Panhellenic Health Sciences cheat sheet

Body planes: sagittal divides left/right, coronal (frontal) divides anterior/posterior, transverse divides superior/inferior.

Cardiac output = heart rate × stroke volume; normal resting CO ≈ 4–8 L/min in adults.

Mean arterial pressure ≈ diastolic pressure + 1/3 (systolic − diastolic); MAP ≥ 60 mmHg is generally needed for organ perfusion.

Normal adult blood pH 7.35–7.65; the lungs regulate CO2 (respiratory buffer) and the kidneys regulate HCO3− (metabolic buffer).

Four primary tissue types: epithelial, connective, muscle, nervous; epithelium is avascular and relies on diffusion from underlying connective tissue.

Gas exchange occurs in alveoli, whose walls plus capillary endothelium form the respiratory membrane; surfactant reduces surface tension and prevents alveolar collapse.

Nephron order: glomerulus → proximal convoluted tubule → loop of Henle → distal convoluted tubule → collecting duct; most reabsorption occurs in the proximal tubule.

Conduction pathway of the heart: SA node → AV node → bundle of His → bundle branches → Purkinje fibers; the SA node is the normal pacemaker at 60–100 impulses/min.

Clotting cascade ends in fibrin formation from fibrinogen via thrombin; vitamin K is required for synthesis of factors II, VII, IX, and X.

Chain of infection: infectious agent → reservoir → portal of exit → mode of transmission → portal of entry → susceptible host; breaking any link interrupts transmission.

Standard precautions apply to all patients regardless of diagnosis: hand hygiene, gloves, gown, mask/eye protection based on exposure risk.

Airborne precautions (e.g., tuberculosis, measles, varicella) require a fit-tested N95 or higher respirator and a negative-pressure room.

Droplet precautions (e.g., influenza, pertussis, meningococcal disease) require a surgical mask and eye protection within about 1 m (3 ft) of the patient.

Contact precautions (e.g., MRSA, C. difficile, VRE) require gloves and gown; C. difficile spores are not killed by alcohol, so soap-and-water handwashing is required.

Hand hygiene moments: before patient contact, before aseptic task, after body-fluid exposure risk, after patient contact, after contact with patient surroundings.

Bacterial growth phases: lag → log (exponential) → stationary → death; most antibiotics are most effective against actively dividing (log-phase) organisms.

Sterilization destroys all microorganisms including spores (e.g., autoclave 121 °C at 15 psi for 15–30 min); disinfection reduces pathogens on inanimate surfaces but may not kill spores.

Gram stain: Gram-positive cells retain crystal violet (thick peptidoglycan) and appear purple; Gram-negative cells decolorize and counterstain pink with safranin.

The six rights: right patient, right drug, right dose, right route, right time, right documentation.

Bioavailability = fraction of an administered dose reaching systemic circulation unchanged; IV route is defined as 100%.

First-pass metabolism occurs in the liver and gut wall after oral administration, reducing oral bioavailability of drugs such as morphine and nitroglycerin.

Half-life (t½) is time for plasma concentration to halve; steady state is generally reached after about 4–5 half-lives with constant dosing.

Loading dose = (target concentration × volume of distribution) / bioavailability; maintenance dosing depends on clearance.

Narrow therapeutic index drugs (e.g., warfarin, digoxin, lithium, phenytoin, aminoglycosides) require therapeutic drug monitoring.

High-alert medications (e.g., insulin, heparin, opioids, concentrated electrolytes) require independent double-checks and standardized concentrations.

Antidotes: naloxone for opioids, flumazenil for benzodiazepines, acetylcysteine for acetaminophen, vitamin K (phytonadione) for warfarin, protamine for heparin, N-acetylcysteine and sodium bicarbonate for tricyclic overdose.

Look-alike/sound-alike pairs (e.g., hydrOXYzine vs hydrALAZINE) require tall-man lettering and read-back verification of verbal orders.

Primary survey order: airway, breathing, circulation, disability (neuro), exposure (ABCDE).

Normal adult vital ranges: respiratory rate 12–20/min, heart rate 60–100/min, blood pressure <120/<80 mmHg (normal), temperature 36.1–37.2 °C, SpO2 ≥ 95% on room air.

OPQRST for pain: onset, provocation/palliation, quality, region/radiation, severity, time.

SAMPLE history: signs/symptoms, allergies, medications, past medical history, last meal, events preceding the complaint.

Glasgow Coma Scale: eye 1–4, verbal 1–5, motor 1–6; total 3–15; score ≤ 8 indicates severe impairment and airway risk.

Pulse assessment: rate, rhythm, amplitude (0 absent to 4 bounding), and symmetry; compare radial and femoral to screen for coarctation or vascular compromise.

Auscultation landmarks: aortic valve right 2nd intercostal space, pulmonic left 2nd, tricuspid left 4th–5th parasternal, mitral (apex) left 5th midclavicular line.

Orthostatic hypotension: drop of ≥20 mmHg systolic or ≥10 mmHg diastolic within 3 minutes of standing; suggests volume depletion or autonomic dysfunction.

Edema grading: 1+ = 2 mm, 2+ = 4 mm, 3+ = 6 mm, 4+ = 8 mm pitting depth with slow rebound.

Informed consent requires capacity, disclosure of material risks/benefits/alternatives, comprehension, and voluntariness.

Four core ethical principles: autonomy, beneficence, nonmaleficence, justice; veracity and confidentiality are commonly added.

Confidentiality exceptions include patient authorization, legal reporting duties (e.g., certain communicable diseases, suspected abuse), and imminent serious harm to self or others.

Scope of practice is defined by law and licensure; delegation is permitted only for tasks within the delegatee's training and the delegator's authority.

Negligence elements: duty, breach of duty, causation, and damages; all four must be shown.

HIPAA Privacy Rule permits disclosure of the minimum necessary information for treatment, payment, and operations; psychotherapy notes have stricter rules.

Advance directives include living wills and durable power of attorney for health care; a DNR order is a separate physician order.

Mandatory reporting commonly covers suspected child or elder abuse, certain gunshot wounds, and specified communicable diseases; exact lists are jurisdiction-specific.

Documentation principles: objective, timely, legible, signed, and accurate; late entries must be labeled as late with date/time of the original event.

Levels of prevention: primary (prevent onset, e.g., vaccination), secondary (early detection, e.g., screening), tertiary (limit disability, e.g., rehabilitation).

Incidence = new cases / population at risk per time period; prevalence = all existing cases / total population at a point or period.

Crude mortality rate = (deaths in a period / population) × 100,000; infant mortality rate = infant deaths under 1 year per 1,000 live births.

Herd immunity threshold ≈ 1 − 1/R0; for measles (R0 ≈ 12–18) this requires roughly 92–95% coverage.

Sensitivity = true positives / (true positives + false negatives); specificity = true negatives / (true negatives + false positives).

Screening test performance is influenced by prevalence: positive predictive value falls as prevalence falls, even with fixed sensitivity and specificity.

Leading modifiable risk factors for noncommunicable disease include tobacco use, harmful alcohol use, unhealthy diet, and physical inactivity.

Study designs: cohort measures incidence and supports relative risk; case-control is efficient for rare outcomes and yields odds ratios.

Ottawa Charter health promotion actions: build healthy public policy, create supportive environments, strengthen community action, develop personal skills, reorient health services.

Prefixes: tachy- fast, brady- slow, hyper- above, hypo- below, dys- difficult, a-/an- without.

Suffixes: -itis inflammation, -ectomy removal, -otomy incision, -ostomy opening, -emia blood condition, -uria urine condition, -algia pain.

Root examples: cardi- heart, nephr- kidney, hepat- liver, pulmon- lung, gastr- stomach, oste- bone, derm- skin, neur- nerve.

Directional terms: proximal nearer the trunk, distal farther, medial toward midline, lateral away, supine face up, prone face down.

SOAP note structure: Subjective (patient report), Objective (findings), Assessment (interpretation), Plan (next steps).

Abbreviations to avoid per safety guidance: U (unit), IU (international unit), qd/QD (daily), qhs (nightly), MS/MSO4, trailing zeros (write 5 mg, not 5.0 mg).

Blood pressure documentation: systolic/diastolic in mmHg with site and position if relevant (e.g., 128/82 mmHg, right arm, seated).

Diagnosis coding uses ICD; procedure coding uses CPT (outpatient) or ICD-10-PCS (inpatient); documentation must support the code assigned.

Telephone or verbal order documentation must include read-back, the ordering clinician's name, date/time, and the receiving clinician's signature.

Adult basic life support: check responsiveness and breathing, call for help, start compressions at 100–120/min, depth 5–6 cm, full recoil, ratio 30:2 without an advanced airway.

Defibrillation for shockable rhythms (ventricular fibrillation, pulseless ventricular tachycardia) should occur as early as possible; each minute of delay lowers survival.

Shockable rhythms are VF and pulseless VT; non-shockable are asystole and pulseless electrical activity (PEA).

Adult cardiac arrest drug dosing: epinephrine 1 mg IV/IO every 3–5 minutes; amiodarone 300 mg then 150 mg for refractory VF/VT.

Reversible causes of arrest (Hs and Ts): hypovolemia, hypoxia, hydrogen ion (acidosis), hypo/hyperkalemia, hypothermia, tension pneumothorax, tamponade, toxins, thrombosis (coronary and pulmonary).

Anaphylaxis: intramuscular epinephrine 0.3–0.5 mg of 1:1,000 solution into the anterolateral thigh, repeated every 5–15 minutes as needed.

Tension pneumothorax signs: unilateral absent breath sounds, tracheal deviation away from the affected side, hypotension, distended neck veins; treatment is immediate needle decompression.

Sepsis screening: suspected infection plus organ dysfunction (e.g., qSOFA: respiratory rate ≥22, altered mentation, systolic BP ≤100 mmHg).

Hypoglycemia protocol: check glucose for altered mental status; treat with oral glucose if able to swallow, otherwise IV dextrose or IM/SC glucagon.

Electronic health record (EHR) functions include clinical documentation, order entry, results review, and decision support; the longitudinal record follows the patient across encounters.

Meaningful use and interoperability standards rely on HL7 for messaging and FHIR for modern application programming interfaces.

HIPAA Security Rule requires administrative, physical, and technical safeguards for electronic protected health information (ePHI).

Access control principle of least privilege: users receive the minimum access needed for their role; audit logs track who viewed which record.

Data quality dimensions: accuracy, completeness, timeliness, consistency, and validity; incomplete records undermine both care and research.

Appraisal of online health information: check authorship and credentials, date of publication, evidence cited, sponsorship, and whether claims are corroborated by independent sources.

Health literacy strategies: plain-language materials at about a 6th–8th grade reading level, teach-back, and avoidance of unexplained jargon.

Digital health tools include telehealth, remote patient monitoring, and wearables; data privacy and consent apply to consumer-generated data as well as clinical records.

Interoperability barriers include non-standard terminologies (SNOMED CT, LOINC, ICD serve different purposes) and inconsistent patient matching.