CHIEF COMPLAINT: throat pain

PRESENT ILLNESS: This is a 59 year-old Greek woman who has no history of throat
infections or throat abscesses, who presents with 1-2 days of
worsening throat pain, pain with swallowing, and decreased oral
intake with subjective fevers. She also noted some intermittent
drooling during these two days. She has noted some
muffled-sounding voice change. She also notes minimal difficulty
with breathing, but her breathing is not noisy.She has no
trismus or neck stiffness.

MEDICAL HISTORY: Chronic Sinusitis with nasal polyposis s/p FESS x 2, HTN,
Asthma, GERD, Osteoarthritis

MEDICATION ON ADMISSION: Advair, Diovan, Lipitor, Pantoprazole, Proair, Singulair,
Nasonex, Claritin OTC

ALLERGIES: Penicillins / Ciprofloxacin

PHYSICAL EXAM: UPON DISCHARGE ([**2147-6-30**]):

FAMILY HISTORY: Non-contributory.  There is a history of ovarian cancer in two
family members.

SOCIAL HISTORY: Operates a greek restaurant with her husband. [**Name (NI) **] denies
smoking, acknowledges social drinking, and denies illicit
substance abuse.
Edema of larynx,Pure hypercholesterolemia,Acute pharyngitis,Esophageal reflux,Asthma, unspecified type, unspecified,Unspecified essential hypertension,Osteoarthrosis, unspecified whether generalized or localized, site unspecified,Unspecified sinusitis (chronic)
Edema of larynx,Pure hypercholesterolem,Acute pharyngitis,Esophageal reflux,Asthma NOS,Hypertension NOS,Osteoarthros NOS-unspec,Chronic sinusitis NOS
Name:  [**Known lastname 14608**],[**Known firstname **]                  Unit No:   [**Numeric Identifier 14609**]

Admission Date:  [**2147-6-28**]              Discharge Date:   [**2147-6-30**]

Date of Birth:  [**2088-3-8**]             Sex:   F

Service: OTOLARYNGOLOGY

Allergies:
Penicillins / Ciprofloxacin

Attending:[**First Name3 (LF) 14610**]
Addendum:
Medically, patient should return to work within 7-10 days, given
her hospitazliation period.

Discharge Disposition:
Home

                             [**First Name11 (Name Pattern1) 77**] [**Last Name (NamePattern4) 14611**] MD [**MD Number(1) 4800**]

Completed by:[**2147-6-30**]

Admission Date:  [**2147-6-28**]              Discharge Date:   [**2147-6-30**]

Date of Birth:  [**2088-3-8**]             Sex:   F

Service: OTOLARYNGOLOGY

Allergies:
Penicillins / Ciprofloxacin

Attending:[**First Name3 (LF) 4181**]
Chief Complaint:
throat pain

Major Surgical or Invasive Procedure:
None

History of Present Illness:
This is a 59 year-old Greek woman who has no history of throat
infections or throat abscesses, who presents with 1-2 days of
worsening throat pain, pain with swallowing, and decreased oral
intake with subjective fevers. She also noted some intermittent
drooling during these two days. She has noted some
muffled-sounding voice change. She also notes minimal difficulty
with breathing, but her breathing is not noisy.She has no
trismus or neck stiffness.

She denies chest pain, exertional shortness of breath, nausea,
vomiting or sick contacts. She was admitted on [**2147-6-28**] to the
ICU given concern for airway compromise in the setting of
pharyngitis, supraglottitis.

Past Medical History:
Chronic Sinusitis with nasal polyposis s/p FESS x 2, HTN,
Asthma, GERD, Osteoarthritis


Social History:
Operates a greek restaurant with her husband. [**Name (NI) **] denies
smoking, acknowledges social drinking, and denies illicit
substance abuse.

Family History:
Non-contributory.  There is a history of ovarian cancer in two
family members.


Physical Exam:
UPON DISCHARGE ([**2147-6-30**]):

VITALS: T 99.1  97.6  P 76  BP 138/62  RR 12 95%RA

HEENT: Normocephalic, atraumatic. Extraocular muscles intact
with equally symmetric and reactive pupils bilaterally. Nares
clear. Oropharynx with minimal posterior oropharyngeal erythema,
but no plaques or exudates. Mucous membranes moist. Neck supple
without lymphadenopathy.

[**2147-6-29**] NPL: Minimal aryepiglottic edema with watery epiglottic
edema noted, but improved from admission laryngoscopy. Some
evidence of aryepiglottic erythema, but glottic opening and
vocal folds normal, with widely patent airway.

[**2147-6-30**] NPL: Improved aryepiglottic edema with no erythema
noted. Widely patent glottis with normal true vocal folds.

CVS: Regular rate and rhythm, no murmur, rub or gallop.

RESP: Bilaterally decreased breath sounds anteriorly, but
without other adventitious sounds. No wheezing, rhonchi or
rales.

EXTR: 2+ peripheral pulses, no cyanosis, clubbing or edema.


Pertinent Results:
[**2147-6-28**] 01:03PM BLOOD WBC-12.1*# RBC-5.08 Hgb-14.2 Hct-41.9
MCV-82 MCH-28.0 MCHC-34.0 RDW-13.8 Plt Ct-317

[**2147-6-29**] 04:05AM BLOOD WBC-9.9 RBC-4.41 Hgb-12.5 Hct-36.5 MCV-83
MCH-28.3 MCHC-34.2 RDW-13.7 Plt Ct-281

[**2147-6-29**] BLOOD CULUTRE: Pending, but no growth.


Brief Hospital Course:
NEURO/PAIN: The patient was admitted without neurologic issue or
pain control issues. While she complained of some sore throat,
this was treated adequately with Morphine sulfate 2 mg IV as
needed. She had minimal pain issues.

CARDIOVASCULAR: The patient remained hemodynamically stable
throughout her admission, and on telemetry while in the ICU. She
had no cardiac issues. Her home antihypertensive medication,
Valsartan, was maintained. Her daily dose of Lipitor was
continued.

RESPIRATORY: The patient was admitted without evidence of
respiratory distress. Her oxygen saturations in the ED were >95%
with nasal cannula at 3-5 L O2. The patient was admitted to the
ICU with close monitoring. She was weaned from 3 L O2 nasal
cannula to room air, and she maintained her oxygen saturations.
She had no drooling or stridulous noises. She has a known asthma
history, and was maintained on albuterol nebs with montelukast
and fluticasone-salmeterol at her home dose.

FEN/GI: She was maintained NPO while in the ICU and then started
on a diabetic/MCC diet after 12 hours of close airway
monitoring, without issue. IV fluid hydration was maintained
until she had adequate PO intake.

RENAL: No active issues.

ENDOCRINE: The patient has an unconfirmed history of diabetes.
She received Decadron 10 mg IV Q8 hours upon admission and into
HOD#2 for airway edema. She was maintained on a low dose sliding
scale of insulin. Her blood sugars were maintained <200 mg/dL on
sliding scale insulin. She was discharged on a Medrol dose pak
for steroid taper.

HEME/ID: Her hematocrit was normal on admission and she remained
hemodynamically stbale. Her white count on admission was 12.1
and had come down to 9.9 on HOD#2. She was maintained on
Clindamycin and Levquin IV on HOD#1 and switched to PO Bactrim
DS for antibiotics. She remained afebrile after admission. She
was discharged on 10 days of Bactrim DS [**Hospital1 **] for an antibiotic
course.

PROPHYLAXIS: She was maintained on DVT prophylaxis with Heparin
5000 Units SQ TID. She was encouraged to ambulate twice daily.

Medications on Admission:
Advair, Diovan, Lipitor, Pantoprazole, Proair, Singulair,
Nasonex, Claritin OTC

Discharge Medications:
1. Fluticasone-Salmeterol 500-50 mcg/Dose Disk with Device Sig:
[**11-26**] Disk with Devices Inhalation [**Hospital1 **] (2 times a day).
2. Valsartan 40 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily).

3. Atorvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
4. Montelukast 10 mg Tablet Sig: One (1) Tablet PO HS (at
bedtime).
5. Medrol (Pak) 4 mg Tablets, Dose Pack Sig: Four (4) Tablets,
Dose Pack PO as directed ().
Disp:*1 Tablets, Dose Pack(s)* Refills:*2*
6. Sulfamethoxazole-Trimethoprim 800-160 mg Tablet Sig: One (1)
Tablet PO BID (2 times a day) for 10 days.
Disp:*20 Tablet(s)* Refills:*0*


Discharge Disposition:
Home

Discharge Diagnosis:
Supraglottitis, airway edema


Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.


Discharge Instructions:
Seek immediate medical attention for fever >101.5, chills,
increased redness, swelling of neck, decreased oral intake,
drooling or difficulty opening your mouth, chest pain, shortness
of breath, or anything else that is troubling you. No strenuous
exercise or heavy lifting until follow up appointment, at least.
You should call Dr.[**Name (NI) 37917**] office at [**Telephone/Fax (1) **] to
schedule a follow up appointment. Please call to reschedule if
you cannot make this appointment time. Plase take the Bactrim DS
antibiotic for 10 days, as prescribed. Please take the Medrol
dose pak steroids, as prescribed. Call your primary care
provider to make [**Name Initial (PRE) **] follow up appointment in [**11-26**] weeks.

Followup Instructions:
You should call Dr.[**Name (NI) 37917**] office at [**Telephone/Fax (1) **] to
schedule a follow up appointment in [**11-26**] weeks.

Please call your primary care physician to schedule [**Name Initial (PRE) **] follow-up
appointment in [**11-26**] weeks.
{'Edema of larynx,Pure hypercholesterolemia,Acute pharyngitis,Esophageal reflux,Asthma, unspecified type, unspecified,Unspecified essential hypertension,Osteoarthrosis, unspecified whether generalized or localized, site unspecified,Unspecified sinusitis (chronic)'}


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: throat pain

PRESENT ILLNESS: This is a 59 year-old Greek woman who has no history of throat
infections or throat abscesses, who presents with 1-2 days of
worsening throat pain, pain with swallowing, and decreased oral
intake with subjective fevers. She also noted some intermittent
drooling during these two days. She has noted some
muffled-sounding voice change. She also notes minimal difficulty
with breathing, but her breathing is not noisy.She has no
trismus or neck stiffness.

MEDICAL HISTORY: Chronic Sinusitis with nasal polyposis s/p FESS x 2, HTN,
Asthma, GERD, Osteoarthritis

MEDICATION ON ADMISSION: Advair, Diovan, Lipitor, Pantoprazole, Proair, Singulair,
Nasonex, Claritin OTC

ALLERGIES: Penicillins / Ciprofloxacin

PHYSICAL EXAM: UPON DISCHARGE ([**2147-6-30**]):

FAMILY HISTORY: Non-contributory.  There is a history of ovarian cancer in two
family members.

SOCIAL HISTORY: Operates a greek restaurant with her husband. [**Name (NI) **] denies
smoking, acknowledges social drinking, and denies illicit
substance abuse. 

### Response:
{'Edema of larynx,Pure hypercholesterolemia,Acute pharyngitis,Esophageal reflux,Asthma, unspecified type, unspecified,Unspecified essential hypertension,Osteoarthrosis, unspecified whether generalized or localized, site unspecified,Unspecified sinusitis (chronic)'}
