CHIEF COMPLAINT: Hematemesis, syncope.

PRESENT ILLNESS: This is a 38 year-old male with
a questionable history of peptic ulcer disease who presented
on [**2119-7-14**] to the Emergency Department after fainting and
vomiting up blood.  The patient had four days of
melanotic/bloody stools, and a feeling of increasing fatigue.
The patient also had one month of intermittent epigastric
pain and vomiting up clears, possibly triggered after an ETOH
binge.  The patient got relief with Maalox and Zantac.  The
patient stated he had a similar episode of abdominal pain and
vomiting up blood seven years ago, but has been asymptomatic
since then.

MEDICAL HISTORY: Gastric ulcer (by report) about five
years ago.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: Noncontributory.

SOCIAL HISTORY: The patient denies tobacco or elicit drug
use.  He drinks alcohol on an occasional basis.
Gastroesophageal laceration-hemorrhage syndrome,Acute posthemorrhagic anemia
Mallory-weiss syndrome,Ac posthemorrhag anemia
Admission Date:  [**2119-7-15**]     Discharge Date:  [**2119-7-16**]

Date of Birth:   [**2081-5-21**]     Sex:  M

Service:  [**Hospital1 212**]

CHIEF COMPLAINT:  Hematemesis, syncope.

HISTORY OF PRESENT ILLNESS:  This is a 38 year-old male with
a questionable history of peptic ulcer disease who presented
on [**2119-7-14**] to the Emergency Department after fainting and
vomiting up blood.  The patient had four days of
melanotic/bloody stools, and a feeling of increasing fatigue.
The patient also had one month of intermittent epigastric
pain and vomiting up clears, possibly triggered after an ETOH
binge.  The patient got relief with Maalox and Zantac.  The
patient stated he had a similar episode of abdominal pain and
vomiting up blood seven years ago, but has been asymptomatic
since then.

In the Emergency Department the patient was tachycardic at
115.  He had a blood pressure of 130/60 and was orthostatic.
His respiratory rate was 18.  The patient had a hematocrit on
admission of 21.  The patient received 2 liters of
intravenous fluid, and had a nasogastric lavage that did not
clear bright red blood after 1 liter.  The patient was
transfused 3 units of packed red blood cells.  Emergent
esophagogastroduodenoscopy revealed a small nonbleeding
[**Doctor First Name **]-[**Doctor Last Name **] tear, a small amount of fresh blood and no
evidence of peptic ulcer disease.  The patient was
transferred to the MICU where he was stabilized and was no
longer tachycardic or bleeding.  The patient was started on
Protonix.

REVIEW OF SYSTEMS:  Once the patient was on the floor the
patient denied any abdominal pain or epigastric pain.  He
denies nausea, vomiting, fevers or chills.  The patient
denied shortness of breath or chest pain.

PAST MEDICAL HISTORY:  Gastric ulcer (by report) about five
years ago.

MEDICATIONS:  The patient has been using Maalox and Zantac
the past month.

ALLERGIES:  No known drug allergies.

SOCIAL HISTORY:  The patient denies tobacco or elicit drug
use.  He drinks alcohol on an occasional basis.

FAMILY HISTORY:  Noncontributory.

PHYSICAL EXAMINATION:  Vital signs pulse 60.  Respirations
24.  Blood pressure 98/42.  In general, the patient appears
comfortable.  HEENT pupils are equal, round and reactive to
light and accommodation.  Mucous membranes are moist.  Neck
supple, no lymphadenopathy.  Cardiovascular regular rate and
rhythm.  No murmurs, rubs or gallops.  Lungs clear to
auscultation bilaterally.  Abdomen soft, nontender,
nondistended.  Positive bowel sounds bilaterally.
Extremities no clubbing, cyanosis or edema.  Neurological
alert and oriented times three.  No focal findings.

LABORATORY:  White blood cell count 7.3, hemoglobin 8.6,
hematocrit 24.4, platelets 113, sodium 140, potassium 3.6,
chloride 108, bicarb 23, BUN 19, creatinine 0.6, glucose 88,
calcium 7.3, magnesium 1.8, phos 3.1.

HOSPITAL COURSE:  1.  Gastrointestinal:  The patient was
diagnosed with [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **]-[**Doctor Last Name **] tear on the basis of an
esophagogastroduodenoscopy.  While on the floor the patient
was essentially asymptomatic.  While his hematocrit started
at 21.6 on admission with the 3 units of packed red blood
cells he received initially his hematocrit jumped up to 28.5
on discharge.  The patient was advised to continue Prilosec
on an outpatient basis.  He also was advised to start iron as
the patient was judged to be iron deficient based on his
blood loss.

2.  Fluids, electrolytes and nutrition:  The patient was
initially orthostatic on admission.  However, his vital signs
stabilized.  He was started on D5 one half normal saline at
125 cc per hour.  Eventually the patient was able to take
clears and then regular po and the intravenous fluids were
stopped.  The patient no longer had any orthostasis.

CONDITION ON DISCHARGE:  Good.

DISCHARGE STATUS:  The patient is to go home with his family.

DISCHARGE MEDICATIONS:  1.  Prilosec 20 mg po q.d.  2.
Ferrous sulfate 325 mg po t.i.d.

FOLLOW UP:  The patient is to follow up in the [**Hospital **] Clinic in
the Clinical Center on [**2119-7-25**] at 3:20 with Dr.
[**Last Name (STitle) 22494**].  In addition, because the patient does not have a
primary care physician he will follow up with Dr. [**Last Name (STitle) **] at
[**Company 191**] West on [**2119-8-1**] at 1:30 p.m.

DISCHARGE DIAGNOSES:
1.  [**Doctor First Name **]-[**Doctor Last Name **] tear.
2.  Gastroesophageal reflux disease.
3.  Anemia.






                          [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 1207**], M.D.  [**MD Number(1) 1208**]

Dictated By:[**Name8 (MD) 4990**]

MEDQUIST36

D:  [**2119-7-16**]  18:06
T:  [**2119-7-18**]  08:35
JOB#:  [**Job Number **]
{'Gastroesophageal laceration-hemorrhage syndrome,Acute posthemorrhagic anemia'}


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: Hematemesis, syncope.

PRESENT ILLNESS: This is a 38 year-old male with
a questionable history of peptic ulcer disease who presented
on [**2119-7-14**] to the Emergency Department after fainting and
vomiting up blood.  The patient had four days of
melanotic/bloody stools, and a feeling of increasing fatigue.
The patient also had one month of intermittent epigastric
pain and vomiting up clears, possibly triggered after an ETOH
binge.  The patient got relief with Maalox and Zantac.  The
patient stated he had a similar episode of abdominal pain and
vomiting up blood seven years ago, but has been asymptomatic
since then.

MEDICAL HISTORY: Gastric ulcer (by report) about five
years ago.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: Noncontributory.

SOCIAL HISTORY: The patient denies tobacco or elicit drug
use.  He drinks alcohol on an occasional basis. 

### Response:
{'Gastroesophageal laceration-hemorrhage syndrome,Acute posthemorrhagic anemia'}
