CHIEF COMPLAINT: 

PRESENT ILLNESS: Mr. [**Known lastname 6884**] is a 27 -year-old man
with a history of substance abuse, attention deficit disorder
with hyperactivity, and depression, who was transported to
the Emergency [**Hospital1 **] after being found slumped against a car
outside of a nightclub.  Bystanders mentioned that he may
have been using drugs and/or alcohol in the course of that
evening.  The patient was brought to the Emergency [**Hospital1 **] and
intubated for airway protection.  He was given 15 mg of
Versed for sedation for agitation.  Electrocardiogram in the
Emergency [**Hospital1 **] showed tall T-waves and possible J-point
elevations in the anterior precordial leads.  Toxicology
screen in the Emergency [**Hospital1 **] was positive for alcohol at a
level of 148, as well as for amphetamines.

MEDICAL HISTORY: 1.  Substance abuse with cocaine and GHB.
2.  Gonococcal urethritis.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: Unknown.

SOCIAL HISTORY: Cocaine use and GBH use, documented in the
past.  The patient also came in with a prison identification
card and a temporary alcohol license.  Cigarettes were found
in his pockets.
Opioid abuse, episodic,Attention deficit disorder with hyperactivity,Acute respiratory failure,Depressive disorder, not elsewhere classified
Opioid abuse-episodic,Attn deficit w hyperact,Acute respiratry failure,Depressive disorder NEC
Admission Date:  [**2168-6-12**]     Discharge Date:  [**2168-6-12**]

Date of Birth:                  Sex:  M

Service:  MICU

HISTORY OF PRESENT ILLNESS:  Mr. [**Known lastname 6884**] is a 27 -year-old man
with a history of substance abuse, attention deficit disorder
with hyperactivity, and depression, who was transported to
the Emergency [**Hospital1 **] after being found slumped against a car
outside of a nightclub.  Bystanders mentioned that he may
have been using drugs and/or alcohol in the course of that
evening.  The patient was brought to the Emergency [**Hospital1 **] and
intubated for airway protection.  He was given 15 mg of
Versed for sedation for agitation.  Electrocardiogram in the
Emergency [**Hospital1 **] showed tall T-waves and possible J-point
elevations in the anterior precordial leads.  Toxicology
screen in the Emergency [**Hospital1 **] was positive for alcohol at a
level of 148, as well as for amphetamines.

PAST MEDICAL HISTORY:
1.  Substance abuse with cocaine and GHB.
2.  Gonococcal urethritis.

ALLERGIES:  No known drug allergies.

ADMITTING MEDICATIONS:  Effexor and Adderall.

Social history:  Cocaine use and GBH use, documented in the
past.  The patient also came in with a prison identification
card and a temporary alcohol license.  Cigarettes were found
in his pockets.

FAMILY HISTORY:  Unknown.

PHYSICAL EXAMINATION:  The patient's temperature was 96.2 F,
pulse of 80, blood pressure was 134/70.  The patient was
mechanically ventilated with oxygen saturation of 96%.  In
general, he was a sedated, non-responsive male, intubated and
on a ventilator.  Head, eyes, ears, nose and throat
examination was normocephalic with a cut on the lower lip.
Pupils were equal, round, and reactive to light, size was 4.0
mm baseline and 3.0 mm and reactive to light.  oral mucosa
were moist and an endotracheal tube was in place.  Chest
examination significant for a few inspiratory wheezes;
otherwise clear to auscultation bilaterally.  Cardiovascular
examination: the patient had a regular rhythm, normal S1, S2,
no murmurs, rubs, or gallops.



Abdominal examination was soft, nontender, nondistended,
there were normoactive bowel sounds and no
hepatosplenomegaly.  The patient's extremities were warm,
peripheral pulses were 2+.  There was no cyanosis, clubbing
or edema.  Neurologic examination: the patient was sedated,
cranial nerves examination demonstrated a positive
oculocephalic and gag reflexes.  Strength: the patient was
moving all four extremities in the Emergency [**Hospital1 **].  Reflexes
are 1+ throughout.

NOTABLE LABORATORY DATA:  Arterial blood gas with pH of 7.33,
PaCO2 is 48, PO2 is 206.  The patient had a white blood cell
count of 12.1, hematocrit of 45.6, and platelets of 278,000.
The differential was 83 neutrophils, 14 lymphocytes, 2
monocytes, and 1 eosinophils.  His Chem 7 included a sodium
of 143, potassium of 3.5, chloride 103, bicarbonate of 20,
BUN of 8.0, creatinine of 1.0, glucose of 99, and an anion
gap of 20.  The patient also had osmotic gap of 4.0.

The patient's urinalysis indicated a few amorphic crystals,
otherwise within normal limits.  Serum toxicology screen:
alcohol was 148, A.S.A., Tylenol, barbiturates,
benzodiazepine, and Tri-Cyclen antidepressants were negative.
 Urine toxicology screen: amphetamine was positive and
benzodiazepine, opiates, cocaine, and methadone were
negative.

Chest x-ray indicated an endotracheal tube and orogastric
tube were in place.  There was no pneumothorax or infiltrate.

HOSPITAL COURSE:  The patient was admitted to the Medical
Intensive Care Unit and given charcoal.  Serial
electrocardiograms were concerning for the possible J-point
elevations in the anterior precordial leads, versus
repolarization abnormalities.  The Cardiology Fellow was
called and a nitroglycerin was started.  Cardiac enzymes were
drawn which were negative.

The patient became increasingly agitated in the Intensive
Care Unit and it was decided to wean the patient's sedation
and extubate the patient, which was done without any
difficulty.  As the patient became more alert, he provided
additional history, stating that he had taken Ecstasy and GHB
prior to losing consciousness.  He described his reaction as
an accident and denied suicidal ideation.

After further consultation with Cardiology, it was decided
that the electrocardiogram changes were probably benign in
nature and reflected repolarization abnormality.  A Substance
Abuse consult was ordered.  Psychiatry came to evaluate the
patient and found that he did not have active suicidal
ideation.  Further, the patient has been enrolled in
intensive rehabilitation and day hospital program for his
drug abuse and psychiatric issues.  According to Psychiatry,
the patient has excellent follow-up in these areas.

After the patient was cleared to go home, both by Psychiatry
and by the Intensive Care Unit team, his mental status having
cleared and cardiac issues resolved, he was discharged to
home.

DISCHARGE DIAGNOSIS:
Ecstasy and GHB intoxication.

FOLLOW-UP:  The patient is to follow-up with his primary care
provider, [**Last Name (NamePattern4) **]. [**Last Name (STitle) 8310**], within one to two weeks.  He will also
report back to his psychiatric day hospital program the day
following discharge.



                          [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 3090**], M.D.
[**MD Number(1) 3091**]

Dictated By:[**Last Name (NamePattern1) 194**]

MEDQUIST36

D:  [**2168-6-13**]  14:18
T:  [**2168-6-13**]  22:02
JOB#:  [**Job Number 28371**]
{'Opioid abuse, episodic,Attention deficit disorder with hyperactivity,Acute respiratory failure,Depressive disorder, not elsewhere classified'}


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: Mr. [**Known lastname 6884**] is a 27 -year-old man
with a history of substance abuse, attention deficit disorder
with hyperactivity, and depression, who was transported to
the Emergency [**Hospital1 **] after being found slumped against a car
outside of a nightclub.  Bystanders mentioned that he may
have been using drugs and/or alcohol in the course of that
evening.  The patient was brought to the Emergency [**Hospital1 **] and
intubated for airway protection.  He was given 15 mg of
Versed for sedation for agitation.  Electrocardiogram in the
Emergency [**Hospital1 **] showed tall T-waves and possible J-point
elevations in the anterior precordial leads.  Toxicology
screen in the Emergency [**Hospital1 **] was positive for alcohol at a
level of 148, as well as for amphetamines.

MEDICAL HISTORY: 1.  Substance abuse with cocaine and GHB.
2.  Gonococcal urethritis.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: Unknown.

SOCIAL HISTORY: Cocaine use and GBH use, documented in the
past.  The patient also came in with a prison identification
card and a temporary alcohol license.  Cigarettes were found
in his pockets. 

### Response:
{'Opioid abuse, episodic,Attention deficit disorder with hyperactivity,Acute respiratory failure,Depressive disorder, not elsewhere classified'}
