CHIEF COMPLAINT: tongue swelling

PRESENT ILLNESS: 43 yo F with hereditary angioedema [**1-5**] C1 esterase inhibitor
deficiency s/p intubation x3, who p/w mouth swelling on day of
admission. Reports that symptoms first began on Friday as abd
pain.  Reports severe crampy diffuse abd pain that progresses to
stabbing pain throughout abdomen and nausea.  Resolved by Sat
w/o intervention/symptomatic tx.  this AM noticed swelling
around the site of a pimple on R chin.  Progressed to frank
edema of chin/lower face and patient reported to ED for
evaluation.  Denies fevers/chills/vocal changes/difficulty
swallowing/sob/cp nausea/vomiting/diarrhea.  Also noted R arm
swelling, which she states is "classic".  On anabolic steroid at
home, stanazol which she has been taking since [**Month (only) **] but
decreased dosing interval from qday to QOD one month ago.
Patient is currently menstruating.
.
In ED, VSS oxygenating well on RA.  ED discussed case w/ pt's
allergist at [**Hospital1 112**], rec'd toradol, 2U FFP and stanazol 4mg. ENT
called to evaluate but patient refused otolaryngoscopy.

MEDICAL HISTORY: angioedema, which resulted in intubation times three and
multiple ED visits w/ abdominal pain.

MEDICATION ON ADMISSION: stanazol 1mg QOD,
compazine prn and narcotics in ED for angioedema
flares.

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: t96.5, bp
well appearing female in nad
perrl
op clr. no tonsillar/uvular/pharyngeal edema.  +mild swelling of
chin and lower face.  no erythma. no tenderness.
regular s1,s2. no m/r/g
lca b/l
+ bs. soft. nt. nd
no le edema
+ R arm edema to just above elbow.

FAMILY HISTORY: There is a family history of C1 esterase
inhibitor deficiency in the family.  The patient's two
brothers and father also have the disease.

SOCIAL HISTORY: Raised in [**Location (un) 5131**].  now  lives with her husband and has
occasional tobacco use.  She does have alcohol on occasion as
well.
Other deficiencies of circulating enzymes,Angioneurotic edema, not elsewhere classified,Surgical or other procedure not carried out because of patient's decision
Defic circul enzyme NEC,Angioneurotic edema,No proc/patient decision
Admission Date:  [**2119-8-14**]              Discharge Date:   [**2119-8-15**]

Date of Birth:  [**2076-7-11**]             Sex:   F

Service: MEDICINE

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 297**]
Chief Complaint:
tongue swelling

Major Surgical or Invasive Procedure:
NONE


History of Present Illness:
43 yo F with hereditary angioedema [**1-5**] C1 esterase inhibitor
deficiency s/p intubation x3, who p/w mouth swelling on day of
admission. Reports that symptoms first began on Friday as abd
pain.  Reports severe crampy diffuse abd pain that progresses to
stabbing pain throughout abdomen and nausea.  Resolved by Sat
w/o intervention/symptomatic tx.  this AM noticed swelling
around the site of a pimple on R chin.  Progressed to frank
edema of chin/lower face and patient reported to ED for
evaluation.  Denies fevers/chills/vocal changes/difficulty
swallowing/sob/cp nausea/vomiting/diarrhea.  Also noted R arm
swelling, which she states is "classic".  On anabolic steroid at
home, stanazol which she has been taking since [**Month (only) **] but
decreased dosing interval from qday to QOD one month ago.
Patient is currently menstruating.
.
In ED, VSS oxygenating well on RA.  ED discussed case w/ pt's
allergist at [**Hospital1 112**], rec'd toradol, 2U FFP and stanazol 4mg. ENT
called to evaluate but patient refused otolaryngoscopy.


Past Medical History:
angioedema, which resulted in intubation times three and
multiple ED visits w/ abdominal pain.

Social History:
Raised in [**Location (un) 5131**].  now  lives with her husband and has
occasional tobacco use.  She does have alcohol on occasion as
well.

Family History:
There is a family history of C1 esterase
inhibitor deficiency in the family.  The patient's two
brothers and father also have the disease.

Physical Exam:
t96.5, bp
well appearing female in nad
perrl
op clr. no tonsillar/uvular/pharyngeal edema.  +mild swelling of
chin and lower face.  no erythma. no tenderness.
regular s1,s2. no m/r/g
lca b/l
+ bs. soft. nt. nd
no le edema
+ R arm edema to just above elbow.

Pertinent Results:
[**2119-8-14**] 06:00PM   PT-11.6 PTT-25.3 INR(PT)-1.0
[**2119-8-14**] 06:00PM   PLT COUNT-273
[**2119-8-14**] 06:00PM   NEUTS-71.8* LYMPHS-23.0 MONOS-3.6 EOS-1.4
BASOS-0.3
[**2119-8-14**] 06:00PM   WBC-10.0 RBC-4.06* HGB-13.4 HCT-38.4 MCV-95
MCH-33.1* MCHC-35.0 RDW-12.6
[**2119-8-14**] 06:00PM   GLUCOSE-73 UREA N-12 CREAT-0.9 SODIUM-138
POTASSIUM-4.0 CHLORIDE-102 TOTAL CO2-26 ANION GAP-14

Brief Hospital Course:
In ED, VSS oxygenating well on RA.  ED discussed case w/ pt's
allergist at [**Hospital1 112**]. Pt recieved toradol, 2U FFP and stanazol 4mg.
ENT called to evaluate but patient refused otolaryngoscopy. Pt
was subsequently transfered to the MICU for overnight
monitoring. Tongue swelling resolved by the time the pt arrived
in the MICU. Pt was continued on 4mg Stanozolol for a total of 4
doses. Pt was discharged on 2mg [**Hospital1 **] after discussion with the
pt's allergist. On discharge only facial swelling and rigth
forearm swelling was persistent.

Medications on Admission:
stanazol 1mg QOD,
compazine prn and narcotics in ED for angioedema
flares.

Discharge Medications:
1. Stanozolol (Bulk) 100 % Powder Sig: Two (2) mg Miscell.
every twelve (12) hours: please continue to taper as per Dr.
[**First Name (STitle) **].
Disp:*100 mg* Refills:*0*


Discharge Disposition:
Home

Discharge Diagnosis:
Angioedema

Discharge Condition:
stable

Discharge Instructions:
Please take all your medications and follow up with all your
appointments. Please report to the ED or to your physician if
you have any worsening swelling, shortness of breath, fevers or
any other concerns.

Followup Instructions:
Please make an appointment to see your primary care physician in
the next 1-2 weeks. You have an appointment with your allergist,
Dr. [**First Name (STitle) **], at 8am tomorow, Wednesday, [**2119-8-16**].
.
Please make an appointment to see the ENT doctor in next 2
weeks.
{"Other deficiencies of circulating enzymes,Angioneurotic edema, not elsewhere classified,Surgical or other procedure not carried out because of patient's decision"}


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: tongue swelling

PRESENT ILLNESS: 43 yo F with hereditary angioedema [**1-5**] C1 esterase inhibitor
deficiency s/p intubation x3, who p/w mouth swelling on day of
admission. Reports that symptoms first began on Friday as abd
pain.  Reports severe crampy diffuse abd pain that progresses to
stabbing pain throughout abdomen and nausea.  Resolved by Sat
w/o intervention/symptomatic tx.  this AM noticed swelling
around the site of a pimple on R chin.  Progressed to frank
edema of chin/lower face and patient reported to ED for
evaluation.  Denies fevers/chills/vocal changes/difficulty
swallowing/sob/cp nausea/vomiting/diarrhea.  Also noted R arm
swelling, which she states is "classic".  On anabolic steroid at
home, stanazol which she has been taking since [**Month (only) **] but
decreased dosing interval from qday to QOD one month ago.
Patient is currently menstruating.
.
In ED, VSS oxygenating well on RA.  ED discussed case w/ pt's
allergist at [**Hospital1 112**], rec'd toradol, 2U FFP and stanazol 4mg. ENT
called to evaluate but patient refused otolaryngoscopy.

MEDICAL HISTORY: angioedema, which resulted in intubation times three and
multiple ED visits w/ abdominal pain.

MEDICATION ON ADMISSION: stanazol 1mg QOD,
compazine prn and narcotics in ED for angioedema
flares.

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: t96.5, bp
well appearing female in nad
perrl
op clr. no tonsillar/uvular/pharyngeal edema.  +mild swelling of
chin and lower face.  no erythma. no tenderness.
regular s1,s2. no m/r/g
lca b/l
+ bs. soft. nt. nd
no le edema
+ R arm edema to just above elbow.

FAMILY HISTORY: There is a family history of C1 esterase
inhibitor deficiency in the family.  The patient's two
brothers and father also have the disease.

SOCIAL HISTORY: Raised in [**Location (un) 5131**].  now  lives with her husband and has
occasional tobacco use.  She does have alcohol on occasion as
well. 

### Response:
{"Other deficiencies of circulating enzymes,Angioneurotic edema, not elsewhere classified,Surgical or other procedure not carried out because of patient's decision"}
