CHIEF COMPLAINT: Pedestrian struck

PRESENT ILLNESS: Ms. [**Known lastname 37173**] is a 33 year old female who was struck from behind
by a motor vehicle while getting into her car.  She was
medflighted to [**Hospital1 18**] for further evaluation.

MEDICAL HISTORY: 1. Crohn's disease with perianal fistuals s/p surgery, disease
in TI and cecum, 14 years of disease
-[**2131**] with ileosigmoid fistual
-s/p colectomy
-admitted in [**2141**] for flare, txt w/ steroids c/b
anxiety/pressured speech with resolved
-25 cm stricture and sessile poly on c-scope at [**Hospital1 1474**]
2. WPW s/p ablation [**48**] years ago at [**Hospital1 336**], Dr [**Last Name (STitle) 7047**]
3. Osteopenia on bone scan
4. Glucose intolerance

MEDICATION ON ADMISSION: Toprol 100mg daily
Pentaz 6 tabs [**Hospital1 **]
Flagyl
Prilosec
Ambien
Klonopin
Cipro

ALLERGIES: Codeine / Compazine / Zantac / Hydromorphone

PHYSICAL EXAM: BP:134/71  HR:112  RR:13  GCS:15
Awake, alert
CTA b/l
RRR
S/NT/ND
LLE: + ecchymosis in hip area,
     NVI distally
superficial abrasions BLE

FAMILY HISTORY: 1. Father- DM2
2. Breast and ovarian cancer on maternal side

SOCIAL HISTORY: RN unable to work [**3-19**] to disease
Closed unspecified fracture of pelvis,Closed fracture of lumbar vertebra without mention of spinal cord injury,Concussion with loss of consciousness of unspecified duration,Unspecified intestinal obstruction,Regional enteritis of unspecified site,Open wound of forehead, without mention of complication,Motor vehicle traffic accident involving collision with pedestrian injuring pedestrian,Other disorders of muscle, ligament, and fascia,Anemia, unspecified
Pelvic fracture NOS-clos,Fx lumbar vertebra-close,Concussion w coma NOS,Intestinal obstruct NOS,Regional enteritis NOS,Open wound of forehead,Mv coll w pedest-pedest,Muscle/ligament dis NEC,Anemia NOS
Admission Date:  [**2145-6-17**]              Discharge Date:   [**2145-7-15**]

Date of Birth:  [**2112-2-29**]             Sex:   F

Service: ORTHOPAEDICS

Allergies:
Codeine / Compazine / Zantac / Hydromorphone

Attending:[**First Name3 (LF) 11415**]
Chief Complaint:
Pedestrian struck

Major Surgical or Invasive Procedure:
[**2145-6-17**]: Left femur traction pin placement
[**2145-6-21**]: ORIF Left anterior pelvis and iliac [**Doctor First Name 362**]
[**2145-6-24**]: ORIF Left posterior wall and column
[**2145-6-27**]: Facial sutures removed
[**2145-7-1**]: Left hip I&D with VAC placement
[**2145-7-2**]: VAC changed at bedside
[**2145-7-6**]: VAC removed
[**2145-7-14**]: Anterior staples removed
[**2145-7-14**]: PICC placement in interventional radiology

History of Present Illness:
Ms. [**Known lastname 37173**] is a 33 year old female who was struck from behind
by a motor vehicle while getting into her car.  She was
medflighted to [**Hospital1 18**] for further evaluation.

Past Medical History:
1. Crohn's disease with perianal fistuals s/p surgery, disease
in TI and cecum, 14 years of disease
-[**2131**] with ileosigmoid fistual
-s/p colectomy
-admitted in [**2141**] for flare, txt w/ steroids c/b
anxiety/pressured speech with resolved
-25 cm stricture and sessile poly on c-scope at [**Hospital1 1474**]
2. WPW s/p ablation [**48**] years ago at [**Hospital1 336**], Dr [**Last Name (STitle) 7047**]
3. Osteopenia on bone scan
4. Glucose intolerance


Social History:
RN unable to work [**3-19**] to disease


Family History:
1. Father- DM2
2. Breast and ovarian cancer on maternal side

Physical Exam:
BP:134/71  HR:112  RR:13  GCS:15
Awake, alert
CTA b/l
RRR
S/NT/ND
LLE: + ecchymosis in hip area,
     NVI distally
superficial abrasions BLE

Pertinent Results:
[**2145-7-12**] 05:10AM BLOOD WBC-7.5 RBC-3.75* Hgb-10.6* Hct-31.5*
MCV-84 MCH-28.3 MCHC-33.7 RDW-15.9* Plt Ct-358
[**2145-7-10**] 01:38PM BLOOD WBC-8.3 RBC-3.77* Hgb-10.7* Hct-31.4*
MCV-83 MCH-28.5 MCHC-34.2 RDW-16.0* Plt Ct-426
[**2145-7-8**] 04:42AM BLOOD WBC-7.5 RBC-3.69* Hgb-10.2* Hct-31.5*
MCV-85 MCH-27.6 MCHC-32.3 RDW-16.2* Plt Ct-511*
[**2145-7-10**] 01:38PM BLOOD Neuts-69.8 Lymphs-17.5* Monos-7.9
Eos-4.3* Baso-0.6
[**2145-7-12**] 05:10AM BLOOD Glucose-114* UreaN-4* Creat-0.6 Na-140
K-3.9 Cl-105 HCO3-30 AnGap-9
[**2145-6-17**] 01:25PM BLOOD ALT-36 AST-57* AlkPhos-49 Amylase-31
TotBili-0.2
[**2145-7-12**] 05:10AM BLOOD Calcium-8.7 Phos-3.9 Mg-1.7
[**2145-7-10**] 01:38PM BLOOD Calcium-8.7 Phos-3.6 Mg-1.7
[**2145-6-17**] 01:25PM BLOOD ASA-NEG Ethanol-NEG Acetmnp-NEG
Bnzodzp-NEG Barbitr-NEG Tricycl-NEG

Brief Hospital Course:
Ms. [**Known lastname 37173**] presented to the [**Hospital1 18**] on [**2145-6-17**] via medflighted.
She was evaluated by the trauma service and found to have a left
acetabular fracture.  Orthopedics evaluated the patient was
placed a femoral traction pin under conscious sedation in the
emergency room.  She was then brought to the TSICU for further
care and monitoring.  She was transfused one unit PRBC's and her
tetanus was updated.  She was found to have no other injuries
and she was transferred to the floor on the orthopedic service.
On [**2145-6-21**] she was prepped and brought to the operating room for
fixation of her left anterior pelvis and iliac [**Doctor First Name 362**] fractures.
She tolerated the procedure well.  On [**2145-6-23**] she was transfused
with 2 units of packed red blood cells due to post operative
anemia.  On [**2145-6-23**] the acute pain service was consulted for
recommendations in her pain management.  On [**2145-6-24**] she was
again taken to the operating room for the posterior wall and
column ORIF of her left acetabular.  She tolerated the procedure
well.  An NGT was placed in the operating room and it was
maintained on low wall suction.  On [**2145-6-27**] her facial sutures
were removed.  On [**2145-6-28**] she underwent an abdominal CT scan.
Her NGT was also removed and her diet was slowly advanced.  On
[**2145-7-1**] she returned to the operating room for a left hip
washout of her Merelli lesion.  A VAC was placed in the left hip
wound.  She was also placed on a KinAir bed for skin protection.
 On [**2145-7-2**] the VAC drain was changed at the bedside.  On
[**2145-7-6**] the VAC was removed at the bedside.  On [**2145-7-8**] her
prozac was restarted at her request.  A abdominal CT was done on
[**2145-7-10**] which showed no interval change.  On [**2145-7-14**] a PICC line
was placed in interventional radiology for long term
antibiotics.  The remainder of her hospital course was otherwise
without incident.  She was seen by physical and occupational
therapy to improve her strength and mobility through her
hospital stay.  Her labs and vitals remained stable.  Her pain
was well controlled.  She is being discharged today in stable
condition.

Medications on Admission:
Toprol 100mg daily
Pentaz 6 tabs [**Hospital1 **]
Flagyl
Prilosec
Ambien
Klonopin
Cipro

Discharge Medications:
1. Ancef 1 g Recon Soln Sig: Two (2) gm Injection every eight
(8) hours for 4 weeks.
2. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2)
Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed.
3. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30)
ML PO BID (2 times a day) as needed.
4. Senna 8.6 mg Tablet Sig: Two (2) Tablet PO BID (2 times a
day) as needed.
5. Diazepam 5 mg Tablet Sig: One (1) Tablet PO every eight (8)
hours as needed for muscle spasm.
6. Mesalamine 250 mg Capsule, Sustained Release Sig: Six (6)
Capsule, Sustained Release PO BID (2 times a day) as needed for
Chrons disease.
7. Oxycodone 40 mg Tablet Sustained Release 12 hr Sig: One (1)
Tablet Sustained Release 12 hr PO Q8H (every 8 hours).
8. Miconazole Nitrate 2 % Cream Sig: One (1) Appl Topical [**Hospital1 **] (2
times a day).
9. Ciprofloxacin 500 mg Tablet Sig: One (1) Tablet PO BID (2
times a day).
10. Metronidazole 500 mg Tablet Sig: One (1) Tablet PO BID (2
times a day).
11. Enoxaparin 40 mg/0.4 mL Syringe Sig: One (1) 40mg syringe
Subcutaneous DAILY (Daily) for 4 weeks.
12. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID
(2 times a day).
13. Fluoxetine 10 mg Capsule Sig: One (1) Capsule PO DAILY
(Daily).
14. Oxycodone 5 mg Tablet Sig: One (1) Tablet PO Q3H (every 3
hours) as needed.
15. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID
(2 times a day).
16. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One
(1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours).
17. Metoclopramide 10 mg Tablet Sig: One (1) Tablet PO Q6-8H
(every 6 to 8 hours) as needed.


Discharge Disposition:
Extended Care

Facility:
[**Hospital 5503**] Rehab hospital

Discharge Diagnosis:
1. Left pelvic/sacral/acetabular fracture
2. Transverse process fractures L2, L3, L4
3. Laceration to forehead (sutured)
4. Post operative anemia

Discharge Condition:
Stable

Discharge Instructions:
Please continue to be touchdown weight bearing on your left leg.

Continue your IV antibiotics for a total of 4 weeks as
instructed.

Keep your incision clean and dry, you may apply a dry sterile
dressing as needed for drainage or comfort

If you notice any increased redness, swelling, drainage,
report to the emergency room.

Please continue your lovenox injections for a total of 4 weeks.


You may resume any normal home medications.

Please follow up as below.  Call with any questions.
Physical Therapy:
Activity:  Activity as tolerated
 Right lower extremity:  Full weight bearing
 Left lower extremity:  Non weight bearing

Treatment Frequency:
You may apply a dry sterile dressing daily or as needed for
drainage or comfort

Followup Instructions:
Please follow up with Dr. [**Last Name (STitle) 37174**] at the [**Hospital1 18**] orthopedic
clinic next week.  Call [**Telephone/Fax (1) **] to make that appointment.

Provider: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 7167**], RD Phone:[**Telephone/Fax (1) 3681**]
Date/Time:[**2145-7-27**] 11:00
Provider: [**Name10 (NameIs) **] [**Name8 (MD) **], MD Phone:[**Telephone/Fax (1) 463**]
Date/Time:[**2145-11-30**] 1:00


                             [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 2235**] MD, [**MD Number(3) 11417**]

Completed by:[**2145-7-15**]
{'Closed unspecified fracture of pelvis,Closed fracture of lumbar vertebra without mention of spinal cord injury,Concussion with loss of consciousness of unspecified duration,Unspecified intestinal obstruction,Regional enteritis of unspecified site,Open wound of forehead, without mention of complication,Motor vehicle traffic accident involving collision with pedestrian injuring pedestrian,Other disorders of muscle, ligament, and fascia,Anemia, 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: Pedestrian struck

PRESENT ILLNESS: Ms. [**Known lastname 37173**] is a 33 year old female who was struck from behind
by a motor vehicle while getting into her car.  She was
medflighted to [**Hospital1 18**] for further evaluation.

MEDICAL HISTORY: 1. Crohn's disease with perianal fistuals s/p surgery, disease
in TI and cecum, 14 years of disease
-[**2131**] with ileosigmoid fistual
-s/p colectomy
-admitted in [**2141**] for flare, txt w/ steroids c/b
anxiety/pressured speech with resolved
-25 cm stricture and sessile poly on c-scope at [**Hospital1 1474**]
2. WPW s/p ablation [**48**] years ago at [**Hospital1 336**], Dr [**Last Name (STitle) 7047**]
3. Osteopenia on bone scan
4. Glucose intolerance

MEDICATION ON ADMISSION: Toprol 100mg daily
Pentaz 6 tabs [**Hospital1 **]
Flagyl
Prilosec
Ambien
Klonopin
Cipro

ALLERGIES: Codeine / Compazine / Zantac / Hydromorphone

PHYSICAL EXAM: BP:134/71  HR:112  RR:13  GCS:15
Awake, alert
CTA b/l
RRR
S/NT/ND
LLE: + ecchymosis in hip area,
     NVI distally
superficial abrasions BLE

FAMILY HISTORY: 1. Father- DM2
2. Breast and ovarian cancer on maternal side

SOCIAL HISTORY: RN unable to work [**3-19**] to disease 

### Response:
{'Closed unspecified fracture of pelvis,Closed fracture of lumbar vertebra without mention of spinal cord injury,Concussion with loss of consciousness of unspecified duration,Unspecified intestinal obstruction,Regional enteritis of unspecified site,Open wound of forehead, without mention of complication,Motor vehicle traffic accident involving collision with pedestrian injuring pedestrian,Other disorders of muscle, ligament, and fascia,Anemia, unspecified'}
