Clinical Officers Council Pre-Internship flashcards

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

Parkland burn formula

4 mL/kg body weight multiplied by percentage total body surface area burned of Ringer's lactate in 24 hours; half is given in the first 8 hours after injury and the rest over 16 hours.

Alvarado score

Clinical score for suspected appendicitis using migration of pain, anorexia, nausea, right iliac fossa tenderness, rebound, fever and leucocytosis; a score of 7 or more supports appendicectomy.

Pritchard regimen

Magnesium sulphate regimen for eclampsia: 4 g IV plus 10 g IM loading dose, then 5 g IM every 4 hours, continued for 24 hours after delivery or the last fit.

McRoberts manoeuvre

First-line manoeuvre for shoulder dystocia: lay the woman flat, remove the head of the bed and hyperflex the maternal hips onto the abdomen to open the pelvic outlet.

Postpartum haemorrhage first-line

Uterine atony is the commonest cause; give uterine massage, oxytocin 10 IU intramuscularly, tranexamic acid 1 g IV within 3 hours, and IV fluids while seeking the cause.

Apgar score components

Five items scored 0-2 each at 1 and 5 minutes: appearance or colour, pulse rate, grimace or reflex irritability, activity or muscle tone, and respiration.

Zinc in childhood diarrhoea

20 mg elemental zinc daily, or 10 mg if under 6 months, given for 10-14 days; it shortens the duration and severity of diarrhoea and reduces recurrence.

F-75 in severe malnutrition

Stabilisation milk providing about 75 kcal per 100 mL with low protein and no iron, given in small frequent feeds to avoid refeeding syndrome until appetite returns.

Neonatal resuscitation threshold

Positive pressure ventilation is indicated when the newborn's heart rate remains below 100 beats per minute after 60 seconds of the initial steps.

Sensitivity of a test

Proportion of people who truly have the disease and test positive; calculated as true positives divided by true positives plus false negatives.

Herd immunity threshold

Proportion of a population that must be immune to interrupt transmission, approximated as 1 minus 1/R0, where R0 is the basic reproduction number.

Compartment syndrome hallmark

Severe pain out of proportion to the injury, worsened by passive stretch of the compartment muscles, is the earliest sign; pulselessness is late and unreliable.

Neuroleptic malignant syndrome

Life-threatening antipsychotic reaction with rigidity, hyperthermia, autonomic instability and raised creatine kinase; stop the drug, cool the patient, hydrate and consider dantrolene or bromocriptine.

Serotonin syndrome triad

Mental status change, autonomic hyperactivity and neuromuscular abnormalities such as clonus and hyperreflexia, caused by serotonergic drugs; stop the agent and give supportive care.

Wernicke encephalopathy treatment

Give parenteral thiamine before or with glucose in malnourished or alcoholic patients to prevent irreversible Korsakoff amnesia; the triad is confusion, ataxia and ophthalmoplegia.

Trachoma SAFE strategy

Surgery for trichiasis, Antibiotics mainly azithromycin, Facial cleanliness and Environmental improvement, the WHO package used to eliminate blinding trachoma.

Acute angle-closure glaucoma

Painful red eye with a fixed mid-dilated pupil, halos and headache; lower the pressure with topical beta-blocker, pilocarpine and IV acetazolamide, and refer urgently.

Rinne and Weber tests

Rinne compares air with bone conduction; Weber lateralises to the affected ear in conductive loss and to the better ear in sensorineural loss.

Scabies treatment

Permethrin 5% cream applied from the neck down, washed off after 8-12 hours and repeated after 7 days; treat all household contacts and hot wash bedding.

Glasgow Coma Scale minimum

The lowest possible score is 3 (E1V1M1) and the maximum is 15; a score of 8 or below indicates the airway is unprotected.

Ketamine anaesthesia

Dissociative agent giving analgesia and amnesia while preserving airway reflexes and spontaneous breathing; it causes emergence delirium and raises blood pressure and heart rate.

Maximum lidocaine dose

3 mg/kg without adrenaline and 7 mg/kg with adrenaline; exceeding these doses risks seizures and cardiovascular collapse, for which IV lipid emulsion is the rescue treatment.

Informed consent elements

Disclosure of diagnosis, proposed treatment, risks, benefits, alternatives and consequences of refusal, given voluntarily by a patient with capacity, then documented and signed.

Medical negligence four elements

A duty of care owed to the patient, breach of the accepted standard, causation of harm by that breach, and actual damage; all four must be proved.

Notifiable disease reporting

Clinicians must report diseases such as cholera, plague, yellow fever, measles and poliomyelitis to the nearest public health authority immediately so that outbreak response can begin.

Initial ART regimen

First-line antiretroviral therapy for adults is tenofovir plus lamivudine plus dolutegravir, a single daily tablet, started regardless of the CD4 count.

Infant HIV PCR testing

In children under 18 months HIV is diagnosed by DNA PCR because maternal antibodies persist; test at 6 weeks of age or at the earliest contact.

PEP for HIV

Post-exposure prophylaxis using three antiretroviral drugs, started as soon as possible and no later than 72 hours after exposure, then continued for 28 days.

Emergency contraception timing

Levonorgestrel 1.5 mg orally within 72 hours of unprotected intercourse, or a copper IUCD inserted within 5 days; earlier use gives greater efficacy.

Isoniazid preventive therapy

Six months of daily isoniazid given to people living with HIV and others at high risk after active tuberculosis has been excluded, to prevent progression to disease.

Hyperkalaemia emergency sequence

Give IV calcium gluconate first to protect the myocardium, then insulin with dextrose and nebulised salbutamol to shift potassium into cells, then remove potassium from the body.

Hyponatraemia correction limit

Correct chronic hyponatraemia by no more than 8-10 mmol/L in 24 hours to avoid osmotic demyelination; hypertonic saline is reserved for seizures or coma.