Iraqi Board Family Medicine flashcards

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

First-contact care

The primary care attribute whereby patients access the health system first through the family physician, who acts as an entry point and coordinates onward referral to secondary care.

Genogram symbol for deceased

A diagonal cross drawn through the individual's symbol (square for male, circle for female) indicates that the person is deceased; age at death is often written beside it.

Subclinical hypothyroidism

Elevated TSH with a normal free T4 level. Treatment is considered when TSH exceeds 10 mIU/L, symptoms are present, or thyroid peroxidase antibodies are positive.

Four pillars of heart failure therapy

For heart failure with reduced ejection fraction: ACE inhibitor/ARB or ARNI, beta-blocker, mineralocorticoid receptor antagonist, and SGLT2 inhibitor - each independently reduces mortality.

Kawasaki disease diagnostic criteria

Fever for at least five days plus four of five features: bilateral conjunctivitis, oral mucosal changes, polymorphous rash, extremity changes, and cervical lymphadenopathy. Treat with IVIG and aspirin.

Bronchiolitis management

Supportive care with oxygen if saturation falls below 90-92% and hydration support. Bronchodilators, corticosteroids, and antibiotics are not routinely indicated; respiratory syncytial virus is the commonest cause.

Naegele's rule

Estimated date of delivery is calculated by adding 280 days, or nine months and seven days, to the first day of the last menstrual period, assuming a regular 28-day cycle.

Magnesium sulfate in pre-eclampsia

Given for seizure prophylaxis in severe pre-eclampsia and for treatment of eclampsia. Monitor respiratory rate, deep tendon reflexes, and urine output for toxicity.

Ottawa ankle rule

Ankle X-ray is indicated when there is malleolar pain plus bone tenderness at the posterior edge of either malleolus or inability to bear weight for four steps.

Triple assessment of breast lump

Combined clinical examination, imaging (ultrasound under 40 years, mammography at 40 or above), and tissue sampling by fine-needle aspiration or core biopsy.

Serotonin syndrome triad

Mental status change, autonomic instability, and neuromuscular hyperactivity such as clonus and hyperreflexia, usually after combining serotonergic drugs. Stop the offending agents.

PHQ-9 threshold

A nine-item depression screening tool scored 0-27; a score of 10 or more indicates moderate depression and warrants further assessment and treatment planning.

Herd immunity threshold

The proportion of a population that must be immune to interrupt transmission, calculated as 1 minus 1 divided by the basic reproduction number R0.

Relationship of prevalence and incidence

In steady state, prevalence approximately equals incidence multiplied by average disease duration; longer survival with a disease raises prevalence without changing incidence.

Positive likelihood ratio

Calculated as sensitivity divided by (1 minus specificity); values above 10 substantially increase the probability of disease, while values near 1 are unhelpful.

Intention-to-treat analysis

All randomized participants are analyzed in their originally assigned groups regardless of adherence or crossover, preserving the benefits of randomization and limiting attrition bias.

Lead-time bias

Apparent survival appears longer in screened populations because diagnosis occurs earlier, even when screening does not change the time of death; mortality is the unbiased outcome.

USPSTF Grade D

The service has moderate or high certainty of no net benefit or that harms outweigh benefits; clinicians should discourage its use in eligible asymptomatic people.

Ottawa Charter action areas

Five health promotion strategies from 1986: build healthy public policy, create supportive environments, strengthen community action, develop personal skills, and reorient health services.

Five A's for smoking cessation

Ask about tobacco use, Advise quitting, Assess willingness, Assist with counseling or pharmacotherapy, and Arrange follow-up. Brief advice alone measurably increases quit rates.

Anaphylaxis adrenaline dose

Intramuscular adrenaline 0.5 mg of 1:1000 solution (0.5 mL) into the anterolateral thigh for adults, repeated every five minutes if needed, with oxygen and IV fluids.

qSOFA criteria

Three bedside items for suspected sepsis: respiratory rate 22 or more per minute, altered mentation, and systolic blood pressure 100 mmHg or less; two or more signal high risk.

Fried frailty phenotype

Five criteria: unintentional weight loss, exhaustion, low physical activity, slow gait speed, and weakness. Three or more criteria define frailty; one or two define prefrailty.

Beers criteria

A list of potentially inappropriate medications for older adults, including benzodiazepines, anticholinergics, and long-acting sulfonylureas, used to reduce adverse drug events.

SPIKES protocol

A six-step framework for breaking bad news: Setting, Perception, Invitation, Knowledge, Empathy, and Strategy with summary. It structures a patient-centred disclosure conversation.

Gillick competence

A legal test in minors under 16 assessing whether the child has sufficient understanding and intelligence to make a particular healthcare decision independently.

PICO question format

A structured clinical question specifying Population, Intervention, Comparator, and Outcome; it guides literature searching and makes the evidence appraisal focused and reproducible.

Allocation concealment

The process of hiding the upcoming treatment assignment from those enrolling participants, distinct from blinding, preventing selection bias in randomized controlled trials.

Number needed to treat

The reciprocal of the absolute risk reduction; it estimates how many patients must receive an intervention for one additional patient to benefit.

Miller's pyramid

A four-level model of clinical competence: knows, knows how, shows how, and does. Assessment methods should match the intended level of competence.

GRADE evidence certainty

Rates evidence as high, moderate, low, or very low based on risk of bias, inconsistency, indirectness, imprecision, and publication bias; used to grade recommendations.

Wilson-Jungner screening criteria

Ten criteria for screening programmes: important condition, accepted treatment, adequate facilities, recognizable latent stage, suitable test, and agreed policy on whom to treat, among others.