Kuwait MOH Doctor 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 systolic <90 or diastolic ≤60, age ≥65; each scores one point.

DKA management

IV saline, insulin infusion after potassium >3.3 mmol/L, add dextrose when glucose <11.1 mmol/L; monitor potassium and anion gap; avoid rapid osmolar shifts.

Heart failure four pillars

For HFrEF: ARNI/ACEi/ARB, evidence-based beta-blocker, mineralocorticoid receptor antagonist, and SGLT2 inhibitor; each reduces mortality and should be titrated to target dose.

Alvarado score

Appendicitis score: migration of pain, anorexia, nausea/vomiting, right iliac fossa tenderness, rebound tenderness, fever, leukocytosis, left shift; score ≥7 suggests appendicitis.

Trauma primary survey

Airway with cervical spine protection, Breathing, Circulation with hemorrhage control, Disability (GCS), Exposure/environment; adjuncts include FAST, chest and pelvis X-ray.

Femoral hernia risk

Femoral hernias have the highest risk of strangulation among groin hernias; early elective repair is recommended, and tender or irreducible hernias need urgent surgery.

Pediatric dehydration plan C

For severe dehydration: IV Ringer's lactate 100 mL/kg; give 30 mL/kg bolus first, then reassess; continue according to WHO plan C with frequent monitoring.

Kawasaki disease criteria

Fever ≥5 days plus 4 of 5: conjunctivitis, oral changes, rash, extremity changes, cervical lymphadenopathy; treat with IVIG 2 g/kg and aspirin; echocardiography for coronary aneurysms.

Simple febrile seizure

Generalized seizure lasting <15 minutes, occurring once in 24 hours, in a child aged 6 months to 5 years; no routine lumbar puncture if meningeal signs are absent.

Preeclampsia severe features

Blood pressure ≥160/110, platelets <100,000, elevated liver enzymes, pulmonary edema, visual or cerebral symptoms, or renal insufficiency; requires magnesium sulfate and delivery planning.

Postpartum hemorrhage

Uterine atony is the most common cause; treat with uterotonics, bimanual massage, tranexamic acid within 3 hours, and balloon tamponade or surgery if refractory.

Gestational diabetes screening

75 g OGTT at 24–28 weeks: fasting ≥5.1 mmol/L, 1-hour ≥10.0, or 2-hour ≥8.5 mmol/L; lifestyle first, then insulin or metformin if targets are not met.

Hypertension first-line drugs

Thiazide-type diuretics, ACE inhibitors or ARBs, and calcium channel blockers are first-line for hypertension; choice depends on comorbidities and patient characteristics.

Type 2 diabetes add-on

Add SGLT2 inhibitor or GLP-1 receptor agonist for atherosclerotic cardiovascular disease, heart failure, or chronic kidney disease; metformin remains first-line unless contraindicated.

Antibiotic stewardship

Do not prescribe antibiotics for viral upper respiratory infections, acute bronchitis, or uncomplicated rhinosinusitis without criteria; use delayed prescriptions when appropriate.

Anaphylaxis treatment

IM epinephrine 0.3–0.5 mg (1:1000) into the anterolateral thigh, repeat every 5–15 minutes; adjuncts include IV fluids, oxygen, bronchodilators, and antihistamines; observe for biphasic reaction.

Cardiac arrest CPR

Compressions at 100–120/min, depth 5–6 cm, full recoil, minimize interruptions; defibrillate shockable rhythms immediately; epinephrine 1 mg every 3–5 minutes.

Sepsis bundle

Measure lactate, obtain cultures, give broad-spectrum antibiotics within 1 hour, and 30 mL/kg crystalloid for hypotension or lactate ≥4 mmol/L; reassess perfusion.

Status epilepticus

Benzodiazepine first-line (lorazepam 0.1 mg/kg IV, diazepam, or midazolam IM); if persistent, second-line antiepileptic such as levetiracetam, valproate, or fosphenytoin.

Major depressive episode

At least five symptoms for two weeks including depressed mood or anhedonia; assess suicide risk; first-line psychotherapy or SSRI; continue treatment 6–12 months after remission.

Serotonin syndrome

Clonus, hyperreflexia, agitation, and hyperthermia after serotonergic agents; stop offending drugs, supportive care, benzodiazepines, and cyproheptadine for moderate-severe cases.

Neuroleptic malignant syndrome

Rigidity, fever, autonomic instability, altered mental status, and elevated CK after dopamine antagonists; stop the agent, provide supportive care, and consider dantrolene or bromocriptine.

Alcohol withdrawal

Use CIWA-Ar guided therapy with benzodiazepines; give thiamine before glucose to prevent Wernicke encephalopathy; monitor for delirium tremens and autonomic instability.

Cardiac output

Cardiac output equals heart rate multiplied by stroke volume; stroke volume depends on preload, afterload, and contractility; the Fick principle estimates output from oxygen consumption.

Henderson-Hasselbalch equation

pH = 6.1 + log([HCO3−]/(0.03 × PaCO2)); used to assess acid-base status; Winter's formula predicts expected PaCO2 in metabolic acidosis.

First-order kinetics

Half-life t½ = 0.693 × volume of distribution / clearance; steady state is reached in about 4–5 half-lives; loading dose = volume of distribution × target concentration / bioavailability.

Informed consent

Requires capacity, adequate information about diagnosis, risks, benefits, and alternatives, and voluntariness; document the discussion; emergency exception applies when no surrogate is available.

Capacity assessment

Patient can understand information, appreciate consequences, reason, and communicate a choice; capacity is decision-specific and presumed unless clinical evidence suggests otherwise.

Confidentiality exceptions

Disclosure without consent is permitted for reportable communicable diseases, imminent harm to self or others, and suspected child or elder abuse, as required by law.

Sensitivity and specificity

Sensitivity = TP/(TP+FN); specificity = TN/(TN+FP); positive predictive value depends on disease prevalence; screening programs require high sensitivity and acceptable PPV.

Herd immunity threshold

Threshold = 1 − 1/R0; for measles with R0 12–18, about 92–95% immunity is needed; for influenza with R0 ~1.3, about 25% is needed.

Levels of prevention

Primary prevents onset (vaccination), secondary detects early disease (screening), and tertiary limits disability (rehabilitation); each level targets a different stage of disease.