ECOM-CR Medical Licensure flashcards

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

Osmolality formula

Serum osmolality is estimated as 2 times sodium plus glucose divided by 18 plus blood urea nitrogen divided by 2.8, all in mg/dL; effective osmolality excludes urea.

Henderson-Hasselbalch equation

pH equals 6.1 plus the log of bicarbonate concentration divided by 0.03 times PaCO2; it relates the bicarbonate buffer system to blood pH.

Competitive inhibition kinetics

A competitive inhibitor binds the active site, raising apparent Km while Vmax stays unchanged; increasing substrate concentration can overcome the inhibition.

Renal clearance formula

Clearance equals urine concentration times urine flow divided by plasma concentration; inulin clearance estimates glomerular filtration rate and PAH clearance estimates renal plasma flow.

Autosomal recessive recurrence risk

Two carrier parents have a 25 percent chance of an affected child per pregnancy; unaffected siblings have a two-thirds chance of being carriers.

Diabetic ketoacidosis management

DKA presents with anion-gap metabolic acidosis and ketones; treat with isotonic saline, an insulin infusion, and potassium replacement once serum potassium is below 5.2 mEq/L.

Heart failure four pillars

In heart failure with reduced ejection fraction, combine an ARNI or ACE inhibitor, a beta-blocker, a mineralocorticoid receptor antagonist, and an SGLT2 inhibitor to reduce mortality.

Hyperkalemia emergency treatment

For hyperkalemia with ECG changes, give intravenous calcium first to stabilize membranes, then insulin with glucose or a beta-agonist to shift potassium intracellularly.

CURB-65 criteria

CURB-65 scores confusion, urea above 7 mmol/L, respiratory rate at least 30, low blood pressure, and age at least 65 to guide pneumonia site of care.

Thyroid storm treatment

Thyroid storm is treated with a beta-blocker, a thionamide, iodine given after the thionamide, and glucocorticoids, along with supportive cooling and fluids.

Shock index

Shock index is heart rate divided by systolic blood pressure; a value above 0.9 suggests occult hemorrhage and need for further trauma evaluation.

ATLS primary survey

The primary survey addresses airway with cervical spine protection, breathing, circulation with hemorrhage control, disability, and exposure with environmental control, reassessing after each step.

Malignant hyperthermia antidote

Malignant hyperthermia causes hypercarbia, muscle rigidity, and rising temperature after volatile anesthetics or succinylcholine; dantrolene is the specific treatment.

Holliday-Segar maintenance fluids

Pediatric maintenance fluids use 4 mL/kg/h for the first 10 kg, 2 mL/kg/h for the next 10 kg, and 1 mL/kg/h for each kilogram above 20.

APGAR score components

APGAR scores Appearance, Pulse, Grimace, Activity, and Respiration from 0 to 2 each at 1 and 5 minutes; a total of 7 or more is generally reassuring.

Kawasaki disease criteria

Kawasaki disease requires fever for at least 5 days plus 4 of 5 features: rash, conjunctivitis, mucosal changes, extremity changes, and cervical lymphadenopathy; treat with IVIG and aspirin.

Intussusception presentation

Intussusception causes colicky abdominal pain, currant-jelly stool, and a sausage-shaped mass; an air or contrast enema is both diagnostic and therapeutic.

Naegele rule

Estimated due date equals the first day of the last menstrual period plus 7 days minus 3 months, corresponding to 280 days from the last menstrual period.

Preeclampsia definition

Preeclampsia is new hypertension after 20 weeks of gestation with proteinuria or end-organ dysfunction; delivery is the definitive treatment.

Postpartum hemorrhage cause

Uterine atony is the most common cause of postpartum hemorrhage; initial management is uterine massage followed by oxytocin and other uterotonic agents.

Ectopic pregnancy management

A positive hCG without intrauterine pregnancy on ultrasound suggests ectopic pregnancy; methotrexate is used if stable, while surgery is needed if ruptured.

Serotonin syndrome features

Serotonin syndrome presents with clonus, hyperreflexia, agitation, and autonomic instability after serotonergic drugs; stop the agent and give benzodiazepines.

Neuroleptic malignant syndrome

Neuroleptic malignant syndrome causes rigidity, hyperthermia, autonomic instability, and elevated creatine kinase after dopamine antagonists; treat with dantrolene or bromocriptine.

Delirium core features

Delirium is an acute fluctuating disturbance of attention and awareness with altered level of consciousness; identify and treat the underlying medical cause.

Lithium toxicity signs

Lithium toxicity causes tremor, ataxia, confusion, and vomiting; levels above 1.5 mEq/L require stopping the drug and considering hemodialysis for severe cases.

Sensitivity and specificity

Sensitivity is true positives divided by all diseased, while specificity is true negatives divided by all non-diseased; both are independent of disease prevalence.

Number needed to treat

Number needed to treat is the reciprocal of absolute risk reduction; it estimates how many patients must be treated to prevent one additional adverse outcome.

Herd immunity threshold

The herd immunity threshold equals 1 minus 1 divided by R0; a more transmissible pathogen with higher R0 requires higher vaccination coverage.

Informed consent elements

Valid informed consent requires patient capacity, adequate disclosure of risks and alternatives, patient understanding, and voluntariness; emergencies may justify an exception.

Anaphylaxis first-line drug

Anaphylaxis is treated first with intramuscular epinephrine 0.3 to 0.5 mg of 1:1000 solution into the anterolateral thigh, repeated every 5 to 15 minutes as needed.

High-quality CPR parameters

High-quality CPR uses compressions at 100 to 120 per minute, 5 to 6 cm deep, with full recoil and minimal interruptions; defibrillate shockable rhythms promptly.

Glasgow Coma Scale

The Glasgow Coma Scale sums eye responses 1 to 4, verbal 1 to 5, and motor 1 to 6; a score of 8 or less generally requires airway protection.

Sepsis initial bundle

For sepsis, measure lactate, obtain cultures, give broad-spectrum antibiotics, and provide 30 mL/kg crystalloid for hypotension or lactate of 4 or more.