Arab Board IM Final Written flashcards

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

STEMI criteria

ST elevation ≥1 mm in two contiguous limb leads, ≥2 mm in V2–V3 (men ≥40) or ≥1.5 mm (women), or new LBBB with ischemic symptoms.

CHA₂DS₂-VASc score

Stroke risk in atrial fibrillation: CHF, hypertension, age ≥75 (2), diabetes, stroke/TIA (2), vascular disease, age 65–74, female sex. Score ≥2 (men) or ≥3 (women) warrants anticoagulation.

Cardiac tamponade signs

Beck triad: hypotension, elevated JVP, muffled heart sounds; plus pulsus paradoxus and electrical alternans on ECG. Treat with urgent pericardiocentesis.

COPD GOLD staging

Post-bronchodilator FEV1/FVC <0.70 confirms obstruction; GOLD 1 FEV1 ≥80%, GOLD 2 50–79%, GOLD 3 30–49%, GOLD 4 <30% predicted.

CURB-65

Pneumonia severity score: Confusion, Urea >7 mmol/L, Respiratory rate ≥30, Blood pressure <90/60, age ≥65. Score 0–1 outpatient, 2 admit, ≥3 severe.

Light's criteria

Pleural fluid is exudate if protein ratio >0.5, LDH ratio >0.6, or pleural LDH >2/3 upper limit of normal serum LDH; otherwise transudate.

Spontaneous bacterial peritonitis

Ascitic fluid polymorphonuclear cells ≥250/mm³ in cirrhosis; treat with IV cefotaxime and albumin 1.5 g/kg day 1, 1 g/kg day 3 if renal or liver dysfunction.

Hepatorenal syndrome treatment

Functional renal failure in cirrhosis; terlipressin plus albumin is first-line; avoid NSAIDs, ACE inhibitors, and nephrotoxic drugs; liver transplant is definitive.

Wilson disease features

Low ceruloplasmin, high urinary copper, Kayser-Fleischer rings, Coombs-negative hemolysis, neuropsychiatric symptoms; treat with penicillamine or trientine plus zinc.

AKI KDIGO definition

Serum creatinine rise ≥0.3 mg/dL within 48 h, or ≥1.5× baseline within 7 days, or urine output <0.5 mL/kg/h for 6 h.

Hyperkalemia emergency treatment

IV calcium gluconate for cardiac protection, insulin with dextrose, nebulized salbutamol, sodium bicarbonate if acidotic; dialysis for refractory cases.

Nephrotic syndrome criteria

Proteinuria >3.5 g/day, hypoalbuminemia <3.0 g/dL, edema, hyperlipidemia; minimal change disease responds to steroids; membranous treated with rituximab or cyclophosphamide.

DKA management

IV 0.9% saline, insulin infusion 0.1 U/kg/h once K⁺ ≥3.3 mmol/L, add 5% dextrose when glucose <13.9 mmol/L; monitor K⁺, pH, anion gap every 2–4 h.

Thyroid storm treatment

Propylthiouracil, iodine at least 1 h later, beta-blocker, hydrocortisone, and supportive care; Burch-Wartofsky score ≥45 supports diagnosis.

Primary hyperaldosteronism

Aldosterone/renin ratio >20–30 with high aldosterone; confirm with saline suppression; adrenal CT and adrenal vein sampling; treat with spironolactone or adrenalectomy.

Iron deficiency anemia

Low ferritin (<30 ng/mL) is most specific; low MCV, low serum iron, high TIBC, transferrin saturation <20%; investigate GI blood loss in men and postmenopausal women.

Tumor lysis syndrome

Hyperkalemia, hyperphosphatemia, hyperuricemia, hypocalcemia after rapid tumor cell death; prevent with hydration and allopurinol or rasburicase in high-risk patients.

Neutropenic fever

ANC <0.5 ×10⁹/L with fever ≥38.3°C once or ≥38.0°C sustained; start empirical anti-pseudomonal beta-lactam within 1 h.

Sepsis-3 definition

Life-threatening organ dysfunction from infection; qSOFA ≥2 (RR ≥22, altered mentation, SBP ≤100) indicates high risk; septic shock includes vasopressor need and lactate >2 mmol/L.

Bacterial meningitis empiric therapy

Adults: ceftriaxone plus vancomycin, with dexamethasone before or with first antibiotic dose; add ampicillin if Listeria risk (age >50, immunocompromised).

HIV opportunistic prophylaxis

Co-trimoxazole for PCP when CD4 <200; azithromycin for MAC when CD4 <50; start ART for all regardless of CD4 count.

Rheumatoid arthritis serology

Rheumatoid factor and anti-CCP; anti-CCP is more specific; methotrexate is first-line disease-modifying therapy, with biologics if inadequate response.

Gout crystals

Negatively birefringent needle-shaped monosodium urate crystals; acute flare treated with NSAIDs, colchicine, or steroids; urate-lowering target <6 mg/dL.

Giant cell arteritis

Age >50 with headache, jaw claudication, visual loss, ESR >50; start high-dose prednisolone immediately; confirm with temporal artery biopsy or ultrasound.

Acute ischemic stroke thrombolysis

IV alteplase 0.9 mg/kg (max 90 mg) within 4.5 h of onset; blood pressure must be <185/110 mmHg; thrombectomy for large vessel occlusion up to 24 h in selected cases.

Status epilepticus treatment

IV lorazepam 4 mg or IM midazolam 10 mg first-line; second-line IV levetiracetam, valproate, or phenytoin; refractory cases require intubation and anesthetic infusion.

Guillain-Barré syndrome

Ascending areflexic weakness with albuminocytologic dissociation (high CSF protein, normal cells); treat with IVIG or plasma exchange; monitor vital capacity.

Delirium management

Acute fluctuating confusion and inattention; identify and treat precipitating cause (infection, drugs, pain, constipation, hypoxia); avoid antipsychotics unless severe agitation.

Revised cardiac risk index

Perioperative risk factors: ischemic heart disease, heart failure, cerebrovascular disease, insulin-treated diabetes, creatinine >2 mg/dL, high-risk surgery; ≥2 points indicates elevated risk.

SJS/TEN classification

Stevens-Johnson syndrome <10% body surface detachment, overlap 10–30%, toxic epidermal necrolysis >30%; stop culprit drug and provide supportive care.

CYP3A4 interactions

Inhibitors (macrolides, azoles, grapefruit) increase drug levels; inducers (rifampicin, carbamazepine, St John's wort) decrease levels; warfarin INR monitoring is essential.

Anaphylaxis treatment

Intramuscular adrenaline 0.5 mg (1:1000) in anterolateral thigh, repeat every 5 min; IV fluids; antihistamines and steroids are adjuncts, not first-line.