CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 73 year-old
woman with a history of ataxia and dizziness associated with
nausea and vomiting since [**2160-3-29**].  She was evaluated
by the a GI physician and the examination was unremarkable.
She had a head CT, which showed a cerebellar mass.  The
patient essentially is wheel chair bound due to the ataxia
and also complained of back pain.  She has had weight loss
from frequent vomiting, 20 pounds.

MEDICAL HISTORY: 1.  Asthma.
2.  Hypertension.
3.  Gastritis.
4.  Hiatal hernia.
5.  Mitral regurgitation EF of 60%.
6.  Normal mammogram in [**2159-10-30**] and normal pap smear
in [**2159-8-30**].

MEDICATION ON ADMISSION: 

ALLERGIES: Sulfa.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Secondary malignant neoplasm of brain and spinal cord,Malignant neoplasm of lower lobe, bronchus or lung,Mitral valve disorders,Unspecified essential hypertension,Asthma, unspecified type, unspecified
Sec mal neo brain/spine,Mal neo lower lobe lung,Mitral valve disorder,Hypertension NOS,Asthma NOS
Admission Date:  [**2160-7-5**]       Discharge Date:  [**2160-7-16**]

Date of Birth:   [**2086-11-9**]       Sex:  F

Service: Neurosurgery

HISTORY OF PRESENT ILLNESS:  The patient is a 73 year-old
woman with a history of ataxia and dizziness associated with
nausea and vomiting since [**2160-3-29**].  She was evaluated
by the a GI physician and the examination was unremarkable.
She had a head CT, which showed a cerebellar mass.  The
patient essentially is wheel chair bound due to the ataxia
and also complained of back pain.  She has had weight loss
from frequent vomiting, 20 pounds.

PAST MEDICAL HISTORY:
1.  Asthma.
2.  Hypertension.
3.  Gastritis.
4.  Hiatal hernia.
5.  Mitral regurgitation EF of 60%.
6.  Normal mammogram in [**2159-10-30**] and normal pap smear
in [**2159-8-30**].

PAST SURGICAL HISTORY:
1.  Appendectomy.
2.  Tubal ligation.

ALLERGIES:  Sulfa.

MEDICATIONS:
1.  Decadron 4 mg q 6 hours.
2.  Verapamil 240 mg q day.
3.  Prevacid 30 mg q.d.
4.  Tylenol #3 for pain.
5.  Phenergan prn for severe nausea.

PHYSICAL EXAMINATION:  The patient's temperature is 98.7.
Blood pressure 162/80.  Heart rate 73.  Respiratory rate 20.
Sats 95% on room air.  The patient is awake, alert and
oriented times three and in no acute distress.  Mucous
membranes are moist.  No lesions.  Tongue midline.  Neck
supple.  Lungs cleared bilaterally.  Cardiac regular rate and
rhythm.  2/6 systolic murmur.  Gastrointestinal abdomen soft,
nontender, positive bowel sounds.  No hepatosplenomegaly.
Back nontender.  No costovertebral angle tenderness.
Extremities no edema.  2+ pedal pulses.  Neurologically
awake, alert and oriented times three.  Pupils are equal,
round and reactive to light.  Extraocular movements intact.
Negative drift.  Smile symmetric.  Cranial nerves II through
XII intact.  Finger to nose intact.  No dysmetria.  Motor
strength is 5 out of 5 in all muscle groups.  Normal
sensation to light touch.  MRI shows 3 by 3 cm cerebellar
mass with some mass effect.

The patient is admitted to the Neurosurgery Service and
started on Decadron 4 mg intravenous q 6 hours.  The patient
had a chest, abdomen and pelvis CT, which showed a lung mass.
The patient was taken to the Operating Room on [**2160-7-8**] for
debulking of this tumor.  Postoperatively, she was monitored
in the Intensive Care Unit.  Her vital signs were stable.
She was afebrile. She was awake, alert and oriented.  Pupils
are equal, round and reactive to light.  Extraocular
movements intact.  Her incision was clean, dry and intact.
Her lungs were clear.  Chest CT did show a 3 by 3.7 cm right
lower lobe mass.  The patient was seen by the Cardiothoracic
Service for possible treatment and biopsy of that lung mass.
She remained in the Intensive Care Unit with some episodes of
confusion, transferred to the regular floor on [**2160-7-11**] with
a sitter due to confusion.  She was awake, alert and oriented
times three, although had episodes of confusion.  Her vital
signs remained stable.  She was afebrile.  She was seen by
Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 724**] from the Neuro/oncology Service.
Postoperatively, she did have bilateral ophthalmoplegia
secondary to third nerve problems due to tumor resection.
Dr. [**Last Name (STitle) 724**] recommended an LP to rule out leptomeningeal
metastasis due to her mental status confusion and agitation.
She also had an LDH and a CEA level sent.  Her pathology came
back small cell CA of the lung with mets to the brain.  She
was seen by physical therapy and occupational therapy and
found to require rehab.  Her vital signs remained stable.
She was afebrile.

MEDICATIONS ON DISCHARGE:
1.  Labetalol 300 mg po b.i.d. hold for systolic less then
110.
2.  Decadron current getting 4 mg po q 12 hours.
3.  Captopril 12.5 mg po t.i.d.
4.  Insulin sliding scale.
5.  Famotidine 20 mg po b.i.d.
6.  Verapamil 240 mg po q 24 hours.
7.  Dilantin 100 mg po t.i.d.
8.  Colace 100 mg po b.i.d.
9.  Percocet one to two tabs po q 4 hours prn for pain.
10.  Dulcolax suppository one pr q.h.s. prn.

CONDITION ON DISCHARGE:  Stable.  She will follow up in the
Brain [**Hospital 341**] Clinic in two weeks and follow up in the thoracic
oncology clinic in two weeks after discharge.






                            [**Name6 (MD) **] [**Last Name (NamePattern4) **], M.D.  [**MD Number(1) 1133**]

Dictated By:[**Last Name (NamePattern1) 344**]
MEDQUIST36

D:  [**2160-7-15**]  10:39
T:  [**2160-7-15**]  11:17
JOB#:  [**Job Number 48180**]
{'Secondary malignant neoplasm of brain and spinal cord,Malignant neoplasm of lower lobe, bronchus or lung,Mitral valve disorders,Unspecified essential hypertension,Asthma, unspecified type, 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: 

PRESENT ILLNESS: The patient is a 73 year-old
woman with a history of ataxia and dizziness associated with
nausea and vomiting since [**2160-3-29**].  She was evaluated
by the a GI physician and the examination was unremarkable.
She had a head CT, which showed a cerebellar mass.  The
patient essentially is wheel chair bound due to the ataxia
and also complained of back pain.  She has had weight loss
from frequent vomiting, 20 pounds.

MEDICAL HISTORY: 1.  Asthma.
2.  Hypertension.
3.  Gastritis.
4.  Hiatal hernia.
5.  Mitral regurgitation EF of 60%.
6.  Normal mammogram in [**2159-10-30**] and normal pap smear
in [**2159-8-30**].

MEDICATION ON ADMISSION: 

ALLERGIES: Sulfa.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Secondary malignant neoplasm of brain and spinal cord,Malignant neoplasm of lower lobe, bronchus or lung,Mitral valve disorders,Unspecified essential hypertension,Asthma, unspecified type, unspecified'}
