CHIEF COMPLAINT: Headache, nausea.

PRESENT ILLNESS: 50 year old male with known GBM diagnosed with biopsy by Dr.
[**Last Name (STitle) **] last year present with severe headache on the night of
[**1-12**], which was associated with nausea. He went to his radiation
appointment on [**1-13**] in the morning and was sent for a stat head
CT. The scan showed significant edema around the area of the
mass. His wife also reports that he has had difficulty with
depth perception recently. For example, when opening the cabinet
to get a coffee cup, he would hit his head on the cabinet door.
Similarly, he runs into polls that are right in front of him.
The patient was given 4 mg of decadron and sent to the ER.

MEDICAL HISTORY: 1. Recurrent left spontaneous pneumothoraces with left apical
blebs, s/p left upper lobe bleb resection, pleurodesis, and
sclerosis in [**2105**]; had post operative air leak requiring
exploratory thoracotomy
2. Right tension pneumothorax, s/p bullectomy with mechanical
pleurodesis in [**2108**]
3. Childhood strabismus, s/p multiple corrective procedures,
last
at age 14
4. Benign connective tissue nevus

MEDICATION ON ADMISSION: FIORICET - 50 mg-325 mg-40 mg Tablet - 1-2 Tablets by mouth q4-6
hrs as needed for for headaches. try not to take more than 2/day
DEXAMETHASONE - 4 mg Tablet by mouth three times a day
LEVETIRACETAM - 500 mg Tablet - 2 Tablet(s) by mouth twice daily
ZOFRAN - 8 mg Tablet - 1 Tablet(s) by mouth once a day take one
hour before Temodar
PROPRANOLOL - 60 mg Capsule,Sustained Action 24 hr - Start at
one
tab qD, then in 2 weeks increase up to 2 tabs qD if not enough
effect
SUMATRIPTAN SUCCINATE - 100 mg Tablet - 1 Tablets by mouth PRN
severe h/a take at onset of severe h/a. [**Month (only) 116**] repeat x 1 in 2 hrs
if not enough effect. Not to exceed 2 tabs in a 24 hr period
TEMOZOLOMIDE - 140 mg Capsule - 1 Capsule(s) by mouth once a day
take on empty stomach one hour before radiation. Take 7
days/week
IBUPROFEN - 200 mg Tablet - 2 Tablet(s) by mouth PRN

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: On Admission:
T:97.9  BP:138/96     HR:89    RR:14       O2Sats:100% RA
Gen: WD/WN, comfortable, NAD.
HEENT: Pupils:PERRL         EOMs-intact
Neck: Supple.
Lungs: CTA bilaterally.
Cardiac: RRR. S1/S2.
Abd: Soft, NT, BS+
Extrem: Warm and well-perfused.
Neuro:
Mental status: Awake and alert, cooperative with exam, normal
affect.
Orientation: Oriented to person, place, and date.
Language: Speech fluent with good comprehension and repetition.
Naming intact. No dysarthria or paraphasic errors.

FAMILY HISTORY: Son had a febrile seizure at age eight.  Has a niece with
generalized seizures, now ~age 27.   No stroke, hemorrhage, or
aneurysm.

SOCIAL HISTORY: Lives with wife and two children. Former smoker, 1-2 packs daily
for 10 years but quit years ago. He denies a history of illicit
drug use. He drinks "an occasional beer."
Malignant neoplasm of parietal lobe,Generalized convulsive epilepsy, without mention of intractable epilepsy,Cerebral edema,Anxiety state, unspecified
Mal neo parietal lobe,Gen cnv epil w/o intr ep,Cerebral edema,Anxiety state NOS
Admission Date:  [**2122-1-13**]              Discharge Date:   [**2122-1-19**]

Date of Birth:  [**2071-3-22**]             Sex:   M

Service: NEUROSURGERY

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 3227**]
Chief Complaint:
Headache, nausea.

Major Surgical or Invasive Procedure:
[**2122-1-15**]: Right sided craniotomy for mass resection


History of Present Illness:
50 year old male with known GBM diagnosed with biopsy by Dr.
[**Last Name (STitle) **] last year present with severe headache on the night of
[**1-12**], which was associated with nausea. He went to his radiation
appointment on [**1-13**] in the morning and was sent for a stat head
CT. The scan showed significant edema around the area of the
mass. His wife also reports that he has had difficulty with
depth perception recently. For example, when opening the cabinet
to get a coffee cup, he would hit his head on the cabinet door.
Similarly, he runs into polls that are right in front of him.
The patient was given 4 mg of decadron and sent to the ER.

Past Medical History:
1. Recurrent left spontaneous pneumothoraces with left apical
blebs, s/p left upper lobe bleb resection, pleurodesis, and
sclerosis in [**2105**]; had post operative air leak requiring
exploratory thoracotomy
2. Right tension pneumothorax, s/p bullectomy with mechanical
pleurodesis in [**2108**]
3. Childhood strabismus, s/p multiple corrective procedures,
last
at age 14
4. Benign connective tissue nevus


Social History:
Lives with wife and two children. Former smoker, 1-2 packs daily
for 10 years but quit years ago. He denies a history of illicit
drug use. He drinks "an occasional beer."

Family History:
Son had a febrile seizure at age eight.  Has a niece with
generalized seizures, now ~age 27.   No stroke, hemorrhage, or
aneurysm.


Physical Exam:
On Admission:
T:97.9  BP:138/96     HR:89    RR:14       O2Sats:100% RA
Gen: WD/WN, comfortable, NAD.
HEENT: Pupils:PERRL         EOMs-intact
Neck: Supple.
Lungs: CTA bilaterally.
Cardiac: RRR. S1/S2.
Abd: Soft, NT, BS+
Extrem: Warm and well-perfused.
Neuro:
Mental status: Awake and alert, cooperative with exam, normal
affect.
Orientation: Oriented to person, place, and date.
Language: Speech fluent with good comprehension and repetition.
Naming intact. No dysarthria or paraphasic errors.

Cranial Nerves:
I: Not tested
II: Pupils equally round and reactive to light, to 3-2 mm
bilaterally. Visual fields are full to confrontation.
III, IV, VI: Extraocular movements intact bilaterally without
nystagmus.
V, VII: Facial strength and sensation intact and symmetric.
VIII: Hearing intact to voice.
IX, X: Palatal elevation symmetrical.
[**Doctor First Name 81**]: Sternocleidomastoid and trapezius normal bilaterally.
XII: Tongue midline without fasciculations.

Motor: Normal bulk and tone bilaterally. No abnormal movements,
tremors. Strength full power [**4-21**] throughout. No pronator drift.

Sensation: Intact to light touch bilaterally.

Toes downgoing bilaterally

On Discharge:
NEURO EXAM IS INTACT HOWEVER HE LISTS TO THE LEFT WHEN
AMBULATING AND HAS A BILATERAL HOMONYMOUS HEMIANOPSIA ON THE
LEFT

Pertinent Results:
Labs on Admission:

[**2122-1-13**] 12:10PM BLOOD WBC-15.8*# RBC-4.67 Hgb-14.9 Hct-40.4
MCV-87 MCH-31.9 MCHC-36.9* RDW-13.4 Plt Ct-322
[**2122-1-13**] 12:10PM BLOOD Neuts-86.7* Lymphs-9.8* Monos-2.0 Eos-1.1
Baso-0.4
[**2122-1-14**] 02:19AM BLOOD PT-13.9* PTT-30.6 INR(PT)-1.2*
[**2122-1-14**] 02:19AM BLOOD Calcium-9.2 Phos-3.5 Mg-2.1

IMAGING:
Head CT [**1-13**]:
FINDINGS: While the known right parietal mass is suboptimally
evaluated on
this noncontrast head CT, it appears significantly larger than
on [**2121-12-7**]. A hyperdense rim within the mass may
indicate blood products. There is a marked increase in vasogenic
edema surrounding the mass. There is a mild shift of the septum
pellucidum and the third ventricle to the left. There is
near-complete effacement of the atrium of the right lateral
ventricle. The temporal [**Doctor Last Name 534**] of the right lateral ventricle is
newly dilated, suggestive of trapping.A right parietal burr hole
is again seen. The imaged portions of the paranasal sinuses and
mastoid air cells are normally aerated.

[**Known lastname **],[**Known firstname **] K [**Medical Record Number 98999**] M  50  [**2071-3-22**]

Radiology Report MR HEAD W & W/O CONTRAST Study Date of [**2122-1-16**]
10:06 AM


[**Last Name (LF) **],[**First Name7 (NamePattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 12630**] TSICU [**2122-1-16**] SCHED
MR HEAD W & W/O CONTRAST   Clip # [**0-0-**]
Reason: please evaluate for residual tumor burden. Must be
completed
Contrast: MAGNEVIST



[**Hospital 93**] MEDICAL CONDITION:
   50 year old man with
REASON FOR THIS EXAMINATION:
   please evaluate for residual tumor burden. Must be completed
within 36hrs
   post-op
CONTRAINDICATIONS FOR IV CONTRAST:
   None.



Provisional Findings Impression: DBH [**First Name9 (NamePattern2) **] [**2122-1-16**] 4:20 PM
PFI: Status post resection of glioblastoma with no evidence of
residual
enhancing tumor.


Final Report
MR HEAD WITHOUT AND WITH CONTRAST [**2122-1-16**]

HISTORY: Evaluate for residual after tumor resection.

Sagittal and axial short TR, short TE spin echo imaging was
performed through
the brain. After administration of 14 ml of Magnevist
intravenous contrast,
axial imaging was performed with FLAIR, gradient echo, long TR,
long TE fast
spin echo, diffusion, and short TR, short TE spin echo
technique. Sagittal
MP-RAGE images were obtained and reformatted into axial and
coronal
orientations. Comparison to a brain MR [**First Name (Titles) **] [**2122-1-13**].

FINDINGS: In the interval, the patient has undergone resection
of the right
temporal and deep white matter masses noted on the prior study.
Although
there is a thin rim of enhancement surrounding the surgical
site, the best
radiologic evidence is that the enhancing neoplasm has been
completely
resected. Again seen is high signal intensity on the FLAIR
images, extending
across the splenium of the corpus callosum, presumably
reflecting tumor
infiltration. There is expected postoperative hemorrhage at the
surgical site
and a tiny fluid collection is noted. There is mild dural
thickening, again
presumably related to surgery. Although the enhancing portion of
the tumor
appeared to reach the ependymal surface of the right lateral
ventricle, there
is no evidence of intraventricular enhancement to suggest
seeding of the
tumor.

CONCLUSION: Status post resection of glioblastoma with no
evidence of
residual enhancing tumor.


DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **]. [**Last Name (NamePattern1) 7415**]
Approved: SAT [**2122-1-17**] 4:22 PM

  Imaging Lab

[**Known lastname **],[**Known firstname **] K [**Medical Record Number 98999**] M  50  [**2071-3-22**]

Radiology Report CT HEAD W/O CONTRAST Study Date of [**2122-1-15**]
3:19 PM


[**Last Name (LF) **],[**First Name7 (NamePattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 12630**] TSICU [**2122-1-15**] SCHED
CT HEAD W/O CONTRAST   Clip # [**Clip Number (Radiology) 99000**]
Reason: please evaluate for post-op bleeding; must be completed
with



[**Hospital 93**] MEDICAL CONDITION:
   50 year old man with
REASON FOR THIS EXAMINATION:
   please evaluate for post-op bleeding; must be completed
within 4hrs post-op
CONTRAINDICATIONS FOR IV CONTRAST:
   None.



Provisional Findings Impression: [**First Name9 (NamePattern2) **] [**First Name8 (NamePattern2) **] [**2122-1-15**] 7:56 PM
No major vascular territorial infarction or other acute
intracranial
abnormality.


Final Report
HISTORY: 50-year-old male status post resection of mass.
Evaluate for
postoperative bleed.

TECHNIQUE: Contiguous axial images were obtained through the
brain. No
contrast was administered.

FINDINGS: The patient is status post right parietal craniotomy
and resection
of a right parietal mass. There is a small amount of expected
post-surgical
pneumocephalus and hemorrhage seen in the resection bed. In
addition there is
expected bifrontal pneumocephalus. There is persistent stable
edema in the
resection bed. Subgaleal soft tissue edema is noted over the
right parietal
vertex. No acute major vascular territory infarction is noted.
The visualized
portion of the paranasal sinuses and mastoid air cells are well
aerated.

IMPRESSION: Expected post-surgical appearance with minimal
post-surgical
hemorrhage in the resection bed. No evidence of major vascular
territory
infarction or new shift of the normally midline structures.

The study and the report were reviewed by the staff radiologist.


DR. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **]
DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **]. [**Last Name (NamePattern1) 7415**]
Approved: [**First Name9 (NamePattern2) **] [**2122-1-16**] 10:01 AM

  Imaging Lab


[**Hospital1 69**]
[**Location (un) 86**], [**Telephone/Fax (1) 15701**]

Pathology Examination

Name Birthdate    Age     Sex Pathology #     [**Hospital1 18**] [**Known lastname 99001**],[**Known firstname **] K       [**2071-3-22**]    50 Male      [**Numeric Identifier 99002**]
[**Numeric Identifier 99003**]
Report to:   DR. [**Last Name (STitle) **]. [**Doctor Last Name **]
Gross Description by:   DR. [**Last Name (STitle) **]. [**Doctor Last Name **]/dif



SPECIMEN SUBMITTED: Right Temporal Tumor, Right Temporal Tumor.

Procedure date     Tissue received     Report Date    Diagnosed
by
[**2122-1-15**] [**2122-1-15**] [**2122-1-18**] DR. [**Last Name (STitle) **] [**Last Name (NamePattern4) **]/vf
Previous biopsies:    [**-7/4988**]  0 TP , -9, -10, -11, -12, -13,
-14, -1, -2, -3, -4, -5,
  [**-7/2553**]  R BUTTOCK (1 JAR).
  [**-5/1959**]  RIGHT APEX UPPER LOBE AND POSTERIOR WEDGE RIGHT
UPPER
  [**Numeric Identifier 99004**]  RT-LT VAS/in.
(and more)

DIAGNOSIS:

Right temporal tumor, biopsies:



1.  Frozen section (A):Malignant glioma with palisading necrosis
and diffuse infiltration.

2.  Permanent (B-D):Glioblastoma, WHO grade IV (See note).

Note:  Highly atypical glial cells are present, along with
microvascular proliferation and necrosis.  Scattered mitotic
figures are found.

[**Known lastname **],[**Known firstname **] K [**Medical Record Number 98999**] M  50  [**2071-3-22**]

Radiology Report CHEST (PORTABLE AP) Study Date of [**2122-1-14**] 2:43
PM


[**Last Name (LF) **],[**First Name7 (NamePattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 12630**] TSICU [**2122-1-14**] SCHED
CHEST (PORTABLE AP)   Clip # [**Clip Number (Radiology) 99005**]
Reason: please eval for cardio-pulm process



[**Hospital 93**] MEDICAL CONDITION:
   50 year old man with GBM and mental status changes scheduled
for OR [**2122-1-15**] for
   resection
REASON FOR THIS EXAMINATION:
   please eval for cardio-pulm process



Provisional Findings Impression: LCpc WED [**2122-1-14**] 7:08 PM
No signs of acute cardiopulmonary process.


Final Report
CHEST PORTABLE AP

REASON FOR EXAM: 50-year-old man with GBM and mental status
changes scheduled
for OR for resection. Please evaluate for cardiopulmonary
process.

Since [**2121-12-4**], lungs remain clear. Relative lucency of
the left
lung is only technical. Scarring at the left apex is unchanged
with prior
wedge resection. The cardiomediastinal silhouette and hilar
contours are
normal. There is no pleural effusion.

The study and the report were reviewed by the staff radiologist.


DR. [**First Name8 (NamePattern2) 4078**] [**Name (STitle) 4079**]
DR. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 4130**]
Approved: WED [**2122-1-14**] 7:53 PM



Brief Hospital Course:
50 year old male with known GBM diagnosed with biopsy by Dr.
[**Last Name (STitle) **] last year present with severe headache last night which
was associated with nausea. Work up revealed tumor progression
with increased vasogenic edema.

He was brought the the OR for tumor debulking.  His neurologic
examination remained unchanged relative to his preoperative
neurologic status.  He was in the PACU overnight and then
transferred to the floor.  His diet and activity were advanced.
His steroids were tapered appropriately.

He was seen by PT OT and deemed safe for discharge with services
at home. He was neurologically non-focal at the time of
discharge.


Medications on Admission:
FIORICET - 50 mg-325 mg-40 mg Tablet - 1-2 Tablets by mouth q4-6
hrs as needed for for headaches. try not to take more than 2/day
DEXAMETHASONE - 4 mg Tablet by mouth three times a day
LEVETIRACETAM - 500 mg Tablet - 2 Tablet(s) by mouth twice daily
ZOFRAN - 8 mg Tablet - 1 Tablet(s) by mouth once a day take one
hour before Temodar
PROPRANOLOL - 60 mg Capsule,Sustained Action 24 hr - Start at
one
tab qD, then in 2 weeks increase up to 2 tabs qD if not enough
effect
SUMATRIPTAN SUCCINATE - 100 mg Tablet - 1 Tablets by mouth PRN
severe h/a take at onset of severe h/a. [**Month (only) 116**] repeat x 1 in 2 hrs
if not enough effect. Not to exceed 2 tabs in a 24 hr period
TEMOZOLOMIDE - 140 mg Capsule - 1 Capsule(s) by mouth once a day
take on empty stomach one hour before radiation. Take 7
days/week
IBUPROFEN - 200 mg Tablet - 2 Tablet(s) by mouth PRN


Discharge Medications:
1. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One
(1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours).
Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2*
2. Butalbital-Acetaminophen-Caff 50-325-40 mg Tablet Sig: [**12-19**]
Tablets PO Q4H (every 4 hours) as needed for headache: DO NOT
DRIVE WHILE ON THIS MEDICATION.
Disp:*40 Tablet(s)* Refills:*0*
3. Levetiracetam 500 mg Tablet Sig: Two (2) Tablet PO BID (2
times a day).
Disp:*60 Tablet(s)* Refills:*2*
4. Propranolol 60 mg Capsule,Sustained Action 24 hr Sig: One (1)
Capsule,Sustained Action 24 hr PO DAILY (Daily).
5. Dexamethasone 2 mg Tablet Sig: Three (3) Tablet PO TID (3
times a day) as needed for brain edema.
Disp:*90 Tablet(s)* Refills:*2*
6. Colace 100 mg Capsule Sig: [**12-19**] Capsules PO twice a day.
Disp:*60 Capsule(s)* Refills:*2*


Discharge Disposition:
Home With Service

Facility:
Partners [**Name (NI) **] [**Name2 (NI) **]

Discharge Diagnosis:
Glioblastoma
Anxiety


Discharge Condition:
Neurologically stable


Discharge Instructions:
General Instructions/Information

??????	Have a friend/family member check your incision daily for
signs of infection.
??????	Take your pain medicine as prescribed.
??????	Exercise should be limited to walking; no lifting, straining,
or excessive bending.
??????	You may wash your hair only after sutures and/or staples have
been removed. If your wound closure uses dissolvable sutures,
you must keep that area dry for 10 days.
??????	You may shower before this time using a shower cap to cover
your head.
??????	Increase your intake of fluids and fiber, as narcotic pain
medicine can cause constipation. We generally recommend taking
an over the counter stool softener, such as Docusate (Colace)
while taking narcotic pain medication.
??????	Unless directed by your doctor, do not take any
anti-inflammatory medicines such as Motrin, Aspirin, Advil, and
Ibuprofen etc.
??????	You have been discharged on Keppra (Levetiracetam), you will
not require blood work monitoring.
??????	If you are being sent home on steroid medication, make sure
you are taking a medication to protect your stomach (Prilosec,
Protonix, or Pepcid), as these medications can cause stomach
irritation.  Make sure to take your steroid medication with
meals, or a glass of milk.
??????	Clearance to drive and return to work will be addressed at
your post-operative office visit.
??????	Make sure to continue to use your incentive spirometer while
at home.
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: increasing redness,
increased swelling, increased tenderness, or drainage.
??????	Fever greater than or equal to 101?????? F.

Followup Instructions:
Follow-Up Appointment Instructions

??????Please return to the office in [**6-26**] days (from your date of
surgery) for a wound check. This appointment can be made with
the Nurse Practitioner.  Please make this appointment by calling
[**Telephone/Fax (1) 1669**]. If you live quite a distance from our office,
please make arrangements for the same, with your PCP.
??????THE BRAIN [**Hospital **] CLINIC WILL CALL YOU TO ASSIST IN SCHEDULING
YOUR APPOINTMENT FOR FOLLOW UP.
The Brain [**Hospital 341**] Clinic is located on the [**Hospital Ward Name 516**] of [**Hospital1 18**],
in the [**Hospital Ward Name 23**] Building. Their phone number is [**Telephone/Fax (1) 1844**].
Please call if you need to change your appointment, or require
additional directions.
??????You will not need an MRI of the brain.

Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 2308**], MD Phone:[**Telephone/Fax (1) 2309**]
Date/Time:[**2122-6-23**] 9:15



Completed by:[**2122-1-19**]
{'Malignant neoplasm of parietal lobe,Generalized convulsive epilepsy, without mention of intractable epilepsy,Cerebral edema,Anxiety state, 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: Headache, nausea.

PRESENT ILLNESS: 50 year old male with known GBM diagnosed with biopsy by Dr.
[**Last Name (STitle) **] last year present with severe headache on the night of
[**1-12**], which was associated with nausea. He went to his radiation
appointment on [**1-13**] in the morning and was sent for a stat head
CT. The scan showed significant edema around the area of the
mass. His wife also reports that he has had difficulty with
depth perception recently. For example, when opening the cabinet
to get a coffee cup, he would hit his head on the cabinet door.
Similarly, he runs into polls that are right in front of him.
The patient was given 4 mg of decadron and sent to the ER.

MEDICAL HISTORY: 1. Recurrent left spontaneous pneumothoraces with left apical
blebs, s/p left upper lobe bleb resection, pleurodesis, and
sclerosis in [**2105**]; had post operative air leak requiring
exploratory thoracotomy
2. Right tension pneumothorax, s/p bullectomy with mechanical
pleurodesis in [**2108**]
3. Childhood strabismus, s/p multiple corrective procedures,
last
at age 14
4. Benign connective tissue nevus

MEDICATION ON ADMISSION: FIORICET - 50 mg-325 mg-40 mg Tablet - 1-2 Tablets by mouth q4-6
hrs as needed for for headaches. try not to take more than 2/day
DEXAMETHASONE - 4 mg Tablet by mouth three times a day
LEVETIRACETAM - 500 mg Tablet - 2 Tablet(s) by mouth twice daily
ZOFRAN - 8 mg Tablet - 1 Tablet(s) by mouth once a day take one
hour before Temodar
PROPRANOLOL - 60 mg Capsule,Sustained Action 24 hr - Start at
one
tab qD, then in 2 weeks increase up to 2 tabs qD if not enough
effect
SUMATRIPTAN SUCCINATE - 100 mg Tablet - 1 Tablets by mouth PRN
severe h/a take at onset of severe h/a. [**Month (only) 116**] repeat x 1 in 2 hrs
if not enough effect. Not to exceed 2 tabs in a 24 hr period
TEMOZOLOMIDE - 140 mg Capsule - 1 Capsule(s) by mouth once a day
take on empty stomach one hour before radiation. Take 7
days/week
IBUPROFEN - 200 mg Tablet - 2 Tablet(s) by mouth PRN

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: On Admission:
T:97.9  BP:138/96     HR:89    RR:14       O2Sats:100% RA
Gen: WD/WN, comfortable, NAD.
HEENT: Pupils:PERRL         EOMs-intact
Neck: Supple.
Lungs: CTA bilaterally.
Cardiac: RRR. S1/S2.
Abd: Soft, NT, BS+
Extrem: Warm and well-perfused.
Neuro:
Mental status: Awake and alert, cooperative with exam, normal
affect.
Orientation: Oriented to person, place, and date.
Language: Speech fluent with good comprehension and repetition.
Naming intact. No dysarthria or paraphasic errors.

FAMILY HISTORY: Son had a febrile seizure at age eight.  Has a niece with
generalized seizures, now ~age 27.   No stroke, hemorrhage, or
aneurysm.

SOCIAL HISTORY: Lives with wife and two children. Former smoker, 1-2 packs daily
for 10 years but quit years ago. He denies a history of illicit
drug use. He drinks "an occasional beer." 

### Response:
{'Malignant neoplasm of parietal lobe,Generalized convulsive epilepsy, without mention of intractable epilepsy,Cerebral edema,Anxiety state, unspecified'}
