DHA Specialist Exam flashcards
DHA Specialist Exam · Build recall with a focused review session.
32 cards. Read the term and the definition here. The deck at the top of this page is optional.
- Informed consent elements
- Capacity, disclosure of material risks, benefits, and alternatives, comprehension by the patient, and voluntary choice. All four must be documented before the procedure.
- WHO 5 Moments
- Hand hygiene before patient contact, before aseptic task, after body fluid exposure risk, after patient contact, and after touching patient surroundings.
- SBAR handoff
- Situation, Background, Assessment, Recommendation. A structured communication format that reduces omissions and errors during transitions of care.
- Door-to-balloon time
- Target interval of 90 minutes or less from hospital arrival to primary percutaneous coronary intervention in ST-elevation myocardial infarction.
- Standard precautions
- Infection-control practices applied to all patients regardless of diagnosis, including gloves, gown, mask, and eye protection based on anticipated exposure.
- ESI triage levels
- Emergency Severity Index 1 to 5, where level 1 requires immediate resuscitation and level 5 predicts no resources needed.
- Anaphylaxis first-line drug
- Intramuscular epinephrine 0.01 mg/kg of 1:1000 concentration, maximum 0.5 mg, injected into the anterolateral thigh. Antihistamines and steroids are adjuncts.
- Anion gap formula
- Sodium minus the sum of chloride and bicarbonate; normal range approximately 8 to 12 mmol/L. Elevated gap suggests ketoacidosis, lactic acidosis, or toxin.
- Sepsis-3 definition
- Suspected infection plus an acute increase in SOFA score of 2 or more points. qSOFA is a bedside risk flag, not a diagnostic criterion.
- Delta-delta calculation
- Compares the rise in anion gap above 12 with the fall in bicarbonate below 24. A ratio near 1 indicates pure high-gap acidosis; deviation suggests a mixed disorder.
- DKA diagnostic triad
- Hyperglycemia above 250 mg/dL, arterial pH below 7.3 with bicarbonate under 18, and ketonemia or ketonuria with an elevated anion gap.
- Hyponatremia correction limit
- Correct serum sodium by no more than 8 to 10 mmol/L in 24 hours to reduce the risk of osmotic demyelination syndrome.
- HEART score use
- History, ECG, Age, Risk factors, Troponin. Stratifies six-week major adverse cardiac event risk in undifferentiated chest pain to guide disposition.
- Sensitivity formula
- True positives divided by true positives plus false negatives. The proportion of diseased patients correctly identified by the test.
- Specificity formula
- True negatives divided by true negatives plus false positives. The proportion of non-diseased patients correctly identified as negative.
- Positive likelihood ratio
- Sensitivity divided by one minus specificity. Values above 10 substantially increase post-test probability of disease.
- Predictive value dependence
- Positive and negative predictive values depend on disease prevalence in the tested population, unlike sensitivity and specificity which are test-intrinsic.
- Spectrum bias
- Diagnostic accuracy is overestimated when a study enrolls only severely ill cases and clearly healthy controls rather than the full clinical spectrum.
- ALARA principle
- Radiation exposure should be kept as low as reasonably achievable. Justify each study and use the lowest dose that answers the clinical question.
- Post-test probability conversion
- Convert pre-test probability to odds, multiply by the likelihood ratio to obtain post-test odds, then convert back: probability equals odds divided by odds plus one.
- Swiss cheese model
- Harm results when failures align across multiple defensive layers. Interventions should strengthen system barriers rather than blame individuals.
- Root cause analysis
- A retrospective structured review after a sentinel event that identifies contributing system factors and produces actionable recommendations with measurable follow-up.
- FMEA purpose
- Failure mode and effects analysis is a prospective risk assessment scoring severity, occurrence, and detection to prioritize process redesign before harm occurs.
- Six aims of improvement
- Care should be safe, effective, patient-centered, timely, efficient, and equitable, as defined by the Institute of Medicine framework.
- High-alert medications
- Drugs with high risk of significant harm when misused, including insulin, heparin, opioids, and concentrated electrolytes. Require independent double-checks.
- Surgical time-out
- A pause before incision where the team confirms patient identity, procedure, site, side, consent, and relevant allergies or implants aloud.
- Four ethical principles
- Autonomy, beneficence, non-maleficence, and justice. For a capacitated adult, autonomy generally outweighs competing principles.
- Decision-making capacity
- A task-specific clinical determination requiring the patient to understand, appreciate, reason about, and communicate a choice. It differs from legal competence.
- SPIKES protocol
- Setting, Perception, Invitation, Knowledge, Empathy, Strategy and Summary. A structured framework for delivering bad news to patients and families.
- Surrogate decision hierarchy
- Order typically used absent an advance directive: spouse or partner, adult children, parents, siblings, then close friends, applying substituted judgment.
- Confidentiality exceptions
- Disclosure without consent is permitted for mandatory reporting, court orders, or imminent threat to an identifiable person, limited to the minimum necessary.
- Value-based reimbursement
- Payment models linking reimbursement to quality measures and outcomes rather than volume of services, in contrast with fee-for-service payment.