MRCPI GM Part I flashcards

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

CHA2DS2-VASc score components

Scores congestive heart failure, hypertension, age ≥75 (2 points), diabetes, stroke/TIA (2), vascular disease, age 65–74, and female sex; anticoagulate men ≥2 and women ≥3.

Severe aortic stenosis criteria

Peak jet velocity ≥4 m/s, mean gradient ≥40 mmHg, or aortic valve area <1.0 cm²; symptomatic severe disease warrants aortic valve replacement.

Acute pericarditis diagnostic criteria

Diagnosis requires at least two of: pericarditic chest pain, friction rub, widespread ST elevation or PR depression, and new or worsening pericardial effusion.

CURB-65 score components

Confusion, urea >7 mmol/L, respiratory rate ≥30/min, systolic BP <90 or diastolic ≤60 mmHg, and age ≥65; score ≥2 suggests hospital admission.

Light criteria for exudate

Pleural fluid is exudative if protein ratio >0.5, LDH ratio >0.6, or pleural LDH > two-thirds the serum upper limit of normal.

COPD spirometry criterion

Post-bronchodilator FEV1/FVC <0.70 confirms persistent airflow obstruction; severity is graded by FEV1 percent predicted.

Serum-ascites albumin gradient

SAAG ≥11 g/L indicates portal hypertension, while <11 g/L suggests non-portal causes such as peritoneal carcinomatosis, tuberculosis, or pancreatitis.

Spontaneous bacterial peritonitis threshold

Ascitic fluid polymorphonuclear cell count ≥250/mm³ establishes spontaneous bacterial peritonitis; start a third-generation cephalosporin and add albumin in renal impairment.

Primary biliary cholangitis features

Cholestatic liver enzymes with positive antimitochondrial antibodies; first-line treatment is ursodeoxycholic acid, with obeticholic acid or fibrates as add-on.

Diabetic ketoacidosis criteria

Glucose >11 mmol/L, ketonaemia or ketonuria, pH <7.3 or bicarbonate <15 mmol/L; treat with fluids, insulin infusion, and potassium replacement.

Corrected calcium formula

Corrected calcium (mmol/L) = measured calcium + 0.02 × (40 − albumin g/L); use when albumin is abnormal to interpret total calcium.

Primary thyroid dysfunction patterns

Low TSH with high free T4 indicates primary hyperthyroidism; high TSH with low free T4 indicates primary hypothyroidism; subclinical disease has abnormal TSH with normal free T4.

KDIGO acute kidney injury criteria

Creatinine rise ≥26.5 µmol/L within 48 hours, ≥1.5 times baseline within 7 days, or urine output <0.5 mL/kg/h for 6 hours.

Serum anion gap formula

Anion gap = sodium − (chloride + bicarbonate), normally 8–12 mmol/L; raised gap suggests ketoacidosis, lactic acidosis, renal failure, or toxins.

Nephrotic syndrome diagnostic triad

Proteinuria >3.5 g/day, hypoalbuminaemia <30 g/L, and oedema; hyperlipidaemia is common, and complications include thrombosis and infection.

Bacterial meningitis CSF findings

Neutrophil-predominant pleocytosis, low glucose (CSF/serum ratio <0.4), and high protein; give immediate empiric antibiotics and dexamethasone before or with antibiotics.

Guillain-Barré syndrome features

Ascending symmetrical weakness with areflexia and albuminocytologic dissociation in CSF; treat with intravenous immunoglobulin or plasma exchange, monitoring vital capacity.

Stroke thrombolysis time window

Intravenous alteplase or tenecteplase is indicated within 4.5 hours of ischaemic stroke onset after excluding haemorrhage; selected patients may undergo thrombectomy up to 24 hours.

Gout crystal appearance

Needle-shaped monosodium urate crystals showing negative birefringence under polarised light; acute attacks are treated with NSAIDs, colchicine, or intra-articular glucocorticoid.

Giant cell arteritis red flags

Age >50 years with new headache, jaw claudication, visual symptoms, and raised ESR/CRP; start high-dose glucocorticoid immediately and confirm with temporal artery biopsy or ultrasound.

Iron deficiency ferritin pattern

Low serum ferritin with microcytic hypochromic anaemia; ferritin is an acute-phase reactant, so a normal value does not exclude deficiency in inflammation.

Thrombotic thrombocytopenic purpura features

Microangiopathic haemolytic anaemia, thrombocytopenia, neurological symptoms, renal impairment, and fever; caused by ADAMTS13 deficiency and treated urgently with plasma exchange.

Chronic myeloid leukaemia hallmark

Philadelphia chromosome from t(9;22) producing BCR-ABL1 tyrosine kinase; targeted therapy with imatinib or another tyrosine kinase inhibitor achieves high remission rates.

Sepsis initial management bundle

Measure lactate, obtain blood cultures before antibiotics, give broad-spectrum antibiotics within one hour for septic shock, and start 30 mL/kg crystalloid for hypotension or lactate ≥4.

Drug-sensitive tuberculosis treatment

Initial intensive phase uses rifampicin, isoniazid, pyrazinamide, and ethambutol for two months, followed by rifampicin and isoniazid continuation for four months.

CYP enzyme inducers

Rifampicin, carbamazepine, phenytoin, and St John's wort induce cytochrome P450 enzymes, reducing concentrations of many co-administered drugs such as warfarin and oral contraceptives.

Paracetamol overdose antidote

N-acetylcysteine replenishes glutathione and is most effective within eight hours; use the Rumack-Matthew nomogram to guide treatment after acute single overdose.

Delirium clinical features

Acute onset of fluctuating attention and cognition, often with altered sleep-wake cycle; identify and treat precipitants such as infection, drugs, pain, constipation, and retention.

Beers criteria purpose

Lists potentially inappropriate medications in older adults, including long-acting benzodiazepines, anticholinergics, and NSAIDs, to reduce adverse drug events and falls.

Sensitivity and specificity

Sensitivity is the proportion of diseased people correctly identified; specificity is the proportion of non-diseased correctly identified; both are independent of disease prevalence.

Number needed to treat

NNT = 1/absolute risk reduction; it estimates how many patients must receive an intervention for one additional beneficial outcome.

Hardy-Weinberg equilibrium equation

p² + 2pq + q² = 1, where p and q are allele frequencies; genotype frequencies remain constant in large random-mating populations without selection, mutation, or migration.