Medical AbbrevationMedical AbbrevationMedical AbbrevationMedical Abbrevation

Nantawarn Kitikannakorn, Nantawarn Kitikannakorn, B.Pharm,Pharm.DB.Pharm,Pharm.D

AbbreviationAbbreviationAdvantagesAdvantages

•Convenience•Time saver•Space saver•a way of avoiding the

possibility of misspelling words

AbbreviationAbbreviationDisadvantagesDisadvantages

• Hard to understand• Misread• interpreted incorrectly• Lengthen time needed to train

individuals in the health field• Waste time to tracking down their

meaning• Time’s delay patient care• Occasionally results in patient harm

Dangerous abbrevati Dangerous abbrevationon

Problem term I nterpreteedO.D. Once daily Right eye

q.o.d. Every other day Every once a day

q.d. Once daily Four time a day(q.i.d)

q hs Every night Every hour

TIW Three times aweek

Tuesday&Wednesday(T/W)

T/d Once per day Three time a day(TID)

Easily misread Easily misread AbbreviationAbbreviation

Terms Interprete Terms Interprete

HCTZ50 Hydrochlorothiazide

50 mgHCT250 Hydrocortisone

250 mgs without c with

U Unit U,u “0”, “cc”, “4”,”6”

EPO Eening prim rose EPO Epogen

MTX Methotrexate HN2 Mechlorethamine

Na warfarin Sodium warfarin Na warfarin No warfarin

Ambiguous Ambiguous meaningsmeanings

Term Meaning

AMI Amitriptyline Amifostine

AZT Zidovudine Azathioprine

CLD Chronic liver disease Chronic lung disease

DW Dextrose in water Distilled wate

DXM Dexamethasone Dextromethorphan

NI TRO Nitroglycerine Na Nitroprusside

Controlled vocabulator Controlled vocabulatoryy

Standard What not to use or do100 mg100(space)mg

100mg

1 mg1(space)mg

1.0 mg

0.1 mL0.1(space)mL

.1 mL

Once daily QD(Q.I .D), OD(right eye)Unit Umg mg., Mg., Mg, MG, mgm, mgsmL mL., Ml, Ml., mls., mLs, cc

Controlled vocabulator Controlled vocabulatoryy

Standard What not to use or do“and” “/”, “&”h, hr

grain gr (misread as gram)“specific dose” 2 vials, 2 ampules

Prescription Prescription must be specified...must be specified...

•Dosage form•Strength•Direction• Indication

Glasgow coma scale*Glasgow coma scale*Best motor response

Obeys 6

Localized 5

Withdraws 4

Abnormal flexion 3

Extends 2

Nil 1

Verbal response Oriented 5

Confused conversation

4

Inappropiate words 3

Incomprehensible sounds

2

Nil 1

Eye opening Spontaneous 4

To speech 3

To pain 2

Nil 1

Score Mortality in

head injury

3-5 > 60%

6-8 12%

9-12 2%

MVE

* References : Leaderman RJ.The internal Medicine& critical care pocket book. California: Tarascon publishing; 1997.

Folstein Mini-Mental Folstein Mini-Mental State*State*

Level of conciousness

0 points

Assess along continuum“Alert-Drowsy-Stuporous-ComatousAlert-Drowsy-Stuporous-Comatous”

Orientation 5 points

Year, season, date, day, month

3 points

State, country, town, hospital, floor

Registration 3 points

Patient recites three consecutive objects name (eg. Ball, flag, tree)

Attention Calculation

5 points

Serial 7’s (5 response), alternatively spell “World” backwards

Recall 3 points

Three objects registered above

Language 2 points

Name a pencil watch

1 points

Repeat “ No ifs, ands, or buts”

3 points

3-stage command:“take a paper in your right hand, fold it in half, and put it on the floor”

1 points

Read and obey “close your eyes”

1 points

Wright a sentence

1 points

Copy design

Score : - 023 suggests cognitive dysfunction, 23-29 altered mental status

Staging breast cancerStaging breast cancerStage Tumor Lymph nodes Mets TNM class

0 Non invasive carcinoma in situ; Paget’s disease of nipple

(-) No (-) TisN0M0

I Greastest dimension < 2 cm(T1)

(-) No (-) T1N0M0

IIA 2 cm < tumor < 5 cm (T2)

(+) Ipsilateral but not fixed (N1)

(-) T0-1N1M0T2N0M0

IIB 2 cm < tumor < 5+ cm (T3)

(+) Ipsilateral but not fixed (N1)

(-) T2N1M0T3N0M0

IIIA Tumor > 5 cm (T3)

(+) Ipsilateral fixed to each other, skin or chest wall (N2)

(-) T-2N2M0T3N1-2M0

IIIB Any size (T4) with: skin nodules or skin ulceration or fixation to skin/ chest wall or chest edema include peau d’orange

Supra/ infraclavicular LNs; edema of arm + palpable anxillary LNs (N3)

(-) T4NanyM0

TanyN3M0

IV Any size Any status (+) TanyNanyM1

* References : Leaderman RJ.The internal Medicine& critical care pocket book. California: Tarascon publishing; 1997.

Staging ovarian cancerFIGO stage

Extent % 5-yr survival

I Ovaries only 15 80%

a 1 ovary, no ascites or tumor on ext. surface, ext. capsule intact

b 2 ovaries, no ext. surface acites or tumor, ext. capsule intact

c Ia or Ib + surface tumor on 1 or 2 ovaries or capsule ruptured or with malignant cell in ascites or peritoneal washings

II Extension into true pelvis 10 60%

a Extenion/metastasis to uterus and/or tubes

b Extension to the other pelvic tissues

c (IIa or IIb) and Ic

III Extenion/metastasis into abdominal cavity including metastasis impkantation on perironeal surface of liver, diaphragm

70 40%

a Macroscopic limited to true pelvis with (-) nodes

b Limited to true pelvis with (-) nodes and implantation on peritoneal > 2 cm

c

IV

Retroperitoneal or inguinal node involvementDistant metastasis, pleural effusion must contain malignant cells

5 0%

Staging prostate cancerStage Extent / Proportion of pts 10-yr survivalA Incidental histological finding, palpitation (10%) A1 Single focal area of well-differentiated tumor A2 Multi foci or poorly-diffentiated tumor

60%

B Tumor palpable but confined to prostate (10%) B1 Single nodule < 2 cm diameter B2 Multiple nodules or single nodles > 2 cm

40%

C Localized to periprostatic area (45%) C1 Seminal vesicles not involved & tumor < 70g C2 Seminal vesicles involved & tumor < 70g

30%

D Advance disease (35%) D1 Pelvic node metastases or ureteral obstruction D2 Distance metastases

10-20%

Staging of lung cancerStaging of lung cancer• TX malignant cell found but not visualized radiographically or bronchoscopicall

y• T0 No evidence of primary tumor• Tis Carcinoma in situ• T1 Tumor < 3 cm surrounded by lung or viseral pleura, without invidence of inv

asion proximal to a lobar bronchus• T2 Tumor > 3 cm or either invades pleura or obstructive pneumonitis exte

nding to the hilar region• T3 Tumor of any size with direct extension to the chest wall• T4 Worse than T3 or malignant pleural effusion• N0 No demonstrable metastases to regional nodes• N1 Mets to peribronchial including direct extension• N2 Mets to ipsilateral mediastinal and subcranial• N3 Mets to contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scal

enece or supracravicular• MO no known distant metastases• M1 Distant metastasis present