CHIEF COMPLAINT: Status post fall.

PRESENT ILLNESS: This is a 44 year old female who
fell down thirteen stairs with loss of consciousness,
lethargic on transport with stable vital signs.  The patient
was complaining of abdominal pain on arrival.

MEDICAL HISTORY: None.

MEDICATION ON ADMISSION: None.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Open wound of forehead, without mention of complication,Tubal pregnancy with intrauterine pregnancy,Hypotension, unspecified,Accidental fall on or from other stairs or steps
Open wound of forehead,Tubal preg w intra preg,Hypotension NOS,Fall on stair/step NEC
Admission Date:  [**2153-9-26**]     Discharge Date:  [**2153-9-30**]

Date of Birth:   [**2108-12-26**]     Sex:  F

Service:  TRAUMA SURGERY

CHIEF COMPLAINT:  Status post fall.

HISTORY OF PRESENT ILLNESS:  This is a 44 year old female who
fell down thirteen stairs with loss of consciousness,
lethargic on transport with stable vital signs.  The patient
was complaining of abdominal pain on arrival.

PAST MEDICAL HISTORY:  None.

PAST SURGICAL HISTORY:  None.

MEDICATIONS ON ADMISSION:  None.

ALLERGIES:  No known drug allergies.

PHYSICAL EXAMINATION:  Temperature 96.7, pulse 80, blood
pressure 80/palpable, oxygen saturation 100%.  Generally, the
patient was lethargic moving all extremities.  Head, eyes,
ears, nose and throat examination - The pupils are equal,
round, and reactive to light and accommodation, 3.0
millimeters bilaterally.  Trachea midline.  Cardiovascular -
regular rate and rhythm.  Respiratory - Breath sounds
bilaterally.  No bruising and no crepitus.  The abdomen was
soft, distended, diffusely tender, pelvis stable.  Rectal
guaiac negative, decreased tone.  Extremities - Dorsalis
pedis present bilaterally, no deformities.  Back - no
step-off, no deformities.

LABORATORY DATA:  White blood cell count 22.0, hematocrit
23.0, platelets 127,000.   Coagulation studies revealed
prothrombin time 16, partial thromboplastin time 35, INR 2.0.
Chem7 revealed sodium 139, potassium 3.5, chloride 111,
bicarbonate 18, blood urea nitrogen 9, creatinine 0.5 and
glucose 183.  Arterial blood gases was pH 7.33, pCO2 36, pO2
280, 20 and -6.

RADIOLOGY:  On [**2153-9-26**], chest x-ray was normal, pelvis
normal.  CT head showed no bleed.  CT of cervical spine no
fractures, congenital C2-C3 fusion.  Thoracic spine negative.
Lumbar spine negative. CT sinuses revealed no fractures,
normal.

HOSPITAL COURSE:  The patient was admitted to the Emergency
Department.  Central line, left subclavian line was placed.
DPL was performed in the Emergency Department with 10 cc
gross blood. The patient was given two units of packed red
blood cells.  The patient was brought emergently to the
operating room where an exploratory laparotomy was performed
with a vertical incision.  Ruptured ectopic on the left side
was found.  Left salpingectomy was performed.  Estimated
blood loss was one liter.  The patient was given five liters
of crystalloid.  The patient subsequently had a pelvic
ultrasound which showed no intrauterine pregnancy and
incidental finding of a small fibroid.  The patient had a
beta HCG drawn on [**2153-9-26**], at 11:00 p.m. that was 20,637.
Beta HCG was repeated on [**2153-9-28**], at 8:00 a.m. which was
5500.  The patient was extubated.  No events except for some
bleeding into her abdominal incision.  The patient's vital
signs remained stable.  With the bleeding, the incision was
repaired with three stitches between the staples at the
bleeding site. No further bleeding.

OB/GYN was consulted and recommended following the HCG and
the pelvic ultrasound with results noted above.  The OB/GYN
team performed the left salpingectomy.

DISCHARGE DIAGNOSES:
1.  Ruptured intrauterine pregnancy, status post left
salpingectomy and exploratory laparotomy.
2.  Facial laceration, status post repair.

MEDICATIONS ON DISCHARGE:
1.  Over the counter Tylenol.
2.  The patient instructed not to take any Ibuprofen
medicine.

CONDITION ON DISCHARGE:  Stable.

DISCHARGE STATUS:  To home.

DISCHARGE PLAN:  The patient notified to follow-up with Dr.
[**Last Name (STitle) 44173**] at [**Hospital3 **] on Friday for repeat HCG.  The patient
is to have staples removed in the Trauma Clinic, telephone
[**Telephone/Fax (1) 42929**], on [**2153-10-7**].  The patient was instructed to
have facial sutures removed on [**2153-10-2**].  Diet is regular.
The patient is ambulating without assistance.






                          [**Name6 (MD) 19851**] [**Name8 (MD) 19852**], M.D.

Dictated By:[**Last Name (NamePattern1) 27824**]

MEDQUIST36

D:  [**2153-9-30**]  16:48
T:  [**2153-10-3**]  18:18
JOB#:  [**Job Number 44174**]
{'Open wound of forehead, without mention of complication,Tubal pregnancy with intrauterine pregnancy,Hypotension, unspecified,Accidental fall on or from other stairs or steps'}


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: Status post fall.

PRESENT ILLNESS: This is a 44 year old female who
fell down thirteen stairs with loss of consciousness,
lethargic on transport with stable vital signs.  The patient
was complaining of abdominal pain on arrival.

MEDICAL HISTORY: None.

MEDICATION ON ADMISSION: None.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Open wound of forehead, without mention of complication,Tubal pregnancy with intrauterine pregnancy,Hypotension, unspecified,Accidental fall on or from other stairs or steps'}
