CHIEF COMPLAINT: Right lower lobe mass

PRESENT ILLNESS: This is a 79-year-old man with a history of hemoptysis who had
subsequent work-up and was found to have a large right lower
lobe mass. PET scan demonstrated increased activity in the right
hilum.

MEDICAL HISTORY: Emphysema
Benign prostatic hypertrophy
Gastroesophageal reflux disease
Herniorrhaphy '[**43**]
Parotidectomy '[**44**]

MEDICATION ON ADMISSION: Hytrin 10mg PO QHS
Prilosec 40mg PO QD

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: On Admission, patient's physical exam is as follows:

FAMILY HISTORY: Laryngeal and lung cancer

SOCIAL HISTORY: 1 PPD for 60 years
Occasional EtOH
No IDU
Worked as Civil Engineer
Malignant neoplasm of lower lobe, bronchus or lung,Accidental puncture or laceration during a procedure, not elsewhere classified,Cardiac complications, not elsewhere classified,Atrial fibrillation,Pulmonary collapse,Other emphysema,Accidental cut, puncture, perforation or hemorrhage during surgical operation,Other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Esophageal reflux,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS),Tobacco use disorder,Family history of malignant neoplasm of other respiratory and intrathoracic organs,Family history of malignant neoplasm of trachea, bronchus, and lung,Orthostatic hypotension
Mal neo lower lobe lung,Accidental op laceration,Surg compl-heart,Atrial fibrillation,Pulmonary collapse,Emphysema NEC,Acc cut/hem in surgery,Abn react-surg proc NEC,Esophageal reflux,BPH w/o urinary obs/LUTS,Tobacco use disorder,Fam hx-intrathoracic mal,Fm hx-trach/bronchog mal,Orthostatic hypotension
Name:  [**Known lastname 2329**],[**Known firstname 33**] N              Unit No:   [**Numeric Identifier 2330**]

Admission Date:  [**2182-9-17**]              Discharge Date:   [**2182-9-27**]

Date of Birth:  [**2103-5-13**]             Sex:   M

Service: TSURG

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**Known firstname 2331**]
Chief Complaint:
Right lower lobe mass

Major Surgical or Invasive Procedure:
Mediastinoscopy
Right lower lobectomy and mediastinal lymph node dissection
Bronchoscopy
Foley catheter
Central Line placement
Epidural placement
Chest tube placement


Brief Hospital Course:
Mr. [**Known lastname **] was finally discharged to [**Location (un) 2332**] House Nursing
& Rehabilitation Center - [**Location (un) 2333**] on [**2182-9-27**].  He stayed due to
feelings of nausea and dizziness when ambulating on [**2182-9-25**]-his
originally scheduled discharge date.  At discharge, Mr.
[**Known lastname **] was ambulating without issue around the hospital floor
with assistance.

Furthermore, he had continued episodes of intermittent atrial
fibrillation.  For continued therapy, his amiodarone was
increased to 400mg PO TID from [**Hospital1 **].  He will then stay on this
for one week and then slowly be weaned the following week to
400mg PO BID, then 400mg PO QD then 200mg PO QD as tolerated.
In that time, he is to continue having his beta-blocker titrated
up for control.  He is to follow up with Dr. [**Last Name (STitle) **] in 6
weeks.

Also, on [**2182-9-26**], patient's INR was 5.2 and he was kept
in-house on fall precautions.  On the day of discharge, it had
trended down to 4.6 and he was deemed able to go to rehab.  He
is asked to have daily INR checks at his rehab facility and to
have his coumadin dosed daily to maintain a therapeutic INR
level between 2 and 3.

Discharge Disposition:
Extended Care

Facility:
[**Hospital3 1174**] [**Hospital **] Hospital - [**Location (un) **]

Discharge Diagnosis:
Squamous cell carcinoma of the lung
Atrial fibrillation
Hypovolemia


Discharge Condition:
Good

                             [**Known firstname 33**] [**Last Name (NamePattern4) 2334**] MD [**MD Number(1) 2335**]

Completed by:[**2182-9-27**]

Admission Date:  [**2182-9-17**]              Discharge Date:   [**2182-9-27**]

Date of Birth:  [**2103-5-13**]             Sex:   M

Service: TSURG

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**Known firstname 4272**]
Chief Complaint:
Right lower lobe mass

Major Surgical or Invasive Procedure:
Mediastinoscopy
Right lower lobectomy and mediastinal lymph node dissection
Bronchoscopy
Foley catheter
Central Line placement
Epidural placement
Chest tube placement

History of Present Illness:
This is a 79-year-old man with a history of hemoptysis who had
subsequent work-up and was found to have a large right lower
lobe mass. PET scan demonstrated increased activity in the right
hilum.

Past Medical History:
Emphysema
Benign prostatic hypertrophy
Gastroesophageal reflux disease
Herniorrhaphy '[**43**]
Parotidectomy '[**44**]

Social History:
1 PPD for 60 years
Occasional EtOH
No IDU
Worked as Civil Engineer

Family History:
Laryngeal and lung cancer

Physical Exam:
On Admission, patient's physical exam is as follows:

Vitals: T=96.2, BP=162/64, P=89, R=12, SpO2=98%RA
Gen: NAD, AAOx3
HEENT: PERRL, EOMI, no LAD, MMM, sclera anicteric
CVS: RRR, no murmurs
Pulm: CTA bilaterally
Abd: soft, NT/ND, +BS
Ext: trace clubbing, no cyanosis or edema
Neuro: no focal deficits, CN2-12 grossly intact

Pertinent Results:
Pathology Examination [**2182-9-17**]
A. 4R paratracheal lymph node: No evidence of malignancy.
B. 2R upper paratracheal lymph node: No evidence of malignancy.
C. 7 subcarinal lymph node: No evidence of malignancy.
D. Right lower lobe: Carcinoma, see synoptic report.
E. 8R paraesophageal node: No evidence of malignancy.
F. Level 7 subcarinal node: No evidence of malignancy.
G. Mediastinal nodes near thymus: 7 lymph nodes with no evidence
of malignancy.

CHEST (PORTABLE AP)  [**2182-9-17**] 7:13 PM
IMPRESSION: Small right pneumothorax

CHEST (PORTABLE AP)  [**2182-9-19**] 11:37 AM
1) Interval placement of a right subclavian venous catheter in
good position.
2) Stable size of the right apical pneumothorax.
3) Stable atelectasis at the left base.

CHEST (PORTABLE AP)  [**2182-9-21**] 10:20 AM
Comparison is made to prior study 2 days ago. Right apical
pneumothorax looks slightly smaller. Basilar density is
essentially unchanged. This may represent consolidation,
atelectasis and/or effusion.

Brief Hospital Course:
Mr. [**Known lastname 14731**] was admitted to the Thoracic Surgery service at
[**Hospital1 18**] under Dr.[**Name (NI) 14732**] care on [**2182-9-17**].  On that day he
underwent a cervical mediastinoscopy with biopsies, fiberoptic
bronchoscopy and right lower lobectomy with mediastinal lymph
node dissection.  For details of the operation, see procedure
note.  Preoperatively, the patient had an epidural line placed
and a foley catheter and 2 chest tubes placed intraoperatively.
His primary issue in the immediate post-op period was pressure
support for which he was placed on a neosynephrine drip-stopped
prior to going to the floor.  Due to his BP issues, his epidural
was removed on POD#1 and a PCA was installed for pain control.

On POD#2, the patient went into atrial fibrillation and was
treated with 2g of IV magnesium sulfate, fluid boluses, 150cc
amiodarone bolus x2, calcium chloride, diltiazem and was then
moved to the critical care unit for BP monitoring.  At that time
he was started on a diltiazem drip.

On POD#3, patient's hematocrit was noted to be 26.8; however, a
repeat hematocrit was 29.3 and it was decided not to transfuse
the patient with blood products. Also, the patient was moved to
the floor after being deemed stable enough on the diltiazem drip
that same day.

On POD#4, the chest tubes and foley catheter were removed.
Also, the patient was started on a Heparin drip and coumadin 5mg
QHS for anticoagulation secondary to the atrial fibrillation.
EPS was consulted at that time and recommended maintaining
amiodarone at 800mg/day for 1 week, 400 mg/day 2 weeks
thereafter and finally 200mg/day to finish.  Also, the diltiazem
drip was subsequently discontinued that day.  They also
requested the patient follow-up with Dr. [**Last Name (STitle) 73**] in
Cardiology/[**Hospital **] Clinic in 6 weeks and to continue on coumadin
until then.

On POD#7, patient became therapeutic on his coumadin with an INR
of 2.3.  He was seen by physical therapy who had recommended he
be placed in a rehabilitation facility for further conditioning
the previous day.  He was finally discharged on POD#8, [**2182-9-25**],
in good condition, tolerating a house diet and ambulating with
assistance.  He is asked to follow-up with Dr. [**Last Name (STitle) 175**] in [**12-7**]
weeks and to call for an appointment.  He must also continue
having his PTT/INR checked on a daily basis for conitnued
coumadin dosing.

Medications on Admission:
Hytrin 10mg PO QHS
Prilosec 40mg PO QD

Discharge Medications:
1. Terazosin HCl 5 mg Capsule Sig: Two (2) Capsule PO HS (at
bedtime).
Disp:*30 Capsule(s)* Refills:*2*
2. Pantoprazole Sodium 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*
3. Nitroglycerin 0.4 mg Tablet, Sublingual Sig: One (1) Tablet,
Sublingual Sublingual PRN (as needed).
Disp:*30 Tablet, Sublingual(s)* Refills:*2*
4. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*2*
5. Amiodarone HCl 200 mg Tablet Sig: Two (2) Tablet PO BID (2
times a day).
Disp:*120 Tablet(s)* Refills:*2*
6. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
Q4-6H (every 4 to 6 hours) as needed.
Disp:*30 Tablet(s)* Refills:*0*
7. Warfarin Sodium 1 mg Tablet Sig: Three (3) Tablet PO HS (at
bedtime).
Disp:*15 Tablet(s)* Refills:*2*
8. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day) as needed.
Disp:*30 Tablet(s)* Refills:*0*
9. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID
(2 times a day).
Disp:*60 Tablet(s)* Refills:*2*


Discharge Disposition:
Extended Care

Facility:
[**Location (un) 931**] House Nursing & Rehabilitation Center - [**Location (un) 932**]

Discharge Diagnosis:
Squamous Cell Carcinoma
Atrial fibrillation
Hypovolemia


Discharge Condition:
Good

Discharge Instructions:
You may restart any medications you were on prior to your
admission.
You may shower.
You may have a regular diet.
You may ambulate with assistance as tolerated.

Followup Instructions:
Please follow-up with Dr. [**Last Name (STitle) 175**] in [**12-7**] weeks.  Please call
[**Telephone/Fax (1) 2348**].

Please follow-up with Dr. [**Last Name (STitle) 73**] in Cardiology/[**Hospital **] clinic in 6
weeks.  Call [**Telephone/Fax (1) 902**] for an appointment.



Completed by:[**2182-9-25**]
{'Malignant neoplasm of lower lobe, bronchus or lung,Accidental puncture or laceration during a procedure, not elsewhere classified,Cardiac complications, not elsewhere classified,Atrial fibrillation,Pulmonary collapse,Other emphysema,Accidental cut, puncture, perforation or hemorrhage during surgical operation,Other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Esophageal reflux,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS),Tobacco use disorder,Family history of malignant neoplasm of other respiratory and intrathoracic organs,Family history of malignant neoplasm of trachea, bronchus, and lung,Orthostatic hypotension'}


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: Right lower lobe mass

PRESENT ILLNESS: This is a 79-year-old man with a history of hemoptysis who had
subsequent work-up and was found to have a large right lower
lobe mass. PET scan demonstrated increased activity in the right
hilum.

MEDICAL HISTORY: Emphysema
Benign prostatic hypertrophy
Gastroesophageal reflux disease
Herniorrhaphy '[**43**]
Parotidectomy '[**44**]

MEDICATION ON ADMISSION: Hytrin 10mg PO QHS
Prilosec 40mg PO QD

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: On Admission, patient's physical exam is as follows:

FAMILY HISTORY: Laryngeal and lung cancer

SOCIAL HISTORY: 1 PPD for 60 years
Occasional EtOH
No IDU
Worked as Civil Engineer 

### Response:
{'Malignant neoplasm of lower lobe, bronchus or lung,Accidental puncture or laceration during a procedure, not elsewhere classified,Cardiac complications, not elsewhere classified,Atrial fibrillation,Pulmonary collapse,Other emphysema,Accidental cut, puncture, perforation or hemorrhage during surgical operation,Other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Esophageal reflux,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS),Tobacco use disorder,Family history of malignant neoplasm of other respiratory and intrathoracic organs,Family history of malignant neoplasm of trachea, bronchus, and lung,Orthostatic hypotension'}
