BMDC RQE flashcards

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

Anion gap

Serum sodium minus the sum of chloride and bicarbonate, normally 8-12 mEq/L; a high gap suggests ketoacidosis, lactic acidosis, renal failure, or toxin ingestion.

CURB-65

Pneumonia severity score using confusion, urea, respiratory rate, blood pressure, and age 65 or older; a score of 2 or more usually indicates hospital admission.

Nephrotic syndrome criteria

Proteinuria above 3.5 g per 24 hours, serum albumin below 3.0 g/dL, edema, and hyperlipidemia; minimal change disease is the commonest childhood cause.

McBurney's point

Point one third of the way along a line from the anterior superior iliac spine to the umbilicus; maximal tenderness there suggests acute appendicitis.

Rule of nines

Burn surface estimate: each arm 9%, each leg 18%, anterior trunk 18%, posterior trunk 18%, head 9%, perineum 1%; used to calculate fluid resuscitation.

Four Ts of postpartum hemorrhage

Tone (uterine atony), trauma (lacerations, rupture), tissue (retained placenta), and thrombin (coagulopathy); atony is the commonest cause of primary postpartum hemorrhage.

Naegele's rule

Estimated delivery date is the first day of the last menstrual period plus 7 days minus 3 months, adjusted for cycle length; first-trimester ultrasound is more accurate.

Preeclampsia diagnostic threshold

Blood pressure of 140/90 mmHg or higher after 20 weeks with proteinuria of 300 mg per 24 hours or other organ dysfunction; severe features require urgent delivery.

Apgar score components

Appearance, pulse, grimace, activity, and respiration, each scored 0-2 at 1 and 5 minutes; a score below 7 at 5 minutes warrants continued assessment.

Simple febrile seizure

A generalized seizure lasting under 15 minutes, occurring once in 24 hours, in a child aged 6 months to 5 years with fever and no prior neurological disease.

Femoral triangle contents

From lateral to medial: femoral nerve, artery, vein, and lymphatics (empty space); bounded by the inguinal ligament, sartorius, and adductor longus.

Zero-order kinetics

Drug elimination at a constant amount per unit time regardless of concentration, giving a half-life that lengthens with dose; examples include ethanol and high-dose phenytoin.

Sensitivity and specificity

Sensitivity is true positives divided by all diseased; specificity is true negatives divided by all non-diseased; both are properties of the test, not of prevalence.

Herd immunity threshold

The proportion immune needed to interrupt transmission, calculated as 1 minus 1/R0; measles with R0 of 12-18 needs roughly 92-95% coverage.

Rigor mortis timing

Muscle stiffening begins in the eyelids and jaw 2-4 hours after death, becomes complete by about 12 hours, and passes off in 24-36 hours.

Organophosphate toxidrome

Muscarinic features such as salivation, lacrimation, urination, diarrhea, bradycardia, bronchorrhea, and miosis, with nicotinic fasciculation; treated with atropine and pralidoxime.

Rinne and Weber tests

Rinne compares air and bone conduction; Weber lateralizes to the affected ear in conductive loss and to the better ear in sensorineural loss.

Acute angle-closure glaucoma

Painful red eye with halos, fixed mid-dilated pupil, shallow anterior chamber, and raised intraocular pressure; treated with pressure-lowering drugs and laser iridotomy.

Nikolsky sign

Separation of epidermis on lateral pressure; positive in pemphigus vulgaris with flaccid bullae and negative in bullous pemphigoid with tense bullae.

Delirium tremens timing

Alcohol withdrawal delirium appears 48-96 hours after cessation with tremor, confusion, hallucinations, and autonomic instability; treated with benzodiazepines and thiamine.

Four principles of bioethics

Autonomy respects informed choice, beneficence promotes welfare, non-maleficence avoids harm, and justice distributes benefits and burdens fairly among patients.

Negligence elements

Duty of care, breach of the standard of a reasonably competent practitioner, causation, and resulting harm; all four must be established for liability.

Henderson-Hasselbalch equation

pH equals 6.1 plus the logarithm of bicarbonate concentration divided by 0.03 times PaCO2; used to interpret metabolic and respiratory acid-base disorders.

Frank-Starling relationship

Stroke volume increases with ventricular preload up to an optimal sarcomere length; beyond that point further filling does not increase output.

Alvarado score

Clinical appendicitis score using migration of pain, anorexia, nausea, tenderness, rebound, fever, and leukocytosis; a score of 7 or more supports surgery.

Parkland formula

Fluid resuscitation for burns using 4 mL per kg per percent burn of crystalloid in 24 hours, with half given in the first 8 hours from injury.

Kussmaul breathing

Deep, rapid, regular respiration seen in severe metabolic acidosis such as diabetic ketoacidosis; often accompanied by acetone breath and dehydration.

Oral rehydration plan

WHO oral rehydration salts: 50-100 mL/kg over 4 hours for some dehydration, 100 mL/kg over 4 hours for severe dehydration, plus zinc for 10-14 days.

Relative risk versus odds ratio

Relative risk compares incidence between exposed and unexposed groups in cohort studies; odds ratio approximates it in case-control studies when disease is rare.

Wilson-Jungner criteria

Screening criteria requiring an important condition, a detectable latent stage, an acceptable test, agreed treatment, and cost-effective case finding.

Carbon monoxide poisoning

Cherry-red skin, headache, and confusion with carboxyhemoglobin above 20%; treated with high-flow oxygen and hyperbaric oxygen for neurological or cardiac involvement.

Papilledema

Bilateral optic disc swelling from raised intracranial pressure; unilateral disc swelling with normal pressure suggests optic neuritis or ischemic optic neuropathy.