Build your second-level appeal vocabulary

by Pamela Guggina, MD

1. Palliative Care
A medical approach which seeks to improve the quality of life through treatments aimed at reducing suffering, reducing disease (tumor burden), and improving symptoms and functioning without necessarily seeking to increase survival or cure disease. Typically used in patients facing a life-limiting illness.

Open Reduction Internal Fixation. An orthopedic procedure to repair a fractured (broken) bone. The bone is surgically exposed and put back into as normal a position as possible (referred to as reduction) and then it is secured in place with screws, plates, or other hardware (fixation). The skin and other tissues are then sutured or stapled closed.

3. Gluten
An umbrella term for the proteins that are found in wheat, barley, rye, and other grains. It is what gives bread products their elastic, chewy texture. It helps bread rise and maintain its shape.

4. Meningitis
A condition caused by infection of the meninges, which are the fibrous coverings of the spinal cord and brain, and the spinal fluid, which flows around the brain and spinal cord. The meninges contain the spinal fluid. Meningitis is diagnosed via a spinal tap, which is a procedure in which a hollow needle is inserted between the bones in the low back and through the meninges. A small amount of fluid is collected and analyzed. Symptoms of meningitis include fever, stiff neck, headache, confusion, and, in some cases, rash. It can be severe, even fatal, if not treated and can leave patients with brain damage, deafness, and chronic disabilities.

5. Hemoglobin A1c
An abbreviation for glycohemoglobin, a form of hemoglobin (the protein in blood which contains iron and binds with oxygen). Hemoglobin A1c is generated in the blood when hemoglobin is exposed to glucose. Hemoglobin A1c is routinely tested for in diabetic patients. Levels can determine the quality of glucose control over the previous three months. A normal level is between 4% and 5.6%.

6. Ejection Fraction
The percentage of blood in the left ventricle that leaves the heart with each beat. A normal ejection fraction, or EF, is about 60%. Congestive Heart Failure results when less than this amount is leaving the heart, causing back up of blood into the pulmonary vasculature and ultimately leakage of fluid into the lungs.

7. Aphasia
Loss of the ability to comprehend or form speech. Most commonly due to a stroke.

8. Neutropenic
An abnormally low level of neutrophils which are one of the infections fighting white blood cells. Neutropenia results in an inability to fight off infections and can be deadly. Common causes are cancer chemotherapy and viral infections, such as HIV.

9. Psychotropic
Any drug or substance that affects one’s psychologic state or ability to function.

10. SSRI
Selective Serotonin Reuptake Inhibitor. A class of antidepressants that are believed to block the neurons in the brain from re-absorbing serotonin. This leads to higher levels of serotonin, which is a neurotransmitter important in the regulation of emotion. SSRIs are classically used in the treatment of depression, but they are also used in anxiety disorders.

11. GRF
Glomerular Filtration Rate. This is a test of kidney function and is an estimate of how much blood passes through the kidneys each minute. It is reported in milliliters per minute (ml/min). A normal level is greater than 60.

12. Apnea
An interruption or stopping of breathing. It can be temporary and brief, such as in sleep apnea, or prolonged and permanent such as in respiratory arrest.

13. Naloxone
A drug which blocks the effects of opioids. It is an opioid receptor antagonist and can rapidly reverse an overdose.

14. Diuretic
A substance or drug that causes increased production of urine and therefore increased excretion of water from the body. There are multiple different classes with different mechanisms of action on the kidney.

15. Catheter
A flexible tube used in healthcare to enter the body to alter the structure of something (such as a cardiac catheter which enters the heart vessels to deliver stents to open a blockage), to deliver fluids, blood, or medications directly into blood vessels (an intravenous catheter), or to remove something from the body (such as a urinary catheter placed in the bladder to drain urine).

16. Aneurysm
A balloon like bulge in a blood vessel, usually an artery and most commonly occurring in the arteries of the brain and the aorta. As they get larger, there is a risk of rupture which can be a life-threatening situation. In this situation, blood flows freely out of the artery.

17. Asperger’s Syndrome
A developmental disorder in which social functioning is impaired. Intelligence is generally normal. This is listed on the Autism Spectrum of Disorders.

18. Herniation
The abnormal protrusion of a body part through an opening that itself may or may not be normal. Examples include a spinal disc protruding beyond the spinal column, causing compression on nerves, intestinal tissue protruding through the abdominal wall fascia causing an inguinal, ventral or incisional hernia, and the brainstem protruding out of the cranium causing compromise of basic life sustaining functions such as breathing.

19. Fistula
An abnormal opening creating a connection between a body cavity or hollow organ and another cavity or organ and the outside world.

20. Syncope
Fainting. Usually characterized by a rapid onset and spontaneous recovery. Typically caused by dehydration, low blood pressure, low blood sugar, or a cardiac dysrhythmia.