CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 69-year-old
male who was first noted to have bilateral lung masses on a
chest x-ray in preparation for possible sinus surgery.  A
follow-up CAT scan of the chest in [**2166-3-26**] originally had
shown a 6.5 cm left upper lobe mass and a 3.5 cm lobulated
right upper lobe mass.  He consequently underwent
fluoroscopic biopsy of the right-sided mass which showed
adenocarcinoma.  Bronchial biopsy of the left upper lobe
showed poorly differentiated large cell carcinoma with
squamous differentiation.  Metastatic work-up of the head,
bone, and abdomen was negative.  His laboratory studies
remained relatively normal.

MEDICAL HISTORY: 1.  Hypertension.  2.
Hypercholesterolemia.  3.  Nasal polyps.  4.  Bilateral lung
carcinoma.  5.  Chronic maxillary and ethmoid sinusitis.  6.
Peptic ulcer disease.

MEDICATION ON ADMISSION: 

ALLERGIES: NO KNOWN DRUG ALLERGIES.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: Likely asbestos exposure.  History of
smoking (60 pack years).
Malignant neoplasm of upper lobe, bronchus or lung,Secondary and unspecified malignant neoplasm of intrathoracic lymph nodes,Acidosis,Paroxysmal ventricular tachycardia,Pure hypercholesterolemia,Unspecified essential hypertension
Mal neo upper lobe lung,Mal neo lymph-intrathor,Acidosis,Parox ventric tachycard,Pure hypercholesterolem,Hypertension NOS
Admission Date:  [**2166-9-5**]       Discharge Date:  [**2166-9-15**]

Date of Birth:   [**2096-7-26**]       Sex:  M

Service:  THORACIC SURGERY

HISTORY OF PRESENT ILLNESS:  The patient is a 69-year-old
male who was first noted to have bilateral lung masses on a
chest x-ray in preparation for possible sinus surgery.  A
follow-up CAT scan of the chest in [**2166-3-26**] originally had
shown a 6.5 cm left upper lobe mass and a 3.5 cm lobulated
right upper lobe mass.  He consequently underwent
fluoroscopic biopsy of the right-sided mass which showed
adenocarcinoma.  Bronchial biopsy of the left upper lobe
showed poorly differentiated large cell carcinoma with
squamous differentiation.  Metastatic work-up of the head,
bone, and abdomen was negative.  His laboratory studies
remained relatively normal.

He was seen by the Oncology Service and started on
chemotherapy.  The follow-up imaging showed marked regression
of his tumor.  He was consequently referred to Thoracic
Surgery for a possible surgical intervention.  The patient
has not lost significant weight and has not had any fevers,
headaches, or chest pain.  He has had good appetite

PAST MEDICAL HISTORY:  1.  Hypertension.  2.
Hypercholesterolemia.  3.  Nasal polyps.  4.  Bilateral lung
carcinoma.  5.  Chronic maxillary and ethmoid sinusitis.  6.
Peptic ulcer disease.

PAST SURGICAL HISTORY:  None.

MEDICATIONS:  Hydrochlorothiazide 25 mg q.d., Lipitor 10 mg
q.d., Atrovent, Vanceril, antihistamines for allergies.

ALLERGIES:  NO KNOWN DRUG ALLERGIES.

SOCIAL HISTORY:  Likely asbestos exposure.  History of
smoking (60 pack years).

PHYSICAL EXAMINATION:  General:  Well-developed, in no
apparent distress.  HEENT:  Anicteric.  No lymphadenopathy
palpated.  Lungs:  Clear to auscultation bilaterally.  Heart:
Regular, rate and rhythm without murmurs.  Abdomen:  Soft,
nontender, nondistended.  Extremities:  Pulses present
bilaterally.  Warm and well perfused.

LABORATORY DATA:  White blood cell count 7.0, hematocrit 38,
platelet count 351; BUN 17, creatinine 0.8, sodium 141,
potassium 3.9, chloride 100, carbon dioxide 28; liver
function tests within normal limits; FEV1 was 44% of the
predicted value.

HOSPITAL COURSE:  Given the diagnosis of bilateral lung
cancer, Thoracic Surgery was consulted.  On [**2166-9-5**],
the patient underwent median sternotomy, left upper
lobectomy, bronchoscopy, pedicled pericardial flap, right
upper wedge resection, and decortication of the left lung.
The patient tolerated the procedure well, and there were no
immediate complications.  Please see the full operative
report for details.

The patient was transferred to the Intensive Care Unit in
fair condition.  He had to be reintubated and maintained on
pressure support.  He was transfused with 2 U of packed red
blood cells for a hematocrit of 23.6.  Chest x-ray obtained
at that time, showed left lower lobe collapse/consolidation
but appeared relatively unchanged.  The patient underwent a
series of therapeutic bronchoscopies during his stay in the
Intensive Care Unit.  It showed mucous plugging and thick
secretions.  He had an increased need of Neo requirement.
The patient was weaned of sedation.  His chest x-ray showed
some interval improvement.

He continued to have low-grade fevers.  He was placed on
Ceftriaxone and Kefzol.  His hematocrit remained stable.
There was some difficulty weaning him off of pressure
support.  In addition, his tube feeding was initiated.  He
continued to have thick oral secretions.  He remained in
sinus rhythm but had an eight-beat run of ventricular
tachycardia was noted.  The patient was started on Amiodarone
drip.  He was transfused again with one unit of red blood
cells.  The patient was successfully extubated on
postoperative day #4.

He was transferred to the red floor on postoperative day #5
in stable condition.  He continued to produce good urine.  He
remained in sinus rhythm.  He continued to be afebrile with
stable blood pressure and heart rate.  Physical Therapy was
consulted which recommended rehabilitation facility upon
discharge.

The chest tubes were removed.  The patient was discharged to
the rehabilitation facility on [**2166-9-16**].

CONDITION ON DISCHARGE:  Good.

DISCHARGE DISPOSITION:  Rehabilitation facility.

DISCHARGE DIAGNOSIS:
1.  Bilateral lung carcinoma status post medial sternotomy,
left upper lobectomy, bronchoscopy, pedicled pericardial
flap, right upper wedge resection, and decortication of the
left lung.
2.  Hypertension.
3.  Hypercholesterolemia.

DISCHARGE MEDICATIONS:  Amiodarone 400 mg q.d. x 1 month,
Ambien 5 mg p.o. h.s., Atenolol 12.5 mg p.o. b.i.d.,
Fluticasone Propionate 110 mcg 2 puffs b.i.d., Keflex 500 mg
q.6 hours p.o. x 7 days, Heparin subcue 5000 U b.i.d. until
sufficiently mobile, Albuterol Ipratropium 1-2 puffs inhalers
q.6 hours p.r.n., Hydrochlorothiazide 25/25 one tab q.d.,
Lipitor 10 mg p.o. q.d., Vanceril.

DISCHARGE INSTRUCTIONS:  1.  The patient is to follow-up with
his surgeon Dr. [**First Name4 (NamePattern1) 951**] [**Last Name (NamePattern1) 952**] in approximately 1-2 weeks.  2.
The patient is to follow-up with his primary care physician
[**Last Name (NamePattern4) **]. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 35888**] in approximately 1-2 weeks.  3.  The patient
is to follow-up with his oncologist as scheduled (Dr. [**First Name8 (NamePattern2) **]
[**Name (STitle) 3274**]).






                            [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 3351**], M.D.  [**MD Number(1) 3352**]

Dictated By:[**Last Name (NamePattern1) 1741**]
MEDQUIST36

D:  [**2166-9-15**]  18:13
T:  [**2166-9-15**]  19:35
JOB#:  [**Job Number 43211**]
{'Malignant neoplasm of upper lobe, bronchus or lung,Secondary and unspecified malignant neoplasm of intrathoracic lymph nodes,Acidosis,Paroxysmal ventricular tachycardia,Pure hypercholesterolemia,Unspecified essential hypertension'}


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: The patient is a 69-year-old
male who was first noted to have bilateral lung masses on a
chest x-ray in preparation for possible sinus surgery.  A
follow-up CAT scan of the chest in [**2166-3-26**] originally had
shown a 6.5 cm left upper lobe mass and a 3.5 cm lobulated
right upper lobe mass.  He consequently underwent
fluoroscopic biopsy of the right-sided mass which showed
adenocarcinoma.  Bronchial biopsy of the left upper lobe
showed poorly differentiated large cell carcinoma with
squamous differentiation.  Metastatic work-up of the head,
bone, and abdomen was negative.  His laboratory studies
remained relatively normal.

MEDICAL HISTORY: 1.  Hypertension.  2.
Hypercholesterolemia.  3.  Nasal polyps.  4.  Bilateral lung
carcinoma.  5.  Chronic maxillary and ethmoid sinusitis.  6.
Peptic ulcer disease.

MEDICATION ON ADMISSION: 

ALLERGIES: NO KNOWN DRUG ALLERGIES.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: Likely asbestos exposure.  History of
smoking (60 pack years). 

### Response:
{'Malignant neoplasm of upper lobe, bronchus or lung,Secondary and unspecified malignant neoplasm of intrathoracic lymph nodes,Acidosis,Paroxysmal ventricular tachycardia,Pure hypercholesterolemia,Unspecified essential hypertension'}
