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Alvarado Score
The Alvarado score is a clinical scoring system used in the diagnosis of appendicitis. Alvarado scoring has largely been superseded as a clinical prediction tool by the Appendicitis Inflammatory Response score. Also known by the mnemonic MANTRELS, the scale has 6 clinical items (3 signs and 3 symptoms) and 2 laboratory measurements, each given an additive point score, with a maximum of 10 points possible. It was introduced in 1986 by Dr. Alfredo Alvarado and although meant for pregnant females, it has been extensively validated in the non-pregnant population. A known limitation of the score is that only 20% of elderly patients present with classic findings on which the score focuses. A modified Alvarado score is at present in use. The score Elements from the person's history, the physical examination and from laboratory tests: * Abdominal pain that migrates to the right iliac fossa * Anorexia (loss of appetite) * Nausea or vomiting * Tenderness in the right iliac fossa * Re ...
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Appendicitis
Appendicitis is inflammation of the Appendix (anatomy), appendix. Symptoms commonly include right lower abdominal pain, nausea, vomiting, fever and anorexia (symptom), decreased appetite. However, approximately 40% of people do not have these typical symptoms. Severe complications of a ruptured appendix include widespread, agonising and awful peritonitis, inflammation of the inner lining of the abdominal wall and sepsis. Appendicitis is primarily caused by a blockage of the Lumen (anatomy), hollow portion in the appendix. This blockage typically results from a Fecalith, faecolith, a calcified "stone" made of feces. Some studies show a correlation between appendicoliths and disease severity. Other factors such as inflamed Mucosa-associated lymphoid tissue, lymphoid tissue from a viral infection, Human parasite, intestinal parasites, gallstone, or Neoplasm, tumors may also lead to this blockage. When the appendix becomes blocked, it experiences increased pressure, reduced blood f ...
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Nausea
Nausea is a diffuse sensation of unease and discomfort, sometimes perceived as an urge to vomit. It can be a debilitating symptom if prolonged and has been described as placing discomfort on the chest, abdomen, or back of the throat. Over 30 definitions of nausea were proposed in a 2011 book on the topic. Nausea is a non-specific symptom, which means that it has many possible causes. Some common causes of nausea are gastroenteritis and other gastrointestinal disorders, food poisoning, motion sickness, dizziness, migraine, fainting, low blood sugar, anxiety, hyperthermia, dehydration and lack of sleep. Nausea is a side effect of many medications including chemotherapy, or morning sickness in early pregnancy. Nausea may also be caused by disgust and depression. Medications taken to prevent and treat nausea and vomiting are called antiemetics. The most commonly prescribed antiemetics in the US are promethazine, metoclopramide, and the newer ondansetron. The word na ...
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Diagnostic Gastroenterology
Gastroenterology (from the Greek gastḗr- "belly", -énteron "intestine", and -logía "study of") is the branch of medicine focused on the digestive system and its disorders. The digestive system consists of the gastrointestinal tract, sometimes referred to as the ''GI tract,'' which includes the esophagus, stomach, small intestine and large intestine as well as the accessory organs of digestion which include the pancreas, gallbladder, and liver. The digestive system functions to move material through the GI tract via peristalsis, break down that material via digestion, absorb nutrients for use throughout the body, and remove waste from the body via defecation. Physicians who specialize in the medical specialty of gastroenterology are called gastroenterologists or sometimes ''GI doctors''. Some of the most common conditions managed by gastroenterologists include gastroesophageal reflux disease, gastrointestinal bleeding, irritable bowel syndrome, inflammatory bowel disease (IBD ...
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Neutrophilia
Neutrophilia (also called neutrophil leukocytosis or occasionally neutrocytosis) is leukocytosis of neutrophils, that is, a high number of neutrophils in the blood. Because neutrophils are the main type of granulocytes, mentions of granulocytosis often overlap in meaning with neutrophilia. The opposite of neutrophilia is neutropenia. Causes Neutrophils are the primary white blood cells that respond to a bacterial infection, so the most common cause of neutrophilia is a bacterial infection, especially pyogenic infections.Table 12-6 in: 8th edition. Neutrophils are also increased in any acute inflammation, so will be raised after a heart attack, other infarct or burns. Some drugs, such as prednisone, have the same effect as cortisol and adrenaline (epinephrine), causing marginated neutrophils to enter the blood stream. Overdoses of some drugs can cause very high levels of neutrophils in the blood. There is a single case report of severe neutrophilia with bupropion overdose. ...
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Blood Serum
Serum () is the fluid and solvent component of blood which does not play a role in clotting. It may be defined as blood plasma without the clotting factors, or as blood with all cells and clotting factors removed. Serum contains all proteins except clotting factors (involved in blood clotting), including all electrolytes, antibodies, antigens, hormones; and any exogenous substances (e.g., drugs, microorganisms). Serum also does not contain all the formed elements of blood, which include blood cells, white blood cells (leukocytes, lymphocytes), red blood cells ( erythrocytes), and platelets. The study of serum is serology. Serum is used in numerous diagnostic tests as well as blood typing. Measuring the concentration of various molecules can be useful for many applications, such as determining the therapeutic index of a drug candidate in a clinical trial. To obtain serum, a blood sample is allowed to clot (coagulation). The sample is then centrifuged to remove the clot and ...
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White Blood Cells
White blood cells (scientific name leukocytes), also called immune cells or immunocytes, are cells of the immune system that are involved in protecting the body against both infectious disease and foreign entities. White blood cells are generally larger than red blood cells. They include three main subtypes: granulocytes, lymphocytes and monocytes. All white blood cells are produced and derived from multipotent cells in the bone marrow known as hematopoietic stem cells. Leukocytes are found throughout the body, including the blood and lymphatic system. All white blood cells have nuclei, which distinguishes them from the other blood cells, the anucleated red blood cells (RBCs) and platelets. The different white blood cells are usually classified by cell lineage ( myeloid cells or lymphoid cells). White blood cells are part of the body's immune system. They help the body fight infection and other diseases. Types of white blood cells are granulocytes (neutrophils, eosino ...
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Leukocytosis
Leukocytosis is a condition in which the white cell (leukocyte) count is above the normal range in the blood. It is frequently a sign of an inflammatory response, most commonly the result of infection, but may also occur following certain parasitic infections or bone tumors as well as leukemia. It may also occur after strenuous exercise, convulsions such as epilepsy, emotional stress, pregnancy and labor, anesthesia, as a side effect of medication (e.g., lithium), and epinephrine administration. There are five principal types of leukocytosis: neutrophilia (the most common form), lymphocytosis, monocytosis, eosinophilia, and basophilia. This increase in leukocyte (primarily neutrophils) is usually accompanied by a "left upper shift" in the ratio of immature to mature neutrophils and macrophages. The proportion of immature leukocytes increases due to proliferation and inhibition of granulocyte and monocyte precursors in the bone marrow which is stimulated by several products o ...
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Fever
Fever or pyrexia in humans is a symptom of an anti-infection defense mechanism that appears with Human body temperature, body temperature exceeding the normal range caused by an increase in the body's temperature Human body temperature#Fever, set point in the hypothalamus. There is no single agreed-upon upper limit for normal temperature: sources use values ranging between in humans. The increase in set point triggers increased muscle tone, muscle contractions and causes a feeling of cold or chills. This results in greater heat production and efforts to conserve heat. When the set point temperature returns to normal, a person feels hot, becomes Flushing (physiology), flushed, and may begin to Perspiration, sweat. Rarely a fever may trigger a febrile seizure, with this being more common in young children. Fevers do not typically go higher than . A fever can be caused by many medical conditions ranging from non-serious to life-threatening. This includes viral infection, viral, b ...
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Vomiting
Vomiting (also known as emesis, puking and throwing up) is the forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose. Vomiting can be the result of ailments like food poisoning, gastroenteritis, pregnancy, motion sickness, or hangover; or it can be an after effect of diseases such as brain tumors, elevated intracranial pressure, or overexposure to ionizing radiation. The feeling that one is about to vomit is called nausea; it often precedes, but does not always lead to vomiting. Impairment due to alcohol or anesthesia can cause inhalation of vomit. In severe cases, where dehydration develops, intravenous fluid may be required. Antiemetics are sometimes necessary to suppress nausea and vomiting. Self-induced vomiting can be a component of an eating disorder such as bulimia nervosa, and is itself now classified as an eating disorder on its own, purging disorder. Complications Aspiration Vomiting is dangerous if gastric content e ...
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Anorexia (symptom)
Anorexia is a medical term for a loss of appetite. While the term outside of the scientific literature is often used interchangeably with anorexia nervosa, many possible causes exist for a loss of appetite, some of which may be harmless, while others indicate a serious clinical condition or pose a significant risk. Anorexia is a symptom, not a diagnosis. The symptom also occurs in non-human animals, such as cats, dogs, cattle, goats, and sheep. In these species, anorexia may be referred to as inappetence. As in humans, loss of appetite can be due to a range of diseases and conditions, as well as environmental and psychological factors. Etymology The term is from (, 'without' + , spelled , meaning 'appetite'). Common manifestations Anorexia simply manifests as a decreased or loss of appetite. This can present as not feeling hungry or lacking the desire to eat. Sometimes people do not even notice they lack an appetite until they begin to lose weight from eating less. In ot ...
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Appendicitis Inflammatory Response Score
The Appendicitis Inflammatory Response (AIR) score is a diagnostic scoring system used to assist with the identification of appendicitis in children and adults. History The scoring system was developed in 2008. The AIR score was developed to overcome some of the drawbacks of the Alvarado score, another diagnostic scoring system for identifying appendicitis. The AIR score is one of the two scores (the other being the Adult Appendicitis Score, AAS) recommended by the 2020 World Society of Emergency Surgery clinical practice guidelines for the diagnosis and treatment of acute appendicitis. Scoring and interpretation The AIR score is calculated by tallying "points" ascribed to meeting its criteria, which are: *Vomiting (no = 0, yes = 1) *Right iliac fossa (RIF) pain (no = 0, yes = 1) * Rebound tenderness (none = 0, light = 1, medium = 2, strong = 3) *Febrile (internal temperature ≥101.3°F or 38.5°C) (no = 0, yes = 1) *Polymorphonuclear leukocytes (<70% = 0, 70-84% = 1, ≥85% ...
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Right Iliac Fossa
The abdomen (colloquially called the gut, belly, tummy, midriff, tucky, or stomach) is the front part of the torso between the thorax (chest) and pelvis in humans and in other vertebrates. The area occupied by the abdomen is called the abdominal cavity. In arthropods, it is the posterior tagma of the body; it follows the thorax or cephalothorax. In humans, the abdomen stretches from the thorax at the thoracic diaphragm to the pelvis at the pelvic brim. The pelvic brim stretches from the lumbosacral joint (the intervertebral disc between L5 and S1) to the pubic symphysis and is the edge of the pelvic inlet. The space above this inlet and under the thoracic diaphragm is termed the abdominal cavity. The boundary of the abdominal cavity is the abdominal wall in the front and the peritoneal surface at the rear. In vertebrates, the abdomen is a large body cavity enclosed by the abdominal muscles, at the front and to the sides, and by part of the vertebral column at the back. Low ...
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