PANRE key terms

The percentage of blood in the left ventricle that is pumped out with each heartbeat; normal is roughly 55 to 70 percent, and a low value suggests systolic heart failure.

A low-pitched extra heart sound heard just after the normal second sound, produced by rapid filling of a stiff or volume-overloaded ventricle; commonly heard in heart failure.

A protein released into the blood when heart muscle is damaged; a rise and fall in its level supports the diagnosis of myocardial infarction.

An exaggerated fall in systolic blood pressure during inspiration, greater than about 10 mm Hg, classically seen in severe asthma and in cardiac tamponade.

The fraction of forced vital capacity exhaled in the first second; a value below about 0.70 after bronchodilator defines obstructive lung disease.

Enlargement and failure of the right ventricle caused by chronic lung disease and high pulmonary artery pressure; produces edema, raised jugular venous pressure, and a loud pulmonic component of the second sound.

Abnormally high carbon dioxide in arterial blood, with PaCO2 above roughly 45 mm Hg, reflecting inadequate alveolar ventilation; causes headache and drowsiness and, at high levels, confusion or coma.

Accumulation of fluid within the peritoneal cavity, usually from portal hypertension or low oncotic pressure; causes abdominal distention, shifting dullness, and a fluid wave on examination.

Fatty, bulky, pale, foul-smelling stool caused by fat malabsorption, as occurs in pancreatic exocrine insufficiency or untreated celiac disease.

Arrest of inspiration when the examiner presses below the right costal margin; a positive sign suggests acute cholecystitis.

The preferred screening antibody for celiac disease; an elevated level with compatible symptoms supports the diagnosis, although duodenal biopsy may still be needed in some patients.

A bony outgrowth at the margin of a joint formed in response to cartilage loss and altered loading; seen on imaging in osteoarthritis and often contributing to pain and stiffness.

Pain, numbness, or weakness following the distribution of a single nerve root, usually from disc herniation or foraminal narrowing; strength and reflexes in that root's territory may be reduced.

Chalky deposits of monosodium urate crystals in skin and soft tissue around joints, seen in chronic tophaceous gout and sometimes draining through the skin.

Swelling of the optic disc caused by raised intracranial pressure; it enlarges the blind spot and causes transient visual obscurations rather than early loss of central acuity.

A tuning-fork test comparing air conduction with bone conduction behind the ear; normally air conduction is better, and a conductive loss reverses that relationship.

A tuning fork placed on the midline of the forehead; sound lateralizes to the ear with conductive hearing loss and away from the ear with sensorineural loss.

Fluid behind an intact tympanic membrane without signs of acute infection; causes a muffled hearing loss and a retracted, sometimes amber-colored drum.

The two numbers used to summarize obstetric history: total pregnancies including the current one, and the count of births after 20 weeks of gestation.

A scoring system using cervical dilation, effacement, consistency, position, and fetal station to predict how readily labor will begin after induction.

New hypertension after 20 weeks of pregnancy accompanied by proteinuria or maternal organ dysfunction; it can progress to seizures and usually requires close monitoring and often delivery.

A sharp midcycle rise in luteinizing hormone that triggers ovulation about 24 to 36 hours later; urine kits detect it to time intercourse or insemination.

Glycated hemoglobin that reflects average blood glucose over the previous two to three months; used both to diagnose diabetes and to monitor long-term control.

A metabolic emergency in which insulin deficiency drives ketone production, causing a high-anion-gap acidosis with hyperglycemia, dehydration, and deep Kussmaul breathing.

A syndrome in which excessive or inappropriately secreted antidiuretic hormone produces concentrated urine, low serum sodium, and euvolemia without a renal or diuretic explanation.

A life-threatening exaggeration of thyrotoxicosis with fever, marked tachycardia, agitation, and altered mental status; treated with beta-blockade, a thionamide, iodine, and supportive care.

Upgoing movement of the great toe with fanning of the other toes when the sole is stroked; in adults it indicates damage to the corticospinal tract.

The band of skin supplied by a single spinal nerve root; mapping where sensation is lost helps localize a radiculopathy or cord lesion.

A score from 3 to 15 combining eye opening, verbal response, and motor response, used to grade and track level of consciousness after injury.

An acquired language disorder from brain injury that affects production or comprehension of words; fluency and repetition patterns help classify it as Broca, Wernicke, or conduction type.

An acute, fluctuating disturbance of attention and awareness usually caused by illness, medications, or withdrawal; unlike dementia, onset is sudden and the disturbance often reverses.

A toxic reaction to serotonergic drugs with agitation, tremor, clonus, hyperreflexia, and fever; clonus and hyperreflexia help distinguish it from neuroleptic malignant syndrome.

A rare reaction to dopamine-blocking drugs causing rigidity, high fever, altered consciousness, and elevated creatine kinase; managed by stopping the drug with supportive care and dantrolene or bromocriptine.

Loss of interest or pleasure in activities that were previously enjoyable; a core symptom of major depression and a common target of treatment monitoring.

Glomerular filtration rate: the volume of plasma filtered by the kidneys each minute, estimated from serum creatinine and used to stage chronic kidney disease.

The percentage of filtered sodium that is excreted in the urine; a value below 1 percent suggests prerenal hypoperfusion, while higher values suggest intrinsic kidney injury.

A pattern of heavy proteinuria, low serum albumin, edema, and high lipids caused by glomerular damage; complications include blood clots and infection.

The volume of urine left in the bladder after voiding, measured by bladder scan or catheterization; a high value suggests outlet obstruction or a weak detrusor muscle.