Full cervical dilatation, delivery of the infant, and passage of the placenta are the 3 stages of labor. 

In the first stage, there are 3 phases; latent, active, and deceleration.

In the early (latent) phase, contractions are stronger, more frequent, and gain regularity.  This involves effacement or thinning of the cervix.  This is the phase that varies the most in women.  Latent phase can take anywhere from hours to days. 

HELLP syndrome happens to about 1 to 2 out of 1,000 women who are pregnant. 

H = hemolysis

EL = elevated liver enzymes

LP = low platelet count

The cause is not known.  There is no known way to prevent HELLP syndrome.  Some symptoms might consist of headache, blurry vision, nausea, fatigue, and nosebleed.

Diastasis recti is a division of the abdomen area.  The rectus abdominis muscle is divided into left and right halves.

It stretches from the belly button to the base of the breastbone and is enlarged with muscle strain.  The part of the belly area that it covers is the front surface.

It typically takes place in pregnant women and newborns.

When tension is increased on the abdominal wall, it may lead to diastasis recti.  Numerous births increase the risk of diastasis recti.

Spider angiomas are atypical groups of blood vessels close to the surface of the skin.  Spider angiomas look like spider legs.  The exact cause is unknown.

They typically appear on face and neck, but also on hands, forearms, and ears.

Spider angiomas are also referred to as spider veins, vascular spider, nevus araneus, and spider telangiectasis.

Please share whatever other information you might have on spider angiomas.

A device used in vehicle extrication to take victims out of motor vehicles is called a KED board.  KED stands for Kendrick Extrication Device. 

The KED secures the neck, head, and torso.  It reduces the possibility of more injuries to these regions of the body during extrication.  The anatomical neutral position that KED secures it in is composed of 6 parts; face forward, stand erect, arms at sides, palms directed forward, toes directed forward, and feet together.  It is typically used in conjunction with a C-collar (cervical collar). 

Are there any other devices you know of that are used in similar situations? 

I had a few questions this week on and vs. or.  I will share the information that I found on it.

The patient denies fevers or chills.
The patient denies fevers and chills.

The question was why is it fevers and chills vs. fevers or chills?

We deny this “and” that, and not this “or” that.  Likewise, the patient says that he has neither fevers nor chills and he denies both.  If he were to say “fevers or chills,” it would sound like he denies only one of the conditions and not both.

When the word follows not or cannot, the “or” form is more common.

I found a PDF regarding and vs. or under Coach’s Column that I found interesting.  It stated that when using “and” it shifts thinking into alternatives other than the 2 opposing positions.  The “and” angle tends to suggest thoughts different from just looking at 2 options.

Let me know what you think and if you have any other information you can share.

UPEP or urine protein electrophoresis is a state in which an atypical protein is in the blood.  A test calculates approximate specific proteins you have in urine.  A clean-catch sample of urine is needed.  Two types of protein are detected called albumin and globulins. 

If there is an existence of protein in urine, it can be a sign of many different disorders (possibly kidney failure, multiple myeloma, diabetic nephropathy and more).  It usually causes no problems.  It can be connected to an additional diagnosis or can develop over the years to other disorders.  One example of a disorder could be a form of blood cancer.  

Please share anything else you might know about UPEP. 

I saw the word “separate” spelled wrong a couple times today and decided to research a way to remember how to spell it.  We have our spell-checker for medical transcription, which should prevent us from spelling it wrong.  People tend to think separate is spelled similar to desperate.  I looked on the Internet and there were several suggestions on remembering how to spell these 2 words.  Here is the one I thought made the best sense.

When you spell separate, think of “get away.”  The 1 e and 2 a’s in get away are the same as the 1 e and 2 a’s that are in separate.

When you spell desperate, think of “needy man.”  The 2 e’s and 1 a in needy man are the same as the 2 e’s and 1 a in desperate.

There was a comment that remembering these 2 suggestions was harder than just remembering how to spell them!  That may be true if you have never had trouble spelling these words.  I think it was clever for someone to come up with it.  You will probably remember it because it is so odd.

The definition I found for acute on chronic:  A short flareup of a long-standing illness.  

I found acute on chronic liver disease and acute on chronic liver failure in the Stedman’s GI/GU Words. 

Other things you may refer to that may be acute on chronic are respiratory failure, heart failure, systolic heart failure, kidney disease, and subdural hematoma. 

Please share any other information you may have on acute on chronic. 

Monoclonal gammopathy of undetermined significance  is a state where the body creates an irregular protein (called paraprotein) that is found in the blood.

MGUS does not usually produce problems.  Some forms of blood cancer can be linked to it along with other diseases.  It can also grow into other disorders over years.

Annual checkups are done to monitor level of M protein (a type of white blood cell).  No treatment is required if there is no increase in protein.

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