CHIEF COMPLAINT: vaginal bleeding

PRESENT ILLNESS: 44 yo G1P1 s/p SVD [**2134-11-27**] presents to ED by EMS with heavy VB.
Per EMT, EBL en route 500cc.  Pt reports that she had been
having lochia c/w period since discharge.  It got heavier this
afternoon, then she began passing large clots with bright red
blood per vagina.  She denies lightheadedness, shortness of
breath, or chest pain.  She denies fevers chills or other
constitutional symptoms.  She denies headache, abd pain, blurry
vision.

MEDICAL HISTORY: PMH: fibroid uterus, no images here
Meds: Tylenol
Allergies: Morphine -> n/v
           Shellfish -> swelling
PSH: Lap Chole, cyst removal L wrist, removal of lesion from R
ear
OB: SVD term [**11-27**]
GYN: fibroid uterus

MEDICATION ON ADMISSION: prenatal vitamins

ALLERGIES: Morphine

PHYSICAL EXAM: 98.4  108  127/90  16 100%RA
Anxious
MM dry
Tachycardic
Clear
Abd obese, soft, NT, fundus firm about 2 cm above pubic ramus.
The perineum is covered in blood.  There is BRB and clot
w/speculum exam.  Cleared approx 300cc blood on exam.  Bimanual,
os 2cm, uterus nontender, firm

FAMILY HISTORY: NC

SOCIAL HISTORY: as above
Delayed and secondary postpartum hemorrhage, postpartum condition or complication,Acute posthemorrhagic anemia,Infections of genitourinary tract in pregnancy, postpartum condition or complication,Candidiasis of other urogenital sites,Anemia of mother, postpartum condition or complication,Tumors of body of uterus, postpartum condition or complication,Leiomyoma of uterus, unspecified,Other injury to pelvic organs, postpartum condition or complication
Delay p/part hem-postpar,Ac posthemorrhag anemia,Gu infection-postpartum,Candidias urogenital NEC,Anemia-postpartum,Uterine tumor-postpartum,Uterine leiomyoma NOS,Inj pelv org NEC-postpar
Admission Date:  [**2134-12-11**]              Discharge Date:   [**2134-12-16**]

Date of Birth:  [**2090-2-1**]             Sex:   F

Service: OBSTETRICS/GYNECOLOGY

Allergies:
Morphine

Attending:[**First Name3 (LF) 83138**]
Chief Complaint:
vaginal bleeding

Major Surgical or Invasive Procedure:
total abdominal hysterectomy
blood transfusion

History of Present Illness:
44 yo G1P1 s/p SVD [**2134-11-27**] presents to ED by EMS with heavy VB.
Per EMT, EBL en route 500cc.  Pt reports that she had been
having lochia c/w period since discharge.  It got heavier this
afternoon, then she began passing large clots with bright red
blood per vagina.  She denies lightheadedness, shortness of
breath, or chest pain.  She denies fevers chills or other
constitutional symptoms.  She denies headache, abd pain, blurry
vision.


Past Medical History:
PMH: fibroid uterus, no images here
Meds: Tylenol
Allergies: Morphine -> n/v
           Shellfish -> swelling
PSH: Lap Chole, cyst removal L wrist, removal of lesion from R
ear
OB: SVD term [**11-27**]
GYN: fibroid uterus


Social History:
as above

Family History:
NC

Physical Exam:
98.4  108  127/90  16 100%RA
Anxious
MM dry
Tachycardic
Clear
Abd obese, soft, NT, fundus firm about 2 cm above pubic ramus.
The perineum is covered in blood.  There is BRB and clot
w/speculum exam.  Cleared approx 300cc blood on exam.  Bimanual,
os 2cm, uterus nontender, firm


Pertinent Results:
[**2134-12-11**] 09:20PM BLOOD WBC-3.7*# RBC-3.05*# Hgb-9.0* Hct-26.9*#
MCV-88 MCH-29.5 MCHC-33.5 RDW-13.0 Plt Ct-294
[**2134-12-12**] 03:39AM BLOOD WBC-11.1*# RBC-3.21* Hgb-9.5* Hct-27.9*
MCV-87 MCH-29.6 MCHC-34.1 RDW-14.6 Plt Ct-217
[**2134-12-12**] 09:48AM BLOOD WBC-10.8 RBC-2.94* Hgb-8.7* Hct-24.8*
MCV-84 MCH-29.6 MCHC-35.1* RDW-14.6 Plt Ct-242
[**2134-12-12**] 11:54AM BLOOD Hct-25.0*
[**2134-12-12**] 03:37PM BLOOD Hct-23.0*
[**2134-12-12**] 09:59PM BLOOD WBC-7.9 RBC-2.47* Hgb-7.3* Hct-21.1*
MCV-85 MCH-29.4 MCHC-34.5 RDW-14.7 Plt Ct-237
[**2134-12-13**] 02:28AM BLOOD WBC-7.5 RBC-3.02* Hgb-8.9* Hct-25.6*
MCV-85 MCH-29.6 MCHC-34.9 RDW-14.4 Plt Ct-205
[**2134-12-13**] 05:22AM BLOOD Hct-24.3*
[**2134-12-13**] 11:20AM BLOOD Hct-24.8*
[**2134-12-14**] 07:25AM BLOOD WBC-8.2 RBC-3.05* Hgb-9.0* Hct-26.2*
MCV-86 MCH-29.6 MCHC-34.5 RDW-14.1 Plt Ct-228
[**2134-12-11**] 11:45PM BLOOD Fibrino-214
[**2134-12-12**] 03:39AM BLOOD Fibrino-266
[**2134-12-12**] 09:48AM BLOOD Fibrino-288
[**2134-12-11**] 09:20PM BLOOD Glucose-80 UreaN-8 Creat-0.7 Na-142 K-3.3
Cl-109* HCO3-24 AnGap-12
[**2134-12-12**] 03:39AM BLOOD Glucose-194* UreaN-9 Creat-0.8 Na-140
K-4.3 Cl-109* HCO3-21* AnGap-14
[**2134-12-12**] 09:48AM BLOOD Glucose-119* UreaN-9 Creat-0.8 Na-139
K-4.9 Cl-107 HCO3-25 AnGap-12
[**2134-12-12**] 09:59PM BLOOD Glucose-106* UreaN-11 Creat-0.8 Na-140
K-3.7 Cl-106 HCO3-28 AnGap-10
[**2134-12-13**] 02:28AM BLOOD Glucose-103 UreaN-11 Creat-0.8 Na-138
K-3.7 Cl-104 HCO3-30 AnGap-8
[**2134-12-11**] 09:20PM BLOOD ALT-12 AST-18 AlkPhos-80 TotBili-0.1
[**2134-12-12**] 06:31AM BLOOD CK(CPK)-159*
[**2134-12-12**] 06:31AM BLOOD CK-MB-3 cTropnT-<0.01
[**2134-12-12**] 03:37PM BLOOD CK-MB-3 cTropnT-<0.01
[**2134-12-12**] 09:59PM BLOOD CK-MB-2 cTropnT-<0.01
[**2134-12-11**] 09:20PM BLOOD UricAcd-3.5
[**2134-12-12**] 03:39AM BLOOD Calcium-8.5 Phos-5.3* Mg-1.5*
[**2134-12-12**] 09:48AM BLOOD Calcium-8.0* Phos-4.5 Mg-1.9
[**2134-12-12**] 09:59PM BLOOD Calcium-7.4* Phos-4.2 Mg-1.7
[**2134-12-13**] 02:28AM BLOOD Calcium-7.2* Phos-4.2 Mg-1.8
[**2134-12-11**] 11:40PM BLOOD Type-ART pO2-87 pCO2-46* pH-7.29*
calTCO2-23 Base XS--4 Intubat-INTUBATED Vent-CONTROLLED
[**2134-12-12**] 12:37AM BLOOD Type-ART pO2-90 pCO2-45 pH-7.31*
calTCO2-24 Base XS--3 Intubat-INTUBATED Vent-CONTROLLED
[**2134-12-12**] 01:47AM BLOOD Type-ART pO2-150* pCO2-37 pH-7.37
calTCO2-22 Base XS--3 Intubat-INTUBATED Vent-CONTROLLED
[**2134-12-12**] 04:12AM BLOOD Type-ART Temp-37.0 pO2-187* pCO2-50*
pH-7.30* calTCO2-26 Base XS--1
[**2134-12-12**] 11:37AM BLOOD Type-ART pO2-192* pCO2-36 pH-7.41
calTCO2-24 Base XS-0

Brief Hospital Course:
Ms. [**Known lastname 174**] was admitted after undergoing total abdominal
hysterectomy for secondary postpartum hemorrhage.  Please see
operative report for full details.  She was admitted to the ICU
postoperatively for close monitoring.  She was transfered out of
the ICU on post-operative day 1 and had an uneventful
post-operative course.  Social work followed her during her
hospital stay.  She was discharged on post-operative day 3 in
stable condition.  She was transfused a total of 7units of RBC,
4units of FFP, and 1 pack platelets.

Medications on Admission:
prenatal vitamins

Discharge Medications:
1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*2*
2. Ferrous Sulfate 325 mg (65 mg Iron) Tablet Sig: One (1)
Tablet PO BID (2 times a day).
Disp:*60 Tablet(s)* Refills:*2*
3. Oxycodone 5 mg Tablet Sig: 1-2 Tablets PO Q3H (every 3 hours)
as needed for pain.
Disp:*60 Tablet(s)* Refills:*0*
4. Motrin 600 mg Tablet Sig: One (1) Tablet PO every six (6)
hours as needed for pain.
Disp:*60 Tablet(s)* Refills:*0*


Discharge Disposition:
Home

Discharge Diagnosis:
secondary postpartum hemorrhage
vaginal yeast infection


Discharge Condition:
stable


Discharge Instructions:
Call your doctor for:
* fever > 100.4
* severe abdominal pain
* difficulty urinating
* vaginal bleeding requiring >1 pad/hr
* abnormal vaginal discharge
* redness or drainage from incision
* nausea/vomiting where you are unable to keep down fluids/food
or your medication

General instructions:
* Take your medications as prescribed.
* Do not drive while taking narcotics.
* No strenuous activity, nothing in the vagina (no tampons, no
douching, no sex), no heavy lifting of objects >10lbs for 6
weeks.
* You may eat a regular diet.

Incision care:
* You may shower and allow soapy water to run over incision; no
scrubbing of incision.  No bath tubs for 6 weeks.
* If you have steri-strips, leave them on. They will fall off on
their own or be removed during your followup visit.
* If you have staples, they will be removed at your follow-up
visit.


Followup Instructions:
Please call your doctor to make a follow-up appointment for
staple removal 7-10 days after your surgery.


                             [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] MD [**MD Number(2) 83139**]
{'Delayed and secondary postpartum hemorrhage, postpartum condition or complication,Acute posthemorrhagic anemia,Infections of genitourinary tract in pregnancy, postpartum condition or complication,Candidiasis of other urogenital sites,Anemia of mother, postpartum condition or complication,Tumors of body of uterus, postpartum condition or complication,Leiomyoma of uterus, unspecified,Other injury to pelvic organs, postpartum condition or complication'}


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: vaginal bleeding

PRESENT ILLNESS: 44 yo G1P1 s/p SVD [**2134-11-27**] presents to ED by EMS with heavy VB.
Per EMT, EBL en route 500cc.  Pt reports that she had been
having lochia c/w period since discharge.  It got heavier this
afternoon, then she began passing large clots with bright red
blood per vagina.  She denies lightheadedness, shortness of
breath, or chest pain.  She denies fevers chills or other
constitutional symptoms.  She denies headache, abd pain, blurry
vision.

MEDICAL HISTORY: PMH: fibroid uterus, no images here
Meds: Tylenol
Allergies: Morphine -> n/v
           Shellfish -> swelling
PSH: Lap Chole, cyst removal L wrist, removal of lesion from R
ear
OB: SVD term [**11-27**]
GYN: fibroid uterus

MEDICATION ON ADMISSION: prenatal vitamins

ALLERGIES: Morphine

PHYSICAL EXAM: 98.4  108  127/90  16 100%RA
Anxious
MM dry
Tachycardic
Clear
Abd obese, soft, NT, fundus firm about 2 cm above pubic ramus.
The perineum is covered in blood.  There is BRB and clot
w/speculum exam.  Cleared approx 300cc blood on exam.  Bimanual,
os 2cm, uterus nontender, firm

FAMILY HISTORY: NC

SOCIAL HISTORY: as above 

### Response:
{'Delayed and secondary postpartum hemorrhage, postpartum condition or complication,Acute posthemorrhagic anemia,Infections of genitourinary tract in pregnancy, postpartum condition or complication,Candidiasis of other urogenital sites,Anemia of mother, postpartum condition or complication,Tumors of body of uterus, postpartum condition or complication,Leiomyoma of uterus, unspecified,Other injury to pelvic organs, postpartum condition or complication'}
