Arab Board Internal Medicine Part 1 flashcards

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

STEMI reperfusion window

Primary PCI is preferred if it can be delivered within 120 minutes of first medical contact; fibrinolysis is used when PCI is unavailable and symptom onset is under 12 hours without contraindications.

CHA2DS2-VASc threshold

Oral anticoagulation is recommended for atrial fibrillation when the score is at least 2 in men or at least 3 in women; a score of 0 requires no antithrombotic therapy.

Light criteria exudate

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

CURB-65 components

Confusion, urea above 7 mmol/L, respiratory rate at least 30, low blood pressure, and age at least 65; the score guides site of care in community-acquired pneumonia.

Spontaneous bacterial peritonitis threshold

Diagnosis is made when ascitic fluid polymorphonuclear neutrophil count is at least 250 cells per cubic millimeter; treat with third-generation cephalosporin and albumin.

Serum-ascites albumin gradient

A gradient of at least 1.1 g/dL indicates portal hypertension as the cause of ascites; a lower gradient suggests peritoneal, pancreatic, or malignant causes.

KDIGO acute kidney injury criteria

Creatinine rise of at least 0.3 mg/dL within 48 hours, or at least 1.5 times baseline within 7 days, or urine output below 0.5 mL/kg/h for 6 hours.

Fractional excretion of urea

A value below 35 percent suggests prerenal azotemia and is useful when diuretics make fractional excretion of sodium unreliable.

Thyroid storm treatment sequence

Give a beta-blocker and a thionamide first, then iodine at least one hour after the thionamide, plus glucocorticoid and supportive care.

DKA insulin initiation rule

Start an insulin infusion only after potassium is at least 3.3 mmol/L; give fluid resuscitation and replace potassium as needed; reserve bicarbonate for pH below 6.9.

Heparin-induced thrombocytopenia features

Platelet count falls by more than 50 percent at 5 to 10 days with paradoxical thrombosis; stop heparin, start a non-heparin anticoagulant, and avoid platelet transfusion.

Neutropenic fever definition

Absolute neutrophil count below 500 per cubic millimeter with a single temperature of at least 38.3 C or sustained 38.0 C; give antipseudomonal beta-lactam within one hour.

Sepsis antibiotic timing

In suspected sepsis with organ dysfunction, obtain cultures when feasible and administer broad-spectrum antibiotics within one hour of recognition.

Tuberculosis standard regimen

Two months of isoniazid, rifampin, pyrazinamide, and ethambutol followed by four months of isoniazid and rifampin for drug-susceptible pulmonary tuberculosis.

Gout crystal finding

Needle-shaped, negatively birefringent monosodium urate crystals in joint aspirate confirm gout; treat acute flares with NSAID, colchicine, or glucocorticoid.

Giant cell arteritis urgency

Start high-dose glucocorticoids immediately when suspected, before temporal artery biopsy, to prevent irreversible vision loss; ESR and CRP are usually elevated.

Stroke thrombolysis window

Intravenous thrombolysis is given within 4.5 hours of ischemic stroke onset after noncontrast CT excludes hemorrhage; thrombectomy is considered for large-vessel occlusion.

Albuminocytologic dissociation

Elevated cerebrospinal fluid protein without pleocytosis supports Guillain-Barre syndrome; treat with IV immunoglobulin or plasma exchange.

Beers criteria example

Benzodiazepines, anticholinergics, and long-acting sulfonylureas are potentially inappropriate in older adults because of falls, delirium, and hypoglycemia risks.

Cockcroft-Gault equation use

Estimates creatinine clearance for drug dosing, incorporating age, weight, sex, and serum creatinine; used to adjust renally cleared medications.

Sensitivity formula

Sensitivity equals true positives divided by true positives plus false negatives; a highly sensitive test is useful for ruling out disease when negative.

Number needed to treat

Calculated as 1 divided by the absolute risk reduction; it estimates how many patients must be treated for one additional beneficial outcome.

Incidence versus prevalence

Incidence counts new cases per population at risk per unit time; prevalence counts all existing cases at a point in time and depends on incidence and duration.

Lead-time bias

Screening that detects disease earlier can appear to prolong survival without changing the disease course; mortality, not survival time, is the valid outcome.

Stages of change model

Precontemplation, contemplation, preparation, action, and maintenance; interventions should match the patient's current stage rather than assume readiness.

Motivational interviewing technique

Uses open-ended questions, reflective listening, and affirmation to strengthen the patient's own motivation for change while avoiding confrontation and direct persuasion.

Informed consent elements

Capacity, disclosure of risks, benefits, and alternatives, comprehension, and voluntariness; the discussion should be documented in the record.

Decision-making capacity components

The patient must understand the information, appreciate the consequences, reason about options, and communicate a choice; capacity is specific to each decision.

Hyponatremia correction limit

Correct chronic hyponatremia by no more than 8 to 10 mmol/L in 24 hours to reduce the risk of osmotic demyelination syndrome.

Severe aortic stenosis criteria

Peak velocity at least 4 m/s, mean gradient at least 40 mmHg, or valve area at most 1.0 cm2 on echocardiography defines severe aortic stenosis.

Tumor lysis syndrome features

Hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia occur after cytotoxic therapy; prevent with hydration and allopurinol or rasburicase.

ARDS Berlin oxygenation criterion

Acute onset within one week with bilateral opacities not explained by cardiac failure and PaO2/FiO2 at most 300 mmHg on PEEP of at least 5 cmH2O.