CHIEF COMPLAINT: Right leg pain

PRESENT ILLNESS: [**Age over 90 **]yoF with h/o multiple recent falls who was walking earlier
today, tripped and fell.  She was able to get up and ambulate
following this but was brought to the ED by nursing hoem she is
in to ensure she has no fracture.  Currently her only complaint
is knee pain.  No numbness/tingling. Does not use assistive
devices at baseline.

MEDICAL HISTORY: PMH
1. Hypertension
2. Hypercholesterolemia
3. GERD
4. ? mild dementia

MEDICATION ON ADMISSION: Lisinopril 2.5 mg daily
Simvastatin 20 mg daily

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: Temp:96.9 HR:108 BP:182/82 Resp:18 O(2)Sat:96 Normal

FAMILY HISTORY: Non contributory

SOCIAL HISTORY: Lives in an [**Hospital3 **]
Tobacco remote, ETOH rare
Closed fracture of pubis,Fall from other slipping, tripping, or stumbling,Unspecified essential hypertension,Pure hypercholesterolemia,Esophageal reflux,Other persistent mental disorders due to conditions classified elsewhere
Fracture of pubis-closed,Fall from slipping NEC,Hypertension NOS,Pure hypercholesterolem,Esophageal reflux,Mental disor NEC oth dis
Name:  [**Known lastname 14174**],[**Known firstname 1715**]                    Unit No:   [**Numeric Identifier 14175**]

Admission Date:  [**2117-1-9**]              Discharge Date:   [**2117-1-11**]

Date of Birth:  [**2022-12-4**]             Sex:   F

Service: SURGERY

Allergies:
No Known Allergies / Adverse Drug Reactions

Attending:[**First Name3 (LF) 844**]
Addendum:
This is an updated list of discharge medications.

tramadol  50 mg Tablet  Sig:  0.5 Tablet PO Q6H (every 6 hours)
as needed for pain.
Disp:*40  Tablet(s)*  Refills:*0*
    oxycodone  5 mg Tablet  Sig:  0.5 Tablet PO Q4H (every 4
hours) as needed for pain.
Disp:*40  Tablet(s)*  Refills:*0*
    docusate sodium  100 mg Capsule  Sig:  One (1) Capsule PO
BID (2 times a day): at 8am and 5pm.
    senna  8.6 mg Tablet  Sig:  One (1) Tablet PO BID (2 times a
day) as needed for constipation.
    multivitamin   Tablet  Sig:  One (1) Tablet PO once a day:
at 8am.
    simvastatin  20 mg Tablet  Sig:  One (1) Tablet PO once a
day: at 8pm.
    Seroquel  25 mg Tablet  Sig:  One (1) Tablet PO three times
a day: give at 8am, 4pm and 10pm.
    Seroquel  25 mg Tablet  Sig:  Two (2) Tablet PO once a day:
give at 12noon.
    trazodone  50 mg Tablet  Sig:  [**12-13**] Tablet PO at bedtime as
needed for insomnia.
    Vitamin B-12  1,000 mcg Tablet  Sig:  One (1) Tablet PO once
a day: give at 8am.
    citalopram  20 mg Tablet  Sig:  One (1) Tablet PO once a
day: at 8am.
    acetaminophen  325 mg Tablet  Sig:  Two (2) Tablet PO three
times a day.
    lisinopril  5 mg Tablet  Sig:  One (1) Tablet PO twice a
day: at 8am and 5pm.
    Ocean Nasal  0.65 % Aerosol, Spray  Sig:  One (1) inh Nasal
twice a day as needed for cold symptoms.


Discharge Disposition:
Extended Care

Facility:
[**Last Name (un) 14176**] house

                             [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 845**] MD [**MD Number(1) 846**]

Completed by:[**2117-1-11**]

Admission Date:  [**2117-1-9**]              Discharge Date:   [**2117-1-11**]


Service: SURGERY

Allergies:
No Known Allergies / Adverse Drug Reactions

Attending:[**First Name3 (LF) 371**]
Chief Complaint:
Right leg pain

Major Surgical or Invasive Procedure:
none


History of Present Illness:
[**Age over 90 **]yoF with h/o multiple recent falls who was walking earlier
today, tripped and fell.  She was able to get up and ambulate
following this but was brought to the ED by nursing hoem she is
in to ensure she has no fracture.  Currently her only complaint
is knee pain.  No numbness/tingling. Does not use assistive
devices at baseline.


Past Medical History:
PMH
1. Hypertension
2. Hypercholesterolemia
3. GERD
4. ? mild dementia

PSH
1. S/P hysterectomy
2. S/P Left mastectomy


Social History:
Lives in an [**Hospital3 **]
Tobacco remote, ETOH rare

Family History:
Non contributory

Physical Exam:
Temp:96.9 HR:108 BP:182/82 Resp:18 O(2)Sat:96 Normal

Constitutional: Comfortable
HEENT: Normocephalic, atraumatic, Pupils equal, round and
reactive to light, Extraocular muscles intact
Chest: Clear to auscultation
Cardiovascular: Regular Rate and Rhythm, Normal first and
second heart sounds
Abdominal: Soft, Nontender, Nondistended
Extr/Back: There is swelling around the right knee; there
is full range of motion of the knee joint. There is some
diffuse tenderness to palpation of the right knee, joint is
stable; motion is slightly decreased in the right hip range
of motion of the hip does cause some pain. It is no
deformity of the right lower extremity
Skin: area of ecchymosis
Neuro: Speech fluent; neuro is grossly intact
Psych: Normal mood, Normal mentation


Pertinent Results:
[**2117-1-9**] 12:46AM   WBC-8.5 RBC-3.40* HGB-10.9* HCT-32.2* MCV-94
MCH-32.1* MCHC-34.0 RDW-13.0
[**2117-1-9**] 12:46AM   NEUTS-70.3* LYMPHS-23.1 MONOS-2.6 EOS-3.6
BASOS-0.4
[**2117-1-9**] 12:46AM   PLT COUNT-236
[**2117-1-9**] 12:46AM   GLUCOSE-129* UREA N-24* CREAT-1.1 SODIUM-137
POTASSIUM-5.2* CHLORIDE-103 TOTAL CO2-26 ANION GAP-13
[**2117-1-9**] 09:53AM   HCT-28.8*
[**2117-1-11**] 05:30AM   HCT-24.1

[**2117-1-9**] CT pelvis:
Acute right superior and inferior pubic rami fractures with
associated pelvic hematoma. No evidence of active arterial
extravasation.



Brief Hospital Course:
Mrs. [**Known lastname 90444**] was evaluated by the Trauma team in the Emergency
Room as well as the Ortho Trauma team.  Her scans were reviewed
and based on her right pubic rami fracture with pelvic hematoma
she was admitted to the ICU for close monitoring and frequent
hematocrit checks.  She maintained stable hemodynamics and her
pain was initially controlled with Morphine.

Her hematocrit was 28.8 on admission and slowly drifted to the
24-26 range.  She was asymptomatic and able to get out of bed
and pivot to a chair with moderate pain.  She was tolerating a
regular diet.

Following transfer to the trauma floor she continued to make
good progress.  She was seen by the Physical Therapy service and
her weight bearing status was weight bearing as tolerated.  She
was able to stand independently

Medications on Admission:
Lisinopril 2.5 mg daily
Simvastatin 20 mg daily

Discharge Medications:
1. acetaminophen 650 mg/20.3 mL Solution Sig: Two (2) tablets PO
TID (3 times a day).
2. tramadol 50 mg Tablet Sig: 0.5 Tablet PO Q6H (every 6 hours)
as needed for pain.
Disp:*40 Tablet(s)* Refills:*0*
3. oxycodone 5 mg Tablet Sig: 0.5 Tablet PO Q4H (every 4 hours)
as needed for pain.
Disp:*40 Tablet(s)* Refills:*0*
4. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
5. senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day) as needed for constipation.
6. multivitamin     Tablet Sig: One (1) Tablet PO once a day.
7. simvastatin 20 mg Tablet Sig: One (1) Tablet PO once a day.
8. lisinopril 2.5 mg Tablet Sig: One (1) Tablet PO once a day.


Discharge Disposition:
Extended Care

Facility:
[**Last Name (un) **] house

Discharge Diagnosis:
S/P Fall
1. Right superior/inferior pubic rami fracture
2. Pelvic hematoma


Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Out of Bed with assistance to chair or
wheelchair.


Discharge Instructions:
* You were admitted to the hospital after falling and you
sustained a fractured pelvis.
* You are able to bear weight but if you develop intolerable
pain then stop.
* You will need pain medication initially and some of those
medicatiions can cause constipation so be sure to take a stool
softener or gentle laxative to keep you regular.
* If you develop any more new aches or pains or any other
symptoms that concern you please call your doctor or return to
the Emergency Room.

Followup Instructions:
Call the [**Hospital **] Clinic at [**Telephone/Fax (1) 1228**] for a follow up
appointment in [**2-12**] weeks.



Completed by:[**2117-1-11**]
{'Closed fracture of pubis,Fall from other slipping, tripping, or stumbling,Unspecified essential hypertension,Pure hypercholesterolemia,Esophageal reflux,Other persistent mental disorders due to conditions classified elsewhere'}


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 leg pain

PRESENT ILLNESS: [**Age over 90 **]yoF with h/o multiple recent falls who was walking earlier
today, tripped and fell.  She was able to get up and ambulate
following this but was brought to the ED by nursing hoem she is
in to ensure she has no fracture.  Currently her only complaint
is knee pain.  No numbness/tingling. Does not use assistive
devices at baseline.

MEDICAL HISTORY: PMH
1. Hypertension
2. Hypercholesterolemia
3. GERD
4. ? mild dementia

MEDICATION ON ADMISSION: Lisinopril 2.5 mg daily
Simvastatin 20 mg daily

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: Temp:96.9 HR:108 BP:182/82 Resp:18 O(2)Sat:96 Normal

FAMILY HISTORY: Non contributory

SOCIAL HISTORY: Lives in an [**Hospital3 **]
Tobacco remote, ETOH rare 

### Response:
{'Closed fracture of pubis,Fall from other slipping, tripping, or stumbling,Unspecified essential hypertension,Pure hypercholesterolemia,Esophageal reflux,Other persistent mental disorders due to conditions classified elsewhere'}
