Mongolia Physician Licensing 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 above 7 mmol/L, respiratory rate 30 or more, low blood pressure, age 65 or older. Two or more points suggest hospital admission.

DKA initial fluid

Isotonic intravenous saline is given first in diabetic ketoacidosis to restore volume before insulin infusion. Insulin is started after potassium is checked and replaced if below 5.2 mmol/L.

McBurney point

Surface landmark one-third of the distance from the anterior superior iliac spine to the umbilicus, where maximal tenderness in acute appendicitis is typically elicited.

Parkland formula

Burn resuscitation estimate of 4 mL per kg per percent total body surface area of lactated Ringer solution over 24 hours, with half given in the first 8 hours from injury.

Magnesium sulfate toxicity antidote

Calcium gluconate is the antidote for magnesium sulfate toxicity, which presents with loss of deep tendon reflexes, respiratory depression, and oliguria. Monitor reflexes during infusion.

Postpartum hemorrhage four Ts

Causes of postpartum hemorrhage: tone (uterine atony), trauma, tissue (retained placenta), and thrombin (coagulopathy). Atony is most common and responds to uterine massage and oxytocin.

Kawasaki disease criteria

Fever for five or more days plus four of five features: conjunctivitis, oral mucosal changes, rash, extremity changes, and cervical lymphadenopathy. Treat with intravenous immunoglobulin and aspirin.

Simple febrile seizure

A generalized seizure lasting under 15 minutes, occurring once in 24 hours, in a child aged 6 months to 5 years with fever and no central nervous system infection.

Sepsis-3 definition

Suspected infection with an acute increase in SOFA score of 2 or more. Septic shock adds vasopressor requirement for mean arterial pressure 65 mmHg or higher and lactate above 2 mmol/L.

Sensitivity formula

Sensitivity equals true positives divided by true positives plus false negatives. It reflects the proportion of people with disease who test positive and is used to rule out disease.

Anaphylaxis first-line drug

Intramuscular epinephrine 0.3 to 0.5 mg of 1:1,000 solution into the anterolateral thigh, repeated every 5 to 15 minutes as needed. Antihistamines and fluids are adjuncts only.

High-quality chest compressions

Compressions at 100 to 120 per minute, depth 5 to 6 cm in adults, full chest recoil, minimal interruptions, and early defibrillation for shockable rhythms such as ventricular fibrillation.

Low back pain red flags

Features requiring urgent evaluation: age over 50 with new pain, fever, weight loss, history of cancer, neurological deficit, bowel or bladder dysfunction, or significant trauma.

PHQ-9 purpose

Nine-item questionnaire that scores depressive symptom severity and supports diagnosis and monitoring. The PHQ-2 is used as an initial screen, followed by PHQ-9 if positive.

Volume of distribution

Apparent volume relating the amount of drug in the body to its plasma concentration. Large values indicate extensive tissue distribution; small values indicate confinement to plasma.

Zero-order kinetics

Drug elimination at a constant rate independent of concentration, seen with phenytoin, ethanol, and high-dose aspirin. Small dose increases can cause disproportionate rises in plasma levels.

AST/ALT ratio

A ratio above 2 suggests alcoholic liver disease; viral hepatitis typically shows ALT higher than AST. The ratio helps distinguish causes of hepatocellular injury.

Air bronchogram

Air-filled bronchi visible against opacified alveoli on chest imaging, indicating alveolar consolidation rather than pleural or mediastinal disease.

Incidence versus prevalence

Incidence counts new cases per population at risk over time. Prevalence counts all existing cases at a point in time and approximates incidence multiplied by disease duration.

Herd immunity

Indirect protection of unvaccinated people when a sufficient proportion of the population is immune, interrupting transmission. The required threshold rises with the pathogen's basic reproduction number.

Informed consent elements

Disclosure of diagnosis, proposed treatment, risks, benefits, and alternatives; assessment of patient capacity; and voluntary agreement without coercion. Emergency exceptions apply when no surrogate is available.

Four ethical principles

Autonomy respects patient choice, beneficence acts for the patient's benefit, non-maleficence avoids harm, and justice requires fair distribution of benefits and burdens.

Cardiac output formula

Cardiac output equals heart rate multiplied by stroke volume. Stroke volume depends on preload, afterload, and contractility, which are the targets of many cardiovascular drugs.

Henderson-Hasselbalch equation

pH equals 6.1 plus the logarithm of bicarbonate concentration divided by 0.03 times PaCO2. It explains the relationship between bicarbonate and carbon dioxide in acid-base disorders.

SPIKES protocol

Six-step framework for breaking bad news: setting, perception, invitation, knowledge, empathy, and strategy with summary. It supports patient-centered communication during difficult conversations.

Motivational interviewing

Patient-centered counseling using open questions, affirmation, reflective listening, and summarization to strengthen the patient's own motivation and confidence for behavior change.

Eclampsia treatment

Magnesium sulfate given as a 4 to 6 g intravenous loading dose over 15 to 20 minutes, then 1 to 2 g per hour, with monitoring of reflexes, respiration, and urine output.

Gestational diabetes thresholds

On a 75 g oral glucose tolerance test at 24 to 28 weeks, fasting 5.1, one-hour 10.0, or two-hour 8.5 mmol/L or higher diagnoses gestational diabetes.

RSV bronchiolitis management

Supportive care with oxygen and hydration is the mainstay for respiratory syncytial virus bronchiolitis. Routine bronchodilators and systemic corticosteroids are not recommended for typical cases.

Warfarin interaction risk

Warfarin is metabolized by cytochrome P450 enzymes, so inhibitors such as ketoconazole and erythromycin raise INR and bleeding risk, while inducers such as rifampicin lower anticoagulant effect.

Outbreak investigation steps

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

Shared decision-making

Presenting treatment options with their benefits and harms, exploring patient values and preferences, and reaching a mutually agreed plan rather than issuing a unilateral recommendation.