Diverticulitis

BMI

Body mass index (BMI)

Description: BMI is a simple, dimensionless index for a rough estimate of body weight in relation to height. It is calculated by dividing body weight in kilograms by the square of height in meters.

Lower abdominal pain

Lower abdominal pain (hypogastrium)

Definition: Lower abdominal pain refers to pain sensations that occur in the area below the navel. The location can be central or limited to one side.

Guarding

Defensive guarding

Definition: Defensive guarding refers to the involuntary stiffening of the abdominal muscles that occurs in response to peritoneal irritation.

Clinical significance: It is an indicator of possible peritoneal irritation and differs from voluntary muscle tension by its reflexive nature and the inability to suppress it.

Nausea

Nausea (feeling of sickness)

Definition: Nausea denotes the subjective sensation of feeling sick or the urge to vomit, without vomiting necessarily occurring.

Constipation

Constipation (bowel movement difficulty)

Definition: Constipation describes impaired bowel evacuation, which may present as less frequent stools, hard stools, or difficulty passing stool.

General context: Causes include low-fiber diet, insufficient fluid intake, medications, or disorders of intestinal motility; newly developed or persistent constipation may require further evaluation.

Hemorrhoids

Hemorrhoids

Definition: Hemorrhoids are enlarged vascular cushions in the anal canal. They can be physiologic but may cause symptoms when pathologically enlarged.

Possible complaints: Clinically there may be bleeding, itching, pain, or prolapse of tissue from the anus. Common associated factors are straining situations or pregnancy.

Anal fissures

Definition:
Anal fissures are painful tears of the mucosa in the region of the anal canal.
Clinical picture:
Typical is a stabbing pain during defecation, often with short-lasting post-defecation pain; occasionally bright red blood is seen on the stool or toilet paper. Acute fissures are intensely painful, chronic fissures may show scarring and a sentinel pile.
Causes and context:
Common triggers are hard stool or repeated straining due to constipation; diarrhea or local trauma can also contribute.
Diagnostics:
Inspection of the anal area is usually sufficient for diagnosis; in atypical courses or suspicion of other diseases, further examinations are indicated.
Therapy and risks:
Treatment begins conservatively with stool regulation and local measures. For chronic or therapy-resistant fissures, topical medical treatments or interventional procedures up to surgical sphincterotomy may be considered. Invasive procedures carry a risk of fecal incontinence, which must be factored into the treatment decision.

gastrointestinal bleeding

Classification and definition:
Gastrointestinal bleeding encompasses blood loss from the gastrointestinal tract and is broadly classified by location: upper bleeding (proximal to the ligament of Treitz), lower bleeding (distal), and occult bleeding (not visible, detectable only by tests).
Clinical signs:
Upper GI bleeding typically presents with vomiting blood or black tarry stools (melena). Massive lower GI bleeding can lead to fresh rectal blood (hematochezia). Occult bleeding is detected solely by a positive stool blood test.
Causes and significance:
Causes range from ulcers, varices, and erosive lesions to inflammation, polyps, or tumors. Severity ranges from minor intermittent bleeds to life-threatening blood loss.
Workup and acute management:
Diagnostics depend on the clinical situation and include laboratory tests and endoscopic procedures to localize and determine the cause; if hemodynamically relevant, stabilization of the circulation is the first priority.

Urological complaints

Term and examples:
Urological complaints are symptoms affecting the urinary tract, kidneys, or male genital organs. Common examples include dysuria (burning or painful urination), hematuria (visible or detectable blood in the urine), pollakiuria, urinary urgency, and flank pain.
Common causes:
These complaints can be caused by urinary tract infections, kidney or ureteral stones, benign prostatic conditions, tumors, or inflammatory diseases.

Sleep apnea syndrome

Definition:
Sleep apnea syndrome is a sleep-related breathing disorder characterized by repeated breathing pauses or markedly reduced breaths during sleep.
Clinical features:
Typical accompanying signs are loud, irregular snoring, repeated nocturnal breathing interruptions, non-restorative sleep and pronounced daytime sleepiness; morning headaches are common.
Diagnostics:
Definitive diagnosis is made by sleep medicine investigations, ideally polysomnography or a validated sleep recording.
Therapy options:
Treatment principles include nonpharmacological measures such as weight reduction and sleep hygiene as well as specific methods like nocturnal positive airway pressure therapy using a CPAP device. For selected patients, mandibular advancement devices or surgical procedures are options. If untreated, the syndrome is associated with increased risk for cardiovascular and metabolic comorbidities.

arterial hypertension

Definition:
Arterial hypertension denotes a persistently elevated arterial blood pressure.
Clinical significance:
Hypertension often has no clear symptoms; occasionally headache, dizziness, or exertional dyspnea are reported. Untreated high blood pressure increases the risk for cardiovascular diseases.
Diagnostics:
Diagnosis is based on repeated blood pressure measurements under standardized conditions; in practice certain thresholds are used for classification.
Therapy principles:
Treatment primarily includes lifestyle measures such as weight reduction, low-salt diet and regular physical activity, and, if indicated, pharmacological blood pressure lowering. Indication for therapy and target values are determined individually considering comorbidities.

Hyperlipidemia

Hyperlipidemia

Definition and significance:
Hyperlipidemia describes elevated concentrations of blood lipids, especially cholesterol and triglyceride fractions. It increases the risk for atherosclerotic disease.

Clinical picture:
The condition often runs asymptomatically and remains unnoticed for a long time; clinical symptoms usually occur only with complication sequelae.

Diagnostics:
Assessment is performed by a blood lipid profile that reports LDL, HDL cholesterol and triglycerides. LDL cholesterol plays a central role for cardiovascular risk.

Importance for therapy planning:
With elevated values, further management depends on individual vascular risk; treatment of hypercholesterolemia is often the focus.

TIA

TIA (transient ischemic attack)

Definition:
A TIA is a sudden, usually short-lasting focal neurological deficit caused by transient cerebral ischemia. Modern definitions often describe TIA as a neurological deficit without evidence of acute infarction on imaging; symptoms typically resolve within minutes to hours.

Clinical features:
Typical deficits are unilateral weakness, sensory disturbances, and impairments of speech or vision, depending on the affected vascular territory.

Diagnostics and significance:
Initial assessment is clinical; to clarify and look for infarction, prompt imaging (preferably MRI) as well as vascular and cardiac investigations are performed. A TIA is a warning sign for impending stroke and requires immediate evaluation and initiation of secondary prevention measures.

Ankylosing spondylitis

Ankylosing spondylitis (Bechterew disease)

Definition and pathology:
Ankylosing spondylitis is a chronic inflammatory disease primarily affecting the spine and sacroiliac joints and can lead to stiffening.

Clinical features:
Characteristically there is inflammatory back pain with morning stiffness, improvement with movement and often night pain. Symptoms often begin in young adulthood.

Diagnostics:
Diagnosis is based on clinical examination, imaging (MRI, X-ray of the sacroiliac joints) and, if applicable, detection of HLA‑B27 as a supportive feature.

Therapy principles:
Therapy goals are pain relief and maintenance of mobility. Measures include nonsteroidal anti-inflammatory drugs, regular physiotherapy and exercise therapy; if response is insufficient, disease-modifying biologics are used.

transurethral prostate surgery

Transurethral prostate surgery

Procedure and goal:
In transurethral prostate surgery, prostatic tissue is removed endoscopically via the urethra, usually to treat benign prostatic enlargement causing urinary outflow obstruction. The goal is to improve urinary flow and relieve voiding symptoms.

Execution and course:
The procedure is usually minimally invasive under anesthesia and typically requires only a short hospital stay.

Possible complications:
Possible complications include bleeding, infections, temporary urinary retention and, in individual cases, persistent disturbances such as incontinence or sexual dysfunction.

benign prostatic syndrome

Benign prostatic syndrome

Term and cause:
The benign prostatic syndrome refers to the functional complaints that can be caused by a benign enlargement of the prostate; this enlargement is called benign prostatic hyperplasia (BPH).

Clinical symptoms:
Typical symptoms affect the urinary tract and include a weakened urinary stream, frequent urination (including at night) and the sensation of incomplete bladder emptying.

Diagnostics and therapy options:
Evaluation includes medical history, physical examination and imaging and laboratory diagnostic procedures to assess size and function. The therapeutic spectrum ranges from conservative measures and drug therapy to surgical procedures, depending on severity and patient factors.

Ramipril

Classification
Ramipril belongs to the group of ACE inhibitors (angiotensin-converting enzyme inhibitors).
Effect
The preparation reduces the formation of angiotensin II by inhibiting the angiotensin-converting enzyme, which leads to dilation of the vessels and a reduction in blood pressure.
Indications
It is used particularly for arterial hypertension, as an adjunct in heart failure and to reduce cardiovascular risks.
Important risks and notes
Known adverse effects include a dry irritating cough, dizziness, increased potassium levels and occasional angioedema as well as impairment of renal function. Ramipril is contraindicated in pregnancy.

Atorvastatin

Classification
Atorvastatin belongs to the active substance group of statins (HMG‑CoA reductase inhibitors).
Effect
The active substance reduces the body’s cholesterol synthesis in the liver and thereby especially lowers LDL cholesterol.
Indications
Atorvastatin is used to treat elevated blood lipid levels and to reduce the risk of cardiovascular events.
Important risks and notes
Common adverse effects are muscle pain and increases in liver values; rarely, more severe muscle and liver complications can occur. Any muscle complaints that occur should be medically evaluated.

Acetylsalicylic acid

Classification
Acetylsalicylic acid (ASA) is a long-established medicinal product with different action profiles.
Effect
At low doses ASA inhibits platelet aggregation and thus acts as an antithrombotic; at higher doses it additionally shows analgesic and anti-inflammatory effects.
Indications
Low-dose ASA is used mainly for secondary prevention after vascular events to reduce recurrent thrombus formation.
Important risks and notes
Possible side effects include gastrointestinal complaints and increased bleeding tendency; with allergies to salicylates various hypersensitivity reactions can occur.

Valerian

Classification
Valerian is an herbal medicinal product that belongs to phytotherapeutics.
Effect
The exact mechanism of action is not fully understood; clinically valerian is mainly attributed a calming and sleep-promoting effect.
Indications
Main areas of use are nervous restlessness and mild difficulties falling asleep.
Important risks and notes
Side effects are rare but can include fatigue or mild gastrointestinal complaints. Interactions with other sedating substances are possible and should be considered.

Urticaria

Definition
Urticaria (hives) denotes the occurrence of transient, itchy wheals on the skin.
Significance and associations
The lesions are usually sharply demarcated, raised and often disappear within hours. Causes can be allergic reactions, infections, medications or idiopathic factors; histamine release often plays a role. Accompanying phenomena can include swelling (angioedema).

Colorectal cancer

Colorectal cancer (colorectal carcinoma)

Definition and development: Malignant neoplasms of the large intestine or rectum, which often arise from initially benign mucosal overgrowths (polyps) and can develop over months to years.

Clinical picture: Early stages are often paucisymptomatic. Possible signs are fresh or occult blood in the stool, persistent changes in bowel habits, unexplained weight loss or decreased performance.

Diagnostics and screening: The confirmed diagnosis is obtained by colonoscopy with histological examination; imaging methods are used for staging. For early detection, endoscopic examination is the central measure.

Therapy: Treatment is planned according to tumor stage; surgical removal of the tumor often forms the basis, supplemented by systemic or local oncological procedures depending on the extent.

Colitis

Colitis

Term: Colitis refers to inflammation of the colonic mucosa.

Causes: The inflammation can be caused by infections, by chronic inflammatory bowel diseases or by circulatory disorders.

Clinic and diagnostics: Typical complaints are diarrhea, abdominal pain and possibly fever as well as blood in the stool. For clarification, history, laboratory tests, stool examinations and, if necessary, endoscopic examination with tissue sampling are used.

Treatment: Therapy depends on the underlying cause and ranges from targeted anti-infective measures to anti-inflammatory and supportive measures in chronic forms.

Appendicitis

Appendicitis

Definition: Acute inflammation of the appendix of the cecum.

Clinical picture: Pain development often begins diffusely, frequently with migration of pain to the right lower abdomen; accompanying symptoms can include nausea, vomiting and fever.

Diagnostics: Assessment is based on history, physical examination, laboratory values and imaging procedures (e.g. ultrasound, possibly CT) for confirmation.

Therapy: In general, surgical removal of the inflamed appendix is the usual treatment option; supplementary conservative measures can be used depending on the findings.

Blood pressure

Blood pressure

Term: Blood pressure describes the force the circulating blood exerts on the vessel walls; clinically it is described in systolic and diastolic components.

Measurement: Blood pressure is recorded using a cuff and measuring device; measurement can be manual (auscultatory with stethoscope) or automated (oscillometric).

Significance: Blood pressure is a central vital parameter and provides information on cardiovascular load and circulatory stability; deviations upward or downward are clinically relevant and require further investigation as appropriate.

Respiratory rate

Respiratory rate

Term: Respiratory rate is the number of breaths per minute and is one of the basic vital parameters.

Norm and deviations: In adults the respiratory rate typically lies in the mid double-digit range; an acceleration (tachypnea) is diagnosed with increased respiratory rate, a slowing (bradypnea) with decreased respiratory rate.

Clinical relevance: Respiratory rate is sensitive to airway, lung or metabolic disorders and serves as a simple indicator of respiratory or systemic impairment.

Oxygen saturation

Oxygen saturation (SpO2)

Definition and significance:
Oxygen saturation gives the percentage of hemoglobin bound with oxygen in arterial blood and is a parameter for assessing oxygen supply.

Measurement method:
It is determined noninvasively with a pulse oximeter, which transmits light of different wavelengths through a body part (e.g. finger, earlobe or toe) and uses absorption to estimate saturation. Continuous measurements show trends and facilitate monitoring.

Limitations:
Interpretation can be impaired by factors such as poor peripheral perfusion, movement, nail polish or certain dyshemoglobinemias (e.g. carbon monoxide or methemoglobin formation), since the device cannot distinguish between hemoglobin forms. If measurement artifacts or dyshemoglobinemia are suspected, additional investigations are required.

Temperature

Body temperature

Significance:
Body temperature describes the heat state of the organism and is a basic vital parameter that can provide indications of infections or metabolic changes.

Measurement sites and comparison:
Different measurement sites yield different values: rectal measurements are considered closest to core temperature, oral values are usually somewhat lower, axillary values tend to be lower still. Usual differences between sites are small but can be clinically relevant.

Application notes:
When comparing measurements the site should be taken into account. Measurement errors can be reduced by correct placement of the thermometer and consideration of disturbing factors (e.g. recent food intake for oral measurement, sweat for axillary measurement).

Abscesses

Abscess

Definition:
An abscess is a localized collection of pus in tissue, usually resulting from a localized bacterial inflammatory reaction.

Clinical signs:
Characteristic signs are a localized swelling with redness, increased warmth, pain and often tenderness to pressure; systemic accompanying symptoms such as fever may occur.

Diagnostics:
Diagnosis is primarily clinical; imaging methods such as ultrasound or, in deeper/complicated cases, CT can assist in delineation and localization.

Therapeutic principles:
Therapeutically, the targeted removal of pus is paramount (e.g., incision/drainage or puncture). Antimicrobial treatment is indicated for extensive infection, systemic signs, or accompanying cellulitis; the specific choice is made individually.

Percussion

Percussion

Purpose:
Percussion is a physical examination method for assessing the condition of underlying tissues and for detecting pathological changes such as fluid collections or air pockets.

Technique:
A firmly placed finger (pleximeter) is positioned on the body and briefly tapped with another finger or a suitable instrument (plexor). The resulting percussion sound is interpreted by hearing and feeling.

Interpretation:
Different percussion sound qualities provide clues about the underlying structures: a tympanitic sound indicates air-filled spaces, a resonant sound indicates air-rich, normal parenchyma, and a dull sound indicates solid or fluid-filled areas.