CHIEF COMPLAINT: Abdominal pain and diarrhea

PRESENT ILLNESS: 81 yo M, living in [**Hospital1 **], with a recent diagnosis of a VRE
psoas abscess, presents with a 2 day h/o fevers and diarrhea. A
CVL was placed in the ER and he was placed on Levophed and
Vasopressin for hypotention. He was admitted to the ICU for
close monitoring.

MEDICAL HISTORY: CAD, HTN, hyperlipidemia, diverticular abscess, atrial
fibrillation, bilateral DVT/PE, rheumatoid arthritis, GI bleed.

MEDICATION ON ADMISSION: ASA, protonix, prednisone 5', lopressor 25", lasix 20'. NPH
4qam/RISS, NTG

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: At time of discharge:

FAMILY HISTORY: Noncontributory.

SOCIAL HISTORY: No etoh, no tob, resided at [**Hospital **] Rehabilitation, previously
lived w/ wife (who is unofficial HCP).
Unspecified septicemia,Septic shock,Intestinal infection due to Clostridium difficile,Atrial fibrillation,Chronic airway obstruction, not elsewhere classified,Severe sepsis,Diverticulitis of colon (without mention of hemorrhage),Old myocardial infarction,Unspecified essential hypertension,Rheumatoid arthritis,Other and unspecified hyperlipidemia
Septicemia NOS,Septic shock,Int inf clstrdium dfcile,Atrial fibrillation,Chr airway obstruct NEC,Severe sepsis,Dvrtcli colon w/o hmrhg,Old myocardial infarct,Hypertension NOS,Rheumatoid arthritis,Hyperlipidemia NEC/NOS
Admission Date:  [**2179-1-5**]              Discharge Date:   [**2179-1-15**]


Service: SURGERY

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 1481**]
Chief Complaint:
Abdominal pain and diarrhea

Major Surgical or Invasive Procedure:
None


History of Present Illness:
81 yo M, living in [**Hospital1 **], with a recent diagnosis of a VRE
psoas abscess, presents with a 2 day h/o fevers and diarrhea. A
CVL was placed in the ER and he was placed on Levophed and
Vasopressin for hypotention. He was admitted to the ICU for
close monitoring.

Past Medical History:
CAD, HTN, hyperlipidemia, diverticular abscess, atrial
fibrillation, bilateral DVT/PE, rheumatoid arthritis, GI bleed.

Social History:
No etoh, no tob, resided at [**Hospital **] Rehabilitation, previously
lived w/ wife (who is unofficial HCP).


Family History:
Noncontributory.

Physical Exam:
At time of discharge:

A&O X 3, NAD
PERRL, EOMI
Heart rate irregularly irregular
Lungs CTAB
Abd soft, NT/ND, +bs, no guarding or rebound
Ext without c/c/e

Pertinent Results:
[**2179-1-12**] 06:22AM BLOOD WBC-11.9* RBC-2.99* Hgb-10.0* Hct-29.3*
MCV-98 MCH-33.5* MCHC-34.2 RDW-16.8* Plt Ct-282
[**2179-1-12**] 06:22AM BLOOD Plt Ct-282
[**2179-1-11**] 04:27AM BLOOD Glucose-77 UreaN-34* Creat-0.7 Na-140
K-4.5 Cl-108 HCO3-26 AnGap-11
[**2179-1-5**] 05:35AM BLOOD ALT-30 AST-29 LD(LDH)-155 CK(CPK)-16*
AlkPhos-99 Amylase-34 TotBili-0.2
[**2179-1-6**] 02:12AM BLOOD Lipase-16
[**2179-1-6**] 02:12AM BLOOD CK-MB-NotDone cTropnT-0.22*
[**2179-1-15**] 06:33AM BLOOD Calcium-7.6* Mg-1.2*
[**2179-1-8**] 10:50AM BLOOD %HbA1c-6.1* [Hgb]-DONE [A1c]-DONE

CT abd [**2179-1-5**]: Features suggestive of proximal colitis,
consistent with C. diff. colitis

Brief Hospital Course:
On [**2179-1-5**] Mr. [**Known lastname 50388**] was admitted to the ICU with a diagnosis
of sepsis under the care of Dr. [**Last Name (STitle) **] and his surgical team.
He was volume resuscitated and placed on broad spectrum
antibiotics. A CT scan showed findings consistent with C. diff.
colitis so he was placed on Flagyl. He slowly improved over the
next 5 days and was transferred out of the ICU. [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] consult
was obtained due to the fact that his blood sugars were out of
control. He was maintained on an insulin drip temporarily while
in the ICU. As his sepsis resolved, his blood sugars were
controlled with NPH and RISS. Once on the floor, his diet was
slowly advanced as his abdominal tenderness resolved. Physical
therapy was consulted and it was determined that he could
benefit from short term rehabilitation. On HD 11 he was
discharged to [**Hospital1 **] and instructed to follow-up with Dr.
[**Last Name (STitle) **] in [**3-5**] weeks. There will be some discussion as to
whether or not Mr. [**Known lastname 50388**] will benefit from a colectomy when he
has recovered fully.

Medications on Admission:
ASA, protonix, prednisone 5', lopressor 25", lasix 20'. NPH
4qam/RISS, NTG

Discharge Medications:
1. Albuterol Sulfate 0.083 % Solution Sig: One (1)  Inhalation
Q6H (every 6 hours) as needed.
2. Metronidazole 500 mg Tablet Sig: One (1) Tablet PO TID (3
times a day) for 3 days. Tablet(s)
3. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every
4 to 6 hours) as needed.
4. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1)
Injection twice a day.
5. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
6. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One
(1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours).
7. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID
(2 times a day).
8. Prednisone 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

9. Insulin Regular Human  Subcutaneous
10. Lasix 20 mg Tablet Sig: One (1) Tablet PO once a day.
11. Insulin NPH Human Recomb 100 unit/mL Cartridge Sig: Four (4)
units Subcutaneous Q breakfast.
12. NTG prn

Discharge Disposition:
Extended Care

Facility:
[**Hospital3 7**] & Rehab Center - [**Hospital1 8**]

Discharge Diagnosis:
C. difficile colitis
HTN, A. fib, DMII


Discharge Condition:
Good


Discharge Instructions:
Please call your doctor or go to the ER if you experience any of
the following: high fevers >101.5, very low blood pressure,
increasing abdominal pain, worsening nausea/vomiting, or severe
diarrhea.

Followup Instructions:
Dr. [**Last Name (STitle) **] in [**3-5**] weeks. Please call for an appointment -
[**Telephone/Fax (1) 102356**]
{'Unspecified septicemia,Septic shock,Intestinal infection due to Clostridium difficile,Atrial fibrillation,Chronic airway obstruction, not elsewhere classified,Severe sepsis,Diverticulitis of colon (without mention of hemorrhage),Old myocardial infarction,Unspecified essential hypertension,Rheumatoid arthritis,Other and unspecified hyperlipidemia'}


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: Abdominal pain and diarrhea

PRESENT ILLNESS: 81 yo M, living in [**Hospital1 **], with a recent diagnosis of a VRE
psoas abscess, presents with a 2 day h/o fevers and diarrhea. A
CVL was placed in the ER and he was placed on Levophed and
Vasopressin for hypotention. He was admitted to the ICU for
close monitoring.

MEDICAL HISTORY: CAD, HTN, hyperlipidemia, diverticular abscess, atrial
fibrillation, bilateral DVT/PE, rheumatoid arthritis, GI bleed.

MEDICATION ON ADMISSION: ASA, protonix, prednisone 5', lopressor 25", lasix 20'. NPH
4qam/RISS, NTG

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: At time of discharge:

FAMILY HISTORY: Noncontributory.

SOCIAL HISTORY: No etoh, no tob, resided at [**Hospital **] Rehabilitation, previously
lived w/ wife (who is unofficial HCP). 

### Response:
{'Unspecified septicemia,Septic shock,Intestinal infection due to Clostridium difficile,Atrial fibrillation,Chronic airway obstruction, not elsewhere classified,Severe sepsis,Diverticulitis of colon (without mention of hemorrhage),Old myocardial infarction,Unspecified essential hypertension,Rheumatoid arthritis,Other and unspecified hyperlipidemia'}
