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Saturday, March 17, 2012

Faux Diagnosis Lexicon

Faux Diagnosis's:
So your patient doesn't look quite rite? Well, just make it up (faux it):

Idiopathic:  You have no clue of the cause. 

Nosocomial disease:  You developed it in the hospital.  Beware, the doctor may have faux't it.

Faux't it:  What a doctor says when he's tired of dealing with nagging and persistent patient's who insist there's something wrong with them.  It's the spontaneous dicision to fake the diagnosis to get the patient to shut up.  (Doctor #1 says:  "How did you come up with the diagnosis?"  Dr. #2 says:  "I faux't it."  See F-it.

Faux it:  A less bedecking way of saying Faux't it or F-it.  It's faking the diagnosis to suit the needs of the doctor and to satiate the persistent and pressing patient.   

F-it:  An abbreviated way of saying, "Faux't it."  Faking the diagnosis.  Not to be confused with Fu#$ it. "Rather than think, the doctor F'd it."

Faux Nosocomial Diseases: See trashcan diagnosis.  Are generally fake (pseudo, faux), disorders that one develops at the convenience of the physician, institution, insurance company, and Centers for Medicare and Medicaide Services in an attempt to lower government and insurance costs and ensure hospital reimbursement.

Trashcan diagnosis:  See Fake diagnosis and Faux Nosocomial disease. A made up diagnosis for idiopathic disorders. 

Fake diagnosis:  Trashcan diagnosis, faux diagnosis, faux nosocomial disease.  May result from any of the following:  1)  The patient pressing the doctor because "something must be wrong with me."  2)  The doctor is tired dealing with it and just wants to be done.  3)  Any attempt to name vague symptoms (i.e. the patient is short of breath is must be asthma).  4)  to meet admission criteria.  5)  To meet reimbursement criteria.

Faux diagnosis:  See fake diagnosis, trashcan diagnosis, Faux nosocomial disease

Faux Pneumonia:  Most common fake diagnosis of any patient admitted to the hospital.  It assures reimbursement criteria will be met so long as breathing treatments are ordered.  As you look at the chart you'll see no indications of pneumonia (no increased wbc count, normal x-ray, etc.).

Aspiration pneumonia:  Most common fake diagnosis of any nursing home, bed ridden, stroke patient in order to assure the patient meets admission and reimbursement criteria.  Any time the patient, or mother of a child perhaps, indicates water, swimming in a lake, or anything like that this is a good diagnosis in order to throw investigators off your track if they see pneumonia ordered too much

Faux obstructive lung disease:  This is nosocomial COPD.  It's degeneration of the lung tissue caused out of the convenience of the physician who wants to assure reimursement criteria and cover his bases.  The patient will deny short of breath, any respiratory history, and benefit from treatment.  Any patient with a history of smoking -- even just one cigarette -- must require breathing treatments.  See cigarbuterol.

Elective induction:  What the OB doctor orders when he doesn't want to be bothered over the weekend, has to go on vacation, or the mom is tired of being pregnant.  Any of the following may be the diagnosis:  faux diabetes, STOP syndrome, Impending macrosonia, pre eclampsia.

Faux Diabetes:  Most common Fake diagnosis for pregnant mothers with large or small fetus's who have to participate in a variety of testing only reimbursed under the diagnosis of diabetes.  As you look at the chart the patient shows no real history of diabetes.

Stop Syndrome (sick and tired of being pregnant):  Faux disorder when mom is complaining of symptoms of being pregnant and is ready for elective induction.

Imprending macrosonia:  Creatively lie that you think the baby is large so reimbursement criteria will be met for elective induction of labor for STOP syndrome.

Pre-eclampsia:  Mom never had a high blood pressure but mom tired of being pregnant, so to meet criteria the doctor just faux's a diagnosis.

Exaggeration of Asthma:  The patient fakes asthma so as to get a break from family, freinds, stress.

Nosocomial COPD:  See Faux obstructive lung disease.  The patient miraculously catches lung disease during admission to hospital.

Adrenal fatigue:  You have any of the following symptoms:  tired often, hate getting up in morning, exhausted on Mondays, need coffee and Coke to function, feeling run down, feeling stress.  If you have any of these otherwise normal symptoms you must have a disease, and we'll give it the faux name Adrenal fatigue. For more on this syndrome, click here.

Faux Bronchiolitis:  A meet criteria diagnosis for kids.  You have a kid in the ER who doesn't look quite right, or the mom is pressing you to admit the patient, or the patient has crummy parents and you question the parents are giving adequate care.  Symptoms may include cold or cough, annoying lung sounds.  Should alternate this diagnosis with faux pneumonitis

Faux pneumonitis:  Same as Faux bronchiolitis.  Again, you will find no evidence on x-ray.

Post election depression:  You're pissed because your guy lost.

Stomach flu:  The patient is nauseated and/ or vomiting and has symptoms of gastroenteritis and the patient is convinced he has the flu, so the doctor just goes with it.  There is no such thing as the stomach flu.

Pseudogout:  The patient complains of general pain (joint, shoulder, hip, back) and the doctor has run a gazillion tests that show up nothing.  The patient insists he has something, so the doctor gives in with this faux diagnosis just to shut the f-ing patient up.

Faux croup:  Usually diagnosed on adults with sleep apnea whereas the snoring or grunting is mistaken by nurses and/ or doctor as stridor.  This is a common post operative diagnosis when the patient with sleep apnea doesn't wake up right away from anesthesia and suffers from apnea episodes.

Faux bronchospasm:  The patient presents with annoying lung sounds that the nurse thinks are wheezes but are really stridor, rhonchi, rhales, crickets or snoring. So instead of thinking the nurse calls respiratory therapy for a breathing treatment.

Fulmonating Pulmonary Edema:  Sudden effuse onset of pink idiopathic pulmonary edema resulting in pink, frothy secretions

Cardiac asthma:  It's generally diagnosed as asthma sans the cardiac part because many nurses and doctors have no clue that all that wheezes is not asthma.  It's a wheeze caused by right or left heart failure that results in increased pulmonary pressure and pulmonary edema squeezing the bronchial tubes large and small resulting in a wheeze.  If the wheeze is audible it's cardiac asthma, yet on paper we'll just call it asthma (simpler that way) and order breathing Q4ever Albuterol. 

ABGbies:  A condition where an RT will become incesantly irritable when viewing a frivolous ABG order.

Fulmonating pulmonary edema:  A better word for heart failure causing pink frothy secretions.

Flash pulmonary edema:  Rapid onset heart failure causing fulmonary pulmonary edema.  It's a cover-your-ass-diagnosis for doctors to explain heart failure due to medical incompitence.  No patient suddenly goes into heart failure without showing signs.  If the doctor or nurse misses the signs, this is the default diagnosis.  It works well in courts.

Plamonia:  (n) A faux diagnosis of pneumonia for a patient admitted to the hospital awaiting placement to a nursing home; pneumonia for pacement

Koff-monia:  Faux Pneumonia diagnosis because the patient had a cough and wasn't sick enough for a real diagnosis.

Chronic bed syndrome: Here you have your typical chronically sick patients who are unable to get out of the bed. They usually present with some grumpiness and fear not bossing you around without saying thank you. They expect you to cater to their every need; to actually know what they need before they ask. They tend to fit into any or all of the following adjectives: grumpy, demanding, purposeful apathy, melancholy, bossy, condescension.

Whoa is me syndrome: Some diseases might be MS, ALS, MSA, trauma, rehabilitation, chronically ill, or any such disease where the patient slowly develops atrophy of muscles and possible paralysis. She needs constant assistance moving and perhaps even drinking. They constantly yearn empathy and can at times fall into the Chronic bed syndrome. Ultimately, they want you to feel sorry for them. Something you might hear from this patient is, "Oh, why did this happen to me."

Faux/ Pseudo pneuomonia:  When a patient is diagnosed with pneumonia just to meet criteria for admission, or criteria for reimbursement.

Fatsma:  Dypspnea with exertion due to obesity.

Faux pneumonia: (n) A fictitious diagnosis of pneumonia simply because pneumonia is the most reimbursable diagnosis.

BDCHF = BiPAP Deferred Congested Heart Failure. BiPAP will prevent fluid from entering the lungs. Indicated for patients with poor kidney function who require large fluid boluses (i.e. for low blood pressure). A bonus is the BiPAP might cause the anxiety needed to raise blood pressure. Note: Ignore silly RT rants about BiPAP decreasing venous return and possibly lowering blood pressure).

DCHF = Deferred Congested Heart Failure. The patient was wet when admitted, but the doctor won't figure it out until the patient has been treated with bronchodilators for three days.

PACHF = Physician Induced Congested Heart Failure.

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