CHIEF COMPLAINT: frequent falls

PRESENT ILLNESS: 60F s/p aneurysm clipping and subsequent stroke in [**2136**] also
with PMH of polycystic kidney and liver disease presents to
emergency room with c/o dizziness/double vision and falls
x3-4days.  Denies any previous trauma except for a [**2136**]
in which she bumped her forehead and broke her arm.  There is no
trauma she can recall until 4 days prior to arrival pt was
bending over to pick something off floor and fell forward,
denies
hitting her head at that time.  Later that same day as she was
trying to get up from chair she fell again to floor. She c/o
2weeks of headaches (not bad enough to take anything for them),
dizziness and blurry vision 3 days prior to arrival which comes
and goes. She denies any new weakness, seizure, speech
difficulty, CP, SOB

MEDICAL HISTORY: PKD
Hemorrhagic stroke (cerebral aneurysm)
HTN

MEDICATION ON ADMISSION: Lamotrigine

ALLERGIES: Iodine; Iodine Containing / Trileptal

PHYSICAL EXAM: T:97.0   BP:191/92    HR:83  RR:14     O2Sats:100%RA
Gen: WD/WN, comfortable, NAD.
HEENT: PERRL#5mm-->4.5mm bilat    EOMs- decreased upgaze
Neck: Supple.
Lungs: CTA bilaterally.
Cardiac: RRR. S1/S2.
Abd: distended
Extrem: Warm and well-perfused.
Neuro:
Mental status: Awake and alert, cooperative with exam, normal
affect.
Orientation: Oriented to person, place, and date.
Language: Speech fluent with good comprehension and repetition.
Naming intact. No dysarthria or paraphasic errors.

FAMILY HISTORY: Son with PKD

SOCIAL HISTORY: Patient lives at home with her husband.
Subdural hemorrhage,Polycystic kidney, autosomal dominant,Unspecified essential hypertension
Subdural hemorrhage,Polycyst kid-autosom dom,Hypertension NOS
Admission Date:  [**2145-12-27**]              Discharge Date:   [**2145-12-29**]

Date of Birth:  [**2085-7-5**]             Sex:   F

Service: NEUROSURGERY

Allergies:
Iodine; Iodine Containing / Trileptal

Attending:[**First Name3 (LF) 1835**]
Chief Complaint:
frequent falls

Major Surgical or Invasive Procedure:
s/p right subdural hematoma evacuation


History of Present Illness:
60F s/p aneurysm clipping and subsequent stroke in [**2136**] also
with PMH of polycystic kidney and liver disease presents to
emergency room with c/o dizziness/double vision and falls
x3-4days.  Denies any previous trauma except for a [**2136**]
in which she bumped her forehead and broke her arm.  There is no
trauma she can recall until 4 days prior to arrival pt was
bending over to pick something off floor and fell forward,
denies
hitting her head at that time.  Later that same day as she was
trying to get up from chair she fell again to floor. She c/o
2weeks of headaches (not bad enough to take anything for them),
dizziness and blurry vision 3 days prior to arrival which comes
and goes. She denies any new weakness, seizure, speech
difficulty, CP, SOB

Past Medical History:
PKD
Hemorrhagic stroke (cerebral aneurysm)
HTN

Social History:
Patient lives at home with her husband.


Family History:
Son with PKD


Physical Exam:
T:97.0   BP:191/92    HR:83  RR:14     O2Sats:100%RA
Gen: WD/WN, comfortable, NAD.
HEENT: PERRL#5mm-->4.5mm bilat    EOMs- decreased upgaze
Neck: Supple.
Lungs: CTA bilaterally.
Cardiac: RRR. S1/S2.
Abd: distended
Extrem: Warm and well-perfused.
Neuro:
Mental status: Awake and alert, cooperative with exam, normal
affect.
Orientation: Oriented to person, place, and date.
Language: Speech fluent with good comprehension and repetition.
Naming intact. No dysarthria or paraphasic errors.

Cranial Nerves:
I: Not tested
II: PERRL @5mm-->4.5mm bilat
III, IV, VI: EOMI w/ decreased upgaze
V, VII: Slight facial and sensation intact and symmetric.
VIII: Hearing intact to voice.
IX, X: Palatal elevation symmetrical.
[**Doctor First Name 81**]: Sternocleidomastoid and trapezius normal bilaterally.
XII: Tongue midline without fasciculations.

Motor: RUE paresis/RLE weakness from old stroke.  Otherwise good
bulk and tone.  LUE triceps 4+ otherwise left side strength 5

Sensation: Intact to light touch


Pertinent Results:
[**2145-12-27**] 10:44PM   TYPE-ART PO2-174* PCO2-37 PH-7.38 TOTAL
CO2-23 BASE XS--2 INTUBATED-INTUBATED VENT-CONTROLLED
[**2145-12-27**] 10:44PM   GLUCOSE-100 LACTATE-0.70 NA+-139 K+-3.3*
CL--112 TCO2-21
[**2145-12-27**] 10:44PM   HGB-9.2* calcHCT-28
[**2145-12-27**] 10:44PM   freeCa-1.08*
[**2145-12-27**] 08:55PM   PT-13.5* PTT-41.4* INR(PT)-1.2*
[**2145-12-27**] 06:00PM   GLUCOSE-85 UREA N-42* CREAT-2.4* SODIUM-136
POTASSIUM-3.9 CHLORIDE-99 TOTAL CO2-24 ANION GAP-17
[**2145-12-27**] 06:00PM   estGFR-Using this
[**2145-12-27**] 06:00PM   ALT(SGPT)-18 AST(SGOT)-22 LD(LDH)-182 ALK
PHOS-78 AMYLASE-144* TOT BILI-0.4
[**2145-12-27**] 06:00PM   LIPASE-101*
[**2145-12-27**] 06:00PM   ALBUMIN-4.6
[**2145-12-27**] 06:00PM   ALBUMIN-4.6
[**2145-12-27**] 06:00PM   ETHANOL-NEG
[**2145-12-27**] 06:00PM   WBC-5.5 RBC-3.32* HGB-10.9* HCT-31.1* MCV-94
MCH-32.9* MCHC-35.1* RDW-13.7
[**2145-12-27**] 06:00PM   NEUTS-66.0 LYMPHS-22.5 MONOS-7.0 EOS-3.9
BASOS-0.7
[**2145-12-27**] 06:00PM   NEUTS-66.0 LYMPHS-22.5 MONOS-7.0 EOS-3.9
BASOS-0.7
[**2145-12-27**] 06:00PM   PLT COUNT-202

Brief Hospital Course:
Pt admitted to emergency room after recent history of falls.  Pt
was taken from the emergency room directly to the operating room
where she underwent a right craniotomy for evacuation of right
subacute subdural hematoma.  Pt had no intraop complications.
To PACU postop where she remained overnoc for close vital sign
monitoring and requent neuro checks.  On postop day #1 pt was
transferred to the floor.  On postop day 1 and 2 pt was seen by
physical therapy and occupational therapy.  Both therapies
agreed with discharge home with home safety evaluation and
outpatient PT/OT.  On POD#2 pt was found to have red rash
covering entire back and back of legs, after consultation with
Dr [**Last Name (STitle) **] the patient was felt safe for discharge after a dose
of decadron and zantac.

Medications on Admission:
Lamotrigine

Discharge Medications:
1. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
Q4-6H (every 4 to 6 hours) as needed for pain.
Disp:*50 Tablet(s)* Refills:*0*
2. Outpatient Occupational Therapy
3. Outpatient Physical Therapy
4. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day): use while taking Percocet.
Disp:*40 Capsule(s)* Refills:*0*
5. Lamotrigine 100 mg Tablet Sig: One (1) Tablet PO BID (2 times
a day).
Disp:*60 Tablet(s)* Refills:*2*


Discharge Disposition:
Home With Service

Facility:
[**Location (un) 86**] VNA

Discharge Diagnosis:
Right subacute subdural hematoma


Discharge Condition:
good


Discharge Instructions:
Please call the office or come to the emergency room for any
change in mental status, worsening or new weakness, speech
difficulties or seizures.  Please call the office or come to the
emergency room for excessive redness or drainage from incision
site or fever >101.5.

Please where a shower cap when showering until stitches are
removed.

Continue dph as ordered
Please no driving while on narcotics.
Please continue home medications.  Do not take any blood
thinners, No aspirin, motrin, NSAIDS, coumadin

Followup Instructions:
Please call the office to make an appointment to have your
stitches out on [**2146-1-6**].  Please call ([**Telephone/Fax (1) 11314**] to make that
appointment.  You will also need to make an appointment for
followup in 4 weeks with Dr. [**Last Name (STitle) **] with a head CT.  The office
can arrange that appointment when you call.



Completed by:[**2145-12-29**]
{'Subdural hemorrhage,Polycystic kidney, autosomal dominant,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: frequent falls

PRESENT ILLNESS: 60F s/p aneurysm clipping and subsequent stroke in [**2136**] also
with PMH of polycystic kidney and liver disease presents to
emergency room with c/o dizziness/double vision and falls
x3-4days.  Denies any previous trauma except for a [**2136**]
in which she bumped her forehead and broke her arm.  There is no
trauma she can recall until 4 days prior to arrival pt was
bending over to pick something off floor and fell forward,
denies
hitting her head at that time.  Later that same day as she was
trying to get up from chair she fell again to floor. She c/o
2weeks of headaches (not bad enough to take anything for them),
dizziness and blurry vision 3 days prior to arrival which comes
and goes. She denies any new weakness, seizure, speech
difficulty, CP, SOB

MEDICAL HISTORY: PKD
Hemorrhagic stroke (cerebral aneurysm)
HTN

MEDICATION ON ADMISSION: Lamotrigine

ALLERGIES: Iodine; Iodine Containing / Trileptal

PHYSICAL EXAM: T:97.0   BP:191/92    HR:83  RR:14     O2Sats:100%RA
Gen: WD/WN, comfortable, NAD.
HEENT: PERRL#5mm-->4.5mm bilat    EOMs- decreased upgaze
Neck: Supple.
Lungs: CTA bilaterally.
Cardiac: RRR. S1/S2.
Abd: distended
Extrem: Warm and well-perfused.
Neuro:
Mental status: Awake and alert, cooperative with exam, normal
affect.
Orientation: Oriented to person, place, and date.
Language: Speech fluent with good comprehension and repetition.
Naming intact. No dysarthria or paraphasic errors.

FAMILY HISTORY: Son with PKD

SOCIAL HISTORY: Patient lives at home with her husband. 

### Response:
{'Subdural hemorrhage,Polycystic kidney, autosomal dominant,Unspecified essential hypertension'}
