i-m
Immune reconstitution inflammatory syndrome (IRIS): A paradoxical clinical worsening of a known infection or the appearance of a new condition after initiating antiretroviral therapy in HIV-infected patients (or recovery from immunosuppression in non-HIV infected patients).
Immunoassay: A blood test for antibodies to antigens that worsen asthma, such as pollen, mold, or dust mites.
Immunogenicity: Ability of a substance to provoke an immune
response.
Immunoglobulin G index: The ratio of immunoglobulin G to
protein in the serum or cerebrospinal fluid.
Immunophenotyping: A process used to identify cells, based on the types of antigens or markers on the surface of the cell. This process is used to diagnose specific types of leukemia and lymphoma by comparing the cancer cells to normal cells of the immune system.
Immunotherapy: A type of biological therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection, and other diseases.
Implantable cardioverter-defibrillator: A device implanted into the heart transvenously with a generator implanted subcutaneously in the pectoral area that provides internal electrical cardioversion of ventricular tachycardia
or
defibrillation of ventricular fibrillation.Incretin effect: A greater insulin stimulatory effect after an oral glucose load than that caused by an intravenous glucose infusion. The majority of the effect is thought to be due to glucose-dependent insulinotropic peptide (GIP) and glucagon like peptide-1 (GLP-1). Patients with type 2 diabetes have a significant reduction of the incretin effect, implying that these patients either have decreased concentration of the incretin hormones, or a resistance to their effects. GLP-1 concentrations are reduced in patients with type 2 diabetes in response to a meal, while GIP concentrations are either normal or increased, suggesting a resistance to the actions of GIP, thus making GLP-1 a more logical target for therapeutic intervention.
Induction: The first treatment given for a disease. It is often part of a standard set of treatments, such as surgery followed by chemotherapy and radiation.
Infantile spasms (West syndrome): A seizure syndrome in infants younger than 1 year. It is characterized by a specific electroencephalogram pattern and spasms or jitters.
Inotropic: Relating to or influencing the force of muscular
contractions.
In-stent restenosis:
Complex process following stent
implantation resulting in smooth muscle cell proliferation within an implanted stent, renarrowing of the arterial lumen, and recurrent ischemia.Insulin resistance: A decreased response to insulin found before or early in the diagnosis of type 2 diabetes mellitus.
International normalized ratio (INR): The ratio of the patient's clotting time to the clinical laboratory's mean reference value; normalized by raising it to the international sensitivity index (ISI) power to account for differences in thromboplastin
reagents. Therefore, INR = (patient's prothrombin time/
laboratory's mean normal prothrombin time)iS!.
Interstitial nephritis: An acute inflammation of the kidney, often due to drugs; patients commonly present with fever, rash, and peripheral eosinophilia.
Intraabdominal: Within the abdominal cavity.
Intraarticular: Administered to or occurring in the space within joints.
Intraperitoneal: Within the peritoneal cavity.
Intravesicular: Situated or occurring within the bladder.
Intussusception: The prolapse of part of the intestine into the
lumen of an immediately adjoining part. Blood supply to the
telescoped region can be compromised leading to necrosis.
Iontophoresis: Introduction of a medication into tissue through
use of an electric current.
Ipsilateral: Occurring on the same side.
Ischemia: Deficient supply of blood to a part(s) of the body.
Ischemic penumbra: Ischemic but still viable cerebral tissue.
Typically a rim of mild to moderately ischemic tissue in
between normally perfused tissue and the area of evolving
infarction; may remain viable for several hours.
synuclein inside some nerve cells.
Jejunal entercocyte: Cells lining the jejunum, a section of the
small intestine connecting the duodenum to the ileum.
Jejunostomy: Operative placement of a new opening into the
Jugular venous distention: Assessed with the patient laying at a
Juvenile myoclonic epilepsy: An epilepsy syndrome that typically
Keratinization: The sloughing of epithelial cells in the hair follicle.
Keratinocytes: The predominant cell type in the outermost layer
Lesch–Nyhan syndrome: A rare inherited gene mutation that
results in accumulation of abnormally high uric acid levels.
Leukocytoclastic vasculitis: Acute cutaneous vasculitis
characterized by purpura (especially of the legs) and
histologically by exudation of neutrophils and sometimes fibrin
around dermal venules, with extravasation of red blood cells.
Leukopenia: A condition where the number of circulating white
blood cells are abnormally low due to decreased production of
new cells, possibly in conjunction with medication toxicities.
Lewy bodies: Abnormal deposits of a protein called alpha-
Lhermitte sign: Tingling or shock-like sensation passing down
the arms or trunk when the neck is flexed.
Libido: Sexual drive or desire.
jejunum, usually associated with feeding tube placement.
Ligament of Treitz: Landmark in the proximal portion of the
jejunum beyond which it is preferred that postpyloric feedings
45 degree angle, and demonstrating a measurement of the right
be delivered to minimize aspiration.
internal jugular vein that is more than 4 cm above the sternal
Linea nigra: Dark vertical line that appears on the abdomen
angle; suggests systemic venous congestion and volume overload.
during pregnancy.
Linear accelerator: A device in which charged particles are
occurs during teenage years and consists of generalized tonic-
accelerated in a straight line by successive impulses from a
seizures and myoclonic jerks. Absence seizures may also occur
series of electric fields.
with this syndrome.
Lipophilic: Having affinity for fatty substances.
Lipoprotein lipase: Enzyme located in the capillary endothelium
involved in the breakdown of intravenous lipid emulsion
of the skin.
particles.
Keratitis: Infection of the cornea.
Livedo reticularis: Purple mottling of the skin.
Keratoconjunctivitis sicca: An eye disease caused by eye dryness,
Lower esophageal sphincter: A manometrically defined zone
which results from either decreased tear production or increased
of the distal esophagus with an elevated basal resting pressure
tear film evaporation. Also known as dry eye syndrome.
that prevents the reflux of gastric material from the stomach.
Kernicterus: Form of brain damage caused by excessive jaundice.
It relaxes on swallowing to permit the free passage of food into
Ketosis: An abnormal increase of ketone bodies present in
the stomach.
conditions of reduced or disturbed carbohydrate metabolism.
Lymphangitis: Inflammation of lymphatic channels.
Korotkoff sounds: The noise heard over an artery by auscultation
Lymphatic: The network of vessels carrying tissue fluids.
when pressure over the artery is reduced below the systolic
Lymphedema: Swelling, primarily in the appendages, caused by a
arterial pressure.
blockage or disruption in the lymphatic system.
Kyphosis: Abnormal curvature of the spine resulting in protrusion
Lymphoproliferative: Of or related to the growth of lymphoid
of the upper back; hunchback.
tissue.
Lactose intolerance: The inability to digest lactose, a sugar found
Magnetic resonance imaging: A form of medical imaging that
in milk products, resulting in diarrhea, bloating, and gas after
measures the response of the atomic nuclei of body tissues to
ingestion.
high-frequency radio waves when placed in a strong magnetic
Lagophthalmos: Poor closure of the upper eyelid.
field, and that produces images of the internal organs.
Lamina cribrosa: A series of perforated sheets of connective
Major malformation: A defect that has either cosmetic or
tissue that the optic nerve passes through as it exits the eye.
functional significance to the patient.
Laminectomy: A surgical operation to remove the back of one or
Maltodextrin: Easily digestible partially hydrolyzed starch.
more vertebrae.
Marcocytosis: Enlargement of red blood cells with near-constant
Laparoscopic: Abdominal exploration or surgery employing a
hemoglobin concentration.
type of endoscope called laparoscope.
Mastalgia: Tenderness of the breasts.
Laparoscopic adjustable gastric banding: A surgical procedure
Mastodynia: Pain in the breast.
for weight loss that elicits its effectiveness through gastric
Matrix metalloproteinases: Any of a group of enzymes, normally
volume limitation. The procedure involves inserting a silicone
located in the extracellular space of tissue, that function to
band lined with an inflatable donut-shaped balloon around the
break down proteins (eg, collagen) and require zinc or calcium
neck of the stomach to be filled with isotonic liquid.
atoms as cofactors for enzymatic activity. Responsible for the
Laparotomy: Surgical opening of the abdominal cavity.
degradation of connective tissue.
Left shift: An increase in the number of immature neutrophils
Meatal stenosis: Narrowing in the opening of the urethra.
(also referred to as bands). A left shift usually indicates infection
Meconium: First intestinal discharge (“stool”) of a newborn
or inflammation. The term originated in the days in which lab
infant, usually green in color and consisting of epithelial cells,
reports were written by hand and the bands were written on the
mucus, and bile.
left-hand side of the lab report. Also known as bandemia.
Medication-assisted treatment: The use of medications with
Lennox–Gastaut syndrome: An epilepsy syndrome
counseling and other behavioral therapies for the treatment of
that often appears early in life that consists of a distinct
substance use disorders.
electroencephalogram pattern, mild to severe developmental
Melasma: Patchy skin pigmentation or dark skin discoloration,
delay, and multiple seizure types.
often seen during pregnancy
Melena: Abnormally dark black, tarry feces containing blood
(usually from gastrointestinal bleeding).
Menarche: The first menstrual cycle.
Meninges: Membranes surrounding the brain and spinal cord.
Meningismus: Symptoms similar to meningitis (nuchal rigidity,
photophobia, and headache) but not caused by meningitis.
Mesial temporal lobe epilepsy: A common epilepsy syndrome
manifested by seizures arising from the mesial temporal lobe
of the brain, and is often associated with an anatomical change,
described as hippocampal sclerosis.
Mesocortical pathway: A neural pathway that connects the
ventral tegmentum to the cortex, particularly the frontal lobes.
It is one of the major dopamine pathways in the brain.
Mesothelioma: A benign or malignant tumor affecting the lining
of the chest or abdomen. Commonly caused by exposure to
asbestos fibers.
Metabolic acidosis: A condition in the blood and tissues that
is a consequence of an accumulation of lactic acid resulting
from tissue hypoxia and anaerobic metabolism. It may also
be caused by a decrease in the concentration of alkaline
compounds (typically bicarbonate).
Metabolic syndrome: Constellation of cardiovascular risk factors
related to hypertension, abdominal obesity, dyslipidemia,
and insulin resistance diagnosed by the presence of at least
three of the following criteria: increased waist circumference,
elevated triglyceride concentrations, decreased high density
lipoprotein (HDL) cholesterol or active treatment to raise HDL
cholesterol, elevated blood pressure or active treatment with
antihypertensive therapy, or elevated fasting glucose or active
treatment for diabetes.
Metastasis: Cancer that has spread from the original site of the
tumor.
Methemoglobinemia: A condition caused by elevated levels
of methemoglobin in red blood cells, resulting in enhanced
oxygen affinity in heme sites and reduced oxygen delivery to
tissues; leads to hypoxia, cyanosis, shortness of breath, mental
status changes, and dizziness. In severe cases, it can lead to
seizures, coma, or death.
Microalbuminuria: Urinary excretion of small but abnormal
amounts of albumin. Confirmed spot urine albumin to
creatinine ratio of 30 to 300 mg/g (3.4–34 mg/mmol creatinine)
is consistent with microalbuminuria. Considered an early sign
of chronic kidney disease.
Microcytosis: A condition in which the erythrocytes are smaller
than normal.
Micrognathia: Abnormal smallness of the jaws.
Micrographia: Small handwriting.
Microsatellite instability (MSI): The condition of genetic
hypermutability that results from impaired DNA mismatch
repair (MMR). The presence of MSI represents phenotypic
evidence that MMR is not functioning normally.
Microvascular: Pertaining to the smaller vessels of the circulatory
system such as capillaries, venules, and arterioles.
Microvascular pulmonary emboli: An obstruction in the small
blood vessels in the lung caused by material (eg, blood clot, fat,
air, foreign body) that is carried through the circulation until it
lodges in another small vessel.
Micturition: Act of passing urine.
Minimum inhibitory concentration: The lowest concentration
of a drug that visually inhibits the growth of a microorganism.
Minor malformation: Defect that has neither cosmetic nor
functional significance to the patient.
APPENDIX C | GLOSSARY 1585
Mixed mood features: Symptoms of mania and depression
occurring simultaneously or in close juxtaposition. Criteria
are either met for a manic/hypomanic episode and there are
also at least three symptoms of depression, or criteria are met
for a depressive episode with at least three manic/hypomanic
symptoms.
Mobilization: A process by which medication(s) are used to
promote the release of hematopoietic stem cells from the
bone marrow to the peripheral blood for the purpose of
collecting a sufficient amount of hematopoietic stem cells for
a hematopoietic stem cell transplant.
Moebius syndrome: Rare congenital neurological disorder
which is characterized by facial paralysis and affects eye
movement.
Monoamine neurotransmitters: Serotonin, norepinephrine,
dopamine.
Monoparesis: Slight or incomplete paralysis affecting a single
extremity or part of one.
Monosodium urate: A crystallized form of uric acid that can
deposit in joints leading to an inflammatory reaction and the
signs and symptoms of gout.
Morphology: Structure and form of a cell.
Mucositis: Inflammatory, erosive, and/or ulcerative process
inside the mouth, which is usually caused by radiation or
chemotherapy.
Multiparity: Condition of having given birth to multiple children.
Muscularis mucosa: The thin layer of smooth muscle found in
most parts of the gastrointestinal tract.
Mydriasis: Pupil dilation.
Myelin: A protein and phospholipid sheath that surrounds the
axons of certain neurons. Myelinated nerves conduct impulses
more rapidly than nonmyelinated nerves.
Myeloablative preparative regimen: Chemotherapy regimens
with or without radiation that cause irreversible cytopenias
without hematopoietic stem cell support.
Myelodysplastic syndrome: A type of cancer in which the bone
marrow does not make enough healthy blood cells (white
blood cells, red blood cells, and platelets) and there are
abnormal cells in the blood and/or bone marrow.
Myelopathy: A neurologic deficit related to the spinal cord.
Myelosuppression: Reduction in white blood cells, red blood
cells, and platelets.
Myocardial infarction: The formation of an infarct, an area of
tissue death, due to a local lack of oxygen. Myocardial cell
death secondary to prolonged ischemia.
Myocarditis: Inflammation of the heart muscle.
Myoglobinuria: The presence of myoglobin in urine.
Myonecrosis: Necrotic damage to muscle tissue.
Myopathy: Any disease of the muscle causing weakness, pain,
and tenderness.
Myringotomy: A surgical incision made in the tympanic
membrane to relieve pressure and drain fluid from the
middle ear.
Myxedema: Hypothyroidism characterized by a relatively hard
edema of subcutaneous tissue, with increased content of
proteoglycans in the fluid; characterized by somnolence, slow
mentation, dryness and loss of hair, increased fluid in body
cavities such as the pericardial sac, subnormal temperature,
hoarseness, muscle weakness, and slow return of a muscle to
the neutral position after a tendon jerk.