A-H 3

Crepitus: A grating sound or sensation typically produced by friction between bone-on-cartilage or bone-on-bone contact. It is also a crackling chest sound that is heard in pneumonia. Cross-allergenicity: Sensitivity to one drug with activity to a different drug with a similar chemical structure. Crypt abscess: Neutrophilic infiltration of the intestinal glands (crypts of Lieberkühn); a characteristic finding in patients with ulcerative colitis. Cutis laxa: Hypereflacidity of the skin with loss of elasticity. Cyanosis: A dark blue or purple discoloration of the skin and mucous membranes due to deficient oxygenation of the blood. Cyclooxygenase: An enzyme that catalyzes the conversion of arachidonic acid to prostaglandins and consists of two isoforms, generally abbreviated COX-1 and COX-2. Cystitis: Inflammation of urinary bladder. Cystocele: Herniation of the urinary bladder into the vagina. Herniation is abnormal protrusion of an organ through a defect or natural opening. Cytokines: Regulatory proteins, such as interleukins and lymphokines, are released by cells of the immune system and act as intercellular mediators in the generation of an immune response. Soluble glycoproteins released by the immune system which act through specific receptors to regulate immune responses. Cytomegalovirus (CMV) disease: This is the term used when patients who are already infected with CMV present with the classically associated symptoms that resemble a viral infection and may include fever, malaise, arthralgias, and others. Cytomegalovirus (CMV) infection: This is the term used when a patient has anti-CMV antibodies in the blood, when CMV antigens are detected in infected cells, or when the virus is isolated from a culture. 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 shortterm 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 (eg, knee, shoulder). Contrast with amphiarthrodial joint (a slightly movable joint; eg, vertebral joint) and synarthrodial joint (an unmovable joint; eg, 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, 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 drug administration 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 indicates the presence or absence of macrolide-induced resistance to clindamycin. Ductus arteriosus: Shunt connecting the pulmonary artery to the aortic arch that allows 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 (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: Pain during or after sexual intercourse. 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 twisting. It may be associated with painful muscle contractions or spasms. Ebstein anomaly: Congenital heart defect in which the opening of the tricuspid valve is displaced towards the apex of the right ventricle. Eburnation: A condition in which bone or cartilage becomes hardened and denser. Ecchymosis: Passage of blood from ruptured blood vessels into subcutaneous tissue causing purple discoloration of the skin. Eclampsia: Seizures associated with high blood pressure. Ectopic pregnancy: Presence of a fertilized ovum outside of the uterine cavity. Effector cells: Cells that become active in response to initiation of the immune response. Ejection fraction: The fraction of the volume present at the end of diastole that is pushed into the aorta during systole. Electroconvulsive therapy: Administration of electric current to the brain through electrodes placed on the head to induce seizure activity in the brain; used in the treatment of certain mental disorders. Electroencephalography: The recording of brain waves via electrodes placed on the scalp or cortex. Embolism: The sudden blockage of a vessel caused by a blood clot or foreign material which has been brought to the site by the flow of blood. Embolization: The process by which a blood clot or foreign material dislodges from its site of origin, flows in the blood, and blocks a distant vessel. Empiric: A strategy or treatment administered without definitive evidence of the cause, ie, often at the onset of symptoms or radiological findings. Endometritis: Inflammation of the endometrium. Endophthalmitis: Inflammation of intraocular fluid (vitreous and aqueous), usually due to infection. Endoscopy: Visual inspection of the inside of hollow organs with an endoscope, mainly for diagnostic purposes; refers to procedures such as gastroscopy, duodenoscopy, colonoscopy, and sigmoidoscopy. Endothelial cell: A single layer of cells surrounding the lumen of arteries. Endovascular: Procedures involving insertion of a catheter containing medications or instruments into a blood vessel for the treatment of vascular disease. End-stage liver disease: Liver failure that is usually accompanied by complications such as ascites or hepatic encephalopathy. Enthesitis: Inflammation of the sites where tendons, ligaments, or fascia attach to bone. Enuresis: Involuntary discharge of urine. Eosinophilic asthma: Sub-phenotype of asthma with elevated tissue and sputum eosinophils, thickening of the basement membrane zone, and corticosteroid responsiveness. Criteria that have been used for medications to treat eosinophilic asthma include blood eosinophil count ≥ 150 cells/µL (0.150 × 109/L) or > 300 cells/µL (0.3 × 109/L) (400 cells/µL [0.4 × 109/L] for reslizumab) in the past year, sputum eosinophil count ≥ 3% (0.03), and exhaled nitric oxide concentration ≥ 50 ppb. Epilepsy: A neurological disorder characterized by recurring motor, sensory, or psychic malfunction with or without loss of consciousness or convulsive seizures. Epistaxis: Nasal hemorrhage with blood drainage through the nostrils; a nosebleed. Erosive esophagitis: A severe form of gastroesophageal reflux disease (GERD) in which the mucous membrane lining the esophagus is inflamed with areas of erosion resulting from abnormal reflux of gastric acid. Erythema nodosum: Inflammation of the fat cells under the skin resulting in termer red nodules or lumps. Erythematous: Flushing of the skin caused by dilation of capillaries. Erythema is often a sign of inflammation and infection. Erythrodermic psoriasis: Generalized erythema covering nearly the entire body surface area. Fever and malaise are common and, while quite rare, can be severe and even fatal; it is usually associated with a worsening of other forms of psoriasis. Erythropoiesis stimulating agents: Agents developed by recombinant DNA technology that have the same biological activity as endogenous erythropoietin to stimulate erythropoiesis (red blood cell production) in the bone marrow. Erythropoietin: A hormone primarily produced by the progenitor cells of the kidney that stimulates red blood cell production in the bone marrow. Lack of this hormone leads to anemia. Esophageal manometry: Measurement of pressures and muscle contractions in the esophagus. Esophageal stricture: Narrowing of the esophageal lumen resulting chronic inflammation and formation of scar tissue. Esophageal varices: Dilated blood vessels in the esophagus. Essential fatty acid deficiency: Deficiency of linoleic acid, linolenic acid, and/or arachidonic acid, characterized by hair loss, thinning of skin, and skin desquamation. Long-chain fatty acids include trienes (containing three double-bonds [eg, 5,8,11-eicosatrienoic acid [or Mead acid], trienoic acids]) and tetraenes (containing four double-bonds [eg, arachidonic acid]). Biochemical evidence of essential fatty acid deficiency includes a triene:tetraene greater than 0.2 and low linoleic or arachidonic acid plasma concentrations. Exanthem: Eruption of the skin. Excess body weight: Calculated as the difference between actual and ideal body weight. Exfoliative dermatitis: Severe inflammation and peeling of the entire skin surface due to a reaction to certain drugs. Exploratory laparotomy: Surgical incision into the abdominal cavity, performed to examine the abdominal organs and cavity in search of an abnormality and diagnosis. External beam radiotherapy (EBRT): An external source of radiation is pointed at a particular part of the body. Extraabdominal: Outside of the abdominal cavity.