation with rapid ventricular response}, AFib with RVR {Atrial fibrillation with rapid ventricular response}, IV {Intravenous therapy}, IV {Intravenous therapy}, sinus 
+pauses {Sinus arrest}, telemetry {Electroencephalogram telemetry}, OSA {Obstructive sleep apnea syndrome}, anticoagulation {Anticoagulant therapy}, electrical cardioversion {Direct current cardioversion}, atrial fibrillation {Atrial fibrillation}, sinus rhythm {Sinus rhythm}, acute heart failure {Acute heart failure}, baseline {Baseline state}, dyspnea on exertion {Dyspnea on exertion}, vital signs {Vital signs finding}, RA {Breathing room air}, stable {Patient's condition stable}, Imaging {Imaging}, CXR {Plain chest X-ray}, hilar adenopathy {Hilar lymphadenopathy}, CXR {Plain chest X-ray}, IV {Intravenous therapy}, no complaints {No complaints}"
+"###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:
+Venous stasis  
+A-fib s/p cardioversion in ___  
+OSA (obstructive sleep apnea) on cpap  
+Lymphadenopathy  
+Hypertension  
+Aortic stenosis, mild  
+ED (erectile dysfunction)  
+Hyperlipidemia  
+Mediastinal adenopathy - found to have sarcoid ___ 
+ 
+
+###RESPONSE: Venous stasis {Venous stasis}, A-fib {Atrial fibrillation}, cardioversion {Cardioversion}, OSA (obstructive sleep apnea {Obstructive sleep apnea syndrome}, Lymphadenopathy {Lymphadenopathy}, Hypertension {Hypertensive disorder, systemic arterial}, Aortic stenosis {Aortic valve stenosis}, erectile dysfunction {Erectile dysfunction}, Hyperlipidemia {Hyperlipidemia}, Mediastinal {Mediastinal structure}, adenopathy {Lymphadenopathy}"
+"###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 died at ___ getting CABG  
+Twin brothers died from alpha 1 antitrypsin
+ 
+
+###RESPONSE: died {Dead}, CABG {Coronary artery bypass grafting}, died {Dead}"
+"###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:
+VITALS: T98.1 ___ 21 96RA 153.5kg  
+ GEN: Morbidly obese middle aged male in no distress  
+ NECK: JVP not visible due to thick neck  
+ HEART: Irreg irreg, normal S1 S2, no murmurs  
+ LUNGS: Basilar crackles  
+ ABD: Soft, NT, mildly distended, normal BS  
+ EXT: 3+ edema to calves bilaterally, 2+ DP and ___ pulses  
+
+DISCHARGE PHYSICAL EXAM:
+
+VS: T97.8 103/82-128/83  ___ 98RA and CPAP
+I/O: 8hr: ___ 24hr: 1320/3350
+Weight: 153.5-> 150.2 -> 150-> 149.3->149.4
+GEN: Morbidly obese middle aged male in no distress , sitting in 
+recliner chair 
+NECK: JVP difficult to assess w thick neck
+ HEART: Distant heart sounds, regular, no murmurs  
+ LUNGS: CTAB, no wheezes, crackles, rhonchi
+ ABD: Soft, NT, mildly distended, normal BS  
+ EXT: 1+ edema to knees bilaterally, 2+ DP pulses, R foot 
+minimal erythema of R MTP, improved
+ 
+
+###RESPONSE: PHYSICAL EXAM {Physical examination procedure}, VITALS {Vital signs finding}, RA {Breathing room air}, GEN {General examination of patient}, Morbidly obese {Morbid obesity}, distress {Distress}, NECK {Physical examination procedure}, JVP {Finding of jugular venous pressure}, neck {Neck structure}, HEART {Cardiovascular physical examination}, normal S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, murmurs {Murmur}, LUNGS {Examination of respiratory system}, crackles {Respiratory crackles}, ABD {Examination of abdomen}, Soft {Abdomen soft}, NT {Abdominal tenderness}, distended {Swollen abdomen}, BS {Normal bowel sounds}, EXT {Examination of limb}, edema {Edema}, 2+ DP and ___ pulses {All pulses present in bilateral lower limbs}, RA {Breathing room air}, GEN {General examination of patient}, Morbidly obese {Morbid obesity}, distress {Distress}, sitting {Sitting position}, NECK {Physical examination procedure}, neck {Neck structure}, HEART {Cardiovascular physical examination}, Distant heart sounds {Heart sounds diminished}, murmurs {Murmur}, LUNGS {Examination of respiratory system}, CTAB {Normal breath sounds}, wheezes {Wheezing}, crackles {Respiratory crackles}, rhonchi {Wheeze - rhonchi}, ABD {Examination of abdomen}, Soft {Abdomen soft}, BS {Normal bowel sounds}, EXT {Examination of limb}, edema {Edema}, knees {Knee region structure}, 2+ DP pulses {All pulses present in bilateral lower limbs}, foot {Foot structure}, erythema {Erythema}, improved {Patient's condition improved}"
+"###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:
+___ 09:45PM BLOOD WBC-7.3 RBC-4.48* Hgb-13.5* Hct-40.6 
+MCV-91 MCH-30.1 MCHC-33.3 RDW-14.7 RDWSD-48.3* Plt ___
+___ 09:45PM BLOOD Glucose-94 UreaN-15 Creat-0.8 Na-137 
+K-3.2* Cl-96 HCO3-28 AnGap-16
+___ 09:45PM BLOOD ___ PTT-34.1 ___
+___ 06:30AM BLOOD ALT-18 AST-20 AlkPhos-56 TotBili-0.8
+___ 09:45PM BLOOD proBNP-1317*
+___ 09:45PM BLOOD cTropnT-<0.01
+___ 06:30AM BLOOD cTropnT-<0.01
+___ 09:45PM BLOOD Calcium-9.2 Phos-3.6 Mg-1.8
+___ 09:51PM BLOOD Lactate-1.3
+
+DISCHARGE LABS:
+
+___ 01:40PM BLOOD WBC-6.8 RBC-4.50* Hgb-13.4* Hct-41.5 
+MCV-92 MCH-29.8 MCHC-32.3 RDW-14.5 RDWSD-49.0* Plt ___
+___ 03:04PM BLOOD ___
+___ 01:40PM BLOOD Glucose-113* UreaN-22* Creat-0.9 Na-133 
+K-4.1 Cl-95* HCO3-26 AnGap-16
+___ 01:40PM BLOOD Calcium-9.2 Phos-3.7 Mg-2.2
+
+MICRO
+
+IMAGING:
+
+___ CXR:
+ 
+Limited exam for which repeat is suggested for more detailed 
+evaluation.  
+Enlarged right hilum could be due to pulmonary artery 
+enlargement or 
+underlying adenopathy and attention suggested on followup. 
+
+ 
+
+###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}, PTT {Partial thromboplastin time, activated}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, proBNP {N-terminal pro-brain natriuretic peptide measurement}, cTropnT {Troponin T cardiac measurement}, cTropnT {Troponin T cardiac 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}, evaluation {Evaluation procedure}, pulmonary artery {Pulmonary artery structure}, enlargement {Enlargement}, adenopathy {Lymphadenopathy}"
+"###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 AFib s/p DCCV ___ on apixaban, bicuspid aortic 
+valve with mild AS, hyperlipidemia, OSA on CPAP, sarcoidosis, 
+presents with dyspnea, AFib with RVR, acute CHF. 
+
+ # Afib with RVR. Symptomatic, up to 150s day of admission, 
+started on sotalol with good effect in the hospital where QTc 
+prolongation was monitored. Cardioversion performed ___ with 
+return to sinus rhythm. Discharged on sotalol 160mg BID and 
+apixaban due to h/o ___ clot in ___. Diltiazem was stopped 
+because of conversion to sinus and presence of sotalol.  
+
+ # Acute on chronic systolic and diastolic heart failure: Cause 
+of acute decompensation is likely from tachycardia-induced 
+cardiomyopathy given AF with RVR. Recent outpatient TTE with 
+impaired EF down to ___ with moderate global hypokinesis, 
+mild AS, mild MR. ___ was found to be in acute heart failure in 
+outpatient setting, and failed outpatient trial of increased 
+torsemide (from 40 to 120mg daily). Good diuresis on Lasix so 
+discharged on Lasix 40mg BID. Potassium levels stable at this 
+dose. Weight at discharge 149.4kg, which should be approximate 
+dry weight. Started on spironolactone 25mg, lisinopril 2.5mg. 
+Recommended low salt diet with 2000mL fluid restriction daily 
+and f/u with cardiology and PCP.
+   
+#acute gouty flare: Describes having gout one previously. 
+Morning of ___ complaining of R ""foot"" pain. R first MTP 
+joint erythematous and swollen, tender to light touch. Given 
+that ___ is anti-coagulated, colchicine is preferred first line 
+treatment. Given 1.8mg day one and one week of 0.6mg 
+prophylaxis.
+
+# Elevated INR: Admission INR 1.6, increased from previous 
+admission in ___, where INR was 1.3-1.4.  Likely from 
+apixaban (can increase INR, though not predictable increases). 
+ 
+ # OSA on CPAP. History of some sinus pauses during last 
+admission, used CPAP well during admission.  
+ 
+
+ 
+
+###RESPONSE: AFib {Atrial fibrillation}, DCCV {Direct current cardioversion}, bicuspid aortic 
+valve {Bicuspid aortic valve}, hyperlipidemia {Hyperlipidemia}, OSA {Obstructive sleep apnea syndrome}, sarcoidosis {Sarcoidosis}, dyspnea {Dyspnea}, AFib with RVR {Atrial fibrillation with rapid ventricular response}, Afib with RVR {Atrial fibrillation with rapid ventricular response}, Cardioversion {Cardioversion}, sinus rhythm {Sinus rhythm}, clot {Blood clot}, sinus {Sinus rhythm}, chronic systolic and diastolic heart failure {Acute on chronic combined systolic and diastolic heart failure}, decompensation {Decompensation}, tachycardia-induced 
+cardiomyopathy {Tachycardia-induced cardiomyopathy}, AF with RVR {Atrial fibrillation with rapid ventricular response}, TTE {Transthoracic echocardiography}, hypokinesis {Hypokinesis of cardiac wall}, MR {Mitral valve regurgitation}, acute heart failure {Acute heart failure}, diuresis {Diuresis}, Potassium levels {Finding of potassium level}, low salt diet {Low sodium diet}, fluid restriction {Fluid restriction}, PCP {Primary care management}, gout {Inflammatory disorder due to increased blood urate level}, foot"" pain {Foot pain}, joint {Joint structure}, erythematous {Erythema}, tender {Tenderness}, first line 
+treatment {First line treatment}, prophylaxis {Preventive procedure}, OSA {Obstructive sleep apnea syndrome}, sinus {Sinus arrest}"
+"###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. Apixaban 5 mg PO BID 
+2. Sildenafil 20 mg PO DAILY:PRN ED 
+3. Diltiazem 90 mg PO TID 
+4. Torsemide 120 mg PO DAILY 
+
+ 
+Discharge Medications:
+1. Apixaban 5 mg PO BID 
+2. Colchicine 0.6 mg PO ONCE Duration: 1 Dose 
+Take for one week. 
+RX *colchicine 0.6 mg 1 capsule(s) by mouth daily Disp #*10 
+Capsule Refills:*0
+3. Furosemide 40 mg PO BID 
+Can take in the morning and mid-day. 
+RX *furosemide 40 mg 1 tablet(s) by mouth twice daily Disp #*60 
+Tablet Refills:*0
+4. Lisinopril 2.5 mg PO DAILY 
+RX *lisinopril 2.5 mg 1 tablet(s) by mouth daily Disp #*30 
+Tablet Refills:*0
+5. Sotalol 160 mg PO BID 
+RX *sotalol [Betapace] 160 mg 1 tablet(s) by mouth twice daily 
+Disp #*60 Tablet Refills:*0
+6. Spironolactone 25 mg PO DAILY 
+RX *spironolactone [Aldactone] 25 mg 1 tablet(s) by mouth daily 
+Disp #*30 Tablet Refills:*0
+7. Sildenafil 20 mg PO DAILY:PRN ED 
+
+ 
+
+###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:
+Atrial fibrillation with RVR
+Acute on chronic systolic and diastolic heart failure (rEF with 
+diastolic dysfunction)
+Acute gouty flare
+
+SECONDARY DIAGNOSES:
+OSA on CPAP
+
+ 
+Discharge Condition:
+Discharge condition stable.
+AOx3
+Able to ambulate safely independently.
+
+ 
+
+###RESPONSE: Atrial fibrillation with RVR {Atrial fibrillation with rapid ventricular response}, Acute on chronic systolic and diastolic heart failure {Acute on chronic combined systolic and diastolic heart failure}, diastolic dysfunction {Diastolic dysfunction}, OSA {Obstructive sleep apnea syndrome}, stable {Patient's condition stable}"
+"###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 came to the hospital because your heart was beating very 
+fast and in an irregular rhythm. This is called atrial 
+fibrillation (""A-fib"") with rapid ventricular response. We 
+started you on a medication to help control the rhythm, called 
+sotalol, and performed a procedure to stop the afib (this 
+procedure is cardioversion).
+
+You will need to keep taking the sotalol twice daily at home. 
+You will stop the diltiazem you were taking, as well as the 
+torsemide. You will keep taking the apixiban for blood thinner. 
+You will also start Lasix twice daily, spironolactone daily and 
+lisinopril daily.
+
+New meds
+==========
+sotalol 160mg twice daily
+Lasix 40mg twice daily
+lisinopril 2.5mg daily
+spironolactone 25mg daily
+
+Stop taking these medications
+=============================
+diltiazem
+torsemide
+
+Keep taking these medications
+================================
+apixiban 
+
+You will follow up with Dr. ___ in ___. They are making 
+the appointment for you and you should be contacted.
+
+Be Well,
+your ___ team
+
+ 
+
+###RESPONSE: heart {Heart structure}, irregular {Irregular heart beat}, atrial 
+fibrillation {Atrial fibrillation}, A-fib {Atrial fibrillation}, procedure {Procedure}, afib {Atrial fibrillation}, procedure {Procedure}, cardioversion {Cardioversion}, follow up {Follow-up arranged}"
+"###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: 
+Zocor
+ 
+Attending: ___.
+ 
+Chief Complaint:
+L leg swelling and pain
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: L leg swelling {Localized swelling of left lower leg}, pain {Pain in left lower limb}"
+"###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 with PMHx of metastatic melanoma s/p resection of
+abdominal mass, axillary LN dissection, resection of R frontal
+mass with Nsurg, on immunotherapy - most recently nivolumab 
+(C8D1
+___, Afib not on AC, PUD with prior GI bleed x2 (___), PE
+s/p IVC filter ___, gastric bypass ___, hypothyroidism,
+adrenal insufficiency who presents from US appointment with new
+LLE DVT. 
+
+Pt states he has been noticing swelling, and increased pain in
+the LLE for the past week. No numbness/tingling. Eventually
+scheduled US appt and was told to go immediately to an ED after
+they found the DVT on exam. Has been feeling weak for the past
+few weeks as well and felt unsteady earlier today. 
+
+In the ED,
+- Initial vitals:  T97.2, HR 85, BP 154/100, RR 16, O2 sat 98% 
+RA
+
+- Exam notable for:  
+Ext: LLE slightly larger compared to R, slight calf tenderness 
+in
+both legs, slight TTP in L thigh, L foot more edematous compared
+to R, DP pulse intact b/l, LLE also with bandage, skin 
+underneath
+erythematous and edematous
+Neuro: sensation intact in ___ b/l, no focal neuro deficits
+appreciated
+- Labs notable for: WBC 10.7 with 79% PMNs, Hgb 12, MCV 103
+- Imaging notable for:  
+___ US
+IMPRESSION:
+Deep venous thrombosis involving the distal left femoral vein 
+and
+extending into the left common femoral vein. There is no 
+evidence
+of thrombus in the right common femoral vein. The patient has an
+IVC filter.
+
+- Pt was given:  
+___ IV CeFAZolin 1 g
+___ PO Omeprazole 20 mg B
+___ PO/NG Dexamethasone 2 mg 
+___ PO/NG Levothyroxine Sodium 75 mcg  
+___ PO/NG Digoxin .125 mg  
+___ PO/NG Codeine Sulfate 15 mg 
+___ PO/NG Torsemide 10 mg 
+___ IV CeFAZolin 1 g  
+___ PO/NG Codeine Sulfate 15 mg 
+___ PO/NG Rivaroxaban 15 mg 
+
+- Vitals prior to transfer: T 99.1, HR 84, BP 135/80, RR 16, O2
+sat 99% RA.
+
+Upon arrival to the floor, the patient shares that he has been
+feeling weak and sustained a fall a couple weeks ago, and has
+been sitting and sleeping on the couch most of the time since
+then. He also recalls feeling lightheaded when getting up once 
+in
+the past week. He confirms that he first notice left leg 
+swelling
+one week ago. He recalls taking an anticoagulation pill in the
+past that was not warfarin (cannot remember name), but stopped
+after having GI bleeds a few years ago. He has not had any 
+recent
+bloody or dark stools. Denies fever/chills, N/V, CP, SOB,
+pleuritic chest pain, pain with deep breathing. No dysuria or
+current GI complaints. 
+ 
+
+ 
+
+###RESPONSE: metastatic melanoma {Metastatic malignant melanoma}, resection {Excision}, abdominal mass {Abdominal mass}, axillary LN dissection {Excision of axillary lymph node}, resection {Excision}, R frontal {Right frontal lobe structure}, mass {Mass}, immunotherapy {Immunotherapy}, Afib {Atrial fibrillation}, PUD {Peptic ulcer}, GI bleed {Gastrointestinal hemorrhage}, PE {Pulmonary embolism}, IVC filter {Inferior vena cava filter in situ}, gastric bypass {Bypass of stomach}, hypothyroidism {Hypothyroidism}, adrenal insufficiency {Adrenal cortical hypofunction}, US {Ultrasonography}, LLE {Structure of left lower limb}, DVT {Deep venous thrombosis}, swelling {Swelling}, increased pain {Increased pain}, LLE {Structure of left lower limb}, numbness/tingling {Numbness and tingling sensation of skin}, US {Ultrasonography}, DVT {Deep venous thrombosis}, exam {Physical examination procedure}, feeling weak {Asthenia}, vitals {Vital signs finding}, O2 sat {Oxygen saturation measurement}, RA {Breathing room air}, Exam {Physical examination procedure}, Ext {Examination of limb}, LLE {Structure of left lower limb}, larger {Increased size}, R {Structure of right lower limb}, calf tenderness {Pain in calf}, both legs {Both lower legs}, TTP {Tenderness}, L thigh {Structure of left thigh}, L foot {Structure of left foot}, edematous {Edema}, R {Structure of right foot}, DP pulse intact {Dorsalis pulse present}, LLE {Structure of left lower limb}, skin 
+underneath
+erythematous {Erythema of skin}, edematous {Edematous skin}, Neuro {Neurological examination}, sensation intact {Normal sensation}, neuro deficits {Neurological deficit}, Labs {Laboratory test}, WBC {White blood cell count}, MCV {Erythrocyte mean corpuscular volume determination}, Imaging {Imaging}, US {Ultrasonography}, Deep venous thrombosis {Deep venous thrombosis}, left femoral vein {Structure of left femoral vein}, common femoral vein {Common femoral vein structure}, no 
+evidence {No abnormality detected}, thrombus {Thrombus}, right common femoral vein {Structure of right femoral vein}, IVC filter {Inferior vena cava filter in situ}, Vitals {Vital signs finding}, O2
+sat {Oxygen saturation measurement}, RA {Breathing room air}, feeling weak {Asthenia}, fall {Falls}, sitting and sleeping on the couch {Semi-recumbent position}, lightheaded {Lightheadedness}, left leg 
+swelling {Localized swelling of left lower limb}, anticoagulation {Anticoagulant therapy}, warfarin {Warfarin therapy}, GI bleeds {Gastrointestinal hemorrhage}, bloody {Hematochezia}, dark stools {Dark stools}, fever {Fever}, chills {Chill}, N/V {Nausea and vomiting}, CP {Chest pain}, SOB {Dyspnea}, pleuritic chest pain {Pleuritic pain}, pain with deep breathing {Chest pain on breathing}, dysuria {Dysuria}, GI complaints {Gastrointestinal symptom}"
+"###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:
+ONCOLOGIC HISTORY:
+Mr. ___ noted a ""blood blister"" on his abdomen many years 
+ago
+which resolved on its own.  Then, approximately a year prior to
+presentation, this started to grow again and bled occasionally.
+He was referred by his PCP to dermatology where he saw ___, NP, on ___ with a 2 x 2
+centimeter inflamed plaque with a central ulcer on the right
+abdomen noted.  Biopsy revealed nodular melanoma, present at
+peripheral and deep margins, at least 7.5 mm deep, at least
+___ level 4, ulcerated, 29 mitoses per millimeter squared,
+absent lymphovascular and perineural invasion on the original
+pathology though the specimen was reviewed in our cutaneous
+oncology conference and felt to show lymphovascular invasion. 
+The patient was referred here for further management.  He went 
+on
+to have a wide local excision and sentinel lymph node biopsy on
+___.  This showed residual melanoma to 11 mm depth, 
+2
+of 6 recovered lymph nodes with micrometastases.
+
+Initial staging scans on ___ revealed metastatic disease 
+in
+the left arm, right peritoneum, right adrenal, and left
+infrahilar lymph node consistent with metastatic disease.  Brain
+MRI showed no CNS metastases.  He underwent FNA of the left arm
+nodule on ___ by Dr. ___ melanoma. 
+
+Admitted to ___ with worsening SOB on ___, found 
+to
+have a PE, put on anticoagulation but developed abdominal wall
+hematoma so, IVC filter placed. He has a history of developing 
+GI
+bleed while on anticoagulation in the past for atrial
+fibrillation.
+
+Was initially considered for Clinical Trial but could not be
+enrolled due to elevated LFTs ( likely in the setting of acute
+heavy alcohol use). 
+
+Pembrolizumab 2 mg/kg every 3 weeks started on ___. 
+Progression seen on scans on ___, therefore treatment
+transitioned to ipi/nivo.
+
+He completed 4 cycles Ipi/Nivo with good response and was
+transitioned to nivolumab monotherapy. He was subsequently
+hospitalized with adrenal failure and was found to have
+metastatic disease to the brain. 
+
+Neurosurgery was completed ___. Subsequent imaging revealed
+ongoing abnormalities in the resection base so received CK
+radiation to the site from ___.
+  
+PAST MEDICAL HISTORY:  
+Gastric bypass
+Shoulder arthritis, rotator cuff injury awaiting surgery
+atrial fibrillation
+diabetes
+alcohol abuse
+fatty liver
+hypertension
+osteoarthritis of the knee
+radial nerve palsy
+sleep apnea
+GI bleed from PUD while on anticoagulation for afib
+ 
+
+###RESPONSE: blood blister {Blood blister}, abdomen {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, resolved {Problem resolved}, bled {Bleeding}, inflamed plaque {Erythematous plaque}, ulcer {Ulcer}, right
+abdomen {Structure of right side of abdomen}, Biopsy {Biopsy}, nodular melanoma {Nodular melanoma}, absent lymphovascular {Lymphatic (small vessel) invasion by tumor absent}, perineural invasion {Perineural invasion by tumor absent}, pathology {Abnormal histology findings}, wide local excision {Wide excision}, sentinel lymph node biopsy {Sentinel lymph node biopsy}, melanoma {Malignant melanoma of skin}, lymph nodes {Structure of lymph node}, metastatic disease {Metastatic malignant neoplasm to brain}, left arm {Left upper arm structure}, peritoneum {Peritoneum (serous membrane) structure}, right adrenal {Structure of right adrenal gland}, lymph node {Structure of lymph node}, metastatic disease {Metastatic malignant neoplasm to brain}, Brain
+MRI {Magnetic resonance imaging of brain}, CNS metastases {Metastatic malignant neoplasm to central nervous system}, FNA {Fine needle biopsy}, left arm
+nodule {Nodule of skin of left upper limb}, melanoma {Malignant melanoma of skin}, worsening {Patient's condition worsened}, SOB {Dyspnea}, PE {Pulmonary embolism}, anticoagulation {Anticoagulant therapy}, abdominal wall
+hematoma {Hematoma of abdominal wall}, IVC filter {Inferior vena cava filter in situ}, placed {Implantation procedure}, GI
+bleed {Gastrointestinal hemorrhage}, anticoagulation {Anticoagulant therapy}, atrial
+fibrillation {Atrial fibrillation}, Clinical Trial {Clinical trial}, elevated LFTs {Liver function test above reference range}, heavy alcohol use {Alcohol intake above recommended sensible limits}, good response {Good therapeutic response}, metastatic disease to the brain {Metastatic malignant neoplasm to brain}, imaging {Imaging}, abnormalities {Imaging result abnormal}, resection {Excision}, radiation {Radiation oncology AND/OR radiotherapy}, Gastric bypass {Bypass of stomach}, Shoulder arthritis {Inflammation of joint of shoulder region}, rotator cuff injury {Injury of rotator cuff}, surgery {Surgical procedure}, atrial fibrillation {Atrial fibrillation}, diabetes {Diabetes mellitus}, alcohol abuse {Alcohol abuse}, fatty liver {Steatosis of liver}, hypertension {Hypertensive disorder, systemic arterial}, osteoarthritis of the knee {Osteoarthritis of knee}, radial nerve {Structure of radial nerve}, palsy {Paralysis}, sleep apnea {Sleep apnea}, GI bleed {Gastrointestinal hemorrhage}, PUD {Peptic ulcer}, anticoagulation {Anticoagulant therapy}, afib {Atrial fibrillation}"
+"###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:
+His brother had skin cancer though he does not think it was 
+melanoma.
+ 
+
+###RESPONSE: skin cancer {Malignant neoplasm of skin}, melanoma {Malignant melanoma 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: Physical Exam:
+ADMISSION PHYSICAL EXAM:  
+VS: ___ 1655 Temp: 98.1 PO BP: 139/91 HR: 72 RR: 18 O2 sat:
+97% O2 delivery: Ra 
+GENERAL: Obese man lying in bed in NAD  
+HEENT: AT/NC, Sclerae anicteric, MMM, poor dentition.
+CV: Irregularly irregular rate and rhythm. No murmurs, rubs, or
+gallops.
+PULM: CTAB, no wheezes, rales, rhonchi.
+ABD: Abdomen soft, obese, nontender to palpation, no
+rebound/guarding, no hepatosplenomegaly, well-healed scar.
+EXT: WWP, no cyanosis, 2+ LLE, 1+ RLE
+SKIN: Warm and well perfused, numerous scatter ecchymoses over
+bilateral upper extremities, mild diffuse poorly circumscribed
+erythema over anterior left lower leg with scant amount of clear
+fluid expressed from a 7mm thin papule
+NEURO: Alert, moving all 4 extremities with purpose, face
+symmetric  
+ACCESS: port
+
+DISCHARGE PHYSICAL EXAM:
+VS: ___ 1500 Temp: 98.9 PO BP: 133/96 HR: 90 RR: 18 O2 sat: 
+95% O2 delivery: RA 
+GENERAL: Obese man lying in bed in NAD  
+HEENT: AT/NC, Sclerae anicteric, MMM, poor dentition.
+CV: Irregularly irregular rate and rhythm. No murmurs, rubs, or 
+gallops.
+PULM: CTAB, no wheezes, rales, rhonchi.
+ABD: Abdomen soft, obese, nontender to palpation, no 
+rebound/guarding, no hepatosplenomegaly, well-healed scar.
+EXT: WWP, no cyanosis, 2+ LLE, 1+ RLE
+SKIN: Warm and well perfused, numerous scatter ecchymoses over 
+bilateral upper extremities, mild diffuse poorly circumscribed 
+erythema over anterior left lower leg
+NEURO: Alert, moving all 4 extremities with purpose, face 
+symmetric  
+ACCESS: port
+ 
+
+###RESPONSE: PHYSICAL EXAM {Physical examination procedure}, O2 sat {Oxygen saturation measurement}, O2 delivery: Ra {Breathing room air}, GENERAL {General examination of patient}, Obese {Obese}, lying in bed {Lying in bed}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, AT/NC {Normal head}, Sclerae anicteric {White sclera}, MMM {Moist oral mucosa}, poor dentition {Impaired dentition}, CV {Cardiovascular physical examination}, Irregularly irregular {Heart irregularly irregular}, rate {Finding of heart rate}, rhythm {Irregular heart beat}, murmurs {Heart murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, PULM {Examination of respiratory system}, CTAB {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, rhonchi {Wheeze - rhonchi}, ABD {Examination of abdomen}, Abdomen soft {Abdomen soft}, obese {Obese abdomen}, nontender {Abdominal tenderness}, palpation {Palpation}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, hepatosplenomegaly {Hepatosplenomegaly}, well-healed {Wound healed}, scar {Scar}, EXT {Examination of limb}, WWP {Normal tissue perfusion}, cyanosis {Cyanosis}, LLE {Structure of left lower limb}, RLE {Structure of right lower limb}, SKIN {Examination of skin}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, ecchymoses {Ecchymosis}, upper extremities {Upper limb structure}, mild {Symptom mild}, erythema {Erythema}, left lower leg {Structure of left lower leg}, papule {Papule}, NEURO {Neurological examination}, Alert {Mentally alert}, moving all 4 extremities {Does move all four limbs}, face
+symmetric {Facial symmetry}, VS {Vital signs finding}, Temp {Body temperature finding}, O2 sat {Oxygen saturation measurement}, RA {Breathing room air}, RA {Breathing room air}, Obese {Obese}, lying in bed {Lying in bed}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, AT/NC {Normal head}, Sclerae anicteric {White sclera}, MMM {Moist oral mucosa}, poor dentition {Impaired dentition}, CV {Cardiovascular physical examination}, Irregularly irregular {Heart irregularly irregular}, rate {Finding of heart rate}, rhythm {Irregular heart beat}, murmurs {Heart murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, PULM {Examination of respiratory system}, CTAB {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, rhonchi {Wheeze - rhonchi}, ABD {Examination of abdomen}, Abdomen soft {Abdomen soft}, obese {Obese abdomen}, nontender {Abdominal tenderness}, palpation {Palpation}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, hepatosplenomegaly {Hepatosplenomegaly}, well-healed {Wound healed}, scar {Scar}, EXT {Examination of limb}, WWP {Normal tissue perfusion}, cyanosis {Cyanosis}, LLE {Structure of left lower limb}, RLE {Structure of right lower limb}, SKIN {Examination of skin}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, ecchymoses {Ecchymosis}, upper extremities {Upper limb structure}, mild {Symptom mild}, erythema {Erythema}, left lower leg {Structure of left lower leg}, NEURO {Neurological examination}, Alert {Mentally alert}, moving all 4 extremities {Does move all four limbs}, face 
+symmetric {Facial symmetry}"
+"###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
+___ 07:56PM BLOOD WBC-10.7* RBC-3.40* Hgb-12.0* Hct-35.0* 
+MCV-103* MCH-35.3* MCHC-34.3 RDW-14.7 RDWSD-55.1* Plt ___
+___ 07:56PM BLOOD Neuts-79.1* Lymphs-7.6* Monos-7.7 
+Eos-0.0* Baso-0.8 NRBC-0.2* Im ___ AbsNeut-8.48* 
+AbsLymp-0.82* AbsMono-0.83* AbsEos-0.00* AbsBaso-0.09*
+___ 07:56PM BLOOD ___ PTT-24.4* ___
+___ 07:56PM BLOOD Glucose-121* UreaN-11 Creat-0.5 Na-135 
+K-3.7 Cl-93* HCO3-29 AnGap-13
+___ 10:29AM URINE Blood-SM* Nitrite-NEG Protein-NEG 
+Glucose-NEG Ketone-NEG Bilirub-NEG Urobiln-NEG pH-7.0 Leuks-NEG
+___ 10:29AM URINE RBC-6* WBC-2 Bacteri-FEW* Yeast-NONE 
+Epi-<1
+___ 10:29AM URINE CastHy-1*
+
+DISCHARGE LABS
+___ 05:02AM BLOOD WBC-8.7 RBC-3.42* Hgb-12.2* Hct-35.9* 
+MCV-105* MCH-35.7* MCHC-34.0 RDW-15.0 RDWSD-57.4* Plt ___
+___ 05:02AM BLOOD Neuts-77.0* Lymphs-10.0* Monos-8.0 
+Eos-0.1* Baso-0.3 Im ___ AbsNeut-6.69* AbsLymp-0.87* 
+AbsMono-0.70 AbsEos-0.01* AbsBaso-0.03
+___ 05:02AM BLOOD ___ PTT-28.7 ___
+___ 05:02AM BLOOD Glucose-97 UreaN-10 Creat-0.5 Na-140 
+K-3.2* Cl-94* HCO3-32 AnGap-14
+___ 05:02AM BLOOD Albumin-2.9* Calcium-8.3* Phos-3.4 Mg-1.7
+___ 05:02AM BLOOD ALT-12 AST-37 LD(LDH)-491* AlkPhos-163* 
+TotBili-0.6
+
+MICRO
+___ UCx and BCx x2 pending
+
+IMAGING
+___ ___
+Focal DVT of the proximal left femoral vein measuring up to 2.3 
+cm.  No other evidence of DVT in the left lower extremity veins.
+
+ 
+
+###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}, 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}, 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}, URINE Blood {Urine blood test}, Nitrite-NEG {Nitrite not detected in urine}, Protein-NEG {Urine protein not detected}, Glucose-NEG {Urine glucose not detected}, Ketone-NEG {Urine ketones not detected}, NEG {No abnormality detected}, Urobiln-NEG {Urine urobilinogen not detected}, pH {pH measurement}, Leuks-NEG {Urine leukocytes not detected}, URINE {Urinalysis}, RBC {Red blood cell count}, WBC {White blood cell count}, Bacteri {Bacteriuria}, URINE {Urine culture}, 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}, 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}, 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}, Albumin {Albumin measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, ALT {Alanine aminotransferase measurement}, AST {Aspartate aminotransferase measurement}, LDH {Lactate dehydrogenase measurement}, AlkPhos {Alkaline phosphatase measurement}, TotBili {Bilirubin, total measurement}, UCx {Urine culture}, BCx {Blood culture}, IMAGING {Imaging}, DVT {Deep venous thrombosis}, left femoral vein {Structure of left femoral vein}, DVT {Deep venous thrombosis}, left lower extremity veins {Structure of vein of left lower limb}"
+"###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:
+PATIENT SUMMARY
+=================
+Mr. ___ is a ___ man with metastatic melanoma on nivolumab 
+monotherapy, atrial fibrillation not on anticoagulation, history 
+of GI bleed x2 (___) and PE s/p IVC filter (___), now 
+presenting with new LLE DVT.
+
+ACTIVE ISSUES
+================
+#DVT
+Presented with 1 week of LLE pain and swelling in the setting of 
+limited mobility (pt reports recent fall, feeling weak, and 
+having occasional lightheadedness when standing). Found to have 
+DVT of proximal L femoral vein on Doppler ultrasound. History 
+notable for PE in ___ s/p IVC filter placement. He reports 
+being on a DOAC in the past, presumably for afib, which was 
+discontinued in setting of 2 GI bleeds in ___. Rivaroxaban 
+started in the ED on ___, transitioned to apixaban on ___ do 
+to preferable bleeding risk profile. H/H stable after initiation 
+of anticoagulation. 
+
+#Concern for cellulitis
+Received IV cefazolin 1g x2 in the ED for presumed cellulitis of 
+LLE. Exam notable for mild erythema and ulceration of LLE with 
+clear discharge, pain, and swelling which could be related to 
+DVT but will continue empiric non-purulent cellulitis treatment 
+for now with plan for Cephalexin 500mg QID to complete a 10 day 
+course (end date ___. 
+
+#Weakness
+Pt reports weakness a fall ~2 weeks ago while on treadmill. He 
+was referred for physical therapy as an outpatient at home. 
+
+#Melanoma
+Pt has stage IV BRAF WT melanoma s/p resection of abdominal mass 
+and axillary LN dissection, resection of R frontal brain mass, 
+progression of disease on Pembrolizumab then ipi/nivo, now with 
+mixed response on nivolumab monotherapy (C8D1 ___.
+
+#Afib
+Continued home digoxin 0.125mg QD.
+
+#Alcohol use disorder
+#Cirrhosis
+History of cirrhosis likely ___ alcohol use. LFTs wnl except for 
+elevated alk phos and LDH. Did not score on CIWA or require 
+Ativan.
+
+CHRONIC ISSUES
+================
+#Adrenal insufficiency
+Likely ___ immune checkpoint inhibitor therapy. Continued home 
+hydrocortisone 20mg QAM, 10mg QHS.
+
+#Hypothyroidism
+Continued home levothyroxine 75mcg QD.
+
+#HTN
+Pt reports that HTN improved after gastric bypass, currently not 
+on home meds. BP 110s-130s/70s-90s this admission.
+
+#Diabetes
+Pt reports that blood sugars improved after gastric bypass, 
+currently not on home meds. Morning glucose 140s-150s this 
+admission.
+
+#Other home medications
+Continued home omeprazole, multivitamins, iron.
+
+TRANSITIONAL ISSUES
+====================
+[] F/u resolution of DVT on apixaban. Could consider 
+transitioning to lovenox, deferred this admission given 
+significantly higher co-pay.
+[] F/u H/H, melena/hematochezia in 2 weeks on apixaban. 
+[] F/u blood glucose, consider checking A1c.
+[] F/u weakness, falls. Arrangements made for home ___.
+ 
+
+###RESPONSE: metastatic melanoma {Metastatic malignant melanoma}, atrial fibrillation {Atrial fibrillation}, anticoagulation {Anticoagulant therapy}, GI bleed {Gastrointestinal hemorrhage}, PE {Pulmonary embolism}, IVC filter {Inferior vena cava filter in situ}, LLE {Structure of left lower limb}, DVT {Deep venous thrombosis}, DVT {Deep venous thrombosis}, LLE {Structure of left lower limb}, pain {Pain}, swelling {Swelling}, limited mobility {Impaired mobility}, fall {Falls}, feeling weak {Asthenia}, lightheadedness {Lightheadedness}, standing {Orthostatic body position}, DVT {Deep venous thrombosis}, L femoral vein {Structure of left femoral vein}, Doppler ultrasound {Doppler ultrasound}, PE {Pulmonary embolism}, IVC filter placement {Insertion of inferior vena caval filter}, afib {Atrial fibrillation}, GI bleeds {Gastrointestinal hemorrhage}, bleeding risk {At increased risk of hemorrhage}, stable {Patient's condition stable}, anticoagulation {Anticoagulant therapy}, cellulitis {Cellulitis}, cellulitis {Cellulitis}, LLE {Structure of left lower limb}, Exam {Physical examination procedure}, mild {Symptom mild}, erythema {Erythema}, ulceration {Ulcer}, LLE {Structure of left lower limb}, discharge {Discharge from skin ulcer}, pain {Pain}, swelling {Swelling}, DVT {Deep venous thrombosis}, purulent {Purulent}, cellulitis {Cellulitis}, Weakness {Asthenia}, weakness {Asthenia}, fall {Falls}, physical therapy {Physical therapy procedure}, Melanoma {Malignant melanoma of skin}, stage IV {Clinical stage IV}, melanoma {Malignant melanoma of skin}, resection {Excision}, abdominal mass {Abdominal mass}, axillary LN dissection {Excision of axillary lymph node}, resection {Excision}, R frontal {Right frontal lobe structure}, brain mass {Mass lesion of brain}, disease {Disease}, Afib {Atrial fibrillation}, Alcohol use disorder {Alcoholism}, Cirrhosis {Cirrhosis of liver}, cirrhosis likely ___ alcohol use {Alcoholic cirrhosis}, LFTs wnl {Liver function tests within reference range}, elevated alk phos {Serum alkaline phosphatase within reference range}, LDH {Serum lactate dehydrogenase level above reference range}, CHRONIC ISSUES {Chronic disease}, Adrenal insufficiency {Adrenal cortical hypofunction}, immune checkpoint inhibitor therapy {Immune checkpoint inhibitor therapy}, Hypothyroidism {Hypothyroidism}, HTN {Hypertensive disorder, systemic arterial}, HTN {Hypertensive disorder, systemic arterial}, improved {Patient's condition improved}, gastric bypass {Bypass of stomach}, Diabetes {Diabetes mellitus}, blood sugars {Blood sugar management}, improved {Patient's condition improved}, gastric bypass {Bypass of stomach}, glucose {Glucose measurement, blood}, resolution {Problem resolved}, DVT {Deep venous thrombosis}, melena {Melena}, hematochezia {Hematochezia}, blood glucose {Glucose measurement, blood}, weakness {Asthenia}, falls {Falls}"
+"###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 may be inaccurate and requires 
+futher investigation.
+1. Colchicine 0.6 mg PO DAILY:PRN gout flare 
+2. Digoxin 0.125 mg PO DAILY 
+3. Hydrocortisone 10 mg PO QHS 
+4. Hydrocortisone 20 mg PO QAM 
+5. Levothyroxine Sodium 75 mcg PO DAILY 
+6. Omeprazole 20 mg PO DAILY 
+7. Cyanocobalamin 100 mcg PO DAILY 
+8. Ferrous Sulfate 325 mg PO DAILY 
+9. Multivitamins W/minerals 1 TAB PO DAILY 
+
+ 
+Discharge Medications:
+1.  Apixaban 10 mg PO BID Duration: 7 Days  
+2.  Cephalexin 500 mg PO QID 
+RX *cephalexin 500 mg 1 capsule(s) by mouth every six (6) hours 
+Disp #*34 Capsule Refills:*0 
+3.  Colchicine 0.6 mg PO DAILY:PRN gout flare  
+4.  Cyanocobalamin 100 mcg PO DAILY  
+5.  Digoxin 0.125 mg PO DAILY  
+6.  Ferrous Sulfate 325 mg PO DAILY  
+7.  Hydrocortisone 10 mg PO QHS  
+8.  Hydrocortisone 20 mg PO QAM  
+9.  Levothyroxine Sodium 75 mcg PO DAILY  
+10.  Multivitamins W/minerals 1 TAB PO DAILY  
+11.  Omeprazole 20 mg PO DAILY  
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+PRIMARY:
+========
+Deep vein thrombosis
+Skin and soft tissue infection 
+
+SECONDARY: 
+==========
+METASTATIC MELANOMA 
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - requires assistance or aid (walker 
+or cane).
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, Deep vein thrombosis {Deep venous thrombosis}, Skin {Infection of skin}, soft tissue infection {Soft tissue infection}, METASTATIC MELANOMA {Metastatic malignant melanoma}, 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 - requires assistance or aid {Finding of walking aid use}, walker {Uses zimmer frame}, cane {Uses single walking stick}"
+"###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. ___,
+ 
+It was a pleasure caring for you at ___ 
+___.  
+ 
+WHY WAS I IN THE HOSPITAL?  
+ - You were admitted for treatment of a blood clot in your leg, 
+known as a deep vein thrombosis (DVT) and a skin infection.
+ 
+WHAT HAPPENED TO ME IN THE HOSPITAL?  
+ - You were started on a medication to thin your blood to treat 
+your DVT
+ - You were given antibiotics to treat a possible skin 
+infection. 
+ 
+WHAT SHOULD I DO AFTER I LEAVE THE HOSPITAL?  
+ - Continue to take all your medicines and keep your 
+appointments.  
+ - Please call your oncologist or return to the emergency 
+department if you experience any of the danger signs listed 
+below. 
+ 
+We wish you the best!  
+ 
+Sincerely,  
+Your ___ Team  
+
+ 
+
+###RESPONSE: blood clot {Blood clot}, leg {Structure of left lower leg}, deep vein thrombosis {Deep venous thrombosis}, DVT {Deep venous thrombosis}, skin infection {Infection of skin}, started {New medication added}, medication to thin your blood {Anticoagulant therapy}, DVT {Deep venous thrombosis}, antibiotics {Antibiotic therapy}, skin 
+infection {Infection of skin and/or subcutaneous tissue}, return to the emergency {Emergency treatment education}"
+"###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:
+chest pain
+ 
+Major Surgical or Invasive Procedure:
+Cardiac cath ___ and ___
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, chest pain {Chest pain}, Cardiac cath {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:
+___ male with a past medical history significant for 
+rheumatoid arthritis, chronic pain, and significant cardiac 
+history including CABG in ___ and PCI 6 months ago presents 
+with severe chest pain with associated arm/jaw pain since 
+___. Pain initially exertional but now at rest, 
+described as sharp like an ice pick with extension to left arm 
+and jaw similar to pain prior to CABG. He notes SOB, 
+nausea/vomiting, palpitations associated with this chest pain. 
+Denies orthopnea, PND. Patient presented to OSH after having a 
+possible syncopal episode when he had pain and weakness climbing 
+stairs from doing laundry and thinks he may have lost 
+consciousness. He had some relief with baby ASA. In ___, 
+afebrile with HR ___ to ___ and systolic BP 140s, oxygen 
+saturation stable on room air, troponin 0.03, EKG with no 
+changes, chest x-ray negative. Patient states that he passed out 
+in ___ lobby, RN reports rapid response due to severe 
+chest pain which was improved with nitro SLx3, IV morphine, 
+clonazepam.  
+On the floor, patient complains of severe ___ chest pain and is 
+tearful. Pain improved with nitro gtt.  
+Review of Systems: As per HPI, otherwise negative. 
+ 
+
+###RESPONSE: rheumatoid arthritis {Rheumatoid arthritis}, chronic pain {Chronic pain}, cardiac {Heart disease}, CABG {Coronary artery bypass grafting}, PCI {Percutaneous coronary intervention}, chest pain {Chest pain}, arm {Pain in upper limb}, jaw pain {Jaw pain}, Pain {Chest pain}, exertional {Chest pain}, at rest {Chest pain at rest}, sharp {Sharp pain}, extension to left arm {Pain radiating to left arm}, jaw {Pain radiating to jaw}, pain {Chest pain}, CABG {Coronary artery bypass grafting}, SOB {Dyspnea}, nausea/vomiting {Nausea and vomiting}, palpitations {Palpitations}, chest pain {Chest pain}, orthopnea {Orthopnea}, PND {Paroxysmal nocturnal dyspnea}, syncopal {Syncope}, pain {Chest pain}, weakness {Asthenia}, lost 
+consciousness {Loss of consciousness}, relief {Pain relief}, ASA {Administration of aspirin}, afebrile {Temperature normal}, HR {Finding of heart rate}, BP {Blood pressure finding}, oxygen 
+saturation {Finding of oxygen saturation}, on room air {Breathing room air}, troponin {Troponin measurement}, EKG {Electrocardiographic procedure}, chest x-ray {Plain chest X-ray}, negative {No abnormality detected}, chest pain {Chest pain}, improved {Patient's condition improved}, chest pain {Chest pain}, tearful {Crying}, Pain improved {Sensation of pain reduced}, Review of Systems {Review of systems}, negative {No abnormality detected}"
+"###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:
+Coronary artery disease status post 5 vessel CABG (___)  
+CHF  
+Hypertension  
+Hypercholesterolemia  
+Rheumatoid arthritis on prednisone  
+Ulcerative colitis  
+GERD  
+Sciatica  
+Appendectomy  
+Knee arthroplasty  
+Anxiety attacks  
+Recent right knee replacement  
+Recent cardiac catheterization in ___ with stent placement 
+x2  
+Chronic back pain  
+Osteoarthritis  
+Depression with recent hospitalization 
+ 
+
+###RESPONSE: Coronary artery disease {Coronary arteriosclerosis}, 5 vessel CABG {Coronary artery bypass grafts x 5}, CHF {Congestive heart failure}, Hypertension {Hypertensive disorder, systemic arterial}, Hypercholesterolemia {Hypercholesterolemia}, Rheumatoid arthritis {Rheumatoid arthritis}, Ulcerative colitis {Ulcerative colitis}, GERD {Gastroesophageal reflux disease}, Sciatica {Sciatica}, Appendectomy {Excision of appendix}, Knee arthroplasty {Arthroplasty of knee}, Anxiety attacks {Anxiety attack}, nt right knee replacement {Total replacement of right knee joint}, cardiac catheterization {Cardiac catheterization}, stent placement {Placement of stent in coronary artery}, Chronic back pain {Chronic back pain}, Osteoarthritis {Osteoarthritis}, Depression {Depressive 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: 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 with CHF
+ 
+
+###RESPONSE: CHF {Congestive heart failure}"
+"###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:
+Vitals - T: 98.1 BP: 141/84 HR: 67 RR: 20 02 sat: 98% on 2L wt 
+204 lbs (OSH)  
+GENERAL: Patient in moderate distress, tearful  
+HEENT: AT/NC, EOMI, PERRL, anicteric sclera, pink conjunctiva, 
+MMM. Xanthelasma present near left eye.  
+NECK: nontender supple neck, no LAD, no JVD  
+CARDIAC: RRR, S1/S2, no murmurs, gallops, or rubs  
+LUNG: CTAB, no wheezes, rales, rhonchi, breathing comfortably 
+without use of accessory muscles  
+ABDOMEN: nondistended, +BS, nontender in all quadrants, no 
+rebound/guarding, no hepatosplenomegaly  
+EXTREMITIES: 2+ ___ edema, moving all 4 extremities with purpose  
+
+PULSES: 2+ DP pulses bilaterally  
+NEURO: CN II-XII intact  
+SKIN: warm and well perfused, no excoriations or lesions, no 
+rashes  
+
+DISCHARGE PHYSICAL EXAM:
+Vitals: T 97.9 96/66 64 (58-82) 18 97% RA  
+Tele: NSR 
+Last 24 hours I/O: ___
+Today's weight: 90.6
+GENERAL: NAD, sitting up in bed  
+HEENT: AT/NC, EOMI, PERRL, anicteric sclera, pink conjunctiva, 
+MMM. Xanthelasma present near left eye.  
+NECK: nontender supple neck, no JVD  
+CARDIAC: RRR, S1/S2, no murmurs, gallops, or rubs  
+LUNG: CTAB, no wheezes, rales, rhonchi, breathing comfortably 
+without use of accessory muscles, + pain with palpation over 
+anterior chest, no pain with deep breath  
+ABDOMEN: nondistended, +BS, nontender in all quadrants  
+EXTREMITIES: no edema, moving all 4 extremities with purpose  
+PULSES: 2+ DP pulses bilaterally  
+NEURO: CN II-XII intact  
+SKIN: warm and well perfused, no excoriations or lesions, no 
+rashes  
+ 
+
+ 
+
+###RESPONSE: PHYSICAL EXAM {Physical examination procedure}, Vitals {Vital signs finding}, T {Body temperature finding}, BP {Blood pressure finding}, HR {Finding of heart rate}, RR {Finding of rate of respiration}, 02 sat {Oxygen saturation measurement}, GENERAL {General examination of patient}, distress {Distress}, tearful {Crying}, HEENT {Physical examination procedure}, NC {Normal head}, EOMI {Normal ocular motility}, PERRL {Pupils equal and reacting to light}, anicteric sclera {White sclera}, pink conjunctiva {Conjunctival hyperemia}, MMM {Moist oral mucosa}, Xanthelasma {Xanthelasma}, left eye {Left eye structure}, NECK {Physical examination procedure}, nontender {Abdominal tenderness}, supple {Normal movement of neck}, LAD {Lymphadenopathy}, JVD {Jugular venous engorgement}, CARDIAC {Cardiovascular physical examination}, RRR {Normal heart rate}, S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, murmurs {Murmur}, gallops {Gallop rhythm}, rubs {Pericardial friction rub}, LUNG {Examination of respiratory system}, CTAB {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, rhonchi {Wheeze - rhonchi}, breathing comfortably {Breathing easily}, accessory muscles {Accessory skeletal muscle}, ABDOMEN {Examination of abdomen}, nondistended {Normal abdominal contour}, +BS {Normal bowel sounds}, nontender {Abdominal tenderness}, rebound {Rebound tenderness}, guarding {Abdominal guarding}, hepatosplenomegaly {Hepatosplenomegaly}, EXTREMITIES {Examination of limb}, edema {Edema}, moving all 4 extremities {Does move all four limbs}, PULSES {Pulse finding}, 2+ DP pulses {All pulses present in bilateral lower limbs}, NEURO {Neurological examination}, CN II-XII intact {Normal central nervous system}, SKIN {Examination of skin}, warm {Warm skin}, well perfused {Normal tissue perfusion}, excoriations {Excoriation}, lesions {Lesion}, rashes {Eruption of skin}, Vitals {Vital signs finding}, T {Body temperature finding}, RA {Breathing room air}, Tele {Cardiac telemetry}, NSR {Normal sinus rhythm}, weight {Weight finding}, RA {Breathing room air}, NAD {No abnormality detected}, sitting up in bed {Fowler's position}, HEENT {Physical examination procedure}, NC {Normal head}, EOMI {Normal ocular motility}, PERRL {Pupils equal and reacting to light}, anicteric sclera {White sclera}, pink conjunctiva {Conjunctival hyperemia}, MMM {Moist oral mucosa}, Xanthelasma {Xanthelasma}, left eye {Left eye structure}, NECK {Physical examination procedure}, supple neck {Normal movement of neck}, JVD {Jugular venous engorgement}, CARDIAC {Cardiovascular physical examination}, RRR {Normal heart rate}, S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, murmurs {Heart murmur}, gallops {Gallop rhythm}, rubs {Pericardial friction rub}, LUNG {Examination of respiratory system}, CTAB {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, rhonchi {Wheeze - rhonchi}, breathing comfortably {Breathing easily}, accessory muscles {Accessory skeletal muscle}, pain {Pain}, palpation {Palpation}, chest {Thoracic structure}, pain with deep breath {Pain provoked by breathing}, ABDOMEN {Examination of abdomen}, +BS {Normal bowel sounds}, EXTREMITIES {Examination of limb}, edema {Edema}, moving all 4 extremities {Does move all four limbs}, PULSES {Pulse finding}, 2+ DP pulses {All pulses present in bilateral lower limbs}, NEURO {Neurological examination}, CN II-XII {Structure of cervical spinal nerve}, intact  
+SKIN {Examination of skin}, warm {Warm skin}, well perfused {Normal tissue perfusion}, excoriations {Excoriation}, lesions {Skin lesion}, 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:
+ADMISSION LABS:
+___ 11:55PM BLOOD WBC-5.7 RBC-4.34* Hgb-12.9* Hct-38.1* 
+MCV-88 MCH-29.8 MCHC-33.9 RDW-15.1 Plt ___
+___ 11:55PM BLOOD Neuts-61.4 ___ Monos-5.2 Eos-3.7 
+Baso-0.6
+___ 11:55PM BLOOD ___ PTT-127.1* ___
+___ 11:55PM BLOOD Glucose-104* UreaN-12 Creat-0.8 Na-142 
+K-3.4 Cl-105 HCO3-28 AnGap-12
+___ 11:55PM BLOOD CK-MB-1 cTropnT-<0.01
+___ 09:05AM BLOOD CK-MB-<1 cTropnT-<0.01
+___ 11:55PM BLOOD Calcium-9.1 Phos-3.4 Mg-2.1
+
+DISCHARGE LABS:
+___ 06:45AM BLOOD WBC-4.2 RBC-4.43* Hgb-12.8* Hct-39.1* 
+MCV-88 MCH-28.9 MCHC-32.8 RDW-15.1 Plt ___
+___ 06:45AM BLOOD Glucose-118* UreaN-18 Creat-1.2 Na-140 
+K-4.4 Cl-101 HCO3-31 AnGap-12
+___ 07:00PM BLOOD CK-MB-<1 cTropnT-<0.01
+___ 12:31AM BLOOD CK-MB-<1 cTropnT-<0.01
+___ 06:45AM BLOOD Calcium-9.1 Phos-4.9* Mg-2.3
+
+IMAGING:
+CARDIAC CATH ___:
+Hemodynamics (see above):
+Coronary angiography:  right dominant
+LMCA: 
+LAD:  90% proximal, 100% mid
+LCX:  40% proximal, 99% distal with patent stent in midvessel 
+and
+occluded OMs
+RCA:  100% proximal
+SVG-:  radial to OM patent, vein to PDA with 75% in-stent
+restenosis, vein to diagonal known patent
+LIMA-LAD:  not injected but known 80% in LAD beyond graft
+Other: 
+
+Assessment & Recommendations
+ 1. Will discuss options after review prior films with probable
+PCI of restenosis of PDA graft and PCI of distal circumflex next
+week.  Both supply small territories.
+
+CARDIAC CATH ___:
+Hemodynamics (see above):
+Coronary angiography:  right dominant
+LMCA: 
+LAD:  known 80% proximal, 100% mid
+LCX:  known diffuse up to 60% with patent stent in mid vessel 
+and
+complex ___ distal with occluded OMs
+RCA:  known ___ proximal
+SVG-:  diagonal patent, vein to PDA with only 30% in-stent
+restenosis after IC nicardipine which is much improved compared
+with angiography 3 days ago, radial to OM2 known patent
+LIMA-LAD:  LAD with 70% beyond anastomosis with diffusely small
+caliber distal vessel
+Other:  Aortogram shows patent vein to diagonal and patent 
+radial
+to OM2
+
+Interventional details
+After IC nicardipine administration showed improvement in distal
+PDA graft, intervention considered no longer necessary on that
+area.  PCI of distal LAD beyond LIMA and PCI of distal 
+circumflex
+would both be difficult but could be considered if recurrent
+angina or markedly positive ETT.
+
+Assessment & Recommendations
+ 1. Continue med Rx.
+ 2. Consider PCI if recurrent angina.
+
+CXR ___:
+Normal lung volumes. Normal appearance of the mediastinum and 
+the hilar
+structures. Sternotomy wires of the CABG show correct alignment. 
+Borderline
+size of the cardiac silhouette. Mild elongation of the 
+descending aorta.  No pneumonia, no pulmonary edema.  No pleural 
+effusions.
+
+EXERCISE STRESS TEST ___:
+Fair exercise tolerance. Atypical/non-anginal type symptoms
+with no ischemic ST segment changes at the achieved level of 
+work.
+Nuclear report sent separately.
+
+CARDIAC PERFUSION STUDY ___:
+1. At level of exercise achieved, no myocardial perfusion 
+defects. 
+2.  Normal left ventricular ejection fraction of 54%.  
+3.  Mildly prominent
+right ventricle.
+ 
+
+###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}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {Red cell distribution width determination}, Neuts {Neutrophil 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}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac 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}, MCV {Erythrocyte mean corpuscular volume determination}, MCH {Mean corpuscular hemoglobin determination}, MCHC {Mean corpuscular hemoglobin concentration determination}, RDW {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}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, CK-MB {Creatine kinase MB isoenzyme measurement}, cTropnT {Troponin T cardiac measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, Coronary angiography {Angiography of coronary artery}, LMCA: {Structure of left coronary artery main stem}, LAD {Structure of anterior descending branch of left coronary artery}, proximal {Structure of proximal portion of anterior descending branch of left coronary artery}, mid {Structure of mid portion of anterior descending branch of left coronary artery}, LCX {Structure of circumflex branch of left coronary artery}, proximal {Structure of proximal portion of circumflex branch of left coronary artery}, distal {Structure of distal portion of circumflex branch of left coronary artery}, patent stent {Coronary stent patent}, midvessel {Structure of mid portion of circumflex branch of left coronary artery}, occluded {Complete obstruction}, OMs {Structure of obtuse marginal branch of circumflex branch of left coronary artery}, RCA {Right coronary artery structure}, proximal {Structure of proximal portion of right coronary artery}, SVG {Aortocoronary artery bypass graft with saphenous vein graft}, radial {Structure of radial artery}, OM {Structure of obtuse marginal branch of circumflex branch of left coronary artery}, vein {Venous structure}, PDA {Structure of posterior descending coronary artery}, stent {Placement of stent}, restenosis {Restenosis}, vein {Venous structure}, diagonal {Structure of diagonal branch of anterior descending branch of left coronary artery}, LIMA {Structure of left internal thoracic artery}, LAD {Structure of anterior descending branch of left coronary artery}, LAD {Structure of anterior descending branch of left coronary artery}, graft {Structure of transplant}, PCI {Percutaneous coronary intervention}, restenosis {Restenosis}, PDA {Structure of posterior descending coronary artery}, graft {Structure of transplant}, PCI {Percutaneous coronary intervention}, distal circumflex {Structure of distal portion of circumflex branch of left coronary artery}, CARDIAC CATH {Cardiac catheterization}, Coronary angiography {Angiography of coronary artery}, right dominant {Right dominant coronary system}, LMCA {Structure of left coronary artery main stem}, LAD {Structure of anterior descending branch of left coronary artery}, proximal {Structure of proximal portion of anterior descending branch of left coronary artery}, mid
+LCX {Structure of mid portion of circumflex branch of left coronary artery}, patent stent {Coronary stent patent}, mid vessel {Structure of mid portion of circumflex branch of left coronary artery}, distal {Structure of distal portion of circumflex branch of left coronary artery}, occluded {Complete obstruction}, OMs {Structure of obtuse marginal branch of circumflex branch of left coronary artery}, RCA {Right coronary artery structure}, proximal {Structure of proximal portion of right coronary artery}, SVG {Aortocoronary artery bypass graft with saphenous vein graft}, diagonal {Structure of diagonal branch of anterior descending branch of left coronary artery}, vein {Venous structure}, PDA {Structure of posterior descending coronary artery}, restenosis {Restenosis}, improved {Patient's condition improved}, angiography {Angiography}, radial {Coronary artery bypass grafting using radial artery graft}, OM2 {Structure of second obtuse marginal branch of circumflex branch of left coronary artery}, LIMA {Structure of left internal thoracic artery}, LAD {Structure of anterior descending branch of left coronary artery}, LAD {Structure of anterior descending branch of left coronary artery}, anastomosis {Anastomosis}, distal vessel {Structure of distal portion of anterior descending branch of left coronary artery}, patent vein {Venous access patent}, diagonal {Structure of diagonal branch of anterior descending branch of left coronary artery}, radial {Coronary artery bypass grafting using radial artery graft}, OM2 {Structure of second obtuse marginal branch of circumflex branch of left coronary artery}, PDA {Structure of posterior descending coronary artery}, graft {Structure of transplant}, PCI {Percutaneous coronary intervention}, distal LAD {Structure of distal portion of anterior descending branch of left coronary artery}, LIMA {Structure of left internal thoracic artery}, PCI {Percutaneous coronary intervention}, distal 
+circumflex {Structure of distal portion of circumflex branch of left coronary artery}, recurrent {Recurrent disease}, angina {Angina}, PCI {Percutaneous coronary intervention}, recurrent {Recurrent disease}, angina {Angina}, Normal lung volumes {Lung volume test normal}, Normal appearance {Normal appearance}, mediastinum {Mediastinal structure}, hilar {Structure of hilum of lung}, Sternotomy {Sternotomy}, CABG {Coronary artery bypass grafting}, cardiac {Heart structure}, descending aorta {Descending aorta structure}, pneumonia {Pneumonia}, pulmonary edema {Pulmonary edema}, pleural 
+effusions {Pleural effusion}, exercise tolerance {Exercise tolerance finding}, Atypical {Atypical angina}, anginal {Angina}, ischemic {Ischemia}, ST segment changes {Finding of electrocardiogram ST segment}, myocardial perfusion 
+defects {Myocardial perfusion defect}, left ventricular {Left cardiac ventricular structure}, right ventricle {Right cardiac ventricular 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:
+___ year old male with a PMHx significant for rheumatoid 
+arthritis, chronic pain, and significant cardiac history 
+including CABG in ___ and PCI 6 months ago presents with severe 
+chest pain with associated arm/jaw pain without EKG changes or 
+troponin leak.  
+
+ACUTE ISSUES:
+#Chest pain: Patient had history of CAD s/p CABG and PCIs with 
+significant chest pain at rest without EKG changes and negative 
+troponins. He underwent catheterization on ___ which showed 
+extensive disease in the LAD, Lcx and RCA. No intervention was 
+performed given that the previous films were not available for 
+review and it was unknown whether the lesions were new or old. 
+He underwent repeat catheterization on ___ without 
+interventions given poor anatomy unchanged from prior PCI. He 
+was continued on aspirin, plavix, metoprolol and atorvastatin. 
+He continued to have significant chest pain at rest and with 
+minimal exertion without EKG changes. He was started on imdur, 
+amlodipine and ranolazine without much improvement in chest 
+pain. He had a stress test and nuclear study which showed no EKG 
+changes or evidence of ischemia. Chest pain was not felt to be 
+due to cardiac ischemia given these findings. He was discharged 
+with plans to follow-up with his PCP/cardiologist for further 
+management. 
+ 
+#Chronic pain: Patient has sciatica and multiple joint surgeries 
+in addition to chronic inflammatory diseases. He is on many pain 
+medications as an outpatient and had a significant requirement 
+for narcotics while hospitalized. He also endorsed symptoms of 
+withdrawal when he did not get his opioid medications. He 
+complained mostly of back and chest pain, which was treated with 
+home medications of oxycodone, oxycontin and gabapentin. He was 
+seen by the chronic pain service given that patient's chest pain 
+was at times reproducible who recommended increasing gabapentin, 
+starting volteran gel and using a lidocaine patch. Patient's 
+chest and back pain improved with these interventions. 
+ 
+#Anxiety: Patient was continued on home clonazepam, trazodone, 
+benadryl prn.   
+
+CHRONIC ISSUES:
+# ___ edema: Patient was continued on home furosemide. 
+
+#Rheumatoid arthritis/ulcerative colitis: Patient is on 
+methotrexate and prednisone at home. He had no flares of joint 
+pain or diarrhea during this hospitalization. He was continued 
+on home prednisone and methotrexate was held.   
+
+TRANSITIONAL ISSUES:
+- Patient was started on Imdur 30mg PO daily, amlodipine 5 mg 
+daily, ranolazine 1000 mg BID
+- increased gabapentin to 900 mg TID
+- started acetaminophen 1000 mg q8h, voltaran cream and 
+lidocaine patches
+- recommend psychiatry follow-up and therapy
+ 
+Discharge Medications:
+1. Aspirin 81 mg PO DAILY 
+2. ClonazePAM 1 mg PO QID 
+3. DiphenhydrAMINE 25 mg PO Q6H:PRN itch 
+4. FoLIC Acid 1 mg PO DAILY 
+5. Furosemide 20 mg PO DAILY 
+6. Gabapentin 600 mg PO BID 
+7. Metoprolol Succinate XL 25 mg PO DAILY 
+8. Omeprazole 20 mg PO DAILY 
+9. OxycoDONE (Immediate Release)  10 mg PO Q8H:PRN pain 
+10. OxyCODONE SR (OxyconTIN) 40 mg PO Q8H 
+11. PredniSONE 5 mg PO BID 
+12. TraZODone 100 mg PO QHS insomnia 
+13. Acetaminophen 650 mg PO Q6H:PRN pain 
+RX *acetaminophen 650 mg 1 tablet(s) by mouth every six (6) 
+hours Disp #*30 Tablet Refills:*0
+14. Atorvastatin 80 mg PO QPM 
+RX *atorvastatin 80 mg 1 tablet(s) by mouth every night Disp 
+#*30 Tablet Refills:*0
+15. Clopidogrel 75 mg PO DAILY 
+RX *clopidogrel 75 mg 1 tablet(s) by mouth daily Disp #*30 
+Tablet Refills:*0
+16. Isosorbide Mononitrate (Extended Release) 30 mg PO DAILY 
+RX *isosorbide mononitrate 30 mg 1 tablet(s) by mouth daily Disp 
+#*30 Tablet Refills:*0
+17. Lidocaine 5% Patch 1 PTCH TD QAM 
+RX *lidocaine 5 % (700 mg/patch) Place 1 patch to area of worst 
+pain every morning. Please remove after 12 hours. every morning 
+Disp #*30 Patch Refills:*0
+18. Nitroglycerin SL 0.3 mg SL Q5MIN:PRN chest pain 
+RX *nitroglycerin [Nitrostat] 0.3 mg 1 tablet(s) sublingually q5 
+minutes Disp #*20 Tablet Refills:*0
+19. Methocarbamol 500 mg PO Q8H 
+20. Methotrexate 15 mg PO 1X/WEEK (___) 
+
+ 
+
+###RESPONSE: rheumatoid 
+arthritis {Rheumatoid arthritis}, chronic pain {Chronic pain}, cardiac {Heart disease}, CABG {Coronary artery bypass grafting}, PCI {Percutaneous coronary intervention}, chest pain {Chest pain}, arm {Pain in upper limb}, jaw pain {Jaw pain}, EKG changes {Electrocardiogram abnormal}, Chest pain {Chest pain}, CAD {Coronary arteriosclerosis}, CABG {Coronary artery bypass grafting}, PCIs {Percutaneous coronary intervention}, chest pain at rest {Chest pain at rest}, EKG changes {Electrocardiogram abnormal}, catheterization {Cardiac catheterization}, LAD {Structure of anterior descending branch of left coronary artery}, Lcx {Structure of circumflex branch of left coronary artery}, RCA {Right coronary artery structure}, lesions {Lesion}, catheterization {Cardiac catheterization}, PCI {Percutaneous coronary intervention}, aspirin {Administration of aspirin}, chest pain at rest {Chest pain at rest}, exertion {Chest pain on exertion}, EKG changes {Electrocardiogram abnormal}, chest 
+pain {Chest pain}, stress test {Electrocardiogram with exercise test}, nuclear study {Nuclear medicine diagnostic procedure on cardiovascular system}, EKG 
+changes {Electrocardiogram abnormal}, ischemia {Ischemia}, Chest pain {Chest pain}, cardiac ischemia {Myocardial ischemia}, Chronic pain {Chronic pain}, sciatica {Sciatica}, joint {Joint structure}, surgeries {Surgical procedure}, chronic inflammatory diseases {Chronic inflammatory disorder}, pain 
+medications {Administration of analgesic}, narcotics {Narcotherapy}, withdrawal {Opioid withdrawal syndrome}, back {Backache}, chest pain {Chest pain}, chronic pain {Chronic pain}, chest pain {Chest pain}, chest {Thoracic structure}, pain improved {Sensation of pain reduced}, Anxiety {Anxiety}, edema {Edema of lower extremity}, Rheumatoid arthritis {Rheumatoid arthritis}, ulcerative colitis {Ulcerative colitis}, joint 
+pain {Joint pain}, 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: Discharge Disposition:
+Home
+ 
+Discharge Diagnosis:
+PRIMARY DIAGNOSIS:
+Chest pain
+Chronic pain 
+Anxiety
+
+SECONDARY DIAGNOSIS:
+CAD s/p ___ 
+ 
+___ Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+ 
+
+###RESPONSE: Chest pain {Chest pain}, Chronic pain {Chronic pain}, Anxiety {Anxiety}, CAD {Coronary arteriosclerosis}, 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:
+Dear Mr. ___, 
+
+You were admitted to ___ with chest pain. Your EKG was 
+unchanged from prior. You had a cardiac cath which was unchanged 
+from your prior cath about six months ago. Given that this was 
+unlikely to be accounting for your chest pain, there was no 
+intervention. You were continued on your home medications, but 
+still had a few episodes of chest pain. A new medication was 
+added to help with this pain. You should continue to take all 
+your home medications as prescribed. 
+
+It was a pleasure taking care of you, 
+Your ___ Doctors
+
+ 
+___ Instructions:
+___
+
+###RESPONSE: chest pain {Chest pain}, EKG {Electrocardiographic procedure}, cardiac cath {Cardiac catheterization}, cath {Cardiac catheterization}, chest pain {Chest pain}, chest pain {Chest pain}, 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:  
+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:
+Diarrhea
+ 
+Major Surgical or Invasive Procedure:
+None
+
+ 
+
+###RESPONSE: No Known Allergies {Allergic disposition}, Adverse Drug Reactions {Propensity to adverse reactions to drug}, 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:
+Mr. ___ is a ___ YO homeless male who presented to the ED for 2 
+days of watery green diarrhea. He was in his usual state of 
+health until 3 days ago when he developed greenish watery 
+diarrhea. He has had > 20 BMs a day. Also has had diffuse mild 
+cramping, nausea, weakness, and pre-syncope. Today he noted 
+fevers and chills. He has also has HA and a cough for 2 months 
+and recently was prescribed a z pack for this ___. He 
+denies emesis but has had loss of appetite (last meal 2 days 
+ago). Denies undercooked meat. Possible sick contacts at the 
+___. There is only one bathroom for > 100 residents. He also 
+recently returned from ATL on a plane.  
+.  
+Of note, Mr. ___ denies current blood in his stool, but he had 
+BRBPR 1 month ago with anemia and states that his PCP wanted to 
+refer him for colonoscopy.  
+.  
+In the ED vital signs were: Temp:97.1 HR:130 BP:108/76 Resp:18 
+O(2)Sat:100 RA. His EKG revealed sinus tacycardia. His abdomen 
+was slightly tender. Patient had a CT scan of abd/pelvis and CXR 
+which were both normal. Hct, chem 7, and LFTs were WNL except 
+for bicarb 21. No anion gap. Patient was given 4 liters of 
+intravenous fluids but remained tachycardic with HR 110-120 and 
+then he spiked a temperature of 100.8. He was given zofran, 
+famotidine, tylenol, and morphine. He was admitted for fluid 
+hydration. Vital signs at the time of transfer were 100.3 111 
+124/76 18 100RA  
+.  
+On the floor, pt is still having multiple bouts of diarrhea, but 
+otherwise denies complaint.  
+.  
+Review of systems:  
+(+) Per HPI. Also + for rhinorha, HA, cough. No SOB, CP, or 
+palpitations. No dysuria. Denied arthralgias or myalgias and 
+rash.
+ 
+
+###RESPONSE: homeless {Homeless}, watery {Liquid stool}, green {Feces color: green}, diarrhea {Diarrhea}, greenish {Feces color: green}, watery {Liquid stool}, diarrhea {Diarrhea}, diffuse {Diffuse pain}, nausea {Nausea}, weakness {Asthenia}, pre-syncope {Near syncope}, fevers {Fever}, chills {Chill}, HA {Headache}, cough {Cough}, emesis {Vomiting}, loss of appetite {Loss of appetite}, blood in his stool {Hematochezia}, BRBPR {Hematochezia}, anemia {Anemia}, colonoscopy {Colonoscopy}, RA {Breathing room air}, EKG {Electrocardiographic procedure}, sinus tacycardia {Sinus tachycardia}, abdomen 
+was slightly tender {Abdominal tenderness}, CT scan of abd/pelvis {Computed tomography of abdomen and pelvis}, CXR {Plain chest X-ray}, LFTs were WNL {Liver function tests within reference range}, intravenous fluids {Intravenous infusion}, tachycardic {Tachycardia}, HR {Finding of heart rate}, Vital signs {Vital signs finding}, diarrhea {Diarrhea}, rhinorha {Nasal discharge}, HA {Headache}, cough {Cough}, SOB {Dyspnea}, CP {Chest pain}, palpitations {Palpitations}, dysuria {Dysuria}, arthralgias {Joint pain}, myalgias {Muscle pain}, rash {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: Past Medical History:
+1. Homelessness: Lives in shelter by ___ for past few months 
+since moved here from ___. Recently applied for ___ 
+___  
+2. bronchitis - presented to ED ___ with multiple complaints - 
+treated with albuterol inhaler and Z pack  
+3. anxiety/depression - presented to ED ___ and ___. Paranoid personality disorder  
+5. nephrolithiasis - seen on CT scan  
+6. Trigger finger - offerred surgery but has declined  
+7. h/o head trauma at age ___ s/p being struck in head with a  
+baseball. Denies LOC at that time.  
+8. s/p MVA ___ years ago, pedestrian struck by utility vehicle. 
++LOC.  
+9. HTN  
+10. spinal stenosis  
+11. PTSD 
+ 
+
+###RESPONSE: Homelessness {Homeless}, bronchitis {Bronchitis}, multiple complaints {Multiple symptoms}, anxiety/depression {Mixed anxiety and depressive disorder}, Paranoid personality disorder {Paranoid personality disorder}, nephrolithiasis {Kidney stone}, CT scan {Computed tomography of abdomen}, Trigger finger {Acquired trigger finger}, head trauma {Injury of head}, head {Head structure}, LOC {Loss of consciousness}, MVA {Motor vehicle accident victim}, LOC {Loss of consciousness}, HTN {Hypertensive disorder, systemic arterial}, spinal stenosis {Spinal stenosis}, PTSD {Posttraumatic stress 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: 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:
+CAD- 4 brothers had MI  
+mother had stent placed  
+father lung cancer  
+sister with depression, daughter with bipolar d/O  
+
+ 
+
+###RESPONSE: CAD {Coronary arteriosclerosis}, MI {Myocardial infarction}, stent placed {Stented coronary artery}, lung cancer {Malignant tumor of lung}, depression {Depressive disorder}, bipolar d/O {Bipolar 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: Physical Exam:
+Vitals: T: 98.3 BP: 135/90 P: 99 R: 18 O2: 100% RA  
+General: Alert, oriented, no acute distress  
+HEENT: Sclera anicteric, dry MM, oropharynx clear  
+Neck: supple, JVP not elevated, no LAD  
+Lungs: Clear to auscultation bilaterally, no wheezes, rales, 
+ronchi  
+CV: tachycardic, normal S1 + S2, no murmurs, rubs, gallops  
+Abdomen: + BS, diffusely tender to palpation in all quadrants, 
+soft, mildly distended, no rebound tenderness or guarding, no 
+organomegaly or ascites, rectal exam revealed no stool in vault, 
+Guaiac neg.  
+Ext: Warm, well perfused, 2+ pulses, no clubbing, cyanosis or 
+edema
+ 
+
+###RESPONSE: Vitals {Vital signs finding}, BP {Blood pressure finding}, RA {Breathing room air}, General {General examination of patient}, Alert {Mentally alert}, oriented {Orientated}, distress {Distress}, HEENT {Physical examination procedure}, Sclera anicteric {White sclera}, dry MM {Mucous membrane dryness}, oropharynx clear {Pharynx normal}, Neck {Physical examination procedure}, supple {Normal movement of neck}, JVP not elevated {Normal jugular venous pressure}, LAD {Lymphadenopathy}, Lungs {Examination of respiratory system}, Clear to auscultation bilaterally {Normal breath sounds}, wheezes {Wheezing}, rales {Respiratory crackles}, ronchi {Wheeze - rhonchi}, CV {Cardiovascular physical examination}, tachycardic {Tachycardia}, normal S1 {Normal first heart sound, S>1<}, S2 {Normal second heart sound, S>2<}, murmurs {Murmur}, rubs {Pericardial friction rub}, gallops {Gallop rhythm}, Abdomen {Examination of abdomen}, BS {Normal bowel sounds}, tender {Abdominal tenderness}, palpation {Palpation}, soft {Abdomen soft}, distended {Swollen abdomen}, rebound {Rebound tenderness}, tenderness {Tenderness}, guarding {Abdominal guarding}, organomegaly {Abdominal organomegaly}, ascites {Ascites}, rectal exam {Rectal examination}, Guaiac {Guaiac test for occult blood in feces specimen}, Ext {Examination of limb}, Warm {Warm skin}, well perfused {Normal tissue perfusion}, 2+ pulses {Peripheral pulses normal}, clubbing {Clubbing}, cyanosis {Cyanosis}, 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:
+___ 09:35PM   LACTATE-1.1
+___ 04:20PM   GLUCOSE-121* UREA N-16 CREAT-1.1 SODIUM-137 
+POTASSIUM-3.8 CHLORIDE-106 TOTAL CO2-21* ANION GAP-14
+___ 04:20PM   ALT(SGPT)-15 AST(SGOT)-25 ALK PHOS-83
+___ 04:20PM   LIPASE-31
+___ 04:20PM   WBC-6.1 RBC-5.17 HGB-14.5 HCT-42.3 MCV-82# 
+MCH-28.0 MCHC-34.2# RDW-13.7
+___ 04:20PM   NEUTS-84.3* LYMPHS-10.7* MONOS-2.6 EOS-2.1 
+BASOS-0.3
+___ 04:20PM   PLT COUNT-265
+
+  OVA + PARASITES (Final ___: 
+      NO OVA AND PARASITES SEEN. 
+      This test does not reliably detect Cryptosporidium, 
+Cyclospora or
+      Microsporidium. While most cases of Giardia are detected 
+by routine
+      O+P, the Giardia antigen test may enhance detection when 
+organisms
+      are rare. 
+
+   FECAL CULTURE - R/O VIBRIO (Preliminary): 
+
+   FECAL CULTURE - R/O YERSINIA (Preliminary): 
+
+   FECAL CULTURE - R/O E.COLI 0157:H7 (Final ___: 
+      NO E.COLI 0157:H7 FOUND. 
+
+   Cryptosporidium/Giardia (DFA) (Preliminary): 
+
+___ 10:16 pm STOOL     CONSISTENCY: NOT APPLICABLE
+      Source: Stool. 
+
+                            **FINAL REPORT ___
+
+   OVA + PARASITES (Final ___: 
+      NO OVA AND PARASITES SEEN. 
+      This test does not reliably detect Cryptosporidium, 
+Cyclospora or
+      Microsporidium. While most cases of Giardia are detected 
+by routine
+      O+P, the Giardia antigen test may enhance detection when 
+organisms
+      are rare. 
+
+___ 7:08 am STOOL     CONSISTENCY: LOOSE      Source: 
+Stool. 
+
+   FECAL CULTURE (Final ___:    NO SALMONELLA OR SHIGELLA 
+FOUND. 
+
+   CAMPYLOBACTER CULTURE (Pending): 
+
+   CLOSTRIDIUM DIFFICILE TOXIN A & B TEST (Final ___: 
+      Feces negative for C.difficile toxin A & B by EIA. 
+           (Reference Range-Negative). 
+
+ 
+
+###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}, NEUTS {Neutrophil count}, LYMPHS {Lymphocyte count}, MONOS {Monocyte count}, EOS {Eosinophil count}, CULTURE {Microbial culture}, CULTURE {Microbial culture}, CULTURE {Microbial culture}, CULTURE {Microbial culture}, CULTURE {Microbial culture}"
+"###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:
+Mr. ___ is a ___ YO homeless male who presented with acute 
+diarrhea and was admitted for rehydration.  
+
+# Diarrhea: Pt has acute onset of diarrhea, fever, nausea, and 
+anorexia, most likely infectious. Given time of year and 
+exposure to sick contacts in crowded shelter Viral 
+gastroenteritis was felt to be the most likley etiology. Stool 
+studies were sent regardless. He was placed on a bland diet and 
+treated symptomatically with loperamide, IVF prn, and tylenol 
+for abdominal pain. On HD2 his diarrhea had improved, he had 
+remiained afebrile with stable VS and was tolerating bland diet 
+with minimal abdominal pain. C diff and HIV were both negative 
+as were O&P x2. There was no salmonella, shigella or Ecoli 
+OH:571. Studies for yersinia, vibrio and cryptosporidum were 
+pending at the time of discharge and should be followed up by 
+his PCP as the results become available.
+.
+. 
+# Sinus tachycardia: Likely from volume depletion. Pt received 
+5L NS in the ED and an additional 1L of NS once on the floor. 
+His tachycardia subsequently resolved and his VS remined stable 
+throughout the course of his hospitalization.
+ 
+.  
+# Chronic cough: CXR no evidence of pneumonia. Pt does have post 
+nasal drip which could contribute to chronic cough. He was not 
+hypoxic nor was he ever in distress. This will need to be 
+adressed by his PCP. 
+.  
+# Depression:  
+COntinued home medications. He will follow up with his 
+depression support group.
+.  
+# Homeless: SW saw and evaluated patient and have made 
+arrangments for temporary housing following discharge. Please 
+refer to their note for details.
+.
+# Hx of BRBRP: Pt denies current bleeding. But had seveal 
+episodes of blood streaked toilet paper during his admission. 
+His HCT remained stable. Thought secondary to hemmorhoids vs 
+irritation from frequent stooling. Pt's last C-scope was ___ years 
+ago in ___ and was reportedly normal. He should follow up 
+with his PCP for appropriate screening/ further workup.
+
+ 
+
+###RESPONSE: homeless {Homeless}, acute 
+diarrhea {Acute diarrhea}, rehydration {Rehydration therapy}, Diarrhea {Diarrhea}, acute onset of diarrhea {Acute diarrhea}, fever {Fever}, nausea {Nausea}, anorexia {Loss of appetite}, infectious {Infectious disease}, Viral 
+gastroenteritis {Viral gastroenteritis}, Stool 
+studies {Stool microscopy}, bland diet {Bland diet}, abdominal pain {Abdominal pain}, diarrhea {Diarrhea}, improved {Patient's condition improved}, stable VS {Normal vital signs}, bland diet {Bland diet}, abdominal pain {Abdominal pain}, HIV {Human immunodeficiency virus infection}, Sinus tachycardia {Sinus tachycardia}, tachycardia {Tachycardia}, his VS remined stable {Normal vital signs}, Chronic cough {Chronic cough}, CXR {Plain chest X-ray}, no evidence {No abnormality detected}, pneumonia {Pneumonia}, post 
+nasal drip {Posterior rhinorrhea}, chronic cough {Chronic cough}, hypoxic {Hypoxia}, distress {Distress}, Depression {Depressive disorder}, Homeless {Homeless}, BRBRP {Hematochezia}, bleeding {Bleeding}, hemmorhoids {Hemorrhoids}, frequent stooling {Frequent defecation}"
+"###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:
+1. risperidone 2 mg Tablet Sig: One (1) Tablet PO at bedtime.  
+2. citalopram Oral 
+
+ 
+Discharge Medications:
+1. risperidone 2 mg Tablet Sig: One (1) Tablet PO at bedtime.  
+2. loperamide 2 mg Capsule Sig: One (1) Capsule PO QID (4 times 
+a day) as needed for loose stools for 5 days.
+Disp:*20 Capsule(s)* Refills:*0*
+3. citalopram  Oral
+
+ 
+
+###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:
+Viral enteritis
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: Viral enteritis {Inflammation of intestine caused by virus}, Mental Status {Neurological mental status determination}, 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:
+You were admitted to ___ because you had diarrhea that made 
+you dehydrated. The most likely cause of your diarrhea was a 
+viral gastroenteritis. We gave you IV fluids and managed your 
+symptoms with a medication called loperamide that helps decrease 
+the frequency of bowel movements. 
+
+While you were here we made the following changes to your 
+medications:
+We started you on Loperamide 2mg every 4 hours as needed for 
+diarrhea.
+
+Otherwise you should continue taking your home medications as 
+prescribed
+ 
+
+###RESPONSE: diarrhea {Diarrhea}, dehydrated {Dehydration}, diarrhea {Diarrhea}, viral gastroenteritis {Viral gastroenteritis}, 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: 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: 
+___
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Agitation, seizure
+ 
+Major Surgical or Invasive Procedure:
+none
+
+ 
+
+###RESPONSE: Agitation {Feeling agitated}, seizure {Seizure}"
+"###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:
+Patient is a ___ y/o M with a hx of intractable seizures on 
+multiple meds and with recent placement of vagal nerve 
+stimulator who presents after having been found to be shaking, 
+""dizzy"" and combative at his home today. He called a family 
+member saying he did not feel well, and he was found shaking, 
+unable to stop on his own, and was brought to the ED
+
+Also of note, he is currently on an abx being treated for 
+diverticulitis. He has been on augmentin for this for an unclear 
+amount of time, likely since ___, the time of his first CT 
+showing acute diverticulitis.
+
+The patient does not remembers dates and exact sequential onset 
+of symptoms. He has had diarrhea, and thinks it probably started 
+after Abx use, but isnt sure.
+
+In the ED, He was extremely agitated, thrashing and using 
+profane language. he recieved 2mg Ativan IV x2. He also got 
+flagyl and cipro IV in the ED.
+ 
+
+###RESPONSE: seizures {Seizure}, placement of vagal nerve 
+stimulator {Insertion of vagal nerve stimulator}, shaking {Tremor}, dizzy {Dizziness}, combative {Aggressive behavior}, not feel well {Malaise}, shaking {Tremor}, abx {Antibiotic therapy}, diverticulitis {Diverticulitis}, CT {Computed tomography}, diverticulitis {Diverticulitis}, diarrhea {Diarrhea}, Abx {Antibiotic therapy}, agitated {Feeling agitated}, IV {Intravenous therapy}, IV {Intravenous 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:
+- intractable seizures
+- s/p VNS (___)
+- h/o post-op psychosis and behavioral problems post anesthesia
+- Meningitis at 6 months old
+- Left temporal head trauma with brief LOC at ___ yo
+- h/o Arm fracture
+- h/o Left orbital fracture--> required surgical repair and had
+residual visual defects
+- Near drowning in ___
+- s/p Left leg amputation s/p prosthesis
+ 
+
+###RESPONSE: seizures {Seizure}, VNS {Insertion of vagal nerve stimulator}, post-op {Postoperative state}, psychosis {Psychotic disorder}, behavioral problems {Problem behavior}, Meningitis {Meningitis}, Left temporal {Left temporal lobe structure}, brief LOC {Brief loss of consciousness}, Arm fracture {Fracture of upper limb}, orbital fracture {Fracture of orbit}, surgical repair {Repair of orbit proper}, visual defects {Visual field defect}, Near drowning {Nonfatal submersion}, Left leg {Structure of left lower limb}, amputation {Amputation of lower limb}"
+"###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 has pacemaker @ ___ yo; healthy mother & two sisters. No 
+family history of epilepsy, vertigo, other neurologic disease.  
+Born in ___, of ___ ancestry, no consanguinity.
+
+ 
+
+###RESPONSE: epilepsy {Epilepsy}, vertigo {Vertigo}, neurologic disease {Disorder of nervous system}, consanguinity {Consanguinity}"
+"###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:
+Vitals: T: 98.1 BP: 134/88 P: 70 RR: 22 O2Sat: 98% 2L
+Gen: No acute distress
+HEENT: EOMI, left pupil dilated (secondary to injury), but 
+reactive to light. rt reactive to light.
+Neck: supple. no LAD
+CV: RRR, nl s1 s2, no g/r/m
+Lungs: clear to ausc, very slow inspiration and expiration 
+secondary to yogic breathing.
+ABd: +BS. tender to palp throughout, esp RLQ. +BS. no HSM. no 
+rebounnd tenderness
+Extremities: below knee amp left leg
+Neuro: please see neuro note for detailed neuro exam.
+ 
+
+###RESPONSE: Vitals {Vital signs finding}, T {Body temperature finding}, BP {Blood pressure finding}, RR {Finding of rate of respiration}, O2Sat {Oxygen saturation measurement}, Gen {General examination of patient}, distress {Distress}, HEENT {Physical examination procedure}, EOMI {Normal ocular motility}, pupil dilated {Dilated pupil}, injury {Traumatic or non-traumatic injury}, reactive to light {Finding of pupil reaction to light}, rt {Structure of pupil of right eye}, reactive to light {Finding of pupil reaction to light}, Neck {Physical examination procedure}, supple {Normal movement of neck}, LAD {Lymphadenopathy}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, nl s1 s2 {Heart sounds normal}, g {Gallop rhythm}, r {Pericardial friction rub}, m {Murmur}, Lungs {Examination of respiratory system}, clear to ausc {Chest clear}, slow inspiration and expiration {Slow respiration}, ABd {Examination of abdomen}, +BS {Normal bowel sounds}, tender {Abdominal tenderness}, palp {Palpation of abdomen}, RLQ {Structure of right lower quadrant of abdomen}, +BS {Normal bowel sounds}, HSM {Hepatosplenomegaly}, tenderness {Tenderness}, Extremities {Examination of limb}, below knee amp left leg {Amputated left lower limb below knee}, Neuro {Neurological examination}, neuro exam {Neurological examination}"
+"###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:
+___ abdomen/pelvis CT with contrast
+IMPRESSION:
+1. Interval progression of inflammatory stranding in the left 
+lower quadrant along a hyperenhancing area of sigmoid colon with 
+multiple diverticula and seberal foci of extraluminal air 
+consistent with diverticulitis with microperforation. No 
+drainable fluid collections.
+2. Prostatic enlargement.
+3. Punctate focus of air within the bladder with no CT evidence 
+for colonic vesicular fistula. Findings may relate to recent 
+instrumentation. Clinical correlation is recommended.
+.
+CXR ___
+FINDINGS: Single bedside AP examination labeled ""upright at 
+13:51"" with patient markedly tilted to his right, is compared 
+with the most recent study dated ___. A metallic 
+neurostimulator device overlies the mid-left hemithorax, as 
+before. Bibasilar subsegmental atelectasis and/or scarring, as 
+well as multiple old healed right rib fractures with associated 
+lateral pleural thickening, are redemonstrated. Allowing for 
+this, no acute focal airspace process is identified. There is no 
+evidence of CHF.
+.
+___ Head CT
+IMPRESSION: No acute intracranial abnormality.
+.
+
+ 
+
+###RESPONSE: abdomen {Computed tomography of abdomen with contrast}, inflammatory {Inflammatory disorder}, left 
+lower quadrant {Structure of left lower quadrant of abdomen}, sigmoid colon {Sigmoid colon structure}, multiple diverticula {Multiple diverticula}, diverticulitis {Diverticulitis}, Prostatic enlargement {Large prostate}, bladder {Urinary bladder structure}, colonic vesicular fistula {Vesicocolic fistula}, CXR {Plain chest X-ray}, left {Left lung structure}, hemithorax {Structure of half of thorax lateral to midsagittal plane}, Bibasilar {Structure of base of lung}, atelectasis {Atelectasis}, scarring {Scar}, right rib {Bone structure of right rib}, fractures {Fracture of multiple ribs}, pleural thickening {Thickening of pleura}, CHF {Congestive heart failure}, Head CT {Computed tomography of head}, intracranial {Intracranial structure}, abnormality {No abnormality detected}"
+"###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:
+Assessment: Pt is a ___ y/o M with hx intractable seizures, s/p 
+VNS placed ___, who presents to the ED in likely post-ictal 
+state, in setting of decreased seizure threshold with 
+diverticulitis. CT showing diverticulitis with microperferation.
+
+Hospital Course By Problem:
+
+Diverticulitis: Pt was diagnosed with divertitulitis intially as 
+an outpatient, on ___. He had a CT scan at that time. A repeat 
+CT on ___ (day of admission), showed progression of disease, 
+patient now with microperforation. Surgery was consulted given 
+this is complicated diverticulitis. He was put on broad spectrum 
+antibiotics, intially zosyn and vancomycin. Vancomycin was 
+eventually discontinued given low suspicion for gram positive 
+infection on bowel. Patient was on bowel rest, NPO, and on TPN. 
+A PICC line was placed for the TPN and IV antibiotics since he 
+has poor venous access. Patients abdominal pain improved slowly. 
+Once minimal, he was started on a liquid diet, which he 
+tolerated, and this was slowly advanced to regular diet. TPN was 
+tapered off. Prior to discharge, the patient was switched to PO 
+augmentin, which he is to continue for a total of 3 weeks of 
+abx, so until ___. He was also seen by nutrition several 
+times, including once with his HCP present, to go over changes 
+in his diet given his new diagnosis of diverticulitis. 
+.
+Diarrhea: Patient had small amounts of diarrhea during 
+hospitaliztion, which came back positive for clostridium 
+dificile. He has a history of difficult to control seizures, so 
+flagyl is avoided since it lowers seizure threshold. He was 
+started on vancomycin PO 250mg q6h, which he was will continued 
+until ___, 2 weeks after augmentin course is done. 
+.
+Agitation: Patient was agitated in the ED, likely has lower 
+seizure threshold given diverticulitus. This may also be 
+delerium from infection. On suggestion by epilepsy service, he 
+was put on ativan standing and PRN
+.
+Hx of seizures: patient has significant hx of seizures, has 
+vagal nerve stimulator since ___. At this time, he likely has 
+lower seizure threshold secondary to infection. He was followed 
+by the epilepsy service while in the hospital. Most of 
+medications were switched to IV during hospitalization while he 
+was NPO. He was continued on the home meds as listed. Levels of 
+carbamazipine and phenytoin were checked almost daily and 
+bolused and adjusted as needed. He was also placed on standing 
+ativan 1mg BID while infected. Once tolerating PO, he was 
+switched back to PO meds, and discharged on the medications he 
+was admitted on. The Ativan was tapered off on discharge. 
+.
+Leukocytosis: likely secondary to diverticulitis, resolved. 
+UA/UC: negative, blood cx negative, CXR normal.
+.
+NSVT on tele: asymptomatic, possible that it was interaction 
+with vagal nerve stimulator. cardiac enzymes negative. EKG 
+normal. no recurrance.
+ 
+
+###RESPONSE: Assessment {Evaluation procedure}, seizures {Seizure}, VNS placed {Insertion of vagal nerve stimulator}, post-ictal 
+state {Post-ictal state}, seizure {Seizure}, diverticulitis {Diverticulitis}, CT {Computed tomography}, diverticulitis {Diverticulitis}, Diverticulitis {Diverticulitis}, divertitulitis {Diverticulitis}, CT scan {Computed tomography of abdomen}, CT {Computed tomography}, disease {Disease}, Surgery was consulted {Medical consultation on hospital inpatient}, diverticulitis {Diverticulitis}, antibiotics {Antibiotic therapy}, infection on bowel {Intestinal infectious disease}, bowel {Intestinal structure}, NPO {Nil by mouth}, on TPN {Total parenteral nutrition}, PICC line {Peripherally inserted central venous catheter in situ}, TPN {Administration of total parenteral nutrition}, IV antibiotics {Intravenous antibiotic therapy}, poor venous access {Poor venous access}, abdominal pain {Abdominal pain}, improved {Patient's condition improved}, liquid diet {Liquid diet}, regular diet {Normal diet}, TPN {Total parenteral nutrition}, seen by nutrition {Seen by hospital-based dietitian}, diet {Dietary finding}, diverticulitis {Diverticulitis}, Diarrhea {Diarrhea}, diarrhea {Diarrhea}, seizures {Seizure}, seizure {Seizure}, Agitation {Feeling agitated}, agitated {Feeling agitated}, seizure {Seizure}, diverticulitus {Diverticulitis}, delerium {Delirium}, infection {Infectious disease}, suggestion by epilepsy service {Medical consultation on hospital inpatient}, seizures {Seizure}, seizures {Seizure}, vagal nerve stimulator {Insertion of vagal nerve stimulator}, seizure {Seizure}, infection {Infectious disease}, epilepsy service {Seen by neurologist}, medications {Administration of drug or medicament}, IV {Intravenous therapy}, NPO {Nil by mouth}, medications {Administration of drug or medicament}, Leukocytosis {Leukocytosis}, diverticulitis {Diverticulitis}, resolved {Problem resolved}, UA {Urinalysis}, UC {Urine culture}, blood cx {Blood culture}, CXR normal {Standard chest X-ray normal}, NSVT {Nonsustained ventricular tachycardia}, tele {Cardiac telemetry}, asymptomatic {Asymptomatic}, vagal nerve stimulator {Insertion of vagal nerve stimulator}, cardiac enzymes negative {Cardiac enzymes within reference range}, EKG 
+normal {Electrocardiogram normal}"
+"###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:
+CARBAMAZEPINE 200 mg--1 tab bid and 2 tabs at bedtime
+DILANTIN 160 mg QAM / 200QPM
+LAMICTAL 150 mg--1 tablet(s) by mouth at 4 pm & 2 tabs @ 10pm
+Multi-Vitamin W/Minerals --1 capsule(s) by mouth daily
+TRILEPTAL 150 mg--1 tablet(s) by mouth daily at 10 am
+AUGMENTIN 875/125 PO BID
+ 
+Discharge Medications:
+1. Dilantin Kapseal 30 mg Capsule Sig: Two (2) Capsule PO every 
+morning.  
+2. Dilantin Kapseal 100 mg Capsule Sig: One (1) Capsule PO every 
+morning.  
+3. Dilantin Kapseal 100 mg Capsule Sig: Two (2) Capsule PO every 
+night.  
+4. Lamotrigine 150 mg Tablet Sig: One (1) Tablet PO at 4pm 
+everday.  
+5. Lamotrigine 150 mg Tablet Sig: Two (2) Tablet PO at 10pm.  
+6. Carbamazepine 200 mg Tablet Sig: One (1) Tablet PO BID (2 
+times a day).  
+7. Carbamazepine 200 mg Tablet Sig: Two (2) Tablet PO QHS (once 
+a day (at bedtime)).  
+8. Oxcarbazepine 300 mg Tablet Sig: One (1) Tablet PO Q10AM ().  
+
+9. Amoxicillin-Pot Clavulanate 250-125 mg Tablet Sig: Two (2) 
+Tablet PO Q8H (every 8 hours) for 12 days: Until ___.
+Disp:*80 Tablet(s)* Refills:*0*
+10. Vancomycin 250 mg Capsule Sig: One (1) Capsule PO Q6H (every 
+6 hours) for 26 days: until ___.
+Disp:*110 Capsule(s)* Refills:*0*
+11. Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO BID (2 times 
+a day) for 5 days: Please take 1 pill twice a day for 2 days; 
+and then 1 pill once a day for 3 days after that. (total 5 
+days).
+Disp:*8 Tablet(s)* Refills:*0*
+12. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One 
+(1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours).
+Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2*
+
+ 
+
+###RESPONSE: mg {Blood magnesium measurement}, 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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Primary
+Diverticulitis
+Clostridium Dificile infection
+
+Secondary:
+Seizures
+
+ 
+Discharge Condition:
+stable.
+
+ 
+
+###RESPONSE: Diverticulitis {Diverticulitis}, Clostridium Dificile infection {Infection caused by Clostridioides difficile}, Seizures {Seizure}, stable {Patient's condition stable}"
+"###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 came to the hospital with abdominal pain. A CT scan was done 
+of your abdomen and you were found to have diverticulitis. You 
+were treated with antibiotics through your IV and bowel rest. 
+Once your abdominal pain got better, you were started on a diet. 
+
+.
+You have been switched to oral antibiotics, Augmentin, which you 
+should take until ___. For the Clostridium Dificile 
+infection, you should continue to take the oral Vancomycin until 
+___. 
+.
+You spoked to a nutritionist while you were here about dietary 
+restrictions with Diverticulosis. She provided you with 
+information sheets about diet. You were intstructed to avoid any 
+food with small seeds, including strawberries. Also avoid small 
+nuts and popcorn. Also try to slowly increase the fiber in your 
+diet. 
+.
+You should continue the epilepsy regimen you were on prior to 
+admission. In addition, you were taking ativan while here, and 
+you should taper that off. Please take 1 pill twice a day for 2 
+days, and then 1 pill once a day for 3 days after that, and then 
+stop taking them. 
+.
+You should not go to work until after you have been cleared by 
+someone in the neurology department or your PCP next week.
+.
+Please call your PCP or go to the hospital if you experience 
+worsening abdominal pain, worsening diarrhea, or increases 
+seizures. 
+ 
+
+###RESPONSE: Discharge Instructions {Final inpatient visit with instructions at discharge}, abdominal pain {Abdominal pain}, CT scan was done 
+of your abdomen {Computed tomography of abdomen}, diverticulitis {Diverticulitis}, treated with antibiotics {Antibiotic therapy}, IV {Intravenous therapy}, bowel rest {Nil by mouth}, abdominal pain {Abdominal pain}, diet {Dietary finding}, oral antibiotics {Oral antibiotic therapy}, Clostridium Dificile 
+infection {Infection caused by Clostridioides difficile}, oral {Administration of drug or medicament via oral route}, spoked to a nutritionist {Seen by hospital-based dietitian}, Diverticulosis {Diverticulosis of large intestine}, diet {Dietary finding}, diet {Dietary finding}, epilepsy {Epilepsy}, regimen {Therapeutic regimen}, PCP {Primary care management}, PCP {Primary care management}, abdominal pain {Abdominal pain}, diarrhea {Diarrhea}, seizures {Seizure}"
+"###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: 
+Patient recorded as having No Known Allergies to Drugs
+ 
+Attending: ___.
+ 
+Chief Complaint:
+gunshot wound to abdomen
+ 
+Major Surgical or Invasive Procedure:
+Exploratory laparotomy and repair of gunshot wound to the 
+stomach and jejunum.
+
+ 
+
+###RESPONSE: No Known Allergies to Drugs {Non-allergic hypersensitivity to drug or medicament}, gunshot wound {Gunshot wound}, abdomen {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, Exploratory laparotomy {Exploratory laparotomy}, repair {Surgical repair}, gunshot wound {Gunshot wound}, stomach {Repair of stomach}, jejunum {Repair of duodenum}"
+"###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:
+Recharge is a ___ year old male who was medflighted from scene to 
+___ after sustaining a single small caliber gunshot wound to 
+his LLQ.  He was taken emergently to the OR.  
+
+He lives in ___, but along with his mother, was visiting his 
+two sisters in ___.  The night of the incident, the pt was 
+with his cousins, + ETOH, ___ was ___ in the ER, when his group 
+was approached by several men.  He heard a shot and the next 
+thing he remembers was being in the helicopter.  
+ 
+
+###RESPONSE: gunshot wound {Gunshot wound}, LLQ {Structure of left lower quadrant of abdomen}"
+"###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:
+Laparoscopic appendectomy
+ 
+
+###RESPONSE: Laparoscopic appendectomy {Laparoscopic appendectomy}"
+"###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:
+NC
+ 
+
+###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:
+PE: Temp: 97.8F   HR 88  BP 108/80  RR 16  O2 Sat 97%RA
+Gen: NAD
+HEENT: PERRL, EOMI, sclera anicteric
+CV: RRR
+Pulm: Moving air well, some occas coarse breath sounds at left 
+base
+Abd: soft, incision clead, dry, intact. Staples in place.  
+Ext: 2+pulses throughout, no c/ce
+
+ 
+
+###RESPONSE: PE {General examination of patient}, Temp {Body temperature finding}, HR {Finding of heart rate}, BP {Blood pressure finding}, RR {Finding of rate of respiration}, RA {Breathing room air}, Gen {General examination of patient}, NAD {No abnormality detected}, HEENT {Physical examination procedure}, PERRL {Pupils equal and reacting to light}, EOMI {Normal ocular motility}, sclera anicteric {White sclera}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, Pulm {Examination of respiratory system}, left 
+base {Structure of base of left lung}, Abd {Examination of abdomen}, soft {Abdomen soft}, incision {Surgical incision wound}, Ext {Examination of limb}, 2+pulses {Peripheral pulses normal}"
+"###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:
+___ 12:48AM BLOOD WBC-13.0* RBC-4.28* Hgb-12.5* Hct-36.9* 
+MCV-86 MCH-29.1 MCHC-33.8 RDW-13.7 Plt ___
+___ 03:45AM BLOOD WBC-19.0* RBC-4.00* Hgb-11.6* Hct-34.9* 
+MCV-87 MCH-29.1 MCHC-33.3 RDW-13.9 Plt ___
+___ 08:11AM BLOOD Hct-33.1*
+___ 06:02AM BLOOD WBC-15.7* RBC-4.22* Hgb-12.4* Hct-36.3* 
+MCV-86 MCH-29.3 MCHC-34.2 RDW-13.4 Plt ___
+___ 07:01PM BLOOD WBC-16.9* RBC-3.97* Hgb-11.9* Hct-34.5* 
+MCV-87 MCH-29.8 MCHC-34.4 RDW-13.6 Plt ___
+___ 06:05AM BLOOD WBC-13.6* RBC-3.76* Hgb-11.1* Hct-32.7* 
+MCV-87 MCH-29.6 MCHC-34.1 RDW-13.6 Plt ___
+___ 06:50AM BLOOD WBC-10.2 RBC-3.62* Hgb-10.5* Hct-31.3* 
+MCV-87 MCH-29.0 MCHC-33.5 RDW-13.3 Plt ___
+___ 03:45AM BLOOD ___ PTT-29.0 ___
+___ 12:48AM BLOOD Glucose-117* UreaN-12 Creat-0.8 Na-146* 
+K-3.0* Cl-108 HCO3-22 AnGap-19
+___ 07:35PM BLOOD Glucose-128* UreaN-12 Creat-0.8 Na-137 
+K-3.8 Cl-101 HCO3-27 AnGap-13
+___ 03:45AM BLOOD Calcium-8.9 Phos-5.2* Mg-1.5
+___ 07:35PM BLOOD Calcium-8.8 Phos-2.6* Mg-2.0
+___ 12:48AM BLOOD ASA-NEG Ethanol-67* Acetmnp-NEG 
+Bnzodzp-NEG Barbitr-NEG Tricycl-NEG
+ 
+
+###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}, 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}, Hct {Hematocrit determination}, 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}, 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}, 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}, 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}, 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}, Calcium {Blood calcium measurement}, Phos {Phosphate, total 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: Brief Hospital Course:
+The pt was medflighted from the scene and was taken emergently 
+to the operating room, discovering a GSW through stomach and 
+into jejunum, with injury to the transverse mesocolon, jejunum 
+distal to ligament of treitz as well as a retroperitoneal 
+hematoma
+
+anterior and posterior gastrostomy and jejunostomy.  These were 
+repaired primarily.  He was also noted to have a small 
+retroperitoneal hematoma.  Postoperatively, he did well and was 
+transferred to the floor from the trauma ICU on POD 1.   
+
+On a CT scan with contrast done to locate the bullet he was 
+noted to have an 8 x 10mm left renal pseudoaneurysm.  He was 
+seen by vascular surgery, but no intervention was required.  
+
+Complicating the pt's stay was the development of fevers and 
+left lobe consolidation thought to be secondary to aspiration 
+pneumonia.  He was started a 10 day course of levaquin.  By time 
+of discharge, he was afebrile, tolerating a regular diet, pain 
+was controlled with po pain medicine, and able to ambulate.  He 
+was discharged home to his sister's house.  He will follow up in 
+the trauma clinic but will most likely return to ___ after 
+that.  
+
+Several staples were removed prior to discharge.  The incision 
+was clean, dry, and intact without signs of infection.  
+ 
+
+###RESPONSE: GSW {Gunshot wound}, stomach {Stomach structure}, jejunum {Jejunal structure}, injury {Traumatic or non-traumatic injury}, transverse mesocolon {Structure of transverse mesocolon}, jejunum {Jejunal structure}, ligament of treitz {Structure of suspensory muscle of duodenum}, retroperitoneal 
+hematoma {Retroperitoneal hematoma}, gastrostomy {Repair of stomach}, jejunostomy {Repair of jejunostomy}, repaired {Surgical repair}, retroperitoneal hematoma {Retroperitoneal hematoma}, CT scan {Computed tomography of abdomen}, left renal {Vascular structure of left kidney}, pseudoaneurysm {Pseudoaneurysm}, fevers {Fever}, left lobe {Left lung structure}, consolidation {Consolidation}, aspiration 
+pneumonia {Aspiration pneumonia}, regular diet {Normal diet}, pain {Chest pain}, pain {Chest pain}, able to ambulate {Able to walk}, follow up {Follow-up arranged}, uma clinic {Outpatient care management}, incision {Surgical incision wound}, signs {Sign}, infection {Postoperative wound infection}"
+"###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. Colace 100 mg Capsule Sig: One (1) Capsule PO twice a day.
+Disp:*60 Capsule(s)* Refills:*0*
+2. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a 
+day) as needed for constipation.
+Disp:*60 Tablet(s)* Refills:*0*
+3. Famotidine 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a 
+day).
+Disp:*60 Tablet(s)* Refills:*0*
+4. Oxycodone-Acetaminophen ___ mg Tablet Sig: ___ Tablets PO 
+Q4H (every 4 hours) as needed for pain.
+Disp:*25 Tablet(s)* Refills:*0*
+5. Levaquin 750 mg Tablet Sig: One (1) Tablet PO once a day for 
+6 days.
+Disp:*6 Tablet(s)* 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:
+Gunshot wound to abdomen
+Pneumonia
+
+ 
+Discharge Condition:
+Stable, afebrile, tolerating a regular diet
+
+ 
+
+###RESPONSE: Gunshot wound {Gunshot wound}, abdomen {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, Pneumonia {Pneumonia}, Stable {Patient's condition stable}, regular diet {Normal diet}"
+"###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 to the hospital after you suffered a gunshot 
+wound to your abdomen and had emergency surgery.  While in the 
+hospital, you developed a pneumonia and you were treated with 
+antibiotics.  You will need to continue the antibiotic for 
+several days after discharge.  
+
+For pain, you can take tylenol or ibuprofen.  For severe pain, 
+you can take the prescription medication, percocet.  If you take 
+the percocet, please do not drive or drink alcohol.  Also, you 
+should not take tylenol with percocet because percocet already 
+contains tylenol.  
+
+Several of your staples were removed.  Your incision was then 
+closed with sticky tape.  You can get this wet but please do not 
+soak in a tub or pool.  The tapes will fall off on their own.  
+
+Please return call your doctor or return to the ER if you 
+develop shortness of breath, chest pain, bloody cough, nausea or 
+vomiting, fever, or other new or concerning symptoms.  
+ 
+
+###RESPONSE: gunshot 
+wound {Gunshot wound}, abdomen {Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall}, emergency surgery {Emergency operation}, pneumonia {Pneumonia}, antibiotics {Antibiotic therapy}, antibiotic {Antibiotic therapy}, pain {Pain}, severe pain {Severe pain}, incision {Surgical incision wound}, shortness of breath {Dyspnea}, chest pain {Chest pain}, bloody cough {Hemoptysis}, nausea {Nausea}, vomiting {Vomiting}, fever {Fever}"
+"###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: 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: 
+Penicillins
+ 
+Attending: ___.
+ 
+Chief Complaint:
+back pain
+ 
+Major Surgical or Invasive Procedure:
+ALIF L4-L5
+Posterior L4-L5 laminectomy and fusion and removal ___ 
+rod
+ 
+
+###RESPONSE: Penicillins {Allergy to penicillin}, back pain {Backache}, ALIF {Interbody fusion of lumbar spine by anterior approach}, L4-L5 laminectomy {Excision of lamina of lumbar vertebra}, fusion {Lumbar spinal fusion}, removal {Removal}"
+"###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:
+___ presented to Dr. ___ office with complaints of 
+worsening back and leg pain. After review of the patients 
+history and physical examination in the office, as well as 
+radiographic studies, it was determined they would be a good 
+candidate for anterior and posterior L4-L5 fusion and removal of 
+___ rod. The patient was in agreement with the plan and 
+consent was obtained and signed.
+ 
+
+###RESPONSE: back {Backache}, leg pain {Pain in lower limb}, history and physical examination {History AND physical examination}, radiographic studies {Imaging}, fusion {Lumbar spinal fusion}, removal {Removal}"
+"###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:
+asthma, allergies
+GI problems
+depression
+OCD/PTSD/bipolar disorder
+pneumonia, migraines, chickenpox
+arthritis
+hemorrhoids
+psoriasis
+
+PSH: thoracic fusion in ___, three neck surgeries, 
+hysterectomy, C-section, bladder sling, polyps removed
+ 
+
+###RESPONSE: asthma {Asthma}, GI {Structure of digestive system}, depression {Depressive disorder}, OCD {Obsessive-compulsive disorder}, PTSD {Posttraumatic stress disorder}, bipolar disorder {Bipolar disorder}, pneumonia {Pneumonia}, migraines {Migraine}, chickenpox {Varicella}, arthritis {Arthritis}, hemorrhoids {Hemorrhoids}, psoriasis {Psoriasis}, thoracic fusion {Fusion of thoracic spine}, neck {Neck pain}, surgeries {Surgical procedure}, hysterectomy {Hysterectomy}, C-section {Cesarean section}, bladder sling {Repair of stress incontinence by suprapubic sling}, polyps removed {Resection of polyp}"
+"###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:
+cancer, diabetes, neurologic disease, skin disease, blood 
+disorders, arthritis, hypertension
+ 
+
+###RESPONSE: cancer {Malignant neoplasm}, diabetes {Diabetes mellitus}, neurologic disease {Disorder of nervous system}, skin disease {Disorder of skin}, disorders {Disease}, arthritis {Arthritis}, hypertension {Hypertensive disorder, systemic arterial}"
+"###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 examination the patient is well developed, well nourished, 
+A&O x3 in NAD. AVSS.
+Range of motion of the lumbar spine is somewhat limited on 
+flexion, extension and lateral bending due to pain.
+Ambulating well with the assistance of a walker and ___, with 
+brace for support.
+Gross motor examination reveals good strength throughout the 
+bilateral lower extremities.
+There is no clonus present. 
+Sensation is intact throughout all affected dermatomes.
+The thoracolumbar incision is clean, dry and intact without 
+erythema, edema or drainage.
+The patient is voiding well without a foley catheter.
+
+ 
+
+###RESPONSE: well nourished {Well nourished}, A {Mentally alert}, O x3 {Oriented to person, time and place}, NAD {No abnormality detected}, AVSS {Vital signs finding}, lumbar spine {Structure of lumbar vertebral column}, limited on 
+flexion, extension and lateral bending {Limitation of joint movement}, pain {Pain}, support {Support}, lower extremities {Lower limb structure}, clonus {Clonus}, Sensation {Normal sensation}, affect {Mood finding}, dermatomes {Dermatome}, thoracolumbar {Structure of thoracic and/or lumbar region of back}, incision {Surgical incision wound}, erythema {Erythema}, edema {Edema}, drainage {Discharge}, voiding {Normal micturition}, foley {Catheterization of urinary bladder}"
+"###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:
+___ 06:24AM BLOOD WBC-6.3 RBC-3.22* Hgb-9.3* Hct-29.5* 
+MCV-92 MCH-28.9 MCHC-31.5* RDW-12.5 RDWSD-41.8 Plt ___
+___ 06:24AM BLOOD Glucose-116* UreaN-6 Creat-0.5 Na-138 
+K-4.2 Cl-96 HCO___-34* AnGap-12
+___ 06:24AM BLOOD Calcium-8.4 Phos-4.7* Mg-2.___riefly, ___ was admitted to the ___ Spine Surgery 
+Service on ___ and taken to the Operating Room for an 
+anterior lumbar interbody fusion L4-L5 through an anterior 
+approach. Please refer to the dictated operative note for 
+further details. The surgery was performed without complication, 
+the patient tolerated the procedure well and was transferred to 
+the PACU in a stable condition. TEDs/pnemoboots were used for 
+postoperative DVT prophylaxis. Intravenous antibiotics were 
+given per standard protocol. Initial postop pain was controlled 
+with a dilaudid PCA. The patient remained NPO. On HD#2, she 
+returned to the operating room for a posterior L4-L5 laminectomy 
+and fusion and ___ rod removal scheduled as part of a 
+staged 2-part procedure. Please refer to the dictated operative 
+note for further details. The second surgery was also without 
+complication and the patient was transferred to the PACU in a 
+stable condition. Postoperative labs were grossly stable. The 
+patient remained NPO until bowel function returned, then diet 
+was advanced as tolerated. The patient was transitioned to oral 
+pain medication when tolerating PO diet. Foley was removed on 
+POD#2 from the second procedure, and the patient was able to 
+void. A hemovac drain that was placed at the time of surgery was 
+also removed on POD#2. A brace was fitted for comfort and 
+support. She received 2 units of pRBCs due to acute 
+post-operative blood loss anemia. Physical therapy was consulted 
+for mobilization OOB to ambulate. Hospital course was otherwise 
+unremarkable. On the day of discharge the patient was afebrile 
+with stable vital signs, comfortable on oral pain control and 
+tolerating a regular diet.
+ 
+
+###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}, AnGap {Anion gap measurement}, Calcium {Blood calcium measurement}, Phos {Phosphate, total measurement}, Mg {Blood magnesium measurement}, anterior lumbar interbody fusion {Interbody fusion of lumbar spine by anterior approach}, surgery {Surgical procedure}, procedure {Surgical procedure}, stable {Patient's condition stable}, DVT prophylaxis {Prevention of deep vein thrombosis}, Intravenous antibiotics {Intravenous antibiotic therapy}, postop pain {Postoperative pain}, PCA {Patient controlled analgesia}, remained NPO {On nothing by mouth status}, laminectomy {Excision of lamina of vertebra}, fusion {Lumbar spinal fusion}, removal {Removal}, procedure {Surgical procedure}, surgery {Surgical procedure}, stable {Patient's condition stable}, stable {Patient's condition stable}, remained NPO {On nothing by mouth status}, bowel {Intestinal structure}, oral {Administration of drug or medicament via oral route}, pain medication {Administration of analgesic}, Foley was removed {Removal of urinary bladder catheter}, able to 
+void {Normal micturition}, removed {Removal of drain}, support {Support}, blood loss anemia {Anemia due to blood loss}, mobilization {Mobilization}, unremarkable {No abnormality detected}, stable {Patient's condition stable}, pain control {Pain control}, tolerating a regular diet {Tolerating normal diet}"
+"###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. dextroamphetamine-amphetamine 15 mg oral QAM 
+2. Amphetamine-Dextroamphetamine XR 30 mg PO DAILY 
+3. Gabapentin 300 mg PO TID 
+4. Diazepam 10 mg PO Q8H:PRN muscle spasm 
+5. Senna 8.6 mg PO BID:PRN constipation 
+6. Morphine SR (MS ___ 30 mg PO Q12H 
+7. OxyCODONE (Immediate Release) 15 mg PO Q6H 
+8. mometasone 220 mcg (14 doses) inhalation DAILY 
+9. Ibuprofen 800 mg PO Q8H:PRN Pain - Mild 
+10. Omeprazole 20 mg PO BID 
+11. Albuterol Sulfate (Extended Release) Dose is Unknown  PO 
+Frequency is Unknown 
+12. Albuterol Inhaler ___ PUFF IH Q6H:PRN wheeze, sob 
+13. Vitamin D ___ UNIT PO DAILY 
+
+ 
+Discharge Medications:
+1.  Acetaminophen 325-650 mg PO Q6H:PRN Pain - Mild/Fever  
+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.  Albuterol Sulfate (Extended Release) 4 mg PO Q12H  
+4.  Diazepam 5 mg PO Q6H:PRN spasm 
+RX *diazepam 5 mg 1 tab by mouth every six (6) hours Disp #*90 
+Tablet Refills:*0 
+5.  Morphine SR (MS ___ 60 mg PO Q12H 
+RX *morphine [MS ___ 60 mg 1 tablet(s) by mouth every twelve 
+(12) hours Disp #*60 Tablet Refills:*0 
+6.  OxyCODONE (Immediate Release) 15 mg PO Q3H:PRN Pain - 
+Moderate 
+RX *oxycodone 15 mg 1 tablet(s) by mouth q3h Disp #*112 Tablet 
+Refills:*0 
+7.  Albuterol Inhaler ___ PUFF IH Q6H:PRN wheeze, sob  
+8.  Amphetamine-Dextroamphetamine XR 30 mg PO DAILY  
+9.  dextroamphetamine-amphetamine 15 mg oral QAM  
+10.  Gabapentin 300 mg PO TID 
+RX *gabapentin [Neurontin] 300 mg 1 capsule(s) by mouth three 
+times a day Disp #*90 Capsule Refills:*0 
+11.  mometasone 220 mcg (14 doses) inhalation DAILY  
+12.  Omeprazole 20 mg PO BID  
+13.  Senna 8.6 mg PO BID:PRN constipation 
+RX *sennosides [senna] 8.6 mg 1 tab by mouth twice a day Disp 
+#*60 Tablet Refills:*0 
+14.  Vitamin D ___ UNIT PO DAILY  
+
+ 
+
+###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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Lumbar spondylosis, scoliosis, and disk degeneration.
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory.
+
+ 
+
+###RESPONSE: Home With Service {Home health aide service management}, Lumbar spondylosis {Lumbar spondylosis}, scoliosis {Scoliosis deformity of spine}, Mental Status {Neurological mental status determination}, Level of Consciousness {Assessment of consciousness level}, Alert {Mentally alert}, Activity Status {Physical functional dependency}"
+"###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:
+ACTIVITY: DO NOT lift anything greater than 10 lbs for 2 weeks. 
+
+___ times a day you should go for a walk for ___ minutes as 
+part of your recovery. You can walk as much as you can tolerate. 
+
+You will be more comfortable if you do not sit or stand more 
+than ~45 minutes without changing positions.
+
+BRACE: You have been given a brace. This brace should be worn 
+for comfort when you are walking. You may take it off when 
+sitting in a chair or while lying in bed.
+
+WOUND: Remove the external dressing in 2 days. If your incision 
+is draining, cover it with a new dry sterile dressing. If it is 
+dry then you may leave the incision open to air. Once the 
+incision is completely dry, (usually ___ days after the 
+operation) you may shower. Do not soak the incision in a bath or 
+pool until fully healed. If the incision starts draining at any 
+time after surgery, cover it with a sterile dressing. Please 
+call the office. 
+Please call the office if you have a fever>101.5 degrees 
+Fahrenheit and/or drainage from your wound.
+
+MEDICATIONS: You should resume taking your normal home 
+medications. Refrain from NSAIDs immediately post operatively.
+
+You have also been given Additional Medications to control your 
+post-operative pain. Please allow our office 72 hours for refill 
+of narcotic prescriptions. Please plan ahead. You can either 
+have them mailed to your home or pick them up at ___ 
+___, ___. We are not able 
+to call or fax narcotic prescriptions to your pharmacy. In 
+addition, per practice policy, we only prescribe pain 
+medications for 6 months from the date of surgery.
+ 
+
+###RESPONSE: walk {Does walk}, walk as much as you can tolerate {Education about increasing activity tolerance}, sit {Does sit}, stand {Does stand}, walking {Does walk}, sitting {Sitting position}, lying in bed {Lying in bed}, WOUND {Wound treatment education}, incision {Surgical incision wound}, draining {Wound discharge}, new dry sterile dressing {Change of dressing}, incision {Surgical incision wound}, incision {Surgical incision wound}, incision {Surgical incision wound}, incision {Surgical incision wound}, draining {Wound discharge}, sterile dressing {Application of dressing, sterile}, fever {Fever}, drainage from your wound {Wound discharge}, post-operative pain {Postoperative 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: 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: 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: 
+Sulfa (Sulfonamide Antibiotics) / Ceftin / Biaxin
+ 
+Attending: ___.
+ 
+Chief Complaint:
+Obesity
+ 
+Major Surgical or Invasive Procedure:
+___: Laparoscopic Roux-en-Y Bypass
+
+ 
+
+###RESPONSE: Sulfa {Allergy to sulfonamide}, Sulfonamide Antibiotics {Allergy to sulfonamide antibiotic}, Ceftin {Allergy to cephalosporin}, Biaxin {Allergy to clarithromycin}, Obesity {Obesity}, Laparoscopic {Laparoscopic procedure}, Roux-en-Y Bypass {Roux-en-Y gastrojejunostomy}"
+"###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:
+Per Dr. ___
+
+___ is a ___ female referred for evaluation
+of gastric restrictive surgery in the treatment and management 
+of
+morbid obesity by her primary care physician ___ in
+___.  ___ was seen and evaluated in our ___ clinic initially ___ and
+___ with follow-up sessions on ___ and ___.  
+
+___ has class II severe obesity with weight of 233.9 pounds as
+of ___.  Her initial screen weight on ___ was 232.8 
+pounds
+with her highest weight in this time period as 236.1 pounds on
+___.  Her height is 65.5 inches and her BMI is 39.2.  Her
+previous weight loss efforts have included Weight Watchers, 
+___, Nutrisystem, the Grapefruit Diet, self-initiated diets 
+and
+exercise.  She has not taken prescription weight loss 
+medications
+or used over-the-counter ephedra-containing appetite
+suppressants/herbal supplements.  She has been able to lose up 
+to
+22 pounds but her weight loss attempts have failed to produce
+lasting results.  She stated that her lowest adult weight was 
+150
+pounds at the age of ___ and her highest weight was 236.1 pounds
+on ___ and she weighed 236 pounds ___ years ago when weighed at
+the ___.  She stated that she has been
+struggling with weight since the birth of her daughter and cites
+as factors contributing to her excess weight large portions,
+convenience eating, emotional eating, inconsistent meal pattern
+and lack of exercise.  Her current physical activity is walking
+her dog for 15 minutes ___ times a day at a slow pace.  She
+denied history of eating disorders - no anorexia, bulimia,
+diuretic or laxative abuse and she denied binge eating.  She 
+does
+have a diagnosis of depression and has been followed by a
+therapist as well as a psychopharmacologist.  She was
+hospitalized for depression in ___ and she is on several
+psychotropic medications (buspirone, duloxetine).
+ 
+
+###RESPONSE: evaluation {Evaluation procedure}, f gastric restrictive surgery {Operation on stomach}, morbid obesity {Morbid obesity}, primary care {Primary care management}, evaluated {Evaluation procedure}, clinic {Outpatient care management}, severe obesity {Severe obesity}, weight {Weight finding}, weight {Weight finding}, weight {Weight finding}, height {Height / growth finding}, BMI {Finding of body mass index}, weight loss {Weight loss}, Weight Watchers {Weight maintenance consultation}, Nutrisystem {Weight maintenance consultation}, Grapefruit Diet {Patient-initiated diet}, self-initiated diets {Patient-initiated diet}, exercise {Exercises}, prescription {Prescription of drug}, weight loss {Weight loss}, weight loss {Weight loss}, weight {Weight finding}, weight {Weight finding}, struggling with weight {Weight maintenance regimen}, birth {Mother delivered}, excess weight {Excessive weight gain}, large portions {Excessive eating}, inconsistent meal pattern {Irregular meal times}, lack of exercise {Lack of exercise}, activity {Finding of functional performance and activity}, walking {Does walk}, eating disorders {Eating disorder}, anorexia {Loss of appetite}, bulimia {Bulimia nervosa}, diuretic {Abuse of diuretics}, laxative abuse {Abuse of laxatives}, binge eating {Binge eating behavior}, depression {Depressive disorder}, depression {Depressive disorder}, psychotropic medications {On psychotropic medication}"
+"###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:
+Her medical history is noteworthy for:
+
+1)  hypertension
+2)  type 2 diabetes with hemoglobin A1c of 8.8% on ___ at 
+    ___ (previous A1c was very high at 9.2%)
+3)  hyperlipidemia with elevated triglycerides
+4)  gastroesophageal reflux
+5)  osteoarthritis of the hand joints
+6)  history of paroxysmal supraventricular tachycardia
+7)  carotid artery stenosis (moderate 50% blockage)
+8)  chronic sinusitis
+9)  history of hiatal hernia
+10) hepatic steatosis by ultrasound
+11) question of thyromegaly
+
+Her surgical history is significant for:
+
+1)  left breast biopsy that was benign
+2)  cataract surgery
+3)  tubal ligation
+4)  tonsillectomy
+
+ 
+
+###RESPONSE: hypertension {Hypertensive disorder, systemic arterial}, type 2 diabetes {Diabetes mellitus type 2}, hemoglobin A1c {Hemoglobin A1c measurement}, hyperlipidemia {Hyperlipidemia}, elevated triglycerides {Serum triglycerides above reference range}, gastroesophageal reflux {Gastroesophageal reflux disease}, osteoarthritis of the hand joints {Degenerative joint disease of hand}, paroxysmal supraventricular tachycardia {Paroxysmal supraventricular tachycardia}, carotid artery stenosis {Carotid artery stenosis}, chronic sinusitis {Chronic sinusitis}, hiatal hernia {Hiatal hernia}, hepatic steatosis {Steatosis of liver}, ultrasound {Ultrasonography of liver}, thyromegaly {Goiter}, left breast {Left breast structure}, cataract surgery {Cataract surgery}, tubal ligation {Ligation of fallopian tube}, tonsillectomy {Tonsillectomy}"
+"###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:
+Her family history is
+noted for father deceased age ___ of ___; mother living age ___ and
+history of atrial fibrillation, colon cancer and arthritis;
+brother deceased age ___ of ___, diabetes and obesity; another
+brother living age ___ with diabetes and carotid stenosis s/p
+carotid endarterectomy; sister living age ___ with history of
+breast CA and thyroid disease. 
+ 
+
+###RESPONSE: deceased {Dead}, atrial fibrillation {Atrial fibrillation}, colon cancer {Malignant neoplasm of colon}, arthritis {Arthritis}, deceased {Dead}, diabetes {Diabetes mellitus}, obesity {Obesity}, diabetes {Diabetes mellitus}, carotid stenosis {Carotid artery stenosis}, carotid endarterectomy {Carotid endarterectomy}, breast CA {Malignant neoplasm of breast}, thyroid disease {Disorder of thyroid gland}"
+"###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:
+Gen: Well appearing female in no acute distress
+CV: Regular rate and rhythm, No M/T/H
+Lungs: CTA b/l
+Abdomen: Soft NT/ND, Incisions clean dry and intact
+Extremeties: No edema, peripheral pulses strong and intact
+ 
+
+###RESPONSE: Gen {General examination of patient}, Well appearing {Well cared for appearance}, no acute {No abnormality detected}, distress {Distress}, CV {Cardiovascular physical examination}, Regular rate and rhythm {Normal heart rate}, Lungs {Examination of respiratory system}, CTA {Normal breath sounds}, Abdomen {Examination of abdomen}, Soft {Abdomen soft}, NT {Abdominal tenderness}, ND {Swollen abdomen}, Incisions {Surgical incision wound}, clean dry and intact {Wound healing well}, Extremeties {Examination of limb}, edema {Edema}, peripheral pulses strong and intact {Peripheral pulses normal}"
+"###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 after admission:
+___ 04:15PM BLOOD Glucose-156* UreaN-16 Creat-0.9 Na-139 
+K-4.8 Cl-106 HCO3-26 AnGap-12
+___ 04:15PM BLOOD Calcium-8.7 Phos-4.0 Mg-2.0
+___ 08:00AM BLOOD WBC-12.7* RBC-3.85* Hgb-11.8* Hct-36.2 
+MCV-94 MCH-30.8 MCHC-32.7 RDW-12.9 Plt ___
+___ 07:56AM BLOOD Type-ART FiO2-70 pO2-83* pCO2-57* 
+pH-7.31* calTCO2-30 Base XS-0 Intubat-NOT INTUBA Comment-SIMPLE 
+FAC
+___ 09:02AM BLOOD ___ PTT-29.3 ___
+
+Labs prior to discharge:
+___ 07:30AM BLOOD WBC-10.1 RBC-3.63* Hgb-11.1* Hct-34.5* 
+MCV-95 MCH-30.5 MCHC-32.1 RDW-13.0 Plt ___
+___ 07:30AM BLOOD Glucose-194* UreaN-9 Creat-0.7 Na-139 
+K-4.2 Cl-100 HCO3-27 AnGap-16
+___ 07:30AM BLOOD Calcium-9.0 Phos-2.1* Mg-1.9
+
+Imaging:
+___ CTA chest, abd, pelvis: 
+1. No pulmonary embolism. 
+2. Ground-glass opacity in the lung apices with diffuse, 
+predominantly 
+central, ground-glass nodules in both lungs, concerning for 
+early 
+bronchopneumonia.  This patient requires a followup chest CT as 
+an outpatient 
+to demonstrate resolution of these nodules after treatment. 
+3. Small bilateral pleural effusions and bibasilar atelectasis. 
+4. No evidence of bowel obstruction or anastomotic leak. 
+
+___  BAS/UGI AIR/SBFT:
+Normal postoperative appearance of the stomach and 
+gastroesophageal junction without obstruction or leak. 
+
+ 
+
+###RESPONSE: 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}, PTT {Partial thromboplastin time, activated}, 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}, BLOOD 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}, CTA chest, abd, pelvis {Computed tomography angiography of thorax and abdomen and pelvis with contrast}, pulmonary embolism {Pulmonary embolism}, Ground-glass opacity {Ground glass lung opacity}, lung apices {Structure of apex of lung}, ground-glass {Ground glass lung opacity}, nodules in both lungs {Nodule of lung}, bronchopneumonia {Bronchopneumonia}, followup {Follow-up consultation}, chest CT {Computed tomography of chest}, resolution {Problem resolved}, nodules {Nodule of lung}, bilateral pleural effusions {Bilateral pleural effusion}, bibasilar {Structure of base of lung}, atelectasis {Atelectasis}, No evidence {No abnormality detected}, bowel obstruction {Intestinal obstruction}, anastomotic leak {Gastrointestinal anastomotic leak}, Normal {No abnormality detected}, postoperative {Postoperative state}, stomach {Stomach structure}, gastroesophageal junction {Cardioesophageal junction structure}, obstruction {Obstruction}, leak {Anastomosis, leaking}"
+"###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 pre-op on ___. Pt was 
+evaluated by anaesthesia and taken to the operating room for 
+laparoscopic Roux-en-Y gastric bypass. There were no adverse 
+events in the operating room; please see the operative note for 
+details. Pt was extubated, taken to the PACU until stable. She 
+was then transferred to ___ 9. On POD #1, Patient had an acute 
+desaturation requiring 70 percent o2 via face mask and was 
+transferred to TSICU. A chest X-ray showed low lung vol, 
+moderate cardiomegaly, signs of mild fluid overload. A CT/CTA 
+was done which ruled out pulmonary embolism but showed b/l 
+pleural eff, apical findings concerning for bronchopneumonia. 
+The patient was managed with a combination of O2 via facemask, 
+chest ___, duonebs, and encouragement of Incentive spirometry. 
+She soon reduced her O2 requirements to 2L via nasal cannula and 
+was stable enough to be transferred out of the TSICU. Since that 
+point she resumed the ___ bariatric gastric bypass pathway. 
+
+Neuro: The patient was alert and oriented throughout 
+hospitalization; pain was initially managed with a PCA and then 
+transitioned to oral Roxicet once tolerating a stage 2 diet. 
+CV: The patient remained stable from a cardiovascular 
+standpoint; vital signs were routinely monitored.
+Pulmonary: The patient remained stable thereafter from a 
+pulmonary standpoint; vital signs were routinely monitored. Good 
+pulmonary toilet, early ambulation and incentive spirometry were 
+encouraged throughout hospitalization. 
+GI/GU/FEN: The patient was initially kept NPO.  An upper GI 
+study (POD1) were both negative for a leak, therefore, the diet 
+was advanced sequentially to a Bariatric Stage 3 diet, which was 
+well tolerated. Patient's intake and output were closely 
+monitored.  JP output remained serosanguinous throughout 
+admission; the drain was removed prior to discharge. Her insulin 
+regimen was adjusted to reflect her lower postoperative blood 
+glucose levels.
+ID: The patient's fever curves were closely watched for signs of 
+infection, of which there were none.
+HEME: The patient's blood counts were closely watched for signs 
+of bleeding, of which there were none.
+Prophylaxis: The patient received subcutaneous heparin and ___ 
+dyne boots were used during this stay and was encouraged to get 
+up and ambulate as early as possible.
+
+At the time of discharge, the patient was doing well, afebrile 
+with stable vital signs.  The patient was tolerating a stage 3 
+diet, ambulating, voiding without assistance, and pain was well 
+controlled.  The patient received discharge teaching and 
+follow-up instructions with understanding verbalized and 
+agreement with the discharge plan.
+
+ 
+
+###RESPONSE: anaesthesia {Anesthesia consultation}, laparoscopic {Laparoscopic procedure}, Roux-en-Y gastric bypass {Roux-en-Y gastrojejunostomy}, operative {Surgical procedure}, extubated {Removal of endotracheal tube}, PACU {Postanesthesia care}, stable {Patient's condition stable}, desaturation {Oxygen saturation below reference range}, o2 via face mask {Oxygen administration by mask}, transferred to TSICU {Patient transfer to intensive care unit}, chest X-ray {Plain chest X-ray}, lung {Lung structure}, cardiomegaly {Cardiomegaly}, signs {Sign}, fluid overload {Hypervolemia}, CT {Computed tomography of chest}, CTA {Computed tomography angiography of chest with contrast}, pulmonary embolism {Pulmonary embolism}, b/l 
+pleural eff {Bilateral pleural effusion}, apical {Structure of apex of lung}, bronchopneumonia {Bronchopneumonia}, O2 via facemask {Oxygen administration by mask}, chest {Thoracic structure}, Incentive spirometry {Incentive spirometry}, nasal cannula {Oxygen administration by nasal cannula}, stable {Patient's condition stable}, bariatric {Bariatric operative procedure}, gastric bypass {Bypass of stomach}, pathway {Care regime}, Neuro {Neurological examination}, alert {Mentally alert}, oriented {Orientated}, pain {Pain}, PCA {Patient controlled analgesia}, oral {Administration of drug or medicament via oral route}, tolerating {Tolerating diet}, CV {Cardiovascular physical examination}, stable {Patient's condition stable}, cardiovascular {Cardiovascular physical examination}, vital signs were routinely monitored {Monitoring of blood pressure, temperature, pulse rate and respiratory rate}, stable {Patient's condition stable}, pulmonary {Examination of respiratory system}, vital signs were routinely monitored {Monitoring of blood pressure, temperature, pulse rate and respiratory rate}, Good {Good therapeutic response}, pulmonary toilet {Airway toilet}, ambulation {Ambulation training}, incentive spirometry {Incentive spirometry}, NPO {Nil by mouth}, upper GI {Upper gastrointestinal tract structure}, study {Evaluation procedure}, negative {No abnormality detected}, leak {Anastomosis, leaking}, diet 
+was advanced {Advance diet as tolerated}, Bariatric {Bariatric operative procedure}, Stage 3 diet {Dietary regime}, well tolerated {Tolerating diet}, intake and output {Measuring intake and output}, monitored {Monitoring procedure}, JP {Insertion of tube into jejunum}, output remained serosanguinous {Serosanguineous discharge from wound}, drain was removed {Removal of drain}, insulin 
+regimen {Insulin regime}, postoperative {Postoperative state}, blood 
+glucose levels {Finding of blood glucose level}, ID {Infection control procedure}, fever {Fever}, watched for signs of 
+infection {Monitoring for signs and symptoms of infection}, blood counts {Blood test}, signs {Sign}, bleeding {Bleeding}, Prophylaxis {Preventive procedure}, heparin {Heparin therapy}, ambulate {Ambulation training}, afebrile {Fever}, stable vital signs {Normal vital signs}, tolerating a stage 3 
+diet {Tolerating diet}, ambulating {Fully mobile}, voiding {Micturition finding}, pain was well 
+controlled {Demonstrates adequate pain control}, teaching {Patient education}, follow-up {Follow-up arranged}, instructions {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:
+The Preadmission Medication list is accurate and complete.
+1. BusPIRone 15 mg PO DAILY 
+2. Duloxetine 30 mg PO DAILY 
+3. Fexofenadine 180 mg PO DAILY 
+4. Lansoprazole Oral Disintegrating Tab 30 mg PO BID 
+5. Lisinopril 10 mg PO DAILY 
+6. Metoprolol Tartrate 25 mg PO DAILY 
+7. Rosuvastatin Calcium 20 mg PO DAILY 
+8. TraZODone 50 mg PO HS 
+
+ 
+Discharge Medications:
+1. OxycoDONE-Acetaminophen Elixir ___ mL PO Q4H:PRN pain 
+RX *oxycodone-acetaminophen [Roxicet] 5 mg-325 mg/5 mL ___ ml 
+by mouth every four (4) hours Refills:*0
+2. Docusate Sodium (Liquid) 100 mg PO BID 
+RX *docusate sodium 50 mg/5 mL 100 mg by mouth twice a day 
+Refills:*0
+3. Ranitidine (Liquid) 150 mg PO BID 
+RX *ranitidine HCl 15 mg/mL 150 mg by mouth twice a day 
+Refills:*3
+4. BusPIRone 15 mg PO DAILY 
+5. Duloxetine 30 mg PO DAILY 
+6. Fexofenadine 180 mg PO DAILY 
+7. Lisinopril 10 mg PO DAILY 
+8. Metoprolol Tartrate 25 mg PO DAILY 
+9. Rosuvastatin Calcium 20 mg PO DAILY 
+10. TraZODone 50 mg PO HS 
+11. Enoxaparin Sodium 30 mg SC BID Duration: 28 Days 
+Start: ___ - ___, First Dose: Next Routine Administration 
+Time 
+RX *enoxaparin 30 mg/0.3 mL 30 mg SC twice a day Disp #*56 
+Syringe Refills:*0
+12. NPH 12 Units Breakfast
+NPH 8 Units Bedtime
+Insulin SC Sliding Scale using HUM Insulin
+RX *NPH insulin human recomb [Humulin N KwikPen] 100 unit/mL (3 
+mL) 12 or 8 units SC 12 Units before BKFT; 8 Units before BED; 
+Disp #*60 Syringe Refills:*3
+
+ 
+
+###RESPONSE: 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 With Service
+ 
+Facility:
+___
+ 
+Discharge Diagnosis:
+Obesity
+
+ 
+Discharge Condition:
+Mental Status: Clear and coherent.
+Level of Consciousness: Alert and interactive.
+Activity Status: Ambulatory - Independent.
+
+ 
+
+###RESPONSE: With Service {Home health aide service management}, Obesity {Obesity}, Mental Status {Neurological mental status determination}, Clear {No abnormality detected}, 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:
+
+###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: Please call your surgeon or return to 
+the emergency department if you develop a fever greater than 
+101.5, chest pain, shortness of breath, severe abdominal pain, 
+pain unrelieved by your pain medication, severe nausea or 
+vomiting, severe abdominal bloating, inability to eat or drink, 
+foul smelling or colorful drainage from your incisions, redness 
+or swelling around your incisions, or any other symptoms which 
+are concerning to you.
+
+Diet: Stay on Stage III diet until your follow up appointment. 
+Do not self advance
+diet, do not drink out of a straw or chew gum.
+
+Medication Instructions:
+Resume your home medications, CRUSH ALL PILLS.
+You will be starting some new medications:
+1.  You are being discharged on medications to treat the pain 
+from your operation. These medications will make you drowsy and 
+impair your ability to drive a motor vehicle or operate 
+machinery safely. You MUST refrain from such activities while 
+taking these medications.
+2. You should begin taking a chewable complete multivitamin with 
+minerals. No gummy vitamins.
+3. You will be taking Zantac liquid ___ mg twice daily for one 
+month. This medicine prevents gastric reflux.
+4. You should take a stool softener, Colace, twice daily for 
+constipation as needed, or until you resume a normal bowel 
+pattern.
+5. You must not use NSAIDS (non-steroidal anti-inflammatory 
+drugs) Examples are Ibuprofen, Motrin, Aleve, Nuprin and 
+Naproxen. These agents will cause bleeding and ulcers in your 
+digestive system.
+
+Activity:
+No heavy lifting of items ___ pounds for 6 weeks. You may 
+resume moderate
+exercise at your discretion, no abdominal exercises.
+
+Wound Care:
+You may shower, no tub baths or swimming. 
+If there is clear drainage from your incisions, cover with 
+clean, dry gauze. 
+Your steri-strips will fall off on their own. Please remove any 
+remaining strips ___ days after surgery.
+Please call the doctor if you have increased pain, swelling, 
+redness, or drainage from the incision sites
+
+ 
+
+###RESPONSE: emergency {Emergency treatment}, fever {Fever}, chest pain {Chest pain}, shortness of breath {Dyspnea}, abdominal pain {Abdominal pain}, pain {Pain}, pain medication {Administration of analgesic}, nausea {Nausea}, vomiting {Vomiting}, abdominal bloating {Abdominal bloating}, inability to eat {Unable to eat}, drink {Unable to drink}, drainage {Wound discharge}, incisions {Surgical incision wound}, redness {Redness of skin over lesion}, swelling {Swelling}, incisions {Surgical incision wound}, Diet {Obesity diet education}, Stage III diet {Dietary regime}, medications {Administration of analgesic}, pain {Pain}, operation {Surgical procedure}, medications will make you {Patient medication education}, drowsy {Drowsy}, impair your ability to drive a motor vehicle or operate 
+machinery safely {Patient should not drive or operate machinery}, activities {Functional activity education}, while 
+taking these medications {Patient medication education}, gastric reflux {Gastric reflux}, take a stool softener {Administration of laxative}, constipation {Constipation}, a normal bowel 
+pattern {Normal bowel habits}, must not use {Patient medication education}, bleeding {Gastrointestinal hemorrhage}, ulcers in your 
+digestive system {Gastrointestinal ulcer}, No heavy lifting {Recommendation to avoid activity of daily living}, exercise {Exercises}, abdominal exercises {Abdominal exercises}, no tub baths {Recommendation to avoid activity of daily living}, drainage {Wound discharge}, incisions {Surgical incision wound}, cover with 
+clean, dry gauze {Application of dressing}, after surgery {Postoperative state}, increased pain {Increased pain}, swelling {Swelling}, redness {Redness of skin over lesion}, drainage {Wound discharge}, incision sites {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:   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: 
+No Known Allergies / Adverse Drug Reactions
+ 
+Attending: ___.
+ 
+Chief Complaint:
+n/v/d
+ 
+Major Surgical or Invasive Procedure:
+None
+ 
+
+###RESPONSE: Adverse Drug Reactions {Propensity to adverse reactions to drug}, n/v/d {Nausea, vomiting and 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:
+Ms. ___ is a ___ woman w/ PMH multiple myeloma s/p 
+chemotherapy currently undergoing GCSF injections in preparation 
+for stem cell transplant this coming ___ presenting with 1 
+week of general malaise and nausea, vomiting, diarrhea x 1 day.
+
+She has had approximately 20 episodes of nonbloody nonbilious 
+emesis as well as nonbloody watery diarrhea. She has had poor 
+p.o. intake and subjective fevers and chills with profuse 
+diaphoresis. She is currently getting treated at ___. 
+Her most recent preparation shot was earlier today. The only 
+other medical problem is anxiety and depression for which she 
+takes Ativan as needed. No significant cough dysuria or 
+hematuria. She does have some epigastric abdominal pain.
+
+Exam was significant for tachycardia, dry mucous membranes, 
+epigastric tenderness to palpation.
+
+VS significant for Tmax 99.7, HR 111, BP 135/69, RR 16, O2Sat 
+94% on RA.
+
+CXR shows: Scattered bilateral densities overlying ribs may in 
+part relate to rib lesions, new since ___, but also raise 
+concern for underlying multifocal infection. No prior for 
+comparison since ___.
+
+CT A/P showed: multiple loops of small bowel with wall edema. 
+Mild wall thickening of ascending colon, transverse colon, 
+rectum. Associated mesenteric edema and small amount of ascites 
+concerning for entero-proctocolitis. Numerous punched out lytic 
+lesions within the pelvis, imaged spine, and proximal femurs
+consistent with multiple myeloma.
+
+She received Zofran, Lorazepam, NS and LR IVF 3L total, 
+Clonazepam, Tylenol 1g, diphenhydramine 25 mg. 
+
+She reports that she started feeling malaise and nausea a week 
+ago. She started taking her GCSF shots 4 days ago. She reports 
+that she started to have worsening nausea with vomiting of NBNB 
+emesis and diarrhea, no  melena/hematochezia. She reports that 
+she is having abdominal pain but also says that she's been 
+having this for awhile and thinks this is from her multiple 
+myeloma. She had a fever this week that she measured at home. 
+She denies chest pains, SOB, cough. She denies lower extremity 
+swelling. She feels
+that all of her bones are aching and she can't get comfortable. 
+She hasn't had morphine or other narcotics all day today. 
+Doesn't feel like the Zofran is working for nausea. Feeling very 
+anxious as well.
+
+ROS: Pertinent positives and negatives as noted in the HPI.  All 
+other systems were reviewed and are negative. 
+
+ 
+
+###RESPONSE: multiple myeloma {Multiple myeloma}, chemotherapy {Chemotherapy}, stem cell transplant {Allogeneic peripheral blood stem cell transplant}, malaise {Malaise}, nausea, vomiting, diarrhea {Nausea, vomiting and diarrhea}, emesis {Vomiting}, watery {Liquid stool}, diarrhea {Diarrhea}, poor 
+p.o. intake {Inadequate oral intake}, fevers {Fever}, chills {Chill}, diaphoresis {Excessive sweating}, anxiety {Anxiety}, depression {Depressive disorder}, cough {Cough}, dysuria {Dysuria}, hematuria {Blood in urine}, epigastric abdominal pain {Epigastric pain}, tachycardia {Tachycardia}, dry mucous membranes {Mucous membrane dryness}, epigastric tenderness {Tenderness of epigastrium}, palpation {Palpation}, RA {Breathing room air}, CXR {Plain chest X-ray}, rib {Bone structure of rib}, lesions {Lesion}, infection {Infectious disease}, CT A/P {Computed tomography of abdomen and pelvis}, small bowel {Structure of small intestine}, edema {Edema}, thickening {Increased thickness}, ascending colon {Ascending colon structure}, transverse colon {Transverse colon structure}, rectum {Rectum structure}, mesenteric {Mesentery structure}, edema {Edema}, ascites {Ascites}, proctocolitis {Proctocolitis}, lytic 
+lesions {Lytic lesion of bone on X-ray}, pelvis {Structure of pelvis}, spine {Structure of vertebral column}, proximal femurs {Bone structure of proximal femur}, malaise {Malaise}, nausea {Nausea}, nausea {Nausea}, vomiting {Vomiting}, emesis {Vomiting}, diarrhea {Diarrhea}, melena {Melena}, hematochezia {Hematochezia}, abdominal pain {Abdominal pain}, multiple 
+myeloma {Multiple myeloma}, fever {Fever}, chest pains {Chest pain}, SOB {Dyspnea}, cough {Cough}, lower extremity 
+swelling {Swelling of lower limb}, aching {Aching pain}, nausea {Nausea}, anxious {Anxiety}"
+"###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:
+Multiple Myeloma
+Chronic obstructive pulmonary disease 
+Gastroesophageal reflux disease 
+Chiari malformation type I 
+Anxiety 
+PTSD (post-traumatic stress disorder) 
+Hypertensive disorder 
+Asthma 
+Colitis 
+Erosive gastritis 
+Anemia 
+Arthritis 
+Hyperlipidemia 
+Depressive disorder 
+Colon polyp 
+HYSTERECTOMY 
+ANTERIOR CRUCIATE LIGAMENT REPAIR 
+
+ 
+
+###RESPONSE: Multiple Myeloma {Multiple myeloma}, Chronic obstructive pulmonary disease {Chronic obstructive lung disease}, Gastroesophageal reflux disease {Gastroesophageal reflux disease}, Chiari malformation type I {Chiari malformation type I}, Anxiety {Anxiety}, PTSD (post-traumatic stress disorder {Posttraumatic stress disorder}, Hypertensive disorder {Hypertensive disorder, systemic arterial}, Asthma {Asthma}, Colitis {Colitis}, Erosive gastritis {Erosive gastritis}, Anemia {Anemia}, Arthritis {Arthritis}, Hyperlipidemia {Hyperlipidemia}, Depressive disorder {Depressive disorder}, Colon polyp {Polyp of colon}, ANTERIOR CRUCIATE LIGAMENT REPAIR {Repair of anterior cruciate ligament of knee joint}"
+"###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:
+Reviewed and found to be not relevant to this illness/reason for 
+hospitalization.
+ 
+
+###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:
+VITALS: 99.1 PO 150 / 84 99 16 95% Ra 
+GENERAL: alert, anxious, tearful, fidgeting, moving around in 
+bed
+a lot
+EYES: Anicteric, pupils equally round
+ENT: Ears and nose without visible erythema, masses, or trauma. 
+Oropharynx without visible lesion, erythema or exudate
+CV: Heart tachycardic, no murmur, no S3, no S4.  No JVD.
+RESP: Lungs clear to auscultation with good air movement
+bilaterally.  Breathing is non-labored
+GI: Abdomen soft, non-distended, tender to palpation over lower
+abdomen.  Bowel sounds present.  No HSM
+GU: No suprapubic fullness or tenderness to palpation
+MSK: Neck supple, moves all extremities, strength grossly full
+and symmetric bilaterally in all limbs
+SKIN: No rashes or ulcerations noted
+NEURO: Alert, oriented, face symmetric, gaze conjugate with 
+EOMI,
+speech fluent, moves all limbs, sensation to light touch grossly
+intact throughout
+PSYCH: tearful, anxious
+
+DISCHARGE EXAM: 
+Vital Signs: 98.8  127/67 98 18 96% RA
+glucose: 
+. 
+GEN: NAD, ambulating , pleasant, interactive, nervous, anxious
+EYES: PERRL, EOMI, conjunctiva clear, anicteric
+ENT: moist mucous membranes, no exudates 
+NECK: supple 
+CV: RRR s1s2 nl, no m/r/g
+PULM: CTA, no r/r/w 
+GI: normal BS, mild diffuse tenderness, no HSM  
+EXT: warm, no c/c/e
+SKIN: no rashes 
+NEURO: alert, oriented x 3, answers ? appropriately, follows 
+commands, non focal
+PSYCH: appropriate
+ACCESS: PIV
+FOLEY: absent
+
+ 
+
+###RESPONSE: GENERAL {General examination of patient}, alert {Mentally alert}, anxious {Anxiety}, tearful {Crying associated with mood}, fidgeting {Fidgeting}, EYES {Ophthalmic examination and evaluation}, Anicteric {White sclera}, pupils equally round {Pupil size and shape normal}, ENT {Abdominal tenderness}, Ears {Ear structure}, nose {Nasal structure}, erythema {Erythema}, masses {Abdominal mass}, trauma {Traumatic injury}, Oropharynx {Oropharyngeal structure}, lesion {Lesion}, erythema {Erythema}, exudate {Exudate}, CV {Cardiovascular physical examination}, Heart {Cardiovascular physical examination}, tachycardic {Tachycardia}, murmur {Murmur}, no S3 {Third heart sound, S>3<, inaudible}, no S4 {Fourth heart sound, S>4<, inaudible}, JVD {Jugular venous engorgement}, RESP {Examination of respiratory system}, Lungs {Examination of respiratory system}, labored {Labored breathing}, GI {Examination of digestive system}, soft {Abdomen soft}, non-distended {Normal abdominal contour}, tender {Abdominal tenderness}, palpation {Palpation}, lower
+abdomen {Lower abdomen structure}, Bowel sounds present {Normal bowel sounds}, HSM {Hepatosplenomegaly}, GU {Examination of genitourinary system}, suprapubic {Hypogastric region structure}, tenderness {Tenderness}, palpation {Palpation}, MSK {Musculoskeletal system physical examination}, Neck {Physical examination procedure}, supple {Normal movement of neck}, all extremities {All extremities}, SKIN {Examination of skin}, rashes {Eruption of skin}, ulcerations {Ulcer}, NEURO {Neurological examination}, Alert {Mentally alert}, oriented {Orientated}, face symmetric {Facial symmetry}, EOMI {Normal ocular motility}, speech fluent {Does speak fluently}, moves all limbs {Does move all four limbs}, sensation to light touch grossly
+intact {Normal light touch sensation}, PSYCH {Psychiatry procedure or service}, tearful {Crying associated with mood}, anxious {Anxiety}, Vital Signs {Vital signs finding}, RA {Breathing room air}, GEN {General examination of patient}, NAD {No abnormality detected}, ambulating {Fully mobile}, anxious {Anxiety}, EYES {Ophthalmic examination and evaluation}, PERRL {Pupils equal and reacting to light}, EOMI {Normal ocular motility}, conjunctiva clear {Conjunctiva normal}, anicteric {White sclera}, ENT {Abdominal tenderness}, moist mucous membranes {Moist oral mucosa}, exudates {Exudate}, NECK {Physical examination procedure}, supple {Normal movement of neck}, CV {Cardiovascular physical examination}, RRR {Normal heart rate}, s1s2 nl {Heart sounds normal}, no m/r/g {Heart sounds normal}, PULM {Examination of respiratory system}, CTA {Normal breath sounds}, GI {Examination of digestive system}, normal BS {Normal bowel sounds}, tenderness {Tenderness}, HSM {Hepatosplenomegaly}, EXT {Examination of limb}, warm {Warm skin}, SKIN {Examination of skin}, rashes {Eruption of skin}, NEURO {Neurological examination}, alert {Mentally alert}, oriented {Orientated}, PSYCH {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:
+ADMIT LABS:
+WBC 54.3, Hgb 13.6, Plt 301
+INR 1.2, PTT 26
+Cr 0.7
+AlkP 173
+trop neg x 1
+phos 2.2
+lactate 2.1
+flu negative
+
+DISCHARGE LABS: 
+___ 06:25AM BLOOD WBC-4.7 RBC-3.81* Hgb-11.1* Hct-34.5 
+MCV-91 MCH-29.1 MCHC-32.2 RDW-15.9* RDWSD-52.6* Plt ___
+___ 06:25AM BLOOD Glucose-87 UreaN-5* Creat-0.5 Na-141 
+K-3.1* Cl-101 HCO3-27 AnGap-13
+___ 06:25AM BLOOD Calcium-8.3* Phos-3.7 Mg-1.8
+
+# CXR (___): Scattered bilateral densities overlying ribs may 
+in part relate to rib lesions, new since ___, but also 
+raise concern for underlying multifocal infection. No prior for 
+comparison since ___.
+
+# CT A/P (___): IMPRESSION: 1. Multiple relatively collapsed 
+loops of small bowel demonstrate wall edema.  Mild wall 
+thickening of the ascending colon and possibly the transverse 
+colon. Mild wall thickening and hyperemia of the rectum.  
+Associated mesenteric edema and small amount of ascites.  
+Findings concerning for entero-proctocolitis. 2. Numerous 
+punched-out lytic lesions within the pelvis, imaged spine, and 
+proximal femurs, consistent with multiple myeloma. 3. Anterior 
+wedge compression deformities of T12 through L2 of indeterminate 
+age, but unlikely to be acute. 
+.
+
+ 
+
+###RESPONSE: WBC {White blood cell count}, 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}, CXR {Plain chest X-ray}, rib {Bone structure of rib}, lesions {Lesion}, infection {Infectious disease}, small bowel {Structure of small intestine}, edema {Edema}, thickening {Increased thickness}, ascending colon {Ascending colon structure}, transverse 
+colon {Transverse colon structure}, thickening {Increased thickness}, hyperemia {Hyperemia}, rectum {Rectum structure}, mesenteric {Mesentery structure}, edema {Edema}, ascites {Ascites}, entero {Inflammation of intestine}, proctocolitis {Proctocolitis}, lytic lesions {Lytic lesion of bone on X-ray}, pelvis {Structure of pelvis}, spine {Structure of vertebral column}, proximal femurs {Bone structure of proximal femur}, multiple myeloma {Multiple myeloma}, compression {Compression}, deformities {Deformity}"
+"###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:
+ASSESSMENT & PLAN: ___ F h/o multiple myeloma s/p chemotherapy 
+currently undergoing GCSF injections in preparation for stem 
+cell transplant this coming ___ presenting with 1 week of 
+general malaise and nausea, vomiting, diarrhea x 1 day.
+
+ACUTE/ACTIVE PROBLEMS:
+# Fever
+# Nausea/vomiting/diarrhea: 
+# Body pain/aches
+   Ms. ___ presented with nausea/vomiting/diarrhea, fever. 
+Although severity of these symptoms reportedly increased in the 
+setting of GCSF initation (x4 days), she reports diarrhea 
+occurring even beforehand. Admit WBC was elevated 54.3, lactate 
+2.1 - but in the setting of GCSF.
+    CT A/P showed evidence of mild enteroproctocolitis. Workup 
+of her symptoms included the following: Flu: neg, Stool cdiff, 
+salmonella/shigella/campylobacter were neg, CMV VL was 
+undetectable.  Of note, CXR was negative. 
+    To evaluate whether the G-CSF may play a role in her 
+symptomology, hematology was consulted.  They felt that her 
+constellation of symptoms were not attributable to the G-CSF.  
+Although there are reports of anaphylaxis to G-CSF use - this 
+was considered unlikely.  
+    She was placed on IV Zofran, lorazepam ___, and hydrated.  On 
+the Day1 of hospitalization, her nausea/vomiting and diarrhea 
+resolved.  There were no further episodes of fever.  Due to low 
+suspicion for bacterial infection, no antibiotics were given.  
+She noted steady improvement in her symptoms with good tolerance 
+of PO solids on day of discharge.  She was reassured that she 
+should expect full recovery from a likely viral gastroenteritis. 
+ . 
+  Cause of Body pain unclear.  ? side effect of the ___ as she 
+describe it as her bones that are hurting her. 
+
+# Leukocytosis:
+# MM
+  Being treated at ___. S/p XRT, chemotherapy (RVD - last 
+___.  Was planned for BMT on ___ per Partner's records. On 
+admit, with high WBC with bands likely due to the effect of 
+GCSF.  Dr. ___ staff at ___ was consulted - and it was 
+felt that harvesting and port would be have to be postponed 
+until she recoevers.  Transfer to ___ was felt not indicated.  
+Reportedly, in the future, a more supervised approach would be 
+adopted for her next Harvesting attempt.  She was continued on 
+acyclovir. 
+
+CHRONIC/STABLE PROBLEMS:
+#Anxiety
+#Depression:
+Continued on home citalopram, venlafaxine.  Ativan above as 
+needed (per ___ hasn't had a prescription since ___
+
+#HTN: continue diltiazem
+
+GENERAL/SUPPORTIVE CARE:
+# Nutrition/Hydration: regular diet
+# Functional status: ambulatory
+# Bowel Function: holding
+# Lines/Tubes/Drains: PIVs
+# Precautions: universal
+# VTE prophylaxis: SQH
+# Consulting Services: none
+# Contacts/HCP/Surrogate and Communication: son
+# Code Status/Advance Care Planning: Full Code, presumed
+# Disposition: Home without services. . 
+
+NOTE: She reports that she has run out of oxycodone (confirmed 
+on PMP).  1 day of oxycodone was provided to provide bridge for 
+her visit/contact with her PCP. 
+
+ 
+
+###RESPONSE: multiple myeloma {Multiple myeloma}, chemotherapy {Chemotherapy}, stem 
+cell transplant {Allogeneic peripheral blood stem cell transplant}, malaise {Malaise}, nausea, vomiting, diarrhea {Nausea, vomiting and diarrhea}, Fever {Fever}, Nausea/vomiting/diarrhea {Nausea, vomiting and diarrhea}, pain {Pain}, nausea/vomiting/diarrhea {Nausea, vomiting and diarrhea}, fever {Fever}, diarrhea {Diarrhea}, WBC was elevated {Leukocytosis}, CT A/P {Computed tomography of abdomen and pelvis}, enteroproctocolitis {Proctocolitis}, Flu {Influenza}, CXR {Plain chest X-ray}, anaphylaxis {Anaphylaxis}, nausea/vomiting and diarrhea {Nausea, vomiting and diarrhea}, fever {Fever}, bacterial infection {Bacterial infectious disease}, viral gastroenteritis {Viral gastroenteritis}, Body pain {Generalized aches and pains}, MM {Plasma cell myeloma}, XRT {X-ray beam therapy}, chemotherapy {Chemotherapy}, Anxiety
+#Depression {Mixed anxiety and depressive disorder}, HTN {Hypertensive disorder, systemic arterial}, regular diet {Normal diet}"
+"###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 may be inaccurate and requires 
+futher investigation.
+1. Vitamin D ___ UNIT PO 1X/WEEK (___) 
+2. Diltiazem Extended-Release 240 mg PO DAILY 
+3. Venlafaxine XR 75 mg PO DAILY 
+4. Citalopram 40 mg PO DAILY 
+5. Dexamethasone 4 mg PO DAILY:PRN during radiation 
+6. OxyCODONE (Immediate Release) 10 mg PO Q4H:PRN Pain - 
+Moderate 
+7. Morphine Sulfate ___ 30 mg PO DAILY 
+8. Morphine Sulfate ___ 60 mg PO QHS 
+9. Acyclovir 400 mg PO Q8H 
+10. Senna 17.2 mg PO DAILY 
+11. Ondansetron 8 mg PO Q8H:PRN Nausea/Vomiting - First Line 
+
+ 
+Discharge Medications:
+1.  Acyclovir 400 mg PO Q8H  
+2.  Citalopram 40 mg PO DAILY  
+3.  Dexamethasone 4 mg PO DAILY:PRN during radiation  
+4.  Diltiazem Extended-Release 240 mg PO DAILY  
+5.  Morphine Sulfate ___ 30 mg PO DAILY  
+6.  Morphine Sulfate ___ 60 mg PO QHS  
+7.  Ondansetron 8 mg PO Q8H:PRN Nausea/Vomiting - First Line  
+8.  OxyCODONE (Immediate Release) 10 mg PO Q4H:PRN Pain - 
+Moderate 
+RX *oxycodone 10 mg 1 tablet(s) by mouth every four (4) hours 
+Disp #*6 Tablet Refills:*0 
+9.  Senna 17.2 mg PO DAILY  
+10.  Venlafaxine XR 75 mg PO DAILY  
+11.  Vitamin D ___ UNIT PO 1X/WEEK (___)  
+
+ 
+
+###RESPONSE: EMPTY: No SNOMED annotations found in this fragment"