Arab Board Family Medicine Final Written cheat sheet

Four principles of family medicine (WONCA/CFPC): skilled clinician, community-based, patient-centred doctor of first contact, resource to the community.

Biopsychosocial model (Engel) integrates biological, psychological and social factors; it is the conceptual basis of family medicine.

Consultation models: Pendleton's tasks, Neighbour's checkpoints (connecting, summarising, handing over, safety netting), Calgary-Cambridge guide.

Patient-centred care: explore illness experience (ideas, concerns, expectations, feelings), understand the whole person, find common ground, enhance prevention, build relationship.

Continuity of care types: relational, informational, management continuity.

Balint groups use case discussion to explore doctor-patient relationship and emotional responses.

Family systems: genogram uses squares for males, circles for females, horizontal line = marriage, vertical = descent.

Defining features of primary care (Starfield): first contact, longitudinality, comprehensiveness, coordination.

Hippocratic tradition: beneficence, non-maleficence; modern bioethics adds autonomy and justice (Beauchamp & Childress).

Informed consent requires capacity, adequate disclosure, comprehension and voluntariness; documentation is mandatory.

Confidentiality exceptions: patient consent, statutory reporting (notifiable diseases, child protection), court order, serious public-health risk.

Professional boundaries: dual relationships, gifts, and social media contact carry risk of boundary violation.

Medical error disclosure: acknowledge, explain, apologise (where legally safe), document, and act to prevent recurrence.

Fitness to practise concerns are reported to the regulator; impairment includes illness, addiction and burnout.

Evidence hierarchy for historical claims: primary sources (records, letters) > secondary > tertiary; bias in autobiography and hagiography.

Whistleblowing is a professional duty when patient safety is at serious risk and internal channels fail.

Ottawa Charter (1986) five actions: build healthy public policy, create supportive environments, strengthen community action, develop personal skills, reorient health services.

Precede-Proceed and the Health Belief Model (perceived susceptibility, severity, benefits, barriers, cues to action, self-efficacy) guide behaviour-change planning.

Stages of change (Prochaska): precontemplation, contemplation, preparation, action, maintenance, relapse.

Motivational interviewing: OARS (open questions, affirmations, reflections, summaries); rolling with resistance, not confronting it.

5A's for behaviour change: ask, advise, assess, assist, arrange.

Screening criteria (Wilson-Jungner): important condition, accepted treatment, adequate test, latent stage detectable, cost-effective, continuous case-finding.

Sensitivity = TP/(TP+FN); specificity = TN/(TN+FP); PPV depends on prevalence.

Number needed to treat = 1/absolute risk reduction; number needed to screen = 1/(mortality reduction × incidence or prevalence).

Primary prevention = prevent onset (immunisation, smoking cessation); secondary = early detection (screening); tertiary = limit disability/rehabilitation.

Lead-time bias inflates survival after screening without changing mortality; length-time bias favours detection of slow-growing disease.

Breast screening: biennial mammography is commonly offered from age 40-50 to 69-74 depending on national programme.

Cervical screening: HPV testing or cytology from age 21-25 to 65; stop after adequate negative screening or hysterectomy.

Colorectal screening: faecal immunochemical test annually/biennially or colonoscopy every 10 years, typically ages 45-50 to 75.

Hypertension screening: office BP ≥140/90 mmHg on two occasions; ambulatory/home monitoring confirms diagnosis.

Lipid screening for adults from around age 40 (earlier with risk factors); calculate 10-year cardiovascular risk to guide statin use.

Immunisation: live vaccines are contraindicated in pregnancy and significant immunosuppression; inactivated and toxoid vaccines are safe.

Acute coronary syndrome: serial high-sensitivity troponin with ECG; STEMI needs reperfusion (primary PCI within 90-120 minutes of first medical contact).

Heart failure with reduced ejection fraction (≤40%): four pillars are ACE inhibitor/ARB/ARNI, beta-blocker, mineralocorticoid antagonist, SGLT2 inhibitor.

Atrial fibrillation stroke risk: CHA2DS2-VASc (CHF, hypertension, age ≥75 = 2, diabetes, stroke/TIA = 2, vascular disease, age 65-74, female sex); bleeding risk: HAS-BLED.

Hypertension first-line: ACE inhibitor/ARB, calcium channel blocker, thiazide-like diuretic, or beta-blocker if compelling indication.

Hypertensive emergency = severe BP elevation with acute target-organ damage; reduce mean arterial pressure by no more than ~25% in the first hour.

Statin therapy: high-intensity (atorvastatin 40-80 mg or rosuvastatin 20-40 mg) lowers LDL by ≥50%.

Peripheral arterial disease: ankle-brachial index ≤0.90 is diagnostic; 0.91-0.99 is borderline; >1.3 suggests non-compressible vessels.

Rheumatic heart disease prevention: benzathine penicillin secondary prophylaxis duration depends on valve involvement and age.

Asthma diagnosis: variable respiratory symptoms plus documented variable airflow limitation (FEV1/FVC <0.70 with ≥12% and 200 mL reversibility, or peak-flow variability).

Asthma control is assessed by symptom frequency, reliever use, activity limitation and night waking over the last four weeks.

COPD diagnosis requires post-bronchodilator FEV1/FVC <0.70; severity is graded by FEV1 percent predicted (GOLD 1-4).

COPD management: smoking cessation, vaccination, bronchodilators (LAMA/LABA), pulmonary rehabilitation; inhaled corticosteroids only with frequent exacerbations or eosinophilia.

Community-acquired pneumonia severity: CURB-65 (confusion, urea >7 mmol/L, respiratory rate ≥30, BP <90/60, age ≥65); score ≥2 suggests admission.

Pneumothorax: tension presents with hypotension and tracheal deviation - immediate needle decompression before imaging.

Tuberculosis: sputum for acid-fast bacilli and culture, plus nucleic acid amplification; standard regimen 2 months HRZE then 4 months HR.

Obstructive sleep apnoea: STOP-BANG screen; diagnosis by polysomnography or home sleep testing; apnoea-hypopnoea index ≥5 with symptoms confirms.

Diabetes diagnosis: fasting glucose ≥7.0 mmol/L, 2-hour OGTT ≥11.1 mmol/L, HbA1c ≥6.5%, or random ≥11.1 with symptoms; repeat unless unequivocal.

Prediabetes: HbA1c 5.7-6.4% or fasting glucose 5.6-6.9 mmol/L; lifestyle intervention reduces progression by ~58%.

Type 1 diabetes: check for ketones, islet autoantibodies; do not delay insulin; screen for associated autoimmune disease.

Hypothyroidism: elevated TSH with low free T4; subclinical = elevated TSH with normal free T4; treat if TSH >10 or symptomatic.

Thyroid nodule: TSH first, then ultrasound; fine-needle aspiration based on size and ultrasound risk features (e.g., TI-RADS).

Obesity: BMI ≥30 kg/m²; waist circumference thresholds (≥94 cm men, ≥80 cm women in many populations) indicate central adiposity.

Vitamin D deficiency: 25-hydroxyvitamin D <30 nmol/L deficient, 30-50 nmol/L insufficient; treat with loading then maintenance dosing.

Diabetic ketoacidosis: glucose >11 mmol/L, ketones, pH <7.3 or bicarbonate <18; managed with isotonic saline, insulin infusion and potassium replacement.

Dyspepsia age threshold for endoscopy is typically 55 years with alarm features (weight loss, dysphagia, anaemia, vomiting, mass).

Helicobacter pylori: urea breath test or stool antigen for diagnosis; test for eradication at least 4 weeks after therapy.

Chronic liver disease: Child-Pugh (bilirubin, albumin, INR, ascites, encephalopathy) and MELD (bilirubin, INR, creatinine, sodium) stratify severity.

Hepatitis B serology: HBsAg = infection; anti-HBc IgM = acute; anti-HBs = immunity; HBeAg = high replication.

Acute kidney injury (KDIGO): creatinine rise ≥26.5 µmol/L in 48 hours or ≥1.5× baseline in 7 days, or urine output <0.5 mL/kg/h for 6 hours.

Chronic kidney disease stages by eGFR: G1 ≥90, G2 60-89, G3a 45-59, G3b 30-44, G4 15-29, G5 <15 mL/min/1.73 m².

Nephrotic syndrome: proteinuria >3.5 g/day, hypoalbuminaemia, oedema, hyperlipidaemia; nephritic: haematuria, hypertension, oliguria.

Constipation red flags: new onset after age 50, rectal bleeding, weight loss, iron-deficiency anaemia, family history of colorectal cancer.

Abnormal uterine bleeding is classified by PALM-COEIN (polyp, adenomyosis, leiomyoma, malignancy/hyperplasia; coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, not otherwise classified).

Cervical cancer screening: liquid-based cytology or HPV testing; colposcopy referral for high-grade cytology or persistent high-risk HPV.

Bacterial vaginosis: clue cells, pH >4.5, positive whiff test, thin grey discharge; treat with metronidazole.

Vulvovaginal candidiasis: thick white discharge, pruritus, pH normal; treat with topical azole or single-dose fluconazole.

Polycystic ovary syndrome (Rotterdam): two of three - oligo/anovulation, clinical/biochemical hyperandrogenism, polycystic ovaries on ultrasound.

Menopause is diagnosed clinically after 12 months of amenorrhoea; FSH is not required in typical women over 45.

Osteoporosis screening: DXA in women ≥65 or younger with risk factors; T-score ≤-2.5 defines osteoporosis.

Emergency contraception: levonorgestrel is effective up to 72 hours, ulipristal up to 120 hours; copper IUD is most effective and can be inserted up to 5 days.

Antenatal schedule (typical): booking visit, then every 4 weeks to 28, every 2 weeks to 36, weekly to delivery; more often if high risk.

Folic acid 400 µg daily pre-conception and through the first trimester; 5 mg for previous neural tube defect, diabetes, obesity, or antiepileptic use.

Dating ultrasound at 11-14 weeks; combined first-trimester screening (nuchal translucency, free β-hCG, PAPP-A) plus maternal age.

Gestational diabetes screening at 24-28 weeks with 75 g OGTT; thresholds vary (e.g., fasting ≥5.1, 1-hour ≥10.0, 2-hour ≥8.5 mmol/L).

Preeclampsia: BP ≥140/90 after 20 weeks plus proteinuria or other organ dysfunction; aspirin 75-150 mg from 12 weeks in high-risk women.

Rhesus prophylaxis: anti-D immunoglobulin at 28 weeks and within 72 hours of delivery of an Rh-positive infant, and after sensitising events.

Group B streptococcus: intrapartum penicillin prophylaxis for colonised women or those with risk factors (preterm labour, prolonged rupture, fever).

Postpartum haemorrhage: >500 mL after vaginal or >1000 mL after caesarean delivery; first-line uterotonic is oxytocin.

Growth charts: weight-for-age, length/height-for-age, weight-for-length/BMI, and head circumference; crossing two centile lines warrants assessment.

Developmental milestones: social smile 6 weeks, head control 3 months, sits unsupported 6-8 months, walks 12-15 months, two-word phrases 18-24 months.

Red flags: no social smile by 8 weeks, no head control by 4 months, no sitting by 9 months, no walking by 18 months, no words by 18 months.

Immunisation schedule varies by country; live MMR is given after 12 months; BCG at birth in high-prevalence settings.

Fever in infants <3 months requires urgent assessment and usually full sepsis screen with empiric antibiotics.

Acute otitis media: bulging tympanic membrane; first-line amoxicillin; observe 48-72 hours in selected older children.

Bronchiolitis: supportive care; no routine bronchodilators or corticosteroids; oxygen if saturations <90-92%.

Kawasaki disease: fever ≥5 days plus 4 of 5 features (conjunctivitis, rash, mucositis, extremity changes, lymphadenopathy); IVIG plus aspirin.

PHQ-9 scores 5-9 mild, 10-14 moderate, 15-19 moderately severe, ≥20 severe; GAD-7 scores 5, 10, 15 as thresholds.

Depression diagnostic criteria (DSM-5): ≥5 symptoms for ≥2 weeks including depressed mood or anhedonia, causing impairment.

First-line treatment for moderate-severe depression: SSRI plus psychological therapy; continue antidepressants at least 6-12 months after remission.

Serotonin syndrome: agitation, clonus, hyperreflexia, hyperthermia after serotonergic agents; stop the drug and give supportive care.

Bipolar disorder: mania requires elevated/irritable mood plus increased energy for ≥1 week with ≥3 of grandiosity, decreased sleep, pressured speech, flight of ideas, distractibility, risky behaviour.

Alcohol withdrawal: CIWA-Ar guides treatment; benzodiazepines are first-line; thiamine before glucose to prevent Wernicke encephalopathy.

Suicide risk assessment: ask directly about ideation, plan, intent, means and protective factors; document and safety plan.

Dementia screening: MMSE or MoCA; delirium is acute, fluctuating with inattention; depression can mimic dementia (pseudodementia).

Ottawa ankle rules: X-ray if pain in malleolar zone plus bone tenderness at posterior edge/tip of either malleolus or inability to bear weight four steps.

Osteoarthritis: activity-related pain, brief morning stiffness (<30 minutes), crepitus, bony enlargement; X-ray shows joint-space narrowing, osteophytes, sclerosis.

Rheumatoid arthritis: symmetrical small-joint swelling, morning stiffness >1 hour, positive anti-CCP; refer within 6 weeks for DMARD therapy.

Gout: negatively birefringent needle-shaped urate crystals; acute treatment NSAID, colchicine or corticosteroid; urate-lowering therapy target <360 µmol/L.

Low back pain red flags: age <20 or >50 at onset, trauma, cancer history, weight loss, fever, neurological deficit, night pain, steroid use.

Skin cancer ABCDE: asymmetry, border irregularity, colour variation, diameter >6 mm, evolving; biopsy suspicious lesions.

Psoriasis: well-demarcated plaques with silvery scale on extensor surfaces; associated with metabolic syndrome and psoriatic arthritis.

Acute red eye: pain, photophobia, reduced vision or ciliary flush suggest serious causes (keratitis, uveitis, acute angle-closure glaucoma) requiring urgent referral.

Comprehensive geriatric assessment domains: medical, functional, cognitive, psychological, social and environmental.

Frailty: Fried phenotype (weight loss, exhaustion, low activity, slow gait, weakness); Clinical Frailty Scale 1-9.

Falls assessment: screen annually; multifactorial assessment includes gait/balance, vision, medications, postural BP, cognition and home hazards.

Beers criteria and STOPP/START identify potentially inappropriate medications in older adults; anticholinergics and benzodiazepines are common offenders.

Delirium: acute onset, fluctuating course, inattention; use 4AT or CAM; treat the underlying cause and use non-pharmacological measures first.

Urinary incontinence types: stress (leak with cough), urge (sudden urgency), overflow, functional; treat accordingly.

Polypharmacy is commonly defined as ≥5 regular medications; deprescribing should be stepwise with monitoring.

Pressure ulcers: Braden scale for risk; staging I-IV based on tissue depth; offloading and nutrition are key.

WHO analgesic ladder: non-opioid, then weak opioid, then strong opioid, with adjuvants at each step.

Morphine dosing: immediate-release for breakthrough at roughly 1/6 of total daily dose; start laxatives with opioids.

Opioid conversion: oral morphine to subcutaneous morphine roughly 2:1; consult local conversion tables.

End-of-life symptoms: dyspnoea (opioids, oxygen if hypoxic), nausea (haloperidol, metoclopramide), terminal secretions (hyoscine butylbromide), agitation (midazolam).

Prognosis tools: Palliative Performance Scale, surprise question, Gold Standards Framework.

Advance care planning: document goals of care, resuscitation status, and substitute decision-maker.

Chronic disease model (Wagner): self-management support, delivery system design, decision support, clinical information systems, community resources.

Bereavement: normal grief can last 12 months; prolonged grief disorder requires persistent yearning and impairment beyond 12 months in adults.

EBM steps: ask a focused question (PICO), acquire evidence, appraise critically, apply to the patient, assess performance.

Study designs: RCT for efficacy, cohort for incidence/prognosis, case-control for rare diseases, cross-sectional for prevalence, systematic review/meta-analysis for synthesis.

Diagnostic accuracy: sensitivity, specificity, likelihood ratios (LR+ = sens/(1-spec), LR- = (1-sens)/spec); LR >10 or <0.1 meaningfully changes probability.

Confidence interval: 95% CI approximates estimate ± 1.96 × standard error; if it excludes the null, the result is statistically significant.

Bias types: selection, information, recall, confounding, publication, attrition; randomisation and blinding reduce bias.

Intention-to-treat analysis preserves randomisation; per-protocol analysis can bias results.

Audit cycle: define standards, measure practice, compare, implement change, re-audit.

Quality improvement models: PDSA (plan-do-study-act), Lean, Six Sigma; safety tools include incident reporting and root-cause analysis.

Screening test evaluation: positive predictive value = prevalence × sensitivity / [(prevalence × sensitivity) + (1-prevalence) × (1-specificity)].

PICO: population, intervention, comparator, outcome; used to structure clinical questions.

Levels of evidence (Oxford CEBM): systematic reviews of RCTs highest for therapy; cohort studies for prognosis; case series lowest.

Absolute risk reduction = control event rate − intervention event rate; relative risk reduction = ARR/control rate.

Odds ratio approximates relative risk when outcome is rare (<10%).

Number needed to harm = 1/absolute risk increase.

Sample size increases with smaller expected effect, greater variability, higher power and lower alpha.

Confounding can be addressed by randomisation, restriction, matching, stratification or multivariable regression.

Clinical audit measures against existing standards; research generates new knowledge and requires ethics approval.

Patient safety: Swiss cheese model of error; human factors and system design reduce incidents.

Root-cause analysis is a structured retrospective review after a serious incident.

Clinical governance pillars: clinical effectiveness, risk management, patient experience, education and training, information and IT, staff management.

Appraisal and revalidation maintain fitness to practise; continuing professional development should be documented.

Practice finance: capitation, fee-for-service, pay-for-performance and blended models; understand local funding.

Access and demand management: triage, skill-mix, extended hours, telephone/telehealth consultations.

Data protection: minimum necessary data, secure storage, patient right of access, breach reporting.

Team roles: practice nurse, pharmacist, physiotherapist, social worker, community matron; clear referral pathways improve efficiency.

Critical appraisal of RCT: randomisation, allocation concealment, blinding, baseline balance, intention-to-treat, completeness of follow-up.

Critical appraisal of diagnostic study: consecutive/random sampling, reference standard applied to all, blinding, spectrum of patients representative.

Forest plot: each study's effect with CI; diamond represents pooled estimate; heterogeneity measured by I².

Funnel plot asymmetry suggests publication bias.

P-value is the probability of the observed result (or more extreme) given the null hypothesis is true; it is not the probability the null is true.

Type I error = false positive (alpha); type II error = false negative (beta); power = 1 − beta.

Correlation coefficient r ranges −1 to +1; r² is the proportion of variance explained.

Qualitative methods: interviews, focus groups, thematic analysis; useful for understanding experiences and barriers.

Guideline appraisal: AGREE II domains - scope and purpose, stakeholder involvement, rigour of development, clarity, applicability, editorial independence.

GRADE rates quality of evidence as high, moderate, low or very low; strength of recommendation as strong or weak.

Shared decision-making uses decision aids, elicits patient values and documents the agreed plan.

Health economics: cost-effectiveness ratio = incremental cost / incremental effect; QALY combines quantity and quality of life.

Budget impact analysis estimates affordability; cost-benefit compares monetary costs and benefits.

Equity: consider access, cultural safety and social determinants in guideline implementation.

Implementation science: barriers and facilitators, fidelity, sustainability, audit and feedback.

Reporting standards: CONSORT for RCTs, PRISMA for systematic reviews, STROBE for observational studies, CARE for case reports.

Electronic health records improve continuity but introduce alert fatigue and documentation burden.

Clinical decision support is most effective when it is actionable, timely and evidence-based.

Confidentiality of records: access on a need-to-know basis; audit trails should be maintained.

Referral letters should state the question, relevant history, investigations and current treatment.

Discharge summaries should reach primary care promptly and include medication reconciliation.

Complaints management: acknowledge, investigate, respond, learn and close the loop.

Quality indicators in primary care: screening uptake, chronic disease control (e.g., HbA1c, BP), prescribing safety, patient experience.

Workforce wellbeing: burnout is measured by Maslach Burnout Inventory (emotional exhaustion, depersonalisation, reduced accomplishment).

Research ethics: informed consent, confidentiality, risk-benefit balance, independent review board approval.

Declaration of Helsinki governs human research; Good Clinical Practice standards apply to trials.

Informed consent for research must disclose purpose, procedures, risks, benefits, alternatives and right to withdraw.

Vulnerable populations (children, prisoners, pregnant women, cognitively impaired) require additional safeguards.

Conflict of interest must be declared and managed; industry sponsorship can influence results.

Data management: anonymisation, secure storage, retention periods and data-sharing agreements.

Peer review and open science improve transparency; pre-registration reduces selective reporting.

Dissemination: publish regardless of direction of results; report to participants and funders.

Sensitivity analysis tests robustness of economic or decision models by varying assumptions.

Decision analysis uses decision trees with probabilities and utilities.

Markov models simulate chronic disease progression over cycles.

Systematic review steps: protocol, search strategy, screening, data extraction, risk-of-bias assessment, synthesis.

Meta-analysis combines effect sizes; random-effects models account for between-study heterogeneity.

Publication bias assessment: funnel plot, Egger's test, trim-and-fill.

Subgroup and sensitivity analyses should be pre-specified to avoid data dredging.

Grading certainty of evidence considers risk of bias, inconsistency, indirectness, imprecision and publication bias.

Quality improvement: Model for Improvement (three questions plus PDSA cycles).

Run charts and statistical process control distinguish common-cause from special-cause variation.

Balancing measures monitor unintended consequences of change.

Audit standards should be evidence-based, measurable and locally agreed.

Patient and public involvement improves relevance and uptake of quality initiatives.

Team-based care with clear roles improves access and outcomes.

Safety huddles and morbidity and mortality meetings identify system issues.

Sustainability of improvement requires leadership, culture and measurement.

Screening programme evaluation: coverage, uptake, detection rate, interval cancers, stage shift, mortality reduction.

Lead-time and length-time bias must be considered when interpreting survival data.

Overdiagnosis causes harm through unnecessary treatment and anxiety.

Decision aids improve knowledge and reduce decisional conflict.

Risk communication: use absolute risks and natural frequencies rather than relative risk alone.

Number needed to screen = 1 / (mortality reduction × prevalence).

Shared decision-making is preferred when evidence is uncertain or trade-offs are close.

Equity in screening: address barriers for underserved groups.

Multimorbidity requires prioritising conditions and aligning treatment with patient goals.

Polypharmacy review: indication, effectiveness, safety, adherence, cost.

Deprescribing: stop or reduce medicines when harms outweigh benefits; taper where withdrawal risk exists.

Medication reconciliation at transitions reduces adverse drug events.

Adverse drug reaction reporting to national pharmacovigilance systems.

Prescribing cascade: a symptom caused by a drug is treated with another drug.

High-risk medicines: anticoagulants, insulin, opioids, methotrexate; require monitoring and clear instructions.

Patient education and adherence support improve outcomes.

Telehealth: suitability, consent, privacy, documentation and safety netting.

Digital triage tools require validation and should not replace clinical judgement.

Remote monitoring can support chronic disease management but needs clear escalation pathways.

Health apps and wearables: assess evidence, data security and usability.

Artificial intelligence tools require transparency, validation and human oversight.

Digital inclusion: consider access, literacy and language.

Cybersecurity: protect patient data, use secure platforms and train staff.

Evaluation of digital interventions: clinical effectiveness, cost, equity and workflow impact.

Leadership styles: transformational, transactional, situational; effective leaders adapt.

Teamwork: psychological safety supports speaking up and learning.

Conflict resolution: address early, focus on interests not positions.

Change management: Kotter's steps, stakeholder engagement, communication.

Workforce planning: skill mix, workload, recruitment and retention.

Mentoring and supervision support professional development.

Organisational culture influences safety and quality.

Reflective practice improves clinical reasoning and wellbeing.

Clinical reasoning: dual-process theory (intuitive and analytical) and cognitive biases.

Common biases: anchoring, availability, confirmation, premature closure.

Diagnostic error reduction: structured handover, checklists, second opinions, diagnostic time-outs.

Test thresholds depend on pre-test probability and test characteristics.

Bayes' theorem updates probability after a test result.

Safety netting: clear advice on when to seek review and documentation.

Morbidity and mortality reviews identify diagnostic and system issues.

Simulation and feedback improve diagnostic performance.

Population health approach: assess needs, plan, implement, evaluate.

Social determinants of health: income, education, housing, employment, environment.

Health equity: fair access and outcomes; monitor disparities.

Community engagement and asset-based approaches build trust.

Prevention programmes require reach, uptake and sustainability.

Health impact assessment of policies.

Partnerships across sectors improve outcomes.

Data dashboards support population health management.

Outbreak investigation steps: verify, define cases, describe, generate hypotheses, test, control, communicate.

Notifiable diseases require statutory reporting.

Vaccination programmes: cold chain, coverage, adverse event monitoring.

Antimicrobial stewardship: prescribe only when indicated, use narrow spectrum, review.

Infection prevention: hand hygiene, PPE, isolation, cleaning.

Contact tracing and quarantine reduce transmission.

Risk communication during outbreaks must be timely and transparent.

Surveillance systems detect trends and inform action.

Global health: burden of disease, health systems strengthening, universal health coverage.

Primary health care (Alma-Ata, Astana) is the foundation of universal health coverage.

Humanitarian response: needs assessment, coordination, ethics.

Migrant and refugee health: screen for TB, anaemia, immunisation status, mental health.

Cultural competence improves care for diverse populations.

Health financing models: tax-based, insurance, out-of-pocket.

Essential medicines lists guide procurement and prescribing.

Sustainable development goals include health targets.