CHIEF COMPLAINT: coma

PRESENT ILLNESS: 75yo woman w HO HTN was in her USOH i.e., fully functional and
parttime employed until 9pm [**2146-11-1**] when the son talked to her
on the phone. THis AM, son called her and she did not respond.
At noon the family went to her place and found her unresponsive
incontinent for stool and urine. Did not move her right side. TX
to our ED.
Of note she had been seen by a neurologist for right sided
"tingling" in the last months. They say, pt had a brain MRI as
well but the family is unable to provide more info.

MEDICAL HISTORY: HTN
Tingling right arm?

MEDICATION ON ADMISSION: ASA
Cozaar
Amitriptilin
alprazolam
atenolol

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Vitals: 98, 187/108, 18, 99% intubated
Breathes over the vent.

FAMILY HISTORY: not able to be obtained

SOCIAL HISTORY: Lives alone.
Smoking: none
ETOH: rare
Illicit drugs: none
Intracerebral hemorrhage,Urinary tract infection, site not specified,Alkalosis,Other convulsions,Osteoporosis, unspecified,Unspecified essential hypertension,Pure hypercholesterolemia
Intracerebral hemorrhage,Urin tract infection NOS,Alkalosis,Convulsions NEC,Osteoporosis NOS,Hypertension NOS,Pure hypercholesterolem
Admission Date:  [**2145-12-3**]              Discharge Date:   [**2145-12-7**]

Date of Birth:  [**2070-2-19**]             Sex:   F

Service: NEUROLOGY

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 5868**]
Chief Complaint:
coma

Major Surgical or Invasive Procedure:
made CMO

History of Present Illness:
75yo woman w HO HTN was in her USOH i.e., fully functional and
parttime employed until 9pm [**2146-11-1**] when the son talked to her
on the phone. THis AM, son called her and she did not respond.
At noon the family went to her place and found her unresponsive
incontinent for stool and urine. Did not move her right side. TX
to our ED.
Of note she had been seen by a neurologist for right sided
"tingling" in the last months. They say, pt had a brain MRI as
well but the family is unable to provide more info.


Past Medical History:
HTN
Tingling right arm?


Social History:
Lives alone.
Smoking: none
ETOH: rare
Illicit drugs: none


Family History:
not able to be obtained

Physical Exam:
Vitals: 98, 187/108, 18, 99% intubated
Breathes over the vent.

HEENT: The neck feels supple. Hard to appreciate any carotid
bruits.
Pulmonary: Clear to auscultation bilaterally, no crackles or
wheezes.
Cardiovascular: Regular rate and rhythm
Abdomen: soft, non-tender, non-distended, negative bowel sounds.

MENTAL STATUS
GCS: 6
eyes   (none)
verbal (none)
motor  (localizes)

CRANIAL NERVES:
Corneal reflex present on the left. Eye position midline. Pupils
are equal in size (3mm) and react directly and indirectly to
light. Nystagmus not present. Conjugated deviation is not
present. Oculocephalic testing not done due to neck in collar.

MOTOR:
Tone- both side hypertonic. Responds w localization w the left
but on the right only withdraws the leg and moves the arm away
from the stimulus weakly.

SENSATION:
As above

REFLEXES:
Right brisker. Present on the rest of the joints.

TOES:
Equivocal


Pertinent Results:
[**2145-12-3**] 07:50PM   TYPE-ART TEMP-38.9 RATES-/14 TIDAL VOL-500
PO2-553* PCO2-42 PH-7.42 TOTAL CO2-28 BASE XS-3
INTUBATED-INTUBATED VENT-CONTROLLED
[**2145-12-3**] 02:30PM URINE  COLOR-Straw APPEAR-Cloudy SP [**Last Name (un) 155**]-1.014
[**2145-12-3**] 02:30PM URINE  BLOOD-LG NITRITE-NEG PROTEIN-500
GLUCOSE-NEG KETONE-15 BILIRUBIN-NEG UROBILNGN-NEG PH-6.5
LEUK-NEG
[**2145-12-3**] 02:30PM URINE  RBC-[**4-29**]* WBC-[**1-22**] BACTERIA-MANY
YEAST-NONE EPI-<1
[**2145-12-3**] 02:11PM   GLUCOSE-172* UREA N-20 CREAT-0.7 SODIUM-138
POTASSIUM-5.3* CHLORIDE-99 TOTAL CO2-24 ANION GAP-20
[**2145-12-3**] 02:11PM   CK(CPK)-424*
[**2145-12-3**] 02:11PM   cTropnT-<0.01
[**2145-12-3**] 02:11PM   CK-MB-10 MB INDX-2.4
[**2145-12-3**] 02:11PM   CALCIUM-9.8 PHOSPHATE-3.8 MAGNESIUM-1.7
[**2145-12-3**] 02:11PM   WBC-11.0 RBC-4.31 HGB-14.1 HCT-40.5 MCV-94
MCH-32.7* MCHC-34.8 RDW-12.9
[**2145-12-3**] 02:11PM   NEUTS-70 BANDS-19* LYMPHS-7* MONOS-4 EOS-0
BASOS-0 ATYPS-0 METAS-0 MYELOS-0
[**2145-12-3**] 02:11PM   HYPOCHROM-NORMAL ANISOCYT-NORMAL
POIKILOCY-NORMAL MACROCYT-NORMAL MICROCYT-NORMAL
POLYCHROM-NORMAL
[**2145-12-3**] 02:11PM   PLT COUNT-296
[**2145-12-3**] 02:11PM   PT-13.0 PTT-23.5 INR(PT)-1.1

[**2145-12-3**] NCHCT:  large left temporal, parietal, and occipital
intraparenchymal hemorrhage, with extension into the ventricles
and midline shift with prominence of the right lateral
ventricles.

[**2145-12-5**] NCHCT:  1. No change in the degree of extensive
intraparenchymal and subarachnoid hemorrhage compared to the
prior study.
2. Slight increase in the amount of surrounding edema and
subfalcine and uncal herniation, left-to-right.

Brief Hospital Course:
Mrs. [**Known lastname 104190**] was admitted to the neuro ICU for management of
the intracerebral hemorrhage.  She was started on mannitol for
impending herniation, and antibiotics for UTI, dilantin for
seizure prophylaxis, and antihypertensives for BP control.
Despite interventions, she continued to decline, and after
multiple family discussions regarding the patient's wishes, she
was made comfort measures only and died shortly afterwards.

Medications on Admission:
ASA
Cozaar
Amitriptilin
alprazolam
atenolol


Discharge Medications:
deceased

Discharge Disposition:
Expired

Discharge Diagnosis:
deceased

Discharge Condition:
deceased

Discharge Instructions:
deceased

Followup Instructions:
deceased
{'Intracerebral hemorrhage,Urinary tract infection, site not specified,Alkalosis,Other convulsions,Osteoporosis, unspecified,Unspecified essential hypertension,Pure hypercholesterolemia'}


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: coma

PRESENT ILLNESS: 75yo woman w HO HTN was in her USOH i.e., fully functional and
parttime employed until 9pm [**2146-11-1**] when the son talked to her
on the phone. THis AM, son called her and she did not respond.
At noon the family went to her place and found her unresponsive
incontinent for stool and urine. Did not move her right side. TX
to our ED.
Of note she had been seen by a neurologist for right sided
"tingling" in the last months. They say, pt had a brain MRI as
well but the family is unable to provide more info.

MEDICAL HISTORY: HTN
Tingling right arm?

MEDICATION ON ADMISSION: ASA
Cozaar
Amitriptilin
alprazolam
atenolol

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Vitals: 98, 187/108, 18, 99% intubated
Breathes over the vent.

FAMILY HISTORY: not able to be obtained

SOCIAL HISTORY: Lives alone.
Smoking: none
ETOH: rare
Illicit drugs: none 

### Response:
{'Intracerebral hemorrhage,Urinary tract infection, site not specified,Alkalosis,Other convulsions,Osteoporosis, unspecified,Unspecified essential hypertension,Pure hypercholesterolemia'}
