Reference

National Kidney Foundation Primer on Kidney Diseases.

SEVERELY INCREASED ALBUMINURIA

Urine albumin levels greater than 300 mg/day. This was previously referred

to as macroalbuminuria.

Reference

National Kidney Foundation Primer on Kidney Diseases.

ACUTE KIDNEY INJURY

Acute kidney injury (AKI) is defined as any of the following:

Increase in SCr by >0.3 mg/dL (>26.5 μmol/L) within 48 hours; or

Increase in SCr to 1.5 times baseline, which is known or presumed to

have occurred within the prior 7 days; or

Urine volume <0.5 mL/kg/h for 6 hours.

Reference

KDIGO 2012 Guidelines on CKD.

CHRONIC KIDNEY DISEASE

Chronic kidney disease (CKD) is defined as abnormalities of kidney

structure or function, present for >3 months with implications for health.

Criteria for CKD (either of the following present for >3 months)

Markers of kidney damage (one or

more)

Albuminuria (AER >/= 30 mg/24 hours; ACR >/= 30

mg/g

Urine sediment abnormalities

Electrolyte and other abnormalities due to tubular

disorders

Abnormalities detected by histology

Structural abnormalities detected by imaging

History of kidney transplantation

Decreased GFR GFR <60 mL/min/1.73 m2

(GFR categories G3a–G5)

Reference

•

•

•

•

•

KDIGO 2012 Guidelines on CKD.

NEPHROTIC SYNDROME

Nephrotic syndrome is a clinical syndrome characterized by:

Proteinuria—adult >3.5 g/day, child >40 mg/h per m2

Hypoalbuminemia— <3.5 g/dL

Edema

Hypercholesterolemia

Lipiduria.

Reference

Comprehensive clinical nephrology, John Feehally.

UNCOMPLICATED UTI AND COMPLICATED UTI

Uncomplicated UTI

Uncomplicated urinary tract infection refers to acute cystitis or pyelonephritis

in nonpregnant outpatient women without anatomic abnormalities or

instrumentation of the urinary tract.

Complicated UTI

The term complicated UTI encompasses all other types of UTI.

Reference

Jameson JL, Fauci AS, Kasper DL, et al. Harrison’s Principles of Internal Medicine, 20th

edition. United States of America: McGraw-Hill Education; 2018.

ASYMPTOMATIC BACTERIURIA

Asymptomatic bacteriuria is defined as the presence of two separate

consecutive clean-voided urine specimens, both with 10

5 or more colonyforming units per milliliter (cfu/mL) of the same uropathogen in the absence

of symptoms referable to the urinary tract.

Reference

Johnson RJ, Feehally J. Comprehensive clinical nephrology. US: Mosby; 2000.

•

–

–

–

–

–

•

NEUTROPENIA AND AGRANULOCYTOSIS

Neutropenia is defined as absolute neutrophil count (ANC) ≤1.5 × 109/L

Agranulocytosis defined as ANC ≤0.2 × 109/L which carries a risk of

severe infections with susceptibility to opportunistic organisms.

Reference

Newburger PE, Dale DC. Evaluation and management of patients with isolated neutropenia.

Semin Hematol. 2013;50(3):198-206.

FEBRILE NEUTROPENIA

Febrile neutropenia is defined as a single fever [101°F (38.3°C)] or

sustained elevated temperature [100.4°F (38°C)] in a patient with a current

or anticipated absolute neutrophil count (ANC) <500 cells/mm.

Reference

Freifeld AG, Bow EJ, Sepkowitz KA, et al. Clinical practice guideline for the use of

antimicrobial agents in neutropenic patients with cancer: 2010 update by the Infectious

Diseases Society of America. Clin Infect Dis. 2011;52(4):e56-93.

LYMPHADENOPATHY

Lymphadenopathy is defined as lymph nodes of:

Abnormal size, generally >1 cm, although definition of normal size range

varies by lymph node regions and age of patient;

Jugulodigastric lymph nodes (often the largest of cervical lymph

nodes) >1.5 cm are considered abnormal

Epitrochlear lymph nodes >5 mm are considered abnormal

Any palpable supraclavicular, popliteal, or iliac lymph nodes are

considered abnormal

Abdominal lymph nodes vary from 6–10 mm; retrocrural lymph nodes

>6 mm, retroperitoneal lymph nodes >10 mm, and pelvic lymph

nodes >8–10 mm are considered abnormal

Inguinal lymph nodes >1.5 cm in diameter are considered abnormal.

Abnormal dimensions, consistency or mobility.

Reference

•

•

•

•

Gaddey HL, Riegel AM. Unexplained Lymphadenopathy: Evaluation and Differential

Diagnosis. Am Fam Physician. 2016;94(11):896-903.

GENERALIZED LYMPHADENOPATHY

Generalized lymphadenopathy is defined as involvement of ≥2

noncontiguous lymph node groups and is typically indicative of systemic

disease.

Reference

Gaddey HL, Riegel AM. Unexplained Lymphadenopathy: Evaluation and Differential

Diagnosis. Am Fam Physician. 2016;94(11):896-903.

MASSIVE SPLENOMEGALY

Spleen is massively enlarged when it is palpable >8 cm below the left costal

margin or its drained weight is ≥1,000 g.

Reference

Harrison’s Principles of internal medicine.

HYPERSPLENISM

Hypersplenism defined as a syndrome comprised of:

Splenomegaly

Anemia, leukopenia, and/or thrombocytopenia

Compensatory bone marrow hyperplasia

Improvement after splenectomy (if performed).

Reference

Pozo AL, Godfrey EM, Bowles KM. Splenomegaly: investigation, diagnosis and

management. Blood rev. 2009;23(3):105-11.

STUPOR

Stupor is a state of baseline unresponsiveness that requires repeated

application of vigorous stimuli to achieve arousal.

Reference

•

•

•

•

Bradley’s Neurology in Clinical Practice, 5, 34-50.e1

COMA

Coma is a state of complete unresponsiveness to arousal, in which the

patient lies with the eyes closed.

Reference

Bradley’s Neurology in Clinical Practice, 5, 34-50.e1

CONFUSION

Confusion is a general term denoting the patient’s incapacity to think with

customary speed, clarity, and coherence.

Reference

Ropper AH, Samuels MA, Klein JP, et al. Adams and Victor’s Principles of Neurology, 11th

edition. United States of America: McGraw-Hill Education; 2019.

DEMENTIA

Dementia denotes a deterioration of all intellectual or cognitive functions

with little or no disturbance of consciousness or perception.

Reference

Ropper AH, Samuels MA, Klein JP, et al. Adams and Victor’s Principles of Neurology, 11th

edition. United States of America: McGraw-Hill Education; 2019.

DELIRIUM

The American Psychiatric Association’s Diagnostic and Statistical Manual,

5th edition (DSM-5) defines delirium as:

Disturbance of consciousness with reduced ability to focus, sustain, or

shift attention.

The disturbance develops over a short period of time (usually hours to

days) and tends to fluctuate during the course of a day.

An additional disturbance in cognition (e.g. memory deficit,

disorganization, language, visuospatial ability, or perception).

•

•

A change in cognition or development of a perceptual disturbance that is

not better accounted for by a pre-existing, established, or evolving

dementia.

There is evidence from history, physical examination, or laboratory

findings that the disturbance is caused by medical condition, substance

intoxication or withdrawal (i.e. due to a drug of abuse or to a medication),

or exposure to a toxin, or is due to multiple etiologies.

AKINETIC MUTISM

Akinetic mutism refers to a state in which the patient, although seemingly

awake remains silent and motionless.

Reference

Brazis P, Masdeu JC, Biller J. Localization in clinical neurology. Philadelphia: Wolters

Kluwer Health; 2016.

LOCKED IN SYNDROME

The locked in syndrome refers to a condition in which the patient is mute

and motionless but remains awake, alert, aware of self and capable of

perceiving sensory stimuli.

Reference

Brazis P, Masdeu JC, Biller J. Localization in clinical neurology. Philadelphia: Wolters

Kluwer Health; 2016.

ABULIA

Abulia refers to difficulty in initiating and sustaining spontaneous movements

and reduction in emotional responsiveness, spontaneous speech and social

interactions.

Reference

Campbell WW. De Jong’s The Neurological Examination. Philadelphia: Lippincott Williams

& Wilkins; 2012.

ATTENTION AND CONCENTRATION

1.

2.

Attention is the ability to focus on a particular sensory stimulus to the

exclusion of others.

Concentration is sustained attention.

Reference

Neurologic History & Examination. In: Simon RP, Aminoff MJ, Greenberg DA (Eds). Clinical

Neurology, 10th edition. New York, NY: McGraw-Hill; 2017.

MEMORY

Memory is the ability to register, store, and retrieve information.

Reference

Neurologic History & Examination. In: Simon RP, Aminoff MJ, Greenberg DA (Eds). Clinical

Neurology, 10th edition. New York, NY: McGraw-Hill; 2017.

AMNESIA

The amnesic state, defined by Ribot possesses two salient features that

may vary in severity but are always conjoined:

An impaired ability to recall events and other information that has been

firmly established before the onset of illness (retrograde amnesia).

An inability to acquire new information, learn or form new memories

(anterograde amnesia).

Reference:

Ropper AH, Samuels MA, Klein JP, et al. Adams and Victor’s Principles of Neurology, 11th

edition. United States of America: McGraw-Hill Education; 2019.

AGNOSIA

A conceptual inability to recognize objects, persons or sensory stimuli in the

absence of a primary deficit in the sensory modality.

Reference

Ropper AH, Samuels MA, Klein JP, et al. Adams and Victor’s Principles of Neurology, 11th

edition. United States of America: McGraw-Hill Education; 2019.

INSOMNIA

A chronic inability to sleep despite adequate opportunity to do so. It

indicates any impairment in the duration, depth or restorative properties of

sleep.

Reference

Ropper AH, Samuels MA, Klein JP, et al. Adams and Victor’s Principles of Neurology, 11th

edition. United States of America: McGraw-Hill Education; 2019.

APHASIA

Loss of the production or comprehension of spoken or written language

because of an acquired lesion in the brain.

Reference

Ropper AH, Samuels MA, Klein JP, et al. Adams and Victor’s Principles of Neurology, 11th

edition. United States of America: McGraw-Hill Education; 2019.

DYSARTHRIA

A defect in articulation of speech with intact mental functions, and

comprehension of spoken and written language and normal syntax

(grammatical construction of sentences).

Reference

Ropper AH, Samuels MA, Klein JP, et al. Adams and Victor’s Principles of Neurology, 11th

edition. United States of America: McGraw-Hill Education; 2019.

APHONIA AND DYSPHONIA

A loss (aphonia) or alteration (dysphonia) of voice due to a disorder of the

larynx or its innervation.

Reference

Ropper AH, Samuels MA, Klein JP, et al. Adams and Victor’s Principles of Neurology, 11th

edition. United States of America: McGraw-Hill Education; 2019.

AGRAPHIA/DYSGRAPHIA

Loss of the ability to write not due to weakness, incoordination, or other

neurologic dysfunction of the arm or hand is called agraphia.

Milder involvement may be referred to as dysgraphia.

Reference

Campbell WW. De Jong’s The Neurological Examination. Philadelphia: Lippincott Williams

& Wilkins; 2012.

ALEXIA

Loss of the ability to read in the absence of actual loss of vision is alexia.

Reference

Campbell WW. De Jong’s The Neurological Examination. Philadelphia: Lippincott Williams

& Wilkins; 2012.

ECHOLALIA

Echolalia is the meaningless repetition of heard words.

Reference

Campbell WW. De Jong’s The Neurological Examination. Philadelphia: Lippincott Williams

& Wilkins; 2012.

PALILALIA

Palilalia is the repetition of one’s own speech.

Reference

Campbell WW. De Jong’s The Neurological Examination. Philadelphia: Lippincott Williams

& Wilkins; 2012.

PERSEVERATION

Perseveration is the persistence of one reply or one idea in response to

various questions.

Reference

Campbell WW. De Jong’s The Neurological Examination. Philadelphia: Lippincott Williams

& Wilkins; 2012.

NEOLOGISMS

Neologisms are new words, usually meaningless, coined by the patient and

usually heard in psychotic states or in aphasic patients.

Reference

Campbell WW. De Jong’s The Neurological Examination. Philadelphia: Lippincott Williams

& Wilkins; 2012.

IDIOGLOSSIA

Idioglossia is the imperfect articulation with utterance of meaningless

sounds; the individual may speak with a vocabulary all his own.

Reference

Campbell WW. De Jong’s The Neurological Examination. Philadelphia: Lippincott Williams

& Wilkins; 2012.

DYSLOGIA

Dyslogia refers to abnormal speech due to mental disease, and it is most

often used to refer to abnormal speech in dementia.

Reference

Campbell WW. De Jong’s The Neurological Examination. Philadelphia: Lippincott Williams

& Wilkins; 2012.

CONFABULATION

The creative falsification of memory in an alert, responsive individual.

Reference

Ropper AH, Samuels MA, Klein JP, et al. Adams and Victor’s Principles of Neurology, 11th

edition. United States of America: McGraw-Hill Education; 2019.

TONE

Tone is resistance of a muscle to passive movement at a joint.

Reference

Neurologic History & Examination. In: Simon RP, Aminoff MJ, Greenberg DA, (Eds). Clinical

Neurology, 10th edition. New York, NY: McGraw-Hill; 2017.

RIGIDITY

Rigidity is characterized by a plastic resistance to passive movements that

affects both agonist and antagonist muscles to a similar extent and that is

constant throughout the entire range of movement.

Reference

Brazis P, Masdeu JC, Biller J. Localization in clinical neurology. Philadelphia: Wolters

Kluwer Health; 2016.

COGWHEEL RIGIDITY

Cogwheel rigidity is characterized by periodic modifications of muscle tone

due to the superimposed tremor that can be seen and felt when passively

moving the extremity.

Reference

Brazis P, Masdeu JC, Biller J. Localization in clinical neurology. Philadelphia: Wolters

Kluwer Health; 2016.

AKATHISIA

Akathisia refers to a feeling of inner restlessness that is often relieved by

movement.

Reference

Brazis P, Masdeu JC, Biller J. Localization in clinical neurology. Philadelphia: Wolters

Kluwer Health; 2016.

ASTERIXIS

Sudden loss of muscle tone during sustained contraction of an outstretched

limb.

Reference

Talley and O’Connor’s Clinical examination.

ATHETOSIS

Athetosis is characterized by slow, uncoordinated, twisting, writhing, and

involuntary movements of wide amplitude. These predominantly involve the

distal appendicular musculature, especially the upper extremities, although

face and axial muscles may also be involved.

Reference

Brazis P, Masdeu JC, Biller J. Localization in clinical neurology. Philadelphia: Wolters

Kluwer Health; 2016.

CHOREA

Chorea is characterized by sudden, brief, spontaneous, involuntary,

purposeless, continuous, irregular, and unpredictable jerks that randomly

involve the appendicular, facial, or truncal musculature.

Reference

Brazis P, Masdeu JC, Biller J. Localization in clinical neurology. Philadelphia: Wolters

Kluwer Health; 2016.

DYSTONIA

Dystonia is characterized by slow, long sustained, contorting, involuntary

movements, and postures involving proximal appendicular and axial

muscles.

Reference

Brazis P, Masdeu JC, Biller J. Localization in clinical neurology. Philadelphia: Wolters

Kluwer Health; 2016.

HEMIBALLISMUS

Hemiballismus is characterized by occurrence of sudden, paroxysmal, large

amplitude, flinging, throwing movements of the arm, and leg contralateral to

a lesion in or near the subthalamic nucleus.

Reference

Brazis P, Masdeu JC, Biller J. Localization in clinical neurology. Philadelphia: Wolters

Kluwer Health; 2016.

•

•

•

•