CHIEF COMPLAINT: Delerium tremens.

PRESENT ILLNESS: The patient is a 22 year-old
female brought into the Emergency Room by EMS after [**Location (un) **]
police entered her apartment after someone called for
disorderly conduct.  She was found by police intoxicated with
multiple bruises.  In the Emergency Room the patient was at
first lucent with complaints of back pain and claims that she
fell a lot while she was drinking.  She admitted to drinking
large amounts of alcohol with vomiting.  In the Emergency
Room the patient soon became agitated with delirium and
reported hallucinations.  She was very tremulous.  She was
given Ativan 5 mg intravenous times four and Valium 5 mg as
well as a banana bag with vitamins.

MEDICAL HISTORY: Alcohol use.

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient lives with her boyfriend.  She
drinks daily.  She denies abuse.
Alcohol withdrawal delirium,Acute pancreatitis,Alcohol abuse, unspecified,Unspecified deficiency anemia
Delirium tremens,Acute pancreatitis,Alcohol abuse-unspec,Deficiency anemia NOS
Admission Date:  [**2156-7-7**]     Discharge Date:  [**2156-7-13**]

Date of Birth:   [**2133-11-23**]     Sex:  F

Service:

CHIEF COMPLAINT:  Delerium tremens.

HISTORY OF PRESENT ILLNESS:  The patient is a 22 year-old
female brought into the Emergency Room by EMS after [**Location (un) **]
police entered her apartment after someone called for
disorderly conduct.  She was found by police intoxicated with
multiple bruises.  In the Emergency Room the patient was at
first lucent with complaints of back pain and claims that she
fell a lot while she was drinking.  She admitted to drinking
large amounts of alcohol with vomiting.  In the Emergency
Room the patient soon became agitated with delirium and
reported hallucinations.  She was very tremulous.  She was
given Ativan 5 mg intravenous times four and Valium 5 mg as
well as a banana bag with vitamins.

PAST MEDICAL HISTORY:  Alcohol use.

MEDICATIONS:  None.

SOCIAL HISTORY:  The patient lives with her boyfriend.  She
drinks daily.  She denies abuse.

PHYSICAL EXAMINATION:  Afebrile.  Blood pressure 131/80.
Pulse 104.  Respirations 18.  99% on room air.  General 22
year-old female sitting looking at ceiling.  HEENT multiple
bruises.  Neck supple.  Lungs clear to auscultation.
Cardiovascular tachycardia, S1 and S2.  Abdomen soft,
nontender.  Extremities multiple ecchymoses on left shoulder,
left thigh, right thigh.  Neurological confused, moving all
four extremities.  Skin diffuse ecchymoses and bruises on
back.  There were no obvious bony deformities.

LABORATORY:  White blood cell count 5.6, hematocrit 31.1,
platelets 135, sodium 134, potassium 2.3, chloride 90,
bicarbonate 25, BUN 6, creatinine 0.5, glucose 75.  Coag
studies PT 12.7, PTT 25.1, INR 1.1.  Serum alcohol level 17.
Serum tox negative.  CT of head showed no acute intracranial
hemorrhage.

HOSPITAL COURSE:  The patient was initially admitted to the
Intensive Care Unit for treatment of delirium tremens.  She
was started on admission with a CIWA scale.  She did not have
any evidence of seizures.  She was continued on Diazepam
intravenous per CIWA with continuous monitoring of her vital
signs.  The patient was found to have acute pancreatitis
likely due to alcohol use.  Lipase was 2422, amylase 505, CK
141.  The patient was also found to have a transaminitis.
ALT 158, AST 408, alkaline phosphatase 356.  The patient was
kept NPO and received an abdominal ultrasound, which showed
an echogenic liver consistent with fatty infiltration.  The
patient also found to be anemic with a macrocytic anemia
likely due to alcohol use.  Iron studies were normal as well
as B-12 and folate.  The patient was seen by social work to
discus domestic violence issues.  A psychiatric consult was
also ordered to evaluate the patient's mental status and
capacity to make decisions.  Psychiatry pronounced the
patient with impaired judgement secondary to delirium and
declared her unable to demonstrate that she understands the
risk to her health.  As a result when the patient wanted to
leave AMA she was not allowed.  A one to one sitter was
established for the patient.  Social work continued to follow
with the patient throughout her admission.  The patient
continued to deny domestic violence in her home and stated
she felt very safe there.  The patient expressed interest in
alcohol rehab program, however, did not wish to enter one in
the hospital while an inpatient.  The patient wished to
receive information about outpatient programs so she could
return to school.

The patient continued to do well and was transferred to the
regular medicine floor [**Hospital1 139**] firm on [**2156-7-10**].  She had
begun eating while in Intensive Care Unit, had decreased her
Ativan requirement greatly.  Her pancreatic enzymes and liver
function tests continued to improve.  Discussions were
continued on the floor about the patient's discharge plans.
She was then with capacity to make decisions per psychiatry.
The patient decided she would go home and look into programs
from there.

CONDITION ON DISCHARGE:  Stable.

DISCHARGE DIAGNOSES:
1.  Delirium tremens.
2.  Alcohol use.
3.  Pancreatitis.
4.  Transaminitis.
5.  Anemia.

DISCHARGE MEDICATIONS:  None.

FOLLOW UP PLANS:  The patient does not have a current primary
care physician.  [**Name10 (NameIs) **] will see me [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 3315**] in the [**Hospital 191**]
Clinic for follow up on [**8-9**].  The patient was encouraged
to go to her appointment with me to establish care.  I told
her the social workers would meet her at the appointment and
we would discuss treatment options again.  The patient was
discharged to home with her aunt.






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

Dictated By:[**Last Name (NamePattern1) 51084**]

MEDQUIST36

D:  [**2156-7-13**]  05:16
T:  [**2156-7-18**]  08:47
JOB#:  [**Job Number 51085**]
{'Alcohol withdrawal delirium,Acute pancreatitis,Alcohol abuse, unspecified,Unspecified deficiency anemia'}


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: Delerium tremens.

PRESENT ILLNESS: The patient is a 22 year-old
female brought into the Emergency Room by EMS after [**Location (un) **]
police entered her apartment after someone called for
disorderly conduct.  She was found by police intoxicated with
multiple bruises.  In the Emergency Room the patient was at
first lucent with complaints of back pain and claims that she
fell a lot while she was drinking.  She admitted to drinking
large amounts of alcohol with vomiting.  In the Emergency
Room the patient soon became agitated with delirium and
reported hallucinations.  She was very tremulous.  She was
given Ativan 5 mg intravenous times four and Valium 5 mg as
well as a banana bag with vitamins.

MEDICAL HISTORY: Alcohol use.

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient lives with her boyfriend.  She
drinks daily.  She denies abuse. 

### Response:
{'Alcohol withdrawal delirium,Acute pancreatitis,Alcohol abuse, unspecified,Unspecified deficiency anemia'}
