CHIEF COMPLAINT: bleeding from rectum along with weakness/fatigue

PRESENT ILLNESS: Pt is a 86 yo man with hx of metastatic pancreatic cancer dx'ed
in the past yr who presented to the ED with chief complaint of
fatigue and bright red blood per rectum.

MEDICAL HISTORY: metastatic pancreatic cancer

MEDICATION ON ADMISSION: iron
pain killer

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: T 96 P 69 163/72 18 o2 sat 100% RA
cachexic elderly man
perrl, eomi
neck supple
cv - rrr
CTA
abd is soft and nt/nd
ext without edema
no rashes
alert and oriented

FAMILY HISTORY: nc

SOCIAL HISTORY: nc
Malignant neoplasm of other specified sites of pancreas,Cholangitis,Iron deficiency anemia secondary to blood loss (chronic),Chronic kidney disease, unspecified,Hypovolemia,Secondary malignant neoplasm of other specified sites,Malignant neoplasm of prostate
Malig neo pancreas NEC,Cholangitis,Chr blood loss anemia,Chronic kidney dis NOS,Hypovolemia,Secondary malig neo NEC,Malign neopl prostate
Admission Date:  [**2145-6-7**]              Discharge Date:   [**2145-6-9**]


Service: MEDICINE

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 9240**]
Chief Complaint:
bleeding from rectum along with weakness/fatigue

Major Surgical or Invasive Procedure:
none


History of Present Illness:
Pt is a 86 yo man with hx of metastatic pancreatic cancer dx'ed
in the past yr who presented to the ED with chief complaint of
fatigue and bright red blood per rectum.

Past Medical History:
metastatic pancreatic cancer

Social History:
nc

Family History:
nc

Physical Exam:
T 96 P 69 163/72 18 o2 sat 100% RA
cachexic elderly man
perrl, eomi
neck supple
cv - rrr
CTA
abd is soft and nt/nd
ext without edema
no rashes
alert and oriented

Pertinent Results:
[**2145-6-7**] 06:16PM   HCT-26.7*
[**2145-6-7**] 03:28AM URINE  COLOR-Amber APPEAR-Hazy SP [**Last Name (un) 155**]-1.015
[**2145-6-7**] 03:28AM URINE  BLOOD-LG NITRITE-POS PROTEIN->300
GLUCOSE-NEG KETONE-15 BILIRUBIN-LG UROBILNGN-1 PH-6.5 LEUK-NEG
[**2145-6-7**] 03:27AM   GLUCOSE-67* UREA N-24* CREAT-1.1 SODIUM-144
POTASSIUM-3.7 CHLORIDE-109* TOTAL CO2-24 ANION GAP-15
[**2145-6-7**] 03:27AM   ALT(SGPT)-85* AST(SGOT)-101* ALK PHOS-332*
TOT BILI-5.5*
[**2145-6-7**] 03:27AM   CALCIUM-7.8* PHOSPHATE-3.2 MAGNESIUM-1.9
[**2145-6-7**] 03:27AM   WBC-15.5* RBC-3.11*# HGB-9.8*# HCT-30.5*#
MCV-98 MCH-31.5 MCHC-32.2 RDW-19.7*
[**2145-6-7**] 03:27AM   NEUTS-80* BANDS-9* LYMPHS-5* MONOS-5 EOS-0
BASOS-0 ATYPS-1* METAS-0 MYELOS-0
[**2145-6-7**] 03:27AM   HYPOCHROM-NORMAL ANISOCYT-2+ POIKILOCY-1+
MACROCYT-3+ MICROCYT-1+ POLYCHROM-OCCASIONAL OVALOCYT-1+
TARGET-1+ SCHISTOCY-1+ BURR-1+
[**2145-6-7**] 03:27AM   PLT COUNT-237
[**2145-6-7**] 03:27AM   PT-14.9* PTT-26.1 INR(PT)-1.3*
[**2145-6-6**] 10:17PM   COMMENTS-GREEN TOP
[**2145-6-6**] 10:17PM   HGB-9.5* calcHCT-29
[**2145-6-6**] 03:40PM URINE  HOURS-RANDOM
[**2145-6-6**] 03:40PM URINE  GR HOLD-HOLD
[**2145-6-6**] 03:40PM URINE  COLOR-Amber APPEAR-Clear SP [**Last Name (un) 155**]-1.016
[**2145-6-6**] 03:40PM URINE  BLOOD-NEG NITRITE-NEG PROTEIN-NEG
GLUCOSE-NEG KETONE-NEG BILIRUBIN-SM UROBILNGN-8* PH-6.0 LEUK-NEG
[**2145-6-6**] 12:02PM   GLUCOSE-83 UREA N-24* CREAT-1.4* SODIUM-142
POTASSIUM-3.2* CHLORIDE-105 TOTAL CO2-24 ANION GAP-16
[**2145-6-6**] 12:02PM   ALT(SGPT)-117* AST(SGOT)-222* LD(LDH)-272*
ALK PHOS-376* AMYLASE-33 TOT BILI-3.2* DIR BILI-2.2* INDIR
BIL-1.0
[**2145-6-6**] 12:02PM   LIPASE-9
[**2145-6-6**] 12:02PM   ALBUMIN-3.1*
[**2145-6-6**] 12:02PM   WBC-20.5*# RBC-2.03* HGB-6.7* HCT-20.2*
MCV-100* MCH-33.0* MCHC-33.1# RDW-18.0*
[**2145-6-6**] 12:02PM   NEUTS-93* BANDS-4 LYMPHS-2* MONOS-1* EOS-0
BASOS-0 ATYPS-0 METAS-0 MYELOS-0
[**2145-6-6**] 12:02PM   HYPOCHROM-1+ ANISOCYT-1+ POIKILOCY-NORMAL
MACROCYT-2+ MICROCYT-NORMAL POLYCHROM-OCCASIONAL
[**2145-6-6**] 12:02PM   PLT SMR-NORMAL PLT COUNT-302
[**2145-6-6**] 12:02PM   PT-13.9* PTT-28.3 INR(PT)-1.2*
[**2145-6-6**] 12:00PM   GLUCOSE-79 UREA N-25* CREAT-1.4* SODIUM-143
POTASSIUM-3.3 CHLORIDE-106 TOTAL CO2-26 ANION GAP-14
[**2145-6-6**] 12:00PM   CALCIUM-7.9* PHOSPHATE-4.3 MAGNESIUM-1.9

Brief Hospital Course:
1. BRBPR: He was admitted to the ICU. His initial hct was 20 so
he was transfused. He had imaging of his abd which revealed a
large pancreatic mass encasing his celiac axis. He was treated
for pain.

2. Pancreatic mass and Prostate Cancer: Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] had a
family mtn with the pt and his family and the decision was made
to make the pt comfort measures only with hopes of home hospice.
He was tx'ed to 11R on [**2145-6-8**].

3. dispo: sent to inpt. Hospice facility

Medications on Admission:
iron
pain killer

Discharge Medications:
1. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every
4 to 6 hours) as needed.
Disp:*0 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. Morphine Concentrate  Oral


Discharge Disposition:
Extended Care

Facility:
[**Hospital **] health center

Discharge Diagnosis:
Metastatic pancreatic cancer


Discharge Condition:
poor


Discharge Instructions:
Please call the hospice team and/or your primary care doctor
with any questions about your care.

Followup Instructions:
Followup with your primary care doctor, Dr. [**First Name (STitle) **] [**Name (STitle) **], if you
have any questions
{'Malignant neoplasm of other specified sites of pancreas,Cholangitis,Iron deficiency anemia secondary to blood loss (chronic),Chronic kidney disease, unspecified,Hypovolemia,Secondary malignant neoplasm of other specified sites,Malignant neoplasm of prostate'}


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: bleeding from rectum along with weakness/fatigue

PRESENT ILLNESS: Pt is a 86 yo man with hx of metastatic pancreatic cancer dx'ed
in the past yr who presented to the ED with chief complaint of
fatigue and bright red blood per rectum.

MEDICAL HISTORY: metastatic pancreatic cancer

MEDICATION ON ADMISSION: iron
pain killer

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: T 96 P 69 163/72 18 o2 sat 100% RA
cachexic elderly man
perrl, eomi
neck supple
cv - rrr
CTA
abd is soft and nt/nd
ext without edema
no rashes
alert and oriented

FAMILY HISTORY: nc

SOCIAL HISTORY: nc 

### Response:
{'Malignant neoplasm of other specified sites of pancreas,Cholangitis,Iron deficiency anemia secondary to blood loss (chronic),Chronic kidney disease, unspecified,Hypovolemia,Secondary malignant neoplasm of other specified sites,Malignant neoplasm of prostate'}
