CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 27-year-old
male with hypertensive emergency and kidney disease.  The
patient arrived to [**Location (un) 86**] yesterday morning from [**Doctor First Name 46234**] on a visit.  The patient was complaining of a severe
headache as the plane was landing; frontal, around the eyes,
and severe enough that the patient came straight from the
airport to the hospital.

MEDICAL HISTORY: 1.  Hypertension; diagnosed two to three years ago.
2.  Renal insufficiency; first notified in [**2148-10-8**],
but he had no followup.

MEDICATION ON ADMISSION: None.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: No tobacco.  No alcohol.  No intravenous
drug use.  No other illicit drug abuse.  He is from [**Country 3992**].
He came to the United States six years ago.  He is single.
He lives and works in [**Doctor First Name 5256**] with a cousin at a nail
salon.
Hypertensive chronic kidney disease, malignant, with chronic kidney disease stage V or end stage renal disease,Nephritis and nephropathy, not specified as acute or chronic, with other specified pathological lesion in kidney,Disorders of phosphorus metabolism
Mal hyp kid w cr kid V,Nephritis NEC,Dis phosphorus metabol
Admission Date:  [**2149-2-23**]     Discharge Date:  [**2149-2-26**]

Date of Birth:   [**2121-9-13**]     Sex:  M

Service:  [**Location (un) **]

HISTORY OF PRESENT ILLNESS:  The patient is a 27-year-old
male with hypertensive emergency and kidney disease.  The
patient arrived to [**Location (un) 86**] yesterday morning from [**Doctor First Name 46234**] on a visit.  The patient was complaining of a severe
headache as the plane was landing; frontal, around the eyes,
and severe enough that the patient came straight from the
airport to the hospital.

The patient has a history of occasional headaches about once
a month in a similar distribution, but not usually as severe
and usually relieved by rest.  No nausea or vomiting.  No
chest pain.  No shortness of breath.  No visual changes.  No
weakness.  No paresthesias.  No diaphoresis.

Approximately two weeks ago, the patient had an episode of
the flu which went away after one week of rest and treatment
with Motrin and Tylenol.  The patient was seen at [**Hospital 4199**]
Hospital complaining of a bilateral frontal headache and with
blood pressures of 200s/140s.  He had laboratories drawn, and
electrocardiogram taken, and a chest x-ray.  He was given
intravenous Lopressor, labetalol, and hydralazine.  His blood
pressure went down to the 180s/100s, and he was transferred
to the [**Hospital1 69**] Intensive Care
Unit.

PAST MEDICAL HISTORY:
1.  Hypertension; diagnosed two to three years ago.
2.  Renal insufficiency; first notified in [**2148-10-8**],
but he had no followup.

MEDICATIONS ON ADMISSION:  None.

ALLERGIES:  No known drug allergies.

SOCIAL HISTORY:  No tobacco.  No alcohol.  No intravenous
drug use.  No other illicit drug abuse.  He is from [**Country 3992**].
He came to the United States six years ago.  He is single.
He lives and works in [**Doctor First Name 5256**] with a cousin at a nail
salon.

CODE STATUS:  The patient is full code status.

PHYSICAL EXAMINATION ON PRESENTATION:  Physical examination
revealed vital signs with a temperature of 97.2, heart rate
was 60, blood pressure was 150/115, respiratory rate was 16,
and oxygen saturation was 98% on room air.  Fingerstick blood
glucose was 92.  In general, alert and oriented times three.
Cardiovascular examination revealed normal first heart sounds
and second heart sounds.  A regular rate and rhythm.  No
murmurs, rubs, or gallops.  The lungs were clear to
auscultation bilaterally.  The abdomen was soft, nontender,
and nondistended.  Positive bowel sounds.  Extremities were
warm and well perfused.  Radial and posterior tibialis pulses
were 2+.  No edema.  Neurologic examination revealed cranial
nerves II through XII were grossly intact.

PERTINENT LABORATORY VALUES ON PRESENTATION:  Laboratories on
admission revealed complete blood count with a white blood
cell count of 11.4, hematocrit was 36.6, platelets were 285,
and mean cell volume was 80.  Electrolytes revealed sodium
was 139, potassium was 4.1, chloride was 107, bicarbonate was
23, blood urea nitrogen was 44, creatinine was 2.9, and blood
glucose was 116.  Magnesium was 1.8, calcium was 5.4, and
phosphorous was 4.6.  Creatine kinases were 110, 111, and
144.  CK/MB fractions were 2, 2, and 2.  Troponin I levels
were 1.1, 0.8, and 0.5.  Total cholesterol was 292,
high-density lipoprotein was 42, low-density lipoprotein was
202, and triglycerides were 240.  ALT was 13, AST was 16, LDH
was 161, and albumin was 2.5.  Urinalysis revealed a specific
gravity of 1.025, greater than 300 protein, greater than 50
red blood cells, and 0 to 2 white blood cells.

RADIOLOGY/IMAGING FINDINGS:  Electrocardiogram showed a sinus
bradycardia, left ventricular hypertrophy, with ST-T wave
changes, and ST elevations in leads V1 through V3.

An echocardiogram on [**2149-2-23**] and [**2149-2-24**]
showed left ventricular ejection fractions of 35%, left
atrium mildly dilated, mild symmetric left ventricular
hypertrophy, moderate global left ventricular hypokinesis,
overall left ventricular systolic function was moderately
depressed, aortic valve leaflets were normal with no
regurgitation, mitral valve leaflets were mildly thickened
with mild mitral regurgitation.  No pericardial effusion.
Estimated pulmonary artery systolic pressures were normal.

A magnetic resonance angiography of the kidney showed no
renal artery stenosis, poor corticomedullary differentiation;
suggestive of chronic renal disease, 0 to 2 bilateral renal
cysts, and normal sized kidneys.

ASSESSMENT AND PLAN:  This is a 27-year-old Vietnamese male
with an initial presentation of malignant hypertension now
with hypertension and renal disease.

HOSPITAL COURSE BY ISSUE/SYSTEM:

1.  CARDIOVASCULAR SYSTEM:  At the outside hospital, the
patient had a reported blood pressure of 200s/140s.  The
patient was started metoprolol, amlodipine, and
hydrochlorothiazide to bring his blood pressure down to
130s/90s by discharge.  Atorvastatin was started for
hyperlipidemia.

2.  RENAL ISSUES:  The patient had numerous laboratories
sent; including a hepatitis panel, metanephrines, compliment
factors, antinuclear antibody, and antineutrophil cytoplasmic
antibody.

Due to the recent ingestion of nonsteroidal antiinflammatory
drugs, a renal biopsy was postponed until at least one week
later for followup.

CONDITION AT DISCHARGE:  Condition on discharge was stable.

DISCHARGE DIAGNOSES:
1.  Hypertension.
2.  Kidney disease.

MEDICATIONS ON DISCHARGE:
1.  Atorvastatin 10 mg p.o. q.d.
2.  Norvasc 10 mg p.o. q.d.
3.  Metoprolol 50 mg p.o. b.i.d.
4.  Hydrochlorothiazide 25 mg p.o. q.d.
5.  Renagel 800 mg p.o. b.i.d.

DISCHARGE INSTRUCTIONS/FOLLOWUP:  The patient had an
appointment for a renal biopsy on Wednesday, [**3-5**], at
8 a.m., at [**Hospital Ward Name 121**] Eight.  He was given strict instructions to
not have any nonsteroidal antiinflammatory drugs or aspirin,
and to be nothing by mouth the midnight before the kidney
biopsy.





                          [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 4122**], M.D.  [**MD Number(2) 11535**]

Dictated By:[**Last Name (NamePattern1) 21948**]

MEDQUIST36

D:  [**2149-3-2**]  19:14
T:  [**2149-3-2**]  19:24
JOB#:  [**Job Number **]
{'Hypertensive chronic kidney disease, malignant, with chronic kidney disease stage V or end stage renal disease,Nephritis and nephropathy, not specified as acute or chronic, with other specified pathological lesion in kidney,Disorders of phosphorus metabolism'}


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: The patient is a 27-year-old
male with hypertensive emergency and kidney disease.  The
patient arrived to [**Location (un) 86**] yesterday morning from [**Doctor First Name 46234**] on a visit.  The patient was complaining of a severe
headache as the plane was landing; frontal, around the eyes,
and severe enough that the patient came straight from the
airport to the hospital.

MEDICAL HISTORY: 1.  Hypertension; diagnosed two to three years ago.
2.  Renal insufficiency; first notified in [**2148-10-8**],
but he had no followup.

MEDICATION ON ADMISSION: None.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: No tobacco.  No alcohol.  No intravenous
drug use.  No other illicit drug abuse.  He is from [**Country 3992**].
He came to the United States six years ago.  He is single.
He lives and works in [**Doctor First Name 5256**] with a cousin at a nail
salon. 

### Response:
{'Hypertensive chronic kidney disease, malignant, with chronic kidney disease stage V or end stage renal disease,Nephritis and nephropathy, not specified as acute or chronic, with other specified pathological lesion in kidney,Disorders of phosphorus metabolism'}
