Reference
Glossary
Terms used across the journey, with short definitions. Terms marked in blue inside chapters open a quick definition on hover or tap.
Tachycardia
FoundationsAn abnormally fast heart rate. The heart is a pump, and its rate is one of its two key levers (rate × stroke volume = how much blood it moves per minute). Tachycardia is often the first sign that the body is under stress and is accelerating the pump to keep blood pressure and flow up.
Bradycardia
FoundationsAn abnormally slow heart rate. A slow rate is normal in athletes and during sleep, but if the pump is too slow to move enough blood, it can cause low pressure, lightheadedness, or fainting.
Hypotension
FoundationsBlood pressure that is too low to keep adequate blood flowing to organs. Because organs need pressure to push blood through their vessels, very low pressure starves the brain, kidneys, and heart of oxygen.
Hypertension
FoundationsA chronic elevation of blood pressure that puts strain on the heart, arteries, brain, kidneys, and eyes. Because it is usually silent, it is called a 'silent killer' and is a major risk factor for heart attack, stroke, and kidney disease.
Mean arterial pressure (MAP)
FoundationsThe time-averaged arterial pressure that actually pushes blood into the brain, kidneys, and heart. It sits between systolic and diastolic pressure and is the number clinicians use to judge whether organs are being perfused.
Cardiac output
FoundationsThe amount of blood the heart ejects each minute, equal to heart rate × stroke volume. It is the 'flow' side of blood pressure and determines how much oxygen-rich blood reaches the tissues.
Stroke volume
FoundationsThe volume of blood ejected by the left ventricle with each contraction. It depends on how much blood returns to the heart, how hard the muscle contracts, and how much resistance it must overcome.
Systemic vascular resistance
FoundationsThe sum of the resistance offered by all the small arteries and arterioles. Together with cardiac output it determines blood pressure (MAP = CO × SVR). Vessels can narrow (raise resistance) or relax (lower it).
Sinoatrial node
FoundationsA small cluster of cells in the right atrium that generates each heartbeat's electrical trigger. It sets the resting rhythm and speeds up or slows down in response to the autonomic nervous system.
SA node
FoundationsShort for the sinoatrial node, the heart's natural pacemaker in the right atrium.
Funny current
FoundationsA sodium/potassium ion current (called If, or 'funny') that flows in SA node cells between beats. It leaks positive charge in, pushing the cell toward its firing threshold - the engine of spontaneous heartbeat.
Phase 4 depolarization
FoundationsThe gradual buildup of positive charge inside pacemaker (SA node) cells between beats that eventually triggers the next action potential. It is the electrical basis for automatic, rhythmic heartbeat.
Baroreceptor
FoundationsStretch-sensitive nerve endings in the carotid arteries and aortic arch that constantly measure blood pressure. When pressure falls, they send fewer signals, prompting a reflex that raises heart rate and constricts vessels.
Reflex tachycardia
FoundationsThe heart speeding up in response to a sensed fall in blood pressure. It is a compensatory reflex, not the primary disease - it tells you the pump is working harder to defend pressure.
Hypovolemic shock
PathologyA state of inadequate organ perfusion caused by low circulating volume - from bleeding, severe dehydration, or fluid loss (vomiting, diarrhea, burns). The tank is too empty to fill the pump.
Distributive shock
PathologyA form of shock in which blood pressure falls because the small vessels lose tone and dilate, even when the heart pumps hard. The blood is there, but it pools instead of being pushed to organs.
Cardiogenic shock
PathologyInadequate organ perfusion because the heart cannot pump enough blood, most often after a major heart attack or in severe heart failure. The pump itself is the problem.
Obstructive shock
PathologyA form of shock where a physical blockage prevents the heart from filling or pumping - a tension pneumothorax compressing the chest, a massive pulmonary embolism, or cardiac tamponade squeezing the heart.
pH
FoundationsThe concentration of hydrogen ions in the blood. Normal blood is kept in a very narrow range because enzymes and cells only work within it. Acid-base disorders push pH out of this range.
Acidosis
FoundationsA state in which blood pH falls below normal. It can result from too much acid added, too little acid removed, or too much bicarbonate lost.
Alkalosis
FoundationsA state in which blood pH rises above normal, from too much base, too much acid loss, or excessive CO2 blowing off.
Metabolic acidosis
FoundationsAcidosis originating in metabolism or kidney/bicarbonate handling rather than the lungs. The pH falls because too much acid is made, acids are not excreted, or bicarbonate is lost. The lungs compensate by blowing off CO2.
Metabolic alkalosis
FoundationsAlkalosis from acid loss or bicarbonate gain. The body compensates by breathing more slowly to retain CO2 and, slowly, by the kidneys excreting bicarbonate.
Respiratory acidosis
FoundationsWhen the lungs cannot blow off carbon dioxide (too slow or too shallow breathing, or lung disease), CO2 builds up and dissolves into acid, lowering pH.
Respiratory alkalosis
FoundationsWhen breathing is too fast or deep, CO2 is blown off faster than produced, so blood acid falls and pH rises.
Compensation
FoundationsThe body's corrective responses that mask or limit an underlying problem. The lungs and kidneys compensate for acid-base shifts on different timescales, and the heart and vessels compensate for pressure changes.
Anion gap
FoundationsA value computed from the major measured ions that catches the presence of 'unmeasured' acids (lactate, ketoacids, toxins). A high anion gap means some acid is present that the standard panel does not directly measure.
Bicarbonate
FoundationsBicarbonate is the chief buffer in the blood, soaking up hydrogen ions to keep pH stable. The kidneys control its level, so bicarbonate is a key number on the blood gas.
Creatinine
FoundationsA byproduct of muscle metabolism that the kidneys filter out. Because it is produced at a fairly steady rate, a rising creatinine means the kidneys are filtering less well.
BUN
FoundationsA waste product made as the body breaks down protein. It is filtered by the kidneys and rises when filtration drops or when the body is dehydrated and reabsorbing water.
Sodium
FoundationsThe dominant electrolyte in the blood, which controls how water is distributed in the body and is essential for nerve and muscle signaling. Its level changes reflect body water, not just salt.
Potassium
FoundationsA charged particle concentrated inside cells that is critical for the electrical activity of nerves, muscles, and especially the heart. Both high and low potassium disturb heart rhythm.
Electrolyte
FoundationsDissolved salts (sodium, potassium, calcium, magnesium, chloride, bicarbonate) that carry electric charge. They are essential for nerve signaling, muscle contraction, hydration, and many chemical reactions.
Hemoglobin
FoundationsThe molecule inside red blood cells that binds oxygen in the lungs and releases it in the tissues. Hemoglobin levels reflect how much oxygen the blood can carry.
Hematocrit
FoundationsThe percentage of blood volume that is red blood cells. It tracks hemoglobin and rises or falls with red-cell mass and hydration.
Platelet
FoundationsSmall fragments that plug leaks in blood vessels and build clots. Too few platelets (thrombocytopenia) raises bleeding risk; too many raises clotting risk.
White blood cell
FoundationsA family of blood cells (neutrophils, lymphocytes, monocytes, eosinophils, basophils) that defend the body. The total and the breakdown (differential) help point to infection versus inflammation.
Oxygen saturation (SpO2)
FoundationsA noninvasive measure (by pulse oximeter) of how much of the blood's oxygen-carrying capacity is currently loaded. Low saturation means little oxygen is being delivered to tissues.
Kidney
FoundationsOne of two organs that filter the blood, remove wastes, regulate water and electrolytes, and control acid-base balance. Each contains about a million filtering units (nephrons).
Nephron
FoundationsThe functional unit of the kidney, made of a filter (glomerulus) and a tubule that adjusts what is reabsorbed and excreted. About a million nephrons work in each kidney.
Glomerulus
FoundationsA ball of tiny blood vessels where blood is filtered. It holds back blood cells and large proteins while letting water, salt, and small wastes through to become urine.
Sepsis
PathologyA serious condition in which an infection triggers a widespread, dysregulated inflammatory response that can damage organs and drop blood pressure. When blood pressure falls despite fluids, it becomes septic shock.
Septic shock
PathologyThe most severe form of sepsis, in which infection causes such widespread vessel dilation and leakiness that blood pressure cannot be maintained, starving organs of oxygen despite fluid replacement.
Hypoxia
FoundationsA state where body tissues do not get enough oxygen, which can starve organs. It can arise from low oxygen in the blood, poor circulation, too few red cells, or cells unable to use oxygen.
Ischemia
FoundationsInsufficient blood supply to a tissue, depriving it of oxygen and nutrients. If severe or prolonged, it causes cell death (infarction) - as in heart attack or stroke.
Coronary
FoundationsThe coronary arteries supply oxygenated blood to the heart muscle. Coronary artery disease is narrowing or blockage of these vessels, a leading cause of heart attack.
Antibiotic resistance
PharmacologyThe ability of bacteria to survive drugs that once killed them. Overuse and broad-spectrum use drive resistance, making infections harder to treat.
Corticosteroids
PharmacologyCortisol and its synthetic relatives (e.g., prednisone, dexamethasone) that broadly dampen inflammation and immune activity by altering gene expression.
Beta-adrenergic receptors
PharmacologyCell-surface receptors that respond to adrenaline and noradrenaline. Beta-blockers attach to them, blocking the stimulatory effects on the heart.
Plasmin
PharmacologyAn enzyme that breaks down the fibrin mesh of a clot. Thrombolytic drugs convert plasminogen into plasmin to dissolve dangerous clots.
Lumbar puncture
ProceduresA procedure that samples cerebrospinal fluid (CSF) from the space around the spinal cord. It is the definitive test for meningitis and a key tool for other nervous-system conditions.
Granuloma
PathologyA collection of immune cells that forms in response to chronic inflammation, seen in sarcoidosis, tuberculosis, and some infections.
Granulomas
PathologyClusters of immune cells (macrophages and lymphocytes) that wall off persistent inflammation or infection; characteristic of sarcoidosis, tuberculosis, and fungal infections.
Systemic lupus erythematosus
PathologyAn autoimmune disease where the immune system attacks skin, joints, kidneys, blood cells, and brain. It is a 'great imitator' diagnosed with clinical criteria and specific antibodies.
Paraneoplastic syndrome
PathologyA set of symptoms caused not by the tumor itself but by the body's immune response to it, or by substances the tumor releases. Symptoms can appear before the cancer is found.
Differential diagnosis
MethodThe structured list of possible diagnoses that could account for a patient's symptoms and findings, ranked by likelihood and danger, revised as new data arrives.
Cognitive biases
MethodSystematic errors in thinking that distort how evidence is weighed, such as anchoring, confirmation bias, and premature closure. They are a major cause of diagnostic error.
Occam's razor
MethodThe principle that the simplest explanation - one disease explaining all findings - is usually correct. It is a useful starting bias, not proof.
Hickam's dictum
MethodThe counter-principle to Occam's razor: patients can have as many diseases as they please, so sometimes findings are several separate problems rather than one unifying disease.
Anaphylaxis
PathologyA severe, potentially life-threatening allergic reaction causing swelling, breathing trouble, and low blood pressure. It is an emergency treated with epinephrine.
Empiric therapy
PharmacologyTreatment begun based on the most likely diagnosis before test results confirm it, often broad-spectrum, then narrowed once the organism or cause is identified.
Allosteric site
PharmacologyA site on a receptor separate from the main binding site. Binding there (as benzodiazepines do on GABA-A) changes how the receptor responds to its main signal.
Chelation
PathologyA treatment that uses drugs to bind heavy metals in the body so they can be excreted. It is used for lead, mercury, and other heavy-metal poisoning under specialist guidance.
Prion
PathologyAn abnormal misfolded protein that can recruit normal proteins to misfold, spreading through the brain and causing rare, fatal neurodegenerative disease.
Anticoagulation
PharmacologyMedication that reduces the blood's ability to clot, used to treat or prevent dangerous clots such as deep vein thrombosis, pulmonary embolism, and some strokes.
Thrombolytic
PharmacologyA medication that dissolves blood clots by activating the body's clot-dissolving system. It is used for the most dangerous clots in stroke, heart attack, and pulmonary embolism.
Ventilator
ProceduresA machine that supports or replaces a patient's breathing when they cannot do so themselves, delivering oxygen and removing carbon dioxide through an airway tube.
Pneumothorax
ProceduresA condition where air collects in the space around the lung, causing it to collapse. It can occur spontaneously or from trauma or procedures and may require drainage.
Hemoptysis
ProceduresCoughing up blood from the respiratory tract. It is a concerning symptom that requires investigation for infection, tumor, or bleeding disorders.
Autoimmune disease
PathologyA condition in which the immune system mistakenly attacks the body's own cells and organs, such as lupus, rheumatoid arthritis, and vasculitis.
Aphasia
FoundationsImpaired ability to understand or produce language, caused by damage to the language areas of the brain, such as from stroke, tumor, or inflammation.
Encephalitis
PathologyInflammation of the brain, usually from infection or an autoimmune cause, causing fever, confusion, seizures, and neurologic symptoms.
Meningitis
PathologyInflammation of the meninges, the membranes covering the brain and spinal cord, usually from infection. It is a medical emergency diagnosed by lumbar puncture.
Granulomatous
PathologyDescribing a pattern of inflammation that forms granulomas, seen in sarcoidosis, tuberculosis, and certain fungal infections.
Vasculitis
PathologyInflammation of blood vessel walls that can affect any organ, causing a wide range of symptoms depending on which vessels are involved.
Amyloid
PathologyInsoluble clumps of misfolded protein that deposit in organs such as the heart, kidneys, and nerves, disrupting their function in amyloidosis.
Anchoring
MethodA cognitive bias in which the clinician fixates on an initial diagnosis and fails to adjust it as new, conflicting evidence arrives.
Confirmation bias
MethodThe tendency to notice and value evidence that supports a favored hypothesis while ignoring evidence against it, a major cause of diagnostic error.
Premature closure
MethodThe cognitive error of accepting a diagnosis once a plausible explanation is found, without fully considering alternatives.
GABA
PharmacologyGamma-aminobutyric acid, the primary inhibitory neurotransmitter in the brain. It dampens neuronal activity and is the target of many sedative and anticonvulsant drugs.
GABA-A
PharmacologyAn ion-channel receptor for GABA that, when activated, allows chloride ions in and inhibits the neuron. Benzodiazepines bind an allosteric site on it to enhance GABA's effect.
GABA-A receptor
PharmacologyAn ion-channel receptor for GABA that, when activated, allows chloride ions in and inhibits the neuron. Benzodiazepines bind an allosteric site on it to enhance GABA's effect.
Lorazepam
PharmacologyA benzodiazepine (brand name Ativan) used for anxiety, seizures, and sedation. It enhances GABA-A receptor function, producing calming and anticonvulsant effects.
Neutrophils
FoundationsThe most abundant type of white blood cell, a first-line defender against bacterial infection. High counts suggest bacterial infection or inflammation; low counts raise infection risk.
Lymphocytes
FoundationsWhite blood cells that include T cells and B cells. They drive viral immunity and antibody production; high counts suggest viral infection or certain blood disorders.
Eosinophils
FoundationsA white blood cell type that rises with allergic reactions, asthma, and parasitic infections. High eosinophils are a useful diagnostic clue.
Basophils
FoundationsThe least common white blood cell, involved in allergic and inflammatory responses. Abnormal levels can point to certain blood or allergic conditions.
Monocytes
FoundationsWhite blood cells that migrate into tissues and become macrophages, engulfing debris and pathogens. They rise in chronic infection and inflammation.
Ketoacidosis
FoundationsA metabolic state in which the body breaks down fat for fuel, producing acidic ketones. It occurs in diabetic ketoacidosis and starvation and causes a high-anion-gap acidosis.
Gadolinium
FoundationsA contrast agent used in MRI that brightens areas of abnormal blood-brain barrier, inflammation, or tumor. It is generally avoided in severe kidney disease.
Infarction
FoundationsDeath of tissue caused by interruption of its blood supply. Common examples include heart attack (myocardial infarction) and stroke (cerebral infarction).
Anion gap (high)
FoundationsSee 'Anion gap'. A high anion gap metabolic acidosis means extra acid is present that routine panels do not directly measure.
Kussmaul breathing
FoundationsA pattern of very deep, sometimes rapid breathing seen when the body tries to compensate for metabolic acidosis by exhaling carbon dioxide, which is acidic in solution.
Renal compensation
FoundationsOver 24-72 hours, the kidneys adjust acid-base balance by retaining or generating bicarbonate and excreting hydrogen ions. It is slower than lung compensation but can handle a large acid load.
Ammoniagenesis
FoundationsThe kidney's process of producing ammonia from amino acids, used to shuttle hydrogen ions out in the urine as ammonium. It is a key way the kidneys excrete acid during metabolic acidosis.
Winters' formula
FoundationsA formula that predicts the degree of respiratory compensation expected for a metabolic acidosis, so a mismatched result flags a mixed acid-base disorder.
Auscultation
FoundationsListening to internal body sounds - heart, lungs, and vessels - with a stethoscope. It turns the examiner into a sensor, spotting murmurs, crackles, wheezes, and added heart sounds.
Heart sounds S1 and S2
FoundationsS1 ('lub') is the sound of the atrioventricular valves closing as the ventricles begin to contract; S2 ('dub') is the semilunar valves closing as the ventricles relax. They mark the two phases of the mechanical cycle.
Murmur
FoundationsA blowing or whooshing sound caused by turbulent flow through a valve or vessel. Murmurs are timed (systolic vs diastolic) and graded, and help identify valve disease.
Electrocardiogram (ECG)
FoundationsA recording of the heart's electrical signals from electrodes on the skin. It reveals rate, rhythm, ischemia, and damage by showing the sequence of electrical activation.
P wave
FoundationsThe first small wave on the ECG, representing the atria depolarizing (electrically firing) to squeeze blood into the ventricles.
QRS complex
FoundationsThe tall deflection on the ECG representing the ventricles depolarizing and contracting - the main pumping event. A wide QRS means the impulse is spreading slowly.
ST segment
FoundationsThe flat portion between the QRS and the T wave, representing the ventricle between depolarization and repolarization. Elevation or depression here flags heart ischemia or injury.
T wave
FoundationsThe upright wave after the QRS representing the ventricles repolarizing (recharging) after a beat. Abnormal T waves can signal ischemia or electrolyte imbalance, especially potassium.
Alveolus
FoundationsOne of millions of tiny air sacs in the lungs where oxygen enters the blood and carbon dioxide leaves it, across a thin membrane.
Diffusion
FoundationsThe passive movement of molecules from an area of higher concentration to lower concentration, across a membrane. It is how oxygen and CO2 move in the lungs and how many drugs act.
Surfactant
FoundationsA soap-like substance lining the alveoli that reduces surface tension, keeping the tiny air sacs open on exhalation. It is key to normal breathing.
Loop of Henle
FoundationsThe hairpin-shaped middle segment of the nephron that creates a concentration gradient in the kidney, allowing water reabsorption and concentrated urine.
Distal convoluted tubule
FoundationsA nephron segment after the loop of Henle that adjusts salt reabsorption and calcium balance, and is a site for certain diuretics (thiazides).
Collecting duct
FoundationsThe final nephron segment where antidiuretic hormone (ADH) controls water reabsorption and where acid is finally adjusted, deciding how concentrated and acidic the urine is.
Antidiuretic hormone (ADH)
FoundationsA hormone released when the body is dehydrated that acts on the kidney's collecting duct to reabsorb water and concentrate urine, preserving body water.
Aldosterone
FoundationsA hormone that acts on the kidney to reabsorb sodium and excrete potassium, which pulls water with the sodium and raises blood pressure.
Preload
FoundationsThe degree of stretch of the ventricular muscle at the end of filling, determined by how much blood returns to the heart. More stretch usually means a stronger squeeze (Frank-Starling).
Afterload
FoundationsThe pressure the ventricle must overcome to push blood out. High afterload (like hypertension or a narrowed valve) makes the heart work harder to eject.
Frank-Starling law
FoundationsThe principle that the heart contracts more forcefully when its chambers are more filled before a beat, up to a physiological limit. It matches cardiac output to venous return.
Tension pneumothorax
ProceduresA life-threatening condition where air enters the chest and gets trapped, building pressure that collapses the lung and pushes the heart and major vessels, cutting off blood return.
Acute coronary syndrome
PathologyA group of conditions caused by sudden reduced blood flow to the heart muscle - unstable angina, and myocardial infarction (heart attack) with or without ST elevation.
Diabetic ketoacidosis
PathologyA serious complication of diabetes (most often type 1) in which, without enough insulin, the body breaks down fat for fuel, producing acidic ketones and causing a high-anion-gap metabolic acidosis.
Sensitivity
MethodThe proportion of truly diseased patients the test correctly identifies as positive (true positives / all with disease). A very sensitive test rarely misses disease, so a negative result helps rule it OUT.
Specificity
MethodThe proportion of truly healthy people the test correctly identifies as negative (true negatives / all without disease). A very specific test rarely mislabels healthy people as diseased, so a positive result helps rule disease IN.
Pretest probability
MethodThe estimated likelihood of the disease in a patient before a test result is known, based on the population, risk factors, and presentation. It determines how much the test actually changes your decision.
Positive predictive value
MethodThe proportion of positive test results that are true positives (how likely a positive result is correct). It rises with specificity and with pretest probability.
Negative predictive value
MethodThe proportion of negative test results that are true negatives (how likely a negative result is correct). It rises with sensitivity and with how unlikely the disease already is.
Likelihood ratio
MethodThe factor by which a test result shifts pretest to posttest probability. A positive likelihood ratio (LR+) raises the odds of disease; a negative one (LR-) lowers it. Values far from 1 are more informative.
CT scan
FoundationsAn imaging method using rotating X-rays to build cross-sectional slices of the body. Fast and detailed, it is excellent for trauma, chest, abdomen, bleeding, and guiding procedures.
MRI
FoundationsAn imaging method using strong magnetic fields and radio waves to image soft tissue in fine detail, ideal for the brain, spinal cord, joints, and soft tissue.
PET scan
FoundationsAn imaging method that detects where cells are metabolically active, lighting up cancers, infections, and inflammation rather than just anatomy.
CSF
FoundationsCerebrospinal fluid bathes the brain and spinal cord, cushioning and nourishing them. It is sampled by lumbar puncture to diagnose meningitis, hemorrhage, inflammation, and CNS malignancy.
ANA
MethodAn antibody that attacks the cell nucleus, found in most patients with systemic lupus (SLE) and some other autoimmune diseases. It is sensitive but not very specific.
ANCA
MethodAn antibody against white blood cells associated with ANCA-associated vasculitides, which inflame small blood vessels and often cause pulmonary-renal syndrome.
DIC
PathologyA dangerous condition in which widespread clotting consumes the clotting factors and platelets, then triggers bleeding. It complicates sepsis, trauma, obstetric emergencies, and malignancy.
HELLP syndrome
PathologyA serious hypertensive disorder of pregnancy characterized by hemolysis (red-cell breakdown), elevated liver enzymes, and a low platelet count, often related to preeclampsia.
Wilson disease
PathologyAn autosomal-recessive disorder (caused by mutations in ATP7B) in which copper is not properly transported and accumulates in the liver and brain, causing hepatic and neuropsychiatric disease.
Hereditary angioedema
PathologyA genetic disorder, often from C1-inhibitor deficiency, causing recurrent episodes of non-hive swelling (skin, abdomen, airway) that does not respond to allergy treatment.
Carbon monoxide
PathologyA toxic gas, from combustion (fires, heaters, exhaust), that binds hemoglobin far more tightly than oxygen, reducing oxygen delivery to tissues and causing hypoxia without a low SpO2 necessarily obvious.
Shock
PathologyA state in which organs do not receive enough oxygen because of low blood flow, low volume, vessel dilation, pump failure, or obstruction. The four broad types are hypovolemic, distributive, cardiogenic, and obstructive.