CHIEF COMPLAINT: Left hip drainage

PRESENT ILLNESS: 83yo F s/p L DHS (intertroch fx) on [**4-28**] c/b failed fixation by
migration of screw & infection, s/[**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] [**6-12**] w/ Abx Spacer then
s/p Left Hemi [**6-18**] w/ ORIF Greater Troch, now p/w increasing L
hip pain.

MEDICAL HISTORY: -Coronary Artery Disease status post MI in [**2180-12-24**] (3VD
on cardiac cath but managed non-operatively)
-Depression
-Anxiety
-Atrial Fibrillation (not on anticoagulation)
-Crohn's Disease
-Chronic obstructive pulmonary disease
-distant history of tonsillectomy and adenoidectomy
-L hip ORIF [**2181-4-28**]

MEDICATION ON ADMISSION: Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6
hours).
Senna 8.6 mg Tablet Sig: 1-2 Tablets PO BID (2 times a day) as
needed for Constipation.
 Multivitamin     Tablet Sig: One (1) Cap PO DAILY (Daily).
 Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: One (1)
Tablet PO DAILY (Daily).
Amiodarone 200 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

ALLERGIES: Fosamax / Prozac

PHYSICAL EXAM: Gen: AFVSS
HEENT: Clear OP, MMM
NECK: Supple, No LAD, No JVD
CV: RR, NL rate. NL S1, S2. No murmurs, rubs or gallops
LUNGS: CTA, BS BL, No W/R/C
ABD: Soft, NT, ND. NL BS.  No HSM
EXT: No edema. 2+ DP pulses BL
SKIN: No lesions
NEURO: A&Ox3. Appropriate. CN 2-12 grossly intact. Preserved
sensation throughout. 5/5 strength throughout. [**11-24**]+ reflexes,
equal BL. Normal coordination. Gait assessment deferred
PSYCH: Listens and responds to questions appropriately, pleasant

FAMILY HISTORY: She reports multiple family members with heart problems.

SOCIAL HISTORY: Pt transported here from [**Hospital6 **]
Other complications due to internal joint prosthesis,Pressure ulcer, stage III,Urinary tract infection, site not specified,Surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation,Coronary atherosclerosis of native coronary artery,Old myocardial infarction,Dysthymic disorder,Chronic airway obstruction, not elsewhere classified,Atrial fibrillation,Colostomy status,Hip joint replacement
Comp-internal joint pros,Pressure ulcer,stage III,Urin tract infection NOS,Abn react-artif implant,Crnry athrscl natve vssl,Old myocardial infarct,Dysthymic disorder,Chr airway obstruct NEC,Atrial fibrillation,Colostomy status,Joint replaced hip
Admission Date:  [**2181-6-28**]              Discharge Date:   [**2181-7-10**]

Date of Birth:  [**2098-1-8**]             Sex:   F

Service: ORTHOPAEDICS

Allergies:
Fosamax / Prozac

Attending:[**First Name3 (LF) 8587**]
Chief Complaint:
Left hip drainage

Major [**First Name3 (LF) 2947**] or Invasive Procedure:
[**6-28**]: I & D L hip, large haematoma evacuated
[**7-2**]: I & D L hip, surface VAC + Hemovacs x2 thru VAC sponge


History of Present Illness:
83yo F s/p L DHS (intertroch fx) on [**4-28**] c/b failed fixation by
migration of screw & infection, s/[**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] [**6-12**] w/ Abx Spacer then
s/p Left Hemi [**6-18**] w/ ORIF Greater Troch, now p/w increasing L
hip pain.

Past Medical History:
-Coronary Artery Disease status post MI in [**2180-12-24**] (3VD
on cardiac cath but managed non-operatively)
-Depression
-Anxiety
-Atrial Fibrillation (not on anticoagulation)
-Crohn's Disease
-Chronic obstructive pulmonary disease
-distant history of tonsillectomy and adenoidectomy
-L hip ORIF [**2181-4-28**]

Social History:
Pt transported here from [**Hospital6 **]


Family History:
She reports multiple family members with heart problems.

Physical Exam:
Gen: AFVSS
HEENT: Clear OP, MMM
NECK: Supple, No LAD, No JVD
CV: RR, NL rate. NL S1, S2. No murmurs, rubs or gallops
LUNGS: CTA, BS BL, No W/R/C
ABD: Soft, NT, ND. NL BS.  No HSM
EXT: No edema. 2+ DP pulses BL
SKIN: No lesions
NEURO: A&Ox3. Appropriate. CN 2-12 grossly intact. Preserved
sensation throughout. 5/5 strength throughout. [**11-24**]+ reflexes,
equal BL. Normal coordination. Gait assessment deferred
PSYCH: Listens and responds to questions appropriately, pleasant

Pertinent Results:
[**2181-6-27**] 07:50PM   SED RATE-48*
[**2181-6-27**] 07:50PM   CRP-68.1*
[**2181-6-27**] 07:50PM   WBC-20.8* RBC-3.54* HGB-10.7* HCT-32.7*
MCV-92 MCH-30.2 MCHC-32.7 RDW-15.8*

Brief Hospital Course:
Mrs. [**Known lastname 29878**] is an 83 year old femaile who was admitted from
[**Hospital6 **] for increasing hip pain after being
discharged on [**6-20**] for a presumed left hip infection, washout
and hemiarthroplasty.  Mrs.  [**Known lastname 29878**] had numberous cultures
drawn from her wound, but they never grew out anything.  The
patient was discharged to her rehab center on lovenox and her
previous meds.  She was then admitted for this hospital stay on
[**2181-6-28**].  She was brought to the OR on [**2181-6-28**] for I&D of her left
hip and a large hematoma was evacuated and a surface VAC was
placed.  On POD1 the patient was restarted on lovenox and home
medications.  The VAC produced 200-300cc of serosangous drainage
per day and as a result was brought back to the OR on [**7-2**] for
another washout and surface VAC placement.  During her
procedures, intra-op cultures were drawn but all returned
negative.  The infectious disease team was consulted and her
medications were adjusted.  It was felt taht dispite the
negative cultures, we would aggresively treat this as an
infection due to the high suspicion and aftermath of a missed
infection.  The wound continued to drain a large amount of
serosangous fluid and on [**7-7**] the orthopaedic team decided to
stop the patient's lovenox and begin the patient on low dose
coumadin with an INR goal of 1.3-1.5 for DVT prophylaxis.  On
[**7-9**] the wound had completely stopped draining and she was felt
stable to return to the rehab center.  She is being discharged
today back to her nursing home in stable condition.


Medications on Admission:
Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6
hours).
Senna 8.6 mg Tablet Sig: 1-2 Tablets PO BID (2 times a day) as
needed for Constipation.
 Multivitamin     Tablet Sig: One (1) Cap PO DAILY (Daily).
 Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: One (1)
Tablet PO DAILY (Daily).
Amiodarone 200 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

Buspirone 5 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day).
Captopril 12.5 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day).
Famotidine 20 mg Tablet Sig: One (1) Tablet PO Q24H (every 24
hours).
Furosemide 40 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily).
 Metoprolol Tartrate 25 mg Tablet Sig: 0.25 Tablet PO BID (2
times a day).
Mirtazapine 15 mg Tablet Sig: One (1) Tablet PO HS (at bedtime).

Oxycodone 5 mg Tablet Sig: 0.5 Tablet PO Q4H (every 4 hours) as
needed for pain.
 Calcium Carbonate 500 mg Tablet, Chewable Sig: Two (2) Tablet,
Chewable PO BID (2 times a day).
Psyllium 1.7 g Wafer Sig: One (1) Wafer PO DAILY (Daily).
Albuterol Sulfate 0.63 mg/3 mL Solution for Nebulization Sig:
Two (2) Puff Inhalation q6h PRN as needed for wheeze.
Ipratropium Bromide 17 mcg/Actuation Aerosol Sig: Two (2) Puff
Inhalation Q6H PRN () as needed for sob, wheeze.
 Vancomycin 750 mg IV Q 24H
Please restart
 Morphine Sulfate 0.5-2 mg IV Q4H:PRN pain
Heparin Flush (10 units/ml) 2 mL IV PRN line flush
Lovenox SQ 40mg daily


Discharge Medications:
1. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every
6 hours).
2. Senna 8.6 mg Tablet Sig: 1-2 Tablets PO BID (2 times a day)
as needed for Constipation.
3. Multivitamin     Tablet Sig: One (1) Cap PO DAILY (Daily).
4. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: One (1)
Tablet PO DAILY (Daily).
5. Amiodarone 200 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
6. Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
7. Buspirone 5 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day).
8. Captopril 12.5 mg Tablet Sig: One (1) Tablet PO BID (2 times
a day).
9. Famotidine 20 mg Tablet Sig: One (1) Tablet PO Q24H (every 24
hours).
10. Furosemide 40 mg Tablet Sig: Two (2) Tablet PO DAILY
(Daily).
11. Metoprolol Tartrate 25 mg Tablet Sig: 0.25 Tablet PO BID (2
times a day).
12. Mirtazapine 15 mg Tablet Sig: One (1) Tablet PO HS (at
bedtime).
13. Oxycodone 5 mg Tablet Sig: 0.5-1 Tablet PO Q4H (every 4
hours) as needed for pain.
14. Calcium Carbonate 500 mg Tablet, Chewable Sig: Two (2)
Tablet, Chewable PO BID (2 times a day).
15. Psyllium 1.7 g Wafer Sig: One (1) Wafer PO DAILY (Daily).
16. Warfarin 2 mg Tablet Sig: One (1) Tablet PO QPM (once a day
(in the evening)): INR goal: 1.3-1.5.
Disp:*30 Tablet(s)* Refills:*2*
17. Albuterol Sulfate 0.63 mg/3 mL Solution for Nebulization
Sig: Two (2) Puff Inhalation q6h PRN as needed for wheeze.
18. Ipratropium Bromide 17 mcg/Actuation Aerosol Sig: Two (2)
Puff Inhalation Q6H PRN () as needed for sob, wheeze.
19. Vancomycin 750 mg IV Q 24H
Please restart
20. Morphine Sulfate 0.5-2 mg IV Q4H:PRN pain
21. Heparin Flush (10 units/ml) 2 mL IV PRN line flush
PICC, heparin dependent: Flush with 10mL Normal Saline followed
by Heparin as above daily and PRN per lumen.
22. Vancomycin 750 mg Recon Soln Sig: One (1)  Intravenous once
a day for 4 weeks.
Disp:*56 750mg soln* Refills:*0*
23. Outpatient Lab Work
Draw weekly:
Vancomycin trough
BUN and creatinine
CBC w/diff
Fax results to infectious disease: [**Telephone/Fax (1) 432**]


Discharge Disposition:
Extended Care

Facility:
[**Hospital6 459**] for the Aged - [**Location (un) 550**]

Discharge Diagnosis:
Left hip hematoma s/p hemiarthroplasty


Discharge Condition:
stable


Discharge Instructions:
Keep dressing clean and dry.

If you experience any shortness of breath, new redness,
increased swelling, pain, or drainage, or have a temperature
>101, please call your doctor or go to the emergency room for
evaluation.

Please resume all of the medications you took prior to your
hospital admission. Take all medication as prescribed by your
doctor.

You have been prescribed a narcotic pain medication.  Please
take only as directed and do not drive or operate any machinery
while taking this medication.  There is a 72 hour (Monday
through Friday, 9am to 4pm) response time for prescription refil
requests.  There will be no prescription refils on Saturdays,
Sundays, or holidays.  Please plan accordingly.
Physical Therapy:
Left lower extremity is weight bearing as tolerated.
PT daily for ambulation advance, no limits, patient currently
OOBTC with assist.
Fall precautions
Treatments Frequency:
please keep incision dry

Take out stitches on POD#10


Followup Instructions:
2 weeks in orthopaedic trauma clinic with [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], NP.
 Please call [**Telephone/Fax (1) 1228**] to schedule this appointment.

Other Appointments:
[**Last Name (LF) **],[**First Name7 (NamePattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **] SPECIALTIES CC-3 (NHB) Phone:[**Telephone/Fax (1) 274**]
Date/Time:[**2181-7-25**] 2:00

DR. [**First Name (STitle) **] BLOOD Phone:[**Telephone/Fax (1) 457**] Date/Time:[**2181-8-13**] 10:00
{'Other complications due to internal joint prosthesis,Pressure ulcer, stage III,Urinary tract infection, site not specified,Surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation,Coronary atherosclerosis of native coronary artery,Old myocardial infarction,Dysthymic disorder,Chronic airway obstruction, not elsewhere classified,Atrial fibrillation,Colostomy status,Hip joint replacement'}


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: Left hip drainage

PRESENT ILLNESS: 83yo F s/p L DHS (intertroch fx) on [**4-28**] c/b failed fixation by
migration of screw & infection, s/[**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] [**6-12**] w/ Abx Spacer then
s/p Left Hemi [**6-18**] w/ ORIF Greater Troch, now p/w increasing L
hip pain.

MEDICAL HISTORY: -Coronary Artery Disease status post MI in [**2180-12-24**] (3VD
on cardiac cath but managed non-operatively)
-Depression
-Anxiety
-Atrial Fibrillation (not on anticoagulation)
-Crohn's Disease
-Chronic obstructive pulmonary disease
-distant history of tonsillectomy and adenoidectomy
-L hip ORIF [**2181-4-28**]

MEDICATION ON ADMISSION: Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6
hours).
Senna 8.6 mg Tablet Sig: 1-2 Tablets PO BID (2 times a day) as
needed for Constipation.
 Multivitamin     Tablet Sig: One (1) Cap PO DAILY (Daily).
 Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: One (1)
Tablet PO DAILY (Daily).
Amiodarone 200 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

ALLERGIES: Fosamax / Prozac

PHYSICAL EXAM: Gen: AFVSS
HEENT: Clear OP, MMM
NECK: Supple, No LAD, No JVD
CV: RR, NL rate. NL S1, S2. No murmurs, rubs or gallops
LUNGS: CTA, BS BL, No W/R/C
ABD: Soft, NT, ND. NL BS.  No HSM
EXT: No edema. 2+ DP pulses BL
SKIN: No lesions
NEURO: A&Ox3. Appropriate. CN 2-12 grossly intact. Preserved
sensation throughout. 5/5 strength throughout. [**11-24**]+ reflexes,
equal BL. Normal coordination. Gait assessment deferred
PSYCH: Listens and responds to questions appropriately, pleasant

FAMILY HISTORY: She reports multiple family members with heart problems.

SOCIAL HISTORY: Pt transported here from [**Hospital6 **] 

### Response:
{'Other complications due to internal joint prosthesis,Pressure ulcer, stage III,Urinary tract infection, site not specified,Surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation,Coronary atherosclerosis of native coronary artery,Old myocardial infarction,Dysthymic disorder,Chronic airway obstruction, not elsewhere classified,Atrial fibrillation,Colostomy status,Hip joint replacement'}
