Question | Answer |
CC | CHEIF COMPLAINT |
C/0 | COMPLAINS OF |
Dx | DIAGNOSIS |
FH | FAMILY HISTORY |
HEENT | HEAD, EAR, EYES, NOSE THROAT |
H AND P | HISTORY AND PHYSICAL |
HPI, PI | HISTORY OF PRESENT ILLNESS, PRESENT ILLNESS |
Hx | HISTORY |
IMP | IMPRESSION |
L AND W | LIVING AND WELL |
NAD | NO ACUTE DISTRESS |
NKA, NKDA | NO KNOWN ALLERGIES, NO KNOWN DRUG ALLERGIES |
O | OBJECTIVE INFORMATION |
OH | OCCUPATIONAL HISTORY |
P | PLAN (RECOMMENDATION, DISPOSITION |
PE OR Px | PHYSICAL EXAMINATION |
PERRLA | PUPILS EQUAL, ROUND & REACTIVE TO LIGHT AND ACCOMMODATION |
PH, PMH | PAST HISTORY, PAST MEDICAL HISTORY |
R/O | RULE OUT |
ROS, SR | REVIEW OF SYSTEMS, SYSTEMS REVIEW |
S | SUBJECTIVE INFORMATION |
SH | SOCIAL HISTORY |
Sx | SYMPTOM |
UCHD | USUAL CHILDHOOD DISEASES |
WNL | WITHIN NORMAL LIMITS |
ACUTE | SHARP, HAVING INTENSE, SEVERE SYMPTOMS & A SHORT COURSE |
CHRONIC | CONDITION THAT DEVELOPS SLOWLY & PERSIST OVER A PERIOD OF TIME |
BENIGN | MILD OR NONCANCEROUS |
MALIGNANT | HARMFUL OR CANCEROUS |
DEGENERATION | GRADUAL DETERIORATION OF NORMAL CELLS AND BODY FUNCTIONS |
DEGENERATIVE DISEASE | ANY DISEASE IN WHICH DETERIORATION OF THE STRUCTURE OR FUNCTION OF THE TISSUE OCCURS |
DIAGNOSIS | DETERMINATION OF THE PRESENCE OF A DISEASE BASED ON AN EVALUATION OF SYMPTOMS, SIGNS AND TEST FINDINGS |
ETIOLOGY | STUDY OF THE CAUSE OF A DISEASE |
EXACERBATION | INCREASE IN SEVERITY OF DISEASE WITH AGGRAVATION OF SYMPTOMS |
REMISSION | A PERIOD IN WHICH SYMPTOMS AND SIGNS STOP OR ABATE |
FEBRILE | RELATING TO A FEVER (ELEVATED TEMPERATURE |
IDIOPATHIC | A CONDITION OCCURRING WITHOUT A CLEARLY IDENTIFIED CAUSE |
LOCALIZED | LIMITED TO A DEFINITE AREA OR PART |
SYSTEMIC | RELATING TO THE WHOLE BODY, RATHER THAN A PART |
MALAISE | FEELING OF UNEASINESS OR DISCOMFORT, OFTEN FIRST INDICATION OF ILLNESS |
MARKED | SIGNIFICANT |
MORBIDITY | SICK, A DISEASED STATE |
MORTALITY | BEING SUBJECT TO DEATH |
PROGNOSIS | PREDICTION OF THE LIKELY OUTCOME OF A DISEASE, BASED ON THE GENERAL HEALTH STATUS OF THE PATIENT (PROGNOSIS "GOOD") |
PROGRESSIVE | THE ADVANCE OF A CONDITION AS SIGNS & SYMPTOMS INCREASE IN SEVERITY |
PROPHYLAXIS | A PROCESS OR MEASURE THAT PREVENTS DISEASE |
RECURRENT | TO OCCUR AGAIN; A RETURN OF SYMPTOMS AND SIGNS AFTER A PERIOD OF INACTIVITY |
SEQUELA | A DISORDER OR CONDITION USUALLY RESULTING FROM A PREVIOUS DISEASE OR INJURY |
SIGN | AM MARK; OBJECTIVE EVIDENCE OF DISEASE THAT CAN BE SEEN OR VERIFIED BY AN EXAMINER |
SYMPTOM | EVIDENCE OF DISEASE THAT IS PERCEIVED BY THE PATIENT, OFTEN NOTED IN THEIR OWN WORDS |
SYNDROME | COMBINATION OF SYMPTOMS THAT GIVE A DISTINCT CLINICAL PICTURE INDICATING A CONDITION OR DISEASE |
NONCONTRIBUTORY | NOT INVOLVED IN BRINGING ON THE CONDITION OR RESULT |
UNREMARKABLE | COMMON, NOT OF THE ORDINARY OR SIGNIFICANT |
A | ASSESSMENT |
A AND W | ALIVE AND WELL |