CHIEF COMPLAINT: Right lower lobe lung cancer.

PRESENT ILLNESS: Mr. [**Known lastname 4300**] is a 57-year-old gentleman who is referred to me at
the thoracic multidisciplinary clinic by Dr. [**First Name4 (NamePattern1) 449**] [**Last Name (NamePattern1) 410**] for
evaluation of an incidentally
noted right lower lobe mass.  Mr. [**Known lastname 4300**] has a history of
polysubstance abuse and has had multiple admissions for
pancreatitis and trauma.  In a preoperative x-ray for ankle
surgery, he was noted to have a nodule back in [**2198-10-12**].
This was followed on a CT of the chest on [**2199-5-6**].  This
showed the right lower lobe had a 2.1 cm suspicious nodule.
There were enlarged lymph nodes in the subcarinal station and
right peribronchial lymph node station.  There were also
prominent though non-pathologically enlarged nodes in the right
peribronchial region, left hilus, and left paratracheal
stations. In addition, there was a 5-mm nodule in the right
upper lobe and a 4-mm nodule in the right lower lobe of
indeterminate significance.  On [**2199-8-2**] he had a CT of the chest
which showed a right middle lobe mass suspicious for malignancy
that had increased in size.  On  [**2199-8-21**] he underwent a
flexible bronchoscopy with alveolar lavage of the superior
segment of the right lower lobe, cervical mediastinoscopy which
was negative.  He is admitted for a right lower lobectomy.

MEDICAL HISTORY: 1.Right lower lobe mass
2.ETOH abuse
3.HCV
4.Frequent episodes of pancreatitis related to etoh abuse
5.CAD with [**2195**] MIBI showing mod partially reversible defect in
LAD region
6.Osteoarthritis
7.s/p colectomy for ?SBO/bowel perforation, done at [**Hospital1 112**]

MEDICATION ON ADMISSION: ASA 325 mg once daily
Atenolol 25 once daily
Lisinopril 10 mg once daily
Omeprazole 40 mg once daily
Sildenafil PRN

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: GENERAL: Well-appearing middle-aged African-American man in no
acute distress.
HEENT:  No scleral icterus.  Oropharynx clear.
LUNGS:  Right decreased lungs with faint crackles inferiorly,
Left breath sounds clear
HEART:  Regular rate and rhythm, normal S1 and S2, no murmurs,
rubs or gallops appreciated.
ABDOMEN:  Soft, nontender, nondistended.  No masses or
hepatosplenomegaly appreciated.
Wound: Right incision clean, dry intact, chest tube site clean
EXTREMITIES: warm no edema
Neuro: non-focal

FAMILY HISTORY: Dad with ETOH cirrhosis, uncle with Diabetes, Mom with MI at 72.

SOCIAL HISTORY: He is married lives with his wife and has grown children.   He
currently drinks 1-2 beers daily but states he has been drug
free since [**2198-12-12**] after an arrest for possession of
cocaine.  He is currently on probation.    He is on social
security disability.
Malignant neoplasm of other parts of bronchus or lung,Alcoholic cardiomyopathy,Acute pancreatitis,Chronic hepatitis C without mention of hepatic coma,Other and unspecified alcohol dependence, continuous,Unspecified essential hypertension
Mal neo bronch/lung NEC,Alcoholic cardiomyopathy,Acute pancreatitis,Chrnc hpt C wo hpat coma,Alcoh dep NEC/NOS-contin,Hypertension NOS
Admission Date:  [**2199-9-13**]              Discharge Date:   [**2199-9-18**]

Date of Birth:  [**2141-10-13**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 5790**]
Chief Complaint:
Right lower lobe lung cancer.


Major Surgical or Invasive Procedure:
Flexible bronchoscopy.
Thoracoscopic right lower lobe wedge resection.
VATS, right lower lobectomy.
Mediastinal lymph node dissection.


History of Present Illness:
Mr. [**Known lastname 4300**] is a 57-year-old gentleman who is referred to me at
the thoracic multidisciplinary clinic by Dr. [**First Name4 (NamePattern1) 449**] [**Last Name (NamePattern1) 410**] for
evaluation of an incidentally
noted right lower lobe mass.  Mr. [**Known lastname 4300**] has a history of
polysubstance abuse and has had multiple admissions for
pancreatitis and trauma.  In a preoperative x-ray for ankle
surgery, he was noted to have a nodule back in [**2198-10-12**].
This was followed on a CT of the chest on [**2199-5-6**].  This
showed the right lower lobe had a 2.1 cm suspicious nodule.
There were enlarged lymph nodes in the subcarinal station and
right peribronchial lymph node station.  There were also
prominent though non-pathologically enlarged nodes in the right
peribronchial region, left hilus, and left paratracheal
stations. In addition, there was a 5-mm nodule in the right
upper lobe and a 4-mm nodule in the right lower lobe of
indeterminate significance.  On [**2199-8-2**] he had a CT of the chest
which showed a right middle lobe mass suspicious for malignancy
that had increased in size.  On  [**2199-8-21**] he underwent a
flexible bronchoscopy with alveolar lavage of the superior
segment of the right lower lobe, cervical mediastinoscopy which
was negative.  He is admitted for a right lower lobectomy.


Past Medical History:
1.Right lower lobe mass
2.ETOH abuse
3.HCV
4.Frequent episodes of pancreatitis related to etoh abuse
5.CAD with [**2195**] MIBI showing mod partially reversible defect in
LAD region
6.Osteoarthritis
7.s/p colectomy for ?SBO/bowel perforation, done at [**Hospital1 112**]


Social History:
He is married lives with his wife and has grown children.   He
currently drinks 1-2 beers daily but states he has been drug
free since [**2198-12-12**] after an arrest for possession of
cocaine.  He is currently on probation.    He is on social
security disability.


Family History:
Dad with ETOH cirrhosis, uncle with Diabetes, Mom with MI at 72.


Physical Exam:
GENERAL: Well-appearing middle-aged African-American man in no
acute distress.
HEENT:  No scleral icterus.  Oropharynx clear.
LUNGS:  Right decreased lungs with faint crackles inferiorly,
Left breath sounds clear
HEART:  Regular rate and rhythm, normal S1 and S2, no murmurs,
rubs or gallops appreciated.
ABDOMEN:  Soft, nontender, nondistended.  No masses or
hepatosplenomegaly appreciated.
Wound: Right incision clean, dry intact, chest tube site clean
EXTREMITIES: warm no edema
Neuro: non-focal


Pertinent Results:
Studies:
CXR:
[**2199-9-17**] Interval removal of two chest tubes with linear lucency
at right base suggestive of a right basilar pneumothorax.
Persistent right lower lung airspace opacification.

Cultures:
[**9-15**] BCx - Pending
[**9-15**] Ucx - Neg

[**2199-9-17**] Chemistry  BS: 113  BUN: 25; Cre: 1.2 Na: 138; K+ 4.8;
[**2199-9-17**] CBC: WBC: 7.9, Hct 33/ Hgb: 11.1; Plts 271


Brief Hospital Course:
The patient was admitted to Thoracic Surgery and underwent
successful flexible bronchoscopy, thoracoscopic right lower lobe
wedge resection, and mediastinal lymph node dissection.  The
patient tolerated the procedure well and was transferred to the
PACU in stable condition then later to the floor.  On POD#2 the
patient spiked a fever to 101.4. A chest x-ray was done.  His
urine culture was negative the blood cultures x 2  are still
pending.  The patient also had serial chest X-rays showing a RLL
opacity.  On POD#4 the patient's chest tubes were removed
without complication.  The patients oxygen saturation was 86% on
room air at rest and 83% with activity.  On postoperative day 5
he was discharged to home on oxygen 2 liters via nasal cannula
to maintain saturations greater than 90%.  He was
hemodynamically stable, tolerating po feeds, pain controlled on
po pain meds, and ambulating well.  He will follow-up with Dr.
[**Last Name (STitle) **] as an outpatient.

Medications on Admission:
ASA 325 mg once daily
Atenolol 25 once daily
Lisinopril 10 mg once daily
Omeprazole 40 mg once daily
Sildenafil PRN

Discharge Medications:
1. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
3. Atenolol 50 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
Disp:*60 Tablet(s)* Refills:*2*
4. Ibuprofen 600 mg Tablet Sig: One (1) Tablet PO Q8H (every 8
hours) as needed for pain.
Disp:*40 Tablet(s)* Refills:*0*
5. Hydromorphone 4 mg Tablet Sig: 1-2 Tablets PO Q3H (every 3
hours) as needed.
Disp:*80 Tablet(s)* Refills:*0*
6. Lisinopril 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

7. Omeprazole 40 mg Capsule, Delayed Release(E.C.) Sig: One (1)
Capsule, Delayed Release(E.C.) PO once a day.
8. Furosemide 20 mg Tablet Sig: One (1) Tablet PO once a day for
3 days.
Disp:*3 Tablet(s)* Refills:*0*
9. Oxygen @ 2 LPM continuous Via nasal Cannula to maintain Sats
> 90%


Discharge Disposition:
Home With Service

Facility:
[**Location (un) 86**] VNA

Discharge Diagnosis:
Right lower lobe lung cancer s/p right lobe lobectomy
Hypertension
Alcoholic cardiomyopathy (EF 25-30%),
EtOH abuse
Alcoholic pancreatitis
Hepatitis C


Discharge Condition:
Good


Discharge Instructions:
Call Dr.[**Name (NI) 2347**] office if experience any of the
following:
-Fever > 101 or chills
-Increased shortness of breath, cough or sputum production
-Chest pain
Dressing: remove chest tube dressing on Friday.  Cover with a
clean bandaid.  Should site start to drain cover with a clean
dressing and change as needed.  Keep site clean and dry.
After showering cover chest to site with bandaid.
Monitor incision site for increased warmth or purulent
discharge.
No swimming or bathing for 6 weeks
No driving while taking narcotics.
Take stool softners while taking narcotics. i.e. colace, senna
Resume regular diet.
Continue to walk throughout day.
Continue to use incentive spirometer.
Take lasix 20 mg once daily for 3 days. Eat a banana or drink
[**Location (un) 2452**] juice daily while taking lasix
Oxygen 2 liters to maintain sats: > 90%


Followup Instructions:
Follow-up with Dr. [**Last Name (STitle) **] on [**10-1**] at 1:30 on the
[**Hospital Ward Name 517**], [**Location (un) **] [**Hospital Ward Name 23**] Clinical Center.
Report to the [**Location (un) **] radiology department for a chest x-ray
45 minutes before your schedule appointment.
Follow-up with your PCP [**Last Name (NamePattern4) **]. [**Last Name (STitle) **]



Completed by:[**2199-9-18**]
{'Malignant neoplasm of other parts of bronchus or lung,Alcoholic cardiomyopathy,Acute pancreatitis,Chronic hepatitis C without mention of hepatic coma,Other and unspecified alcohol dependence, continuous,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: Right lower lobe lung cancer.

PRESENT ILLNESS: Mr. [**Known lastname 4300**] is a 57-year-old gentleman who is referred to me at
the thoracic multidisciplinary clinic by Dr. [**First Name4 (NamePattern1) 449**] [**Last Name (NamePattern1) 410**] for
evaluation of an incidentally
noted right lower lobe mass.  Mr. [**Known lastname 4300**] has a history of
polysubstance abuse and has had multiple admissions for
pancreatitis and trauma.  In a preoperative x-ray for ankle
surgery, he was noted to have a nodule back in [**2198-10-12**].
This was followed on a CT of the chest on [**2199-5-6**].  This
showed the right lower lobe had a 2.1 cm suspicious nodule.
There were enlarged lymph nodes in the subcarinal station and
right peribronchial lymph node station.  There were also
prominent though non-pathologically enlarged nodes in the right
peribronchial region, left hilus, and left paratracheal
stations. In addition, there was a 5-mm nodule in the right
upper lobe and a 4-mm nodule in the right lower lobe of
indeterminate significance.  On [**2199-8-2**] he had a CT of the chest
which showed a right middle lobe mass suspicious for malignancy
that had increased in size.  On  [**2199-8-21**] he underwent a
flexible bronchoscopy with alveolar lavage of the superior
segment of the right lower lobe, cervical mediastinoscopy which
was negative.  He is admitted for a right lower lobectomy.

MEDICAL HISTORY: 1.Right lower lobe mass
2.ETOH abuse
3.HCV
4.Frequent episodes of pancreatitis related to etoh abuse
5.CAD with [**2195**] MIBI showing mod partially reversible defect in
LAD region
6.Osteoarthritis
7.s/p colectomy for ?SBO/bowel perforation, done at [**Hospital1 112**]

MEDICATION ON ADMISSION: ASA 325 mg once daily
Atenolol 25 once daily
Lisinopril 10 mg once daily
Omeprazole 40 mg once daily
Sildenafil PRN

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: GENERAL: Well-appearing middle-aged African-American man in no
acute distress.
HEENT:  No scleral icterus.  Oropharynx clear.
LUNGS:  Right decreased lungs with faint crackles inferiorly,
Left breath sounds clear
HEART:  Regular rate and rhythm, normal S1 and S2, no murmurs,
rubs or gallops appreciated.
ABDOMEN:  Soft, nontender, nondistended.  No masses or
hepatosplenomegaly appreciated.
Wound: Right incision clean, dry intact, chest tube site clean
EXTREMITIES: warm no edema
Neuro: non-focal

FAMILY HISTORY: Dad with ETOH cirrhosis, uncle with Diabetes, Mom with MI at 72.

SOCIAL HISTORY: He is married lives with his wife and has grown children.   He
currently drinks 1-2 beers daily but states he has been drug
free since [**2198-12-12**] after an arrest for possession of
cocaine.  He is currently on probation.    He is on social
security disability. 

### Response:
{'Malignant neoplasm of other parts of bronchus or lung,Alcoholic cardiomyopathy,Acute pancreatitis,Chronic hepatitis C without mention of hepatic coma,Other and unspecified alcohol dependence, continuous,Unspecified essential hypertension'}
