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AAA
Abdominal Aortic Aneurysm
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abrasion
superficial wound to the top most layer of skin (scratch)
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afib with RVR
Atrial fibrillation with rapid ventricular response
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ambulate
to walk (ambulatory, ambulated)
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anti-emetic
nausea medication
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antipyretic
fever reducing medication
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aphasia
no speech ( can be expressive or receptive)
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Appy
appendicitis, appendectomy
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Avulsion
forcible tearing of the skin from the body
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BLE
bilateral Lower extremity
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Bradycardia
slow heart rate below 60 ppm
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BS
bowel sounds, breath sounds, blood sugar
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BUE
bilateral upper extremities
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CABG
coronary artery bypass graft
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Cachectic
physical wasting appearance
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CAD
coronary artery disease
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CAP
Community acquired pneumonia
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Carotid Bruit
abnormal blood flow into the carotid artery
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Cellulitis
bacterial skin infection
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cerumen impaction
excessive earwax
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Cervial Motion tenderness (CMT)
paint with movement of the cervix
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CHF
Congestive Heat Failure
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Cholecystectomy (chole)
surgical remove of the gallbladder
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Cholecystitis
inflammation of the gallbladder
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Cholelithiasis
gallstones
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Clear rhinorrhea
clear nasal drainage, "runny" nose
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Contusion
blunt force trauma to tissue under the skin (deep Bruise)
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COPD
chronic obstructive pulmonary disease
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Costovertebral Angle Tenderness (CVAT)
pain with tapping on the back in the region of the kidneys
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CPR
Cardiopulmonary resuscitation
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Crepitus
cracking or popping sounds under the skin (chest wall)
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CT
Computerized tomography scan
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CVA
cerebrovascular accident (stroke)
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Debridement
removal of foreign matter or dead tissue from the wound
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Diaphoresis
sweating (diaphoretic)
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Dyspnea
difficulty breathing
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Dyspnea on exertion (DOE)
difficulty reaching with movement/ambulation
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Dysuria
difficulty/painful urination
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Ecchymosis
large area of ruptured blood vessels (superficial bruise)
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EENT
eyes, ears, nose, throat
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ESRD
End Stage Renal Disease
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Extra Ocular Movements Intact (EMOI)
physical exam of eye movement
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Exudate
oozing fluid from the throat
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FROM
full range of motion
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GERD
gastroesophageal reflux disease
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Gravid
pregnant (gravida=number of pregnancies, para=number of live births)
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Guaiac
test detecting the presence of fecal occult blood
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Hematemesis
blood in vomit
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hematochezia
blood in stool (red in color)
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hematoma
damage to the blood vessels that causes a lump under the skin
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HPI
history of present illness
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Hypercholesterolemia
high cholesterol
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hyperkalemia
high potassium levels
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Hyperlipidemia
High cholesterol
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Hypernatremia
high sodium levels
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hysterectomy (hys)
surgical removal of the uterus
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IBS
Irritable bowel syndrome
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Icterus
yellowing of the sclera
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I&D
incision and drainage
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Incontinence
loss of control of bladder/bowel
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Induration
localized hardening of the soft tissue
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Jaundice
yellow skin color
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LBBB
left bundle branch block
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Lethargy
fatigue or exhaustion
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LMP
last menstrual period
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LOC
Loss of consciousness/level of consciousness
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LVH
left ventricular hypertrophy
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Macular papular
flat, red area covered with small, confluent bumps
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MAE
moves all extremities
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Malaise
vague feeling of discomfort
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Malocclusion
misalignment of the teeth and dental arches
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Mastectomy
surgical removal of the breasts
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Melena
black, tarry stools
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Meningismus
collection of symptoms including neck stiffness, photophobia, and headache
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MVC
Motor Vehicle Collision
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NKDA
no known drug allergies
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Nontoxic appearing
minimal distress
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Normocephalic atraumatic
normal appearance of the head
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NPO
nothing per os (nothing by mouth)
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Nuchal rigidity
neck stiffness
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Nystagmus
involuntary rapid eye movement
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Orthopnea
difficulty breathing when laying down
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Otitis media
middle ear infection
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PAC
premature atrial contractions
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Palpable
able to be touched or easily perceived
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Paraspinal tenderness
pain adjacent to the spine
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PCP
primary care physician
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PE
physical exam; pulmonary embolism
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PEA
pulseless electrical activity
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Pharyngeal erythema
redness of the throat
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Photophobia
abnormal intolerance of light/sensitivity to light
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Polyuria
excessive urination
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Puncture wound
wound caused by an object piercing the skin, causing a small hole
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purulent
the presence of pus
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pustules
small collection of pus under the skin
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PVC
premature ventricular contractions
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Rales (crackles)
wet, crackly sound upon inspiration
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RBBB
right bundle branch block
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Rectal tone
anal elasticity of rectal sphincter
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RLE
right lower extremity
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RRR
regular rate and rhythm
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Rubs
scratching or clicking sound of the heart
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RUE
right upper extremity
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Saddle anesthesia
a loss of sensation near the buttocks
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SBO
small bowel obstruction
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septal deviation
displacement of the nasal septum
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snuff box tenderness
pain around the thumb area (possible indication of scaphoid fracture)
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Somnolent
drowsy or sleepy
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STEMI
ST elevated myocardial infarction
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Subconjuctival hemorrhage
bright red patch in whites of eyes
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Tachycardia
rapid heart rate above 100bpm
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tachypnea
rapid respiration rate (tachyneic)
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Thrombocytopenia
disorder in which there is an abnormally low platelet count
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TIA
transient ischemic attack (mini stroke)
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Tinnitus
ringing in the ears
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Tonsillectomy
surgical removal of the tonsils
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Transient
passing into and out of existence
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Trismus
inability to open mouth normally
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Tubal ligation
tying of the fallopian tubes
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Tympanic membrane (TM)
eardrum
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URI
Upper respiratory infection
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Vertigo
room spinning sensation
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Visual acuity
acuteness/sharpness of vision based off eye chart exam
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Waxing and waning
gradual increase or decrease in severity of constant pain
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Wheals and flares
irregular blanched raised area surrounding redness
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Wheezes
continuous whistling sounds
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