CHIEF COMPLAINT: CC:[**CC Contact Info 63379**]
Major Surgical or Invasive Procedure:
Intubation
Upper Endoscopy

PRESENT ILLNESS: HPI:
38 yo male with hx of suicide attempts initially presented to
[**Hospital1 18**] after a suicide attempt with ? 12 clonazepam and endorsing
suicidal ideation. While in the ED, he revealed that he had
ingested broken glass. Of note, the patient was recently
discharged from [**Hospital1 2177**] on [**10-5**] after ingesting broken glass and [**10-1**]
for ingesting razor blades. He has a history of swallowing glass
and razor blades. He had an EGD here in [**2196**] after he swallowed
multiple razor blades. Denied hematemesis or LGIB. Denied any
lightheadedness. He does note diffuse abdominal pain. Denies
nausea, vomiting.
.
In the ED:
-urine tox- positive for cocaine
- 2mg IV morphine for abdominal pain
-portable CXR, abdomen negative for free air, or glass
-PA and lat - no free air, no glass seen, no widened mediastinum
- GI saw patient and will scope tonight
- admitted to MICU for upper endoscopy

MEDICAL HISTORY: - suicide attempt
- swallowing glass and razor blades
- bipolar
- depression
- splenectomy

MEDICATION ON ADMISSION: protonix 40mg daily
seroquel 300mg qhs and 25mg [**Hospital1 **]
depakote 1000mg QDay
Inderal 20mg daily

ALLERGIES: Haldol

PHYSICAL EXAM: VS: T: 96.7 BP: 102/66 HR: 66 RR: 12  O2: 99% on RA
HEENT: normocephalic, anicteric, PERRLA, EOMI, no pharyngeal
injection, exudate, neck supple, dentition fair, no LAD, no
thyromegaly
CV: +s1+s2 RRR
PULM: CTA B/L No RRW
ABD:
EXT: no clubbing, no edema

FAMILY HISTORY: father [**Name (NI) 63380**]
sister with depression and psychiatric hospitalizations

SOCIAL HISTORY: The patient reports that he was born in the [**Location (un) 86**] area and the
youngest of 3, he has 2 older sisters. His father was an abusive
alcoholic and his mother was extremely abusive to the children.
He said "she burned my hands and all kind of things." His mother
placed all her children in a catholic institution when he was 3
where he was sexually abused by a priest. [**Name (NI) **] sued the
Archdiocesan and was awarded $350,000 which he says is in a
trust. He was adopted at age 12 and was abused by his adoptive
mother. At one point he went to [**State 4565**] to live with his
biological mother and graduated from High School in [**Location (un) 11177**]
after attending 3 high schools. He has worked in banks,retail,
as a model, a stripper , selling cars but is now on disability.
He
is close with a family in [**Hospital1 **] who he refers to as his
godparents and also to one of his sisters. [**Name (NI) **] currently lives
alone in [**Location (un) 4310**], never married and no children.
.
- smokes [**1-30**] PPD, recreational cocaine and marijuana use;
occasional EtOH use
Foreign body in intestine and colon,Suicide and self-inflicted injury by other specified means,Internal injury to unspecified or ill-defined organs without mention of open wound into cavity,Poisoning by benzodiazepine-based tranquilizers,Suicide and self-inflicted poisoning by tranquilizers and other psychotropic agents,Cocaine abuse, unspecified,Unspecified essential hypertension,Other specified gastritis, without mention of hemorrhage,Borderline personality disorder,Lack of housing,Depressive disorder, not elsewhere classified
FB in intestine & colon,Injury-NEC,Internal inj NOS-closed,Pois-benzodiazepine tran,Poison-psychotropic agt,Cocaine abuse-unspec,Hypertension NOS,Oth spf gstrt w/o hmrhg,Borderline personality,Lack of housing,Depressive disorder NEC
Admission Date:  [**2198-10-7**]              Discharge Date:   [**2198-10-12**]

Date of Birth:  [**2159-12-27**]             Sex:   M

Service: MEDICINE

Allergies:
Haldol

Attending:[**First Name3 (LF) 2297**]
Chief Complaint:
CC:[**CC Contact Info 63379**]
Major Surgical or Invasive Procedure:
Intubation
Upper Endoscopy

History of Present Illness:
HPI:
38 yo male with hx of suicide attempts initially presented to
[**Hospital1 18**] after a suicide attempt with ? 12 clonazepam and endorsing
suicidal ideation. While in the ED, he revealed that he had
ingested broken glass. Of note, the patient was recently
discharged from [**Hospital1 2177**] on [**10-5**] after ingesting broken glass and [**10-1**]
for ingesting razor blades. He has a history of swallowing glass
and razor blades. He had an EGD here in [**2196**] after he swallowed
multiple razor blades. Denied hematemesis or LGIB. Denied any
lightheadedness. He does note diffuse abdominal pain. Denies
nausea, vomiting.
.
In the ED:
-urine tox- positive for cocaine
- 2mg IV morphine for abdominal pain
-portable CXR, abdomen negative for free air, or glass
-PA and lat - no free air, no glass seen, no widened mediastinum
- GI saw patient and will scope tonight
- admitted to MICU for upper endoscopy

Past Medical History:
- suicide attempt
- swallowing glass and razor blades
- bipolar
- depression
- splenectomy

Social History:
The patient reports that he was born in the [**Location (un) 86**] area and the
youngest of 3, he has 2 older sisters. His father was an abusive
alcoholic and his mother was extremely abusive to the children.
He said "she burned my hands and all kind of things." His mother
placed all her children in a catholic institution when he was 3
where he was sexually abused by a priest. [**Name (NI) **] sued the
Archdiocesan and was awarded $350,000 which he says is in a
trust. He was adopted at age 12 and was abused by his adoptive
mother. At one point he went to [**State 4565**] to live with his
biological mother and graduated from High School in [**Location (un) 11177**]
after attending 3 high schools. He has worked in banks,retail,
as a model, a stripper , selling cars but is now on disability.
He
is close with a family in [**Hospital1 **] who he refers to as his
godparents and also to one of his sisters. [**Name (NI) **] currently lives
alone in [**Location (un) 4310**], never married and no children.
.
- smokes [**1-30**] PPD, recreational cocaine and marijuana use;
occasional EtOH use


Family History:
father [**Name (NI) 63380**]
sister with depression and psychiatric hospitalizations

Physical Exam:
VS: T: 96.7 BP: 102/66 HR: 66 RR: 12  O2: 99% on RA
HEENT: normocephalic, anicteric, PERRLA, EOMI, no pharyngeal
injection, exudate, neck supple, dentition fair, no LAD, no
thyromegaly
CV: +s1+s2 RRR
PULM: CTA B/L No RRW
ABD:
EXT: no clubbing, no edema

Pertinent Results:
DATA:
EKG: NSR @ 77. Normal axis and intervals. No ST-T wave changes.
.
CXR: [**2198-10-7**]:
No evidence of radiopaque foreign object. No subdiaphragmatic
free air. A lateral radiograph is recommended to further and
more closely assess the esophagus.
.
ABd XRay: [**2198-10-7**]:
FINDINGS: On this single supine view, the presence of free air
cannot be directly assessed. The bowel gas pattern is
unremarkable. No air-fluid levels or distended loops of small
bowel are present. Limited views of the hips and sacroiliac
joints are unremarkable
.

[**2198-10-7**] 01:10AM   GLUCOSE-86 UREA N-16 CREAT-1.0 SODIUM-143
POTASSIUM-3.7 CHLORIDE-102 TOTAL CO2-23 ANION GAP-22*
[**2198-10-7**] 01:10AM   ALT(SGPT)-63* AST(SGOT)-66* LD(LDH)-251* ALK
PHOS-73 AMYLASE-40 TOT BILI-0.3
[**2198-10-7**] 01:10AM   LIPASE-19
[**2198-10-7**] 01:10AM   ALBUMIN-4.6
[**2198-10-7**] 01:10AM   WBC-11.4*# RBC-4.50* HGB-14.5 HCT-41.6 MCV-92
MCH-32.2* MCHC-34.9 RDW-14.3
[**2198-10-7**] 01:10AM   NEUTS-60.5 LYMPHS-33.1 MONOS-5.4 EOS-0.7
BASOS-0.3
[**2198-10-7**] 01:10AM   PLT COUNT-340
[**2198-10-7**] 08:30AM URINE  bnzodzpn-POS barbitrt-NEG opiates-NEG
cocaine-POS amphetmn-NEG mthdone-NEG

Brief Hospital Course:
#multiple ingestions of objects - Patient was initially admitted
for ingestion of glass and klonapin.  While in house he
additionally ingested metal pieces from a coke can and pieces of
a lighter.  He was taken for endoscopy mulitple times by GI.
They were able to remove some metal fragments, but not all of
the pieces.  He was followed in house with serial HCTs and
abdominal exams.  HCT and the abdominal exams were stable
Surgery was consulted and they declined intervention.  The
patient left against medical advice after the risks were
explained to him.  He stated that if he had a problem, he would
go to the emergency room.
.
# Psych:  Psych was consulted for the patients intial suicide
attempt.  He was placed on a 1:1 sitter while in house.  Because
of the patient's extensive history, psych did not believe that
he was a candidate for inpatient psychiatric hospitalization.
Please see the psychiatric note in OMR dated [**2198-10-12**] from Dr.
[**Last Name (STitle) **] for an extensive review of his psychiaric history.  They
also stated he could not be held against his will.  At the time
of discharge, the patient stated that he did not have any plans
to hurt himself or others.
.
# Abdominal Pain-  Patient was found to have erosive
gastritis/duodenitis on EGD.  He was continued on a PPI [**Hospital1 **].
.
#HTN- Patient was initially admitted on inderal for control of
his hypertension.  It was stopped in house so his vital signs
could be closely followed in case he developed an obstruction or
perforation.  He left AMA before an alternative antihypertensive
could be discussed.  However, inderal is a poor choice in this
patient with active use of cocaine.


Medications on Admission:
protonix 40mg daily
seroquel 300mg qhs and 25mg [**Hospital1 **]
depakote 1000mg QDay
Inderal 20mg daily

Discharge Disposition:
Home

Discharge Diagnosis:
Multiple ingestions of foreign bodies

Discharge Condition:
Patient left against medical advice


Completed by:[**2198-10-12**]
{'Foreign body in intestine and colon,Suicide and self-inflicted injury by other specified means,Internal injury to unspecified or ill-defined organs without mention of open wound into cavity,Poisoning by benzodiazepine-based tranquilizers,Suicide and self-inflicted poisoning by tranquilizers and other psychotropic agents,Cocaine abuse, unspecified,Unspecified essential hypertension,Other specified gastritis, without mention of hemorrhage,Borderline personality disorder,Lack of housing,Depressive disorder, not elsewhere classified'}


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: CC:[**CC Contact Info 63379**]
Major Surgical or Invasive Procedure:
Intubation
Upper Endoscopy

PRESENT ILLNESS: HPI:
38 yo male with hx of suicide attempts initially presented to
[**Hospital1 18**] after a suicide attempt with ? 12 clonazepam and endorsing
suicidal ideation. While in the ED, he revealed that he had
ingested broken glass. Of note, the patient was recently
discharged from [**Hospital1 2177**] on [**10-5**] after ingesting broken glass and [**10-1**]
for ingesting razor blades. He has a history of swallowing glass
and razor blades. He had an EGD here in [**2196**] after he swallowed
multiple razor blades. Denied hematemesis or LGIB. Denied any
lightheadedness. He does note diffuse abdominal pain. Denies
nausea, vomiting.
.
In the ED:
-urine tox- positive for cocaine
- 2mg IV morphine for abdominal pain
-portable CXR, abdomen negative for free air, or glass
-PA and lat - no free air, no glass seen, no widened mediastinum
- GI saw patient and will scope tonight
- admitted to MICU for upper endoscopy

MEDICAL HISTORY: - suicide attempt
- swallowing glass and razor blades
- bipolar
- depression
- splenectomy

MEDICATION ON ADMISSION: protonix 40mg daily
seroquel 300mg qhs and 25mg [**Hospital1 **]
depakote 1000mg QDay
Inderal 20mg daily

ALLERGIES: Haldol

PHYSICAL EXAM: VS: T: 96.7 BP: 102/66 HR: 66 RR: 12  O2: 99% on RA
HEENT: normocephalic, anicteric, PERRLA, EOMI, no pharyngeal
injection, exudate, neck supple, dentition fair, no LAD, no
thyromegaly
CV: +s1+s2 RRR
PULM: CTA B/L No RRW
ABD:
EXT: no clubbing, no edema

FAMILY HISTORY: father [**Name (NI) 63380**]
sister with depression and psychiatric hospitalizations

SOCIAL HISTORY: The patient reports that he was born in the [**Location (un) 86**] area and the
youngest of 3, he has 2 older sisters. His father was an abusive
alcoholic and his mother was extremely abusive to the children.
He said "she burned my hands and all kind of things." His mother
placed all her children in a catholic institution when he was 3
where he was sexually abused by a priest. [**Name (NI) **] sued the
Archdiocesan and was awarded $350,000 which he says is in a
trust. He was adopted at age 12 and was abused by his adoptive
mother. At one point he went to [**State 4565**] to live with his
biological mother and graduated from High School in [**Location (un) 11177**]
after attending 3 high schools. He has worked in banks,retail,
as a model, a stripper , selling cars but is now on disability.
He
is close with a family in [**Hospital1 **] who he refers to as his
godparents and also to one of his sisters. [**Name (NI) **] currently lives
alone in [**Location (un) 4310**], never married and no children.
.
- smokes [**1-30**] PPD, recreational cocaine and marijuana use;
occasional EtOH use 

### Response:
{'Foreign body in intestine and colon,Suicide and self-inflicted injury by other specified means,Internal injury to unspecified or ill-defined organs without mention of open wound into cavity,Poisoning by benzodiazepine-based tranquilizers,Suicide and self-inflicted poisoning by tranquilizers and other psychotropic agents,Cocaine abuse, unspecified,Unspecified essential hypertension,Other specified gastritis, without mention of hemorrhage,Borderline personality disorder,Lack of housing,Depressive disorder, not elsewhere classified'}
