Medical-Surgical Nursing: Biliary Disorders, Renal Conditions, HIV/AIDS, Sepsis, and Anaphylaxis

Comprehensive practice flashcards covering terminology, definitions, diagnostic thresholds, pathophysiology, and management across biliary disorders, acute and chronic renal disease, dialysis modalities, HIV/AIDS, sepsis, and anaphylaxis.

Cholelithiasis

The most common biliary system disorder, characterized by the formation of gallstones when cholesterol, bile salts, and calcium composition is altered and solidifies into biliary sludge.

Cholecystitis

Inflammation of the gallbladder wall or mucosal lining, usually associated with gallstone obstruction of the cystic duct, resulting in a swollen, bloody, and distended gallbladder containing pus and bile.

Acalculous Cholecystitis

Inflammation of the gallbladder occurring in the absence of gallstones, primarily affecting older adults and critically ill patients.

Steatorrhea

Fatty stools occurring in biliary tract obstruction due to the lack of bile salts needed to emulsify and digest dietary fats in the duodenum.

Subphrenic Abscess

A complication of cholecystitis characterized by an accumulation of pus in inflamed tissue located beneath the diaphragm.

Endoscopic Retrograde Cholangiopancreatography (ERCP)

An endoscopic diagnostic and therapeutic study of the pancreatic and biliary ducts requiring pre-procedure informed consent, NPO status from midnight until the return of the gag reflex, and post-procedure complication monitoring.

Extracorporeal Shock-Wave Lithotripsy (ESWL)

A non-invasive medical procedure that uses shock waves combined with oral bile acids to disintegrate gallstones within $1\text{ to }2\text{ hours}$ when they cannot be extracted via endoscope.

Laparoscopic Cholecystectomy

The surgical treatment of choice for gallbladder disease, involving excision of the gallbladder through $3\text{ to }4$ small puncture incisions following insufflation of the abdominal cavity with $3\text{ to }4\text{ L}$ of $\text{CO}_2$.

T-Tube

A specialized drainage tube inserted directly into the common bile duct during an open incisional cholecystectomy to maintain duct patency and divert excess bile externally.

Dialysis

The movement of fluid and solutes across a semi-permeable membrane from one compartment to another, used to correct fluid and electrolyte imbalances, remove waste products during kidney failure, or treat drug overdoses.

Diffusion (in Dialysis)

The fundamental dialysis principle defined as the movement of solutes from an area of higher concentration to an area of lower concentration across a semi-permeable membrane.

Ultrafiltration

The removal of excess water and dissolved waste products across a semi-permeable membrane that occurs when an osmotic or hydrostatic pressure gradient is created.

Automated Peritoneal Dialysis (APD)

A peritoneal dialysis system that utilizes an automated cycler to control the timing and execution of dialysate infusion, dwell time, and fluid drainage cycles.

Continuous Ambulatory Peritoneal Dialysis (CAPD)

A manual form of peritoneal dialysis carried out continuously throughout the day, in which exchanges of dialysate solution are performed manually by the patient.

Arteriovenous (AV) Fistula

The gold-standard permanent vascular access for hemodialysis, constructed by a direct surgical anastomosis between an artery and a vein, which offers lower infection and thrombosis rates.

Arteriovenous (AV) Graft

A surgically created vascular access made by tunneling a synthetic tube under the skin to bridge an artery and a vein when native blood vessels are not suitable for a fistula.

Distal Ischemia (Steal Syndrome)

A complication of an AV fistula caused by arterial blood shunting away from the distal extremity, presenting with pain distal to the access site, coldness, finger numbness or tingling, and poor capillary refill.

Chronic Kidney Disease (CKD)

A worsening, irreversible decline in renal function defined by the presence of kidney damage (blood, urine, or imaging markers) or a Glomerular Filtration Rate ($\text{GFR}$) of $<60\text{ mL/min}$ for $3\text{ months}$ or longer.

Uremia

A toxic clinical syndrome resulting from severe kidney decline where multiple body systems deteriorate due to waste accumulation, typically seen when $\text{GFR} \le 15\text{ mL/min}$.

Oliguria

A marked reduction in urine volume, characterized as urine output between $300\text{ and }500\text{ mL/day}$ in worsening chronic kidney disease, or $<400\text{ mL/day}$ in acute kidney injury.

Anuria

The near-complete cessation of urine production, defined as urine output of $<40\text{ mL/day}$, which commonly occurs during or following maintenance dialysis.

Uremic Frost

A rare dermatological manifestation of advanced chronic kidney disease in which crystallized urea deposits precipitate on the skin as high-urea sweat evaporates.

Uremic Fetor

A distinctive urine- or ammonia-like odor on the breath caused by the salivary breakdown of excess systemic urea in uremic patients.

End-Stage Renal Disease (ESRD)

The terminal stage of chronic kidney failure defined by a $\text{GFR} < 15\text{ mL/min}$, requiring renal replacement therapy (dialysis or kidney transplantation) to sustain life.

Azotemia

An accumulation of nitrogenous waste products, such as blood urea nitrogen ($\text{BUN}$) and serum creatinine, in the bloodstream caused by reduced kidney filtration.

Prerenal Acute Kidney Injury

Acute kidney impairment precipitated by systemic factors that decrease effective blood circulation and renal perfusion (e.g., severe hypovolemia, hemorrhage, low blood pressure, sepsis).

Intrarenal Acute Kidney Injury

Acute kidney impairment caused by direct parenchymal tissue damage to the nephrons, resulting from conditions such as acute tubular necrosis, nephrotoxic medications (e.g., vancomycin), or prolonged renal ischemia.

Postrenal Acute Kidney Injury

Acute kidney impairment caused by mechanical or physical obstruction of urinary outflow distal to the kidneys, such as prostatic hypertrophy, renal calculi, or tumors.

Oliguric Phase of AKI

The initial phase of acute kidney injury developing within $1\text{ to }7\text{ days}$ of insult, characterized by urine output $<400\text{ mL/day}$, fluid volume overload, hyperkalemia, hyponatremia, and metabolic acidosis.

Diuretic Phase of AKI

The intermediate phase of acute kidney injury lasting $1\text{ to }3\text{ weeks}$, characterized by an increase in daily urine output to $1\text{ to }3\text{ L/day}$ (up to $3\text{ to }5\text{ L/day}$), accompanied by risks of hypovolemia, dehydration, and hypotension.

Recovery Phase of AKI

The convalescent phase of acute kidney injury spanning $3\text{ to }12\text{ weeks}$ (taking up to $12\text{ months}$), indicated by an increasing $\text{GFR}$ followed by plateauing and reduction of $\text{BUN}$ and serum creatinine.

Minimal Change Nephrotic Syndrome (MCNS)

The most common idiopathic form of childhood nephrotic syndrome, characterized by increased glomerular permeability that leads to massive urinary protein loss.

The Big Four of Nephrotic Syndrome

The four hallmark diagnostic criteria of nephrotic syndrome: massive proteinuria, generalized edema, hypoalbuminemia, and hypercholesterolemia (hyperlipidemia).

Human Immunodeficiency Virus (HIV)

An RNA retrovirus that infects and destroys $\text{CD4}^+$ T cells, causing progressive immune system deterioration when cell counts drop below $500\text{ cells}/\mu\text{L}$.

Acquired Immune Deficiency Syndrome (AIDS)

The advanced stage of HIV infection diagnosed when an individual's $\text{CD4}^+$ T-cell count falls below $200\text{ cells}/\mu\text{L}$ ($\text{cells/mm}^3$) or when an AIDS-defining opportunistic infection, opportunistic cancer, or wasting syndrome ($\ge 10\%$ BMI loss) manifests.

AIDS Dementia Complex (ADC)

A central nervous system manifestation of late-stage HIV/AIDS characterized by progressive cognitive, motor, and behavioral impairments, seen in up to $70\%$ of AIDS patients.

Pre-Exposure Prophylaxis (PrEP)

A daily prophylactic antiretroviral regimen (such as tenofovir/Truvada) taken by HIV-negative individuals at high risk to prevent acquisition of the virus.

Post-Exposure Prophylaxis (PEP)

An emergency combination antiretroviral regimen initiated promptly following a potential high-risk exposure to HIV (via needlestick, body fluids, or sexual contact) to abort viral infection.

Highly Active Antiretroviral Therapy (HAART)

A drug regimen combining three or more antiretroviral medications from distinct pharmacological classes to maximize viral suppression, decrease drug resistance, and preserve $\text{CD4}^+$ counts.

Sepsis

Life-threatening organ dysfunction caused by a dysregulated, exaggerated host systemic inflammatory response to a documented or suspected infection, causing vasodilation, increased capillary permeability, and vital organ hypoperfusion.

Quick Sequential Organ Failure Assessment (qSOFA)

A bedside scoring tool identifying high sepsis risk when at least two of three criteria are met: systolic blood pressure $\le 100\text{ mmHg}$, altered mental status, and respiratory rate $\ge 22\text{ breaths/min}$.

Disseminated Intravascular Coagulation (DIC)

A severe hematologic complication in sepsis characterized by widespread microvascular clotting due to excess thrombin, resulting in concurrent widespread thrombosis and paradoxical severe bleeding from platelet depletion.

Anaphylaxis

An acute, severe, life-threatening clinical hypersensitivity reaction triggered by allergen exposure in a sensitized individual, causing massive mediator release leading to bronchoconstriction, systemic vasodilation, hypotension, and angioedema.

Double-Blind, Placebo-Controlled Food Challenge

The diagnostic gold standard used under strict medical supervision to definitively diagnose or exclude a true IgE-mediated food allergy.