Myanmar MMLE flashcards

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

CURB-65

Community-acquired pneumonia severity score: Confusion, Urea >7 mmol/L, Respiratory rate ≥30/min, Blood pressure systolic <90 or diastolic ≤60 mmHg, Age ≥65 years. Each scores 1 point.

DKA diagnostic triad

Hyperglycaemia >11 mmol/L, ketonaemia (β-hydroxybutyrate ≥3 mmol/L), and metabolic acidosis (pH <7.3 or bicarbonate <15 mmol/L).

Tuberculosis presumptive case

Cough for ≥2 weeks with any of fever, night sweats, weight loss, or haemoptysis. Sputum Xpert MTB/RIF Ultra is the initial diagnostic test.

Stroke thrombolysis window

Intravenous alteplase within 4.5 hours of ischaemic stroke onset, after non-contrast CT excludes haemorrhage and BP is <185/110 mmHg.

CKD staging

G1 eGFR ≥90, G2 60-89, G3a 45-59, G3b 30-44, G4 15-29, G5 <15 mL/min/1.73 m², with or without albuminuria.

Severe malaria features

Impaired consciousness, prostration, multiple convulsions, acidosis, hypoglycaemia <2.2 mmol/L, severe anaemia Hb <5 g/dL, renal impairment, jaundice, or pulmonary oedema. Treat with IV artesunate.

Alvarado score

Appendicitis score: migratory pain, anorexia, nausea/vomiting, right iliac fossa tenderness, rebound pain, fever, leukocytosis, left shift. Score ≥7 suggests appendicectomy.

ATLS primary survey

A Airway with cervical spine protection, B Breathing and ventilation, C Circulation with haemorrhage control, D Disability (GCS, pupils), E Exposure with hypothermia prevention.

Parkland formula

Crystalloid for burns in first 24 hours = 4 mL × weight in kg × %TBSA burned. Give half in first 8 hours from injury, remainder over 16 hours.

Haemorrhagic shock classes

Class I <15% blood loss, class II 15-30% (tachycardia, narrowed pulse pressure), class III 30-40% (hypotension, confusion), class IV >40% (lethargy, negligible urine output).

Surgical antibiotic prophylaxis timing

Administer within 60 minutes before incision (within 120 minutes for vancomycin or fluoroquinolones); re-dose every two half-lives or after 1500 mL blood loss.

Femoral hernia risk

Femoral hernia has a higher risk of strangulation than inguinal hernia and requires urgent surgical referral when irreducible and painful.

Pre-eclampsia severe features

BP ≥160/110 mmHg, platelets <100,000/µL, elevated liver enzymes, pulmonary oedema, or visual/cerebral symptoms in a woman with new hypertension after 20 weeks.

Primary postpartum haemorrhage

Blood loss ≥500 mL after vaginal birth or ≥1000 mL after caesarean within 24 hours. First-line uterotonic is oxytocin 10 IU IM; add tranexamic acid 1 g IV within 3 hours.

Ectopic pregnancy methotrexate criteria

Haemodynamically stable, unruptured ectopic pregnancy with hCG <5000 IU/L and no fetal cardiac activity; monitor hCG until non-pregnant.

Gestational diabetes thresholds

75 g OGTT at 24-28 weeks: fasting ≥5.1 mmol/L, 1-hour ≥10.0 mmol/L, or 2-hour ≥8.5 mmol/L (IADPSG criteria).

Active third stage

Administration of a uterotonic, controlled cord traction, and uterine massage after birth of the baby to reduce postpartum haemorrhage.

Combined pill contraindications

Migraine with aura, smoking at age ≥35, BP ≥160/100 mmHg, history of VTE, and known thrombophilia are contraindications to combined oral contraceptives.

Cervical cancer screening

Start at age 30 (or 25) with HPV testing every 5 years or cytology every 3 years. HPV 16 and 18 cause about 70% of cervical cancers.

Ovarian cancer RMI

Risk of malignancy index = CA-125 × menopausal status × ultrasound score. Refer to gynaecologic oncology if RMI >250.

Paediatric CPR ratio

Compression-to-ventilation ratio 30:2 for a single rescuer and 15:2 for two rescuers; compression depth at least one-third of chest AP diameter; rate 100-120/min.

Neonatal resuscitation threshold

Positive pressure ventilation if apnoeic or heart rate <100/min; chest compressions if heart rate <60/min after effective ventilation.

WHO severe dehydration

Sunken eyes, slow skin pinch, lethargy, drinking poorly. Give IV Ringer's lactate 100 mL/kg over 3 hours for infants or 30 mL/kg in first hour then 70 mL/kg over 2.5 hours for older children.

Infant weight doubling

Birth weight doubles by 5 months and triples by 12 months; birth length ~50 cm increases 25 cm in the first year.

Kawasaki disease criteria

Fever ≥5 days plus 4 of 5: rash, cervical lymphadenopathy, conjunctivitis, oral mucositis, extremity changes. Treat with IV immunoglobulin 2 g/kg and aspirin.

Severe acute malnutrition

WHO defines it as weight-for-height z-score < -3, MUAC <115 mm, or bilateral pitting oedema. Treat with ready-to-use therapeutic food and monitor for refeeding syndrome.

Myanmar EPI schedule

BCG and OPV at birth; pentavalent DTP-HepB-Hib at 2, 4, 6 months; measles-rubella at 9 and 18 months; vitamin A every 6 months for children 6-59 months.

Incidence vs prevalence

Incidence counts new cases per population at risk per time; prevalence counts all existing cases at a point or period. Incidence × duration ≈ prevalence for stable conditions.

Sensitivity and specificity

Sensitivity = TP/(TP+FN); specificity = TN/(TN+FP). Positive predictive value depends on disease prevalence in the population tested.

Outbreak investigation steps

Verify diagnosis, confirm outbreak, define cases, describe by time/place/person, generate hypotheses, test hypotheses, implement control, communicate findings.

Study design measures

Cohort studies measure incidence and relative risk; case-control studies measure odds ratio; randomised controlled trials give strongest causal evidence; cross-sectional studies measure prevalence.

Herd immunity threshold

Proportion needing immunity = 1 - 1/R0, where R0 is the basic reproduction number of the pathogen in a fully susceptible population.