Albania State Medical Exam (Provimi i Shtetit - Mjekësi) flashcards

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

CURB-65

A pneumonia severity score: confusion, urea >7 mmol/L, respiratory rate >=30/min, low blood pressure, and age >=65. Each item scores one point and guides site of care.

Anion gap formula

Anion gap = sodium - (chloride + bicarbonate). Normal is roughly 8-12 mEq/L; elevated gap suggests ketoacidosis, lactic acidosis, renal failure, or toxin ingestion.

Nephrotic syndrome criteria

Proteinuria greater than 3.5 g per day, hypoalbuminemia, peripheral edema, and hyperlipidemia. Minimal change disease is the most common cause in children.

Alvarado score

Clinical score for appendicitis using migratory pain, anorexia, nausea, right lower quadrant tenderness, rebound, fever, and leukocytosis. A score of 7 or more supports surgery.

Hesselbach triangle borders

Bounded by the inferior epigastric vessels laterally, the rectus abdominis medially, and the inguinal ligament inferiorly. Direct inguinal hernias protrude through this triangle.

ATLS primary survey

A structured sequence: control catastrophic hemorrhage, then Airway with cervical spine protection, Breathing, Circulation, Disability, and Exposure with environmental control.

Magnesium sulfate in eclampsia

First-line therapy for eclamptic seizures and severe preeclampsia prophylaxis. Loading dose 4-6 g IV, then 1-2 g/hour infusion, monitoring reflexes and respiratory rate.

Postpartum hemorrhage causes

Remember the four T's: Tone (uterine atony, most common), Trauma, Tissue (retained products), and Thrombin (coagulopathy). Atony is managed first with massage and oxytocin.

Gestational diabetes thresholds

On a 75 g oral glucose tolerance test at 24-28 weeks: fasting >=92, one hour >=180, or two hours >=153 mg/dL. One abnormal value establishes the diagnosis.

Kawasaki disease criteria

Fever for at least five days plus four of: rash, conjunctivitis, oral mucosal changes, extremity changes, and cervical lymphadenopathy. Treat with IVIG and aspirin.

Bronchiolitis management

Respiratory syncytial virus is the most common cause. Treatment is supportive with oxygen and hydration; routine bronchodilators and corticosteroids are not recommended.

Simple febrile seizure features

Generalized seizure lasting under 15 minutes, occurring once in 24 hours, in a child aged 6 months to 5 years. Routine EEG and long-term anticonvulsants are not indicated.

Relative risk

Incidence in exposed divided by incidence in unexposed. A value of 1 indicates no association; greater than 1 indicates increased risk in the exposed group.

Sensitivity and specificity

Sensitivity is true positives divided by all diseased; specificity is true negatives divided by all non-diseased. Both are properties of the test, independent of prevalence.

Herd immunity threshold

Calculated as 1 minus (1 divided by R0). Higher basic reproduction numbers require higher vaccination coverage to interrupt transmission in a population.

Loading dose formula

Loading dose equals volume of distribution times target concentration, divided by bioavailability. It rapidly achieves therapeutic levels before maintenance dosing sustains them.

Paracetamol antidote

N-acetylcysteine replenishes glutathione and is most effective when given early after overdose. The Rumack-Matthew nomogram guides treatment using timed serum levels.

Organophosphate antidotes

Atropine reverses muscarinic effects such as bradycardia and secretions; pralidoxime reactivates acetylcholinesterase and addresses nicotinic effects. Decontamination is also required.

Coagulative necrosis

Cell death from ischemia in most solid organs, preserving tissue architecture temporarily. Nuclei undergo pyknosis, karyorrhexis, and karyolysis; the heart and kidney are typical sites.

Two-hit hypothesis

Tumor suppressor genes such as RB and APC require inactivation of both alleles for loss of function. One inherited mutation plus one somatic mutation can initiate tumor formation.

Distributive shock

A form of shock with widespread vasodilation and maldistribution of blood flow, seen in sepsis, anaphylaxis, and neurogenic injury. It often presents with warm skin and low vascular resistance.

Metformin first-line therapy

Recommended initial pharmacotherapy for type 2 diabetes alongside lifestyle change. SGLT2 inhibitors or GLP-1 agonists are added when cardiovascular or renal disease is present.

PHQ-9 screening

A nine-item questionnaire that screens for depression severity. A positive screen requires a diagnostic interview and assessment of suicide risk before treatment decisions.

High-quality chest compressions

Compressions at 100-120 per minute, 5-6 cm deep, with full chest recoil and minimal interruptions. Defibrillate ventricular fibrillation or pulseless ventricular tachycardia as early as possible.

Anaphylaxis treatment

Intramuscular epinephrine 0.3-0.5 mg of 1 mg/mL solution into the anterolateral thigh, repeated every 5-15 minutes as needed. Fluids, oxygen, and antihistamines are adjuncts, not substitutes.

Sepsis bundle essentials

Obtain blood cultures before antibiotics, give broad-spectrum antibiotics within one hour, and provide 30 mL/kg crystalloid for hypotension or lactate >=4 mmol/L.

Serotonin syndrome features

Caused by serotonergic drugs and marked by agitation, clonus, hyperreflexia, and hyperthermia. Treatment is stopping the offending agent and supportive care with benzodiazepines.

Status epilepticus sequence

Give a benzodiazepine first, then a second-line anticonvulsant such as levetiracetam, valproate, or phenytoin. Refractory cases require anesthetic doses of agents like propofol or midazolam.

Parkinson disease cardinal signs

Bradykinesia, rigidity, resting tremor, and postural instability. Levodopa-carbidopa remains the most effective symptomatic treatment for motor symptoms.

Informed consent elements

Requires patient capacity, disclosure of risks, benefits, and alternatives, and voluntary agreement without coercion. Consent may be withdrawn at any time by a capable patient.

Capacity assessment

Determines whether a patient can understand information, appreciate consequences, reason about options, and communicate a choice. Capacity is decision-specific and can fluctuate.

Confidentiality exceptions

Disclosure without consent is permitted when required by law, such as reportable infectious diseases, suspected child abuse, or imminent serious harm to the patient or others.