NUR 515 - Terms

Jaundice

(also called icterus) yellowing of the skin and sclera caused by an accumulation of bile pigment (bilirubin) in the blood - often a sign of a high amount of RBC breakdown but can also occur in liver disorders

Poliomyelitis

(polio) is a highly infectious viral disease that largely affects children under 5 years of age - enters the body through the fecal-oral route - causes damage to the motor neurons of the CNS - post-polio syndrome (PPS) can occur in older adults who are polio survivors - preventable through routine immunization

Coagulopathy

A condition in which the blood's ability to clot is impaired - patient can exhibit spontaneous bruising, nosebleeds, and hematemesis

Variant Creutzfeldt-Jakob Disease

A form of Creutzfeldt-Jakob Disease that may be caused by consumption of BSE-contaminated foods - affects younger people (average age of onset at 33 years) - symptoms begin with psychiatric problems or problems with hearing, seeing, or smelling then progress to poor muscle coordination, muscle spasms, and mental confusion - death occurs an average of 13 months after the first symptoms are noted

Granulocyte

A group of leukocytes (WBCs) containing granules in their cytoplasm; neutrophils, eosinophils, basophils.

Candidiasis

A yeast (fungal) infection typically on the skin or mucous membranes caused by candida

Anthracosis

AKA coal miner's lung disease or black lung characterized by coal particles of 1 to 2 mm in diameter and larger coal nodules in the lungs; patient exhibits cough with gray sputum, wheezes, and dyspnea on exertion

Leukopenia

Abnormally low white blood cell count - increases risk of infection, decreases signs of infection, and diminishes healing ability

Chemical burns

Account for less than 10% of all burn injuries and generally occur after an industrial accident or ingestion of harsh household chemicals, including strong acids, alkalis, and corrosive materials. Produces a characteristic gray coloring of the skin.

Monocytes

An agranular leukocyte (WBC) that is able to migrate into tissues and transform into a macrophage - macrophage engulfs, ingests, and enzymatically destroys antigenic substances and cellular debris (phagocytosis) - can also become dendritic cells, which are specialized cells that present antigens to T cells

Hay Fever

An allergic response usually to outdoor airborne allergens such as pollen or sometimes indoor allergens such as dust mites or pet dander; also called allergic rhinitis.

Celiac disease

Autoimmune disorder triggered by gluten, which causes malabsorption Individuals with celiac disease show a positive antibody titer of IgA TTG

Chronic Lymphocytic Leukemia (CLL)

B-cell lymphocyte malignancy found in elderly individuals (median age 70 years) symptoms: Pallor, Bruises, Nosebleeds, Lymphadenopathy, splenomegaly, and hepatomegaly.

Malar rash

Butterfly-shaped rash over the cheeks - Systemic Lupus Erythematosus (SLE)

Colon cancer

Cancer of the large intestine usually starts as a polyp, a tumorous mass that projects into the intestinal lumen

Aplastic Anemia

Complete disruption of bone marrow function inhibits manufacture of all blood cells; life-threatening disorder that can be caused by cancer, sepsis, or radiation exposure

Cobblestone appearance

Crohn's disease bowel mucosa develops granulomas (masses of immune cells that develop due to inflammation)

Calcium

Daily Recommended Allowance = 1,000 mg is an important element in the body because of its role in the formation and function of bones and teeth, normal clotting, and regulation of neuromuscular irritability

Chronic renal insufficiency

Decline in renal (kidney) function; mildly elevated BUN/CRT - develops slowly, progressive loss of kidney function leads to fluid retention in the body, anaemia and a myriad of symptoms as a result of the increase in urea in the blood (uraemia) - most common causes of chronic renal insufficiency are chronic diseases such as glomerulonephritis, high blood pressure or diabetes mellitus

Hepatitis D

Delta Hepatitis; inflammation of the liver caused by the hepatitis D virus (HDV) - Only develops in patients with Hepatitis B - Similar to HBV, it's spread by blood products, body fluids, or sexual contact

Small intestine

Digestive organ where most chemical digestion and absorption of nutrients takes place - duodenum, jejunum, ileum, and ileocecal valve

Tdap vaccine

Diphtheria-tetanus-pertussis - administered in five doses to infants at 2 months, 4 months, 6 months, and 15 to 18 months and then children at age 4 to 6 years - booster vaccine should be administered to children at age 10 to 12 years and every 10 years thereafter

Steatorrhea

Fat in the stools; may be associated with pancreatic disease.

Irritable bowel syndrome (IBS)

GI disorder characterized by abdominal pain and altered bowel activity in the absence of specific pathology - i.e. colitis, irritable colon, or spastic colon

Hemophilia B

Genetic disorder; lack of factor IX causes decreased clotting ability

Hemophilia A

Genetic disorder; lack of factor VIII causes decreased clotting ability

Factor VIII

Hemophilia A is caused by a deficiency of __________.

Factor IX

Hemophilia B is a deficiency of ___________.

Chronic hepatitis

Hepatitis is considered chronic when inflammation and necrosis of hepatic tissue continue for 6 months or longer. - predisposes a patient to cirrhosis or carcinoma of the liver

H. pylori esophagus

In GERD, acid and H. pylori constantly reflux upward into the esophagus. The esophageal epithelial mucosa becomes severely irritated by acid, and H. pylori can cause ulceration in the lower esophageal cells.

Plasma cell proliferation

In plasma cell neoplasms, a clonal population of plasma cells proliferates, forming a tumor either in bone or soft tissue

Gastroesophageal reflux disease (GERD)

Inability of the lower esophageal sphincter (LES) to completely close; the opening permits the reflux (backflow) of acid contents from the stomach up into the esophagus. The epithelium of the esophagus can become metaplastic; this condition is called Barrett's esophagus - Symptoms: dysphagia, heartburn, epigastric pain, and regurgitation

Crohn's disease

Inflammation of any part of the GI tract from the mouth to anus; involves the whole thickness of the intestine's wall, characteristic skip lesions, cobblestone mucosa, and anal fistulas. This may be an autoimmune disorder.

Gastroenteritis

Inflammation of the GI lining ( stomach, small intestine, or large intestine) caused by a pathogen (virus, bacteria, parasite, or chemical toxin) - transmitted from person to person or can be a waterborne or foodborne illness - Symptoms: nausea, vomiting, colicky abdominal cramping, and watery diarrhea

Ulcerative colitis

Inflammation of the large bowel (involves the mucosal layer of intestine) - Ulcerated areas become covered by granulation tissue, leading to formation of inflammatory areas of protruding growths termed pseudopolyps - predisposes individuals to colon cancer

Dysuria

Pain and burning on urination - Common Cause = UTI

Murphy's sign

Pain with palpation of gallbladder (seen with cholecystitis)

Helminth infection

Parasitic helminths, commonly known as worms, cause infectious disease in animals and humans - Ex: enterobiasis (pinworms), trichuriasis, ascariasis (roundworm), hookworm, strongyloides, trichinosis, filariasis, schistosomiasis, and tapeworm infection

Urea breath test

Patients swallow urea with radiolabeled carbon 14. After 10 to 30 minutes, the detection of radioactive carbon dioxide in the patient's exhaled breath indicates that the urea was split, indicating the presence of H. pylori bacteria.

Small Bowel Obstruction (SBO)

Physical blockage of the small intestine - tumor, adhesions, hernia, or inflammation can cause obstruction - partial obstruction = decreases the flow of intestinal contents through the bowel - complete obstruction = prevents passage of all contents and fluid through the bowel (surgical emergency)

Electrical Burns

Produces intense tissue damage and cellular death, which can lead to metabolic acidosis. Analysis of arterial blood gases to assess acid-base balance is necessary. - commonly causes internal organ injury - degree of injury depends on the amount of voltage, length of contact, and pathway of current

Acute Myelocytic Leukemia (AML)

Proliferation of myeloid blast cells in bone marrow. Overproliferation of myeloblasts in organs such as lymph nodes, spleen, and liver.

McBurney's point

RLQ point tenderness indicative of appendicitis

Dumping syndrome

Rapid gastric emptying because of removal of part of the stomach - causes malabsorption of important nutrients, vitamins, and minerals - Phase 1: abdominal pain, diarrhea, diaphoresis - Phase 2: gastric fullness, symptoms of hypoglycemia

Hemorrhagic pancreatitis

Rapid progression of acute pancreatitis with the rupture of pancreatic vessels and subsequent hemorrhage bleeding into the flanks = Grey Turner's sign bleeding in umbilical area = Cullen sign

Zollinger-Ellison Syndrome (ZES)

Rare disorder most commonly caused by a gastrin-secreting tumor (gastrinoma) of the pancreas - Gastrinoma stimulates excessive acid in the stomach

Acute Kidney Injury (AKI)

Reversible failure of the kidneys caused by prerenal, intrinsic, or postrenal disorders - causes a rapid decrease in renal filtration function

Bariatric surgery

Surgical therapy to decrease obesity for persons with a BMI of 40 or greater and individuals with a BMI of between 35 and 40 who have medical problems related to their obesity. two categories: gastric bypass and gastric restrictive procedures

Peripheral edema

Swelling in the limbs, particularly the feet and ankles, due to an accumulation of interstitial fluid.

Autoimmune Disease

The body's own immune system becomes intolerant to its own cells, attacks its own tissues, and renders organs dysfunctional

Humoral immune response

The branch of adaptive immunity that involves the activation of B cells and that leads to the production of antibodies, which defend against bacteria and viruses in body fluids. - "antibody-mediated immunity"

Epigastric area

The upper part of your abdomen just below your rib cage

Eosinophils

WBCs that are generated by the bone marrow and released mainly during allergic reactions and parasitic infection - 1% to 7% of all WBCs

Chemotaxis

White blood cells migrate to the site of tissue damage.

Helicobacter pylori (H. pylori)

a bacterial organism that erodes the gastric mucosa to cause peptic ulcer disease - is thought to be a cause of stomach cancer

Erythema Infectiosum (Fifth Disease)

a common childhood viral exanthem caused by human parvovirus B19 - characterized by a face that appears as "slapped cheeks," a fiery red rash on the cheeks.

Cullen's sign

a dark-blue discoloration around the umbilicus that resembles a bruise resulting from blood in the peritoneal cavity because of hemorrhagic pancreatitis

Anemia

a deficiency of red blood cells

Bile

a digestive juice secreted by the liver and stored in the gallbladder

Active Acquired Immunity

a form of long-term, acquired immunity that protects the body against a new infection as the result of antibodies that develop naturally after an initial infection or artificially after a vaccination

Sickle cell anemia

a genetic disorder in which erythrocytes (RBCs) take on an abnormal curved or "sickle" shape - caused by an abnormal kind of Hgb called Hgb S that distorts the RBC's shape upon exposure to hypoxia or severe stress

Hyperbilirubinemia

a high amount of bilirubin in the bloodstream - causes jaundice (icterus) - occurs because of one of three specific etiologies: • Excessive RBC hemolysis • Hepatocellular injury • Bile duct obstruction - can also cause kernicterus (bilirubin encephalopathy) which can cause confusion, lethargy, and stupor to coma

Gluten intolerance

a response to gluten involving digestive distress but not causing the intestinal tissue damage of celiac disease - gluten is a byproduct of wheat, barley, and rye

Angioedema

a swelling of the facial regions — particularly the lips, mouth, and periorbital regions

Biliary colic

a syndrome of spasmodic pain associated with irritation of the gallbladder, commonly secondary to gallstones typical pain experienced by individuals with gallbladder or pancreatic disease

Type 2 hypersensitivity response

a transfusion reaction in which cells from an incompatible donor react with host Igs Ex: if type A blood from a donor is administered to a type B recipient, the anti-A Igs of the recipient will attack and destroy the type A red blood cells, causing a massive hemolytic reaction

PICA

a unique sign of iron deficiency - a craving for nonfood substances such as ice, clay, starch, chalk, dirt, or other material

Adhesions

abnormal bands of internal scar tissue between tissues or organs

Adhesions from surgery

abnormal bands of internal scar tissue that can form after invasive surgical procedures; most common cause of bowel obstruction

Achalasia

absence of peristalsis of the lower esophagus resulting in difficulty swallowing, regurgitation, and sometimes pain

Large intestine

absorbs water/salt and stores feces until defecation - made up of the cecum; ascending, transverse, descending, and sigmoid colon; rectum; and anal canal

Rubella

aka German measles - RNA virus classified as a Rubivirus - spread by droplet infection from cough or sneeze and infects the respiratory epithelium - rash (discrete, red macules on the face that spread to the neck, trunk, and extremities) may be the first manifestation, followed by fever, sore throat, and rhinitis - generalized, tender lymphadenopathy that involves all node - common childhood illness less than 50 years ago, but now less common because of widespread vaccination

Group A beta hemolytic streptococcus (GABHS)

aka Streptococcus pyogenes - a bacterium that causes many different infections - Ex: Pharyngitis, impetigo, upper respiratory tract infection, rheumatic fever, scarlet fever, glomerulonephritis

T lymphocytes

aka T cells - cell-mediated immunity - attack antigens themselves - mature within the thymus gland

Immunoglobulin (Ig)

aka antibody a large, Y-shaped protein used by the immune system to identify and neutralize foreign objects such as pathogenic bacteria and viruses

Lower esophageal sphincter (LES)

aka cardiac sphincter - ring of muscles between the esophagus and stomach - contracted in resting state and opens in response to nerve stimulation

Vitamin B-12

aka cyanocobalamin or cobalamin - a cofactor for two important processes: synthesis of DNA in RBCs and normal synthesis of the myelin cells that surround neurons - deficiency can have widespread neurologic effects; sensory, motor, and cognitive problems

Streptococcus pyogenes

aka group A beta-hemolytic streptococcus (GABHS) - a bacterium that causes many different infections - Ex: Pharyngitis, impetigo, upper respiratory tract infection, rheumatic fever, scarlet fever, glomerulonephritis

Chronic Gastritis

aka nonerosive gastritis Atrophy of the gastric mucosa and achlorhydria, most commonly caused by H. pylori infection that attacks the mucosal layer of the stomach wall. Lack of HCl decreases absorption of iron and vitamin B12. Achlorhydria increases risk of stomach cancer.

Polycythemia vera

aka primary polycythemia - occurs when there is an excess of all blood cell types—RBCs, WBCs, and platelets—in the bone marrow - excess RBCs make the blood viscous and it flows slowly, especially through small vessels

Rh antigen

also called D antigen - antigen on the surface of RBCs - RBC surface has the Rh factor = Rh+ - RBC does not have the Rh factor = Rh-

C-reactive protein (CRP)

an acute-phase protein produced by the liver in response to inflammation in the body - produced in response to atherosclerosis, which is basically an inflammatory process

Hepatic encephalopathy

an alteration of mental status and cognitive function in the presence of liver failure - symptoms from confusion and disorientation to stupor and coma - asterixis ("liver flap") may be present

Granuloma

an area where macrophages (WBCs) have aggregated and are transformed into epithelial-like or epithelioid cells - form as a reaction to infections, inflammation, irritants or foreign objects - a chronic inflammatory granuloma = tubercle

Opportunistic infection

an illness caused by a pathogen that takes advantage of the lack of immune defenses within the host

Bordetella pertussis (whooping cough)

an infection of the respiratory tract infected individual has episodes of spasmodic, forceful coughing with an audible whoop

Peptic Ulcer Disease (PUD)

an inflammatory erosion in the stomach (gastric ulcer) or duodenal lining (duodenal ulcer) - most frequent causes are the bacterium H. pylori and the use of NSAIDs or aspirin

Candida albicans

an opportunistic pathogenic yeast (fungi) that is a common member of the human gut flora

Pernicious anemia (PA)

anemia resulting when digestive system absorbs insufficient amount of vitamin B12, which is necessary for erythrocyte (RBC) production - occurs as a result of a lack of intrinsic factor (IF) - most commonly seen in older adults

End-stage renal disease (ESRD)

any type of kidney disease in which there is little or no remaining kidney function, requiring the patient to undergo dialysis or kidney transplant for survival

Campylobacter jejuni

bacteria found in animal feces, particularly those of birds; most common causes of gastroenteritis in the world; improper meat or poultry preparation is the usual cause of infection; causes abdominal pain, fever, and diarrhea, often containing blood

Clostridium difficile (C. diff)

bacteria which causes severe watery diarrhea and other intestinal disease when competing bacteria have been wiped out by antibiotics; It is spread by spores that are difficult to kill and can be carried on the hands of caregivers who have direct contact with residents or an environmental surface (i.e., floors, toilets, bedpans).

Lactobacillus

bacterium which produces lactic acid from the fermentation of carbohydrates - normal part of vaginal and gut microbiota - changes in the vaginal bacterial flora from Lactobacillus to a mixture of gram-negative and anaerobic bacterial organisms causes Bacterial vaginosis (BV)

Retroperitoneal

behind the peritoneum (kidneys)

Jugular vein distention (JVD)

bilateral bulging blue neck veins - clinical sign of backward pressure within the superior vena cava (SVC) - sign of right ventricular failure (RVF)

Platelets (thrombocytes)

blood cells that cause clotting of the blood - too low (thrombocytopenia) = bleeding or bruising can occur - too high (thrombocytosis) = clotting can occur

Hematuria

blood in the urine

Hematemesis

blood in vomit - bright-red, bloody streaks (bleeding is currently occurring from a blood vessel) - dark coffee-ground appearance (blood has mixed with the stomach's acid)

Cyanosis

bluish discoloration of the skin and mucous membranes, occurs with hypoxia

Ecchymosis

bruising - exhibit various colors from reddish to brown to yellow-green

Fecalith

calcified feces - hypothesized to cause appendicitis

Clubbing of fingers

can be a sign of chronic oxygen deprivation (hypoxia)

Leukemia

cancer of developing WBCs within the bone marrow - Myelocytic leukemias are also called myelogenous, myeloblastic, or nonlymphocytic leukemias - Lymphocytic leukemias are also called lymphoblastic or lymphogenous leukemias.

Amebiasis

caused by the protozoan parasite Entamoeba histolytica; contracted by consuming contaminated food or water containing the cyst stage of the parasite

Gallstones

causes severe epigastric pain; associated with prolonged storage of bile in the gallbladder

Plasma cells

cells that develop from B cells and produce antibodies

Zone of coagulation

central part of a burn, worst-affected region - core of the wound with the greatest degree of irreversible tissue necrosis that occurs from protein coagulation and cellular death

"Dewdrop on a rose petal."

characteristic chickenpox vesicle, surrounded by an erythematous halo

Staphylococcus aureus

colonizes the skin, vagina, nares, and oropharynx as normal flora - can change from normal flora to an infectious agent - Common Disease Presentations: skin and wound infections, impetigo, pneumonia, septicemia - leading cause of health-care-associated infection and surgical wound infection - has developed resistance to many antibiotics, and strains such as MRSA and VRSA are commonly encountered in clinical settings

Slapped cheek appearance

common with Erythema infectiosum (fifth disease)

systemic lupus erythematosus (SLE)

commonly called lupus, is a multisystem autoimmune disease characterized by autoantibodies, particularly antinuclear antibodies (ANAs) - characterized by remissions and exacerbations with fever; skin rash (malar); joint inflammation; and damage to the kidney, lungs, and serosal membranes

Portal hypertension

congestion and high pressure within the portal vein - occurs in liver disease - cause for the development of esophageal varices - alcoholic and viral cirrhosis of the liver are the major diseases associated with esophageal varices - ultrasound can be used to diagnose - Signs of portal vein hypertension include ascites, splenomegaly, esophageal varices, caput medusa, and hemorrhoids

Hemoptysis

coughing up blood or blood-stained sputum - usually associated with serious illness such as infection, tumor, or TB

Rheumatic heart disease

damage to the heart muscle or heart valves caused by one or more episodes of rheumatic fever - antibodies developed against GABHS mistakenly attack heart valve tissue and cause valvular deformities

Paralytic ileus

decrease or absence of intestinal motility that occurs during peritonitis - bowel sounds are absent - can occur post anestesia

Neutropenia

deficiency of neutrophils - most frequent kind of leukopenia

Gastroparesis

delayed emptying of gastric contents into the duodenum - Symptoms: anorexia, nausea, vomiting, early satiety, and abdominal bloating (distention) - can be caused by pyloric stenosis

Dysphagia

difficulty swallowing

Toxoplasmosis

disease caused by the parasite protozoan Toxoplasma gondii - Cysts present in cat feces - Very dangerous to pregnant women (Important to educate to stay away from cat litter boxes)

Human immunodeficiency virus (HIV)

disease that has three stages: acute HIV infection, chronic HIV infection, and a third stage termed AIDS - transmitted via semen, vaginal secretions, breast milk, blood, and transplanted tissues - As virus increases in the blood, CD4 cell count decreases, which diminishes both humoral and cell-mediated immunity, leaving the patient susceptible to opportunistic infections - HIV RNA assay is the earliest and most sensitive test

Parasitic infection

diseases caused by organisms that live off of another living thing - Ex: malaria, giardiasis, helminth infections, and prion infections

Diabetes mellitus

disorder of carbohydrate metabolism characterized by high levels of blood glucose resulting from the body's inability to produce or utilize insulin

Hemolytic Uremic Syndrome (HUS)

disorder that causes progressive renal failure, hemolytic anemia, thrombocytopenia commonly preceded by E. coli

Thyroid disease

disorders resulting from defects of the thyroid gland, can be genetic or acquired, results in either an increase or decrease in metabolism, controlled by drugs or surgery

Hodgkin's lymphoma (HL)

distinguished from other lymphomas by the presence of large, cancerous lymphocytes known as Reed-Sternberg cells - possible connection to Epstein-Barr virus (EBV)

Grey Turner's sign

ecchymosis (bruising) in the flank region - due to release of pancreatic enzymes that cause inflammation and bleeding within the retroperitoneal region in severe pancreatitis

Ascites

edema within the peritoneal cavity; patient develops a fluid-filled, distended abdomen

Bacterial Infections

elevated neutrophils treatment: antibiotics Ex: Clostridium difficile, Salmonella, MRSA, E. coli, Lyme disease, Diphtheria, Pertussis, and Tetanus

Asterixis

elicited by having the patients extend their arms and bend the wrists backward - patients with hepatic encephalopathy have a sudden forward movement of the wrist, known as a "liver flap"

Esophageal varices

engorged varicose veins that develop in the lower third of the esophagus because of portal vein hypertension in the liver - cirrhosis of the liver is the major cause - have fragile membranes, so rupture with hemorrhage is common

Hepatomegaly

enlargement of the liver - can cause elevated liver enzymes and jaundice

Splenomegaly

enlargement of the spleen

Amylase

enzyme that breaks down starch; Serum amylase levels are elevated with perforation of the bowel or an organ

Allergic reaction

eosinophils are the dominant type of WBC in the infiltrate; Common localized reactions include hives (urticaria); nasal and conjunctival discharge; bronchial asthma; and allergic gastroenteritis. Common allergens include pollen, animal dander, dust, shellfish, peanuts, chocolate, and medications such as penicillin.

Intrinsic Factor (IF)

essential carrier protein of vitamin B12 in the stomach - without IF, vitamin B12 is not absorbed into the bloodstream - pernicious anemia occurs as a result of a lack of intrinsic factor

Keloid formation

excessive accumulation of epithelium and collagen can form a hypertrophic (thick, raised) scar - complication of wound healing

Thrombocytosis

excessive number of platelets - essential = high platelet number because of an unknown cause - secondary = almost always caused by iron deficiency; inflammation, cancer, or infection; or underlying myelodysplastic disorder

Anaphylaxis

extreme manifestation of an allergic reaction: Common causes include penicillin and other medications, food allergies (shellfish and peanuts are common), iodinated radiological contrast media, Hymenoptera (wasp and red ant) bites, and bee stings.

Pallor

extreme paleness of the skin

Vitamin D

facilitates the absorption of calcium from the gastrointestinal tract into the bloodstream - activation is dependent on kidney and parathyroid gland function and adequate sunlight - key in the maintenance of bone health

Macules

flat, distinct, discolored area of skin less than 1 centimeter (cm) - Ex: freckle, petechiae, birthmark, mongolian spot

Influenza

flu virus - three major types of influenza virus, A, B, and C, are among the most common causes of upper and lower respiratory tract infection affecting all age groups - transmission occurs through droplet infection and aerosols generated by coughs and sneezes of individuals - usually presents as abrupt onset of fever, chills, headache, myalgias (muscle aches/pain), arthralgias (joint pain), cough, and sore throat

Mast cells

found in the connective tissue of the dermis; respond to injury, infection, or allergy by producing and releasing substances, including heparin and histamine

Constipation

frequency of fewer than three stools per week - most common GI complaint of the adult population

Diarrhea

frequent passage of loose, watery stools

Pneumocystis jiroveci

fungus responsible for Pneumocystis pneumonia (PCP) - most common opportunistic infection in patients with HIV

Curling's ulcer

gastric ulcer that develops in individuals who are severely burned due to the extensive stress response - proton pump inhibitors (PPIs) are commonly administered early in treatment to prevent this disorder

Gastrinoma

gastrin-secreting tumor that causes continuous high levels of acid secretion and ulcers - Zollinger-Ellison Syndrome (ZES)

Malaise

general sense of being unwell, often accompanied by fatigue, diffuse pain, or lack of interest in activities

Oncogenes

genes that cause cancer

Tumor suppressor genes

genes that inhibit uncontrolled cellular mitosis and persistent proliferation

Thalassemia

genetic disorder that causes defects in Hgb synthesis - hemolysis of abnormal RBCs occurs and large amounts of erythropoiesis in the bone marrow leads to deformities and weakening of bones (chipmunk cheeks and hair on end skull) - enlarged spleen and liver - jaundice

Von Willebrand Disease

genetic disorder transmitted as an autosomal trait that causes a deficiency or defect of vWF - causes decreased platelet adhesion and reduced levels of active factor VIII, which result in defective clot formation

Thymus

gland in the thoracic cavity above the heart where T lymphocytes mature - degenerates with age, contributing to decreased immunocompetence in old age

Escherichia coli (E. coli)

gram-negative, rod-shaped bacteria that inhabit the human intestine - although most strains are harmless, the organisms can cause cholecystitis, bacteremia, cholangitis, UTI, traveler's diarrhea, neonatal meningitis, and pneumonia

Barrett's Esophagus

healthy esophageal epithelium is replaced with metaplastic columnar cells; usually the result of repeated exposure to stomach acid (commonly seen in people with GERD)

Multiple Myeloma (MM)

hematologic neoplasm that arises in B lymphocytes - B lymphocytes that become plasma cells proliferate uncontrollably within the bone marrow - excessive number of Igs are secreted by the plethora of plasma cells - abnormally large numbers of abnormal Igs and Ig fragments

Perforation

hole that completely penetrates a structure

Erythropoietin (EPO)

hormone secreted by the kidney to stimulate the production of red blood cells by bone marrow

Nosocomial infection

hospital-acquired or health-care-acquired infection - difficult to treat because they are often caused by antibiotic-resistant bacteria

Borborygmi

hyperactive bowel sounds that are loud and growling

Band Neutrophils

immature neutrophils When a high number are present, clinicians often use the phrase "shift to the left" which indicates that an acute inflammatory process is occurring

Blast cells

immature precursor cells for each WBC cell line

Rheumatoid arthritis

immune system cells, such as T cells and B cells, are triggered by an unknown antigen to attack the body's own joints - symmetrical, tender, swollen joints, most commonly of the fingers, wrists, knees, hips, and feet - movement of joint decreases pain

IgA

immunoglobulin A - Location: sweat, saliva, tears, breast milk, nasal, bronchial, and digestive tract secretions - Function: Protect mucous membranes of genitourinary, gastrointestinal, and pulmonary systems - Activity not related to infection; has a protective and preventive role

IgD

immunoglobulin D - Location: Attached to surface of B cells - Function: Binds antigens to B cells - Most active in early stages of infection, when antigen has first entered the body

IgE

immunoglobulin E - Location: Found on mast cells in pulmonary and gastrointestinal tracts - Function: Active in allergic reactions; binds to mast cells and basophils to release histamine and leukotrienes - Not related to infection, found in persons with allergies

IgM

immunoglobulin M - Location: Throughout bloodstream - Function: Initiates complement activity and further immune responses and controls ABO blood reactions - Earliest immunoglobulin to respond to infection

Immunosuppression

impaired ability to provide an immune response - predisposes the individual to infection and other diseases

Cholesterol

important component in the body's hormonal systems for the manufacture of bile acids, steroid hormones, and vitamin D

Large bowel obstruction (LBO)

inability of intestinal contents to move through the large intestine - can be complete or partial - causes include diverticular disease, volvulus, hernia, and neoplasm

Shock

inability of the heart and lungs to satisfy the metabolic and oxygen requirements of the peripheral tissues - needs to be reversed quickly, or else inadequate organ perfusion and ischemia occur, causing widespread anaerobic metabolism, which leads to lactic acidosis

Leukocytosis

increased number of leukocytes (WBCs) are released from the bone marrow into the bloodstream

left shift

indicates immature WBCs are rising within the bloodstream in an acute infection

Passive acquired immunity

individual is given pre-made, fully formed antibodies against an antigen - provides immediate immunity, but short term, not long lasting

Viral infection

infection by a virus that is pathogenic to humans

Cholecystitis

inflammation of the gallbladder; usually associated with gallstones

Glomerulonephritis

inflammation of the glomeruli in the kidneys - most commonly caused by GABHS antibodies that develop against the antigen (strep)

Hepatitis A

inflammation of the liver caused by the hepatitis A virus (HAV) - usually caused by ingestion of contaminated food or water or contracted from person to person by the fecal-oral route

Hepatitis B

inflammation of the liver caused by the hepatitis B virus (HBV) - spread by blood products, body fluids, or sexual contact - individuals carry HBV for life

Hepatitis C

inflammation of the liver caused by the hepatitis C virus (HCV) - transmission is via blood, as in IV drug use; sexual transmission is not as likely - can live dormant in the patient for years before symptoms develop - chronic hepatitis with HCV is common

Pancreatitis

inflammation of the pancreas that causes pancreatic insufficiency, malabsorption, and diabetes - can be acute or chronic

Peritonitis

inflammation of the peritoneal membrane caused by bacterial infection or leakage of intestinal contents into the peritoneal cavity - often occurs as a complication of another condition or surgical complication - commonly caused by rupture of organs into the peritoneal cavity

Pharyngitis

inflammation of the pharynx (sore throat) - usually caused by a virus - GABHS can cause bacterial pharyngitis - lymphoid follicles of the tonsils are swollen and often covered with white exudate - cervical lymph nodes may be enlarged and tender (test to rule out EBV) - malaise, fever, and sore throat

Appendicitis

inflammation of the vermiform appendix; causes intense abdominal pain and requires surgery; abdominal pain that originates in the umbilical region radiating to the RLQ, also known as McBurney's point; Positive psoas sign, Rovsing's sign, and obturator sign are indicative of appendicitis

Diverticulitis

inflammatory disorder of the colon - Diverticuli (weak areas that form pouches off the wall of the large intestine) become filled with stagnant intestinal contents, leading to obstruction and inflammation of the bowel wall

Bronchospasm

involuntary contraction of the smooth muscle in the walls of the bronchi and bronchioles that tighten and squeeze the airway shut

Acute Lymphoblastic Leukemia (ALL)

involves blast-type cells and primarily affects children

Hemoglobin

iron-containing protein in red blood cells that carries oxygen for delivery to cells

Reed-Sternberg (RS) cells

large abnormal lymphocytes with multiple nuclei - characteristic cells found in Hodgkin's lymphoma (HL)

Reye's syndrome

life-threatening disorder in which mitochondrial failure leads to liver failure and encephalopathy - most common among children who take aspirin to treat symptoms during a viral infection or illness

Hepatocytes

liver cells

Cirrhosis

liver demonstrates fibrosis and scar tissue - often a silent and gradual disease; most patients remain asymptomatic until a late stage of liver impairment marked by ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, or variceal bleeding from portal hypertension

Liver

located in the right upper quadrant (RUQ) of the abdomen, immediately beneath the diaphragm - converts of bilirubin into bile - secretes bile into the intestine - produces most of the body's albumin - stores vitamin A, D, B12, iron, and copper - produces B lymphocytes

Stomach

located in the upper part of the abdomen and consists of three portions: - the fundus, the uppermost portion of the stomach - the body, the center and largest part of the stomach - the pylorus, the lower portion of the stomach - peristaltic function enables the mixing of food and digestive enzymes

Renal failure

loss of kidney function resulting in its inability to remove waste products from the body and maintain electrolyte balance

Thrombocytopenia

low platelet count - increases susceptibility to bleeding and ecchymosis (bruising), nosebleeds (epistaxis), gingival bleeding, or subcutaneous hemorrhaging resulting in purpura or petechiae

Staphylococcus saprophyticus

lower UTIs

B lymphocytes (B cells)

lymphocytes which mature in the bone marrow and that are involved in the production of antibodies

Antihistamines

medicines that reduce the production of histamines; prescribed for allergic reactions

Iron deficiency anemia

most common causes are inadequate intake of iron, excessive menstrual blood loss, and GI blood loss - most common cause of anemia worldwide - Unique symptoms: hair loss; cheilitis (inflammation and small cracks on the lips); glossitis (inflammation of the tongue); nail changes called koilonychias (spoon-shaped nails); and pica (craving for nonfood substances such as ice, clay, starch, chalk, dirt, or other material)

Malaria

most commonly occurs when the female Anopheles mosquito bites a human and injects the microscopic Plasmodium parasites into the bloodstream

Esophagus

muscular tube that connects the mouth to the stomach

Pyloric stenosis

narrowing of the opening of the stomach to the duodenum (pyloric sphincter) - delays the emptying of the gastric contents, causing gastroparesis (distended stomach)

Iron

needed in the diet to synthesize Hgb in RBCs and myoglobin, a component of muscle cells - absorbed primarily in the duodenum and upper jejunum - deficit is related to fatigue and anemia

Lymphoma

neoplasms of lymphocytes and are commonly solid tumors found in lymphoid tissue - falls into one of two major categories: 1. Hodgkin's lymphoma (HL) 2. non-Hodgkin's lymphoma (NHL)

Uric acid

nitrogenous waste excreted in the urine - stones are associated with high purine intake, malignancy, and gout.

NSAIDs

nonsteroidal anti-inflammatory drugs - Ex: aspirin, ibuprofen, naproxen sodium, and celecoxib

Fecal impaction

occurs when hard stool that cannot be passed is lodged in the sigmoid colon and rectum

Hiatal hernia

occurs when part of the stomach pushes up through the opening in the diaphragm and protrudes into the thoracic cavity

Dehiscence

opening of a wounds suture line

Zone of hyperemia

outer zone of a burn - eddened from vasodilation and increased blood flow but has minimal tissue damage and heals quickly

Rebound tenderness

pain upon removal of pressure rather than application of pressure to the abdomen

Odynophagia

painful swallowing

Lipase

pancreatic enzyme necessary to digest fats

Autodigestion

pancreatic enzymes destroy its own tissue leading to inflammation; seen with pancreatitis

Petechiae

pinpoint red-purple areas of bleeding that resemble a rash - can be the first sign of thrombocytopenia

Upper GI bleed (UGIB)

presence of bleeding in the esophagus, stomach, or duodenum - most common causes are esophageal varices and peptic ulcer disease - hematemesis, melena, hypotension

Nitrogenous wastes

products of cellular metabolism that contain nitrogen (i.e. ammonia, urea, uric acid, and creatinine) - excreted by the kidneys - renal failure causes accumulation in the bloodstream - brain cannot function in a high nitrogenous environment and encephalopathy occurs

Rheumatoid Factor (RF)

proteins made by your immune system that can attack healthy tissue in the body - high levels in the blood are most often related to autoimmune diseases, such as rheumatoid arthritis

Plasmodium malariae

protozoan organism that can infect humans and cause malaria

Purpura

purplish lesion caused by free red blood cells in the skin - does not blanch on pressure and may be nodular

toxic shock syndrome (TSS)

rare but serious condition caused by certain strains of bacteria - causes toxins to spread into the bloodstream, causing severe organ damage or death - often associated with tampon use during menstruation

Radiation burns

redness and blistering on the surface of the skin or other organs caused by intense exposure to ionizing radiation

Encephalopathy

refers to mental status changes that can occur, such as disorientation, confusion, and memory loss - any brain disease that alters brain function or structure

Stasis ulcer

related to diminished circulation and are usually found in the lower extremities - associated factors: venous insufficiency, obesity, pregnancy, family history, old age, and blood clotting disorders

Hepatorenal syndrome (HRS)

renal failure resulting from abnormal kidney perfusion in patients with cirrhosis of the liver and ascites

CD4 cell (T helper cells)

responsible for coordinating much of the immune response; one of the main targets damaged by HIV

Thermal burns

result after exposure to fire, hot objects, scalding liquids, hot grease, or steam - produce damage to the skin and underlying tissues after exposure to temperatures greater than 111.2°F (40°C) - injuries can range from superficial, affecting only the epidermis, to full thickness, which injure subdermal tissues

Heparin-induced thrombocytopenia (HIT)

results from the development of an antibody to heparin - not associated with bleeding, but it is paradoxically associated with increased risk of thrombosis

Folic acid deficiency

results in megaloblastic anemia; no neurologic symptoms (as opposed to vitamin B12 deficiency)

Rhinorrhea

runny nose

lacrimal and salivary glands

secrete tears and saliva - Sjögren's syndrome (SS)

Disseminated Intravascular Coagulation (DIC)

severe malfunction of the coagulation system, which causes unpredictable episodes of both bleeding and clotting - commonly caused by sepsis

Hemoglobin S

sickle cell hemoglobin

Bradycardia

slow heart rate (less than 60 bpm)

Haemophilus influenzae

small, gram-negative, coccobacillus-shaped bacterium most virulent strain is type b (Hib) - Meningitis, upper and lower respiratory tract infections

Natural killer cells (NK cells)

specific kind of T lymphocyte that directly attacks antigens - can destroy tumor cells and virus-infected cells without previous exposure

Stroke

specific type of brain injury caused by ischemia of brain tissue or hemorrhage of a cerebral blood vessel - disruption in cerebral circulation triggers abrupt neurological deficits that are permanent - ischemic stroke is caused by a thrombus or embolus that lodges in a cerebral artery and blocks blood flow to the brain tissue - hemorrhagic stroke is caused by rupture and hemorrhage of a cerebral artery, leading to compression and toxicity of brain cells and loss of cerebral blood flow

Rule of nines

standardized method used to quickly assess how much body surface area has been burned on a patient - only applied to partial-thickness (second-degree) and full-thickness (third-degree) burns

Nuchal rigidity

stiff neck - can be confirmed on physical assessment by Kernig's and Brudzinski's signs - when accompanied by headache, photophobia, and high fever = key signs of meningitis

Inflammatory mediators

substances that promote or inhibit inflammatory reactions

Acute Pancreatitis

sudden, short-term episode of inflammation of the pancreas that causes pancreatic insufficiency, malabsorption, and diabetes

Zone of stasis

surrounds the zone of coagulation of a burn - characterized by decreased tissue perfusion and can be salvaged with appropriate fluid resuscitation and treatment - if treatment is inadequate, the zone of stasis is lost and the central zone of coagulation expands

Epstein-Barr virus (EBV)

the cause of infectious mononucleosis, a common infection of adolescents and young adults - spread by oral secretions because the virus infects the epithelium of the oropharynx and salivary glands

Neutrophils

the most abundant of the white blood cells - first responders to an infection, stressful event, or inflammatory reaction - engulfs microbes by phagocytosis - Common Cause of Elevation = Bacterial infection

Fibrosis

the thickening and scarring of connective tissue, usually as a result of injury (formation of fibrous tissues)

Hyperviscosity

thick, concentrated blood

Erythrocyte sedimentation rate (ESR)

timed test that measures the rate at which red blood cells settle through a volume of plasma

TBSA

total body surface area (referring to % of body burned in a burn patient)

Pseudopolyp

ulcerated areas become covered by granulation tissue, leading to the formation of inflammatory areas of protruding growths - characteristic of ulcerative colitis

Varicella Zoster

virus that causes chickenpox and shingles - largely a childhood disease - highly contagious - triad of rash, malaise, and low-grade fever are typical signs

Giardiasis

water-borne protozoan infection caused by Giardia lamblia - majority of patients are asymptomatic but can also present with dysentery (intestinal disease that causes severe diarrhea that is often bloody)

Leukocytes

white blood cells - protect the body against infection - within the innate immune system(macrophages) - within the adaptive immune system (B lymphocytes and T lymphocytes)

Primary intention

wound healing where edges of the wound are clearly demarcated, cleanly lacerated, and easily brought together, and there is no missing tissue within the injured area - best exemplified by healing of a clean, surgical laceration

Tertiary intention

wound is missing a large amount of deep tissue and is contaminated - cleaned and left open for 4 to 5 days before closure - wound may require temporary packing with sterile gauze and have extensive drainage that often requires insertion of a drainage tube - prominent scarring with healing - commonly requires a skin graft