CHIEF COMPLAINT: Difficulty Breathing

PRESENT ILLNESS: 56 y.o. male PMH sarcoidosis and h/o L vocal cord paralysis s/p
mediastinoscopy presented on [**2194-7-31**] for L VC gelfoam injection.
Patient was stable when discharged from PACU however approx 3
hours later began to develop respiratory distress.  The patient
first presented to [**Hospital 1474**] Hospital ED where he received 10mg
Decadron and was then transfered to [**Hospital1 18**] SICU.

MEDICAL HISTORY: Sarcoidosis
Lupus
Arthritis
Bipolar
GERD
Anemia
Asthma
HTN

MEDICATION ON ADMISSION: Prednisone 8mg PO qd
Singulair
Wellbutrin
Exelon
Fosamax
Imipramine
Lithium
Abilify
Plaquenil
Advair
Testosterone patch
B12
Atenolol

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: At D/C
97.7  97.7  80  120/70  18  97-99%RA
NAD
HEENT: EOMI, PERRL
FOE: L TVC paralysis, R TVC mobile.  Patent airway - 8mm. LAE
fold edema markedly decreased.
CV:  RRR
LUNGS: CTA b/l no w/r/r

FAMILY HISTORY: Non contrib

SOCIAL HISTORY: Denies tobacco, EtOH.  Works at [**Company 7546**]
Unilateral paralysis of vocal cords or larynx, partial,Sarcoidosis,Systemic lupus erythematosus,Unspecified essential hypertension,Asthma, unspecified type, unspecified,Esophageal reflux,Anemia, unspecified,Osteoarthrosis, unspecified whether generalized or localized, site unspecified,Bipolar disorder, unspecified
Vocal paral unilat part,Sarcoidosis,Syst lupus erythematosus,Hypertension NOS,Asthma NOS,Esophageal reflux,Anemia NOS,Osteoarthros NOS-unspec,Bipolar disorder NOS
Admission Date:  [**2194-8-1**]              Discharge Date:   [**2194-8-4**]

Date of Birth:  [**2138-6-10**]             Sex:   M

Service: OTOLARYNGOLOGY

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 7729**]
Chief Complaint:
Difficulty Breathing

Major Surgical or Invasive Procedure:
None


History of Present Illness:
56 y.o. male PMH sarcoidosis and h/o L vocal cord paralysis s/p
mediastinoscopy presented on [**2194-7-31**] for L VC gelfoam injection.
Patient was stable when discharged from PACU however approx 3
hours later began to develop respiratory distress.  The patient
first presented to [**Hospital 1474**] Hospital ED where he received 10mg
Decadron and was then transfered to [**Hospital1 18**] SICU.

Past Medical History:
Sarcoidosis
Lupus
Arthritis
Bipolar
GERD
Anemia
Asthma
HTN

Social History:
Denies tobacco, EtOH.  Works at [**Company 7546**]

Family History:
Non contrib

Physical Exam:
At D/C
97.7  97.7  80  120/70  18  97-99%RA
NAD
HEENT: EOMI, PERRL
FOE: L TVC paralysis, R TVC mobile.  Patent airway - 8mm. LAE
fold edema markedly decreased.
CV:  RRR
LUNGS: CTA b/l no w/r/r


Pertinent Results:
[**2194-8-2**] 01:26AM BLOOD WBC-11.4* RBC-4.17* Hgb-12.1* Hct-35.1*
MCV-84 MCH-28.9 MCHC-34.4 RDW-14.8 Plt Ct-228
[**2194-8-1**] 04:55AM BLOOD WBC-13.0*# RBC-4.44* Hgb-12.7* Hct-36.7*
MCV-83 MCH-28.5 MCHC-34.5 RDW-14.9 Plt Ct-213
[**2194-8-1**] 04:55AM BLOOD Neuts-96.7* Lymphs-1.9* Monos-0.8*
Eos-0.3 Baso-0.4
[**2194-8-2**] 01:26AM BLOOD Plt Ct-228
[**2194-8-2**] 01:26AM BLOOD PT-12.2 PTT-21.8* INR(PT)-1.0
[**2194-8-1**] 04:55AM BLOOD Poiklo-1+ Microcy-1+
[**2194-8-1**] 04:55AM BLOOD Plt Ct-213
[**2194-8-1**] 04:55AM BLOOD PT-12.3 PTT-21.8* INR(PT)-1.1
[**2194-8-2**] 01:26AM BLOOD Glucose-144* UreaN-12 Creat-1.0 Na-145
K-4.1 Cl-107 HCO3-28 AnGap-14
[**2194-8-1**] 04:55AM BLOOD Glucose-172* UreaN-12 Creat-1.1 Na-142
K-3.8 Cl-106 HCO3-22 AnGap-18
[**2194-8-2**] 01:26AM BLOOD Calcium-9.4 Phos-2.4* Mg-2.2

Brief Hospital Course:
Patient was initally admitted to the [**Hospital1 18**] SICU.  He was started
on Decadron 8mg IV q8h as well as heliox.  He improved t/o the
DOA and on HD2 was moved to the floor with continuous O2 Sat
monitoring.  On HD3 the patient had the Decadron discontinued
and was then re-started on his normal dose of Prednisone.
While on the floor the patient was on RA without hypoxia - sats
ranging from 97-100%.  The patient was anxious t/o hospital stay
due to hoarseness in throat - this was addressed with
phenaseptic throat spray.  He also had some complaints of mild
SOB, however CV/Pulm PE were normal and CXR was clear without
abnormalities.  All of the patients symptoms continued to
improve at time of discharge.

Medications on Admission:
Prednisone 8mg PO qd
Singulair
Wellbutrin
Exelon
Fosamax
Imipramine
Lithium
Abilify
Plaquenil
Advair
Testosterone patch
B12
Atenolol

Discharge Medications:
1. Phenol-Phenolate Sodium 1.4 % Mouthwash Sig: One (1) Spray
Mucous membrane  every 4-6 hours as needed.
Disp:*1 Bottle* Refills:*0*
2. Prednisone 5 mg Tablet Sig: One (1) Tablet PO once a day.
Disp:*30 Tablet(s)* Refills:*1*
3. Prednisone 1 mg Tablet Sig: Three (3) Tablet PO DAILY
(Daily).
Disp:*90 Tablet(s)* Refills:*1*
4. Augmentin 500-125 mg Tablet Sig: One (1) Tablet PO every
twelve (12) hours for 7 days.
Disp:*14 Tablet(s)* Refills:*0*


Discharge Disposition:
Home

Discharge Diagnosis:
Left AE Fold Edema s/p LTVC gelfoam injection


Discharge Condition:
Stable


Discharge Instructions:
Continue soft solid diet
Continue Home meds as well as new prescriptions

[**Name8 (MD) **] MD or return to ED if any of the following:
Difficulty breathing
Temp >101.5
Intractable Nausea/Vomiiting

Followup Instructions:
F/U with Dr. [**First Name (STitle) **] at regular scheduled Post-OP appointment
[**2194-8-13**]. ([**Telephone/Fax (1) 7767**]

F/U with PCP for PMH maintenance.


Completed by:[**2194-8-4**]
{'Unilateral paralysis of vocal cords or larynx, partial,Sarcoidosis,Systemic lupus erythematosus,Unspecified essential hypertension,Asthma, unspecified type, unspecified,Esophageal reflux,Anemia, unspecified,Osteoarthrosis, unspecified whether generalized or localized, site unspecified,Bipolar disorder, unspecified'}


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: Difficulty Breathing

PRESENT ILLNESS: 56 y.o. male PMH sarcoidosis and h/o L vocal cord paralysis s/p
mediastinoscopy presented on [**2194-7-31**] for L VC gelfoam injection.
Patient was stable when discharged from PACU however approx 3
hours later began to develop respiratory distress.  The patient
first presented to [**Hospital 1474**] Hospital ED where he received 10mg
Decadron and was then transfered to [**Hospital1 18**] SICU.

MEDICAL HISTORY: Sarcoidosis
Lupus
Arthritis
Bipolar
GERD
Anemia
Asthma
HTN

MEDICATION ON ADMISSION: Prednisone 8mg PO qd
Singulair
Wellbutrin
Exelon
Fosamax
Imipramine
Lithium
Abilify
Plaquenil
Advair
Testosterone patch
B12
Atenolol

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: At D/C
97.7  97.7  80  120/70  18  97-99%RA
NAD
HEENT: EOMI, PERRL
FOE: L TVC paralysis, R TVC mobile.  Patent airway - 8mm. LAE
fold edema markedly decreased.
CV:  RRR
LUNGS: CTA b/l no w/r/r

FAMILY HISTORY: Non contrib

SOCIAL HISTORY: Denies tobacco, EtOH.  Works at [**Company 7546**] 

### Response:
{'Unilateral paralysis of vocal cords or larynx, partial,Sarcoidosis,Systemic lupus erythematosus,Unspecified essential hypertension,Asthma, unspecified type, unspecified,Esophageal reflux,Anemia, unspecified,Osteoarthrosis, unspecified whether generalized or localized, site unspecified,Bipolar disorder, unspecified'}
