CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 74-year-old
woman with chronic obstructive pulmonary disease, glaucoma,
rheumatoid arthritis, osteoarthritis, hypertension,
osteopenia, and status post right femoral bypass.  The
patient now presents with a fall and right hip pain.  The
patient lives in [**Location 7581**], [**State 531**], but was visiting her
daughter in the [**Name (NI) 86**] Area, when she noted a cold right
foot.  She was worked up and found to have peripheral
vascular disease.  She underwent right femoral bypass surgery
and was at a rehabilitation center after the bypass surgery.
She was standing at the bathroom sink when she fell.  She
denied any loss of consciousness, preceding symptoms, head
injury, chest pain, dizziness, abdominal pain, hemoptysis,
and the patient noted right hip pain after falling and
presented to [**Hospital1 69**].

MEDICAL HISTORY: History is as mentioned above.  The
patient also had an episode of deep venous thrombosis six
years ago, treated at [**Hospital **] Medical Center.

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: The patient has no family history of
clotting disorder.  Again, she lives in [**State 531**] and she was
visiting her daughter at [**Name (NI) 86**].  She recently quit smoking
on [**7-5**], and she denies any alcohol use.

SOCIAL HISTORY: 
Closed fracture of intertrochanteric section of neck of femur,Acute kidney failure, unspecified,Urinary tract infection, site not specified,Other emphysema,Anemia, unspecified,Unspecified essential hypertension,Cardiac pacemaker in situ,Fall from other slipping, tripping, or stumbling
Intertrochanteric fx-cl,Acute kidney failure NOS,Urin tract infection NOS,Emphysema NEC,Anemia NOS,Hypertension NOS,Status cardiac pacemaker,Fall from slipping NEC
Admission Date:  [**2130-7-28**]       Discharge Date:[**2130-8-2**]

Date of Birth:   [**2056-4-9**]       Sex:  F

Service:  [**Location (un) 259**]

HISTORY OF THE PRESENT ILLNESS:  The patient is a 74-year-old
woman with chronic obstructive pulmonary disease, glaucoma,
rheumatoid arthritis, osteoarthritis, hypertension,
osteopenia, and status post right femoral bypass.  The
patient now presents with a fall and right hip pain.  The
patient lives in [**Location 7581**], [**State 531**], but was visiting her
daughter in the [**Name (NI) 86**] Area, when she noted a cold right
foot.  She was worked up and found to have peripheral
vascular disease.  She underwent right femoral bypass surgery
and was at a rehabilitation center after the bypass surgery.
She was standing at the bathroom sink when she fell.  She
denied any loss of consciousness, preceding symptoms, head
injury, chest pain, dizziness, abdominal pain, hemoptysis,
and the patient noted right hip pain after falling and
presented to [**Hospital1 69**].

PAST MEDICAL HISTORY:  History is as mentioned above.  The
patient also had an episode of deep venous thrombosis six
years ago, treated at [**Hospital **] Medical Center.

FAMILY HISTORY:  The patient has no family history of
clotting disorder.  Again, she lives in [**State 531**] and she was
visiting her daughter at [**Name (NI) 86**].  She recently quit smoking
on [**7-5**], and she denies any alcohol use.

MEDICATIONS AS AN OUTPATIENT:
1.  Atrovent.
2.  Lasix.
3.  Colace.
4.  Plavix.
5.  Metoprolol.
6.  Prednisone.
7.  Eye drops for glaucoma.
8.  Lisinopril 7.5 q.d.
9.  Protonix
10. ..................
11. Nicotine patch.
12. Subcutaneous heparin in rehabilitation.
13. The patient was finishing up a course of Keflex for
cellulitis, day 8 of 10.

PHYSICAL EXAMINATION:  On examination, the patient was
afebrile with a temperature of 97.8, heart rate 98, breathing
at a rate of 22, blood pressure 116/62, saturating 95% on
room air.  She was a thin, elderly woman in no acute
distress.  Physical examination was significant for arcus
senilis on eye examination.  NECK:  She had a supple neck; no
bruits, no JVD, no palpable masses in the neck.  LUNGS:
Lungs were clear bilaterally.  HEART:  Regular rate and
rhythm, S1 and S2, no murmurs, rubs, or gallops.  ABDOMEN:
Nontender, soft, positive bowel sounds, and no organomegaly.
EXTREMITIES:  The right leg was shortened and externally
rotated.

LABORATORY DATA:  Laboratory data revealed the following:
White count 13.5, hematocrit of 35.4, platelet count of 507.
Sodium 133 and 7.3 potassium; however the sample was
hemolyzed.  Chloride 97, bicarbonate 26, BUN and creatinine
26 and 0.6, glucose 101.  PT was 12, PTT 28.1, INR 1.  The
urinalysis was significant for 30 white blood cells, few
bacteria, 6 to 10 epithelial cells.

On chest x-ray, she had hyperinflated lungs, no pneumothorax,
no rib fracture, no pulmonary effusion, and also significant
on chest x-ray were demineralized bones,  Hip film:  The
patient had nondisplaced intertrochanteric femur fracture.
Chest CT with contrast showed no PE, no pneumothorax, again
spinal demineralization.  The patient also had hepatic cysts,
positive gallstones, calcified aorta, emphysematous changes,
and enlarged right thyroid.

EKG:  EKG showed LVH unchanged from previous T-wave
flattening in one.

HOSPITAL COURSE:  This is a 74-year-old woman admitted for
right hip fracture.  She underwent open reduction and
internal fixation surgery by the Department of Orthopedics.
She did well postoperatively with good pain control with PCA
morphine.  She was then switched to OxyContin 80 mg b.i.d.
with good pain control and the OxyContin was decreased to
60  mg PO b.i.d. with Oxycodone for breakthrough pain.

Hospital course was significant for anemia for which she has
had a longstanding history; acute renal failure, which
resolved with IV hydration and holding of Lasix; and
asymptomatic UTI diagnosed by urinalysis with urine culture
pending.

The patient was transfused with a total of two units of
packed red blood cells during this hospital stay with
appropriate rises in her hematocrit.  Creatinine on [**8-1**], went to 1.0 from her baseline of 0.4.  She was given IV
hydration.  Lasix was held.  She was taking poor POs at that
time and with IV hydration and holding of Lasix, the
creatinine went back down to 0.5 the next day.  Urinalysis
showed moderate leukocyte esterase with white blood cells,
hazy appearance.  The patient was started on Cipro 250 mg PO
b.i.d. to be continued until [**2130-8-7**].  Urine
culture is still pending.  The patient remained stable.  The
patient was screen by rehabilitation and the patient is to be
discharged to rehabilitation in good condition with the
diagnosis of right hip fracture.  She is to be discharged on
the following medications:

DISCHARGE MEDICATIONS:
1.  Atrovent two puffs q.i.d.
2.  Colace 100 mg PO b.i.d.
3.  Senna one to two tablets PO t.i.d.
4.  Coumadin 2.5 mg PO q.d.
5.  Metoprolol 12.5 mg PO b.i.d.
6.  Prednisone 2.5 mg PO q.d. for rheumatoid arthritis.
7.  Latanoprost one drop OD q.h.s.
8.  Betaxolol HCL 0.25% one drop to both eyes q.a.m.
9.  Lisinopril 7.5 mg PO q.d.
10. Protonix 40 mg PO q.d.
11. Nicotine patch 14 mg transdermally q.d.
12. Lovenox 30 mg subcutaneously b.i.d.
13. Calcitonin 200 IU, intranasal q.d.
14. Calcium carbonate 500 mg PO q.d.
15. OxyContin 60 mg PO b.i.d.
16. Oxycodone 5 mg to 10 PO q.4h.to 6h.p.r.n.pain.
17. Ciprofloxacin 250 mg PO b.i.d. to be finished, last day
[**2130-8-7**].
18. Plavix 75 mg PO q.d.

The patient is to be weaned off OxyContin.  OxyContin can be
decreased to 40 mg b.i.d. if the patient has not been asking
for oxycodone breakthrough pain and then to 20 mg PO b.i.d.,
and then to 10 mg and then to be discontinued with Oxycodone
p.r.n.pain.  The patient's staples from the hip surgery are
to be removed on [**2130-8-12**].  Lovenox is to be
continued until the INR reaches the therapeutic goal of 1.5
to 2.0 on Coumadin at which point Lovenox can be
discontinued.  Please check INR every day.  Coumadin is to be
continued until the patient follows up with Dr. [**Last Name (STitle) 284**],
Orthopedic Surgeon on [**8-24**].  Decision to stop
Coumadin will be deferred to Dr. [**Last Name (STitle) 284**].  The patient has
a follow-up appointment with Dr. [**Last Name (STitle) 284**] in [**Hospital Ward Name 23**] [**Location (un) 25799**] on [**2130-8-24**] at 9 AM.  Phone #:
[**Telephone/Fax (1) 33838**].

                            [**Name6 (MD) 7853**] [**Last Name (NamePattern4) 7854**], M.D.
[**MD Number(1) 7855**]

Dictated By:[**Name8 (MD) 15578**]
MEDQUIST36
D:  [**2130-8-2**]  09:34
T:  [**2130-8-2**]  10:11
JOB#:  [**Job Number 43825**]
{'Closed fracture of intertrochanteric section of neck of femur,Acute kidney failure, unspecified,Urinary tract infection, site not specified,Other emphysema,Anemia, unspecified,Unspecified essential hypertension,Cardiac pacemaker in situ,Fall from other slipping, tripping, or stumbling'}


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 74-year-old
woman with chronic obstructive pulmonary disease, glaucoma,
rheumatoid arthritis, osteoarthritis, hypertension,
osteopenia, and status post right femoral bypass.  The
patient now presents with a fall and right hip pain.  The
patient lives in [**Location 7581**], [**State 531**], but was visiting her
daughter in the [**Name (NI) 86**] Area, when she noted a cold right
foot.  She was worked up and found to have peripheral
vascular disease.  She underwent right femoral bypass surgery
and was at a rehabilitation center after the bypass surgery.
She was standing at the bathroom sink when she fell.  She
denied any loss of consciousness, preceding symptoms, head
injury, chest pain, dizziness, abdominal pain, hemoptysis,
and the patient noted right hip pain after falling and
presented to [**Hospital1 69**].

MEDICAL HISTORY: History is as mentioned above.  The
patient also had an episode of deep venous thrombosis six
years ago, treated at [**Hospital **] Medical Center.

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: The patient has no family history of
clotting disorder.  Again, she lives in [**State 531**] and she was
visiting her daughter at [**Name (NI) 86**].  She recently quit smoking
on [**7-5**], and she denies any alcohol use.

SOCIAL HISTORY:  

### Response:
{'Closed fracture of intertrochanteric section of neck of femur,Acute kidney failure, unspecified,Urinary tract infection, site not specified,Other emphysema,Anemia, unspecified,Unspecified essential hypertension,Cardiac pacemaker in situ,Fall from other slipping, tripping, or stumbling'}
