MDCG Medical Exam flashcards

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

Informed consent elements

Capacity, disclosure of diagnosis, material risks, benefits, alternatives, and consequences of refusal; comprehension and voluntary decision; documentation of the discussion.

Negligence four elements

Duty owed to the patient, breach of the standard of care, causation (actual and proximate), and damages; all four must be established.

Confidentiality exceptions

Patient authorization, statutory reporting duties, imminent serious harm, and court orders; minimum necessary disclosure applies to permitted uses.

Emergency consent exception

Treatment may proceed without consent when the patient lacks capacity, delay risks serious harm, and no valid refusal or directive is known.

Primary survey ABCDE

Airway, Breathing, Circulation, Disability, Exposure; identify and treat immediate life threats before proceeding to the secondary survey.

SBAR handoff

Situation, Background, Assessment, Recommendation; a structured communication tool that reduces omission of critical information during transitions.

qSOFA criteria

Altered mentation, systolic blood pressure ≤100 mmHg, and respiratory rate ≥22/min; ≥2 criteria flag higher risk in suspected infection.

Medication reconciliation

Systematic comparison of the patient's current medications with new orders at transitions; includes OTC drugs, supplements, and adherence history.

Sensitivity formula

True positives divided by true positives plus false negatives; the probability of a positive test among people with disease.

Specificity formula

True negatives divided by true negatives plus false positives; the probability of a negative test among people without disease.

Positive predictive value

True positives divided by all positives; the probability that a positive test is correct, which rises with disease prevalence.

Likelihood ratio positive

Sensitivity divided by (1 − specificity); values above 10 substantially increase post-test probability of disease.

Number needed to treat

The reciprocal of the absolute risk reduction; the number of patients treated to prevent one additional adverse outcome.

Half-life and steady state

Half-life equals 0.693 times volume of distribution divided by clearance; steady state is reached in about four to five half-lives.

Loading dose formula

Target concentration times volume of distribution divided by bioavailability; used to reach therapeutic levels quickly.

CYP450 inhibitors

Drugs such as azole antifungals, macrolides, and grapefruit inhibit metabolism and raise substrate concentrations, increasing toxicity risk.

CYP450 inducers

Drugs such as rifampin, carbamazepine, and St. John's wort increase enzyme activity and lower substrate concentrations, reducing efficacy.

Narrow therapeutic index drugs

Agents such as warfarin, digoxin, lithium, phenytoin, and aminoglycosides require therapeutic drug monitoring because small changes cause toxicity or failure.

Incidence versus prevalence

Incidence counts new cases in the population at risk over time; prevalence counts all existing cases in the total population at a point or period.

Relative risk

Incidence in the exposed divided by incidence in the unexposed; a ratio measure of association from cohort studies.

Odds ratio

Odds of exposure among cases divided by odds of exposure among controls; approximates relative risk when the disease is rare.

Herd immunity threshold

Approximately 1 minus 1 divided by the basic reproduction number R0; the coverage needed to interrupt transmission in a population.

Levels of prevention

Primordial avoids risk factors, primary prevents disease onset, secondary detects and treats early, and tertiary reduces complications and disability.

SOAP note

Subjective, Objective, Assessment, Plan; each documented problem should have an assessment linked to a specific plan.

E/M MDM elements

Number and complexity of problems, amount and complexity of data reviewed, and risk of complications, morbidity, or mortality determine the service level.

ICD-10-CM specificity

Code to the highest documented specificity, including laterality, episode of care, and combination codes; unspecified codes should be avoided when details exist.

Medical necessity

The documented diagnosis and clinical rationale must support the service provided; payers may deny claims when documentation does not establish necessity.

High-quality CPR

Compressions at 100–120 per minute, depth 5–6 cm, full chest recoil, minimal interruptions, and avoidance of excessive ventilation.

Anaphylaxis first-line treatment

Intramuscular epinephrine 0.3–0.5 mg of 1:1000 concentration in the mid-outer thigh for adults, repeated every 5–15 minutes as needed.

Sepsis bundle

Measure lactate, obtain blood cultures before antibiotics, give broad-spectrum antibiotics and 30 mL/kg crystalloid for hypotension or lactate ≥4 mmol/L.

PDSA cycle

Plan, Do, Study, Act; a small-scale iterative test of change used within the Model for Improvement to learn and refine interventions.

RCA versus FMEA

Root cause analysis is retrospective after a sentinel event; failure mode and effects analysis is prospective and prioritizes risks by severity, occurrence, and detection.