CHIEF COMPLAINT: 

PRESENT ILLNESS: Mr. [**Known lastname 20622**] is a 58 year-old
gentleman status post cadaveric renal transplant, which had
recently failed for which he was on hemodialysis.  He had a
recent hospitalization for acute cholecystitis.  He
represented in clinic with biliary colic and it was thought
best that the patient undergo an elective cholecystectomy.

MEDICAL HISTORY: 1.  Type 1 diabetes mellitus.
2.  Status post living related kidney transplant in [**2130**].
3.  Chronic renal insufficiency for which he is on
hemodialysis.
4.  Recurrent pneumonia.
5.  Multiple pulmonary nodules.
6.  MGUS with SPEP significant for monoclonal IGG spikes.
7.  Obstructive sleep apnea.
8.  Anemia.
9.  Deep venous thrombosis of left thigh.
10.  Coronary artery disease status post non ST elevation
myocardial infarction in [**2139-3-12**].
11.  Left ventricular systolic as well as diastolic
dysfunction with echocardiogram in [**2141-8-8**] with an ejection
fraction of 40%.
12.  Right pontine lacunar infarction.
13.  Gastroesophageal reflux disease.
14.  Diverticulosis.
15.  C-difficile.
16.  Methicillin resistant staph aureus bacteremia
complicated by septic pulmonary emboli and empyema.
17.  Hypoglycemic coma.

MEDICATION ON ADMISSION: 1.  ProAmatine 5 mg three tabs po t.i.d.
2.  Prednisone 5 mg one tablet po q day.
3.  Neurontin 300 mg two tablets po b.i.d.
4.  Pravachol 40 mg one tablet po q day.
5.  Atenolol 200 mg one tablet po q day.
6.  Isosorbide 90 mg one tablet po q day.
7.  Procardia 60 mg one tablet po q day.
8.  Glargine 20 units one dose at bedtime.
9.  Humalog insulin sliding scale.
10.  Renagel 800 mg three tables po t.i.d.
11.  Nephrocaps one capsule po q day.
12.  Calcitriol vitamin D .25 micrograms one tablet po q day.
13.  Levoxyl 25 micrograms one capsule po q day.
14.  Protonix 40 mg one tablet po q day.
15.  [**Year (4 digits) **].
16.  Daily vitamins.
17.  Tums.

ALLERGIES: Dicloxacillin and Compazine.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Calculus of gallbladder with other cholecystitis, without mention of obstruction,Complications of transplanted kidney,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Other specified complications of procedures not elsewhere classified,Diabetes with neurological manifestations, type I [juvenile type], not stated as uncontrolled,Other specified disorders of gallbladder,Laparoscopic surgical procedure converted to open procedure
Cholelith w cholecys NEC,Compl kidney transplant,Hyp kid NOS w cr kid V,Oth spcf cmplc procd NEC,DMI neuro nt st uncntrld,Dis of gallbladder NEC,Lap surg convert to open
Admission Date:  [**2142-1-26**]       Discharge Date:  [**2142-2-7**]

Date of Birth:   [**2083-10-25**]       Sex:  M

Service:  TRANSPLANT

HISTORY OF PRESENT ILLNESS:  Mr. [**Known lastname 20622**] is a 58 year-old
gentleman status post cadaveric renal transplant, which had
recently failed for which he was on hemodialysis.  He had a
recent hospitalization for acute cholecystitis.  He
represented in clinic with biliary colic and it was thought
best that the patient undergo an elective cholecystectomy.

PAST MEDICAL HISTORY:
1.  Type 1 diabetes mellitus.
2.  Status post living related kidney transplant in [**2130**].
3.  Chronic renal insufficiency for which he is on
hemodialysis.
4.  Recurrent pneumonia.
5.  Multiple pulmonary nodules.
6.  MGUS with SPEP significant for monoclonal IGG spikes.
7.  Obstructive sleep apnea.
8.  Anemia.
9.  Deep venous thrombosis of left thigh.
10.  Coronary artery disease status post non ST elevation
myocardial infarction in [**2139-3-12**].
11.  Left ventricular systolic as well as diastolic
dysfunction with echocardiogram in [**2141-8-8**] with an ejection
fraction of 40%.
12.  Right pontine lacunar infarction.
13.  Gastroesophageal reflux disease.
14.  Diverticulosis.
15.  C-difficile.
16.  Methicillin resistant staph aureus bacteremia
complicated by septic pulmonary emboli and empyema.
17.  Hypoglycemic coma.

ALLERGIES:  Dicloxacillin and Compazine.

MEDICATIONS ON ADMISSION:
1.  ProAmatine 5 mg three tabs po t.i.d.
2.  Prednisone 5 mg one tablet po q day.
3.  Neurontin 300 mg two tablets po b.i.d.
4.  Pravachol 40 mg one tablet po q day.
5.  Atenolol 200 mg one tablet po q day.
6.  Isosorbide 90 mg one tablet po q day.
7.  Procardia 60 mg one tablet po q day.
8.  Glargine 20 units one dose at bedtime.
9.  Humalog insulin sliding scale.
10.  Renagel 800 mg three tables po t.i.d.
11.  Nephrocaps one capsule po q day.
12.  Calcitriol vitamin D .25 micrograms one tablet po q day.
13.  Levoxyl 25 micrograms one capsule po q day.
14.  Protonix 40 mg one tablet po q day.
15.  [**Year (4 digits) **].
16.  Daily vitamins.
17.  Tums.

PHYSICAL EXAMINATION:  Vital signs temperature 96.8.  Blood
pressure 145/57.  Heart rate 73.  Respiratory rate 18.
Sating 97% on room air.  General, he is a well developed,
well nourished and in no acute distress.  Head, eyes, ears,
nose and throat normocephalic, atraumatic.  Extraocular
movements intact.  Pupils are equal, round and reactive to
light.  Oropharynx was clear.  Neck was supple.  Chest was
clear to auscultation bilaterally.  Heart was regular rate
and rhythm.  Abdomen was soft, nontender, nondistended.
Bowel sounds present.  No masses.  PD catheter in place.
Extremities are well perfuse.  No clubbing, cyanosis or
edema.

LABORATORY:  Laboratories on [**1-18**] sodium 139,
potassium 2.9, chloride 96, bicarb 33, BUN 42, creatinine
5.0, glucose 172, ALT 25, AST 34, alkaline phosphatase 150,
amylase 59, total bilirubin 0.8, direct bilirubin 0.3,
albumin 3.3.  White blood cell count 7.8, hematocrit 38.4 and
platelets of 169.

HOSPITAL COURSE:  Mr. [**Known lastname 20622**] is a 58 year-old gentleman with
long standing diabetes mellitus for which he underwent a
cadaveric renal transplant that has failed and the patient is
apparently on hemodialysis.  He had a recent hospital
admission for acute cholecystitis.  He presented to [**Hospital1 1444**] on [**2142-1-26**] for an
elective cholecystectomy.  The patient was taken to the
Operating Room wherein an initially a laparoscopic approach
was initiated, however, this was converted to an open
cholecystectomy secondary to anatomy.  The patient tolerated
the procedure well and was extubated and brought to the
Recovery Room and later then to the floor.  It was noted
immediately postoperatively that the patient spiked a fever.
He was pan cultured, blood cultures, urine as well as chest
x-rays were performed all of which were negative.  He was
initially placed on Vancomycin and Levofloxacin and after
consulting with infectious disease it was thought best to
place the patient on Zosyn and Vancomycin for empiric
treatment.  The patient continued to have fever spikes
throughout his hospital admission, however, his white blood
cell count continued to be within normal limits.  On
postoperative day three the patient was found to be slightly
unresponsive.  It was felt best at this point to transfer the
patient to the Intensive Care Unit for closer monitoring.
Given his unclear source of fevers he continued to be
hemodynamically stable and with improving mental status and
defervesced it was thought that the patient would be stable
for transfer back to the floor where he continued to slowly
improve.

A CAT scan of the abdomen was obtained, was showed some fluid
in the gallbladder fossa, however, this was thought to be
consistent with normal postoperative change.  No abscesses
were evident.  The patient's diet was slowly advanced, which
he tolerated.  Throughout this time the patient was on
hemodialysis.  [**Hospital **] clinic was consulted for management of
blood sugar.  By postoperative day twelve the patient
continued to be afebrile for several days.  His mental status
had returned to baseline.  It was felt best that the patient
be discharged to a rehabilitation center for therapy for
further recovery.  The patient is to be discharged with one
week of Augmentin to follow up at the Transplant Center in
seven to ten days.

CONDITION ON DISCHARGE:  Stable.

DISCHARGE STATUS:  To rehabilitation.

DISCHARGE DIAGNOSES:
History of cholecystitis status post elective open
cholecystectomy complicated by postoperative fevers of
unclear etiology.

DISCHARGE MEDICATIONS:
1.  Prednisone 5 mg one tablet po q day.
2.  Levothyroxine 25 micrograms one tablet po q day.
3.  B-complex vitamin with folic acid one capsule po q day.
4.  Tums 500 mg one tablet po b.i.d.
5.  Calcitriol .25 micrograms capsule one capsule po q day.
6.  Pantoprazole 40 mg one capsule po q day.
7.  Nifedipine 60 mg one tablet po q day.
8.  Calcium acetate 667 mg two tablets po t.i.d. with meals.
9.  Isosorbide 60 mg one tablet po q day.
10.  Colace 100 mg one tablet po b.i.d.
11.  Gabapentin 300 mg one capsule po b.i.d.
12.  Pravastatin 20 mg two tablets po q day.
13.  Midodrine 5 mg one tablet po t.i.d.
14.  Heparin subq 5000 units q 8 hours until fully
ambulatory.
15.  Tylenol 325 mg two tablets po q 4 to 6 hours prn pain.
16.  Atenolol 100 mg tablet two tablets po q day.
17.  Insulin, the patient is to follow the insulin regimen
followed by the [**Hospital **] Clinic.
18.  Augmentin 500 mg one tablet po q day fro seven days.

FOLLOW UP PLANS:  The patient is to follow up at the
Transplant Center at [**Telephone/Fax (1) 673**] at the [**Last Name (un) 2443**] Building on
[**2141-2-22**] at 3:00 p.m.  He is to continue to have
regular laboratories drawn, which include a CBC, chem 10 as
well as liver function tests.






                            [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], M.D.  [**MD Number(1) 1331**]

Dictated By:[**Last Name (NamePattern1) 12360**]
MEDQUIST36

D:  [**2142-2-7**]  01:14
T:  [**2142-2-7**]  10:40
JOB#:  [**Job Number 20635**]
{'Calculus of gallbladder with other cholecystitis, without mention of obstruction,Complications of transplanted kidney,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Other specified complications of procedures not elsewhere classified,Diabetes with neurological manifestations, type I [juvenile type], not stated as uncontrolled,Other specified disorders of gallbladder,Laparoscopic surgical procedure converted to open procedure'}


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: 

PRESENT ILLNESS: Mr. [**Known lastname 20622**] is a 58 year-old
gentleman status post cadaveric renal transplant, which had
recently failed for which he was on hemodialysis.  He had a
recent hospitalization for acute cholecystitis.  He
represented in clinic with biliary colic and it was thought
best that the patient undergo an elective cholecystectomy.

MEDICAL HISTORY: 1.  Type 1 diabetes mellitus.
2.  Status post living related kidney transplant in [**2130**].
3.  Chronic renal insufficiency for which he is on
hemodialysis.
4.  Recurrent pneumonia.
5.  Multiple pulmonary nodules.
6.  MGUS with SPEP significant for monoclonal IGG spikes.
7.  Obstructive sleep apnea.
8.  Anemia.
9.  Deep venous thrombosis of left thigh.
10.  Coronary artery disease status post non ST elevation
myocardial infarction in [**2139-3-12**].
11.  Left ventricular systolic as well as diastolic
dysfunction with echocardiogram in [**2141-8-8**] with an ejection
fraction of 40%.
12.  Right pontine lacunar infarction.
13.  Gastroesophageal reflux disease.
14.  Diverticulosis.
15.  C-difficile.
16.  Methicillin resistant staph aureus bacteremia
complicated by septic pulmonary emboli and empyema.
17.  Hypoglycemic coma.

MEDICATION ON ADMISSION: 1.  ProAmatine 5 mg three tabs po t.i.d.
2.  Prednisone 5 mg one tablet po q day.
3.  Neurontin 300 mg two tablets po b.i.d.
4.  Pravachol 40 mg one tablet po q day.
5.  Atenolol 200 mg one tablet po q day.
6.  Isosorbide 90 mg one tablet po q day.
7.  Procardia 60 mg one tablet po q day.
8.  Glargine 20 units one dose at bedtime.
9.  Humalog insulin sliding scale.
10.  Renagel 800 mg three tables po t.i.d.
11.  Nephrocaps one capsule po q day.
12.  Calcitriol vitamin D .25 micrograms one tablet po q day.
13.  Levoxyl 25 micrograms one capsule po q day.
14.  Protonix 40 mg one tablet po q day.
15.  [**Year (4 digits) **].
16.  Daily vitamins.
17.  Tums.

ALLERGIES: Dicloxacillin and Compazine.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Calculus of gallbladder with other cholecystitis, without mention of obstruction,Complications of transplanted kidney,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Other specified complications of procedures not elsewhere classified,Diabetes with neurological manifestations, type I [juvenile type], not stated as uncontrolled,Other specified disorders of gallbladder,Laparoscopic surgical procedure converted to open procedure'}
