Albania State Medical Exam (Provimi i Shtetit - Mjekësi) key terms

A clinical syndrome in which the heart cannot pump enough blood to meet the body's needs, producing breathlessness, fatigue, fluid retention and raised jugular venous pressure. Diagnosed by history, examination and echocardiography, and treated with diuretics and rate- or load-reducing drugs.

The percentage of blood in the left ventricle that is ejected with each contraction, usually measured by echocardiography. A value below about 40 percent indicates systolic dysfunction and guides treatment and prognosis in heart failure.

A sudden reduction in blood flow to heart muscle caused by plaque rupture or thrombosis, covering unstable angina and myocardial infarction. It presents with chest pain and is confirmed by serial troponin and electrocardiography.

Death of heart muscle due to prolonged ischaemia, typically from coronary artery occlusion. It causes severe chest pain, ST-segment changes and a rise in cardiac troponin, and requires urgent reperfusion.

Proteins released into the blood when heart muscle cells are damaged. Highly specific markers used to detect myocardial infarction; a rising and falling pattern over hours supports the diagnosis.

Rapid accumulation of fluid in the lung alveoli, usually from left heart failure, causing severe breathlessness, orthopnoea, crackles and pink frothy sputum. Treated with oxygen, diuretics and vasodilators while sitting the patient upright.

Inflammation of the vermiform appendix, classically causing migrating right lower quadrant pain, anorexia and tenderness at McBurney's point. Untreated it may perforate, so surgical removal is the standard treatment.

Acute inflammation of the peritoneum, often from a perforated viscus or infected appendix, producing rigid abdominal wall, severe pain and systemic signs. It is a surgical emergency requiring resuscitation, antibiotics and source control.

Rebound tenderness elicited by pressing slowly on the abdomen and releasing quickly, causing sharp pain. It suggests peritoneal irritation such as appendicitis or peritonitis.

Blockage of the bowel lumen that prevents passage of contents, causing colicky pain, vomiting, distension and absolute constipation. Causes include adhesions, hernia and tumour; management ranges from conservative decompression to surgery.

A pregnancy disorder appearing after 20 weeks with new hypertension and proteinuria or organ dysfunction. It threatens mother and fetus and is managed by close monitoring, antihypertensives, magnesium sulphate for seizures and timely delivery.

The occurrence of generalized seizures in a woman with preeclampsia, not explained by other causes. It is a life-threatening obstetric emergency treated with magnesium sulphate, airway support and delivery of the fetus.

A severe variant of preeclampsia marked by haemolysis, elevated liver enzymes and low platelets. It causes right upper quadrant pain and bleeding risk and often requires urgent delivery.

Excessive bleeding after childbirth, conventionally more than 500 mL after vaginal delivery or 1000 mL after caesarean. Common causes are uterine atony, retained placenta, genital tract tears and clotting disorders; treatment starts with uterine massage and uterotonics.

Failure of the uterus to contract after delivery, making it the commonest cause of postpartum haemorrhage. The uterus feels soft and enlarged; management includes massage, oxytocin and other uterotonic drugs.

A deficit of body water and electrolytes in a child, usually from vomiting or diarrhoea, graded as mild, moderate or severe. Signs include dry mucosa, reduced skin turgor, sunken eyes and lethargy; treatment is oral or intravenous rehydration.

Giving a balanced glucose and electrolyte solution by mouth to correct dehydration, especially in diarrhoeal illness. It is the first-line treatment for mild to moderate dehydration and reduces the need for intravenous fluids.

Passage of loose stools three or more times daily for less than two weeks, usually caused by viral or bacterial gut infection. Main risk is dehydration; management centres on fluids, continued feeding and selective antibiotics.

The number of new cases of a disease arising in a defined population during a specified period, divided by the population at risk. It measures how fast new disease occurs and is used to study causation and prevention.

The proportion of a population that has a disease at a given point or period, counting both old and new cases. It reflects the overall burden of disease and is influenced by incidence and duration.

The ratio of disease risk in an exposed group to the risk in an unexposed group. A value above one suggests increased risk from the exposure; it is a core measure in cohort and cross-sectional studies.

An observational study that compares people with a disease (cases) to similar people without it (controls) and looks back at past exposures. It is efficient for rare diseases but prone to recall and selection bias.

A characteristic, behaviour or exposure statistically associated with an increased likelihood of developing a disease. It may be causal or merely a marker, and identifying it guides prevention and screening.

The ethical and legal rule that a patient must receive adequate information about a proposed intervention and freely agree to it before it is carried out. Consent must be voluntary, informed and given by a person with capacity.

The duty of health professionals to keep patient information secret and share it only with those involved in care or when the law permits. It protects trust and privacy and may be overridden only in defined situations such as serious public health risk.

A patient's ability to understand relevant information, appreciate the consequences of choices and communicate a decision about their own care. When capacity is absent, decisions are made in the patient's best interests, often with a surrogate.

How the body handles a drug over time, covering absorption, distribution, metabolism and excretion. It determines the concentration of drug at its site of action and guides dosing intervals and dose adjustments.

What a drug does to the body, including its mechanism of action, receptor effects and the relationship between concentration and response. It explains therapeutic effects, side effects and interactions between drugs acting on the same system.

The time taken for the blood concentration of a drug to fall by half. It helps decide dosing frequency and how long a drug persists after stopping; repeated dosing reaches steady state in about four to five half-lives.

A substance that counteracts the toxic effect of a poison by binding it, blocking its action or restoring normal physiology. Examples include naloxone for opioids and acetylcysteine for paracetamol overdose; it is given alongside supportive care.

Ingestion of paracetamol above the therapeutic dose, which can cause severe liver damage days later. Early signs are mild; treatment with acetylcysteine is most effective when started soon after ingestion, guided by blood levels.

Irreversible death of cells or tissue in a living body, often from ischaemia, infection or toxins. It provokes inflammation and may heal by fibrosis or calcification; types include coagulative, caseous and liquefactive necrosis.

Programmed cell death that removes unwanted or damaged cells without provoking inflammation. It is an orderly, energy-dependent process controlled by genes and differs from necrosis in mechanism and tissue reaction.

A rapid, short-lived response to injury or infection characterised by redness, heat, swelling, pain and loss of function. It involves vasodilatation, increased vessel permeability and migration of neutrophils to the affected tissue.

Life-threatening organ dysfunction caused by a dysregulated host response to infection. It requires prompt recognition, cultures, early antibiotics and fluid resuscitation, and is a major cause of death in hospital.

Sepsis with persistent low blood pressure requiring vasopressors despite adequate fluid resuscitation, together with raised lactate. It is a medical emergency managed with fluids, antibiotics, vasopressors and source control.

A mood disorder with at least two weeks of persistent low mood or loss of interest plus symptoms such as sleep and appetite change, fatigue and poor concentration, causing significant impairment. Treated with psychotherapy and antidepressants.

Thoughts about ending one's own life, ranging from passive wishes to detailed plans. It must always be asked about directly and assessed for intent and means, because it signals urgent psychiatric risk requiring safety planning and referral.

A continuous seizure lasting five minutes or more, or repeated seizures without recovery between them. It is a neurological emergency treated with airway protection, glucose check and stepwise anticonvulsant drugs.

Seizures provoked by fever in children, usually aged six months to five years, without evidence of brain infection. Most are brief and benign; assessment aims to exclude meningitis and to reassure and educate parents.