CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 72 year old
gentleman with a history of left nephrectomy in [**2124**] for
renal cell carcinoma, reportedly diagnosed during workup for
polycythemia.  He now presents with a three day history of
nausea, vomiting, dizziness, a mild frontal headache and mild
lightheadedness, progressing with increased vomiting times
three days, three times today.  He denies sense of spinning
or vertigo.  He notes progressive unsteadiness of gait and
mild photophobia.  He denies chest pain, shortness of breath,
cough, dysuria, abdominal pain or diarrhea.  The patient
reports a positive history of lung metastases, diagnosed in
[**2130-1-2**], treated with two treatments of interleukin-2
with no change in pulmonary metastases on follow-up.

MEDICAL HISTORY: 1.  Renal cell carcinoma with lung
metastases.  2.  Polycythemia.  3.  Glaucoma.  4.  Rash.

MEDICATION ON ADMISSION: Multivitamins, ibuprofen,
cyclobenzaprine.

ALLERGIES: Benadryl.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Secondary malignant neoplasm of brain and spinal cord,Secondary malignant neoplasm of lung,Personal history of malignant neoplasm of kidney,Unspecified essential hypertension,Polycythemia vera,Unspecified glaucoma
Sec mal neo brain/spine,Secondary malig neo lung,Hx of kidney malignancy,Hypertension NOS,Polycythemia vera,Glaucoma NOS
Admission Date:  [**2130-9-20**]       Discharge Date:  [**2130-9-28**]

Date of Birth:   [**2055-12-18**]       Sex:  M

Service:  Neurosurge

HISTORY OF PRESENT ILLNESS:  The patient is a 72 year old
gentleman with a history of left nephrectomy in [**2124**] for
renal cell carcinoma, reportedly diagnosed during workup for
polycythemia.  He now presents with a three day history of
nausea, vomiting, dizziness, a mild frontal headache and mild
lightheadedness, progressing with increased vomiting times
three days, three times today.  He denies sense of spinning
or vertigo.  He notes progressive unsteadiness of gait and
mild photophobia.  He denies chest pain, shortness of breath,
cough, dysuria, abdominal pain or diarrhea.  The patient
reports a positive history of lung metastases, diagnosed in
[**2130-1-2**], treated with two treatments of interleukin-2
with no change in pulmonary metastases on follow-up.

MEDICATIONS ON ADMISSION:  Multivitamins, ibuprofen,
cyclobenzaprine.

ALLERGIES:  Benadryl.

PAST MEDICAL HISTORY:  1.  Renal cell carcinoma with lung
metastases.  2.  Polycythemia.  3.  Glaucoma.  4.  Rash.

PAST SURGICAL HISTORY:  Left nephrectomy in [**2124**].

PHYSICAL EXAMINATION:  On physical examination, the patient
had a temperature of 95.5, heart rate 77, blood pressure
195/97, respiratory rate 19 and oxygen saturation 93% in room
air.  The patient was a gentleman in no acute distress,
awake, alert and oriented times three, conversant but with
towel over eyes secondary to mild photophobia and headache.
Pupils equal, round, and reactive to light and accommodation,
extraocular movements intact, no nystagmus, tongue midline,
palate rises in midline, facial sensation intact bilaterally,
V1 through V3, smile symmetric, neck supple.  Lungs:  Clear
to auscultation.  Cardiovascular:  Regular rate and rhythm,
no murmur, rub or gallop.  Abdomen:  Soft, nontender,
nondistended, positive bowel sounds.  Sensation intact to
light touch, strength 5/5 in all groups, increased tone
throughout, no clonus, gait deferred, deep tendon reflexes
inconsistent due to increased tone.

LABORATORY DATA:  CT, low density, round 2.5 to 3 cm midline
cerebellar lesion with question of early compression of the
fourth ventricle but no obvious hydrocephalus on lateral
ventricles.  White blood cell count was 12.8, hematocrit
56.7, platelet count 362,000, sodium 137, potassium 4.4,
chloride 101, bicarbonate 25, BUN 26, creatinine 1.5, glucose
118, prothrombin time 13.6, INR 1.2 and partial
thromboplastin time 28.6.  Chest x-ray showed no infiltrates
or congestive heart failure.

HOSPITAL COURSE:  On [**2130-9-22**], the patient
underwent a suboccipital craniotomy for resection of tumor.
There were no intraoperative complications.  Postoperatively,
the patient was monitored in the Surgical Intensive Care
Unit.  He was afebrile with stable vital signs.  His blood
pressure was under control with Nipride.  He was started on
oral Lopressor and Nipride was weaned off.

The patient was transferred to the regular floor on
postoperative day number two.  The patient was seen by
physical therapy and occupational therapy and found to
require rehabilitation prior to discharge to home.  His vital
signs have remained stable.  He has been afebrile, and
neurologically, he is awake, alert and oriented times three,
moving all extremities with no drift.

DISCHARGE MEDICATIONS:
Colace 100 mg p.o.b.i.d.
Lopressor 200 mg p.o.b.i.d., hold for systolic blood pressure
less than 110, heart rate less than 60.
Vasotec 15 mg p.o.b.i.d., hold for systolic blood pressure
less than 110.
Zantac 150 mg p.o.b.i.d.
Decadron 4 mg p.o.q.8h., to wean to 2 mg b.i.d.

CONDITION AT DISCHARGE:  Stable.

FOLLOW-UP:  The patient will follow up in the brain tumor
clinic to see Dr. [**First Name (STitle) **] and is also to see Dr. [**Last Name (STitle) 1327**] in a
week to ten days for staple removal.




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

Dictated By:[**Last Name (NamePattern1) 344**]
MEDQUIST36

D:  [**2130-9-27**]  10:53
T:  [**2130-9-27**]  10:52
JOB#:  [**Job Number 32499**]
{'Secondary malignant neoplasm of brain and spinal cord,Secondary malignant neoplasm of lung,Personal history of malignant neoplasm of kidney,Unspecified essential hypertension,Polycythemia vera,Unspecified glaucoma'}


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 72 year old
gentleman with a history of left nephrectomy in [**2124**] for
renal cell carcinoma, reportedly diagnosed during workup for
polycythemia.  He now presents with a three day history of
nausea, vomiting, dizziness, a mild frontal headache and mild
lightheadedness, progressing with increased vomiting times
three days, three times today.  He denies sense of spinning
or vertigo.  He notes progressive unsteadiness of gait and
mild photophobia.  He denies chest pain, shortness of breath,
cough, dysuria, abdominal pain or diarrhea.  The patient
reports a positive history of lung metastases, diagnosed in
[**2130-1-2**], treated with two treatments of interleukin-2
with no change in pulmonary metastases on follow-up.

MEDICAL HISTORY: 1.  Renal cell carcinoma with lung
metastases.  2.  Polycythemia.  3.  Glaucoma.  4.  Rash.

MEDICATION ON ADMISSION: Multivitamins, ibuprofen,
cyclobenzaprine.

ALLERGIES: Benadryl.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Secondary malignant neoplasm of brain and spinal cord,Secondary malignant neoplasm of lung,Personal history of malignant neoplasm of kidney,Unspecified essential hypertension,Polycythemia vera,Unspecified glaucoma'}
