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WRITTEN QUIZZES Written Quiz—Case 1 Glossary Student ___________________________________ Define the medical terms listed below.
Select the best answer for each of the following statements:
1. Claforan— 11.
The bottom or base of anything. a. hemoglobin b. lyse c. fundus d. proximal
12.
To bring close together or into apposition. a. peritoneum b. approximate c. adhesions d. transabdominal
13.
Appendages or adjunct parts. a. adhesions b. edema c. adnexal mass d. adnexa
14.
Perceptible by touch. a. peritoneum b. bimanual c. embedding d. palpable
15.
The vomiting of blood. a. hematemesis b. hematochezia c. hematocrit d. hematuria
16.
The passage of bloody stools. a. hematemesis b. hematochezia c. hematocrit d. hematuria
2. arthralgia—
3. cul-de-sac—
4. distal—
5. fascia—
6. lyse—
7. melena—
8. peritoneum—
9. retractor—
10. salpingectomy—
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17.
The arrest of bleeding by surgical means. a. hematochezia b. hemoperitoneum c. hemostasis d. hematocrit
18.
Medicinal sedative and antinauseant. a. RhoGAM b. Phenergan c. Vicryl d. Rh-negative
19.
Instrument used to spread open a passage or cavity for ease in its examination. a. staple gun b. retractor c. Vicryl d. speculum
20.
Containing both mucus and pus. a. normal saline b. mucopurulent c. melena d. mesosalpinx
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Written Quiz—Case 2 Glossary Student ________________________________ Define the medical terms listed below.
Select the best answer for each of the following statements:
1. appendicitis— 11.
Diminished appetite. a. clubbing b. edema c. emesis d. anorexia
12.
Unlawful. a. illicit b. in toto c. integument d. inflammatory bowel disease
13.
Distension of the neck veins. a. Endo GIA b. LFTs c. JVD d. OR
14.
Near the cecum. a. purulent b. periappendiceal c. pericecal d. phlegmon
15.
To spread out in all directions from a center. a. supine b. rebound c. osseous d. radiate
16.
Eardrums. a. TMs b. SCDs c. RLQ d. LFTs
2. colonoscopy—
3. emesis—
4. localized—
5. normocephalic—
6. phlegmon—
7. pneumoperitoneum—
8. supine—
9. thyromegaly—
10. WNL—
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17.
The act of listening for sounds within the body. a. clubbing b. auscultation c. dilatation d. guarding
18.
Related to the liver and bile ducts. a. lymphadenopathy b. integument c. hemorrhagic d. hepatobiliary
19.
Causing death of cells. a. normocephalic b. necrotizing c. osseous d. necrotic
20.
The end of the small intestine. a. seminal vesicles b. vermiform appendix c. terminal ileum d. extraocular motions
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Written Quiz—Case 3 Glossary Student ________________________________ Define the medical terms listed below. 1. asystolic—
Select the best answer for each of the following statements: 11.
An anticoagulant drug. a. Coumadin b. Hemoccult c. Xylocaine d. Versed
12.
An abnormal air-filled or fluid-filled sac. a. carina b. epiglottis c. bleb d. clot
13.
Abnormally decreased motor function or activity. a. hypoxic b. hydrocephalus c. congestion d. hypokinesia
14.
Formation or presence of a blood clot. a. ventricles b. thrombosis c. bleb d. infiltrate
15.
Within or into a vein. a. intravenous b. intubation c. infiltrate d. ET tube
16.
Abnormality involving an organ or tissue due to disease process or injury. a. axial sections b. carina c. lesion d. mediastinal
2. alveolitis—
3. cortical atrophy—
4. CT—
5. dialysis catheter—
6. effusion—
7. etiology—
8. glottis—
9. myocardial infarction—
10. tachycardia—
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17.
Swelling of blood vessels due to engorgement with blood. a. congestion b. effusion c. epiglottis d. hilar
18.
The expectoration of blood or blood-stained sputum. a. hemodialysis b. hemoptysis c. brushings d. congestion
19.
An increase in the volume of cerebrospinal fluid in the ventricles of the cerebrum. a. hemoptysis b. hilar c. hydrocephalus d. hypoxic
20.
A vague feeling of bodily discomfort. a. septicemia b. rhonchi c. palpitations d. malaise
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Written Quiz—Case 4 Glossary Student ___________________________________ Match the terms in Column A with the definitions in Column B.
Column A
Column B
1. ______ erythema 2. ______ gingiva 3. ______ palate 4. ______ diffuse 5. ______ albeit 6. ______ stomatitis 7. ______ albumin 8. ______ quiescent 9. ______ kyphosis 10. ______ flare 11. ______ enteritis 12. ______ dehydration 13. ______ arthritis 14. ______ dermatology 15. ______ ecchymosis 16. ______ Arava 17. ______ dysphagia 18. ______ hyporeflexia 19. ______ nephrocalcinosis 20. ______ pitting edema
a. b. c. d. e.
inflammation of the small intestine widely distributed; not concentrated to intensify suddenly humpback indentations when a finger is pressed on the skin f. decreased reflexes g. roof of the mouth h. the pink tissues of the oral mucosa; gums i. even though j. inflammation of the oral mucosa k. difficulty swallowing l. medicine used to treat rheumatoid arthritis m. an antibacterial agent n. the study of the skin o. calcifications in the kidneys leading to renal insufficiency p. at rest; inactive q. a purplish patch on the skin caused by blood passing from a vessel into the tissues r. redness of the skin produced by abnormal accumulation of blood s. a necessary protein substance produced in the liver t. condition resulting from either excessive loss of or inadequate intake of water u. inflammation of the joints v. splitting of the skin
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Written Quiz—Case 5 Glossary Student ___________________________________ Match the terms in Column A with the definitions in Column B.
Column A
Column B
1. ______ impulsivity 2. ______ meningismus 3. ______ osteoarthritis 4. ______ drift 5. ______ carotid bruits 6. ______ sullen 7. ______ tonsillectomy 8. ______ Omnipaque 9. ______ ibuprofen 10. ______ hysterectomy 11. ______ fasciculation 12. ______ dysphoric 13. ______ TMJ 14. ______ homicidal ideations 15. ______ Romberg 16. ______ Detrol 17. ______ curt 18. ______ visual fields 19. ______ tetracycline 20. ______ dementia
a. removal of the uterus b. thoughts about killing another person c. abnormal sounds in a neck artery produced by abnormal blood flow d. rudely abrupt; blunt; brief e. condition characterized by neck stiffness and headache but without meningitis f. an emotional state characterized by anxiety, depression, or unease g. a gradual movement, as from an original position h. implies a silent ill humor and refusal to be sociable i. the progressive loss of cognitive and intellectual functions j. the joint of the jaw k. removal of the entire tonsil l. a nonsteroidal anti-inflammatory agent m. medicine used to treat symptoms of overactive bladder n. thoughts of killing oneself o. inclined to act on impulse rather than thought p. an antibiotic q. the entire scope of vision of each eye r. twitching of groups of muscle fibers s. x-ray contrast medium for use in CT t. arthritis characterized by erosion of the articular cartilage u. removal of both fallopian tubes and ovaries v. test performed for balance
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Written Quiz—Case 6 Glossary Student ___________________________________ Match the terms in Column A with the definitions in Column B.
Column A
Column B
1. ______ diskectomy 2. ______ prone 3. ______ contused 4. ______ ambulating 5. ______ L4-5 6. ______ scoliosis 7. ______ discrete 8. ______ pleura 9. ______ intermittent 10. ______ cesarean section 11. ______ intervertebral 12. ______ aggregating 13. ______ convex 14. ______ focal degeneration 15. ______ Norflex 16. ______ exacerbate 17. ______ lumbosacral 18. ______ blunted 19. ______ Kantrex 20. ______ rongeur
a. to worsen or make more severe b. a serous membrane lining the thoracic cavity c. less sharp; dull d. removal of an intervertebral disk e. delivery of a fetus by making an incision in the abdominal wall and uterus f. bruised g. denotes disk space between the 4th and 5th lumbar vertebrae h. lying face downward i. a surgical instrument used for cutting tough tissue, such as bone j. walking k. drug used to treat mild to moderate pain l. crowding or clustering together m. having a surface that is rounded and somewhat elevated n. made up of separate and distinct parts o. main area or center of deterioration p. periodically stopping and starting again at separated intervals q. located between two adjoining vertebrae r. drug used to treat muscle spasms s. antibiotic t. spoon-shaped surgical instrument for removing tissue from a cavity wall or other bodily surface u. low back and pelvis v. an S-shaped spine
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Written Quiz—Case 7 Glossary Student ________________________________ Define the medical terms listed below. 1. polyuria—
Select the best answer for each of the following statements: 11.
Degenerative joint changes. a. arthrodesis b. arthrosis c. arthritis d. acanthosis nigricans
12.
Made bloodless. a. metatarsal b. equinus c. exsanguinated d. malalignment
13.
A bony outgrowth or protuberance. a. osteophyte b. metatarsal c. equinus d. osteotome
14.
Difficulty or pain with urination. a. subtalar b. malalignment c. polyuria d. dysuria
15.
Within a nerve. a. intraneural b. subtalar c. periosteum d. arthrosis
16.
Chronic enlargement of the thyroid gland. a. polydipsia b. goiter c. equinus d. metatarsal
2. metatarsal—
3. Telfa—
4. hindfoot—
5. Webril—
6. cubonavicular—
7. arthrodesis—
8. Glucophage—
9. polydipsia—
10. Ancef—
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17.
18.
Brand name of narcotic used to treat moderate to severe pain. a. Lantus b. Humalog c. Glucophage d. Lortab Muscle of the foot that extends the 2nd through 5th toes. a. periosteum b. inferior peroneal retinaculum c. extensor digitorum brevis d. posterior tibial tendon
19.
An instrument used for cutting bone. a. Telfa b. osteotome c. osteophyte d. Webril
20.
A fracture of the bone around a plate or screws that are already in place. a. perihardware fracture b. occult fracture c. periosteum d. subtalar
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Written Quiz—Case 8 Glossary Student ___________________________________ Match the terms in Column A with the definitions in Column B.
Column A
Column B
1. ______ osteomyelitis 2. ______ hyperkalemia 3. ______ extruding 4. ______ ectatic 5. ______ organomegaly 6. ______ peripheral vascular disease 7. ______ skilled nursing facility 8. ______ radio-opaque 9. ______ metabolic acidosis 10. ______ heparin 11. ______ creatinine 12. ______ anastomosis 13. ______ Prolene 14. ______ tibioperoneal 15. ______ tortuous 16. ______ C-reactive protein 17. ______ BUN 18. ______ echogenic 19. ______ cardiomegaly 20. ______ thrombolysis
a. medication used to treat and prevent clots b. nonabsorbable suture material used for skin closure c. enlargement of the heart d. inflammation of the bone marrow and adjacent bone e. blood test that measures inflammation f. the condition of thrusting or pressing out g. sudden loss of kidney function h. pertaining to a structure or tissue that is able to be imaged i. refers to disease of blood vessels outside the brain and heart j. a blood test that measures kidney function k. dissolving of a blood clot l. related to or marked by distension, dilatation, or expansion m. having many curves; full of turns and twists n. abnormal enlargement of the abdominal organs o. distension of the kidney with urine p. an operative union of 2 structures q. elevated blood level of potassium r. not transparent to x-rays or other forms of radiation s. abbreviation for blood urea nitrogen, a blood test used to evaluate kidney function t. relating to the tibia and fibula u. pH imbalance in which the body has accumulated too much acid v. SNF
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Written Quiz—Case 9 Glossary Student ___________________________________ Match the terms in Column A with the definitions in Column B.
Column A
Column B
1. ______ flex 2. ______ Zoloft 3. ______ congenital 4. ______ ischium 5. ______ prosthesis 6. ______ adduct 7. ______ acetabulum 8. ______ cephalosporin 9. ______ dysplastic 10. ______ nulliparous 11. ______ polyethylene 12. ______ internal rotation 13. ______ arthroplasty 14. ______ autologous 15. ______ osteotomized 16. ______ abduct 17. ______ osteolysis 18. ______ greater trochanter 19. ______ external rotation 20. ______ allograft
a. softening, absorption, and destruction of bony tissue b. to move away from the middle of the body c. a cup-shaped depression at the base of the hip bone into which the ball-shaped head of the femur fits d. to move toward the middle of the body e. tissue transplant between 2 humans f. creation of an artificial joint to correct advanced degenerative arthritis g. referring to blood or blood components the donor has previously donated and receives at a later time h. an antibiotic i. acquired during development in the uterus and not through heredity j. pertaining to abnormal tissue development k. rotation away from the center of the body l. to bend m. an upper part of the femur to which the gluteus medius and minimus muscles, and others, attach n. rotation toward the center of the body o. the lower and back part of the hip bone where it joins the pelvis p. never having borne a child q. bone that has been surgically cut r. most popular plastic used in the world s. a fabricated substitute used to assist a damaged or replace a missing body part t. medication used to treat depression and anxiety u. nasal spray used to treat seasonal allergies or hay fever v. a cement used in joint replacement surgery
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Written Quiz—Case 10 Glossary Student ________________________________ Define the medical terms listed below. 1. thoracic—
Select the best answer for each of the following statements: 11.
Immediate. a. COPD b. stat c. HJR d. pH
12.
A small space or cavity. a. hemithorax b. pneumothorax c. thoracotomy d. loculus
13.
Trade name of a bronchodilator. a. Rocephin b. Benzoin c. Proventil d. Betadine
14.
Performed through the skin. a. percutaneous b. sclerotherapy c. thoracostomy d. emergent
15.
Separation, detachment, or removal of organ or tissue, especially by surgical means. a. anesthetize b. loculate c. ablation d. sclerotherapy
16.
The production of adhesions between the parietal and visceral pleura. a. pneumothorax b. Pleur-evac system c. pleurodesis d. percutaneous
2. intercostal—
3. hemostat—
4. aorta—
5. hypertension—
6. Rocephin—
7. benzoin—
8. marked—
9. cannula—
10. hemithorax—
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17.
The subsidence or disappearance of a pathologic condition. a. subtherapeutic b. resolution c. marked d. anesthetize
19.
The presence of free air or gas in the pleural cavity. a. hemithorax b. pleurodesis c. pneumothorax d. PO2
18.
Partial pressure of oxygen. a. COPD b. PCO2 c. pH d. PO2
20.
A class of medication that expands the air passages of the lungs. a. bronchodilator b. bronchopleural c. benzoin d. Rocephin
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Written Quiz—Quali-Care Glossaries 1–5 Student ________________________________ Define the medical terms listed below. 1. mitral valve—
Select the best answer for each of the following statements: 11.
Cancer that involves only the site where it began. a. Ewing sarcoma b. carcinoma in situ c. foci d. lymphadenopathy
12.
The tubes connecting the testes with the urethra; carry sperm during ejaculation. a. ureteral orifices b. seminal vesicles c. dorsal venous complex d. vasa deferentia
13.
Lying down on the left side. a. extubated b. aseptic technique c. left lateral decubitus position d. delayed primary closure
14.
The portion of the aorta that is attached to the heart. a. aortic root b. aortic valve c. mitral valve d. left atrium
15.
Condition in which the heart cannot pump enough blood to the body’s other organs. a. emphysema b. myocardial infarction c. dyspnea d. congestive heart failure
2. space of Retzius—
3. wound V.A.C.—
4. cytologic atypia—
5. Ewing sarcoma—
6. aseptic technique—
7. Broviac catheter—
8. spec board—
9. delayed primary closure—
10. 2-D echo—
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16.
A membranous partition that separates the prostate and bladder from the rectum. a. endopelvic fascia b. Denonvilliers fascia c. peritoneum d. urethra
19.
Medication given to prevent nausea and vomiting caused by surgery or cancer medicines. a. Lasix b. Atrovent c. Coumadin d. Zofran
17.
Denoting fat. a. adipose b. mucinous c. thrombi d. sarcoma
20.
18.
Localized areas of disease. a. lymphadenopathy b. carcinoma in situ c. foci d. neutropenia
Heart valve between the right atrium and right ventricle. a. tricuspid valve b. aortic valve c. mitral valve d. aortic root
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Written Quiz—QC Glossaries 6–10 Student ___________________________________ Match the terms in Column A with the definitions in Column B.
Column A
Column B
1. ______ suicidal ideation 2. ______ lateral epicondyle 3. ______ carotid upstrokes 4. ______ straight-leg raise 5. ______ peroneal artery 6. ______ vertebral body 7. ______ Bovie cautery 8. ______ general anesthesia 9. ______ external fixator 10. ______ L2-3 11. ______ cauda equina syndrome 12. ______ gastrocsoleus complex 13. ______ gadolinium 14. ______ proprioception 15. ______ palpitations 16. ______ Kocher approach 17. ______ FPL 18. ______ degenerative disk disease 19. ______ anterior tibial artery 20. ______ waist
a. artery that runs from the knee to the ankle on the front of the leg b. material used as contrast media for magnetic resonance imaging c. artery that runs deeply on the back outside of the leg d. the narrowed portion of a vessel during inflation of a balloon to try to expand the vessel e. the awareness of the position of one’s body f. test performed by having the patient lie flat on a bed and, with the leg straight, raise the foot off the bed and hold it in the air g. compression of L2-S3 nerve roots with symptoms of numbness in groin or bowel/bladder disturbance h. the muscles of the calf i. refers to wear changes in individual disks of the spine j. denotes disk space between the 2nd and 3rd lumbar vertebrae k. a curve in the spine that points to the left l. main portion of each of the bones of the spine; bears about 80% of the load while standing m. limping n. the pulse that can be felt in the neck arteries when the heart is contracting o. rapid or irregular heartbeats p. name of a machine used to close small blood vessels with heat (Continued)
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q. device with screws that are inserted into a broken bone and come through the skin r. muscle of the forearm that flexes the thumb s. loss of ability to perceive pain with loss of consciousness produced by intravenous or inhalation agents t. approach to the humerus for open reduction, internal fixation u. outside elbow bone v. thoughts of killing oneself
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Written Quiz—QC Glossaries 11–15 Student ________________________________ Define the medical terms listed below. 1. inframammary fold—
Select the best answer for each of the following statements: 11.
Canal leading from the bladder, discharging urine externally. a. ureter b. urethra c. ureteroscopy d. pyeloscopy
12.
Examination of the colon by means of a flexible, elongated scope. a. cystoscopy b. pyeloscopy c. ureteroscopy d. colonoscopy
13.
Presence of renal stones. a. subluxation b. diverticula c. nephrolithiasis d. calyces
14.
One of 2 vessels that collects blood from the brain, superficial parts of the face and neck, and carries it to the heart. a. internal jugular vein b. internal carotid artery c. prevertebral fascia d. mons pubis
15.
One of the muscles on the chest wall. a. umbilicus b. platysma c. pectoralis d. prevertebral fascia
2. appendiceal orifice—
3. internal carotid artery—
4. retrograde pyelogram—
5. differential diagnosis—
6. globus sensation—
7. Aspen cervical collar—
8. bilateral mastectomies—
9. prokinetic agent—
10. total abdominal hysterectomy—
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16.
The crushing of a stone in the kidney, ureter, or bladder by mechanical force, laser, or sound energy. a. nephrolithiasis b. retrograde pyelogram c. pyeloscopy d. lithotripsy
17.
Removal of an intervertebral disk in the neck through an incision in the front of the neck, then placement of bone graft after the disk has been removed. a. posterior longitudinal ligament b. retrograde pyelogram c. EGD d. anterior cervical diskectomy and fusion
18.
Feeling full after eating less than normal or feeling full sooner than normal. a. early satiety b. globus sensation c. regurgitation d. flatus
19.
Inflammation of the colon. a. polyps b. diverticula c. colitis d. internal hemorrhoids
20.
Treatment based on experience, usually without adequate data to support its use. a. differential diagnosis b. empiric c. subluxation d. prokinetic agent
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Written Quiz—QC Glossaries 16–20 Student ___________________________________ Match the terms in Column A with the definitions in Column B.
Column A
Column B
1. ______ bipolar disorder 2. ______ fem-fem bypass 3. ______ hyperopia 4. ______ L1-2 5. ______ ABIs 6. ______ pronation 7. ______ bradycardia 8. ______ supine position 9. ______ senescent 10. ______ lumbar lordosis 11. ______ preeclampsia 12. ______ Hunter canal 13. ______ FluoroScan 14. ______ aortobifemoral bypass 15. ______ interdigitation 16. ______ radial artery 17. ______ supination 18. ______ MR spectroscopy 19. ______ articulation 20. ______ placenta
a. slow heartbeat b. in pregnancy, development of hypertension with protein in the urine or edema, or both c. the mutual interlocking of toothed or tonguelike processes d. brain condition that causes unusual mood swings from overly “high” and irritable to sad and hopeless e. the space in the thigh through which the femoral vessels pass f. the organ of metabolic interchange between the fetus and the mother g. farsightedness h. growing old i. rotation of the forearm such that the palm is upward j. the normal curved segment of the lower back k. a broad, flat rubber bandage used as a tourniquet during surgery l. a procedure in which blood flow is diverted around a blocked portion of the femoral artery m. vessel that passes along the radial side of the forearm n. denotes disk space between the 1st and 2nd lumbar vertebrae o. bypass of clogged arteries in the lower abdomen and upper legs using a graft p. any of various diseases of the brain q. lying face upward r. in speech, the act or manner of producing a sound (Continued)
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s. measurement of blood pressure in the ankle and in the arm t. allows noninvasive exploration of the molecular composition of tissue u. x-ray device v. rotation of the forearm such that the palm is downward
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Written Quiz—QC Glossaries 21–25 Student ___________________________________ Match the terms in Column A with the definitions in Column B.
Column A
Column B
1. ______ ActCel gauze 2. ______ P-R interval 3. ______ Achenbach Youth Self Report 4. ______ interscalene block 5. ______ dental rehabilitation 6. ______ glenohumeral joint 7. ______ animated 8. ______ purulence 9. ______ paronychia 10. ______ orthopnea 11. ______ presyncope 12. ______ SLAP lesion 13. ______ passive 14. ______ clavicle 15. ______ caries 16. ______ EBIce 17. ______ syncope 18. ______ phalanx 19. ______ acromion 20. ______ amalgam restoration
a. the formation of cavities in the teeth by the action of bacteria b. discomfort in breathing that is brought on by lying flat c. a sensation of shortness of breath that awakens the patient from sleep d. when placed in wound, it facilitates the clotting process and converts to a gel that dissolves into glucose and saline e. tending not to take an active or dominant part f. full of vigor and spirit; lively g. an assessment test for violent behavior h. the ball-and-socket joint between the head of the humerus and the glenoid cavity of the scapula i. a type of labral tear seen in overhead-throwing athletes j. one of the parts of an electrocardiogram tracing that shows electrical heart activity k. infection of the nail fold surrounding the nail plate l. lightheadedness m. regional anesthetic used for shoulder, arm, and elbow surgery n. the condition of containing or forming pus o. bony prominence at the top of the shoulder blade that forms the point of the shoulder p. cold therapy system with adjustable settings
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q. a tooth cement composed of an alloy of mercury with another metal r. one of the long bones of the digits s. restoration involving the rebuilding of natural teeth and filling in spaces where teeth are missing t. the part of the nail under the nail plate u. collar bone v. loss of consciousness; fainting
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Grammar/Punctuation/Style Rules Review Section I: Correct grammar, punctuation, style in each of the following sentences. Neither rewrite nor rephrase these sentences. 1. Lucy Owens chief complaint I am feeling dizzy was the reason we called Neurology in consult however we called OB/GYN when her beta-hCG came back positive (8 errors) 2. Keep patient npo after midnight (before his blood drawn for a cbc with differential and a lipid panel (8 errors) 3. The official hillcrest policies & procedures manual and confidentiality policy is to be completed and documented by each new employee within four weeks of being hired (8 errors) 4. To few qualified patient’s are being admitted to the Metformin study so we need to make alot more calls in order to expand it 10 folds (8 errors) 5. The emergency room doc called with a consult on a 15 year old asian guy with 2nd degree burns over his trunk from a charmglow gas grill accident (8 errors)
Section II: Mark each of the following as either C (correct) or I (incorrect). If incorrect, write in the correction to the right. 1. ___
nsaid
2. ___
mm of Hg
3. ___
7-0 Silk
4. ___
Jerome Hall III
5. ___
dl
6. ___
SpO2
7. ___ 3/6 murmur 8. ___
7 ⫻ .5 ⫻ 3
9. ___
RH-negative
10. ___
15 years old
11. ___
see section
12. ___
PH
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13. ___
naris are
14. ___
a.s.
15. ___
digit IV = little finger
Section III: Read each of the following statements, then write in your answers below. All answers can be found in the text-workbook. 1. List 5 key decisions made by the medical transcriptionist on the job.
2. Explain what is meant by the phrase “the basic 4.”
3. List 10 of the 11 possible contents of a discharge summary.
4. Explain what is meant by a “pack-year.”
5. Explain when a dictated age is hyphenated and when it is not hyphenated.
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