CHIEF COMPLAINT: 

PRESENT ILLNESS: Mrs. [**Known lastname **] is an 80 year old
unfortunate woman who was an unrestrained back seat passenger
in an SUV sustaining a motor vehicle accident.  The patient
was ejected outside of the car and found sort of unresponsive
by the paramedics.  Shortly after she recovered consciousness
and she was taken to the [**Hospital3 **] Emergency Room.  Over
there an evaluation and computerized tomography scan revealed
a C2 fracture, left scapular fracture and a question of a
subarachnoid hemorrhage.  This is the reason why Mrs.
[**Known lastname **] was airlifted and transferred here via [**Location (un) **] to
the [**Hospital6 256**] for further
evaluation and treatment.

MEDICAL HISTORY: Significant for hypertension, aortic
valve repair in [**2127**] in the state of [**State 108**], left inguinal
hernia repair, bilateral cataract surgery, bilateral carpal
tunnel release surgery.

MEDICATION ON ADMISSION: The patient is taking aspirin 325
mg p.o. q. day, Fosamax and a beta blocker that she does not
remember the name of.

ALLERGIES: The patient has no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: Non-contributory

SOCIAL HISTORY: She denies any history of tobacco and no
history of alcohol.  She lives with her husband.  She was
visiting her daughter and attending her grandson's graduation
when she suffered this accident.
Closed fracture of second cervical vertebra,Other noncollision motor vehicle traffic accident injuring passenger in motor vehicle other than motorcycle,Closed fracture of metatarsal bone(s),Closed fracture of scapula, unspecified part,Unspecified essential hypertension
Fx c2 vertebra-closed,Mv traff acc NEC-pasngr,Fx metatarsal-closed,Fx scapula NOS-closed,Hypertension NOS
Admission Date:  [**2136-5-6**]       Discharge Date:  [**2136-5-12**]


Service:

HISTORY OF PRESENT ILLNESS:  Mrs. [**Known lastname **] is an 80 year old
unfortunate woman who was an unrestrained back seat passenger
in an SUV sustaining a motor vehicle accident.  The patient
was ejected outside of the car and found sort of unresponsive
by the paramedics.  Shortly after she recovered consciousness
and she was taken to the [**Hospital3 **] Emergency Room.  Over
there an evaluation and computerized tomography scan revealed
a C2 fracture, left scapular fracture and a question of a
subarachnoid hemorrhage.  This is the reason why Mrs.
[**Known lastname **] was airlifted and transferred here via [**Location (un) **] to
the [**Hospital6 256**] for further
evaluation and treatment.

PAST MEDICAL HISTORY:  Significant for hypertension, aortic
valve repair in [**2127**] in the state of [**State 108**], left inguinal
hernia repair, bilateral cataract surgery, bilateral carpal
tunnel release surgery.

ALLERGIES:  The patient has no known drug allergies.

MEDICATIONS ON ADMISSION:  The patient is taking aspirin 325
mg p.o. q. day, Fosamax and a beta blocker that she does not
remember the name of.

SOCIAL HISTORY:  She denies any history of tobacco and no
history of alcohol.  She lives with her husband.  She was
visiting her daughter and attending her grandson's graduation
when she suffered this accident.

FAMILY HISTORY:  Non-contributory

PHYSICAL EXAMINATION:  Upon arrival to the Emergency Room,
temperature 92, heartrate 69, blood pressure 117/73,
respiratory rate 16, 100% on 2 liters of nasal cannula.
[**Location (un) 2611**] coma scale was 15.  She was noticed to have her left
eye swollen and ecchymotic, shut completely because of the
extensive edema.  The right pupil was reactive 2 to 1 mm to
light and accommodation.  There was a left forehead contusion
and ecchymosis of the upper lip.  A cervical collar was in
place.  The trachea was in the midline.  Lungs were clear to
auscultation bilaterally and anteriorly.  She had a regular
rate and rhythm.  Abdomen was soft, nondistended, nontender.
Bowel sounds were present.  Pelvis was stable.  Her left
upper extremity was tender to mobilization but there was no
obvious bone deformity.  There were abrasions across her left
ankle, palpable dorsalis pedis and posterior tibial
bilaterally.  Her face was intact.

LABORATORY DATA:  Her hematocrit upon arrival was 27, white
count 16.4, platelet count of 235.  Sodium was 138, potassium
3.4, chloride 103, carbon dioxide 25, BUN 28, creatinine 1.0
with a glucose of 193.  Her urinalysis showed [**1-31**] red blood
cells.  Toxicology screen was negative.  Amylase was 77 and
her gas was within normal limits.  Her initial films were as
follows - Her chest x-ray was unremarkable.  Pelvis was
normal.  Head computerized tomography scan showed no major
intracranial hemorrhage but question of a tiny subarachnoid.
Cervical spine computerized tomography scan showed a Type 2
odontoid fracture, minimally displaced anteriorly.  Chest
computerized tomography scan was negative.  Computerized
tomography scan of the abdomen from the outside hospital
which was read by our radiologist was unremarkable.  Left
shoulder film showed a nondisplaced left scapular fracture
and left ankle film showed a base of the fifth metatarsal
fracture as well.

HOSPITAL COURSE:  Mrs. [**Known lastname **] was admitted to the [**Hospital6 1760**] Intensive Care Unit for
frequent neurologic checks.  A spine consult was obtained,
Dr. [**Last Name (STitle) 1327**] evaluated the patient and recommended to obtain
spine magnetic resonance imaging scan.  The magnetic
resonance imaging scan was negative for spinal cord
compromise which just revealed and confirmed the computerized
tomography scan finding, Type 2 odontoid fracture.  The
recommendation at that time was to keep the patient on a
cervical collar for three months and there was no need of
surgical intervention.  The patient was also evaluated by
Orthopedics who placed a short leg cast on her left leg and
her left upper extremity was placed in a sling for comfort.
The recommendation was also nonsurgical at this point.  The
first night she remained hemodynamically stable and
neurologically intact.  Serial hematocrits and hemodynamic as
well as vital sign checks were normal.  On hospital day #3,
the patient was taking adequate p.o. and since she remained
hemodynamically stable she was transferred to a regular floor
on the clinical center 6.  Once on the floor her pain regimen
was optimized and she was receiving Dilaudid both p.o. and
subcutaneously.  She was able to come out of bed with the
assistance of physical therapy and the nursing staff but was
still complaining of a significant amount of pain.  At this
point it was decided to obtain a rehabilitation consult prior
to discharge to her home since the patient lived in [**State 108**].
At that time the patient's family preference was to obtain
[**Hospital3 4419**] Center consult and this was done.
The rest of her hospital course was relatively unremarkable.
She continued to work every day with physical therapy and the
nursing staff and today she was found to be stable to be
discharged to the extended care facility for physical therapy
and to continue her recovery.

CONDITION ON DISCHARGE:  Stable.

DISPOSITION:  She is being sent to [**Hospital3 4419**].

DISCHARGE MEDICATIONS:
1.  Lopressor 25 mg p.o. b.i.d. with instructions to hold for
systolic blood pressure of less than 110 and heartrate less
than 60
2.  Levothyroxine 75 mcg p.o. q. day
3.  Dilaudid .5 mg intramuscular, intravenous or
subcutaneously q. 3 to 4 hours prn
4.  Dilaudid 2-4 mg p.o. q. 4-6 hours prn
5.  Heparin 5000 units subcutaneously b.i.d.
6.  Iron 325 mg p.o. q. day
7.  Alendronate Sodium 5 mg p.o. q. day
8.  Colace 100 mg p.o. b.i.d.
9.  Zantac 150 mg p.o. q. day
10. Zofran 4 mg intravenously q. 6 hours prn

DISCHARGE INSTRUCTIONS:  Diet is a regular house diet with
Boost supplements.  The patient is supposed to remain in the
cervical collar for at least three months and then she will
schedule a follow up appointment with Dr. [**Last Name (STitle) 1327**] in the
[**Hospital 16364**] Clinic, having cervical spine films prior to
her appointment.  She is also supposed to follow up with Dr.
[**First Name8 (NamePattern2) **] [**Name (STitle) 1022**] on the [**Hospital **] Clinic in two weeks, please
call [**Telephone/Fax (1) 4301**] to make and schedule a follow up
appointment.





                            [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) **], M.D.
[**MD Number(1) 6066**]

Dictated By:[**Last Name (NamePattern4) 26544**]
MEDQUIST36

D:  [**2136-5-11**]  18:29
T:  [**2136-5-11**]  20:18
JOB#:  [**Job Number 39001**]
{'Closed fracture of second cervical vertebra,Other noncollision motor vehicle traffic accident injuring passenger in motor vehicle other than motorcycle,Closed fracture of metatarsal bone(s),Closed fracture of scapula, unspecified part,Unspecified essential hypertension'}


You are an AI assistant analyzing clinical admission notes from the MIMIC III dataset. Your task is to map symptoms mentioned in the notes to a list of provided ICD-9 LONG_TEXT.



### Clinical text :
CHIEF COMPLAINT: 

PRESENT ILLNESS: Mrs. [**Known lastname **] is an 80 year old
unfortunate woman who was an unrestrained back seat passenger
in an SUV sustaining a motor vehicle accident.  The patient
was ejected outside of the car and found sort of unresponsive
by the paramedics.  Shortly after she recovered consciousness
and she was taken to the [**Hospital3 **] Emergency Room.  Over
there an evaluation and computerized tomography scan revealed
a C2 fracture, left scapular fracture and a question of a
subarachnoid hemorrhage.  This is the reason why Mrs.
[**Known lastname **] was airlifted and transferred here via [**Location (un) **] to
the [**Hospital6 256**] for further
evaluation and treatment.

MEDICAL HISTORY: Significant for hypertension, aortic
valve repair in [**2127**] in the state of [**State 108**], left inguinal
hernia repair, bilateral cataract surgery, bilateral carpal
tunnel release surgery.

MEDICATION ON ADMISSION: The patient is taking aspirin 325
mg p.o. q. day, Fosamax and a beta blocker that she does not
remember the name of.

ALLERGIES: The patient has no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: Non-contributory

SOCIAL HISTORY: She denies any history of tobacco and no
history of alcohol.  She lives with her husband.  She was
visiting her daughter and attending her grandson's graduation
when she suffered this accident. 

### Response:
{'Closed fracture of second cervical vertebra,Other noncollision motor vehicle traffic accident injuring passenger in motor vehicle other than motorcycle,Closed fracture of metatarsal bone(s),Closed fracture of scapula, unspecified part,Unspecified essential hypertension'}
