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Chapter 12 Gastroenterology Instructor: Kathleen A. Bishop, MS, PHD. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins How this class will work…. • This is an open book Seminar. • Be prepared to respond to the questions on each slide. • Be prepared to share your thoughts with the other class participants. • You will see an answer slide so you can check how you did. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Resource Materials • Medical Dictionary • Word Books • Pharmaceutical References • Abbreviation Books • Style Guides • Anatomy & Physiology Textbooks • English Dictionary • Electronic Reference Materials • Online Resources • Other Reference Sources Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Medical Dictionary • Two popular dictionaries are Dorland’s Illustrated Medical Dictionary and Stedman’s Medical Dictionary. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Pharmaceutical References • Popular drug books are Drake and Drake Pharmaceutical Word Book, Quick-Look Drug Book, The American Drug Book, Physicians’ Desk Reference (PDR), and Dorland’s Illustrated Medical Dictionary. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Other References • Anatomy & Physiology Textbook • English Dictionary • Telephone Books • Current Magazines • Current Medical Terminology • American Hospital Association Guide to the Health Care Field • American Medical Association Membership Directory Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Online References • www.aamt.org/aamt--AAMT Web Page • www.stedmans.com • www.textware.com • www.transcriptiongear.com • www.mtjobs.com • www.dailygrammar.com • Check out these sites and tell me what you find? Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Best Practices for Success • Each week we will cover a variety of topics that will help you be successful in your career. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Soundalike Word Choice Choose the correct word in the following sentences. 1. The patient fell and suffered a fracture of his right (palate, patella). 2. Many medical transcriptionists confuse the terms (ilium, ileum), which is the lower portion of the small intestine, and (ilium, ileum), which is the flaring portion of the hip bone. 3. Due to the patient's recent stroke and subsequent (dysphagia, dysphasia), a percutaneous gastrostomy tube was placed for feeding purposes. 4. Ms. Cox's (MELT, MELD) score was high enough to place her at the top of the transplant list. 5. His stomach was so damaged by disease that a(n) (vitrectomy, antrectomy) had to be performed. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Soundalike Word Choice Answers 1. The patient fell and suffered a fracture of his right (palate, patella). 2. Many medical transcriptionists confuse the terms (ilium, ileum), which is the lower portion of the small intestine, and (ilium, ileum), which is the flaring portion of the hip bone. 3. Due to the patient's recent stroke and subsequent (dysphagia, dysphasia), a percutaneous gastrostomy tube was placed for feeding purposes. 4. Ms. Cox's (MELT, MELD) score was high enough to place her at the top of the transplant list. 5. His stomach was so damaged by disease that a(n) (vitrectomy, antrectomy) had to be performed. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Soundalike Word Choice • 6. On postoperative day 1, the patient was afebrile with no evidence of (ciliary, biliary) sepsis. • 7. She was sent to the emergency room, where on examination she reported abdominal pain consistent with mild (constipation, lactation). • 8. His (bile, bowel) obstruction was relieved with enemas given every 8 hours. • 9. A prescription was provided for GoLYTELY in preparation for anticipated (colonoscopy, colposcopy) to evaluate the large intestine. • 10. The family history is unremarkable for GI abnormalities except for the mother having gastroesophageal (reflex, reflux) during her pregnancy. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Soundalike Word Choice Answers 6. On postoperative day 1, the patient was afebrile with no evidence of (ciliary, biliary) sepsis. 7. She was sent to the emergency room, where on examination she reported abdominal pain consistent with mild (constipation, lactation). 8. His (bile, bowel) obstruction was relieved with enemas given every 8 hours. 9. A prescription was provided for GoLYTELY in preparation for anticipated (colonoscopy, colposcopy) to evaluate the large intestine. 10. The family history is unremarkable for GI abnormalities except for the mother having gastroesophageal (reflex, reflux) during her pregnancy. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Medical Terminology Review Choose the correct word in the following sentences. 1. The stomach turns food into (chyme, chemosis) before it enters the duodenum. 2. Visual examination of the digestive tract is called (ductoscopy, endoscopy). 3. A HIDA scan is also referred to as a (cholescintigraphy, cholecystectomy). 4. The presence of gallstones in the common bile duct is referred to (cholelithiasis, choledocholithiasis). 5. Palmar (edema, erythema) is a condition in which the palms of the hands may be reddish and blotchy. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Medical Terminology Review Answers 1. The stomach turns food into (chyme, chemosis) before it enters the duodenum. 2. Visual examination of the digestive tract is called (ductoscopy, endoscopy). 3. A HIDA scan is also referred to as a (cholescintigraphy, cholecystectomy). 4. The presence of gallstones in the common bile duct is referred to (cholelithiasis, choledocholithiasis). 5. Palmar (edema, erythema) is a condition in which the palms of the hands may be reddish and blotchy. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Medical Terminology Review • 6. An upper GI series uses (barium, balium) as a contrast material. • 7. A scope can be used to examine the stomach only, called a (gastroduodenoscopy, gastroscopy). • 8. (Genophils, genotypes) are hepatitis C genes that mutate into new variations. • 9. Another name for the GI system is the (alimentary, augumentary) tract. • 10. The (antrum, cardia) is the lower portion of the stomach. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Medical Terminology Review Answers • 6. An upper GI series uses (barium, balium) as a contrast material. • 7. A scope can be used to examine the stomach only, called a (gastroduodenoscopy, gastroscopy). • 8. (Genophils, genotypes) are hepatitis C genes that mutate into new variations. • 9. Another name for the GI system is the (alimentary, augumentary) tract. • 10. The (antrum, cardia) is the lower portion of the stomach. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Multiple Choice Answer the following questions by circling the correct term in the Choices (right) column. 1. What is another name for upper GI series? barium enema, barium swallow, laparoscopy 2. What is the middle part of the small intestine? ileum, antrum, jejunum 3. What is the opening at the end of the digestive tract? anus, rectum, colon 4. What is bleeding in the stomach called? anus, rectum, colon 5. What is the bacterium involved in gastritis? H. pylori, H. pylorus, H. papillus Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers 1. What is another name for upper GI series? barium enema, barium swallow, laparoscopy 2. What is the middle part of the small intestine? ileum, antrum, jejunum 3. What is the opening at the end of the digestive tract? anus, rectum, colon 4. What is bleeding in the stomach called? hematemesis, melanoma, melena 5. What is the bacterium involved in gastritis? H. pylori, H. pylorus, H. papillus Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Multiple Choice (cont.) 6. What is a yellowish cast to the skin? xanthoma, bilirubin, jaundice 7. What is the condition in which feces contain excessive fat? steatohepatitis, steatorrhea, cirrhosis 8. What is the pouch at the beginning of the large intestine called? cecum, colon, cardia 9. What is inflammation of the cells pancreatitis, gastritis, hepatitis of the liver called? 10. What is another word for hidden? occult, obtund, obese Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers 6. What is a yellowish cast to the skin? xanthoma, bilirubin, jaundice 7. What is the condition in which feces contain excessive fat? steatohepatitis, steatorrhea, cirrhosis 8. What is the pouch at the beginning of the large intestine called? cecum, colon, cardia 9. What is inflammation of the cells pancreatitis, gastritis, hepatitis of the liver called? 10. What is another word for hidden? occult, obtund, obese Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Transcription Tip • The stool softener docusate is frequently mistranscribed because it is mispronounced. The correct pronunciation of the medication sounds like DOCK-yoo-sate, but dictators sometimes pronounce the word as DUCK-a-sate (Gilmore, 2009). Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Transcription Tip • According to the AAMT Book of Style, when transcribing hepatitis terminology, the word hepatitis is not capitalized, but capital letters are used to designate type. Example: The patient was diagnosed with hepatitis A (Gilmore, 2009). Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Transcription Tip • A typical dictation error concerns the plural of the word diverticulum, which is diverticula, not diverticulae, diverticulas, or diverticuli. Be sure to transcribe the plural form of diverticulum correctly, even if the dictated form is incorrect (Gilmore, 2009). Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Transcription Tip • When dictating blood work results, physicians may refer to the value of bilirubin, which can be expressed as total bilirubin or direct bilirubin, or both, as brief forms such as bili, direct bili, total bili, or T bili. You should avoid the use of these brief forms and transcribe the term in full, for example, bilirubin, direct bilirubin, and total bilirubin (Gilmore 2009). Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins What are the meanings to the following? 1. EGD 2. ERCP 3. EUS 4. GERD 5. GES 6. GI 7. HAV 8. HBV 9. HCV 10.HIDA Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Abbreviation Answers 1. EGD 1. esophagogastroduodenoscopy 2. ERCP 2. endoscopic retrograde cholangiopancreatography 3. EUS 3. endoscopic ultrasound 4. GERD 4. gastroesophageal reflux disease 5. GES 5. gastric emptying study 6. GI 6. gastrointestinal 7. HAV 7. hepatitis A virus 8. HBV 8. hepatitis B virus 9. HCV 9. hepatitis C virus 10.HIDA 10.hepatobiliary iminodiacetic acid Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins What are the meanings to the following? 1. 2. 3. 4. 5. IBD IBS INR IPAA MELD 6. MRCP 7. NASH 8. PUD Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Abbreviation Answers 1. 2. 3. 4. 5. IBD IBS INR IPAA MELD 6. MRCP 7. NASH 8. PUD 1. 2. 3. 4. 5. irritable bowel disease irritable bowel syndrome international normalized ratio ileal pouch anal anastomosis Model for End-Stage Liver Disease 6. magnetic resonance cholangiopancreatography 7. nonalcoholic steatohepatitis 8. peptic ulcer disease Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Define the following? 1. antibody test 2. adenocarcinoma 3. rectum 4. bilirubin 5. irritable bowel syndrome (IBS) 6. histamine-2 (H2) blockers 7. proton pump inhibitors (PPIs) 8. brain-gut axis 9. Crohn disease 10.choledocholithiasis Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Define the following…Answers. 1. A blood test to indicate the body's reaction to infection. 2. A cancers of the cells that line the inside of the colon and rectum. 3. A chamber that begins at the end of the large intestine, immediately following the sigmoid colon. 4. A chemical formed from the degradation of hemoglobin in the blood, which is processed by the liver and then secreted into the bile. 5. A chronic disorder of motility of the digestive tract. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Define the following…Answers. 6. A class of drugs that reduce the production of acid in the stomach. 7. A class of drugs that reduce the production of acid in the stomach but that are more potent than H2 blockers and, thus, promote healing of ulcers in a shorter period of time. 8. A communication of the nerve cells between the digestive system and the brain. 9. A condition causing open sores affecting all layers lining the entire wall of the large and/or small intestine. 10.A condition in which gallstones form inside the common bile duct. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Define the following? 1. cholelithiasis 2. cirrhosis 3. steatorrhea 4. malabsorption 5. palmar erythema 6. ascites 7. peptic ulcer disease (PUD) 8. gastroesophageal reflux disease (GERD) 9. ostomy bag 10.barium sulfate Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Define the following…Answers. 1. A condition in which gallstones form inside the gallbladder. 2. A condition in which normal liver cells are damaged and replaced by scar tissue. 3. A condition in which the feces contain excessive fat, causing them to float and be very foul-smelling. 4. A condition in which the intestinal tract cannot digest fats as well as it should. 5. A condition in which the palms of the hands may be reddish and blotchy. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Define the following…Answers. 6. A condition that occurs when fluid accumulates in the abdomen. 7. A condition whereby a peptic ulcer develops in the stomach. 8. A condition whereby an excessive amount of stomach acids and enzymes flow backward from the stomach into the lower esophagus. 9. A container attached to a stoma in the abdomen that collects the contents of the small intestine and unformed waste after an ileostomy procedure. 10.A contrast material used for radiographic study of the gastrointestinal tract. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Define the following? 1. fissure 2. peritonitis 3. pancreatic cancer 4. diverticular disease 5. antibiotic 6. epiglottis 7. polyp 8. endoscope 9. colonoscope 10.inflammatory bowel disease (IBD) Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Define the following…Answers. 1. A crack in the anal membrane. 2. A dangerous inflammation and infection of the lining of the abdominal wall. 3. A disease in which cancerous cells are found in the tissues of the pancreas. 4. A disorder of the large intestine characterized by diverticula that protrude through the muscular layer of the colon. 5. A drug used to inhibit the growth of organisms that cause infection. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Define the following…Answers. 6. A flap of cartilage at the root of the tongue which prevents food and fluids from entering the airway. 7. A fleshy growth of tissue that starts in the lining and grows into the center of the colon or rectum. 8. A flexible tube with a light and camera attached that is used to examine the interior surfaces of an organ. 9. A flexible, elongated endoscope used to view the inside of the entire colon and rectum. 10.A group of disorders that cause the intestines to become chronically inflamed and swollen. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Define the following? 1. pancreas 2. small intestine 3. large intestine 4. international normalized ratio (INR) 5. fecal fat test 6. gastroenterologist 7. antacid 8. laparoscopic cholecystectomy 9. tongue 10.esophagus Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Define the following…Answers. 1. A large gland that lies in front of the upper spine and behind the stomach, which allows digestive enzymes to flow into the duodenum. 2. A long tube that connects the stomach to the large intestine and is responsible for the actual digestion of food. 3. A long, tube-like organ that moves waste material from the small intestine to be excreted by the body. 4. A measurement of bilirubin and prothrombin time (PT) in the blood. 5. A measurement of the fat contained in a sample of stool. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Define the following…Answers. 6. A medical specialist who cares for patients with diseases and disorders of the gastrointestinal system. 7. A medication that neutralizes stomach acids. 8. A minimally invasive procedure using the laparoscope and small incisions to remove the gallbladder. 9. A mobile mass of muscular tissue covered with mucous membrane, occupying the cavity of the mouth and forming part of its floor. It is the organ of taste and assists in the chewing and swallowing of food as well as articulating speech. 10.A muscular channel that connects the throat with the stomach. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Define the following? 1. stomach 2. chyme 3. stricture 4. local transanal resection 5. peptic ulcer 6. endoscopy 7. esophageal sphincter 8. parotid (glands) 9. submandibular (glands) 10.sublingual (glands) Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Define the following…Answers. 1. A muscular, sac-like organ that receives food from the esophagus during digestion. 2. A mushy liquid that food is converted to by the stomach. 3. A narrowing of part of the intestine. 4. A non-invasive procedure whereby tumorous tissue is removed from the rectum. 5. A nonmalignant sore that develops in the lining of the stomach or duodenum. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Define the following…Answers. 6. A nonsurgical procedure used to examine the digestive tract using a flexible tube with a light and camera attached to it. 7. A one-way valve located between the esophagus and stomach that regulates the entry of food into the stomach. 8. A pair of salivary glands located at the side of the face and in front of and below the external ear. 9. A pair of salivary glands located beneath the lower jaw (mandible). 10.A pair of salivary glands located under the tongue. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins