I am very new at this, I just started my correspondence course and was wondering if any other new students would like to have a study time online or some kind of chat room where we could help each other out and just talk about what we are doing, support etc.
Please let me know, it would be great to do!

Nadine,
Sounds like a good idea to me. I am new to this as well and I have almost completed my courses. I have learned alot so far. I do already have a few connections in the field to help me get started when I'm ready, and for that I feel fortunate. E-mail me so we can work out details.~~
tjohnsonnetmail@netscape.net

------------------
tj

Nadine,
Check your e-mail.
tj~

------------------
tj

tj, if you see this, I guess we just kept missing each other..please let me know if you are still interested? Would love to get together sometime!

Nadine (and TJ) and anyone else who would like to correspond regarding MT - please email me at kathy@sandiego.com. I'm new also, but would love to share whatever information I have.

Kathy

I am also interested in a study group. I'm in the middle of course and was curious about what courses others were taking.Mine is the meditech course.

Nadine,
I just had surgery about a week ago. I suppose we do deep missing each other. I am still very much interested in a chat group, and looks as though others are also wanting to chat as well. Just do me a favor and email me again on what we need to do to get started. And that goes for Mum and Kathy as well. Email me soon!!

------------------
tj

Nadine, TJ, MUM
I'm a student too. Doing both a course at a business school and correspondence. Am not a young person and need to hit the ground running. Would like to hear about your course work and what materials you use etc. Thirsty for info and want to talk to others in my position. Nervous about whether or not I'll be prepared when I look for a job. E-mail at andreawayne@citlink.net

------------------

I'd be interested in joining a chat. I just finished a program at CCHS.
Please email me with details.
tuggers@erols.com

Somara, I was just wondering what the frown face meant ? Thanks

Actually it was supposed to be a "sad" face, but the closest image I had was the frown.

I'm just sad to hear about a chat group being formed on our own bulletin board, especially about learning medical transcription, when all the MTs that visit the Gab could benefit so much from reading friendly and informative exchanges among other MTs.

I feel it is analogous to inviting some friends to your restaurant for a free dinner and then they openly make plans about eating somewhere else - as if there was something wrong with your place. I think it would just be courteous that plans to eat somewhere else would be made outside, so the owner wouldn't be offended.

Of course we're new to hosting a free bulletin board and we do fund it so that MTs can meet and exchange ideas - and that is all that is being done. So, I guess I'm too sensitive. I suppose I'll get a thicker skin over time.

SOMara

Somara, I am so sorry that I offended you. I had no intent to cause anyone any injured feelings. I was just trying to find a way to benefit myself and have a fast and convenient way to commuicate. So I guess I was being selfish and didn't think of others feelings, so please take down my post and to the others feelings I may have hurt, I am truly sorry. Thank you to all who replied, I am sorry.
Nadine

Nadine:

Please do not be so hard on yourself! I knew that anything that was done was completely unintentional and without any malice. I know you did not intend to offend us and your offer to others was quite innocent. I really believe this.

As I said, we have a lot to learn about offering free usage of the board to the public. I think I have to learn that I cannot and should not comment on how people decide to use the forum (within reason).

It is just that there are so many people out there who would truly benefit from some discussions that MTs decide to have among themselves. The spirit of MT Gab is to share your experiences, problems, solutions, so others may benefit. A lot of members do not contribute but I can assure you they visit the Gab and read all the messages - I see the numbers every day.

A lot of our members love to read what people have to say and even have their favourites. It's almost like following a soap opera for some members.

By the way, as Administrator, I always have the ability to stop a thread, delete a membership, or delete a forum - which I did not do - and I have been following the thread since its inception. So, you see, I was not THAT upset. I am sorry I made you feel so guilty, as that really was not my intention when I commented on the thread, and did not mean to make it sound like any remarks were directed to you personally.

(You really have to understand that for any web site or bulletin board to have any hope of being financially self-sufficient at some point, everything depends on page "hits." The more page hits a site has, the more likely it is to get sponsors. Therefore, anything that takes people away from the site, and lowers page hits, makes owners and webmasters go into a cold sweat - I'm sure I simply over-reacted.)

As I said, I'm learning and have never been known to hold a grudge - so please just continue to use our BB as you would like.
[img]http://www.medword.com/ubb/smile.gif[/img] [img]http://www.medword.com/ubb/smile.gif[/img]

Sincerely,

SOMara

What? No cat fight??? heheh Just joking!!

I have visited other MT Message Boards and this is the most friendly and relaxing of the ones I have seen. Sometimes my heart palpitates when I read how rude some people can be.

Regarding Nadine's post, SOMara, I was just wondering if Medword.com has a chat room or if they would consider starting one. It might be a good idea for people like Nadine who would like a one-on-one. ...just a thought... the wheels are always turning...

SOMara, I would like to own up to my part in the scandal lol, It was my idea to ask about the frown face becuase we really truely did not know anything was wrong, both Nadine and I saw it about the same time, But I just had to find out what it meant.( which is how all this got started ) After you posted and explained, I know that Nadine was very sorry that she had upset anyone. I know for a fact that was not her intention. I think I speak for a lot of people when I say that these message boards are our lifeline to information we would not have otherwise. They are appreciated so much and also the people that keep them going.I do understand your point SOMara, we just did'nt think of it that way until you explained. What I'm trying to say is that it was an innocent mistake and I know you realize that and I wanted to thank you for understanding SOMara. And to you Nadine.. it WAS a good idea while it lasted! lol. Sorry SOMara I had to say it!

Glad to see everyone talking. Thought the chat was a good idea but now I see that this is better, more thought-provoking. Having time between posts to see what has been said and think about replies is easier for me, not so quick on my feet (or is it fingers?).
Just starting. Trying to accumulate library of useful tools. Anyone have any ideas about a good place to start? What about the AAMT style book/disc? Anyone use it? Do the different docs set up their own styles or is it up to us?
Ange

------------------

Ange,
thought I would tell you about a book that I found VERY informative and helpful in helping me make my decision to get into this field. "The Independent Medical Transcriptionist" by Donna Avil-Weis and Mary Glaccum. You can probably get it at the library thats where I got mine. It answers all questions you might have and has info that you can use for future reference. I'm going to buy a copy to keep. Hope this helps!

Hello everyone:

Nadine: Everything I said still stands. No hard feelings and I don't want to make a "mountain out of a molehill." As I said, go ahead and make any plans here for your chat sessions. At least you're visiting here and still contributing to other forums. I hope all that is behind us and there are no hard feelings.


Jeany: What if I started a new Forum for correspondence courses? - not the same as chat though. Also, if you set up your Gab member profile so you are e-mailed whenever a comment is made in the forum, you can get a decent flow of conversation going. We have had a lot of people purchase "Personal Edge" Training courses, so I was considering opening a forum up on correspondence and "at-home" courses, as people often find this support helpful.

mum1218:

Ditto for my comment to Nadine. Also, you said to Nadine:
I would hate to think I put the brakes on anything that lets people communicate or learn, so that is why I said that you can continue to make plans here at the Gab if you need to.

ange42:

You said:

This is one of the reasons we decided on a bulletin board rather than other communication systems. BBs are also cheaper to buy, easier to set up, and much easier for inexperienced people to use.

mum1218:

I don't believe in the paranormal, but I do believe in coincidence, something that just happened. I was reviewing our book sales (looking for the top 10 books) and right after I determined that our #2 seller since October 1998, is "The Independent Medical Transcriptionist" by Donna Avil-Weis and Mary Glaccum. Right at the moment I realized that, I got a notification of your post - wherein you discuss the same book. (Insert Twilight Zone music here ).

If anyone is interested in purchasing (sorry for the sales plug) or reading more about this book, here is the link:
www.amazon.com/exec/obidos/ASIN/1877810231/medword

By the way, we hope to be adding a new page on the top 10 requested books at our site soon.

SOMara

[This message has been edited by SOMara (edited June 05, 1999).]

SOMara,
Wow!! Lots of answers there! I think the forum you mentioned would be a great addition. Things are so much more complicated now than when I went to MT school a million years ago, so I'm sure it will benefit many. Also, regarding the EMail, I don't think mine is set up that way, but when I take breaks from work, I check out MTGab. I actually come here before checking my mail. I use a different computer than this one to work on, so I get a little exercise walking from one room to the other LOL. Enjoy the rest of your weekend!

Great Idea on the book site! The first thing I did when I became interested in learning more about MT was to search the library for books on the subject...I found 1. Then I went to the bookstore and they had lots of medical books but none specific on MT. They said they could order but I had no titles or knew what was available. I'm sure every MT wanna be has went thru this. I think having a list of books on the subject available would be SOOO helpful. Especially in a top 10 sellers list so we would know what is worth purchasing. Go for it!

Nadine, Jeany et al:

A new forum under "The Pit" has been opened where people taking MT courses can exchange ideas and experiences.

mum1218:

We already have two pages devoted to medical books only on our website. The page to which I was referring was a page showing our Top 10 sellers, that we hope to add soon. Glad you like the idea.

Editor Note: Content Above No longer relevant, but link below has been updated.

Our Medical & other book pages are at:

Medword's Amazon Store
2010 / 2011 Medical Coding Books

SOMara

MUM1218,
Thanks for the book tip. Will try my library again. As you said in another message, libraries are very short on MT books. Checked out Amazon.com but found the books so expensive I wouldn't want to buy without being able to know something more about them. Exchanging info on books would be very helpful.
Ange42

------------------

ange42:

I'm surprised you think the books at amazon.com are expensive - or do you just mean that the books are expensive - regardless who is selling them?

Unfortunately, you will find (or already know) that almost all profession-specific books, university required-texts, and not just medical books, are more expensive than many other books.

Some people who have mainly purchased "bestsellers" or non-technical books for most of their life are often quite surprised at the cost of some books. Do you think this was your experience?

SOMara

SOMara,
I guess I meant the cost in general. You're right. Technical books cost much and I can understand why but that is why I want to look and hear about before I take the plunge. I have been used to using libraries so I have been spoiled. Now that I'm interested in something that libraries don't have I'm experiencing "sticker shock".
Ange

------------------

ange42:

"Sticker Shock" is exactly the right phrase. I went through it eons ago at 13 when I got into photography as a hobby. I still have - and use - the books I bought over the years, as much of the technical information is still valid. The good thing about many of the reference books is that they do often have enduring usability. You might have to buy a new drug book about every two years but the paperbacks are a pretty reasonable price. A good illustrated medical dictionary is usually easily good for five years. A medical atlas,if you buy a good one, is good for a very long time, probably never requiring replacing. Books on writing styles and conventions are usually good for a very, very, long time, only needing replacement when changes in writing style are firmly established and therefore widely published. I would say that a new MT needs to be prepared to spend about $300.00 - $500.00 on books, maybe less and maybe more, depending on what you decide to purchase. I believe that this is a very small investment indeed for some basic tools for your profession. Of course,if an MT is operating as a home-based small business, books are just another business expense.

SOMara

[This message has been edited by SOMara (edited June 11, 1999).]

SOMara,
I'm still a student and trying to acquire a library of books I can use when I begin to work. Thanks for your input. What would be really helpful is some info from you and other MTs on a basic "library shelf", books you use, can't do without, have on your wish lists, etc.
What about a medical atlas? How necessary?
Is the AAMT style book the best?
What about software? You see so many ads. Do any of you use some kind of specialized software?
Sorry for so many questions, am in the soaking it up like a sponge phase.
Love the bulletin boards!
Ange

------------------

ange42:

Must-have books for basic medical transcription reference: (in my opinion)

Illustrated and tabbed medical dictionary
Book of abbreviations and acronyms
Book on writing style
Medical Atlas of Human Anatomy
Drug index


Must-have Software: (in my opinion)

Purely personal choice for word-processing software. We have used WordPerfect for over 10 years. Other word-processors are pretty well all the same these days, differing mainly in levels of customization, macro language, etc.

An electronic medical dictionary that will integrate with your word-processor's spell-checker is also a must-have.

A database program may be needed for tracking names and addresses and inserting them into reports unless you are using some kind of on-line system with an employer or client. MS Office and WordPerfect Suite come with database programs.

============================

We have a page of the Top 10 books purchased by MTs through our site and are working on a "must-have" list just like the one above.

Medword.com's Listmania:

Medword's Amazon Listmania

Hope this helps.

SOMara

SOMara,
Just what the doctor ordered!
Thanks, thanks and thanks again. Looking forward to the must have list you're putting together. Going to the top ten list site now.
As always, you guys come through.
Ange

------------------

SOMara,
Fascinating the quality of work you put in! Wonder if you have any tips on how to get work for an Off shore MT unit?

[This message has been edited by Bindu (edited 24 June 1999).]

Somara:

Do you know if there is such a thing as a book of medical slang? I just blew a word on an assessment because of a slang word.

I should have figured it out on my own but I guess I was basically brain dead that day. With everything happening at home and two kids that are ten years apart in age, it's no wonder.

Thanks again.

SamT
paise@earthlink.net

I think the study groud/chat is a great idea. I am also a student, about half-way through my course, and would love to interact with other students.

I will e-mail the link.


kmfields

I am very interested in joining/forming a study group. Let's see if we can start this. If it is already started, I'd like to joinl. Email me at kmfields76@att.net if you are interested.

kmfields

I know I am very late to this topic, but has there been a group started?? I would love to join one. I come here often and read some posts and such but I often feel very alone in the course I am taking. Let me know!

Anyone starting Allied soon?

hello,

i am new at this, but i am very desperate because im stuck on quiz 19, from course 3 of at home professions,medical trans. it is one of the hardest, i cannot understand the guy dictating, has anyone done this one? i could use some help!!!
please let me know, thanks!!!

Nadine and everyone else I'm very interested in a chat room where we can all help each other out and give each other support. I'm near the end of my course excited but nervous. Please e-mail me at sjs1@pics.net

I am interested my e-mail is homebound2ca@yahoo.com I am an allied student on chapter 9 almost done.

I know this conversation was started 12yrs ago but anyone that would like to chat let me know just e-mail me!

Good idea. My email is francis_s2011@yahoo.in
Thanks

Did a study group chat get set up, how does it work and how do I join in.

My e-mail is ashhartzfeld@ducom.tv.

Thanks.

Can anyone summarize all the interested emails in this topic so we can start off?

Hello,

I am new to this forum and to the MT world. I am just starting quiz 19, course 3 with AHP. I am looking for a study partner, would you be interested.

Hi , I m new to this group. I have a question if any one can help? I m on quiz 30, report 4, Moses Isaac, format #2 and its a Discharge Summary. Physical Examination is dictated in it. I just wanna know that, are we gonna do it in modified block? as I have checked everything and I did not see a physical exam in a DISCHARGE SUMMARY. I emailed the instructor but nobody replied. Any kind of help will be highly appreciated. And also if anybody interested in combined study. I am totally up for that.

Thanks

I am mid-way through my online course that I am taking through Allied Business School. WOuld be interested in a chat/study group with others who are taking the same course.

I agree some of this stuff is very confusing. I am also on Quiz 30.Page 42-18 says DIAGNOSIS headings, IMPRESSION, ASSESSMENT AND PHYSICAL EXAMINATION headings (except GENERAL) are MODIFIED BLOCK. (use 2.5" tab).

So does that mean it is flush left? That's where I put it.

I'm interested in combined study....how would it work?

Hey!Just read your post. I`m new here too and I`m doing MT with AHP. Everyone seems to be on Quiz 30 or something and I`m only on Quiz 18. I find myself needing help a lot. Don`t know how much help I can be but I sure want to try

I need someone to send me dictation for quiz 18 please because part 2 (Ned Hallman #030501) and part 3 (#030503) because I lost my CD and I have to submit my quiz pleeeeeeeeeeeese.

Cherry,
Go to this website: resources.at-homeprofessions.edu
enter "ahpmedtran" in both the user name and password blanks.
Hit "medical transcripting and editing"
scroll down & you will find your quiz number.
Do you use ExpressScribe? If so, you can down load the quiz to EXSC and listen to it there. You can do this with any of the lessons in this course. I do not even listen to my CDs anymore.
Hope this helps.

Hi I am new at this. I am at the end of my fourth MT course with At Home Professions. I am currently working on Quiz 28 Lesson 40 and any help would be appreciated.
Thanks

What do you need Angel?

I am new to this group/site. I am working on quiz 20. Is there anyone out there, who can proofread my quiz for me? I have been very discouraged by the instructors.



Name: Mary Charles DISCHARGE SUMMARY
# 040303
Dr. Sung Pak

DISCHARGE SUMMARY

ADMITTING DIAGNOSIS
Intrauterine gestation at the term of in active labor.

PRESENT ILLNESS
The patient is a 14-year-old gravida 1, para 0, who presented in active labor without prior prenatal care.

LABORATORY FINDINGS
Urine culture positive for Escherichia coli. Lochia culture negative for aerobic and anaerobic cultures.

HOSPITAL COURSE
Spontaneous vaginal delivery produced a viable male infant, weighing 3,450 g, with Apgar scores of 7 at five minutes and 9 at ten minutes. There were twenty units of Pitocin administered postpartum. No tocolysis was administered. Delivery was complicated by the presence of a nuchal cord, which probably accounted for the early low Apgar scores. There was 4 + meconium present. The pediatrician attended to the neonatal postpartum. Following normal vaginal delivery of a viable infant, the placenta was delivered intact. Three cord vessels were identified. Cord blood samples were sent to Pathology. A midline episiotomy was performed for the delivery after using local anesthesia. Two days postpartum, the patient developed a temperature of 105 ̊F, with dysuria and foul lochia. On Gantrisin, patient defervesced and dysuria resolved.

DISPOSITION
Discharged to home with infant.

FOLLOW-UP
Return in two weeks’ time for repeat urine culture and six weeks’ for routine postpartum care.

CONDITION ON DISCHARGE
Stable.

DISCHARGE DIAGNOSIS
1. Normal spontaneous vaginal delivery with midline episiotomy.



CONTINUED
Name: Mary Charles DISCHARGE SUMMARY
# 040303
Page 2

2. Cystitis. Puerperal infection not evident at present time.

PLAN
Repeat clean-void urine culture and lochia culture in two weeks. Tubal ligation had been planned but will be deferred until infection is completely resolved.

DISCHARGE MEDICATIONS
Medications none.

Name: Merry Rogers DISCHARGE SUMMARY
#040364
Ali Ibrahami
DISCHARGE SUMMARY

ADMITTING DIAGNOSIS
1. Genuine stress urinary incontinence.
2. Symptomatic grade II sister cell and rectal cell. (neopartka?)
3. Mental metraogia.

HISTORY OF PRESENT ILLNESS
The patient has a six month history of loss of urine with coughing, sneezing, running, lifting objects requiring pad at all times. There is no history of increasing frequency or dysuria. There is vaginal laxity with sister cell. The patient also had history of mental metrologia for approximately six months, ending four months ago at which time cervical conization showed cystic hyperplasia. This was treated with Provera 10 mg for ten days x 3 months. The conization was repeated and showed benign under cervical polifratia. The patient was admitted for definitive treatment.

PERTINENT PAST HISTORY
Drug I V estradiol for two.

LABORATORY FINDINGS
Hematocrit 36%. Melagrophin showed no dominant mass or cluster masses or cluster classification.
Calcifications: The breast. The breasts consist of dense fibrograndular tissue.

HOSPITAL COURSE
Upon admission, the patient underwent a vaginal hysterectomy posterial colporrhaphy and vault procedure without complications and without significant blood loss. The procedure was performed under general anesthesia. At surgery, a carpus lutein cyst was incidentally found at the left adnexa. The post-operative course was uneventful.

DISPOSITION
The patient was discharged to home.

FOLLOW-UP
The patient is to return to clinic in two weeks.

CONDITION ON DISCHARGE
Good.

DISCHARGE DIAGNOSIS


CONTINUED
Name: Merry Rogers DISCHARGE SUMMARY
# 040364
Page 2

1. Status post vaginal hysterectomy for undermitrial hyperplasia, hyperplasia, and minermitrialasia .
2. Geniun stress urinary incontinence.
3. Symptomatic grade 2 sister cell and rectal cell.

PROGNOSIS
Good.

DISCHARGE MEDICATIONS
Morthin 600 mg p.o. q. 4 h p.r.n. for pain.

Name: Cindy Charming
# 040364


PROBLEM #2 Secondary amenorrhea.


SUBJECTIVE
The patient presents with a four-week history of secondary amenorrhea. LNMP one month ago. Menses are normally at 28 days with a duration of 3-5 days. Gravida 0, para 0, ab 0. Patient has had one week of fatigue. No history of fever, chills, nausea, vomiting, or diarrhea. No history of abdominal pain. The patient is sexually active.

OBJECTIVE
The pelvic exam reveals a normal vulva and vaginal vault. The cervix is cyanotic and nontender. The endocervical canal is closed. The uterus is enlarged to 6 weeks’ size to anteverted. There is a 4 cm left adnexal mass that is nontender and freely moveable. The right adnexa is unremarkable. There is no evidence of cystocele or rectocele or cul-de-sac fullness.

ASSESSMENT
The findings are consistent with an early intrauterine gestation. The left adnexal mass maybe a corpus luteum cyst but a follicular cyst or dermoid cannot be excluded at the present time.

PLAN
1. Alpha-fetoprotein and beta-HCG pregnancy test.
2. Repeat pelvic examination at 12 weeks to look for resolution of left adnexal mass.

I am new to the MT gab group, and having trouble with quiz 23. Is there anyone that can proof read it for me? Thanks, Cheryl

Name: Billie Tree DISCHARGE SUMMARY
# 040401
Dr. Sung Pak

DISCHARGE SUMMARY

ADMITTING DIAGNOSIS:
1. Hypertension.
2. Polyuria.
3. Muscular weakness.

HISTORY OF PRESENT ILLNESS
This is a 44-year-old woman with a 20-year history of hypertension, controlled with medications with increasing doses. She has had a two-year history of (polyuria) and progressive muscular weakness.

LABORATORY FINDINGS:
Serum potassium 2.6. Aldosterone level is 112. Open front is normal 12-36 cross frontess. CT scan showed a mass in the right adrenal gland measuring 3 x 4 cm.

HOSPITAL COURSE:
After admission and initial evaluation, the patient was referred for elective right adrenalectomy, which she underwent without complications. Her postoperative course has been remarkable for fluctuations in her serum potassium, which has been mostly hyperkalemia and which has responded well to supplementation. Additionally, she has had polyuria. Urine osmolality and electrolytes are pending. This is decreasing, and with return of bowel functions yesterday, she is being started back on oral intake today. Discussion centered on differential of polyuria, and possibility of obligatory polyuria, secondary to chronic potassium loss. Hospital obligatory.

DISPOSITION
Discharge to home on fifth postoperative day.

FOLLOW-UP
Return to clinic in two weeks’ for blood pressure check.

CONDITION ON DISCHARGE
Improving.

DISCHARGE DIAGNOSIS
1. Conn’s Syndrome.
2. Aldosterone secreting adrenal corticoid adenoma, status post right adrenalectomy.



CONTINUED

Name: Billie Tree DISCHARGE SUMMARY
# 040401
Dr. Sung Pak Page 2


PROGNOSIS
Good.

DISCHARGE MEDICATIONS
Vicodin 1 tablet every p.o. q.4 h for pain.



____________________________________
Sung Pak, MD


D: 1/18/2012
T: 1/19/2012
SP: CRH






























Name: Lidia Cruz DISCHARGE SUMMARY
# 040403
Dr. Dilip Patel

DISCHARGE SUMMARY

ADMITTING DIAGNOSIS
1. Diabetes mellitus, Type 2 out of control.
2. Rule out cholecystitis.

HISTORY OF PRESENT ILLNESS
The patient is a 59-year old Latin female with Type 2 diabetes mellitus for eight years, admitted to the general surgery service with a one-day history of right upper quadrant pain.

PERTINENT PAST HISTORY? Ask about this whole paragraph
The patient has had Type II diabetes mellitus for eight years and until the recent admission was controlled with Tolbutamide 500 mg t.i.d. and diet. No prior surgeries. NO ALLERGIES TO MEDICATIONS.

LABORATORY FINDINGS
Tolbutamide 500 mg t.i.d.
Admitting blood sugar 324. Urinalysis: Glucose 4+ by Dextrostix.
ABDOMINAL: Sonograph demonstrated normal glyburide without evidence of cholecystitis. Abdominal CT within the normal limits.

HOSPITAL COURSE
Following the patients’ admission and the normal sonography and CT, the patients’ right upper quadrant pain resolved. Endocrinology consultation was obtained for the patients abdominal glucose. The patient was switched to glyburide 10 mg b.i.d. and showed a gradual return to normal of her blood sugars over 72 hours. In the interim, the patient was placed on a short acting insulin, but this was discontinued as the glyburide became effective.

DISPOSITION
Discharge to home.

FOLLOW-UP
Return in for fasting, blood sugar, and dripped blood pressure after morning medications. Return to clinic in two days.

CONDITION ON DISCHARGE
Good.


CONTINUED

Name: Lidia Cruz DISCHARGE SUMMARY
#040403
Dr. Dilip Patel Page 2

DISCHARGE DIAGNOSIS
Diabetes mellitus, Type 2.

PROGNOSIS
Improving.

DISCHARGE MEDICATIONS:
Glyburide 10 mg b.i.d.



____________________________________
Dilip Patel, MD


D: 10/31/2011
T: 11/01/2011
DP:CRH
























Name: Sonya Wells ENDOCRONOLOGY CONSULTATION REPORT
#040409
Dr. Anne Jones

CONSULTATION REPORT

HISTORY OF PRESENT ILLNESS
The patient is a 70-year-old black female who was previously healthy until 2 weeks prior to admission when she noticed increased shortness of breath and orthopnea, 2-3 pillows, and pedal edema. There was evidence of fever or chills. The patient had diarrhea for two days. No chest pain, cough. No history of hypertension, stroke, or other cardiovascular abnormalities. Denies heat intolerance, weight change, or palpitations.

PAST HISTORY
ALLERGIES: NKDA.
Illnesses: Arthritis of right knee.
Medications: Took sulfa drugs three weeks ago for a rash.

PHYSICAL EXAMINATION
GENERAL: Well nourished, black female who is in moderate distress, fidgety, does not always answer questions, scratches constantly.
HEENT: Normal cephalic. A traumatic perla. Upper and lower dentures.
Neck: Supple with positive JVD. No bruits. The thyroid is enlarged with normal texture, no nodules, and non-tender.
VITAL SIGNS: Pulse: 130. Blood Pressure: 122/88. Respiratory rate: 50. Temperature: 100.6 ̊F.
CHEST: Clear. Heart: Irregular rhythm, no murmurs or gallops. There is a grade II/ six systolic injection murmur.
ABDOMEN: Negative.
EXTREMITIES: No clubbing or cyanosis 1+ edema in both ankles.
NEUROLOGIC: There is a fine trimmer.

IMPRESSION
1. Thyroid toxicosis.
2. Congestive heart failure with atrial flutter.

It may be that the patients’ cardiac symptoms are secondary to her thyroid toxicosis since she has no history of prior heart disease or cardiac symptoms. As her thyrotoxicosis resolves, we want to monitor her digoxin closely as she will be metabolizing it quite rapidly until she is no longer toxic.

PLAN
1. Begin digoxin 1 quarter mg p.o. q.d.
2. Lasix 20 mg p.o. q.d.

CONTINUED
Name: Sonya Wells ENDOCRONOLOGY CONSULTATION REPORT
#040409
Dr. Anne Jones Page 2


3. Tapazole 10 mg p.o. b.i.d.

REASON FOR REFERRAL
Abnormal thyroid function tests and congestive failure.



____________________________________
Anne Jones, MD


D: 11/08/2011
T: 11/09/2011
AJ:CRH

Glad to be back after a long vacation. Now struggling with Quiz 25.

What is up ??
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Can anyone proof read Sharon LaPalma Psychiatric Consultation Report for me; Quiz 25?

You can email me @ delilahsweetpea@aol.com

Thanks,
Cheryl

Name: Sharon LaPalma PSYCHIATRY CONSULTATION REPORT
#040604
Dr. Sansuk Sudsai

CONSULTATION REPORT

REASON FOR REFERRAL
The patient is a 43-years-old Caucasian female with a Master Degree who recently left her apartment and is presently homeless. She has worked as an MFCC and teacher in the past. She (is (dictated) or was (b/c of context used in paragraph)) brought in by the Brooklyn city police after exhibiting bizarre behavior in the restaurant, refusing to leave when asked to do so by the management.

HISTORY OF PRESENT ILLNESS
The patient has a long history of psychiatric illness with symptoms of both mood disorder and {bizarre/odd} disorder in the past. Most recent diagnosis was bipolar disorder, manic. The patient has been in {Weston} hospital twice, and also in {Orange hospital} twice this year on 72 hour hold for bizarre behavior. The reasons for previous admission resemble remarkable reasons for this admission. On the day of admission, the patient was in a sushi restaurant. She found the lavatory, because she caused extreme heat, to go to the bathroom, disrupt, soaked her clothes in the sink, and put the clothing back on and returned to the restaurant. The restaurant owners said that she had been there all day already and as it was 4:30 p.m., they asked her to leave, and she refused to do so and the police were called. She was violent with the police and was brought to the psychiatric emergency area.

PHYSICAL EXAMINATION
GENERAL: The patient had a physical exam, which revealed no acute physical findings.
NEUROLOGIC: Mental status: {Mental status exam was significant only for certain (____) un kept appearance perhaps secondary to her being soaking wet and hostile effect and very irritable mood. Also, remarkable in her mental status exam claimed that she was actually the result of genetic manic depression plutonian scientists and that she had come to earth from that planet. The patient was given a mental diagnosis of Psychosis NOS,} rule out bipolar disorder, rule out schizo-effective disorder, and was admitted.

ASSESSMENT
Axis I Psychosis or Organic Disease: Bipolar disorder, manic. Ethanol abuse.
Axis II Personality Disorder: None.
Axis III Medical Condition or Diseases: None.
Axis IV Psychosocial Stressor Level: Mild.
Axis V Global Assessment of Function Scale: Fifteen. The six-month prediction is 40. The twelve-month prediction is 40. Past-year prediction was 60.




CONTINUED
Name: Sharon LaPalma PSYCHIATRY CONSULTATION REPORT
#040604
Dr. Sansuk Sudsai Page 2


RECOMMENDATIONS
Thorazine 100 mg p.o. b.i.d. and 200 mg p.o. h.s.s.



_____________________________________
Sansuk Sudsai, MD


D: 02/21/2012
T: 02/22/2012
SS: CRH