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Nov 7 10:24
• A large amount of ________ material was extracted from the cavity.
+ mp3 posted
Wed Nov 22 15:17:10 2017 mp3 posted
note: epidermal inclusion cyst I&D

• (Cataract surgery). A side s/l forward incision created at 5 oclock.
- nt
Wed Nov 22 12:34:57 2017 nt

** • i found forward side cut incision so maybe you heard that right. - b o l b o m
Wed Nov 22 13:10:28 2017 b o l b o m

**** • thank you! - nt
Wed Nov 22 14:06:35 2017 nt


• There was some tympanosclerosis associated with both the incus and the ...
+ mp3
Wed Nov 22 10:54:54 2017 mp3
There was some tympanosclerosis associated with both the incus and the malleus. This was also removed and the drum was left adherent to the malleus. _____ there was no skin on the medial surface of this. There was a small retraction pocket in the pars flaccida region, but _____ was easily seen. The ossicular chain after removal of mucosal disease surrounding it, was determined to be intact including the IS joint and the stapes
** • the end of this could be easily seen #2 - b o l b o m
Wed Nov 22 12:24:59 2017 b o l b o m

** • never mind. Thanks to anyone who tried. - guy
Wed Nov 22 11:07:21 2017 guy


• Next, mastoidectomy was performed using correctively smaller cutting a ...
+ wav
Wed Nov 22 10:36:50 2017 wav
Next, mastoidectomy was performed using correctively smaller cutting and then diamond burs. The sigmoid sinus was noted to be quite anterior, but was identified and preserved and similarly the tegmen was identified and the ear canal ____. The right few air cells, but they were eventually identified after _____ septum had been cleared and there was submucosal disease filling these air cells.
** • never mind. Thanks to anyone who tried. - guy-wag
Wed Nov 22 11:07:10 2017 guy-wag


• There had been no otorrhea on the left side and no other infectious sy ...
+ wav
Wed Nov 22 10:13:02 2017 wav
There had been no otorrhea on the left side and no other infectious symptoms for some time. On exam, she had a large subtotal anterior inferior perforation with _____ through it. Audiogram revealed moderate conductive loss with an air-bone gap of 30 to 40 and the CT that had proceeded for initial surgery showed bilateral contracted mastoid bone on the left side
** • to muffled for me - poi
Wed Nov 22 10:36:39 2017 poi

**** • Thanks for the effort. - guy-wag
Wed Nov 22 10:37:05 2017 guy-wag


• PREOPERATIVE DIAGNOSIS: CHRONIC SUPPURATIVE OTITIS MEDIA, LEFT TYMP ...
+ wav
Wed Nov 22 10:03:42 2017 wav
PREOPERATIVE DIAGNOSIS:
CHRONIC SUPPURATIVE OTITIS MEDIA, LEFT TYMPANIC MEMBRANE PERFORATION.

PROCEDURE:
LEFT TYMPANOPLASTY, MASTOIDECTOMY, AND CANALOPLASTY.

FINDINGS: Stenotic ear canal, subtotal tympanic membrane perforation, extensive middle ear mucosal disease and tympanosclerosis. Intact and mobile ossicular chain, _____ eustachian tube, contracting mastoid with few air cells. No evidence of cholesteatoma.
** • polyp(s) in ? - taco
Wed Nov 22 10:06:17 2017 taco

**** • Thanks a lot. - guy
Wed Nov 22 10:11:34 2017 guy


• Use of Escharus
+ cjt
Wed Nov 22 09:42:26 2017 cjt
Physician is saying, he has 2 "escharus" regions on his left foot. He has used this term before, and this is how I spelled it, but wondering if it should be another way. Can't find it anywhere in reference or dictionary.
Thanks
** • Thanks. I will change and put in my autotext to remember. - ct
Wed Nov 22 10:40:20 2017 ct

** • see message + lb
Wed Nov 22 09:59:37 2017 lb
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4626714/ this site has it as escharous.
** • I'd say it would be escharous, similar to tuberous, poisonous, bulbous and others. - nm
Wed Nov 22 09:49:01 2017 nm


• This is a 39-year-old woman with a two-week history of tympanic membra ...
+ wav
Wed Nov 22 08:55:25 2017 wav
This is a 39-year-old woman with a two-week history of tympanic membrane perforation which was iatrogenic after an incident involving cerumen debridement. She had no history of prior otologic infections or surgery. We had a small amount of otorrhea obtained immediately after the event, but this had resolved over the last 18 months. The perforation _____ to close. The patient did not experience any significant hearing loss, a very small air-bone gap on her audiogram; however, the dry ear precautions were interfering with her quality of life, since she is a water sport participant.
** • ____ but failed to close. - poi
Wed Nov 22 09:02:26 2017 poi

**** • Thanks a lot. - guy
Wed Nov 22 09:02:50 2017 guy


• black stone _____ noted. A 10-French 7 cm Boston Scientific single _____ stent
+ wav
Wed Nov 22 07:33:46 2017 wav
The endoscope was brought to the second portion of the duodenum. The bile duct was cannulated and cholangiogram obtained. Significant dilatation of bile duct was noted. Stone was noted in the distal duct, to be about 5 to 6 mm. After a sphincterotomy, it was removed with the help of endoscopic balloon. A good drainage was noted. The stone was pigmented black stone _____ noted. A 10-French 7 cm Boston Scientific single _____ stent was placed into the duct. It was placed in good position and prompt drainage was noted. The procedure was tolerated by the patient.


** • black gravel, that is. - mn
Wed Nov 22 08:50:45 2017 mn

** • I hear "gravel" for the first blank. - mn
Wed Nov 22 08:47:23 2017 mn

**** • Thanks a lot. - guy
Wed Nov 22 08:54:58 2017 guy


• PREOPERATIVE DIAGNOSIS: RIGHT CARPAL TUNNEL SYNDROME. PROCED ...
+ wav
Wed Nov 22 05:55:53 2017 wav
PREOPERATIVE DIAGNOSIS:
RIGHT CARPAL TUNNEL SYNDROME.

PROCEDURE:
RIGHT CARPAL TUNNEL RELEASE.

We made a longitudinal incision on the palmar surface in line with the ulnar border of the middle finger extending from the mid palm to approximately 1 cm distal to the distal wrist crease. The incision was deepened through subcutaneous tissue sharply and carried down through the subcutaneous fat and through the palmar fascia. We took care to stay radial to Guyons canal to avoid damage to the ulnar neurovascular bundle. The incision was further sharpened through the palmar fascia _____ the transverse carpal ligament. A small nick was made in the transverse carpal ligament and a Freer elevator was used to elevate the rest of the transverse carpal ligament and the rest of the ligament was incised sharply.

• PREOPERATIVE DIAGNOSIS: THIS IS A 36-YEAR-OLD GRAVIDA 3, PARA 3-0-0 ...
+ wav
Tue Nov 21 23:59:37 2017 wav
PREOPERATIVE DIAGNOSIS:
THIS IS A 36-YEAR-OLD GRAVIDA 3, PARA 3-0-0-3 WITH POSTPARTUM HEMORRHAGE AND CONCERN FOR MORBIDLY ADHERENT PLACENTA.

PROCEDURE:
TOTAL ABDOMINAL HYSTERECTOMY, BILATERAL SALPINGECTOMY, AND CYSTOSCOPY.

FINDINGS: Intraop Findings: An ____ boggy uterus. Normal bilateral tubes and ovaries.
** • I think I hear "Findings: Had a _____ enlarged boggy uterus." - Questyr
Wed Nov 22 02:21:53 2017 Questyr

**** • Thanks a lot. - guy
Wed Nov 22 05:55:23 2017 guy


• Please help with medication. it sounds like "exordazine"
+ f p l c p e
Tue Nov 21 20:43:12 2017 f p l c p e
Patient has generalized anxiety disorder, major depressive disorder, alcohol dependence, mental illness. TIA!
** • please give surrounding words, before and after - nm
Wed Nov 22 08:22:44 2017 nm

** • Sorry, I had no luck. - Questyr
Tue Nov 21 21:50:41 2017 Questyr


• PREOPERATIVE DIAGNOSIS: RULE OUT TEMPORAL ARTERITIS. PROCEDU ...
+ wav
Tue Nov 21 18:12:47 2017 wav
PREOPERATIVE DIAGNOSIS:
RULE OUT TEMPORAL ARTERITIS.

PROCEDURE:
RIGHT TEMPORAL ARTERY BIOPSY.

The patient is a 74-year-old male with a past medical history of cataracts who presented with three weeks of right eye blurriness, jaw claudication, and temporal pain, right side greater than left. _____ elevated upon admission, the patient was treated empirically for temporal arteritis with IV steroids.
** • ???ESR and CRP??? (see link) + Questyr
Tue Nov 21 19:27:46 2017 Questyr
link
**** • Thanks a lot. - guy
Tue Nov 21 23:57:01 2017 guy

** • never mind. Thanks to anyone who tried. - guy
Tue Nov 21 19:25:35 2017 guy

**** • ... + c c h c l l
Wed Nov 22 05:55:32 2017 c c h c l l


• Pt with cvid and mgus
+ Dee
Tue Nov 21 17:44:07 2017 Dee
Will repeat labs and s/l colon survey.
** • sounds right - SM + b o l b o m
Tue Nov 21 17:53:19 2017 b o l b o m
Common Variable Immune Deficiency (CVID) is one of the most frequently diagnosed ... malabsorption of fat and certain sugars or inflammatory bowel disease
**** • Thanks! - a j i b o b
Tue Nov 21 19:28:47 2017 a j i b o b


• Nasal septal deviation, nasal obstruction, and left concha bullosa.
+ b o h b c p
Tue Nov 21 16:59:47 2017 b o h b c p
When the cartilage spur was completely free of the mucosa and other attachments, a "Targerhash" was used to remove the spur off the maxillary crest.
** • Takahashi - Got it!
Tue Nov 21 17:00:58 2017 Got it!


• liver oil, Iberogast, super B complex, ________, astragalus root
- mp3 posted
Tue Nov 21 15:27:02 2017 mp3 posted

** • I have till tomorrow to submit report if anybody has any suggestions - OP
Tue Nov 21 16:15:22 2017 OP

**** • flagged - OP
Wed Nov 22 01:24:44 2017 OP


• Psychotherapeutic work
+ b o h b c p
Tue Nov 21 13:35:26 2017 b o h b c p
Patient was able to have a "rote approach Mont" with parents and able to recognize that they were acting in patient's best interest.
** • rapprochement - nm
Tue Nov 21 13:43:33 2017 nm

**** • Thank you! + b o h b c p
Tue Nov 21 13:46:39 2017 b o h b c p
:o)

• patient, a **cart washing** door was dropped onto his finger
+ ?
Tue Nov 21 11:42:38 2017 ?
is a pleasant 62-year-old male who presents to the emergency room for evaluation of injury sustained at work. As per the patient, a **cart washing** door was dropped onto his finger. He sustained the aforementioned injury during his work schedule. There was no associated loss of consciousness, negative nausea and vomiting, and negative change in mental status. Pressure was applied in order to stop the bleeding. However, given the nature of his injury, he presented to the emergency room for evaluation.
** • flagging - -
Tue Nov 21 12:10:58 2017 -


• , it appeared to have ** skived** the bladder neck
+ sm
Tue Nov 21 10:12:12 2017 sm
Using video assistance, a 22-French Storz cystoscope was inserted retrograde per urethra to the bladder. The urethra was unremarkable. The bladder was examined with both 30- and 70-degree lenses. Both ureteral orifices were identified in normal position and effluxed clear urine. There was no evidence of tumors, no calculi.

A needle was introduced through the cystoscope. At this point, it appeared to have ** skived** the bladder neck, venous bleeding was encountered; therefore, the needle was removed, replaced with a Bugbee electrode and the bladder neck was fulgurated. There was no evidence of active bleeding.


** • Yes, skived + sm
Tue Nov 21 12:12:11 2017 sm
https://www.google.com/search?ei=wF0UWt2QKomFmQGko5GYAQ&q=needle+skive&oq=needle+skive&gs_l=psy-ab.3..35i39k1.96635.97274.0.97946.4.4.0.0.0.0.95.361.4.4.0....0...1.1.64.psy-ab..0.4.361...33i160k1.0.I8Z3dDi1L3E
** • flagged - -
Tue Nov 21 11:46:01 2017 -


• U1-RNP QN? sm
+ deb
Tue Nov 21 09:38:01 2017 deb
ANA positive with U1-RNP QN positive at a dilution of 3.9.

Finding U1-RNP but not the QN part.
** • maybe QAlb = albumin quotient - just a thought
Tue Nov 21 12:32:12 2017 just a thought

** • Just a thought, maybe QN referring to "quantity not" positive? nm - GinnyG
Tue Nov 21 10:05:59 2017 GinnyG

**** • Sent with a note. I'll let you know if I find out. Thanks! nm - dep
Tue Nov 21 11:36:08 2017 dep


• 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

**** • ROTEM provides the most complete and rapid information on hemostasis. ... + nm
Tue Nov 21 10:45:00 2017 nm
ROTEM provides the most complete and rapid information on hemostasis. Unlike other clotting assays, ROTEM analyzes whole blood and provides ...
**** • 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




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