CHIEF COMPLAINT: right carotid body tumor

PRESENT ILLNESS: 56F with a known right carotid body tumor.  This was first
identified back in [**2149**] when she saw Dr. [**First Name (STitle) **] [**Name (STitle) 2719**] for a
right-sided shoulder and neck pain and he identified a mass in
her carotid which proved to be a carotid body tumor.  She was
subsequently seen by Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 1837**] in [**2152**] and he
advised resection of the tumor as it had been enlarging but she
had deferred.  She has recently developed increasing pain in the
side and difficulty lying on that side of her neck with some
discomfort, although no dysphagia and has finally agreed to have
surgery.

MEDICAL HISTORY: hypothyroidism, anxiety

MEDICATION ON ADMISSION: 1. Levothyroxine 25 mcg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
2. Trazodone  Oral
3. Cetirizine 5 mg Tablet Oral
4. Omeprazole (patient reports not taking)

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Discharge day:

FAMILY HISTORY: Noncontributory

SOCIAL HISTORY: Nonsmoker, lives with husband, no IVDU, no heavy EtOH use.
Malignant neoplasm of carotid body,Unspecified acquired hypothyroidism,Anxiety state, unspecified
Mal neo carotid body,Hypothyroidism NOS,Anxiety state NOS
Admission Date:  [**2154-8-21**]              Discharge Date:   [**2154-8-25**]

Date of Birth:  [**2098-4-5**]             Sex:   F

Service: SURGERY

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 2597**]
Chief Complaint:
right carotid body tumor

Major Surgical or Invasive Procedure:
[**2154-8-21**] - coil embolization of right carotid body tumor
[**2154-8-22**] - resection of right carotid body tumor


History of Present Illness:
56F with a known right carotid body tumor.  This was first
identified back in [**2149**] when she saw Dr. [**First Name (STitle) **] [**Name (STitle) 2719**] for a
right-sided shoulder and neck pain and he identified a mass in
her carotid which proved to be a carotid body tumor.  She was
subsequently seen by Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 1837**] in [**2152**] and he
advised resection of the tumor as it had been enlarging but she
had deferred.  She has recently developed increasing pain in the
side and difficulty lying on that side of her neck with some
discomfort, although no dysphagia and has finally agreed to have
surgery.

Past Medical History:
hypothyroidism, anxiety

Social History:
Nonsmoker, lives with husband, no IVDU, no heavy EtOH use.

Family History:
Noncontributory

Physical Exam:
Discharge day:

97.5  70  134/76  16  98RA
Gen NAD
HEENT R neck incision site clean/dry/intact; CN 2-12 intact
CV RRR
Chest CTAB
Abd soft, nontender, nondistended
Ext WWP; 2+ pulses at DP/PT b/l; strength/sensation equal and
intact bilaterally with the exception of mild R hand grip
weakness, stable since previous rotator cuff surgery

Brief Hospital Course:
Ms. [**Known lastname 22107**] was admitted to the vascular surgery service on
[**2154-8-21**] following embolization of her known right carotid body
tumor by the interventional radiology department.  She was
monitored in the CVICU overnight and found to be neurologically
intact and stable.  In the morning of [**2154-8-22**] she underwent an
uncomplicated resection of the right carotid body tumor.
Postoperatively she complained of chest pain which appeared to
be reproducible on palpation; an EKG and cardiac enzymes were
negative and the chest pain was self-limited.  On the evening of
POD #0 she did demonstrate a mild right mouth droop.  In
addition her right hand grip was slightly weak, however the
patient reported this was her baseline since having had right
rotator cuff surgery in [**2150**].  She remained otherwise
neurologically intact and her pain was well-controlled with
tylenol.

On POD# [**1-23**] she did complain of intermittent mild frontal
headaches which were alleviated with tylenol.  The ENT service
followed the patient throughout her admission and did a
postoperative laryngoscopy (see OMR for full report).  She
underwent a speech and swallow evaluation and was delared safe
for pureed solids and thin liquids.

On POD #3 the JP drain in her neck was removed.  She was able to
tolerate a diet and swallow her pills without difficulty.  She
denied pain and she was able to ambulate without difficulty.
She was discharged to home in good condition with scheduled
follow-up with [**Hospital **] clinic, vascular surgery clinic, and
speech/swallow clinic.

Medications on Admission:
1. Levothyroxine 25 mcg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
2. Trazodone  Oral
3. Cetirizine 5 mg Tablet Oral
4. Omeprazole (patient reports not taking)

Discharge Medications:
1. Levothyroxine 25 mcg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
2. Trazodone  Oral
3. Cetirizine 5 mg Tablet Oral
4. Percocet 5-325 mg Tablet Sig: 1-2 Tablets PO every four (4)
hours as needed for pain.
Disp:*30 Tablet(s)* Refills:*0*
5. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day) as needed for constipation: Use while taking
percocet for pain.
Disp:*60 Capsule(s)* Refills:*0*


Discharge Disposition:
Home

Discharge Diagnosis:
right carotid body tumor


Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.


Discharge Instructions:
Please call Dr.[**Name (NI) 5695**] office or Dr.[**Name (NI) 20390**]
office if you experience fevers, chills, nausea, vomiting, chest
pain, shortness of breath, weakness in face or arms, difficulty
speaking, hoarseness, or increasing redness or drainage from the
incision site.

You may remove bandages or dressings in 24 hours.  You may
shower and bathe as desired.  You may resume your normal
activities, however it is normal to feel somewhat tired for the
first several days after surgery.

Do not drive while you are taking percocet (narcotic pain
medication).

Continue a pureed solids / thin liquids diet until your
follow-up speech and swallow appointment.

Followup Instructions:
Provider: [**First Name4 (NamePattern1) 177**] [**Last Name (NamePattern1) **], MD Phone:[**Telephone/Fax (1) 41**]
Date/Time:[**2154-8-30**] 3:20

Provider: [**First Name11 (Name Pattern1) 1112**] [**Last Name (NamePattern4) 2604**], MD Phone:[**Telephone/Fax (1) 1237**]
Date/Time:[**2154-9-9**] 2:30

Speech/swallow eval: call [**Telephone/Fax (1) 3731**] to schedule appointment
{'Malignant neoplasm of carotid body,Unspecified acquired hypothyroidism,Anxiety state, unspecified'}


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: right carotid body tumor

PRESENT ILLNESS: 56F with a known right carotid body tumor.  This was first
identified back in [**2149**] when she saw Dr. [**First Name (STitle) **] [**Name (STitle) 2719**] for a
right-sided shoulder and neck pain and he identified a mass in
her carotid which proved to be a carotid body tumor.  She was
subsequently seen by Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 1837**] in [**2152**] and he
advised resection of the tumor as it had been enlarging but she
had deferred.  She has recently developed increasing pain in the
side and difficulty lying on that side of her neck with some
discomfort, although no dysphagia and has finally agreed to have
surgery.

MEDICAL HISTORY: hypothyroidism, anxiety

MEDICATION ON ADMISSION: 1. Levothyroxine 25 mcg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
2. Trazodone  Oral
3. Cetirizine 5 mg Tablet Oral
4. Omeprazole (patient reports not taking)

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Discharge day:

FAMILY HISTORY: Noncontributory

SOCIAL HISTORY: Nonsmoker, lives with husband, no IVDU, no heavy EtOH use. 

### Response:
{'Malignant neoplasm of carotid body,Unspecified acquired hypothyroidism,Anxiety state, unspecified'}
