Egyptian Board Family Medicine flashcards

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

First-contact care

The attribute of primary care in which the practice serves as the population's entry point into the health system for each new health problem, coordinating onward referral rather than requiring patients to self-refer to specialists.

Longitudinality

A person-focused relationship with a clinician or team sustained over time, distinct from disease-focused continuity, and associated with better preventive care and chronic disease outcomes.

HbA1c diagnostic threshold

An HbA1c of 6.5 percent or 48 mmol/mol or higher meets the diagnostic criterion for diabetes; an asymptomatic result must be confirmed by a repeat test on another day.

Four pillars of heart failure therapy

For heart failure with reduced ejection fraction, the four prognostic drug classes are a renin-angiotensin system inhibitor or ARNI, a beta-blocker, a mineralocorticoid receptor antagonist and an SGLT2 inhibitor.

Developmental red flag at 18 months

No single words by 18 months, or no walking by 18 months, warrants developmental assessment and referral; loss of previously acquired skills at any age is also a red flag.

Bronchiolitis first-line management

Management is supportive, with oxygen for saturations below 90 to 92 percent, adequate hydration and nasal suction; bronchodilators, corticosteroids and antibiotics are not routinely indicated.

Preeclampsia definition

New hypertension arising after 20 weeks of gestation accompanied by proteinuria or maternal organ dysfunction; delivery is the definitive treatment and low-dose aspirin reduces risk in high-risk women.

Postpartum hemorrhage four T's

The causes of postpartum hemorrhage are remembered as tone (uterine atony, commonest), trauma, tissue (retained placenta) and thrombin (coagulopathy); blood loss is 500 mL or more after vaginal birth.

Appendicitis classic features

Periumbilical pain migrating to the right iliac fossa, anorexia, nausea and low-grade fever with raised inflammatory markers; ultrasound or CT is used when the diagnosis is equivocal.

Glasgow Coma Scale total

Eye responses score 1 to 4, verbal 1 to 5 and motor 1 to 6, giving a total of 3 to 15; a score of 8 or less indicates the need for airway protection.

Anaphylaxis adrenaline dose

Adults receive 0.5 mg intramuscular adrenaline, which is 0.5 mL of 1:1000 solution, into the anterolateral thigh; children receive 0.01 mg per kg, repeated after five minutes if needed.

Delirium versus dementia

Delirium has acute onset, a fluctuating course and inattention, and is a medical emergency requiring a search for the cause; dementia is chronic, progressive cognitive decline affecting daily function.

Alcohol withdrawal timeline

Withdrawal symptoms begin 6 to 24 hours after the last drink, seizures occur at 6 to 48 hours and delirium tremens at 48 to 96 hours; benzodiazepines and thiamine are the mainstays.

Herd immunity threshold

The proportion immune needed to interrupt transmission equals 1 minus 1 divided by R0; for measles with an R0 of 12 to 18, this exceeds 90 to 95 percent coverage.

Sensitivity and specificity

Sensitivity is true positives divided by all people with disease; specificity is true negatives divided by all people without disease; both are intrinsic test properties unaffected by prevalence.

Number needed to treat

The reciprocal of the absolute risk reduction; it estimates how many patients must be treated for one additional patient to benefit, and reflects baseline risk unlike relative risk reduction.

Length-time bias

Screening preferentially detects slow-growing disease with a long preclinical phase, making screened patients appear to survive longer even when screening does not change the time of death.

Wilson-Jungner criteria

Criteria for justifying screening: an important health problem, accepted treatment, facilities for diagnosis and treatment, a recognizable latent stage, a suitable test and agreed policy on whom to treat.

Comprehensive geriatric assessment

A multidimensional evaluation of medical, functional, cognitive, psychological and social status leading to a coordinated plan; it reduces functional decline and hospitalisation in frail older adults.

Fried frailty phenotype

Frailty is identified by three or more of unintentional weight loss, exhaustion, low physical activity, slow gait speed and weakness; it predicts falls, disability and mortality better than age alone.

ABCDE of melanoma

Asymmetry, Border irregularity, Colour variation, Diameter greater than 6 mm and Evolving change; Breslow thickness is the most important prognostic factor once melanoma is diagnosed.

Cellulitis management

Mark the border of erythema, treat with an antibiotic covering streptococci and staphylococci, elevate the limb, and review within 48 hours; abscess formation requires incision and drainage.

Four principles of bioethics

Autonomy respects informed choice, beneficence promotes welfare, non-maleficence avoids harm and justice concerns fair distribution; they are balanced against each other rather than ranked absolutely.

Four-stage capacity test

A person has capacity for a decision if they can understand the information, retain it, weigh it in the balance and communicate their decision; capacity is decision-specific and may fluctuate.

Third-next-available appointment

A practice access measure recording the number of days until the third available routine appointment; it smooths out short-term variation and reflects true routine waiting time.

Audit cycle steps

Choose a standard, collect data, compare practice with the standard, implement change and re-audit; audit improves care against existing standards rather than generating new knowledge like research.

GRADE certainty ratings

GRADE rates certainty of evidence as high, moderate, low or very low, and strength of recommendation as strong or weak; strong recommendations apply to most patients, weak ones require shared decisions.

Likelihood ratio interpretation

The positive likelihood ratio is sensitivity divided by 1 minus specificity; values above 10 substantially raise post-test probability, values below 0.1 substantially lower it, and 1 leaves probability unchanged.

Parkland formula

For burns, give 4 mL per kg body weight per percent total body surface area of crystalloid in 24 hours, with half given in the first 8 hours measured from the time of injury.

Sepsis bundle essentials

Take blood cultures before antibiotics, give broad-spectrum antibiotics within one hour of recognition, and give 30 mL per kg crystalloid for hypotension or lactate of 4 mmol/L or more.

Neonatal jaundice warning

Visible jaundice within the first 24 hours of life is always pathological; plot bilirubin against age in hours, exclude haemolysis and infection, and treat with phototherapy per threshold charts.

Kawasaki disease treatment

Fever for five days or more with four of five mucocutaneous features is treated with intravenous immunoglobulin and aspirin to prevent coronary artery aneurysms; echocardiography is required.

PALM-COEIN classification

Abnormal uterine bleeding is classified as polyp, adenomyosis, leiomyoma, malignancy, coagulopathy, ovulatory dysfunction, endometrial, iatrogenic and not otherwise classified causes.

Anti-D prophylaxis timing

Rh-negative unsensitised women receive anti-D immunoglobulin at around 28 weeks and within 72 hours of delivery of an Rh-positive infant, and after sensitising events such as miscarriage.

Serotonin syndrome triad

Altered mental state, autonomic instability and neuromuscular hyperactivity such as clonus and hyperreflexia after serotonergic drugs; management is stopping the drug and supportive care.

Neuroleptic malignant syndrome

Fever, rigidity, autonomic instability and raised creatine kinase after dopamine antagonists; treatment is stopping the drug, cooling, fluids and dantrolene or bromocriptine.

Inverse care law

The availability of good medical care tends to vary inversely with the need of the population served; equity audits compare uptake between deprived and affluent groups to detect it.

Notifiable disease purpose

Reporting specified infectious diseases to public health authorities enables contact tracing, outbreak investigation and control measures; examples include measles, tuberculosis and meningococcal disease.

Lead-time bias

Earlier detection through screening appears to prolong survival even when the time of death is unchanged, because survival is measured from diagnosis rather than from a fixed biological onset.

Intention-to-treat analysis

Analysis of all participants according to their randomised group regardless of adherence; it preserves randomisation and avoids attrition bias, estimating effectiveness rather than ideal efficacy.

Folic acid preconception dose

Women planning pregnancy take 400 micrograms daily; those with previous neural tube defect, diabetes, obesity or valproate use take 5 mg daily, started before conception and continued through the first trimester.

Newborn blood spot screening

Heel-prick testing in the first week detects congenital hypothyroidism, phenylketonuria, cystic fibrosis and haemoglobinopathies; hearing and pulse oximetry screening are done alongside.

STOPP and START tools

Explicit criteria that identify potentially inappropriate medicines in older adults (STOPP) and omissions of indicated treatment (START), used alongside clinical judgement in medication review.

SPIKES framework

A six-step approach to breaking bad news: setting, perception, invitation, knowledge, empathy, and strategy with summary; it emphasises responding to emotion before giving more information.

Stevens-Johnson syndrome red flags

Mucosal involvement, blistering, fever, eosinophilia and organ dysfunction after a new drug suggest severe cutaneous adverse reaction; stop the drug immediately and refer urgently.

Scabies treatment principle

Treat the patient and all close contacts simultaneously with topical permethrin or oral ivermectin, and wash bedding and clothing hot; itching may persist for weeks after successful treatment.

Gillick competence

A child who has sufficient understanding and intelligence to comprehend a proposed treatment may consent to it; refusal of life-saving treatment by a minor can still be overridden by a court.

Negligence four elements

A successful claim requires a duty of care, a breach of the standard of a reasonable practitioner, causation and actual damage; the standard is judged against peers and current evidence.

Significant event analysis

A structured, blame-free team review of an incident that examines what happened, why, and what system changes will reduce recurrence, feeding into practice improvement.

Generic prescribing indicator

The proportion of prescriptions written by generic name; a higher rate usually lowers cost and reduces confusion, but must be balanced against intentional brand prescribing for narrow therapeutic index drugs.

PICO question format

A focused clinical question specifies the population, intervention, comparator and outcome; this structure makes literature searching and critical appraisal more efficient and reproducible.

AGREE II domains

A tool for appraising guidelines covering scope and purpose, stakeholder involvement, rigour of development, clarity, applicability and editorial independence; low scores signal cautious use.

Inverse care law

The principle that good medical care tends to be least available where need is greatest; primary care teams counter it with outreach, registers and equity audits of uptake.

Safety netting

Advice given at the end of a consultation specifying what symptoms should prompt return, when to seek urgent care, and how to access it, documented in the record.

CHA2DS2-VASc score

A stroke risk score in atrial fibrillation awarding points for heart failure, hypertension, age, diabetes, stroke and vascular disease; higher scores support anticoagulation.

H pylori eradication confirmation

After treatment, confirm eradication with a urea breath test or stool antigen test performed at least four weeks after antibiotics and two weeks after stopping a proton pump inhibitor.

Testicular torsion urgency

Sudden severe scrotal pain with a high-riding testis and absent cremasteric reflex requires immediate surgical exploration; imaging must not delay surgery when suspicion is high.

Acute pancreatitis criteria

Diagnosis requires two of characteristic epigastric pain, lipase or amylase more than three times the upper limit of normal, and imaging findings; early fluids and analgesia are the mainstay.

PRECEDE-PROCEED model

A planning framework that assesses social, epidemiological, behavioural and environmental needs before designing, implementing and evaluating a health promotion programme.

Maternal mortality ratio

Maternal deaths divided by 100,000 live births in a defined period; it is a key indicator of health system performance and is used to monitor progress in safe motherhood.

PAINAD tool

An observational pain scale for people with advanced dementia, scoring breathing, negative vocalisation, facial expression, body language and consolability; scores of 4 or more suggest pain.

Spinal cord compression

Progressive back pain with limb weakness, sensory level or bladder dysfunction in a patient with cancer is an emergency; give dexamethasone immediately and arrange urgent imaging.