GLOSSARY: D TERMS

Debridement

Removal of necrotic tissue to promote wound healing and reduce risk of further infection.

Delayed peak response

The effects of medication take longer than expected to initiate.

Delirium

Transient brain syndrome presenting as disordered attention, cognition, psychomotor behavior, and perception.

Delirium tremens (DTs)

Symptom of alcohol withdrawal characterized by hallucinations, delirium, severe agitation, fever, elevations of blood pressure and heart rate, and possible cardiac arrhythmias.

Dematiaceous

Darkly pigmented colored spores or fungal hyphae

Dennie-Morgan line

A line or fold below the lower eyelids; associated with atopy.

Dermatophyte

Any microscopic fungus that grows on the skin, scalp, and nails.

Desensitization

The process of giving a medication in a controlled and gradual manner, which allows the person to tolerate it temporarily without an allergic reaction.

Desquamation

Peeling or shedding of the epidermis (superficial layer of the skin) in scales or flakes.

Diabetes insipidus

An uncommon disorder that occurs when the kidneys pass an abnormally large volume of urine (3–20 quarts/day of urine versus the typical 1–2 quarts/day) that is dilute and odorless (“insipid”). Unrelated to diabetes mellitus, although both conditions cause frequent urination and constant thirst. Individuals with diabetes insipidus have normal blood glucose levels; however, their kidneys cannot balance fluid in the body.

Diabetic ketoacidosis

A reversible but life-threatening short-term complication primarily seen in patients with type 1 diabetes caused by the relative or absolute lack of insulin that results in marked ketosis and acidosis.

Dialysate

The physiologic solution used during dialysis to remove excess fluids and waste products from the blood.

Dialysis

The process of removing fluid and waste products from the blood across a semi-permeable membrane to maintain fluid, electrolyte, and acid-base balance in patients with kidney failure.

Diaphoresis

Sweating or profuse perspiration, generally as a symptom of a disease or an adverse drug effect.

Diarthrodial joint

A freely moveable joint (e.g., knee, shoulder). Contrast with amphiarthrodial joint (a slightly movable joint; e.g., vertebral joint) and synarthrodial joint (an unmovable joint; e.g., fibrous joint).

Dilated cardiomyopathy

Ability of the heart to pump blood is decreased because the left ventricle is enlarged and weakened.

Diphasic dyskinesia

The motor fluctuations occur while the plasma levodopa concentrations are rising and when they are falling. In each dosing interval, the patient may experience improvement, dyskinesia, and improvement (IDI) or dyskinesia, improvement, and dyskinesia (DID).

Direct current cardioversion

The process of administering a synchronized electrical shock to the chest, the purpose of which is to simultaneously depolarize all of the myocardial cells, resulting in restoration of normal sinus rhythm.

Directly observed treatment

Method to increase adherence to medications when a patient is observed taking the medication by a health care worker.

Disease-free survival

Period of time from the end of treatment that the patient survives without signs or symptoms of the disease.

Disease progression

In cancer, at least a 20% increase in the sum of the longest diameter of target lesions from baseline, including new lesions discovered during treatment.

Disseminated erythrosquamous papules

Widespread or whole body red, scaly psoriatic lesions.

Disseminated intravascular coagulation (DIC)

A thrombotic and hemorrhagic disorder marked by uncontrolled systemic coagulation resulting in thrombosis, which may lead to generalized bleeding due to the depletion of clotting factors and increased fibrinolysis.

DNA mismatch repair (dMMR) genes

Genes that control an intrinsic intracellular mechanism which corrects nucleotide insertion errors made during DNA replication, by excising the mismatched base pairs that escaped correction by the proofreading activities of DNA polymerases and replacing the mismatched bases with the correct ones.

Door-to-needle time

Time from arrival in hospital to adminis tration of treatment in appropriate patients.

Dose density

The total amount of drug given in a fixed unit of time (usually 1 week), thus is a function of dose and frequency of administration.

D-test

Double disk diffusion microbiological testing which indi cates the presence or absence of macrolide-induced resistance to clindamycin.

Ductus arteriosus

Shunt connecting the pulmonary artery to the aortic arch that allows most of the blood from the right ventricle to bypass fetal lungs.

Duodenal enterocyte

Cells lining the duodenum, which is the first of three parts of the small intestine.

Dysarthria

Speech disorder due to weakness or incoordination of speech muscles; speech is slow, weak, and imprecise.

Dysentery

A number of disorders marked by inflammation of the intestines, especially of the colon, and attended by pain in the abdomen, tenesmus, and frequently stools containing blood and mucus.

Dysesthesia

An unpleasant abnormal sensation.

Dyskinesia

Abnormal involuntary movements, which include dystonia, chorea, and akathisia.

Dyslipidemia

Elevation of the total cholesterol, low-density lipoprotein cholesterol, or triglyceride concentrations, or a decrease in high-density lipoprotein cholesterol concentration in the blood.

Dysmenorrhea

Crampy pelvic pain occurring with or just prior to menses. “Primary” dysmenorrhea implies pain in the setting of normal pelvic anatomy, while “secondary” dysmenorrhea is secondary to underlying pelvic pathology.

Dyspareunia

Painful sexual intercourse due to medical or psychological causes.

Dyspepsia

Upper abdominal symptoms that may include pain or discomfort, bloating, feeling of fullness despite little food intake, unusual fullness after meals, nausea, loss of appetite, heartburn, regurgitation of food or acid, and belching.

Dysphagia

Painful or difficult swallowing, accompanied by a sensation of food being stuck in passage

Dysphonia

Impairment of the voice or difficulty speaking.

Dyspnea

Difficult or labored breathing.

Dystonia

A type of dyskinesia. The movement is slow and twist ing. It may be associated with painful muscle contractions or spasms.