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ABBREV. AAA abd ALOC AMA AMS ASA ASC AVF b.i.d. bld BP c/o CAD CC CHF COPD CP CSF C-spine CT CTD CVA CVA CVDZ CxR D&C DC DM DOE Dx Dz EENT EKG ETOH EVAL FB FROM FT FTND Fx G GERD GU GYN H&P h/o HA HBP HEENT DEFINITION abdominal aortic aneurysm abdomen Altered loss of consciousness against medical advise altered mental state asprin altered state of consciousness arteriorvenous fistula twice daily blood blood pressure complaints of, complaints coronary cartery disease chief complaint congestive heart failure chronic obstructive pulmonary disease chest pain cerebrospinal fluid cervical spine computed axial tomography connective tissue disease A stroke ("cerebrovascular accident") costrovertebral angle Cardiovascular disease chest x-ray dilation and curettage - removes fetus following miscarriage discharges diabetes mellitus dyspnea on exertion diagnosis disease eyes, ears, nose, throat electrocardiogram ethanol evaluation foreign body full range of motion full term full term normal delivery fracture gravida gastroesophageal reflux disease genitrouinary Gynecology history and physical history of headache high blood pressure head, eyes, ears, nose, throat ABBREV. HPI HR HTN Hx I&D IUP IUTD K L lac LE LLE LLL LLQ LMP LOC LUE LUL LUQ MI MVC MVA N NAD NKA NSAID NSR NSVD NTG NVID OM p/w PE PERRLA PID pos PT PTA PTE q q.d. q.i.d R R/O RLE RLL RLQ RML ROM DEFINITION history of present illness heart rate hypertension history incision and drainage intrauterine pregnancy immunization up to date potassium left laceration lower extremities left lower extremity left lower lobe left lower quadrant last menstrual period loss of consciousness left upper extremity left upper lobe left upper quadrant myocardial infarction motor vehicle collision motor vehicle accident nausea no acute distress no known allergies nonsteriodal anti-inflammatory drug normal sinus rythum normal spontaneous vaginal delivery nitroglycerine neurovascularly intact otitis media presents with physical examination pupils equal, round, reactive to light and accomodation (normal) pelvic inflammatory disease positive patient prior to arrival prior to evaluation every every day four times a day right rule out right lower extremity right lower lobe right lower quadrant right middle lobe range of motion ABBREV. ROS RTED RUE RUL RUQ Rx S/P SAB SL SLR SOB ST STD SVT SX SXS t.i.d TIA TTP Tx UA URI US V Tach VS wt y.o yrs DEFINITION review of systems return to emergency depart right upper extremity right upper lobe right upper quadrant Prescription status/post spontaneous abortion under the tongue straight leg raise shortness of breath sorethroat sexually transmitted disease supraventricula tachycardia symptom symptoms three times a day transient ischemic attack tenderness to palpation treatment urinalysis upper respiratory infection ultrasound ventricular tachycardia vital signs weight years old years