CHIEF COMPLAINT: right upper lobe lung cancer

PRESENT ILLNESS: This is an 85 year old female who presented to [**Hospital1 18**] after a CXR
at [**Hospital 46**] rehab demonstrated a RUL mass.  A CT scan confirmed a
mass as well as pericardial adenopathy and an sooiciated RLL
nodule.  A bone scan showed increased uptake in her left hip.
She was admitted to the thoracic surgery service for work up of
her nodules.

MEDICAL HISTORY: A-fib, COPD, HTN, CHF, neuropathy, asthma, OA, depression

MEDICATION ON ADMISSION: duonebs, advair, ventolin, xalatan, coumadin, diovan, HCTZ,
colace, pravachol, singulair, vicodin, xanax

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: VS- 98.1, 51, 142/58, 18, 94% 3L
Gen- NAD
CV: S1S2, irregular
Resp: coarse rales b/l
Abd: soft, NT/ND
Ext: no c/c/e

FAMILY HISTORY: brother- breast CA, brother- brain CA, mother- cervical CA,
brother- stomach CA

SOCIAL HISTORY: 45 pack year smoker
Malignant neoplasm of upper lobe, bronchus or lung,Secondary and unspecified malignant neoplasm of intrathoracic lymph nodes,Chronic airway obstruction, not elsewhere classified,Secondary malignant neoplasm of bone and bone marrow,Pathologic fracture of neck of femur,Atrial fibrillation,Congestive heart failure, unspecified,Other pulmonary insufficiency, not elsewhere classified,Hip joint replacement,Unspecified hereditary and idiopathic peripheral neuropathy,Unspecified essential hypertension
Mal neo upper lobe lung,Mal neo lymph-intrathor,Chr airway obstruct NEC,Secondary malig neo bone,Path fx neck of femur,Atrial fibrillation,CHF NOS,Other pulmonary insuff,Joint replaced hip,Idio periph neurpthy NOS,Hypertension NOS
Admission Date:  [**2166-9-4**]              Discharge Date:   [**2166-9-8**]


Service: CARDIOTHORACIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 2969**]
Chief Complaint:
right upper lobe lung cancer

Major Surgical or Invasive Procedure:
bronchoscopy, needle aspiration


History of Present Illness:
This is an 85 year old female who presented to [**Hospital1 18**] after a CXR
at [**Hospital 46**] rehab demonstrated a RUL mass.  A CT scan confirmed a
mass as well as pericardial adenopathy and an sooiciated RLL
nodule.  A bone scan showed increased uptake in her left hip.
She was admitted to the thoracic surgery service for work up of
her nodules.

Past Medical History:
A-fib, COPD, HTN, CHF, neuropathy, asthma, OA, depression

Social History:
45 pack year smoker

Family History:
brother- breast CA, brother- brain CA, mother- cervical CA,
brother- stomach CA

Physical Exam:
VS- 98.1, 51, 142/58, 18, 94% 3L
Gen- NAD
CV: S1S2, irregular
Resp: coarse rales b/l
Abd: soft, NT/ND
Ext: no c/c/e

Pertinent Results:
[**2166-9-4**] 07:40PM BLOOD WBC-14.8* RBC-4.18* Hgb-10.7* Hct-32.8*
MCV-79* MCH-25.7* MCHC-32.7 RDW-16.7* Plt Ct-219
[**2166-9-6**] 03:17AM BLOOD WBC-19.7*# RBC-3.92* Hgb-10.1* Hct-30.8*
MCV-79* MCH-25.8* MCHC-32.8 RDW-16.5* Plt Ct-186
[**2166-9-4**] 07:40PM BLOOD PT-15.8* PTT-25.1 INR(PT)-1.4*
[**2166-9-4**] 07:40PM BLOOD Glucose-99 UreaN-21* Creat-0.6 Na-139
K-4.0 Cl-105 HCO3-25 AnGap-13

Brief Hospital Course:
This is an 85 year old female who was admitted on [**2166-9-4**] for
workup of a right sided lung nodule.  A CT scan demonstrated
extensive mediastinal and bilateral hilar lymphadenopathy with
the cavitary spiculated lesion in the right upper lobe and a
second spiculated lesion in the right middle lobe. There was
also  a right pleural effusion and a small pericardial effusion.
 Geriatrics was consulted.  Orthopedics was consulted for a left
minimally displaced femoral greater trochanter fracture,
possibly due to metastatic disease.  A bronchoscopy was done HD
2, as well as needle aspiration.  NSCLC was suspected.  She
desaturated later that night, but she is DNR/DNI.  After
extensive discussion with her family, the desicion was made to
refrain from further intervention and control her pain only.  On
HD 4, a morphine dripe oversedated her.  MS contin was started
with some success.  On HD 5, she was discharged to hospice.


Medications on Admission:
duonebs, advair, ventolin, xalatan, coumadin, diovan, HCTZ,
colace, pravachol, singulair, vicodin, xanax

Discharge Medications:
1. Morphine Concentrate 20 mg/mL Solution Sig: 5-20 mg PO Q 2hrs
PRN as needed for pain: disp 30 ml.
Disp:*30 ml* Refills:*2*
2. Ativan 0.5 mg Tablet Sig: One (1) Tablet PO Q 4 hrs PRN.
Disp:*12 Tablet(s)* Refills:*2*
3. Albuterol Sulfate 0.083 % Solution Sig: One (1)  Inhalation
Q6H (every 6 hours) as needed.
Disp:*1 inhaler* Refills:*2*
4. Ipratropium Bromide 0.02 % Solution Sig: [**12-23**]  Inhalation Q6H
(every 6 hours).
Disp:*1 inhaler* Refills:*2*
5. Fluticasone-Salmeterol 100-50 mcg/Dose Disk with Device Sig:
[**12-23**] Disk with Devices Inhalation [**Hospital1 **] (2 times a day).
Disp:*1 Disk with Device(s)* Refills:*2*
6. Morphine 2 mg/mL Syringe Sig: [**12-23**]  Injection Q2H (every 2
hours) as needed: breakthrough pain.
Disp:*30 ml* Refills:*2*


Discharge Disposition:
Extended Care

Facility:
[**Last Name (un) 14710**] House (Hospice Home) - [**Location (un) 620**]

Discharge Diagnosis:
right sided lung cancer


Discharge Condition:
terminal


Discharge Instructions:
Please discharge patient to Hospice

Followup Instructions:
Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 2038**], MD Phone:[**Telephone/Fax (1) 22**]
Date/Time:[**2167-3-18**] 11:00



Completed by:[**2166-9-8**]
{'Malignant neoplasm of upper lobe, bronchus or lung,Secondary and unspecified malignant neoplasm of intrathoracic lymph nodes,Chronic airway obstruction, not elsewhere classified,Secondary malignant neoplasm of bone and bone marrow,Pathologic fracture of neck of femur,Atrial fibrillation,Congestive heart failure, unspecified,Other pulmonary insufficiency, not elsewhere classified,Hip joint replacement,Unspecified hereditary and idiopathic peripheral neuropathy,Unspecified essential hypertension'}


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: right upper lobe lung cancer

PRESENT ILLNESS: This is an 85 year old female who presented to [**Hospital1 18**] after a CXR
at [**Hospital 46**] rehab demonstrated a RUL mass.  A CT scan confirmed a
mass as well as pericardial adenopathy and an sooiciated RLL
nodule.  A bone scan showed increased uptake in her left hip.
She was admitted to the thoracic surgery service for work up of
her nodules.

MEDICAL HISTORY: A-fib, COPD, HTN, CHF, neuropathy, asthma, OA, depression

MEDICATION ON ADMISSION: duonebs, advair, ventolin, xalatan, coumadin, diovan, HCTZ,
colace, pravachol, singulair, vicodin, xanax

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: VS- 98.1, 51, 142/58, 18, 94% 3L
Gen- NAD
CV: S1S2, irregular
Resp: coarse rales b/l
Abd: soft, NT/ND
Ext: no c/c/e

FAMILY HISTORY: brother- breast CA, brother- brain CA, mother- cervical CA,
brother- stomach CA

SOCIAL HISTORY: 45 pack year smoker 

### Response:
{'Malignant neoplasm of upper lobe, bronchus or lung,Secondary and unspecified malignant neoplasm of intrathoracic lymph nodes,Chronic airway obstruction, not elsewhere classified,Secondary malignant neoplasm of bone and bone marrow,Pathologic fracture of neck of femur,Atrial fibrillation,Congestive heart failure, unspecified,Other pulmonary insufficiency, not elsewhere classified,Hip joint replacement,Unspecified hereditary and idiopathic peripheral neuropathy,Unspecified essential hypertension'}
