CPSP IMM Medicine key terms

Acute myocardial injury with a rise and fall in cardiac troponin and at least one value above the 99th percentile, caused by atherosclerotic plaque rupture or erosion with thrombus formation and reduced myocardial blood flow.

An umbrella clinical diagnosis covering unstable angina, non-ST-elevation myocardial infarction, and ST-elevation myocardial infarction, all sharing abrupt reduction in coronary blood flow that threatens myocardium.

A cardiac sarcomeric protein released into blood when myocytes are injured; high-sensitivity assays detect small amounts and serial measurement distinguishes acute injury from chronic elevation.

Upward displacement of the ECG segment between the end of the QRS complex and the start of the T wave, which when new and in contiguous leads suggests transmural ischaemia needing urgent reperfusion.

A clinical syndrome of congestion or low output with a left ventricular ejection fraction of 40 percent or less, usually treated with guideline-directed combination therapy that improves survival.

A hormone released by stretched ventricular myocardium (BNP and its precursor NT-proBNP) that promotes natriuresis; blood levels help confirm or exclude heart failure in breathless patients.

The percentage of ventricular end-diastolic volume expelled with each contraction, commonly measured by echocardiography, used to classify systolic function and guide heart failure therapy.

A supraventricular arrhythmia with disorganised atrial activation, absent P waves, and an irregularly irregular ventricular response, raising the risk of thromboembolic stroke and requiring rate or rhythm control plus anticoagulation assessment.

A point score adding age, sex, heart failure, hypertension, diabetes, stroke, vascular disease and thromboembolism items to estimate stroke risk in atrial fibrillation and decide whether anticoagulation is indicated.

Severe blood pressure elevation with acute target-organ damage such as encephalopathy, pulmonary oedema, aortic dissection or acute kidney injury, managed with controlled parenteral reduction rather than rapid normalisation.

Persistently elevated arterial blood pressure confirmed by repeated out-of-office or office measurement, a major modifiable driver of stroke, ischaemic heart disease, heart failure and chronic kidney disease.

Persistent, usually progressive airflow limitation caused by airway and alveolar abnormalities from inhaled noxious particles, diagnosed by a post-bronchodilator FEV1/FVC ratio below 0.70.

A lung function test measuring forced expired volumes and flows; the post-bronchodilator FEV1/FVC ratio separates obstructive from restrictive patterns and the FEV1 percent predicted grades severity.

A chronic inflammatory airway disorder with variable expiratory airflow limitation, recurrent wheeze, cough and breathlessness, showing reversibility or variability and managed with inhaled corticosteroids.

An acute worsening of respiratory symptoms beyond normal day-to-day variation that requires additional therapy, commonly triggered by infection and treated with bronchodilators, corticosteroids and sometimes antibiotics.

An acute infection of lung parenchyma acquired outside hospital, diagnosed by compatible symptoms plus a new infiltrate, with severity scores guiding site of care and empirical antibiotic choice.

Abnormal accumulation of fluid in the pleural space; transudates reflect hydrostatic or oncotic imbalance while exudates reflect inflammation, infection or malignancy, and thoracentesis with Light criteria classifies it.

Occlusion of pulmonary arteries by thrombus, usually from deep veins of the legs, producing acute dyspnoea, chest pain or syncope; risk stratification guides anticoagulation and thrombolysis decisions.

A fibrin degradation product that rises when clot is formed and broken down; a negative result in a low or intermediate pretest probability patient can safely exclude venous thromboembolism.

Retrograde flow of gastric contents causing troublesome heartburn or regurgitation and sometimes oesophagitis; diagnosis is clinical, and alarm features or refractory symptoms warrant endoscopy.

A urease-producing bacterium that colonises gastric mucosa, causing chronic gastritis and strongly associated with peptic ulcer disease and gastric adenocarcinoma; detected by urea breath test, stool antigen or biopsy.

A mucosal defect extending through the muscularis mucosae in stomach or duodenum, most often driven by Helicobacter pylori infection or NSAID use and presenting with dyspepsia or bleeding.

Bleeding arising proximal to the ligament of Treitz, presenting as haematemesis or melaena; resuscitation comes first, then risk scoring and endoscopy within 24 hours for most patients.

Sudden pancreatic inflammation diagnosed when two of three criteria are met: characteristic epigastric pain, lipase or amylase above three times the upper limit, or imaging findings; early care centres on fluids and analgesia.

Advanced hepatic fibrosis with regenerative nodules causing portal hypertension and impaired synthetic function, staged clinically by complications such as ascites, varices and encephalopathy.

Pathological fluid accumulation in the peritoneal cavity, most often from portal hypertension in cirrhosis; diagnostic paracentesis with a serum-ascites albumin gradient classifies the cause.

Infection of ascitic fluid without a surgical source, diagnosed by a polymorphonuclear cell count of 250 per microlitre or more, requiring prompt antibiotics and often albumin.

Chronic immune-mediated intestinal inflammation comprising Crohn disease, which can affect any segment transmurally, and ulcerative colitis, which is confined to the colon mucosa.

A group of metabolic disorders with chronic hyperglycaemia from insulin deficiency, insulin resistance or both, diagnosed by HbA1c, fasting glucose, oral glucose tolerance or random glucose with symptoms.

Glycated haemoglobin reflecting average blood glucose over roughly the preceding two to three months; used to diagnose diabetes and to monitor long-term glycaemic control.

A hyperglycaemic emergency with ketonaemia, metabolic acidosis and volume depletion, most typical of absolute insulin deficiency, treated with fluids, intravenous insulin and potassium replacement.

Abnormally low blood glucose, usually below 3.9 mmol/L in treated diabetes, causing autonomic and neuroglycopenic symptoms and requiring fast-acting oral carbohydrate or intravenous glucose.

A pituitary hormone that rises when thyroid hormone output is low and falls when output is excessive; a first-line test for thyroid dysfunction because the relationship is inverse and sensitive.

Deficiency of thyroid hormone causing fatigue, weight gain, cold intolerance, constipation and bradycardia, confirmed by high TSH with low free thyroxine and treated with levothyroxine.

An abrupt fall in kidney function, defined by a creatinine rise or urine output reduction over hours to days, classified as prerenal, intrinsic or postrenal and often reversible if the cause is corrected.

A calculated index of kidney filtration derived from serum creatinine, age and sex, used to stage chronic kidney disease and adjust drug dosing.

Kidney damage or reduced filtration persisting more than three months, staged by estimated glomerular filtration rate and albuminuria, and managed by controlling blood pressure, proteinuria and cardiovascular risk.

Serum potassium above the normal range, dangerous because it can cause peaked T waves, widened QRS and ventricular arrhythmia; treatment stabilises myocardium, shifts potassium intracellularly and removes it from the body.

Microcytic anaemia from depleted iron stores, shown by low ferritin or transferrin saturation; in adults, especially men and postmenopausal women, it requires investigation for gastrointestinal blood loss.