DOH Doctor Exam flashcards

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

Anion gap formula

Anion gap equals serum sodium minus the sum of chloride and bicarbonate; normal range is 8 to 12 mmol/L, and elevated values suggest ketoacidosis, lactic acidosis, or toxin ingestion.

DKA insulin initiation threshold

Start continuous insulin infusion in diabetic ketoacidosis only after serum potassium is at least 3.3 mmol/L; if lower, replete potassium first because insulin drives potassium intracellularly.

HFrEF four pillars

Guideline-directed therapy for heart failure with reduced ejection fraction includes ARNI or ACE inhibitor/ARB, evidence-based beta-blocker, mineralocorticoid receptor antagonist, and SGLT2 inhibitor.

Metformin first-line exception

Metformin is first-line for type 2 diabetes unless eGFR is below 30 mL/min/1.73 m², severe hepatic disease, or acute metabolic decompensation; consider SGLT2 or GLP-1 for cardiorenal disease.

ATLS primary survey order

The primary survey sequence is catastrophic hemorrhage control, airway with cervical spine protection, breathing and ventilation, circulation with hemorrhage control, disability, and exposure with environmental control.

Alvarado score threshold

An Alvarado score of 7 or more in suspected appendicitis supports surgical evaluation; the score combines migration of pain, anorexia, nausea, tenderness, rebound, fever, and leukocytosis.

Postoperative fever timeline

In postoperative fever, consider atelectasis or pneumonia in the first 48 hours, urinary infection around days 3 to 5, and surgical site infection after day 5.

Simple febrile seizure criteria

A simple febrile seizure occurs in children aged 6 months to 5 years, is generalized, lasts less than 15 minutes, and occurs only once in 24 hours.

Bronchiolitis first-line support

Bronchiolitis management is supportive with hydration and oxygen if hypoxemic; routine bronchodilators, corticosteroids, and antibiotics are not recommended because they do not improve outcomes.

Neonatal jaundice red flag

Jaundice appearing within the first 24 hours after birth is pathologic and requires urgent bilirubin measurement and evaluation for hemolysis, sepsis, or biliary obstruction.

Colorectal screening start age

Average-risk colorectal cancer screening begins at age 45; options include colonoscopy every 10 years or annual fecal immunochemical testing, with shared decision-making.

Statin risk threshold

Moderate-intensity statin therapy is recommended for adults aged 40 to 75 with diabetes or a 10-year atherosclerotic cardiovascular disease risk of 7.5% or higher.

Asthma reversibility criterion

Asthma is supported by spirometry showing an increase in forced expiratory volume in one second of at least 12% and 200 mL after a bronchodilator.

Preeclampsia diagnostic threshold

Preeclampsia is new hypertension at or above 140/90 mmHg after 20 weeks with proteinuria or end-organ dysfunction; delivery is the definitive treatment.

Postpartum hemorrhage first step

Uterine atony is the most common cause of postpartum hemorrhage; initial management is fundal massage, oxytocin, and rapid assessment of blood loss and hemodynamic status.

Gestational diabetes screening window

Screen for gestational diabetes at 24 to 28 weeks with a 50-g one-hour glucose challenge; abnormal results require a 100-g three-hour oral glucose tolerance test.

Anaphylaxis epinephrine dose

Give intramuscular epinephrine 0.3 to 0.5 mg of 1:1000 concentration into the anterolateral thigh for anaphylaxis; repeat every 5 to 15 minutes if symptoms persist.

Stroke thrombolysis window

Intravenous alteplase may be given for acute ischemic stroke within 4.5 hours of symptom onset if there are no contraindications; thrombectomy may extend to 24 hours in selected cases.

Tension pneumothorax decompression

Tension pneumothorax requires immediate needle decompression before imaging, using the second intercostal space midclavicular line or fourth/fifth space anterior axillary line.

Serotonin syndrome triad

Serotonin syndrome presents with mental status change, autonomic hyperactivity, and neuromuscular abnormalities such as clonus and hyperreflexia after serotonergic drugs.

Alcohol withdrawal first-line

Benzodiazepines are first-line for alcohol withdrawal; give thiamine before glucose to prevent Wernicke encephalopathy in at-risk patients.

Capacity four abilities

Decision-making capacity requires the ability to communicate a choice, understand relevant information, appreciate the situation and consequences, and reason about options.

Anion gap metabolic acidosis

An elevated anion gap metabolic acidosis suggests accumulation of unmeasured acids such as ketones, lactate, uremia, or toxins; remember MUDPILES for causes.

Sensitivity definition

Sensitivity is the proportion of people with disease who test positive; a highly sensitive test is useful for ruling out disease when the result is negative.

First-order half-life steady state

In first-order pharmacokinetics, steady state is reached after approximately four to five half-lives; loading dose depends on volume of distribution, not clearance.

Informed consent elements

Informed consent requires disclosure of diagnosis, proposed treatment, material risks and benefits, alternatives, and consequences of refusal, followed by voluntary patient authorization.

Capacity versus competence

Capacity is a clinical, decision-specific assessment; competence is a legal determination. A patient with capacity may refuse treatment even if the choice seems unwise.

WHO five hand hygiene moments

The five moments are before patient contact, before aseptic procedure, after body fluid exposure risk, after patient contact, and after touching patient surroundings.

Notifiable disease immediate reporting

Cholera, plague, anthrax, and measles require immediate notification to public health authorities; hepatitis, tuberculosis, and salmonellosis require timely reporting.

Isolation versus quarantine

Isolation separates people known to be infected; quarantine restricts asymptomatic people exposed to an infectious agent during the incubation period.

Obesity pharmacotherapy threshold

Pharmacotherapy for obesity may be considered when BMI is 30 or higher, or 27 or higher with a weight-related comorbidity, alongside diet and exercise.

Screening test validity criteria

A worthwhile screening program requires an important disease, a detectable preclinical phase, an acceptable and accurate test, effective early treatment, and acceptable cost and access.