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<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Loraine Wicks is a 67 y.o. woman here for difficulty sleeping past 3 weeks. Difficulty falling asleep, waking up early, and tossing and turning at the night. Notably, her son past away at the end of June. Her trouble sleeping started just after. Ambient at night has not helped. She notes that 4 days ago she saw her son Leonard sitting at the table, but knows it was not real. She also notes feeling tired and less interested in her hobbies such as scrapbooking. Her appetite has increased and she is eating more, but notes no changes in weight. She denies decreased concentration, feeling restless, or any suicidal ideation. She has good support at home from her husband and other family. Does not snore. Drink 1 cup of coffee in the morning. ROS: negative except as above Medications: HCTZ, ambient last 5 days PMHx: breast cancer 10 years ago PSHx: lumpectomy, appendectomy Social: retired, no tobacco use. Liv. Extract phrases from this text which may help understand the patient's medical condition.[/INST]appetite has increased, eating more, son past away at the end of June, woman, tossing and turning, 67 y.o, Difficulty falling asleep, past 3 weeks, Ambient has not helped, feeling tired, less interested, saw her son knows it was not real, waking up early, denies suicidal ideation, difficulty sleeping, trouble sleeping</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67yo F presents with trouble sleeping. She reports trouble falling asleep, trouble staying asleep, and early morning awakening. Her trouble sleeping began 3 weeks ago. At that time, her son passed away and she has been very upset about that. She lives with her husband and say they rely on each other for support. Before 3 weeks ago, she slept well, going to bed at 10:45pm and sleeping 8 hours through the night. Good sleep hygeine, with no TV or screens before bed. Received Ambien from friend past 5 nights, did not help, has had hallucinations. PMH: HTN, Breast cancer (dx 10 yrs ago; in remission now) PSH: Lumpectomy 10 yrs ago Meds: HCTZ, Lisinopril, and for past 5 nights has tried Ambien. Allergies: none Fam Hx: Father died of stroke age 75; mother living with long hx Depression Social: retired receptionist, drinks in moderation (2-3 glasses couple times/week), no tobacco, no drugs Psych: Endorses signs of depression, deny SI. Extract phrases from this text which may help understand the patient's medical condition.[/INST]At that time, her son passed away, F, 67yo, trouble falling asleep, began 3 weeks ago, 3 weeks ago, Ambien did not help, with long hx Depression mother, early morning awakening, deny SI, trouble sleeping, trouble staying asleep, trouble sleeping</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 67 yo F presenting with insomnia x 3 weeks since the death of her son. Pt has difficulty falling asleep, tosses and turns while sleeping, wakes up early. Sleeps 4-5 hours/day. Nothing worsens/alleviates sx. Tried Ambien for 5 days but did noto feel like it helped and has stopped taking it. Patient reports feeling drained and tired from lack of sleep and eating more than usual. She reports seeing her son in the kitchen one day and also thinking she heard a party next door when there was none. she feels sad and has a loss of normal interests and low neergy, but does not feel any guilt, psychomotor agitation/slowing down, or any suicidal ideation. No fevers, cold sx, wt loss or wt gain, changes to elimination. PMHx: high BP; remission from breast cancer. PSHx: lumpectomy with breast cancer 10 years ago, laparoscopic appendectomy in her 20s. Meds: HCTZ, lisinopril, ambien. FHx: high BP, depression. SHx: no smoking, alcohol, drugs.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]eating more than usual, x 3 weeks since the death of her son, F, reports thinking she heard a party next door when there was none, tosses and turns, 67 yo, difficulty falling asleep, x 3 weeks, Tried Ambien did noto feel like it helped, feeling drained, tired, low neergy, loss of normal interests, reports seeing her son in the kitchen one day, FHx depression, wakes up early, does not feel any suicidal ideation, insomnia, Sleeps 4-5 hours/day</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs Loraine Wicks a 67 Y old F pt presenting to the office with Insomnia. The condition started 3 Wks ago following the death of her son James. Pt also reports Auditory hallucinations of her son on two different occasions. There is also Loss of interest, Increased appetite and feeling of fatigue. Patient treid ambien but it didnt help. Patient denies Feeling of Guilt, Suicidal Ideations ,Excessive caffeine intake. ROS Negative except as above PMH: HTN. Meds: HCTZ, Lisinopril and Ambien, NKDA PSH: None, Hospitalizations: Non-significant Family H: Father had HTN, Mother Has Depression. Social H: Lives with her husband, Denies Smoking/Drugs. Etoh Occasionally Sexual H: Monogamous with Husband . Extract phrases from this text which may help understand the patient's medical condition.[/INST]Increased appetite, 3 Wks ago death of her son, Mrs, F, Auditory hallucinations, 67 Y old, started 3 Wks ago, treid ambien but it didnt help, fatigue, Loss of interest, Mother Has Depression, denies Suicidal Ideations, Insomnia</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 67 year old female with PMH of high blood pressure and breast cancer who comes in with difficulty sleeping. Problems began 3 weeks ago after her son passed away. She reports difficulty falling asleep, staying asleep and going back to sleep. She endorses multiples symptoms of depression including decreased sleep, energry, interest and appetite. Denies suicidal ideation or lack of will to live. PAtient reports good sleep hygeine with no tv, caffeine, excessive water or computer time before bed. Sh denies symptoms consistent with thyroid disease inclouding weight gain, skin changes hair changes or palpitations. Patient reports getting suport from family and friends and does not want to see a counselor. Pt also reports seeing her son once after he passed and hearing unexplained noises before falling asleep one night. Patient denies snoring . Extract phrases from this text which may help understand the patient's medical condition.[/INST]3 weeks ago son passed away, female, hearing unexplained noises before falling asleep one night, 67 year old, difficulty falling asleep, began 3 weeks ago, decreased energry, decreased interest, reports seeing her son once after he passed, Denies suicidal ideation, difficulty sleeping, difficulty staying asleep, difficulty going back to sleep, decreased sleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Wicks is a 67 yo F h/o HTN and breast ca in remission 10 y who p/w difficulty sleeping. She states that she has been having difficulty falling asleep and staying asleep for the past three weeks with associated early awakenings, correlated with the tragic passing of her son in an MVA. She has attempted 5 nights of ambien use without changes in her symptoms. Denies snoring, weight gain/loss, other sx besides difficulty sleeping. She has been having some difficulty coping with this loss, but has a good support system in her family and husband. No desire for additional counseling at this time. Denies depression, SI, guilt, psychomotor sx. Endorses increased appetite, difficulty sleeping, decreased energy, anhedonia. PMH: htn, breast ca (10 yr remission) PSH: lumpectomy, lap appy MED: hctz, lisinopril all: nkda SH: no drug/tobacco use, no recent ETOH use but otherwise 2 drinsk 2-3nights/wk FH: father (CVA), mother (MDD). Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, passing of her son, Ms., F, 67 yo, difficulty falling asleep, past three weeks, ambien use without changes in her symptoms, decreased energy, anhedonia, mother (MDD), early awakenings, Denies SI, difficulty sleeping, difficulty staying asleep, difficulty sleeping, difficulty sleeping</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo woman comes due to 3 weeks sleep disturbances, accompanied by loss of interest, changes in apettite, fatigue she has problems falling asleep, and wakes up a lot of times at night she ahs had visual and hearing hallucinations her son died 3 weeks ago ROS: no wieaght changes, skin probles, contipation urinary problems, weakness in limbs PMH: htn SH: none alllergies: none Meds: ACEI, HCTZ FH: mother: depression, father: HTC, stroke S:" wine 2-3 glasses a week. Extract phrases from this text which may help understand the patient's medical condition.[/INST]son died 3 weeks ago, woman, hearing hallucinations, 67 yo, problems falling asleep, 3 weeks, fatigue, loss of interest, visual hallucinations, mother: depression, sleep disturbances, wakes up a lot of times at night</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo F presenting with 3 weeks of insomnia. Pt reports difficulty falling asleep, waking up early, and daytime somulance. Pt states her son passed away on Aug 31st of this year. She state feeling sad and missing him. She alos reports seeing him sitting at the breakfast table 3 days ago. She is aware that this was not really happening. She also mentioned hearing distant music and talking at neighbors house, but no one was there. Denies command voieces. Denies snoring, suicidal/homicidal thoughts, constipation, dry brittle skin, recent medication changes PMH: HTN, breast cancer s/p lumectomy, radiation, and chemo. remission for past 10 years PSH: lumectomy, lap appy Meds: HCTZ, lisinopril Allergies: NKDA FH: father with HLD, HTN died from storke. Mother with h/o depression Social: drinks 2-3 glasses of wine a week. Denies smoking, recreational drug use. Extract phrases from this text which may help understand the patient's medical condition.[/INST]son passed away on Aug 31st, F, hearing distant music and talking at neighbors house, but no one was there, 67 yo, difficulty falling asleep, with 3 weeks, daytime somulance, reports seeing him sitting at the breakfast table 3 days ago aware that this was not really happening, Mother with h/o depression, waking up early, Denies suicidal/homicidal thoughts, insomnia</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo F presents with difficulty falling aslep and multiple night time awakenings for the last few weeks. This began after the death of her son a few weeks ago. She has been feeling depressed, fatigued, has increased appetite, and has decreased interest in daily activities. Denies guilt suicidal thoughts. Has a good support system of husband and friends. Has had one episode of seeing her son in the kitchen and has had one epidose of hearing noises. They did not send her any messages and she could not understand them. ROS - Denies nocturia, snoring, SOB at night, chest pain, changes to weight, heat or cold intolerance, changes to hair or skin, hoarseness, dizziness. PMH - Hypertension. Remission from breast cancer 10 yrs ago. PSH - Laparotomy for Appendectomy, Meds - HCTZ Lisinopril Sleeping meds. Allergies - None Menstrual Hx - menopause at 50 years Fhx - none Shx - Retired. Denies alcohol drug and tobacco use,. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, death of her son a few weeks ago, F, one epidose of hearing noises, 67 yo, difficulty falling aslep, for the last few weeks, fatigued, decreased interest, one episode of seeing her son in the kitchen, Denies suicidal thoughts, night time awakenings</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo f c/o difficulty sleeping started 3 wks ago after her son passed away discribed as early awakining at 4 am and difficulty falling asleep daily activity difficult to do , assoc w polyphadia but no wight gain no bowel change in bowel habits no urinary symptoms , noe episode of delusion that son was at home but knows its no true (normal insght) no hallusination , no snoring no cough no palpitations no diaphoresis no headache no visual changes no urinary sym no weakness no numbness no tingling no diahrea no vomiting no heartburn mood sad normal affect no suicide no homocide judgement intact FH father has HTN and dyslipidemia died of a strok mother has depression sexualy active w husband alon no condom use no smoking no recreational drugs no EtOH G1P1A0 normal vaginal delivery no previous hospitalisation no trauma no surg. Extract phrases from this text which may help understand the patient's medical condition.[/INST]polyphadia, 3 wks ago son passed away, f, 67 yo, difficulty falling asleep, started 3 wks ago, delusion that son was at home, mother has depression, early awakining, no suicide, difficulty sleeping</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Wicks is a 67 y/o F with a history of hypertension and breast cancer who presents with three weeks of difficulty sleeping. She states that this began after her son died in an accident. She has had increased sleep latency, increased night-time awakenings, and is waking up earlier in the morning. She also complains of loss of interest in usual activities, sadness, and anhedonia, but denies guilt, loss of concentration, suicidality or homicidality. PMH: Hypertension, breast cancer s/p mastectomy and chemoradiation 10 years ago, remains in remission PSHx: mastectomy, uncomplicated laparotomy for burst appendix Fam Hx: father with hypertension deceased from stroke, mother living with history of depression Social Hx: denies tobacco or illicit drugs, drank wine with meals before son's death CAGE: 0, retired receptionist, scrapbooks and reads in spare time, sexually active with husband - no sexual complaints, good support. Extract phrases from this text which may help understand the patient's medical condition.[/INST]three weeks son died, Ms, F, 67 y/o, increased sleep latency, with three weeks, loss of interest, anhedonia, mother history of depression, waking up earlier, denies suicidality, difficulty sleeping, increased night-time awakenings</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo female presents with new-onset trouble sleeping. Starte 3 weeks ago when son passed away. Has difficulty falling asleep and wakes up early. Still able to do daily activities but feels drained and low energy. States she has been feeling sad, has decreased interest in activities she used to enjoy, low energy, and is eating more than usual, but denies guilt, psychomotor slowing or self-harm intent or suicidality. Has been taking ambien, which she gets from a friend, for the past five days but has not helped with sleep. She states she has a good support system at home. Denies any recent illnesses, pain, or palpatations. PMHx hypertension, no past surgeries, takes lisinopril, HCTZ, and ambien. NKDA. Family history of depression (mother) and hypertension, hyperlipidemia, and stroke (father). Lives with husband and feels safe at home, is retired.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]eating more, 3 weeks ago when son passed away, female, 67 yo, difficulty falling asleep, Starte 3 weeks ago, ambien has not helped, feels drained, low energy, low energy, decreased interest, depression (mother), wakes up early, denies suicidality, denies self-harm intent, trouble sleeping</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Weeks is a 67 yo female with 3 weeks of trouble sleeping difficulty sleeping started 3 weeks ago after death of son Leonard in MVA on Jan 31st has difficulty falling asleep, usually takes 1 hr early morning awakening, cannot get back to sleep, sleeping total of 4-5 hours per night endorsed devastated, sad mood associated with anhedonia, decreased energy, increased appetite, audiutory and visual hallucinations of son leonard and people having a party denied guilt, decreased concentration, SI/HI, psychomotor agitation/retardation, anxiety, disorganized thinking, paranoia, delusions denied nause, vomiting, shortness of breath PMH: lumpactomy for breast cancer and lap appy. HTN. FH: father died from stroke, has HTN and HLD. mother still alive, had prior boutsw of dperession SH: monoganous with husband. retired. social drinker. denied smokin or drug use Meds: HCTZ and lisinopril. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, 3 weeks ago death of son, Ms, female, audiutory hallucinations, 67 yo, difficulty falling asleep, with 3 weeks, started 3 weeks ago, decreased energy, anhedonia, visual hallucinations, dperession mother, early morning awakening, denied SI, trouble sleeping, difficulty sleeping, sleeping total of 4-5 hours per night</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo F in office c/o trouble sleeping x 3 weeks. Pt reports prior to onset of symptoms her son died.Has tried Ambien with no relief.Pt sleeps 4-5 hours a night, has early morning awakenings, loss of interest, sadness, fatigue, and increase in appetite.Last night patient heard loud music which reminded her of her son , when she asked her neighbor whether there was noise was informed that there was none. Pt also reports seeing son sitting at table a few days ago but was aware that he was not there. Pt denies guilt, change in weight, suicidal ideation, change in skin/hair, intolerances to weather changes. ROS NEG except above PMH HTN x 15 years, Meds HCTZ, Lisinopril, NKDA PSH/HOSP/Trauma none FH Father Hypertension, hypercholesterolemia, stroke . Mother has hx of depression SH Pt is retired, lives with husband. Denies smoking, drinks 2-3 glasses of red wine a week, denies illicit drug use.sexually active with husband.NO hx of std. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increase in appetite, prior to onset of symptoms son died, F, Last night patient heard loud music was informed that there was none, 67 yo, x 3 weeks, Ambien with no relief, fatigue, loss of interest, reports seeing son sitting at table a few days ago but was aware that he was not there, Mother has hx of depression, early morning awakenings, denies suicidal ideation, trouble sleeping</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 year old female c.o trouble sleeping for past 3 weeks. 3 weeks ago her son died in a motor vehicle accident. She has trouble falling asleep, it takes over an hour, she awakens early at 4 am, and has multiple awakenings at night. She sleeps 4-5 hours per night. She is tired during the day. She denies day time sleeping. She drinks 1 coffe in the morning.Reports decreased sleep, anhedonia, decreased energy, increased appetite. Denies suicidal thoughts. Retired and lives with husband, has good support system. Describes good sleep hygiene. Denies snoring. /denies feeeling hot or cold, no skin or hair changes. PMH: HTN, in remission from breast cancer, surgical: lumpectomy, lap. appendectomy, meds: HCTZ, lisinopril, took ambein past 5 nights, counseled not to take prescription meds without doctors supervision, NKDA SH: retired receptionist, lives w husband, no tobacco, 1-2 glasses of wine at dinner, not any etoh in past 3 weeks. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, 3 weeks ago her son died, female, 67 year old, trouble falling asleep, past 3 weeks, tired, decreased energy, anhedonia, awakens early, Denies suicidal thoughts, trouble sleeping, multiple awakenings at night, sleeps 4-5 hours per night, decreased sleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: 67 yo F complains of trouble sleeping HPI: Sleeps only 4-5 hrs per night, has difficulty falling asleep, waking up early (4-5 am), and nighttime awakenings for 3 weeks. Patient reports dayttime fatigue and urge to nap Patient used to sleep within 15 min of laying in bed and slept for 8 hrs. No relief w/ Ambien. Recent death of son on February 14. Patient also reports feeling sadness, anhedonia, low energy, and increased appetite. No feelings of guilt, changes in concentration, or sucidial ideation or plan. Recent visual hallucination of son 4 days ago and auditory hallucination of neighbor's playing music last night. No changes in urine or BM, cold intolerance, or hoarseness of voice. ROS: Negative except above PMH: HTN, Breast cancer remission for 10 years Meds: HCTZ, Lisinopril, Ambien Allergies: NKDA PSH: Lumpectomy 10 years ago, Laparatomy in 20s FH: Mother had depression. SH: Red wine 2-3x/wk. No drug usage. Retired.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, Recent death of son on February 14, F, "auditory hallucination of neighbors playing music last night", 67 yo, difficulty falling asleep, for 3 weeks, No relief w/ Ambien, dayttime fatigue, low energy, anhedonia, visual hallucination of son, Mother had depression, waking up early, No sucidial ideation, trouble sleeping, Sleeps only 4-5 hrs per night, nighttime awakenings</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is 67 yr female presenting with trouble sleeping for 3wks. Has problem falling and staying asleep with tossing/turning. Wakes up early in the morning. Doesn't feel refreshed when waking up. Gets 4-5hrs of interuppted sleep. Normaly got 8hrs. Son died Jun19th. Describes mood as sad. Saw image of son last night and heard music from neighbors when there was no music. Hallucinations not frightenining. Tried Ambien last 5 nights-no relief. Increased appetite for carbs. Drinks 1cup coffee in the morning. No guilt/hopelessness. Low energy. Lack of interests. No suicidal ideation. Has good support with husband/friends. PMH:HTN/remission from breast cancer 10 yrs. MEDS: HCTZ/lisinopril/ambien. Allergy:none. Surghx: lumpectomy Famhx: Father-htn, high cholesterol, died of stroke. mom-hx of depression. Retired from receptionist. Likes to read/scrapbook. etoh-2-3glasses wine/week. No tobacco/drugs. No sick contacts/travel. ROS: pertinent listed.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Increased appetite, Son died Jun19th, female, heard music from neighbors when there was no music, tossing/turning, 67 yr, problem falling asleep, for 3wks, Tried Ambien no relief, Low energy, Lack of interests, Saw image of son last night, mom-hx of depression, Wakes up early, No suicidal ideation, trouble sleeping, problem staying asleep, Gets 4-5hrs of interuppted sleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo F presenting with trouble sleeping for the past 3 weeks. Reports difficulty falling asleep, early awakening, and feeling as if she is tossing and turning at night. Denies snoring. She lost her son three weeks ago, and since then she has been experiencing problems with sleep, depressed mood ("devastated"), loss of interest in scrapbooking. Has also had auditory and visual hallucinations related to son. Denies guilt, thoughts of hurting self or others. Has had increased appetite, but no weight gain. ROS: no fever, chills, abdominal pain, nausea, vomiting, diarrhea, constipation, blood in stool PMH: breast cancer in remission for 10 years, HTN PSH: lumpectomy, appendectomy Meds: hydrochlorothiazide, lisinopril, ambien (from friend) Social History: never smoker, a couple glasses of wine 2-3 times per week (has not had a drink for past few weeks), no illicit drugs. Previous receptionist, retired for 2 years. Lives with husband. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, lost her son three weeks ago, F, auditory hallucinations, tossing and turning, 67 yo, difficulty falling asleep, past 3 weeks, loss of interest, visual hallucinations, early awakening, Denies thoughts of hurting self, trouble sleeping, problems with sleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: patient is a 67 yo F who presents with 3 week history of unable to sleep. Patient reports son passed away 3 weeks ago. Notes she usually sleeps from 11pm-6am and practices good sleep hygiene. Lately has been falling asleep at 12am, with tossing and turning at night, and waking up an hour earlier. Denies any apneic episodes, excessive use of caffeine, or naping during the day. Has tried alking ambien without alleviation. Notes sadness, lack of energy, and feeling tired. Reports visual disturbances. Denies any feelings of guilt, impairment of concentration, or changes in appetite. Denies any suicidal ideation. ROS: as stated in HPI PMH: HTN and Breast cancer (in remission) PSH: lumpectomy, abd laparotomy Meds: HCTZ 25mg, lisinopril 20mg Allergies: NKDA FH: father had HTN, deceased of stroke, mother 90yo had depression SH: good support system, retired, lives with husband, no tobacco, alcohol, or drug use. Extract phrases from this text which may help understand the patient's medical condition.[/INST]son passed away 3 weeks ago, F, tossing and turning, 67 yo, usually sleeps from 11pm falling asleep at 12am, 3 week history, tried alking ambien without alleviation, lack of energy, feeling tired, mother had depression, waking up an hour earlier, Denies any suicidal ideation, unable to sleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Loraine Wicks is a 67 y/o F who presents with a chief complaint of "trouble sleeping" for the past 3 weeks. - Difficulty falling asleep and staying asleep. - Coincided with son dying in an MVA (3 weeks ago). - Lost interest in normal activities, describes a depressed mood and decreased energy. - Reports good social support network - husband and many friends. PMH: HTN PSH: none FamHx: Dad- stroke, HTN, hyperlipidemia. Mom - depression. SocHx: Retired, receptionist. Never smoker, occasional alcohol, no drug use.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Coincided with son dying 3 weeks ago, Ms, F, 67 y/o, Difficulty falling asleep, past 3 weeks, 3 weeks ago, decreased energy, Lost interest, Mom - depression, trouble sleeping, Difficulty staying asleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 y/o F presenting to clinic for 3 weeks of trouble sleeping, both in falling asleep and staying asleep -Son died in MVC Oct 25th of this year. Pt has been "devastated" since then -no hx of difficulty sleeping in the past -no aggravating or relieving factors. No relief from Ambien she got from a friend -admits to decreased interest, decreased energy, decreased appetite, and an overall "sad" mood -denies SI/HI -says she has a good support group (husband, family) Denies fevers, chills, weight loss/gain, N/V, shortness of breath or chest pain PMH: HTN PSH: denies Meds: Ambien from a friend, HCTZ, Lisinopril Allergies: NKDA FH: denies mental health disase in family Social: occasional wine 2-3x/week, less so recently, denies tobacco or drug use. Is married and lives with husband and children. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Son died Oct 25th, F, 67 y/o, trouble falling asleep, for 3 weeks, No relief from Ambien, decreased energy, decreased interest, denies SI, trouble sleeping, trouble staying asleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Wicks is a 67yo F presenting with 3 weels of insomnia. She reports difficulty falling asleep and wakes up at 3:30-4am. She reports 4-5 of sleep nightly. Caffeine intak is 1 cup of coffee/day. Excessive daytime sleepiness but unable to fall aleep for a nap. Tried taking a friends Rx of ambien with no imporovemnt. assocaited symtpoms of anhedonia, decreased energy, increased appertite, and "devastation". She report a stressor caused by her son's death 3 weeks ago. Denies feeleing of guilt, SI, changes in weight, concentration or phychomotor movement. Reports a "great support system" by husband and friends PMH: HTN MEdications: HCTZ and lisinopril Past Surgical Hx: None Allergies: None FH: Father - HTN and hyperlipedmia. mother- depression social: reitred, regular diet, regualr exercise but recently none, denies tobacco and illicit drugs. drinks glass of iwne 2-3 times/week. sexually active with husband. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appertite, "sons death 3 weeks ago", Mrs, F, 67yo, difficulty falling asleep, with 3 weels, unable to fall aleep for a nap, Tried ambien with no imporovemnt, Excessive daytime sleepiness, decreased energy, anhedonia, mother- depression, wakes up at 3:30-4am, Denies SI, insomnia, 4-5 of sleep nightly</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 F with c/o trouble sleeping x 3 weeks. She admits to drinking only 1 cup of coffee in the morning, but sleeps only 4-5 hours per night, difficulty falling asleep, and early awakening, decrease interest in daily activites, decreased energy. She denies snoring, SOB, chest pain, palpitations, no weight changes. She states that her son passed away 3 weeks ago, no suicidal ideation. PMH: hypertension, remission breast CA 10 years Allergies: NKDA Medications: HCTZ, lisinopril, ambien Hospitalization: lumpectomy, laparoscoy appendix burst FH: Father has hypertension & died of stroke, mother still living SH: retired, admits occasional walking as exercise, still sexually active with husband, non smoker, no illicit drugs, drinks red wine 2-3 week 0/4 CAGE. Extract phrases from this text which may help understand the patient's medical condition.[/INST]son passed away 3 weeks ago, F, 67, difficulty falling asleep, x 3 weeks, decreased energy, decrease interest, early awakening, no suicidal ideation, trouble sleeping, sleeps only 4-5 hours per night</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: MS. WICKS IS A 67 YO FEMALE PRESENTING WITH TROUBLE SLEEPING. SHE HAS DIFFICULTY FALLING ASLEEP. USED TO TAKE 15 MINUTES, NOW TAKES AN HOUR. TOSSES AND TURNS AND WAKES EARLIER AT 4-5 AM. FEELS DRAINED AND TIRED THROUGHOUT DAY. GOOD SLEEP HYGIENE. 1 CUP OF COFFEE IN MORNING. SON DIED RECENTLY. MOOD DEVASTATED, EATING MORE, UNINTERESTED IN ACTIVITIES SHE USED TO ENJOY. hAS GOOD SUPPORT SYSTEM WITH HUSBAND. SEEN LENORD IN KITCHEN FEW DAYS AGO. AUDITORY HALLUCINATIONS OF NEIGHBOR HAVING PARTY AT NIGHT. NO SUICIDAL IDEATION. PMH: HTN, 10 YR REMISSION FORM BREAST CANCER MEDS: HCTZ, LISINOPRIL, AMBIEN- STARTED 5 DAYS AGO, NOT HELPED SLEEP FMH: DAD-HTN, HLD, STROKE. MOM-DEPRESSION SEXUALLY ACTIVE WITH HUSBAND, NO PROTECTION. NO TOBACCO, DRUGS. GLASS OF WINE WITH DINNER 2-3 TIMES A WEEK.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]EATING MORE, SON DIED RECENTLY, FEMALE, AUDITORY HALLUCINATIONS OF NEIGHBOR HAVING PARTY AT NIGHT, TOSSES AND TURNS, 67 YO, USED TO TAKE 15 MINUTES, NOW TAKES AN HOUR, DIFFICULTY FALLING ASLEEP, AMBIEN- STARTED 5 DAYS AGO, NOT HELPED SLEEP, FEELS DRAINED, TIRED THROUGHOUT DAY, UNINTERESTED, SEEN LENORD IN KITCHEN FEW DAYS AGO, MOM-DEPRESSION, WAKES EARLIER AT 4-5 AM, NO SUICIDAL IDEATION, TROUBLE SLEEPING</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 y/o F c/o of difficulty sleeping for the past 3 weeks. She reports difficulty falling asleep, difficulty staying asleep, and waking up early in the morning without feeling rested. She denies that she snores. She reports drinking 1 cup of coffee daily and only 2-4 glasses of wine daily. She also report that her son died a few weeks ago and she has had difficulty dealing with his death despite a good social support system. She says last night she thought she heard voices from a neighbors' party despite that a party never occurred. Also days 4 days ago she "saw her deceased son in the kitchen." She denies nausea, vomiting, shortness of breath, chest pain, joint pain, new rashes, or trouble urinating or defecating. She takes Ambien for trouble sleeping but does not find it to be helpful. ROS: otherwise - PMH: breast cancer (in remission), hypertension Meds: HCTZ, Lisinopril, Ambien Allergies: NKDA SH: social drinker, non-smoker. Extract phrases from this text which may help understand the patient's medical condition.[/INST]son died a few weeks ago, F, "thought she heard voices from a neighbors party despite that a party never occurred", 67 y/o, difficulty falling asleep, for the past 3 weeks, takes Ambien but does not find it to be helpful, "saw her deceased son in the kitchen.", waking up early, difficulty sleeping, difficulty staying asleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: cc trouble sleeping HPI 67 year old female presents with sleeping diffuculuties, loss of interest, feeling of saddness and visual hallucinations since her son passed away 3 weeks ago. Having trouble going to sleep and reports early morning awakening. Patient denies changes in psychomotor response or feelings of guilt. she has tried talking ambein for sleep but with no relief. She reports increased appeitite. Patient denies cold intolerance skin and hair changes, fatigue. ROS negative except for abvove PMH HTN Meds HCTZ lisinopril ambien 5 mg Allergies none HF HTN and stroke in father and MDD in mother SH is retired lives with husband , decreased amount of walks recently since son passed loss interest, drinks alcohol 3x/weekly and denies tabacoo and illicit drug use. regular diet. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appeitite, son passed away 3 weeks ago, female, 67 year old, trouble going to sleep, tried talking ambein for sleep but with no relief, loss of interest, loss interest, visual hallucinations, MDD in mother, early morning awakening, trouble sleeping, sleeping diffuculuties</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: trouble sleeping HPI: Loraine Wicks, a 67yoF c/o trouble sleeping for the last 2 weeks. Pts only son died on May 14th last month. Pt has feelings of sadness, loss of interest, decreased energy, increased and appetite. Denies feelings of guilt, loss of concentration, and also denies suicidal ideation. Sleep has been lasting about 4-5 hours a night. she has taken ambien the last few nights to try to improve sleep, but it has not been effective. She has trouble falling alseep, and trouble staying asleep, despite proper sleep hygiene. Pt practices good sleep hygiene. Drinks only 1 cup of coffee/ day and has well balanced diet. ROS a PMH: HTN MEDs: ambien recently. ALLERGIES: n/a FH: Dad: HTN, Hypercholesterolism, COD:stoke. Mom: depression SH: no tobacco, social drinker, no recreational drug use. Married to husband and has friends and brothers locally - good support system.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, son died on May 14th last month, F, 67yo, trouble falling alseep, last 2 weeks, ambien has not been effective, decreased energy, loss of interest, Mom: depression, denies suicidal ideation, trouble sleeping, trouble sleeping, Sleep has been lasting about 4-5 hours a night, trouble staying asleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 y.o. F presents with difficulty sleeping. Started 3 weeks ago following the death of her son. Ambien did not help her sleep. She goes to bed at 11 and wakes up at 4-5 sleeping only 4-5 hours per night. She complains of waking up early, tossing and turning, and feeling fatigued throughout the day. Since her son passed away, he has lost interest in doing anything, been fatiged, and has been eating more. She states that she has been seeing and hearing things that are not there including her son at the kitchen table, and muffled voices and music at a neighbors party. ROS: Negative except for above Vitals: Hypertensive, otherwise WNL. Surg: Lumpectomy, appendecotmy. PMHx: HTN for which she takes HCTZ + lisinopril Allergies: none Soc Hx: Pt lives w/ husband, retired, no tobacco or illegal drug use. Drank wine 2 glasses 3 times per week prior to son passing away. Good support system. Sexually active with husband.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]eating more, 3 weeks ago following the death of her son, 3 weeks ago following the death of her son, F, hearing things that are not there including muffled voices and music at a neighbors party, tossing and turning, 67 y.o, Started 3 weeks ago, Ambien did not help her sleep, feeling fatigued, been fatiged, has lost interest, seeing things that are not there including her son at the kitchen table, wakes up at 4-5, waking up early, difficulty sleeping, sleeping only 4-5 hours per night</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: Trouble sleeping Loraine Wickws, 67 F presenting w trouble sleeping for the past 3 wks. Difficulty getting to sleep, staying asleep, and wakes up earlier than usual. Son died 3 weeks ago. She feels devasted. Has lost interest in hobbies (romance novels). Eating more. Has been hearing voices and seeing her son for the past 2 weeks. No guilt, no psychomotor agitation, No suicidality, Feels drained, no memory changes. ROS: No hair changes, no cold intolerence. PMH: HTN, breast Ca 20 y/o tx w bilateral mastectomy (PSH) Medications: HCTZ, lisinopril, Ambien FH: Dad - high cholesterol, HTN, died at 75 of stroke, Mom 90, depression. SH: Regular diet, used to exercise by walking, Used to drink 1-2 glasses of wine per day, 2-3x/wk, No cigarettes, or drugs, sexually active w husband.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Eating more, Son died 3 weeks ago, F, hearing voices, 67, Difficulty getting to sleep, past 3 wks, Feels drained, lost interest, seeing her son, Mom depression, wakes up earlier than usual, No suicidality, Trouble sleeping, trouble sleeping, Difficulty staying asleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67-year-old female, has come to the physician's office because of trouble sleeping. Started 3 weeks ago for the first time after his son died and since it sarted it is getting worst. Describe as problems to fall to sleep and wake up early in the morning tht don't improves even when she took a ambien for the last 5 days. Also she reports feel tire during the day but can't take a nap because can't fall to slee. Refers feel sad, drained, loss in interest, eating more and feel safe at home. Denied plan to harm herself or otherm headaches, weakness, nubness, adominal pain, chest pain, joint pain, changes in bowel or urinary habits, convulsions,changes in weight, fever o SOB. ROS: none except above PMH: HBP MED: HCTZ, beta blocker ALL: NKDA PS: none, no trauma OBG: LMP at 52 y/o SH: retired marriage with children, no smoke, 2-3 glass wine at weeks, no ilicit drugs, sexually active with husband, no STDs . Extract phrases from this text which may help understand the patient's medical condition.[/INST]eating more, 3 weeks ago son died, female, 67-year-old, problems to fall to sleep, Started 3 weeks ago, "cant take a nap because cant fall to slee", "dont improves even when she took a ambien", tire during the day, feel drained, loss in interest, wake up early, Denied plan to harm herself, trouble sleeping</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Wicks is a 67 year old female who presents with 3 weeks of trouble sleeping. She has been sleeping 4-5 hours per night since the death of her son Leonard on July 5. She reports that she has had trouble falling asleep, she tosses and turns, and is tired and has low energy during the day. She has been taking Ambien for the past 5 nights but has not seen an improvement. She has lost interest and has diffculty concentrating on her hobbies but is still able to complete her ADLs. She does not feel guilt. Her appetite has increased, but she denies weight gain. She denies suicidal and homicidal ideation and says her husband has been supportive. Denies cold intolerance, changes in skin or bowel habits. PMH: HTN, breast cancer in remission for 10 yrs Meds: HCTZ 25mg once daily, lisinopril 20mg once daily SH: never smoked, occasional wine, none for past 3 weeks, no recreational drugs FH: father died of stroke age 75, mother h/o depression. Extract phrases from this text which may help understand the patient's medical condition.[/INST]appetite has increased, death of her son Leonard on July 5, Mrs, female, tosses and turns, 67 year old, trouble falling asleep, with 3 weeks, taking Ambien has not seen an improvement, tired, low energy, lost interest, mother h/o depression, denies suicidal ideation, trouble sleeping, sleeping 4-5 hours per night</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 y/o female with 3 weeks of insomina. She has trouble falling asleep; it takes up to one hour to fall asleep. She wakes up often in the middle of the night tossing and turning without need to go to the bathroom. She also wakes up earlier than usual. Her sleep time is from 11pm till 4-5 am at this point. She often feels very tired in the morning and throughout the day. This has occurred every day for the past 3 weeks. She lost her son 3 weeks ago, and is dealing with that. She has a strong support system at home. She has not consumed more alcohol than usual. She has low interest in her activities, low energy, increased appetite, no suicidal ideation or homicidal ideation. She has auditory halcuinations thinking the neighbors are having a party. She has visual hallucination of seeing her son even though he is not there. PMHx: HTN, breast cancer 10 years ago PSHx: lumpectomy, appendectomy Social: Lives w/ husband. 2-3 drinks per week.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, lost her son 3 weeks ago, female, auditory halcuinations, tossing and turning, 67 y/o, trouble falling asleep, takes up to one hour to fall asleep, with 3 weeks, for the past 3 weeks, feels very tired, low energy, low interest, visual hallucination, wakes up earlier than usual, no suicidal ideation, insomina, wakes up often in the middle of the night</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 year old F presening with a history of difficulty sleeping for the past few weeks. She states that it takes her longer to fall asleep, she tosses and turns throughout the night and she gets up earlier than usual. Her son recently passed away on September 30 which she associates with the onset of her trouble sleeping. Currently sleeping about 4-5 hours a night. Tried ambien, did not help. Has had visual hallucination of her deceased son. Increase in appetite over the past few weeks, has no energy, no longer takes evening walks, and has lost interest in her hobbies. Denies feeling guilt, She states she has a strong support system. Denies suicidal ideation. Denies, blurred vision, chest pain, SOB. PMHx: HTN, breast cancer; Meds: HCTZ, lisinopril; NKDA; Surg: lumpectomy, laparotomy for appendix; Gyn: G1P1, vaginal birth no complications; menopause age 52 FHx: father deceased age 75 stroke, HTN, hypercholest; mother depression. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Increase in appetite, son recently passed away, F, tosses and turns, 67 year old, longer to fall asleep, past few weeks, ambien, did not help, no energy, lost interest, visual hallucination of her deceased son, mother depression, gets up earlier than usual, Denies suicidal ideation, trouble sleeping, sleeping about 4-5 hours a night, difficulty sleeping</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 Y/O F C/O SLEEPING PROBLEMX 1 MONTH AGO AFTER HER SON PASSED AWAY. SHE HAD DIFFICULLTY FALLING ASLEEP, GETTING UP EARLY IN MORNING. REPORTS FEELING SAD ,SEEING HER SON 3 DAYS AGO AND HEARING SOME PARTY VOICES LAST NIGHT THAT NOONE ELSE CAN HEAR. SHE HAS POOR ENERGY, LACK OF CONSENTRATION, ANHEDONIA, BUT SHE CAN TAKE CARE OF HERSELF, AND HAS A GOOD SUPPORT FAMILY AND FRIENDS. ALSO REPORTS THAT SHE EATING MORE THAN USUAL. DENIES FEELING GUILTY, WEIGHT LOSS, CONTROLED BY SOMEONE ELSE, SUICIDAL THOUGHTS, ROS:NEGATIVE EXCEPT AS ABOVE/PMH: HTN/PSH:NONE/MEDICATIONS: HTCZ. LISINOPRIL/FH: MOHTER HAD DEPRESSION/ SH: NOT SMOKER. 2BEERS/ WEEK. USES APN FOR LASTFEW DAYS. Extract phrases from this text which may help understand the patient's medical condition.[/INST]EATING MORE THAN USUAL, 1 MONTH AGO SON PASSED AWAY, HEARING SOME PARTY VOICES LAST NIGHT THAT NOONE ELSE CAN HEAR, 67 Y/O, DIFFICULLTY FALLING ASLEEP, X 1 MONTH, POOR ENERGY, ANHEDONIA, SEEING HER SON 3 DAYS AGO, MOHTER HAD DEPRESSION, GETTING UP EARLY IN MORNING, DENIES SUICIDAL THOUGHTS, SLEEPING PROBLEM</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI:67 Y F c/o trouble sleeping since last 3 weeks, son died in a motor vehicle accident 3 weeks ago when the symptoms started,takes AMPIEN for problem but not relieved completely. no compla complains of eating more since then, no complaints of,no weight gain, constipation. PMH:kc/o high blood pressure takes HCTZ since last 15 years and LIsinopril since last 5 years, h/o breast cancer- lumpectomy 10 years ago h/o laparotomy for appendicitis at 20 years of age, no history of travel FH: not significant SH: retired receptionist, lives with husband, no smokig, drinks occasionally, no recreational drugs sexually active with husband. Extract phrases from this text which may help understand the patient's medical condition.[/INST]eating more, son died 3 weeks ago, F, 67 Y, last 3 weeks, takes AMPIEN not relieved completely, trouble sleeping</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 year old woman with hypertension and history of breast cancer in remission here with difficulty sleeping for past 3 weeks since son passed away in MVA. - prior to 3 weeks ago, slept 8 hours per night. - since son passed away, has taken1 hr to fall asleep, tossed and turned through the night, and wakes at 4-5 am. - no changes to sleep hygeine - no screen time, though decreasd exercise. - Denies feelings of guilt for son's loss, denies SI or thoughts of self-harm, has good social support network. - has had hallucination of son but knew it was just a hallucination. also 1 hypnogogic hallucination. - no snoring, or morning headache, weight loss, or other systemic symptom - took ambien for past 5 nights, without improvement. Meds - hctz, lisinopril, ambien (past 5 nights) pmhx - breast cancer in remission, HTN. fam med - dad with CVA. Social - 1-2 glass wine/week, no tobacco or drugs. no allergies. Extract phrases from this text which may help understand the patient's medical condition.[/INST]3 weeks since son passed away, 3 weeks ago son passed away, woman, 1 hypnogogic hallucination, tossed and turned, 67 year old, 1 hr to fall asleep, past 3 weeks, prior to 3 weeks ago, ambien without improvement, hallucination of son, wakes at 4-5 am, denies SI, denies thoughts of self-harm, difficulty sleeping</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Wicks is a 61F w/ insomnia. Difficulty falling asleep, with frequent awakenings, only getting 4 hours total/night and feeling fatigued. Does not look at screens before bed or spend time in bedroom when not trying to sleep. She does not snore. Her son passed away on August 9th of this year, and she has been grieving. Reports sad mood, anhedonia, decreased energy, increased appetite. Denies psychomotor agitation/retardation, guiltyness, difficulty concentrating, and suicidal ideation. No history of mania. Also reports she "saw her son" in the living room, although she knew he was not there. Denies prior hallucinations, paranoid thinkings, ideas of reference, or thought broadcasting. No sensitivity to temperature, skin/hair changes, or cahnges in bowel movements. PMH: HTN, breast cancer, PSH: lumpetomy, laparotmy. Meds HCTZ, lisinopril, ambien. NKDA. SH: 2/3 ETOh/wk. No drugs or tobacco. FH: Mother depressed. Father: HTN. Sexual . Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, son passed away on August 9th, Ms., F, 61, Difficulty falling asleep, feeling fatigued, decreased energy, anhedonia, "saw her son" in the living room, although she knew he was not there, Denies suicidal ideation, insomnia, frequent awakenings, only getting 4 hours total/night</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Loraine Wicks is a 67 year old female with past history of hypertension breast cancer (in remission) presenting for evaluation of difficulty sleeping. She explains that she has difficulty both falling asleep and staying asleep that began 3 weeks ago. At this time, she explained that her son died unexpectedly. She has used ambien to help her sleep for the lat 5 nights, but it has not helped. She gets 4-5 hours of sleep. She indicates an increased appetite, but denies thoughts of hurting self/others, guilt or difficulty concentrating, fevers, chills, night sweats, changes in weight, chest pain, SOB, nausea, vomiting, changes in her hair. Social Hx: follows no particular diet, exercise - walks every day, but has not recently due to her son's death, caffeine - 1 coffee/day. Medical Hx: HTN, breast cancer (in remission). Allergies: none. Surg Hx: lumpectomy, appendectomy, Family Hx: mother - depression, Meds: hydrochlorothiazide, lisinopril. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, 3 weeks ago son died, female, 67 year old, difficulty falling asleep, began 3 weeks ago, ambien has not helped, mother - depression, denies thoughts of hurting self, difficulty sleeping, difficulty staying asleep, 4-5 hours of sleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo female presents with 3 weeks of insomnia with recent death of son. describes difficulty falling asleep and maintaining sleeps. wakes up multiple times during the night. thinks about son at night. no nocturia. no snoring. reports depressed mood, anhedonia, increase appettite, inability to enjoy activitie, fatigues. reports hearing a party that did not happen and seeing son in kitchen . denies fever, chills, night sweats, weight changes, palpitations, cold symptoms, changes in hair skin or nails, cold/heat intolerance, headaches, dizziness, numbness, weakness, tingling, nausea, vomiting, diarrhea, constipation or other chnages in urianry habits or bowel movements. PMhx: hypertension, breast cancer 10 y ago. PSHx: lumpectomy, laparotomy for appendix. FMHx: hypertension. high cholesterol, stroke in father. depression in mother. NKA. Takes HCTZ, lisniopril, and ambien from friend. No drugs or smoking. drinks 2-3 wine/wk. 0/4 cage. sex. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increase appettite, recent death of son, female, reports hearing a party that did not happen, 67 yo, difficulty falling asleep, with 3 weeks, fatigues, anhedonia, inability to enjoy activitie, seeing son in kitchen, depression in mother, insomnia, difficulty maintaining sleeps, wakes up multiple times during the night</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Wicks is a 76 yo F who presents with "trouble sleeping," difficulty falling asleep, and early morning awakening. This started 3 weeks ago. Roughly 3 weeks ago her son passed away. In addition to sleeping difficulties, she has had decreased interest level, decreased energy, increased appetite, no suicidal thoughts, no guilty feelings. Has had visual hallucinations of her son, and has heard voices recently: she has never had previous episodes like this before. No skin/hair changes. She has tried ambien to help with sleep, but it has not helped. No other relieving or exacerbating factors. No increased anxiety or fluctations in mood, no intrusive thoughts. ROS: negative except for HPI Medications: HCTZ for HTN, lisinopril Allergies: NKDA PMHx: breast cancer survivor (remission 10 years) PSurghx: R. breast lumpectomy, laparotomy appendix as a teenager Socialhx: ret. receptionist, 2-3 drinks/week, no illicit drugs,lives w/husband. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, 3 weeks ago her son passed away, Ms, F, has heard voices recently, difficulty falling asleep, started 3 weeks ago, ambien has not helped, decreased energy, decreased interest level, visual hallucinations, early morning awakening, no suicidal thoughts, trouble sleeping, sleeping difficulties</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is 67F who presents with trouble sleeping since 3 weeks ago. Patient states 3 weeks ago her son died suddenly in a MVA and since then she has had trouble sleeping as well as waking up multiple times throughout the night. She has tried taking Ambien but it has not helped. 4 days ago patient states she saw her son in her kitchen, admits she knows it is impossible he could be there. Additionally she heard sounds of party from neighbor previous night, though neightbor states there was no party. Patient has lost interest in her favorite activities since events of her son's passing, does not feel guilt, notes decreased energy levels, and increased appetite. Denies decrease in concentration, psychomotor retardation or thoughts of suicide. 1 cup coffee in morning. ROS: Neg except as stated above PMH: HTN, Remission Breast Cancer, NKDA Meds: HCTZ, Lisinopril EtoH - 2-3 glass wine/week (0/4 CAGE), denies smoking, drugs.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, 3 weeks ago her son died, F, heard sounds of party from neighbor previous night, though neightbor states there was no party, 67, since 3 weeks, tried taking Ambien but it has not helped, decreased energy levels, lost interest, saw her son in her kitchen, Denies thoughts of suicide, trouble sleeping, trouble sleeping, waking up multiple times throughout the night</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Wicks, 67 yo F presents with 3 week history of difficulty falling asleep, early awakenings, and tossing and turning. She gets 4-5 hours of sleep throughout the night, does not feel refreshed upon awakening, and is tired throughout the day. She tried taking Ambien for the last 5 days but it does not help. Her son passed away 3 weeks ago and she has been feeling sad. She has been seeing her son and hearing late-night parties, which she knows are not real. She also reports loss of interest, low energy, increased appetite. She has a good support system. She has a mild cough which she says is due to someone's perfume. Denies constipation, cold intolerance, hair/skin/nail ROS: negative except as above PMH: HTN PSH: none Meds: hydrochlorothiazide, lisinopril Allergies: NKDA SH: lives with husband, no tobacco or drugs, couple glasses of wine 2-3 times per week, CAGE 0/4 FH: dad- HTN, high cholesterol, died of stroke; mom-depression. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, son passed away 3 weeks ago, Mrs., F, hearing late-night parties, which she knows are not real, tossing and turning, 67 yo, difficulty falling asleep, 3 week history, Ambien does not help, low energy, tired throughout the day, loss of interest, seeing her son nows are not real, mom-depression, early awakenings, gets 4-5 hours of sleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: Loaraine Wicks is a 67 y/o female who presents with trouble sleeping for the last 3 weeks. She said this trouble sleeping started around the time of the the death of her son. She used to get 8 hrs a sleep a night, but now she wakes up around 4AM or 5AM with about 3 hours of sleep completed. She has been more fatigued lately, and has had a lost of interest in activities. She had 1 episode of seeing a vision of her son that passed away. She has also had 1 episode of hearing voices outside her door, thinking that it was her neighbor. Ambien has not provided any relief. ROS: negative except above. Allergies: none Meds: hydroclorthiazide, lisinopril PMH: HTN PSH: lumbectomy, appendix removal SH: retired, lives with husbadn, no smoking, drinks red wine about 2-3 times per week, no recreational drug usage. FH: father had HTN and high cholesterol, mother is 98 with hx of depression . Extract phrases from this text which may help understand the patient's medical condition.[/INST]3 weeks death of her son, female, 1 episode of hearing voices outside her door, 67 y/o, last 3 weeks, Ambien has not provided any relief, fatigued, lost of interest, 1 episode of seeing a vision of her son, mother hx of depression, wakes up around 4AM or 5AM, trouble sleeping, trouble sleeping, 3 hours of sleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Wicks is a 67 yo woman who presents to clinic with trouble sleeping for the past 3 weeks. She started having trouble sleeping after her son died in an accident. She reports that she has trouble both falling asleep and staying asleep and has been waking up early. She is getting about 4-5 hours of sleep a night. She also reports that she has been sad, had an increased appetite, lost interest in her acitivites, and had a low energy level. She reports that she has seen her son James at the breakfast table and heard a party she knows was not real. She denies any headaches, dizziness, SOB, CP, fevers, chills, nausea, vomiting, weight loss or gain. ROS: see above PMSH: HTn for 15 years Meds: HCTZ, lisinopril, ambien for the past week PSH: None FH: Father had HTN and HLD died of stroke, mother 90 and healthy with depression SocHx: No tobacco or illicit drugs, 2-3 glasses wine/week, sexually active with husband, retired receptionist. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, 3 weeks after her son died, Mrs., woman, heard a party she knows was not real, 67 yo, trouble falling asleep, for the past 3 weeks, low energy, lost interest, has seen her son James at the breakfast table, mother with depression, waking up early, trouble sleeping, trouble sleeping, trouble staying asleep, getting about 4-5 hours of sleep a night</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo F, presents w/ 3 weeks of sleep disturbances. takes an hour to fall asleep. multiple nightly awakenings, sleeps ~ 4-5 hr each night. no naps during the day. does not snore. reports that her son died 3 weeks ago in an MVA. has good support system (husband and close friends). reports this limits her daily activity. tried sleeping pills but didn't help. No intolerence to heat/cold. no nighttime sweats. Meds: HCTZ, lisinopril. Allergies: none PMH: High BP, Breast cancer survivor (10 years) PSH: rt. Lumpectomy 10 ya. Laparotomy and appendectoy in her 20s. SH: no smoking or drug history. drinks wine 2-3 glasses a week. . Extract phrases from this text which may help understand the patient's medical condition.[/INST]son died 3 weeks ago, F, 67 yo, takes an hour to fall asleep, w/ 3 weeks, "tried sleeping pills but didnt help", limits her daily activity, sleep disturbances, multiple nightly awakenings, sleeps ~ 4-5 hr each night</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI:67 YO F C/O DIFFICULTY IN SLEEPING X 3WKS, STARTED AFTER SHE LOST HER SON, DIFFICUTY IN FALLING ASLEEP, STAYING ASLEEP AND EARLY MORNING AWAKING, ASSOCIATED WITH FATIGUE, LOSS OF INTERST, FLASHBACKS OF HER SON SITTING IN FRONT OF HER, FEELING SAD INCREASE APPETITE. SHE DENIES COLD INTOERANCE ,CHANGE IN APPETITE, WEIGHT CHANGE, DECREASE CONCENTRATION, FEELING GUILTY, SUICIDAL THOUGHTS. SHE REPORTS THAT SHE HAD A GOOD SUPPORT FROM HER HUSBAND AND FRIENDS. ROS:NO CHEST PAIN ,CHANGE IN BOWEL OR URINARY HABITS. PMH:HTN X15 Y, COMPLIANT WITH TX. MEDS:HCTZ. SH:NO SMOKES, OCCASIONAL ETOH, NO ILLICIT DRUGS. SEXUALLY ACTIVE WITH HUSBAND. OB/GY:LMP AT AGE 52.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]INCREASE APPETITE, 3WKS, STARTED AFTER SHE LOST HER SON, F, 67 YO, DIFFICUTY IN FALLING ASLEEP, X 3WKS, FATIGUE, LOSS OF INTERST, FLASHBACKS OF HER SON SITTING IN FRONT OF HER, EARLY MORNING AWAKING, DENIES SUICIDAL THOUGHTS, DIFFICULTY IN SLEEPING, DIFFICUTY STAYING ASLEEP</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67yo woman presents with 3 weeks of difficulty falling asleep. 3 weeks ago her son was killed in an auto accident. Pt says that it takes her a long time to fall asleep as shes thinking about her son, and she tosses and turns. Pt has tried to take naps during the day, but has been unable to fall asleep. Pt endorses a good support network including a loving and understanding husband. Pt endorses increased appetite lately. No change in weight. Pt describes herself as sad, but not depressed. She has diminished interest in hobbies, but is socializing. Pt tried ambien to sleep but it didn't help. Pt denies chest pain, SOB, fever, chills, nausea, vomiting, abdominal pain. PMH sig for HTN treated with lisinopril and HCTZ, and pt is a 10yr breast CA survivor s/p lumpectomy. Pt doesn't smoke, occassional EtOH use, no illicit drugs. Home BPs measurements have been good.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, 3 weeks ago her son was killed, woman, tosses and turns, 67yo, difficulty falling asleep, takes her a long time to fall asleep, with 3 weeks, tried to take naps during the day, but has been unable to fall asleep, "tried ambien to sleep but it didnt help", diminished interest</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67-year-old female, has come to the physician's office because of trouble sleeping. Patient said her only son died 3 weeks ago unexpectedly in an MVA. Since then she's been feeling sad, eating more, has lost interest in hobbies. Patient describes difficulty falling asleep, tossing and turning and waking up early. Patient also says she saw her son at the kitchen table 4 days ago, but knows he wasn't there. She also states she heard loud "party like noises" from neighbor's house 2 nights ago, but neighbor did not have a party. Patient tried ambien for last 5 days but hasn't helped. No fever, chills, nausea, vomiting, chest pain. ROS negative except as noted above PMH - HTN, breast cnacer PSH - lumpectomy, lap appendectomy Meds - hctz, lisonpril, ambien FH - Father - HTN, HLD, Mother - dperession Social - never smoker, drinks a couple glasses of wine 2-3 nightsper week, no drugs, lives at home with husband.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]eating more, son died 3 weeks ago, female, heard loud "party like noises" from neighbor\s house 2 nights ago, but neighbor did not have a party, tossing and turning, 67-year-old, difficulty falling asleep, "ambien hasnt helped", has lost interest, "saw her son at the kitchen table 4 days ago, but knows he wasnt there", Mother - dperession, waking up early, trouble sleeping</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Wicks is a 67 year old woman with history of HTN who presents for difficulty sleeping for 3 weeks. 3 weeks ago her only son Leonnard died. She thought she saw him once in the kitchen after he died and she has also heard a party at her neighbor's that wasn't there. These false perceptions do not bother her. Her primary issue is diffuclty sleeping. She goes to bed at 11 PM, falls asleep at midnight, and has poor sleep. Awkaens at 4 or 5 AM. Also has very low energy throughout day but performs daily tasks like cooking. Has a good support system of family and friends. Tried ambien for 5 nights which did not help. She has no thoughts of suicidality or self harm. No nightmares. No nausea, no chest pain, no difficutly breathing. family history of HTN and CVA in father, depression in mother Allergies: none Meds: HCTZ, lisinopril, ambien (for last 5 days) Surg Hx: lumpectomy, laparotomy Soc: no smoking, occasional etoh, no drugs. Extract phrases from this text which may help understand the patient's medical condition.[/INST]3 weeks ago her only son Leonnard died, Mrs., woman, "heard a party at her neighbors that wasnt there", 67 year old, goes to bed at 11 PM, falls asleep at midnight, for 3 weeks, Tried ambien which did not help, low energy, aw him once in the kitchen after he died, depression in mother, Awkaens at 4 or 5 AM, no thoughts of suicidality, difficulty sleeping, diffuclty sleeping, has poor sleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67yo F c/o trouble sleeping x3weeks. Pt states her son passed away 3 weeks prior when her insomnia started. She states she has trouble falling asleep, and trouble staying asleep. States she feels "tired and groggy" in the morning upon waking. States feelings of sadness and devastation since losing her son, states loss of interest in hobbies, low energy, increased appetite. +ve Visual hallucinations of son x1. +ve auditory hallucinations (hypnogogic) prior to falling asleep x1. Denies weight changes, feelings of guilt, lack of concentration, psychomotor retardation. Denies skin/hair changes. No change in caffeine intake. PMH: HTN, Breast CA remission Allergies and Meds: NKDA, HCTZ, Ambien for sleep FH: Dad-Stroke, deceased. Mother-Depression. SH: retired, married. Denies smoking, drugs. Drinks socially on weekends.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, son passed away 3 weeks prior, F, auditory hallucinations x1, 67yo, trouble falling asleep, x3weeks, 3 weeks prior insomnia started, feels "tired, low energy, loss of interest, Visual hallucinations of son x1, Mother-Depression, trouble sleeping, trouble staying asleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Wicks is a 67yo who presents for difficulty sleeping. She reports that for the past 3 weeks, she has been experiencing difficulty falling asleep and staying asleep. October 13, her only son Leonard passed away. Since then, she has been experiencing increased appetite and difficulty sleeping. She has tried taking ambien. Endorses feeling down. Denies any feelings of guilt. Denies any thoughts of hurting herself or others. Endorses audio and visual hallucinations. Thought she saw her son sitting at the table, and thought she heard voices like her neighbor was having a party when she was not. Denies that hallucinations have told her to hurt herself or others. PMH: high blood pressure PSH: laparotomy for appendicitis, mastectomy for breast cancer (14 years in remission) FH: none Social: lives with husband, strong support network, feels safe at home Substance Use: no smoking, drinks 1-2 drinks per week Work: retired. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, October 13, her only son passed away, Ms, audio hallucinations, heard voices like her neighbor was having a party when she was not, 67yo, difficulty falling asleep, past 3 weeks, visual hallucinations, saw her son sitting at the table, Denies any thoughts of hurting herself, difficulty sleeping, difficulty staying asleep, difficulty sleeping</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67yo F presents with difficulty sleeping for 3 weeks after loosing her son. she has difficulty falling asleep, staying asleep and has early morning awakening. she gets about 4/5 hours of sleep a night and feels drained throughout the day. she also reports hearing muffled voices (like a lot of people having a party) that was not actually happening, she also reports seeing her dead son for a few seconds. she also has increased appetite, loss of interest in things she liked to do and anhedonia. shes in menopause and has had a mammogram last year and apapsmear 2 years ago. she had 1 child by normal vaginal delivery PMH Hypertension, 10 years in remission from breast cancer PSH: lumpectomy 10 years ago, laparotomy for appendicitis SHX she doesbt smoke or use illicit drugs but she drinks a few glasses of wine 2-3 times a week mother had depression, father died of stroke . Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, 3 weeks after loosing her son, F, hearing muffled voices that was not actually happening, 67yo, difficulty falling asleep, for 3 weeks, feels drained, loss of interest, anhedonia, reports seeing her dead son, mother had depression, early morning awakening, difficulty sleeping, difficulty staying asleep, 4/5 hours of sleep a night</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: A 67 YO F COMPLAINS OF TROUBLE SLEEPING SINCE 3 WEEKS AGO. SHE RELATE THE ONSET OF SYMPTOMS WITH THE LOSS OF HER SON THIS PAST NOVEMBER. SHE REFERS ANHEDONIA, DEPRESSED MOOD, FEELING DRAINED AND HAVING EXPERIENCED INCREASED APPETITE. SHE DENIES SUICIDE THOUGHTS, NO PSYCHOMOTOR RETARDATION OR AGITATION, RASHES OR COLD INTOLERANCE. SHE USUALLY TAKES A RELAXING BATH BEFORE GOING TO SLEEP AND USED TO SLEEP FOR 7-8 HRS PER NIGHT, BUT NOW IS ONLY GETTING 4-5 HRS. SHE HAS TRIED AMBIENS FOR THE PAST 5 NIGHTS BUT THEY ARE NOT OF MUCH HELP. SHE DENIES HAVING ANY OTHER STRESSES AT HOME AND REPORTS THAT HER HUSBAND IS VERY SUPPORTIVE. ROS: SAME AS ABOVE PMH: ARTERIAL HYPERTENSION. NKDA MEDICATIONS: AMBIEN, HCTZ AND LISINOPRIL PSH: C-SECTION FOR PREGNANCY. FH: FATHER HAD ARTERIAL HYPERTENSION AND HYPERCHOLESTEROLEMIA PASSED AWAY OF STROKE. MOTHER SUFFERS FROM DEPRESSION SH: RETIRED. LIVES WITH HUSBAND. ETOH 2-3CUPS OF WINEX3 PER WEEK.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]INCREASED APPETITE, LOSS OF HER SON THIS PAST NOVEMBER, F, 67 YO, SINCE 3 WEEKS AGO, AMBIENS NOT OF MUCH HELP, FEELING DRAINED, ANHEDONIA, MOTHER SUFFERS FROM DEPRESSION, DENIES SUICIDE THOUGHTS, TROUBLE SLEEPING, SLEEP ONLY GETTING 4-5 HRS</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 y/o F comes to the clinic c/o trouble sleeping. Started 3 weeks ago, for the first time, since it started is getting worst. Refers that she only sleep 4-5 hours, awake at 3- 4 am and is no able to fall asleep agian. Refers not feeling rested during the day and can not takes nap. Refers her son died a months ago, and she feels devasted about this. Refers increased appetite, refers an episodes that she saw her dead son in the kitchen and loss of interest in her daily activities. No suicidadal ideation and refers that her husband and friends are very supportive. Denies fever, nausea, vomiting, problem with concentration, recent infections, weakness, nuimbness, changes in GI/GU or pain in chest, abdomen, or joints. ROS: none, except as above. PM: HTN for 15 years; All: NKDA; Med: HCTZ, lisinopril; FM: father died of a stroke and mother has MDD. OB: Menopause 53 y/o. SH: retired, drinks 3-4 cup of wines per week, no recreational drug. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, son died a months ago, F, 67 y/o, Started 3 weeks ago, can not takes nap, not feeling rested during the day, loss of interest, saw her dead son in the kitchen, mother has MDD, awake at 3- 4 am, No suicidadal ideation, trouble sleeping, sleep 4-5 hours</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: The patient is a 67 yo woman with trouble sleeping. Her son was killed in an MVA 3 weeks ago, and since that time she has had difficulty falling and staying asleep and early morning awakening. No schedule change and normal healthy sleep hygeine. She has tried ambien the past few nights but did not feel that it helped. Since her son's death, she has had decreased energy, loss of sleep, increased food intake, and sadness. She denies psychomotor agitation or retardation, worthlessness or guilt, and suicidal ideation. Normal concentration. She denies being hot or cold, weight loss or weight gain, changes in timing, consistency, or color of bowel movements, hair or skin changes.] ROS PMH: HTN, breast cancer in remission for 10 years PSH: laparotomy for appendectomy, mastectomy Meds: HCTZ, lisinopril, ambien Allergies: none Family: Father stroke age 75, HTN, HLD, Mother depression No smoking, EtOH 2x/wk., no drugs, sex with husband. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased food intake, son was killed 3 weeks ago, "sons death", woman, 67 yo, difficulty falling asleep, 3 weeks ago, and since that time, tried ambien did not feel that it helped, decreased energy, Mother depression, early morning awakening, denies suicidal ideation, trouble sleeping, difficulty staying asleep, loss of sleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt. is a 67 y/o causcaisun female coming in for 3 week hx. of trouble sleeping. She states she has also had hallucinations for the past 4 days. Her son recently passed away 3 weeks ago in a MVA and ever since then she has had trouble going to sleep, waking up early, feeling tired all the time, eating more. She states usually she is a happy person but has been down recently. She sleeps about 4-5 hrs a night now. She has good sleep hygeiene. She has tried ambien but doesnt help. Hallucinations she states she saw her son 4 days ago, and last night she heard music and partying when there wasnt any. She has lost interest in her hobbies as well. Denies suicidality. No psych hx. Good support systems. PMH: High blood pressure, breast cancer in remission PSH: Lumpectomy, laparotomy for appendix FH: mom- depression SH: retired receptionist. Normal diet and exercise. No smoking, alcohol some CAGE neg. Meds: HCTZ, lisinopril Allergies: None. Extract phrases from this text which may help understand the patient's medical condition.[/INST]eating more, son recently passed away 3 weeks ago, female, heard music and partying when there wasnt any, 67 y/o, trouble going to sleep, 3 week hx, tried ambien but doesnt help, feeling tired all the time, lost interest, Hallucinations she states she saw her son 4 days ago, mom- depression, waking up early, Denies suicidality, trouble sleeping, sleeps about 4-5 hrs</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo F presents to the clinic with the c/o decreased sleep for the last 3 weeks which happened after her son died on June the 6th. PREVIOUSLY SHE MANAGED TO SLEEP FOR A GOOD 8 HOURS, SLEEPING AT 11PM AND WAKING UP AT 7AM. CURRENTLY SHE gpes to bed at 11pm and falls asleep at midnight afte much tossing and turning, wakes up at 4am, sometimes will wake up in between, no snoring, restless sleep. activities before sleeping are dinner and conversation with husband. coffee intake is 1 in the morning. interest has gone down, crying spelLs, no feeling ofguilt, decreased energy and fatigued, decreased ability to concentrate, apetite has gone up, no weight changes, no suicidal ideations. denies any skin /hair chnages no constipation. PMH HTN, Regression for Breats cancer PSH lumpectomy, laparatomy for appendix removal FH father died of stroke mum had depression SH unremarkable, good relationsip with husband DRUGS,HCTZ,AMBIAN,LISINOPR . Extract phrases from this text which may help understand the patient's medical condition.[/INST]apetite has gone up, son died on June the 6th, F, tossing and turning, 67 yo, gpes to bed at 11pm and falls asleep at midnight, for the last 3 weeks, decreased energy and fatigued, interest has gone down, mum had depression, wakes up at 4am, no suicidal ideations, decreased sleep, sometimes will wake up in between, restless sleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Wicks is a 67 year old female who presents to the clinic due to difficulty sleeping. This has been occurring for 3 weeks in which she has difficulty falling asleep and staying asleep. She recently lost her son unexpectedly in a MVA and has been grieving. Since his death, she has been having trouble sleeping. She used to get 8 hours now she gets 4-5 hours and is not able to take naps. She tried taking Ambien which she got from a friend which has not helped her sleep. She has also had visual hallucinations of her son and auditory hallucinations of others. Depression screening: no suicidal ideation. Has had anhedonia, increased appetite, trouble sleeping ROS: neg Allergies: NKDA Meds: HCTZ, Lisinopril, Ambien MH: Hypertension, Remission of Breast Cancer 10 years ago SH: Lumpectomy, Laparotomy (appendix) Social: Retired Receptionist, lives with husband Rober, sexually active, never smoked, EtOH: 0/4 CAGE , no recreational drugs. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, recently lost her son, Mrs., female, auditory hallucinations of others, 67 year old, difficulty falling asleep, occurring for 3 weeks, not able to take naps, Ambien has not helped, anhedonia, visual hallucinations of her son, no suicidal ideation, difficulty sleeping, difficulty staying asleep, trouble sleeping, used to get 8 hours now she gets 4-5 hours, trouble sleeping</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 y female presents to the clinic compaling of trouble sleeping. she states that her son passsed away 3 weeks ago on april 16 and she is devastated. she states that she has a strong support system and is still able to spend time withy friends and husband whi sis very supportive at the moment. denies inabillity to concentrate, eight gain, cold intolerance. admits to fatigue and being emotionally drain. states that she is sad but not depress. denies suicidal ideation. denies nausea, vomiting. states that she is still able to cook and clean. pMH: HBP contoilled, remission for breat cancer 10 years ago. allergies: none meds: ATCZ, linopril, ambien for sleep. PH: father died at 75 of stroke, had HBP, and dyslipedemia. mother is healthy. social history: no ciggarretes, drinks wine 2-3 times a week 0/4 cage. no drugs sexual history: sexually active with husband. Extract phrases from this text which may help understand the patient's medical condition.[/INST]son passsed away 3 weeks ago, female, 67 y, fatigue, emotionally drain, denies suicidal ideation, trouble sleeping</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo female presenting with 3 wk history of difficulty falling asleep/staying asleep coinciding with passing of her son Leonard 3 wks ago. She has not had issues with sleeping in the past, has tried Ambien without success during this episode, and is unclear why it is happening. ROS -: headache, chest pain, cough, wheeze, abdominal pain, numbness/tingling. She describes her sleep hygiene as unchanged: consisting of dinner at 6.30, spending time with husband until 10.30, then washing and sleeping without TV or exposure to electronics. Recently, she is eating more food, not exercising as much with her walks, and had 2 episodes of seeing "visions" of her son and hearing a neighbor's party. PMH: HTN, breast cancer in remission Meds: HCTZ, lisinopril. No allergy. Surgery: lumpectomy and laparotomy for appendicitis in past. Social: retired 2 yrs ago, healthy diet, no smoking/drugs, 2-3 red wine cups/wk. Not sucidal/diminished will to live.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]eating more food, passing of her son 3 wks ago, female, "episodes of hearing a neighbors party", 67 yo, difficulty falling asleep, 3 wk history, tried Ambien without success, episodes of seeing "visions" of her son, Not sucidal, difficulty staying asleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Loraine Wicks 67yo F with PMH HTN on HCTZ and lisinopril presents with 3 weeks history of difficulty sleeping. She has difficulty falling asleep and remaining asleep. She tosses and turns at night. She takes 1 hr to fall asleep and gets about 4-5hrs of sleep a night. She has tried ambien for 5 days; it does not help. She is a retired community college receptionist and spends her days doing house chores. She recently picked up scrapbooking and reading, but has been less interested in doing so lately. She admits to increased appetite, though with no weight changes, and decreased energy levels. Her son recently died and she admits to seeing/hearing things that she knows are not real. Her concentration is normal and she does not feel guilty. She had a lumpectomy 10years ago for breast cancer and is in remission, laparotomy for appendicitis many years ago. FHx: father- HTN/HLD, died of stroke. mother-healthy, depression in the past.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, son recently died, F, hearing things that she knows are not real, tosses and turns, 67yo, difficulty falling asleep, takes 1 hr to fall asleep, 3 weeks history, tried ambien for 5 days; it does not help, decreased energy, less interested, seeing things that she knows are not real, mother depression in the past, difficulty sleeping, difficulty remaining asleep, gets about 4-5hrs of sleep a night</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HOI: 67 y/o F c/o difficulty falling asleep and staying asleep for the last 3 wks. She is also c/o hearing voices and visual hallucinations. She sleeps an average of 4 hrs, is fatigued, and has no energy to do her daily activities. Pts son recently died in a car accident and she is depressed since then. No suicidal thoughts or ideation, feelings of guilt, appetite problems, diarrhea, tremors, heat intolerance or excessive caffiene intake. Pt started taking Ambien from a friend recently and symptoms excaerbated since then. ROS: Negative except as above. PMH: CA Breast, Hypertensive for the last 15 yrs. Menopause 20 years ago. PSH: B/L mastectomy. Medications: HCTZ, Lisinopril, AMBIEN Allergies: NKDA. SH: Pt is aretired receptionist and vdoes not use any alcohol, illicit drugs or tobacco. FH: Mother has depression amd father had stroke, HTN.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]son recently died, F, hearing voices, 67 y/o, difficulty falling asleep, started taking Ambien from a friend recently and symptoms excaerbated since then, for the last 3 wks, fatigued, has no energy, visual hallucinations, Mother has depression, No suicidal thoughts or ideation, difficulty staying asleep, sleeps an average of 4 hrs</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Wicks is a 65 y.o. F with a history of 3 wks of insomnia after suffering the loss of her only child 3 weeks ago in an MVA. trouble falling sleep, taking approx 1 hour and waking up in the early morning not being able to go to bed. Getting about 4-5 hrs as opposed to regular 8 hours. No excessive worries or intrusive thoughts overnight. NO changes in sleep habits. Good sleep hygeine--1 cup of coffee per day. Has tried ambien a few nights and does not notice a changeShe does feel sad and have loss of interest in regular acitviites, decreased energy, increased appetite. No suicidal ideation. No fevers, weight changes. No cold or heat intolerance, skin changes, hair changes. PMH: r Breat ca-10 yrs remiss, s/p surg, chem, rad. HTN PSH: ex lap for append, R lumpect Meds: HCTZ, lisinopril. Recent ambien FH: Mom depression- unsure of tx SH: good support sys, lives w/ husb. No tobacco, 2-3 wine/wk, less since incident. Retired.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, loss of her only child 3 weeks ago, Ms., F, 65 y.o., trouble falling sleep, history of 3 wks, tried ambien and does not notice a change, decreased energy, loss of interest, Mom depression, waking up in the early morning, No suicidal ideation, insomnia, Getting about 4-5 hrs as opposed to regular 8 hours</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 67,f,c/o trouble sleeping for the past 3 weeks since his only son passed away due to car accident. She goes to bed at 10PM and have difficulty of maintaining sleep. She reports early morning awakening and felt tired during the day. She talks with his husband before sleeping. She also noted seeing his son and hearing noises at night but which apparently are not present at that time. She also noted increased in appetite but no weight changes. Patient has a good support system. No snoring, no SOB, no orthropnea, no paroxysmal nocturnal dyspnea. ROS: No weight changes, no loss of interest, no urinary or bowel problems Allergies: NKDA Medications: HCTZ, Lisinopril, NBN PMHx: HTN, Breast CA on remission x20yrs PSHx: Bilateral Mastectomy 20 years ago SHx: Lives with husband, retired for 2 years, 2-3glasses of redwine/wk, no tobacco, no illicit drugs FHx: Father died at 75 due to stroke and with HTN; Mother 90 with Depression . Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased in appetite, 3 weeks since his only son passed away, f, hearing noises at night but which apparently are not present, 67, past 3 weeks, felt tired, noted seeing his son, Mother 90 with Depression, early morning awakening, trouble sleeping, difficulty of maintaining sleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI - 67 yo F c/o insomnia for 3 weeks. It started after death of her son. Is costant and feels tired, Has drowsiness during a day. has increased apetite. Has difficulty to fall asleep, awakes during night and also earlier at morning.No change of body weight, headache, nause/vomiting, change of vision. No cold intolerance. No chest pain, palpitations, shortness of breath. ROS - Negative except as above Allergy - NKDA Meds - Hydrocholothiazide, Licenopril PMH- Breast cancer 11 years ago. Hypertension. Lapratomy in the past. FH - High BP and died from stroke. Mother had depression. SH - Retired college receptionist. Drinks 1-2 glass vine 3 times per week. No smoking or illicit drug use.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased apetite, for 3 weeks started after death of her son, F, 67 yo, difficulty to fall asleep, for 3 weeks, feels tired, drowsiness during a day, Mother had depression, awakes earlier at morning, insomnia, awakes during night</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo F comes to the clinic with a complaint of difficulty to sleep. She recalls it starting 3 weeks ago. At that date, she lost her sudden unexpectedly after a car accident. She isn't doing any strenuous activity or having heavy meals before bedtime. She has trouble starting sleeping and takes about 1 hour to fall asleep. She also wakes up many times a night. She recalls no snoreing or shortness of breath in the middle of the night. No nightmares. She feels sad, has low energy and has lost interest in most of the activities she used to take pleasure on. She tried to use Ambien with no help. She didn't contemplate suicide. No guilty feelings. She has no change in skin or hair, no changes in her bowel movements, no intolerance for extreme weather. ROS: None except above PMH: Hypertension treated. Breast cancer 10 y ago.. Takes HCTZ and enalapril. Ambien. NKDA. PSH lumpec. and apendect. FH: Mom had Depression.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, 67 yo, trouble starting sleeping, takes about 1 hour to fall asleep, starting 3 weeks ago, tried to use Ambien with no help, low energy, lost interest, Mom had Depression, difficulty to sleep, wakes up many times a night</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Loraine Wicks is a 67 y/o AAF who presents with trouble sleeping for the last 3 weeks after the recent dead of her only son who past in a MVC. She reports 4/5 h of sleep per night, difficulty falling asleep and not feeling rested upon waking. She feels devastated and drained and had increased appetite for a couple weeks with no changes in weight. She also reports decreased intrest in reading which she used to enjoy very much. Denies feelings of guilt, headaches, changes in vision. Positive for visual and auditory hallucinations. PMHx: HTN for 15 years, controlled with HCTz and lisinopril PFHx: Father - HTN, high cholesterol; stroke (deceased); Mother - depression Social: no smoking or illegal drugs; couple glasses of wine 1-2/wk; lives with husband and receives support from him and friends No allergies No surgical history. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, 3 weeks after the recent dead of her only son, AAF, auditory hallucinations, 67 y/o, difficulty falling asleep, last 3 weeks, not feeling rested upon waking, feels drained, decreased intrest, visual hallucinations, Mother - depression, trouble sleeping, 4/5 h of sleep per night</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo female comes to office complainong of trouble sleeping. she has trouble going to sleep, and wakes up early. This started 3 weeks ago suddnely after her son died in a MVA. She only sleep 4-5 hours a day, without any naps. She reports good sleep hygiene. She reports depressive symptoms of decrease sleep, energy, interest in fond activitys of scrap booking and reading. She doesn ot have any suicidal ideations. Sher concentration and memory are good. She hears her son James make coffee sometimes. She also heard loud music/party where there wasn't one. Her mom had history of depression. Denies chest pain, SOB, Urinary symotoms, bowel changes. ROS: as per HPI PMHx: none, PMSHx; none NKDA, screening recently normal, no smoking or illicity dugs, drinks 2 glasses of wine 2-3 x week, CAGE neg famil Hx: mom had depress, dad has high BP and cholesterol Social Hx: lives iwth husband, feels safe, he is supportive . Extract phrases from this text which may help understand the patient's medical condition.[/INST]3 weeks ago son died, female, "heard loud music/party where there wasnt one", 67 yo, trouble going to sleep, started 3 weeks ago, without any naps, decrease energy, decrease interest, mom had history of depression, mom had depress, wakes up early, interest doesn ot have any suicidal ideations, decrease sleep, trouble sleeping</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo F presenting with trouble sleeping for 3 wks and fatigue. Her son died 1 month ago in an MVA. She reports early awakening, loss of interest in daily activities, low energy, increased apetite. No guilt or psychomotor retardation, no suicidal ideation. Reports seeing visions of her son and hearing muffled voices and music that she knows are not there. Voices are not saying anything. Tried ambien but nothing makes sleeping problems better or worse ROS: Denies headache, dizziness, weight change, chest pain, palpitations, SOB, cough, abdominal pain, hematuria, hematochezia, muscle aches/paines, hair loss. PMHx: HTN, breast ca in remission 10 yrs PSHx: lumpectomy, laparotomy for appendicitis Meds: HCTZ, lisinopril, Ambien x 5 days FH: noncontributory GYN: G1P1, normal vaginal delivery. Menarche 13, Menopasuse 52 SH: Drinks 2 glasses red wine couple times/wk. No smoking/illicit drug use. Retired. Sexually active w/husband. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased apetite, son died 1 month ago, F, hearing muffled voices and music that she knows are not there, 67 yo, for 3 wks, Tried ambien but nothing makes sleeping problems better, fatigue, low energy, loss of interest, seeing visions of her son, early awakening, no suicidal ideation, trouble sleeping</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 YO post-menopausal female with a history of HTN presenting with about 3 weeks of difficulty sleepng. She notes that on 11/15/17 her son passed away. Since that time she's been having difficulty falling asleep and staying asleep. She also has had fatigue/reduced energy, increased eating, depressed mood, with reduced interest in doing enjoyrable activities. She denies suicidal thoughts. No difficulty concentrating. She has never had anything like this before, although she notes her mother has Major Depressive Disorder. She notes ample family support in this difficult time.No difficulty sleeping with menopause changes. ROS: No headahce, vision changes, palpitations, abdominal pain, urinary or BM changes. PMH: HTN - on HCTZ and lisinipril PSHx: none FHx: dad - HTN, HLD, stroke; Mother - MDD Social: lives with family. Ample family support.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased eating, on 11/15/17 her son passed away, female, 67 YO, difficulty falling asleep, with about 3 weeks, fatigue, reduced energy, reduced interest, mother has Major Depressive Disorder, Mother - MDD, denies suicidal thoughts, difficulty sleepng, difficulty staying asleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 y.o female c/o poor sleeps for past month. Pt notes her son, leonard, died in a MVA x3 weeks ago and hasn't been able to get good sleep since. Pt also endorses anhedonia, poor concentration, and fatigue. Pt notes she is only able to get 4-5 hours of sleep every night. Pt has tried ambien pill w/o releif. No snoring per husband. Pt notes good sleep environment. One cup of coffee in the AM only, no energy drinks or eating close to bedtime. Denies any Fever, chills, night sweats, weight loss, GI or GU sxs. ROS: negative except as above. Allergies: NKDA Meds: HCTZ, Ambien PMH: breast CA survivor currently in remission. x10 years. PSH: Appendectomy x20 years ago. Lumpectomy x10 years ago. OB: G1P1A0 one uncomplicated normal spontaneous vaginal delivery at term. FH: Paternal HTN, HLD, and CVA. Mom and 5 brothers in goo dhealth. SH: No tobacco or drugs. Drinks 2-3 glasses wine per week .No travel. retired ocupation.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]son died x3 weeks ago, female, 67 y.o, past month, 3 weeks ago, tried ambien pill w/o releif, fatigue, anhedonia, poor sleeps, "hasnt been able to get good sleep", 4-5 hours of sleep every night</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo F presents with 3 weeks of trouble sleeping - lost son 3 weeks ago - notes waking too early and tossing and turinin in sleep - get 4/5 hours sleep a night - loss of interest in previou activities as reading - increase in appetite -note low energy throughout day - no suicidal ideation has tried taking ambien for sleep no help - hearing voices next door, with no command -seeing images of her son in dining room, PMH of HTN, no PSH, on HCTZ, lisinopril , NKDA SH of retired , nonsmoker, no alcohol, use to drink 2/3 cups of wine FH of depressin in mother, father passed of stroke . Extract phrases from this text which may help understand the patient's medical condition.[/INST]increase in appetite, lost son 3 weeks ago, F, hearing voices next door, tossing and turinin, 67 yo, with 3 weeks, ambien for sleep no help, low energy, loss of interest, seeing images of her son in dining room, depressin in mother, waking too early, no suicidal ideation, trouble sleeping, get 4/5 hours sleep a night</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 67 yo F c/o 3 weeks of trouble sleeping and feeling "drained" with associated early waking, increase in appetite, reduced intrest in activities, no guilt. Onset of insomnia associated with son's death. Associated visual and auditory hallucinations of seeing son and hearing party. Has insight into hallucinations. Denies suicidal or homocidal ideation. No changes in weight, able to carry out activites of daily living. This has never happened before, no history of psychiatric hospitilizations. ROS: negative except for above Allergies: none Meds: HCTZ, lisinopril, ambien for past 5 nights - did not help sleep. PMH: HTN, breast cancer in remission - 10 years PSH: lumpectomy, laparatomoty (for appendicitis) Social: Used to drink 2/3 times per week, now stopped. No smoking/drugs. Lives with husband, retired. FH: Father - passed at 75 from stroke, had HLD, HTN. Mother - history of depression. 5 brothers - no known issues.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increase in appetite, "3 weeks sons death", F, auditory hallucinations, 67 yo, c/o 3 weeks, ambien did not help sleep, feeling "drained", reduced intrest, visual hallucinations of seeing son, Mother - history of depression, early waking, Denies suicidal ideation, trouble sleeping, insomnia</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: a 67 yo female patient complains of difficulty sleeping for the past 3 months , her son has passed away on february. she doesnt drink caffiene products or smoke before sleep nor watch TV , she now sleeps 4-5 hours per night when she used to sleep 8 hours before, she has difficulty falling asleep and mainatining asleep, she tried Ambien for 5 days but it didnt work ,she denies snoring and night mares however she mentions that she gets auditory hallucination before she fell asleep one night but denies any hallucinations on waking up, she denies any daytime sleepinessl.patient hasnt had changes in weight, apetite,skin or hair,no costipation.however sh complain of sad mood,loss of interest and fatigue. Allergies:NKDA meds: Hydrochlorothiazide, Ambien, lisinopril PMH:HTN , breast cancer 8 years ago and in remission PSH: lumpectomy for breast cancer, laparotom SH:retired,non smoker, 2-3 wine week(CAGE 0/4 Fh:dad stroke,mom depression. Extract phrases from this text which may help understand the patient's medical condition.[/INST]her son has passed away on february, female, gets auditory hallucination, 67 yo, difficulty falling asleep, tried Ambien but it didnt wor, fatigue, loss of interest, mom depression, difficulty sleeping, sleeps 4-5 hours per night when she used to sleep 8 hours before, difficulty mainatining asleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: This is a 67 year old woman with HTN and remote breast cancer history who presents with 3 week history of insomnia. Of note, these symptoms began same day her son died tragically. She reports multiple SIGECAPS symptoms including decreaed energy, difficulty enjoying activites, and increased appetite. She denies SOB, CP, edema, nausea, and bowel/bladder symptoms. ROS: Negative except per above. Allergies: None Meds: HCTZ, lisinopril. Tried ambien from friend 5x PMH: HTN, Br Ca 2011 PSH: Lumpectomy 2011, Laparoscopic appendectomy in 20s. SH: Lives with supportive husband. Is retired receptionist. Walks daily at baseline. No tobacco, 1-2/week redwine, 0/4 CAGE. FH: Mother with depression (alive). Father with stroke (deceased). Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, began same day her son died, woman, 67 year old, 3 week history, decreaed energy, difficulty enjoying activites, Mother with depression, insomnia</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Wicks is a 67 yo F who presents with difficulty sleeping. 3 weeks ago her son died, since then she's had difficulty falling and staying asleep, tosses and turns in bed, sleeps 4-5 hrs previously 8 hrs per night. She feels devastated and tired but endorses a strong support system, denies suicidal ideation. She endorses losing interest in hobbies and increaed appetite. Last night she heard noises from neighbor's yard that were not present, and few days ago saw image of her son in the kitchen but knows these are not based in reality. Denies intrusive thoughts, auditory hallucinations, skin and hair changes, weight gain. Tried ambien without effect. ROS: negative except as above PMH: Htn, remission from breast cancer 10 yrs ago, Meds: ambien, hydrochlorothiazide, lisinopril; NKDA FHx: noncontributory SHx: retired, strong support network, denies tobacco, EtOH, illicit drugs; 1 cup coffee per morning. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increaed appetite, 3 weeks ago her son died, Ms, F, "heard noises from neighbors yard that were not present", tosses and turns, 67 yo, difficulty falling asleep, Tried ambien without effect, tired, endorses losing interest, saw image of her son in the kitchen but knows these are not based in reality, denies suicidal ideation, difficulty sleeping, difficulty staying asleep, sleeps 4-5 hrs</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 y/o F complains of problems sleeping for 3 weeks. the symptoms started after her son died. she used to sleep 8 hours a night, now she sleeps 4 hours a night, feels tired and sleepy during the day. She tried some medications for her sleep, but nothing helped. patient feels sad, complains of lack of interest and energy. increased appetite, with no weight changes. reports visual and auditory hallucinations about her dead son, however she knows they are not real.no suicidal nor homicidal ideation.does not feel guilty. No hot or cold intolerance. no changes in her bowel habits. drinks 1 cup of coffee a day. ROS:negative except as above Allergies:none Medication:HCTZ, Lisinopril,Ambien. PMH:Hypertension,breast cancer PSH:lumpectomy,laparotomy with removal of the appendex in her 20s SH:no smoking.2-3 drinks a week. no illicit drugs. sexually active with her husband. FH:mother had depression. Father had stroke. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, 3 weeks after her son died, F, auditory hallucinations, 67 y/o, for 3 weeks, tried some medications for her sleep, but nothing helped, feels tired, sleepy during the day, lack of energy, lack of interest, visual hallucinations, mother had depression, no suicidal ideation, problems sleeping, sleeps 4 hours a night</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI 67yo F with c/o imsomnia. She cannot fell asleep and wakes up earlier than usual for 3 weeks. Since his son James passed away on April 16, her imsomnia started. Ambian does not help her sleep that much. she hear some playful music but other people did not hear that. She also see visual hallusination of her late son. Family and friends are all supportive and she does not feel hopelessness or suicidal thoughts. Appetite is increasing and weight is the same. no chill, no fever. Duration of sleep is 4-5 hours. ROS n.p. other than mentioned above PMH HTN PSH Father HTN, Hypercholeterolemia, stroke Allergy NKDA, Med HCTZ statin, smbian Sx -cig, ETOH 2-3 wine/night but after her son's death she stopped drinking. illegal drug(-). Extract phrases from this text which may help understand the patient's medical condition.[/INST]Appetite is increasing, son passed away on April 16, F, hear some playful music but other people did not hear that, 67yo, cannot fell asleep, for 3 weeks, Ambian does not help, visual hallusination, wakes up earlier than usual, does not feel suicidal thoughts, imsomnia, imsomnia, Duration of sleep is 4-5 hours</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yr old w f presented with isomnia dec energy low mood inc apetite norma wt has experience hallucinations has seen his decesaed son in home taht dies 3 weeks ago aloso been hearing voices which others dont , dec intersest in daily activities has no feeling of guilt no suicida ideation no memmoer loss, .HAS HTN FROM 15 YRS ON hctz NAD LISINOPRIL FROM 5 YRS on bre=ast ca remission from 10 yrs takin ambian for sleep from 5 days has appendicetomy done at 20 yrs no traum urination and bowel movemment fine no cold intolerance hair thining dry skin or hoarese voice , FHX mother healty 90 as high cholestrol father died of stroke LMP at age of 52 G1P1A0, SSEXUALLY ACTIVE ONLY WITHY HUSBAND NEVER TESTED FOR STDS, NON SMOKER DRINKS OCCASIONALY 2 GLASS WINE WITH DINNER NO REC DRUGS RETIRED RECEPTIONIST. Extract phrases from this text which may help understand the patient's medical condition.[/INST]inc apetite, son dies 3 weeks ago, f, hearing voices which others dont, 67 yr old, dec energy, dec intersest, hallucinations has seen his decesaed son, no suicida ideation, isomnia</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 67 yo woman who lost her only son 3 weeks ago and now presents with trouble sleeping x3 weeks. She has never had trouble sleeping before. She has trouvble sleeping and when she sleeps, wakes frequently. Get about 4-5 hours of sleep daily. she denies and loss of interest and suiidal thoughts. she sometimes sees her son standing on the kitchen but know it isnt real. She is married and lived with her husband. PMH_ hypertensive x 15 yrs on HCTZ and lisinopril-compliant. Had breast cancer but has been on remission for 10 years. SH: no tobbaco, no etoh, no recreatonal drugs. FH: mpther had depression and is alive and well.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]lost her only son 3 weeks ago, woman, 67 yo, x3 weeks, sees her son standing on the kitchen but know it isnt real, mpther had depression, wakes frequently, denies suiidal thoughts, trouble sleeping, trouvble sleeping, 4-5 hours of sleep daily</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Wicks is a 67 year old woman with history of hypertension on HCTZ/Lisinopril who presents with 3 week history of poor sleep. Her son died three weeks ago, and ever since she has been unable to fall asleep, stay asleep, and she feels as if she spends all night tossing/turning. She also endorses seeing her son at times but she knows he isn't there. She also endorses one episode of auditory hallucinations at night when she thought she heard a party going on only to discover there was not one. She denies any other medical symptoms at this time, including chest pain, shortness of breath, nausea, vomiting, diarrhea, constipation, changes in urination, abdominal pain, or headaches. She denies suicidal ideation or homicidal ideation. She also denies difficulty concentrating, psychomotor agitation/retardation. She endorses an increased apetite with no associated weight changes. She has tried ambien for five nights with no benefit.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased apetite, son died three weeks ago, Mrs., woman, one episode of auditory hallucinations at night when she thought she heard a party going on only to discover there was not one, tossing/turning, 67 year old, unable to fall asleep, 3 week history, tried ambien with no benefit, "seeing her son at times but she knows he isnt there", denies suicidal ideation, poor sleep, unable to stay asleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Lorainne Wick is a 67 y.o. female who presents due to trouble sleeping. She states that she has problems falling asleep as well as waking up early. She usually goes to sleep with the help of a warm bath, doesn't watch TV before sleepign, and takes no naps during the day. She drinks one cup of caffeine in the morning. These symptoms are occuring following the death of her son on Dec. 10 from a MVA. She has had decreased sleep, decreased interest level in things she once enjoyed, decreased energy, increased appetite. She has no thoughts of active or passive suicide or self harm. ROS is neg for fever, skin changes, hair changes, pain, heat/cold intolerance, lumps, or swelling. She has a good support system Med: HTN Medications: HCTZ, lisionpril PSH: none FMH: Mom with depression Social: no smoke, alcohol +, CAGE -, sexually active with husband, does not exercise since death.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, death of her son on Dec. 10, female, 67 y.o., problems falling asleep, decreased energy, decreased interest level, Mom with depression, waking up early, no thoughts of active or passive suicide, trouble sleeping, decreased sleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Loraine Wicks, a 67-year-old female, presents because of trouble sleeping. She has had trouble falling and staying asleep for the last 3 weeks, and recently experienced the death of her son on August 29th. Her mood is "devastated" and she feels "drained" and uninterested in her normal activites and has been eating more than usual. 3 days ago she also experienced seeing her son at the kitchen table and heard what she described as a party later than evening, but she knows that both of these things did not actually happen. She has no previous episodes like this and her FH is negative. She denies thoughts of hurting herself or others, denies psychomotor changes, denies difficulty concentrating. She reports a good support system at home with her family. She has good sleep hygiene. ROS:negative FH:non-contributory SH: normally 1-2 glasses of wine, none last few weeks, no tobacco, no recreational drugs SurgH: negative PMH: none. Extract phrases from this text which may help understand the patient's medical condition.[/INST]eating more, death of her son on August 29th, female, heard what she described as a party later than evening these things did not actually happe, 67-year-old, trouble falling asleep, last 3 weeks, feels "drained", uninterested, experienced seeing her son at the kitchen table these things did not actually happe, denies thoughts of hurting herself, trouble sleeping, trouble staying asleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Wicks is a 67 year old woman with a history of HTN and breast cancer who presents with difficulty sleeping. This began 3 weeks ago at the time of her son's death. She has trouble falling asleep, staying asleep, and wakes up early in the morning. Her mood is sad. She has decreased interest in her normal activites, fatigued. Denies feeling guilty, decreased concentration or attention, feeling hyperactive or lethargic, denies suicidality. She reports having 1 auditory and 1 visual hallucination in past few days. No prior mood disorders. Denies - HA, weight change, vision changes, chest pain, SOB PMH: HTN, breast cancer 10 years prior PSH: lumpectomy, laparotomy for appendectomy Medications: HCTZ, lisinopril, ambien x5 days Allergies: NKDA FH: father died of stroke at 70, HTN, HLD. mother with prior depression SH: lives with husband, drinks less than 7 drinks per week, never smoker, no drugs ROS: as above, otherwise negative. Extract phrases from this text which may help understand the patient's medical condition.[/INST]"3 weeks ago time of her sons death", Ms, woman, 1 auditory hallucination, 67 year old, trouble falling asleep, began 3 weeks ago, fatigued, decreased interest, 1 visual hallucination, mother with prior depression, wakes up early in the morning, denies suicidality, difficulty sleeping, trouble staying asleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HO1 67 F presenting with difficulty sleeping past 3 weeks, diufficulty initialting sleep and getting up early. previosuly no similar episodes . son passed away 3 weeks ago and has been notices lack of energy and low mood since visual and auditory hallucinations once since then.lack of interest in daily activities,no change in weight but has been eating more than usual. denies snoring.or any urinary or bowl complaints. ros -ve except as above pmhx htn on medication past 15 year s pshx nil fhx mother alive and well has a history of major depression medications lisinopril and hctz shx non smoker drink 2-3 glasses of wine a week cage 0/4 monogamous with hysband retired receptionist excersise regularly till 3 weeks ago. Extract phrases from this text which may help understand the patient's medical condition.[/INST]eating more than usual, son passed away 3 weeks ago, F, auditory hallucinations, 67, diufficulty initialting sleep, past 3 weeks, lack of energy, lack of interest, visual hallucinations, mother history of major depression, getting up early, difficulty sleeping</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67year old female with pmh of breast cancer in remission 11yrs presents with difficulty sleeping. Patient notes poor sleep began 3 weeks ago. Baseline sleep 8hrs, but now only gets 4-5hrs sleep, difficulty failing asleep as well as waking up early. Bed hygiene- only uses bed for sex and sleep, no changes in last 3 wks. NOtes lows of her son Leonard january 31 at around the same time. Notes decreased interest in hobies, denies hopelessness/guilt, notes decreased energy, increased appetitie, denies suidical ideation of hx of suicide attempts. Notes "saw Leonard" 4 days ago, and heard muffled voices from neighbor (neigbor denies). Denies command hallucinations. Pt has triend ambien without relief, nothing helps, nothing makes worse. Denies drug/substance use, 1 cup of coffee in morning. Per pt, husband denies snoring, no daytime fatigue pmh- htn, br cancer psh - laparotomy appendix med - hctz, lisinopril, ambien famhx- mom depression. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetitie, lows of her son around the same time, female, heard muffled voices from neighbor (neigbor denies), 67year old, difficulty failing asleep, began 3 weeks ago, triend ambien without relief, decreased energy, decreased interest, saw Leonard" 4 days ago, mom depression, waking up early, denies suidical ideation, difficulty sleeping, Baseline sleep 8hrs, but now only gets 4-5hrs sleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo F present with trouble sleeping. Pt states that it began 3 weeks ago and describes as difficulty falling asleep, waking up early, and tossing and turning at night. Never had this problem before, tried taking a friends ambien, and it did not help. Pts son died on Aug 17 in an MVA. Pt states that she has a sad mood, loss of interest in activites, decreased energy level, difficulty sleeping, increased appetite, and hallucinations of seeing son, and hearing people next door. ROS: negative except for above allergies: none meds HCTZ 25 mg QD, lisinopril 20 mg QD PMH: HTN (15 years), in remission for breast cancer (10 years), ruptured appendicitis PSHx: lumpectomy, laperatomy in 20s FH: father with HTN, hypercholesterolemia, died of stroke, mother with DM SH: married (45 years), drinks EtOH 2-3 times per week (-) cage, good support system, denies tobacco and recreational drug use. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, son died on Aug 17, F, hallucinations of hearing people next door, tossing and turning, 67 yo, difficulty falling asleep, began 3 weeks ago, ambien did not help, decreased energy level, loss of interest, hallucinations of seeing son, waking up early, trouble sleeping, difficulty sleeping</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yr old woman presents today with difficulty sleeping over the last 3 weeks. she has difficulty falling asleep and maintaing sleep, she has fairly normal sleep hygine practices and does not consume excessive caffinated beverages of note she has a history of traumatic event and now feels tired , has excessive thoughts of her son who passed has a depressed mood and has no issues with memory or concentration she does not complain of suicidal thoughts but has occasional hallucinations hearing and seeing things that arent there pmh: HTN x 5 yrs on HCTZ and lisonopril, breast CA in remission psh: lumpectomy 10 years ago, laparotomy for appendicitis in her 20s DH: no allergies social: doesnt smoke father HTN, mother: depression. Extract phrases from this text which may help understand the patient's medical condition.[/INST]woman, hearing things that arent there, 67 yr old, difficulty falling asleep, last 3 weeks, tired, seeing things that arent there, mother: depression, not complain of suicidal thoughts, difficulty sleeping, difficulty maintaing sleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67-year-old female, has come to the physician's office because of trouble sleeping. She said that everything happened 3 weeks ago. At holidays, during Christmas her son died in a car accident. She feels devastated. He is retired and lives with her husband, no alcohol. no smoking. ROS as in HPI Allergies:NKDA Meds: ACTC, NBN for sleeping PMH: HTN PSH: Lumpectomy(breast cancer) FMH: Mother 90 yo, episodes of depression, Father passed away and had HBP, hypercholesteremia.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]during Christmas her son died, female, 67-year-old, 3 weeks ago, Mother episodes of depression, trouble sleeping</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patien F 62 yo, C/C: Sleeping problems -Started 3 weeks ago, wake up many times at night relate with her son died, she is eating more than normal -She is feeling very sad, she was taking Ambien for sleep but did not work. -PMH: HTN -PSH: none MEds: HCTZ and lisinopril -ALLs: NKDA -FH: father HTN, High cholesterol died of stroke, mother Depresion ROS: denied constipation, weight change and headache SH: ETOH, 3 or 4 glass of wine 2 or 3 times a week, walking sometime, sexual active with husband, she is retired. Extract phrases from this text which may help understand the patient's medical condition.[/INST]eating more, relate with her son died, F, 62 yo, Started 3 weeks ago, Ambien did not work, mother Depresion, Sleeping problems, wake up many times at night</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 year old female presenting for trouble sleeping that started 3 weeks prior. She has toruble falling asleep, has been moving alot during sleepin and has early morning awkening. Assocaited with feeling tired throughout the day. prior to symptoms, her son passed away 3 weeks prior from an accident. associated with increase appetite 4 days ago, saw deceased son in kitchen, and 3 days ago heard loud music . Denies changes in concentration, interest, no suicidal thoughts, no guilt. Failed to relieve with ambiant and no exacberaing fact. Drinks 1 cup of coffee ROS Denies headhace, nausea, vomiting, chest pain, SOB, Abdominal pain, changes in bowel and bladder, numbness and tingling in extremities Alleriges NKDA Medication HCTZ, lisoranil, ambiant PMH Hypertension, Breast cancer PSH Lumbectomy with radiation and laptromy for appectectomy FH - non-contributor SH retired, denies tobacco and recreational drug use, ocassial drinking,. Extract phrases from this text which may help understand the patient's medical condition.[/INST]son passed away 3 weeks prior, female, 67 year old, toruble falling asleep, started 3 weeks prior, Failed to relieve with ambiant, feeling tired, saw deceased son in kitchen, early morning awkening, no suicidal thoughts, trouble sleeping, moving alot during sleepin</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67-year-old female, has come to the physician's office because of trouble sleeping. pt had this issue for 3 weeks. trouble falling asleep and wake up at night. fatigue. visual and auditory hallucinations for a few days sadness, no interest in recent activity, low energy, increase in appetite. pmhx: high cholesterol. b/l mastectomy for meds: ambien, hctz, lisinopril fmhx dad stroke and htn and high cholesterol depression screening: sadness, no interest in recent activity, low energy, increase in appetite. no suicide, difficulty concentraitin or guilt.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increase in appetite, increase in appetite, female, auditory hallucinations, 67-year-old, trouble falling asleep, for 3 weeks, fatigue, low energy, low energy, no interest, no interest, visual hallucinations, no suicide, trouble sleeping, wake up at night</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Wicks is a 67 y/o f presenting with a 3 week history of difficulty sleeping. She states that she gets 4-5 hours per night of restless, intermittent sleep. She has tried taking Ambien for the last 5 nights but that has not helped. She states that her son died in an MVC a few days before this problem started and that she has been devastated since his accident. She notes that four days ago she saw and heard her son in the kitchen even though she knew it wasn't really him, and then the next night heard a party going on next door which didn't really happen. She states that she is really depressed, has lost interest in her daily activities, has no energy, is feeling slow, and has an increased appetite. She has a good support system but would be open to seeing a psychiatrist/psychologist. ROS is negative except as per mentioned above.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, son died a few days before this problem started, Ms., f, "heard a party going on next door which didnt really happen", 67 y/o, 3 week history, tried taking Ambien but that has not helped, has no energy, has lost interest, "she saw and heard her son in the kitchen even though she knew it wasnt really him", difficulty sleeping, gets 4-5 hours per night of restless, intermittent sleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 y/o F c/o insomnia for the past 3 weeks. Her son passed away in a MVA 3 weeks ago and she is upset over her loss. She has difficulty falling alseep and wakes up at odd hours (4/5am). She has lost interest in daily acitivies and feels fatigued. She notes an increased appetite and no changes in weight. She states she often hears noises from her neighbors home right before falling alseep. She is in remission from breast cancer. She does not nap in the day. She denies loss of concentration and feelings of guilt. She has a good support system at home and lives with her husband. Denies skin changes and cold intolerance. ROS: negative except above Allergies: NKDA Medications: HYdrochlorothiazide, Lisinopril, Ambien PMH: breast cancer, HTN PSH: lymphectomy of breast, Laparotomy for burst appendix FH: Father passed of stroke, Mother alive and healthy SOcial: does not smoke, drinks 2/3 glasses of wine a week(CAGE negative),. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, son passed away 3 weeks ago, F, 67 y/o, difficulty falling alseep, past 3 weeks, feels fatigued, lost interest, wakes up at odd hours (4/5am), insomnia</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo f presents with trouble sleeping for past few weeks, related to death of only child, a son, in an MVA. Since the MVA on July 30th, 2019, pt has had difficulty falling asleep, as well as increased early morning awakenings. Pt reports lack of interest in things she typically does, decreased energy, increased appetite, no weight gain. Denies SI. Pt has extended support system of of, family and close friends. No CV sx. No Chest sx. No ABD sx or constipation. PMH: HTN x 15 years, Breast Cancer (in remission x 10 years) Allergies: NKDA Meds: HCTZ, Lisinopril, Ambien PSH: Lumpectomy, Appendectomy in 20s SH: married x 15 years. no smoking, no ETOH, no drugs. Retired.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, death of only child on July 30th, f, 67 yo, difficulty falling asleep, past few weeks, decreased energy, lack of interest, early morning awakenings, Denies SI, trouble sleeping</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Identity: Loraine Wicks, a 67-year-old female CC: trouble sleeping HPI: For the past 3-weeks she has had trouble falling asleep, she is waking up earlier and is also experincing "tossing and turning", where she awakens feeling poorly rested - she is not waking to use restroom. This is affecting her life and ability to do things around the house. Of note, her son unfortunately passed away 3 weeks ago. In addition to trouble with sleep, she has lost interest in things she enjoy, her energy is poor, her appetite is increased. Denies any guilt over son's death, reports no trouble with concentration, denies psychomotor slowing, and denies any acitve/passive suicidality or intent to harm others. Pt. tried Ambien from friend 5 days ago, and 4 days ago reports AVHs. She lives at home where she feels very safe with her extremely supportive husband. She says she has a strong support group. Safety plan was discussed. . Extract phrases from this text which may help understand the patient's medical condition.[/INST]appetite is increased, son unfortunately passed away 3 weeks ago, female, tossing and turning, 67-year-old, trouble falling asleep, past 3-weeks, energy is poor, lost interest, waking up earlier, denies any acitve/passive suicidality, trouble sleeping, trouble with sleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Loraine Wicks is a 67 yo F with a history of HTN, breast cancer s/p lumpectomy in 2009 who presents to the offive with trouble sleeping. She reports her son dying 3 weeks ago, after which she has difficulty falling asleep and staying asleep. She reports her mood is down but is still able to do chores. Denies feelings of guilts or concentration issues. Her appetite has increased but no weight change. She reports seeing her son last night even though she knows he died. Denies memory loss, nocturia, constipation, skin changes, or TV watching in bed. Denies suicidal i PMH: HTN, breast cancer s/p lumpectomy Medications: HCTZ, lisinopril Allergies: NKDA FH: Father with HTN, HLD, and died of stroke. Mother with depression. PSH: Lumpectomy in 2009. Laparatomy around 20 yo for appendiceal perforation. SH: Retired. Lives with husband. Drinks 2 glasses of wine 2-3 times per week. Denies tobacco or illicit drug use. ROS: wnl except as above.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]appetite has increased, son dying 3 weeks ago, F, 67 yo, difficulty falling asleep, reports seeing her son last night even though she knows he died, Mother with depression, Denies suicidal i, trouble sleeping, difficulty staying asleep</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 67 yo F, G1P1, c/o trouble sleeping for the past 3 weeks, Pt is tossing and turning at night, has trouble falling asleep, staying asleep and wakes up early in the morning. Total hours of sleep are usually 4-5. Pt's son died 3 weeks in MVA. Since then pt reports seeing her son 4 days ago at the kitchen counter, reports hearing strange muffled noises in the distance. Pt feels extremely devastated and sad due to the death of her son, she has no suicidal ideation. She eats a balanced diet and her appetite has increased, she has a great support system however she has lost interest in things that were once pleasurable and is fatigued throughout the day. Denies weight or skin changes. ROS: Negative except for above Allergies: NKDA; Medications: Lisinopril, HCTZ, Ambien to help with sleep in the past 4 nights which had no affect. PMH: Hypertension, complient with medication and monitors BP regularly. Breast CA FH: mom with depression. Extract phrases from this text which may help understand the patient's medical condition.[/INST]appetite has increased, son died 3 weeks, F, reports hearing strange muffled noises in the distance, tossing and turning, 67 yo, trouble falling asleep, past 3 weeks, Ambien had no affect, fatigued, lost interest, reports seeing her son, mom with depression, wakes up early, no suicidal ideation, trouble sleeping, trouble staying asleep, hours of sleep are usually 4-5</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67F w/ PMH of breast CA in remission, presenting w/ insomnia for 3 weeks. Pt has troubles falling asleeping and wakes up early. No changes in sleeping habits, sleeps around 11pm, drinks 1 cup of coffee per day. Increased appetite, no changes in weight. Reports fatigue and decreased interest, but no difficulties concentrating. Feels sad about son passing away 3 weeks ago, no suicidal ideations. Has good support system w/ husband and family. hallucinations Started taking Ambien 5 days ago for insomnia, no improvement. Denies fevers, chills, chest pain, SOB, back pain, leg edema. PMH: breast CA in remission for 10 yrs s/p chemoradiation and surgery PSH: lumpectomy, laparotomy for ruptured appendix, Meds: HCTZ 25mg, lisinopril 20mg, Ambien 5mg, Social: No tobacco, 3-4 wine/week, no illicit drugs. Sexually active w/ husband, no protection. Menopause at age 52. FH: Grandfather stroke, HTN. Grandmother w/ depression.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Increased appetite, son passing away 3 weeks ago, F, 67, troubles falling asleeping, for 3 weeks, Started taking Ambien no improvement, fatigue, decreased interest, wakes up early, no suicidal ideations, insomnia</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Wicks is a 67 year old F PMH HTN, Breast CA (in remission 10 years) who presents with sleep isues in the setting of the loss of her son. Her son passed away October 20th (3 weeks ago) and since then she has had trouble initiating sleep, waking early, tossing and turning. Her bed partner (husband) has not had sleep disturbance. She has tried taking ambien x5nights without relief. Over the last 3 weeks, her sleep issues have been stable. Before, she was getting 8 hours, now 4 hours of sleep/night. She is fatigued and unable to take naps. She reports no changes in diet/increased caffeine. Incr appetite, dec energy, no suicidal no wt change, PHQ2 1/2 (positive for anhedonia).suppor PMH: HTN, breast ca PSH: lumpectomy, laparotomy (appendicitis) Fhx: father stroke HTN, HLD, mother w/ depression shx: lives w/ husband, feels safe, is retired. No smoking, 1-2 glasses wine 2-3x/wk, no drugs Meds: HCTZ, lisinopril, ambien all: none RO. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Incr appetite, son passed away October 20th, loss of her son 3 weeks ago, Ms., F, tossing and turning, 67 year old, trouble initiating sleep, Over the last 3 weeks, unable to take naps, tried taking ambien without relief, fatigued, dec energy, anhedonia, mother w/ depression, waking early, no suicidal, sleep isues, sleep issues, now 4 hours of sleep/night</s>