Cambodia Medicine Exit Exam key terms

A tuberculosis control strategy in which a trained observer watches the patient swallow each dose, combined with sputum testing, reliable drug supply, and recording of outcomes. It reduces treatment failure and prevents drug resistance.

Tuberculosis caused by bacilli resistant to at least isoniazid and rifampicin, the two strongest first-line drugs. It requires longer treatment with second-line agents and is often detected by rapid molecular testing.

Examination of a stained sputum sample under a microscope to look for acid-fast bacilli. It is inexpensive and widely used in Cambodia to diagnose and monitor pulmonary tuberculosis, though it misses paucibacillary cases.

A cartridge-based nucleic acid amplification test that detects Mycobacterium tuberculosis DNA and rifampicin resistance within about two hours. It is the recommended initial test for suspected drug-resistant or HIV-associated tuberculosis.

First-line malaria treatment pairing a fast-acting artemisinin derivative with a longer-acting partner drug. The combination clears parasites quickly and reduces the chance that resistance will emerge to either component.

The malaria parasite species most likely to cause severe disease and death. It produces high parasite loads, infects red cells of all ages, and can cause cerebral malaria, severe anaemia, and acidosis.

Malaria with danger signs such as impaired consciousness, convulsions, respiratory distress, shock, jaundice, or very high parasitaemia. It is a medical emergency requiring parenteral artesunate and intensive supportive care.

Clinical features marking increased risk of progression to severe dengue: persistent abdominal pain, vomiting, fluid accumulation, mucosal bleeding, lethargy, liver enlargement, and rising haematocrit with falling platelets. They guide admission and close monitoring.

Severe dengue with circulatory failure from plasma leakage, shown by rapid weak pulse, narrow pulse pressure, cold clammy skin, and altered consciousness. Management is urgent fluid resuscitation with close reassessment.

The proportion of blood volume occupied by red cells, expressed as a percentage. In dengue it rises as plasma leaks into tissues, so serial measurements help detect plasma leakage and guide fluid therapy.

Combination drug treatment that suppresses HIV replication, restores immune function, and prevents transmission. Current regimens use at least three drugs from different classes, and adherence is essential to avoid resistance.

The number of CD4-positive T lymphocytes per microlitre of blood, a marker of immune status in HIV infection. Low counts predict opportunistic infections and guide prophylaxis and urgency of treatment.

The amount of HIV RNA in blood plasma, usually reported as copies per millilitre. It is the main test for monitoring treatment success; a rising load suggests adherence problems or drug resistance.

The proportion of people who truly have a disease and are correctly identified as positive by a test. A highly sensitive test rarely misses disease, so it is useful for screening and ruling out.

The proportion of people without a disease who are correctly identified as negative by a test. A highly specific test rarely produces false positives, so it is useful for confirming a diagnosis.

The probability that a person with a positive test result actually has the disease. It depends on disease prevalence as well as test sensitivity and specificity, and falls when prevalence is low.

The ratio of the risk of an outcome in an exposed group to the risk in an unexposed group. A value above one indicates increased risk; it is the main measure of association in cohort studies.

The ratio of the odds of exposure among cases to the odds among controls. It approximates relative risk when the outcome is rare and is the standard measure in case-control studies.

A range of values that is likely to contain the true population estimate, usually stated at 95 percent. A narrow interval indicates a precise estimate, and one crossing 1.0 for a ratio suggests no significant effect.

An experiment in which participants are randomly allocated to intervention or control groups. Randomisation balances known and unknown confounders, making it the strongest design for establishing cause and effect.

Distortion of the association between exposure and outcome by a third factor linked to both. It can create a spurious association or hide a real one, and is addressed by design or statistical adjustment.

Systematic error arising when the groups compared differ in ways related to the outcome because of how participants were chosen or retained. It threatens validity and cannot be fixed by increasing sample size.

The proportion of people diagnosed with a condition who die from it within a stated period. It measures severity rather than how common the disease is, and is widely used in outbreak reporting.

The number of new cases of a disease arising in a population per unit of person-time at risk. It measures how fast new disease occurs and is used to compare risk between populations and over time.

The proportion of a defined population that develops illness during a limited outbreak, usually after a common exposure. It is calculated as cases divided by population at risk and helps identify the source.

Essential health services made accessible to everyone in a community at affordable cost, including promotion, prevention, treatment, and rehabilitation. It is the foundation of Cambodia's health coverage strategy, delivered largely through health centres.

The absence of avoidable differences in health status between population groups, particularly between rich and poor and between urban and rural communities. Achieving it requires allocating resources according to need.

Financial arrangements such as health equity funds and community-based schemes that remove cost barriers to care for poor and vulnerable people. In Cambodia these mechanisms reimburse facilities for treating enrolled poor patients.

Out-of-pocket health spending that consumes a large share of a household's capacity to pay, forcing cuts to other essentials or debt. It is a key indicator of financial hardship caused by illness.

A patient's voluntary agreement to a procedure or treatment after receiving adequate information about its nature, benefits, risks, and alternatives. It requires decision-making capacity and may be withdrawn at any time.

A patient's ability to understand relevant information, appreciate the consequences of a decision, reason about options, and communicate a choice. When capacity is absent, a legally recognised surrogate should decide.

The duty to keep information learned in a clinical relationship private and to share it only with those who need it for the patient's care or as permitted by law. Breach without justification is a professional and legal violation.

A disease that clinicians and laboratories must report to public health authorities so that surveillance, outbreak investigation, and control measures can be triggered. Reporting is a legal obligation that overrides usual confidentiality.

Life-threatening organ dysfunction caused by a dysregulated host response to infection. It is identified by signs such as altered mentation, low blood pressure, and raised respiratory rate, and requires urgent antibiotics and fluids.

Sepsis with persisting hypotension requiring vasopressors to maintain mean arterial pressure and with raised lactate despite adequate fluid resuscitation. Mortality is high and early recognition and treatment are critical.

A bedside screening tool for sepsis using three items: respiratory rate of 22 or more per minute, altered mental status, and systolic blood pressure of 100 mmHg or less. Two or more positive items prompt further assessment.

New-onset generalised seizures in a pregnant or recently delivered woman with pre-eclampsia, not explained by other causes. It is an obstetric emergency treated with magnesium sulphate and prompt delivery.

A pregnancy disorder of raised blood pressure after 20 weeks with proteinuria or other organ dysfunction. It can progress to seizures, liver and kidney injury, and fetal growth restriction, so close monitoring is needed.

The drug of choice for preventing and treating seizures in pre-eclampsia and eclampsia. It is given by loading and maintenance doses with monitoring of reflexes, respiration, and urine output for toxicity.

Bleeding of 500 mL or more after vaginal birth or 1000 mL or more after caesarean birth, or any bleeding causing haemodynamic compromise. Uterine atony is the commonest cause and is managed with uterotonics and massage.

A package of measures to prevent postpartum haemorrhage: a prophylactic uterotonic drug, controlled cord traction, and uterine massage after delivery of the placenta. It reduces blood loss and retained placenta.

Failure of the uterus to contract firmly after delivery of the placenta, allowing heavy bleeding from the placental site. It is the leading cause of postpartum haemorrhage and is treated with massage and uterotonic drugs.