CHIEF COMPLAINT: Respiratory failure.

PRESENT ILLNESS: A 61-year-old male with
metastatic renal carcinoma status post multiple rigid bronchs
for multiple pulmonary metastases.  The patient came today
the OR at the procedure and was subsequently extubated, but
remained hypoxic on O2 sats at about 82%.  He remained
agitated, confused, diaphoretic, and required reintubation.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: Married, consultant, former smoker.
Secondary malignant neoplasm of lung,Acute respiratory failure,Personal history of malignant neoplasm of kidney,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension
Secondary malig neo lung,Acute respiratry failure,Hx of kidney malignancy,DMII wo cmp nt st uncntr,Hypertension NOS
Admission Date:  [**2118-2-9**]     Discharge Date:  [**2118-2-11**]

Date of Birth:   [**2056-10-30**]     Sex:  M

Service:  MICU
CHIEF COMPLAINT:  Respiratory failure.

HISTORY OF PRESENT ILLNESS:  A 61-year-old male with
metastatic renal carcinoma status post multiple rigid bronchs
for multiple pulmonary metastases.  The patient came today
the OR at the procedure and was subsequently extubated, but
remained hypoxic on O2 sats at about 82%.  He remained
agitated, confused, diaphoretic, and required reintubation.

Of note, the patient has had one more complication in the
past requiring reintubation.

1. Renal cell carcinoma diagnosed in [**2115-3-5**] status
post right nephrectomy.
2. Excision of the right atrium as well as multiple pulmonary
metastases.
3. Diabetes mellitus type 2.
3. Hypertension.

MEDICATIONS:
1. Lopressor 25 [**Hospital1 **].
2. Norvasc 10 q day.
3. Terazosin 10 [**Hospital1 **].
4. Glucotrol 20 q day.
5. Tylenol.
6. Ativan.

ALLERGIES:  No known drug allergies.

SOCIAL HISTORY:  Married, consultant, former smoker.

PHYSICAL EXAMINATION:  Afebrile, heart rate 100, blood
pressure 100/50, sedated and intubated.  No jugular venous
distention.  Tachycardic, S1, S2 with no murmurs, rubs, or
gallops.  Lung examination:  Coarse breath sounds with
decreased breath sounds at the bases bilaterally.  Abdomen
was soft, nontender, nondistended with normoactive bowel
sounds, no edema, [**2-3**]+ pulses.

BRIEF HOSPITAL COURSE:  The patient is admitted to Medical
Intensive Care Unit for further observation of respiratory
distress.  On hospital day #2, the patient underwent
bronchoscopy which revealed multiple hemorrhagic metastases
extending through the large portion of the bronchial tree.

At this point, a discussion with the family was initiated with
the presence of medical oncology, interventional pulmonology and
critical care.  As there were no more therapeutic options
available from an oncologic or airway standpoint, all were in
agreement that it would be in the best interest for
the patient to pursue a nonaggressive approach.  Therefore,
the patient was made comfort measures only, and was started
on a Morphine drip.  He expired the same day in the Medical
Intensive Care Unit.




                          [**First Name8 (NamePattern2) **] [**Name8 (MD) **], M.D.  [**MD Number(1) 7585**]

Dictated By:[**Name8 (MD) 5094**]

MEDQUIST36

D:  [**2118-2-13**]  14:15
T:  [**2118-2-16**]  07:31
JOB#:  [**Job Number 32189**]
{'Secondary malignant neoplasm of lung,Acute respiratory failure,Personal history of malignant neoplasm of kidney,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension'}


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: Respiratory failure.

PRESENT ILLNESS: A 61-year-old male with
metastatic renal carcinoma status post multiple rigid bronchs
for multiple pulmonary metastases.  The patient came today
the OR at the procedure and was subsequently extubated, but
remained hypoxic on O2 sats at about 82%.  He remained
agitated, confused, diaphoretic, and required reintubation.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: Married, consultant, former smoker. 

### Response:
{'Secondary malignant neoplasm of lung,Acute respiratory failure,Personal history of malignant neoplasm of kidney,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension'}
