DHA GP Exam flashcards

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

Anion gap formula

Sodium minus (chloride plus bicarbonate), normally 8–12 mEq/L. An elevated gap suggests methanol, uremia, diabetic ketoacidosis, or lactic acidosis.

DKA diagnostic triad

Hyperglycemia above 250 mg/dL, ketonemia or ketonuria, and anion-gap metabolic acidosis with pH below 7.30. Treatment is fluids, insulin infusion, and potassium replacement.

Hyperkalemia ECG progression

Peaked T waves appear first, followed by PR prolongation, widened QRS, and a sine wave. IV calcium is given immediately when ECG changes are present.

STEMI reperfusion targets

Primary PCI within 90 minutes of first medical contact is preferred; fibrinolysis within 30 minutes is the alternative when PCI is unavailable and symptoms are under 12 hours.

Stroke thrombolysis window

Intravenous alteplase may be given up to 4.5 hours from last known well. Thrombectomy is offered up to 24 hours in selected large-vessel occlusions with salvageable brain tissue.

HFrEF quadruple therapy

For ejection fraction 40% or less, combined ARNI or ACE inhibitor, beta-blocker, mineralocorticoid receptor antagonist, and SGLT2 inhibitor reduce mortality and hospitalization.

Hyponatremia correction limit

Serum sodium should rise no more than 8–10 mEq/L in 24 hours to avoid osmotic demyelination. Hypertonic saline is reserved for seizures or severe neurologic symptoms.

Prediabetes HbA1c range

An HbA1c of 5.7–6.4% defines prediabetes. Structured lifestyle intervention reduces progression to type 2 diabetes by roughly 58% over three years.

Colorectal screening starting age

Average-risk adults begin screening at 45 years and continue to 75. Colonoscopy every 10 years or annual fecal immunochemical testing are accepted strategies.

Statin primary prevention threshold

Adults aged 40–75 with at least one risk factor and a 10-year ASCVD risk of 10% or greater should receive a moderate-intensity statin.

Acute otitis media first-line

High-dose amoxicillin 80–90 mg/kg/day is first-line therapy. Observation for 48–72 hours is reasonable in children aged 2 years or older with nonsevere illness.

Outpatient pneumonia antibiotic choice

Without comorbidity, amoxicillin or doxycycline is used. With comorbidity, prescribe amoxicillin-clavulanate plus a macrolide, or a respiratory fluoroquinolone alone.

Smoking cessation pharmacotherapy

Varenicline, bupropion, or nicotine replacement combined with counseling is first-line. Combining nicotine patch with a short-acting form is more effective than a single product.

Febrile neonate rule

Any infant 28 days old or younger with temperature 38.0°C or higher needs a full sepsis evaluation and empirical antibiotics, regardless of how well the infant appears.

Pediatric maintenance fluid rule

Holliday-Segar 4-2-1 rule: 4 mL/kg/hour for the first 10 kg, 2 mL/kg/hour for the next 10 kg, and 1 mL/kg/hour for each kilogram above 20.

Bronchiolitis supportive care

Management is oxygen, hydration, and nasal suction. Routine bronchodilators, systemic corticosteroids, and antibiotics are not recommended for RSV bronchiolitis.

Kawasaki disease criteria

Fever for 5 days or more plus 4 of 5 features: conjunctivitis, oral changes, rash, extremity changes, cervical lymphadenopathy. Give IVIG and aspirin to prevent coronary aneurysms.

Neonatal jaundice treatment threshold

Phototherapy is started using hour-specific bilirubin nomograms by risk category. Exchange transfusion is indicated near threshold levels or with signs of acute bilirubin encephalopathy.

Infant motor milestones

Most infants sit without support by 8 months and walk independently by 12–15 months. Loss of previously achieved milestones requires developmental evaluation.

Pediatric dehydration signs

Reduced skin turgor, capillary refill over 2 seconds, sunken eyes, and decreased urine output indicate 5% or greater dehydration needing oral or intravenous rehydration.

Preeclampsia diagnostic criteria

Blood pressure 140/90 mmHg or higher after 20 weeks plus proteinuria or end-organ dysfunction. Magnesium sulfate prevents and treats eclamptic seizures.

Gestational diabetes screening

Screen at 24–28 weeks with a 50-g one-hour glucose challenge. A positive screen is followed by a 3-hour 100-g test using Carpenter-Coustan thresholds.

Postpartum hemorrhage definition

Blood loss of 1000 mL or more, or any loss causing hemodynamic instability, within 24 hours of birth. Uterine atony is the most common cause.

Rh immune globulin timing

Anti-D is given at 28 weeks and within 72 hours of delivering an Rh-positive infant, and also after amniocentesis, miscarriage, or antepartum bleeding.

Ectopic pregnancy methotrexate criteria

Methotrexate suits hemodynamically stable, unruptured ectopic pregnancy with hCG below 5000 mIU/mL, mass under 4 cm, and no fetal cardiac activity.

Active phase labor progress

The active first stage runs from 6 to 10 cm dilation, progressing at least 1 cm per hour in nulliparas; slower progress prompts evaluation for arrest.

ATLS primary survey order

Airway with cervical spine protection, breathing, circulation with hemorrhage control, disability, then exposure with prevention of hypothermia.

Parkland burn formula

Give 4 mL × weight in kg × percent total body surface area burned of lactated Ringer over 24 hours, with half infused in the first 8 hours after injury.

Tension pneumothorax management

Immediate needle decompression is followed by chest tube insertion. Treatment must not be delayed for imaging when clinical signs are present.

Anaphylaxis first-line treatment

Intramuscular epinephrine 0.3–0.5 mg of 1:1000 solution into the anterolateral thigh, repeated every 5–15 minutes as needed. Antihistamines and steroids are adjuncts only.

Septic shock one-hour bundle

Measure lactate, draw blood cultures, and give broad-spectrum antibiotics plus 30 mL/kg crystalloid within the first hour of recognizing septic shock.

Appendicitis Alvarado score

The score combines migratory pain, anorexia, nausea, right lower quadrant tenderness, rebound, fever, and leukocytosis; a score of 7 or more supports appendicitis.