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Scribing > Medical Terminology > Flashcards

Medical Terminology Flashcards

1
Q

C-Spine

A

Cervical Spine region, (C1-C7)

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2
Q

-ectomy

A

surgical removal (e.g. tonsillectomy)

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3
Q

Epigastric Region

A

Upper central region of the abdomen

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4
Q

Fontanel

A

Soft-spot of infant’s skull

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5
Q

-itis

A

inflammation (e.g. appendicitis)

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6
Q

-scopy

A

viewing with a scope (e.g. colonoscopy)

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7
Q

L-Spine

A

Lumbar Spine region, (L1-L5)

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8
Q

Suprapubic Region

A

Lower central region of the abdomen

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9
Q

auscultation

A

listening with a stethoscope

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10
Q

Fluctuating vs. Intermittent

A

Fluctuating - Sx always present, but varying in intensity without resolving

Intermittent - Sx completely resolve sometimes but continue to return.

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11
Q

baseline

A

the normal state of being for each specific patient

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12
Q

benign

A

normal, of no danger to health

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13
Q

catheter

A

Tube inserted into vessels or body cavities to permit injection or withdrawal of fluids or to keep passage open

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14
Q

Paroxysmal

A

Occasional, sporadic, transient

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15
Q

differential diagnosis

A

the diseases that a physician is considering as the reason for the patient’s symptoms

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16
Q

Transient

A

Resolving spontaneously after onset

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17
Q

FHx

A

Family History, the part of the patient history listing diseases and health conditions within the patient’s family.

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18
Q

grossly

A

obviously; a lot; wholly

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19
Q

hemorrhage

A

excessive or profuse bleeding

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20
Q

infarct

A

area of dead tissue after a lack of blood supply (e.g. myocardial infarction)

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21
Q

R/o

A

Rule out

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22
Q

Review of Symptoms (ROS)

A

The part of the chart containing the symptoms a patient has or does not have, grouped by body/organ system. This section is subjective.

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23
Q

ischemia

A

lack of blood supply to a specific area

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24
Q

palpation

A

examine by touch

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25
Q

affect

A

the expressed or observed emotional and social responses

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26
Q

auditory hallucinations

A

hearing voices, noises, music, or sounds that are not actually real

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27
Q

depressed

A

appearing sad, unhappy

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28
Q

S/p

A

Status post (a procedure or event)

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29
Q

SHx

A

Social History, the part of a patient’s history listing substance use, occupation, diet, exercise, living situation, marital status, etc.

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30
Q

flat affect

A

lack of normal interactions, monotone, unemotional

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31
Q

homicidal ideation

A

thoughts of killing another person

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32
Q

suicidal ideation

A

thoughts of killing oneself

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33
Q

tangential thoughts

A

though processes that do not follow normal or logical progressions

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34
Q

Sx

A

Symptoms

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35
Q

visual hallucinations

A

seeing objects, people, or things that do not actually exist

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36
Q

Tx

A

Treatment

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37
Q

UTD

A

Up to Date

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38
Q

aphasic

A

absence of the ability to neurologically generate or understand language. Either inability to create words or inability to understand spoken words

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39
Q

WNL

A

Within Normal Limits (normal, not concerning)

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40
Q

ataxia

A

loss of coordination

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41
Q

cephalgia

A

headache

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42
Q

epilepsy

A

seizure disorder

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43
Q

Abcess

A

A collection of pus underneath the skin

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44
Q

Appendicitis

A

Dangerous infection of the appendix

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45
Q

Arthritis

A

Inflammation of the joints

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46
Q

facial asymmetry

A

dropping of one side of the face indicating neurological damage

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47
Q

Atrial Fibrillation (Afib)

A

Arryhthmia characterized by irregularly contracting atria, often rapidly.

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48
Q

hemiparesis

A

weakness of one half of the body

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49
Q

hemiplegia

A

paralysis of one half of the body

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50
Q

loss of consciousness (LOC)

A

passing out

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51
Q

meningitis

A

infection of the meninges, the outer lining of of the brain and spinal cord

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52
Q

Bell’s Palsy

A

Localized facial nerve dysfunction causing facial droop and numbness

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53
Q

moves all extremities (MAEx4)

A

the patients moves their arms and legs normally, indicating normal motor function

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54
Q

Bronchitis

A

Inflammation/infection of the bronchi (upper airway)

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55
Q

normal DTRs

A

normal deep tendon reflexes, rated as 2/4

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56
Q

oriented x3

A

oriented to person, place, and time

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57
Q

CA

A

Cancer, Carcinoma

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58
Q

paresthesia

A

abnormal tactile sensation often described as tingling, numbness, or pinpricking

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59
Q

Cellulitis

A

Inflammation of the skin cells

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60
Q

CVA

A

Cerebrovascular Accident, AKA stroke. Blood flow to the brain is restricted by a clot or hemorrhage causing neurological damage and dysfunction.

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61
Q

postictal

A

the state of somnolence and decreased responsiveness after a seizure

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62
Q

syncope

A

passing out, LOC or fainting

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63
Q

Cholecystitis

A

Inflammation of the gall bladder

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64
Q

vertigo

A

room-spinning dizziness (not light-headed)

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65
Q

Cholelithiasis

A

Production of gall stones

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66
Q

abrasian

A

scrape of the skin due to something abrasive

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67
Q

COPD

A

Chronic Obstructive Pulmonary Disease, a chronic inflammation of the lungs that obstructs airflow

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68
Q

avulsion

A

a forcible pulling away of a part or structure

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69
Q

CRF

A

Chronic Renal Failure, a decrease in the kidney’s capacity to filter waste and fluid from the blood

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70
Q

cyanosis

A

blue color of the skin due to lack of oxygen

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71
Q

diaphoresis

A

sweating

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72
Q

Conjunctivitis

A

Inflammation or infection of the outer layer of the eye

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73
Q

ecchymosis

A

bruising

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74
Q

CABG

A

Coronary Artery Bypass Graft, a heart surgery done to open blood flow to the heart in the coronary arteries if blocked/obstructed.

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75
Q

eczematous rash

A

dry, scaly skin consistent with eczema

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76
Q

edema

A

swelling

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77
Q

erythema/erythematous

A

redness/red

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78
Q

fascia

A

fibrous membrane of connective tissue supporting and separating muscles and body organs

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79
Q

fluctuance

A

palpable fluid beneath the skin indicative of infection/pus

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80
Q

CAD

A

Coronary Artery Disease, Buildup of plaque in the arteries supplying blood to the heart.

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81
Q

hematoma

A

raised area with underlying blood which occurs in tissue resulting from ruptured blood vessels

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82
Q

Costochondritis

A

Inflammation of the rib cartilage

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83
Q

incision and drainage (I&D)

A

procedure used to drain and abscess to relieve pain and speed healing

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84
Q

Croup

A

Viral infection of the upper airway with a barking cough and often stridor

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85
Q

DVT

A

Deep Venous Thrombosis, a blood clot formed deep in the body, typically the leg

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86
Q

induration

A

hardened area of tissue; soft tissue that becomes extremely firm

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87
Q

keloid

A

hypertrophic scar; raised scar

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88
Q

Dermatitis

A

Inflammation of the skin

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89
Q

laceration

A

splitting of the skin due to trauma (a cut due to something sharp)

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90
Q

Diverticulitis

A

Acute inflammation of the diverticula pouches

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91
Q

maculopapular rash

A

a rash that is both raised and red

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92
Q

Ectopic Pregnancy

A

Egg developing/implanted outside of the uterus; extremely dangerous due to risk of rupture

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93
Q

mottled

A

patchy skin color due to poor blood circulation

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94
Q

pallor

A

pale skin typically due to anemia

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95
Q

Endometriosis

A

Presence of functioning endometrial tissue outside of the uterus

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96
Q

papular

A

raised bumps

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97
Q

petechial rash

A

red or purple discolorations on the skin that do not blanch (lighten) on applying pressure (a sign of meningitis)

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98
Q

Gastroenteritis

A

General term for inflammation of the GI tract

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99
Q

GERD

A

Gastroesophageal Reflux Disease, AKA acid reflux. Occurs when stomach acid or food and fluids back up into the esophagus

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100
Q

pitting edema

A

edema that retains an imprint when touched

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101
Q

pruritic

A

itchy

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102
Q

purulence/purulent

A

pus/pus-like

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103
Q

Gout

A

A type of arthritis characterized by uric acid crystallizing in the joints

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104
Q

serosanguinous

A

consisting of serum and blood

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105
Q

subungual

A

BENEATH NAIL

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106
Q

Hepatitis

A

Inflammation of the liver

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107
Q

tenting

A

slow return of the skin to its normal position after being pinched, a sign of either dehydration or aging, or both

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108
Q

IDDM

A

Insulin Dependent Diabetes Mellitus, AKA Type 1 Diabetes.

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109
Q

Lymphangitis

A

Inflammation of a lymphatic vessel, appears as red streaking

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110
Q

turgor

A

skin elasticity (poor turgor is a sign of dehydration or age)

111
Q

ulcerations

A

blisters or open sores

112
Q

Multiple Sclerosis

A

MS, autoimmune demyelinating disease affecting the central nervous system (brain and spinal cord)

113
Q

urticarial rash/wheals

A

a patchy red, raised rash, consistent with allergic reactions

114
Q

MI

A

Myocardial infarction, death of cardiac muscle due to prolonged ischemia. AKA heart attack

115
Q

vesicular rash

A

vesicles; fluid filled blisters (e.g. herpes)

116
Q

arthralgias

A

joint aches

117
Q

Nephrolithiasis/renal calculi

A

Kidney stone

118
Q

atrophic

A

showing signs of tissue degradation or breakdown

119
Q

NIDDM

A

Non-insulin dependent diabetes mellitus, AKA Type 2 Diabetes.

120
Q

bony tenderness

A

tenderness of the bone indicative of a fracture

121
Q

Otitis externa

A

Infection of the outer ear (Ear canal)

122
Q

deformity

A

visual abnormality of a bone or anatomical structure

123
Q

OM

A

Otitis Media, Infection of the inner ear (Behind the TM)

124
Q

dislocation

A

disconnected joint; complete misalignment of the joint

125
Q

fracture (Fx)

A

broken bone

126
Q

Pancreatitis

A

Inflammation of the pancreas

127
Q

kyphosis

A

hunchback, rounded thoracic convexity of the spine

128
Q

PID

A

Pelvic Inflammatory Disease, inflammation of a woman’s reproductive organs

129
Q

malleolus

A

bony prominence on each side of the ankle (medial malleolus and lateral malleolus)

130
Q

PUD

A

Peptic ulcer disease, ulcers develop in the stomach causing pain and emesis

131
Q

Pericarditis

A

Inflammation or infection of the pericardium, the protective membrane surrounding the heart

132
Q

myalgia

A

muscular pain

133
Q

PVD

A

Peripheral vascular disease, causes narrowing, blockage, or spasming of peripheral blood vessels

134
Q

paraspinal tenderness

A

tenderness of the muscles beside the spine

135
Q

range of motion (ROM)

A

capability of a joint to go through its complete spectrum of movements

136
Q

Pharyngitis

A

Throat infection/inflammation

137
Q

Pneumonia

A

Infiltration or infection inside of the lung tissue

138
Q

vertebral point-tenderness

A

tenderness directly over the spine (vertebrae), increased likelihood of fracture

139
Q

PTX

A

Pneumothorax, presence of air or gas in the pleural space; a collapsed lung

140
Q

Psoriasis

A

Autoimmune skin disease the causes dry, scaly, red, itchy patches of skin

141
Q

PE

A

Pulmonary Embolism, blockage of the pulmonary artery or one of its branches due to a translocated clot

142
Q

adnexal tenderness

A

tenderness of the ovaries during the pelvic exam indicative of ovarian cyst or torsion

143
Q

Pyelonephritis

A

Inflammation of the kidneys

144
Q

Sciatica

A

Compression of the sciatic nerve causing back pain with radiation to posterior leg

145
Q

c-section

A

cesarean section

146
Q

cervical os

A

the opening of the cervix; always will be closed unless passing tissue from the cervix

147
Q

Sepsis

A

Dangerous infection of the blood, bacteria within the blood stream

148
Q

Sinusitis

A

Infection/inflammation of the sinuses

149
Q

CVA tenderness

A

costovertebral angle tenderness; tenderness over the kidneys

150
Q

dysmenorrhea

A

painful menstruation

151
Q

dysuria

A

painful urination

152
Q

Tinea

A

Fungal rash

153
Q

TIA

A

Transient ischemic Attack, AKA mini-stroke. Neurological function is regained completely over time.

154
Q

foley catheter

A

a tube inserted through the urethra to drain urine, often left in place

155
Q

frequency

A

urinating often

156
Q

URI

A

Upper Respiratory Tract Infection, an infection of the upper airway (sinuses, throat, lungs, or airways.

157
Q

G/P/Ab

A

gravida (the # of times pregnant)/para(the # of live children born)/abortion(# of failed pregnancies)

158
Q

BMP

A

Basic Metabolic Panel, blood test measuring 8 different substances to eval kidney function, fluid and electrolyte balance, blood sugar levels, acid/base balance, and metabolism

159
Q

gravid

A

the state of being pregnancy; appearing pregnant

160
Q

hematuria

A

blood in the urine

161
Q

intrauterine pregnancy (IUP)

A

when a fertilized egg implants and starts to develop within the uterus, where it is supposed to be

162
Q

CXR

A

Chest X-Ray

163
Q

last normal menstrual period (LMP)

A

last time they had a menstrual period

164
Q

CBC

A

Complete Blood Count. A blood test used to evaluate overall health and detect a wide range of disorders including anemia, infection, and leukemia.
-w/ Diff: Includes specific counts of immune lymphocytes, granulocytes, and phagocytes
-w/ peripheral smear: evals number and appearance of RBCs.

165
Q

OB/GYN

A

obstetrics and gynecology

166
Q

spotting

A

passing very small amounts of blood from the vagina

167
Q

urgency

A

abrupt onset of urge to urinate

168
Q

dyspepsia

A

indigestion

169
Q

dysphagia

A

difficulty swallowing

170
Q

emesis

A

vomiting

171
Q

hematemesis

A

gross amounts of blood in the vomit

172
Q

hematochezia

A

bright red blood in the stool

173
Q

CMP

A

Comprehensive Metabolic Panel. Measures BMP + LFTs and Kidney Function.

174
Q

hepatomegaly

A

enlarged liver

175
Q

hernia

A

protrusion of part of an internal organ or tissue bulges through a weak area of muscle

176
Q

CT

A

Computer Assisted Tomography. An X-ray providing cross sectional scans of the body.

177
Q

McBurney’s point

A

RLQ point tenderness indicative of appendicitis

178
Q

melena

A

black tarry stool indicative of an upper GI bleed

179
Q

Murphy’s sign

A

pain with palpation of the RUP during a deep breath, indicative of cholecystitis

180
Q

H&H

A

Hemoglobin and Hematocrit, two chemicals measured to evaluate anemia

181
Q

N/V/D

A

nausea/vomiting/diarrhea

182
Q

organomegaly

A

enlarged organ

183
Q

peritoneal signs (rebound, guarding, or rigidity)

A

signs indicative of acute abdominal inflammation (peritonitis)

184
Q

UA

A

Urinalysis, used to detect a variety of disorders including infection, kidney and liver dysfunction, diabetes, etc.

185
Q

Abx

A

Antibiotics

186
Q

splenomegaly

A

enlarged spleen

187
Q

ASA

A

Aspirin

188
Q

BID

A

Twice Daily

189
Q

bradypnea

A

decreased respiratory rate

190
Q

IM

A

Intramuscular

191
Q

NKDA

A

No Known Drug Allergies

192
Q

NSAID

A

Non-steroidal anti-inflammatory Drug

193
Q

clear to auscultation (CTA)

A

no abnormal sounds when listening to the lungs with a stethoscope

194
Q

PO

A

Per os (by mouth)

195
Q

PRN

A

As needed

196
Q

QHS

A

At bedtime

197
Q

QID

A

Taken four times a day

198
Q

dyspnea

A

difficulty/labored breathing, shortness of breath

199
Q

Rx

A

Prescription

200
Q

TID

A

Three times a day

201
Q

dyspnea on exertion (DOE)

A

feeling short of breath during very light exercise (E.g. walking)

201
Q

Afebrile

A

Not having a fever

202
Q

Ambulatory

A

Able to move around, not confined to bed

203
Q

Cachectic

A

Extremely skinny, bony, malnourished

204
Q

hemoptysis

A

coughing up gross amounts of blood

205
Q

Constitutional

A

The general appearance and nature of a patient

206
Q

hypoxia

A

low oxygen saturation of the body, not enough oxygen in the blood

207
Q

Distress

A

A patient’s inability to tolerate their body-state, No Acute Distress (NAD) commonly written for comfortable patients.

208
Q

pleurisy

A

general terms for pain with breathing

209
Q

rales

A

crackles; wet crackling heard in the lungs, typically due to pneumonia or CHF

210
Q

Lethargic

A

Septic, very sick, about to die.

211
Q

rhonchi

A

sounds of mucous rolling around the bronchioles/bronchi

212
Q

Malaise

A

Generalized discomfort or weakness

213
Q

shortness of breath (SOB)

A

air hunger, difficulty breathing, or breathlessness

214
Q

Non-toxic

A

Appearing stable and at no risk of deterioration

215
Q

sputum

A

any mixed matter with the saliva that is passed through the mouth

216
Q

Sommnolent

A

Appearing drowsy

217
Q

Unkempt

A

Poorly kept hygiene

218
Q

Well developed

A

Normal state of mental and physical development

219
Q

Cornea

A

Transparent covering of the eye in front of the iris and pupil

220
Q

stridor

A

upper airway noise; common sign in croup

221
Q

tachypnea

A

increased respiratory rate

222
Q

wheezing

A

high pitched sound heard in the lungs with asthmatics or lung disease

223
Q

Aneurysm

A

Localized ballooning of a vessel due to a weakened vessel wall

224
Q

EOMI

A

Extraocular movements intact

225
Q

Fundoscopic exam

A

Examination of the interior surface of the posterior eye using an ophthalmoscope

226
Q

Arrhythmia

A

irregular heartbeat

227
Q

Artery

A

blood vessel carrying blood away from the heart, muscular, contractile

228
Q

Nystagmus

A

Involuntary “shaking” eye movements

229
Q

Ophthalmalgia

A

Pain in the eye

230
Q

bradycardia

A

slow heart rate (HR<60)

231
Q

Pale conjunctiva

A

Pale inner aspect of the eyelid most often due to anemia

232
Q

cardiomegaly

A

enlarged heart

233
Q

coronary artery

A

artery that supplies the heart with blood

234
Q

Periorbital ecchymosis

A

Bruising around the eyes, indicative of trauma

235
Q

dorsalis pedis pulse

A

pulse that is palpable on the dorsum (top) of foot

236
Q

Photophobia

A

Light sensitivity

237
Q

murmur

A

abnormal heart sound rated on a 1-6 scale

238
Q

PERRL

A

Pupils equal round and reactive to light

239
Q

Scleral icterus

A

Yellowing of the sclera due to jaundice

240
Q

normal sinus rhythm (NSR)

A

the rhythm of a healthy heart

241
Q

Subconjunctival hemorrhage

A

Blood in the white part of the eye

242
Q

Palpitation

A

to beat rapidly, irregularly, or forcibly (usually related to the heart)

243
Q

Cerumen

A

Wax

244
Q

pulse exam

A

carotid, brachial, radial, femoral popliteal, dorsalis pedis (DP) or posterior tibia (PT)

245
Q

Dentition

A

Teeth

246
Q

Dry mucosa

A

Dry tongue, mouth, lips, indicative of dehydration

247
Q

Edentulous

A

Without teeth

248
Q

regular rate and rhythm (RRR)

A

normal heart sounds with a regular rate (60-100 bpm)

249
Q

Epistaxis

A

Nose bleed

250
Q

Gingiva

A

Gums

251
Q

Nare

A

Nostril

252
Q

stenosis

A

narrowing of a body opening or passage

253
Q

Oropharynx

A

The back of the mouth where it meets the throat

254
Q

tachycardia

A

fast heart rate (HR>100 bpm)

255
Q

Otalgia

A

Ear pain

256
Q

Pharyngeal erythema

A

redness of the pharynx, indicating a throat infection

257
Q

thrombus

A

blood clot or blockage

258
Q

Rhinorrhea

A

Runny nose

259
Q

vein

A

vessel carrying blood towards the heart, soft, compressible.

260
Q

Tinnitus

A

Ringing ears

261
Q

Carotid bruit

A

whooshing blood flow heart with auscultation (carotid narrowing or plaque)

262
Q

TM Erythema

A

Redness of the TM often due to infection

263
Q

Tonsillar exudate

A

Pus on the tonsils, indicating infection

264
Q

lymphadenopathy

A

enlarged lymph nodes

265
Q

T&A

A

Tonsillectomy and Adenoidectomy

266
Q

meningismus

A

stiff neck/signs of meningitis

267
Q

supple

A

flexible, not-stiff

268
Q

thyromegaly

A

enlarged thyroid

269
Q

jugular vein distention (JVD)

A

jugular vein distention, sign of heart dysfunction

270
Q
A
271
Q

TM

A

Tympanic Membrane, AKA the ear drum

272
Q
A

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