CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 50-year-old
male with a history of multiple myeloma and multiple
compression fractures of the lower spine with also a left hip
lesion.  On physical exam his strength is four plus in the
IPs on the right, three on the left.  Hamstrings are five on
the right and four plus on the left.  Quad dorsiflexion and
plantar flexion are five bilaterally.  His knee reflexes are
absent.  His ankles are one plus.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Multiple myeloma, without mention of having achieved remission,Hematoma complicating a procedure,Pathologic fracture of vertebrae,Peripheral stem cells replaced by transplant
Mult mye w/o achv rmson,Hematoma complic proc,Path fx vertebrae,Trspl sts-perip stm cell
Admission Date: [**2109-3-18**]        Discharge Date: [**2109-3-31**]

Date of Birth:  [**2058-4-17**]        Sex:  M

Service:  NSU


HISTORY OF PRESENT ILLNESS:  The patient is a 50-year-old
male with a history of multiple myeloma and multiple
compression fractures of the lower spine with also a left hip
lesion.  On physical exam his strength is four plus in the
IPs on the right, three on the left.  Hamstrings are five on
the right and four plus on the left.  Quad dorsiflexion and
plantar flexion are five bilaterally.  His knee reflexes are
absent.  His ankles are one plus.

His MRI scan shows a pathologic fracture of L3 with
mechanical lower back pain.  The patient is admitted to the
neurosurgical service status post an embolization of the L3
vertebral body tumor and post procedure his strength was five
out of five on the right side, two on the IP on the left and
otherwise five out of five.  He underwent embolization
without complication.

Post procedure his vital signs were stable.  He was afebrile.
He was awake, alert and oriented times three.  He was then
pre-op'd for surgery and taken to the O.R. on [**2109-3-19**], and
underwent an L2 to L5 fusion with L3 vertebrectomy.  There
were no intraoperative complications.  Postoperative his
vital signs were stable and he was afebrile.  He was
transfused with four units of packed red blood cells
intraoperatively.  His vital signs remained stable, his
neurologic exam was stable, his IPs on the right remained
four out of five, on the left three out of five.  His
sensation was intact to light touch.  His dressing was clean,
dry and intact.  He was transferred to the regular floor
after recovering in the Postanesthesia Care Unit.

He had [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 1661**]-[**Location (un) 1662**] in place, which was removed on
postoperative day number three.  He was seen by Physical
Therapy and Occupational Therapy.  He was seen by Radiation
Oncology and began radiation treatments to his left hip.  On
[**2109-3-26**] he had treatment planning for radiation therapy
and began therapy the following day and had five days of
radiation treatments.

The patient developed left leg swelling and had Doppler
studies to rule out a DVT, which was ruled out.  He then had
an MRI of his pelvis, which showed no evidence of a DVT, but
showed evidence of a retroperitoneal hematoma.  The patient
then began to ooze blood from his drain site from that
hematoma.  He had two stitches placed in the drain site and
the leakage did stop, however, he was monitored in hospital
for two days to continue to monitor the bleeding.  The
bleeding had stopped and he was discharged on [**2109-3-31**] in
stable condition with followup with Dr. [**Last Name (STitle) 1327**] on [**2109-4-2**], for staple removal and followup with orthopedics and
with Dr. [**Last Name (STitle) **].

DISCHARGE MEDICATIONS:
1. Colace 100 mg p.o. twice a day
2. Ferrous sulphate 325 p.o. once daily
3. Tylenol 650 p.o. q. 4h prn.
4. Percocet 1-2 tabs p.o. q. 4h prn.
5. Senna 2 tabs p.o. twice a day


CONDITION ON DISCHARGE:  Stable.



                        [**Name6 (MD) **] [**Last Name (NamePattern4) **], [**MD Number(1) 12001**]

Dictated By:[**Last Name (NamePattern1) **]
MEDQUIST36
D:  [**2109-4-1**] 11:50:14
T:  [**2109-4-1**] 12:37:36
Job#:  [**Job Number 21312**]
{'Multiple myeloma, without mention of having achieved remission,Hematoma complicating a procedure,Pathologic fracture of vertebrae,Peripheral stem cells replaced by transplant'}


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 a 50-year-old
male with a history of multiple myeloma and multiple
compression fractures of the lower spine with also a left hip
lesion.  On physical exam his strength is four plus in the
IPs on the right, three on the left.  Hamstrings are five on
the right and four plus on the left.  Quad dorsiflexion and
plantar flexion are five bilaterally.  His knee reflexes are
absent.  His ankles are one plus.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Multiple myeloma, without mention of having achieved remission,Hematoma complicating a procedure,Pathologic fracture of vertebrae,Peripheral stem cells replaced by transplant'}
