Arab Board Emergency Medicine Clinical Exam key terms

Life-threatening circulatory failure caused by infection, marked by persistent hypotension requiring vasopressors and a raised serum lactate despite adequate fluid resuscitation. Recognise early, give antibiotics within the first hour, and obtain source control.

The reappearance of a palpable pulse and an organised cardiac rhythm after resuscitation, signalling that chest compressions can stop. It is the first milestone towards survival, not the end of treatment.

A constellation of brain injury, myocardial dysfunction, systemic ischaemia-reperfusion injury and the precipitating cause that follows resuscitation. It drives early haemodynamic instability and later neurological death, so care targets oxygenation, blood pressure and temperature.

Deliberate control of core temperature after cardiac arrest, typically 32 to 37.5 degrees Celsius, maintained for at least 24 hours with avoidance of fever afterwards. It limits secondary brain injury; shivering, bradycardia and electrolyte shifts are predictable complications.

Structured first assessment of a seriously injured patient in the order airway, breathing, circulation, disability and exposure, with immediate treatment of any life threat found before moving on. It is repeated whenever the patient deteriorates.

A pre-agreed sequence for delivering blood products rapidly to a patient with major haemorrhage, usually balanced red cells, plasma and platelets with early tranexamic acid and calcium. Activation is time-critical and must be paired with definitive haemorrhage control.

A resuscitation guide for major burns giving four millilitres of crystalloid per kilogram per percent total body surface area in the first 24 hours, half of it in the first eight hours from injury. It is only a starting estimate and must be titrated to urine output.

Surgical incision through unyielding burned skin and underlying fascia to relieve raised tissue pressure. It is performed urgently for circumferential chest or limb burns that impair ventilation or limb perfusion, and can be done at the bedside.

A rapidly spreading deep soft-tissue infection that tracks along fascial planes, causing pain out of proportion, swelling, bullae and crepitus with systemic toxicity. Immediate broad-spectrum antibiotics with radical surgical debridement are the only effective treatment.

Acute myocardial infarction with ST-segment elevation in contiguous leads, or an equivalent pattern, indicating complete coronary occlusion. Reperfusion by primary angioplasty, or fibrinolysis when timely transfer is impossible, must be achieved as fast as possible.

A tear in the aortic intima allowing blood to track within the media, usually presenting with abrupt severe tearing chest or back pain and a pulse or blood pressure differential. Type A needs urgent surgery; type B is usually managed medically.

Circulatory failure due to pump failure, with hypotension, cool peripheries, raised filling pressures and end-organ hypoperfusion despite adequate volume. Treat the cause, support perfusion with inotropes or vasopressors, and consider mechanical circulatory support early.

Severe blood pressure elevation with acute target-organ damage such as encephalopathy, pulmonary oedema, aortic dissection, retinal haemorrhage or renal injury. Lower pressure gradually with titratable intravenous agents, avoiding abrupt falls that can cause cerebral or coronary ischaemia.

Obstruction of pulmonary arteries by thrombus, presenting with dyspnoea, pleuritic pain, tachycardia and hypoxia; massive cases cause obstructive shock. Risk-stratify with clinical scores, D-dimer or imaging, then give anticoagulation, with thrombolysis for haemodynamic instability.

Acute hypoxaemic respiratory failure with bilateral pulmonary infiltrates not explained by cardiac failure, arising within a week of a known insult. Managed with lung-protective low tidal volumes, adequate positive end-expiratory pressure, prone positioning and treatment of the underlying cause.

Air trapped in the pleural space under pressure, collapsing the lung and obstructing venous return, causing severe dyspnoea, distended neck veins and hypotension. It is a clinical diagnosis requiring immediate needle decompression followed by intercostal drain insertion.

Delivery of positive pressure ventilation through a tight-fitting mask without intubation, used mainly in acute exacerbations of chronic obstructive pulmonary disease and cardiogenic pulmonary oedema. It reduces work of breathing and intubation rates; agitation, vomiting or worsening gas exchange means failure.

A score from three to fifteen assessing eye opening, best verbal response and best motor response, with the motor component carrying the strongest prognostic value. Record the components separately because sedation, intubation, aphasia and facial swelling distort scoring.

Continuous seizure activity lasting five minutes or more, or repeated seizures without regaining consciousness between them. It is a medical emergency: give a benzodiazepine first, then a second-line antiseizure drug, and correct hypoglycaemia, hypoxia and other reversible causes.

Calculated as mean arterial pressure minus intracranial pressure, with a normal target of roughly 60 to 70 millimetres of mercury. It drives cerebral blood flow, so maintaining it means supporting systemic blood pressure while controlling raised intracranial pressure.

Bleeding into the subarachnoid space, classically a sudden maximal thunderclap headache, often with neck stiffness, photophobia and vomiting. Confirm with CT, then lumbar puncture if CT is negative and suspicion persists; secure aneurysms early and give nimodipine.

A recognisable cluster of signs, such as cholinergic, anticholinergic, opioid, sympathomimetic or sedative-hypnotic, that points to a class of poisoning and guides treatment before confirmatory testing. Pupils, skin, bowel sounds and mental state are the key bedside findings.

Calculated as sodium minus chloride and bicarbonate, normally about 8 to 12 millimoles per litre, with a raised value suggesting unmeasured acid such as ketones, lactate, urate, toxins or retained renal acids. Used to classify metabolic acidosis and screen for poisoning.

A potentially fatal excess of serotonergic activity causing altered mental state, autonomic instability and neuromuscular hyperactivity such as clonus and hyperreflexia. Stop the offending drugs, give supportive care and benzodiazepines, and use cyproheptadine in severe cases.

Inhalation of carbon monoxide, which binds haemoglobin avidly and produces tissue hypoxia despite normal arterial oxygen tension. Suspect it with headache, confusion and syncope after smoke or faulty heater exposure; treat with high-flow oxygen and consider hyperbaric oxygen for severe or pregnant cases.

A rapid first-impression tool based on appearance, work of breathing and circulation to skin. Abnormality in any domain identifies a child needing immediate assessment, and it is applied from the doorway before touching the child.

Viral lower respiratory infection of infants under two years, peaking in winter, with coryza, wheeze, crackles and feeding difficulty. Treatment is supportive with oxygen, fluids and suction, and there is no routine role for bronchodilators, steroids or antibiotics.

Viral laryngotracheitis causing inspiratory stridor, a barking cough and hoarse voice in young children. Give dexamethasone, add nebulised adrenaline for severe disease, and avoid agitating the child or inspecting the throat.

Implantation outside the uterine cavity, usually in the fallopian tube, presenting with amenorrhoea, abdominal pain and vaginal bleeding; rupture causes shock. Use ultrasound and serial human chorionic gonadotropin levels, and treat with surgery or methotrexate depending on stability.

Pregnancy hypertension arising after 20 weeks with proteinuria or maternal organ dysfunction. Features include headache, visual disturbance, epigastric pain and oedema; give magnesium sulphate for seizure prophylaxis and deliver the baby for definitive cure.

Blood loss over 500 millilitres after vaginal birth or 1000 millilitres after caesarean section, most often from uterine atony. Manage with uterine massage, oxytocin, tranexamic acid, escalating drugs, balloon tamponade or surgery while resuscitating simultaneously.

Raised pressure within a closed fascial compartment that impairs tissue perfusion, causing pain out of proportion, pain on passive stretch and tense swelling. Pulses usually remain palpable, so do not delay urgent fasciotomy, since delay risks muscle necrosis and limb loss.

Compression of the lumbosacral nerve roots causing bilateral leg pain or weakness, saddle anaesthesia and urinary retention with overflow incontinence. It requires urgent MRI and surgical decompression, because delay produces permanent neurological deficit.

A metabolic emergency of insulin deficiency with hyperglycaemia, ketonaemia and metabolic acidosis. Treat with fluids, intravenous insulin, potassium replacement and treatment of the precipitating illness, monitoring glucose, potassium and acid-base status closely.

Serum potassium above about 5.5 millimoles per litre, causing weakness and peaked T waves with a risk of ventricular arrhythmia. Give calcium for myocardial protection, shift potassium intracellularly and remove it from the body while treating the cause.

Acute cortisol deficiency, usually in known adrenal insufficiency, presenting with hypotension, vomiting, abdominal pain, hyponatraemia and hyperkalaemia. Take cortisol samples but give intravenous hydrocortisone and saline immediately without waiting for the results.

A bedside ultrasound examination of the pericardium, hepatorenal and splenorenal recesses and pelvis, extended in some protocols to the thorax. Free fluid in an unstable patient prompts laparotomy; it is quick, repeatable and requires minimal preparation.

Pre-oxygenation followed by rapidly acting sedative and neuromuscular blocking drugs to secure the airway while limiting aspiration risk. It demands haemodynamic preparation, a planned failed-airway strategy and confirmation of tube placement.

Simple triage and rapid treatment: a mass-casualty tool that first directs walking casualties away, then assesses breathing, perfusion and mental status to assign immediate, delayed, minor or deceased categories in seconds per patient.

An incident whose casualty numbers overwhelm normal local resources, requiring activation of major incident plans, triage, casualty clearing and coordination with other agencies. Command structure, communications and documentation largely determine the outcome.