MDCN Assessment flashcards

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

Shock index

Heart rate divided by systolic blood pressure. A value of 0.9 or above in an adult suggests occult hypoperfusion and should prompt urgent reassessment of resuscitation.

Anion gap

Serum sodium minus the sum of chloride and bicarbonate, normally 8–12 mmol/L. It helps classify metabolic acidosis into high-gap and normal-gap causes.

Albumin-corrected anion gap

Add 2.5 mmol/L to the measured anion gap for every 1 g/dL that albumin falls below 4 g/dL, because hypoalbuminaemia lowers the measured gap.

Osmolar gap

Measured osmolality minus calculated osmolality (2×Na + glucose + urea). A gap above 10 mmol/L suggests an unmeasured osmole such as ethanol, methanol, or ethylene glycol.

Wells score for DVT

A clinical probability tool assigning points for cancer, immobilisation, leg swelling, calf tenderness, collateral veins, and prior DVT; a score of 2 or more suggests DVT is likely.

CHA₂DS₂-VASc score

Stroke-risk score in atrial fibrillation: one point each for heart failure, hypertension, diabetes, vascular disease, age 65–74, female sex; two points for age 75+ and prior stroke.

CURB-65

Community pneumonia severity score: confusion, urea above 7 mmol/L, respiratory rate 30 or more, low blood pressure, and age 65 or older, each scoring one point.

KDIGO AKI staging

Stage 1: creatinine rise of 26.5 µmol/L in 48 hours or 1.5–1.9× baseline. Stage 2: 2.0–2.9×. Stage 3: 3× or more, creatinine 354 µmol/L or higher, or dialysis.

High-sensitivity troponin interpretation

Serial sampling is required: a rising or falling pattern across timed samples indicates acute myocardial injury, whereas a static elevation may reflect chronic disease.

Glasgow Coma Scale components

Eye opening (1–4), verbal response (1–5), and motor response (1–6), summed to a total of 3–15. A score of 8 or below generally indicates coma.

Sepsis-3 definition

Life-threatening organ dysfunction from a dysregulated host response to infection, identified clinically by an acute rise in the SOFA score of 2 points or more.

qSOFA criteria

Bedside screen for suspected sepsis: respiratory rate 22 or more, altered mentation, and systolic blood pressure 100 mmHg or less. Two or more criteria indicate higher risk.

HbA1c diagnostic threshold

An HbA1c of 48 mmol/mol (6.5%) or above, confirmed on repeat testing, meets the diagnostic criterion for diabetes mellitus in most non-pregnant adults.

Corrected calcium formula

Corrected calcium equals measured calcium plus 0.02 × (40 − albumin in g/L). This adjusts for low albumin, which falsely lowers total measured calcium.

Child-Pugh score

Cirrhosis severity score using bilirubin, albumin, INR, ascites, and encephalopathy. Class A scores 5–6, class B 7–9, and class C 10–15.

MELD score

Liver disease severity score derived from bilirubin, INR, and creatinine, used to prioritise transplant allocation and estimate short-term mortality risk.

Cockcroft-Gault equation

Estimates creatinine clearance: (140 − age) × weight ÷ (0.814 × serum creatinine in µmol/L), multiplied by 0.85 for women. Used for drug dose adjustment.

Universal tooth numbering

Permanent teeth numbered 1 to 16 from the maxillary right third molar across to the maxillary left, then 17 to 32 from the mandibular left to right.

FDI two-digit notation

The first digit is the quadrant (1 upper right, 2 upper left, 3 lower left, 4 lower right) and the second digit is the tooth number from the midline.

Primary dentition count

Twenty teeth in total, five per quadrant. Eruption usually begins around six months with the mandibular central incisors and completes near two to three years.

Permanent eruption sequence

First molars erupt around age 6, followed by central incisors, lateral incisors, first premolars, canines, second premolars, second molars, and third molars in late adolescence.

Periodontal staging

Stages I to IV reflect severity by interdental clinical attachment loss and tooth loss, from 1–2 mm in stage I to 5 mm or more in stage IV.

Periodontal grading

Grades A to C estimate progression rate using bone loss divided by age and other risk factors; grade B is the moderate progression default.

Caries risk assessment

A structured evaluation of plaque, dietary sugar frequency, fluoride exposure, salivary flow, and past caries, used to decide recall interval and preventive treatment intensity.

Lidocaine maximum dose

4.4 mg/kg with adrenaline in adults. Each 2% cartridge with 1:100,000 adrenaline contains 36 mg lidocaine and 18 micrograms adrenaline.

Articaine maximum dose

7 mg/kg in adults, the highest among common dental local anaesthetics. A 4% cartridge contains 68 mg articaine, so cartridge counts must be calculated per patient weight.

Reversible pulpitis

Sharp, stimulus-provoked pain that resolves quickly once the stimulus is removed, with no spontaneous pain and a vital, responsive pulp on testing.

Irreversible pulpitis

Spontaneous or lingering pain, often worse at night or with heat, indicating pulp damage beyond repair and requiring root canal treatment or extraction.

Periapical diagnosis categories

Normal, symptomatic apical periodontitis, asymptomatic apical periodontitis, acute apical abscess, chronic apical abscess, and condensing osteitis, based on symptoms and radiographs.

Infective endocarditis prophylaxis

Indicated before invasive dental procedures for prosthetic valves, prior endocarditis, certain congenital heart disease, and transplant valvulopathy; not for routine joint prostheses.

Dental antibiotic prophylaxis regimen

A single 2 g oral dose of amoxicillin 30–60 minutes before the procedure; clindamycin is no longer preferred for allergy, with cephalexin or azithromycin used instead.

Dentine hypersensitivity mechanism

Fluid movement within exposed dentinal tubules stimulates pulpal nerve endings. Treatment occludes tubules or reduces nerve excitability with desensitising agents.

Pulp testing modalities

Thermal (cold) and electric pulp tests assess nerve responsiveness, while percussion and palpation assess the periapical tissues; no single test is diagnostic alone.