CHIEF COMPLAINT: diffuse interstitial
lung pattern on chest x-ray and shortness of breath.

PRESENT ILLNESS: This 44-year-old female with rheumatoid
arthritis and Crohn's disease, now with diffuse interstitial
lung pattern on chest x-ray and shortness of breath.

MEDICAL HISTORY: Crohn's, RA

MEDICATION ON ADMISSION: asacol 1200'", Levo,Singular, Vit B12, folic acid, Remicaid,
prednisone 40', pentamidine 230', MTX 2.5 M-F, Xopene, Tussinex

ALLERGIES: Erythromycin Base

PHYSICAL EXAM: general: 40 yo dyspneic female in moderate resp distress.
COR: RRR S1, S2
Lungs: course wheezes and rhonchi through out.
Abd: soft, NT, ND, +BS
Extrem: no C/C/E
Neuro: A+OX3 -no focal deficits

FAMILY HISTORY: non-contributory

SOCIAL HISTORY: non-contributory
Regional enteritis of unspecified site,Rheumatoid arthritis,Unspecified allergic alveolitis and pneumonitis,Antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use
Regional enteritis NOS,Rheumatoid arthritis,Allerg alveol/pneum NOS,Adv eff antineoplastic
Admission Date:  [**2165-7-6**]              Discharge Date:   [**2165-7-11**]

Date of Birth:  [**2121-1-2**]             Sex:   F

Service: CARDIOTHORACIC

Allergies:
Erythromycin Base

Attending:[**First Name3 (LF) 281**]
Chief Complaint:
diffuse interstitial
lung pattern on chest x-ray and shortness of breath.


Major Surgical or Invasive Procedure:
transbronchial biopsy


History of Present Illness:
This 44-year-old female with rheumatoid
arthritis and Crohn's disease, now with diffuse interstitial
lung pattern on chest x-ray and shortness of breath.


Past Medical History:
Crohn's, RA

Social History:
non-contributory

Family History:
non-contributory

Physical Exam:
general: 40 yo dyspneic female in moderate resp distress.
COR: RRR S1, S2
Lungs: course wheezes and rhonchi through out.
Abd: soft, NT, ND, +BS
Extrem: no C/C/E
Neuro: A+OX3 -no focal deficits

Pertinent Results:
CXR: UPRIGHT CHEST: Comparison with examination of same day,
7:36 a.m. Lungs appear improved in terms of aeration, though
there is residual opacity on both sides. No definite
pneumothorax or pleural effusion seen. Cardiac, mediastinal, and
hilar contours are unchanged. The bowel gas pattern is normal.
Bony structures are unchanged.

IMPRESSION: Improved appearance of both lungs.

BLOOD GASES Type Temp Rates Tidal V PEEP FiO2 O2 Flow pO2 pCO2
pH calHCO3 Base XS
[**2165-7-7**] 12:26AM    ART             89 33* 7.47* 25 0


Brief Hospital Course:
pt was admitted to the interventional pulmonology service.  She
was initially stablized and her respiratory status monitored.
This was done in the ICU.  On HD 3 she underwent transbroncheal
biopsy of suspicious looking cat scan findings, the pathology of
which is still pending.  After her biopsy however, her condition
improved without any direct intervention.  Her oxygen
requirement improved, as did her objective examination.  She had
been started on prednisone as well, which appeared to help, she
will continue this as a taper as an outpt.  On HD 5 she was
doing well, but due to social circumstances, had to stay until
HD 6, when she was d/c'ed home.

Medications on Admission:
asacol 1200'", Levo,Singular, Vit B12, folic acid, Remicaid,
prednisone 40', pentamidine 230', MTX 2.5 M-F, Xopene, Tussinex

Discharge Medications:
1. Albuterol-Ipratropium 103-18 mcg/Actuation Aerosol Sig: [**2-18**]
Puffs Inhalation Q6H (every 6 hours).
Disp:*2 * Refills:*2*
2. Mesalamine 400 mg Tablet, Delayed Release (E.C.) Sig: Three
(3) Tablet, Delayed Release (E.C.) PO TID (3 times a day).
3. Folic Acid 1 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily).

4. Levofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q24H (every
24 hours).
5. Sodium Chloride 0.65 % Aerosol, Spray Sig: [**2-18**] Sprays Nasal
TID (3 times a day) as needed.
Disp:*1 * Refills:*0*
6. oxygen
oxygen 2 liters continuous for portabilty pulse dose system.
7. Prednisone 20 mg Tablet Sig: One (1) Tablet PO once a day for
15 days: follow dosage instructions as provided.
40mg x 3 days, 30mg x 3 days, 20 mg x 3 days, 10 mg x 3days .
Disp:*12 Tablet(s)* Refills:*0*


Discharge Disposition:
Home With Service

Facility:
[**Hospital 6549**] Medical

Discharge Diagnosis:
? methotrexate lung injury


Discharge Condition:
improved.


Discharge Instructions:
If you have increased difficulty breathing, chest pain or
productive cough, fever, or chills, plaese call Dr. [**First Name (STitle) **] at
[**Telephone/Fax (1) 3020**].

Followup Instructions:
Call you pulmonologist and rheumatologist for follow up
appointments.


                             [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 286**]

Completed by:[**2165-7-11**]
{'Regional enteritis of unspecified site,Rheumatoid arthritis,Unspecified allergic alveolitis and pneumonitis,Antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use'}


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: diffuse interstitial
lung pattern on chest x-ray and shortness of breath.

PRESENT ILLNESS: This 44-year-old female with rheumatoid
arthritis and Crohn's disease, now with diffuse interstitial
lung pattern on chest x-ray and shortness of breath.

MEDICAL HISTORY: Crohn's, RA

MEDICATION ON ADMISSION: asacol 1200'", Levo,Singular, Vit B12, folic acid, Remicaid,
prednisone 40', pentamidine 230', MTX 2.5 M-F, Xopene, Tussinex

ALLERGIES: Erythromycin Base

PHYSICAL EXAM: general: 40 yo dyspneic female in moderate resp distress.
COR: RRR S1, S2
Lungs: course wheezes and rhonchi through out.
Abd: soft, NT, ND, +BS
Extrem: no C/C/E
Neuro: A+OX3 -no focal deficits

FAMILY HISTORY: non-contributory

SOCIAL HISTORY: non-contributory 

### Response:
{'Regional enteritis of unspecified site,Rheumatoid arthritis,Unspecified allergic alveolitis and pneumonitis,Antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use'}
