CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 52 year old
male with a history of recurrent squamous cell carcinoma of
the right pharynx, initially diagnosed as T3 N3 M0, status
post completion of radiation therapy and chemotherapy.  The
patient's posttherapeutic CT scan had shown a decrease in the
size of the neck mass but persistence of the lesion in the
right pharynx.  On [**2156-3-5**], by direct laryngoscopy and
biopsy, the patient was diagnosed with invasive recurrent
squamous cell carcinoma.  The patient was admitted on
[**2156-5-4**], for direct laryngoscopy and right neck exploration.

MEDICAL HISTORY: The patient denies diabetes mellitus
and hypertension.  The [**Hospital 228**] medical history includes
chronic obstructive pulmonary disease and emphysema per
x-ray, anemia, also fatigue, weight loss, anorexia.  The
patient denies bleeding problems, fevers or chills.

MEDICATION ON ADMISSION: 1.  Duragesic patch 25 mcg q3days.
2.  Percocet two tablets q4-5hours.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Malignant neoplasm of posterior wall of oropharynx,Secondary malignant neoplasm of other specified sites,Chronic airway obstruction, not elsewhere classified,Cardiac complications, not elsewhere classified,Cardiac arrest,Anoxic brain damage,Nutritional marasmus,Tobacco use disorder
Mal neo post oropharynx,Secondary malig neo NEC,Chr airway obstruct NEC,Surg compl-heart,Cardiac arrest,Anoxic brain damage,Nutritional marasmus,Tobacco use disorder
Admission Date:  [**2156-5-4**]     Discharge Date:  [**2156-5-8**]

Date of Birth:   [**2104-4-26**]     Sex:  M

Service:

HISTORY OF PRESENT ILLNESS:  The patient is a 52 year old
male with a history of recurrent squamous cell carcinoma of
the right pharynx, initially diagnosed as T3 N3 M0, status
post completion of radiation therapy and chemotherapy.  The
patient's posttherapeutic CT scan had shown a decrease in the
size of the neck mass but persistence of the lesion in the
right pharynx.  On [**2156-3-5**], by direct laryngoscopy and
biopsy, the patient was diagnosed with invasive recurrent
squamous cell carcinoma.  The patient was admitted on
[**2156-5-4**], for direct laryngoscopy and right neck exploration.

PAST MEDICAL HISTORY:  The patient denies diabetes mellitus
and hypertension.  The [**Hospital 228**] medical history includes
chronic obstructive pulmonary disease and emphysema per
x-ray, anemia, also fatigue, weight loss, anorexia.  The
patient denies bleeding problems, fevers or chills.

PAST SURGICAL HISTORY:  Right neck mass biopsy [**2156-2-7**],
and [**2155-6-9**], and gastrostomy tube placement.

ALLERGIES:  No known drug allergies.

MEDICATIONS ON ADMISSION:
1.  Duragesic patch 25 mcg q3days.
2.  Percocet two tablets q4-5hours.

PHYSICAL EXAMINATION:  On physical examination, vital signs
revealed blood pressure 120/83, pulse 104, oxygen saturation
98%.  The patient is cachectic, stooped with full beard,
unkempt, but cooperative, and appears older than stated age.
Head, eyes, ears, nose and throat - Tender obvious neck mass
at the right side of the neck with umbilicated papule
inferior to the right ear, very limited neck mobility.  Chest
is clear to auscultation bilaterally.  Positive for kyphosis.
Cardiac examination - S1 and S2, regular rate and rhythm.
Abdomen is scaphoid.  Gastrostomy tube in epigastric area.
Generalized guarding.  The patient states is nontender.
Abdomen is firm.  Aortic pulsations left side of the midline.
Extremities - no edema.  Pulses palpable bilaterally.

HOSPITAL COURSE:  On [**2156-5-4**], the patient underwent right
neck exploration and direct laryngoscopy.  He was placed on
Roxicet, Fentanyl patch and Morphine intravenous p.r.n. for
pain.  He was also placed on perioperative antibiotics,
Cefazolin one gram q8hours, and his tube feeds were started.
Overnight, the patient was found to be unresponsive.  Code
Blue was called.  The patient was intubated and resuscitated,
and was then transferred to the unit for further observation.
During cardiac arrest, the patient presented with dilated
fixed pupils.  Therefore, a CT of the head with and without
contrast was ordered to rule out brain injury.  CT was
negative for acute intracranial hemorrhage or infarction.
Ethics Committee was consulted to discuss the code status of
the patient and family meeting was arranged for the next day,
[**2156-5-6**].  In the meantime, the patient's code status was
changed to DNR/DNI and intravenous antibiotics were
discontinued.  Postoperative day three, the patient failed
extubation and was reintubated.  The next day the code status
of the patient was changed to comfort measures only per
family.  The patient was extubated.  The patient passed away
[**2156-5-8**], at 6:34 p.m.




                       [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 39**], M.D., D.M.D.  [**MD Number(1) 11390**]

Dictated By:[**Last Name (NamePattern1) 23784**]

MEDQUIST36

D:  [**2156-7-28**]  17:45
T:  [**2156-7-31**]  09:06
JOB#:  [**Job Number 48852**]
{'Malignant neoplasm of posterior wall of oropharynx,Secondary malignant neoplasm of other specified sites,Chronic airway obstruction, not elsewhere classified,Cardiac complications, not elsewhere classified,Cardiac arrest,Anoxic brain damage,Nutritional marasmus,Tobacco use disorder'}


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 52 year old
male with a history of recurrent squamous cell carcinoma of
the right pharynx, initially diagnosed as T3 N3 M0, status
post completion of radiation therapy and chemotherapy.  The
patient's posttherapeutic CT scan had shown a decrease in the
size of the neck mass but persistence of the lesion in the
right pharynx.  On [**2156-3-5**], by direct laryngoscopy and
biopsy, the patient was diagnosed with invasive recurrent
squamous cell carcinoma.  The patient was admitted on
[**2156-5-4**], for direct laryngoscopy and right neck exploration.

MEDICAL HISTORY: The patient denies diabetes mellitus
and hypertension.  The [**Hospital 228**] medical history includes
chronic obstructive pulmonary disease and emphysema per
x-ray, anemia, also fatigue, weight loss, anorexia.  The
patient denies bleeding problems, fevers or chills.

MEDICATION ON ADMISSION: 1.  Duragesic patch 25 mcg q3days.
2.  Percocet two tablets q4-5hours.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Malignant neoplasm of posterior wall of oropharynx,Secondary malignant neoplasm of other specified sites,Chronic airway obstruction, not elsewhere classified,Cardiac complications, not elsewhere classified,Cardiac arrest,Anoxic brain damage,Nutritional marasmus,Tobacco use disorder'}
