CHIEF COMPLAINT: S/P Fall with SAH

PRESENT ILLNESS: 87 y/of female with was celebrating her birthday yesterday at a
restaurant with her daughter and fell while stepping out of the
booth. The patient was on coumadin and became more lethargic
over the next 24 hours, not recognizing her daughters. Pt lives
with daughter, [**Name (NI) 6480**] since [**2182-1-4**] when family noticed pt
losing some short term
memory and confusing her pills.

MEDICAL HISTORY: Hypertension
Autonomic Failure
Recent Memory Loss
A-Fib
Dementia
Glaucoma
Hypothyroidism

MEDICATION ON ADMISSION: Exelon patch, Rythmolol, Sectrol, Captopril, Norvasc,
midrodrine, levoxyl, xalatan, alphagan, senna, mvi and e-mycin
eye drops

ALLERGIES: Penicillins / Phenytoin / Nitrofurantoin / Carbamazepine /
Naproxen

PHYSICAL EXAM: On admission
Pupils: [**1-4**]
Head: left temple abrasion/laceration, no hemotypanum
Neck: C-Collar in place
Abd: soft nontender
Cardiac: Regular no murmers
Neuro: Prefers eyes closed pupils [**1-4**], did not follow commands,
localizes bilaterally

FAMILY HISTORY: Non contributory

SOCIAL HISTORY: Widower lives with daughter
Other and unspecified cerebral laceration and contusion, without mention of open intracranial wound, with brief [less than one hour] loss of consciousness,Urinary tract infection, site not specified,Accidental fall from chair,Obstructive sleep apnea (adult)(pediatric),Other persistent mental disorders due to conditions classified elsewhere,Unspecified acquired hypothyroidism,Long-term (current) use of anticoagulants,Unspecified essential hypertension,Atrial fibrillation,Closed fracture of carpal bone, unspecified
Brain lac NEC-brief coma,Urin tract infection NOS,Fall from chair,Obstructive sleep apnea,Mental disor NEC oth dis,Hypothyroidism NOS,Long-term use anticoagul,Hypertension NOS,Atrial fibrillation,Fx carpal bone NOS-close
Admission Date:  [**2182-3-25**]              Discharge Date:   [**2182-3-29**]


Service: NEUROSURGERY

Allergies:
Penicillins / Phenytoin / Nitrofurantoin / Carbamazepine /
Naproxen

Attending:[**First Name3 (LF) 2724**]
Chief Complaint:
S/P Fall with SAH

Major Surgical or Invasive Procedure:
None


History of Present Illness:
87 y/of female with was celebrating her birthday yesterday at a
restaurant with her daughter and fell while stepping out of the
booth. The patient was on coumadin and became more lethargic
over the next 24 hours, not recognizing her daughters. Pt lives
with daughter, [**Name (NI) 6480**] since [**2182-1-4**] when family noticed pt
losing some short term
memory and confusing her pills.


Past Medical History:
Hypertension
Autonomic Failure
Recent Memory Loss
A-Fib
Dementia
Glaucoma
Hypothyroidism

Social History:
Widower lives with daughter

Family History:
Non contributory

Physical Exam:
On admission
Pupils: [**1-4**]
Head: left temple abrasion/laceration, no hemotypanum
Neck: C-Collar in place
Abd: soft nontender
Cardiac: Regular no murmers
Neuro: Prefers eyes closed pupils [**1-4**], did not follow commands,
localizes bilaterally


Pertinent Results:
[**2182-3-29**] 06:40AM BLOOD WBC-7.7 RBC-3.43* Hgb-10.6* Hct-30.7*
MCV-89 MCH-30.9 MCHC-34.5 RDW-14.2 Plt Ct-170
[**2182-3-29**] 06:40AM BLOOD Plt Ct-170
[**2182-3-25**] 09:20PM BLOOD Fibrino-424*
[**2182-3-29**] 06:40AM BLOOD Glucose-89 UreaN-24* Creat-0.7 Na-141
K-4.1 Cl-112* HCO3-20* AnGap-13
[**2182-3-25**] 09:20PM BLOOD Amylase-116*
[**2182-3-29**] 06:40AM BLOOD Calcium-8.1* Phos-2.0* Mg-2.3
[**2182-3-25**] 09:21PM BLOOD Glucose-150* Lactate-1.6 Na-141 K-4.1
Cl-102 calHCO3-21

Brief Hospital Course:
Mrs. [**Known lastname 43113**] was admitted to the ICU for two day was montored with
close neurological checks and follow up head CTs showed decrease
bilateral subarachnoid hemorrhage layering along the sulci,1.5
cm focus of right frontal intraparenchymal hemorrhage and mild
surrounding edema is also unchanged. She had an MRI due to
unusual right frontal bleed, which was negative for any tumor.
On [**3-27**] she was transferred the the floor each day he became
more awake though disorientated she would follow commands and
move all extremeties. She was diagnosed with a right wrist
fracture and was placed in a splint. On [**3-28**] she was noted to
have WBC increased fro 7.9-> 11.4 but was afebrile a UA showed a
UTI an she was started on a Bactrim. Her Exelon patch was dc'd
as family reported that her fall occurred shortly after starting
on that medication. On discharge she remained confused but would
follow commands, moving all extremities strongly.


Medications on Admission:
Exelon patch, Rythmolol, Sectrol, Captopril, Norvasc,
midrodrine, levoxyl, xalatan, alphagan, senna, mvi and e-mycin
eye drops

Discharge Disposition:
Extended Care

Facility:
[**Hospital3 1107**] [**Hospital **] Hospital - [**Location (un) 38**]

Discharge Diagnosis:
SAH s/p fall
Left wrist fracture


Discharge Condition:
Neurologically stable


Discharge Instructions:
CALL YOUR SURGEON IMMEDIATELY IF YOU EXPERIENCE ANY OF THE
FOLLOWING:

??????	New onset of tremors or seizures
??????	Any confusion or change in mental status
??????	Any numbness, tingling, weakness in your extremities
??????	Pain or headache that is continually increasing or not
relieved by pain medication
??????	Any signs of infection at the wound site: redness, swelling,
tenderness, drainage
??????	Fever greater than or equal to 101?????? F


Followup Instructions:
Please follow up with Orthopaedics, Dr. [**Last Name (STitle) **] on [**2182-4-11**], call
[**Telephone/Fax (1) 2007**] for an appointment
Follow up with Dr [**Last Name (STitle) 548**] in 4 weeks with a head CT call
[**Telephone/Fax (1) 2992**] for an appointment
{'Other and unspecified cerebral laceration and contusion, without mention of open intracranial wound, with brief [less than one hour] loss of consciousness,Urinary tract infection, site not specified,Accidental fall from chair,Obstructive sleep apnea (adult)(pediatric),Other persistent mental disorders due to conditions classified elsewhere,Unspecified acquired hypothyroidism,Long-term (current) use of anticoagulants,Unspecified essential hypertension,Atrial fibrillation,Closed fracture of carpal bone, unspecified'}


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: S/P Fall with SAH

PRESENT ILLNESS: 87 y/of female with was celebrating her birthday yesterday at a
restaurant with her daughter and fell while stepping out of the
booth. The patient was on coumadin and became more lethargic
over the next 24 hours, not recognizing her daughters. Pt lives
with daughter, [**Name (NI) 6480**] since [**2182-1-4**] when family noticed pt
losing some short term
memory and confusing her pills.

MEDICAL HISTORY: Hypertension
Autonomic Failure
Recent Memory Loss
A-Fib
Dementia
Glaucoma
Hypothyroidism

MEDICATION ON ADMISSION: Exelon patch, Rythmolol, Sectrol, Captopril, Norvasc,
midrodrine, levoxyl, xalatan, alphagan, senna, mvi and e-mycin
eye drops

ALLERGIES: Penicillins / Phenytoin / Nitrofurantoin / Carbamazepine /
Naproxen

PHYSICAL EXAM: On admission
Pupils: [**1-4**]
Head: left temple abrasion/laceration, no hemotypanum
Neck: C-Collar in place
Abd: soft nontender
Cardiac: Regular no murmers
Neuro: Prefers eyes closed pupils [**1-4**], did not follow commands,
localizes bilaterally

FAMILY HISTORY: Non contributory

SOCIAL HISTORY: Widower lives with daughter 

### Response:
{'Other and unspecified cerebral laceration and contusion, without mention of open intracranial wound, with brief [less than one hour] loss of consciousness,Urinary tract infection, site not specified,Accidental fall from chair,Obstructive sleep apnea (adult)(pediatric),Other persistent mental disorders due to conditions classified elsewhere,Unspecified acquired hypothyroidism,Long-term (current) use of anticoagulants,Unspecified essential hypertension,Atrial fibrillation,Closed fracture of carpal bone, unspecified'}
