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A couple questions regarding Cardiology/Hematology

Posted By: tiffany on 2008-06-02
In Reply to:

Subject: A couple questions regarding Cardiology/Hematology


He does have some mild jugular venous distention (JVD). He does have a slightly positive patojugular reflex.


He does have a grade 1-2/6 murmur load on the lower left sternal border and apex. The lungs: He continues to have a few fine basaloreals on the posterior lower lobe. The abdomen is somewhat softer today, it is rounded.




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A couple of questions regarding Cardiology/Hematology
Subject: A couple of questions regarding Cardiology/Hematology

Hi, sure hope this helps. I had that recently. It is he has a slight hepatojuglar reflux sometimes referred to as reflex but more correctly it is reflux. Also it is "He continues to have a few basilar rales in the posterior lobe."
Couple of lab questions... sm
Subject: Couple of lab questions... sm

Can't catch what Mr. Mush-mouth is saying. 


Postoperative serial white blood cell count demonstrated a stable white blood cell count at 11,900.  s/l *hemansa* hemoglobin stable at 28.9 and 9.4. 


Have a couple of questions, please sm
Subject: Have a couple of questions, please sm

Sorry, filling in for somebody and this doctor is really fast -
1. Patient takes a s/l plepharde of medications.
2. Patient still has constipation despite taking s/l Cerafac.

Thanks!
A couple questions relating to pancreas
Subject: A couple questions relating to pancreas

This is a patient with advanced pancreatic cancer.  Here's the part I'm having trouble with.  He was admitted to the hospital.  "The patient did undergo attempts at [s/l ESRT or "e ester tee"?].  However, the tumor was protruding through the duodenum [s/l ambule] and common bile duct cannot be cannulated.  He was determined to be unresectable and underwent a choledochojejunostomy, gastrojejunostomy, and enteroenterostomy for diversion."  Whew!  Any ideas?
Pulling my hair out - just a couple questions
Subject: Pulling my hair out - just a couple questions

This study is a right ilia-femoral ultrasound. 


 


Is it ilia-femoral or iliac-femoral, and what about the hyphen?


 


ALSO......


 


I cannot figure out what he is saying here:


 


PROCEDURE REPORT:  The abdominal aorta and right ilia-femoral (see above..) systems were S/L: insinated or instinated with a Doppler ultrasound transducer. 


 


Thanks for any help!!


Need help with the MR angiogram in mesage, couple of questions and maybe more :) sm
Subject: Need help with the MR angiogram in mesage, couple of questions and maybe more :) sm

the MR angiogram of the posterior circulation intracranially showed a variant circulation with prominent bilateral “fetal” origin of the PCAs and distal basilar and "P1 segmental" hypoplastic were absent. 
Cardiology questions
Subject: Cardiology questions

Systemic vascular resistance is 1547 dyne to the negative 5th. I would like to know how to transcribe the above correctly. Any help would be greatly appreciated.
HEMATOLOGY
Subject: HEMATOLOGY

Dictation:  Bone marrow analysis was read out as hypercellular marrow with active increased s/l trilinear chematopoesis.


Thank you 


Hematology help
Subject: Hematology help

History of s/l polycitine manevara-have no ideas! TIA
Hem/Onc (hematology and oncology.
Subject: Hem/Onc (hematology and oncology.

x
hematology question
Subject: hematology question

I can't even do a s/l on this one, but it does sound like it starts with an s. The patient does not require any ____ repletion given that his hemoglobin is otherwise stable and way above the recommendations for starting erythropoietin supplementation.  Any ideas?? TIA
hematology question
Subject: hematology question

This doctor usually sounds like he is saying LDAH, but sometimes LDH. I don't know that much about hematology oncology, when he is saying labs he will do, which one is the most likely? TIA
Under Hematology Morphology Critique
Subject: Under Hematology Morphology Critique

I found something about this I don't understand.  Maybe you can look it up on the internet and find out how to write it.  Sorry.
hematology oncolology interview
Subject: hematology oncolology interview

 


I suddenly got a call for an interview with a hematology/oncology group. Does anyone know of a site that I could quickly go to try and review some of the words, maybe some chemotherapy drugs, etc.  I have been working with a urology group and a pain management group for 10 years.  I have probably forgotten what little I did know about this specialty. I have been looking, but no luck. Thanks for any help. Mary Lou  P.S. Just stumbled across this site.  It is awesome!


Could be Hem/Onc as in Hematology/Oncology. Especially if she has cancer. nm
Subject: Could be Hem/Onc as in Hematology/Oncology. Especially if she has cancer. nm

nm
Hematology - know your chemotherapy and dosages well, same anatomy. n/m
Subject: Hematology - know your chemotherapy and dosages well, same anatomy. n/m

 
There are a couple...sm
Subject: There are a couple...sm

Here is a great site with a couple of choices that sound like your term.

http://www.suffolkobgyn.com/medicalTerms#G
a couple T's
Subject: a couple T's

tap water enema
theophylline olmamine enema
tranexamic acid enema
turpentine enema
A couple more....
Subject: A couple more....

he went on to have an aortic valve replacement with a "number tommy five" bioprosthetic valve as well as bypass "sinus tree" vessels


pseudo normal LV filling pressure with "chronkomittent" abnormal relaxation


Patient is New York Heart Association class III in the setting of ischemic cardiomyopathy and "he feels" compensated


beta blockers, carvedilol "a target dose", "aldolsol" inhibitor


 


THANKS!


 


I too would like to know a couple of shortcuts..
Subject: I too would like to know a couple of shortcuts..

such as, I end each letter from my doc with "Thank you for the referral of the patient." Sincerely, John R. Brown, MD JEB/trh. I know there must be a way to store this so that all I have to do is strike 1 key to end my letters, but I don't knave a clue how to do this. Anyone have any suggetstions? Thanks

a couple of thoughts
Subject: a couple of thoughts

First to address the issue of subcu - Joint Commission created a list several years ago that deals with this wording - and JC trumps BOS.  From Joint Commissions List of Dangerous Abbreviations:


Abbreviation: S.C. or S.Q. (for subcutaneous)


Potential Problem:  Mistaken as SL for sublingual, or "5 every"


Preferred Term:  Write "Sub-Q", "subQ", or "subcutaneously"


As far as what the man was trying to express to you was his opinion that truncated words (partial words used to express a complete word) should be avoided.  Trach is not a word.  Trachea, tracheostomy, etc., are words.  Alk is not a word.  Alkaline is a word.  There are also lab and other words that are commonly acceptable in their abbreviated form, such as INR, CPAP, MRI, etc.


There are acceptable abbreviations of certain words that are commonplace.  For example, lab is widely accepted to represent laboratory.  Exam is acceptable to represent examination.  HIV is another example.


If you understand the difference between the use of an abbreviation and avoiding the use of truncated words, your work will reflect a much clearer intent of the dictation.


Your company needs to decide which side of the fence it wants to sit on, and it appears there may be some changes in your QA future.  If this man is in charge of QA and you want to continue working there, you might want to begin taking note of what he is saying.


a couple of things......SM
Subject: a couple of things......SM

Jehovah's Witness


myoclonic gammopathy?  not myoclinic


possibly *gammopathy*


*h* in Jehovah's Witness


couple of possibilities (sm)
Subject: couple of possibilities (sm)

If you're sure you're hearing "radio" that could be a "short-speak" way of saying radiograph.

Another possibility is RDI (respiratory disturbance index).
I have a couple of docs that do this. sm
Subject: I have a couple of docs that do this. sm

The terms sound similar anyway, and if they say them a little too fast, or there's a flaw in the sound, these words sound exactly the same.

But sometimes there's a clue in what's being tested, blood or urine, and/or the diagnosis.

Also, if you can slow the sound down a little, sometimes you can hear a slight difference, just enough to know it's one or the other.

If that doesn't help, the best thing would be to send on to QA. If they can't figure it out, the docs may become tired of blanks and learn to enunciate more clearly. How difficult could that be!

Sorry I can't be of more help, but maybe someone else has a foolproof way to tell.
I have a couple of docs that do this. sm
Subject: I have a couple of docs that do this. sm

The terms sound similar anyway, and if they say them a little too fast, or there's a flaw in the sound, these words sound exactly the same.

Is there a clue in the dx?

If you can slow the sound down a little, sometimes you can hear a slight difference, just enough to know it's one or the other.

If that doesn't help, the best thing would be to send on to QA. If they can't figure it out, the docs may become tired of blanks and learn to enunciate more clearly. How difficult could that be!

Sorry I can't be of more help, but maybe someone else has a foolproof way to tell.
There are a couple of possibilities. Context?
Subject: There are a couple of possibilities. Context?


Here are a couple of links for you to send them....
Subject: Here are a couple of links for you to send them....

http://72.14.253.104/search?q=cache:_yrLOF4eEkIJ:emcrit.org/pdf/Wound%2520Care%2520Syllabi.pdf+XAP+topical+pediatric&hl=en&ct=clnk&cd=13&gl=us (at bottom of page 8)  Hope this helps...When the doc spelled it for me, it was for a laceration repair on a kid.  But, if it's a dental block in the ER, they might be using ZAP for topical in the mouth.  Was something that was really confusing for me at the time, which is why I tried to get some info on it.
Can we have a couple of lines from the report
Subject: Can we have a couple of lines from the report

so we'll know where he is?
New to ortho and have a couple words.
Subject: New to ortho and have a couple words.

s/l *jo-lie-tandis* pain with hyperflexion.  (knee)


 


Negative s/l  *feralmis* test.  (wrist)


 


TIA!


Have heard it used a couple of times
Subject: Have heard it used a couple of times

Just another way to say serial cardiac enzymes, I believe
If he already gave you a couple, then it would be 'all other...' nm
Subject: If he already gave you a couple, then it would be 'all other...' nm

s
Thank You! That's it. He always swallows the first couple of letters when I need them the most.
Subject: Thank You! That's it. He always swallows the first couple of letters when I need them the most.


Can't understand a couple of words
Subject: Can't understand a couple of words

If you're transcribing a report about someone with sinusitis, and the doctor says the ___ are red and swollen (and it doesn't sound like nostrils or nares or membranes) what could it be?  And in the PLAN if he says ___ fluids, rest, and follow up within 7 to 10 days....what could he be saying.  It almost sounds like "Push fluids."  Can anyone help?  Thanks!
Depends on a couple of things
Subject: Depends on a couple of things

The first point would be the hospital's desires. They may or may not want abbreviations spelled out in a report. Also, usually if it's in a diagnosis somewhere, it almost always has to be spelled out, as most hospitals abide by the joint commission rule of no abbreviations. In a regular physical exam somewhere in the text of the report, most hospitals, clinics, etc., seem to want whatever abbreviations the doc may use, so in that case you would just leave it as it is (although this may differ in correspondence as some places prefer a more formal policy of no abbreviations in letters, so check account specifics).
couple of web sites in case you
Subject: couple of web sites in case you

can use them:

revolutionhealth.com/search
M.D. Anderson Cancer Institute, Houston

pathology.washington

bloodjournal.org
Thanks, she did it with a couple others, so that makes sense
Subject: Thanks, she did it with a couple others, so that makes sense


A couple of grammar rules are at play here
Subject: A couple of grammar rules are at play here

First of all, both got and gotten are correct forms of the verb get.  However, got is a past tense or past participle depending on whether or not the word "has" or "have" is used in front of it.  Gotten, however, is past participle and should be used with the word "has" or "have" in front of it.


It has gotten increasingly larger - okay.  It gotten increasingly larger - not okay.  It got increasingly larger - okay.  It has got increasingly larger - okay.


So if your doc says it anyway but "It gotten increasingly larger", he is correct.  It's simply a matter of preference.  Brits don't generally use the word "gotten", and therefore, a lot of people think it is not a legitimate word, but it is.


Does he state 20 the first couple of days or does he give any time along with that? SM
Subject: Does he state 20 the first couple of days or does he give any time along with that? SM

If not, I would just type as dictated and maybe put quotations around it if you are certain of what he is saying.  HTH
SKIN: She has a couple of dermal nevi, nothing that looks suspicious. A few MILEAM on the nose. nm
Subject: SKIN: She has a couple of dermal nevi, nothing that looks suspicious. A few MILEAM on the nose. nm


Hematology/oncology vs. radiation oncology -- what are the big differences?
Subject: Hematology/oncology vs. radiation oncology -- what are the big differences?

I have experience with hematology/oncology but not radiation oncology.  Is it a difficult jump from one to the other?  Broad learning curve?  Any info would be greatly appreciated.  Thanks.


2 questions
Subject: 2 questions

Okay I have 2 questions.  I'll just go ahead and paste in the parts that I need help with:


1.  Chordee with pain and scrotal engulfment.  For this one just want to make sure that the word in bold is the correct spelling for this type of report. 


2Penoplasty with _____ flaps.  The blank s/l Bier's flap, but not sure of the spelling.


 


Any help will be greatly appreciated.


2 questions, sm.
Subject: 2 questions, sm.

 


 Two questions please: What is the proper way to type this?  Are my caps incorrect? 


 


The patient’s B-type Natriuretic Peptide was 312.


 


Also, how would you type half liter of normal saline?  Thanks so much


PE questions
Subject: PE questions

Skin exam: Some psoriatic s/l bliaksing.       bly-ack-sing


------------------------------------------------------------------------


GU exam: No prostate masses or colon masses.


How far up is he feeling???? Help!


Two questions
Subject: Two questions

1. Drug name is Zoloft. It is used for depression. 2. EE prime (supposed to use an umlaut but can spell it out) prime ratio is 16.

BOS-2 questions available on IM!
Subject: BOS-2 questions available on IM!

Just add me to your Yahoo IM and as long as I am online (and that's quite a bit), I'll help with BOS-2 questions!


No lengthy conversations, though, and no e-mails, please. 


BOS2-Lady


questions sm
Subject: questions sm

i found a med Cryselle. it is an oral contraceptive. is the patient female?
Sorry with all the questions but I need help again
Subject: Sorry with all the questions but I need help again

I have worked for 3 years for 2 ENT docs who no longer perform surgery.   They have just added a new doc to the practice and he does perform surgeries.  He is describing the tonsils as essentially "kissing" on examination.   Is this correct? Thanks
A lot of the questions you have been
Subject: A lot of the questions you have been

asking are very, very basic.  You might be getting in over your head if these terms are unfamiliar to you.  Maybe you are just nervous about taking a test and are struggling because of that.  I hope that is the case.  However, it is my opinion that asking for others for help on a test is cheating.  I'm sure you probably didn't think of it this way, otherwise you would not have shared at this point that you are testing.  Iknow you are desperate for help, but the company is testing YOU, not us on the word board.  You have to stand on your own skills when testing.  If you don't pass, then it means you are not ready.  Good luck to you.


a few questions please sm
Subject: a few questions please sm

I have a few questions:


1. Patient worked as a bartender in "Mike Dulin's". (The patient lives in NJ, if that helps.)


2. Regarding meds, doctor says Nasacort 8 q.  Is this supposed to mean q 8?


3. Under PE, eyes revealed s/l *archosenilis*.


4. The patient has severe COPD with PFTs severely reduced. Then doctor says "The patient was unable to *apiliprate* on nitrogen washout for lung volumes.


Any help would be greatly appreciated!!! Thanks! :)


2 questions
Subject: 2 questions

Intraoperative permanent films showed good position of the fracture and hardware, but when (discopiously) lavaged, the fascia was closed using 1 Vicryl.

2 questions:
1. disc-o-p-us-lee
2. The dictator just said 1 Vicryl, but should I change it to 1-0?
2 questions
Subject: 2 questions

PROCEDURE: Medial branch block of the L4-5 and L5-S1 facets on the right. Under fluoroscopic guide, the (scheduled procedured) patient was brought to (ob-suse)with operating room, placed in prim position.

Scheduled procedured patient I THINK is right, but I am not sure. It doesn't sound right.

The second one I am just lost on.