CHIEF COMPLAINT: endstage liver failure

PRESENT ILLNESS: 25 F w/ etoh cirrhosis and bulimia who presents from an OSH w/
endstage liver disease (encephalopathy, ascites/SBP, portal htn,
ARF). Pt was admitted to OSH on [**2164-12-18**] w/ fever, abdominal
distention, elevated WBCs, b/l LE edema. SBP was diagnosed by
paracentesis (Group B beta hemolytic Streptococcus), Pt was
placed on Vancomycin and Zosyn. Pt had alcohol withdrawal.
Transferred to OSH ICU w/ encephalopathy on [**2164-12-26**]. Intubated
on [**2164-12-29**] for respiratory distress (ARDS) thought secondary to
aspiration and shock (reported as septic). Hypotension managed
with dopamine (renal dose) and vasopressin (both off at
tansfer). Sepsis managed untimately managed w/ imipenem.

MEDICAL HISTORY: --etoh abuse (since age 12)
--cirrhosis
--bulimia
--erosive esophagitis

MEDICATION ON ADMISSION: 

ALLERGIES: Zosyn

PHYSICAL EXAM: FiO2=50%, Vt=400, RR=18, PEEP=5
T=101.4
BP=112/75
HR=88
RR=18
O2sat=97%
WT=75.6 kg
HT=68 in
GEN:  young female intubated, lying in bed in nad
HEENT:  scleral icterus, eomi, perrl, no lad
CV:  rrr, 2/6 systolic murmur @ LUSB
PULMO:  ctab anteriorly
ABD:  soft, bs+, nt, distended
EXT:  warm, no c/c, 2+ pitting edema b/l up to knees, 2+DP
SKIN:  jaundiced, caput medusa, spider angioma

FAMILY HISTORY: Father is a recovering alcoholic.  No known hx of congenital
liver dz.

SOCIAL HISTORY: Etoh abuse.  Tobacco use (unclear amount).  Parents are her
legal guardians.  [**Name (NI) 1403**] as a waitress.  Father is an attorney.
Mother is a secretary.  Younger sibling.  Was taking are of ADLs
before hospitalization.
Unspecified septicemia,Alcoholic cirrhosis of liver,Acute respiratory failure,Spontaneous bacterial peritonitis,Acute kidney failure with lesion of tubular necrosis,Other and unspecified alcohol dependence, continuous,Hepatic encephalopathy,Hyperosmolality and/or hypernatremia,Pneumonitis due to inhalation of food or vomitus,Portal vein thrombosis,Other tracheostomy complications,Hemorrhage complicating a procedure,Severe sepsis,Bulimia nervosa,Other specified erythematous conditions,Anemia of other chronic disease,Other specified disorders of pancreatic internal secretion,Encounter for palliative care,Adrenal cortical steroids causing adverse effects in therapeutic use,Other drugs and medicinal substances causing adverse effects in therapeutic use
Septicemia NOS,Alcohol cirrhosis liver,Acute respiratry failure,Spontan bact peritonitis,Ac kidny fail, tubr necr,Alcoh dep NEC/NOS-contin,Hepatic encephalopathy,Hyperosmolality,Food/vomit pneumonitis,Portal vein thrombosis,Tracheostomy comp NEC,Hemorrhage complic proc,Severe sepsis,Bulimia nervosa,Erythematous cond NEC,Anemia-other chronic dis,Pancreatic disorder NEC,Encountr palliative care,Adv eff corticosteroids,Adv eff medicinal NEC
Admission Date:  [**2165-1-5**]              Discharge Date:   [**2165-1-26**]

Date of Birth:  [**2139-10-18**]             Sex:   F

Service: MEDICINE

Allergies:
Zosyn

Attending:[**First Name3 (LF) 2297**]
Chief Complaint:
endstage liver failure

Major Surgical or Invasive Procedure:
trach tube placement
multiple line placements


History of Present Illness:
25 F w/ etoh cirrhosis and bulimia who presents from an OSH w/
endstage liver disease (encephalopathy, ascites/SBP, portal htn,
ARF). Pt was admitted to OSH on [**2164-12-18**] w/ fever, abdominal
distention, elevated WBCs, b/l LE edema. SBP was diagnosed by
paracentesis (Group B beta hemolytic Streptococcus), Pt was
placed on Vancomycin and Zosyn. Pt had alcohol withdrawal.
Transferred to OSH ICU w/ encephalopathy on [**2164-12-26**]. Intubated
on [**2164-12-29**] for respiratory distress (ARDS) thought secondary to
aspiration and shock (reported as septic). Hypotension managed
with dopamine (renal dose) and vasopressin (both off at
tansfer). Sepsis managed untimately managed w/ imipenem.

Past Medical History:
--etoh abuse (since age 12)
--cirrhosis
--bulimia
--erosive esophagitis

Social History:
Etoh abuse.  Tobacco use (unclear amount).  Parents are her
legal guardians.  [**Name (NI) 1403**] as a waitress.  Father is an attorney.
Mother is a secretary.  Younger sibling.  Was taking are of ADLs
before hospitalization.

Family History:
Father is a recovering alcoholic.  No known hx of congenital
liver dz.

Physical Exam:
FiO2=50%, Vt=400, RR=18, PEEP=5
T=101.4
BP=112/75
HR=88
RR=18
O2sat=97%
WT=75.6 kg
HT=68 in
GEN:  young female intubated, lying in bed in nad
HEENT:  scleral icterus, eomi, perrl, no lad
CV:  rrr, 2/6 systolic murmur @ LUSB
PULMO:  ctab anteriorly
ABD:  soft, bs+, nt, distended
EXT:  warm, no c/c, 2+ pitting edema b/l up to knees, 2+DP
SKIN:  jaundiced, caput medusa, spider angioma

Brief Hospital Course:
[**Known firstname **] [**Known lastname 71716**] was transferred to the ICU on [**2165-1-5**] for liver
failure and respiratory failure. Over the next few weeks, her
liver failure worsened and she had persistent fevers of unclear
source despite intensive workup. She developed kidney failure
and was deemed to not be a liver transplant candidate. She
remained dependent on the ventilator. CVVH was begun but her
overall status continued to decline. Her situation was felt to
be futile by the MICU team and the liver team. Her family agreed
with withdrawl of care and she died at 9 pm on [**2165-1-27**].

Discharge Disposition:
Expired

Discharge Diagnosis:
alcoholic liver failure
kidney failure
fever of unknown origin
respiratory failure

Discharge Condition:
expired

Discharge Instructions:
expired

Followup Instructions:
expired
{'Unspecified septicemia,Alcoholic cirrhosis of liver,Acute respiratory failure,Spontaneous bacterial peritonitis,Acute kidney failure with lesion of tubular necrosis,Other and unspecified alcohol dependence, continuous,Hepatic encephalopathy,Hyperosmolality and/or hypernatremia,Pneumonitis due to inhalation of food or vomitus,Portal vein thrombosis,Other tracheostomy complications,Hemorrhage complicating a procedure,Severe sepsis,Bulimia nervosa,Other specified erythematous conditions,Anemia of other chronic disease,Other specified disorders of pancreatic internal secretion,Encounter for palliative care,Adrenal cortical steroids causing adverse effects in therapeutic use,Other drugs and medicinal substances causing adverse effects in therapeutic use'}


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: endstage liver failure

PRESENT ILLNESS: 25 F w/ etoh cirrhosis and bulimia who presents from an OSH w/
endstage liver disease (encephalopathy, ascites/SBP, portal htn,
ARF). Pt was admitted to OSH on [**2164-12-18**] w/ fever, abdominal
distention, elevated WBCs, b/l LE edema. SBP was diagnosed by
paracentesis (Group B beta hemolytic Streptococcus), Pt was
placed on Vancomycin and Zosyn. Pt had alcohol withdrawal.
Transferred to OSH ICU w/ encephalopathy on [**2164-12-26**]. Intubated
on [**2164-12-29**] for respiratory distress (ARDS) thought secondary to
aspiration and shock (reported as septic). Hypotension managed
with dopamine (renal dose) and vasopressin (both off at
tansfer). Sepsis managed untimately managed w/ imipenem.

MEDICAL HISTORY: --etoh abuse (since age 12)
--cirrhosis
--bulimia
--erosive esophagitis

MEDICATION ON ADMISSION: 

ALLERGIES: Zosyn

PHYSICAL EXAM: FiO2=50%, Vt=400, RR=18, PEEP=5
T=101.4
BP=112/75
HR=88
RR=18
O2sat=97%
WT=75.6 kg
HT=68 in
GEN:  young female intubated, lying in bed in nad
HEENT:  scleral icterus, eomi, perrl, no lad
CV:  rrr, 2/6 systolic murmur @ LUSB
PULMO:  ctab anteriorly
ABD:  soft, bs+, nt, distended
EXT:  warm, no c/c, 2+ pitting edema b/l up to knees, 2+DP
SKIN:  jaundiced, caput medusa, spider angioma

FAMILY HISTORY: Father is a recovering alcoholic.  No known hx of congenital
liver dz.

SOCIAL HISTORY: Etoh abuse.  Tobacco use (unclear amount).  Parents are her
legal guardians.  [**Name (NI) 1403**] as a waitress.  Father is an attorney.
Mother is a secretary.  Younger sibling.  Was taking are of ADLs
before hospitalization. 

### Response:
{'Unspecified septicemia,Alcoholic cirrhosis of liver,Acute respiratory failure,Spontaneous bacterial peritonitis,Acute kidney failure with lesion of tubular necrosis,Other and unspecified alcohol dependence, continuous,Hepatic encephalopathy,Hyperosmolality and/or hypernatremia,Pneumonitis due to inhalation of food or vomitus,Portal vein thrombosis,Other tracheostomy complications,Hemorrhage complicating a procedure,Severe sepsis,Bulimia nervosa,Other specified erythematous conditions,Anemia of other chronic disease,Other specified disorders of pancreatic internal secretion,Encounter for palliative care,Adrenal cortical steroids causing adverse effects in therapeutic use,Other drugs and medicinal substances causing adverse effects in therapeutic use'}
