MOHAP Doctor Exam flashcards

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

STEMI reperfusion window

Primary percutaneous coronary intervention should be performed within 90 minutes of first medical contact; if unavailable, fibrinolysis should be given within 30 minutes of hospital arrival.

CURB-65 components

Confusion, urea greater than 7 mmol/L, respiratory rate 30 or more per minute, blood pressure systolic below 90 or diastolic 60 or less, and age 65 or older. Score 2 or more warrants admission.

DKA potassium rule

In diabetic ketoacidosis, begin potassium replacement when serum potassium is below 5.5 mmol/L and urine output is adequate; insulin shifts potassium intracellularly and can cause dangerous hypokalemia.

Hypertensive emergency MAP reduction

Reduce mean arterial pressure by no more than 25 percent in the first hour, then to about 160/100 mmHg over 2 to 6 hours to avoid cerebral and coronary hypoperfusion.

Stroke thrombolysis dose

Intravenous alteplase for acute ischemic stroke is 0.9 mg/kg, maximum 90 mg, with 10 percent as a bolus and the remainder infused over 60 minutes, within 4.5 hours of onset.

CKD eGFR stage G3a

An estimated glomerular filtration rate of 45 to 59 mL/min/1.73 m² defines stage G3a chronic kidney disease, which requires monitoring for complications such as anemia and mineral bone disease.

Asthma severe exacerbation magnesium

Intravenous magnesium sulfate 2 g over 20 minutes is indicated for severe asthma exacerbation not responding to inhaled bronchodilators and systemic corticosteroids; it relaxes bronchial smooth muscle.

HFrEF four pillars

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

Alvarado score threshold

The Alvarado score for appendicitis sums migratory pain, anorexia, nausea, right iliac fossa tenderness, rebound tenderness, fever, leukocytosis, and neutrophil shift; a score of 7 or more suggests high probability.

Parkland burn formula

For burns, give 4 mL/kg per percent total body surface area of lactated Ringer's in the first 24 hours, with half in the first 8 hours from injury and the remainder over the next 16 hours.

Trauma primary survey order

The primary survey follows ABCDE: airway with cervical spine protection, breathing and ventilation, circulation with hemorrhage control, disability using Glasgow Coma Scale, and exposure with prevention of hypothermia.

Postoperative fever timeline

Fever within 48 hours suggests atelectasis; days 3 to 5 suggest urinary tract infection or pneumonia; days 5 to 10 suggest surgical site infection or anastomotic leak; after 7 days consider deep vein thrombosis.

Acute cholecystitis management

Early laparoscopic cholecystectomy within 72 hours of presentation is preferred for acute cholecystitis, along with intravenous antibiotics covering gram-negative enteric organisms.

Strangulated hernia signs

Severe pain, tenderness, fever, and an irreducible mass suggest strangulation of a hernia, which requires emergent surgical exploration rather than elective repair.

Bowel obstruction initial care

Initial management of bowel obstruction includes nil by mouth, intravenous fluids, nasogastric decompression, and analgesia; urgent surgery is needed for closed-loop obstruction, strangulation signs, or failure to resolve.

Thyroidectomy nerve complications

Recurrent laryngeal nerve injury causes hoarseness, external branch of the superior laryngeal nerve injury causes voice fatigue, and parathyroid injury causes hypocalcemia typically 24 to 72 hours after thyroidectomy.

Preeclampsia severe features

Severe features include blood pressure 160/110 mmHg or higher, platelets below 100,000/µL, elevated liver enzymes, creatinine above 1.1 mg/dL, pulmonary edema, or new cerebral or visual symptoms.

Postpartum hemorrhage uterotonics

First-line treatment for postpartum hemorrhage is oxytocin 10 IU intramuscularly or intravenously; carboprost 250 µg intramuscularly or misoprostol 800 µg sublingually may follow, plus tranexamic acid 1 g intravenously.

Methotrexate ectopic criteria

Methotrexate 50 mg/m² intramuscularly is suitable for a hemodynamically stable, unruptured ectopic pregnancy with mass under 3.5 to 4 cm, no fetal cardiac activity, and hCG below 5000 IU/L.

Gestational diabetes diagnostic thresholds

On a 75 g 2-hour oral glucose tolerance test, gestational diabetes is diagnosed if fasting glucose is 92 mg/dL or higher, 1-hour is 180 mg/dL or higher, or 2-hour is 153 mg/dL or higher.

Magnesium sulfate toxicity antidote

Calcium gluconate 10 percent, 10 mL intravenously, is the antidote for magnesium sulfate toxicity; monitor deep tendon reflexes, respiratory rate above 12 per minute, and urine output above 30 mL/h.

Cervical cancer screening start

Cervical cancer screening begins at age 21 with cytology every 3 years, or at age 30 with cytology plus HPV co-testing every 5 years, and may stop at age 65 after adequate negative screening.

Ovarian torsion management

Sudden severe unilateral pelvic pain with nausea suggests ovarian torsion; Doppler may be normal, and treatment is laparoscopic detorsion with ovarian preservation rather than oophorectomy.

Endometrial cancer risk factors

Unopposed estrogen exposure, obesity, nulliparity, diabetes, and tamoxifen use increase endometrial cancer risk; postmenopausal bleeding requires endometrial biopsy for evaluation.

Pediatric CPR ratio

In pediatric basic life support, the compression-to-ventilation ratio is 30:2 for a single rescuer and 15:2 for two rescuers, with compression depth at least one-third of chest anteroposterior diameter.

Acute otitis media antibiotic

High-dose amoxicillin 80 to 90 mg/kg/day is first-line for acute otitis media; clavulanate is added for recent amoxicillin use, treatment failure, or purulent conjunctivitis.

Bronchiolitis supportive care

Bronchiolitis management is supportive with oxygen for saturation below 90 to 92 percent, hydration, and nasal suction; routine bronchodilators, corticosteroids, and antibiotics are not recommended.

Kawasaki disease treatment

Kawasaki disease, fever for 5 days or more plus 4 of 5 criteria, is treated with intravenous immunoglobulin 2 g/kg and aspirin to reduce coronary artery aneurysm risk.

WHO dehydration oral rehydration

Some dehydration with two or more WHO signs is treated with oral rehydration solution 75 mL/kg over 4 hours; severe dehydration requires intravenous Ringer's lactate 100 mL/kg.

Simple febrile seizure features

A simple febrile seizure lasts less than 15 minutes, is generalized, and occurs once in 24 hours; routine lumbar puncture, EEG, and neuroimaging are not needed in a well-appearing child.

Pediatric growth chart choice

Use WHO growth charts for children younger than 2 years and CDC charts for those 2 years and older; failure to thrive is weight below the 5th percentile or crossing two major percentile lines downward.

Neonatal jaundice phototherapy

Phototherapy thresholds for neonatal jaundice depend on age in hours, gestational age, and risk factors; exchange transfusion is indicated for severe hyperbilirubinemia or acute bilirubin encephalopathy signs.