CHIEF COMPLAINT: Motorcycle collision

PRESENT ILLNESS: 50 year old male s/p motorcycle collision on [**2119-5-9**] resulting
in a right hip and femur fracture both requiring surgical
management.

MEDICAL HISTORY: Hypertension
Hypercholexterolemia

MEDICATION ON ADMISSION: HCTZ
amoxopril

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Constitutional: Comfortable
HEENT: Normocephalic, atraumatic
Oropharynx within normal limits
Chest: Clear to auscultation
Cardiovascular: Regular Rate and Rhythm, Normal first and
second heart sounds
Abdominal: Soft, Nontender, Nondistended
Extr/Back: Right mid femur ecchymosis, pulse 2+ in right
leg, cap refill less than 2 seconds, patient with right
distal leg laceration
Skin: No rash, Warm and dry

FAMILY HISTORY: n/a

SOCIAL HISTORY: No ETOH, NO drugs, No Smoking
Closed fracture of shaft of femur,Acute posthemorrhagic anemia,Closed fracture of intertrochanteric section of neck of femur,Other motor vehicle traffic accident involving collision with motor vehicle injuring motorcyclist,Open wound of knee, leg [except thigh], and ankle, without mention of complication,Unspecified essential hypertension,Pure hypercholesterolemia,Hypotension, unspecified
Fx femur shaft-closed,Ac posthemorrhag anemia,Intertrochanteric fx-cl,Mv collis NOS-motorcycl,Open wnd knee/leg/ankle,Hypertension NOS,Pure hypercholesterolem,Hypotension NOS
Admission Date:  [**2119-5-9**]              Discharge Date:   [**2119-5-17**]

Date of Birth:  [**2068-8-10**]             Sex:   M

Service: ORTHOPAEDICS

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 8587**]
Chief Complaint:
Motorcycle collision

Major Surgical or Invasive Procedure:
[**2119-5-10**]: s/p open reduction internal fixation right hip and
femur.
[**2119-5-10**]: s/p irrigation & debridement with wound clousre right
ankle and knee.


History of Present Illness:
50 year old male s/p motorcycle collision on [**2119-5-9**] resulting
in a right hip and femur fracture both requiring surgical
management.

Past Medical History:
Hypertension
Hypercholexterolemia

Social History:
No ETOH, NO drugs, No Smoking

Family History:
n/a

Physical Exam:
Constitutional: Comfortable
HEENT: Normocephalic, atraumatic
Oropharynx within normal limits
Chest: Clear to auscultation
Cardiovascular: Regular Rate and Rhythm, Normal first and
second heart sounds
Abdominal: Soft, Nontender, Nondistended
Extr/Back: Right mid femur ecchymosis, pulse 2+ in right
leg, cap refill less than 2 seconds, patient with right
distal leg laceration
Skin: No rash, Warm and dry


Pertinent Results:
[**2119-5-9**] 04:04PM   FIBRINOGE-295
[**2119-5-9**] 04:04PM   PT-11.7 PTT-24.5 INR(PT)-1.0
[**2119-5-9**] 04:04PM   PLT COUNT-324
[**2119-5-9**] 04:04PM   WBC-14.3* RBC-4.12* HGB-12.6* HCT-38.6*
MCV-94 MCH-30.6 MCHC-32.7 RDW-13.0
[**2119-5-9**] 04:04PM   ASA-NEG ETHANOL-NEG ACETMNPHN-NEG
bnzodzpn-NEG barbitrt-NEG tricyclic-NEG
[**2119-5-9**] 04:04PM   cTropnT-<0.01
[**2119-5-9**] 04:04PM   LIPASE-22
[**2119-5-9**] 04:04PM   estGFR-Using this
[**2119-5-9**] 04:04PM   UREA N-25* CREAT-0.9
[**2119-5-9**] 04:14PM   GLUCOSE-131* LACTATE-1.7 NA+-140 K+-3.5
CL--103 TCO2-23
[**2119-5-9**] 04:30PM URINE  HYALINE-0-2
[**2119-5-9**] 04:30PM URINE  RBC-[**5-25**]* WBC-0-2 BACTERIA-FEW
YEAST-NONE EPI-0-2
[**2119-5-9**] 04:30PM URINE  BLOOD-LG NITRITE-NEG PROTEIN-25
GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-6.0
LEUK-NEG
[**2119-5-9**] 04:30PM URINE  COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]-1.021
[**2119-5-9**] 04:30PM URINE  bnzodzpn-NEG barbitrt-NEG opiates-NEG
cocaine-NEG amphetmn-NEG mthdone-NEG
[**2119-5-9**] 04:30PM URINE  HOURS-RANDOM
[**2119-5-9**] 04:30PM URINE  HOURS-RANDOM
[**2119-5-9**] 06:00PM   HGB-9.3*# HCT-28.3*#
[**2119-5-9**] 06:00PM   CK(CPK)-519*
[**2119-5-9**] 06:00PM   GLUCOSE-171* UREA N-25* CREAT-1.0 SODIUM-140
POTASSIUM-4.0 CHLORIDE-111* TOTAL CO2-23 ANION GAP-10
[**2119-5-9**] 06:37PM   HGB-10.0* calcHCT-30
[**2119-5-9**] 08:25PM   cTropnT-<0.01
[**2119-5-9**] 10:40PM   HCT-35.0*

Brief Hospital Course:
On [**2119-5-9**], the patient was admitted to the trauma surgery ICU
for close monitoring and fluid resuscitation for hypotension in
the ED.  Although there was concern for T12 vertebral injury
based on CT scan, his spine was cleared clinically by general
surgery.  On [**2119-5-10**], he underwent open reduction internal
fixation of his right hip and femur without complication. He
also underwent irrigation and debridement with wound closure of
his right ankle and knee lacerations. He was admitted to
orthopedic surgery post-operatively and transferred to the floor
in stable condition. On [**2119-5-11**] he was transfused 2 units of
PRBCs for post operative blood loss anemia then again on
[**2119-5-12**].  Also on [**2119-5-12**] he had a ultrasound of his right leg
due to calf pain, which was negative for DVT.

The rest of his hospital stay was uneventful with his lab data
and vital sings within normal limits and his pain controlled.
He is being discharged today in stable condition.


Medications on Admission:
HCTZ
amoxopril

Discharge Medications:
1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
2. Alum-Mag Hydroxide-Simeth 200-200-20 mg/5 mL Suspension Sig:
15-30 MLs PO QID (4 times a day) as needed for Dyspepsia.
3. Senna 8.6 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
4. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2)
Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed for
Constipation.
5. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30)
ML PO BID (2 times a day) as needed for Dyspepsia.
6. Acetaminophen 500 mg Tablet Sig: Two (2) Tablet PO Q6H (every
6 hours).
7. Oxycodone 5 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours)
as needed for pain.
8. Enoxaparin 30 mg/0.3 mL Syringe Sig: One (1)  Subcutaneous
Q12H (every 12 hours).
9. Lorazepam 2 mg/mL Syringe Sig: 0.25 mg  Injection Q6H (every
6 hours) as needed for anxiety.
10. Ondansetron HCl (PF) 4 mg/2 mL Solution Sig: One (1)
Injection Q8H (every 8 hours) as needed for nausea.
11. Cefazolin 10 gram Recon Soln Sig: One (1) Recon Soln
Injection Q8H (every 8 hours).


Discharge Disposition:
Extended Care

Facility:
[**Hospital3 1107**] [**Hospital **] Hospital - [**Location (un) 38**]

Discharge Diagnosis:
1. Right hip fracture
2. Right mid shaft femur fracture.
3. Right ankle laceration.
4. Right knee laceration.
5. Post operative blood loss anemia.


Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).


Discharge Instructions:
Wound Care:
-Keep Incision dry.
-Do not soak the incision in a bath or pool.

Activity:
-Continue to be touch down weight bearing on your right leg.

Other Instructions
- Resume your regular diet.
- Avoid nicotine products to optimize healing.
- Resume your home medications. Take all medications as
instructed.
- Continue taking the Lovenox to prevent blood clots.

-You have also been given Additional Medications to control your
pain.  Please allow 72 hours for refill of narcotic
prescriptions, so plan ahead.  You can either have them mailed
to your home or pick them up at the clinic located on [**Hospital Ward Name 23**] 2.
 We are not allowed to call in narcotic (oxycontin, oxycodone,
percocet) prescriptions to the pharmacy.   In addition, we are
only allowed to write for pain medications for 90 days from the
date of surgery.



- Narcotic pain medication may cause drowsiness.  Do not drink
alcohol while taking narcotic medications.  Do not operate any
motor vehicle or machinery while taking narcotic pain
medications.  Taking more than recommended may cause serious
breathing problems.



If you have questions, concerns or experience any of the below
danger signs then please call your doctor at [**Telephone/Fax (1) 1228**] or go
to your local emergency room.

Physical Therapy:
Right lower extremity touch down weight bearing.
Treatments Frequency:
Remove staples and sutures 14 days from date of surgery

Followup Instructions:
2 weeks in the [**Hospital **] clinic with [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], NP.
Please call [**Telephone/Fax (1) 1228**] to make this appointment.



Completed by:[**2119-5-17**]
{'Closed fracture of shaft of femur,Acute posthemorrhagic anemia,Closed fracture of intertrochanteric section of neck of femur,Other motor vehicle traffic accident involving collision with motor vehicle injuring motorcyclist,Open wound of knee, leg [except thigh], and ankle, without mention of complication,Unspecified essential hypertension,Pure hypercholesterolemia,Hypotension, 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: Motorcycle collision

PRESENT ILLNESS: 50 year old male s/p motorcycle collision on [**2119-5-9**] resulting
in a right hip and femur fracture both requiring surgical
management.

MEDICAL HISTORY: Hypertension
Hypercholexterolemia

MEDICATION ON ADMISSION: HCTZ
amoxopril

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Constitutional: Comfortable
HEENT: Normocephalic, atraumatic
Oropharynx within normal limits
Chest: Clear to auscultation
Cardiovascular: Regular Rate and Rhythm, Normal first and
second heart sounds
Abdominal: Soft, Nontender, Nondistended
Extr/Back: Right mid femur ecchymosis, pulse 2+ in right
leg, cap refill less than 2 seconds, patient with right
distal leg laceration
Skin: No rash, Warm and dry

FAMILY HISTORY: n/a

SOCIAL HISTORY: No ETOH, NO drugs, No Smoking 

### Response:
{'Closed fracture of shaft of femur,Acute posthemorrhagic anemia,Closed fracture of intertrochanteric section of neck of femur,Other motor vehicle traffic accident involving collision with motor vehicle injuring motorcyclist,Open wound of knee, leg [except thigh], and ankle, without mention of complication,Unspecified essential hypertension,Pure hypercholesterolemia,Hypotension, unspecified'}
