CHIEF COMPLAINT: Neck pain with inability to move arms and legs.

PRESENT ILLNESS: 50 yo male unrestrained driver partially ejected from car.  No
motor function or sensation below nipple level; gross upper
extremity movement.  +LOC, +EtOH

MEDICAL HISTORY: HTN
Cardiomegaly
MVP
Depression
Anxiety

MEDICATION ON ADMISSION: 1. Insulin Regular Human 100 unit/mL Solution Sig: One (1)
syringe Injection ASDIR (AS DIRECTED).
2. Venlafaxine 37.5 mg Tablet Sig: One (1) Tablet PO BID (2
times a day).
3. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2
times a day).
4. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every
4 to 6 hours) as needed.
5. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID
(2 times a day).
6. Lisinopril 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

ALLERGIES: No Drug Allergy Information on File

PHYSICAL EXAM: A&O X 3
VSS
HEENT- trachea midline, PERRLA
Neuro- deminished sensation bilateral lower extremities
Chest- CTA B
CV- RRR
Abd- soft NT/ND; FAST neg
Pelvis- stable
Back/Spine- no tenderness or stepoffs
Rectal- normal tone, guiac neg
Ext- UE strength 5/5 bilaterally
     LE no movement bilaterally

FAMILY HISTORY: N/C

SOCIAL HISTORY: +EtOH
Closed dislocation, multiple cervical vertebrae,Mitral valve disorders,Closed fracture of C5-C7 level with unspecified spinal cord injury,Motor vehicle traffic accident due to loss of control, without collision on the highway, injuring driver of motor vehicle other than motorcycle,Unspecified essential hypertension
Disloc mult cerv vert-cl,Mitral valve disorder,C5-c7 fx-cl/cord inj NOS,Loss control mv acc-driv,Hypertension NOS
Admission Date:  [**2100-8-28**]              Discharge Date:   [**2100-9-2**]

Date of Birth:  [**2049-10-20**]             Sex:   M

Service: SURGERY

Allergies:
No Drug Allergy Information on File

Attending:[**First Name3 (LF) 371**]
Chief Complaint:
Neck pain with inability to move arms and legs.

Major Surgical or Invasive Procedure:
Anterior/Posterior cervical fusion C5-7


History of Present Illness:
50 yo male unrestrained driver partially ejected from car.  No
motor function or sensation below nipple level; gross upper
extremity movement.  +LOC, +EtOH

Past Medical History:
HTN
Cardiomegaly
MVP
Depression
Anxiety

Social History:
+EtOH

Family History:
N/C

Physical Exam:
A&O X 3
VSS
HEENT- trachea midline, PERRLA
Neuro- deminished sensation bilateral lower extremities
Chest- CTA B
CV- RRR
Abd- soft NT/ND; FAST neg
Pelvis- stable
Back/Spine- no tenderness or stepoffs
Rectal- normal tone, guiac neg
Ext- UE strength 5/5 bilaterally
     LE no movement bilaterally


Pertinent Results:
[**2100-8-31**] 02:11AM BLOOD WBC-9.6 RBC-2.84* Hgb-9.2* Hct-25.5*
MCV-90 MCH-32.5* MCHC-36.1* RDW-13.2 Plt Ct-128*
[**2100-8-29**] 03:26AM BLOOD WBC-9.7 RBC-3.49* Hgb-11.1* Hct-31.1*
MCV-89 MCH-31.9 MCHC-35.7* RDW-12.0 Plt Ct-192
[**2100-8-28**] 09:25PM BLOOD WBC-13.9* RBC-3.60* Hgb-11.9* Hct-32.3*
MCV-90 MCH-33.0* MCHC-36.9* RDW-12.4 Plt Ct-175
[**2100-8-31**] 02:11AM BLOOD Glucose-154* UreaN-18 Creat-0.8 Na-144
K-4.1 Cl-106 HCO3-32 AnGap-10
[**2100-8-30**] 01:50AM BLOOD Glucose-205* UreaN-17 Creat-0.9 Na-138
K-4.4 Cl-104 HCO3-27 AnGap-11
[**2100-8-29**] 03:26AM BLOOD Glucose-119* UreaN-15 Creat-0.8 Na-138
K-4.1 Cl-99 HCO3-24 AnGap-19
[**2100-8-29**] 10:02AM BLOOD Glucose-155* Lactate-1.2 Na-135 K-4.0
Cl-104
[**2100-8-29**] 08:49AM BLOOD Glucose-140* Lactate-1.4 Na-133* K-3.8
Cl-103
[**2100-8-29**] 06:59AM BLOOD Glucose-134* Lactate-1.3 Na-134* K-3.9
Cl-102

Brief Hospital Course:
Mr. [**Known lastname **] was admitted to the Trauma after sustaining injuries
relating to his MVC.  he was evaluated in the EW and noticed to
have decreased strength and sensation in the lower extremities.
CT of the c-spine showed a comminuted fracture of the left
lamina, pedicle and articulating facet of C6 with posterolateral
displacement of the fracture fragments.  It was his lone injury.
 He was infomed and consented for an emergent anterior/posterior
cervical decompression and fusion.  He agreed to this procedure
and elected to proceed.  Please see Operative Notes for
procedures in detail.
Post-operatively he was transferred to the T/SICU for further
evaluation.  He was administered antibiotics and pain
medication.  His functioning in his lower extremities began to
slowly return and he was able to lift his legs off the bed.  His
was hemodynamically stable and afebrile during his hospital stay
and he was pain was well controlled.  An IVC filter was placed
inraopertively for PE prophylaxis by the vascular surgery team.
He was screened for rehab and discharged in good condition.  His
incision were clean and dry upon discharge.

Medications on Admission:
1. Insulin Regular Human 100 unit/mL Solution Sig: One (1)
syringe Injection ASDIR (AS DIRECTED).
2. Venlafaxine 37.5 mg Tablet Sig: One (1) Tablet PO BID (2
times a day).
3. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2
times a day).
4. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every
4 to 6 hours) as needed.
5. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID
(2 times a day).
6. Lisinopril 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

7. Hydrochlorothiazide 25 mg Tablet Sig: 0.5 Tablet PO DAILY
(Daily).



Discharge Medications:
1. Insulin Regular Human 100 unit/mL Solution Sig: One (1)
syringe Injection ASDIR (AS DIRECTED).
2. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) inj
Injection TID (3 times a day).
3. Clonazepam 1 mg Tablet Sig: One (1) Tablet PO TID (3 times a
day).
4. Venlafaxine 37.5 mg Tablet Sig: One (1) Tablet PO BID (2
times a day).
5. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2
times a day).
6. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every
4 to 6 hours) as needed.
7. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID
(2 times a day).
8. Lisinopril 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

9. Hydrochlorothiazide 25 mg Tablet Sig: 0.5 Tablet PO DAILY
(Daily).
10. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
Q4-6H (every 4 to 6 hours) as needed.


Discharge Disposition:
Extended Care

Facility:
Cape and Islands

Discharge Diagnosis:
C6 L lamina fracture
C6 facet fracture-dislocation


Discharge Condition:
Good


Discharge Instructions:
Please continue to take your pain medication with an over the
counter laxative.  Call the clinic if you notice any redness or
discharge from the incision site.  Call the clinic for any
additional concerns.

Followup Instructions:
Please follow up in the Spine Clinic in 10 days. Call [**Telephone/Fax (1) 18552**] to schedule an appointment.



Completed by:[**2100-9-1**]
{'Closed dislocation, multiple cervical vertebrae,Mitral valve disorders,Closed fracture of C5-C7 level with unspecified spinal cord injury,Motor vehicle traffic accident due to loss of control, without collision on the highway, injuring driver of motor vehicle other than motorcycle,Unspecified essential hypertension'}


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: Neck pain with inability to move arms and legs.

PRESENT ILLNESS: 50 yo male unrestrained driver partially ejected from car.  No
motor function or sensation below nipple level; gross upper
extremity movement.  +LOC, +EtOH

MEDICAL HISTORY: HTN
Cardiomegaly
MVP
Depression
Anxiety

MEDICATION ON ADMISSION: 1. Insulin Regular Human 100 unit/mL Solution Sig: One (1)
syringe Injection ASDIR (AS DIRECTED).
2. Venlafaxine 37.5 mg Tablet Sig: One (1) Tablet PO BID (2
times a day).
3. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2
times a day).
4. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every
4 to 6 hours) as needed.
5. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID
(2 times a day).
6. Lisinopril 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

ALLERGIES: No Drug Allergy Information on File

PHYSICAL EXAM: A&O X 3
VSS
HEENT- trachea midline, PERRLA
Neuro- deminished sensation bilateral lower extremities
Chest- CTA B
CV- RRR
Abd- soft NT/ND; FAST neg
Pelvis- stable
Back/Spine- no tenderness or stepoffs
Rectal- normal tone, guiac neg
Ext- UE strength 5/5 bilaterally
     LE no movement bilaterally

FAMILY HISTORY: N/C

SOCIAL HISTORY: +EtOH 

### Response:
{'Closed dislocation, multiple cervical vertebrae,Mitral valve disorders,Closed fracture of C5-C7 level with unspecified spinal cord injury,Motor vehicle traffic accident due to loss of control, without collision on the highway, injuring driver of motor vehicle other than motorcycle,Unspecified essential hypertension'}
