Medical Residency Independent Final Attestation (Kazakhstan) 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/min, systolic BP <90 or diastolic <=60 mmHg, age >=65. Each item scores 1 point; >=3 points suggests intensive care assessment.

KDIGO AKI stage 1

Serum creatinine rise >=26.5 micromol/L within 48 hours or >=1.5 times baseline within 7 days, or urine output <0.5 mL/kg/h for 6 hours.

Alvarado score

Clinical score for acute appendicitis: migration of pain, anorexia, nausea/vomiting, right lower quadrant tenderness, rebound tenderness, fever >=37.3 C, leukocytosis, left shift. Score >=7 supports operative management.

Tokyo Guidelines cholecystitis

Severity grading of acute cholecystitis from grade I (mild) to grade III (organ dysfunction). Grades I-II are managed by early laparoscopic cholecystectomy within 72 hours; grade III may need percutaneous drainage first.

Magnesium sulfate in preeclampsia

Loading dose 4-6 g IV over 15-20 minutes followed by 1-2 g/h for seizure prophylaxis in severe preeclampsia or eclampsia; monitor reflexes, respiratory rate, and urine output; antidote is calcium gluconate 10%.

Gestational diabetes thresholds

On a 75 g oral glucose tolerance test at 24-28 weeks, diagnosis is confirmed by any one value: fasting >=5.1, 1 hour >=10.0, or 2 hours >=8.5 mmol/L.

Neonatal resuscitation ratio

When chest compressions are required for a newborn with heart rate below 60/min despite effective ventilation, use a 3:1 compression-to-ventilation ratio with 90 compressions and 30 breaths per minute.

WHO dehydration classification

Severe dehydration is defined by two or more of: lethargy, sunken eyes, inability to drink, very slow skin pinch; it requires intravenous Ringer's lactate 100 mL/kg with reassessment during rehydration.

Adult CPR compression parameters

Compress at 100-120 per minute to a depth of 5-6 cm with full chest recoil and minimal interruptions; use a 30:2 ratio without an advanced airway, then continuous compressions with a breath every 6 seconds.

Anaphylaxis first-line treatment

Intramuscular adrenaline 0.5 mg (1:1000) into the anterolateral thigh, repeated every 5 minutes as needed, together with trigger removal, oxygen, and intravenous crystalloid; antihistamines and steroids are adjuncts.

Sepsis-3 definition

Life-threatening organ dysfunction caused by a dysregulated host response to infection, identified by a SOFA score increase of 2 or more points; septic shock adds vasopressor requirement for MAP >=65 mmHg and lactate >2 mmol/L.

Herd immunity threshold

The proportion of a population that must be immune to interrupt transmission, calculated as 1 minus 1/R0. For measles with R0 around 12, approximately 92% coverage is required.

Standard tuberculosis regimen

For new drug-susceptible pulmonary tuberculosis: two months of isoniazid, rifampicin, pyrazinamide, and ethambutol, followed by four months of isoniazid and rifampicin, with adherence monitored by DOTS.

OSMS in Kazakhstan

Obligatory social health insurance funded by employer and state contributions, administered by the Social Health Insurance Fund, providing citizens and legal residents with a defined package of medical services.

Informed voluntary consent

A legal requirement before any medical intervention: the patient with capacity receives information on diagnosis, proposed treatment, risks, alternatives, and consequences of refusal, and documents agreement; consent may be withdrawn.

Warfarin INR targets

Target INR 2.0-3.0 for most indications such as atrial fibrillation and venous thromboembolism; 2.5-3.5 for mechanical mitral valve prostheses; vitamin K is the antidote for over-anticoagulation.

Half-life and steady state

Half-life equals 0.693 times volume of distribution divided by clearance; steady-state concentration is reached after approximately four to five half-lives of regular dosing, which also guides interval adjustment.

ALARA principle

As Low As Reasonably Achievable: every radiological examination must be justified by clinical need and optimised so the radiation dose is the lowest that still achieves diagnostic image quality.

High-sensitivity troponin

The preferred biomarker of myocardial injury, measured serially with 0/1-hour or 0/3-hour algorithms; a rise and fall pattern with clinical ischaemia supports acute myocardial infarction diagnosis.

SPIKES protocol

Six-step framework for breaking bad news: Setting, Perception, Invitation, Knowledge, Emotions, Strategy and summary; it emphasises clear language, empathy, and confirming the patient's understanding.

Four ethical principles

Autonomy (respect for patient choice), beneficence (act in the patient's interest), non-maleficence (avoid harm), and justice (fair distribution of care); they guide clinical decisions and are reflected in healthcare law.

Dual antiplatelet therapy in ACS

Aspirin plus a P2Y12 inhibitor (ticagrelor, prasugrel, or clopidogrel) given in acute coronary syndrome, combined with anticoagulation and high-intensity statin; duration depends on ischaemic and bleeding risk.

Modified Atlanta classification

Grades acute pancreatitis as mild, moderately severe, or severe based on organ failure duration and local complications; severity determines need for intensive care and nutritional support.

Anti-D prophylaxis

Anti-D immunoglobulin 300 micrograms given to Rh-negative unsensitised women at 28 weeks and within 72 hours of delivery of an Rh-positive infant, and after abortion, amniocentesis, or antepartum haemorrhage.

Apgar score

Assessment at 1 and 5 minutes of Appearance, Pulse, Grimace, Activity, and Respiration, each scored 0-2; it describes the newborn's condition but does not define asphyxia or guide resuscitation.

Status epilepticus management

First-line benzodiazepine (diazepam 10 mg IV or midazolam 10 mg IM), followed by levetiracetam, valproate, or phenytoin; refractory cases require anaesthetic doses, intubation, and intensive care.

Xpert MTB/RIF

Nucleic acid amplification test for Mycobacterium tuberculosis that also detects rifampicin resistance mutations; results are available within about two hours and support early treatment decisions.

Guaranteed volume of free care

The package of medical services financed by the state budget and provided free of charge to citizens and legal residents under the Code on Public Health and the Healthcare System of Kazakhstan.

Loading dose formula

Loading dose equals volume of distribution multiplied by target plasma concentration divided by bioavailability; it rapidly achieves therapeutic concentration when the half-life is long.

AWaRe classification

WHO antimicrobial classification into Access, Watch, and Reserve groups, used in stewardship programmes to guide empirical prescribing and preserve last-resort agents for resistant infections.

Silhouette sign

Loss of the normal border between two adjacent structures of different density on a chest radiograph, localising an opacity to the adjacent structure, such as the heart or diaphragm.

Medical confidentiality limits

Patient information may be disclosed only with consent or where legislation requires it, such as notifiable infectious diseases, a serious threat to third parties, or a court order; documentation is mandatory.