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Nov 7 10:24
• Patient undergoing cABG. At termination of the procedure due to abnormal ____ the sm
+ wav :)
Tue Nov 21 01:16:08 2017 wav :)
patient is getting 2 units of fresh frozen plasma.
** • wav does not match - nm
Tue Nov 21 01:17:43 2017 nm

**** • try refreshing with Ctrl-F5. - billybob
Tue Nov 21 02:40:10 2017 billybob

**** • strange when i listened it matched. Oh well I found it. Thanks though. - :)
Tue Nov 21 02:11:54 2017 :)


• Really difficult ESL doing patch repair of ASD
+ RMT
Mon Nov 20 13:00:16 2017 RMT
The patient has a large atrial septal defect with a ???? S/L QP vacuoles of 2.3. After discussing risks and benefits, she consented to the procedure.

I'm not sure what is normally heard here, and Google isn't helping thus far. I'm off to search archives, but just in case I hit a wall, I thought I'd go ahead and post.
** • Googling is showing Qp which is referring to pulmonary flow....and + Questyr
Mon Nov 20 13:16:08 2017 Questyr
they also talk about a Qp:Qs ratio (or Qp/Qs ratio)...so I'm wondering if the sound of vacuole may be some words that include the word flow? where ole=flow? (see general link about Qp
**** • Thank you, Questyr! I think you're right. I relistened, and now I believe I am hearing + RMT
Mon Nov 20 13:21:04 2017 RMT
a Qp by Qs of 2.3, so Qp:Qs makes sense to me.
****** • Great! - Q
Mon Nov 20 13:22:15 2017 Q

**** • or may be "Qp value of" - Q
Mon Nov 20 13:20:28 2017 Q


• med s/l miranem
+ ?
Mon Nov 20 12:04:16 2017 ?
The patient is an 80-year-old right handed man brought to the emergency room after an episode of cardiac respiratory arrest. The patient does have a history of type 2 diabetes mellitus, hypertension, and hyperlipidemia. Cooling protocol was applied. The patient is now intubated, no new vent in the ICU.

MEDICATIONS: The patient is on Lacri-Lube ophthalmic ointment, aspirin 81 mg, Lipitor 10 mg, Peridex 0.12%, Pepcid, TriCor insulin, Ativan, fentanyl, Vibramycin, _____, Lipitor, Levophed, Ativan, and heparin subcu.

** • flagging - -
Mon Nov 20 12:22:08 2017 -


• CT Of the abdomen and pelvis showed
+ Dee
Mon Nov 20 11:27:29 2017 Dee
Of the abdomen and pelvis showed several small paraaortic s/l empiric ever lymph nodes
** • ....showed several small paraaortic and paracaval lymph nodes? - mn
Mon Nov 20 11:32:50 2017 mn

**** • Yes. Thank you! - n m l a i h
Mon Nov 20 12:25:14 2017 n m l a i h


• How is this transcribed? "mg/m2 body surface area/days"
+ mp3
Mon Nov 20 11:24:34 2017 mp3
He was then placed on flecainide 20 mg/mL suspension taking 0.7 mL or 14 mg by mouth every 8 hours, which is 80-90 mg_____.
** • What were the actual words he used? mg slash meters squared etc? or mg per meter squared + Questyr
Mon Nov 20 12:19:17 2017 Questyr
etc? ....give the dictated line all the way to the end of your quote.
**** • I posted an mp3. He said "milligrams per m2 body surface area slash days." - op
Mon Nov 20 15:43:33 2017 op

****** • There are 2 issues...see message + Questyr
Mon Nov 20 16:26:16 2017 Questyr
1. If you follow BoS2 it says in situations where superscripting cannot be done, that you should avoid putting the numeral on the line (in your example m2, which stands for meters squared). It says to use the abbreviation...in your case.... sq m
2. Also it says not to use the slash (also called virgule) for non technical terms ....(in your case....body surface area)

Put those two together and you would end up with:
80-90 mg/sq m body surface area per days



******** • ... - thanks
Mon Nov 20 18:00:34 2017 thanks


• We placed a *muscle* patch and DuraGen and Evicel over the dural sac
+ sm
Mon Nov 20 11:08:23 2017 sm
At this point, we appreciated a small durotomy around L5 nerve root. We primarily repaired this 6-0 Gore-Tex and no CSF leak was appreciated. A valsalva maneuver was performed. No CSF leak was appreciated. At this point, we thoroughly irrigated the wound. We placed a ______ patch and DuraGen and Evicel over the dural sac. We then closed the muscle and fascial layer with 0 PDS stitches in multiple layers. We closed the subcuticular layer with 2-0 PDS stitches. We closed the skin layer with nylon. After this, sterile dressing was placed. The patient was gently transferred to the hospital bed. The patient was extubated in the operating room and grossly moving all extremities prior to be transferred to recovery.
** • Yes. See PubMed article link + Questyr
Mon Nov 20 12:21:50 2017 Questyr
link
** • flagging - -
Mon Nov 20 11:53:45 2017 -


• appropriate amount of *version*, an extramedullary
+ sm
Mon Nov 20 10:49:49 2017 sm
At this point, the rotator interval was incised. The biceps was transected proximally within the level of the glenohumeral joint, at which point the subscapularis tendon was elevated off the bone. Tagging sutures #2 FiberWire sutures were placed into the subscapularis and elevated, at which point with the appropriate amount of _____, an extramedullary guide was used to cut the humeral head. At this point, I reamed to a size 10 and then broached to a size 10 in the appropriate amount of retroversion.
** • yes, version is correct - k e k l l f
Mon Nov 20 11:36:44 2017 k e k l l f

**** • thanks - -
Mon Nov 20 11:53:19 2017 -


• standard 0 Polyethylene *note* standard tray
+ ?
Mon Nov 20 10:48:40 2017 ?
IMPLANTS USED: Biomet comprehensive reverse total shoulder stem size 10, mini baseplate size 36 glenosphere, and standard 0 Polyethylene _____ standard tray.

PREOPERATIVE DIAGNOSES:
1. Right glenohumeral arthritis.
2. Right rotator cuff tear.

** • Could be. This link describing the surgical technique indicates + Questyr
Mon Nov 20 12:34:33 2017 Questyr
there is an inverse/reverse instrument tray used in addition to a standard tray (of instruments). (Type in...standard tray... in the Find Box at the top of the page to reach the proper section)
**** • Also, I would put a comma after polypropylene - Q
Mon Nov 20 12:35:03 2017 Q

** • flagged - nm
Mon Nov 20 11:53:31 2017 nm


• requiring volume *influsion* (should this be infusion - doesn't quite s/l it) Neo-
+ sm
Mon Nov 20 09:49:06 2017 sm
Pacemaker placement

Pocket wound was then closed subcutaneously with double running layers of #2-0 Vicryl suture and skin closure was performed with a #4-0 Monocryl running subcuticular suture, followed by Steri-Strips and dry sterile dressing. The patient had some blood pressure issues at the end of the procedure related to his hypertrophic cardiomyopathy requiring volume *influsion* and Neo-Synephrine.
** • yes, infusion. maybe he got twist-tongue'ld. - b o l b o m
Mon Nov 20 10:29:56 2017 b o l b o m

**** • thank you - :)
Mon Nov 20 10:48:56 2017 :)


• Abdominoplasty: , the abdominal wound was irrigated. _______ was placed.....
+ mp4
Mon Nov 20 09:00:21 2017 mp4
This was excised. While in this position, the abdominal wound was irrigated. _______ was placed. The abdominal skin was then closed in layers
** • ... - mp4 deleted
Mon Nov 20 10:04:31 2017 mp4 deleted


• shoulder surgery for instability
+ sm please
Mon Nov 20 08:21:16 2017 sm please
I established a posterior portal with a s/l kayla. I then roughed up that posteroinferior capsule, removed the old suture and anchor from there, and placed two more anchors at about the 3 o'clock and 5 o'clock positions.
** • Could he be saying cannula? - Questyr
Mon Nov 20 12:38:17 2017 Questyr


• There was normal nuchal translucency on early ultrasound, normal _____ scan, and sm
+ wav :)
Mon Nov 20 01:03:17 2017 wav :)
later normal cervical length when checked.
** • Wonder if the sound was cut off and if she's really saying "anatomy scan" (see link) + Questyr
Mon Nov 20 02:57:38 2017 Questyr
link
**** • Yes that is it. Thanks. - :)
Mon Nov 20 04:32:59 2017 :)


• on October 30, 2017, an angiogram was performed which showed reconstitution of the
+ mp3
Sun Nov 19 14:36:16 2017 mp3
on October 30, 2017, an angiogram was performed which showed reconstitution of the right temporal fistula through middle meningeal branches draining to a ___ in the midtemporal gyrus with complete cortical drainage of the fistula.
** • vein - poi
Sun Nov 19 15:00:38 2017 poi

**** • ... - thanks
Sun Nov 19 15:54:29 2017 thanks


• There was no abnormal growth pattern. It was just a single layer of s ...
+ mp3
Sat Nov 18 10:23:14 2017 mp3
There was no abnormal growth pattern. It was just a single layer of skin and so this was _____ and saved for further use to realign the defect with skin. Bone was removed until the tegmen had been thinned and glide smoothly into the antrum which was inspected and could be seen to be clear of cholesteatoma.
** • this was laid forward and saved - ltt
Sat Nov 18 10:26:04 2017 ltt

**** • Thanks a lot. - guy
Sat Nov 18 10:26:38 2017 guy


• At this time, the skin was elevated off of bony ear canal and into the ...
+ wav
Sat Nov 18 10:22:30 2017 wav
At this time, the skin was elevated off of bony ear canal and into the scutal defect. A drill was used to carefully remove bone so that the entire epitympanum was saucerized and exposed. This was followed back until a large _____ had been made and the defect was probed. There was not significant extension of keratin into this area and so it was carefully retracted forward and a smooth layer of skin was removed from this defect
** • sinusotomy? ... + c l n f g p
Sat Nov 18 10:30:05 2017 c l n f g p
sinusotomy?
**** • in the ear? - b o l b o m
Sat Nov 18 11:02:39 2017 b o l b o m


• CT scan showed near complete erosion of the scutum with thinning of th ...
+ mp3
Sat Nov 18 10:03:37 2017 mp3
CT scan showed near complete erosion of the scutum with thinning of the tegmen and absence of stapes with significant erosion of the incus and malleus and soft tissue extending into the epitympanum and the attic. The mastoid was ____. On visible findings, an inside-out mastoidectomy approach was planned since there were very few air cells on the mastoid with the exception of the antrum and an ossicular chain reconstruction was planned in the event that there was not significant cholesteatoma remaining in the middle ear.
** • sclerotic without very many air cells - taco
Sat Nov 18 10:19:45 2017 taco

**** • Thanks a lot. - guy
Sat Nov 18 10:22:06 2017 guy

** • never mind. Thanks to anyone who tried. - guy
Sat Nov 18 10:16:30 2017 guy


• He understood that at this point, hearing loss would be difficult to r ...
+ mp3
Sat Nov 18 09:48:10 2017 mp3
He understood that at this point, hearing loss would be difficult to restore. On exam, he was found to have keratin extending from a superior posterior scutal defect with an unclear _____ termination based on office exam with no clear landmarks of the tympanic membrane, except for the umbo
** • extent of - taco
Sat Nov 18 09:59:45 2017 taco

**** • Thanks a lot. - guy
Sat Nov 18 10:00:13 2017 guy


• This is a 55-year-old man with a four-decade history of right-sided ot ...
+ wav
Sat Nov 18 09:46:23 2017 wav
This is a 55-year-old man with a four-decade history of right-sided otorrhea, had multiple ear infections in the right ear as a child and subsequently had poor hearing _____. He has intermittent episodes of vertigo and tinnitus, but has had none of these recently.
** • never mind. Thanks to anyone who tried. - guy
Sat Nov 18 10:16:22 2017 guy

**** • ... + c l n f g p
Sat Nov 18 10:22:25 2017 c l n f g p


• Small cell lung cancer chemo
+ Dee
Sat Nov 18 09:15:44 2017 Dee
The patient started on Cisplatin and s/l weepycistine chemotherapy.
** • Later he says etoposide. ... + j e m l g k
Sat Nov 18 09:29:42 2017 j e m l g k
Later he says etoposide.

• FINDINGS: 1. Defect of scutum. 2. Cholesteatoma in attic exten ...
+ mp3
Sat Nov 18 09:09:32 2017 mp3
FINDINGS:
1. Defect of scutum.
2. Cholesteatoma in attic extending to antrum with termination there.
3. Atelectatic tympanic membrane.
4. Ossicles _____.
5. Stapes footplate intact and mobile.

** • s/l ossicles gone except for umbra remnant (not real sure about the word "gone") - ltt
Sat Nov 18 09:30:13 2017 ltt

**** • Thanks a lot. - guy
Sat Nov 18 09:43:01 2017 guy


• PROCEDURE: LEFT RADIOCEPHALIC FISTULA CREATION. Heparinized ...
+ wav
Sat Nov 18 05:44:07 2017 wav
PROCEDURE:
LEFT RADIOCEPHALIC FISTULA CREATION.

Heparinized saline was used to distend the vein and it was noted that there was an area of stenosis near the area that the silks were used to ligate the tributaries, so the vein was just cut back to that level where _____ up nicely and there was still adequate vein to get to the artery without any tension or kinking.
** • never mind. Thanks to anyone who tried. - guy
Sat Nov 18 09:09:49 2017 guy


• Acetowhite acid was then placed on the cervix. No distinct lesions we ...
+ mp3
Fri Nov 17 23:36:32 2017 mp3
Acetowhite acid was then placed on the cervix. No distinct lesions were visualized. No masses. No _____. Furthermore, the transformation zone was unable to be adequately visualized enough and adequate colposcopy was performed.
** • mosaicism - Questyr
Sat Nov 18 00:07:33 2017 Questyr

** • never mind. Thanks to anyone who tried. same word in both wav and mp3. - guy
Fri Nov 17 23:46:13 2017 guy

**** • Actually it sounds like there is some word(s)more than just the mosaicism on the one below - Q
Sat Nov 18 00:09:52 2017 Q

****** • Thanks a lot. - guy
Sat Nov 18 05:40:39 2017 guy


• PROCEDURE: EXAM UNDER ANESTHESIA, COLPOSCOPY. On exam under ...
+ wav
Fri Nov 17 23:14:41 2017 wav
PROCEDURE:
EXAM UNDER ANESTHESIA, COLPOSCOPY.

On exam under anesthesia, 2.1 cm mobile, soft vaginal mass extruding from left vaginal sidewall at 2 oclock. On colposcopy, acetowhite acid placed on cervix. No distinct lesions visualized. No _____ transformation zone furthermore not adequately visualized and adequate colposcopy.
** • ???______. No mosaicism." - Questyr
Sat Nov 18 00:08:43 2017 Questyr

**** • Thanks a lot. - guy
Sat Nov 18 05:41:10 2017 guy

** • never mind. Thanks to anyone who tried. - guy
Fri Nov 17 23:45:56 2017 guy


• The anterior horn and lateral meniscus were released and the tibia was ...
+ wav
Fri Nov 17 18:17:56 2017 wav
The anterior horn and lateral meniscus were released and the tibia was subluxed anteriorly with _____ maneuver.
** • got it. thanks. + guy
Fri Nov 17 18:25:46 2017 guy
RanSall maneuver


• the left *anon* and extending into the noncoronary sinu
+ ?
Fri Nov 17 12:13:54 2017 ?
The aortic cross-clamp was reapplied. The volume was removed from aorta prior to it and then the myocardium was rearrested with another 750 cc of Del Nido cardioplegia solution administered in antegrade fashion. The aortotomy was reopened and additional pledgeted sutures were placed as directed by the transesophageal echo, i.e., at the commissure between the left *anon* and extending into the noncoronary sinus. Two pledgeted sutures were utilized for this repair. The aortotomy was then reclosed and the aortic cross-clamp was released with the patient in steep Trendelenburg position.
** • ostium? - WAG
Fri Nov 17 12:19:52 2017 WAG


• Allergy: Penicillin, sodium, iodine sm
+ deb
Fri Nov 17 12:01:30 2017 deb
So not 100% sure if she's saying sodium, iodine or sodium iodine, or sodium iodide.

Will flag but just curious.
** • Off the top of my head, I have never heard of a sodium allergy - nt
Fri Nov 17 12:05:24 2017 nt


• s/l noffit criteria. Sm for context plse
+ nt
Fri Nov 17 11:52:29 2017 nt
Diagnostic workup showed no hemodynamically significant stenoses according to **Noffitt criteria** there were no aneurysms of the circle of Willis.

(not sure if new sentence starting at "according" or "there were no aneurysms..."

Thanks for any help


** • got it - NASCET - nt
Fri Nov 17 12:18:06 2017 nt


• The hernia sac was closed with 3-0 PDS and easily reduced into the per ...
+ mp3
Fri Nov 17 10:15:14 2017 mp3
The hernia sac was closed with 3-0 PDS and easily reduced into the peritoneal cavity. A 6 x 6 Prolene mesh was cut to appropriate size for the hernia defect. There was no direct _____ was examined, felt to be strong and intact, and the mesh was then brought towards the surgical site.
** • never mind. Thanks to anyone who tried. - guy
Fri Nov 17 10:24:31 2017 guy

**** • mp3 deleted. - n p j o f d
Fri Nov 17 10:25:50 2017 n p j o f d


• PREOPERATIVE DIAGNOSIS: RIGHT INGUINAL HERNIA. PROCEDURE: ...
+ wav
Fri Nov 17 09:45:35 2017 wav
PREOPERATIVE DIAGNOSIS:
RIGHT INGUINAL HERNIA.

PROCEDURE:
OPEN RIGHT INGUINAL HERNIA REPAIR WITH MESH.

This is a 55-year-old male with history of HIV, diabetes, who presented with a right inguinal hernia which has been present for approximately five months but was previously reducible, stopped being able to reduce it four days prior to presentation _____ prior to surgery with associated pain and nausea and vomiting for one day. The hernia was reduced in the emergency department, but a CAT scan showed dilated bowel
** • got it. thanks. + guy
Fri Nov 17 10:23:31 2017 guy
presentation and five days prior

• The gallbladder was then taken off of the liver bed using electrocaute ...
+ wav
Fri Nov 17 09:17:16 2017 wav
The gallbladder was then taken off of the liver bed using electrocautery. The gallbladder was placed in the Endo Catch bag and the specimen was taken off the field under direct vision. The liver bed was checked for hemostasis which had been achieved. The remnant cystic duct and cystic artery were reinspected. The clips were appropriately placed and there was neither leakage nor bleeding from the _____.
** • operative site? ----something site - b o l b o m
Fri Nov 17 09:36:42 2017 b o l b o m

**** • Thanks a lot. - guy
Fri Nov 17 09:41:49 2017 guy


• This was noted to stabilize the fracture and there was no longer a dor ...
+ mp3
Fri Nov 17 04:55:00 2017 mp3
This was noted to stabilize the fracture and there was no longer a dorsal subluxation. Next, we placed a second K-wire _____ across the base of the fifth metacarpal into the fourth and into the third and the concern for subluxation of the fourth metacarpal.
** • ... + n p j o f d
Fri Nov 17 09:17:08 2017 n p j o f d

** • transversely - b o l b o m
Fri Nov 17 07:11:08 2017 b o l b o m

**** • Thanks a lot. - guy
Fri Nov 17 09:17:01 2017 guy


• The patients right hand was examined under fluoroscopy and he was not ...
+ wav
Fri Nov 17 04:49:09 2017 wav
The patients right hand was examined under fluoroscopy and he was noted to have a healing fifth metacarpal fracture at the base with an _____ component and evidence of subluxation at the CMC joint.
** • intraarticular - b o l b o m
Fri Nov 17 07:11:42 2017 b o l b o m

**** • Thanks a lot. - guy
Fri Nov 17 09:16:53 2017 guy


• Instrument count, needle counts, and sponge counts were correct x2. ...
+ wav
Fri Nov 17 02:20:47 2017 wav
Instrument count, needle counts, and sponge counts were correct x2.

SURGEON _____: I was present for the entire operation and performed the surgery in its entirety.

** • got it. thanks. + guy
Fri Nov 17 02:24:03 2017 guy
SURGEON ATTESTATION

• In the right pelvis, a 3.5 cm mass adjacent to the right ____ artery is thought sm
+ wav :) 2 blank
Fri Nov 17 01:59:40 2017 wav :) 2 blank
likely to represent a ____ aneurysm.
** • saccular - Questyr
Fri Nov 17 02:17:50 2017 Questyr

** • It represent a saccular aneurysm ... + guy
Fri Nov 17 02:17:28 2017 guy
It represent a saccular aneurysm
** • I think he is saying iliac artery but is saying il-le-ock. - :)
Fri Nov 17 02:01:50 2017 :)


• Diabetic neuropathy with probable autonomic ____. history of subdural hematoma. sm
+ :) wav
Fri Nov 17 01:16:49 2017 :) wav
I think I am missing more than just one word in there.
** • Sorry, I can't get it either - Questyr
Fri Nov 17 01:44:42 2017 Questyr

**** • Thanks for trying Q. - :_
Fri Nov 17 01:57:36 2017 :_


• POSTOPERATIVE PLAN: The patient will remain in an _____ ulnar gutter ...
+ mp3
Fri Nov 17 00:08:09 2017 mp3
POSTOPERATIVE PLAN: The patient will remain in an _____ ulnar gutter splint and will return to our clinic in two weeks for followup x-ray.
** • ??orthoplastic??? - Questyr
Fri Nov 17 00:47:03 2017 Questyr

**** • Thanks a lot. - guy
Fri Nov 17 01:19:52 2017 guy

** • never mind. Thanks to anyone who tried. - guy-wag
Fri Nov 17 00:20:33 2017 guy-wag


• PREOPERATIVE DIAGNOSIS: RIGHT FIFTH METACARPAL FRACTURE. PRO ...
+ wav
Thu Nov 16 23:56:02 2017 wav
PREOPERATIVE DIAGNOSIS:
RIGHT FIFTH METACARPAL FRACTURE.

PROCEDURE:
EXAM UNDER ANESTHESIA, MANIPULATION OF RIGHT FIFTH METACARPAL FRACTURE.

The patient is a 27-year-old right-hand-dominant male who presented to our clinic with a right fifth metacarpal fracture which occurred approximately three weeks ago. The patient _____ care and then was diagnosed one week later with the fracture, splinted, and referred to our clinic.
** • the patient initially did not seek care. - :)
Fri Nov 17 01:17:31 2017 :)

** • ???The patient did not seek care etc??? - Questyr
Fri Nov 17 00:45:49 2017 Questyr

**** • Thanks a lot everybody - guy
Fri Nov 17 01:19:46 2017 guy

** • never mind. Thanks to anyone who tried. - guy
Fri Nov 17 00:20:26 2017 guy


• Postoperative MRI looked good with some minimal patchy enhancement and complete
+ tia
Thu Nov 16 23:07:31 2017 tia
Postoperative MRI looked good with some minimal patchy enhancement and complete removal of the *tumor cyst*.

What is a tumor cyst? Aren't those 2 distinct entities?
** • I do find the term used in medical journal articles (see link) ...and + Questyr
Thu Nov 16 23:26:59 2017 Questyr
while in googling I find it shown as tumor cyst....I also find some doing tumor/cyst. Since I can't find it in the dictionary and since the journal articles are not using the virgule, I would just type it as tumor cyst. BTJMO
**** • ... - thanks
Fri Nov 17 02:33:04 2017 thanks


• Proximally, the Freer was again inserted and the transverse carpal lig ...
+ mp3
Thu Nov 16 22:47:04 2017 mp3
Proximally, the Freer was again inserted and the transverse carpal ligament was released sharply with a #15 blade extending proximally just across the wrist visualizing the median nerve at all times. Mayo scissors was inserted to release the distal aspect of the _____ fascia. Closed Metzenbaum scissors was inserted _____ noted to be no restrictions with free movement.
** • NOTE: Scissors always take a plural verb (i.e. scissors were (not was) see link + Questyr
Thu Nov 16 23:42:42 2017 Questyr
link
** • #1 ???antebrachial??? - Q
Thu Nov 16 23:33:21 2017 Q

** • #2 in the canal. There was - Questyr
Thu Nov 16 23:28:45 2017 Questyr

**** • Thanks a lot. Thanks for the correction. - guy
Thu Nov 16 23:43:39 2017 guy

** • can't get either one. sorry - poi
Thu Nov 16 22:52:51 2017 poi

**** • Thanks for the effort. - guy
Thu Nov 16 22:54:43 2017 guy

****** • never mind. Thanks to anyone who tried. - guy
Thu Nov 16 22:59:57 2017 guy


• The patient is a 39-year-old female with a history of bilateral carpal ...
+ wav
Thu Nov 16 22:35:13 2017 wav
The patient is a 39-year-old female with a history of bilateral carpal tunnel syndrome, status post endoscopic release of right arm who presented with worsening symptoms on her left side and desire release. The patient had complains of paraesthesia of the right radial three digits, not relieved with nighttime splinting. Risks, benefits, and alternatives of the procedure of open carpal tunnel release was discussed with the patient with the risks including, but not limited to pain, infection, bleeding, damage to surrounding structures, longer scar _____ endoscopic approach, _____ persistent numbness, stiffness, and other wound complications. The patient expressed understanding of the risks and informed consent was obtained.,
** • 1. compared to the?? Can't get #2 - poi
Thu Nov 16 22:49:15 2017 poi

**** • Thanks a lot. - guy
Thu Nov 16 22:52:25 2017 guy


• PREOPERATIVE DIAGNOSIS: PROSTATE CANCER. PROCEDURE: ROBOT ...
+ wav
Thu Nov 16 21:25:01 2017 wav
PREOPERATIVE DIAGNOSIS:
PROSTATE CANCER.

PROCEDURE:
ROBOT-ASSISTED PROSTATECTOMY WITH PELVIC LYMPH NODE DISSECTION.

FINDINGS: ____ nerve-sparing approach.
** • never mind. Thanks to anyone who tried. bad dictator. - guy
Thu Nov 16 21:41:05 2017 guy


• The contra catheter was then swept out for Glide catheter. The Glidew ...
+ wav
Thu Nov 16 19:19:54 2017 wav
The contra catheter was then swept out for Glide catheter. The Glidewire was used to attempt to get through the superficial femoral artery. We got into the popliteal artery such that the Glide catheter for the _____ catheter to get across the superficial femoral artery. The wire was then swept out to V-18 controller
** • TrailBlazer support - Questyr
Thu Nov 16 19:21:41 2017 Questyr

**** • Thanks a lot. - guy
Thu Nov 16 19:24:53 2017 guy


• INDICATIONS FOR PROCEDURE: The patient is a 42-year-old left-hand-dom ...
+ mp3
Thu Nov 16 18:00:24 2017 mp3
INDICATIONS FOR PROCEDURE: The patient is a 42-year-old left-hand-dominant male who presented with a saw injury while at work to the dorsum of his hand and forearm. On exam, the patient was noted to have a large _____ laceration extending from the mid dorsal forearm ____ down across the wrist extending to the dorsum of the hand on the radial aspect of the index finger.
** • On #1 I think she's just stumbling on "laceration" ..#2 laterally - Questyr
Thu Nov 16 18:14:28 2017 Questyr

**** • Thanks a lot. - guy
Thu Nov 16 18:14:57 2017 guy

****** • I think I hear 1) non-continuous laceration. #2 s/l "longitudinally" - ltt
Thu Nov 16 18:35:21 2017 ltt

******** • Thanks a lot. - guy-wag
Thu Nov 16 18:40:26 2017 guy-wag


• PREOPERATIVE DIAGNOSIS: RIGHT DORSAL FOREARM AND HAND LACERATION. ...
+ wav
Thu Nov 16 17:54:27 2017 wav
PREOPERATIVE DIAGNOSIS:
RIGHT DORSAL FOREARM AND HAND LACERATION.

PROCEDURE:
RIGHT FOREARM AND HAND EXPLORATION, RIGHT SECOND RADIAL DIGITAL NERVE REPAIR, RIGHT SECOND METACARPAL OPEN REDUCTION AND INTERNAL FIXATION, RIGHT SECOND MCP JOINT EXTENSION PINNING, RIGHT ECRB AND EPL REPAIR, RIGHT MCP JOINT COLLATERAL LIGAMENT REPAIR.

IMPLANTS: 2.0 mm Synthes variable angle _____ plate.
** • I wonder if she's saying "extending"...see link + Questyr
Thu Nov 16 18:17:46 2017 Questyr
link
**** • Type ...exten... into the Find Box at the top of the page and click till you come to + Q
Thu Nov 16 18:21:20 2017 Q
an image......plate has multiple holes. They don't specifically call it an extending plate, but the procedure title says they doing extension pinning....and the sound I am hearing is something like "stending"
**** • Thanks a lot. - guy
Thu Nov 16 18:18:30 2017 guy


• ..An inspection of the ________ rotator cuff tear was executed ..
+ mp4 posted
Thu Nov 16 16:28:56 2017 mp4 posted
The subacromial space was digitally enlarged, and then retractors were placed. An inspection of the ________ rotator cuff tear was executed and then the supraspinatus was advanced into a position
** • pattern of? - poi
Thu Nov 16 19:38:17 2017 poi

** • Hi. I'm still waiting on this. Don't think I'm done yet. :) - mp4 posted
Thu Nov 16 17:50:10 2017 mp4 posted

**** • Maybe with a bit longer clip it might help to get into his rhythm, although with + Questyr
Thu Nov 16 18:22:16 2017 Questyr
the cough I'm not sure.
****** • Thanks. He may just mean...inspection of rotator cuff tear.. - mp4
Thu Nov 16 19:08:51 2017 mp4


• patient has bilateral foot drop, peripheral neuropathy sm
+ Rourke
Thu Nov 16 14:52:09 2017 Rourke
Wears bilateral s/l "maf hose" and uses a cane
** • MAFOs - nm
Thu Nov 16 17:51:14 2017 nm

**** • I think you nailed it. - Q
Thu Nov 16 18:22:53 2017 Q

** • ???TED hose??? - Questyr
Thu Nov 16 15:27:08 2017 Questyr


• clear as a bell, s/l osteostasis but can't confirm...any input?
+ nm
Thu Nov 16 13:27:03 2017 nm
?
** • I think he means orthostasis, but I can't prove it...and I am unable to satisfactorily + Questyr
Thu Nov 16 13:46:09 2017 Questyr
document osteostasis. Also archives indicate this difficulty has presented itself before with no adequate answer. Sorry.
**** • thanks, I am going to blank it. thanks for responding + nm
Thu Nov 16 13:48:44 2017 nm
c
** • any more context? - poi
Thu Nov 16 13:32:48 2017 poi

**** • sorry.....He has multisystem degenerative s/l osteostasis as well as Parkinson's disease. + nm
Thu Nov 16 13:40:08 2017 nm
forgot the rule
****** • ... + l m d n n d
Thu Nov 16 21:24:33 2017 l m d n n d


• gastric sleeve surgery
+ sm
Thu Nov 16 11:52:15 2017 sm
The wrap was taken down, as was the cicatrix, and a leak test was performed, which was negative. s/l Tist seal was placed along the cut length of the mesentery and the staple line, and the staple line was reinforced with a clip applier.
** • Tisseel - taco
Thu Nov 16 12:26:28 2017 taco

**** • Thank you! - nm
Thu Nov 16 12:36:12 2017 nm


• probably fail this year, her mother still plans to do the ___ next year
+ WAV
Thu Nov 16 11:44:56 2017 WAV
Given she will probably fail this year, her mother still plans to do the ___ next year
** • help please!!! - anyone??
Thu Nov 16 12:04:07 2017 anyone??

**** • I can't get it. How about some context? - t
Thu Nov 16 12:25:50 2017 t

****** • pt has possible autism and is refusing to go to school so school is failing her this grade + .
Thu Nov 16 12:27:08 2017 .
pt has possible autism and is refusing to go to school so regular school is failing her based on nonattendance and mother is going to homeschool.
******** • sorry - can't get it. First word sounds like yearex or yurix? - t
Thu Nov 16 12:32:24 2017 t

********** • thanks for trying! - dt
Thu Nov 16 12:52:06 2017 dt


• There is a ___________ lesion or cyst beneath the articular surface of ...
+ mp3 posted
Thu Nov 16 10:37:35 2017 mp3 posted
There is a ___________ lesion or cyst beneath the articular surface of the medial tibial plateau.

Pt is status post Baker's cyst removal
** • I hear "lytic lesion" but I can't tell if it is a stumble or a word before "lytic" - taco
Thu Nov 16 10:41:15 2017 taco

**** • maybe "apparent lytic" or "apparently a lytic" but I'm not sure that's it. - t
Thu Nov 16 10:42:29 2017 t

****** • thanks Taco. He says 9 mm lytic lesion or cyst in the impression. - OP
Thu Nov 16 10:44:56 2017 OP


• under _____ environment
+ wav
Thu Nov 16 08:21:42 2017 wav
Above the suprasternal notch, a small transverse incision was made and brought down through the skin, subcutaneous tissues, and to the level of the platysma down to the pretracheal fascia. Trachea was entered focally with needle electrocautery under _____ environment, and tracheostomy hook was put in place. Takahashi rongeur allowed enlargement of this tracheostomy tube site and underlying endotracheal tube was identified. No active bleeding was seen.
** • low oxygen (?) - b o l b o m
Thu Nov 16 08:50:51 2017 b o l b o m

** • flagged - h b d b o g
Thu Nov 16 08:41:34 2017 h b d b o g


• The ramus vessel was dissected free (and fortunately OR unfortunately) it bifurcated
+ ?
Thu Nov 16 08:03:16 2017 ?
Pericardium was now opened. Epiaortic sonography was performed, which did not identify a significant disease of the ascending aorta. Utilizing concentric pursestring sutures, the aorta and right atrium were cannulated and the patient was placed on cardiopulmonary bypass after an appropriate ACT was obtained. Via the right superior pulmonary vein, a left ventricular sump was placed. With cooling, the heart was fibrillated and the coronary arteries were dissected free.

The LAD was noted to be about 1.75 mm in size and I felt a target. The ramus vessel was dissected free ______ it bifurcated. The larger of the two branches was about 1.25 to 1.5 mm in size but I felt a target. The high first marginal was dissected free. It was about 1.5 mm in size and I felt a target.

• Would change anticoagulation therapy to Lovenox. Warfarin or _______ sm
+ wav :)
Thu Nov 16 03:05:26 2017 wav :)
oral anticoagulant starting tomorrow.
** • Got this. - :)
Thu Nov 16 03:13:51 2017 :)


• SVA, pls help
+ ink+
Wed Nov 15 21:22:33 2017 ink+
A series of three images of the hand ___ presented.

is?
are?
thanks
** • A series is presented. + sm
Sat Nov 18 13:15:34 2017 sm
When it has the singular sense of "one set," it takes a singular verb, even when series is followed by of and a plural noun: A series of lectures is scheduled.
** • thanks for the help - ink+
Wed Nov 15 22:47:38 2017 ink+

** • When in doubt check Merriam Webster Dictionary listing...you will + Questyr
Wed Nov 15 22:42:01 2017 Questyr
find that they show the work series AND indicate that it is plural.
**** • oops typo..they show the word series AND indicate it is plural - Q
Wed Nov 15 22:42:31 2017 Q

** • series are, 3 images are. - b o l b o m
Wed Nov 15 21:46:35 2017 b o l b o m

**** • Incorrect. The dishes are in the sink. A set of dishes IS in the sink. + sm
Sat Nov 18 13:18:28 2017 sm
When it has the singular sense of "one set," it takes a singular verb, even when series is followed by of and a plural noun: A series of lectures is scheduled.

• X-rays - quadriceps s/l burr
+ sm
Wed Nov 15 17:36:32 2017 sm
X-rays showed an avulsed piece off the superior pole of the patella which they said was a quadriceps "burr."

Pt s/p total knee replacement.

Thanks.
** • Q - I decided to leave a blank. Thanks for trying to help me. - OP
Wed Nov 15 18:03:58 2017 OP

** • Wonder if he's saying "spur" (see link) + Questyr
Wed Nov 15 17:53:23 2017 Questyr
link
**** • Click on the word...spur....in the Find Box at the top of the screen - Q
Wed Nov 15 17:54:04 2017 Q

****** • Doesn't sound like spur, really does sound like burr. - Thanks.
Wed Nov 15 18:01:34 2017 Thanks.

******** • I was thinking the "s" of quadriceps hid the - Q
Wed Nov 15 18:18:36 2017 Q

********** • oops...continuing...hid the "s" or spur making it s/l burr - Q
Wed Nov 15 18:19:10 2017 Q

************ • No, he always dictates quad and I make it quadriceps, so the "s" sound isn't - there. Thanks. OP
Wed Nov 15 19:01:41 2017 there. Thanks. OP

************** • but spur makes so much more sense. google quadriceps spur - b o l b o m
Wed Nov 15 21:47:29 2017 b o l b o m


• .. and this was incised using _______. Full release...
+ mp3
Wed Nov 15 15:36:34 2017 mp3
There was a small, tight band noted in the proximal portion of the transverse carpal ligament. We reinserted the endoscope, identified the band, and this was incised using _______. Full release of the transverse carpal ligament was noted
** • the blade - mn
Wed Nov 15 15:37:48 2017 mn

**** • Thank you. - mp3
Wed Nov 15 15:47:16 2017 mp3




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