CHIEF COMPLAINT: Right Renal mass

PRESENT ILLNESS: 58yM who presented with headache and a frontal lobe brain mass
that was found to be metastatic RCC.  Large R kidney tumor and
IVC thrombus, as well as RP lymphadenopathy.

MEDICAL HISTORY: HTN
HL
GERD
PVD

MEDICATION ON ADMISSION: Nexium 20 mg Po daily
ASA 81 mg PO daily
Pravastatin 40 mg Po daily
Azopt 1% 1 drop OU tid
Combigan 0.2-0.5% 1 drop OU tid
Xalatan 0.005% 1 drop OU qhs
Keppra 1125 mg PO qhs
Colace 100 mg PO daily

ALLERGIES: IV Dye, Iodine Containing Contrast Media / myeclog cream

PHYSICAL EXAM: NAD
incision clean, dry, intact

FAMILY HISTORY: Mother with [**Name (NI) 11964**] / renal cell carcinoma
Father with stroke in 60's
Sister with brain tumor - unknown what type, family says it is
"deep" and inoperable so she is being monitored, asymptomatic
and
has been stable.

SOCIAL HISTORY: Lives at home with wife and step daughter. [**Name (NI) 1403**] as a machinist
for GE. Never smoked, drinks occasional alcohol. Denies
illicits.
Malignant neoplasm of kidney, except pelvis,Secondary malignant neoplasm of other specified sites,Hemorrhage complicating a procedure,Personal history of venous thrombosis and embolism,Unspecified essential hypertension,Peripheral vascular disease, unspecified,Esophageal reflux,Unspecified glaucoma,Removal of other organ (partial) (total) causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Accidents occurring in residential institution
Malig neopl kidney,Secondary malig neo NEC,Hemorrhage complic proc,Hx-ven thrombosis/embols,Hypertension NOS,Periph vascular dis NOS,Esophageal reflux,Glaucoma NOS,Abn reac-organ rem NEC,Accid in resident instit
Admission Date:  [**2184-12-7**]              Discharge Date:   [**2184-12-11**]

Date of Birth:  [**2126-8-27**]             Sex:   M

Service: UROLOGY

Allergies:
IV Dye, Iodine Containing Contrast Media / myeclog cream

Attending:[**First Name3 (LF) 11304**]
Chief Complaint:
Right Renal mass

Major Surgical or Invasive Procedure:
Radical Right open nephrectomy w/ mobilization of liver and
tumor embolectomy and then patch repair of vena cava.


History of Present Illness:
58yM who presented with headache and a frontal lobe brain mass
that was found to be metastatic RCC.  Large R kidney tumor and
IVC thrombus, as well as RP lymphadenopathy.


Past Medical History:
HTN
HL
GERD
PVD

PSH:
L knee surgery
Umbilical hernia repair


Social History:
Lives at home with wife and step daughter. [**Name (NI) 1403**] as a machinist
for GE. Never smoked, drinks occasional alcohol. Denies
illicits.


Family History:
Mother with [**Name (NI) 11964**] / renal cell carcinoma
Father with stroke in 60's
Sister with brain tumor - unknown what type, family says it is
"deep" and inoperable so she is being monitored, asymptomatic
and
has been stable.


Physical Exam:
NAD
incision clean, dry, intact


Brief Hospital Course:
Patient was admitted to Urology after undergoing Right radical
open nephrectomy,with mobilization of liver and tumor
embolectomy and then patch repair of vena cava. patient had a
large volume blood loss during the case of approximately 7 L ;
please see dictated operative note for details. The patient
received perioperative antibiotic prophylaxis. On POD0, the
patient was taken to the ICU intubated and sedated.   On POD1,
the patient was extubated without any issues and his hematocrit
remained stable.  He remained in the ICU until the evening of
POD1 when he was ambulating and pain was well controlled. On
POD2, the patient was started on sips, which he tolerated well
and advanced to clear liquids. On POD3 his foley was removed and
the patient voided without any issues.  The remainder of the
hospital course was relatively unremarkable. The patient was
discharged in stable condition, eating well, ambulating
independently, voiding without difficulty, and with pain control
on oral analgesics. On exam, incision was clean, dry, and
intact, with no evidence of hematoma collection or infection.
The patient was given explicit instructions to follow-up in
clinic with Dr. [**Last Name (STitle) 3748**] in 3 weeks.


Medications on Admission:
Nexium 20 mg Po daily
ASA 81 mg PO daily
Pravastatin 40 mg Po daily
Azopt 1% 1 drop OU tid
Combigan 0.2-0.5% 1 drop OU tid
Xalatan 0.005% 1 drop OU qhs
Keppra 1125 mg PO qhs
Colace 100 mg PO daily


Discharge Medications:
1. hydromorphone 2 mg Tablet Sig: One (1) Tablet PO Q4H (every 4
hours) as needed for pain.
Disp:*75 Tablet(s)* Refills:*0*
2. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*2*


Discharge Disposition:
Home

Discharge Diagnosis:
Renal Cell Ca


Discharge Condition:
Stable


Discharge Instructions:
You may shower but do not bathe, swim or immerse your incision.

-Do not lift anything heavier than a phone book (10 pounds) or
drive until you are seen by your Urologist in follow-up

-Tylenol should be your first line pain medication, a narcotic
pain medication has been prescribed for breakthough pain >4.
Replace Tylenol with narcotic pain medication.  Max daily
Tylenol dose is 4gm, note that narcotic pain medication also
contains Tylenol (acetaminophen)

-Do not drive or drink alcohol while taking narcotics

-Colace has been prescribed to avoid post surgical constipation
and constipation related to narcotic pain medication,
discontinue if loose stool or diarrhea develops.

-Resume all of your home medications, except hold NSAID
(aspirin,  and ibuprofen containing products such as advil &
motrin,) until you see your urologist in follow-up

-Call your Urologist's office today to schedule/confirm your
follow-up appointment in 3 weeks AND if you have any questions.

-If you have fevers > 101.5 F, vomiting, or increased redness,
swelling, or discharge from your incision, call your doctor or
go to the nearest ER

-Do not eat constipating foods for 2-4 weeks, drink plenty of
fluids


Followup Instructions:
-Call Dr.[**Name (NI) 11306**] office ([**Telephone/Fax (1) 8791**] &#8206;for follow-up
AND if you have any questions (page Dr. [**Last Name (STitle) 3748**] at [**Telephone/Fax (1) 2756**]).
{'Malignant neoplasm of kidney, except pelvis,Secondary malignant neoplasm of other specified sites,Hemorrhage complicating a procedure,Personal history of venous thrombosis and embolism,Unspecified essential hypertension,Peripheral vascular disease, unspecified,Esophageal reflux,Unspecified glaucoma,Removal of other organ (partial) (total) causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Accidents occurring in residential institution'}


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: Right Renal mass

PRESENT ILLNESS: 58yM who presented with headache and a frontal lobe brain mass
that was found to be metastatic RCC.  Large R kidney tumor and
IVC thrombus, as well as RP lymphadenopathy.

MEDICAL HISTORY: HTN
HL
GERD
PVD

MEDICATION ON ADMISSION: Nexium 20 mg Po daily
ASA 81 mg PO daily
Pravastatin 40 mg Po daily
Azopt 1% 1 drop OU tid
Combigan 0.2-0.5% 1 drop OU tid
Xalatan 0.005% 1 drop OU qhs
Keppra 1125 mg PO qhs
Colace 100 mg PO daily

ALLERGIES: IV Dye, Iodine Containing Contrast Media / myeclog cream

PHYSICAL EXAM: NAD
incision clean, dry, intact

FAMILY HISTORY: Mother with [**Name (NI) 11964**] / renal cell carcinoma
Father with stroke in 60's
Sister with brain tumor - unknown what type, family says it is
"deep" and inoperable so she is being monitored, asymptomatic
and
has been stable.

SOCIAL HISTORY: Lives at home with wife and step daughter. [**Name (NI) 1403**] as a machinist
for GE. Never smoked, drinks occasional alcohol. Denies
illicits. 

### Response:
{'Malignant neoplasm of kidney, except pelvis,Secondary malignant neoplasm of other specified sites,Hemorrhage complicating a procedure,Personal history of venous thrombosis and embolism,Unspecified essential hypertension,Peripheral vascular disease, unspecified,Esophageal reflux,Unspecified glaucoma,Removal of other organ (partial) (total) causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Accidents occurring in residential institution'}
