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283 Cards in this Set
- Front
- Back
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abd, abdom
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abdominal, abdomen
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abt
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about
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ABX, abx
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antibiotic
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Acc, acc
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accommodation
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accid
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accident
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Admin
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admit; admission; admitted
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adv
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advice, advise
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AMA
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American Medical Association
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ASA
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asprin
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asap, ASAP
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as soon as possible
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C
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cervical; centigrade; Celsius
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C & S
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culture and sensitivity test
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c (with a line over it)
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with
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Ca, CA
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cancer, carcinoma
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canc, cncl
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cancel, canceled
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cauc
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caucasian
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CBC
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complete blood cell count
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cc
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cubic centimeter (measure of volume)
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CC
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chief complaint
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CO, C/O
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complains of
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dc
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discontinue
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DC, D/C, d/c
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discharge
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DC
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dressing change
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diff.
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differential
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DNA
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does not apply
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DOB
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date of birth
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ER
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emergency room
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ex, exam
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examination
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biopsy
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removal of tissue for examination
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ROI
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release of information
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ft
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foot; feet
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H
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hospital call
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Ht, ht
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height
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HV
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hospital visit
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HX
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history
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HX PX
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history and physical examination
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PRN or prn
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as needed; as necessary
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PRN, p.r.n.
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as necessary
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pt
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patient
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PX
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procedure - in MOP
can be physical exam in real world |
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re ch
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recheck
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RO, R/O
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rule out
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rx
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prescription; any medicaton or treatment ordered
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s (with a line over it)
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without
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S/S
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signs and symptoms
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SLR
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straight leg raising
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slt
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slight
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sp gr
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specific gravity
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SR
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suture removal;
sedimentation rate |
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SubQ
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subcutaneous
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Tr.
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treatment
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UR, ur
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urinalysis or urine analysis
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VS
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vital signs
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W
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work; white
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WF
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white female
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WM, W/M
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white male
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WNL
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within normal limits
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WNWD
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well nourished well developed
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wt
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weight
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ALL
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allergy
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CMA
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certified medical assistant
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cont.
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continue
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CPC
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certified professional coder
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CPE, CPX
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complete physical examination
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DEM
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Doctor of emergency medicine
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Dg, dg, DX, dx
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diagnosis
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diag.
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diagnosis, diagnostic
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disch.
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discharged
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DNKA
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did not keep appointment
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DNS
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did not show
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E
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emergency
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ECG
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electrocardiogram; electrocardiograph
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ED
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emergency department
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EEG
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electroenchephalogram; electroencephalograph
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EENT
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eye, ear, nose, and throat
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EKG
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electrocardiogram; electrocardiograph
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EMG
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electromyogram, electromyelogram
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EMT
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emergency medical technician
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epith.
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epithelial
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ESR
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erythrocyte sedimentation rate
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est.
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established; estimated
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FACS
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Fellow of American College of Surgery
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FU, F/U
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follow-up
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FUO
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fever of unknown origin;
fever of undetermined origin |
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fx
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fracture
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H & P
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history and physical
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HPI
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history of present illness
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I & D
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incision and drainage
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IM
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intramuscular
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L
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left
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LVN
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licensed vocational nurse
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mg
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milligram
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MO or mo
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month
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MT (ASCP)
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Medical technologist
(certified by the Registry of American Society of Clinical Pathologists) |
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ofc
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office
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P & S
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permanent and stationary
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PA-C
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Physician's assistant, certified
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prog
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prognosis
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re-exam, reex
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re-examination
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RPT
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Registered physical therapist
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SD
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state disability
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UA, U/A, UR
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Urinalysis, urine analysis
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VN
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visiting nurse
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calculi
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mineral deposits
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WBC, wbc
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white blood cell or count;
well baby care |
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wks
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weeks
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X or x
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times
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yr
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year
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A
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abortion; allergies
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CXR
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chest x-ray
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etiol.
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etiology
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EU
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etiology unknown
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F
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Fahrenheit
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GC
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gonorrhea
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h.
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hour
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HIPAA
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Health Insurance Portability and Accountability Act
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HX
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history
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Lt (ell-t)
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left
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P
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pulse;
preterm parity or deliveries before term |
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P & S
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permanent and stationary
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p.o.
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by mouth
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PD
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permanent disability
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perf.
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performed
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PERRLA, PERLA
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pupils equal, round, react to light and to accomodation
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pH
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hydrogen ion concnetration
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PH
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past history
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phys.
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physical
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PID
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pelvic inflammatory disease
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PMH
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past medical history
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PND
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postnasal drip;
paroxysmal nocturnal dyspnea |
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PO
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postoperative check,
phone order |
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pos.
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positive
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post.
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posterior
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postop, post-op
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postoperative
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PTR
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patient to return
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q.
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every (each)
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rec
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recommend
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REF, ref
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referral
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reg.
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regular
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ret, retn, rtn
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return
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rev
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review
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RT
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respiratory therapy
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SE
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special examination
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T
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termperature
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a.m.
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morning
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AP & L
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anteroposterior and lateral
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approx
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approximate
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asst
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assistant
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Ba
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barium
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BM
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bowel movement
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BMR
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basal metabolic rate
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BP ck
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blood pressure check
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BP, B/P
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blood pressure
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breast ck
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breast check
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BUN
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blood urea nitrogen
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Bx, BX, BI
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biopsy
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cm
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centimeter
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dilat
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dilate
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DPT
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diptheria, pertussis, and tetanus
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Dr, drsg
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dressing
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Dx, dx
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diagnosis
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i.e.
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that is
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inj.
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injection
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L (with a circle around it)
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left
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M (with a circle around it)
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murmur
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N
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negative, none
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O (with a line over it)
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no, not, negative
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p (with a line over it)
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after
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P & A
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percussion and auscultation
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PC
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present complaint; pregnancy confirmation
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VD
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venereal disease
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VDRL
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Venereal Disease Research Laboratory
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XR
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xray
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AgNO3
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silver nitrate
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Ant
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anterior
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AP
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anterior posterior; anteroposterior;
antepartum care |
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g
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gram
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G
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gravida
(number of pregnancies) |
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GTT
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glucose tolerance test
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HCI
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hydrochloric acid
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Hgb
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hemoglobin
(measure of iron in RBCs) |
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Inc
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include
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Inf, INF
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infection, infected
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Inflame., INFL
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inflammation
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Init
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initial
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Int, INT
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Internal
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M
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medication, married
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MA
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mental age
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Med., MED
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medicine
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MH
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marital history
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ml
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milliliter
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MM
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mucous membrane
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MMR
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measles, mumps, rubella vaccine
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N & V
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nausea and vomiting
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N/S, NS
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no-show
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NA, N/A
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not applicable
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NAD
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no appreciable disease
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New OB
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new obstetric patient
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NFA
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no future appointment
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NP, N/P, (N)
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newpatient
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NTRA
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no telephone requests for antibiotics
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NYD
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not yet diagnosed
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OB
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obstetrical patient, obstetrics; prenatal care
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OC
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office call
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occ
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occasional
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ofc
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office
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OR
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operating room
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Orig.
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original
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OT
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Occupational therapy
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OV
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office visit
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RBC
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Red blood cells
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RO or R/O
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rule out
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RTO
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return to office
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RV
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return visit
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Sed rate
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sedimentation rate
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Temp.
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temperature
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TIA
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transient ischemic attack
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TMs
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tympanic membranes
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TTD
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total temporary disability
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TURB
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transurethral resection of bladder
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TURP
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transurethral resection of prostate
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UCHD
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usual childhood diseases
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UCR
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usual, customary, and reasonable
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UGI
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upper gastrointestinal series
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UTI
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urinary tract infection
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O with a line through it
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negative
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*
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birth
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/s, w/o
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without
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+
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positive
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-, o (with a line overit)
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negative
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R with a circle around it
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right
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Cast ck.
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cast check
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Chem.
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chemistry
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CVA
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Costovertebral angle; cardovascular accident; cerebrovascular
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EDC
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Establised date of confinement; due date of baby
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Exc.
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excision
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Ext
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external
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FH
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family history
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FHS
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fetal heart sounds
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Flu syn
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influenza syndrome
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Fluor
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fluoroscopy
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HC
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house call; hospital call; hospital consultation
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HCD
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house call, day
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Hosp
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hospital
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IV, I.V.
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intravenous
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K35
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Kollmann (dilator)
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No show
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patient did not show for appt
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OP, op
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operation, operative, outpatient
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p.m.
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evening; afternoon
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PDA
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personal digital assistant
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PT
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physical therapy
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S, M, W, D
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single, married, widowed, divorced
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Sig. sigmoido
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sigmoidoscopy
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Smr, sm.
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smear
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Surg.
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surgery
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Sx.
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Symptoms
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T & A
|
tonsillectomy and adenoidectomy
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tb, tbc, TB
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tuberculosis
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TD
|
termorary disability
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CDC
|
calculated date of confinement
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CHF
|
congestive heart failure
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Chr
|
chronic
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CI (eye)
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color index
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Ck
|
check
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CPX
|
complete physical exam
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DSHA
|
does she have appointment
|
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HBP
|
high blood pressure
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HCN
|
house call, night
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Hr, hrs
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hour, hours
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HS
|
hospital surgery
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intermed
|
intermediate
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Interpret
|
interpretation
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IUD
|
intrauterine device
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IVP
|
intravenous phelogram
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JVD
|
jugulovenous distention
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KUB
|
kidneys, ureters, bladder
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L & A, l/a
|
light and accommodation
|
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lab, LAB
|
laboratory
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Lac
|
laceration
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POR
|
problem orientated record
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Rh-
|
rhesus negative (blood)
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RHD
|
rheumatic heart disease
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VAC
|
vaccine
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