CHIEF COMPLAINT: Status post fall from standing position.

PRESENT ILLNESS: The patient is a 76 year-old
male with a history of CLL, hypertension, presents status
post fall from standing position.  He is unsure why he fell,
but he remembers he felt his legs getting weak.  By report he
struck his head on furniture, unclear if he had loss of
consciousness.  At the time of presentation he had a
headache, right orbital pain and right sided chest wall pain.

MEDICAL HISTORY: 1.  CLL under treatment at the VA by
[**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **].  2.  Hypertension.  3.  Status post
laparoscopic cholecystectomy.

MEDICATION ON ADMISSION: Zantac 100 mg po b.i.d.,
Felodipine 5 mg po q day, aspirin 81 mg po q day,
multivitamins q.d.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: No tobacco or alcohol use.  No drug use.
His usual care is at the VA.
Other specified cardiac dysrhythmias,Subarachnoid hemorrhage following injury without mention of open intracranial wound, unspecified state of consciousness,Unspecified pleural effusion,Chronic lymphoid leukemia, without mention of having achieved remission,Unspecified fall,Unspecified essential hypertension,Contusion of eyelids and periocular area
Cardiac dysrhythmias NEC,Traum subarachnoid hem,Pleural effusion NOS,Ch lym leuk wo achv rmsn,Fall NOS,Hypertension NOS,Contusion periocular
Admission Date:  [**2138-10-20**]       Discharge Date:  [**2138-10-28**]

Date of Birth:   [**2062-10-1**]       Sex:  M

Service:  [**Hospital1 **]

CHIEF COMPLAINT:  Status post fall from standing position.

HISTORY OF PRESENT ILLNESS:  The patient is a 76 year-old
male with a history of CLL, hypertension, presents status
post fall from standing position.  He is unsure why he fell,
but he remembers he felt his legs getting weak.  By report he
struck his head on furniture, unclear if he had loss of
consciousness.  At the time of presentation he had a
headache, right orbital pain and right sided chest wall pain.

PAST MEDICAL HISTORY:  1.  CLL under treatment at the VA by
[**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **].  2.  Hypertension.  3.  Status post
laparoscopic cholecystectomy.

ALLERGIES:  No known drug allergies.

MEDICATIONS ON ADMISSION:  Zantac 100 mg po b.i.d.,
Felodipine 5 mg po q day, aspirin 81 mg po q day,
multivitamins q.d.

SOCIAL HISTORY:  No tobacco or alcohol use.  No drug use.
His usual care is at the VA.

PHYSICAL EXAMINATION ON ADMISSION:  Temperature 98.6.  Blood
pressure 140/68.  Pulse 64.  Respiratory rate 18.  O2 sat 95%
on room air.  In general, alert and oriented times three.
Glascow coma score 15.  HEENT examination pupils are equal,
round, and reactive to light and accommodation bilaterally.
Pupils 2 mm.  Extraocular movements intact.  Positive
ecchymoses surrounding right eye.  Face stable.  Oropharynx
clear.  Tympanic membranes clear.  C spine nontender.  No
carotid bruits.  Cardiovascular examination regular rate and
rhythm.  Normal S1 and S2.  Lungs clear to auscultation
bilaterally.  Right sided diffuse wall tenderness.  Right
lung fields, decreased breath sounds diffusely.  Abdomen
soft, nontender, nondistended, normoactive bowel sounds.
Rectal normal tone, normal prostate, guaiac negative.  Pelvis
nontender.  Back mild tenderness at upper T spine.  No step
off, otherwise nontender.  Extremities normal range of
motion, no deformities, palpable pulses in all extremities.

LABORATORIES ON ADMISSION:  White blood cell count 54.5,
hematocrit 31.3, platelets 80, sodium 137, potassium 4.3,
chloride 103, bicarbonate 24, BUN 23, creatinine 1.6, glucose
135.  X-rays of C spine negative, degenerative changes.
Chest x-ray lateral right sided effusion, no fractures, no
pneumothorax.  Pelvis is negative.  C spine negative.  CT of
the head bifrontal subarachnoid hemorrhages with small area
of intraparenchymal bleed on right.  Electrocardiogram normal
sinus rhythm no acute ST or T wave changes.

IMPRESSION:  The patient is a 76 year-old male status post
fall from standing position, bifrontal subarachnoid
hemorrhages and loculated lateral right sided pulmonary
effusion without definite rib fracture.  Difficult to
ascertain cause of fall.  Initially obtained a syncope
workup.

HOSPITAL COURSE:  1.  syncope:  The patient's syncope was
felt to be due to symptomatic bradycardia, which was treated
with a DDD pacemaker, which was implanted on [**2138-10-24**] by Dr. [**Last Name (STitle) **] [**Name (STitle) 1911**] without complications.  The
pacer was working well post implant.  Neurosurgery evaluation
for the subarachnoid hemorrhage felt that the bleeds were
stable and would not be amenable to surgical intervention and
were not operated upon.

2.  Pulmonary:  Right loculated pleural effusion was drained
by ultrasound guided thoracentesis, which drained
serosanguinous fluid, which showed exudates with no evidence
of empyema, no organisms grew and cytology was negative.
This finding was consistent with prior films obtained from
the VA, which showed that the pleural effusion has been
present for at least the last three to four months without
change.

3.  Hematology/Oncology:  The patient was under treatment for
his CLL several times in the past and currently is not on
therapy for his CLL.  His treatment was coordinated in the
past by [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] at the [**Hospital **] Hospital, however, at this
time [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] cannot be reached after multiple attempts.
He is now no longer with the VA.  Hematology/Oncology in
house recommended holding off on treating CLL as there is no
acute need for treatment.  The patient's white blood cell
count remained relatively stable throughout his hospital stay
with predominant lymphocytosis.

4.  Deconditioning:  The patient after his fall is afraid of
further movement and is being followed by physical therapy
for evaluation and treatment of his deconditioning and
recommended rehabilitation in order to improve his mobility.
The patient will be discharged to a rehabilitation facility
for further management.

DISCHARGE DIAGNOSES:
1.  Syncope.
2.  Status post bilateral subarachnoid hemorrhages.
3.  Status post pacemaker implantation.
4.  Right loculated pleural effusion.
5.  CLL.
6.  Status post fall.

DISCHARGE CONDITION:  Fair.  The patient is to be discharged
to a rehab facility.

MEDICATIONS ON DISCHARGE:  Tylenol prn, Docusate 100 mg po
b.i.d., Senna one tab po b.i.d. prn, Milk of Magnesia 30 mg
po q 6 hours prn, Cepacol lozenges prn, morphine prn.  Zantac
150 mg po b.i.d.






                            [**First Name11 (Name Pattern1) 2515**] [**Last Name (NamePattern4) 4517**], M.D.  [**MD Number(1) 4521**]

Dictated By:[**Doctor Last Name 9869**]
MEDQUIST36

D:  [**2138-10-28**]  09:08
T:  [**2138-10-28**]  09:34
JOB#:  [**Job Number **]
{'Other specified cardiac dysrhythmias,Subarachnoid hemorrhage following injury without mention of open intracranial wound, unspecified state of consciousness,Unspecified pleural effusion,Chronic lymphoid leukemia, without mention of having achieved remission,Unspecified fall,Unspecified essential hypertension,Contusion of eyelids and periocular area'}


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: Status post fall from standing position.

PRESENT ILLNESS: The patient is a 76 year-old
male with a history of CLL, hypertension, presents status
post fall from standing position.  He is unsure why he fell,
but he remembers he felt his legs getting weak.  By report he
struck his head on furniture, unclear if he had loss of
consciousness.  At the time of presentation he had a
headache, right orbital pain and right sided chest wall pain.

MEDICAL HISTORY: 1.  CLL under treatment at the VA by
[**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **].  2.  Hypertension.  3.  Status post
laparoscopic cholecystectomy.

MEDICATION ON ADMISSION: Zantac 100 mg po b.i.d.,
Felodipine 5 mg po q day, aspirin 81 mg po q day,
multivitamins q.d.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: No tobacco or alcohol use.  No drug use.
His usual care is at the VA. 

### Response:
{'Other specified cardiac dysrhythmias,Subarachnoid hemorrhage following injury without mention of open intracranial wound, unspecified state of consciousness,Unspecified pleural effusion,Chronic lymphoid leukemia, without mention of having achieved remission,Unspecified fall,Unspecified essential hypertension,Contusion of eyelids and periocular area'}
