Arab Board Family Medicine Part 1 cheat sheet

Metabolic syndrome requires ≥3 of: waist >102 cm (men)/>88 cm (women), TG ≥150 mg/dL, HDL <40 (men)/<50 (women) mg/dL, BP ≥130/85, fasting glucose ≥100 mg/dL.

HbA1c ≥6.5% diagnoses diabetes; 5.7–6.4% is prediabetes; confirm an abnormal result on a second test unless classic symptoms plus random glucose ≥200 mg/dL.

In heart failure with reduced ejection fraction, four drug classes reduce mortality: ARNI/ACEi/ARB, beta-blocker, MRA, and SGLT2 inhibitor.

CURB-65 for pneumonia severity scores confusion, urea >7 mmol/L, respiratory rate ≥30, low BP, and age ≥65; ≥2 points suggests admission.

Anion gap = Na − (Cl + HCO3); normal 8–12 mEq/L; elevated gap with acidosis suggests ketoacidosis, lactic acidosis, renal failure, or toxin.

Acute upper GI bleed: pre-endoscopy Glasgow-Blatchford score guides need for intervention; IV proton-pump inhibitor before endoscopy for suspected nonvariceal bleeding.

Wells score and age-adjusted D-dimer are used to risk-stratify suspected pulmonary embolism before CT pulmonary angiography.

Hypertension is confirmed with ≥2 readings ≥140/90 mmHg on separate occasions; home/ambulatory monitoring is preferred for diagnosis.

Normal infant weight: doubles birth weight by ~5 months, triples by ~12 months; birth length increases ~50% by 12 months.

Developmental red flags: no social smile by 2 months, no sitting without support by 9 months, no words by 16 months, no two-word phrases by 24 months.

Kawasaki disease: fever ≥5 days plus ≥4 of conjunctivitis, oral changes, rash, extremity changes, cervical lymphadenopathy; treat with IVIG plus aspirin.

Acute otitis media requires middle-ear effusion plus acute signs; first-line is high-dose amoxicillin unless recent amoxicillin use or penicillin allergy.

Neonatal jaundice within 24 hours of birth is always pathologic and requires urgent bilirubin measurement and investigation.

In children, dehydration is assessed by capillary refill, skin turgor, mucous membranes, and mental status; severe dehydration needs IV isotonic fluid bolus.

Febrile seizure: age 6 months–5 years, generalized, <15 minutes, once in 24 hours; simple febrile seizures do not require routine EEG or neuroimaging.

Pediatric maintenance fluids use the Holliday-Segar method: 100 mL/kg for first 10 kg, 50 mL/kg for next 10 kg, 20 mL/kg thereafter per 24 hours.

Estimated date of delivery by Naegele rule: first day of last menstrual period + 7 days − 3 months (add 1 year).

Preeclampsia: BP ≥140/90 after 20 weeks plus proteinuria or end-organ dysfunction; delivery is the definitive treatment.

RhD-negative unsensitized women receive anti-D immunoglobulin at 28 weeks and within 72 hours of delivery of an RhD-positive infant.

First-trimester bleeding with an empty uterus and positive hCG suggests ectopic pregnancy; check quantitative hCG and transvaginal ultrasound.

Gestational diabetes screening: 50-g glucose challenge at 24–28 weeks; abnormal result followed by 100-g 3-hour oral glucose tolerance test.

Postpartum hemorrhage is blood loss >500 mL after vaginal or >1000 mL after cesarean delivery; uterine atony is the most common cause.

Cervical cancer screening starts at age 21 (cytology) or 25 (HPV testing) depending on guideline; stop after age 65 if prior screening is adequate.

Combined oral contraceptives are contraindicated with migraine with aura, prior VTE, smoking over age 35, and uncontrolled hypertension.

Acute appendicitis: migration of periumbilical pain to right lower quadrant with rebound tenderness; Alvarado score aids clinical risk stratification.

Small bowel obstruction: colicky pain, vomiting, distension, absolute constipation; air-fluid levels on erect abdominal film; CT defines transition point.

In trauma, ATLS sequence is primary survey (airway, breathing, circulation, disability, exposure) before secondary survey and definitive imaging.

Cholecystitis: right upper quadrant pain, positive Murphy sign, fever, leukocytosis; ultrasound shows wall thickening, pericholecystic fluid, stones.

Burns: Parkland formula gives 4 mL × body weight (kg) × %TBSA lactated Ringer over 24 hours, half in first 8 hours from injury.

Testicular torsion is a surgical emergency; Doppler ultrasound must not delay detorsion when clinical suspicion is high.

Postoperative fever within 48 hours is usually atelectasis; consider pneumonia, urinary infection, wound infection, and deep vein thrombosis by day and site.

Hernia strangulation signs: irreducible, tender, overlying skin change, and obstruction or systemic toxicity; requires urgent operative repair.

Major depressive disorder requires ≥5 symptoms for ≥2 weeks including depressed mood or anhedonia, causing impairment.

Serotonin syndrome: clonus, hyperreflexia, agitation, hyperthermia after serotonergic agents; stop the agent and give supportive care with benzodiazepines.

Neuroleptic malignant syndrome: rigidity, fever, autonomic instability, elevated CK after dopamine antagonists; stop drug, supportive care, dantrolene or bromocriptine.

Alcohol withdrawal: use a benzodiazepine-based symptom-triggered protocol; thiamine before glucose to prevent Wernicke encephalopathy.

Delirium is acute, fluctuating inattention; dementia is chronic progressive cognitive decline without impaired consciousness.

First-line pharmacotherapy for generalized anxiety disorder and panic disorder includes SSRIs or SNRIs; benzodiazepines are short-term only.

Suicide risk assessment: ask directly about ideation, plan, intent, access to means, and prior attempts; high risk warrants urgent safety planning and referral.

Opioid use disorder maintenance options include buprenorphine and methadone; both reduce mortality and are preferred over abrupt withdrawal.

Sensitivity = TP/(TP+FN); specificity = TN/(TN+FP); positive predictive value depends on prevalence.

Number needed to treat = 1/absolute risk reduction; number needed to harm = 1/absolute risk increase.

Screening test principles: important disease, detectable preclinical phase, acceptable test, effective early treatment, and favorable benefit-to-harm balance.

Colorectal cancer screening starts at age 45 in average-risk adults; options include colonoscopy every 10 years or annual fecal immunochemical test.

Immunization is contraindicated with live vaccines in pregnancy and severe immunosuppression; inactivated vaccines are generally safe.

Primary prevention reduces incidence (e.g., vaccination, smoking cessation); secondary prevention detects early disease (screening).

Herd immunity threshold depends on basic reproduction number R0: threshold = 1 − 1/R0.

Lead-time bias makes survival appear longer after screening even when mortality is unchanged; mortality is the preferred outcome measure.

Incidence measures new cases per population at risk per time; prevalence measures all existing cases at a point or period.

Relative risk = incidence in exposed / incidence in unexposed; odds ratio approximates RR when disease is rare.

Attributable risk = incidence in exposed − incidence in unexposed; population attributable fraction estimates impact at population level.

Case-control studies are efficient for rare diseases but susceptible to recall and selection bias; cohort studies measure incidence directly.

Confounding is a third variable associated with exposure and outcome; randomization, restriction, matching, and adjustment reduce it.

Bias types: selection, information, recall, and observer bias; blinding and standardized measurement reduce information and observer bias.

Outbreak investigation steps: verify diagnosis, define cases, describe by time-place-person, generate hypothesis, test, control, and communicate.

Screening program evaluation uses process, outcome, and cost measures; coverage and follow-up of abnormal results are key quality indicators.

Adult basic life support: high-quality compressions at 100–120/min, depth 5–6 cm, full recoil, minimize interruptions, early defibrillation.

Anaphylaxis: intramuscular epinephrine 0.5 mg (1:1000) into the lateral thigh, repeat every 5–15 minutes as needed; adjuncts do not replace epinephrine.

Acute coronary syndrome: obtain ECG within 10 minutes of arrival; aspirin plus reperfusion strategy based on ST elevation and timing.

Stroke: activate stroke pathway, check glucose, obtain CT to exclude hemorrhage; thrombolysis window is generally up to 4.5 hours from onset.

Sepsis: recognize organ dysfunction, obtain cultures, give broad-spectrum antibiotics and fluid resuscitation promptly.

Diabetic ketoacidosis: isotonic saline, insulin infusion after potassium is ≥3.3 mmol/L, and replace potassium as needed; monitor anion gap.

Status epilepticus: benzodiazepine first-line, then second-line antiseizure medication if seizures persist beyond the initial dose.

Tension pneumothorax is a clinical diagnosis; immediate needle decompression precedes imaging.

Osmolality ≈ 2 × Na + glucose/18 + urea/2.8 (all in mg/dL); effective osmolality excludes urea.

Corrected sodium for hyperglycemia: add 1.6 mEq/L to measured Na for every 100 mg/dL glucose above 100.

Acid-base interpretation: check pH, then PCO2, then bicarbonate; use Winter formula expected PCO2 = 1.5 × HCO3 + 8 ± 2 in metabolic acidosis.

Pharmacokinetics: half-life determines time to steady state (~4–5 half-lives); clearance and volume of distribution determine loading and maintenance doses.

Cytochrome P450 interactions: CYP3A4 inhibitors (e.g., macrolides, azoles) raise levels of statins, warfarin, and many other drugs.

Bacterial genetics: plasmids transfer resistance via conjugation; transposons and integrons mobilize resistance genes.

Sensitivity, specificity, and likelihood ratios convert pretest probability to posttest probability using Bayes theorem.

Renal function estimation uses creatinine-based equations; drug dosing should be adjusted for estimated glomerular filtration rate.

Four ethical principles: autonomy, beneficence, nonmaleficence, and justice; apply them to resolve clinical dilemmas.

Informed consent requires capacity, adequate information, understanding, voluntariness, and authorization; document the discussion.

Confidentiality may be breached only with patient consent or legal/public-health duty (e.g., notifiable disease, imminent serious harm).

Decision-making capacity requires understanding, appreciation, reasoning, and expressing a choice; it is decision-specific.

Advance directives and surrogate decision-makers guide care when capacity is lost; substituted judgment or best interests apply.

Breaking bad news: use a structured approach with preparation, assessing understanding, inviting questions, and summarizing next steps.

Medical error disclosure includes acknowledging the error, explaining what happened, expressing regret, and outlining prevention; never conceal.

Health systems: primary care gatekeeping, referral pathways, and continuity of care improve coordination and reduce fragmented utilization.