CHIEF COMPLAINT: 

PRESENT ILLNESS: Ms. [**Known firstname 42408**] [**Known lastname 3671**] is a
48-year-old woman with a history of end-stage renal disease
(on hemodialysis), hypothyroidism, seizure disorder, and a
history of migraine headaches who presented to the Emergency
Department with complaints of a severe headache for several
days.

MEDICAL HISTORY: 1.  End-stage renal disease (on hemodialysis for the past
five years).
2.  Hypothyroidism.
3.  Seizure disorder.
4.  Low back pain (chronic).
5.  Status post right partial colectomy secondary to
intussusception.
6.  Status post small-bowel obstruction.
7.  Status post cholecystectomy.
8.  Migraine headaches.

MEDICATION ON ADMISSION: (To the Intensive Care Unit)
1.  Fentanyl and labetalol drips.
2.  Zestril 10 mg by mouth twice per day.
3.  Synthroid 125 mcg by mouth once per day.
4.  Dilantin 300 mg by mouth once per day.
5.  Percocet by mouth as needed.
6.  Renagel 800 mg by mouth three times per day.
7.  Extra-Strength Tums four tablets three times per day.
8.  Soma.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: She is an ex-smoker.  No alcohol.  She is a
teacher.  She is married.
Hypertensive chronic kidney disease, malignant, with chronic kidney disease stage V or end stage renal disease,Other convulsions,Hyposmolality and/or hyponatremia,Anemia, unspecified,Unspecified acquired hypothyroidism
Mal hyp kid w cr kid V,Convulsions NEC,Hyposmolality,Anemia NOS,Hypothyroidism NOS
Admission Date:  [**2120-11-14**]     Discharge Date:  [**2120-11-19**]

Date of Birth:   [**2072-5-1**]     Sex:  F

Service:  MICU

HISTORY OF PRESENT ILLNESS:  Ms. [**Known firstname 42408**] [**Known lastname 3671**] is a
48-year-old woman with a history of end-stage renal disease
(on hemodialysis), hypothyroidism, seizure disorder, and a
history of migraine headaches who presented to the Emergency
Department with complaints of a severe headache for several
days.

Her headache began two days prior, with a sudden onset,
preceded by spots in front of her eyes.  On the day prior to
admission, she continued to have a headache at dialysis.
After dialysis, she vomited at home and subsequently had a
tonic-clonic seizure which was witnessed.

She presented to the Emergency Department where she had a
repeat tonic-clonic seizure lasting two to three minutes.
She received intravenous Ativan and a Dilantin load.  Her
systolic blood pressure was noted to be greater than 200.
She was ultimately placed on a nitroprusside drip in the
Emergency Department for control.  This resulted in a
resolution of the majority of her headache.

A computed tomography of the head and a lumbar puncture were
negative.  The patient was admitted to the Medical Intensive
Care Unit for hypertensive urgency.

PAST MEDICAL HISTORY:
1.  End-stage renal disease (on hemodialysis for the past
five years).
2.  Hypothyroidism.
3.  Seizure disorder.
4.  Low back pain (chronic).
5.  Status post right partial colectomy secondary to
intussusception.
6.  Status post small-bowel obstruction.
7.  Status post cholecystectomy.
8.  Migraine headaches.

ALLERGIES:  No known drug allergies.

MEDICATIONS ON ADMISSION: (To the Intensive Care Unit)
1.  Fentanyl and labetalol drips.
2.  Zestril 10 mg by mouth twice per day.
3.  Synthroid 125 mcg by mouth once per day.
4.  Dilantin 300 mg by mouth once per day.
5.  Percocet by mouth as needed.
6.  Renagel 800 mg by mouth three times per day.
7.  Extra-Strength Tums four tablets three times per day.
8.  Soma.

SOCIAL HISTORY:  She is an ex-smoker.  No alcohol.  She is a
teacher.  She is married.

PHYSICAL EXAMINATION ON PRESENTATION:  On admission her vital
signs revealed a temperature of 97 degrees Fahrenheit, her
blood pressure was 161/79, her heart rate was 82, her
respiratory rate was 14, and her oxygen saturation was 100%
on room air.  In general, she was an uncomfortable
African-American woman moving in bed in distress.  The pupils
were equal, round, and reactive to light and accommodation.
The extraocular muscles were intact.  There was no
photophobia.  The oral mucosa were moist.  The oropharynx was
clear.  The pupils were 1 mm.  Her heart rate and rhythm were
regular with a 2/6 systolic ejection murmur at the left
sternal border.  Normal first heart sounds and second heart
sounds.  The lungs were clear to auscultation bilaterally.
The abdomen was obese, soft, nontender, and nondistended.
The extremities were warm and dry without edema.
Neurologically, cranial nerves II through XII were intact.
She was alert and interactive.

PERTINENT LABORATORY VALUES ON PRESENTATION:  White blood
cell count was 7.2, her hematocrit was 36.6, and her
platelets were 157.  Chemistry-7 was significant for a blood
urea nitrogen of 31 and a creatinine of 7.4.  She had a
phenytoin level of 2.9.

PERTINENT RADIOLOGY/IMAGING:  A computed tomography of the
head showed no bleed and no mass.

BRIEF SUMMARY OF HOSPITAL COURSE:  After admission to the
Intensive Care Unit, her blood pressure was controlled with
intravenous labetalol, and she was weaned off the intravenous
nitroprusside.

Over the next 48 hours she was transitioned again to oral
intake, and her lisinopril was bumped up to better control
her blood pressure.  She had no recurrent episodes of
hypertension while hospitalized.

She was reloaded on her phenytoin.  The levels were checked
and were in the therapeutic range.  Throughout the remainder
of her hospitalization, she had no further seizure activity.
She was followed by the Neurology Service in consultation
while in house.

Her headaches improved shortly after admission with a dose of
metoclopramide.  It was believed that these actually did
represent true migraine headaches; although, they may have
also been related to her hypertensive urgency.

She was discharged to the floor in stable condition and from
the floor was discharged to home.  She was to follow up with
her regular nephrologist and with Neurology.

DISCHARGE DIAGNOSES:
1.  End-stage renal disease (on hemodialysis).
2.  Hypertensive urgency.
3.  Chronic hypertension.
4.  Migraine headache.

DISCHARGE STATUS:  Discharge status was to home.

CONDITION AT DISCHARGE:  Condition on discharge was good.

DISCHARGE INSTRUCTIONS/FOLLOWUP:  The patient was instructed
to follow up with her regular nephrologist (Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 174**])
and with her primary care physician.






                          [**Name6 (MD) 2467**] [**Last Name (NamePattern4) 10404**], M.D.  [**MD Number(1) 10405**]

Dictated By:[**Name8 (MD) 4733**]

MEDQUIST36

D:  [**2122-3-3**]  11:43
T:  [**2122-3-3**]  15:06
JOB#:  [**Job Number 97303**]
{'Hypertensive chronic kidney disease, malignant, with chronic kidney disease stage V or end stage renal disease,Other convulsions,Hyposmolality and/or hyponatremia,Anemia, unspecified,Unspecified acquired hypothyroidism'}


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: Ms. [**Known firstname 42408**] [**Known lastname 3671**] is a
48-year-old woman with a history of end-stage renal disease
(on hemodialysis), hypothyroidism, seizure disorder, and a
history of migraine headaches who presented to the Emergency
Department with complaints of a severe headache for several
days.

MEDICAL HISTORY: 1.  End-stage renal disease (on hemodialysis for the past
five years).
2.  Hypothyroidism.
3.  Seizure disorder.
4.  Low back pain (chronic).
5.  Status post right partial colectomy secondary to
intussusception.
6.  Status post small-bowel obstruction.
7.  Status post cholecystectomy.
8.  Migraine headaches.

MEDICATION ON ADMISSION: (To the Intensive Care Unit)
1.  Fentanyl and labetalol drips.
2.  Zestril 10 mg by mouth twice per day.
3.  Synthroid 125 mcg by mouth once per day.
4.  Dilantin 300 mg by mouth once per day.
5.  Percocet by mouth as needed.
6.  Renagel 800 mg by mouth three times per day.
7.  Extra-Strength Tums four tablets three times per day.
8.  Soma.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: She is an ex-smoker.  No alcohol.  She is a
teacher.  She is married. 

### Response:
{'Hypertensive chronic kidney disease, malignant, with chronic kidney disease stage V or end stage renal disease,Other convulsions,Hyposmolality and/or hyponatremia,Anemia, unspecified,Unspecified acquired hypothyroidism'}
