CHIEF COMPLAINT: right upper lobe lung nodule

PRESENT ILLNESS: Pt is a 54 year old man with h/o colon cancer s/p resection who
presents with a rising CEA and right upper lobe mass as well as
a left lower lobe nodule. Patient underwent a cervical
mediastinoscopy with lymph node biopsy on [**2121-11-27**] which
revealed no evidence of malignancy. He presents for elective
VATS with right upper lobectomy. He does not have any
fever/weight loss/nausea or vomiting but does report mild
shortness of breath with exertion.

MEDICAL HISTORY: rectosigmoid CA s/p resection [**2116**] and chemo/XRT
HTN
hyperlipidemia

MEDICATION ON ADMISSION: Lisinopril 10', ASA 325', trazadone 50'

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Gen: well appearing, NAD
HEENT: PERRL, EOMI, nares patent, oropharynx clear
Neck: no masses
CV: RRR, no m/r/g
Lung: CTA B, no w/c, incision sites bandaged c/d/i
Abd: soft, NT/ND, +BS
Ext: no edema/cyanosis
Neuro: aao x 4

FAMILY HISTORY: Father died of cirrhosis at the age of 49. One
sibling with paranoid schizophrenia. One grandparent died of TB.

SOCIAL HISTORY: Seven to ten pack year history, discontinued in
the [**2086**]. He has had exposure to asbestos working in a shipyard
Secondary malignant neoplasm of lung,Other emphysema,Personal history of malignant neoplasm of large intestine,Other and unspecified hyperlipidemia,Unspecified essential hypertension
Secondary malig neo lung,Emphysema NEC,Hx of colonic malignancy,Hyperlipidemia NEC/NOS,Hypertension NOS
Admission Date:  [**2121-12-10**]              Discharge Date:   [**2121-12-16**]

Date of Birth:  [**2067-3-30**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 5790**]
Chief Complaint:
right upper lobe lung nodule

Major Surgical or Invasive Procedure:
VATS w/right upper lobectomy


History of Present Illness:
Pt is a 54 year old man with h/o colon cancer s/p resection who
presents with a rising CEA and right upper lobe mass as well as
a left lower lobe nodule. Patient underwent a cervical
mediastinoscopy with lymph node biopsy on [**2121-11-27**] which
revealed no evidence of malignancy. He presents for elective
VATS with right upper lobectomy. He does not have any
fever/weight loss/nausea or vomiting but does report mild
shortness of breath with exertion.

Past Medical History:
rectosigmoid CA s/p resection [**2116**] and chemo/XRT
HTN
hyperlipidemia

Social History:
Seven to ten pack year history, discontinued in
the [**2086**]. He has had exposure to asbestos working in a shipyard

from [**2090**] to [**2095**]. He uses alcohol occasionally and socially.
He denies any exposure to uranium, nickel, cadmium, or radon.

Family History:
Father died of cirrhosis at the age of 49. One
sibling with paranoid schizophrenia. One grandparent died of TB.

One grandparent had a stroke. One grandparent had an MI.

Physical Exam:
Gen: well appearing, NAD
HEENT: PERRL, EOMI, nares patent, oropharynx clear
Neck: no masses
CV: RRR, no m/r/g
Lung: CTA B, no w/c, incision sites bandaged c/d/i
Abd: soft, NT/ND, +BS
Ext: no edema/cyanosis
Neuro: aao x 4

Pertinent Results:
[**2121-12-15**] 09:26AM BLOOD WBC-8.0 RBC-4.11* Hgb-13.1* Hct-36.4*
MCV-89 MCH-31.8 MCHC-35.9* RDW-12.8 Plt Ct-279#
[**2121-12-15**] 09:26AM BLOOD Plt Ct-279#
[**2121-12-15**] 09:26AM BLOOD Glucose-92 UreaN-14 Creat-0.9 Na-138
K-4.1 Cl-103 HCO3-26 AnGap-13
[**2121-12-15**] 09:26AM BLOOD Calcium-8.6 Phos-3.1 Mg-1.8

Brief Hospital Course:
Patient was admitted and underwent an uncomplicated VATS with
right upper lobectomy. He was transferred to the PACU extubated
and with two pleural [**Doctor Last Name **] drains in place to suction. While
being transferred to the PACU, it was noted that the patient's
epidural was not functioning, and he did c/o significant pain
postoperatively. He remained in the PACU with poor pain control
despite iv morphine and dilaudid as well as toradol. He was also
noted to be hypotensive postoperatively, necessitating a
neosynephrine drip overnight secondary to hypotension with
decreased urine output. Overnight he remained stable with better
control of his BP to the point that his neo drip was weaned. He
did have adequate urine output.
POD #1: cont on morphine PCA with some relief of pain.
Transferred to the floor. Tolerating po's however patient
demonstrated poor inspiratory effort secondary to pain. Pain
service consulted who recommended reinsertion of epidural
catheter, however, patient refused. [**Doctor Last Name 406**] drains put to bulb
suction.
POD #2: Poor pain control, patient started on q6h toradol x 6
doses with good relief of his pain in addition to his morphine
PCA. One [**Doctor Last Name **] drain discontinued with no change on post-pull
CXR.
POD #3: Foley catheter discontinued with adequate urine output.
Pain better controlled, patient remained with an oxygen
requirement on 2L nasal cannula O2.
POD #4: PCA discontinued, patient started on po percocet as well
as iv dilaudid as needed with good pain control.
POD #5: high [**Doctor Last Name **] drain output (>300cc) overnight, patient
doing well. Given iv lasix 20mg x 1 for diuresis.
POD#6 [**Doctor Last Name **] output minimal. Drain d/c'd - no PTX on post pull
CXR. Responded well to diuresis.
d/c'd to home w/ supportive sevices.

Medications on Admission:
Lisinopril 10', ASA 325', trazadone 50'

Discharge Medications:
1. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
Q4-6H (every 4 to 6 hours) as needed.
Disp:*100 Tablet(s)* Refills:*0*
2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*2*
3. Trazodone 50 mg Tablet Sig: 0.5 Tablet PO HS (at bedtime) as
needed for sleep.
4. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day) as needed.
5. Fluoxetine 20 mg Capsule Sig: One (1) Capsule PO DAILY
(Daily).
6. Lisinopril 40 mg Tablet Sig: One (1) Tablet PO once a day.


Discharge Disposition:
Home With Service

Facility:
Broctkon VNA

Discharge Diagnosis:
right upper lobe mass


Discharge Condition:
stable


Discharge Instructions:
Please call Dr. [**Last Name (STitle) **] at [**Telephone/Fax (1) 25078**] if you have any
bleeding, pain, redness or oozing from your surgical site. Call
if you have fever, nausea/vomiting, weakness or dizziness,
shortness of breath or inability to eat or drink.
Please do not drive while taking pain medications.
take your first shower on thursday. After showering, remove your
chest tube dressing and coverthe area with a clean bandaid every
day until healed. If there is yellow pink drainage, this is
expected and you may need to cover with a clean gauze. No tub
bathing or swimming for 3 weeks.

Followup Instructions:
Please follow up with Dr. [**Last Name (STitle) **] in [**10-24**] days. Call for an
appointment.



Completed by:[**2121-12-17**]
{'Secondary malignant neoplasm of lung,Other emphysema,Personal history of malignant neoplasm of large intestine,Other and unspecified hyperlipidemia,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: right upper lobe lung nodule

PRESENT ILLNESS: Pt is a 54 year old man with h/o colon cancer s/p resection who
presents with a rising CEA and right upper lobe mass as well as
a left lower lobe nodule. Patient underwent a cervical
mediastinoscopy with lymph node biopsy on [**2121-11-27**] which
revealed no evidence of malignancy. He presents for elective
VATS with right upper lobectomy. He does not have any
fever/weight loss/nausea or vomiting but does report mild
shortness of breath with exertion.

MEDICAL HISTORY: rectosigmoid CA s/p resection [**2116**] and chemo/XRT
HTN
hyperlipidemia

MEDICATION ON ADMISSION: Lisinopril 10', ASA 325', trazadone 50'

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Gen: well appearing, NAD
HEENT: PERRL, EOMI, nares patent, oropharynx clear
Neck: no masses
CV: RRR, no m/r/g
Lung: CTA B, no w/c, incision sites bandaged c/d/i
Abd: soft, NT/ND, +BS
Ext: no edema/cyanosis
Neuro: aao x 4

FAMILY HISTORY: Father died of cirrhosis at the age of 49. One
sibling with paranoid schizophrenia. One grandparent died of TB.

SOCIAL HISTORY: Seven to ten pack year history, discontinued in
the [**2086**]. He has had exposure to asbestos working in a shipyard 

### Response:
{'Secondary malignant neoplasm of lung,Other emphysema,Personal history of malignant neoplasm of large intestine,Other and unspecified hyperlipidemia,Unspecified essential hypertension'}
