MEDICAL WRITING ABBREVIATIONS SYMBOLS AND UNITS OF MEASURE Michael

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					MEDICAL WRITING:
ABBREVIATIONS, SYMBOLS, AND
     UNITS OF MEASURE

          Michael Blumenthal
    Disability Determination Services
                Austin, TX
                      Goals

Raise awareness;

Provide useful examples;

Suggest ways to discover the meanings of unknown
abbreviations;

Provide references;

Involve participants; and

Have fun.
       Pre-Seminar Exercise
1. Which of the following is correct:

A.   25 mgs
B.   25 mg
C.   25 mg.
D.   25 Mg
E.   25mg
2. Which of the following is correct:

A.   1 x 4 x .5 cm
B.   1 x 4 x 0.5 cm
C.   1.0 x 4.0 x 0.5 cm
D.   1x4.0x.5 cm
E.   1.0 x 4.0 x 0.5 cms
3. Which of the following is correct:

A.   36.4oC
B.   36.4 oC
C.   36.4o C
D.   none of the above
4. Which of the following is correct:

A.   Glucose:   105   mg/dL
B.   Glucose:   105   mg/dl
C.   Glucose:   105   mg%
D.   Glucose:   105   mg.%
E.   A and C
     What is the meaning of the
     abbreviation:
                           ac
A.   before meals
B.   acute cholecystitis
C.   antibody
D.   ascending colon
E.   all of the above
   Transcriptions

Pathology Reports
Diagnostic Studies
Operative Reports
Autopsies
History and Physical Exams
Machine Generated
   Documents

Laboratory Reports
 Imaging Studies
  Handwritten
  Documents

Progress Notes
Orders
Prescriptions
ABBREVIATIONS
Abbreviation (from Latin brevis
"short") is strictly a shorter form of a
word, but more particularly, an
abbreviation is a letter or group of
letters, taken from a word or words,
and employed to represent them for
the sake of brevity.
          http://www.answers.com/topic/abbreviation
       Types of abbreviations

     Apart from the common form of
     shortening one word, there are
     many types of abbreviations.

1.   First letters of each word        AIDS
2.   First letters plus added vowels   FIESTA
3.   Latin                             STAT
4.   You name it!
      First Abbreviations
INRI
IESVS NAZARENVS REX IVDAEORVM
Jesus of Nazareth, King of the Jews

SPQR
senatus populusque romanus
The Senate and the People of Rome

RIP
Requiescat in Pace
Rest in Peace
      Abbreviations

“Presently there are no
standards for abbreviations”
which “are not always
understood and at times are
misinterpreted.”

                                                           Neil M. Davis
                                                           Communications
     Medical Abbreviations: Conveniences at the Expense of Communications and Safety
      What does this mean?
…73 YO WDWNAAF BIBA admitted to
 CPETU. TBNA in EDTU last wk for CP
 relieved by NTG.

…73 year old well-developed, well-nourished
 African-American female brought in by
 ambulance admitted to chest pain
 evaluation and treatment unit. Treated but
 not admitted in emergency diagnostic and
 treatment unit last week for chest pain
 relieved by nitroglycerine.
What language is the
 abbreviation in?
       Latin?
      Spanish?
      English?

        or…

    a combination
What does



   ac
represent?
         Latin



ante cibum. before meals.
              Spanish
AC

anticonceptivos. contraceptives.
anticuerpo. AB | antibody.
arritmia cardíaca. cardiac arrhythmia.
aseguramiento de la calidad. quality control.
auscultación cardíaca. cardiac auscultation.
            English
AC

abdominal circumference
acute cholecystitis
adrenal cortex
anticoagulant
ascending colon
 Style Conventions

It is generally best to
write out the full
meaning of abbreviations
in translations.
   Latin Abbreviations
Most Latin abbreviations should be in
lower case letters and end with periods.

Some authors prefer to use italics to
highlight Latin abbreviations.

i.e.     id est           that is
e.g.     exempli gratia   for example
b.i.d.   bis in die       twice a day
t.i.n.   ter in nocte     three at night
p.o.     per os           by mouth
p.r.n.   pro re nata      as required
        Latin Abbreviations
Two exceptions to the lower case with periods standard:

In the abbreviation et al. the word et is not an abbreviation
and should not have a period.

                   et al. not et. al.

                            and

                   A.D. = Anno Domini

“…it is conventional in English writing for A.D. to precede
the year (A.D. 2004)”
                   http://ancienthistory.about.com/od/time/g/AD.htm
       Latin Abbreviations
Prescriptions
    ut dict. ut dictum     as directed
    h.s.      hora somni   at bedtime

Charting
    c        cum           with
    s        sine          without
The X Abbreviations may have:

The same letters for same meanings
Bx       biopsia        Bx biopsy

Different letters for same meanings
Qx         quirúrgica     Sx surgical

Multiple meanings in both languages
Sx
signo,síntoma, síndrome   sign, symptom, syndrome
                   Rx
                  English
                Prescription

Eye of Horus [Egyptian]
Jupiter [Roman]

                  Spanish
           Rayos X     X rays
  History and Physical
                                      MC
Motivo de la Consulta                       Chief Complaint

                                      PA
Padecimiento Actual                         Current Illness

                                      APP
Antecedentes Personales Patológicos         Medical History

                                      TA
Tensión Arterial                            Blood Pressure

                                      ROT
Reflejo OsteoTendinoso                      Deep Tendon Reflex
MC
EA

RAS
APP

APF

FI
   Laboratory Studies
                     QS
química sanguínea         blood chemistry

                     BH
biometría hemática        complete blood count

                    EGO
examen general de orina urinalysis

                      LCR
líquido cefalorraquídeo   cerebrospinal fluid
   Hematocrit

Multiple abbreviations
 for the same thing

         HTO
          HT
     HCT, Hct, hct
        Hcto
         crit
       Progress Notes
                    RsCsRs
ruidos cardiacos rítmicos sinus rhythm

                     CsPs
campos pulmonares           lung fields

                     RR
ritmo respiratorio          respirations

                     RC
ritmo cardiaco              heart rate
Diagnostic Studies
                  IRM
    imagen por resonancia magnética

                   or

                  RMN
      resonancia magnética nuclear
    MRI | magnetic resonance imaging

                  PFP
      pruebas de función pulmonar
     PFT | pulmonary function tests

                  TAC
     tomografía axial computarizada
              CT/CAT scan

                  PA
            posteroanterior
RMN and IRM
 Chemical Elements


Ca        Calcium
Cl        Chlorine
Fe        Iron
K         Potassium
Pb        Lead
Na        Sodium
  Determining the Meaning of
Unknown Spanish Abbreviations

 Use a Search Engine, such as Google, and
 choose the Spanish language preference.

 If there are no hits the abbreviation is
 probably unique to the author.

 Search in English to check the possibility
 of an English abbreviation in a Spanish
 text.
Determining the Meaning of
    Unknown Spanish
      Abbreviations

If there are hundreds of hits
there are probably multiple
meanings, add key words that
are appropriate to the context.
  Determining the Meaning of
Unknown Spanish Abbreviations



  Assure that context is
  appropriate by adding
  accessory words.
Heart Doppler
Heart Doppler
For example, if you are translating a
diagnostic study of the heart and the
abbreviation VI appears, it is very likely
that the V represents ventrículo.

Search: “ventrículo * (VI)” “Doppler”
                 626 hits
  “Ventrículo izquierdo (VI)” “Doppler”
                 301 hits
Since we know that this is a Heart
Doppler, we can guess that there will
be heart measurements at systole
and diastole. So we try:

“* Diastólico Ventrículo Izquierdo”
             1,580 hits
“diámetro diastólico del ventrículo izquierdo”
                   308 hits

“diámetro diastólico del ventrículo izquierdo
                   (DDVI)”
                   24 hits

“diámetro diastólico del ventrículo izquierdo
             (DDVI)” “Doppler”
                   9 hits
Word order reversal is the standard
first option.

 diámetro diastólico del ventrículo izquierdo


 “left ventricular diastolic diameter (LVDD)” “Doppler”

                     28 hits
What if the internet search is not
           successful?
Consult resources

The Davis Book of Medical Abbreviations, Mitchell-Hatton

Stedman’s ABBREV.: Abbreviations, Acronyms, & Symbols

MEDical ABBREViations
Davis

Mosby's Survival Guide to Medical Abbreviations, Acronyms,
Prefixes and Suffixes, Symbols and the Greek Alphabet
(Hardcover)
June M Campbell, Joe Bill Campbell


http://www.statref.com/
What if the internet search
   is not successful?


Ask People!
What if all attempts to determine the
 meaning of the abbreviation fail?


Write a translator’s note:

[Translator’s Note | The
meaning of the letters “DDVI”
is undetermined.]
ACRONYMS
      ACRONYM
A word formed from the initial letters
or syllables of other words.

              radar
   Radio Detecting and Ranging
             library.thinkquest.org/23846/library/terms/
      Acronyms
SIDA
Síndrome de Inmunodeficiencia
Adquirida


PIRLA
Pupilas Iguales y Reactivas a la
Luz y Acomodación
Acronyms Used in Spanish Texts

STAT
Statim
Immediately

SMAC-20
Sequential Multiple Analysis Computer

BIRADS
Breast Imaging Reporting and Data System
        Tomography

             CAT
   Computed Axial Tomography

               PET
  Positron Emission Tomography

               SPECT
Single Photon Emission Tomography
    MRI Pulse Sequences
                   FIESTA
Fast Imaging Employing Steady-sTate Acquisition

                    GRASS
Gradient Recalled Acquisition in the Steady State

                    FLAIR
     FLuid Attenuated Inversion Recovery



Do not translate these protocols. Use
them as written in English.
MENTAL MEASUREMENT TOOLS
              DASH
Developmental Assessment for the
      Severely Handicapped


            WISC-R
 Weschler Intelligence Scale for
       Children - Revised
             Cancer Chemotherapy
ACRONYM &                         DRUG
INDICATION
                  Generic name             Trade name

CHOP              cyclophosphamide         Cytoxan
(Non-Hodgkin’s    doxorubicin              Adriamycin
Lymphoma)         vincristine              Oncovin
                  prednisone               Deltasone

FAC               fluorouracil (5-FU)      Adrucil
(Breast cancer)   doxorubicin              Adriamycin
                  cyclophosphamide         Cytoxan

                                        Nursing94 Drug Handbook
                Acronyms
While in general acronyms are written in full
capital letters without punctuation, acronyms that
have become accepted as words by themselves
may be written in lower case:

laser
light amplification by stimulated emission of
radiation

lasik
laser in situ keratomileusis

tens
transcutaneous electrical nerve stimulation
SYMBOLS
          Symbol

An arbitrary sign…that has
acquired a conventional
significance.
     http://wordnet.princeton.edu/perl/webwn?s=symbol
Dr. Ben Casey’s Symbols
             Greek Alphabet
α      α fetoprotein
       alpha fetoprotein

γ      γ glutamyl transferase
       gamma glutamyl transferase

μ      μg/dL
       micrograms/deciliter

    Use the symbol if your equipment can
    reproduce it, otherwise write out the
    symbol’s meaning.
        Pulse Grading

0                completely absent
+ =+1 = 1+       markedly impaired
++ = +2 = 2+     moderately impaired
+++ = +3 = 3+    slightly impaired
++++ = +4 = 4+   normal
        Reflex Grading

++++ = 4+   hyperactive or very brisk
+++ = 3+    brisker than average
++ = 2+     average or normal
+ = 1+      somewhat diminished
0           no response
    Symbols and Numbers
The following symbols should always appear
directly in front of or directly following the
number they refer to with no spacing.

                        o

                       +
                       %
                       #
                       $
                       -
                       &
                       /
98oC      not   98o C
45%       not   45 %
3+        not   3+
D&C       not   D&C
60-110    not   60 - 110
106/mm3   not   106/ mm3
Symbols with Multiple Meanings
                  X or x

                    by
               4.0 x 2.0 cm

                  times
                 2x3=6

                   per
                4.6 xmm3
      representing a series of letters
                    Dx
Symbols with Multiple Meanings
              O

           Degree
            36oC

            Hour
             1o
NUMBERS
Add a zero after the decimal point
and whole number for consistency in
the set of numbers containing a
decimal fraction.

Not                          8.5 x 5 x 4
But rather                   8.5 x 5.0 x 4.0

             Fordney and Diehl, Medical Transcription Guide
Add a 0 before units that are <1



      0.5        not             .5

         Fordney and Diehl, Medical Transcription Guide
       SYMBOLS FOR NUMBERS
Symbol    Prefix   Log     Quantity

T         tera     1012     1,000,000,000,000
G         giga     109      1,000,000,000
M         mega     106      1,000,000
k         kilo     103      1,000
h         hecto    102      100
da        deka     101      10
unit                        1
d         deci     10-1    0.1
c         centi    10-2    0.01
m         milli    10-3    0.001
μ         micro    10-6    0.000 001
n         nano     10-9    0.000 000 001
p         pico     10-12   0.000 000 000 001
f         femto    10-15   0.000 000 000 000 001
          English                         Spanish
USA           Britain

thousand         thousand                 mil
million          million                  millón
billion          milliard                 millardo
trillion         billion                  billón
quintillion      trillion                 trillón
septillion       quadrillion              cuatrillón
          http://www.class.uh.edu/mcl/fll/Span/cardinal.html#Millón
ROMAN NUMERALS
    I      1
    V      5
    X     10
    L     50
    C    100
    D    500
    M   1000
 Heart Murmur Grading

1/6   =   I/VI     very faint
2/6   =   II/VI    quiet
3/6   =   III/VI   moderately loud
4/6   =   IV/VI    loud
5/6   =   V/VI     very loud
6/6   =   VI/VI    extremely loud
Anti-streptolysin 0 Antibodies
          1:80        Positive
          1:160       Positive
          1:320       Positive
          1:640       Positive
          1:1280      Negative

An antibody titer is reported as the last dilution
that causes an antigen-antibody reaction, or
agglutination. Thus, in this example, the
laboratory report would read:

                ASO titer 1:640
          Writing

    1.234,56 vs. 1,234.56


In many Spanish-speaking
countries, a comma
separates decimals and a
period to separate thousands.
     Dates

What is this date?

    01/02/06
American Date Format


  Month, Day, Year



  January 2, 2006
European Date Format


  Day, Month, Year



  February 1, 2006
International Standards
  Organization Format

 Year, Month, Day



 February 6, 2001
              Time
hour, minute, second | 12 hour with
a.m. or p.m.

hour, minute, second | 24 hour, with
the local time zone presumed

hour, minute, second | 24 hour,
stating the time zone
          Isotopes
The iodine isotope used in SPECT
studies is pronounced iodine 123 or I
123 and is written as:

           123I

           Iodine 123
           I-123
 Units
  of
Measure
           Metric Units
System of weights and measures based on
                units of:

            Measurement
               Meter

               Weight
               Gram

               Volume
                Liter
All metric units with numbers should be
written in lower case except for liter (L),
degrees Celcius (oC), and symbols derived
from the name of a person (Pa) for Pascal.

kg           not            Kg
mg/dL        not            mg/dl
1L           not            1l
36.4oC       not            36.4oc
        mg/dL is equivalent to:
           mg/% and mg%
milligram/deciliter = milligram percent
A space should separate the number
and symbol

          25 kg vs. 25kg
          Unit Abbreviations

Unit abbreviations do not have an
appended period (.) unless they appear at
the end of a sentence.

   cm            not            cm.

No plural forms are used

   2 cm          not            2 cms
 Metric Units with Numbers

Write out measurements when they
are used without a number

The cut was several centimeters
long.
                Medical Transcription Guide
Laboratory Studies
Reference Values
       vs.
 Normal Values
Reference values vary with:

Age
Sex
From laboratory to laboratory
Serum vs. plasma
        International Unit
An international unit (IU) is an
internationally accepted amount of a
substance. This type of measure is
used for the fat-soluble vitamins
(such as vitamins A, D and E) and
certain hormones, enzymes, and
biologicals (such as vaccines).
 http://www.medterms.com/script/main/art.asp?articlekey=9650
             SI Units

The 11th General Conference on
Weights and Measures (1960)
adopted the name Système
International d'Unités (International
System of Units, international
abbreviation SI), for the
recommended practical system of
units of measurement.
                       http://www.bipm.fr/en/si/
 Units in Laboratory Studies

%       Hematocrit
fL      Mean Corpuscular Volume
pg      Mean Corpuscular Hemoglobin
mg/dL   Cholesterol
g/dL    Hemoglobin
mEq     Electrolytes
U/L     Enzymes
g/dL not gr
  /mm3
   U/L
   g/dL
               Eponyms

Bodansky Unit    alkaline phosphatase

Somogyl Unit     amylase

Todd Unit        antistreptolysin O
  Letters and Numbers
 Misinterpreted as Words

           TIMONO

           T1 M0 N0

Tumor Grade              1
Metastasis               0
Lymph Node Involvement   0
Progress Notes
Prescriptions
           Disp
        dispense

        Sig |signetur
      let it be labeled

        po | por os
         by mouth

qam | quaque ante meridiem
       every morning

 qhs | quaque hora somni
       every bedtime
Let it be labeled: Take 4
tablets by mouth every
morning and 6 tablets
by mouth at bedtime
Drug:         Viagra 50 mg
Quantity:     10 tablets
Directions:   Take 1 tablet
              1 hour prior to sex
              as directed
                  In Review

1. Write out the full meanings of most
   abbreviations;

2. Write English acronyms and chemical and
   numeric symbols as they appear in the original
   text;

3. Use lower case letters with metric units;

4. Don’t pluralize metric units;

5. Leave a space between a number and an
   abbreviation;
                  In Review
6. Use colons to express ratios;

7. Leave spaces between numbers and
   abbreviations;

8. Don’t leave spaces between numbers and
   abbreviations when used with symbols;

9. Place a zero before a decimal point so it is not
   misread as a whole number; and

10. If in doubt about the meaning of any
    abbreviation, use a translator’s note.
       Post-Seminar Exercise
1. Which of the following is correct:

A.   25 mgs
B.   25 mg
C.   25 mg.
D.   25 Mg
E.   25mg
B.   25 mg
2. Which of the following is correct:

A.   1 x 4 x .5 cm
B.   1 x 4 x 0.5 cm
C.   1.0 x 4.0 x 0.5 cm
D.   1x4.0x0.5 cm
E.   1.0 x 4.0 x 0.5 cms
C. 1.0 x 4.0 x 0.5 cm
3. Which of the following is correct:

A.   36.4oC
B.   36.4 oC
C.   36.4o C
D.   none of the above
A.   36.4oC
4. Which of the following is correct:

A.   Glucose:   105   mg/dL
B.   Glucose:   105   mg/dl
C.   Glucose:   105   mg%
D.   Glucose:   105   mg.%
E.   A and C
E. A and C
5. What is the meaning of the
   abbreviation ac:

A.   before meals
B.   acute cholecystitis
C.   antibody
D.   ascending colon
E.   all of the above
E. All of the above
  Style Guide




ISBN 0-7216-3798-1
   Michael Blumenthal


    mblumenthal@austin.rr.com
Michael.Blumenthal@txdds.state.tx.us