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					                                                HEARTBEAT OF SVC
                                                       SEPTEMBER 2005
                                                       Volume 2, Issue 5

       2005 OFFICERS                                                 TABLE OF CONTENTS

PRESIDENT                          President’s Message, by Margie Flatley, CMT…..………………… 1
Margie Flatley, CMT                Membership Update.……….....………………………..……………. 2
717-258-3120                       Upcoming AAMT Events & Meetings……………………………..… 2              SVC Meeting – 09/24/2005..… …………………………………….. 3
                                   Greater Pittsburgh Chapter Symposium………………………….…3
VICE-PRESIDENT                     Maryland Association for Medical Transcription Symposium……. 4
Shonna L. Bradley Bender,CMT       Taking the New Format CMT Exam........................... ……………. 4
717-873-5476                       On Becoming a Fellow of AAMT……….. …………………………. 5                 Medicine in the News………………………………………………... 7
                                   Sites of Interest……………………………………………………….. 7
SECRETARY                          “Two Errors Human” – Approved for CEC (MT Tools)……………. 8
Sandy Kovacs, CMT, FAAMT           Help Wanted Ad – Spheris………………………………………….. 8
717-337-2260                       Medical Terminology Defined…?.................................................. 9                “Two Errors Human” – Quiz Answers…………………………….. 10
                                   Spotlight On ……………………………..……………………………11
TREASURER                          Ophthalmology Terms & Sample Reports…………………………13
Mary Sanders, CMT                  SVC-AAMT Membership Application ………………………………17

                                                                  PRESIDENT’S MESSAGE
MEMBERSHIP                                                         By Margie Flatley, CMT
Barbara Weckel, CMT, FAAMT                Hello there, everyone. The Annual Convention and Exposition in Hawaii
                                   is almost here! I am so excited about going.
Shonna L. Bradley Bender,CMT
                                   Our next chapter meeting is coming up soon also: Saturday, September
HOSPITALITY                        24th at Lancaster General Hospital. Sharon Allred has put together a
Margie Flatley, CMT                fabulous program for us. Make sure to come, and bring a friend.

BYLAWS                             We also had a chapter board meeting on August 20. We accomplished a
Shonna L. Bradley Bender,CMT       lot and set dates for next year’s meetings. We decided to go ahead and
                                   have a meeting during the summer. Our last meeting was in March, and
CONTINUING EDUCATION               that was too long to go without seeing everybody. Please make note of
Sandy Kovacs, CMT, FAAMT
                                   the dates of the meetings and put them on your calendar!
Shonna L. Bradley Bender,CMT       Next newsletter, I will have details of Hawaii for you!                        Hope you are
                                   having a good summer.
Trina Sprecher, CMT                                              2006 SVC-AAMT Meetings

     UPCOMING EVENTS                                                        January 21
                                                                             March 18
SVC-AAMT Business &                                                           May 20
Educational Meeting –
                                                                             June 24
September 24 – Lancaster, PA
For a complete list of upcoming                                            September 9
events for MTs, see page 2.                                                November 11

                                            MEMBERSHIP UPDATE
                     By Barbara Weckel, CMT, FAAMT, SVC-AAMT Membership Committee Chair

We are and have been accepting component-only membership for Susquehanna Valley Chapter since this spring.

Our fees for memberships are:
        AAMT practitioner member: $25
        Component-only member: $35
        Not a member of AAMT or SVC but attending meeting/CEC: $10

If you are not a member of SVC and would like to be, please complete the application form at the end of this newsletter
and come to our September 24th meeting.

SVC membership is one of the best bargains ever. You receive this wonderful newsletter, you attend SVC meetings free,
and you will get to know the best MTs ever! Membership is an investment - money well spent. Besides our great
continuing education speakers, we have terrific membership meeting awards, such as the eMpTy bucket. When a name
is drawn for an SVC member and that person is in attendance, he/she wins $5.00. At every meeting we also have an
attendance award (different category at each meeting). We have a "perfect attendance" award for 2005 meetings. SVC
membership is so important, and we try to make sure we recognize this in as many creative ways as possible.

We do need help in membership recruiting. If you would like to be on the membership committee please contact Barb
Weckel or any other board member. Please bring a guest to the September meeting or forward the September
information to an MT who has never attended an SVC meeting. Hope to see you September 24th in Lancaster.

                                     UPCOMING AAMT EVENTS AND MEETINGS

September 24, 2005 – SVC-AAMT Business & Educational Meeting, Lancaster General Hospital, Lancaster, PA. Details
in this newsletter.

September 28, 2005 – ADVANCE Job Fair & CE Event - M&T Stadium, Baltimore, MD. Preapproved by AAMT for 4.5
CECs. Details at

October 1, 2005 – LVC-AAMT Fall Symposium. For more information, contact Theresa M. Gonzalez, CMT, FAAMT,
President, at

October 8, 2005 – Maryland Association for Medical Transcription Annual Symposium, Harbor Hospital, Baltimore, MD.
Details in this newsletter.

October 14, 2005 – ADVANCE Job Fair & CE Event – Atlantic City Convention Center, Atlantic City, NJ. Preapproved by
AAMT for 4.5 CECs. Details at

October 22, 2005 – Greater Pittsburgh Chapter Fall Symposium, UPMC Montefiore Hospital. Details in this newsletter.
For more information, contact Flossie D. Jack, CMT, President, at

November 12, 2005 – SVC-AAMT Business & Educational Meeting. Details to follow.

April 28-29, 2006 – PAMT Annual Meeting and Educational Conference, Wyndham Garden Hotel, Harrisburg, PA

August 2-5, 2006 – AAMT Annual Convention and Expo, Boston, MA Details at (Beginning in the
November issue of our newsletter, we will publish a registry of MTs planning to attend ACE 2006 in Boston. Please let us
know if you are planning to attend, how you are getting there, and if you are in need of a roommate or travel companion.)

                   Keep current with Susquehanna Valley Chapter by visiting us at our new web site:


                                  SVC-AAMT EDUCATIONAL & BUSINESS MEETING

                                             Saturday, September 24, 2005
                                              Lancaster General Hospital

Our first meeting of the fall is right around the corner on September 24. Sharon Allred, Supervisor of Transcription at
Lancaster General Hospital, is our hostess. She has a fantastic educational program planned.

The tentative schedule is as follows:

8:00 to 8:45 a.m.       Registration/networking/food

8:45 to 9:45 a.m.       Dr. Scott Flood, Director of Wound Care Center/Hyperbaric Oxygen Therapy
                        Topic: Latest Advances in hyperbaric oxygenation and wound care.

9:45 to 10 a.m.         Break

10 to 12 noon           Stacey Youcis, director of LGH Orthopedic Center
                        Topic: Latest Advances in Orthopedic Surgery including a PowerPoint presentation and a tour of
                        the Orthopedic Center with an emphasis on OR technology and instrumentation.

12 noon                 Business meeting

The meetings will be held in the Stager Conference Center, Room #5 (where we met last year). The Stager Conference
Center is on the ground floor of the hospital and is easily accessed from the James Street Parking Garage by taking the
elevator to the ground floor. There will be signs posted. Get directions to the hospital at
Plan now to join us for this great education day and getting acquainted with other MTs. Any healthcare professional can
attend our meetings. Membership is not required to attend. If you have any questions, please contact Sandy Kovacs,
CMT, FAAMT, at 717-337-2260.


                                                     October 22, 2005
                                                    UPMC Montefiore
                                               7th floor LHAS Auditorium


7:30 - 8:30             Registration, continental breakfast and greeting by President, Flossie Jack, CMT.

8:30 - 9:30             Juan Ochoa, M.D., Trauma Medicine. Topic not chosen yet.

9:30 - 10:30            Jules Youngner, M.D. – Salk Vaccine - Dr. Youngner worked along with Dr. Jonas Salk
                        on the Salk vaccine.

10:30 – 11:30           Omar Awais, M.D. - Gastric Bypass Surgery

11:30 – 12:30           Lunch, networking, and vendors

12:30 – 1:30            Sherrill Shepler, C.R.N.P. Stem Cell Research

1:30 - 2:30             Richard Bjerke, M.D. - Preoperative Risk Assessment

2:30 - 3:30             Carol Croft, CMT, FAAMT, 2005 PAMT President. The MT Team Challenge.

3:30 - 4:30             Business meeting

Note: Speakers and topics may change without notice.

For more information, contact Flossie Jack, CMT, GPC President, at

                                            Saturday, October 8, 2005
                                                  Harbor Hospital
                                              3001 S. Hanover Street
                                                   Baltimore, MD
                                   Max & Rosalie Baum Medical Conference Center

8:00 - 8:30 a.m.        Registration and Continental Breakfast
8:30 - 8:45 a.m.        Welcome and Introductions
8:45 - 9:45 a.m.        End of Life Decision Making, Peter Terry, M.D. (1 Medicolegal)
9:45 - 10:00 a.m.       Break - Vendor Exhibits
10:00 - 11:00 a.m.      Advances in Prostate Cancer Therapy, Michael Carducci, M.D. (1 Clinical Medicine)
11:00 - 12:00           TBA
12:00 - 1:00            Lunch
1:15 -- 3:15            Professional Values in Medical Transcription, Brenda Hurley, CMT, FAAMT (2 Medicolegal)
For more info, contact Chris Dill at or Ginny Foster CMT, Treasurer, MDAMT, 8444 Loch Raven
Boulevard, Baltimore MD 21286.

                                        TAKING THE NEW FORMAT CMT EXAM
                                               By Trina Sprecher, CMT

Editor’s Note: SVC-AAMT is pleased to announce that Trina Sprecher, CMT, is our chapter’s new Cert Connector!

I have only been a medical transcriptionist for 3 years, and each day I enjoy the art of transcription more and more. When
I learned about the benefits of taking and hopefully passing the CMT exam, I knew that was something I needed to

There are so many valuable books and information available that are helpful while preparing to take the CMT exam. I
studied for the exam using many different sources, and I’ll try to list the items I used to help prepare for taking the exam.
The JAAMT magazines were very helpful and informative, and I especially benefitted from taking the Medicine Match-Up
and Word Warrior quizzes that are available in this publication. A large part of the exam is multiple choice, and so I found
studying from material written in multiple-choice format to be very helpful. I also read through my Chabner’s Language of
Medicine book and reviewed the numerous note cards I had made while I was a student at Andrews School. Another
valuable study aid for me was The Medical Transcription Workbook by Health Professions Institute. This book has so
much information in it concerning all aspects of transcription, and it is designed as a workbook so you can take the
quizzes and then check your answers. That was invaluable for me to see where my weaknesses were and what areas I
needed to concentrate on studying. AAMT is also offering an on-line CMT prep assessment which would be a wonderful
tool to assess your knowledge. This test covers over 20 body systems and has 25 questions for each system, along with
voice clips. There are also references to various web sites, Book of Style, and medical texts. This exam costs $100 for
AAMT members and $125 for nonmembers. This would definitely be worth looking into if you are considering preparing
for the CMT exam. You can access the information for this assessment at and then clicking on
Certification. At that web site you can also order the Multiple-Choice Self-Assessment Workbook for $25 for members
and $35 for nonmembers. This was something I bought, and it was probably one of the most valuable things I studied
from. I would highly recommend the workbook not only to anyone thinking of taking the exam, but also as a refresher to
any MT who wants to brush up on their medical knowledge. Last but certainly not least, I read my AAMT Book of Style,
Second Edition, from cover to cover. I’m not kidding...I took that book to so many soccer practices, gymnastic meets,
football games, and doctor’s appointments. I don’t think I ever left the house without taking the Book of Style along with
me. I even had it with me while I stayed at the hospital when my daughter had her appendix removed! This is definitely
an important book to study!!

                                                   (continued on page 5)

                                         TAKING THE NEW FORMAT CMT EXAM
                                                By Trina Sprecher, CMT
                                                (continued from page 4)

I realize this is quite an extensive list of books and reading materials, and I know the materials to help prepare for the
CMT exam are certainly not limited to these items I have mentioned. Please know that I truly believe that it is not so much
which book you choose to review and study from, but rather the fact that you spend some time studying, reading, and
preparing for the exam. The more information you put into your brain, the more information that will be available to you
when it comes time to take the exam!

You will find all the information you need regarding the CMT exam at the AAMT web site listed above, and I highly
recommend reviewing that. Briefly, when you decide to take the exam you must first apply through an application
available through the AAMT web site. Once this is complete, you will receive an Authorization to Test letter along with
instructions for registering with Prometric, which is where you will be taking the actual exam. At that point, you will contact
Prometric and schedule an exam date.

On the day of the exam, you will need to bring the confirmation number provided by Prometric and a currently valid
government-issued photo ID such as a driver’s license. No study material may be brought into the exam area, as well as
no personal items. A locker is provided for any personal items such as keys, cell phone, or purse. You are assigned a
computer which has the CMT exam already loaded and ready for you. There may be other people in the testing room
who are taking various other exams available through Prometrics. The day I took my exam there were 11 people in the
testing area, and I was the only person taking the CMT exam at that time. You will be given an opportunity to listen to a
tutorial on the computer which you will be using to take the exam. This explains all that you will need to know to properly
answer the questions. Once this tutorial is complete, you may begin the exam when you are comfortable. The exam is
timed and will begin when you look at the first exam question. You will want to plan on the exam lasting approximately 6
hours with a 10-minute break in the middle.

The first section of the exam was in multiple-choice format and covered such topics as medical language (prefixes,
suffixes, root words, plural forms, terminology, and spelling), anatomy and physiology, disease processes, English
language, and medicolegal issues. The second half of the exam covered transcription performance. Headphones are
provided, and you control the “snippets” with the mouse. There is no foot pedal. I found this very simple and easy to
learn, so don’t be worried about not having a foot pedal to use when taking the exam. In some cases you will transcribe
what is dictated, while at other times you might edit or proofread against the audio. You will hear a short portion of a
dictation while at the same time seeing the words on the computer screen. From that point, you just follow the directions
for each question. I thought this portion of the exam was very interesting! There was a clock on the computer screen
keeping track of how much time I had left, and I had plenty of time to go back through and check my answers for each

I was part of the beta group taking the new CMT exam, and I had to wait until the testing was complete for the beta phase
so I didn’t get my results until several months later. Anyone taking the CMT exam now will have the luxury of knowing
whether you passed as soon as you submit the final question. I think that would alleviate a LOT of anxiety waiting on
those results!

I hope this information is helpful to anyone considering taking the CMT exam. I’d like to encourage any MT who is
interested in advancing in their career or simply wanting the satisfaction of knowing that they earned the designation of
Certified Medical Transcriptionist to gather up those study materials and get ready to take the CMT exam! We as MTs
have to maintain such a high quality of work and a large fund of knowledge to be good at what we do. We are constantly
learning and adding to what we know as we research words of which we’re unsure or when that particularly difficult
dictator says something we have never heard of before. I think that medical transcriptionists deserve much credit for the
work that we do, and earning the CMT credential is something to help honor the difficult and challenging work we do each
day. Passing the CMT exam has been a very rewarding accomplishment for me, and I hope many of you will consider
taking the exam in the near future!

                                               ON BECOMING A FELLOW
                                              By Sandy Kovacs, CMT, FAAMT

You may be wondering what those initials after my name mean…..FAAMT. This designation is Fellow of the American
Association for Medical Transcription. To become a Fellow, an MT must be a practitioner member of AAMT and earn at
least 50 fellowship points in eight different categories in the 5 years preceding the application. This honor is earned by
MTs who have been involved in activities which demonstrate a balance between professional and community
contributions.                                                                                      (continued on page 6)
                                             ON BECOMING A FELLOW
                                            By Sandy Kovacs, CMT, FAAMT
                                                (continued from page 5)

The categories include Association Membership, Professional Meeting Attendance, Leadership, Publications and
Presentations, Mentorship, Civic Activities, Awards, and Certification. There is a maximum amount of points allowed for
each category, so the MT Fellow must demonstrate participation in a minimum of 5 areas. There is a one-time $75
application fee, and Fellows retains their title as long as they are a practitioner member of AAMT.

Why did I want to be a Fellow? Because I am proud of my achievements in the profession I love, the profession which
has given me much more than money to pay the bills over the years. I have gained confidence in myself by volunteering
to be committee chairs and by being elected in various leadership positions at the local chapter and state association
levels. I have established a network of MTs around the country on whom I can call for opinions and ideas. I have been
fortunate to be able to give back to the profession by being involved with editing Stedman’s word books and by helping to
teach new MTs by being involved with M-TEC, an on-line medical transcription school. My career has advanced into
mentoring, training, editing, and recruiting for national medical transcription services. However, the friendships I have
made and sustained over the years has been the greatest benefit of association membership and becoming involved at
different levels.

When I see an MT who is a FAAMT, I see someone who has spent time and effort on sharing their expertise with their
peers, someone who cares about our profession and is proud to share our philosophy, someone who is not afraid to step
out of the box and reach beyond their comfort zone to work with others on projects that will be beneficial to others.

I encourage you to review the application for fellowship at under membership.            Be proud of your
accomplishments…..become a Fellow of AAMT today!

                     Category I – Association Membership (maximum 10 total points allowed)
National Association                                    2 points per year per association
Local State/Regional or Chapter Association             1 point per year per association

                 Category II – Professional Meeting Attendance (maximum 10 points allowed)
AAMT Annual Convention & Expo                           2 points per year
Component Association Meeting                           1 point per year per meeting

                            Category III – Leadership (maximum 12 total points allowed)
Each AAMT elected position                                 5 points per year
Each State/Regional elected position                       2 points per year
Each Chapter elected position                              2 points per year
Each AAMT or Component appointed position                  1 point per year

                   Category IV – Publications and Presentation (maximum 12 total points allowed)
Author or co-author of a published book                    4 points per book
Contributor to a textbook or editorial review              2 points per publication
Published articles in JAAMT or newsletters                 1 point per article
Formal presentations to peers                              2 points each

                              Category V – Mentorship (maximum 6 total points allowed)
Mentor affiliated with an association or school           1 point per year per mentee
CMT Exam Proctor                                          1 point per exam

                           Category VI – Civic Activities (maximum 6 total point allowed)
Civic Activities                                            1 point for each activity per year

                                Category VII – Awards (maximum 6 total points allowed)
Each National and Component award                          3 points per award
Each local chapter or university award                     2 points per award
Other awards                                               1 point per award

                            Category VIII – Certification (maximum 15 total points allowed)
Certified Medical Transcriptionist                           5 points per year
                                                      MEDICINE IN THE NEWS
                                                   By Shonna L. Bradley Bender, CMT

                     Philadelphia Doctors Testing Aneurysm Blocking Device. The FDA has approved testing of a
                      stent at the Hospital of the University of Pennsylvania. The device, manufactured by W. L. Gore and
                      Associates, Inc., of Flagstaff, Arizona, is made of a Teflon-like material and is the first FDA-approved
                       grafting system for treating aneurysms of the descending thoracic aorta. HUP is one of only seven
                facilities nationwide training doctors in the use of the new device. (Associated Press, 08/19/2005)

             24% of PA Adults Are Obese. Data from the Centers for Disease Control and Prevention shows that
             nationally 22.7% of adults are considered obese. States with the highest percentage of obese adults are
            Alabama, West Virginia, Mississippi, Louisiana, and Tennessee. The states with the lowest percentage of
obese adults are Massachusetts, Colorado, Rhode Island, Connecticut, Vermont, and Montana. (Associated Press,

FDA Restricting Access to Accutane. By December 31, 2005, the FDA will require Accutane users to enroll in a
national registry (iPLEDGE) that ensures they understand the acne drug’s risks. The March of Dimes is pleased with the
decision, claiming Accutane’s worst risk is Accutane-damaged pregnancies. If a woman becomes pregnant while taking
Accutane, the baby can suffer severe brain and heart defects, mental retardation and other abnormalities. Other side
effects of Accutane are depression and suicidal thoughts. (Associated Press, 08/13/2005)

Recent FDA Drug Approvals

         Aptivus (tipranavir) was approved for the adjunctive treatment of HIV-1 infections. The drug is manufactured by
         Boehringer Ingleheim. (Approved June 2005 -

         Takeda’s drug Rozerem (ramelteon) was approved for treatment of sleep-onset insomnia. (Approved July 2005 –

                                                   SITES OF INTEREST
                                                    By Tabi Dougherty

                      Editor’s Note: “Sites of Interest” is a new feature that will appear in each issue of Heartbeat of

                      Welcome to sites of interest, a column to introduce new (and used) medical transcription reference
                      sites! I am always looking for sites, so send them my way at

   1.    Stedman’s main website –
   2.    A great website for HIPAA information with links to other sites –
   3.    Another HIPAA website -
   4.    For up-to-date medical news and information –
   5.    Search engine for medical information only –
   6.    For elements of style –
   7.    The Merck Manual –
   8.    Great orthopedic site –
   9.    Reference for street drugs –
   10.   A comprehensive site of MT resources – – some of which is free, but can also subscribe to this.
   11.   A neat site for buying MT-related products –
   12.   A different type of search engine – This brings up encyclopedic information and dictionaries
         as well as web sites.
   13.   Drug site with a “fuzzy” search capability –
   14.   A hospital finding website -
   15.   To find information regarding the senate in PA –
   16.   Another grammar website -
   17.   A doctor directory –
   18.   Another doctor directory -
   19.   Medline plus online dictionary -
   20.   A medical transcription directory –

                                     TWO ERRORS HUMAN – AN EDITING QUIZ
                                               1 CEC – MT Tools
                                          By Ellen Drake, CMT, FAAMT

Editor’s Note: Susquehanna Valley Chapter is very grateful to Ellen Drake, CMT, FAAMT, for allowing us to reprint this
credit-worthy quiz in our newsletter. Ellen is the Director of Certification and Education for AAMT. This quiz has been
approved by AAMT for 1 CEC in MT Tools. Submit the completed quiz with your recertification paperwork at the end of
your 3-year cycle.

This is an editing quiz. There are 16 errors in the report below. The errors are all words (not grammar or punctuation).
Can you find the errors?

       The patient was admitted because of fever, chills, cough and basically asymptomatic condition. He appeared
       weak and malnourished, obviously do to an adequate diet. On x-ray of the pelvis, there did appear to be a fracture
       of the hip. As the patient denied any injuries, it was felt that this could be pathologic. A diagnosis of a traumatic
       fracture was made. On physical exam, the only pertinent findings, other than those mentioned above, were a
       regular rhythm of atrial fibrillation with gallop heard.

       The patient was taken to surgery, and repair of the hip fracture was done through a curvalinear incision. A small
       2-ml mole near the incision sight was dessicated with cautery after a biopsy was taken. Sitology was benign.

        The patients coarse was afebrile one, with temperatures over 100 degrees, in spite of inadequate antibiotic
        regimen. Finally, the patient responded to treatment and was discharged ambulent and on irregular diet.

The answers to this quiz are on page 10.

                                        MEDICAL TERMINOLOGY DEFINED…?

Editor’s Note: Thank you to Sharon Tallman, newsletter editor for Greater Memphis Chapter, for sharing this with us!

In recognition of MT Week in May 2005, corporate employees of Spheris were asked to define several medical terms that
are familiar to medical transcriptionists. After reading this, aren’t you glad corporate employees don’t transcribe medical

Q: What is the medical term for abnormal contraction of the bronchi?

Corporate answers: Emphysema, Pneumonia, Bronchitis
Correct answer: Bronchospasms

Q: What is the medical term for headache?

Corporate answers: Children, Migraine, Concussion, Lobotomy
Correct answer: Cephalgia

Q: What is the medical term for a woman who has never been pregnant?

Corporate answers: Celibate, Antiboyotics, Sanscretin
Correct answer: Nulligravida

Q: What is the medical term for a substance that causes disease?

Corporate answers: Plagocyte, Mad Cows, Tobacco
Correct answer: Pathogen

Q: Where is the Circle of Willis?

Corporate answers: Inside the bone, In the kidney, Different Strokes
Correct answer: Brain

Q: What is the medical term for redness of the skin?

Corporate answers: Rug Burn, Eythrocyte, Jaundice
Correct answer: Erythema

Q: What is the medical term for excessive vomiting?

Corporate answers: Toomuchdrinkitis, Hyperpukis, Hemostasis
Correct answer: Hyperemesis

Q: What is the medical term for an insatiable craving for food?

Corporate answers: Anorexia, Cantputtheforkdownitis, Refrigeratoritis, Count Choculitis
Correct answer: Bulimia

Q: RSV is a common infection. It stands for what?

Corporate answers: Restroom Smell Ventilation, Retinonsaliclate Vacillation, Rosacea Syndrome Variety
Correct answer: Respiratory Syncytial Virus

Q: What is the medical term for excessive hairiness?

Corporate answers: Herpecia, Bigfootemia, Sweaterchestitis, Orchalosis
Correct answer: Hirsutism

Poll compiled by Jill Watkins, HR Administrative Assistant of Spheris. Poll used with permission from Spheris.
                                       TWO ERRORS HUMAN – AN EDITING QUIZ
                                                 1 CEC – MT Tools
                                            By Ellen Drake, CMT, FAAMT
                                               (continued from page 8)

Here are the answers:

          The patient was admitted because of fever, chills, cough, and basically symptomatic(1) condition. He appeared
          weak and malnourished, obviously due(2) to inadequate(3) diet. On x-ray of the pelvis, there did appear to be a
          fracture of the hip. As the patient denied any injuries, it was felt that this could be pathologic. A diagnosis of
          atraumatic(4) fracture was made. On physical exam, the only pertinent findings, other than those mentioned
          above, were irregular(5) rhythm of atrial fibrillation with gallop heard.

          The patient was taken to surgery, and repair of the hip fracture was done through a curvilinear(6) incision. A
          2-mm(7) mole near the incision site(8) was desiccated(9) with cautery after a biopsy was taken. Cytology(10) was

          The patient's(11) course(12) was a febrile(13) one, with temperatures over 100 degrees in spite of an
          adequate(14) antibiotic regimen. Finally, the patient responded to treatment and was discharged ambulant(15)
          and on a regular(16) diet.

Error Analysis

    1.    The dictator might have used the article "a" or simply said "uh" in front of symptomatic. Context is king!
    2.    I call this a "copy-type" error; transcribing by sound and not by meaning.
    3.    MT misheard "in" as "an."
    4.    Hearing okay but not thinking of context. A pathologic fracture is one that occurs without trauma (atraumatic).
    5.    MT misheard "ir" as "a." Context, context, context! Atrial fibrillation is irregular by definition.
    6.    This is a commonly misspelled word. Recommend MTs study lists of commonly misspelled English and medical
          words, many of which are available on the Internet.
    7.    Typo, MT not thinking or doesn't know appropriate abbreviations for different metric units of measure.
    8.    MT not thinking or doesn't know homonyms. Again, recommend MTs study lists of common English and medical
          homonyms and near-homonyms.
    9.    Another commonly misspelled word.
    10.   MT not thinking or doesn't know homonyms.
    11.   The possessive of patient is needed. Confusing patient's and patients and its and it's can be typos, but more
          often they're not. If repeated, these are red flags identifying the uneducated.
    12.   Another homonym.
    13.   Typo, MT not thinking. The line that follows clearly indicates the patient was febrile, not afebrile. It's not
          uncommon for students to attach articles to the words that follow or mishear prefixes as articles. Proofreading
          after the fact without the audio should catch errors such as this.
    14.   MT misheard "an" as "in." The phrase "in spite of" is a clue to meaning.
    15.   Commonly misspelled word.
    16.   The reverse of #4, MT misheard "a" and "ir".

I think it's important for MTs (especially students and the inexperienced) to analyze their errors and try to figure out why
they make them. Some of these errors could be due to lack of knowledge or experience. Most of these errors, especially
if made by an experienced MT, are what I call errors due to a copytyping mentality. Copy typists copy errors because
they type what they see and are not taught to correct as they go. MTs who listen this way are doomed. The difference
between what we do and what speech recognition does is that we process the sounds coming into our ears, all the while
evaluating for sense and making judgment calls. Speech recognition simply interprets the sounds phonetically based on
patterns that have been fed into it earlier.

SVC CHALLENGES YOU! We are challenging YOU to write a credit-worthy article or quiz to be published in an
upcoming newsletter. You can use the guidelines in AAMT's CEC Requirements Table (under "CERTIFICATION") when
writing your article or quiz. (Please take a look at this chart - the requirements have been updated recently!) After you
write your article, you must submit it to AAMT for approval for credit before it is published. If you have any questions or
need assistance with having your article or quiz approved for CEC, our newsletter staff will be happy to help you. Writing
an article or CEC is not only beneficial to your colleagues, but you can use that information for both your CMT
recertification as well as points towards your FAAMT designation! We’ll be looking for your article!
                                                 Margie Flatley, CMT
                                 Information compiled by Barbara Weckel, CMT, FAAMT

                          CURRENT POSITION AND YEARS IN THIS POSITION: I have just started a new job with
                          DataKey as a QA editor.

                          HOW DID YOU EVER HEAR OF MEDICAL TRANSCRIPTION: I answered an ad in the paper
                          when I was unemployed in 1992.

                          EDUCATION FOR MEDICAL TRANSCRIPTION: I went to training for WordPerfect while I
                          was unemployed. I had learned medical terminology when I worked as a health claims
                          examiner for Prudential Insurance Company in the 1980s.


CHANGES IN TRANSCRIPTION OVER THE YEARS (GOOD OR BAD): I like the technological changes that have
occurred. I had the good fortune to work with Dictaphone as a beta site for speech recognition. Technology has made
our job easier over the years.

FIRST JOB IN TRANSCRIPTION AND MEMORY OF IT: I worked evening shift at a Community Hospital doing all work
types. I worked every Saturday during the day and got to type the Friday night drunk fights in the ER.

FAVORITE SPECIALTIES: I like cardiology and psych the best.

LEAST FAVORITE SPECIALTIES: I find all aspects of medicine fascinating.

FUNNIEST THING YOU TRANSCRIBED: Speech recognition said the patient was a 12-year-old Amish girl with an injury
to her penis.

OTHER JOBS YOU HAD NOT RELATED TO MEDICAL TRANSCRIPTION: Department store sales, customer service
for department store, billing clerk for an insurance company, health insurance claims examiner, temporary data entry clerk
at night, human resources for a temp agency, data entry for the Commonwealth of Pennsylvania Department of
Education, fuel tax clerk for a trucking company, then promoted to the operations department and eventually became
safety director, then they went out of business and I qualified for retraining while I was unemployed.


AAMT INVOLVEMENT/LOCAL INVOLVEMENT: Practitioner member since 2000, founding president of Susquehanna
Valley Chapter of AAMT. Love to go to meetings and hear speakers and talk to people about transcription.

FAMILY - SPOUSE/CHILDREN/GRANDCHILDREN/PETS: Divorced twice. Can't seem to pick the right guy. Have a
boyfriend. We do not live together but have been "dating" for 13 years. Two boys, one from each marriage. Alex is 27
years old and an animator currently working on a movie based on a children's book, The Ant Bully. He lives in Irving,
Texas. John is 20 years old and in the Pennsylvania National Guard. He currently has a temporary full time job with the
Guard at Indiantown Gap. He will be flying to Hawaii with me, and Alex will be meeting us there. We will have a couple of
days to pal around before the convention activities begin. Then they can do stuff while I am in meetings. Have four cats -
Daisey 13, Clover 11, Midnight 11 and Holly 6.                                                    (continued on page 12)

                                                    SPOTLIGHT ON…
                                                   Margie Flatley, CMT
                                                 (continued from page 11)

HOBBIES: Shopping, eating out.

COMMUNITY INVOLVEMENT: Active in my church. I was on the St. Patrick School Board for 3 years - Secretary for
one year. Helped raise funds for a playground in a nearby park over 10 years ago.

YOUR DREAM VACATION: Round the world cruise. If I can't do that, I would like to go to Austria where I was born and
to Ireland, the land of my ancestors.

WHAT YOU ARE LOOKING FORWARD TO IN RETIREMENT: Time to get rid of all my junk!

years, becoming the supervisor after 5 years. I loved that job. When they eliminated it in 2002, I was devastated. It has
been a long grieving process for me but I think I am coming out of it. I love this profession because it stretches my brain.
I learn something new every day.

ANYTHING ELSE YOU CARE TO SHARE: I grew up as an Army Brat and lived in many, many places. My current
home is the 29th place that I have lived. Somehow I have managed to stay here for 14 years! Can't believe it!

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Deadline for submissions of articles for the November issue: OCTOBER 15, 2005!

                                               by Grace M. LaConte

Editor’s Note: Grace is a medical transcriptionist with Memorial Eye Institute in Harrisburg, Pennsylvania. We are pleased that
she is sharing some of the more obscure ophthalmology terminology and sample reports with us!


        Age-Related Macular Degeneration: Destruction and loss of the photoreceptors in the macula region of the retina resulting
        in decreased central vision and, in advanced cases, blindness.
        B-scan: ultrasonic procedure used to check for abnormalities or locate foreign bodies within the eye.
        Barraquer Cyro-Lathe: Instrument used in performing refractive surgery to correct extreme myopia or hyperopia.
        Best Corrected Visual Acuity (BCVA): Measure of best acuity while wearing corrective lenses like glasses or contact
        CrystaLens: An intraocular lens that is designed to change focus from distant to near objects. It is the first of its kind to
        achieve FDA approval.
        Diabetic Retinopathy: Also called non-proliferative or "background" retinopathy. Condition that damages tiny blood vessels
        that supply the retina. In early stages, the retinal vessels weaken and develop bulges that may leak blood or fluid into the
        surrounding tissue.
        Fluorescein Angiography: Test to examine blood vessels in the retina, choroid, and iris. A special dye is injected into a vein
        in the arm and pictures are taken as the dye passes through blood vessels in the eye.
        Macular Edema: The collection of fluid in and under the macular portion of the retina causing swelling.
        Manifest Refraction: An examination of the eye to determine refractive error while the natural crystalline lens is able to
        Nuclear Sclerosis: Commonly known as cataracts. Opacity or clouding of the natural crystalline lens that may prevent a clear
        image from forming on the retina. Cataracts occur naturally and can be induced by trauma. The cataractous lens may require
        surgical removal if visual loss becomes significant, with lost optical power replaced with an intraocular lens.
        Ocular Hypertension: Elevated intraocular pressure.
        Pachymetry: Procedure used to measure the thickness of the cornea.
        Phacoemulsification: Surgical cataract procedure which uses an ultrasonic vibration to shatter and break up a cataractous
        lens, making it easier to remove.
        Phoropter: An optical instrument containing many lenses which is used to determine the required power of glasses or
        refractive error.
        Photocoagulation: The process of tissue destruction accomplished by visible light radiation.
        Posterior Vitreous Detachment: Separation of the vitreous body from the retinal surface due to shrinkage from degenerative
        or inflammatory conditions or trauma.
        Schirmer Test: Tiny strips of filter paper are placed in the patient's eyes just under the lids. After five minutes the distance the
        tears have stained the paper is measured. The greater the distance, the higher the natural tear production.


Advanced Medical Optics                                                  Ophthalmic Imaging Systems
Aesculap-Meditec (abbreviated “Meditec”)                                 Summit
Bausch & Lomb                                                            Sunrise Technologies
Chiron                                                                   Topcon
Coherent Medical Group                                                   Vector Vision
Humphrey Instruments                                                     Visx
Laser Diagnostic Technologies                                            WaveLight
LaserSight                                                               Welch Allyn



        Glaucoma: In the field of glaucoma, the most recent approval (2004) is Istalol (Ista Pharmaceuticals), a new topical
        formulation of the beta-blocker timolol. An emerging trend in glaucoma medications is combination agents. Some
        combinations in phase III development include Pfizer's Xalcom (latanoprost and timolol), Alcon's Extravan (travoprost and
        timolol), and Allergan's Combigan (brimonidine tartrate and timolol) and Lumigan (bimatoprost) with timolol.
        Dry eye: The more recently approved agents for dry eye include over-the-counter ophthalmic solutions Soothe (Alimera) and
        Systane (Alcon Laboratories).

                                                         (continued on page 14)

                                                by Grace M. LaConte
                                              (continued from page 13)

      AMD drugs: There are several therapies under investigation for the treatment of age-related macular degeneration (AMD),
      most of which target the angiogenesis pathway that leads to the choroidal neovascularization (CNV) characteristic of wet
      AMD. Pegaptanib sodium (Macugen, Pfizer/Eyetech), the first angiostatic treatment approved by the FDA (in December 2004),
      is a VEGF blocker administered intravitreally every 6 weeks. Another VEGF blocker, ranibizumab (Lucentis, Genentech),
      injected intravitreally 13 times per year, may gain approval this year. The novel angiostatic cortisene anecortave acetate
      (Retaane, Alcon) may also gain approval this year.
      Antibiotics:       The most recent antibiotic approval, tobramycin/lotoprednol (Zylet, Bausch & Lomb), is a
      corticosteroid/aminoglycoside combination therapy indicated for steroid-responsive inflammatory ocular conditions with
      superficial bacterial infection or risk of infection.
      Anti-inflammatory: The topical non-steroidal anti-inflammatory drug (NSAID), bromfenac (Xibrom, Ista Pharmaceuticals),
      was approved in the first quarter of 2005 for the twice-daily treatment of postoperative inflammation after cataract surgery.
      Cataract: A novel concept in cataract therapy is a drug intended for cataract prevention. OT-551 (Othera Pharmaceuticals) is
      intended to counteract the detrimental effects of free radical-induced oxidative damage.

        Source: Ophthalmic drugs: what's in the pipeline? Ophthalmology Times/Special Report, by Mark B. Abelson, M.D., Matthew
        Chapin, Annie Plumer;


        Argon Laser: Laser light produced from argon gas. The main wavelengths are 488.0 nm blue and 514.5-nm pea green light,
        but nine separate wavelengths in the blue-green visible light spectrum are produced.
        Buttonhole Flap: A complication of LASIK caused when the microkeratome breaks through the top of the cornea while
        creating a flap of corneal tissue. Buttonhole flaps are most often caused by loss of suction of the ring that holds the
        microkeratome to the eye. The usual response is to stop the surgery, replace the flap, protect the flap with a contact bandage
        for a few days, then about three months later do the surgery again. The vast majority of people who have buttonhole flaps
        have no long-term problems at all and are able to have LASIK after the flap has sufficiently healed.
        Complete Ophthalmic Analysis System: An integration of WaveFront Sciences’ wavefront technology with Asclepion
        excimer laser system. The manufacturers say COAS will enable improved visual acuity in persons with vision defects.
        Complex Wavefront Retreatment: A secondary surgery using wavefront-guided ablation in an attempt to reduce higher
        order aberrations induced by previous surgery. Complex Wavefront Retreatment is an off-label use of the excimer laser.
        Contact Lens Assisted Pharmacologically Induced Kerato Steepening: A process of accommodating hyperopic
        overcorrection following LASIK, PRK and RK, by molding the cornea with a tight fitting contact lens and nonsteroidal anti-
        inflammatory drugs.
        Enhancement: Secondary refractive surgery treatments made to refine or improve the original visual result. Outcome
        predictability is reduced at higher corrections. Higher corrections and wider optical zones require deeper sculpting and
        consequently undercorrection and overcorrection are more common. Enhancement treatment by contrast is usually a small
        correction and usually has higher outcome predictability.
        Epikeratome: A mechanical device similar to a microkeratome that uses a blunt separator rather than a sharp blade to
        produce an epithelial sheet for Epi-LASIK. Rather than a more destructive alcohol mixture to loosen the epithelial cells used in
        LASEK. The epithelial cells are moved over the treatment area after Excimer-Laser energy has been applied.
        Epi-LASIK: Modified LASEK with the epithelial cells removed by a mechanical microkeratome using a blunt, rather than
        sharp, blade. more
        Femtosecond Laser: An infrared range laser that delivers pulses of energy within the cornea, causing a small controlled
        explosion of gas that separates the layers of the cornea. The femtosecond laser for ophthalmology use on the eye is
        manufactured by Intralase and is used to create a LASIK flap in a procedure commonly called IntraLASIK or "all laser LASIK".
        Intralase: Manufacturer of a femtosecond laser for use in creating a LASIK flap and other precise corneal incisions. LASIK
        with the Intralase laser created flap is called IntraLASIK. See IntraLASIK details.
        IntraLASIK: LASIK with the corneal flap being created by a femtosecond laser rather than with a mechanical microkeratome.
        See IntraLASIK details.
        Laser Assisted In-Situ Keratomileusis: An advanced laser procedure combining ALK and PRK to reshape the central
        cornea, thereby decreasing or eliminating myopia, hyperopia, and astigmatism. The refractive surgeon uses an automated
        microkeratome to shave off a thin, hinged layer of the cornea. This flap is then lifted like a hinged door and the exposed
        surface is reshaped using the excimer laser. After altering the corneal curvature, the flap is replaced and adheres without
        Laser Assisted Epithelium Keratomileusis: Laser Assisted Sub-Epithelium Keratomileusis (LASEK) is the detachment of
        the epithelium with the use of an alcohol solution that softens the epithelium and allows it to be rolled back into a flap. The flap
        of epithelium is then be repositioned over the cornea following excimer ablations.
        Macro Striae: Wrinkles in the LASIK flap.

                                                         (continued on page 15)

                                                 by Grace M. LaConte
                                               (continued from page 14)


         Microkeratome: A surgical device for creating a flap of corneal tissue used in LASIK and some transplant techniques. There
         are two classes of microkeratomes: mechanical and laser. Both are affixed to the eye by use of a vacuum ring, flatten the
         cornea with a clear applanation plate, then cut across the cornea under the plate.
         The mechanical microkeratome uses a very sharp and thin metal blade. The femtosecond laser microkeratome uses amplified
         light energy to cause tiny bubbles to form at a predetermined depth. Thousands of these bubbles next to each other create an
         Penetrating Keratoplasty: Abbreviated as PK or PKP. A surgical procedure when a button-like full thickness segment of the
         cornea is removed and replaced with a donor cornea from another person; a corneal transplant
         Radial Keratotomy: Abbreviated as RK. A surgical procedure that permanently alters the shape of the cornea by placing
         microscopically thin relaxing incisions in the peripheral cornea. The incisions cause the central portion of the cornea to flatten,
         thereby reducing the power of the cornea.
         YAG Laser: YAG is an abbreviation for neodymium yttrium-aluminum-garnet, the material used generate a short pulsed, high-
         energy light beam in the infra red wavelength of 1064 nm. The YAG laser is a surgical instrument that can be precisely
         focused by computer to cut, photovaporize, or fragment tissue.
         Zyoptix: The brand name for wavefront guided custom ablation on the Bausch & Lomb Technolas excimer laser.

Acular                                           Kenalog                                           pilocarpine
Alphagan P                                       levobunolol                                       Plaquenil therapy
atropine drops                                   Lidocaine 2% jelly                                Pred Forte drops
balanced salt solution                           Marcaine                                          tetracaine
Betadine scrub and Betadine                      Miochol                                           TobraDex drops
solution                                         Muro drops                                        Travatan
Betagan                                          Mydriacyl                                         Viscoat
Celestone                                        Neo-Synephrine                                    viscoelastic
Cyclogyl 1%                                      Neptazane                                         Visudyne
fluorescein dye                                  Ocufen                                            Xalatan
Garamycin                                        Ocuflox                                           Xylocaine
Healon                                           Ophthetic
Iopidine                                         Patanol


Right eye 11% false-negative errors with a foveal threshold of 21. There is depression primarily temporally but also
somewhat superiorly. This is in contrast to the left eye with 2% false-positive errors and a foveal threshold of 36 (foveal
threshold of 21 OD) and a field which is reported as statistically within normal limits.

Impression: Abnormal visual field OD with normal field OS.


Normal OD; OS there is hemorrhage in the inferior macula and midperiphery.

Demonstrates hyperfluorescence on the optic nerve OS with blocked fluorescence from blood. Significant ischemia may
be present inferiorly OS. There may be some arteriolar narrowing OD.

1. Branch retinal vein occlusion OS with edema, questionable ischemia, and positive retinal hemorrhage.
2. Questionable neovascularization OS.
3. Hypertensive retinal vascular disease.

Follow-up in a few weeks will be planned.


B-scan ultrasonography dynamically performed with the Quantel unit. Demonstrates traction retinal detachment involving
the posterior pole. Complex vitreoretinal membranes are evident with marked vitreous hemorrhage.

Traction retinal detachment and probable PVD [posterior vitreous detachment] OD.

Consideration for retinal reattachment surgery with a vitrectomy and lensectomy could ensue.


OD: 20/70-
OS: 20/40

OD: 10/10
OS: 1/10

PUPILS: Reactive without afferent defect.

OD: Supratemporal paracentral depression.
OS: Full.


MOTILITY: Full and smooth.

OD: 14
OS: 16


Demonstrates some dermatochalasis.

Cornea shows some epitheliopathy and scar. Minimal edema is appreciated. No significant cell or flare is noted. On the
left the cornea is clear. Anterior chamber is deep and clear. Iris is normal. Nuclear and cortical lens changes are noted.
On the left PC IOL posterior capsular intraocular lens is noted with an intact capsule.

Demonstrates sharp disc margins with a cup-to-disc ratio of 0.2. AV arteriovenous ratio is 2:3. Drusen are present about
the fovea OD and I do not believe there is lipid, although there is some element of suspicion. There may be some cystoid
edema. I do not believe there is a serous detachment. On the left, minimal pigment change is appreciated. There is no
fluid, lipid, or hemorrhage and no substantial drusen.

1. Age-related maculopathy of a mild extent OU with questionable exudation OD.
2. Questionable cystoid macular edema OD.
3. Corneal epitheliopathy and scarring secondary to HZO [herpes zoster ophthalmicus].
4. Cataract OS.

We review the diagnoses outlined above. Photography and angiography are planned today and we will review these
findings with her next week. We might consider Argon laser photocoagulation, further PDT [photodynamic therapy] with
Visudyne, or Macugen therapy. An AREDS [Age-Related Eye Disease Study] formula may be considered.
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