ABPS Internal Medicine flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

STEMI reperfusion time goal

Primary PCI within 120 minutes of first medical contact; fibrinolysis within 30 minutes if PCI is unavailable and no contraindications, with door-to-needle 30 minutes or less.

Heart failure reduced EF therapy

For HFrEF, guideline-directed therapy includes ARNI/ACEi/ARB, beta blocker, MRA, and SGLT2 inhibitor; diuretics relieve congestion.

Atrial fibrillation stroke risk

CHA2DS2-VASc estimates stroke risk in nonvalvular AF; anticoagulation recommended when score is 2 or more in men or 3 or more in women.

COPD exacerbation initial therapy

Inhaled short-acting bronchodilators, systemic corticosteroids for 5 days, and antibiotics when increased sputum purulence or ventilatory support; controlled oxygen targets 88-92%.

Light criteria exudate

Pleural fluid is exudative if protein ratio over 0.5, LDH ratio over 0.6, or fluid LDH over two-thirds the upper normal serum LDH.

ARDS Berlin definition

Acute onset within 1 week, bilateral opacities not fully explained by effusion, collapse, or nodule, PaO2/FiO2 300 or less with PEEP 5 or more, not primarily cardiogenic.

Variceal bleed management

Resuscitate, start octreotide and prophylactic antibiotics, perform endoscopy within 12 hours with band ligation; consider balloon tamponade or TIPS for refractory bleeding.

Early aggressive lactated Ringer

For acute pancreatitis, isotonic crystalloid (lactated Ringer) 5-10 mL/kg/hr initially, reassess after 6-12 hours; avoid over-resuscitation in cardiorenal disease.

Spontaneous bacterial peritonitis

Ascitic fluid PMN 250/mm3 or higher diagnoses SBP; start a third-generation cephalosporin and albumin 1.5 g/kg day 1, 1 g/kg day 3 to reduce renal failure.

DKA diagnostic triad

Hyperglycemia over 250 mg/dL, anion gap metabolic acidosis, and ketonemia or ketonuria; treat with isotonic fluids, insulin infusion, and potassium replacement when K under 5.2.

Thyroid storm treatment

Give propylthiouracil or methimazole, iodine at least 1 hour later, beta blocker, hydrocortisone, and supportive care; treat the precipitating illness.

Primary hyperaldosteronism screen

Elevated aldosterone with suppressed renin; screen with plasma aldosterone-to-renin ratio when hypertension plus hypokalemia, resistant hypertension, or adrenal incidentaloma.

Bacterial meningitis empiric

Adults: vancomycin plus ceftriaxone plus ampicillin if Listeria risk; add dexamethasone before or with first antibiotic dose when pneumococcal meningitis is suspected.

Infective endocarditis blood cultures

Obtain three sets from separate sites before antibiotics; for prosthetic valves or suspected S. aureus, draw at least three sets over 1 hour.

Latent TB treatment

Isoniazid plus rifapentine weekly for 12 weeks (3HP) or rifampin daily for 4 months are preferred; isoniazid daily for 9 months is an alternative.

Hyperkalemia emergency treatment

IV calcium for cardiac membrane stabilization, insulin with glucose and beta-2 agonist to shift potassium intracellularly, then sodium zirconium cyclosilicate or dialysis for removal.

Hyponatremia correction limit

Correct chronic hyponatremia by 8-10 mmol/L or less in 24 hours to avoid osmotic demyelination; use hypertonic saline only for severe symptoms.

Nephrotic syndrome criteria

Proteinuria over 3.5 g/day, hypoalbuminemia under 3.0 g/dL, edema, and hyperlipidemia; biopsy guides therapy when secondary causes are excluded.

Neutropenic fever empiric

Absolute neutrophil count under 500/mcL plus fever 38.3 C or higher once or 38.0 C or higher sustained; start anti-pseudomonal beta-lactam within 60 minutes.

Tumor lysis syndrome

Hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia from rapid cell lysis; treat with IV hydration and rasburicase or allopurinol.

Warfarin reversal major bleed

Give vitamin K 5-10 mg IV plus four-factor prothrombin complex concentrate; fresh frozen plasma is an alternative if PCC is unavailable.

Delirium prevention bundle

Address orientation, sleep, mobility, hydration, nutrition, hearing and vision, and medications; multicomponent nonpharmacologic programs reduce incidence in hospitalized older adults.

USPSTF colorectal cancer screening

Screen adults 45-75 years; options include colonoscopy every 10 years or annual fecal immunochemical test; start individualized decisions at 76-85.

Gout acute treatment

NSAIDs, colchicine, or glucocorticoids; do not start urate-lowering therapy during an acute flare unless already established, and use prophylaxis when initiating.

Giant cell arteritis treatment

Start high-dose glucocorticoids immediately when suspected to prevent vision loss; temporal artery biopsy within 2 weeks; tocilizumab reduces steroid need.

Acute ischemic stroke tPA window

IV alteplase within 4.5 hours of last known well, after excluding hemorrhage; mechanical thrombectomy up to 24 hours in selected large-vessel occlusion.

Status epilepticus first line

Benzodiazepine (lorazepam 0.1 mg/kg IV or midazolam IM) first; if seizures continue, second-line levetiracetam, fosphenytoin, or valproate.

Migraine red flags

Thunderclap onset, fever with neck stiffness, new focal deficit, age over 50 with new headache, or papilledema warrant urgent imaging and evaluation.

Melanoma ABCDE

Asymmetry, border irregularity, color variation, diameter over 6 mm, and evolving lesion; any changing pigmented lesion warrants biopsy.

SJS/TEN management

Stop the culprit drug, transfer to a burn unit, give supportive care and fluids; systemic corticosteroids or IVIG are adjuncts with uncertain benefit.

Serotonin syndrome triad

Mental status change, autonomic hyperactivity, and neuromuscular abnormalities such as clonus and hyperreflexia; stop serotonergic drugs and give cyproheptadine for severe cases.

Alcohol withdrawal treatment

Benzodiazepines symptom-triggered using CIWA-Ar; give thiamine before glucose to prevent Wernicke encephalopathy, and monitor for delirium tremens.