CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is an
87-year-old lady with a history of dementia and hypertension
who presented with a basal ganglia bleed.  According to the
patient, she has been living at [**Hospital1 **] [**Location (un) **] [**Hospital3 **] for the past year.  Her family states that she cannot
take care of herself.  She has a long history of gait
imbalance and falling backwards.

MEDICAL HISTORY: 1.  Dementia.
2.  Hypertension.
3.  History of prior stroke, details unknown, the patient
denied.

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: She lives in the [**Hospital1 **] [**Location (un) **] [**Hospital3 **].  She walks without assistance but is unsteady, as
stated.  She is otherwise independent in her activities of
essential living.  She denied smoking or drinking alcohol.
Intracerebral hemorrhage,Urinary tract infection, site not specified,Other persistent mental disorders due to conditions classified elsewhere,Unspecified essential hypertension,Abnormality of gait,Unspecified acquired hypothyroidism,Syncope and collapse,Other drugs and medicinal substances causing adverse effects in therapeutic use,Pain in joint, pelvic region and thigh
Intracerebral hemorrhage,Urin tract infection NOS,Mental disor NEC oth dis,Hypertension NOS,Abnormality of gait,Hypothyroidism NOS,Syncope and collapse,Adv eff medicinal NEC,Joint pain-pelvis
Admission Date:  [**2200-11-25**]     Discharge Date: [**2200-11-28**]

Date of Birth:                  Sex:

Service:

PLEASE NOTE:  The projected date of discharge is [**2200-11-29**].

HISTORY OF THE PRESENT ILLNESS:  The patient is an
87-year-old lady with a history of dementia and hypertension
who presented with a basal ganglia bleed.  According to the
patient, she has been living at [**Hospital1 **] [**Location (un) **] [**Hospital3 **] for the past year.  Her family states that she cannot
take care of herself.  She has a long history of gait
imbalance and falling backwards.

Yesterday, she fell once while she was with her son.  On
[**Holiday 1451**] she fell while putting clothing in the drawer.
Yesterday, she fell after hanging up her coat and then
turning around.  Each time she could not get up on her own
because she states that she was weak and unsteady.  She was
sent to [**Hospital3 2063**] in the morning and told the staff at
[**Hospital1 **] about her fall.  The staff at [**Hospital1 **] have no
further details about her falls or gait imbalance.

PAST MEDICAL HISTORY:
1.  Dementia.
2.  Hypertension.
3.  History of prior stroke, details unknown, the patient
denied.

ADMISSION MEDICATIONS:
1.  Aspirin.
2.  Plavix.
3.  Atican.
4.  Detrol.
5.  Toprol.
6.  Aricept.
7.  Prilosec.
8.  Quinine.

SOCIAL HISTORY:  She lives in the [**Hospital1 **] [**Location (un) **] [**Hospital3 **].  She walks without assistance but is unsteady, as
stated.  She is otherwise independent in her activities of
essential living.  She denied smoking or drinking alcohol.

PHYSICAL EXAMINATION ON ADMISSION:  On physical examination,
the blood pressure was 212/80, heart rate 84, respiratory
rate 18.  The patient appeared comfortable.  The oropharynx
was clear.  There were no carotid bruits.  There was no JVD.
No thyromegaly.  The cardiac examination was notable for a
regular rate and rhythm.  The chest was clear to
auscultation.  The abdomen was benign.  No clubbing, cyanosis
or edema of the extremities.  There was periorbital
ecchymoses in different stages of blood product breakdown.

On the neurological examination, on mental status, the
patient was awake, alert, and oriented times three.  She was
slow in the month, year backwards and stopped midway.
Language testing demonstrated normal naming of high and low
frequency, objects and good repetition.  Normal fluency and
comprehension.  The patient could read and write sentences to
dictation. She remember me 30 minutes later.  Formal memory
testing was not performed.  The cranial nerves revealed that
the optic disks were normal.  Pupils were equal, round, and
reactive to light.  The extraocular muscles were intact.
Visual fields were full to confrontation, [**4-23**] through [**4-25**]
were intact to light touch and to pinprick.  There was a
subtle left facial droop.  The tongue, palate, and
sternocleidomastoid moved symmetrically.  Hearing was intact
to finger rub bilaterally.  On motor examination, she had no
drift or asterixis.  She has a mild left hemiparesis of the
arms.  She has symmetrical give-way weakness of the legs.
Sensory examination revealed light touch, pinprick, and joint
position sense were normal.  Reflexes:  Biceps, triceps,
brachial, patella, ankle, and plantar were 2 throughout.  Her
toes are upgoing bilaterally.  Coordination, finger-to-nose,
rapid alternating movements, and fast finger movements were
normal.  Gait was slow and cautious, but steady and she did
not fall.

LABORATORY DATA/OTHER STUDIES:  A CT showed a right basal
ganglia bleed, around 40 cc, impinging on the lateral
ventricle without extension, shift, or evidence of
hydrocephalus.  There was also an old area of
encephalomalacia in the right occipital and temporal lobes.

HOSPITAL COURSE:  The patient was admitted to the Neurology
Service.  She was restarted on her outpatient medications
with the exception of aspirin and Plavix which were
discontinued because of her hemorrhage.

She had blood pressures in the 170-210 range and, therefore,
was started on Norvasc 5 mg p.o. q.d. to be titrated up.  The
etiology of her intracerebral hemorrhage is presumed to be
hypertensive and Norvasc was felt to be the best [**Doctor Last Name 360**] to
control her hypertension.

The patient had minimal deficits by hospital day number two
and was seen by Physical Therapy who recommended that she
could be discharged back to her [**Hospital3 **] facility.
The patient will be discharged back on [**2200-11-29**].

DISCHARGE DIAGNOSIS:
1.  Right basal ganglia hemorrhage.
2.  Hypertension.
3.  History of prior stroke.
4.  Dementia.

MEDICATIONS ON DISCHARGE:
1.  Atican 32 mg p.o. q.d.
2.  Protonix 40 mg p.o. q.d.
3.  Toprol 25 mg p.o. q.d.
4.  Multivitamin one capsule p.o. q.d.
5.  Aricept 10 mg p.o. q.h.s.
6.  Lipitor 10 mg p.o. q.d.
7.  Norvasc 5 mg p.o. q.d.

FOLLOW-UP:  The patient will follow-up with me, Dr. [**First Name4 (NamePattern1) **]
[**Last Name (NamePattern1) 1206**], [**Telephone/Fax (1) 46808**], for Neurology as an outpatient.



                          [**Doctor Last Name **] [**Name8 (MD) 8346**], M.D.  [**MD Number(1) **]

Dictated By:[**Last Name (NamePattern1) 5476**]

MEDQUIST36

D:  [**2200-11-28**]  17:08
T:  [**2200-12-2**]  21:05
JOB#:  [**Job Number 46809**]
{'Intracerebral hemorrhage,Urinary tract infection, site not specified,Other persistent mental disorders due to conditions classified elsewhere,Unspecified essential hypertension,Abnormality of gait,Unspecified acquired hypothyroidism,Syncope and collapse,Other drugs and medicinal substances causing adverse effects in therapeutic use,Pain in joint, pelvic region and thigh'}


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 an
87-year-old lady with a history of dementia and hypertension
who presented with a basal ganglia bleed.  According to the
patient, she has been living at [**Hospital1 **] [**Location (un) **] [**Hospital3 **] for the past year.  Her family states that she cannot
take care of herself.  She has a long history of gait
imbalance and falling backwards.

MEDICAL HISTORY: 1.  Dementia.
2.  Hypertension.
3.  History of prior stroke, details unknown, the patient
denied.

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: She lives in the [**Hospital1 **] [**Location (un) **] [**Hospital3 **].  She walks without assistance but is unsteady, as
stated.  She is otherwise independent in her activities of
essential living.  She denied smoking or drinking alcohol. 

### Response:
{'Intracerebral hemorrhage,Urinary tract infection, site not specified,Other persistent mental disorders due to conditions classified elsewhere,Unspecified essential hypertension,Abnormality of gait,Unspecified acquired hypothyroidism,Syncope and collapse,Other drugs and medicinal substances causing adverse effects in therapeutic use,Pain in joint, pelvic region and thigh'}
