Arab Board EM Final Written flashcards

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

Defibrillation energy in VF

Biphasic shock of 150-200 J for ventricular fibrillation or pulseless ventricular tachycardia, followed immediately by two minutes of CPR before rhythm recheck.

Adrenaline timing in arrest

Give 1 mg IV every 3-5 minutes; in shockable rhythms it is given only after the third shock, while in asystole or PEA it is given as early as possible.

CURB-65 components

Confusion, urea greater than 7 mmol/L, respiratory rate 30 or more, low systolic or diastolic blood pressure, and age 65 or older; each scores one point.

Tension pneumothorax management

Immediate needle decompression followed by chest drain, based on clinical diagnosis alone; imaging must never delay decompression in an unstable patient.

Stroke thrombolysis window

Intravenous thrombolysis is offered within 4.5 hours of symptom onset; thrombectomy may extend to 24 hours in selected large-vessel occlusion with favourable imaging.

Status epilepticus first-line drug

A benzodiazepine such as IV lorazepam or IM midazolam is first line, followed by a second-line agent like levetiracetam, valproate, or phenytoin.

Spontaneous bacterial peritonitis threshold

An ascitic fluid neutrophil count of 250 cells per cubic millimetre or more is diagnostic; treat with a third-generation cephalosporin and consider albumin.

Hyperkalaemia with ECG changes

Give IV calcium gluconate first for membrane stabilisation, then insulin-dextrose and salbutamol to shift potassium intracellularly, followed by removal strategies.

Permissive hypotension in trauma

Aim for a systolic pressure near 90 mmHg until surgical haemorrhage control in penetrating trauma without head injury; give tranexamic acid within three hours.

Compartment syndrome key sign

Pain out of proportion to injury and pain on passive stretch are the earliest signs; pulselessness is late and is not required for the diagnosis.

Paracetamol overdose antidote

N-acetylcysteine, dosed according to the Rumack-Matthew nomogram from four hours post-ingestion; start empirically if the timing is unknown or staggered.

Tricyclic overdose treatment

Sodium bicarbonate for sodium-channel blockade with QRS widening beyond 100 ms; avoid class IA and IC antiarrhythmic drugs.

DKA insulin initiation rule

Start an insulin infusion only after potassium is at least 3.3 mmol/L; add dextrose when glucose falls, since total body potassium is depleted.

Heat stroke definition

Core temperature above 40 degrees Celsius with central nervous system dysfunction; rapid cooling and intravenous fluids are the immediate priorities.

Paediatric defibrillation dose

Use 4 joules per kilogram for the first shock, increasing to 10 joules per kilogram for subsequent shocks in children with shockable rhythms.

Croup treatment

Dexamethasone for all cases, with nebulised adrenaline added for moderate to severe stridor; the classic feature is a barking cough.

Eclampsia treatment drug

Magnesium sulfate is the drug of choice for seizure control and prophylaxis; monitor deep tendon reflexes, respiratory rate, and urine output during infusion.

Postpartum haemorrhage first step

Uterine atony is the commonest cause; begin uterine massage and oxytocin, then add ergometrine, carboprost, or misoprostol, plus tranexamic acid.

Septic shock definition

Sepsis with persisting hypotension requiring vasopressors and a lactate above 2 mmol/L despite adequate fluid resuscitation.

Neutropenic sepsis antibiotics

Fever of 38 degrees Celsius or more with neutrophils below 0.5 x 10^9/L requires immediate empirical antipseudomonal beta-lactam antibiotics.

FAST exam purpose

Detects free intraperitoneal or pericardial fluid using four views; a negative scan does not exclude solid organ injury.

Lung ultrasound B-lines

Vertical comet-tail artifacts indicating interstitial fluid; their presence supports pulmonary oedema, while absent lung sliding suggests pneumothorax.

Succinylcholine contraindications

Hyperkalaemia, burns or crush injury beyond 24-48 hours, and known pseudocholinesterase deficiency, because of the risk of dangerous hyperkalaemic responses.

Post-intubation confirmation

Waveform capnography is the standard confirmation of tracheal tube placement, supplemented by chest auscultation and tube securing.

START disaster triage

Assesses respiration, perfusion, and mental status in under 60 seconds per patient, assigning colour codes from immediate to expectant.

SBAR handover tool

A structured communication format covering situation, background, assessment, and recommendation, used to reduce errors during clinical handover.

Positive likelihood ratio formula

Sensitivity divided by one minus specificity; it is independent of disease prevalence and indicates how much a positive test raises the odds.

Number needed to treat

The reciprocal of the absolute risk reduction; it estimates how many patients must be treated for one additional beneficial outcome.

Aortic dissection rate control

Give a beta-blocker to achieve a heart rate near 60 beats per minute before adding a vasodilator, limiting shear stress on the aortic wall.

Non-invasive ventilation in COPD

Indicated for exacerbation with pH between 7.25 and 7.35 and hypercapnia; target oxygen saturation of 88-92 percent in at-risk patients.

Glasgow Coma Scale range

Sums eye, verbal, and motor scores for a total of 3 to 15; a score of 8 or less generally indicates the need for airway protection.

Ovarian torsion management

Sudden unilateral pelvic pain with nausea warrants urgent surgical detorsion; do not delay for imaging when clinical suspicion is high.