CHIEF COMPLAINT: presented s/p near drowning episode

PRESENT ILLNESS: 76 RH yo woman with h/o old stroke (no residual weakness),
HTN, who was swimming in [**Doctor First Name **], MA with her daughter and
husband this AM.  A bystander noticed her face down in the
ocean,
swam out to retrieve her, and started CPR (x 5-10 min).  She was
likely face down for 2-3 minutes.  Found to be unresponsive,
pulseless, with spontaneous breathing.  Taken to OSH ->
intubated and sedated, CT head showed deep right hemisphere
bleed without mass effect or bleed, transferred to [**Hospital1 18**] for
further management.

MEDICAL HISTORY: HTN
Stroke [**2169**], had right sideded weakness that resolved after
several months of phys therapy.
Osteoarthritis
Macular degeneration

MEDICATION ON ADMISSION: prinovil
actonel
asa 325
anemia "mild"
supplements:  calcium, mag, lutein, likopeic?, Vit E, vit C,
iron, glucosamine chondroitin.

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: VITALS:  T 97.8 rectal, 172/79 (after 10mg IV labetolol), HR 74,
O2 sat 100% on mechanical ventilation.
GEN:  intubated and sedated
SKIN:  no rash, blood around nasopharynx/oropharynx
HEENT:  dry tongue, ETT in place
NECK: hard cervical collar in place
CHEST:  CTA bilat anteriorly
CV:  regular rate and rhythm without murmurs
ABD:  +BS, nontender, softly distended
EXTREM:  no edema

FAMILY HISTORY: Sister had a stroke, etiology unknown to family

SOCIAL HISTORY: PCP [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 1693**] [**Telephone/Fax (1) 57926**]
No tob/etoh/drugs.  Lives with husband and daughter.  Daughter
[**First Name8 (NamePattern2) **] [**Known lastname 6164**] is HCP [**Telephone/Fax (1) 57927**], [**Telephone/Fax (1) 57928**] (home).  DNR, not
DNI.  Retired ice cream scooper, quit 15 yrs ago.
Intracerebral hemorrhage,Accidental drowning and submersion while engaged in other sport or recreational activity without diving equipment,Hemiplegia, unspecified, affecting unspecified side,Pneumonia, organism unspecified,Paroxysmal ventricular tachycardia,Unspecified essential hypertension,Iron deficiency anemia, unspecified,Hypocalcemia
Intracerebral hemorrhage,Swimming accident NOS,Unsp hemiplga unspf side,Pneumonia, organism NOS,Parox ventric tachycard,Hypertension NOS,Iron defic anemia NOS,Hypocalcemia
Admission Date:  [**2176-6-25**]              Discharge Date:   [**2176-7-2**]

Date of Birth:  [**2100-2-5**]             Sex:   F

Service: NMED

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 5868**]
Chief Complaint:
presented s/p near drowning episode

Major Surgical or Invasive Procedure:
None

History of Present Illness:
76 RH yo woman with h/o old stroke (no residual weakness),
HTN, who was swimming in [**Doctor First Name **], MA with her daughter and
husband this AM.  A bystander noticed her face down in the
ocean,
swam out to retrieve her, and started CPR (x 5-10 min).  She was
likely face down for 2-3 minutes.  Found to be unresponsive,
pulseless, with spontaneous breathing.  Taken to OSH ->
intubated and sedated, CT head showed deep right hemisphere
bleed without mass effect or bleed, transferred to [**Hospital1 18**] for
further management.

Seen by Nsurg in ED -> no intervention.  Given versed 2mg,
fentanyl 100 mcg, 10mg of labetolol IV in ED.

Additional history - no weakness or numbness preceeding event.
Pt walks one mile each day without fail. No fever/chills, or
complaints of pain per family.


Past Medical History:
HTN
Stroke [**2169**], had right sideded weakness that resolved after
several months of phys therapy.
Osteoarthritis
Macular degeneration

No h/o DM, MI, CAD.


Social History:
PCP [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 1693**] [**Telephone/Fax (1) 57926**]
No tob/etoh/drugs.  Lives with husband and daughter.  Daughter
[**First Name8 (NamePattern2) **] [**Known lastname 6164**] is HCP [**Telephone/Fax (1) 57927**], [**Telephone/Fax (1) 57928**] (home).  DNR, not
DNI.  Retired ice cream scooper, quit 15 yrs ago.

Family History:
Sister had a stroke, etiology unknown to family


Physical Exam:
VITALS:  T 97.8 rectal, 172/79 (after 10mg IV labetolol), HR 74,
O2 sat 100% on mechanical ventilation.
GEN:  intubated and sedated
SKIN:  no rash, blood around nasopharynx/oropharynx
HEENT:  dry tongue, ETT in place
NECK: hard cervical collar in place
CHEST:  CTA bilat anteriorly
CV:  regular rate and rhythm without murmurs
ABD:  +BS, nontender, softly distended
EXTREM:  no edema

NEURO:
Mental status:  intubated and sedated with versed and fentanyl
Cranial Nerves:
I:  deferred
II: Fundoscopic exam: unable to visualize discs. Pupils: 2.5->
2.0 bilat, consensual constriction to light.
III, IV, VI: unable to perform doll's head 2o2 c-collar
V: Corneal reflex present bilaterally.
VII:  unable to appreciate, no wincing to pain
VIII;  unable to assess
IX, X:  unable to assess, ETT in place
[**Doctor First Name 81**]: unable to assess
XII:  unable to assess

Sensory:  withdrawls both legs to pain, not arms.
Motor:
Normal bulk, tone.  No fasciculations.  No adventitious
movements.  Moves right leg spontaneously to a flexed-knee
position.
Reflexes: Brisk RUE>LUE.  Crossed adductors bilaterally, 3+
patellar and 2+ ankles. Toes equivocal bilaterally.

Coordination: unable to assess

Gait: unable to assess


Pertinent Results:
WBC 11.5, Hct 33.5, plt 227, MCV 93
Chem:  BUN/Cr 20/0.9, Na 146, K 2.8, Cl 118, gluc 268, lactate
2.2, amylase 120
serum tox screen negative
coags WNL

CT without contrast of head:  approx 25cc intracranial bleed,
deep in the right putamen area.  No shift.

EKG:  100 bpm, LAD, NSR? may have ectopic p wave as p wave
invertd in I, V2.  Nl intervals.

Brief Hospital Course:
The patient was admitted to our NICU service for close
monitoring.  She was intubated and treated with IV labetolol to
control her blood pressures (keep it below 140 systolic).  Over
the course of the next several days, she became more alert as
the sedation was weaned and eventually was extubated without
incident.  A chest xray showed an infiltrate worrisome for a
pneumonia so she was begun on levofloxacin (this course will end
on [**2176-7-9**]).  She was titrated off of the iv anti-hypertensives
and titrated up on captopril, then ultimately switched to
lisinopril for once a day dosing.

Her neurologic exam now on the day of discharge is significant
for left sided weakness and a left hemi-neglect (both of these
have been improving).  She is now stable and ready for discharge
for to rehab for further physical therapy.

Medications on Admission:
prinovil
actonel
asa 325
anemia "mild"
supplements:  calcium, mag, lutein, likopeic?, Vit E, vit C,
iron, glucosamine chondroitin.


Discharge Medications:
lisinopril 40 qd
docusate prn
iron 325 qd
protonix 40 qd
levofloxacin 500 qd


Discharge Disposition:
Extended Care

Facility:
[**Hospital **] Hospital of [**Location (un) **] & Islands - [**Location (un) 6251**]

Discharge Diagnosis:
1. stroke
2. hypertension
3. reflux disease

Discharge Condition:
Stable, talking and alert.

Discharge Instructions:
Please restart ASA in one week.

Followup Instructions:
Please follow-up with your primary care physician [**Name Initial (PRE) 176**] 4 weeks
or as needed.


Completed by:[**2176-7-2**]
{'Intracerebral hemorrhage,Accidental drowning and submersion while engaged in other sport or recreational activity without diving equipment,Hemiplegia, unspecified, affecting unspecified side,Pneumonia, organism unspecified,Paroxysmal ventricular tachycardia,Unspecified essential hypertension,Iron deficiency anemia, unspecified,Hypocalcemia'}


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: presented s/p near drowning episode

PRESENT ILLNESS: 76 RH yo woman with h/o old stroke (no residual weakness),
HTN, who was swimming in [**Doctor First Name **], MA with her daughter and
husband this AM.  A bystander noticed her face down in the
ocean,
swam out to retrieve her, and started CPR (x 5-10 min).  She was
likely face down for 2-3 minutes.  Found to be unresponsive,
pulseless, with spontaneous breathing.  Taken to OSH ->
intubated and sedated, CT head showed deep right hemisphere
bleed without mass effect or bleed, transferred to [**Hospital1 18**] for
further management.

MEDICAL HISTORY: HTN
Stroke [**2169**], had right sideded weakness that resolved after
several months of phys therapy.
Osteoarthritis
Macular degeneration

MEDICATION ON ADMISSION: prinovil
actonel
asa 325
anemia "mild"
supplements:  calcium, mag, lutein, likopeic?, Vit E, vit C,
iron, glucosamine chondroitin.

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: VITALS:  T 97.8 rectal, 172/79 (after 10mg IV labetolol), HR 74,
O2 sat 100% on mechanical ventilation.
GEN:  intubated and sedated
SKIN:  no rash, blood around nasopharynx/oropharynx
HEENT:  dry tongue, ETT in place
NECK: hard cervical collar in place
CHEST:  CTA bilat anteriorly
CV:  regular rate and rhythm without murmurs
ABD:  +BS, nontender, softly distended
EXTREM:  no edema

FAMILY HISTORY: Sister had a stroke, etiology unknown to family

SOCIAL HISTORY: PCP [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 1693**] [**Telephone/Fax (1) 57926**]
No tob/etoh/drugs.  Lives with husband and daughter.  Daughter
[**First Name8 (NamePattern2) **] [**Known lastname 6164**] is HCP [**Telephone/Fax (1) 57927**], [**Telephone/Fax (1) 57928**] (home).  DNR, not
DNI.  Retired ice cream scooper, quit 15 yrs ago. 

### Response:
{'Intracerebral hemorrhage,Accidental drowning and submersion while engaged in other sport or recreational activity without diving equipment,Hemiplegia, unspecified, affecting unspecified side,Pneumonia, organism unspecified,Paroxysmal ventricular tachycardia,Unspecified essential hypertension,Iron deficiency anemia, unspecified,Hypocalcemia'}
