Brazil Revalida cheat sheet

SUS principles: universality (health as a right for all), integrality (prevention, promotion, treatment, rehabilitation), and equity (priority to those with greater need) are constitutional directives (CF/88, art. 196-200).

Primary care attribution: first contact, longitudinality, comprehensiveness, coordination, family and community orientation, and cultural competence are the essential attributes of primary health care (Starfield).

Notifiable diseases: immediate notification (within 24h) for suspected measles, polio, rabies, yellow fever, dengue with warning signs, and severe acute respiratory illness; weekly for others per Ministry of Health list.

Hypertension diagnosis: office BP ≥140/90 mmHg on two occasions, or home BP ≥135/85, or 24h ABPM ≥130/80; stage 1 starts at 140-159/90-99.

Diabetes diagnosis: fasting glucose ≥126 mg/dL, HbA1c ≥6.5%, 2h OGTT ≥200 mg/dL, or random glucose ≥200 with symptoms; repeat to confirm in asymptomatic patients.

Antibiotic prophylaxis in surgery: single dose within 60 minutes before incision; re-dose if surgery exceeds two half-lives or blood loss >1500 mL; discontinue within 24h for most procedures.

Pediatric dehydration: WHO plan A (no dehydration) oral rehydration at home; plan B (some dehydration) 75 mL/kg ORS over 4h; plan C (severe) IV Ringer's lactate 100 mL/kg (30 mL/kg in 1h then 70 mL/kg in 5h for infants).

Ethics: informed consent requires capacity, information, and voluntariness; in emergencies without a responsible surrogate, treat under the principle of beneficence and document.

Maternal mortality: hypertension (eclampsia/preeclampsia) and hemorrhage are leading causes; magnesium sulfate is first-line for eclampsia prevention and treatment.

OSCE station structure: read the task, wash hands, introduce yourself, confirm patient identity, obtain consent, perform focused history and exam, summarize, and close with safety netting.

Vital sign thresholds for immediate action: respiratory rate >30 or <8, SpO2 <90%, systolic BP <90 mmHg, heart rate >120 or <50, temperature >39°C or <35°C, altered consciousness (GCS <15).

Airway management sequence: assess patency, use head-tilt/chin-lift (or jaw thrust if trauma), suction secretions, insert oropharyngeal airway if no gag reflex, and prepare for bag-mask ventilation.

Cardiopulmonary resuscitation: high-quality compressions at 100-120/min, depth 5-6 cm, full recoil, minimize interruptions <10s, and switch compressor every 2 minutes.

Defibrillation: for shockable rhythms (VF/pulseless VT), deliver single shock (biphasic 120-200 J), resume compressions immediately for 2 minutes before rhythm check.

Venipuncture and IV access: choose distal vein, apply tourniquet 10 cm above site for <1 minute, clean with alcohol, insert bevel up at 15-30°, confirm flashback, release tourniquet, secure and label.

Suturing: use local anesthetic with epinephrine for hemostasis (avoid in digits, nose, ears, penis), irrigate wound, approximate edges with simple interrupted sutures, and remove facial sutures in 3-5 days, limbs in 10-14 days.

Pelvic exam: explain steps, use dorsal lithotomy position, inspect external genitalia, speculum exam for cervix and vaginal walls, bimanual exam to assess uterus and adnexa; maintain privacy and chaperone.

Communication: use open-ended questions, reflective listening, teach-back to confirm understanding, and involve the patient in shared decision-making.