ABPS Internal Medicine key terms

A clinical syndrome in which the left ventricle pumps poorly, with ejection fraction of 40 percent or less, producing congestion and low forward output. Treatment combines diuretics with guideline-directed neurohormonal blockade, including renin-angiotensin agents, beta blockers, and mineralocorticoid antagonists.

Complete or near-complete coronary artery occlusion causing transmural myocardial injury, recognized by ST-segment elevation in contiguous leads. Emergent reperfusion by primary percutaneous coronary intervention or fibrinolysis limits infarct size and preserves ventricular function.

An irregularly irregular supraventricular rhythm with chaotic atrial activation and absent organized P waves, which raises stroke risk. Management centers on anticoagulation guided by stroke risk scores, rate control, and selective rhythm control.

Progressive calcific narrowing of the aortic valve that obstructs left ventricular outflow, causing exertional dyspnea, angina, and syncope. Severe symptomatic disease carries a poor prognosis and warrants surgical or transcatheter valve replacement.

An acute worsening of dyspnea, cough, or sputum in a person with chronic obstructive pulmonary disease, usually triggered by respiratory infection or irritants. Treatment combines short-acting bronchodilators, systemic corticosteroids, antibiotics when indicated, and controlled oxygen.

Sudden noncardiogenic pulmonary edema from alveolar-capillary injury, producing bilateral opacities and severe hypoxemia that does not fully respond to supplemental oxygen. Care is largely supportive: lung-protective ventilation, prone positioning, and treatment of the underlying cause.

A clot, usually traveling from deep leg veins, that lodges in pulmonary arteries and obstructs blood flow, causing dyspnea, pleuritic chest pain, and hypoxemia. Anticoagulation is standard; hemodynamically unstable patients may require thrombolysis.

Bleeding arising above the ligament of Treitz, often from peptic ulcers or esophageal varices, presenting as hematemesis, coffee-ground emesis, or melena. Resuscitation, risk stratification, acid suppression, and timely endoscopy are central to management.

Accumulation of fluid within the peritoneal cavity, most often from portal hypertension in cirrhosis. Paracentesis establishes the diagnosis; a high serum-ascites albumin gradient indicates portal hypertension, and spontaneous bacterial peritonitis must be excluded.

Sudden pancreatic inflammation, usually from gallstones or alcohol, causing severe epigastric pain radiating to the back with elevated lipase. Treatment emphasizes fluids, analgesia, early enteral feeding, and recognition of complications such as necrosis or pseudocyst.

A metabolic emergency of insulin deficiency with ketone overproduction, causing hyperglycemia, high anion gap metabolic acidosis, dehydration, and total-body potassium depletion. Treatment pairs volume repletion with intravenous insulin and careful potassium replacement.

A blood test reflecting average glucose over roughly the preceding three months by measuring glucose attached to hemoglobin. It diagnoses and monitors diabetes, though hemoglobin variants, anemia, and pregnancy can distort results.

Deficiency of thyroid hormone causing fatigue, cold intolerance, weight gain, constipation, and bradycardia, most often from autoimmune thyroiditis. Diagnosis rests on elevated thyroid-stimulating hormone with low free thyroxine; levothyroxine replaces the missing hormone.

Life-threatening organ dysfunction caused by a dysregulated host response to infection, identified by rising organ-dysfunction scores in a patient with suspected infection. Early antibiotics, cultures, fluid resuscitation, and source control improve survival.

Infection of the endocardial surface, most often heart valves, typically arising from bacteremia with staphylococci, streptococci, or enterococci. Blood cultures and echocardiography establish the diagnosis, and prolonged intravenous antibiotics are required, sometimes with surgery.

An abrupt decline in kidney function over hours to days, shown by rising creatinine or falling urine output, from prerenal, intrinsic, or postrenal causes. Management means correcting the cause, reviewing nephrotoxins, and controlling fluid and electrolyte derangements.

Serum sodium below the normal range, usually reflecting excess water relative to body solute rather than true sodium loss. Assessment depends on volume status, urine osmolality, and urine sodium; correction must be gradual to avoid osmotic demyelination.

Elevated serum potassium that can destabilize cardiac membranes and provoke fatal arrhythmias, often from kidney failure, drugs, or acidosis. Emergent care uses intravenous calcium to protect the heart plus agents that shift potassium into cells or remove it.

A mild to moderate normocytic anemia driven by inflammation, which raises hepcidin and limits iron availability despite adequate body stores. Ferritin is typically normal or high, and treatment targets the underlying inflammatory illness.

Fever in a patient with a dangerously low neutrophil count, an oncologic emergency because infection can progress rapidly. Blood cultures followed by prompt empiric broad-spectrum antibiotics are required, with growth factors added in selected cases.

Rapid breakdown of many cancer cells after treatment releases potassium, phosphate, and nucleic acids, causing hyperkalemia, hyperphosphatemia, hypocalcemia, and uric acid nephropathy. Aggressive hydration and urate-lowering therapy prevent acute kidney injury.

Concurrent use of multiple medications, commonly five or more, which raises the risk of interactions, adverse effects, and nonadherence in older adults. Structured medication review with deprescribing aims to align regimens with goals of care.

An acute, fluctuating disturbance of attention and awareness, often triggered by infection, medications, pain, or metabolic derangement in vulnerable older patients. Nonpharmacologic prevention and treating the trigger are first-line; antipsychotics are not routinely indicated.

An ongoing conversation process in which patients record values and preferences for future care, including surrogate decision makers and code status. It guides clinicians when the patient can no longer express preferences directly.

An inflammatory arthritis caused by monosodium urate crystals deposited in joints and soft tissues, producing sudden severe pain, most often at the first metatarsophalangeal joint. Joint aspiration confirms the diagnosis; urate-lowering therapy prevents recurrence.

A small-vessel vasculitis associated with antibodies against neutrophil proteins, affecting kidneys and lungs with glomerulonephritis and alveolar hemorrhage. Treatment combines glucocorticoids with immunosuppression, typically rituximab or cyclophosphamide.

A chronic symmetric inflammatory polyarthritis that chiefly affects small joints and can erode bone and cause extra-articular disease. Early disease-modifying therapy, usually methotrexate, prevents joint destruction and preserves function.

Brain infarction from arterial occlusion, producing sudden focal neurologic deficits; thrombolysis or thrombectomy within a narrow time window can salvage threatened tissue. Rapid imaging and exclusion of hemorrhage must precede reperfusion decisions.

Continuous seizure activity, or repeated seizures without recovery, lasting five minutes or more, constituting a neurologic emergency. Benzodiazepines are given first, followed by longer-acting antiseizure drugs while the precipitating cause is sought.

Severe drug-related mucocutaneous reactions with skin detachment, ranging from limited to extensive epidermal loss. Care involves stopping the culprit drug, supportive burn-type management, wound care, eye protection, and monitoring for infection and fluid loss.

Acute bacterial infection of the deep dermis and subcutaneous fat producing spreading warmth, erythema, and tenderness, usually from streptococci or staphylococci. Elevation and appropriate antibiotics treat most cases, while abscess formation requires drainage.

A toxic state from serotonergic drugs, marked by agitation, clonus, hyperreflexia, diaphoresis, and fever. Offending agents are stopped and supportive care given; severe cases may need cyproheptadine and aggressive cooling.

A spectrum from tremor and anxiety to seizures and delirium tremens after abrupt cessation of heavy drinking, driven by central nervous system hyperexcitability. Benzodiazepines are first-line, alongside thiamine, fluids, and monitoring for complications.