recurrent bilateral effusions and it was *kylus** and they thought it was due to thoracic duct injur
Posted By: Stacee on 2008-01-07
In Reply to:
Subject: recurrent bilateral effusions and it was *kylus** and they thought it was due to thoracic duct injur
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pleural effusions with s/l *kylus* drainage
Subject: pleural effusions with s/l *kylus* drainage
Need help with a neonatal progress note. Infant is status post "bilateral pleural effusions with s/l "kylus" drainage. Any ideas?
is it thoracic? Maybe TESI - thoracic epidural steroid injection? Just a guess - nm
Subject: is it thoracic? Maybe TESI - thoracic epidural steroid injection? Just a guess - nm
xx
MRI of thoracic spine. There is a relatively normal thoracic s/l hi-pos-is.
Subject: MRI of thoracic spine. There is a relatively normal thoracic s/l hi-pos-is.
::-)
Is typing biapical ok or should I put bilateral apical as he does say bilateral towards the end of t
Subject: Is typing biapical ok or should I put bilateral apical as he does say bilateral towards the end of the dictation?
effusions every six weeks
Subject: effusions every six weeks
This is under the medication list. the patient has lung pleurisy
yes, effusions is a valid word
Subject: yes, effusions is a valid word
x
How about "stability" of pleural effusions???
Subject: How about "stability" of pleural effusions???
x
OME = otitis media with effusion or effusions. nm
Subject: OME = otitis media with effusion or effusions. nm
Pt with bilateral breast reconstruction. She had bilateral
Subject: Pt with bilateral breast reconstruction. She had bilateral
s/l NoWet sponges in the area of both breasts. Ideas????
bilateral conjunctivae...example...bilateral knees..nm
Subject: bilateral conjunctivae...example...bilateral knees..nm
recurrent pain?
Subject: recurrent pain?
DL branc -recurrent croup
Subject: DL branc -recurrent croup
Pt with recurrent episodic croup "PLAN: s/l "DL branc," rule out anatomical narrowing. Did briefly discuss reflux, but I would like to do a s/l "DL branc" beforehand to make sure there is not an anatomic issue.
The only DL branc that I could find had to do with TB, but this is a pediatric pt with no previous hx of TB etc. 
recurrent breast abscess
Subject: recurrent breast abscess
Recurrent laryngeal carcinoma
Subject: Recurrent laryngeal carcinoma
I plan to treat him with a combination of Erbitrux and chemotherapy. I have explained to him that it is experimental therapy. There is no guarantee of success. The turbacent toxicities are substantial and these were discussed with the patient. The patient wishes to proceed and will see me back next week.
This patient has recurrent laryngeal carcinoma. - Thanks so much for helping.
I think it might be that, as she has recurrent rectocele but I am flagging it
Subject: I think it might be that, as she has recurrent rectocele but I am flagging it
for QA anyway. Don't want to put in the wrong thing. Thanks for all your help!!
possibly recurrent atelectasis???
Subject: possibly recurrent atelectasis???
nm
Neonatal circ with recurrent adhesions
Subject: Neonatal circ with recurrent adhesions
This has to be circumcision, right? But he is saying the patient can get beneath the foreskin clean, but blah, blah. But if he was circumcised, he would not have foreskin, right? Or with the adhesions, would there still be some there? I'm confused! TIA
Recurrent ***losis secondary to MRSA.
Subject: Recurrent ***losis secondary to MRSA.
The patient takes tetracycline to treat these areas on her buttocks. TIA!!!
Patient has recurrent gastric outlet obstruction and ...
Subject: Patient has recurrent gastric outlet obstruction and ...
megagastrium. Cannot find this anywhere! Did he make it up? TIA!!
She has a history of recurrent silarities and lymphedema. Definitely not abnormalities. please sm
Subject: She has a history of recurrent silarities and lymphedema. Definitely not abnormalities. please sm
Doc is from Puerto Rico and has a heavy accent.
Stensen duct
Subject: Stensen duct
According to Dorland's dictionary and it is in the mouth.
sac of the cystic duct ??
Subject: sac of the cystic duct ??
Does the cystic duct have a sac????/ It sounds like sac....but here it is in context...
The gallbladder was elevated with the sac of the cystic duct free initially. It was a relatively long structure.
hx of recurrent UTI - The patient was encouraged not to use a condom Foley and continue 'SIMC.
Subject: hx of recurrent UTI - The patient was encouraged not to use a condom Foley and continue 'SIMC.'
speaking of recurrent thyroid cancer..so in that area the intra-media-sty-num sm
Subject: speaking of recurrent thyroid cancer..so in that area the intra-media-sty-num sm
Interestingly the PET scan revealed minimal FDG uptake in the right thyroid bed consistent with the right anterior tracheal lesion, and also minimal uptake in what is believed to be persistent thymic tissue in the "intra-media-stynum", but nowhere else is it noted. MRI was reviewed as well. This confirms a 1.4 cm enlarged lymph node on the right side at the level of C3......
maybe common duct exploration? nm
Subject: maybe common duct exploration? nm
x
partially occluded s/l eep duct
Subject: partially occluded s/l eep duct
I need help with this part on a not so great recording. The doctor says "At the bronchus intermedius is a partially occluded [s/l eep] duct and [s/l polyp or polished] white pale tissue which [bled (I think)] easily." Can anyone shed any light? Thanks.
maybe inflamed meibomian duct?
Subject: maybe inflamed meibomian duct?
sounds like sialic duct
Subject: sounds like sialic duct
TIA!!
Stenson's duct gland?
Subject: Stenson's duct gland?
Anyone know this? I can't confirm this as being right..."Stenson's duct gland?" It's in the mouth...
Thanks!
could it be "...the neck and cystic duct..." ??
Subject: could it be "...the neck and cystic duct..." ??
Got it, "some bile duct" . . thanks!
Subject: Got it, "some bile duct" . . thanks!
I wonder if it's common bile duct stone? nm
Subject: I wonder if it's common bile duct stone? nm
nm
Lacrimal duct balloon inflated to 8 s/l bar? nm
Subject: Lacrimal duct balloon inflated to 8 s/l bar? nm
extrahepatic or biliary? bile duct? nm
Subject: extrahepatic or biliary? bile duct? nm
It does not sound like biliary/bile duct!
Subject: It does not sound like biliary/bile duct!
ejection fraction ______ (titer? hi duct?)
Subject: ejection fraction ______ (titer? hi duct?)
CLueless here.... The patient had right upper quadrant pain and the ultrasound did not show gallbladder disease. Says we may need to do an ejection fraction _____. titer? hi duct? Can't make out any better than that. Ideas?
Hmmm. Can you hear alveolar duct? Maybe polypoid for the second s/l? nm
Subject: Hmmm. Can you hear alveolar duct? Maybe polypoid for the second s/l? nm
x
Hepatic duct was dilated with a s/l Chahyndra dilator.
Subject: Hepatic duct was dilated with a s/l Chahyndra dilator.
mild s/l muritzes of the common bile duct. TIA!!!
Subject: mild s/l muritzes of the common bile duct. TIA!!!
probably stands for common bile duct exploration--CBDE.
Subject: probably stands for common bile duct exploration--CBDE.
x
Is the common bile duct and intrahepatic biliary tree--sm
Subject: Is the common bile duct and intrahepatic biliary tree--sm
two separate structures. Should they be listed under two headings?
could it be all T as in all thoracic
Subject: could it be all T as in all thoracic
spine vertebrae?
thoracic
Subject: thoracic
What did he say about thoracic spine
Subject: What did he say about thoracic spine
earlier in the report?
We don't have all the clues here.
thoracic surgery
Subject: thoracic surgery
There is a Robicheck wire. Maybe?
thoracic kyphosis, maybe
Subject: thoracic kyphosis, maybe
nm
Thoracic kyphosis is the most likely sm
Subject: Thoracic kyphosis is the most likely sm
Unless the doc goes on to describe other abnormalities, "thoracic" is probably what you're looking for.
s/l thoracic lumbar-sure
Subject: s/l thoracic lumbar-sure
Still has a significant paraspinal muscle spasm throughout entire cervical spine and this does extend into upper aspects of thoracic lumbar-sure down to the T4 area.
thoracic spine
Subject: thoracic spine
there is no mass/displacement overlying s/l catagolist paraspinous tissue structures.
Any idea with this term? This is x-ray of thoracic spine.
PE [s/l furcod] thoracic CT
Subject: PE [s/l furcod] thoracic CT
thoracic back pain after MVA
No vertebral tenderness on palpation. She does have some tenderness on palpating rhomboids and s/l Q L's and paraspinal muscles.
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