CHIEF COMPLAINT: hepatocellular carcinoma

PRESENT ILLNESS: Mr. [**Known lastname 4541**] is a 62-year-old malewith a recent diagnosis of NASH.
He developed a hepatoma and completed his transplant work-up and
now presents for liver
transplant.

MEDICAL HISTORY: HTN
DM2
HCC
BPH
NASH

MEDICATION ON ADMISSION: Atenolol
ASA 81mg PO daily
Lisinopril 5mg PO daily
Terazosin 5mg PO daily
Ursodiol 250mg PO TID
Glyburide 5mg PO BID
MVI
VitE

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: NAD
EOMI, PERRLA, no scleral icterus
supple neck, no LAD
RRR
CTAB
s/nt/nd; +BS
no c/c/e

FAMILY HISTORY: daughter: HepC
Brother: DM2
Father: deceased, lung cancer
Mother: CVA

SOCIAL HISTORY: occasional EtOH
30 pack years, quit 25 years ago
married with 3 kids
Malignant neoplasm of liver, primary,Cirrhosis of liver without mention of alcohol,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Unspecified disorder of gallbladder,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS)
Mal neo liver, primary,Cirrhosis of liver NOS,DMII wo cmp nt st uncntr,Hypertension NOS,Dis of gallbladder NOS,BPH w/o urinary obs/LUTS
Admission Date:  [**2175-4-28**]              Discharge Date:   [**2175-5-5**]

Date of Birth:  [**2111-7-10**]             Sex:   M

Service: SURGERY

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 668**]
Chief Complaint:
hepatocellular carcinoma

Major Surgical or Invasive Procedure:
orthotopic liver transplant [**2175-4-28**]


History of Present Illness:
Mr. [**Known lastname 4541**] is a 62-year-old malewith a recent diagnosis of NASH.
He developed a hepatoma and completed his transplant work-up and
now presents for liver
transplant.


Past Medical History:
HTN
DM2
HCC
BPH
NASH

Social History:
occasional EtOH
30 pack years, quit 25 years ago
married with 3 kids

Family History:
daughter: HepC
Brother: DM2
Father: deceased, lung cancer
Mother: CVA

Physical Exam:
NAD
EOMI, PERRLA, no scleral icterus
supple neck, no LAD
RRR
CTAB
s/nt/nd; +BS
no c/c/e

Pertinent Results:
[**4-28**] hepatic u/s: "1) Normal grayscale images of the liver,
without evidence of intra/extrahepatic biliary ductal dilatation
or perihepatic fluid collections.  2) Patent intrahepatic
vasculature, as discussed above. Slightly increased diastolic
flow within the hepatic arteries may be a transient phenomenon
in a recently transplanted liver."

[**4-29**] hepatic u/s: "1) Normal-appearing liver transplant without
evidence of intrahepatic biliary ductal dilatation or
perihepatic fluid collection.
2) Patent intrahepatic vasculature with interval increase in the
resistive indices of the right, left, and main hepatic arteries
as described above. No increase in diastolic flow seen as
demonstrated on the prior exam."

[**5-3**] T-tube cholangiogram: "No evidence of leak. Patent
anastomosis. No ductal dilatation."

Brief Hospital Course:
Mr. [**Known lastname 4541**] was taken to the OR for his orthotopic liver
transplant on [**2175-4-28**].  Please see Dr.[**Name (NI) 670**] Operative Note
for detail.

He was transferred to the ICU in stable condition.  His initial
hepatic ultrasound was normal except for increased diastolic
flow.  A repeat ultrasound on POD#1 had no evidence of increased
diastolic flow but notable for increased resistive indices.  On
POD #1, he was weaned off his pressors and extubated without
incident.  He was transferred to the floor on POD#1 in stable
condition.

Mr. [**Known lastname 4541**] did well on the floor.  He began to tolerate a
regular diet, had vigorous urine output, and had good pain
control.  He continued to receive induction immunosuppresants:
he was tapered off Solumederol, continued to receive Cellcept 1g
[**Hospital1 **], and his Tacrolimus levels were adjusted daily (and
discharged on 7mg PO BID).  He received 2 doses of Simulect 20g
IV, once in the OR and on POD#4.

On POD#5, Mr. [**Known lastname 4541**] had a t-tube cholangiogram that had no
evidence of stricture or leak.  His t-tube was capped and his
lateral JP drain was pulled.  On POD #6, an expectant bump in
his LFTs occurred but the transaminases were declining on POD#7.
 On POD #6, his medial JP was pulled.

At the time of discharge on POD #7, Mr. [**Known lastname 4541**] had minimal pain,
was tolerating a regular diet, ambulating and voiding without
difficulty, and feeling well.  He was discharged home with
specific instructions for follow-up and the liver transplant
coordinator was notified of his discharge.

Medications on Admission:
Atenolol
ASA 81mg PO daily
Lisinopril 5mg PO daily
Terazosin 5mg PO daily
Ursodiol 250mg PO TID
Glyburide 5mg PO BID
MVI
VitE

Discharge Medications:
1. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.) Sig:
One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours).

2. Terazosin HCl 5 mg Capsule Sig: One (1) Capsule PO HS (at
bedtime).
3. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
Q4-6H (every 4 to 6 hours) as needed.
Disp:*30 Tablet(s)* Refills:*0*
4. Fluconazole 200 mg Tablet Sig: Two (2) Tablet PO Q24H (every
24 hours).
5. Trimethoprim-Sulfamethoxazole 80-400 mg Tablet Sig: One (1)
Tablet PO DAILY (Daily).
6. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
7. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO BID
(2 times a day).
8. Mycophenolate Mofetil 500 mg Tablet Sig: Two (2) Tablet PO
BID (2 times a day).
9. Lisinopril 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

10. Insulin Glargine 100 unit/mL Solution Sig: Seventeen (17)
units Subcutaneous at bedtime.
11. Insulin Lispro (Human) 100 unit/mL Solution Sig: follow
sliding scale units Subcutaneous four times a day: follow
sliding scale.
12. Tacrolimus 5 mg Capsule Sig: One (1) Capsule PO BID (2 times
a day): take with 1-one mg capsule for total dose of 6mg twice a
day.
13. Prograf 5 mg Capsule Sig: One (1) Capsule PO twice a day:
take with 2-one mg capsule for total dose of 7mg twice daily.
14. Prograf 1 mg Capsule Sig: Two (2) Capsule PO twice a day:
take with a 5mg capsule for total dose of 7mg twice daily.
15. Prednisone 5 mg Tablet Sig: Four (4) Tablet PO once a day.
16. Valcyte 450 mg Tablet Sig: Two (2) Tablet PO once a day.


Discharge Disposition:
Home With Service

Facility:
[**Hospital 119**] Homecare

Discharge Diagnosis:
orthotopic liver transplant [**2175-4-28**]
NASH/cirrhosis
HCC
Type II DM, insulin requiring
hypertension


Discharge Condition:
stable

Discharge Instructions:
Call transplant office if fevers, chills, nausea, vomiting,
inability to take medications, juandice, abdominal pain, redness
or pus/bleeding from incision or any questions
Labs every Monday & Thursday for cbc, chem 10, ast, alt, alk
phos, t.bili, albumin and trough prograf level. Fax results
immediately to transplant office [**Telephone/Fax (1) 697**]
[**Month (only) 116**] shower
no driving while taking pain medication or until ok with MD

Followup Instructions:
Provider: [**First Name11 (Name Pattern1) **] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **], M.D. Where: [**Hospital6 29**]
[**Hospital3 249**] Phone:[**Telephone/Fax (1) 250**] Date/Time:[**2175-5-5**]
11:00
Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 707**], MD, PHD[**MD Number(3) **]: LM [**Hospital Unit Name 3126**] CENTER Phone:[**Telephone/Fax (1) 673**] Date/Time:[**2175-5-10**] 9:50
Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 1330**], MD Where: LM [**Hospital Unit Name 3126**] CENTER Phone:[**Telephone/Fax (1) 673**] Date/Time:[**2175-5-18**] 9:10
{'Malignant neoplasm of liver, primary,Cirrhosis of liver without mention of alcohol,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Unspecified disorder of gallbladder,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS)'}


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: hepatocellular carcinoma

PRESENT ILLNESS: Mr. [**Known lastname 4541**] is a 62-year-old malewith a recent diagnosis of NASH.
He developed a hepatoma and completed his transplant work-up and
now presents for liver
transplant.

MEDICAL HISTORY: HTN
DM2
HCC
BPH
NASH

MEDICATION ON ADMISSION: Atenolol
ASA 81mg PO daily
Lisinopril 5mg PO daily
Terazosin 5mg PO daily
Ursodiol 250mg PO TID
Glyburide 5mg PO BID
MVI
VitE

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: NAD
EOMI, PERRLA, no scleral icterus
supple neck, no LAD
RRR
CTAB
s/nt/nd; +BS
no c/c/e

FAMILY HISTORY: daughter: HepC
Brother: DM2
Father: deceased, lung cancer
Mother: CVA

SOCIAL HISTORY: occasional EtOH
30 pack years, quit 25 years ago
married with 3 kids 

### Response:
{'Malignant neoplasm of liver, primary,Cirrhosis of liver without mention of alcohol,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Unspecified disorder of gallbladder,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS)'}
