AMC CAT MCQ flashcards

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

CURB-65

Pneumonia severity score: confusion, urea above 7 mmol/L, respiratory rate 30 or more, low blood pressure, and age 65 or older. Two or more points suggest inpatient care.

DKA first steps

Isotonic saline resuscitation, then fixed-rate intravenous insulin infusion. Potassium is replaced once it is not high, and dextrose is added when glucose falls to allow continued insulin.

Heart failure quadruple therapy

For reduced ejection fraction, combine an ACE inhibitor or ARNI, a beta-blocker, a mineralocorticoid receptor antagonist, and an SGLT2 inhibitor. Each class reduces mortality and is titrated to tolerance.

Thrombolysis window in stroke

Intravenous thrombolysis is considered within 4.5 hours of onset after imaging excludes haemorrhage. Thrombectomy may extend to 6 hours, or selected cases to 24 hours, for large-vessel occlusion.

Hyperkalaemia with ECG changes

Give intravenous calcium first to protect the myocardium. Then shift potassium intracellularly with insulin and dextrose or salbutamol, and arrange definitive removal via dialysis or binders.

Acute severe asthma treatment

Oxygen to target saturation, repeated inhaled short-acting beta-2 agonist, ipratropium, and systemic corticosteroids. Magnesium sulfate is added for refractory disease, with ICU review for exhaustion or rising carbon dioxide.

Alvarado score components

Migratory right iliac fossa pain, anorexia, nausea or vomiting, tenderness, rebound tenderness, fever, leucocytosis, and neutrophilia. Higher totals increase the likelihood of acute appendicitis.

Bowel obstruction initial management

Nil by mouth, intravenous fluids, nasogastric decompression, analgesia, and serial abdominal examination. Urgent surgery is indicated for strangulation, perforation, closed-loop obstruction, or peritonitis.

Haemorrhagic shock classes

Class I is under 15 percent blood loss, class II 15 to 30 percent, class III 30 to 40 percent, and class IV over 40 percent. Hypotension usually appears only in class III.

Acute pancreatitis diagnosis

Two of three features are required: typical epigastric pain, lipase or amylase above three times the upper limit, and characteristic imaging. Early care is fluids, analgesia, and enteral nutrition.

Rule of nines burns

Each arm 9 percent, each leg 18 percent, anterior trunk 18 percent, posterior trunk 18 percent, head 9 percent, perineum 1 percent. This estimates total body surface area burned in adults.

Parkland fluid formula

Give 4 mL per kg per percent burn of crystalloid in the first 24 hours, with half in the first 8 hours from the time of injury and the remainder over the following 16 hours.

Strangulated hernia features

An irreducible, tender hernia with severe pain, vomiting, absent flatus, or overlying skin changes. It is a surgical emergency, and manual reduction is avoided when peritonism is present.

Revised cardiac risk index

Six predictors: ischaemic heart disease, heart failure, cerebrovascular disease, insulin-treated diabetes, creatinine above 177 micromol/L, and high-risk surgery. Each adds about one point.

Pre-eclampsia definition

New hypertension after 20 weeks of gestation with proteinuria or maternal organ dysfunction. Delivery is definitive treatment; magnesium sulfate prevents and treats seizures in severe disease.

Four T causes of postpartum haemorrhage

Tone (uterine atony, most common), trauma, tissue (retained placenta), and thrombin (coagulopathy). Management proceeds from uterine massage and uterotonics to tranexamic acid and escalation.

Ectopic pregnancy presentation

Positive pregnancy test with abdominal pain, vaginal bleeding, and an empty uterus on ultrasound. Haemodynamic instability requires urgent surgery; stable cases may be managed medically.

Ovarian torsion management

Sudden severe unilateral pelvic pain with nausea and an adnexal mass suggests torsion. It is a surgical emergency, and detorsion with ovarian preservation is preferred when the ovary remains viable.

First-line menorrhagia treatment

In the absence of structural pathology, the levonorgestrel intrauterine system is first-line. Non-hormonal options include tranexamic acid and non-steroidal anti-inflammatory drugs.

Fetal heart rate decelerations

Late decelerations suggest uteroplacental insufficiency, variable decelerations suggest cord compression, and early decelerations reflect head compression. Prolonged bradycardia needs intrauterine resuscitation and possible expedited delivery.

Shoulder dystocia sequence

Begin with the McRoberts manoeuvre and suprapubic pressure, then internal rotational manoeuvres. Fundal pressure is never used, and the mother should be prepared for postpartum haemorrhage.

Gestational diabetes first-line therapy

Screen with an oral glucose tolerance test in the second or third trimester. Initial treatment is dietary and lifestyle change, with insulin added if glucose targets are not achieved.

Paediatric BLS ratio

Start with five rescue breaths, then compress at 100 to 120 per minute. Use a ratio of 15 compressions to 2 breaths with two rescuers, or 30 to 2 for a lone lay rescuer.

Holliday-Segar maintenance fluids

Give 4 mL/kg/hour for the first 10 kg, 2 mL/kg/hour for the next 10 kg, and 1 mL/kg/hour for each kilogram thereafter. Replace deficits and ongoing losses separately.

Neonatal jaundice red flag

Jaundice appearing within the first 24 hours of life is always pathological. Unconjugated hyperbilirubinaemia is treated with phototherapy, and exchange transfusion is reserved for severe or rapidly rising levels.

Acute bronchiolitis care

Management is supportive: oxygen if saturations fall, hydration, and nasal suctioning. Routine bronchodilators, corticosteroids, and antibiotics are not recommended for typical viral bronchiolitis.

Kawasaki disease criteria

Fever for 5 days or more plus four of five features: rash, conjunctivitis, oral changes, extremity changes, and cervical lymphadenopathy. Intravenous immunoglobulin and aspirin reduce coronary artery risk.

Intussusception features

Intermittent colicky pain with leg drawing, vomiting, and redcurrant-jelly stool in a child aged 6 months to 3 years. Air or contrast enema is diagnostic and therapeutic if there is no peritonitis.

Simple febrile seizure

A generalised seizure lasting under 15 minutes, occurring once in 24 hours, in a febrile child without central nervous system infection. Investigation targets the source of fever rather than the seizure.

Childhood height milestones

Birth length typically doubles by age 4 years and triples by age 13. Crossing two or more centile lines downward warrants assessment for failure to thrive or endocrine disease.

Paediatric dehydration signs

Reduced skin turgor, sunken eyes, dry mucous membranes, delayed capillary refill, tachycardia, and reduced urine output. Severe dehydration with shock requires rapid isotonic fluid boluses.

Croup management

Barking cough, hoarse voice, and inspiratory stridor in a young child. Treat with a single dose of oral dexamethasone; nebulised adrenaline is added for moderate to severe stridor.