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Chapter 1
Learning Terminology
| Pericolonic | Around the colon |
| Dentalgia | Toothpain |
| Dysmenorrhea | Abnormal Menses |
| Hepatomegaly | enlarged liver |
| vasculitis | inflammation of the blood vessels |
| hypotension | abnormally low blood pressure |
| epigastric | area above the stomach |
| phlebotomy | incision (or going into) the vein |
| a | before |
| ac | before meals |
| AMI | Acute myocardial infarction |
| bid | twice a day |
| BP | blood pressure |
| c/o | Complaining of |
| Ca | Cancer/carcinoma |
| CC | Chief Complaint |
| CHF | Congestive Heart Failure |
| COPD | Chronic Obstructive pulmonary disease (emphysema, chronic bronchitis) |
| CXR | chest x-ray |
| DOB | Date of Birth |
| Dx | Diagnosis |
| ECG, EKG | Electrocardiogram |
| GI | Gastrointestinal |
| HEENT | Head, ears, eyes, nose, throat |
| h/o | History of |
| HTN | Hypertension |
| Hx | History |
| IM | Intramuscular |
| LAC | Laceration |
| LOC | Level of consciousness |
| mcg | Micrograms |
| NKDA | No known drug allergies |
| npo | Nothing by mouth |
| po | By mouth |
| PRN | as needed |
| qid | Four times a day |
| Rx or Tx | Treatment |
| SOB | shortness of breath |
| tid | three times a day |
| w/o or s | without |
| WNL | within normal limits |
| Medical Record | created with a patient's phone call or visit to a physician's office |
| CBC | Complete Blood Count |
| BID | Twice a Day |
| SNOMED | Systematized Nomenclature Medicine |
| Pharmacology | Dispensing medication to treat ailments |
| EMR | Electronic Health Record |
| ICD | International Classification of Diseases |
| A (blank) is creataed with a patient's phone call or visit to a physician Office | Medical Record |
| The medical record must be (blank) each time there is a communication (blank ) or (blank) a patient | documented; with, about |
| The format of the documentation and () may (). The medical () will typically be the same to avoid () | Medical record, vary, terminology, mistakes |
| () Procedures are treatments that require invasive cutting into the body to repair or remove a diseased part. () is the diagnosis of the disease or condition. | Surgical; Pathology |
| SNOMED is a medical terminology standard developed for use in () medical records | electronic |
| Implementation of SNOMED will not take place until some time int he future because most US hospital and physicians use () medical records | paper |
| ICD is the current standard for () coding | diagnosis |