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    Oncology Dictation Key: Transcription411

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    The patient returns for follow up of his diffuse large B-cell lymphoma. He has been hospitalized recently for hypokalemia and pneumonia. His main complaint is numbness in his left hand. Labs are normal except for a glucose of 116. The plan is for chemotherapy on Friday including reduced vincristine due to neuropathy, and 6 doses of Neupogen to address previous neutropenia. He will return for follow up in two weeks.

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    Oncology Dictation Key: Transcription411

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    The patient returns for follow up of his diffuse large B-cell lymphoma. He has been hospitalized recently for hypokalemia and pneumonia. His main complaint is numbness in his left hand. Labs are normal except for a glucose of 116. The plan is for chemotherapy on Friday including reduced vincristine due to neuropathy, and 6 doses of Neupogen to address previous neutropenia. He will return for follow up in two weeks.

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    Original Title

    Oncology Followup Note

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    The patient returns for follow up of his diffuse large B-cell lymphoma. He has been hospitalized recently for hypokalemia and pneumonia. His main complaint is numbness in his left hand. Labs are normal except for a glucose of 116. The plan is for chemotherapy on Friday including reduced vincristine due to neuropathy, and 6 doses of Neupogen to address previous neutropenia. He will return for follow up in two weeks.

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    Oncology Dictation Key: Transcription411

    Uploaded by

    rohit
    The patient returns for follow up of his diffuse large B-cell lymphoma. He has been hospitalized recently for hypokalemia and pneumonia. His main complaint is numbness in his left hand. Labs are normal except for a glucose of 116. The plan is for chemotherapy on Friday including reduced vincristine due to neuropathy, and 6 doses of Neupogen to address previous neutropenia. He will return for follow up in two weeks.

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    ONCOLOGY FOLLOWUP NOTE

    DIAGNOSES:
    1. Diffuse large B-cell lymphoma, stage III-A.
    2. Anemia, chronic disease.
    3. Chemotherapy-related neutropenia.
    4. Dysphagia.
    5. Hypokalemia.
    6. Coronary artery disease.

    SUBJECTIVE: The patient returns to clinic today for continued evaluation of


    his lymphoma. He is unfortunately not due for chemotherapy until this
    Friday, and it is unclear why he was scheduled this day. In the past few
    weeks, he has needed to be taken by ambulance to XXXX Hospital. He was
    apparently significantly hypokalemic, although we do not have records, and
    although it appears that he only received replacement with oral potassium
    rather than intravenous potassium. He was also told that he had “a touch
    of pneumonia,” and apparently got a z-pack; he has improved. Apparently,
    he had rigors. The patient never takes his temperature at home, so we do
    not know if he had a fever. Today, he is feeling fairly good. His major
    complaint today, besides the dysphagia which has improved, is numbness in
    his left hand, greater than his right hand.

    OBJECTIVE: TEMPERATURE: 97.9 degrees Fahrenheit; BLOOD PRESSURE: 154/69;


    PULSE: 85; WEIGHT: 159 pounds. On examination today he still has a mass in
    the retropharyngeal space.

    LABORATORY DATA: From today, chemistries and liver function tests are
    normal, other than a glucose of 116. His potassium is normal at 4.5. CBC:
    White count 7.6; hemoglobin 15.5; hematocrit 46.8; platelet count is 266.
    Differential is 68.6% neutrophils; 15.8% lymphocytes.

    ASSESSMENT: A XX-year-old gentleman with diffuse large B-cell lymphoma who


    will be due for chemotherapy on Friday, and I will write his orders
    today. Unfortunately, he did not receive enough Neupogen. It is unclear
    if he was neutropenic at the time that he had pneumonia, and for this
    cycle, he will get 6 doses of Neupogen. In addition, because of his
    neuropathy, I will cut is vincristine dose to 1 mg.

    PLAN:
    1. Cancel chemotherapy nurse today.
    2. Chemotherapy nurse to be scheduled on Friday.
    3. Premedication with ondansetron 8 mg and dexamethasone 12 mg IV
    piggyback.
    4. Cytoxan, 1,400 mg IV push.
    5. Vincristine, 1 mg IV push.
    6. Prednisone, 100 mg p.o. q. day x5 days.
    7. Rituximab, 700 mg IV.
    8. Neupogen 300 mcg, subcutaneous q. day x6 days beginning 1 day
    following chemotherapy.
    9. Return on August 2, 2005 for post-chemotherapy check.

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