COMLEX Level 1 flashcards

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

TART criteria

TART is the mnemonic for the four diagnostic criteria of somatic dysfunction: Tissue texture abnormality, Asymmetry of anatomic landmarks, Restriction of motion, and Tenderness to palpation.

Fryette law I

In neutral mechanics, sidebending of a group of vertebrae precedes and is coupled with rotation to the opposite side; the curve is named for the side of sidebending and occurs in the thoracic and lumbar spine.

Fryette law II

In non-neutral mechanics, a single vertebral unit is flexed or extended with sidebending and rotation to the same side; the curve is named for the side of rotation and predominates in the lumbar spine.

Counterstrain technique

Counterstrain places the patient in a position of comfort that shortens the involved muscle for about 90 seconds, reducing tender-point activity through a spinal reflex, then returns slowly to neutral.

Muscle energy technique

Muscle energy uses a patient's voluntary isometric contraction against an operator-applied counterforce at the restrictive barrier, followed by relaxation, to lengthen restricted muscles and improve motion.

Cranial rhythmic impulse rate

The cranial rhythmic impulse is the palpable rhythm of the primary respiratory mechanism, normally 10 to 14 cycles per minute, reflecting CNS motility and cerebrospinal fluid fluctuation.

Landmark for lumbar puncture

Lumbar puncture is performed at L3-L4 or L4-L5, identified by Tuffier's line at the level of the iliac crests, safely below the conus medullaris in adults.

Blood culture order of draw

Blood cultures for sterility are drawn first, followed by light blue citrate, red or gold serum, green heparin, lavender EDTA, and gray fluoride-oxalate tubes.

Thoracentesis insertion site

Thoracentesis is performed one or two rib spaces below the upper fluid level, typically the 7th to 8th intercostal space in the posterior midscapular line, above the diaphragm.

Suture removal timing

Nonabsorbable sutures are removed at about 4-5 days on the face, 7-10 days on the scalp and trunk, and 10-14 days on the extremities to allow adequate tensile strength.

Paracentesis safe site

Paracentesis is performed in the left lower quadrant, about 2 cm below the umbilicus and lateral to the rectus sheath, an area relatively free of major vessels.

Sensitivity

Sensitivity is TP/(TP+FN), the proportion of truly diseased patients who test positive; a highly sensitive test is useful for ruling out disease when negative.

Specificity

Specificity is TN/(TN+FP), the proportion of disease-free patients who test negative; a highly specific test is useful for ruling in disease when positive.

Positive predictive value

PPV is TP/(TP+FP), the probability that a patient with a positive test truly has disease; unlike sensitivity and specificity, PPV rises as disease prevalence increases.

Number needed to treat

NNT is 1 divided by the absolute risk reduction, the number of patients who must be treated for one additional patient to benefit; lower values indicate greater benefit.

Phase III clinical trial

Phase III trials randomize large numbers of patients to compare a new treatment with standard therapy or placebo for efficacy and adverse effects, generating data used for drug approval.

PDSA cycle

Plan-Do-Study-Act is an iterative quality improvement method in which a small change is tested, measured, and refined before broader implementation across a practice system.

ACGME core competencies

The six ACGME competencies are patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice.

Level I evidence

Level I evidence derives from systematic reviews or meta-analyses of well-designed randomized controlled trials; the hierarchy descends through individual trials, cohort studies, case-control studies, and case series.

Root cause analysis

Root cause analysis is a structured, systems-focused review after a sentinel event that identifies underlying process failures rather than individual blame and produces corrective action plans.

SPIKES protocol

SPIKES is a six-step framework for breaking bad news: Setting, Perception, Invitation, Knowledge, Empathy, and Strategy or Summary, used to structure difficult clinical conversations.

OARS micro-skills

OARS stands for Open-ended questions, Affirmations, Reflections, and Summaries, the core motivational interviewing skills used to evoke and reinforce a patient's own motivation to change.

Teach-back method

Teach-back asks the patient to restate in their own words what was explained, confirming understanding and revealing gaps in health literacy before the patient leaves.

SBAR handoff

SBAR is a structured handoff format covering Situation, Background, Assessment, and Recommendation, used to convey clinical information concisely and reduce errors during transitions of care.

Fiduciary duty

Fiduciary duty obligates the physician to act in the patient's best interest ahead of self-interest, encompassing competence, confidentiality, loyalty, and disclosure of conflicts of interest.

Mandatory HIPAA disclosures

HIPAA permits or requires disclosure without authorization for public health reporting, suspected abuse or neglect, imminent serious threat to an identifiable person, and court orders or subpoenas.

Impaired physician reporting

A physician unable to practice with reasonable skill because of substance use or illness should be referred to a physician health program, which emphasizes treatment and monitored recovery.

Informed refusal

A patient with decisional capacity may refuse recommended care after being informed of the diagnosis, proposed treatment, risks of refusal, and alternatives; the discussion should be documented.

IOM six aims

The Institute of Medicine aims for health care that is safe, effective, patient-centered, timely, efficient, and equitable, forming a framework for measuring quality improvement.

Diagnosis-related group payment

DRGs are prospective fixed hospital payments based on principal diagnosis, procedures, and complications, giving hospitals incentive to reduce length of stay and cost per case.

Quality-adjusted life year

A QALY weights survival time by health-related utility from 0 (death) to 1 (perfect health) and is used in cost-effectiveness analysis to compare interventions across diseases.

Relative value unit

RVUs quantify physician work, practice expense, and malpractice cost; Medicare payment equals total RVUs multiplied by a geographic adjustment factor and a conversion factor.