AOBIM Internal Medicine 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 roughly 8 to 12 mEq/L and helps classify metabolic acidosis.

CURB-65 components

Confusion, blood urea nitrogen elevation, respiratory rate 30 or higher, low blood pressure, and age 65 or older; scores guide site-of-care decisions in community-acquired pneumonia.

Septic shock definition

Sepsis with persisting hypotension requiring vasopressors to maintain mean arterial pressure 65 mm Hg or higher and serum lactate above 2 mmol/L despite adequate fluid resuscitation.

STEMI reperfusion window

Primary percutaneous coronary intervention should be performed within 90 minutes of first medical contact at a PCI-capable center; fibrinolysis is an alternative when timely PCI is unavailable.

HFrEF four pillars

Guideline-directed therapy includes an ARNI, ACE inhibitor, or ARB; an evidence-based beta-blocker; a mineralocorticoid receptor antagonist; and an SGLT2 inhibitor, each shown to reduce mortality.

DKA potassium rule

Total body potassium is depleted in diabetic ketoacidosis; begin replacement when serum potassium is below 5.2 mEq/L and hold insulin until potassium is above 3.3 mEq/L.

Thyroid storm treatment order

Give a beta-blocker for adrenergic control, then a thionamide to block synthesis, then iodine at least one hour later, plus glucocorticoid to block peripheral conversion.

Hyperkalemia with ECG changes

Intravenous calcium stabilizes cardiac membranes first; insulin with glucose and inhaled beta-agonist then shift potassium intracellularly while definitive removal is arranged.

MUDPILES causes

Methanol, uremia, diabetic ketoacidosis, paraldehyde, isoniazid, lactic acidosis, ethylene glycol, and salicylates cause a high anion gap metabolic acidosis.

Hyponatremia correction limit

Correct chronic hyponatremia by no more than 8 to 10 mEq/L in 24 hours to reduce the risk of osmotic demyelination syndrome.

Atrial fibrillation anticoagulation

Use CHA2DS2-VASc to estimate stroke risk; anticoagulation is generally recommended when the score is 2 or higher in men and 3 or higher in women.

Acute pancreatitis diagnosis

Requires two of three features: characteristic epigastric pain, serum lipase or amylase at least three times the upper limit of normal, and imaging findings consistent with pancreatitis.

Upper GI bleed initial step

Resuscitate with intravenous fluids and blood products as indicated, then perform endoscopy within 24 hours for risk stratification and hemostatic therapy.

COPD exacerbation therapy

Inhaled short-acting bronchodilators, systemic corticosteroids for about five days, antibiotics when bacterial features are present, and controlled oxygen targeting saturation of 88 to 92 percent.

Pulmonary embolism diagnostic step

Assess pretest probability; a low-probability D-dimer can exclude pulmonary embolism, while high probability or positive D-dimer warrants CT pulmonary angiography.

Acute gout treatment

Treat flares with NSAIDs, colchicine, or systemic glucocorticoids; do not start or stop urate-lowering therapy during an acute attack unless already established.

AKI prerenal versus intrinsic

Fractional excretion of urea below 35 percent suggests prerenal azotemia; a fractional excretion of sodium below 1 percent also favors prerenal causes when diuretics are not in use.

Metformin and contrast

Hold metformin before iodinated contrast when kidney function is reduced and restart after 48 hours once renal function is confirmed stable.

Tuberculosis latent treatment

Options include four months of rifampin, three months of weekly isoniazid plus rifapentine, or nine months of isoniazid; screen for hepatitis and interactions first.

SGLT2 inhibitor benefits

Reduce heart failure hospitalization and slow chronic kidney disease progression independent of glucose lowering, making them useful in HFrEF and proteinuric CKD.

Cirrhosis ascites first-line

Dietary sodium restriction plus spironolactone with or without furosemide; large-volume paracentesis with albumin is used for tense or refractory ascites.

Spontaneous bacterial peritonitis

Ascitic fluid polymorphonuclear cell count of 250 cells per microliter or greater establishes the diagnosis; start empiric third-generation cephalosporin and give albumin.

Anaphylaxis first drug

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

OCC longitudinal assessment

Osteopathic continuous certification uses recurring question-based longitudinal assessment modules each cycle instead of a single high-stakes recertification examination.

OCC licensure requirement

Certification requires an active, unrestricted license to practice medicine; restrictions or adverse actions must be reported to the certifying board and may affect status.

OCC CME requirement

Each cycle requires a specified number of continuing medical education credits, including AOA Category 1 credits and any mandated topic hours such as opioid or ethics education.

OCC practice performance

Certification requires participation in practice performance or quality improvement activities, such as OPPI modules, demonstrating engagement in measured improvement of patient care.

OCC attestation

Periodic attestation to professional standing, licensure, and privileges is required; false attestation can jeopardize certification and must be completed accurately and on time.

OCC missed assessment

Failure to complete longitudinal assessment requirements within the cycle can result in loss of certification; remediation pathways exist and should be started early.

OCC documentation

Retain records of CME, quality improvement participation, and licensure renewals; the assessment platform tracks completion but audits may require source documents.

OCC cycle verification

Specific question counts, deadlines, and fees change over time; verify current requirements directly with the AOA Board of Internal Medicine before each cycle.

Osteopathic board certification

Board certification through the AOA demonstrates specialty competence and is maintained through continuous certification rather than a one-time examination.