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May 21 13:00
• This struck me as funny. See message. + nymt
Fri Jul 4 16:56:03 2008 nymt
"She does not complain of any chest pain and I do not feel the need to be on Imdur at this point." Fine for you, but how about the patient.
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Fri Jul 4 17:03:52 2008 Lo
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• this is the PA I love to hate. medication s/l pen-uh-dee-an + Loluv
Fri Jul 4 16:49:57 2008 Loluv
She mispronounces everything, so I have no idea.
MEDICATIONS: Lipitor, Benicar, Aciphex, Zetia, Cenestin, Singulair, aspirin, Macrodantin, s/l penadian.
PAST MEDICAL HISTORY:
1. Acid reflux.
2. Asthma.
3. Ménière’s disease.
4. Hiatal hernia.
PAST SURGICAL HISTORY:
1. Bladder surgery.
2. Hysterectomy.
3. Knee surgery.
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• s/m - I am questioning delta P/delta t and biastolic 5 mg + wolfe
Fri Jul 4 16:27:11 2008 wolfe
He is reluctant to use beta blockers, but I have convinced him to use biastolic 5 mg once a day to see if that would help control his blood pressure and hopefully it will reduce the delta P/delta t, i.e. the surface tension that might cause the aortic dilatation to increase.
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Fri Jul 4 16:53:04 2008 Lo
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Fri Jul 4 16:57:47 2008 wolfe
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Fri Jul 4 17:03:18 2008 Lo
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• patient with autism. is on s/l Fulcan, Risperdal, and clonidine. + Loluv
Fri Jul 4 16:08:09 2008 Loluv
no other info. ER note. His only PMH is autism. those are his only meds. 5-year-old boy.
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Fri Jul 4 16:12:36 2008 darlene
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Fri Jul 4 16:16:54 2008 Mgt
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Fri Jul 4 16:13:57 2008 Lo
it around.
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• S/L empiric hearing. Please sm. + nymt
Fri Jul 4 15:23:18 2008 nymt
"PAST MEDICAL HISTORY: He has a history of s/l empiric hearing and autism." ???
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Fri Jul 4 15:32:56 2008 o j h i b m
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• Pt w/ probable cholangiocarcinoma. + jen
Fri Jul 4 15:22:05 2008 jen
He had a liver biopsy,and his "CN-9" was over 11,000.
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Fri Jul 4 15:22:40 2008 k b p e d a
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Fri Jul 4 15:26:09 2008 jen
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• provocative ?? drip test + ed
Fri Jul 4 15:00:55 2008 ed
drain placed for CSF leak via nose, and used a provocative _____crimp? test to check for resolution.
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Fri Jul 4 16:04:20 2008 darlene
File Format: PDF/Adobe Acrobat - View as HTML
A provocative tilt test was performed before patient discharge. to assess the integrity of the CSF leak repair.
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Fri Jul 4 15:03:23 2008 ed
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• he "awoke" with shortness of breath (I always confuse awoke awakened ?? ) - Mtt
Fri Jul 4 14:33:48 2008 Mtt
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Fri Jul 4 16:13:00 2008 Lo
someone or something woke him up. (He was awakened by the thunder.) Awoke is used if he did it all by himself. (He awoke with a smile on his face.)
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Fri Jul 4 14:36:06 2008 Mtt
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Fri Jul 4 14:34:27 2008 LiliK
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• Neck range of motion shows mild limitation. Forward flexion is chin two + mumbles
Fri Jul 4 14:06:55 2008 mumbles
fingerbreadths s/l of the chest. Does fingerbreadths of the chest sound correct?
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Fri Jul 4 14:10:30 2008 LiliK
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Fri Jul 4 14:15:19 2008 sam carter
or higher lol. Snorrrrreee.......**face hits keyboard**
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Fri Jul 4 14:09:48 2008 Mgt
"of" can mean "from," or "away from by....(whatever amount)," the same concept expressed by "short of..."
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Fri Jul 4 14:09:17 2008 sam carter
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• Does diakineses have anything to do with the heart? + o j h i b m
Fri Jul 4 14:06:55 2008 o j h i b m
I just need to find out if I am right or way off the mark. I had a report with an echocardiogram in it and this is what the doctor dictated. "Markedly dilated LV with stress and rest consistent with global hypokinesis and apical s/l diokinesis." I could not find the word diokinesis anywhere and he definitely was not saying dyskinesis. I found the word diakinesis, but in regard to chromosome change in cell division. I could not find any connection between diakinesis and the heart, so I left a blank and it came back with diakinesis in the blank. I emailed 2 supervisors about it asking them to let me know if this was right or wrong and have not heard back. Does anyone on here know anything about this? I would like to know so if I hear it again, I will know what to use.
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Fri Jul 4 14:16:59 2008 h b d l d f
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Fri Jul 4 14:16:52 2008 nm
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Fri Jul 4 14:09:31 2008 o j h i b m
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Fri Jul 4 14:13:53 2008 Mgt
there. Usually it is only cardiologists who use unusual or unexpected words talking about an echo (generalists use ordinary words). I bet your doc actually has something specific in mind; I tend to doubt he just slipped a cog here, though that happens often enough.
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Fri Jul 4 14:22:08 2008 o j h i b m
it seems to get filled in without any real reason. Isn't it better for it to go back to the doctor as a blank so he will know he screwed it up?
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Fri Jul 4 16:07:07 2008 Mgt
I'm sure each QA has a different "job description"...the one requested of him/her by the account, and the one his or her own ethics require for peace of mind and job satisfaction.
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• Had a "bicuspid tricuspid" valve. SM please + ?
Fri Jul 4 13:50:34 2008 ?
1-month-old child who was resuscitated at birth with an apgar of 1, had a bicuspid tricuspid valve, flown to **** Hospital, kept there for 2 weeks after birth.
The infant has been home for about 3 weeks with no problems, but is now coming in to the ER with a barky-type cough.
Not sure what a bicuspid tricuspid valve would be, and can't really find anything on it. Thanks.
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Fri Jul 4 16:08:58 2008 darlene
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Fri Jul 4 13:56:56 2008 billybob
because it has three cusps -- but in this case the valve in that location only has two.
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Fri Jul 4 14:02:03 2008 :) OP
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Fri Jul 4 13:54:16 2008 cusps. SM Margaret
Can be assoc w/ Ebstein's anomaly
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Fri Jul 4 13:55:22 2008 OP
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Fri Jul 4 13:56:45 2008 OP
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Fri Jul 4 13:56:35 2008 Mgt
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Fri Jul 4 13:52:26 2008 LiliK
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Fri Jul 4 13:53:28 2008 OP
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Fri Jul 4 13:55:37 2008 Mgt
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Fri Jul 4 13:51:40 2008 p h n k h l
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Fri Jul 4 13:56:25 2008 OP
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Fri Jul 4 13:58:07 2008 LiliK
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Fri Jul 4 13:59:38 2008 OP
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Fri Jul 4 13:54:09 2008 p h n k h l
tricuspid valve should have 3 flaps (cusps), but this baby has only 2 flaps (cusps) in the tricuspid valve which is anaomaly
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Fri Jul 4 13:57:46 2008 OP
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Fri Jul 4 13:52:45 2008 OP
Do you see what I mean? He's saying bicuspid tricuspid valve.
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Fri Jul 4 13:56:16 2008 LiliK
specific to the heart. "The" tricuspid valve has 3 parts that open and close, and maybe doc is saying that in this particular case, "the tricuspid valve" (a specific valve in the heart on the right side), which should have 3 parts (thus its name), only has 2 of those parts.
Confusing? :-)
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• viral "s/l drum" vasculitis + Please sm
Fri Jul 4 13:50:33 2008 Please sm
This is a young female who presented with a three-week history of progressive fatigue, weakness, and chest pain. On my review of her MRI, there is possible mild hyperintensity on FLAIR images at the right parietal, cortical, and subcortical regions. However, this is not confirmed by the radiologist. Possible etiology for her symptoms include viral "w/l drum" vasculitis process, less likely neuromuscular disorder.
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Fri Jul 4 13:54:33 2008 p h k c i j
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Fri Jul 4 14:04:24 2008 LiliK
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Fri Jul 4 13:53:35 2008 LiliK
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Fri Jul 4 13:56:55 2008 thank you
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• Basic blood work, including *A B and P* and CBC are warranted. SM for + more info
Fri Jul 4 13:30:36 2008 more info
Pt on ventilatory support at home. Comes in with anxiety and shortness of breath.
Based on the patient's history and physical examination, it is warranted to assess for the possibility of an underlying lung infection which could be compromising the patient's ventilation and oxygenation. In addition, a respiratory consult and basic blood work, including *A B and P* and a CBC are warranted at this time.
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Fri Jul 4 13:31:05 2008 LiliK
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Fri Jul 4 13:32:50 2008 quit?! Thanks!
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Fri Jul 4 13:36:42 2008 LiliK
looking for a stupid bone formation that looked like a rabbit, and I am NOT kidding. Doc said what sounded like "bunny prominence," and I, by golly, was going to find that!! When I realized, happily before I sent in the note, that he had said "bony prominence," I just about quit on the spot. :-)
We all have 'em, and it's good to have another set of ears, even cyber ears, sometimes.
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Fri Jul 4 14:02:26 2008 Margaret
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Fri Jul 4 14:03:37 2008 LiliK
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Fri Jul 4 13:44:30 2008 Mgt
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Fri Jul 4 13:40:49 2008 OP
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Fri Jul 4 13:49:54 2008 zz
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Fri Jul 4 13:38:53 2008 Lo
exactly what I needed to hear from someone! Glad it was you!
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Fri Jul 4 13:48:49 2008 best one. SM LiliK
On advice of an older MT, she set up her expander so that the sound "-tion" was always indicated by the letter j. flexj = flexion, funcj = function, opj = operation, etc.
Well, one fine day, she intended to type, "For further information, please see Dr. Smith's long dictation," for which her shortcut was dicj, but she inadvertently hit the "k" instead of the "j." She said the nursing staff from the hospital received the note and called her supervisor, and they were laughing so hard they could barely tell her what had happened. "...please see Dr. Smith's long _____." Her supervisor then called her, practically in tears from laughing so hard (pardon the pun) with the nurses, and M. says if she hadn't had caller ID, she wouldn't have known who it was on the phone.
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Fri Jul 4 13:59:13 2008 tbay
I once typed a doctor's first name as Anal instead of Ana... kinda fit though LOL
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Fri Jul 4 13:54:12 2008 sam c arter
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Fri Jul 4 13:53:37 2008 zz
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• ortho - sm + o o p d m i
Fri Jul 4 13:28:45 2008 o o p d m i
Patient is listed with shoulders right and his hips to the left, manually trying to overcome this with a “s/l side binding that will doccufy” the pain.
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Fri Jul 4 13:30:40 2008 LiliK
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Fri Jul 4 13:42:38 2008 Thanks anyways.
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• for archives hearing Hemaduct drain. S/l Hemovac at first but relistened and + sam carter
Fri Jul 4 13:12:42 2008 sam carter
was Hemaduct..
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Fri Jul 4 13:53:36 2008 billybob
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• Patient's sputum culture was positive for Stenotrophomonas maltophilia s/l "proto- + c l d h o d
Fri Jul 4 13:05:38 2008 c l d h o d
species" and Acinetobacter s/l "co-co-ca-dias" which was sensitive to Tobramycin.
Thank you!
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Fri Jul 4 13:18:07 2008 LiliK
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Fri Jul 4 13:19:58 2008 c l d h o d
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Fri Jul 4 13:24:14 2008 enough to SM LiliK
I don't know enough about this stuff to be sure. I can find reputable sites using the word protospecies in a way similar to the way your doc uses it. That's all I know, though.
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Fri Jul 4 13:28:25 2008 Mgt
I think he means that, so far, the organism has not yet been fully identified, but is in a "category" sharing some traits similar to the named organism, with the implication that it would probably be sensitive to the same type of antibiotics? No knowledge, though, just a hunch.
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• Patient receiving wound care with s/l bonnelle solution, then switched to + g b c k j f
Fri Jul 4 12:59:57 2008 g b c k j f
ascetic acid 0.25%.
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Fri Jul 4 13:30:28 2008 sam carter
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Fri Jul 4 13:23:55 2008 sam carter
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Fri Jul 4 13:25:39 2008 LiliK
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Fri Jul 4 13:28:41 2008 sam carter
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Fri Jul 4 13:25:06 2008 sam carter
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Fri Jul 4 13:25:06 2008 LiliK
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Fri Jul 4 13:19:21 2008 LiliK
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Fri Jul 4 13:14:40 2008 sam carter
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• mitral regurgitation with "pea-ah" pressure grade in 60 mmHg - c e o d n i
Fri Jul 4 12:53:03 2008 c e o d n i
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Fri Jul 4 12:53:54 2008 billybob
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Fri Jul 4 12:59:30 2008 c e o d n i
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• city in MA...sixteen acres?? doc says rx called into Walgreens s/l 16 acres - abc
Fri Jul 4 12:49:13 2008 abc
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Fri Jul 4 12:57:50 2008 abc
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Fri Jul 4 12:56:36 2008 LiliK
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• .wav file posted.. pl sm + l m o d l f
Fri Jul 4 12:38:46 2008 l m o d l f
Because of recurrent seizure and his homeless situation, we will put him under observation and watch him overnight to make sure he does not have another seizure ____ Dilantin ____ in his system.
thanks for your suggestion
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Fri Jul 4 12:42:09 2008 l m o d l f
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• A *corotomy* was made at short distance distally, what appeared to be useful bowel + ?
Fri Jul 4 12:33:58 2008 ?
A corotomy was made at short distance distally, what appeared to be useful bowel and a 10 French catheter was passed through the colon down to the sigmoid to demonstrate patency of the remainder of the colon.
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Fri Jul 4 12:36:29 2008 thnx
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• s/l right *cokes* arthrosis for which pt having in growth right total hip. + me
Fri Jul 4 12:29:18 2008 me
Female RN who couldn't begin to pronounce correctly, but who is also eating while dictating.
Not getting hip, thought might be saying troch, but just can't get that either.
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Fri Jul 4 12:32:28 2008 op
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• incision from ulnar to radial *in addition to the* pronator quadratus + ?
Fri Jul 4 12:25:27 2008 ?
An L-shaped incision was then made in the pronator quadratus over the distal one-third of the distal radial metaphyseal segment along the radial border of the radial shaft up to the level of the styloid and then in a transverse incision from ulnar to radial ____ pronator quadratus and the palmar ligamentous complex taking care to preserve the palmar ligamentous complex.
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Fri Jul 4 12:40:40 2008 -
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• s/l *enterolysis* + e j g g b o
Fri Jul 4 12:13:42 2008 e j g g b o
At that time, she had extensive abdominopelvic s/l *enterolysis* and partial revision of her stoma and repair of the ventral wall hernia.
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Fri Jul 4 12:16:23 2008 nm
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Fri Jul 4 12:19:39 2008 e j g g b o
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• There is no s/l *chest bulkiness*. + b e f n p d
Fri Jul 4 12:01:15 2008 b e f n p d
LUNGS: Clear to auscultation. There is no s/l *chest bulkiness*. could this be right? thanks
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Fri Jul 4 12:11:33 2008 Lou
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• what would you do? + law
Fri Jul 4 11:51:35 2008 law
Physical exam of person with a rash. He groups it all together and not sure if I leave it together or break it up. The abdomen is where it is all grouped.
HEENT: No evidence of rash in the scalp or face. The rash completely spares the head and neck.
CHEST: Upper chest anterior and posterior, likewise is spared of any rash.
ABDOMEN: Spared from rash, as well as the back, with the exception of the pubis, where she has shaved and has isolated red lesions about 1 mm in diameter. These are scattered throughout the pubic hair area.
EXTREMITIES: Upper extremities show scattered isolated lesions that are excoriated on the lateral forearms. These are very isolated in nature, very distinct, scabbed flat lesions. The highest concentration of this rash is on the thighs and upper calves around the knees. It tends to spare the dorsal aspect of both lower extremities, and concentrates on the anterior and lateral. There are both isolated scabbed lesions, as well as confluent erythe
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Fri Jul 4 11:59:32 2008 d h j b a i
would give you a very big paragraph. :) Also, the reader will understand it either way, so don't worry about it.
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Fri Jul 4 11:56:50 2008 f p b i n p
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• Ultimately, after several days of an s/l inpass, it was decided + Purpleadvocate
Fri Jul 4 11:47:20 2008 Purpleadvocate
Ultimately, after several days of an inpass, it was decided that because of the patient's intellectual limitations, his potentially volatile mental illness, and the extreme instability of the situation in regards to his residence, which is unwilling to take him back with some payment, that the patient's safety would be insured by hospitalization and thus he was admitted to our available bed on XXXX.
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Fri Jul 4 11:49:48 2008 nm
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Fri Jul 4 11:50:16 2008 Purpleadvocate
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• T-spine reveals an age indeterminant compression fracture. Does this sound correct? - ortho note
Fri Jul 4 11:40:29 2008 ortho note
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Fri Jul 4 11:42:54 2008 d h j b a i
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Fri Jul 4 11:48:15 2008 c b i c h k
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• ER note. please someone help me. thank u + c b i c h k
Fri Jul 4 11:25:50 2008 c b i c h k
The patient has known history of lung CA with s/l mets to brain.
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Fri Jul 4 11:49:06 2008 c b i c h k
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Fri Jul 4 11:39:17 2008 d h j b a i
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Fri Jul 4 11:30:56 2008 h g n m p h
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Fri Jul 4 11:27:12 2008 Mgt's fan
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• Renal mass s/l bosnea Class 3? - a a j l k o
Fri Jul 4 11:18:35 2008 a a j l k o
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Fri Jul 4 11:19:59 2008 jerseygal
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Fri Jul 4 11:20:57 2008 jerseygal
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Fri Jul 4 11:33:25 2008 a a j l k o
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• Patient is on Coumadin for atrial fibrillation with a s/l "chad" score of 4? Thank U - Dee
Fri Jul 4 11:08:42 2008 Dee
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Fri Jul 4 11:10:06 2008 jerseygal
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Fri Jul 4 11:13:18 2008 Dee
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• Reason for Exam: Difficult PLAX & *A4* windows + Echo report
Fri Jul 4 10:44:11 2008 Echo report
I am reading a report and not sure if this is correct. Please help.
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Fri Jul 4 10:53:24 2008 d h j b a i
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Fri Jul 4 10:54:40 2008 d h j b a i
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Fri Jul 4 10:44:56 2008 nm
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Fri Jul 4 10:53:38 2008 Txczech
Journal of Diagnostic Medical Sonographyechocardiogram. and chose. portions. of the PLAX-LV and ALAX. view. to. be saved. in. a. cine. loop. Another observer then. made. independent. measurements ...
jdm.sagepub.com/cgi/reprint/10/6/305.pdf - Similar pages
[PDF] Guidelines and Standards for Performance of a Pediatric ...File Format: PDF/Adobe Acrobat - View as HTML
PLAX, Parasternal long-axis; PSAX, parasternal short-axis; SSN, supraster-. nal notch. ..... ibility and accuracy of echocardiographic measurements of left ...
www.asecho.org/freepdf/pediatricechoguidelines.pdf - Similar pages
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• No history of exposure to *noel dusts* but says she was exposed to *lung* gas + sm
Fri Jul 4 10:27:07 2008 sm
while in the Army requiring hospitalization.
ESL. This is under social history. Pt being seen for possible sleep apnea.
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Fri Jul 4 14:00:03 2008 OP/sm
why didn't doc say it that way?! LOL.
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Fri Jul 4 10:42:03 2008 Mgt's fan
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Fri Jul 4 10:40:27 2008 Txczech
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Fri Jul 4 10:38:36 2008 Txczech
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Fri Jul 4 10:43:24 2008 OP/sm
getting any of those. The quality of the voice isn't that great, so that's adding to my uncertainty. I'm going to flag these and move on. Thanks again! I really appreciate it.
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Fri Jul 4 10:33:08 2008 Txczech
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Fri Jul 4 10:35:35 2008 OP
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Fri Jul 4 11:22:37 2008 Margaret
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• Seen for possible sleep apnea. Denies *un-con-troll-tah-bole* sensation in legs. + SM for context
Fri Jul 4 10:20:27 2008 SM for context
She also gives a history of tossing and turning in bed but denies any (long pause here) *un-con-troll-tah-bole* sensation in the lower extremities. She does not have paresthesias but does get some pain which occurs at different times of the day.
I thought of uncontrollable but just not sure makes sense in that context. ESL.
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Fri Jul 4 10:27:24 2008 Joe
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Fri Jul 4 10:22:24 2008 billybob
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Fri Jul 4 10:21:41 2008 Txczech
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Fri Jul 4 10:27:48 2008 OP
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• neck is supple, *JD* or *JV* is flat? i'm not sure, anyone know? thanks - b e f n p d
Fri Jul 4 10:20:01 2008 b e f n p d
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Fri Jul 4 10:21:16 2008 billybob
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Fri Jul 4 10:21:01 2008 nm
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Fri Jul 4 10:20:55 2008 zen
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Fri Jul 4 10:20:50 2008 Txczech
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Fri Jul 4 10:26:43 2008 b e f n p d
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• pl sm + l m o d l f
Fri Jul 4 10:06:11 2008 l m o d l f
Please don't laugh at the s/l.
The patient was in sinus bradycardia was still feeling dizzy. We placed him on the s/l*furniture* unit overnight.
I know it has to be something like ICU, CCU etc.. but what?
thanks
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Fri Jul 4 10:10:41 2008 l m o d l f
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• Meniscus s/l treffination was performed. + i j d l i l
Fri Jul 4 10:04:00 2008 i j d l i l
Meniscus s/l treffination was performed with an 18 gauge spinal needle to increase the blood supply to the tear, and then we performed a medial meniscus repair with two ultra FasT-Fix devices in horizontal mattress construct.
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Fri Jul 4 10:06:50 2008 sm
it just may ask, "did you mean?" In your case, it did. : )
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Fri Jul 4 10:17:59 2008 Happy 4th!
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Fri Jul 4 10:04:57 2008 Diana
Consider trephination
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Fri Jul 4 12:28:56 2008 e g k g k j
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• consistent with a *jest* + m e d e c n
Fri Jul 4 09:44:36 2008 m e d e c n
This patient has no current significant GI symptoms. However, she does have a family history of stomach cancer and she has a small lesion consistent with a _________ in her proximal stomach.
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Fri Jul 4 09:51:19 2008 m e d e c n
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Fri Jul 4 09:49:07 2008 just helpin'
nm
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Fri Jul 4 09:47:51 2008 zen
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