CHIEF COMPLAINT: ESRD

PRESENT ILLNESS: Ms. [**Known lastname 39143**] is a 46-year-old
female with end-stage renal disease secondary to type 1
diabetes mellitus, who presents for a kidney transplantation

MEDICAL HISTORY: Her past medical history is significant only for diabetes,
hypertension, hypercholesterolemia, and end-stage renal disease.

MEDICATION ON ADMISSION: 

ALLERGIES: Morphine

PHYSICAL EXAM: On physical examination, Mr. [**Known lastname 39143**] is a very pleasant
46-year-old female in no apparent distress. Chest is clear.
Abdomen is soft,
nontender, and nondistended. No cervical or supraclavicular
adenopathy. No carotid bruits. Her abdominal incision site is
clean, and intact with overlying abdominal pads for drainage
control. She has had
no recent fevers or chills or drainage. Her femorals are 2+ and
equal bilaterally. She has 2+ to 3+ peripheral edema. No
evidence of lower extremity ulcers or ischemic changes

FAMILY HISTORY: 

SOCIAL HISTORY: 
Diabetes with renal manifestations, type I [juvenile type], not stated as uncontrolled,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Complications of transplanted kidney,Thrombotic microangiopathy,Hemolytic-uremic syndrome,Hematoma complicating a procedure,Acute posthemorrhagic anemia,Congestive heart failure, unspecified,Acute kidney failure, unspecified,Hypocalcemia,Surgical operation with transplant of whole organ causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere,End stage renal disease,Polyneuropathy in diabetes,Long-term (current) use of insulin
DMI renl nt st uncntrld,Hyp kid NOS w cr kid V,Compl kidney transplant,Thrombot microangiopathy,Hemolytic uremic synd,Hematoma complic proc,Ac posthemorrhag anemia,CHF NOS,Acute kidney failure NOS,Hypocalcemia,Abn react-org transplant,Nephritis NOS in oth dis,End stage renal disease,Neuropathy in diabetes,Long-term use of insulin
Admission Date:  [**2107-1-11**]              Discharge Date:   [**2107-2-6**]

Date of Birth:  [**2060-1-14**]             Sex:   F

Service: SURGERY

Allergies:
Morphine

Attending:[**First Name3 (LF) 668**]
Chief Complaint:
ESRD

Major Surgical or Invasive Procedure:
[**1-25**]:Exploration of kidney transplant, renal
biopsy, wash-out hematoma and replacement of tunneled
dialysis catheter.
[**1-11**]:Kidney transplant, left iliac fossa,
living unrelated donor.


History of Present Illness:
Ms. [**Known lastname 39143**] is a 46-year-old
female with end-stage renal disease secondary to type 1
diabetes mellitus, who presents for a kidney transplantation

Past Medical History:
Her past medical history is significant only for diabetes,
hypertension, hypercholesterolemia, and end-stage renal disease.

She has had two prior C-sections, a laparoscopic
cholecystectomy,
and then PermCath that is placed in the right internal jugular
vein.


Physical Exam:
On physical examination, Mr. [**Known lastname 39143**] is a very pleasant
46-year-old female in no apparent distress. Chest is clear.
Abdomen is soft,
nontender, and nondistended. No cervical or supraclavicular
adenopathy. No carotid bruits. Her abdominal incision site is
clean, and intact with overlying abdominal pads for drainage
control. She has had
no recent fevers or chills or drainage. Her femorals are 2+ and
equal bilaterally. She has 2+ to 3+ peripheral edema. No
evidence of lower extremity ulcers or ischemic changes

Pertinent Results:
[**2107-1-11**] 01:52PM   GLUCOSE-140* UREA N-19 CREAT-3.3*# SODIUM-141
POTASSIUM-3.9 CHLORIDE-106 TOTAL CO2-24 ANION GAP-15
[**2107-1-11**] 01:52PM   PHOSPHATE-2.8# MAGNESIUM-1.2*
[**2107-1-11**] 01:52PM   WBC-5.2 RBC-4.13* HGB-11.6* HCT-36.1 MCV-87
MCH-28.0 MCHC-32.0 RDW-16.0*
[**2107-1-11**] 01:52PM   PLT COUNT-179
[**2107-1-11**] 12:53PM   TYPE-ART PO2-118* PCO2-35 PH-7.44 TOTAL
CO2-25 BASE XS-0
[**2107-1-11**] 12:53PM   TYPE-ART PO2-118* PCO2-35 PH-7.44 TOTAL
CO2-25 BASE XS-0
[**2107-1-11**] 12:53PM   HGB-11.0* calcHCT-33
[**2107-1-11**] 12:53PM   GLUCOSE-107* LACTATE-2.7* NA+-141 K+-3.8
CL--107
[**2107-1-11**] 12:53PM   freeCa-1.16
[**2107-1-11**] 10:35AM   TYPE-ART PO2-111* PCO2-37 PH-7.45 TOTAL
CO2-27 BASE XS-1 INTUBATED-INTUBATED
[**2107-1-11**] 10:35AM   GLUCOSE-226* LACTATE-1.6 NA+-139 K+-4.1
CL--102
[**2107-1-11**] 10:35AM   HGB-11.7* calcHCT-35
[**2107-1-11**] 10:35AM   freeCa-1.05*
[**2107-2-6**] 06:30AM BLOOD WBC-6.1 RBC-3.04* Hgb-8.9* Hct-25.5*
MCV-84 MCH-29.4 MCHC-35.0 RDW-14.6 Plt Ct-370
[**2107-2-5**] 06:10AM BLOOD WBC-4.7 RBC-3.22* Hgb-9.2* Hct-26.9*
MCV-84 MCH-28.6 MCHC-34.2 RDW-14.6 Plt Ct-321
[**2107-2-4**] 06:07AM BLOOD WBC-4.6 RBC-3.14* Hgb-9.2* Hct-26.5*
MCV-84 MCH-29.2 MCHC-34.6 RDW-14.7 Plt Ct-255
[**2107-2-3**] 05:30AM BLOOD WBC-5.4 RBC-3.22* Hgb-9.5* Hct-26.4*
MCV-82 MCH-29.3 MCHC-35.8* RDW-14.8 Plt Ct-189
[**2107-2-2**] 04:40PM BLOOD WBC-5.7 RBC-3.44* Hgb-10.5* Hct-28.7*
MCV-84 MCH-30.4 MCHC-36.5* RDW-14.7 Plt Ct-189
[**2107-2-2**] 05:45AM BLOOD WBC-4.7# RBC-3.43* Hgb-10.1* Hct-28.2*
MCV-82 MCH-29.5 MCHC-35.9* RDW-14.9 Plt Ct-155
[**2107-2-1**] 08:20PM BLOOD Hct-30.0*
[**2107-2-1**] 02:59AM BLOOD WBC-2.1* RBC-3.07* Hgb-9.2* Hct-25.4*
MCV-83 MCH-30.0 MCHC-36.2* RDW-15.2 Plt Ct-135*
[**2107-1-31**] 04:05AM BLOOD WBC-1.1* RBC-3.45* Hgb-10.2* Hct-30.1*
MCV-87 MCH-29.4 MCHC-33.7 RDW-14.8 Plt Ct-122*

Brief Hospital Course:
Ms. [**Known lastname 39143**] is a 46-year-old female with end-stage renal disease
secondary to type 1
diabetes mellitus, who presents for a kidney transplantation
[**2107-1-11**]. Procedure was performed by Dr. [**First Name (STitle) **]. Please see
operative note for details. Her postoperative course was
complicated by hemolysis thought to be due to antibody immunity
rejection. At the same time, she developed retroperitoneal
hematoma. At the same time, she developed a malfunctioning
dialysis catheter. On [**2107-1-25**] she returned to the operating
room for kidney exploration and retroperitoneal wash-out and
replacement of dialysis catheter which was advised and accepted.
Postoperatively after washout she remained in the SICU for
multiple plasmapheresis. She remaim stable and was tranasfered
to the transplant surgery floor [**Hospital Ward Name 121**] 10 [**2107-2-2**]. On [**2107-2-6**]
after evaluation by Transplant surgery, medicine and physical
therapy staff patient was advise that she was safe to go home.
Patient was educated on wound care  and agreed with plan of
discharge.


Discharge Medications:
1. Monistat 3 200 mg Suppository Sig: One (1)  Vaginal at
bedtime for 3 days: use at bedtime.  Vaginal supp-use at night x
3 days.
Disp:*qs 4% cream* Refills:*0*
2. Tums
Take 2 over the counter tums at night before bed
3. Trimethoprim-Sulfamethoxazole 80-400 mg Tablet Sig: One (1)
Tablet PO DAILY (Daily). Tablet(s)
4. Nystatin 100,000 unit/mL Suspension Sig: Five (5) ML PO QID
(4 times a day).
5. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
6. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every
6 hours) as needed.
7. Levothyroxine 75 mcg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
8. Citalopram 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

9. Albuterol Sulfate 0.083 % Solution Sig: One (1)  Inhalation
Q4H (every 4 hours) as needed.
10. Flonase 50 mcg/Actuation Aerosol, Spray Sig: One (1)  Nasal
[**Hospital1 **] ().
11. Ezetimibe 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily)
for 2 weeks.
Disp:*14 Tablet(s)* Refills:*0*
12. Sirolimus 1 mg Tablet Sig: Five (5) Tablet PO DAILY (Daily)
for 1 weeks.
Disp:*7 Tablet(s)* Refills:*0*
13. Mycophenolate Mofetil 500 mg Tablet Sig: One (1) Tablet PO
QID (4 times a day) for 1 weeks.
Disp:*28 Tablet(s)* Refills:*0*
14. Acetaminophen 500 mg Tablet Sig: Two (2) Tablet PO QDAY  ()
for 1 weeks.
Disp:*14 Tablet(s)* Refills:*0*
15. Prednisone 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily)
for 1 weeks.
Disp:*14 Tablet(s)* Refills:*0*
16. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day) as needed for 1 weeks.
Disp:*14 Tablet(s)* Refills:*0*
17. Medroxyprogesterone 2.5 mg Tablet Sig: One (1) Tablet PO
DAILY (Daily).
18. Conjugated Estrogens 0.625 mg Tablet Sig: One (1) Tablet PO
DAILY (Daily).
19. Valganciclovir 450 mg Tablet Sig: One (1) Tablet PO QMOWEFR
(Monday -Wednesday-Friday).
Disp:*6 Tablet(s)* Refills:*0*
20. Albuterol 90 mcg/Actuation Aerosol Sig: 1-2 Puffs Inhalation
Q6H (every 6 hours) as needed.
21. Albuterol Sulfate 0.083 % Solution Sig: One (1)  Inhalation
Q6H (every 6 hours) as needed.
22. Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO Q8H (every 8
hours) as needed.
23. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One
(1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours).
Disp:*14 Tablet, Delayed Release (E.C.)(s)* Refills:*0*
24. Carvedilol 12.5 mg Tablet Sig: One (1) Tablet PO BID (2
times a day) for 1 weeks.
Disp:*14 Tablet(s)* Refills:*0*
25. Hydromorphone 2 mg Tablet Sig: One (1) Tablet PO Q4-6H
(every 4 to 6 hours) as needed for pain for 7 doses.
Disp:*7 Tablet(s)* Refills:*0*
26. Metoclopramide 10 mg Tablet Sig: 0.5 Tablet PO QIDACHS (4
times a day (before meals and at bedtime)).
Disp:*40 Tablet(s)* Refills:*0*
27. Epoetin Alfa 10,000 unit/mL Solution Sig: One (1)  Injection
QMOWEFR (Monday -Wednesday-Friday).
Disp:*6 10,000 unit/mL * Refills:*0*
28. Simethicone 80 mg Tablet, Chewable Sig: One (1) Tablet,
Chewable PO TID (3 times a day) as needed for gas discomfort.
Disp:*30 Tablet, Chewable(s)* Refills:*0*
29. Furosemide 40 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*14 Tablet(s)* Refills:*0*
30. Sirolimus 1 mg Tablet Sig: Six (6) Tablet PO DAILY (Daily)
for 1 weeks.
Disp:*7 Tablet(s)* Refills:*0*
31. NIFEdipine 30 mg Tablet Sustained Release Sig: One (1)
Tablet Sustained Release PO Q 12H (Every 12 Hours) for 14 doses.
Disp:*14 Tablet Sustained Release(s)* Refills:*0*


Discharge Disposition:
Home With Service

Facility:
[**Hospital6 486**]

Discharge Diagnosis:
end-stage renal disease secondary to type 1
diabetes mellitus


Discharge Condition:
stable


Discharge Instructions:
Please call transplant surgery at [**Telephone/Fax (1) 673**]  if any fevers,
chills, nausea, vomiting, abdominal pain, inability to eat food
or drink liquids.  If you have any increase drainage to
incision, change in color on incision.  Also if you have
increase vaginal bleeding please call immediately. Please
contact [**Telephone/Fax (1) 673**] to arrange appointment for lab works on
[**2107-2-8**] and administration of Rituximab   [**2107-2-10**]

Followup Instructions:
Please Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 4653**], MD Phone:[**Telephone/Fax (1) 274**]
Date/Time:[**2107-2-8**] 11:00
Provider: [**Name10 (NameIs) 454**],TWELVE DAY CARE [**Hospital Ward Name **] 8 Date/Time:[**2107-2-8**]
12:00
Provider: [**Name10 (NameIs) 2105**] [**Name11 (NameIs) 2106**], MD Phone:[**Telephone/Fax (1) 673**]
Date/Time:[**2107-2-8**] 2:00



Completed by:[**2107-2-6**]
{'Diabetes with renal manifestations, type I [juvenile type], not stated as uncontrolled,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Complications of transplanted kidney,Thrombotic microangiopathy,Hemolytic-uremic syndrome,Hematoma complicating a procedure,Acute posthemorrhagic anemia,Congestive heart failure, unspecified,Acute kidney failure, unspecified,Hypocalcemia,Surgical operation with transplant of whole organ causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere,End stage renal disease,Polyneuropathy in diabetes,Long-term (current) use of insulin'}


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: ESRD

PRESENT ILLNESS: Ms. [**Known lastname 39143**] is a 46-year-old
female with end-stage renal disease secondary to type 1
diabetes mellitus, who presents for a kidney transplantation

MEDICAL HISTORY: Her past medical history is significant only for diabetes,
hypertension, hypercholesterolemia, and end-stage renal disease.

MEDICATION ON ADMISSION: 

ALLERGIES: Morphine

PHYSICAL EXAM: On physical examination, Mr. [**Known lastname 39143**] is a very pleasant
46-year-old female in no apparent distress. Chest is clear.
Abdomen is soft,
nontender, and nondistended. No cervical or supraclavicular
adenopathy. No carotid bruits. Her abdominal incision site is
clean, and intact with overlying abdominal pads for drainage
control. She has had
no recent fevers or chills or drainage. Her femorals are 2+ and
equal bilaterally. She has 2+ to 3+ peripheral edema. No
evidence of lower extremity ulcers or ischemic changes

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Diabetes with renal manifestations, type I [juvenile type], not stated as uncontrolled,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Complications of transplanted kidney,Thrombotic microangiopathy,Hemolytic-uremic syndrome,Hematoma complicating a procedure,Acute posthemorrhagic anemia,Congestive heart failure, unspecified,Acute kidney failure, unspecified,Hypocalcemia,Surgical operation with transplant of whole organ causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere,End stage renal disease,Polyneuropathy in diabetes,Long-term (current) use of insulin'}
