CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 61-year-old
man, recently discharged from [**Hospital1 188**] on [**2145-1-22**], who had an episodic asymptomatic
hypoglycemia that was incidentally discovered in [**Month (only) 547**].  The
patient suffered a cerebrovascular accident on [**2144-6-13**] with
right hemiparesis.  He was told he suffered from diabetes,
but no glucose levels or hemoglobin A1c values were
available.  The patient was evaluated for a stroke on [**2144-7-20**].  During the hospital stay, his hemoglobin A1c was 6.4%
(normal is less than 5).  The patient began checking finger
sticks at home, which were normal early in the morning, and
usually they were in the 40s by the late morning.  He was
always asymptomatic during these episodes.  The patient
reports a weight loss of approximately 15 pounds since [**2144-5-17**].

MEDICAL HISTORY: Hypertension, dyslipidemia, left
middle artery division stroke/left basal ganglion internal
capsule with residual right hemiparesis in [**2144-5-17**].

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Neoplasm of uncertain behavior of other and unspecified digestive organs,Other and unspecified hyperlipidemia,Unspecified essential hypertension,Late effects of cerebrovascular disease, hemiplegia affecting unspecified side
Unc behav neo GI NEC,Hyperlipidemia NEC/NOS,Hypertension NOS,Late ef-hemplga side NOS
Admission Date:  [**2145-2-19**]       Discharge Date:  [**2119-4-17**]

Date of Birth:   [**2083-5-2**]       Sex:  M

Service:  GEN [**Doctor First Name 147**]

HISTORY OF PRESENT ILLNESS:   The patient is a 61-year-old
man, recently discharged from [**Hospital1 188**] on [**2145-1-22**], who had an episodic asymptomatic
hypoglycemia that was incidentally discovered in [**Month (only) 547**].  The
patient suffered a cerebrovascular accident on [**2144-6-13**] with
right hemiparesis.  He was told he suffered from diabetes,
but no glucose levels or hemoglobin A1c values were
available.  The patient was evaluated for a stroke on [**2144-7-20**].  During the hospital stay, his hemoglobin A1c was 6.4%
(normal is less than 5).  The patient began checking finger
sticks at home, which were normal early in the morning, and
usually they were in the 40s by the late morning.  He was
always asymptomatic during these episodes.  The patient
reports a weight loss of approximately 15 pounds since [**2144-5-17**].

On [**2144-10-3**], his serum glucose was 56, C-peptide 3.1,
and insulin 36, hemoglobin A1c of 5.6%.  On [**1-5**], the
patient's wife found him sitting in front of his lunch,
staring ahead, unresponsive to verbal stimuli.  The patient
was taken to [**Hospital3 1280**] Emergency Department and was found to
have a [**Hospital3 **] sugar of 16.  Further workup revealed a glucose
of 93, an insulin of 17, and pro-insulin of 4.2.  He was
negative for insulin antibodies.  Prolactin level was 9.7.
Urine panel was negative.  Chest x-ray was normal.

The patient had a CT done on [**2-4**] that showed a 1.3 x
1.4 cm pancreatic mass at the tail, hypervascular lesion.
There were no metastases.

PAST MEDICAL HISTORY:   Hypertension, dyslipidemia, left
middle artery division stroke/left basal ganglion internal
capsule with residual right hemiparesis in [**2144-5-17**].

MEDICATIONS:   Aspirin 325 mg once daily, Norvasc 5 mg once
daily, Lipitor 10 mg once daily, folate 1 mg by mouth once
daily, Trazodone 25 mg by mouth daily at bedtime, Detrol LA 4
mg by mouth once daily.

ALLERGIES:   No known drug allergies.

PHYSICAL EXAMINATION:   Pulse 92, [**Year (4 digits) **] pressure 164/78.  The
chest was clear to auscultation, with decreased breath sounds
at the bases.  Cardiac was regular rate and rhythm, S1, S2.
He was obese, soft, nontender, positive bowel sounds, no
bruit.  The right lower extremity was in a brace.  The
dorsalis pedis pulses were palpable bilaterally.

HOSPITAL COURSE:   The patient was found to have insulinoma
and underwent a distal pancreatectomy and splenectomy with
intraoperative ultrasound on [**2145-2-19**], by Dr. [**Last Name (STitle) 1305**]
and Dr. [**Last Name (STitle) 22214**].  Please see operative note for further
details.  Postoperatively, the patient went without
complications.  Postoperative hematocrit was 40.4.  Sodium
was 138, potassium 3.9.  The patient's finger sticks were
within normal limits throughout the hospital stay.

Urinalysis on postoperative day two revealed trace glucose,
15 ketones.  The patient was treated for pain with epidural.
On postoperative day three, the patient was started on
clears, had bowel sounds.  The nasogastric tube was removed.
He was advanced on diet as tolerated.  The patient started
oral intake, and was switched to oral pain medications.  The
epidural was clamped on [**2-23**], postoperative day four.
The patient tolerated clears. The epidural was removed.  The
[**Location (un) 1661**]-[**Location (un) 1662**] drain remained serosanguinous.  The Foley was
discontinued, and he was able to void.  He was taking a
regular diet.  The [**Location (un) 1661**]-[**Location (un) 1662**] amylase was 210.

The patient is to be discharged to rehabilitation, given his
cerebrovascular accident, difficulty ambulating and
difficulty with care of self.  Date of discharge and
rehabilitation placement are pending.  The patient received
his H. influenza and pneumococcal vaccines on [**2145-2-23**].  The patient, in hospital, was on heparin 5000
subcutaneously twice a day, Zantac 50 intravenously every
eight hours, insulin sliding scale, and percocet for pain.
The rest of this dictation is pending rehabilitation
placement.




                            [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 1306**], M.D.  [**MD Number(1) 1307**]

Dictated By:[**Name8 (MD) 6908**]
MEDQUIST36

D:  [**2145-2-23**]  23:43
T:  [**2145-2-24**]  00:30
JOB#:  [**Job Number 33381**]


Name: [**Known lastname 5842**],[**Known firstname 5843**]            Unit No: [**Unit Number 5844**]

Admission Date:  [**2145-2-24**]     Discharge Date:

Date of Birth:                  Sex:

Service:

ADDENDUM:  The patient left to rehabilitation.  There was no
change in medications.  The JP was removed on postoperative
day #5.  On the date of discharge, the JP amylase was 210.




                          [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 1255**], M.D.  [**MD Number(1) 1256**]

Dictated By:[**Name8 (MD) 3713**]

MEDQUIST36

D:  [**2145-2-24**]  12:57
T:  [**2145-2-24**]  13:04
JOB#:  [**Job Number 5845**]
{'Neoplasm of uncertain behavior of other and unspecified digestive organs,Other and unspecified hyperlipidemia,Unspecified essential hypertension,Late effects of cerebrovascular disease, hemiplegia affecting unspecified side'}


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 61-year-old
man, recently discharged from [**Hospital1 188**] on [**2145-1-22**], who had an episodic asymptomatic
hypoglycemia that was incidentally discovered in [**Month (only) 547**].  The
patient suffered a cerebrovascular accident on [**2144-6-13**] with
right hemiparesis.  He was told he suffered from diabetes,
but no glucose levels or hemoglobin A1c values were
available.  The patient was evaluated for a stroke on [**2144-7-20**].  During the hospital stay, his hemoglobin A1c was 6.4%
(normal is less than 5).  The patient began checking finger
sticks at home, which were normal early in the morning, and
usually they were in the 40s by the late morning.  He was
always asymptomatic during these episodes.  The patient
reports a weight loss of approximately 15 pounds since [**2144-5-17**].

MEDICAL HISTORY: Hypertension, dyslipidemia, left
middle artery division stroke/left basal ganglion internal
capsule with residual right hemiparesis in [**2144-5-17**].

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Neoplasm of uncertain behavior of other and unspecified digestive organs,Other and unspecified hyperlipidemia,Unspecified essential hypertension,Late effects of cerebrovascular disease, hemiplegia affecting unspecified side'}
