CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 74 -year-old
white male with a history of Hodgkin's lymphoma and left lung
adenocarcinoma with metastatic cerebellar brain tumor.  The
patient had noted slurred speech for the past month with
clumsiness in his right hand for four weeks.  His slurred
speech progressed over the past week.  He denied headache or
nausea or vomiting.  Metastatic work up revealed bilateral
adrenal metastases, bilateral lung metastases, bone
metastases, as well as the cerebellar lesion.

MEDICAL HISTORY: 1.  Hypertension.
2.  Lung cancer.
3.  Hodgkin's lymphoma.

MEDICATION ON ADMISSION: 

ALLERGIES: Prilosec.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: Nonsmoker.
Secondary malignant neoplasm of brain and spinal cord,Personal history of malignant neoplasm of bronchus and lung,Other malignant lymphomas, unspecified site, extranodal and solid organ sites,Unspecified essential hypertension
Sec mal neo brain/spine,Hx-bronchogenic malignan,Oth lymp unsp xtrndl org,Hypertension NOS
Admission Date:  [**2103-7-12**]     Discharge Date:  [**2103-7-16**]

Date of Birth:   [**2028-11-9**]     Sex:  M

Service:  NEUROSURG

ADMITTING DIAGNOSIS:
Metastatic cerebellar tumor.

DISCHARGE DIAGNOSIS:
Metastatic cerebellar tumor.

HISTORY OF PRESENT ILLNESS:  The patient is a 74 -year-old
white male with a history of Hodgkin's lymphoma and left lung
adenocarcinoma with metastatic cerebellar brain tumor.  The
patient had noted slurred speech for the past month with
clumsiness in his right hand for four weeks.  His slurred
speech progressed over the past week.  He denied headache or
nausea or vomiting.  Metastatic work up revealed bilateral
adrenal metastases, bilateral lung metastases, bone
metastases, as well as the cerebellar lesion.

PAST MEDICAL HISTORY:
1.  Hypertension.
2.  Lung cancer.
3.  Hodgkin's lymphoma.

PAST SURGICAL HISTORY:
1.  Left lobectomy.
2.  Appendectomy.
3.  Cholecystectomy.

ADMITTING MEDICATIONS:  Nifedipine, Toprol, aspirin, Lipitor,
and hydrochlorothiazide.

ALLERGIES:  Prilosec.

SOCIAL HISTORY:  Nonsmoker.

ADMISSION LABORATORY DATA:  Sodium 137, potassium 3.6,
chloride 98, bicarbonate 26, BUN 19, creatinine 1.0, glucose
84.  White count 7.8, hematocrit 33.5, platelets 201,000.  PT
12.5, PTT 26.5, INR 1.0.  Electrocardiogram within normal
limits.  Chest x-ray normal.

PHYSICAL EXAMINATION:  Speech fluent, fluent naming and
repetition, dysarthric speech.  Face symmetric, no drift.
Pupils were equal, round, and reactive to light and
accommodation, extraocular movements full with bilateral end
gaze nystagmus.  Deltoids, biceps, triceps, iliopsoas,
quadriceps, anterior tibialis, gastrocnemius all [**4-7**]
bilaterally.  Sensation intact to light touch.  Heart:
regular rate and rhythm, S1, S2, no murmurs, rubs, or
gallops.  Lungs clear to auscultation bilaterally on the
right and the left upper lungs.  Extremities: warm, soft, no
edema.  Abdomen: soft, nontender, nondistended, positive
bowel sounds.

HOSPITAL COURSE:  The patient was admitted on [**2103-7-12**],
prepped for a suboccipital craniectomy, excision of
metastatic cerebellar tumor.  The patient was taken to the
Operating Room on [**2103-7-13**].  He tolerated the procedure well.
He was transferred to the Post Anesthesia Care Unit in stable
condition.  His neurologic examination remained stable.  He
remained alert and oriented times three.  He had slight
decrease in grasp on the right, [**3-8**].  On [**2103-7-15**], his
Decadron taper was begun, dressing was changed with no active
drainage.  He was out of bed.

On [**2103-7-16**], the patient remained stable, his vital signs
were stable, and he was seen by rehabilitation.  He was
ambulating well and it was decided that the patient was okay
for discharge.

DISPOSITION:  The patient was discharged home on [**2103-7-16**] in
stable condition on 5.0 mg Decadron taper, Zantac, and told
to follow-up with Dr. [**Last Name (STitle) 1327**] in three weeks.



                          [**Name6 (MD) 1339**] [**Last Name (NamePattern4) 1340**], M.D.  [**MD Number(1) 1341**]

Dictated By:[**Last Name (NamePattern1) 4985**]

MEDQUIST36

D:  [**2103-7-16**]  16:34
T:  [**2103-7-21**]  17:40
JOB#:  [**Job Number 35093**]
{'Secondary malignant neoplasm of brain and spinal cord,Personal history of malignant neoplasm of bronchus and lung,Other malignant lymphomas, unspecified site, extranodal and solid organ sites,Unspecified essential hypertension'}


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: 

PRESENT ILLNESS: The patient is a 74 -year-old
white male with a history of Hodgkin's lymphoma and left lung
adenocarcinoma with metastatic cerebellar brain tumor.  The
patient had noted slurred speech for the past month with
clumsiness in his right hand for four weeks.  His slurred
speech progressed over the past week.  He denied headache or
nausea or vomiting.  Metastatic work up revealed bilateral
adrenal metastases, bilateral lung metastases, bone
metastases, as well as the cerebellar lesion.

MEDICAL HISTORY: 1.  Hypertension.
2.  Lung cancer.
3.  Hodgkin's lymphoma.

MEDICATION ON ADMISSION: 

ALLERGIES: Prilosec.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: Nonsmoker. 

### Response:
{'Secondary malignant neoplasm of brain and spinal cord,Personal history of malignant neoplasm of bronchus and lung,Other malignant lymphomas, unspecified site, extranodal and solid organ sites,Unspecified essential hypertension'}
