CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 49-year-old
female, MICU call out with history of gestational diabetes
[**Hospital **] transferred from outside hospital with DKA and
sepsis.  The patient was admitted on [**2122-6-7**].  There she
recalled a history of virus and three days of nausea and
vomiting with black material and vomitus.  At outside
hospital patient had dry mucus membranes and found to be
lethargic and tachycardic with O2 sat decreased to 89% on
room air.  Head CT with old infarct, negative chest x-ray,
blood glucose 765.  At outside hospital had atrial
fibrillation and started on Diltiazem drip and converted to
normal sinus rhythm.  Blood cultures were positive for gram
negative rods.  Patient started on antibiotics and
Ceftazidime and Cipro and continued on insulin and Diltiazem
drip.  The patient was also found to have pyelonephritis as
source of the gram negative rods.  Cultures initially grew
out Enterobacter sensitive to Cipro.  Insulin drip was
discontinued on [**6-8**], as was Diltiazem drip.

MEDICAL HISTORY: Gestational diabetes 7 years ago.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: Not applicable.

SOCIAL HISTORY: Positive tobacco use, married.
Acute pyelonephritis without lesion of renal medullary necrosis,Other specified bacterial infections in conditions classified elsewhere and of unspecified site, other gram-negative organisms,Diabetes with ketoacidosis, type II or unspecified type, not stated as uncontrolled,Atrial fibrillation,Candidiasis of vulva and vagina
Ac pyelonephritis NOS,Oth gram negatv bacteria,DMII keto nt st uncntrld,Atrial fibrillation,Candidal vulvovaginitis
Admission Date:  [**2122-6-7**]     Discharge Date:  [**2122-6-12**]

Date of Birth:   [**2072-6-13**]     Sex:  F

Service:

HISTORY OF PRESENT ILLNESS:  The patient is a 49-year-old
female, MICU call out with history of gestational diabetes
[**Hospital **] transferred from outside hospital with DKA and
sepsis.  The patient was admitted on [**2122-6-7**].  There she
recalled a history of virus and three days of nausea and
vomiting with black material and vomitus.  At outside
hospital patient had dry mucus membranes and found to be
lethargic and tachycardic with O2 sat decreased to 89% on
room air.  Head CT with old infarct, negative chest x-ray,
blood glucose 765.  At outside hospital had atrial
fibrillation and started on Diltiazem drip and converted to
normal sinus rhythm.  Blood cultures were positive for gram
negative rods.  Patient started on antibiotics and
Ceftazidime and Cipro and continued on insulin and Diltiazem
drip.  The patient was also found to have pyelonephritis as
source of the gram negative rods.  Cultures initially grew
out Enterobacter sensitive to Cipro.  Insulin drip was
discontinued on [**6-8**], as was Diltiazem drip.

PAST MEDICAL HISTORY:  Gestational diabetes 7 years ago.

ALLERGIES:  No known drug allergies.

TRANSFER MEDICATIONS:  Ciprofloxacin 400 mg IV bid, Protonix
40 mg q d, Insulin 35 units q a.m., 17 units q p.m., Diflucan
100 mg q d, subcutaneous Heparin, Magnesium Oxide 400 mg [**Hospital1 **],
Neutra-Phos 2 tid, Regular insulin sliding scale.

SOCIAL HISTORY:  Positive tobacco use, married.

FAMILY HISTORY:  Not applicable.

PHYSICAL EXAMINATION:  (On admission) Temperature 99, heart
rate 96-103, blood pressure 120/59-68, O2 saturation 96-98%.
General appearance, pleasant but groggy female in no apparent
distress.  HEENT:  Normocephalic, atraumatic, moist mucus
membranes.  Pupils are equal, round, and reactive to light
and accommodation, extraocular movements intact.  Heart,
regular rate and rhythm, negative murmurs, rubs or gallops.
Lungs, clear to auscultation bilaterally.  Abdomen, soft,
nontender, non distended, normoactive bowel sounds.
Extremities, no clubbing, cyanosis or edema.  Pulses 2+ DP.
Neuro, alert and oriented times three.  Cranial nerves II
through XII intact.

LABORATORY DATA:  Radiology: [**6-8**], head CT negative for
bleed.  Abdominal CT positive bilateral pyelonephritis.
Chest x-ray times two negative.

HOSPITAL COURSE:  The patient is a 49-year-old female with
past medical history significant for gestational diabetes
mellitus, presenting in DKA.  The patient was transferred
from the MICU in stable condition status post resolved
hypernatremia, gram negative rod sepsis due to Enterobacter
aerogens and bilateral pyelonephritis.  While on medical
floor, the patient was scheduled for diabetes education from
the learning center/[**Hospital **] Clinic.  The patient's
Ciprofloxacin was converted to po.  Her Protonix was
continued and PT evaluated her and deemed her safe for
discharge to home.  On [**2122-6-12**] the patient was very much more
improved, tolerating increased po intake and ambulating,
vital signs were stable and she was afebrile on po Cipro.
The patient will follow-up with an appointment with [**Hospital **]
Clinic in [**1-18**] weeks.  The patient will also follow-up with
her PCP in one week, Dr. [**Last Name (STitle) 12167**].  The patient was discharged
to home on [**2122-6-12**].

CONDITION ON DISCHARGE:  Stable.

DISCHARGE DIAGNOSIS:
1.  DKA.
2.  Pyelonephritis.

DISCHARGE MEDICATIONS:  Lipitor 10 mg po q d, Ciprofloxacin
500 mg po q d times 14 days, Diflucan 100 mg po q d times
three days, Protonix 40 mg po q d, Insulin NPH 28 units q
a.m., 14 units q p.m. and Regular insulin sliding scale.




                      [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 3090**], M.D.  [**MD Number(1) 3091**]

Dictated By:[**Last Name (NamePattern1) 1183**]

MEDQUIST36

D:  [**2122-8-27**]  14:59
T:  [**2122-9-1**]  13:35
JOB#:  [**Job Number 35125**]
{'Acute pyelonephritis without lesion of renal medullary necrosis,Other specified bacterial infections in conditions classified elsewhere and of unspecified site, other gram-negative organisms,Diabetes with ketoacidosis, type II or unspecified type, not stated as uncontrolled,Atrial fibrillation,Candidiasis of vulva and vagina'}


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 49-year-old
female, MICU call out with history of gestational diabetes
[**Hospital **] transferred from outside hospital with DKA and
sepsis.  The patient was admitted on [**2122-6-7**].  There she
recalled a history of virus and three days of nausea and
vomiting with black material and vomitus.  At outside
hospital patient had dry mucus membranes and found to be
lethargic and tachycardic with O2 sat decreased to 89% on
room air.  Head CT with old infarct, negative chest x-ray,
blood glucose 765.  At outside hospital had atrial
fibrillation and started on Diltiazem drip and converted to
normal sinus rhythm.  Blood cultures were positive for gram
negative rods.  Patient started on antibiotics and
Ceftazidime and Cipro and continued on insulin and Diltiazem
drip.  The patient was also found to have pyelonephritis as
source of the gram negative rods.  Cultures initially grew
out Enterobacter sensitive to Cipro.  Insulin drip was
discontinued on [**6-8**], as was Diltiazem drip.

MEDICAL HISTORY: Gestational diabetes 7 years ago.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: Not applicable.

SOCIAL HISTORY: Positive tobacco use, married. 

### Response:
{'Acute pyelonephritis without lesion of renal medullary necrosis,Other specified bacterial infections in conditions classified elsewhere and of unspecified site, other gram-negative organisms,Diabetes with ketoacidosis, type II or unspecified type, not stated as uncontrolled,Atrial fibrillation,Candidiasis of vulva and vagina'}
