CHIEF COMPLAINT: Pre-op for liver/kidney Tx with recent hospitalization for UGIB,
grade 1 varices, hepatorenal syndrome

PRESENT ILLNESS: 55 y/o male with ESLD secondary to Hep C and ETOH cirrhosis
recently admitted in early [**Month (only) **] for an UGIB requiring blood
transfusions. Readmission on [**2102-6-5**] with pre-syncope most
likely related to intravascular volume depletion. Called in for
potential liver/kidney Tx on [**2102-6-13**]

MEDICAL HISTORY: Hepatitis C/ETOH induced cirrhosis
(SBP [**2100-1-7**], no variceal bleeds, EGD [**2101-10-19**] Grade 1 varices)
Mitral valve prolapse
Hypertension
Gout
Osteopenia
CKD - baseline creatinine 2.0
Anemia
UGIB [**5-30**]

MEDICATION ON ADMISSION: Lactulose 30''', Allopurinol 100 qod, Colchicine 0.6, Atenolol
25, Omeprazole 20', Levo 250, simethicone 80'''', protonix 40'',

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: On admission:
VS: 97.5, 89/55, 96, 18, 96% RA, 69 kg
In NAD
OMM, + icterus
Lungs CTA bilaterally
Cardio: RRR
Abd: + BS, + Ascites, Sl TTP RLQ (at baseline)
Trace LE edema

FAMILY HISTORY: Father-HTN, MI in his 80s
Mother- "spine cancer"

SOCIAL HISTORY: The pt denies current cigarette use, but reports smoking 10
cig/day for 20 years.  He also quit drinking 1 [**12-26**] yr ago but
prior had drank for 23 years with 1 pint of gin or brandy a day.
He denies IVDU, but has snorted cocaine in the past.  He works
at the JP VA currently and lives in the [**Location (un) 4398**] alone.  His
sister is his HCP and is very supportive
Alcoholic cirrhosis of liver,Unspecified viral hepatitis C without hepatic coma,End stage renal disease,Hepatorenal syndrome
Alcohol cirrhosis liver,Hpt C w/o hepat coma NOS,End stage renal disease,Hepatorenal syndrome
Admission Date:  [**2102-6-13**]              Discharge Date:   [**2102-6-21**]

Date of Birth:  [**2047-3-26**]             Sex:   M

Service: SURGERY

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 3127**]
Chief Complaint:
Pre-op for liver/kidney Tx with recent hospitalization for UGIB,
grade 1 varices, hepatorenal syndrome

Major Surgical or Invasive Procedure:
Liver and kidney transplant on [**2102-6-14**]


History of Present Illness:
55 y/o male with ESLD secondary to Hep C and ETOH cirrhosis
recently admitted in early [**Month (only) **] for an UGIB requiring blood
transfusions. Readmission on [**2102-6-5**] with pre-syncope most
likely related to intravascular volume depletion. Called in for
potential liver/kidney Tx on [**2102-6-13**]

Past Medical History:
Hepatitis C/ETOH induced cirrhosis
(SBP [**2100-1-7**], no variceal bleeds, EGD [**2101-10-19**] Grade 1 varices)
Mitral valve prolapse
Hypertension
Gout
Osteopenia
CKD - baseline creatinine 2.0
Anemia
UGIB [**5-30**]


Social History:
The pt denies current cigarette use, but reports smoking 10
cig/day for 20 years.  He also quit drinking 1 [**12-26**] yr ago but
prior had drank for 23 years with 1 pint of gin or brandy a day.
He denies IVDU, but has snorted cocaine in the past.  He works
at the JP VA currently and lives in the [**Location (un) 4398**] alone.  His
sister is his HCP and is very supportive


Family History:
Father-HTN, MI in his 80s
Mother- "spine cancer"

Physical Exam:
On admission:
VS: 97.5, 89/55, 96, 18, 96% RA, 69 kg
In NAD
OMM, + icterus
Lungs CTA bilaterally
Cardio: RRR
Abd: + BS, + Ascites, Sl TTP RLQ (at baseline)
Trace LE edema


Pertinent Results:
Labs on discharge: [**2102-6-21**]
Na 140 K: 3.5  Cl:108  Co2: 27  BUN:15 Creat 0.8   Glucose:72

Ca: 7.6 Mg: 1.2 P: 2.6
AST: 64 ALT: 225 AP: 136 Tbili: 1.1 Alb: 2.2
UricA:3.6
WBC: 4.7 Hgb: 9.3  Hct: 27.0  Plt:  56

Labs on Admission: [**2102-6-13**]
GLUCOSE-91 UREA N-37* CREAT-2.9* SODIUM-136 POTASSIUM-4.1
CHLORIDE-110* TOTAL CO2-15* ANION GAP-15
ALT(SGPT)-43* AST(SGOT)-137* ALK PHOS-360* TOT BILI-3.3*
ALBUMIN-3.3* CALCIUM-8.4 PHOSPHATE-2.8 MAGNESIUM-1.7
WBC-6.3 RBC-2.85* HGB-8.9* HCT-25.9* MCV-91 MCH-31.1 MCHC-34.2
RDW-18.5*
PLT COUNT-82*
PT-16.3* PTT-35.1* INR(PT)-1.5*
FIBRINOGEN-102*

Brief Hospital Course:
Pt admitted from home for liver/kidney transplant.
-Orthotopic liver transplant, piggyback technique,
portal vein-to-portal vein, hepatic artery-to- hepatic artery
and bile duct-to-bile duct anastomoses.
-Right iliac fossa renal transplant with 6-French double-J
stent.
[**6-15**] Doppler for L arm swelling r/o dvt left upper extremity arm
swelling. No thrombus seen
Extubated on POD 2. Uneventful post-op course. Liver enzymes
trending down and creatinine down to baseline creat around 0.8

Medications on Admission:
Lactulose 30''', Allopurinol 100 qod, Colchicine 0.6, Atenolol
25, Omeprazole 20', Levo 250, simethicone 80'''', protonix 40'',


Discharge Medications:
1. Fluconazole 200 mg Tablet Sig: Two (2) Tablet PO Q24H (every
24 hours).
2. Prednisone 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

3. Insulin Regular Human 100 unit/mL Solution Sig: One (1)
Injection ASDIR (AS DIRECTED).
4. Mycophenolate Mofetil 500 mg Tablet Sig: Two (2) Tablet PO
BID (2 times a day).
5. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
6. Trimethoprim-Sulfamethoxazole 80-400 mg Tablet Sig: One (1)
Tablet PO DAILY (Daily).
7. Valganciclovir 450 mg Tablet Sig: Two (2) Tablet PO DAILY
(Daily).
8. Tacrolimus 5 mg Capsule Sig: One (1) Capsule PO BID (2 times
a day).
9. Allopurinol 100 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
10. Colchicine 0.6 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily) for 1 doses.


Discharge Disposition:
Home With Service

Facility:
[**Hospital 119**] Homecare

Discharge Diagnosis:
S/P liver/kidney transplant for HCV/cirrhosis


Discharge Condition:
Good


Discharge Instructions:
Call [**Telephone/Fax (1) 673**] if you develop fever, chills, nausea,
vomiting, increased abdominal pain/discomfort, increased or
bloody drainage from wound sites or drain. Also call if you
notice a decrease in urine output or if you have
frequency,urgency or blood in your urine.
Lab tests every Monday and Thursday: CBC, Chem 10, Calcium,
Phos, AST, ALT, Alk Phos, T Bili, albumin, U/A and trough
Prograf level. Fax results to transplant office: [**Telephone/Fax (1) 697**]
Do not drive if using pain medications

Followup Instructions:
Provider: [**Name10 (NameIs) 1344**] [**Last Name (NamePattern4) 3125**], MD Phone:[**Telephone/Fax (1) 673**]
Date/Time:[**2102-6-26**] 10:30
Provider: [**Name10 (NameIs) 1344**] [**Last Name (NamePattern4) 3125**], MD Phone:[**Telephone/Fax (1) 673**]
Date/Time:[**2102-7-3**] 8:50
Provider: [**Name10 (NameIs) 1344**] [**Last Name (NamePattern4) 3125**], MD Phone:[**Telephone/Fax (1) 673**]
Date/Time:[**2102-7-10**] 9:10



Completed by:[**2102-7-10**]
{'Alcoholic cirrhosis of liver,Unspecified viral hepatitis C without hepatic coma,End stage renal disease,Hepatorenal syndrome'}


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: Pre-op for liver/kidney Tx with recent hospitalization for UGIB,
grade 1 varices, hepatorenal syndrome

PRESENT ILLNESS: 55 y/o male with ESLD secondary to Hep C and ETOH cirrhosis
recently admitted in early [**Month (only) **] for an UGIB requiring blood
transfusions. Readmission on [**2102-6-5**] with pre-syncope most
likely related to intravascular volume depletion. Called in for
potential liver/kidney Tx on [**2102-6-13**]

MEDICAL HISTORY: Hepatitis C/ETOH induced cirrhosis
(SBP [**2100-1-7**], no variceal bleeds, EGD [**2101-10-19**] Grade 1 varices)
Mitral valve prolapse
Hypertension
Gout
Osteopenia
CKD - baseline creatinine 2.0
Anemia
UGIB [**5-30**]

MEDICATION ON ADMISSION: Lactulose 30''', Allopurinol 100 qod, Colchicine 0.6, Atenolol
25, Omeprazole 20', Levo 250, simethicone 80'''', protonix 40'',

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: On admission:
VS: 97.5, 89/55, 96, 18, 96% RA, 69 kg
In NAD
OMM, + icterus
Lungs CTA bilaterally
Cardio: RRR
Abd: + BS, + Ascites, Sl TTP RLQ (at baseline)
Trace LE edema

FAMILY HISTORY: Father-HTN, MI in his 80s
Mother- "spine cancer"

SOCIAL HISTORY: The pt denies current cigarette use, but reports smoking 10
cig/day for 20 years.  He also quit drinking 1 [**12-26**] yr ago but
prior had drank for 23 years with 1 pint of gin or brandy a day.
He denies IVDU, but has snorted cocaine in the past.  He works
at the JP VA currently and lives in the [**Location (un) 4398**] alone.  His
sister is his HCP and is very supportive 

### Response:
{'Alcoholic cirrhosis of liver,Unspecified viral hepatitis C without hepatic coma,End stage renal disease,Hepatorenal syndrome'}
