SOAP Terms

Acute: it started recently or is a sharp severe symptom

Chronic: it has been going on for a while now

Exacerbation: it is getting worse

Abrupt: all of a sudden

Febrile: to have a fever

Afebrile: to not have a fever

Malaise: not feeling well

Progressive: more and more each day

Symptom: something a patient feels

Noncontributory: not related to this specific problem

Lethargic: a decrease in level consciousness; usually an indication that a patient is really sick

Genetic/Hereditary: it runs in the family

Alert: able to answer questions; responsive

Oriented: being aware of who he or she is

Marked: it really stands out

Unremarkable: another way of saying normal

Auscultation: to listen

Percussion: to hit something and listen to the resulting sound or feel for the resulting vibration

Palpitation: to feel

Impression: another way of saying assessment

Diagnosis: what the healthcare professional thinks the patient has

Differential Diagnosis: a list of conditions the patient may have based on the symptoms they have and the results of the exam

Benign: safe

Malignant: dangerous; a problem

Degeneration: to be getting worse

Remission: to get better or improve; most often used when discussing cancer; DOES NOT mean cure

Idiopathic: no known specific cause; it just happens

Localized: stays in a certain part of the body

Systemic/generalized: all over the body (or most of it)

Prognosis: the chances for things getting better or worse 

Occult: hidden

Lesion: diseased tissue

Recurrent: to have again

Sequela: a problem resulting from a disease or injury

Pending: waiting for

Pathogen: the organism that causes the problem

Morbidity: the risk for being sick

Mortality: the risk for dying

Etiology: the cause

Disposition: what happened to the patient at the end of the visit

Discharge: literally, to unload; (1) to send home; (2) fluid coming out of a part of the body

Palliative: treating the symptoms, but not getting rid of the cause

Observation: watch, keep an eye on

Reassurance: to tell the patient that the problem is not serious or dangerous

Supportive Care: to treat the symptoms and make the patient feel better

Sterile: extremely clean, germ-free conditions

Prophylaxis: preventative treatment