January 2006
MT Newsletter
SMT Faculty
Jessie Jacob
Manu Prakash
Rema Valsala 		Thought for the month: Courage is resistance to fear, mastery of fear - not absence of fear.
        ...Mark Twain
Answers to the previous issue

FAQs

Standards

Questionnaire

     A disease that spreads in a hidden and usually injurious way is insidious.

     The idiom, "Push the envelope" means -- To go to the limits..

     He denies facial pain or a thick nasal discharge.

     The patient is compliant with this medication regimen.

     This patient has pleuritic chest pain with new onset consolidation of left pleural area and cardiomegaly.

     Her extremities are warm and well perfused.

     Presenting a case of hepatic failure with known cirrhosis. 



   Urethral:      Relating to the urethra.  The canal leading from the bladder, discharging the urine externally.   




   Ureteral:      Relating to the ureter.  The tube that conducts the urine from the renal pelvis to the bladder.

                       It consists of an abdominal part and a pelvic part.




   Fusion:        Joining, as in "The patient has agreed to undergo ankle fusion procedure."




   Effusion:       Escape of fluid from tissues, as in "The patient was noted to have pleural effusion."



                                    
   Infusion:       Introduction of fluid, as in "The patient required intravenous infusion of midazolam." 




   Extent:          Point to which a thing extends, as in "He is aware of the extent of damage drinking has caused to his liver."




   Extend:         Stretch out, as in "He was asked to extend his hand for the test."  

                        Span an interval of distance or time, as in "The therapy sessions are extended over three more weeks."




FAQs

Q. What is the Hemoccult test?

Hemoccult test - also called a stool guaiac test - is the trade name for a simple chemical test done to check stool samples for traces of blood that cannot be seen with the naked eye. The stool guaiac test is the most common form of fecal occult blood test (FOBT) in use today. Occult (hidden, not visible) blood in stool (feces) is detected by the peroxidase activity of hemoglobin. Guaiac is the reagent used in testing for occult blood.

A test kit can be used at home and the specimens (usually 3 stool specimens are collected on sequential days) are mailed to a laboratory for evaluation. The test is safe and painless, since it uses samples taken from normal daily bowel movements. Doctors usually recommend an annual fecal occult blood test for all adults beginning at age 50. If the test is positive, the doctor will usually recommend an additional screening procedure such as colonoscopy or flexible sigmoidoscopy.

Colonoscopy: A procedure in which a thin, flexible tube with a light and camera attached to it is inserted into the rectum. The images are then sent back to a monitor so the doctor can view the inside of the colon (large intestine).

Flexible sigmoidoscopy: An examination of the rectum and the lower colon using a viewing tube (a short version of colonoscopy).

Conditions that produce a positive result:

The Hemoccult test can detect bleeding from almost anywhere along the length of the digestive tract ansd so several conditions can cause the result to be positive. They include:

· Esophagitis

· Esophageal varices

· Gastritis

· Peptic ulcer disease

· Stomach cancer

· Ulcerative colitis

· Colorectal cancer

· Colon polyps

· Inflammatory bowel disease

· Hemorrhoids


False positive result:

To properly prepare for this examination, individuals are asked to abstain (for 3-5 days before stool collection) from certain foods, medications and vitamins that can produce a positive fecal occult blood test even when there is no bleeding from the digestive tract. They include:

· Red meat (beef or lamb)

· Vitamins (especially vitamin C)

· Iron

· Aspirin

· Nonsteroidal anti-inflammatory drugs or NSAIDs (medications, such as ibuprofen or naproxen)

· Raw fruits and vegetables, especially melons, radishes, broccoli, turnips, and horseradish

This fecal occult blood test is usually used as a screening test to detect colorectal cancer (cancer of the colon and rectum), especially when the cancer is in its early stages and is not causing any symptoms.

The importance of colorectal cancer screening:

Colon cancer is one of the most important causes of death from malignancy, and after the age of 50, it is important to screen for cancer and polyps. Polyps are benign tumors of the large intestine. Benign polyps do not invade nearby tissue or spread to other parts of the body. Benign polyps can be easily removed during colonoscopy, and are not life threatening. If benign polyps are not removed from the large intestine, they can become malignant (cancerous) over time. Most of the cancers of the large intestine are believed to have developed from polyps.

A person who tests positive for stool occult blood has a thirty to forty-five percent chance of having a colon polyp, and a three to five percent chance of having a colon cancer. Colon cancers found under these circumstances tend to be early and have a better long-term prognosis.

Cancer of the colon and rectum can invade and damage adjacent tissues and organs. Cancer cells can also break away and spread to other parts of the body (such as liver and lung) where new tumors form. The spread of colon cancer to distant organs is called metastasis of the colon cancer. Once metastasis has occurred in colorectal cancer, a complete cure of the cancer is unlikely.

The most effective prevention of colon cancer is early detection and removal of precancerous colon polyps before they turn cancerous. Even in cases where cancer has already developed, early detection still significantly improves the chances of a cure by surgically removing the cancer before the disease spreads to other organs.

Note: Stool that has tested positive for occult blood does not necessarily mean the person has colon cancer as other conditions can cause occult blood in the stool. However, patients with a positive stool occult blood should undergo further evaluations involving barium enema x-rays, colonoscopies, and other tests to exclude colon cancer, and to explain the source of the bleeding. It is also important to realize that stool which has tested negative for occult blood does not mean the absence of colorectal cancer or polyps. Even under ideal testing conditions, at least twenty percent of colon cancers can be missed by stool occult blood screening.

In patients suspected of having colon tumors, and in those with high risk factors for developing colorectal polyps and cancer, flexible sigmoidoscopies or screening colonoscopies are performed even if the stool occult blood tests are negative.



Q. What is a shotgun prescription?

An irrational prescription containing many ingredients, some of which may be useless, in an attempt to cover all possible types of therapy that may be needed.




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Standards

CAPITALIZATION:

1. Capitalize business organizations.


Examples:

National Broadcasting Company

Primary Care Unit

American Medical Association


2. Use initial capital letters in eponymic terms.
Eponyms are names or phrases formed from or including the name of a person. The common noun following the eponym is lowercase.

Examples:

Down syndrome

McBurney incision

Hodgkin disease

Achilles tendon

Oedipus complex

Foley catheter


Note: Words derived from eponyms are not capitalized nor are those that have acquired independent common meaning.

Examples:

Parkinson disease, but parkinsonism.

Cushing syndrome, but cushingoid facies.

Addison disease, but addisonian crisis.

Gram Stain, but gram positive results


3. Capitalize trade names and propriety names of drugs and brand names of manufactured products and equipment. Do not capitalize generic names or descriptive terms.

Examples:

Trade names of drugs include Keflex, Motrin and Bayer Aspirin.
Corresponding generic terms are cephalexin, ibuprofen, and aspirin.

Trade names of suture materials include Vicryl, Dexon and Prolene.
Corresponding generic terms include chromic catgut, silk, nylon and cotton (plain, braided or twisted).

Miscellaneous brand names include Kleenex, Vaseline and Scotch tape.
Corresponding generic terms are tissue, petroleum jelly and cellophane tape.


4. Departmental names within the Medical Center are lowercase.

Examples:

operating room

blood bank

post anesthesia recovery


5. Capitalize both the nouns and the adjectives when they make reference to a specific geographic location.

Examples:

The patient was born in the South-West.

We plan to stay at a resort by the Great Lakes.

We visited the Statue of Liberty.


6. Capitalize the names of diseases that contain proper nouns, eponyms or genus names. The common names of diseases and viruses are not capitalized .

Examples:

Rocky Mountain spotted fever (proper noun)

diphtheria, pertussis and tetanus (common disease)

chlamydia infections (genus)


7. Capitalize the proper names of languages, races, religions and sects. Do not capitalize the common nouns following these designations. Do not capitalize informal designations of race, i.e., white or black.

Examples:

African-Americans

Hispanic people

of Jewish ancestry


8. Capitalize oceans, seas, and rivers. .

Examples:

River Thames

Great Lakes

Atlantic Ocean


9. As a courtesy, positive allergy information should be in capital letters in order to call attention to this vital information.

Examples:

The patient is allergic to TETRACYCLINE.

ALLERGIES: PENICILLIN, ASPIRIN, and PEANUTS.


10. Capitalize acronyms but not the words from which the acronym is derived.

Examples:

nonsteroidal anti-inflammatory drug (NSAID)

coronary artery bypass graft (CABG)

computed axial tomography (CAT)


11. Capitalize days and months.

Examples:

Monday, Thursday, July, and December.







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Questionnaire

Q. The term used for the medical or developmental history of a patient is _____________.
a. abarognosis
b. anamnesis
c. acrognosis


Q. The idiom, "Toe the line" means _____________.
a. To queue up
b. Follow the rules and regulations
c. Tidy and clean


Q. Fill in the blanks with the suitable word given in brackets:

1. Palpation of the abdomen did not ______ any pain. (illicit, elicit)

2. She put ______ a wonderful suggestion. (fourth, forth)

3. He had a bout of asthma last week, but now he is doing ______ well. (quiet, quite)

4. The patient had extensive postoperative ______. (scarring, scaring)

5. Scan revealed a ______ valve in his heart. (prosthetic, prostatic)


Q. Find the meaning of these homonyms:

   heal and heel

   imminent and eminent

   infraction and infarction


See the answers in the next month's issue....
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