Ukom Kolegium Dokter flashcards

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

Anaphylaxis first-line drug

Intramuscular epinephrine 1:1000 at 0.01 mg/kg (max 0.5 mg) into the anterolateral thigh. Repeat every 5–15 minutes if symptoms persist. Antihistamines and corticosteroids are adjuncts, never substitutes.

CURB-65 components

Confusion, Urea >7 mmol/L, Respiratory rate ≥30/min, Blood pressure systolic <90 or diastolic ≤60 mmHg, Age ≥65 years. Score 0–1 outpatient, 2 short inpatient, ≥3 consider intensive care.

qSOFA criteria

Respiratory rate ≥22/min, altered mentation (GCS <15), and systolic blood pressure ≤100 mmHg. Two or more criteria identify patients at higher risk of poor outcome from sepsis.

STEMI reperfusion window

Primary percutaneous coronary intervention within 120 minutes of first medical contact. If unavailable within 120 minutes and symptom onset is under 12 hours, fibrinolysis is indicated.

Stroke thrombolysis window

Intravenous alteplase 0.9 mg/kg (max 90 mg) within 4.5 hours of symptom onset after non-contrast head CT excludes hemorrhage. Mechanical thrombectomy may extend to 24 hours in selected large-vessel occlusion.

DKA diagnostic triad

Hyperglycemia >250 mg/dL, ketonemia or ketonuria, and metabolic acidosis with pH <7.3 or bicarbonate <18 mEq/L. Potassium must be ≥3.3 mEq/L before starting insulin infusion.

Hypertensive emergency management

Severe blood pressure elevation with target-organ damage. Reduce mean arterial pressure by no more than 25% in the first hour, then to 160/100 mmHg over 2–6 hours using titratable intravenous agents.

Primary survey sequence

Airway with cervical spine protection, Breathing, Circulation, Disability (GCS, pupils, glucose), and Exposure with environmental control. Life-threatening problems are corrected before proceeding to the next step.

Life-threatening asthma signs

Silent chest, inability to speak in sentences, bradycardia, exhaustion, cyanosis, or peak expiratory flow <33% predicted. Give oxygen, repeated inhaled bronchodilators, ipratropium, and systemic corticosteroids.

Sepsis bundle timing

Measure lactate, obtain blood cultures, and start broad-spectrum antibiotics within 1 hour of recognition. Give 30 mL/kg crystalloid for hypotension or lactate ≥4 mmol/L, then vasopressors if hypotension persists.

WHO dehydration plan C

For severe dehydration: Ringer's lactate 100 mL/kg IV. Infants receive 30 mL/kg in the first hour then 70 mL/kg over 5 hours; older children receive 30 mL/kg in 30 minutes then 70 mL/kg over 2.5 hours.

WHO dehydration plan B

For some dehydration: oral rehydration solution 75 mL/kg over 4 hours, reassessing hydration status periodically. Breastfeeding continues; plan A applies when no dehydration is present.

Neonatal resuscitation compression ratio

Chest compressions begin when heart rate remains <60/min after effective positive pressure ventilation. Use a 3:1 compression-to-ventilation ratio, delivering 90 compressions and 30 breaths per minute.

Neonatal resuscitation initial steps

Provide warmth, dry, stimulate, and position the airway for 30 seconds. If heart rate is <100/min or apnea persists, start positive pressure ventilation with room air; use oxygen only if saturation targets are not met.

Preeclampsia magnesium sulfate dosing

Loading dose 4–6 g IV over 15–20 minutes, then maintenance 1–2 g/hour. Monitor for magnesium toxicity (loss of deep tendon reflexes, respiratory depression, oliguria) and have calcium gluconate available.

Postpartum hemorrhage uterotonics

Oxytocin is first-line. Ergometrine is contraindicated in hypertension; carboprost is contraindicated in asthma; misoprostol is an alternative. Uterine atony is the most common cause of postpartum hemorrhage.

First-line TB regimen

New cases receive 2 months of isoniazid, rifampicin, pyrazinamide, and ethambutol (HRZE), followed by 4 months of isoniazid and rifampicin (HR). Fixed-dose combinations improve adherence.

Dengue warning signs

Abdominal pain, persistent vomiting, fluid accumulation, mucosal bleeding, lethargy, liver enlargement >2 cm, and rising hematocrit with falling platelets. Give isotonic crystalloid 5–10 mL/kg/h and titrate.

Antimicrobial stewardship review

Obtain cultures before antibiotics when feasible. Reassess at 48–72 hours using culture results and clinical response. De-escalate to the narrowest effective agent and shortest effective duration.

Surgical safety checklist phases

Sign in before induction of anesthesia; time out before skin incision confirming patient, site, procedure, allergies, and imaging; sign out before leaving the operating room confirming instrument and sponge counts and specimen labeling.

Informed consent elements

Capacity, disclosure of diagnosis, material risks, benefits, and alternatives including no treatment, and voluntariness. Emergency exception applies when immediate treatment prevents serious harm and the patient cannot consent.

Acute heart failure initial therapy

Sit the patient upright, give oxygen if hypoxemic, and administer intravenous loop diuretic (furosemide) for congestion. Use nitrates for hypertensive pulmonary edema and noninvasive ventilation for respiratory distress.

Hypoglycemia treatment

If conscious, give 15–20 g oral glucose and recheck in 15 minutes. If unconscious or unable to swallow, give 25 g intravenous dextrose (or 1 mg glucagon IM) and recheck glucose after 10–15 minutes.

Acute upper GI bleeding

Resuscitate with crystalloid and blood products as needed. Start intravenous proton pump inhibitor and perform endoscopy within 24 hours. Consider variceal bleeding and add vasoactive drug plus prophylactic antibiotics.

Pediatric febrile seizure

Occurs in children aged 6 months to 5 years with fever and no central nervous system infection. Simple febrile seizures last under 15 minutes and do not recur within 24 hours; management is supportive.

Childhood asthma exacerbation

Give oxygen to target saturation 94–98%, repeated inhaled salbutamol, and systemic corticosteroids. Add ipratropium for severe exacerbations. Assess response by work of breathing and oxygen saturation.

Acute otitis media antibiotics

Amoxicillin is first-line at 80–90 mg/kg/day for 10 days in children under 2 years or with severe symptoms. Observation for 48–72 hours is an option for older children with mild symptoms.

Hypertension in pregnancy treatment

For severe hypertension (≥160/110 mmHg), use labetalol, hydralazine, or nifedipine. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are contraindicated in pregnancy.

Tetanus prophylaxis wound

Give tetanus toxoid if the patient has an incomplete primary series or a dirty wound with last dose over 5 years ago. Add tetanus immunoglobulin for dirty wounds with incomplete vaccination.

Rabies post-exposure prophylaxis

Wash the wound with soap and water for 15 minutes, then give rabies vaccine on days 0, 3, 7, and 28. Add rabies immunoglobulin for category III exposures (transdermal bites, scratches, or mucosal contamination).

Acute kidney injury staging

KDIGO stage 1: creatinine rise ≥0.3 mg/dL in 48 hours or 1.5–1.9 times baseline. Stage 2: 2.0–2.9 times baseline. Stage 3: ≥3.0 times baseline, creatinine ≥4.0 mg/dL, or renal replacement therapy.

Hyperkalemia emergency treatment

Give intravenous calcium gluconate for cardiac membrane stabilization, insulin with glucose and inhaled salbutamol to shift potassium intracellularly, and sodium polystyrene sulfonate or dialysis to remove potassium.