Arab Board EM Final Written key terms

Delivery of an unsynchronised high-energy electrical shock across the myocardium to terminate ventricular fibrillation or pulseless ventricular tachycardia by depolarising all cardiac cells simultaneously and allowing natural pacemakers to resume control.

Delivery of a shock timed to the QRS complex so it avoids the vulnerable repolarisation period, used for unstable tachyarrhythmias that still produce a pulse, such as atrial fibrillation or flutter and regular narrow-complex tachycardia.

The restoration of a palpable pulse and effective perfusion after cardiac arrest, evidenced by signs of life, a measurable blood pressure or an organised rhythm on the monitor, and marking the transition from resuscitation to post-arrest care.

Controlled cooling of a comatose patient after cardiac arrest to a constant target between 32 and 36 degrees Celsius for at least 24 hours, aiming to limit reperfusion brain injury while avoiding fever thereafter.

A constellation of brain injury, myocardial dysfunction, systemic ischaemia-reperfusion response and the unresolved precipitating pathology that follows resuscitation, requiring ventilatory, haemodynamic and neurological support in a critical care setting.

Acute coronary occlusion producing persistent ST-segment elevation in contiguous leads, or a new left bundle branch block, that warrants immediate reperfusion by primary percutaneous coronary intervention or fibrinolysis where transfer is delayed.

A cardiac biomarker released on myocyte injury, interpreted with serial sampling and a validated protocol so that a very low value on arrival or a small rise over one to three hours can safely exclude acute myocardial infarction.

Inadequate tissue perfusion caused by cardiac pump failure, recognised by sustained hypotension with cold clammy peripheries, raised lactate, oliguria and pulmonary congestion, most often complicating extensive myocardial infarction and carrying high mortality.

A tear in the aortic intima allowing blood to track within the media, causing abrupt severe tearing chest or back pain with pulse or blood pressure asymmetry, and requiring urgent imaging and blood pressure control or surgery.

Severe blood pressure elevation accompanied by acute target-organ damage such as encephalopathy, pulmonary oedema, aortic dissection or acute kidney injury, managed with titrated parenteral agents and gradual pressure reduction rather than rapid normalisation.

Acute-onset hypoxaemic respiratory failure with bilateral opacities not fully explained by cardiac failure, arising within a week of a known insult, and classified by the ratio of arterial oxygen to inspired oxygen on positive pressure ventilation.

A ventilatory strategy using small tidal volumes of roughly six millilitres per kilogram predicted body weight, limited plateau pressures and permissive hypercapnia to reduce ventilator-induced injury in acute respiratory distress syndrome.

Delivery of positive pressure through a tight-fitting mask to support breathing without an artificial airway, used mainly in acute hypercapnic exacerbations of chronic obstructive pulmonary disease and cardiogenic pulmonary oedema.

Progressive accumulation of air in the pleural space under pressure that collapses the lung and impedes venous return, causing hypotension and distended neck veins, and treated immediately by decompression before confirmatory imaging.

Pulmonary embolism causing sustained hypotension or shock from right ventricular failure, treated with systemic thrombolysis or embolectomy, in contrast to submassive disease with dysfunction but preserved pressure.

Bedside sonographic assessment of the pleura and lung using vertical artefacts, absent lung sliding and consolidation patterns to rapidly distinguish pneumothorax, pulmonary oedema, pneumonia and effusion.

Continuous seizure activity, or repeated seizures without recovery of consciousness, lasting five minutes or more, requiring immediate benzodiazepine therapy and a structured sequence of escalating anticonvulsants to prevent neuronal injury.

A scored assessment of eye opening, verbal response and motor response, totalling three to fifteen, used to grade and trend impaired consciousness, with a score of eight or less prompting consideration of airway protection.

Sudden neurological deficit from cerebral artery occlusion, eligible for intravenous thrombolysis within a defined window or mechanical thrombectomy when large-vessel occlusion is shown, after haemorrhage is excluded by imaging.

Bleeding into the subarachnoid space, classically presenting with a sudden maximal headache, meningism and possible reduced consciousness, diagnosed by non-contrast CT and, if negative and suspicion persists, lumbar puncture or angiography.

An acute fluctuating disturbance of attention and awareness with altered cognition caused by an underlying medical insult, drug or withdrawal, distinguished from dementia by its abrupt onset and reversibility.

Haemorrhage proximal to the ligament of Treitz presenting as haematemesis or melaena, risk-stratified by validated scores, resuscitated with blood products and treated by endoscopic haemostasis after initial stabilisation.

Infection of ascitic fluid in cirrhosis without an evident surgical source, diagnosed by a raised ascitic neutrophil count, and treated promptly with intravenous antibiotics, often with albumin to reduce renal failure.

A vasopressin analogue used in acute variceal haemorrhage and hepatorenal syndrome to splanchnically vasoconstrict and reduce portal pressure, given with careful monitoring for ischaemic complications.

An abrupt decline in renal function identified by a rise in serum creatinine or fall in urine output over hours to days, staged by severity and managed by treating the cause, optimising perfusion and avoiding nephrotoxins.

Breakdown of skeletal muscle releasing myoglobin and intracellular contents into circulation, causing dark urine, raised creatine kinase and risk of acute kidney injury, prevented by aggressive intravenous fluid resuscitation.

A rapid bedside ultrasound protocol examining pericardial, perihepatic, perisplenic and pelvic windows, extended to the thorax and lungs, to detect free fluid or air in a haemodynamically unstable trauma patient.

A strategy for major haemorrhage balancing blood products with minimal crystalloid, permissive hypotension before surgical control, early tranexamic acid and active warming to prevent the lethal triad of acidosis, coagulopathy and hypothermia.

A pre-agreed, rapidly activated system for delivering balanced blood components, typically red cells, plasma and platelets, with defined triggers, laboratory monitoring and correction of calcium and temperature during exsanguinating haemorrhage.

Raised pressure within a closed fascial compartment that compromises perfusion, producing pain out of proportion, pain on passive stretch and tense swelling, and requiring urgent fasciotomy before permanent nerve and muscle death.

Systemic consequences of prolonged limb compression, including rhabdomyolysis, hyperkalaemia and hypovolaemia, which may decompensate on release of the crushing force and demand pre-emptive fluid and electrolyte management.

A recognisable constellation of clinical features grouped by the pharmacological class involved, such as anticholinergic, cholinergic, opioid, sympathomimetic or sedative-hypnotic, that guides empirical treatment before laboratory confirmation.

A competitive opioid receptor antagonist given to reverse opioid-induced respiratory depression, titrated to restore adequate breathing rather than full wakefulness, and repeated or infused because its duration is shorter than many opioids.

A low-bicarbonate acidosis with raised unmeasured anions, calculated from sodium minus chloride and bicarbonate, prompting consideration of toxins, ketoacidosis, lactate and renal failure as causes.

Severe hyperthermia with core temperature above forty degrees Celsius and central nervous system dysfunction after heat exposure, treated by immediate aggressive cooling and supportive care for multiorgan failure.

Life-threatening organ dysfunction caused by a dysregulated host response to infection, operationalised as a rise in the sequential organ failure score, requiring prompt cultures, antibiotics and source control.

Sepsis with persisting hypotension requiring vasopressors to maintain mean arterial pressure and a raised lactate despite adequate fluid resuscitation, carrying high mortality and demanding early balanced resuscitation.

Sequential administration of a sedative and a neuromuscular blocker to secure the airway rapidly while minimising aspiration risk, preceded by preoxygenation, a planned rescue strategy and haemodynamic optimisation.

Emergency decompression of a suspected tension pneumothorax by inserting a wide-bore cannula into the pleural space, followed by definitive tube thoracostomy, performed on clinical grounds without waiting for imaging.

Focused bedside cardiac ultrasound used to assess contractility, chamber size, pericardial effusion and right ventricular strain, helping to categorise undifferentiated hypotension and guide immediate resuscitation decisions.

New hypertension after twenty weeks of gestation with proteinuria or other maternal organ dysfunction, managed with blood pressure control, magnesium sulphate for seizure prophylaxis and timely delivery of the fetus.

Generalised seizures in a woman with pre-eclampsia, treated immediately with magnesium sulphate, blood pressure control and delivery once the mother is stabilised.

Excessive blood loss after delivery, commonly defined as more than five hundred millilitres, managed by uterine massage, uterotonic drugs, tranexamic acid, and escalation to balloon tamponade, surgery or transfusion.

The reciprocal of the absolute risk reduction, expressing how many patients must receive an intervention for one additional patient to benefit, and useful for judging clinical relevance alongside relative effects.

A range of values around an estimate within which the true population value is likely to lie at a stated probability, conveying precision and allowing inference when it excludes the null value.

A quality improvement cycle that compares observed practice against an agreed standard, identifies shortfalls, implements change and re-measures, aiming to improve care rather than to generate new generalisable knowledge.

A structured retrospective investigation of a serious adverse event that maps the sequence of contributing system factors rather than individual blame, producing recommendations to prevent recurrence.