CHIEF COMPLAINT: Nausea/Vomiting

PRESENT ILLNESS: Pt is a 22 y.o male with PMH of DM1 with prior episodes of DKA,
he is unable to quantify how many,who presented to the ED today
with N/V and was found to be in DKA after missing "some insulin"
doses. Pt reports that he has been dealing with epigastric
abdominal pain for days/n/v. PT not very specific to details of
further questions. However, he denies
f/c/sob/cp/dysuria/headache/LH
In the [**Name (NI) **] pt was started on an insulin gtt.

MEDICAL HISTORY: -DM type 1 dx [**2130**]
DKA [**2138-5-6**] after a night of drinking and and missing insulin
doses, multiple admits per report of DKA/N/V
-?gastroparesis, reportedly normal gastric emptying study
-depression
-HTN
-hypothyroidism
-esophageal tear

MEDICATION ON ADMISSION: Humalog
Lantus
Reglan 5mg before meals
Levothyroxine Sodium 25mcg 1 time per day
Maalox Quick Dissolve 600mg as needed
Prilosec 20mg 1 time per day
Lisinopril 10mg 1 time per day
Lax Stool Softener 5 mg
Wellbutrin Sr 150mg twice a day
Phenergan 25mg as needed
Clonidine Hcl 0.2mg as needed
Humalog 100 U/ml twice a day
Senna 8.6mg twice a day
Desyrel 50mg

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: vitals: T 98.6 BP 107/56 HR 68 RR 19 sat 98% on RA
HEENT: nc/at, perrla, eomi, anicteric, very poor dentition
neck: no LAD
chest: b/l ae no w/c/r
heart: s1s2 rrr no m/r/g
abd: +bs, mild epigastric TTP, soft, no guarding, no rebound
ext: no c/c/e 2+pulses
neuro: non-focal

FAMILY HISTORY: Non-contributory

SOCIAL HISTORY: PT lives at home with his parents and reports that he does a
"minimum wage job". Smokes [**11-30**] ppd, denies ETOH or drug use.
Diabetes with ketoacidosis, type I [juvenile type], uncontrolled,Gastroparesis,Unspecified essential hypertension,Unspecified acquired hypothyroidism,Personal history of noncompliance with medical treatment, presenting hazards to health
DMI ketoacd uncontrold,Gastroparesis,Hypertension NOS,Hypothyroidism NOS,Hx of past noncompliance
Admission Date:  [**2141-4-4**]              Discharge Date:   [**2141-4-6**]

Date of Birth:  [**2118-11-27**]             Sex:   M

Service: MEDICINE

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 348**]
Chief Complaint:
Nausea/Vomiting

Major Surgical or Invasive Procedure:
None


History of Present Illness:
Pt is a 22 y.o male with PMH of DM1 with prior episodes of DKA,
he is unable to quantify how many,who presented to the ED today
with N/V and was found to be in DKA after missing "some insulin"
doses. Pt reports that he has been dealing with epigastric
abdominal pain for days/n/v. PT not very specific to details of
further questions. However, he denies
f/c/sob/cp/dysuria/headache/LH
In the [**Name (NI) **] pt was started on an insulin gtt.


Past Medical History:
-DM type 1 dx [**2130**]
DKA [**2138-5-6**] after a night of drinking and and missing insulin
doses, multiple admits per report of DKA/N/V
-?gastroparesis, reportedly normal gastric emptying study
-depression
-HTN
-hypothyroidism
-esophageal tear

Social History:
PT lives at home with his parents and reports that he does a
"minimum wage job". Smokes [**11-30**] ppd, denies ETOH or drug use.


Family History:
Non-contributory

Physical Exam:
vitals: T 98.6 BP 107/56 HR 68 RR 19 sat 98% on RA
HEENT: nc/at, perrla, eomi, anicteric, very poor dentition
neck: no LAD
chest: b/l ae no w/c/r
heart: s1s2 rrr no m/r/g
abd: +bs, mild epigastric TTP, soft, no guarding, no rebound
ext: no c/c/e 2+pulses
neuro: non-focal

Brief Hospital Course:
The patient is a 22 y.o male with DM1 who presents with
abdominal pain/n/v after missing insulin doses and found to be
in DKA.

DKA: The patient presented to the ER after missed "a few" lantus
doses.  He was found to he in DKA.  He received 2L IVF's and
started on an insulin gtt.  Admitted to the ICU and was
maintained on an insulin drip and IVF's.  Anion gap closed  and
the patient was transitioned to SQ insulin.  He was transferred
to the medical floor.  He was restarted on his home doses of
insulin.  His sugars were well controlled and he was discharged
home with plans to follow up at [**Last Name (un) **] next week.


Medications on Admission:
Humalog
Lantus
Reglan 5mg before meals
Levothyroxine Sodium 25mcg 1 time per day
Maalox Quick Dissolve 600mg as needed
Prilosec 20mg 1 time per day
Lisinopril 10mg 1 time per day
Lax Stool Softener 5 mg
Wellbutrin Sr 150mg twice a day
Phenergan 25mg as needed
Clonidine Hcl 0.2mg as needed
Humalog 100 U/ml twice a day
Senna 8.6mg twice a day
Desyrel 50mg

Discharge Medications:
1. Insulin Glargine 100 unit/mL Solution Sig: Thirty (30) units
Subcutaneous once a day.
2. Insulin Lispro 100 unit/mL Solution Sig: 1-20 units
Subcutaneous four times a day: please use sliding scale to
determine doses.
3. Metoclopramide 10 mg Tablet Sig: 0.5 Tablet PO TID (3 times a
day) as needed for with meals.
4. Levothyroxine 25 mcg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
5. Prilosec 20 mg Capsule, Delayed Release(E.C.) Sig: One (1)
Capsule, Delayed Release(E.C.) PO once a day.
6. Lisinopril 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

7. Bupropion 150 mg Tablet Sustained Release Sig: One (1) Tablet
Sustained Release PO BID (2 times a day).
8. Desyrel 50 mg Tablet Sig: One (1) Tablet PO QHS.


Discharge Disposition:
Home

Discharge Diagnosis:
Primary Diagnosis:
DKA

Secondary Diagnosis:
Hypertension
Type I DM
Depression


Discharge Condition:
Stable, tolerating PO's, sugars well controlled.


Discharge Instructions:
You were admitted to the hospital with DKA because of not taking
your insulin.  Please take you insulin EVERY day.  This is very
important.  Please also make sure you follow up at [**Last Name (un) **] next
week.

We did not make any medication changes while you were here.

Please return to the ER for nausea, vomiting, chest pain, or
elevated blood sugar.

Followup Instructions:
You have an appointment with your primary care doctor, [**First Name11 (Name Pattern1) 31804**]
[**Initial (NamePattern1) **]. [**Last Name (NamePattern1) 7405**] on [**2141-5-3**] at 1:30pm.

Please make an appointment with [**Last Name (un) **] next week.
{'Diabetes with ketoacidosis, type I [juvenile type], uncontrolled,Gastroparesis,Unspecified essential hypertension,Unspecified acquired hypothyroidism,Personal history of noncompliance with medical treatment, presenting hazards to health'}


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: Nausea/Vomiting

PRESENT ILLNESS: Pt is a 22 y.o male with PMH of DM1 with prior episodes of DKA,
he is unable to quantify how many,who presented to the ED today
with N/V and was found to be in DKA after missing "some insulin"
doses. Pt reports that he has been dealing with epigastric
abdominal pain for days/n/v. PT not very specific to details of
further questions. However, he denies
f/c/sob/cp/dysuria/headache/LH
In the [**Name (NI) **] pt was started on an insulin gtt.

MEDICAL HISTORY: -DM type 1 dx [**2130**]
DKA [**2138-5-6**] after a night of drinking and and missing insulin
doses, multiple admits per report of DKA/N/V
-?gastroparesis, reportedly normal gastric emptying study
-depression
-HTN
-hypothyroidism
-esophageal tear

MEDICATION ON ADMISSION: Humalog
Lantus
Reglan 5mg before meals
Levothyroxine Sodium 25mcg 1 time per day
Maalox Quick Dissolve 600mg as needed
Prilosec 20mg 1 time per day
Lisinopril 10mg 1 time per day
Lax Stool Softener 5 mg
Wellbutrin Sr 150mg twice a day
Phenergan 25mg as needed
Clonidine Hcl 0.2mg as needed
Humalog 100 U/ml twice a day
Senna 8.6mg twice a day
Desyrel 50mg

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: vitals: T 98.6 BP 107/56 HR 68 RR 19 sat 98% on RA
HEENT: nc/at, perrla, eomi, anicteric, very poor dentition
neck: no LAD
chest: b/l ae no w/c/r
heart: s1s2 rrr no m/r/g
abd: +bs, mild epigastric TTP, soft, no guarding, no rebound
ext: no c/c/e 2+pulses
neuro: non-focal

FAMILY HISTORY: Non-contributory

SOCIAL HISTORY: PT lives at home with his parents and reports that he does a
"minimum wage job". Smokes [**11-30**] ppd, denies ETOH or drug use. 

### Response:
{'Diabetes with ketoacidosis, type I [juvenile type], uncontrolled,Gastroparesis,Unspecified essential hypertension,Unspecified acquired hypothyroidism,Personal history of noncompliance with medical treatment, presenting hazards to health'}
