North Macedonia Physician Licensing Exam key terms

The structured history a physician takes from a patient or family, covering present complaint, past illness, medications, allergies, family history and social circumstances. It precedes examination and usually supplies most of the diagnostic information.

The rapid sorting of patients by urgency so that life-threatening conditions are treated first. In North Macedonian emergency departments it is commonly graded by colour or number, and it determines waiting time and place of treatment rather than the final diagnosis.

A fixed sequence for assessing a critically ill patient: Airway, Breathing, Circulation, Disability (neurological status), Exposure. Each step is treated before moving on, and the cycle is repeated whenever the patient deteriorates.

Life-threatening organ dysfunction caused by a dysregulated host response to infection. It is recognised by a rise in the SOFA score of at least two points and requires immediate antibiotics, fluids and source control; septic shock is the subset with persistent hypotension needing vasopressors.

Treatment started on the basis of the most likely pathogens and the patient's clinical picture, before culture results are available. Choice depends on the suspected site, local resistance patterns and severity, and is later narrowed once microbiology returns.

The ability of bacteria to survive concentrations of an antibiotic that would normally inhibit or kill them. It arises through mutation or gene transfer and is driven by unnecessary or incomplete courses, so prescribing is guided by culture and stewardship rules.

What the body does to a drug: absorption, distribution, metabolism and excretion. These processes determine how quickly a drug acts, how long it lasts and how doses must be adjusted in renal or hepatic impairment.

What a drug does to the body, including receptor binding, potency, efficacy and the shape of the dose-response curve. It explains why two drugs acting on the same target can differ in effect and in side-effect profile.

The range of blood concentrations between the lowest effective dose and the first signs of toxicity. Drugs with a narrow range, such as digoxin, warfarin and lithium, need concentration monitoring to avoid both treatment failure and harm.

The system for detecting, assessing and preventing adverse effects of medicines after marketing. Health professionals are expected to report suspected serious reactions to the national agency, which feeds into regulatory decisions and label changes.

Any unintended harm occurring during medical care, whether or not it was preventable or caused by error. Reporting and analysis of such events, including near misses, is the basis of patient-safety improvement rather than individual blame.

A patient's voluntary agreement to a diagnostic or therapeutic procedure after receiving understandable information about its nature, purpose, benefits, alternatives and risks. It must be documented, and it may be withdrawn at any time by a patient with decision-making capacity.

A patient's legal and mental capacity to understand information and appreciate the consequences of a decision about their own health. It is assessed for a specific decision at a specific time, and its absence triggers substitute decision-making or emergency provisions.

The duty to keep information learned in a professional role secret from third parties. Disclosure without consent is permitted only in defined situations such as legal obligation, serious public-health risk or the patient's own vital interest.

A ranked list of possible conditions that could explain a patient's findings, ordered by likelihood and by danger if missed. It is refined by targeted tests, and each serious option must be excluded or confirmed before the list is closed.

Two properties of a diagnostic test: sensitivity is the proportion of truly diseased people who test positive, specificity the proportion of truly healthy people who test negative. They are fixed for a test and are used to interpret results before the patient's prior probability is considered.

The probability that a person with a positive test result actually has the disease. Unlike sensitivity, it depends strongly on how common the disease is in the tested population, which is why screening programmes and confirmatory testing are designed together.

Systematic testing of apparently healthy people to detect disease at an early, treatable stage. A programme is justified only when the condition is important, a suitable test exists, and treatment at detection improves outcome more than usual care.

Measures taken before disease occurs, such as vaccination, smoking cessation support, safe water and injury prevention. It targets risk factors in the whole population or in high-risk groups and avoids the need for later detection or treatment.

Inducing protective immunity, usually by vaccination, according to a national schedule. Programme success depends on high coverage, a functioning cold chain and surveillance of adverse events, because protection of the community requires most members to be immune.

The legal obligation of a physician to notify designated infectious diseases to the public-health authority, usually within a set time and by a defined form. Notification triggers surveillance, contact tracing and control measures, and overrides ordinary confidentiality.

The number of new cases of a disease arising in a defined population during a defined period, usually expressed per 100,000 person-years. It measures the rate of becoming ill and is the preferred measure for acute conditions and for causal comparisons.

The proportion of a population that has a disease at a given moment or during a period, regardless of when it began. It reflects both incidence and duration, so it rises when patients survive longer without being cured.

The ratio of the risk of an outcome in an exposed group to the risk in an unexposed group. A value of one means no association; it is the usual effect measure in cohort studies and is reported with a confidence interval.

Characteristics, behaviours or exposures statistically associated with a higher probability of disease. They guide prevention and screening priorities, but association alone does not prove causation, which requires temporality and control of confounding.

Inadequate blood supply to a tissue causing a shortage of oxygen and metabolites. If prolonged it progresses to cell death, so the organ affected determines the clinical picture and the window for reperfusion.

Localised death of tissue, or necrosis, caused by interruption of its arterial supply or venous drainage. The resulting lesion heals by fibrosis or scarring, and the affected organ loses part of its function permanently.

A chronic disease of medium and large arteries in which lipid-rich plaques form in the intima and narrow the lumen. Plaque rupture with thrombosis underlies most myocardial infarctions and many ischaemic strokes.

A spectrum of conditions caused by acute reduction of coronary blood flow, ranging from unstable angina to myocardial infarction with or without ST elevation. It is treated as an emergency, with ECG and troponin guiding reperfusion strategy.

Sudden focal neurological deficit caused by vascular disease, either infarction or haemorrhage. Time of onset determines eligibility for thrombolysis or thrombectomy, so rapid imaging and assessment are essential.

A seizure lasting long enough, or repeated seizures without recovery, to threaten permanent injury, conventionally five minutes of continuous convulsion. It requires immediate benzodiazepines, airway support and a search for the cause.

An acute, fluctuating disturbance of attention and awareness with disorganised thinking, usually caused by infection, drugs, metabolic derangement or withdrawal. It is distinguished from dementia by its sudden onset and reversibility.

A pregnancy-specific disorder defined by new hypertension after 20 weeks with proteinuria or other organ dysfunction. It can progress to eclampsia with seizures, so monitoring and timely delivery are the main interventions.

The occurrence of generalised seizures in a woman with preeclampsia, without another neurological cause. It is an obstetric emergency treated with magnesium sulphate to control fits and prompt delivery of the fetus and placenta.

The scheduled monitoring of pregnancy to detect and manage complications in mother and fetus. It includes blood pressure and urine checks, growth assessment, screening tests, vaccination and counselling on danger signs and birth preparedness.

A deficit of total body water with or without electrolyte loss, graded clinically by thirst, skin turgor, mucous membranes, heart rate and urine output. In children, oral rehydration is preferred unless shock or vomiting prevents it.

Prescribing the right drug, at the right dose, for the right indication and duration, with attention to interactions, comorbidity and cost. It is the practical application of clinical pharmacology and the core of antibiotic and polypharmacy stewardship.

The concurrent use of several medicines, conventionally five or more, which raises the risk of interactions, adverse effects and poor adherence. Regular medication review and deprescribing are the main countermeasures, especially in older patients.