`
`Clinician's
`Pocket
`Reference.
`
`Leonard G. Game-Ha
`
`Steven A. Hafst
`
`CSL EXHIBIT 1036
`CSL V. Shire
`
`CSL EXHIBIT 1036
`CSL v. Shire
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`Page 1 of 768
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`

`9th
`
`EDITION
`
`CLINICIAN’S
`POCKET
`REFERENCE
`
`EDITED BY
`
`LEONARD G. GOMELLA, MD, FACS
`The Bernard W. Godwin, Jr., Associate Professor
`Department of Urology
`Jefferson Medical College
`Thomas Jefferson University
`Philadelphia, Pennsylvania
`
`WITH
`Steven A. Haist, MD, MS, FACP
`Professor of Medicine
`Division of General Internal Medicine
`Department of Internal Medicine
`University of Kentucky Medical Center
`Lexington, Kentucky
`
`Based on a program originally developed at the
`University of Kentucky College of Medicine
`Lexington, Kentucky
`
`McGraw-Hill
`MEDICAL PUBLISHING DIVISION
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`Lisbon London Madrid
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`McGraw-Hill
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`Copyright © 2002 by Leonard G.Gomella. All rights reserved. Manufactured in the United
`States of America. Except as permitted under the United States Copyright Act of 1976, no
`part of this publication may be reproduced or distributed in any form or by any means, or
`stored in a database or retrieval system, without the prior written permission of the
`publisher.
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`The material in this eBook also appears in the print version of this title: 0-8385-1552-5.
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`
`TERMS OF USE
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`its licensors reserve all rights in and to the work. Use of this work is subject to these terms.
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`DOI: 10.1036/0071394445
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`To Tricia, Mom, Dad, Leonard, Patrick, Andrew, Michael
`and Aunt Lucy
`
`“We don’t drive the trucks, we only load them.”
`Nick Pavona, MD
`UKMC Class of 1980
`
`Page 6 of 768
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`Page 7 of 768
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`For more information about this book, click here.
`
`CONTENTS
`
`Consulting Editors
`Contributors
`Preface
`Abbreviations
`“So You Want to Be a Scut Monkey”:
`An Introduction to Clinical Medicine
`
`1 History and Physical Examination
`2 Chartwork
`3 Differential Diagnosis: Symptoms, Signs, and Conditions
`4 Laboratory Diagnosis: Chemistry, Immunology, and Serology
`5 Laboratory Diagnosis: Clinical Hematology
`6 Laboratory Diagnosis: Urine Studies
`7 Clinical Microbiology
`8 Blood Gases and Acid-Base Disorders
`9 Fluids and Electrolytes
`10 Blood Component Therapy
`11 Diets and Clinical Nutrition
`12 Total Parenteral Nutrition (TPN)
`13 Bedside Procedures
`14 Pain Management
`15 Imaging Studies
`16 Introduction to the Operating Room
`17 Suturing Techniques and Wound Care
`18 Respiratory Care
`19 Basic ECG Reading
`20 Critical Care
`21 Emergencies
`22 Commonly Used Medications
`
`Appendix
`Index
`Emergency Medications (inside front and back covers)
`
`vii
`viii
`xiii
`xv
`
`1
`
`9
`33
`41
`53
`95
`109
`121
`161
`177
`193
`205
`227
`239
`315
`325
`339
`345
`359
`367
`389
`445
`475
`
`639
`659
`
`Copyright 2002 The McGraw-Hill Companies, Inc. Click Here for Terms of Use.
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`
`Page 9 of 768
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`

`

`CONSULTING EDITORS
`
`MARIANNE BILLETER, PharmD, BCPS
`Associate Professor of Pharmacy Practice, Division of Distance Education, Bernard J.
`Dunn School of Pharmacy, Shenandoah University, Winchester, Virginia
`
`TRICIA L. GOMELLA, MD
`Part-Time Clinical Assistant Professor of Pediatrics, Johns Hopkins University School
`of Medicine, Baltimore, Maryland
`
`IRA HOROWITZ, MD
`Professor of Gynecology and Obstetrics and Oncology, Director of Gynecologic
`Oncology, Emory University, Atlanta, Georgia
`
`ALAN T. LEFOR, MD, MPH, FACS
`Director, Division of Surgical Oncology, Director, Surgical Education and Academic
`Affairs, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California;
`Associate Professor of Clinical Surgery, Department of Surgery, University of
`California, Los Angeles, Los Angeles, California
`
`JOHN A. MORRIS, MD
`Director, Division of Trauma, Department of Surgery, Vanderbilt University Medical
`Center, Nashville, Tennessee
`
`Copyright 2002 The McGraw-Hill Companies, Inc. Click Here for Terms of Use
`
`Page 10 of 768
`
`

`

`CONTRIBUTORS
`
`Aimee G. Adams, PharmD
`Director, Primary Care Pharmacy Practice Residency, University of Kentucky Medical
`Center; Assistant Professor College of Pharmacy and Department of Medicine,
`University of Kentucky, Lexington, Kentucky
`
`Marianne Billeter, PharmD, BCPS
`Associate Professor of Pharmacy Practice, Division of Distance Education,
`Bernard J. Dunn School of Pharmacy, Shenandoah University, Winchester, Virginia
`
`Pasquale Casale, MD
`Chief Resident, Department of Urology, Thomas Jefferson University,
`Philadelphia, Pennsylvania
`
`Murray Cohen, MD
`Clinical Associate Professor of Surgery, Director, Division of Trauma/Critical Care,
`Department of Surgery, Jefferson Medical College, Philadelphia, Pennsylvania
`
`Marisa Davis
`Doctor of Pharmacy Candidate, Bernard J. Dunn School of Pharmacy, Shenandoah
`University, Winchester, Virginia
`
`Neil M. Davis, PharmD, FASHP
`Professor Emeritus of Pharmacy, Temple University, Philadelphia, Pennsylvania;
`Director, Safe Medication Practice Consulting, Inc., Huntingdon Valley, Pennsylvania
`
`Ehab A. El Gabry, MD
`Fellow, Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania
`
`Sue Fosson, MA
`Former Associate Dean for Student Affairs, University of Kentucky College of Medicine,
`Lexington, Kentucky
`
`Leonard G. Gomella, MD, FACS
`The Bernard W. Godwin, Jr., Associate Professor, Department of Urology, Jefferson
`Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
`
`Copyright 2002 The McGraw-Hill Companies, Inc. Click Here for Terms of Use
`
`Page 11 of 768
`
`

`

`Contributors
`
`ix
`
`Steven A. Haist, MD, MS, FACP
`Professor of Medicine, Division of General Internal Medicine, Department of Internal
`Medicine, University of Kentucky Medical Center, Lexington, Kentucky
`
`Sara Maria Haverty, MD
`Senior Resident, Department of Obstetrics and Gynecology, Thomas Jefferson University,
`Philadelphia, Pennsylvania
`
`Mohamed Ismail, MD
`Senior Resident, Department of Urology, Thomas Jefferson University,
`Philadelphia, Pennsylvania
`
`Gregory C. Kane, MD
`Clinical Associate Professor of Medicine, Program Director, Internal Medicine Residency,
`Jefferson Medical College, Philadelphia, Pennsylvania
`
`Matthew J. Killion, MD
`Assistant Professor of Medicine, Jefferson Medical College, Philadelphia, Pennsylvania
`
`Alan T. Lefor, MD, MPH, FACS
`Director, Division of Surgical Oncology, Director, Surgical Education and Academic
`Affairs, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California;
`Associate Professor of Clinical Surgery, Department of Surgery, University of California,
`Los Angeles, Los Angeles, California
`
`Layla F. Makary, MD, MSC, PhD
`Lecturer, Department of Anesthesia, Cairo University, Clinical Fellow, Department
`of Anesthesia, Cleveland Clinic Foundation, Cleveland, Ohio
`
`John Moore, MD
`Clinical Associate Professor, Department of Surgery, Division of Plastic Surgery,
`Jefferson Medical College, Philadelphia, Pennsylvania
`
`Nick A. Pavona, MD
`Associate Professor, Department of Surgery, Division of Urology, Benjamin Franklin
`University Medical Center, Chadds Ford, Pennsylvania
`
`Roger J. Pomerantz, MD, FACP
`Professor of Medicine, Biochemistry and Molecular Pharmacology, Division
`of Infectious Diseases and Center for Human Virology, Jefferson Medical College,
`Thomas Jefferson University, Philadelphia, Pennsylvania
`
`Ganesh Raj, MD, PhD
`Senior Resident, Division of Urology, Department of Surgery,
`Duke University Medical Center, Durham, North Carolina
`
`Page 12 of 768
`
`

`

`x
`
`Contributors
`
`Steven Rosensweig, MD
`Director, Jefferson Center for Integrative Medicine, Jefferson Medical College,
`Philadelphia, Pennsylvania
`
`Paul J. Schenarts, MD
`Instructor in Surgery, Section of Surgical Sciences, Vanderbilt University,
`Nashville, Tennessee
`
`Francis G. Serio, DMD, MS
`Associate Professor and Chairman, Department of Periodontics, University of Mississippi
`School of Dentistry, Jackson, Mississippi
`
`Kelly Smith, PharmD
`Clinical Associate Professor, Division of Pharmacy Practice & Science, University
`of Kentucky College of Pharmacy; Director, Pharmacy Practice Residency,
`University of Kentucky Medical Center, Lexington, Kentucky
`
`Page 13 of 768
`
`

`

`PREFACE
`
`The Clinician’s Pocket Reference is based on a University of Kentucky house manual enti-
`tled So You Want to Be a Scut Monkey: Medical Student’s and House Officer’s Clinical
`Handbook. The Scut Monkey Program at the University of Kentucky College of Medicine
`began in the summer of 1978 and was developed by members of the Class of 1980 to help
`ease the often frustrating transition from the preclinical to the clinical years of medical
`school. From detailed surveys at the University of Kentucky College of Medicine and 44
`other medical schools, a list of essential information and skills that third-year students
`should be familiar with at the start of their clinical years was developed. The Scut Monkey
`Program was developed around this core of material and consisted of reference manuals and
`a series of workshops conducted at the start of the third year. Presented originally as a pilot
`program for the University of Kentucky College of Medicine Class of 1981, the program has
`been incorporated into the third-year curriculum. It is the responsibility of each new fourth-
`year class to orient the new third-year students. The basis of the program’s success is the
`fact that it was developed and taught by students for other students. This method has al-
`lowed us to maintain perspective on those areas that are critical not only for learning while
`on the wards but also for delivering effective patient care. Information on the Scut Monkey
`Orientation Program is available from Todd Cheever, MD, Associate Dean for Academic Af-
`fairs at the University of Kentucky College of Medicine.
`Through the last eight editions, the book has undergone expansion and careful revisions
`as the practice of medicine and the educational needs of students have changed. Although
`the book’s original mission, providing new clinical clerks with essential patient care infor-
`mation in an easy-to-use format, remains unchanged, our readership has expanded. Resi-
`dents, practicing physicians, and allied health professionals all use the Clinician’s Pocket
`Reference as a “manual of manuals.” Even individuals considering careers in medicine have
`used the book in their decision-making process. An attempt is made to cover the most fre-
`quently asked basic management questions that are normally found in many different
`sources, such as procedure manuals, laboratory manuals, drug references, and critical care
`manuals, to name a few. It is not meant as a substitute for specialty-specific reference manu-
`als. The core of information presented is a foundation for new medical students as they
`move through training to more advanced medical studies.
`The book is designed to represent a cross section of medical practices around the coun-
`try. The Clinician’s Pocket Reference has been translated into six different languages with
`electronic media versions in development. I was honored to have been asked to grant per-
`mission to Warner Brothers, the producers of the TV show “ER,” to have the eighth edition
`of the Scut Monkey book as one of the books used on their series.
`I would like to express special thanks to my wife and my family for their long-term sup-
`port of the Scut Monkey project. Linda Davoli, our extraordinary copy editor, had an excep-
`tional eye for detail in helping create this final work. Janet Foltin, Harriet Lebowitz, Lester
`
`Copyright 2002 The McGraw-Hill Companies, Inc. Click Here for Terms of Use
`
`Page 14 of 768
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`

`

`xii
`
`Preface
`
`Sheinis, and the team at McGraw-Hill were instrumental in moving the book forward and in
`giving the ninth edition a fresh, new two-color format. They are also responsible for helping
`reach our long-term goal of the new companion manual, the Clinician’s Pocket Drug Refer-
`ence. A special thanks to my assistant Conchita Ballard, who always kept things organized
`and flowing smoothly. I am indebted to all of the past contributors and readers who have
`helped to keep the Scut Monkey book as a useful reference for students and residents world-
`wide. The original coeditors of this work, G. Richard Braen, MD, and Michael J. Olding,
`MD, are acknowledged for their early contributions.
`Your comments and suggestions for improvement are always welcomed by me person-
`ally, since revisions to the book would not be possible if it were not for the ongoing interest
`of our readers. I hope this book will not only help you learn some of the basics of the art and
`science of medicine but also allow you to care for your patients in the best way possible.
`
`Leonard G. Gomella, MD
`Philadelphia, Pennsylvania
`Leonard.Gomella@mail.tju.edu
`
`Page 15 of 768
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`

`

`ABBREVIATIONS
`
`The following are common abbreviations used in medical records and in this edition
`
`÷: divided dose
`↓: decrease(d), reduce, downward
`ⴛ: times for multiplication sign
`↑: increase(d), upward (as in titrate upward)
`/: per
`±: with or without
`ⴙ: with
`<: less than, younger than
`>: more than, older than
`~=: approximately equal to
`AAA: abdominal aortic aneurysm
`AaDO2: difference in partial pressures of
`oxygen in mixed alveolar gas and
`mixed arterial blood
`A-a gradient: alveolar-to-arterial gradient
`AAI: ankle-arm index
`AAS: acute abdominal series
`AB: antibody, abortion, antibiotic
`A&B: apnea and bradycardia
`ABD: abdomen
`ABG: arterial blood gas
`A/B index: ankle-brachial index
`ABMT: autologous bone marrow trans-
`plantation
`ac: before eating (ante cibum), assist-
`controlled
`ACCP: American College of Chest
`Physicians
`ACE: angiotensin-converting enzyme
`Ach-ase: acetylcholinesterase
`ACLS: Advanced Cardiac Life Support
`ACS: acute coronary syndrome, American
`Cancer Society, American College of
`Surgeons
`ACTH: adrenocorticotropic hormone
`A.D.C. VAAN DIML: mnemonic for
`Admit, Diagnosis, Condition, Vitals,
`Activity, Allergies, Nursing procedures,
`Diet, Ins and outs, Medications, Labs
`
`A.D.C. VAN DISSEL: mnemonic for
`Admit, Diagnosis, Condition, Vitals,
`Activity, Nursing procedures, Diet, Ins
`and outs, Specific drugs, Symptomatic
`drugs, Extras, Labs
`ADH: antidiuretic hormone
`ADHD: attention-deficit hyperactivity
`disorder
`ad lib: as much as needed (ad libitum)
`AEIOU TIPS: mnemonic for Alcohol,
`Encephalopathy, Insulin, Opiates,
`Uremia, Trauma, Infection, Psychi-
`atric, Syncope (diagnosis of coma)
`AF: afebrile, aortofemoral, atrial fibrilla-
`tion
`AFB: acid-fast bacilli
`AFP: alpha-fetoprotein
`A/G: albumin/globulin ratio
`AHA: American Heart Association
`AHF: antihemophilic factor
`AI: aortic insufficiency
`AIDS: acquired immunodeficiency syn-
`drome
`AJCC: American Joint Committee on
`Cancer
`AKA: above-the-knee amputation
`ALAT: alanine aminotransferase
`ALL: acute lymphocytic leukemia
`ALS: amyotrophic lateral sclerosis
`ALT: alanine aminotransferase
`AM: morning
`amb: ambulate
`AMI: acute myocardial infarction
`AML: acute myelocytic leukemia, acute
`myelogenous leukemia
`AMMoL: acute monocytic leukemia
`amp: ampule
`AMP: adenosine monophosphate
`ANA: antinuclear antibody
`
`Copyright 2002 The McGraw-Hill Companies, Inc. Click Here for Terms of Use
`
`Page 16 of 768
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`

`

`xiv
`
`Abbreviations
`
`ANC: absolute neutrophil count
`ANCA: antineutrophil cytoplasmic anti-
`body
`ANLL: acute nonlymphoblastic leukemia
`ANS: autonomic nervous system
`AOB: alcohol on breath
`AODM: adult-onset diabetes mellitus
`AP: anteroposterior, abdominal-perineal
`APAP: acetaminophen
`APL: acute promyelocytic leukemia
`aPPT: activated partial thromboplastin
`time
`APSAC: anisoylated plasminogen strepto-
`kinase activator complex
`APUD: amine precursor uptake (and)
`decarboxylation
`Ara-C: cytarabine
`ARD: antibiotic removal device
`ARDS: adult respiratory distress syndrome
`ARF: acute renal failure
`AS: aortic stenosis
`ASA: American Society of Anesthesiolo-
`gists
`ASAP: as soon as possible
`ASAT: aspartate aminotransferase
`ASCVD: atherosclerotic cardiovascular
`disease
`ASD: atrial septal defect
`ASHD: atherosclerotic heart disease
`ASO: antistreptolysin O
`AST: aspartate aminotransferase
`ATG: antithymocyte globulin
`ATN: acute tubular necrosis
`ATP: adenosine triphosphate
`AUC: area under the curve
`AV: atrioventricular
`A-V: arteriovenous
`A-VO2: arteriovenous oxygen
`B I&II: Billroth I and II
`BACOD: bleomycin, doxorubicin (Adri-
`amycin), cyclophosphamide, vin-
`cristine (Oncovin), dexamethasone
`BACOP: bleomycin, doxorubicin (Adri-
`amycin), cyclophosphamide, vin-
`cristine (Oncovin), prednisone
`BBB: bundle branch block
`BC: bone conduction
`BCAA: branched-chain amino acid
`BCG: bacille Calmette-Guérin
`BE: barium enema
`
`BEE: basal energy expenditure
`bid: twice a day (bis in die)
`bili: bilirubin
`BKA: below-the-knee amputation
`BM: bone marrow, bowel movement
`BMR: basal metabolic rate
`BMT: bone marrow transplantation
`BOM: bilateral otitis media
`BP: blood pressure
`BPH: benign prostatic hypertrophy
`bpm: beats per minute
`BR: bed rest
`BRBPR: bright red blood per rectum
`BRP: bathroom privileges
`bs, BS: bowel sounds, breath sounds
`BSA: body surface area
`BS&O: bilateral salpingo-oophorectomy
`BUN: blood urea nitrogen
`BW: body weight
`Bx: biopsy
`c: with (cum)
`Ca: calcium
`CA: cancer
`CAA: crystalline amino acid
`CABG: coronary artery bypass graft
`CAD: coronary artery disease
`CAF: cyclophosphamide, doxorubicin
`(Adriamycin), 5-fluorouracil
`CALGB: Cancer and Leukemia Group B
`cAMP: cyclic adenosine monophosphate
`CaO2: arterial oxygen content
`caps: capsule(s)
`CAT: computed axial tomography
`CBC: complete blood count
`CBG: capillary blood gas
`CC: chief complaint
`CCI: corrected count increment (platelets)
`CCO: continuous cardiac output
`CCO2: capillary oxygen content
`CCU: clean-catch urine, cardiac care unit
`CCV: critical closing volume
`CD: continuous dose
`CDC: Centers for Disease Control and Pre-
`vention
`CEA: carcinoembryonic antigen
`CEP/CIEP: counterimmunoelectrophore-
`sis
`CF: cystic fibrosis
`CFU: colony-forming unit(s)
`CGL: chronic granulocytic leukemia
`
`Page 17 of 768
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`

`

`Abbreviations
`
`CH50: (total serum) hemolytic complement
`CHD: coronary heart disease
`CHF: congestive heart failure
`CHO: carbohydrate
`CHOP: cyclophosphamide, doxorubicin,
`vincristine (Oncovin), prednisone
`CI: cardiac index
`CIE: counterimmunoelectrophoresis
`CIS: carcinoma in situ
`CK: creatine phosphokinase
`CKI: cyclin-dependent kinase inhibitor
`CK-MB: isoenzyme of creatine kinase
`with muscle and brain subunits
`Cl: chlorine
`CLL: chronic lymphocytic leukemia
`cm: centimeter
`CML: chronic myelogenous leukemia
`CMV: cytomegalovirus
`CN: cranial nerve
`CNS: central nervous system
`CO: cardiac output
`C/O: complaining of
`COAD: chronic obstructive airway disease
`COLD: chronic obstructive lung disease
`COMT: catechol-O-methyltransferase
`conc: concentrate
`cont inf: continuous infusion
`COPD: chronic obstructive pulmonary
`disease
`COX-2: cyclooxygenase-2
`CP: chest pain, cerebral palsy
`CPAP: continuous positive airway pressure
`CPK: creatinine phosphokinase
`CPP: central precocious puberty
`CPR: cardiopulmonary resuscitation
`CR: controlled release
`CrCl: creatine clearance
`CREST: calcinosis cutis, Raynaud’s
`disease, esophageal dysmotility,
`syndactyly, telangiectasia
`CRF: chronic renal failure
`CRH: corticotropin-releasing hormone
`CRP: C-reactive protein
`C&S: culture and sensitivity
`CSF: cerebrospinal fluid, colony-
`stimulating factor
`C-spine: cervical spine
`CT: computed tomography
`CVA: cerebrovascular accident, costoverte-
`bral angle
`
`xv
`
`CVAT: costovertebral angle tenderness
`CVH: common variable hypogammaglobu-
`linemia
`CvO2: oxygen content of mixed venous
`blood
`CVP: central venous pressure
`CXR: chest x-ray
`d: day
`D5LR: 5% dextrose in lactated Ringer’s
`solution
`D5W: 5% dextrose in water
`DAG: diacylglycerol
`DAP: diastolic pulmonary artery pressure
`DAT: diet as tolerated
`DAW: dispense as written
`DC: discontinue, discharge, direct current
`D&C: dilation and curettage
`ddI: dideoxyinosine
`DDx: differential diagnosis
`DEA: United States Drug Enforcement
`Administration
`DES: diethylstilbestrol
`DEXA: dual-energy x-ray absorptiometer
`DHEA: dehydroepiandrosterone
`DHEAS: dehydroepiandrosterone sulfate
`DI: diabetes insipidus
`DIC: disseminated intravascular coagulation
`DIP: distal interphalangeal joint
`DIT: diiodotyrosine
`DJD: degenerative joint disease
`DKA: diabetic ketoacidosis
`dL: deciliter
`DM: diabetes mellitus
`DMSA: dimercaptosuccinic acid
`DNA: deoxyribonucleic acid
`DNP: deoxyribonucleic protein
`DNR: do not resuscitate
`DOA: dead on arrival
`DOCA: deoxycorticosterone acetate
`DOE: dyspnea on exertion
`DOPA: dihydroxyphenylalanine
`DP: dorsalis pedis
`2,3-DPG: 2,3-diphosphoglycerate
`DPL: diagnostic peritoneal lavage
`DPT: diphtheria, pertussis, tetanus
`DR: delayed release
`DRG: diagnosis-related group
`DS: double strength
`DSA: digital subtraction angiography
`DTPA: diethylenetriamine-pentaacetic acid
`
`Page 18 of 768
`
`

`

`xvi
`
`Abbreviations
`
`DTR: deep tendon reflex
`DVT: deep venous thrombosis
`Dx: diagnosis
`EAA: essential amino acid
`EBL: estimated blood loss
`EBV: Epstein–Barr virus
`EC: enteric-coated
`ECG: electrocardiogram
`ECOG: Eastern Cooperative Oncology
`Group
`ECT: electroconvulsive therapy
`EDC: estimated date of confinement
`EDTA: ethylenediamine tetraacetic acid
`EDVI: end-diastolic volume index
`EFAD: essential fatty acid deficiency
`ELISA: enzyme-linked immunosorbent
`assay
`EMD: electromechanical dissociation
`EMG: electromyelogram
`EMS: emergency medical system,
`eosinophilia-myalgia syndrome
`EMV: eyes, motor, verbal response
`(Glasgow Coma Scale)
`ENA: extractable nuclear antigen
`ENT: ear, nose, and throat
`eod: every other day
`EOM: extraocular muscle
`EPO: erythropoietin
`EPSP: excitatory postsynaptic potential
`ER: endoplasmic reticulum, Emergency
`Room, extended release
`ERCP: endoscopic retrograde cholan-
`giopancreatography
`ERV: expiratory reserve volume
`ESR: erythrocyte sedimentation rate
`ESRD: end-stage renal disease
`ET: endotracheal
`ETOH: ethanol
`ETT: endotracheal tube
`EUA: examination under anesthesia
`ExU: excretory urogram
`Fab: antigen-binding fragment
`FANA: fluorescent antinuclear antibody
`FBS: fasting blood sugar
`Fe: iron
`FEV1: forced expiratory volume in 1 s
`FFP: fresh frozen plasma
`FHR: fetal heart rate
`FIGO: Fédération Internationale de
`Gynécologie et d’Obstétrique
`
`FiO2: fraction of inspired oxygen
`FRC: functional residual capacity
`FSH: follicle-stimulating hormone
`FSP: fibrin split product
`ft: foot
`FTA-ABS: fluorescent treponemal
`antibody-absorbed
`FTT: failure to thrive
`FU: follow-up
`5-FU: fluorouracil
`FUO: fever of unknown origin
`FVC: forced vital capacity
`Fx: fracture
`g: gram
`G: gravida
`GABA: gamma-aminobutyric acid
`GAD: glutamic acid decarboxylase
`GC: gonorrhea (gonococcus)
`G-CSF: granulocyte colony-stimulating
`factor
`GDP: guanosine diphosphate
`GERD: gastroesophageal reflux disease
`GETT: general by endotracheal tube
`(anesthesia)
`GFR: glomerular filtration rate
`GGT: gamma-glutamyltransferase
`GH: growth hormone
`GHIH: growth hormone-inhibiting
`hormone
`GI: gastrointestinal
`GM-CSF: granulocyte-macrophage
`colony-stimulating factor
`GNID: gram-negative intracellular
`diplococci
`GnRH: gonadotropin-releasing hormone
`GOG: Gynecologic Oncology Group
`G6PD: glucose-6-phosphate
`dehydrogenase
`gr: grain
`GSW: gunshot wound
`gt, gtt: drop, drops (gutta)
`GTP: guanosine triphosphate
`GTT: glucose tolerance test
`GU: genitourinary
`GVHD: graft-versus-host disease
`GXT: graded exercise tolerance (cardiac
`stress test)
`HA: headache
`HAA: hepatitis B surface antigen
`(hepatitis-associated antigen)
`
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`Abbreviations
`
`HAV: hepatitis A virus
`HBcAg: hepatitis B core antigen
`HBeAg: hepatitis B e antigen
`HBP: high blood pressure
`HBsAg: hepatitis B surface antigen
`HBV: hepatitis B virus
`HCG: human chorionic gonadotropin
`HCL: hairy cell leukemia
`HCT: hematocrit
`HCTZ: hydrochlorothiazide
`HDL: high-density lipoprotein
`HEENT: head, eyes, ears, nose, and throat
`HFV: high-frequency ventilation
`Hgb: hemoglobin
`[Hgb]: hemoglobin concentration
`H/H: hemoglobin/hematocrit,
`Henderson–Hasselbalch equation
`HIAA: 5-hydroxyindoleacetic acid
`HIDA: hepatic 2,6-dimethyliminodiacetic
`acid
`HIV: human immunodeficiency virus
`HJR: hepatojugular reflex
`HLA: histocompatibility locus antigen
`HO: history of
`HOB: head of bed
`H&P: history and physical examination
`hpf: high-power field
`HPI: history of the present illness
`HPLC: high-pressure liquid
`chromatography
`HPV: human papilloma virus
`HR: heart rate
`hs: at bedtime (hora somni)
`HSG: hysterosalpingogram
`HSM: hepatosplenomegaly
`HSV: herpes simplex virus
`5-HT3: 5-hydroxytryptamine
`HTLV-III: human T-lymphotropic virus,
`type III (AIDS agent, HIV)
`HTN: hypertension
`Hx: history
`IC: inspiratory capacity
`ICN: Intensive Care Nursery
`ICS: intercostal space
`ICSH: interstitial cell-stimulating hormone
`ICU: intensive care unit
`ID: identification, infectious disease
`I&D: incision and drainage
`IDDM: insulin-dependent diabetes mellitus
`Ig: immunoglobulin
`
`xvii
`
`IgG1{k}: immunoglobulin G1 kappa
`IHSS: idiopathic hypertrophic subaortic
`stenosis
`IL: interleukin
`IM: intramuscular
`IMV: intermittent mandatory ventilation
`in.: inch
`INF: intravenous nutritional fluid
`INH: isoniazid
`inhal: inhalation
`inj: injection
`INR: international normalized ratio
`I&O: intake and output
`IP3: inositol triphosphate
`IPPB: intermittent positive pressure
`breathing
`IPSP: inhibitory postsynaptic potential
`iPTH: parathyroid hormone by radioim-
`munoassay
`IR: inversion recovery
`IRBBB: incomplete right bundle branch
`block
`IRDM: insulin-resistant diabetes mellitus
`IRV: inspiratory reserve volume
`ISA: intrinsic sympathomimetic activity
`IT: intrathecal
`ITP: idiopathic thrombocytopenic
`purpura
`IV: intravenous
`IVC: intravenous cholangiogram
`IVP: intravenous pyelogram
`JODM: juvenile-onset diabetes mellitus
`JVD: jugular venous distention
`K: potassium
`katal: unit of enzyme activity
`kg: kilogram
`KOR: keep open rate
`17-KSG: 17-ketogenic steroids
`KUB: kidneys, ureters, bladder
`KVO: keep vein open
`L: left, liter
`LAD: left axis deviation, left anterior
`descending
`LAE: left atrial enlargement
`LAHB: left anterior hemiblock
`LAP: left atrial pressure, leukocyte
`alkaline phosphatase
`LBBB: left bundle branch block
`LDH: lactate dehydrogenase
`LDL: low-density lipoprotein
`
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`xviii
`
`Abbreviations
`
`LE: lupus erythematosus
`LH: luteinizing hormone
`LHRH: luteinizing hormone releasing
`hormone
`LIH: left inguinal hernia
`liq: liquid
`LLL: left lower lobe
`LLSB: left lower sternal border
`LMP: last menstrual period
`LNMP: last normal menstrual period
`LOC: loss of consciousness, level of con-
`sciousness
`LP: lumbar puncture
`lpf: low-power field
`LPN: licensed practical nurse
`LSB: left sternal border
`LSD: lysergic acid diethylamide
`LUL: left upper lobe
`LUQ: left upper quadrant
`LV: left ventricle
`LVD: left ventricular dysfunction
`LVEDP: left ventricular end-diastolic pres-
`sure
`LVH: left ventricular hypertrophy
`m: meter
`MAC: Mycobacterium avium complex
`MACE: methotrexate, doxorubicin (Adri-
`amycin), cyclophosphamide,
`epipodophyllotoxin
`MAG3: mercaptoacetyltriglycine
`MAMC: midarm muscle circumference
`MAO: monoamine oxidase
`MAOI: monoamine oxidase inhibitor
`MAP: mean arterial pressure
`MAST: military/medical antishock trousers
`MAT: multifocal atrial tachycardia
`max: maximum
`MBC: minimum bactericidal concentration
`MBT: maternal blood type
`MCH: mean cell hemoglobin
`MCHC: mean cell hemoglobin concentra-
`tion
`MCT: medium-chain triglycerides
`MCTD: mixed connective tissue disease
`MCV: mean cell volume
`MEN: multiple endocrine neoplasia
`meq: milliequivalent
`MESNA: 2-mercaptoethane sulfonate
`sodium
`met-dose: metered-dose
`
`mg: milligram
`Mg: magnesium
`MHA-TP: microhemagglutination-
`Treponema pallidum
`MHC: major histocompatibility complex
`MI: myocardial infarction, mitral insuffi-
`ciency
`MIBG: metaiodobenzyl-guanidine
`MIC: minimum inhibitory concentration
`min: minute, minimum
`MIT: monoiodotyrosine
`mL: milliliter
`MLE: midline episiotomy
`mm: millimeter
`MMEF: maximal midexpiratory flow
`mm Hg: millimeters of mercury
`mmol: millimole
`MMR: measles, mumps, rubella
`mo: month
`mol: mole
`MOPP: mechlorethamine, vincristine
`(Oncovin), procarbazine, prednisone
`6-MP: mercaptopurine
`MPF: M phase-promoting factor
`MPGN: membrane-proliferative glomeru-
`lonephritis
`MPTP: analog of meperidine (used by
`drug addicts)
`MRI: magnetic resonance imaging
`mRNA: messenger ribonucleic acid
`MRS: magnetic resonance spectroscopy
`MRSA: methicillin-resistant Staphylococ-
`cus aureus
`MS: mitral stenosis, morphine sulfate, mul-
`tiple sclerosis
`MSBOS: maximal surgical blood order
`schedule
`MSH: melanocyte-stimulating hormone
`MTT: monotetrazolium
`MTX: methotrexate
`MUGA: multigated (image) acquisition
`(analysis)
`␮m: micrometer
`MVA: motor vehicle accident
`MVI: multivitamin injection
`MVV: maximum voluntary ventilation
`MyG: myasthenia gravis
`Na: sodium
`NAACP: mnemonic for Neoplasm, Allergy,
`Addison’s disease, Collagen-vascular
`
`Page 21 of 768
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`

`Abbreviations
`
`disease, Parasites (causes of
`eosinophilia)
`NAD: no active disease
`Na+/K+-ATPase: sodium/potassium
`adenosine triphosphate
`NAPA: N-acetylated procainamide,
`N-acetylparaaminophenol
`NAS: no added sodium
`NAVEL: mnemonic for Nerve, Artery,
`Vein, Empty space, Lymphatic
`NCV: nerve conduction velocity
`NE: norepinephrine
`neb: nebulizer
`NED: no evidence of recurrent disease
`ng: nanogram
`NG: nasogastric
`NIDDM: non-insulin-dependent diabetes
`mellitus
`NK: natural killer
`NKA: no known allergies
`NKDA: no known drug allergy
`nmol: nanomole
`NMR: nuclear magnetic resonance
`NPC: nuclear pore complex
`NPO: nothing by mouth (nil per os)
`NRM: no regular medicines
`NS: normal saline
`NSAID: nonsteroidal antiinflammatory
`drug
`NSILA: nonsuppressible insulin-like
`activity
`NSR: normal sinus rhythm
`NT: nasotracheal
`NTG: nitroglycerin
`OB: obstetrics
`OCD: obsessive-compulsive disorder
`OCG: oral cholecystogram
`7-OCHS: 17-hydroxycorticosteroids
`OD: overdose, right eye (oculus dexter)
`oint: ointment
`OM: otitis media
`OOB: out