CHIEF COMPLAINT: 

PRESENT ILLNESS: Ms [**Doctor Last Name 103291**] is a 56 year
old female with a history of hypertension,
hypercholesterolemia who presented with facial swelling and
shortness of breath.  The patient was in her usual state of
health on the day of admission and traveled to her daughter's
for dinner where she had pork loin, rice pilaf and string
beans.  After eating the patient was watching television
while sitting on a carpet at her daughter's apartment that
was not new or had not recently been cleaned when she felt
her eyes beginning to water.  Her eyes then began to itch,
she began to sneeze and she had the sensation of throat and
lip swelling and tongue swelling that progressed to throat
tightness.  The patient then had difficulty speaking in more
than one to two word sentences and had difficulty breathing.
She took Advil Allergy & Sinus and her daughter brought her
to the Emergency Department.

MEDICAL HISTORY: 1.  Hypertension; 2.
Hypercholesterolemia; 3.  Total abdominal hysterectomy/
bilateral salpingo-oophorectomy; 4.  Allergic rhinitis with
episode of bronchospasm last year.

MEDICATION ON ADMISSION: Atenolol 100 mg p.o. q. day,
Hydrochlorothiazide 25 mg p.o. q. day.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: No family history of angioedema or allergic
reaction to require a respiratory support.  Mother with
hypertension and with breast cancer.

SOCIAL HISTORY: Negative tobacco, minimal ethyl alcohol, no
intravenous drug use.
Allergy, unspecified, not elsewhere classified,Swelling, mass, or lump in head and neck,Unspecified essential hypertension,Pure hypercholesterolemia,Extrinsic asthma, unspecified,Unspecified drug or medicinal substance causing adverse effects in therapeutic use
Allergy, unspecified,Swelling in head & neck,Hypertension NOS,Pure hypercholesterolem,Extrinsic asthma NOS,Adv eff medicinal NOS
Admission Date:  [**2168-9-7**]       Discharge Date:  [**2168-9-8**]

Date of Birth:   [**2112-6-14**]       Sex:  F

Service: [**Hospital Ward Name 332**] MICU

ADMITTING DIAGNOSIS:
1.  Allergic reaction/angioedema

HISTORY OF PRESENT ILLNESS:  Ms [**Doctor Last Name 103291**] is a 56 year
old female with a history of hypertension,
hypercholesterolemia who presented with facial swelling and
shortness of breath.  The patient was in her usual state of
health on the day of admission and traveled to her daughter's
for dinner where she had pork loin, rice pilaf and string
beans.  After eating the patient was watching television
while sitting on a carpet at her daughter's apartment that
was not new or had not recently been cleaned when she felt
her eyes beginning to water.  Her eyes then began to itch,
she began to sneeze and she had the sensation of throat and
lip swelling and tongue swelling that progressed to throat
tightness.  The patient then had difficulty speaking in more
than one to two word sentences and had difficulty breathing.
She took Advil Allergy & Sinus and her daughter brought her
to the Emergency Department.

In the Emergency Department she was noted to be in mild
respiratory distress with moderate angioedema on examination.
Her vital signs were afebrile, heartrate 75, blood pressure
215/104 that decreased to 155/128 with a respiratory rate of
20 sating 99% on room air.  She was given Benadryl 50 mg
intravenously, Solu-Medrol 125 mg intravenously, Epinephrine
.2 mg subcutaneously and Famotidine 20 mg intravenously times
one.  She was seen by Otorhinolaryngology who noted an
edematous uvula but the posterior pharynx was easily
visualized without evidence of laryngoedema.  Neck was soft
with no fullness or edema.  Their assessment was angioedema
that was responding well to the Epinephrine.  She was
admitted to the Fenard Intensive Care Unit for monitoring of
her respiratory status and of her airway.

PAST MEDICAL HISTORY:  1.  Hypertension; 2.
Hypercholesterolemia; 3.  Total abdominal hysterectomy/
bilateral salpingo-oophorectomy; 4.  Allergic rhinitis with
episode of bronchospasm last year.

MEDICATIONS ON ADMISSION:  Atenolol 100 mg p.o. q. day,
Hydrochlorothiazide 25 mg p.o. q. day.

ALLERGIES:  No known drug allergies.

SOCIAL HISTORY:  Negative tobacco, minimal ethyl alcohol, no
intravenous drug use.

FAMILY HISTORY:  No family history of angioedema or allergic
reaction to require a respiratory support.  Mother with
hypertension and with breast cancer.

PHYSICAL EXAMINATION:  Vital signs revealed temperature 98.2,
heartrate 72, blood pressure 154/82, respiratory rate 20,
oxygen saturation 100% on 2 liters of nasal cannula.
General:  The patient was alert and oriented and appeared
comfortable in minimal respiratory distress.  Head, eyes,
ears, nose and throat:  Pupils were equal, round and reactive
to light.  Extraocular movements intact.  Moist mucous
membranes.  Oropharynx was clear with no evidence of
obstruction or edema.  Neck was supple, no lymphadenopathy
and no swelling.  Heart was regular rate and rhythm without
murmurs, rubs or gallops.  Lungs were clear to auscultation
bilaterally without wheeze, rhonchi or rub.  Abdomen was
soft, nontender, nondistended with positive bowel sounds.
Extremities were warm and well perfused with no edema.

LABORATORY DATA:  None.

HOSPITAL COURSE:  The patient was transferred to the [**Hospital Ward Name 332**]
Intensive Care Unit for further monitoring.  On arrival the
patient was in minimal if any respiratory distress, feeling
much improved.  Based on the recommendation of
Otorhinolaryngology the patient was continued on Benadryl 50
mg intravenously q. 6, Famotidine 20 mg intravenously q. 12,
Dexamethasone 10 mg intravenously q. 8.  The patient
continued to improve and in the morning felt swell without
complaint of respiratory difficulty or shortness of breath.
She complained only of a mild sore throat and slept well for
the prior few hours.

Allergy was contact[**Name (NI) **] regarding the episode and the unknown
etiology or trigger and recommended that she follow up with
her primary care physician on the day after discharge and
then to follow up in the [**Hospital 9039**] Clinic early next week which
was arranged for the patient.  Because she had stabilized and
her breathing had improved, Benadryl and Famotidine were
discontinued.  The patient was put on a short course of
Prednisone 40 mg.  She was taught how to use an EpiPen.  Her
antihypertensive, Hydrochlorothiazide and Atenolol were
restarted and her diet was advanced to a normal house diet.
The patient was discharged on hospital day #2 in stable
condition with Prednisone and the EpiPen and directions to
take Benadryl and use the EpiPen should symptoms recur.  She
was also instructed to avoid seafoods, and the carpet as
these were considered possible triggers for her episode.

Of note, the patient had been hemodynamically stable
throughout her course of stay in the [**Hospital Ward Name 332**] Intensive Care
Unit.

DISCHARGE STATUS:  Stable.

DISCHARGE DIAGNOSIS:
1.  Allergic reaction
2.  Respiratory distress

DISCHARGE MEDICATIONS:
Prednisone 40 mg p.o. q. day times four days
Benadryl as directed prn
EpiPen as needed
Hydrochlorothiazide 25 mg p.o. q. day
Atenolol 100 mg p.o. q. day

FOLLOW UP:  The patient is to follow up with Dr. [**Last Name (STitle) **] her
primary care physician [**Last Name (NamePattern4) **] 1 o'clock PM on the day after
discharge and then will see Dr. [**Last Name (STitle) 59684**] in the [**Hospital 9039**]
Clinic on [**9-15**], at 10 AM for further testing.



                            [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 2437**], M.D.  [**MD Number(1) 2438**]

Dictated By:[**Last Name (NamePattern1) 103292**]
MEDQUIST36

D:  [**2168-9-8**]  16:31
T:  [**2168-9-8**]  17:12
JOB#:  [**Job Number 103293**]
{'Allergy, unspecified, not elsewhere classified,Swelling, mass, or lump in head and neck,Unspecified essential hypertension,Pure hypercholesterolemia,Extrinsic asthma, unspecified,Unspecified drug or medicinal substance causing adverse effects in therapeutic use'}


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: 

PRESENT ILLNESS: Ms [**Doctor Last Name 103291**] is a 56 year
old female with a history of hypertension,
hypercholesterolemia who presented with facial swelling and
shortness of breath.  The patient was in her usual state of
health on the day of admission and traveled to her daughter's
for dinner where she had pork loin, rice pilaf and string
beans.  After eating the patient was watching television
while sitting on a carpet at her daughter's apartment that
was not new or had not recently been cleaned when she felt
her eyes beginning to water.  Her eyes then began to itch,
she began to sneeze and she had the sensation of throat and
lip swelling and tongue swelling that progressed to throat
tightness.  The patient then had difficulty speaking in more
than one to two word sentences and had difficulty breathing.
She took Advil Allergy & Sinus and her daughter brought her
to the Emergency Department.

MEDICAL HISTORY: 1.  Hypertension; 2.
Hypercholesterolemia; 3.  Total abdominal hysterectomy/
bilateral salpingo-oophorectomy; 4.  Allergic rhinitis with
episode of bronchospasm last year.

MEDICATION ON ADMISSION: Atenolol 100 mg p.o. q. day,
Hydrochlorothiazide 25 mg p.o. q. day.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: No family history of angioedema or allergic
reaction to require a respiratory support.  Mother with
hypertension and with breast cancer.

SOCIAL HISTORY: Negative tobacco, minimal ethyl alcohol, no
intravenous drug use. 

### Response:
{'Allergy, unspecified, not elsewhere classified,Swelling, mass, or lump in head and neck,Unspecified essential hypertension,Pure hypercholesterolemia,Extrinsic asthma, unspecified,Unspecified drug or medicinal substance causing adverse effects in therapeutic use'}
