Glossary

the patient sustained an anterior myocardial infarction

Myocardial infarction is necrosis of myocardial tissue which occurs as a result of a deprivation of blood supply, and thus oxygen, to the heart tissue. Blockage of blood supply to the myocardium is caused by occlusion of a coronary artery.

the heart was enlarged--weighing 675 grams--especially the left atrium

The heart weighed 530 grams

410 grams

A normal heart weighs 300 grams (range: 270 to 360 grams).

atherosclerotic narrowing

Atherosclerosis is the deposition of lipid into the intima of arteries, resulting in narrowing of the vessel lumen.

occlusion

An occlusion is a blockage.

thrombus

A thrombus is a solid mass resulting from the aggregation of blood constituents within the vascular system.

palliative surgery

Palliative surgery provides alleviation but is not curative.

15,300

13,000

5000 cells/mm³

13,500 cells/mm³

15,256 cells/mm³

A normal white blood cell count is 4000-11,000 cells/mm³.

infiltrates

infiltrate

An infiltrate is an accumulation of cells in the lung parenchyma--this is a sign of pneumonia.

consolidated

Consolidation is the filling of lung air spaces with exudate--this is a sign of pneumonia.

abscesses

abscess

An abscess is a collection of pus (white blood cells) within a cavity formed by disintegrated tissue.

oral candidiasis

Candidiasis is an infection by the fungus Candida in the oral cavity.

hematuria

Hematuria is the presence of blood in the urine.

pyuria

Pyuria is the presence of white blood cells (pus) in the urine.

septic

Sepsis is the presence and persistence of pathogenic microorganisms and their toxins in the blood.

disseminated intravascular coagulation

DIC is the development of small thrombi within the microcirculation throughout the body.

acid fast bacilli

Acid fast bacilli are not easily decolorized by acid during staining. This is characteristic of mycobacteria.

620 grams

A normal left lung weighs 375 grams (range: 325 to 480 grams).

1230 grams

A normal right lung weighs 450 grams (range: 360 to 570 grams.

pulmonary congestion

Pulmonary congestion is the engorgement of pulmonary vessels with blood. The increased pressure caused by this engorgement leads to transudation of fluid through the capillary walls and into the alveolar and interstitial spaces.

pulmonary edema

Pulmonary edema refers to the accumulation of fluid in the pulmonary alveolar and tissue spaces as a result of changes in capillary permeability and/or increases in capillary hydrostatic pressure.

disseminated tuberculosis

miliary tuberculosis

Disseminated tuberculosis refers to the hematogenous spread of tuberculous lesions throughout the body. It is also known as miliary tuberculosis (which is so-called because the lesions resemble millet).

tuberculosis granulomas

A tuberculosis granuloma is a focus of granulomatous inflammation caused by CHRONIC tuberculosis infection. The granuloma consists of epithelioid cells (activated macrophages) surrounded by lymphocytes, plasma cells, and fibroblasts.

anthracotic pigment

Anthracotic pigment is coal dust deposited in the lungs--it is seen in coal miners, city-dwellers, and smokers.

caseous

Caseous means cheesy.

prostatic carcinoma

Prostatic carcinoma is a highly metastatic form of cancer.

significant pain and discomfort

Back pain resulting from vertebral metastases of prostatic carcinoma is not uncommonly the presenting symptom which leads to the discovery of the carcinoma. Pain occurs late in the metastatic process and is an indicator of a poor outlook for a patient.

peripheral region of the prostate gland

Most commonly, prostatic carcinoma arises in the peripheral region of the gland.

corpora amylacea

Corpora amylacea are small hyaline masses of degenerated cells and inspissated secretions. They are so named because they resemble (but are categorically not) amyloid deposits.

exercise intolerance

Exercise intolerance is the development of shortness of breath upon exertion.

peripheral edema

Peripheral edema refers to the accumulation of fluid in the intercellular tissue spaces of the legs and ankles.

the patient had marked peripheral edema

Marked peripheral edema is usually a manifestation of heart failure -- especially of the right ventricle.

shortness of breath

Shortness of breath is a common clinical manifestation of heart failure.

cardiac enlargement and pulmonary edema

Pulmonary edema refers to the accumulation of abnormal amounts of fluid in the extravascular spaces of the lungs. There are many causes for pulmonary edema. However, it is common clinical manifestation of left ventricular heart failure. Pressures rise in the left atrium and ventricle to compensate for the failure and this causes increased pressure in the pulmonary vasculature. Incrased pulmonary capillary pressure relative to the plasma oncotic pressure cause fluid to leave the vessels and enter the interstitial spaces of the lung.

pleural effusions

Pleural effusion is the presence of fluid in the pleural space. Increased hydrostatic pressure in the pulmonary vasculature, as seen in heart failure, is one cause of pleural effusion.

650 grams

A normal heart weighs 300 grams (range: 270 to 360 grams).

evidence of stenosis

Aortic stenosis (calcification of the aortic valve) is the most common valve abnormality. Calcification of the valve leads to a reduced valve area. Increased pressure is thus needed from the left ventricle to pump blood into the aorta. Over time, the pressure-overloaded ventricle hypertrophies concentrically (increased ratio of wall thickness to cavity radius) in an attempt to reduce wall tension (review the Law of Laplace). Eventually, the left ventricle's contractile capacity is overwhelmed by the stiffness of the ventricle (due to hypertrophy) and pressure begins to increase through the left atrium and into the pulmonary vasculature. Increased pulmonary artery pressures then lead to right ventricular failure.

insufficiency

Aortic insufficiency refers to the inability of the aortic valve to close properly, thus allowing regurgitation of blood into the left ventricle during diastole -- i.e., volume overload. Disease of the aortic valve leaflets is a common cause of insufficiency.

concentric hypertrophy

Concentric hypertrophy is seen in pressure-overloaded hearts.

(700 grams)

A normal heart weighs 300 grams (range: 270 to 360 grams).

34,000 cells/mm³

21,200 cells/mm³

A normal white blood cell count is 4,000 to 11,000 cells per cubic mm.

shift to the left

A shift to the left indicates an increased ratio of immature PMNs (bands) to mature PMNs (segs).

friable

Friable material is easily crumbled.

fecalith

A fecalith is a hardened collection of fecal matter formed within the intestine.

22,700 cells/mm³

A normal white blood cell count is 4,000 to 11,000 cells per cubic mm.

nuchal rigidity

Nuchal rigidity is stiffness of the neck, a common sign of meningeal irritation.

elevated spinal fluid pressure

CNS infections can lead to increased intracranial pressure, which, if severe, can cause death.

800 grams

The normal weight of the right lung in an adult is 450 grams (range: 360 to 570 grams).

jaundice

icterus

Jaundice (or icterus) is a state of hyperbilirubinemia (increased bilirubin in the blood) in which bile pigment is deposited in the skin, mucous membranes, and scleras. This deposition of bile pigment results in a yellow appearance.

41,000 cells/mm³

A normal white blood cell count is 4,000 to 11,000 cells per cubic mm.

630 grams

A normal adult left lung weighs 375 grams (range: 325 to 480 grams). And a normal adult right lung weighs 450 grams (range: 360 to 570 grams).

PPD positive

PPD test

Mycobateria grow very slowly on culture plates, with cultures requiring up to 6 weeks for a positive finding. In lieu of cultures, a more rapid diagnostic test is the PPD--purified protein derivative of tuberculosis--test. PPD is injected under the skin of an individual and then the area is reexamined in 48-72 hours for signs of an inflammatory reaction. A positive test indicates previous exposure to M. tuberculosis.

thoracotomy

A thoracotomy is a surgical procedure in which an opening is made in the chest wall.

emboli

Plural of embolus. An embolus is something that blocks the blood flow in a blood vessel. It may be a gas bubble, a blood clot, a fat globule, a mass of bacteria, or other foreign body. It usually forms somewhere else and travels through the circulatory system until it gets stuck.

iliofemoral venous thrombosis

Thrombosis occurring in the deep veins of the legs is a common sequela seen post-operatively.

BUN

Blood urea nitrogen (BUN) is used as a measure of the glomerular filtration rate and is increased in renal failure.

113 mg/dL

69 mg/dL

112 mg/dL

A normal BUN for this patient would be 10 to 20 mg/dL.

pericardial friction rub

A pericardial friction rub is the characteristic sign of pericarditis. It sounds like the rubbing together of two rough surfaces. The sound may vary over time and patient position.

pericardiectomy

A pericardiectomy is a surgical procedure in which the pericardial sac is opened, a piece is removed, and the sac is left open.

hematemesis

Hematemesis is the vomiting of blood.

melena

Melena is the passage of digested blood in the feces.

colicky pain

Colicky pain is an intermittent abdominal pain.

bilious vomiting

Bilious vomitus is vomitus which contains bile.

upper GI series

An upper GI series is a series of barium-aided radiographs involving the esophagus, stomach, and duodenum.

dissecting aortic aneurysm

A dissecting aortic aneurysm occurs when an intimal tear allows blood--under very high pressure--to enter the media and thus to separate the intima from the adventitia. The separation occurs longitudinally and amounts to the formation of a blood-filled canal parallel to the aortic lumen which may run the entire length of the aorta. The word aneurysm usually refers to an abnormal dilatation of a localized segment of artery. Since marked dilatation of the aorta is not a prominent feature of a dissecting lesion, aortic dissection is now the preferred term.

mechanical prosthetic valve

Prosthetic heart valves are a common source of emboli (blood clots) which may lodge in arteries of the brain and lead to infarction.

cerebrovascular accident

A cerebrovascular accident (CVA) is known as a stroke in layman's terms. The most common cause of CVAs, by far, is a brain infarction resulting from reduced blood flow secondary to a thrombotic embolus (blood clot).

obtundation

Obtunded patients will have mental blunting with mild to moderate reduction in alertness and a diminished sensation of pain.

760-gram

A normal heart weighs 300 grams (range: 270 to 360 grams).

1250-gram brain

A normal brain weighs 1400 grams (range: 1100 to 1700 grams).

gemistocytic astrocytes

Gemistocytic astrocytes (gemistocytes) comprise a form of activated astrocyte in which the cell body becomes round and swollen, the nucleus assumes an eccentric position, and the cytoplasm changes to an easily visible bright pink color.

hemiparesis

Slight paralysis or weakness affecting one side of the body.

angina

Angina pectoris is chest pain produced by myocardial ischemia, it worsens upon exertion.

arrhythmias

Arrhythmias are abnormal heart rhythms.

Aspartate Aminotransferase (AST) 60 IU/L.

AST is a NON-SPECIFIC marker of myocardial infarction (i.e., it is also elevated in other conditions, such as liver disease and skeletal muscle injury). AST levels peak at 48--72 hours following the infarction. A normal AST level would be less than 37 IU/L.

Total Creatine Phosphokinase (CPK) 165 IU/L.

An elevated total CPK (a collective measure of all CPK isoenzymes) is a NONSPECIFIC marker for myocardial infarction. However, an elevation in the level of CPK-MB isoenzyme is a more specific marker for myocardial infarction. The CPK-MM isoenzyme is specific for skeletal muscle. CPK levels begin to rise 4-8 hours following an infarction, usually peak within the first 24-48 hours, and then return to baseline within 3-4 days. A normal CPK level is 35 to 250 IU/L.

Troponin I

Troponin I is a muscle contractile protein that is increased in serum after myocardial necrosis, it is a sensitive and specific marker of acute MI, and better than CK-MB as a cardiac injury marker. Normally troponin I values are less than 10 µg/L but values can rise 5 to 50 times after an acute myocardial infarction.

recanalized

Recanalization is the process of the forming of channels through an organized thrombus so that blood flow is restored.

mural thrombus

mural thrombosis

Mural thrombosis is the formation of multiple thrombi along an injured endocardial wall.

pericarditis

Pericarditis is inflammation of the pericardium - often with deposition of fibrin.

340-gram heart

A normal heart weighs 300 grams (range: 270 to 360 grams).

diaphoresis

Diaphoresis is a profuse perspiration often seen during a myocardial infarction.

premature ventricular contractions (PVCs)

Premature ventricular contractions (PVCs) are a common cardiac arrhythmia. They are present even in healthy individuals, for whom no treatment is indicated. However, in patients with heart disease, PVCs can be significant indicators of disease processes. For example, increased numbers of PVCs are common following an acute myocardial infarction.

oliguria

Oliguria is the occurrence of decreased urine output.

cardiac arrest

Cardiac arrest is the sudden standstill of cardiac function.

950 grams

A normal right lung weighs 450 grams (range: 360 to 570 grams.

750 grams

A normal left lung weighs 375 grams (range: 325 to 480 grams).

viral myocarditis

Viral myocarditis is an inflammatory viral infection of the myocardium.

refractory heart failure

Heart failure that is unresponsive to treatment is termed refractory.

cardiac index

Cardiac index is a measure of a patient's cardiac output in relation to body size.

540 grams

A normal heart weighs 300 grams (range: 270 to 360 grams).

2700 grams

2600 grams

1880 grams

1760 grams

1630 grams

820 grams

A normal liver weighs 1650 grams (range: 1500 to 1800 grams).

chronic passive hepatic congestion

Chronic passive hepatic congestion is a disorder seen in conjunction with right-sided heart failure. In right-sided heart failure, peripheral venous pressures increase and thus reduce outflow from the liver. The result is a chronically congested liver.

Peritonitis

Peritonitis is inflammation of the abdominal cavity.

ascites (500 ml)

Ascities is the accumulation of fluid with in the abdominal cavity. There should be less than 30 ml of fluid in the peritoneal cavity.

splenomegaly (weight

260 grams)

Splenomegaly means enlargement of the spleen. The normal spleen weighs 155 grams.

215 grams

240 grams

97 grams

88 grams

1660

1780

A normal kidney weighs 157 grams (range: 115 to 220 grams).

emphysema

Pulmonary emphysema is a condition in which the air spaces distal to the terminal bronchioles are permanently increased in size due to either destruction of the wall or alveolar dilatation.

3519 grams

Normal lungs weigh 825 grams (range: 685 to 1050 grams).

220 mcg/dL

Normal serum iron levels are 35 to 160 micrograms/dL.

glucose tolerance test

The glucose tolerance test (GTT) is a measure of active insulin and also reflects the power of normal liver to absorb and store large amounts of glucose. Following the administration of a 75-gram dose of glucose, blood glucose levels should return to normal in less than 3 hours.

290 mg/dL

After glucose challenge, the blood glucose level should be back to 110 to 180 mg/dL by 2 hours.

platelet count 58,000

The normal platelet count is 150,000 to 400,000/mm³.

aseptic necrosis

Trauma (from fracture or surgery) is one cause of asceptic (or avascular) necrosis of bone, which is defined as the death of bone and bone marrow in the abscence of an infectious agent.

200 grams

935 gram spleen

The normal spleen weighs 155 grams.

8.0, 9.3, and 8.7 mg/dl

The normal serum uric acid level for a male is 3.9 to 8.1 mg/dl.

tophus

A tophus is a chalky accumulation of urate crystals found in the tissue surrounding a joint.

proteinuria

Protein in the urine is indicative of glomerular dysfunction.

BUN and creatinine

These tests are measures of kidney function. High levels mean low function.

5.2 mg/dL

3.3 mg/dL

The normal creatinine level is 0.7 to 1.3 mg/dL.

alpha-fetoprotein

Alpha-fetoprotein (AFP) is a serum glycoprotein produced during pregnancy by the yolk sac, fetal GI tract, and fetal liver. Elevated serum AFP levels in a pregnant woman can be an indication of a fetal neural tube defect (or something as common as multiple pregnancy). Decreased serum levels are indicative of trisomy 21.

fluorescent in situ hybridization

FISH uses a fluorescent-labeled antibody specific for a particular chromosome.

hematocrit

A hematocrit value represents the number of packed red cells in mL per 100 mL of centrifuged whole blood--expressed as a percentage.

hematocrit was 21%

A hematocrit value represents the number of packed red cells in mL per 100 mL of centrifuged whole blood--expressed as a percentage. A normal hematocrit for a female is 34 to 44%.

7.0 mcg/dL

30.8 mcg/dL

A normal T4 level is 4 to 11 mcg/dL.

2.7 ng/dL

A normal free T4 level is 0.71 to 1.85 ng/dL.

22.0 mcIU/ml

0.22 mcIU/dL

A normal TSH level is 0.32 to 5.00 mcIU/dL.

propylthiouacil

Propylthiouacil blocks the synthesis of thyroid hormones.

45 grams

A normal thyroid gland weighs 25 grams.

bosselated

Bosselated means covered with rounded protuberances.

110 bpm

58 bpm

A normal pulse rate is 60 to 100 bpm.

165/108 mm Hg

138/88

A normal blood pressure reading would be 120/80 mm Hg.

antithyroglobulin antibodies

Antithyroglobulin antibodies are autoimmune antibodies directed against thyroglobulin. Over half of all patients with Hashimotos thyroiditis have positive titers, although they are also found in other types of thyroiditis.

1 to 640

A normal antithyroglobulin antibody titer would be less than 1 to 10.

antimicrosomal antibodies

Antimicrosomal antibodies are autoimmune antibodies directed at the thyroid gland. They are seen in almost all patients with Hashimotos thyroiditis.

1 to 5120

A normal antimicrosomal antibody titer would be less than 1 to 100.

autoimmune

Autoimmune disorders involve an immune response directed at the host's own cells.

berry aneurysm

A berry aneurysm is a small saccular arterial aneurysm usually found at a vessel junction in the circle of Willis. These aneurysms frequently rupture, causing a subarachnoid hemorrhage.

pericardial effusion

A pericardial effusion is a collection of fluid within the pericardial space.

electromechanical dissociation

EMD is a condition in which the heart's electrical rhythm continues despite the mechanical failure of the myocardium.

1330 grams

1875 grams

A normal pair of lungs weighs 825 grams (range: 685 to 1050 grams).

malignant hypertension

Hypertension which has caused end-organ damage is termed malignant. Without proper treatment, these patients will usually die in less than 2 years. Blood pressures in patients with malignant hypertension are frequently 160/110 mm Hg or greater.

PCV was 54%

dropped to 17%

packed red blood cell volume (PCV) was 18%

hematocrit (PCV) of 27%

A normal hematocrit for a male is 39 to 49%.

azotemia

Azotemia is a condition of having excess nitrogen in the blood--a good indicator of reduced kidney function.

increased uptake

Malignant bone lesions are part of the differential for increased uptake of isotope during a bone scan.

143 U/L

A normal alk-phos level is 39 to 117 U/L.

osteomyelitis

Osteomyelitis is usually a pyogenic bacteria induced infection/inflammation of bone.

840 mg/dL

Normal blood glucose levels should be 70 to 100 mg/dL.

8.5 mmol/L

A normal bicarbonate level would be 23 to 29 mmol/L (critical level: <10 or >35 mmol/L).

barium enema

A barium enema is a radiological study of the colon and rectum performed using barium as a contrast agent.

filling defect

Any localized defect in the contour of the stomach, duodenum, or intestine, as seen in the radiograph after a barium enema.

pack-year

A pack-year denotes smoking one pack of cigarettes per day for one year.

tonic-clonic seizure

tonic-clonic seizures

A tonic-clonic seizure involves loss of consciousness followed by tonic, then clonic, convulsions.

22 cells/mm³

A normal number of cells in CSF is <4 lymphocytes per mm³.

88 grams/L

A normal protein level for CSF should be < 0.4 grams/L.

49 mg/dL

A normal CSF glucose level should be approximately 70% of the patient's serum glucose level.

4.30 PMNs/mm³

Normally, there should be no PMNs in a patient's spinal fluid.

morbilliform

Morbilliform means measles-like.

1450 grams

An average adult female brain weighs 1400 grams (range: 1100 to 1700 grams).

epistaxis

Epistaxis is bleeding from the nose.

12% eosinophilia

A normal eosinophil count is less than 5%.

erythrocyte sedimentation rate

An elevated erythrocyte sedimentation rate is a non-specific indicator of inflammation.

icterus

Hyperbilirubinemia making the patient appear yellow. Also called jaundice.

spider angiomata

A focal network of small arteries and arterioles arranged in a radial pattern with a central red spot.

17.1 g/dL

9.5 g/dL

Normal hemoglobin for a male is 14 to 17.2 gm/dL.

106 fL

The normal mean corpuscular volume (MCV) is 83 to 99 fL.

97,000/ml

The normal platelet count is 150,000 to 400,000/ml.

19.2 seconds

A normal prothrombin time is 12.6 to 14.6 seconds.

2.3 g/dL

The normal albumin level 3.9 to 4.8 gram/dL.

3.9

6.5 mg/dL

A normal total bilirubin level is 0 to 1.0 mg/dL.

2190

21.0 U/L

A normal aspartate aminotransferase (AST) for a male is <37 U/L.

1959

56 U/L

A normal alanine aminotransferase (ALT) is 7 to 56 U/L.

120

180 U/L

A normal alkaline phosphatase is 39 to 117 U/L.

125

320 U/L

A normal gamma-glutamyl transpeptidase (GGT) is 0 to 65 U/L.

45 mcg/dL

A therapeutic acetaminophen level 10-40 mcg/dL.

5020

A normal lactate dehydrogenase level is 120 to 240 U/L.

19,000

A normal platelet count is 150,000 to 400,000/ml.

greater than 40

In a normal patient, fibrin degradation products should be less than 10 mcg/dL.

90

The normal fibrinogen level is 184 to 412 mg/dL.

26

A normal partial thromboplastin time is 28 to 37 seconds.

radical mastectomy

A radical mastectomy involves removal of the breast, underlying pectoralis muscles, and axillary lymph nodes.

cardiac tamponade

Cardiac tamponade is compression of the heart by an acute accumulation of fluid within the pericardium.

parametrectomy

Parametrectomy is the surgical removal of supporting tissues that surround the uterus.

147 mg/dL

A blood alcohol level over 100 mg/dL is considered legally drunk.

20 breaths per minute

A normal respiratory rate is 10 to 20 breaths per minute.

52 mm Hg

46 mm Hg

A normal PaO2 is 80 to 105 mm Hg.

54

62 mm Hg

A normal PaCO2 is 35 to 45 mmHg.

7.30

7.26

A normal arterial pH is 7.35 to 7.45.

13% bands

Band neutrophils are immature neutrophils in the circulation that indicates an increased demand, i.e. inflammation. Normal band levels in circulation are 3 to 5%.

Rh-positive

Rh-positive infants of Rh-negative mothers are at particular risk of developing erythroblastosis fetalis (hemolytic disease of newborns) unless preventive treatments are administered. Successful screening for maternal Rh-negativity and subsequent preventive treatment has greatly reduced the incidence of Rh-induced erythroblastosis fetalis. However, ABO incompatibility between the mother and fetus can also cause erythroblastosis fetalis. Thus, the fact that this mother was Rh-positive does not protect the fetus from developing ABO-induced incompatibility if the mother and fetus have different ABO blood types.

Gravida 2 Para 1011

Gravida and para are forms of Latin words which are used in clinical notation. Gravida indicates the number of pregnancies which a woman has had (including a current pregnancy). Thus a pregnant woman with two previous pregnancies (regardless of the outcomes of the pregnancies) would be considered Gravida 3 (abbreviated G3). Para indicates the outcomes of a woman's pregnancies. It is represented by four numbers. First number: term births. Second number: preterm births. Third number: abortions. Fourth number: living children. A woman who is currently pregnant and who has had two previous pregnancies--one child being born preterm and the other term, both now living--would be listed as G3 P1102. A current pregnancy is not included because the outcome is not yet known.

21 weeks gestation

The normal gestation period is 38 to 42 weeks.

alpha-fetoprotein

Alpha-fetoprotein (AFP) is a serum glycoprotein produced during pregnancy by the yolk sac, fetal GI tract, and fetal liver. Elevated serum AFP levels in a pregnant woman can be an indication of a fetal neural tube defect (or something as common as multiple pregnancy). Open fetal neural tube defects allow alpha-fetoprotein to leak into the amniotic fluid, from which it crosses the placenta and enters the maternal bloodstream. Elevated maternal AFP is an indication for amniocentesis (of which an AFP level of amniotic fluid is routine) and an ultrasound. The combination of these two tests are very reliable in detecting neural tube defects.

4.2 times the mean

A maternal serum AFP level is considered elevated if it is greater than 2.5 times the mean.

neural tube defect

The neural plate is a part of the dorsal ectoderm from which the central nervous system develops. During fetal development, this plate folds longitudinally to form the neural tube which is protected by the eventual development of surrounding mesoderm into the skull, vertebral column, and skin. A neural tube defect occurs when this surrounding mesoderm does not properly enclose around the neural tube.

amniocentesis

Amniocentesis is a procedure in which a needle is inserted transabdominally through the uterus, into the amniotic sac, and amniotic fluid is withdrawn.

465-gram

A normal male fetus at this age of development should weigh 360 to 492 grams.

myelomeningocele

A myelomeningocele is the herniation of the spinal cord--within the meninges--through a defect in the vertebral canal.

30 mg/dL

A normal bilirubin level for a child this age would be <2 mg/dL.

intraoperative cholangiogram

Transhepatic cholangiography involves the injection of a radiopaque dye into the intrahepatic ducts of patients with obstructive jaundice. Radiographs are then taken to determine whether a route exists for the dye to leave the liver.

jejunohepatostomy

A jejunohepatostomy is a procedure in which an attempt is made to bypass the biliary tree by having bile drain into the jejunum. Risks of this procedure include the development of bacterial infections of the intrahepatic biliary tree.

liver transplant

Liver transplantation (along with the donor's bile ducts) is the most successful treatment for these patients.

pre-term

Births occurring at 38 to 42 weeks of gestation are considered term pregnancies. Anytime earlier are considered pre-term.

appropriate for gestational age

Appropriate for gestational age (AGA) is a term which means that an infant's weight and height were appropriate when adjusted for the gestational age of the child. Large for gestational age (LGA) and small for gestational age (SGA) are the alternative designations.

2550 grams

The normal weight for a child of this gestational age would be 2250 to 3000 grams.

cyanosis

Cyanosis is a bluish discoloration of the skin and mucous membranes resulting from increased concentrations of reduced hemoglobin in the blood. Cyanosis occurs when the blood oxygen saturation falls below 85%.

respiratory distress syndrome

Respiratory distress syndrome (or hyaline membrane disease) is a common complication of prematurity, though it can also be seen in term births. The syndrome results from the functional immaturity of the neonatal lung. The syndrome usually presents within one hour of birth and is initially exhibited clinically by rapid respirations, grunting, and substernal retractions.

pH 7.31

A normal pH for a child this age would be 7.37.

PaCO2 35

A normal PaCO2 level for a child this age would be 33.

PaO2 35

A normal PaO2 level for a child this age would be 90.

bradycardia

Bradycardia is defined as a heart rate below 60 beats per minute. A normal heart rate for a neonate is 100 to 160 beats per minute.

intravenous pyelogram

The patient is given an intravenous injection of contrast medium that rapidly enters the urine. Radiographs are then taken to show the passage of the contrast-containing urine through the pelvicaliceal system.

550-gram

A normal kidney for a child this age should weigh 50 grams.

meconium staining

Meconium is a dark-green mucilaginous mixture of intestinal secretions and amniotic fluid which is found in the intestine of a full-term fetus. Meconium-stained amniotic fluid, found at delivery, may be an indication of perinatal asphyxia.

meconium ileus

Meconium ileus occurs when abnormally viscid meconium completely obstructs the ileum of a newborn.

atelectasis

Atelectasis is the collapse of an airway and lung, regardless of the cause, resulting in reduced or absent gas exchange.

pneumothorax

A pneumothorax is an accumulation of gas in the pleural space.

urinary retention

"Urinary retention" is the inability to fully empty the bladder during urination.

dysuria

"Dysuria" is the experience of pain upon urination.

cystitis

"Cystitis" refers to an infection of the urinary bladder.

Gram-negative sepsis

Gram-negative sepsis is a systemic inflammatory response caused by the presence of Gram-negative bacteria and their endotoxins in the blood. The microbes usually enter the bloodstream from an area of localized infection. Gram-negative sepsis is the leading cause of septic shock--hence, also known as "endotoxic shock." Septic shock is a syndrome of inflammatory responses which can lead to severe hypotension, multiple organ system failure, and death.

6.5 x 4.8 x 3.2 cm

The dimensions of a normal prostate are 3.6 x 2.8 x 1.9 cm. So this prostate is enlarged.

75 grams

Normally, a prostate in an 80 year old man should weigh about 40 grams.

nodular

Nodular hyperplasia of the prostate--characterized by large discrete prostatic nodules--is a common disorder in men over 50 years of age. The nodules cause the prostate to be enlarged and to have an increased weight. The human prostate is surrounded by a restrictive capsule. These nodules cause increased pressure within the capsule which leads to constriction of the urethra as it passes through the prostate. Urethral constriction leads to retention of urine.

confined within the prostatic capsule

Prostate carcinomas spread through the capsule at an early stage, thus these nodules are more likely not to be cancer.

meningocele

A meningocele is the herniation of the CSF-filled meningeal sac through a vertebral defect.

neurogenic bladder

Neurogenic bladder is a dysfunction of the bladder caused by a nervous system lesion.

renal calculus

A renal calculus is a "kidney stone."

nephrolithiasis

Nephrolithiasis is the presence of a urinary calculus within the kidney.

hesitancy

Hesitancy is the inability to begin the stream of urine.

urgency

Urgency is the experience of an intense and immediate desire to void.

Cystoscopy

Cystoscopy is the direct visual examination of the bladder via a cystoscope.

diverticula

A bladder diverticulum is an out-pouching of the bladder wall, usually caused by chronic urethral obstruction.

prostate-specific antigen

Prostate-specific antigen (PSA) is a product of prostate epithelium which is normally emitted in the semen. Normal men have very low levels of PSA circulating in their blood. PSA levels are slightly raised in men who have prostatic hyperplasia but are greatly elevated in men who have prostate cancer (the level increases proportionately to the severity of the cancer). PSA is a useful marker for both localized and metastatic prostate cancer.

9.7 ng/ml

A PSA level above 4 ng/ml should lead to suspicion of prostate cancer.

plasma acid phosphatase

Plasma acid phosphatase is a useful marker for metastatic prostate cancer but not for localized prostate cancer.

2 to 4 IU/L

A normal level should be less than 0.8 IU/L.

orchiectomy

An orchiectomy is the surgical removal of a testicle. The growth of a prostatic carcinoma is androgen-dependent. Removal of the testes (hence removal of androgens) can lead to tumor regression--although usually temporary.

renal failure

Renal failure is the severe reduction of renal function and often leads to reduced urinary output.

estrogen therapy

Since prostatatic carcinomas are androgen-dependent, estrogen therapy helps to reduce output of testosterone thereby slowing tumor progression.

hydronephrosis

Hydronephrosis is dilation of the renal pelvis and atrophy of the cortex due to increase pressure from retained urine.

nephrostomies

A nephrostomy is the creation of a permanent opening directly into the renal pelvis to allow the drainage of urine.

hypercalcemia

Hypercalcemia is the state of having increased levels of calcium in the blood.

metastatic calcification

The deposition of calcium in normal tissues as a result of elevations in blood calcium.

gastritis

Gastritis is inflammation of the stomach.

300-500 u/L

A normal serum amylase level is 30 to 110 u/L.

pancreatitis

Chronic inflammation of the pancreas (pancreatitis) is most often caused by alcoholism or biliary tract calculi.

pneumonia

In alcoholics, aspiration pneumonia is common--bacteria enter the lung via aspiration of gastric contents.

necrotizing lobar pneumonia

Necrotizing lobar pneumonia is a severe acute pneumonia caused by virulent organisms and aspirated of gastric contents.

cirrhosis

Cirrhosis is a liver disease characterized by necrosis, fibrosis, loss of normal liver architecture, and hyperplastic nodules.