Iran Medical Residency Entrance 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, Blood pressure low (SBP <90 or DBP ≤60), age ≥65. Two or more points favors inpatient management.

Anion gap formula

Sodium minus the sum of chloride and bicarbonate. Normal is roughly 8–12 mmol/L; elevated values suggest ketoacidosis, lactic acidosis, renal failure, or toxin ingestion.

SAAG

Serum-ascites albumin gradient equals serum albumin minus ascitic fluid albumin. A value of 1.1 g/dL or more indicates portal hypertension as the cause of ascites.

Alvarado score

Clinical appendicitis score combining migration of pain, anorexia, nausea, right lower quadrant tenderness, rebound, fever, leukocytosis, and left shift. Higher totals increase probability and support surgery.

Parkland formula

Burn resuscitation estimate: 4 mL of lactated Ringer per kilogram body weight per percent total body surface area in 24 hours, with half given in the first eight hours from injury.

Hesselbach triangle borders

Boundaries are the inferior epigastric vessels laterally, the rectus sheath medially, and the inguinal ligament inferiorly. Direct inguinal hernias protrude through this triangle.

Holliday-Segar maintenance fluids

Pediatric hourly fluid rule: 4 mL/kg for the first 10 kg, 2 mL/kg for the next 10 kg, and 1 mL/kg for each kilogram thereafter.

Kawasaki disease 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 intravenous immunoglobulin and aspirin.

Simple febrile seizure

A generalized seizure lasting under fifteen minutes, occurring once in twenty-four hours, in a child aged six months to five years with fever and no central nervous system infection.

Magnesium sulfate eclampsia dosing

Loading dose of 4–6 g intravenously followed by 1–2 g per hour. Monitor deep tendon reflexes, respiratory rate, and urine output; calcium gluconate reverses toxicity.

Discriminatory hCG zone

A serum beta-hCG level, approximately 3,500 mIU/mL, above which a normal intrauterine pregnancy should be visible on transvaginal ultrasound. Absence suggests ectopic or nonviable pregnancy.

Fetal heart rate category III

Absent baseline variability with recurrent late or variable decelerations, or bradycardia. It is abnormal and requires immediate intrauterine resuscitation and consideration of urgent delivery.

Serotonin syndrome triad

Altered mental status, autonomic hyperactivity, and neuromuscular excitation with clonus and hyperreflexia, following serotonergic drug use. Stop the agent and give supportive care.

Neuroleptic malignant syndrome

Fever, lead-pipe rigidity, autonomic instability, and elevated creatine kinase after dopamine antagonist exposure. Management is drug discontinuation plus dantrolene or bromocriptine.

CIWA-Ar

Clinical Institute Withdrawal Assessment for Alcohol, revised. It quantifies withdrawal severity and guides symptom-triggered benzodiazepine dosing; thiamine is given before glucose.

Femoral triangle contents

From lateral to medial: femoral nerve, artery, vein, empty space, and lymphatics. The borders are the inguinal ligament, sartorius, and adductor longus.

Virchow triad

Three factors promoting thrombosis: endothelial injury, abnormal blood flow such as stasis or turbulence, and hypercoagulability. Each contributes to venous and arterial clot formation.

Zero-order kinetics

Drug elimination at a constant amount per unit time because metabolic enzymes are saturated. Concentration rises disproportionately with dose; phenytoin and ethanol are examples.

Type IV hypersensitivity

Delayed, T-cell mediated reaction peaking at 48–72 hours, exemplified by contact dermatitis and tuberculin testing. It is not antibody mediated.

Sensitivity and specificity

Sensitivity is true positives divided by all diseased; specificity is true negatives divided by all healthy. Both are properties of the test and do not depend on disease prevalence.

Herd immunity threshold

The proportion of a population needing immunity to interrupt transmission, approximated as one minus one divided by the basic reproduction number. Measles requires roughly 92–95 percent coverage.

Levels of prevention

Primordial targets risk factors, primary acts before disease onset, secondary detects disease early, and tertiary limits disability. Each level addresses a different stage of disease development.

Informed consent elements

Capacity, disclosure of material risks, benefits, and alternatives, comprehension, and voluntary choice, followed by documentation. A competent adult may refuse even life-saving treatment.

Decision-making capacity

The ability to understand information, appreciate its relevance, reason about options, and communicate a choice. It is specific to the decision and assessed clinically, not by diagnosis alone.

Four elements of malpractice

Duty to the patient, breach of the standard of care, causation linking breach to harm, and damages. All four must be established for a successful claim.

Standard of care

The level of care a reasonably competent practitioner in the same specialty would provide under similar circumstances, often established through expert testimony and clinical guidelines.

Reportable conditions

Diseases and injuries that law requires clinicians to notify authorities about, commonly including certain communicable diseases, child or elder abuse, and gunshot wounds.

Anaphylaxis first-line treatment

Intramuscular epinephrine 0.3–0.5 mg of the 1:1000 solution into the anterolateral thigh, repeated every 5–15 minutes. Antihistamines and corticosteroids are adjuncts, not first-line.

Sepsis bundle

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

Status epilepticus sequence

A benzodiazepine such as lorazepam or intramuscular midazolam first, followed by a second-line agent such as levetiracetam, phenytoin, or valproate if seizures persist.

Hedging in medical English

Words such as may, suggests, and is associated with express uncertainty and do not assert causation. Options using proves or causes make stronger claims than the passage supports.

Incidence versus prevalence

Incidence counts new cases among people at risk over time; prevalence counts all existing cases at a point in time. Prevalence approximates incidence multiplied by average disease duration.