Arab Board IM Final Written key terms

The difference between measured serum sodium and the sum of chloride and bicarbonate, used to classify metabolic acidosis as high or normal gap and to guide the search for unmeasured acids such as ketones, lactate or toxins.

The difference between measured serum osmolality and calculated osmolality from sodium, glucose and urea; an elevated value suggests unmeasured osmoles such as alcohols, mannitol or glycine.

The percentage of filtered sodium that appears in urine, calculated from paired serum and urine sodium and creatinine; a low value in oliguria favours pre-renal states over intrinsic renal injury.

An abrupt decline in glomerular filtration over hours to days, recognised by a rising serum creatinine or falling urine output, and staged by the magnitude of these changes according to KDIGO criteria.

A serum potassium concentration above the upper reference limit, usually greater than 5.5 mmol/L; dangerous because it depolarises cardiac membranes and can precipitate lethal ventricular arrhythmias.

A glomerular disorder defined by heavy proteinuria, hypoalbuminaemia, oedema and hyperlipidaemia; it predisposes to thrombosis and infection through urinary loss of antithrombin and immunoglobulins.

A glomerular syndrome marked by haematuria with red cell casts, hypertension, oliguria and variable proteinuria, reflecting acute inflammation of the glomerular capillary wall.

A metabolic emergency after rapid destruction of malignant cells, producing hyperuricaemia, hyperkalaemia, hyperphosphataemia and hypocalcaemia that can cause acute kidney injury and arrhythmias.

A metabolic acidosis with an elevated anion gap caused by accumulation of unmeasured acids, commonly lactate, ketones, urate, or toxins such as methanol and ethylene glycol.

A hyperglycaemic emergency of absolute or relative insulin deficiency with ketonaemia and metabolic acidosis, managed with fluids, intravenous insulin, potassium replacement and treatment of the precipitant.

Severe hyperglycaemia with marked hyperosmolality and dehydration but minimal ketosis, typically in older patients with type 2 diabetes; treatment centres on cautious fluid and insulin therapy.

Glycated haemoglobin reflecting average blood glucose over the preceding two to three months; used to diagnose diabetes and to monitor long-term glycaemic control, though it is unreliable in haemoglobinopathies and pregnancy.

Euvolaemic hypotonic hyponatraemia caused by inappropriate ADH secretion, with concentrated urine and continued urinary sodium excretion; managed by fluid restriction and treatment of the underlying cause.

Abnormal thyroid function tests during non-thyroidal illness, typically low T3 with normal or low TSH, which usually resolve on recovery and should not be treated with thyroid hormone replacement.

Acute myocardial necrosis with persistent ST elevation on ECG reflecting complete coronary occlusion, requiring urgent reperfusion by primary percutaneous coronary intervention or fibrinolysis.

A cardiac structural protein released into blood after myocyte injury; high-sensitivity assays detect small elevations and serial measurement is used to diagnose or exclude acute myocardial infarction.

Combined use of aspirin with a P2Y12 inhibitor such as clopidogrel, ticagrelor or prasugrel to prevent stent thrombosis and recurrent events after acute coronary syndrome or percutaneous coronary intervention.

A clinical heart failure syndrome with left ventricular ejection fraction of 40 percent or less, treated with agents that improve survival such as renin-angiotensin system inhibitors, beta-blockers, mineralocorticoid antagonists and SGLT2 inhibitors.

Hormones such as BNP and NT-proBNP released by stretched ventricular myocardium; elevated levels support the diagnosis of heart failure, though obesity, renal impairment and atrial fibrillation alter interpretation.

A supraventricular arrhythmia with disorganised atrial activity and an irregularly irregular ventricular response, carrying risk of thromboembolism that is estimated using the CHA2DS2-VASc score.

A clinical tool that estimates stroke risk in atrial fibrillation from age, sex, heart failure, hypertension, diabetes and prior stroke or vascular disease, guiding decisions about anticoagulation.

Persistent airflow obstruction from airway and alveolar abnormalities, usually related to tobacco smoke, diagnosed by a post-bronchodilator FEV1/FVC ratio below 0.70 with symptoms of dyspnoea and cough.

Hypoxaemia with hypercapnia, defined as arterial oxygen tension below 8 kPa with carbon dioxide tension above 6 kPa, caused by alveolar hypoventilation from lung disease, neuromuscular weakness or obesity.

Delivery of positive pressure support through a mask to improve alveolar ventilation and reduce work of breathing, used first-line in acute hypercapnic exacerbations of chronic obstructive pulmonary disease.

Occlusion of pulmonary arteries by thrombus, usually from deep vein thrombosis, causing dyspnoea, chest pain and right ventricular strain; risk is stratified by haemodynamic status and biomarkers.

A validated clinical prediction rule that estimates the pre-test probability of deep vein thrombosis or pulmonary embolism, guiding whether D-dimer testing or imaging is the appropriate next step.

Bleeding arising proximal to the ligament of Treitz, commonly from peptic ulcer or varices, assessed by haemodynamic status and the Glasgow-Blatchford score to decide timing of endoscopy.

Infection of ascitic fluid in cirrhosis without an obvious intra-abdominal source, diagnosed by an ascitic neutrophil count above 250 cells per microlitre and treated with antibiotics plus albumin.

Functional renal failure in advanced liver disease caused by splanchnic vasodilatation and renal vasoconstriction, diagnosed after excluding other causes and treated with vasoconstrictors and albumin.

A composite score using bilirubin, albumin, prothrombin time, ascites and encephalopathy to grade the severity of cirrhosis and estimate prognosis and operative risk.

Microcytic anaemia from depleted iron stores, shown by low ferritin and transferrin saturation; in adults it requires investigation for gastrointestinal blood loss unless a clear cause exists.

Systemic activation of coagulation causing widespread microvascular thrombosis with consumption of platelets and clotting factors, producing prolonged clotting times, low fibrinogen and raised D-dimer.

Fever or clinical deterioration in a patient with severe neutropenia, treated as a medical emergency with immediate empirical broad-spectrum antibiotics before investigation results return.

A single oral temperature above 38.3 degrees Celsius or sustained fever above 38 degrees with an absolute neutrophil count below 0.5, requiring urgent cultures and empirical antibiotics.

Life-threatening organ dysfunction caused by a dysregulated host response to infection, operationalised as a rise in the SOFA score; managed with early antibiotics, fluids and source control.

Sepsis with persistent hypotension requiring vasopressors to maintain mean arterial pressure and with raised lactate despite adequate fluid resuscitation, carrying high mortality.

An autoantibody directed against the Fc portion of immunoglobulin G, found in most patients with rheumatoid arthritis but also in other autoimmune disease, chronic infection and healthy older people.

An autoantibody with high specificity for rheumatoid arthritis that often precedes clinical disease and predicts more erosive joint damage.

An autoantibody screening test for connective tissue disease; a positive result is common in the general population, so interpretation requires the clinical picture and more specific antibodies.

A thrombotic and obstetric disorder defined by arterial or venous thrombosis or pregnancy loss together with persistent antiphospholipid antibodies, requiring long-term anticoagulation.

Histological examination of a segment of the superficial temporal artery used to confirm giant cell arteritis; treatment with steroids should not be delayed while awaiting the result.

Pharmacological breakdown of thrombus using agents such as alteplase, used in acute ischaemic stroke within a selected time window after excluding haemorrhage by imaging.

A standardised 42-point clinical assessment of neurological deficit in acute stroke, used to grade severity, guide treatment decisions and monitor change over time.

Continuous seizure activity or repeated seizures without recovery lasting five minutes or more, treated in sequence with benzodiazepines followed by second-line anticonvulsants and airway support.

An acute fluctuating disturbance of attention and awareness with altered cognition, common in hospitalised older adults and usually multifactorial; managed by treating causes and non-drug measures first.

The concurrent use of multiple medicines, often defined as five or more, which increases the risk of interactions, adverse effects and falls, and warrants structured medication review.

A toxic reaction to serotonergic drugs causing agitation, clonus, hyperreflexia, tremor and hyperthermia, distinguished from neuroleptic malignant syndrome by brisk reflexes and rapid onset.

A rare idiosyncratic reaction to dopamine antagonists producing rigidity, hyperthermia, autonomic instability and raised creatine kinase, managed by stopping the drug and supportive care.

A severe mucocutaneous reaction, usually drug-induced, with epidermal detachment of less than ten percent of body surface area; larger detachment is termed toxic epidermal necrolysis.

Acute non-cardiogenic hypoxaemic respiratory failure with bilateral infiltrates and reduced lung compliance, graded by the ratio of arterial oxygen to inspired oxygen and managed with lung-protective ventilation.

The ratio between a drug's toxic and therapeutic dose; drugs with a narrow index, such as digoxin, warfarin and lithium, require monitoring of blood concentrations to avoid harm.