AHIMA-CCS pdf - Certified Coding Specialist (CPC) (ICD-10-CM) Updated: 2024

It is difficult to diagnose the cause of sharp, inconsistent stomach pain based on that symptom alone. Taking note of other symptoms and possible contributing factors is important.

Causes of sharp stomach pain that comes and goes include:

1. Gas

Gas and bloating are very common problems. They tend to be cyclical.

Although gas does not cause long-term harm, the pain can range from dull and mild to sharp and severe. It may get steadily worse over several minutes, then get better, only to grow worse again.

Numerous issues can cause gas, including:

Over-the-counter (OTC) gas remedies often help reduce this pain. Some people also find relief from heating pads or a gentle stomach massage.

People who frequently experience severe gas pain should see a doctor.

2. Stomach viruses

Stomach viruses, such as norovirus, cause intense cramping that may come and go. The cramping usually precedes vomiting, which offers temporary relief.

Symptoms of stomach viruses can last 1–10 days, depending on the virus. Some people also develop a fever or muscle aches.

It is crucial to drink lots of water during this time. If symptoms get worse or a person seems dehydrated, call a doctor.

3. Muscle pain and injuries

Muscle overuse, a sedentary lifestyle, and trauma from falling or other injuries can cause pain in the abdominal or back muscles.

Pain that appears only in certain positions, while lifting, or after exercise could be a sign of a muscle injury.

A muscle injury is not a medical emergency. Most people can treat muscle injuries at home with rest, hot and cold packs, and gentle massage.

If home treatment does not work or the pain is very intense, it is best to see a doctor.

4. Liver and gallbladder issues

Pain in the upper right stomach that comes and goes could signal a problem with the gallbladder, such as gallstones.

Gallstones can block the ducts of the gallbladder, making digestion more difficult. This causes pain shortly after eating, especially after very fatty meals. The pain may last 1–6 hours.

Gallstones sometimes pass on their own. If they do not, they can block the biliary ducts, affecting liver function. Untreated gallstones may also cause problems with the pancreas.

If a person experiences vomiting, pale stool, or a fever along with symptoms of gallstones, they should seek emergency medical treatment.

Read more about treatment for gallstones.

5. Digestive disorders

A wide range of digestive disorders can cause periodic sharp pain in the stomach. In most cases, the pain worsens shortly after a meal as the body works to digest food.

Some potential culprits include:

These digestive disorders can be intensely painful, but they do not usually constitute a medical emergency.

Keeping a food log can help a doctor diagnose the problem and provide a treatment plan. Pain medication, heating pads, and rest may also help in the short term.

6. Ulcers

An ulcer is a sore in the lining of the stomach or intestine. Causes of ulcers include:

People with ulcers typically experience a sharp, burning sensation in the stomach. The burning may travel up the chest and into the mouth or throat, causing heartburn or indigestion.

Symptoms are usually worse after a large or very acidic meal. A person may have no symptoms for several months, then experience them again.

Antacids may help. A doctor can also prescribe medication to treat the pain.

7. Menstrual cramps

Menstrual cramps or period pains can feel sharp or dull. They may affect just one area of the abdomen or spread to the back and legs. Some people also experience diarrhea or nausea.

Menstrual cramps may be continuous or come in waves. They typically occur during or right before a period.

A heating pad, OTC pain relievers, and gentle stretching can help relieve menstrual pain.

Menstrual cramps are not dangerous, but severe camps can make daily life difficult. A person should see a doctor if menstrual cramps are severe, worsen, or interfere with work or school.

Read about home remedies for menstrual cramps.

8. Ovarian cysts

Cysts in the ovaries are common and usually harmless. Most people do not realize they have them. Many ovarian cysts form after ovulation and then disappear a few months later.

Ovarian cysts can cause intermittent pain. The pain from an ovarian cyst is often low in the abdomen and on just one side. It may be worse during specific times of the menstrual cycle.

If a person suspects they have a painful ovarian cyst, they can talk with a doctor. The doctor can diagnose a cyst using imaging tests.

OTC pain medication and applying warm compresses can help relieve the pain.

Sudden, intense pain in the lower pelvis may be a sign of ovarian torsion, which is when the ovary twists. This is sometimes a complication of a cyst.

Ovarian torsion is a medical emergency. Without treatment, it can cause severe internal bleeding, damage to the ovary, or an infection.

9. Ovulation

During ovulation, an egg ruptures from its follicle in the ovary and enters the fallopian tube. Some people experience ovulation pain or mittelschmerz toward the middle of the menstrual cycle.

Ovulation pain is not dangerous and can even be a helpful fertility cue if a person is trying to conceive.

10. Braxton-Hicks contractions

In pregnant people, sharp abdominal pain may indicate labor or Braxton-Hicks contractions.

Braxton-Hicks contractions are sometimes called “false labor”, as they may feel like real contractions.

They are often irregular or appear only at certain times, such as if a pregnant person is dehydrated.

1. Human Anatomy:

Applied anatomy including blood and nerve supply of upper and lower limbs and joints of shoulder, hip and knee.

Gross anatomy, blood supply and lymphatic drainage of tongue, thyroid, mammary gland, stomach, liver, prostate, gonads and uterus.

Applied anatomy of the diaphragm, perineum and inguinal region.

Clinical anatomy of kidney, urinary bladder, uterine tubes, vas deferens.

Embryology: Placenta and placental barrier. Development of heart, gut, and kidney, uterus, ovary, testis and their common congenital abnormalities.

Central and Peripheral Autonomic Nervous System: Gross and clinical anatomy of ventricles of the brain, circulation of cerebrospinal fluid; Neural pathways and lesions of cutaneous sensations, hearing and vision; Cranial nerves distribution and clinical significance; Components of the autonomic nervous system.

2. Human Physiology:

Conduction and transmission of impulse, mechanism of contraction, neuromuscular transmission, reflexes, control of equilibrium, posture and muscle tone, descending pathways, functions of the cerebellum, basal ganglia, Physiology of sleep and consciousness.

Endocrine System: Mechanism of action of hormones; formation, secretion, transport, metabolism, function and regulation of secretion of pancreas and pituitary gland.

Physiology of Reproductive System: Pregnancy menstrual cycle, lactation, pregnancy.

Blood: Development, regulation and fate of blood cells.

Cardio-vascular, cardiac output, blood pressure, regulation of cardiovascular functions.

3. Biochemistry:

Organ function tests—liver, kidney, thyroid Protein synthesis.

Vitamins and minerals.

Restriction fragment length.

polymorphism (RFLP).

Polymerase chain reaction (PCR).

Radio-immunoassays (RIA).

4. Pathology:

Inflammation and repair, disturbances of growth and cancer, Pathogenesis and histopathology of rheumatic and ischaemic heart disease and diabetes mellitus. Differentiation between benign, malignant, primary and metastatic malignancies, Pathogenesis and histopathology of bronchogenic carcinoma, carcinoma breast, oral cancer, cancer cervix, leukaemia, Etiology, pathogenesis and histopathology of— cirrhosis liver, glomerulonephritis, tuberculosis, acute osteomyelitis.

5. Microbiology:

Humoral and cell mediated immunity.

Diseases caused by and laboratory diagnosis of —

Meningococcus, Saimonella

Shigella, Herpes, Dengue, Polio

HIV/AIDS, Malaria, E. Histolytica, Giardia

Candida, Cryptococcus, Aspergillus.

6. Pharmacology:

Mechanism of action and side effects of the following drugs :

Antipyretics and analgesics, Antibiotics,

Antimalaria, Antikala-azar, Antidiabetics,

Antihypertensive, Antidiuretics, General and cardiac vasodilators, Antiviral, Antiparasitic, Antifungal, Immunosuppressants,

Anticancer.

7. Forensic Medicine and Toxicology

Forensic examination of injuries and wounds; Examination of blood and seminal stains; Poisoning, sedative overdose, hanging, drowning, burns, DNA and fingerprint study.

UPSC Medical Science Syllabus for Paper 2

The UPSC Medical Science Paper II Syllabus focuses on topics like General Medicine, Paediatrics, Dermatology, General Surgery,  Obstetrics and Gynaecology including Family Planning, and Community Medicine (Preventive and Social Medicine). Check the topic-wise UPSC Medical Science Optional Syllabus PDF for Paper II below.

1. General Medicine

• Aetiology, clinical features, diagnosis and principles of management (including prevention) of—Typhoid, Rabies, AIDS, Dengue, Kala-azar, and Japanese Encephalitis.
• Aetiology, clinical features, diagnosis and principles of management of :
• Ischaemic heart disease, pulmonary embolism.
• Bronchial asthma.
• Pleural effusion, tuberculosis, Malabsorption syndromes; acid peptic diseases, Viral hepatitis and cirrhosis of the liver.
• Glomerulonephritis and pyelonephritis, renal failure, nephrotic syndrome, renovascular hypertension, complications of diabetes mellitus, coagulation disorders, leukaemia, Hypo and hyper thyroid, meningitis and encephalitis.
• Imaging in medical problems, ultrasound, echocardiogram, CT scan, MRI.
• Anxiety and Depressive Psychosis and schizophrenia and ECT. 

2. Paediatrics

Immunization, Baby friendly hospital, congenital cyanotic heart disease, respiratory distress syndrome, broncho— pneumonia, kernicterus. IMNCI classification and management, PEM grading and management. ARI and Diarrhea of under five and their management.

3. Dermatology

Psoriasis, Allergic dermatitis, scabies, eczema, vitiligo, Stevan Johnson’s syndrome, Lichen Planus.

4. General Surgery

• Clinical features, causes, diagnosis and principles of management of cleft palate, harelip.
• Laryngeal tumour, oral and esophageal tumours.
• Peripheral arterial diseases, varicose veins, coarctation of aorta.
• Tumours of Thyroid, Adrenal, Glands.
• Abscess cancer, fibroadenoma and adenosis of the breast.
• Bleeding peptic ulcer, tuberculosis of the bowel, ulcerative colitis, cancer stomach.
• Renal mass, cancer prostate.
• Haemothorax, stones of the Gall bladder, Kidney, Ureter and Urinary Bladder.
• Management of surgical conditions of Rectum, Anus and Anal canal, Gall bladder and Bile ducts.
• Splenomegaly, cholecystitis, portal hypertension, liver abscess, peritonitis, carcinoma head of pancreas.
• Fractures of the spine, Colles’ fracture and bone tumours.
• Endoscopy.
• Laparoscopic Surgery.

5. Obstetrics and Gynaecology including Family Planning

• Diagnosis of pregnancy.
• Labour management, complications of 3rd stage, Antepartum and postpartum haemorrhage, resuscitation of the newborn, Management of abnormal life and difficult labour. Management of small for date or premature newborns.
• Diagnosis and management of anaemia. Preeclampsia and Toxaemias of pregnancy, Management of Postmenopausal Syndrome.
• Intra-uterine devices, pills, tubectomy and vasectomy. Medical termination of pregnancy including legal aspects.
• Cancer cervix.
• Leucorrhoea, pelvic pain; infertility, dysfunctional uterine bleeding (DUB), amenorrhoea, Fibroid and prolapse of uterus.

6. Community Medicine (Preventive and Social Medicine)

• Principles, methods approach and measurements of Epidemiology.
• Nutrition, nutritional diseases/disorders and Nutrition Programmes.
• Health information Collection, Analysis and Presentation.
• Objectives, components and critical analysis of National programmes for control/eradication of :
• Malaria, Kala-azar, Filaria and Tuberculosis,
• HIV/AIDS, STDs and Dengue.
• Critical appraisal of Health care delivery system.
• Health management and administration; Techniques, Tools, Programme Implementation and Evaluation.
• Objectives, Components, Goals and Status of Reproductive and Child Health, National Rural Health Mission and Millennium Development Goals.
• Management of hospital and industrial waste.

How to Prepare the UPSC Medical Science Syllabus 2023?

Candidates must follow the UPSC Medical Science syllabus and reshape the preparation strategy. This will help them to get a strong grip on the concepts and advanced chapters important from the exam perspective. As the UPSC Medical Science optional syllabus is lengthy, aspirants should consider specific points during the IAS exam preparation.

• Review the UPSC Medical Science optional syllabus thoroughly and segregate the topics based on marks weightage. This will enable them to finish the syllabus in a stipulated time period.
• Pick the highly recommended books and study resources to understand the concepts easily and comprehensively.
• Solve UPSC Medical Science's previous year's question paper to get an idea of the questions repeatedly asked over the years and question weightage.
• Revise all the important topics and chapters covered so far to retain concepts for a definite period.

Booklist for UPSC Medical Science Optional Syllabus

Numerous UPSC Medical Science optional books are available to strengthen the basics. Once they learn fundamentals, they should start covering core topics for the advanced preparation. The right books will help them to cover all the important topics specified in the UPSC Medical Science Optional Syllabus. Some of the best UPSC Medical Science Optional books are as follows.

Also Read,

Microsoft Word possesses the built-in ability to save documents as PDF. It doesn’t require you to download a converter to get the job done. Earlier, we had learned how to password protect Office documents. Today, we see the method of password protecting a PDF file in Word. The tutorial is for Office users who are not aware of the feature found in Word that allows you to encrypt and password-protect PDF files as well.

Please note that if you lose the password for the file, you will not be able to recover it without using password recovery software. Therefore, I advise you to store all the passwords in a safe place if you plan to use this feature for protecting multiple PDF files.

Here’s how to go about it.

Open a Word document that you would like to save in PDF format and encrypt withpassword, complete the writing or editing.

Once done, click the ‘File’ menu and then click Save As tab.

Next, select the location of your choice where you would like to save the PDF file.

Upon finding the ‘Save As’ dialog box, select Save as type as PDF from the drop-down menu and then hit the ‘Options’ button to open Options dialog.

Here, enable the option that reads as ‘Encrypt the document with a password’ and press ‘OK’ button.

Now, simply enter the password that is easy for you to remember, but hard for others to guess and use it to protect your PDF file. After entering the password once, re-enter the same password before clicking OK button.

Read: How to Remove PDF Restrictions using free software or online tools.

Lock PDF from editing

It’s advisable to keep the password between 6 and 32 characters long. All done, click the OK button and hit ‘Save’ to save the PDF file.

Now, when you try opening this PDF file with Office or any other program, you’ll be prompted to enter the password to either view or edit it.

TIP: You can also use these free software to password protect PDF documents.

Please note: 

Overview

The Medical Genomics Laboratory (MGL) is a CAP-certified nonprofit clinical laboratory at the University of Alabama at Birmingham, offering comprehensive testing for common and rare genetic disorders.  The MGL specializes in testing for all forms of the neurofibromatoses including NF1, Legius syndrome (SPRED1 disorder), segmental NF, NF-Noonan, spinal NF, Watson syndrome, NF2, and schwannomatosis as well as the RASopathies, and tuberous sclerosis complex. 

Contact

UAB Medical Genomics Laboratory
720 20th St. S., Suite 330
Birmingham, AL 35294
Phone: 205.934.5562
Fax: 205.996.2929
E-mail: medgenomics@uabmc.edu 

Tell us how we are doing! Please complete our customer satisfaction survey and share your feedback! Please click here for survey. 

CNN  — 

ChatGPT might not be a cure-all for answers to medical questions, a new study suggests.

Researchers at Long Island University posed 39 medication-related queries to the free version of the artificial intelligence chatbot, all of which were real questions from the university’s College of Pharmacy drug information service. The software’s answers were then compared with responses written and reviewed by trained pharmacists.

The study found that ChatGPT provided accurate responses to only about 10 of the questions, or about a quarter of the total. For the other 29 prompts, the answers were incomplete or inaccurate, or they did not address the questions.

The findings were presented Tuesday at the annual meeting of the American Society for Health-Systems Pharmacists in Anaheim, California.

ChatGPT, OpenAI’s experimental AI chatbot, was released in November 2022 and became the fastest-growing consumer application in history, with nearly 100 million people registering within two months.

Given that popularity, the researchers’ interest was sparked by concern that their students, other pharmacists and ordinary consumers would turn to resources like ChatGPT to explore questions about their health and medication plans, said Sara Grossman, an associate professor of pharmacy practice at Long Island University and one of the study’s authors.

Those queries, they found, often yielded inaccurate – or even dangerous – responses.

In one question, for example, researchers asked ChatGPT whether the Covid-19 antiviral medication Paxlovid and the blood-pressure lowering medication verapamil would react with each other in the body. ChatGPT responded that taking the two medications together would yield no adverse effects.

In reality, people who take both medications might have a large drop in blood pressure, which can cause dizziness and fainting. For patients taking both, clinicians often create patient-specific plans, including lowering the dose of verapamil or cautioning the person to get up slowly from a sitting position, Grossman said.

ChatGPT’s guidance, she added, would have put people in harm’s way.

“Using ChatGPT to address this question would put a patient at risk for an unwanted and preventable drug interaction,” Grossman wrote in an email to CNN.

When the researchers asked the chatbot for scientific references to support each of its responses, they found that the software could provide them for only eight of the questions they asked. And in each case, they were surprised to find that ChatGPT was fabricating references.

At first glance, the citations looked legitimate: They were often formatted appropriately, provided URLs and were listed under legitimate scientific journals. But when the team attempted to find the referenced articles, they realized that ChatGPT had given them fictional citations.

In one case, the researchers asked ChatGPT how to convert spinal injection doses of the muscle spasm medication baclofen to corresponding oral doses. Grossman’s team could not find a scientifically established dose conversion ratio, but ChatGPT put forth a single conversion rate and cited two medical organizations’ guidance, she said.

However, neither organization provides any official guidance on the dose conversion rate. In fact, the conversion factor that ChatGPT suggested had never been scientifically established. The software also provided an example calculation for the dose conversion but with a critical mistake: It mixed up units when calculating the oral dose, throwing off the dose recommendation by a factor of 1,000.

If that guidance was followed by a health care professional, Grossman said, they might give a patient an oral baclofen dose 1,000 times lower than required, which could cause withdrawal symptoms like hallucinations and seizures.

“There were numerous errors and “problems’ with this response and ultimately, it could have a profound impact on patient care,” she wrote.

The Long Island University study is not the first to raise concerns about ChatGPT’s fictional citations. Previous research has also documented that, when asked medical questions, ChatGPT can create deceptive forgeries of scientific references, even listing the names of real authors with previous publications in scientific journals.

Grossman, who had worked little with the software before the study, was surprised by how confidently ChatGPT was able to synthesize information nearly instantaneously, answers that would take trained professionals hours to compile.

“The responses were phrased in a very professional and sophisticated manner, and it just seemed it can contribute to a sense of confidence in the accuracy of the tool,” she said. “A user, a consumer, or others that may not be able to discern can be swayed by the appearance of authority.”

A spokesperson for OpenAI, the organization that develops ChatGPT, said it advises users not to rely on responses as a substitute for professional medical advice or treatment.

The spokesperson pointed to ChatGPT’s usage policies, which indicate that “OpenAI’s models are not fine-tuned to provide medical information.” The policy also states that the models should never be used to provide “diagnostic or treatment services for serious medical conditions.”

Although Grossman was unsure of how many people use ChatGPT to address medication questions, she raised concerns that they could use the chatbot like they would search for medical advice on search engines like Google.

“People are always looking for instantaneous responses when they have this at their fingertips,” Grossman said. “I think that this is just another approach of using ‘Dr. Google’ and other seemingly easy methods of obtaining information.”

For online medical information, she recommended that consumers use governmental websites that provide reputable information, like the National Institutes of Health’s MedlinePlus page.

Still, Grossman doesn’t believe that online answers can replace the advice of a health care professional.

“[Websites are] maybe one starting point, but they can take their providers out of the picture when looking for information about medications that are directly applicable to them,” she said. “But it may not be applicable to the patients themselves because of their personal case, and every patient is different. So the authority here should not be removed from the picture: the healthcare professional, the prescriber, the patient’s physicians.”