ABPS Urgent Care flashcards

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

Centor score components

Tonsillar exudates, tender anterior cervical adenopathy, fever, and absence of cough are scored; a total of 2 or higher in adults supports rapid streptococcal testing before antibiotics.

Anaphylaxis first-line treatment

Give intramuscular epinephrine 1:1000 at 0.01 mg/kg up to 0.5 mg in the lateral thigh; repeat every 5-15 minutes as needed; antihistamines and steroids are adjuncts.

Ottawa ankle rules

Order an ankle radiograph only when there is malleolar-zone pain plus bone tenderness at the posterior lateral or medial malleolus, or inability to bear weight four steps.

CURB-65 components

Confusion, blood urea nitrogen above 19 mg/dL, respiratory rate 30 or higher, systolic BP below 90 or diastolic 60 or lower, and age 65 or older each score one point.

Asthma exacerbation severity

Moderate exacerbation has peak expiratory flow 40-69% predicted; severe is below 40%; treat with short-acting beta agonist, ipratropium, and systemic corticosteroids.

Uncomplicated cystitis antibiotics

Nitrofurantoin 100 mg twice daily for 5 days, trimethoprim-sulfamethoxazole for 3 days when local resistance is below 20%, or fosfomycin 3 g as a single dose.

Cellulitis antibiotic choice

Nonpurulent cellulitis is treated with cephalexin or dicloxacillin; purulent or systemic illness warrants MRSA coverage with trimethoprim-sulfamethoxazole or doxycycline, and borders are marked.

Maximum lidocaine dose

Without epinephrine the limit is 4.5 mg/kg; with epinephrine it is 7 mg/kg; a 1% solution contains 10 mg/mL, so a 70-kg adult may receive 31.5 mL plain.

Suture removal timing

Remove facial sutures at 4-5 days, scalp at 7-10 days, trunk and extremity at 10-14 days, and over joints at 14 days, adjusting for wound tension.

Wound irrigation pressure

Target 8-12 psi, achieved with a 30-60 mL syringe and 18-19 gauge catheter; use 50-100 mL of normal saline per centimeter of wound length.

Abscess incision and drainage

Incise over the point of maximal fluctuance, break loculations, irrigate, and pack cavities larger than 2 cm; arrange a wound check in 48 hours.

Digital block technique

Inject 2-4 mL of 1% lidocaine without epinephrine at both sides of the base of the digit; current evidence supports epinephrine safety in digits.

Knee arthrocentesis site

Use a lateral or medial parapatellar approach with the knee flexed; send synovial fluid for cell count, crystals, Gram stain, and culture.

Corneal foreign body removal

Remove under slit-lamp magnification after topical anesthetic; never attempt removal of an intraocular foreign body; routine eye patching is not recommended.

Urinalysis nitrite and esterase

Nitrite is specific but insensitive; leukocyte esterase is sensitive but nonspecific; both positive with urinary symptoms substantially raises the probability of urinary tract infection.

Age-adjusted D-dimer

For patients older than 50, use age multiplied by 10 ng/mL as the cutoff instead of 500 ng/mL; apply only when pretest probability is low or intermediate.

High-sensitivity troponin rule-out

Serial sampling at 0 and 1-3 hours is required; a single normal value does not exclude myocardial infarction; interpret with ECG and pretest probability.

HbA1c diagnostic threshold

Diabetes is diagnosed at HbA1c 6.5% or higher; prediabetes is 5.7-6.4%; confirm with repeat testing unless classic symptoms are present.

Rapid strep test accuracy

Sensitivity is about 85-90% and specificity above 95%; a negative result in a child may warrant culture, while a negative adult result generally ends testing.

Spirometry obstruction criterion

Persistent airflow obstruction is a post-bronchodilator FEV1/FVC ratio below 0.70; severity is graded by FEV1 percent predicted.

Tdap booster interval

Adults receive a Tdap booster every 10 years, or sooner for a contaminated wound if more than 5 years have passed since the last tetanus dose.

Colorectal cancer screening ages

Average-risk adults begin screening at age 45 and continue through 75; options include colonoscopy every 10 years or annual fecal immunochemical testing.

HIV post-exposure prophylaxis

Start within 2 hours of a needlestick when possible and no later than 72 hours; use a 28-day three-drug regimen after risk assessment.

Diabetes screening criteria

Screen adults aged 35-70 with overweight or obesity; repeat every 3 years if normal; screen earlier with hypertension, family history, or other risk factors.

Heat acclimatization duration

Workers new to heat should acclimatize over 5-14 days with gradual workload increases; maintain hydration, rest breaks, and monitor for heat illness.

DOT drug test panel

The five-panel screen tests amphetamines, cocaine, marijuana, opioids, and phencyclidine; split specimens allow confirmation and medical review officer interpretation.

CLIA waived test criteria

Waived tests are simple with low risk of erroneous results; sites need a certificate of waiver, while moderate-complexity testing requires a CLIA certificate and proficiency testing.

OSHA bloodborne pathogens rule

Requires an exposure control plan, hepatitis B vaccination offered, personal protective equipment, sharps containers, and post-exposure evaluation and follow-up.

HIPAA breach notification

Notify affected individuals without unreasonable delay and no later than 60 days after discovery; breaches affecting 500 or more people also require media notice.

DEA schedule II refills

Schedule II prescriptions cannot be refilled; schedule III-V prescriptions allow up to five refills within six months of the issue date.

EMTALA core requirement

Any patient presenting to an emergency department must receive a medical screening examination and stabilizing treatment regardless of insurance or ability to pay.

Vaccine cold chain range

Refrigerator storage is 2-8 degrees Celsius; freezer storage is -50 to -15 degrees Celsius; temperatures are logged twice daily and excursions are reported.