CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 59 year old female
with a history of Stage 4 follicular lymphoma and lung cancer
diagnosed in [**2180-6-5**].  Her lymphoma treatment has been very
complicated secondary to multiple recurrences.  She has had a
left lower lobe resection for lung cancer, Stage 1.  For her
lymphoma she underwent total autologous bone marrow
transplant in [**2184-1-6**].  She subsequently underwent two
rounds of Rituxan in [**2185**] and [**2186**] followed by multiple
chemotherapy agents in [**2187**] for recurrences.  The patient has
been maintained on Rituxan treatments every three months.
She had a computerized tomography scan of the abdomen and
pelvis earlier this year which showed progression of the
disease.  The patient was started on a chemotherapy regimen
of Cytoxan, Rituxan and Pentostatin.  Her previous two cycles
had complications of severe nausea and vomiting that required
hospitalization, so she was admitted for the third cycle of
treatment.

MEDICAL HISTORY: 1.  Stage 4 lymphoma, diagnosed in
[**2179**], status post autologous bone marrow transplant in
[**2184-1-6**] status post Rituxan therapy in [**2185**] and [**2186**]
for recurrences of lymphoma, status post chemotherapy in [**2187**]
for recurrences.  2.  Lung cancer, status post partial
resection.  3.  Paget's disease.  4.  History of shingles in
the T4 dermatome area with persistent skin change and pain.
5.  Gastroesophageal reflux disease.  6.  Cholecystectomy.
7.  Total abdominal hysterectomy with bilateral
salpingo-oophorectomy.  8.  Bilateral total knee
replacements.

MEDICATION ON ADMISSION: 

ALLERGIES: The patient denied having drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Acute respiratory failure,Congestive heart failure, unspecified,Herpes zoster with other nervous system complications,Bone marrow replaced by transplant
Acute respiratry failure,CHF NOS,H zoster nerv syst NEC,Trnspl status-bne marrow
Admission Date:  [**2188-11-11**]       Discharge Date:  [**2188-12-2**]

Date of Birth:   [**2129-2-24**]       Sex:  F

Service:  BMT

HISTORY OF PRESENT ILLNESS:  This is a 59 year old female
with a history of Stage 4 follicular lymphoma and lung cancer
diagnosed in [**2180-6-5**].  Her lymphoma treatment has been very
complicated secondary to multiple recurrences.  She has had a
left lower lobe resection for lung cancer, Stage 1.  For her
lymphoma she underwent total autologous bone marrow
transplant in [**2184-1-6**].  She subsequently underwent two
rounds of Rituxan in [**2185**] and [**2186**] followed by multiple
chemotherapy agents in [**2187**] for recurrences.  The patient has
been maintained on Rituxan treatments every three months.
She had a computerized tomography scan of the abdomen and
pelvis earlier this year which showed progression of the
disease.  The patient was started on a chemotherapy regimen
of Cytoxan, Rituxan and Pentostatin.  Her previous two cycles
had complications of severe nausea and vomiting that required
hospitalization, so she was admitted for the third cycle of
treatment.

PAST MEDICAL HISTORY:  1.  Stage 4 lymphoma, diagnosed in
[**2179**], status post autologous bone marrow transplant in
[**2184-1-6**] status post Rituxan therapy in [**2185**] and [**2186**]
for recurrences of lymphoma, status post chemotherapy in [**2187**]
for recurrences.  2.  Lung cancer, status post partial
resection.  3.  Paget's disease.  4.  History of shingles in
the T4 dermatome area with persistent skin change and pain.
5.  Gastroesophageal reflux disease.  6.  Cholecystectomy.
7.  Total abdominal hysterectomy with bilateral
salpingo-oophorectomy.  8.  Bilateral total knee
replacements.

ALLERGIES:  The patient denied having drug allergies.

PHYSICAL EXAMINATION:  Physical examination on presentation
revealed the patient was afebrile, temperature 97.7, blood
pressure 105/67, heartrate 88, respirations 18, 94% on room
air.  Weight was 160 pounds.  In general, the patient was
alert and oriented in no apparent distress.
Head, eyes, ears, nose and throat:  Pupils equal, round, and
reactive to light and accommodation with left ptosis,
extraocular movements intact, full fields, sclera anicteric.
Heart:  Regular rate with systolic ejection murmur in the
left sternal border.
Lungs:  Clear to auscultation bilaterally.
Abdomen:  Nontender, distended with positive bowel sounds.
Extremities:  Warm, well perfused, no edema or cyanosis.
Neurological:  Cranial nerves II through XII are intact.
Skin:  Intact, no erythema.

LABORATORY DATA:  Pertinent laboratory data on admission
revealed white blood cell count 4.7, hematocrit 31.3,
platelets 127.  Electrolytes were all within normal range.
Liver function tests were also normal.  Lumbar puncture was
done [**11-13**], for a change in mental status which the
result was negative for meningitis.

HOSPITAL COURSE:  1.  Respiratory failure - Two days after
the patient received her chemotherapy she developed
respiratory failure that required intubation and required
Intensive Care Unit stay for nine days.  The patient was
successfully extubated and her pulmonary edema was slowly
resolved with high dose of Prednisone which was also slowly
tapered.  On discharge she still required p.o. Lasix to
improve her pulmonary status and to prevent pulmonary edema
from recurring.

2.  Mental status change - Head computerized tomography scan
was negative for any acute change or hemorrhage.  Lumbar
puncture was also done which did not show any acute changes
and did not show any signs of infection.  Her mental status
change is probably due to decrease in hepatic metabolism or
possibly medication side effect.  The patient's mental status
change has slowly been resolved, especially with improvement
of her respiratory status.  On discharge the patient was
alert and oriented and able to converse normally and her
mental status has returned to her baseline.

3.  Neutropenia - After chemotherapy the patient became
neutropenic and required G-CSF and multiple antibiotics and
her neutropenia has resolved with the treatment.  However,
the patient's white blood cells continued to decrease with
the addition of Acyclovir, therefore we held the Acyclovir
and the patient's white cells slowly returned.

4.  Infectious disease - The patient should continue to
receive Bactrim for prophylaxis.

5.  Coffee ground emesis - The patient developed Intensive
Care Unit gastritis, probably due to both being in Intensive
Care Unit and on high dose steroids.  The patient was
hemodynamically stable and hematocrit was stable.  Proton
pump inhibitor was started and the patient did not have
recurrence of coffee ground emesis throughout the rest of her
hospital stay.

CONDITION ON DISCHARGE:  Stable.

DISCHARGE STATUS:  To rehabilitation.

DISCHARGE DIAGNOSIS:
1.  Admission for chemotherapy
2.  Hypoxia
3.  Congestive heart failure, unspecified
4.  Pulmonary edema



                            [**Doctor First Name 1730**] [**Last Name (NamePattern4) 18512**] m.d. [**MD Number(2) **]

Dictated By:[**Name8 (MD) 18513**]
MEDQUIST36

D:  [**2188-11-29**]  15:58
T:  [**2188-11-29**]  16:13
JOB#:  [**Job Number 18514**]






Name:  [**Known lastname 2738**], [**Known firstname 2739**]                    Unit No:  [**Numeric Identifier 2740**]

Admission Date:  [**2188-11-11**]     Discharge Date:  [**2188-12-2**]

Date of Birth:   [**2129-2-24**]     Sex:  F

Service:  .

ADDENDUM TO DISCHARGE SUMMARY:

The patient was discharged to [**Hospital6 908**]
on [**12-2**].

CONDITION AT DISCHARGE:   Stable.

DISCHARGE MEDICATIONS:
1.  Pantoprazole 40 mg p.o. twice a day.
2.  Paroxetine 30 q. day.
3.  Oxycodone 80 mg every eight hours.
4.  Trazodone 1 to 3 mg q. h.s. p.r.n. insomnia.
5.  Alendronate 17 mg every Sunday.
6.  Tolterodine 2 mg p.o. twice a day.
7.  Calcium carbonate 500 mg p.o. three times a day.
8.  Docusate 100 mg p.o. twice a day.
9.  Sennosides, 0.6 mg, two tablets q. h.s.
10. Furosemide 60 mg p.o. q. a.m.
11. Furosemide 20 mg p.o. q. p.m.
12. Potassium chloride 40 mEq p.o. twice a day.
13. Bactrim one tablet every Monday, Wednesday and Friday.
14. Tylenol 325 mg, one to two tablets every four to six
hours p.r.n.
15. Ondansetron 2 mg intravenously every six hours p.r.n.
nausea.
16. Prednisone taper as follows:  Take 20 mg q. day for two
days; 10 mg q. day for another two days, and then 5 mg q. day
for the last two days, and then stop.
17. Neutra-Phos two packets p.o. three times a day.



                            [**Doctor First Name **] [**Last Name (NamePattern4) 2741**] M.D. 12- ahk

Dictated By:[**Name8 (MD) 2742**]

MEDQUIST36

D:  [**2188-12-2**]  11:25
T:  [**2188-12-2**]  13:06
JOB#:  [**Job Number 2743**]
{'Acute respiratory failure,Congestive heart failure, unspecified,Herpes zoster with other nervous system complications,Bone marrow replaced by transplant'}


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: This is a 59 year old female
with a history of Stage 4 follicular lymphoma and lung cancer
diagnosed in [**2180-6-5**].  Her lymphoma treatment has been very
complicated secondary to multiple recurrences.  She has had a
left lower lobe resection for lung cancer, Stage 1.  For her
lymphoma she underwent total autologous bone marrow
transplant in [**2184-1-6**].  She subsequently underwent two
rounds of Rituxan in [**2185**] and [**2186**] followed by multiple
chemotherapy agents in [**2187**] for recurrences.  The patient has
been maintained on Rituxan treatments every three months.
She had a computerized tomography scan of the abdomen and
pelvis earlier this year which showed progression of the
disease.  The patient was started on a chemotherapy regimen
of Cytoxan, Rituxan and Pentostatin.  Her previous two cycles
had complications of severe nausea and vomiting that required
hospitalization, so she was admitted for the third cycle of
treatment.

MEDICAL HISTORY: 1.  Stage 4 lymphoma, diagnosed in
[**2179**], status post autologous bone marrow transplant in
[**2184-1-6**] status post Rituxan therapy in [**2185**] and [**2186**]
for recurrences of lymphoma, status post chemotherapy in [**2187**]
for recurrences.  2.  Lung cancer, status post partial
resection.  3.  Paget's disease.  4.  History of shingles in
the T4 dermatome area with persistent skin change and pain.
5.  Gastroesophageal reflux disease.  6.  Cholecystectomy.
7.  Total abdominal hysterectomy with bilateral
salpingo-oophorectomy.  8.  Bilateral total knee
replacements.

MEDICATION ON ADMISSION: 

ALLERGIES: The patient denied having drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Acute respiratory failure,Congestive heart failure, unspecified,Herpes zoster with other nervous system complications,Bone marrow replaced by transplant'}
