Israel Medical Licensing Exam flashcards

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

CURB-65

Pneumonia severity score: confusion, urea >7 mmol/L, respiratory rate ≥30/min, low blood pressure, and age ≥65. Scores of 0-1 support outpatient care; ≥3 suggest intensive care assessment.

Osmotic demyelination syndrome

Neurological injury from overly rapid correction of chronic hyponatremia, typically more than 8-10 mmol/L in 24 hours. Presents with dysarthria, dysphagia, quadriparesis, or locked-in syndrome.

Holliday-Segar method

Pediatric maintenance fluid calculation: 100 mL/kg/day for the first 10 kg, 50 mL/kg/day for the next 10 kg, and 20 mL/kg/day for each kilogram above 20 kg.

Kawasaki disease

Vasculitis of young children with fever ≥5 days plus conjunctivitis, oral changes, rash, extremity changes, or cervical lymphadenopathy. Treated with intravenous immunoglobulin and aspirin to prevent coronary aneurysms.

Alvarado score

Clinical score for acute appendicitis using migratory pain, anorexia, nausea/vomiting, right lower quadrant tenderness, rebound tenderness, fever, leukocytosis, and left shift. A score ≤4 makes appendicitis unlikely.

Sentinel lymph node biopsy

Minimally invasive staging procedure that identifies the first draining lymph node using blue dye or radiotracer. Standard for clinically node-negative breast cancer and melanoma to avoid unnecessary axillary dissection.

Preeclampsia severe features

Blood pressure ≥160/110 mmHg, platelets <100,000/µL, transaminases >2× normal, creatinine >1.1 mg/dL, pulmonary edema, or cerebral/visual symptoms occurring after 20 weeks of gestation.

Discriminatory hCG zone

Serum human chorionic gonadotropin level above which a normal intrauterine pregnancy should be visible on transvaginal ultrasound, commonly 3,500 mIU/mL. Absence of intrauterine sac suggests ectopic pregnancy.

Serotonin syndrome

Toxicity from serotonergic drugs causing altered mental status, autonomic instability, and neuromuscular hyperactivity with clonus and hyperreflexia. Stop the offending agents and give benzodiazepines; cyproheptadine for severe cases.

Neuroleptic malignant syndrome

Life-threatening reaction to dopamine antagonists with fever, lead-pipe rigidity, autonomic instability, and elevated creatine kinase. Stop the drug, provide supportive care, and use dantrolene or bromocriptine.

CIWA-Ar

Clinical Institute Withdrawal Assessment for Alcohol, a 10-item scale scoring nausea, tremor, sweating, anxiety, agitation, perceptual disturbances, headache, orientation, and seizures to guide benzodiazepine dosing.

Herd immunity threshold

Proportion of a population that must be immune to interrupt transmission, calculated as 1 − 1/R0. Higher R0 requires higher coverage, such as roughly 95% for measles.

Positive predictive value

Probability that a person with a positive test truly has the disease: true positives divided by all positives. Unlike sensitivity and specificity, it depends strongly on disease prevalence.

Intention-to-treat analysis

Analysis that includes all randomized participants in the group to which they were assigned, regardless of adherence. It preserves prognostic balance and avoids bias from selective dropout.

McDonald criteria

Diagnostic criteria for multiple sclerosis requiring dissemination of lesions in space and time, demonstrated clinically, by MRI, or by cerebrospinal fluid oligoclonal bands, with exclusion of alternative diagnoses.

Status epilepticus

Continuous seizure activity lasting more than 5 minutes, or repeated seizures without recovery of consciousness. Treated first with benzodiazepines, then phenytoin, valproate, or levetiracetam.

Albuminocytologic dissociation

Elevated cerebrospinal fluid protein without proportionate pleocytosis, characteristic of Guillain-Barré syndrome and often appearing after the first week of illness.

Berlin ARDS criteria

Acute onset within one week, bilateral opacities not explained by heart failure, and PaO2/FiO2 ≤300 mmHg on positive end-expiratory pressure ≥5 cmH2O. Managed with low tidal volume ventilation.

Malignant hyperthermia

Pharmacogenetic reaction to volatile anesthetics or succinylcholine causing rising end-tidal carbon dioxide, muscle rigidity, hyperthermia, and acidosis. Stop triggers and give dantrolene.

Rapid shallow breathing index

Respiratory rate divided by tidal volume in liters, measured during spontaneous breathing. A value below 105 breaths/min/L predicts successful extubation, especially with clinical readiness.

Lipid emulsion therapy

Intravenous 20% lipid emulsion used as rescue for local anesthetic systemic toxicity, given with airway support and seizure control while avoiding vasopressin, beta-blockers, calcium channel blockers, and further local anesthetic.

Capacity assessment

Evaluation of a patient's ability to understand information, appreciate consequences, reason about options, and express a choice. Capacity is specific to each decision and may fluctuate.

Dying Patient Law

Israeli legislation governing care of terminally ill patients, permitting withholding or withdrawal of certain treatments under defined conditions while prohibiting active euthanasia and physician-assisted suicide.

Helsinki Committee

Institutional review board in Israel that approves medical research involving human subjects, ensuring informed consent, proportionality of risk, and protection of vulnerable populations.

Metformin first-line

Preferred initial pharmacotherapy for type 2 diabetes unless contraindicated, with SGLT2 inhibitors or GLP-1 receptor agonists added when cardiovascular disease, heart failure, or chronic kidney disease is present.

Holliday-Segar fluid rule

Weight-based maintenance fluid calculation used in family medicine and pediatrics: 4 mL/kg/hour for the first 10 kg, 2 mL/kg/hour for the next 10 kg, and 1 mL/kg/hour thereafter.

TNM staging

Cancer staging system describing tumor size and invasion (T), regional lymph node involvement (N), and distant metastasis (M). It guides prognosis and treatment selection across solid tumors.

Brain-respiratory death

Legal determination of death in Israel under the Brain-Respiratory Death Law, based on irreversible cessation of brain function including the brainstem, confirmed by mandated clinical and ancillary testing.

Croup management

Barking cough with inspiratory stridor treated with a single dose of dexamethasone; nebulized epinephrine for moderate to severe stridor. Intubation is rarely required.

Magnesium sulfate toxicity

Signs include loss of deep tendon reflexes, respiratory depression, and oliguria. Stop the infusion and give intravenous calcium gluconate as the antidote.

Sepsis-3 definition

Suspected infection with an acute increase in Sequential Organ Failure Assessment score of at least 2 points. Septic shock adds vasopressor need and lactate >2 mmol/L despite fluids.

Wernicke encephalopathy

Thiamine deficiency causing ophthalmoplegia, ataxia, and confusion, often in alcohol use disorder. Give thiamine before glucose to prevent precipitation or worsening of the syndrome.