Egyptian Board Emergency Medicine flashcards

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

Defibrillation in VF

Deliver an unsynchronized shock immediately on recognizing ventricular fibrillation or pulseless ventricular tachycardia, then resume CPR for two minutes before reassessing the rhythm.

STEMI reperfusion window

Primary percutaneous coronary intervention is preferred when achievable within 120 minutes of first medical contact; otherwise give fibrinolysis within 30 minutes of emergency department arrival.

Perimortem cesarean timing

In maternal cardiac arrest, begin the procedure within four minutes and aim to deliver the fetus by five minutes when the uterine fundus is at or above the umbilicus.

Permissive hypotension

In hemorrhagic shock from trauma, target a systolic pressure of 80 to 90 mmHg until hemorrhage control, except in traumatic brain injury where higher pressure is needed.

Compartment syndrome signs

Pain out of proportion to injury and pain on passive stretch are early signs; pulselessness and paralysis are late. Fasciotomy is indicated when pressure is within 30 mmHg of diastolic.

Tension pneumothorax treatment

A clinical diagnosis of hypotension, distended neck veins, and absent breath sounds requires immediate needle decompression, without waiting for chest radiography or other imaging.

ARDS Berlin criteria

Acute onset within one week, bilateral opacities, non-cardiogenic cause, and a PaO2/FiO2 ratio of 300 mmHg or less on PEEP of at least 5 cmH2O.

Lung-protective ventilation

Use tidal volume of 6 mL/kg predicted body weight, keep plateau pressure below 30 cmH2O, and target driving pressure below 15 cmH2O in patients with acute respiratory distress syndrome.

Septic shock first-line vasopressor

Norepinephrine is the first-line vasopressor, titrated to a mean arterial pressure of at least 65 mmHg, after initial crystalloid resuscitation of 30 mL/kg.

Thrombolysis blood pressure limit

Before giving alteplase for acute ischemic stroke, lower blood pressure below 185/110 mmHg, then maintain below 180/105 mmHg for the first 24 hours after treatment.

Status epilepticus first line

Give a benzodiazepine such as lorazepam 0.1 mg/kg intravenously, up to 4 mg, repeated once, followed by a second-line agent such as levetiracetam or fosphenytoin.

Subarachnoid hemorrhage diagnosis

Thunderclap headache warrants noncontrast CT, which is highly sensitive within six hours; if CT is negative and suspicion persists, perform lumbar puncture for xanthochromia after 12 hours.

Acetaminophen antidote timing

N-acetylcysteine is most effective when started within eight hours of ingestion; the Rumack-Matthew nomogram guides treatment from four hours after a single acute overdose.

Salicylate toxicity treatment

Give sodium bicarbonate to alkalinize serum and urine, correct hypoglycemia, and avoid intubation unless necessary because it removes the compensatory respiratory alkalosis.

Organophosphate antidote regimen

Atropine is titrated to drying of secretions and may require large repeated doses; pralidoxime is added, and succinylcholine should be avoided because paralysis is prolonged.

Heat stroke cooling

Core temperature above 40 °C with central nervous system dysfunction requires immediate cold water immersion; antipyretics are ineffective and should not be used.

Variceal bleeding therapy

Octreotide plus prophylactic ceftriaxone reduce mortality and rebleeding; endoscopic band ligation is the preferred procedure once the patient is resuscitated.

Hyperkalemia with ECG changes

Give intravenous calcium first to stabilize the myocardium, then insulin with glucose, a beta-agonist, and sodium bicarbonate; dialysis is reserved for refractory cases.

Testicular torsion timing

Salvage declines significantly after six hours; obtain urgent urologic consultation and detorsion without delaying for ultrasound when clinical suspicion is high.

Pediatric bradycardia with poor perfusion

Start CPR when the heart rate is below 60 per minute despite adequate oxygenation and ventilation, and give epinephrine 0.01 mg/kg intravenously or intraosseously.

Pediatric defibrillation energy

Use 2 J/kg for the first shock and 4 J/kg for the second, then at least 4 J/kg up to 10 J/kg or the adult dose.

Croup treatment

Give dexamethasone 0.15 to 0.6 mg/kg; add nebulized epinephrine for stridor at rest and observe for at least two to four hours afterward for rebound symptoms.

Kawasaki disease treatment

Give intravenous immunoglobulin 2 g/kg plus aspirin; consider corticosteroids or infliximab for resistant cases and obtain echocardiography to assess for coronary aneurysms.

Postpartum hemorrhage first steps

Uterine atony is the most common cause; give oxytocin, perform uterine massage, add tranexamic acid 1 g within three hours, and use balloon tamponade if bleeding persists.

Magnesium toxicity antidote

Loss of deep tendon reflexes, respiratory depression, and cardiac arrest suggest magnesium toxicity; give calcium gluconate 1 g intravenously as the antidote.

FAST examination windows

Four views are obtained: Morison's pouch, the splenorenal recess, the pelvic windows, and the subxiphoid pericardial window; a positive scan in an unstable patient prompts laparotomy.

Optic nerve sheath diameter

A diameter greater than 5 mm on ocular ultrasound suggests raised intracranial pressure and can support the diagnosis when other signs are equivocal.

START triage categories

Walking patients are green; non-ambulatory patients are assessed by respiration, perfusion, and mental status to assign yellow, red, or black categories.

Emergency Severity Index

A five-level triage system assigning level 1 to patients needing immediate life-saving intervention and higher levels according to acuity and expected resource use.

Emergency exception to consent

Treatment without consent is permitted when immediate intervention is needed to prevent serious harm, the patient lacks capacity, and no surrogate decision maker is available.

Capacity assessment elements

The patient must communicate a choice, understand the relevant information, appreciate the consequences, and reason about options; capacity is specific to each decision.

Likelihood ratio formula

Positive likelihood ratio equals sensitivity divided by one minus specificity; negative likelihood ratio equals one minus sensitivity divided by specificity.

Number needed to treat

The reciprocal of the absolute risk reduction, which equals the control event rate minus the treatment event rate; it expresses how many patients need treatment for one benefit.