CHIEF COMPLAINT: 

PRESENT ILLNESS: This is an 83-year-old woman
with a history or restrictive lung disease, 02 dependent at
home who was transferred from an outside hospital on [**2112-10-31**] for treatment of a right hip intertrochanteric
fracture along with rhabdomyolysis.  The patient was found in
her home on the bathroom floor after sustaining a mechanical
fall.  It was believed that the patient was on the floor for
at least two days before a neighbor noticed that she was not
answering her phone, at which time EMS was alerted and they
went nextdoor.

MEDICAL HISTORY: 1.  Restrictive lung disease, 02 dependent at home.
2.  Osteoarthritis.
3.  Left Bell's palsy.

MEDICATION ON ADMISSION: 

ALLERGIES: The patient has no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient does not smoke.  She does not
use any IV drug use, rare alcohol use.  She is widowed with
two grown children.
Other disorders of muscle, ligament, and fascia,Closed fracture of midcervical section of neck of femur,Acute respiratory failure,Subendocardial infarction, initial episode of care,Atrial fibrillation,Acute kidney failure, unspecified,Congestive heart failure, unspecified,Acidosis
Muscle/ligament dis NEC,Fx femur, midcervic-clos,Acute respiratry failure,Subendo infarct, initial,Atrial fibrillation,Acute kidney failure NOS,CHF NOS,Acidosis
Admission Date:  [**2111-11-2**]     Discharge Date:  [**2111-11-7**]


Service:  MICU

HISTORY OF THE PRESENT ILLNESS:  This is an 83-year-old woman
with a history or restrictive lung disease, 02 dependent at
home who was transferred from an outside hospital on [**2112-10-31**] for treatment of a right hip intertrochanteric
fracture along with rhabdomyolysis.  The patient was found in
her home on the bathroom floor after sustaining a mechanical
fall.  It was believed that the patient was on the floor for
at least two days before a neighbor noticed that she was not
answering her phone, at which time EMS was alerted and they
went nextdoor.

At the outside hospital, x-ray showed the fracture and her
initial CK value was 2,866 with an index of 4, troponin of
1.15.  Her BUN to creatinine ratio was 120:1.9.  She was
initially admitted to a medicine team for fluid rehydration
and treatment of her azotemia prior to going for a right hip
replacement.

Shortly after being admitted to the Medicine Floor, her 02
saturation was approximately 68% on 3 liters of nasal cannula
and she showed increasingly labored breathing.  Her
respiratory rate was between 28 and 32 breaths per minute.
Her heart rate was in the low 100s. Initial arterial blood
gas showed a pH of 7.19, PC02 of 81, P02 66.  Her cardiac
enzymes showed a CK of 1,982 and a troponin greater than 50
with an MB of 81.

PAST MEDICAL HISTORY:
1.  Restrictive lung disease, 02 dependent at home.
2.  Osteoarthritis.
3.  Left Bell's palsy.

ALLERGIES:  The patient has no known drug allergies.

ADMISSION MEDICATIONS:
1.  Detrol.
2.  Vioxx.

SOCIAL HISTORY:  The patient does not smoke.  She does not
use any IV drug use, rare alcohol use.  She is widowed with
two grown children.

LABORATORY DATA:  Her initial laboratories showed a white
blood count of 9.0, hematocrit 42.2, platelet count 143,000.
Sodium 149, potassium 4.2, bicarbonate 23, chloride 112, BUN
111, with a creatinine of 1.5 and a glucose of 136.  Her CKs
showed a peak CK of 1,982, peak troponin greater than 50 and
an MB of 81.

PHYSICAL EXAMINATION ON ADMISSION:  Vital signs:  The patient
was afebrile, heart rate 81 breaths per minute, blood
pressure 101/49, respiratory rate 26 breaths per minute, 02
saturation of 87%.  General:  This is a frail appearing
female.  She was alert and oriented times three.  She was in
minor respiratory distress.  The patient had JVD to the
mandible.  She was without lymphadenopathy.  Heart:  Regular
rate and rhythm with a loud S1, S2, and an S3.  Lungs:  Clear
to auscultation bilaterally.  No wheezing, rales, or rhonchi.
Abdomen:  Midepigastric hernia, well-healed midabdominal
scar.  Extremities:  The patient had extreme pain in her
right hip and was unable to move it in any direction.  She
had no edema, cyanosis, clubbing, but did, however, have some
chronic venostasis change in the lower extremities.

ASSESSMENT/PLAN:  This is an 83-year-old female with a
history of restrictive lung disease.  She was admitted to the
MICU for respiratory distress and further management of her
rhabdomyolysis.

1.  ORTHOPEDICS:  The patient was seen by the Orthopedic
Service.  She had an open reduction and internal fixation of
her right hip.

2.  PULMONARY:  The patient was initially intubated due to
her respiratory distress.  It was later found out that the
patient had a wish to be DNR/DNI.  After stabilizing her, the
decision was made to extubate her.  Following extubation,
after several discussions with the family, it was determined
that if the patient were to develop further respiratory
distress that she would not be reintubated and that she would
be made comfortable.

Unfortunately, shortly after being extubated on [**2111-11-6**], the patient appeared to develop some labored breathing
and was unable to maintain good oxygenation with a BIPAP
machine.  She was then made comfortable and she unfortunately
passed away on [**2111-11-7**].

3.  CARDIAC:  The patient had some nonsustained venous
tachycardia.  It was successfully treated with calcium
channel blockers and a beta blocker.  She did have several
episodes of hypotension for which she required Neo.

4.  RENAL:  The patient had acute renal failure secondary to
rhabdomyolysis.  She was aggressively treated with IV fluids
and gradually her creatinine and BUN decreased.

This covers the period of her admission from [**2111-11-2**]
until her untimely death on [**2111-11-7**].

DIAGNOSIS:
1.  Right hip fracture.
2.  Acute renal failure.
3.  Respiratory distress.
4.  Supraventricular tachycardia.




                          [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **], M.D.  [**MD Number(1) 4561**]

Dictated By:[**Name8 (MD) 6284**]

MEDQUIST36

D:  [**2112-2-24**]  04:28
T:  [**2112-2-24**]  21:02
JOB#:  [**Job Number 14108**]
{'Other disorders of muscle, ligament, and fascia,Closed fracture of midcervical section of neck of femur,Acute respiratory failure,Subendocardial infarction, initial episode of care,Atrial fibrillation,Acute kidney failure, unspecified,Congestive heart failure, unspecified,Acidosis'}


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: This is an 83-year-old woman
with a history or restrictive lung disease, 02 dependent at
home who was transferred from an outside hospital on [**2112-10-31**] for treatment of a right hip intertrochanteric
fracture along with rhabdomyolysis.  The patient was found in
her home on the bathroom floor after sustaining a mechanical
fall.  It was believed that the patient was on the floor for
at least two days before a neighbor noticed that she was not
answering her phone, at which time EMS was alerted and they
went nextdoor.

MEDICAL HISTORY: 1.  Restrictive lung disease, 02 dependent at home.
2.  Osteoarthritis.
3.  Left Bell's palsy.

MEDICATION ON ADMISSION: 

ALLERGIES: The patient has no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient does not smoke.  She does not
use any IV drug use, rare alcohol use.  She is widowed with
two grown children. 

### Response:
{'Other disorders of muscle, ligament, and fascia,Closed fracture of midcervical section of neck of femur,Acute respiratory failure,Subendocardial infarction, initial episode of care,Atrial fibrillation,Acute kidney failure, unspecified,Congestive heart failure, unspecified,Acidosis'}
