CHIEF COMPLAINT: Abd pain

PRESENT ILLNESS: 50M admitted to [**Hospital3 35813**] Center with EtOH pancreatitis
that required ventilatory support and ultimately a Trach and PEG
wh was transferred to [**Hospital1 18**] for elevated tempuratures while on
antibiotics and for the concern of necrotizing pancreatitis.

MEDICAL HISTORY: EtOH abuse
Pancreatitis
MRSA bacteremia
MRSA pneumonia
Alcoholic hepatitis
C diff
ARF
DT
PSVT
Respiratory failure s/p trach and PEG
DMII
High triglyceridemia

MEDICATION ON ADMISSION: None

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Temp 100, HR 110 ST, BP 105/61
Sedated and ventilated
Follows commands when aroused
Tachy with no murmurs
CTA (b)
Soft, Non-tender, Non-distended
mild edema, no clubbing

FAMILY HISTORY: None

SOCIAL HISTORY: + EtOH
Lives alone
2 pack per day
Acute pancreatitis,Methicillin susceptible pneumonia due to Staphylococcus aureus,Other and unspecified alcohol dependence, continuous,Attention to tracheostomy,Attention to gastrostomy,Infection with microorganisms resistant to penicillins,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Tobacco use disorder
Acute pancreatitis,Meth sus pneum d/t Staph,Alcoh dep NEC/NOS-contin,Atten to tracheostomy,Atten to gastrostomy,Inf mcrg rstn pncllins,DMII wo cmp nt st uncntr,Tobacco use disorder
Admission Date:  [**2181-3-22**]              Discharge Date:   [**2181-4-3**]

Date of Birth:  [**2131-2-1**]             Sex:   M

Service: SURGERY

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 148**]
Chief Complaint:
Abd pain

Major Surgical or Invasive Procedure:
None

History of Present Illness:
50M admitted to [**Hospital3 35813**] Center with EtOH pancreatitis
that required ventilatory support and ultimately a Trach and PEG
wh was transferred to [**Hospital1 18**] for elevated tempuratures while on
antibiotics and for the concern of necrotizing pancreatitis.

Past Medical History:
EtOH abuse
Pancreatitis
MRSA bacteremia
MRSA pneumonia
Alcoholic hepatitis
C diff
ARF
DT
PSVT
Respiratory failure s/p trach and PEG
DMII
High triglyceridemia

Social History:
+ EtOH
Lives alone
2 pack per day


Family History:
None

Physical Exam:
Temp 100, HR 110 ST, BP 105/61
Sedated and ventilated
Follows commands when aroused
Tachy with no murmurs
CTA (b)
Soft, Non-tender, Non-distended
mild edema, no clubbing

Pertinent Results:
[**2181-3-23**] 12:50PM BLOOD WBC-16.3* RBC-2.88* Hgb-8.4* Hct-25.5*
MCV-88 MCH-29.0 MCHC-32.8 RDW-15.5 Plt Ct-684*
[**2181-3-23**] 12:50PM BLOOD Plt Ct-684*
[**2181-3-23**] 12:50PM BLOOD Glucose-106* UreaN-19 Creat-0.4* Na-137
K-4.1 Cl-97 HCO3-36* AnGap-8
[**2181-3-23**] 07:31PM BLOOD ALT-17 AST-95* LD(LDH)-996* AlkPhos-136*
Amylase-54 TotBili-0.3
[**2181-3-23**] 07:31PM BLOOD Lipase-97*
[**2181-3-23**] 12:50PM BLOOD Calcium-8.2* Phos-5.1* Mg-1.9
[**2181-3-27**] 04:11AM BLOOD Triglyc-249*
[**2181-4-1**] 01:00AM BLOOD Vanco-13.3*
[**2181-4-3**] 03:07AM BLOOD WBC-9.7 RBC-3.06* Hgb-8.8* Hct-27.3*
MCV-89 MCH-28.8 MCHC-32.3 RDW-15.2 Plt Ct-523*
[**2181-4-3**] 03:07AM BLOOD Plt Ct-523*
[**2181-4-3**] 03:07AM BLOOD PT-12.7 PTT-24.0 INR(PT)-1.0
[**2181-4-3**] 03:07AM BLOOD Glucose-107* UreaN-11 Creat-0.3* Na-135
K-4.0 Cl-100 HCO3-31* AnGap-8
[**2181-4-3**] 03:07AM BLOOD Amylase-42
[**2181-3-30**] 02:05AM BLOOD ALT-24 AST-35 LD(LDH)-237 AlkPhos-159*
Amylase-50 TotBili-0.4
[**2181-4-3**] 03:07AM BLOOD Lipase-90*
[**2181-4-3**] 03:07AM BLOOD Albumin-2.6* Calcium-8.9 Phos-5.4* Mg-1.7

Brief Hospital Course:
Pt was admitted to the SICU on [**3-22**]. He was placed on the
ventilator on arrival. A CT scan was done which showed an
inflammatory phlegmon with no secondary signs of infection. He
was slowly weaned from the ventilator however this required
bronchoscopic clearance of his lungs and aggressive pulmonary
toilet. He was maintained on TPN while his pancreatitis
resloved. Ultimately, he was transitioned to TF and he tolerated
this well. He was maintained on ativan for treatment of his DT
and antibiotics for his pancreatitis. After completing his
course of abx. they were stopped however he began to have
elevated tempuratures and was found to have a recurrent MRSA
pneumonia. He was started on Vancomycin and he is to complete a
14day course for his pneumonia. He achieved his goal of TF and
his TPN was D/C. He began having high stool output. Multiple
samples were sent for C. diff and they were all negative. He was
successfully weaned from the ventilator and tolerated trach
mask. Speech and swallow evaluated him for a Passe-Muir valve.
He was started on lasix for diureses and his sedatives were
stopped. Pt was awake, comfortable, and following commands at
time of discharge. A R PICC was placed on [**4-3**] for continued
antibiotics. He is currently tolerating TF at goal, on trach
mask, and working with PT

Medications on Admission:
None

Discharge Medications:
Ascorbic Acid (Liquid) 500 mg PO DAILY
Ferrous Sulfate 325 mg PO DAILY
Lorazepam 3 mg PO TID
Metoprolol 100 mg PO/NG TID
hold for hr<60, sbp <100
Vancomycin HCl 1500 mg IV Q12H X 7 days
Insulin SC  (per Insulin Flowsheet)
Sliding Scale
Clonidine HCl 0.2 mg PO TID
hold for SBP<110
Morphine Sulfate 2-5 mg IV Q3-4H:PRN pain
Lansoprazole 30 mg PO DAILY
Heparin 5000 UNIT SC TID
Lorazepam 2 mg IV Q2H:PRN



Discharge Disposition:
Extended Care

Facility:
Rehab Hospital Of [**Doctor Last Name **]

Discharge Diagnosis:
Necrotizing pancreatitis
EtOH
DT
MRSA pneumonia
MRSA bacteremia
EtOH hepatitis
C diff
ARF
PSVT
Respiratory failure
s/p Trach and PEG
DMII
High triglycerides
s/p bronchoscopy
s/p PICC

Discharge Condition:
Stable

Discharge Instructions:
Continue TF at goal.
Aggressive pulmonary toilet
OOB and PT consult

Followup Instructions:
F/U with Dr. [**Last Name (STitle) **] in [**3-1**] wks


Completed by:[**0-0-0**]
{'Acute pancreatitis,Methicillin susceptible pneumonia due to Staphylococcus aureus,Other and unspecified alcohol dependence, continuous,Attention to tracheostomy,Attention to gastrostomy,Infection with microorganisms resistant to penicillins,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Tobacco use disorder'}


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: Abd pain

PRESENT ILLNESS: 50M admitted to [**Hospital3 35813**] Center with EtOH pancreatitis
that required ventilatory support and ultimately a Trach and PEG
wh was transferred to [**Hospital1 18**] for elevated tempuratures while on
antibiotics and for the concern of necrotizing pancreatitis.

MEDICAL HISTORY: EtOH abuse
Pancreatitis
MRSA bacteremia
MRSA pneumonia
Alcoholic hepatitis
C diff
ARF
DT
PSVT
Respiratory failure s/p trach and PEG
DMII
High triglyceridemia

MEDICATION ON ADMISSION: None

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Temp 100, HR 110 ST, BP 105/61
Sedated and ventilated
Follows commands when aroused
Tachy with no murmurs
CTA (b)
Soft, Non-tender, Non-distended
mild edema, no clubbing

FAMILY HISTORY: None

SOCIAL HISTORY: + EtOH
Lives alone
2 pack per day 

### Response:
{'Acute pancreatitis,Methicillin susceptible pneumonia due to Staphylococcus aureus,Other and unspecified alcohol dependence, continuous,Attention to tracheostomy,Attention to gastrostomy,Infection with microorganisms resistant to penicillins,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Tobacco use disorder'}
