Afghanistan Medical Exit 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 is about 8 to 12 mmol/L; a raised gap suggests unmeasured anions such as ketones, lactate, or toxins.

Holliday-Segar maintenance fluids

Daily maintenance fluid is 100 mL/kg for the first 10 kg, 50 mL/kg for the next 10 kg, and 20 mL/kg for each kilogram beyond 20, applied to pediatric patients.

CURB-65 score

Pneumonia severity score counting confusion, urea above 7 mmol/L, respiratory rate 30 or more, low blood pressure, and age 65 or older; higher scores predict mortality.

Magnesium sulfate in eclampsia

Magnesium sulfate is the preferred drug to prevent and treat seizures in preeclampsia and eclampsia; monitor reflexes, respiratory rate, and urine output for toxicity.

Sensitivity and specificity

Sensitivity is the proportion of true cases correctly identified; specificity is the proportion of non-cases correctly identified. Neither depends on disease prevalence in the population.

Naloxone

An opioid receptor antagonist that rapidly reverses opioid-induced respiratory depression and sedation. It is titrated intravenously to restore adequate spontaneous breathing without fully reversing analgesia.

Herd immunity threshold

The fraction of a population that must be immune to interrupt transmission, approximated as 1 minus 1 divided by the basic reproduction number R0.

Tension pneumothorax management

A clinical diagnosis with severe dyspnea, hypotension, and absent breath sounds; immediate needle decompression followed by tube thoracostomy is required without waiting for imaging.

Cardiac output equation

Cardiac output equals heart rate multiplied by stroke volume. Normal resting output is approximately five liters per minute and rises with metabolic demand.

Informed consent elements

Valid consent requires patient capacity, adequate disclosure of risks and alternatives, comprehension, and voluntary choice. It is an ongoing process rather than a single signature.

Diabetic ketoacidosis treatment

Manage with isotonic intravenous fluids, an insulin infusion, and potassium replacement once serum potassium is not elevated; monitor glucose, ketones, and electrolytes closely.

ATLS primary survey

A structured trauma assessment: airway with cervical spine protection, breathing, circulation with hemorrhage control, disability with neurologic check, and exposure with environmental control.

Kawasaki disease criteria

Fever for at least five days plus conjunctivitis, oral mucositis, rash, extremity changes, and cervical lymphadenopathy. Treatment with IVIG and aspirin prevents coronary artery aneurysms.

Postpartum hemorrhage first steps

Uterine atony is the commonest cause. Management includes uterine massage, oxytocin, additional uterotonics, tranexamic acid, and escalation to surgical or interventional measures.

Warfarin and INR

Warfarin inhibits vitamin K epoxide reductase, reducing synthesis of clotting factors. Effect is monitored with the INR, and vitamin K reverses excessive anticoagulation.

Acute inflammation cells

Neutrophils predominate in acute inflammation, whereas lymphocytes, plasma cells, and macrophages characterize chronic inflammation and many granulomatous diseases.

Mean arterial pressure estimate

Mean arterial pressure approximates diastolic pressure plus one third of the pulse pressure, reflecting the time-weighted average of arterial pressure across the cardiac cycle.

Assessing decision-making capacity

Clinicians assess whether the patient understands information, appreciates consequences, reasons about options, and communicates a choice. Competence is a separate legal determination.

Anaphylaxis first-line treatment

Intramuscular epinephrine into the anterolateral thigh is the immediate first-line therapy; antihistamines and corticosteroids are adjuncts and do not replace epinephrine.

Appendicitis classic presentation

Periumbilical pain migrating to the right lower quadrant with McBurney point tenderness, anorexia, nausea, and low-grade fever suggests acute appendicitis requiring surgical evaluation.

Neonatal resuscitation heart rate

Provide positive pressure ventilation when the newborn is apneic or heart rate is below 100 per minute; begin chest compressions if heart rate stays below 60 despite effective ventilation.

Preeclampsia definition

New hypertension after 20 weeks of gestation with proteinuria or evidence of end-organ dysfunction; delivery is the definitive treatment, with magnesium sulfate for seizure prophylaxis.

Relative risk versus odds ratio

Relative risk compares incidence between exposed and unexposed groups in cohort studies; the odds ratio is used in case-control studies and approximates relative risk when disease is rare.

Aminoglycoside toxicity

Aminoglycosides can cause nephrotoxicity and ototoxicity. Serum levels are monitored, and concurrent use of other nephrotoxic drugs should be avoided when possible.

Coagulation test pathways

Prothrombin time and INR assess the extrinsic and common pathways, while activated partial thromboplastin time assesses the intrinsic and common pathways of coagulation.

Bohr effect

Rising carbon dioxide, hydrogen ion concentration, and temperature shift the oxygen-hemoglobin dissociation curve to the right, reducing hemoglobin affinity and enhancing tissue oxygen delivery.

Confidentiality limits

Patient confidentiality may be breached only when legally required, such as mandatory reporting of certain communicable diseases or a serious threat to an identifiable person.

Sepsis initial priorities

Recognize infection with organ dysfunction, measure lactate, give broad-spectrum antibiotics and intravenous fluids promptly, and reassess perfusion and response to therapy.

Nephrotic syndrome features

Characterized by proteinuria above 3.5 grams per day, hypoalbuminemia, edema, and hyperlipidemia. In adults, kidney biopsy often guides the underlying cause.

Bowel obstruction initial management

Nil per os, intravenous fluid resuscitation, nasogastric decompression, analgesia, and serial abdominal examinations, with surgery for strangulation, perforation, or failure to resolve.

Intussusception diagnosis and treatment

Colicky abdominal pain with vomiting and currant-jelly stool in a young child; ultrasound shows a target sign, and an air or contrast enema is both diagnostic and therapeutic.

Heparin monitoring and reversal

Unfractionated heparin potentiates antithrombin and is monitored by activated partial thromboplastin time; protamine sulfate is the specific reversing agent for overdose.