MDC PQE flashcards

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

CURB-65 components

Confusion, Urea above 7 mmol/L, Respiratory rate 30/min or more, low Blood pressure, and Age 65 or older. Scores of 3 or more prompt inpatient or ICU-level assessment for community-acquired pneumonia.

Adrenaline dose in anaphylaxis

Adults receive 0.5 mg intramuscularly as 0.5 mL of 1:1000 solution into the anterolateral thigh, repeated every five minutes if needed. Antihistamines and corticosteroids do not replace adrenaline.

DKA diagnostic triad

Hyperglycaemia, ketonaemia, and metabolic acidosis with pH below 7.3 or bicarbonate below 18 mmol/L. Insulin is withheld until potassium is at least 3.3 mmol/L to avoid arrhythmia.

Door-to-balloon time

For ST-elevation myocardial infarction, primary percutaneous coronary intervention should be delivered within 90 minutes of first medical contact at a PCI-capable centre, or within 120 minutes if transfer is required.

Safe hyponatraemia correction rate

Serum sodium should rise by no more than 10 mmol/L in the first 24 hours, and no more than 8 mmol/L in chronic or high-risk cases, to prevent osmotic demyelination syndrome.

Hyperkalaemia emergency sequence

Give intravenous calcium gluconate first to stabilise cardiac membranes, then insulin with dextrose and nebulised salbutamol to shift potassium into cells. Dialysis removes potassium in refractory cases.

Thrombolysis stroke window

Intravenous alteplase may be given up to 4.5 hours after symptom onset once non-contrast CT excludes haemorrhage. Mechanical thrombectomy is offered up to 6 hours, or 24 hours with favourable imaging.

qSOFA criteria

Respiratory rate 22/min or more, altered mentation, and systolic blood pressure 100 mmHg or less. Two or more criteria in a suspected infection indicate high risk and prompt escalation.

Burch-Wartofsky Point Scale

A scored tool for thyroid storm using fever, tachycardia, central nervous system agitation, gastrointestinal symptoms, and precipitant history. A score of 45 or more is highly suggestive.

Sepsis antibiotic timing

Broad-spectrum antibiotics should be administered within one hour of recognising septic shock, alongside blood cultures and fluid resuscitation with 30 mL/kg crystalloid.

Aspirin in acute coronary syndrome

Give 300 mg chewed or crushed immediately, then 75 mg daily long term. Add a P2Y12 inhibitor and anticoagulation as part of dual antiplatelet therapy after acute coronary syndrome.

Hypoglycaemia treatment threshold

Conscious patients with glucose below 4 mmol/L receive 15-20 g fast-acting oral carbohydrate, repeated after 10-15 minutes. Unconscious patients receive intravenous glucose or intramuscular glucagon.

Metformin and eGFR

Continue metformin when eGFR is 45 or above, review the dose at 30-44, and stop when eGFR falls below 30. Withhold during acute illness or before contrast imaging.

Atrial fibrillation stroke score

CHA2DS2-VASc assigns points for heart failure, hypertension, age, diabetes, stroke, vascular disease, and female sex. Anticoagulation is generally recommended at a score of 2 or more.

Digoxin toxicity features

Nausea, vomiting, visual disturbance such as yellow-green halos, bradycardia, and arrhythmias. Hypokalaemia potentiates toxicity; severe cases need digoxin-specific antibody fragments.

Addisonian crisis management

Give intravenous hydrocortisone 100 mg immediately, then repeat every six hours, with 1 L isotonic saline over the first hour. Do not delay steroids while awaiting confirmatory tests.

Periodontal stage thresholds

Stage I is attachment loss 1-2 mm, Stage II is 3-4 mm, Stage III is 5 mm or more with four or fewer teeth lost, and Stage IV adds five or more teeth lost or complex rehabilitation needs.

Periodontal grade calculation

Grade uses the ratio of radiographic bone loss percentage to age: below 0.25 is Grade A, 0.25 to 1.0 is Grade B, and above 1.0 is Grade C. Smoking and HbA1c raise the grade.

Reversible versus irreversible pulpitis

Reversible pulpitis produces sharp pain provoked by stimuli that resolves on removal. Irreversible pulpitis causes spontaneous or lingering pain, often waking the patient, and requires pulpectomy or extraction.

Avulsed tooth storage media

Milk, saline, or Hank balanced salt solution preserves periodontal ligament cells. Replant immediately if extraoral dry time is under 60 minutes, then splint flexibly for two weeks.

Lidocaine maximum dose

Without vasoconstrictor, lidocaine is limited to 4.4 mg/kg; with adrenaline, 7 mg/kg. A 2% lidocaine cartridge with 1:100,000 adrenaline contains 36 mg.

Articaine maximum dose

Articaine is limited to 7 mg/kg in adults, with an absolute cap of 500 mg. A 4% cartridge with 1:100,000 adrenaline contains 68 mg of articaine.

Infective endocarditis prophylaxis

Prophylaxis before invasive dental work applies to prosthetic heart valves, previous infective endocarditis, and specified congenital heart disease. It is not indicated for prosthetic joints or uncomplicated mitral valve prolapse.

Ludwig angina features

Bilateral submandibular and sublingual space infection with floor-of-mouth elevation, tongue displacement, dysphagia, and airway risk. It requires airway assessment, intravenous antibiotics, and urgent surgical drainage.

Bitewing radiograph indication

Bitewings show interproximal caries and crestal bone levels on posterior teeth. They are used for caries detection and monitoring rather than for assessing root apices.

Periapical radiograph indication

Periapicals visualise the full root length and periapical tissues, supporting endodontic diagnosis, working length estimation, and assessment of apical pathology or root fracture.

Fluoride varnish concentration

A 5% sodium fluoride varnish contains 22,600 ppm fluoride. It is applied at least twice yearly to high caries-risk patients, avoiding application to ulcerated mucosa.

Recall interval by caries risk

High-risk patients are reviewed every 3-6 months, moderate risk every 6-12 months, and low risk every 12-24 months, with the interval adjusted after each examination.

Symptomatic apical periodontitis

Inflammation of the apical periodontium producing pain on biting and tenderness to percussion, usually with a vital or necrotic pulp and no significant swelling.

Dental trauma crown fracture rule

Complicated crown fractures exposing pulp need pulp capping or pulpotomy within 24 hours. Uncomplicated enamel-dentine fractures are restored and reviewed for vitality and discolouration.

Dentine hypersensitivity mechanism

The hydrodynamic theory explains sensitivity as fluid movement within exposed dentinal tubules stimulating pulpal nerves. Management includes desensitising agents, occluding tubules, and reducing erosive or abrasive habits.

NICE antibiotic prescribing in dentistry

Antibiotics are not routinely indicated for pulpitis, dentine caries, or periodontitis without systemic involvement. They are reserved for spreading infection, systemic signs, or compromised hosts alongside definitive treatment.

Bisphosphonate osteonecrosis risk

Invasive dental treatment carries risk in patients on intravenous bisphosphonates or long-term oral therapy. Obtain a drug holiday decision from the prescriber and prioritise conservative, minimally traumatic care.