Inflammation, Elimination, and Pediatric Cardiovascular Disorders

Vocabulary practice flashcards covering inflammation concepts, adult GI and renal exemplars, pediatric elimination disorders, and pediatric congenital heart defects.

Inflammation

An immunologic defense and protective physiologic response against tissue injury, infection, or allergy initiated to minimize or remove the pathologic agent and promote healing, which can occur without infection.

C-Reactive Protein (CRP)

A non-specific acute-phase marker for evaluating the course and severity of inflammatory diseases that appears in the blood within $18\text{--}24\text{ hours}$ after tissue damage and peaks at $48\text{--}72\text{ hours}$, with normal values of $< 1.0\,\text{mg/dL}$.

Erythrocyte Sedimentation Rate (ESR)

A laboratory test measuring the speed at which red blood cells settle in a tube of anti-coagulated blood expressed in $\text{mm/hr}$, used to indicate an active inflammatory or pathologic condition.

Cholelithiasis

The formation of gallstones (most commonly cholesterol stones, $75\%$; or calcium pigment stones) that develops when the balance keeping cholesterol, bile salts, and calcium in solution is altered.

Acalculous Cholecystitis

Inflammation of the gallbladder that occurs in the absence of gallstone obstruction, often associated with anesthesia, opioids, adhesions, neoplasms, or severe systemic factors.

Murphy's Sign

A clinical diagnostic indicator for acute cholecystitis characterized by sharp tenderness and an arrest of inspiration when palpating the right upper quadrant.

T-Tube

A surgical drain placed into the common bile duct during an open cholecystectomy to ensure duct patency until edema subsides and allow excess bile to drain while the small intestine adjusts.

Gastritis

Inflammation of the gastric lining caused by a disruption of the protective mucosal barrier that permits hydrochloric acid and pepsin to contact gastric tissue, resulting in edema, hyperemia, and superficial erosion.

Barrett's Esophagus

A precancerous complication of chronic GERD in which the normal squamous lining of the lower esophagus is replaced by columnar-lined epithelium resembling the mucosa of the small intestine.

Nissen Fundoplication

A surgical procedure for severe GERD in which the gastric fundus is wrapped around the distal esophagus and sutured to itself to increase pressure in the lower esophageal sphincter and prevent reflux.

Pyelonephritis

A bacterial infection of the renal tubules and interstitial tissue of one or both kidneys, typically arising from the upward spread of bacteria such as Escherichia coli from the bladder.

Glomerulonephritis

Inflammation of the glomerular capillaries, frequently triggered by post-infectious, medication-induced, or autoimmune responses, which can cause acute nephritic syndrome manifesting with hematuria, edema, azotemia, and proteinuria.

Diverticulum

A saccular dilation or out-pouching of the bowel mucosa extending through a defect in the muscular layer, most commonly found in the left descending sigmoid colon.

Diverticulosis

The presence of multiple out-pouchings (diverticula) in the intestinal wall without active inflammation, often associated with a low-fiber diet and chronic constipation.

Diverticulitis

Infection and inflammation of one or more diverticula that can present with left lower quadrant pain, fever, leukocytosis, and complications including perforation, abscesses, strictures, and bleeding.

Hartmann Procedure

A two-stage surgical resection for diseased bowel where the affected section is excised, the proximal end is brought out as an end colostomy, and the distal pouch is closed and left in the abdomen for future reconnection.

Crohn's Disease

A chronic, transmural inflammatory bowel disease that begins with crypt inflammation and focal ulcers that deepen to produce a characteristic cobblestone appearance, frequently affecting the terminal ileum with skip lesions.

Strictureplasty

A surgical technique used in Crohn's disease to enlarge a narrowed small bowel segment by making a lengthwise incision and suturing it transversely, preserving functional intestinal length.

Ulcerative Colitis

A chronic inflammatory disease limited to the mucosa and submucosa of the colon and rectum, characterized by contiguous ulcerations starting in the rectum, shedding of the epithelium, and frequent bloody, purulent diarrhea.

Tenesmus

The painful and urgent persistent sensation of needing to evacuate the bowels, commonly seen in active ulcerative colitis.

Toxic Megacolon

An acute, severe, life-threatening complication of inflammatory colitis characterized by acute colonic distention, high fever, abdominal tenderness, tachycardia, and elevated risk of perforation and shock.

Fistula

An abnormal tract connecting segments of intestine to other bowel loops, the bladder, vagina, or skin, often seen in transmural Crohn's disease and requiring high-calorie nutrition to heal.

Total Parenteral Nutrition (TPN)

Intravenous hypertonic nutrition consisting of dextrose ($60\%$ of calories), amino acids, lipids, electrolytes, vitamins, and minerals administered via a central venous catheter for bowel rest.

Vesicoureteral Reflux (VUR)

The retrograde backflow of urine from the urinary bladder up into the ureters and renal pelvis during bladder contraction, graded from Grade I (minor) to Grade V (severe).

Voiding Cystourethrogram (VCUG)

A fluoroscopic imaging study where the bladder is filled with contrast medium via a urinary catheter to evaluate bladder filling and emptying and to detect reflux of urine into the ureters.

Intussusception

A pediatric bowel emergency in which a proximal portion of the intestine invaginates or 'telescopes' into an adjacent distal segment, leading to venous stasis, bowel edema, ischemia, and obstruction.

Currant-Jelly Stool

Stool mixed with blood and sloughed mucosal mucus, serving as a classic clinical finding of intestinal ischemia associated with intussusception.

Hirschsprung Disease

A congenital disorder of intestinal motility (congenital aganglionic megacolon) characterized by the absence of ganglion nerve cells in the distal bowel, causing functional obstruction and failure to pass meconium.

Pull-Through Procedure

A surgical repair for Hirschsprung disease in which the diseased aganglionic bowel segment is resected or bypassed, and the healthy ganglionic bowel is connected directly to the child's anus.

Hypertrophic Pyloric Stenosis

Hypertrophy and thickening of the circular muscle of the pylorus that produces a mechanical gastric outlet obstruction, manifesting with projectile nonbilious vomiting and a palpable olive-shaped mass in the right upper quadrant.

Pyloromyotomy

A surgical operation performed to relieve hypertrophic pyloric stenosis by incising the thickened pyloric muscle fibers longitudinally down to, but not through, the submucosa.

Congenital Heart Defect (CHD)

A category of structural anomalies of the heart or great vessels present at birth, classified hemodynamically into disorders of decreased pulmonary blood flow, increased pulmonary blood flow, obstructive defects, or mixed defects.

Ventricular Septal Defect (VSD)

An abnormal opening in the septum separating the right and left ventricles that permits a left-to-right shunt of blood, which can lead to increased pulmonary blood flow, pulmonary hypertension, and heart failure.

Pulmonary Artery Banding

A temporary palliative surgical procedure that places a band around the pulmonary artery to narrow its lumen, reducing excessive blood flow and pressure to the lungs in children with large unrepaired VSDs.

Tetralogy of Fallot (TOF)

A congenital cardiac defect defined by four concurrent anomalies: pulmonary stenosis, ventricular septal defect, overriding aorta, and right ventricular hypertrophy.

Hypercyanotic Spell (Tet Spell)

An acute episode of severe cyanosis and hypoxemia in infants with Tetralogy of Fallot, triggered by acute increases in infundibular spasm or drops in systemic vascular resistance, treated by placing the child in a knee-to-chest position.

Blalock–Taussig Shunt

A palliative surgical anastomosis connecting the subclavian artery to the pulmonary artery to augment pulmonary circulation and oxygenation in cyanotic congenital heart defects such as Tetralogy of Fallot.

Transposition of the Great Vessels (TGV)

A cyanotic congenital cardiac anomaly in which the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle, creating two parallel, separated circulatory circuits.

Arterial Switch Operation

A definitive open-heart corrective surgical procedure performed in the first week of life for TGV that switches the aorta and pulmonary artery to their anatomically correct ventricles.

Cardiac Catheterization

An invasive definitive diagnostic and interventional procedure in which a radiopaque catheter is guided via fluoroscopy through a blood vessel into the heart chambers to measure pressures, inject contrast, and evaluate anatomy.