CHIEF COMPLAINT: 48M Left upper lobe lung nodule Stage IIIa Non small cell lung
cancer, s/p chemo/radiation therapy

PRESENT ILLNESS: 49-year-old gentleman who was found to have a left upper lobe
non-small
cell lung cancer and a positive level 5 lymph node. For this,
he underwent induction chemoradiotherapy and his re-staging
CT scans showed an improvement in the size of the primary
mass and the nodal metastases.

MEDICAL HISTORY: Hypertension, Diabetes Mellitus 2, Hyperlipidemia, Coronary
artery disease s/p CABG [**1-25**], Stage IIIa non small-cell lung CA
left upper lobe, low back pain, mult. herniated disks
s/p chemotherapy and radiation therapy

MEDICATION ON ADMISSION: Nexium 40', atenolol 100", ECASA 81', actos 30', gemfibrozil
600', cxycontin 20'';perc 2q4h

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 

FAMILY HISTORY: not elicited

SOCIAL HISTORY: From prior note. Lives in [**Location 86**] with his wife. [**Name (NI) **] three
children. Prior tobacco abuse of [**2-22**] ppd x 34 years; currently
smoking one to [**1-21**] pack cigarettes/day. Originally from [**Country **]
[**Country **], moved to US in [**2122**]. Previously worked at a paper
recycling factory but stopped approximately 10 years ago after a
work related injury. Denies etoh and recreational drug use.
Malignant neoplasm of upper lobe, bronchus or lung,Accidental puncture or laceration during a procedure, not elsewhere classified,Pulmonary collapse,Coronary atherosclerosis of unspecified type of vessel, native or graft,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Aortocoronary bypass status
Mal neo upper lobe lung,Accidental op laceration,Pulmonary collapse,Cor ath unsp vsl ntv/gft,Hypertension NOS,Hyperlipidemia NEC/NOS,DMII wo cmp nt st uncntr,Aortocoronary bypass
Admission Date:  [**2137-7-19**]              Discharge Date:   [**2137-7-25**]

Date of Birth:  [**2088-4-13**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 5790**]
Chief Complaint:
48M Left upper lobe lung nodule Stage IIIa Non small cell lung
cancer, s/p chemo/radiation therapy

Major Surgical or Invasive Procedure:
 [**7-19**] bronchoscopy, Video assisted thoracoscopy Left upper
lobectomy c/b Left pulmonary artery laceration converted to
anterior thoracotomy, 1L EBL, EKG changes.


History of Present Illness:
49-year-old gentleman who was found to have a left upper lobe
non-small
cell lung cancer and a positive level 5 lymph node. For this,
he underwent induction chemoradiotherapy and his re-staging
CT scans showed an improvement in the size of the primary
mass and the nodal metastases.


Past Medical History:
Hypertension, Diabetes Mellitus 2, Hyperlipidemia, Coronary
artery disease s/p CABG [**1-25**], Stage IIIa non small-cell lung CA
left upper lobe, low back pain, mult. herniated disks
s/p chemotherapy and radiation therapy

Social History:
From prior note. Lives in [**Location 86**] with his wife. [**Name (NI) **] three
children. Prior tobacco abuse of [**2-22**] ppd x 34 years; currently
smoking one to [**1-21**] pack cigarettes/day. Originally from [**Country **]
[**Country **], moved to US in [**2122**]. Previously worked at a paper
recycling factory but stopped approximately 10 years ago after a
work related injury. Denies etoh and recreational drug use.


Family History:
not elicited


Pertinent Results:
Hematology
  COMPLETE BLOOD COUNT WBC RBC Hgb Hct MCV MCH MCHC RDW Plt Ct
[**2137-7-22**] 12:46AM    5.3 3.03* 9.8* 27.6* 91 32.5* 35.7* 20.2*
153
  BASIC COAGULATION (PT, PTT, PLT, INR) PT PTT Plt Ct INR(PT)
[**2137-7-22**] 12:46AM        153
[**2137-7-22**] 12:46AM    12.6 24.6   1.1

Chemistry
  RENAL & GLUCOSE Glucose UreaN Creat Na K Cl HCO3 AnGap
[**2137-7-22**] 12:46AM    115* 11 0.7 137 4.1 98 33* 10
  ENZYMES & BILIRUBIN ALT AST LD(LDH) CK(CPK) AlkPhos Amylase
TotBili DirBili IndBili
[**2137-7-22**] 12:46AM    47* 78*   1066* 56   1.9* 0.9* 1.0
  CPK ISOENZYMES CK-MB MB Indx cTropnT
[**2137-7-22**] 12:46AM    14* 1.3 0.73*1
1 CTROPNT > 0.10 NG/ML SUGGESTS ACUTE MI
  CHEMISTRY TotProt Albumin Globuln Calcium Phos Mg UricAcd Iron

[**2137-7-22**] 12:46AM          9.4 2.9 1.8



Brief Hospital Course:
48M LUL Stage IIIa NSCLC, s/p chemo/XRT  admitted same day on
[**7-19**] for bronchoscopy, mediastinoscopy, LUL lobectomy by VATS
converted to anterior thoracotomy due to tear in superior branch
of pulmonary artery. Patient transfused w/ 2UPRBC intra-op,
stabilized, tolerated procedure, transferred to PACU extubated,
CT to suction, on Neo gtt. Post-op EKG> changes>NSTEMI.
CPK/MB--1066/14, T=.73.  Started on B- blocker post-op.
POD#1<[**2137-7-20**]>- Bronchoscopy for moderate secretions

POD#3 <[**2137-7-22**]>- rhonchi, minimal CT output (50/10/5), CT placed
to waterseal, and left CT(#2) d/c in afternoon. CXRY w/ small
hydropneumothorax. Pt transferred to floor. Loperssor increased
75mg [**Hospital1 **], diuresed w/  lasix 20 mg IV. Clear liqs started.
POD#[**4-24**] decreased drainage from blakes -blakes d/c'd. CXR
stable. [**Last Name (un) 1815**] po pain med.
POD#6- Patient stable, tolerating po pain rx, moved bowels prior
to d/c.  Pt discharged in stable condition late in afternoon in
company of son to home. Discharge instructions given and
reviewed w/ patient and [**Name6 (MD) **] by RN.



Medications on Admission:
Nexium 40', atenolol 100", ECASA 81', actos 30', gemfibrozil
600', cxycontin 20'';perc 2q4h

Discharge Medications:
1. Nexium 40 mg Capsule, Delayed Release(E.C.) Sig: One (1)
Capsule, Delayed Release(E.C.) PO once a day.
2. Gemfibrozil 600 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
3. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO DAILY (Daily).
4. Metoprolol Tartrate 25 mg Tablet Sig: Three (3) Tablet PO BID
(2 times a day): DO NOT TAKE YOUR ATENOLOL WHILE TAKING THIS
MEDICATION.
Disp:*180 Tablet(s)* Refills:*2*
5. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
6. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day) as needed.
7. Ibuprofen 600 mg Tablet Sig: One (1) Tablet PO Q8H (every 8
hours).
Disp:*90 Tablet(s)* Refills:*2*
8. Oxycodone 20 mg Tablet Sustained Release 12HR Sig: One (1)
Tablet Sustained Release 12HR PO Q8H (every 8 hours) as needed
for pain.
Disp:*60 Tablet Sustained Release 12HR(s)* Refills:*0*
9. Oxycodone 5 mg Tablet Sig: Two (2) Tablet PO Q4H (every 4
hours) as needed for breakthrough pain.
Disp:*60 Tablet(s)* Refills:*0*
10. Guaifenesin 100 mg/5 mL Syrup Sig: 5-10 MLs PO Q6H (every 6
hours) as needed for increaased/thickened sputum.
11. Actos 30 mg Tablet Sig: One (1) Tablet PO once a day.


Discharge Disposition:
Home

Discharge Diagnosis:
PMH: Hypertension, Diabetes Mellitus 2, Hyperlipidemia, Coronary
artery disease s/p CABG [**1-25**], Stage IIIa non small-cell lung CA
left upper lobe, low back pain, mult. herniated disks
s/p chemotherapy and radiation therapy


Discharge Condition:
good


Discharge Instructions:
Call Dr.[**Name (NI) 2347**]/Thoracic Surgery office [**Telephone/Fax (1) 170**] for:
fever, shortness of breath, chest pain, excessive foul smelling
drainage from incision sites.
Take previous medications as stated on discharge instructions.
Take new medications as directed and as needed.
You may shower on friday. Remove CT dressing after showering and
change daily as needed w/ bandaid or guaze.
No tub baths or swimming for 3-4 weeks.

Followup Instructions:
Call Dr.[**Name (NI) 2347**]/Thoracic Surgery office [**Telephone/Fax (1) 170**]  for
a follow-up appointment.



Completed by:[**2137-7-29**]
{'Malignant neoplasm of upper lobe, bronchus or lung,Accidental puncture or laceration during a procedure, not elsewhere classified,Pulmonary collapse,Coronary atherosclerosis of unspecified type of vessel, native or graft,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Aortocoronary bypass status'}


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: 48M Left upper lobe lung nodule Stage IIIa Non small cell lung
cancer, s/p chemo/radiation therapy

PRESENT ILLNESS: 49-year-old gentleman who was found to have a left upper lobe
non-small
cell lung cancer and a positive level 5 lymph node. For this,
he underwent induction chemoradiotherapy and his re-staging
CT scans showed an improvement in the size of the primary
mass and the nodal metastases.

MEDICAL HISTORY: Hypertension, Diabetes Mellitus 2, Hyperlipidemia, Coronary
artery disease s/p CABG [**1-25**], Stage IIIa non small-cell lung CA
left upper lobe, low back pain, mult. herniated disks
s/p chemotherapy and radiation therapy

MEDICATION ON ADMISSION: Nexium 40', atenolol 100", ECASA 81', actos 30', gemfibrozil
600', cxycontin 20'';perc 2q4h

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 

FAMILY HISTORY: not elicited

SOCIAL HISTORY: From prior note. Lives in [**Location 86**] with his wife. [**Name (NI) **] three
children. Prior tobacco abuse of [**2-22**] ppd x 34 years; currently
smoking one to [**1-21**] pack cigarettes/day. Originally from [**Country **]
[**Country **], moved to US in [**2122**]. Previously worked at a paper
recycling factory but stopped approximately 10 years ago after a
work related injury. Denies etoh and recreational drug use. 

### Response:
{'Malignant neoplasm of upper lobe, bronchus or lung,Accidental puncture or laceration during a procedure, not elsewhere classified,Pulmonary collapse,Coronary atherosclerosis of unspecified type of vessel, native or graft,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Aortocoronary bypass status'}
