ENAM flashcards

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

ENAM purpose

Mexican national multiple-choice examination that ranks medical graduates for residency placement; higher scores improve access to competitive specialties and training sites.

Single-best-answer format

Each item presents a clinical stem followed by several options, of which exactly one is the most correct; the others are plausible but inferior distractors.

Guessing on ENAM

No points are deducted for incorrect responses, so leaving an item blank strictly lowers expected score; eliminate options and select the best remaining choice.

Stem-final-line technique

Reading the actual question at the end of a long vignette before the answer options prevents solving for the wrong target, such as diagnosis instead of next step.

CURB-65

Pneumonia severity score adding one point each for confusion, urea above 7 mmol/L, respiratory rate 30 or more, low blood pressure, and age 65 or older.

DKA treatment order

Isotonic saline for volume first, then intravenous insulin, then potassium replacement when serum potassium is below the upper normal range but above 3.3 mEq/L.

Diabetes diagnostic thresholds

Fasting glucose 126 mg/dL or higher, two-hour OGTT 200 mg/dL or higher, HbA1c 6.5% or higher, or random glucose 200 mg/dL or higher with classic symptoms.

HFrEF quadruple therapy

For heart failure with reduced ejection fraction, combine a renin-angiotensin system blocker or ARNI, a beta-blocker, a mineralocorticoid receptor antagonist, and an SGLT2 inhibitor.

Hypertensive emergency definition

Severe blood pressure elevation accompanied by acute target-organ damage, such as encephalopathy, aortic dissection, or pulmonary edema; requires titratable intravenous therapy and gradual reduction.

Microcytic versus macrocytic anemia

Low MCV suggests iron deficiency, thalassemia, or anemia of chronic disease; high MCV suggests vitamin B12 or folate deficiency, alcohol use, or hypothyroidism.

Neonatal resuscitation first steps

Provide warmth, dry the infant, stimulate breathing, clear the airway if obstructed, then assess respiration and heart rate; start positive pressure ventilation for apnea or heart rate below 100.

APGAR components

Five elements scored 0 to 2 each at one and five minutes: appearance (color), pulse (heart rate), grimace (reflex irritability), activity (muscle tone), and respiration (effort).

Infant weight milestones

Birth weight is regained by 10 to 14 days, doubles by roughly 5 months, and triples by about 12 months of age in normally growing term infants.

Bronchiolitis management

Most cases are caused by respiratory syncytial virus; treatment is supportive with oxygen and hydration, and routine bronchodilators or systemic corticosteroids are not recommended.

Kawasaki disease criteria

Fever for at least five days plus four of five features: conjunctivitis, oral mucosa changes, cervical lymphadenopathy, polymorphous rash, and extremity changes; treat with IV immunoglobulin and aspirin.

Intussusception presentation

Infants show intermittent colicky pain, vomiting, and currant-jelly stools; air or contrast enema is diagnostic and often therapeutic in hemodynamically stable children.

Naegele's rule

Estimated delivery date equals the first day of the last menstrual period plus 7 days minus 3 months, adding a year, assuming a regular 28-day cycle.

Preeclampsia treatment

Blood pressure of 140/90 mmHg or higher after 20 weeks with proteinuria or organ dysfunction; magnesium sulfate prevents and treats seizures in severe disease, and delivery is definitive.

Postpartum hemorrhage first step

Uterine atony is the leading cause; begin uterine massage and uterotonic drugs such as oxytocin, then escalate to surgical or interventional measures if bleeding persists.

Ectopic pregnancy management

A positive pregnancy test with pain and no intrauterine sac requires serial beta-hCG and follow-up ultrasound; treatment is methotrexate for stable early cases or surgery if ruptured.

Combined pill contraindications

Avoid combined estrogen-progestin contraceptives in migraine with aura, prior venous thromboembolism, and uncontrolled hypertension because of elevated thrombotic risk.

ATLS primary survey

Sequential assessment of airway with cervical spine protection, breathing, circulation with hemorrhage control, disability (neurologic status), and exposure with environmental control.

Hemorrhagic shock class III

Loss of roughly 30 to 40 percent of blood volume produces tachycardia, hypotension, and altered mental status; resuscitation requires blood products rather than crystalloid alone.

Appendicitis classic presentation

Periumbilical pain migrating to the right lower quadrant, with anorexia, nausea, and rebound tenderness at McBurney's point; ultrasound or CT supports the diagnosis.

Bowel obstruction initial care

Colicky pain, vomiting, distension, and absent flatus suggest obstruction; initial management is nothing by mouth, intravenous fluids, and nasogastric decompression.

Postoperative fever timing

Within 48 hours consider atelectasis or drug reaction; days 3 to 5 suggest urinary or wound infection; beyond day 5 consider abscess or deep vein thrombosis.

Sensitivity definition

Proportion of people with the disease who test positive; a highly sensitive test is useful for ruling out disease when the result is negative.

Specificity definition

Proportion of people without the disease who test negative; a highly specific test is useful for ruling in disease when the result is positive.

Positive predictive value

Proportion of positive test results that are truly diseased; it rises with disease prevalence even when sensitivity and specificity remain unchanged.

Relative risk versus odds ratio

Relative risk is calculated in cohort studies; the odds ratio comes from case-control studies and approximates relative risk only when the outcome is rare.

Informed consent elements

Valid consent requires patient capacity, adequate disclosure of benefits, risks, and alternatives, and voluntariness; a capable patient may refuse even life-saving treatment.

Levels of prevention

Primary prevents disease onset through vaccination or risk reduction; secondary detects preclinical disease by screening; tertiary reduces disability through treatment and rehabilitation.