NMCLE 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 using confusion, urea, respiratory rate, blood pressure, and age 65 or older; a score of 2 or more generally indicates need for hospital admission.

Shock index

Heart rate divided by systolic blood pressure. A value above 0.9 suggests significant occult hemorrhage and is used in trauma triage and resuscitation monitoring.

Magnesium sulfate in eclampsia

Drug of choice for prevention and treatment of eclamptic seizures. Monitor deep tendon reflexes, respiratory rate, and urine output; calcium gluconate is the antidote for toxicity.

Kawasaki disease criteria

Fever for at least five days plus four of five features: conjunctivitis, rash, mucosal changes, extremity changes, and cervical lymphadenopathy. Treat with IV immunoglobulin and aspirin.

Sensitivity

Proportion of truly diseased people who test positive, calculated as true positives divided by true positives plus false negatives. It is unaffected by disease prevalence.

Zero-order kinetics

Elimination of a constant amount of drug per unit time regardless of concentration, seen with phenytoin, ethanol, and high-dose aspirin. Small dose changes can cause large level changes.

Apoptosis

Programmed cell death mediated by caspases that is energy-dependent and does not cause inflammation. It removes damaged cells without triggering an immune response.

Mean arterial pressure

Average arterial pressure during a cardiac cycle, approximated as diastolic pressure plus one-third of pulse pressure. It reflects organ perfusion pressure.

Hepatitis B surface antigen

Marker indicating current hepatitis B infection, either acute or chronic. Its presence implies infectivity; clearance with surface antibody development indicates resolved infection and immunity.

Thiamine deficiency

Vitamin B1 deficiency causing beriberi and Wernicke encephalopathy, with risk increased by alcohol use, malnutrition, and prolonged vomiting. Treatment is parenteral thiamine.

Rigor mortis

Postmortem stiffening from ATP depletion in muscle. It begins within hours, peaks around 12 hours, and resolves over 24 to 48 hours, aiding time-of-death estimation.

Acute angle-closure glaucoma

Emergency with severe eye pain, headache, halos, and a mid-dilated fixed pupil. Treat promptly with topical and systemic pressure-lowering agents and definitive laser iridotomy.

HFrEF four pillars

Mortality-reducing therapy for heart failure with reduced ejection fraction: ARNI or ACE inhibitor, beta-blocker, mineralocorticoid receptor antagonist, and SGLT2 inhibitor.

Parkland formula

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

Postpartum hemorrhage management

Most often due to uterine atony. Start uterine massage and oxytocin, then add ergometrine, carboprost, or misoprostol, and escalate to surgery if bleeding persists.

Neonatal jaundice within 24 hours

Jaundice appearing in the first 24 hours of life is always pathologic and requires urgent bilirubin measurement and investigation for hemolysis or sepsis.

Positive predictive value

Proportion of positive test results that are truly diseased. Unlike sensitivity and specificity, it depends strongly on disease prevalence in the tested population.

Volume of distribution

Apparent volume calculated as dose divided by plasma concentration. A large value suggests extensive distribution into tissues rather than confinement to plasma.

Metaplasia

Reversible replacement of one mature cell type by another, often due to chronic irritation, such as squamous metaplasia in smokers' airways. It may precede dysplasia.

Phrenic nerve

Nerve arising from C3 to C5 that supplies the diaphragm. Injury at any level above these roots or in the neck can cause respiratory compromise.

Gram-positive cocci in clusters

Microscopic appearance typical of Staphylococcus aureus. Chains suggest Streptococcus species, and pairs suggest Streptococcus pneumoniae in sputum.

Vitamin C deficiency

Causes scurvy with bleeding gums, poor wound healing, and perifollicular hemorrhage because vitamin C is required for collagen hydroxylation. Treatment is vitamin C replacement.

Negligence elements

A claim requires a duty of care, a breach of that duty, causation linking the breach to harm, and actual damages. All four elements must be established.

Sudden sensorineural hearing loss

Rapid hearing loss in one ear that is an emergency. High-dose corticosteroids should be started promptly to improve the chance of recovery.

Diabetic ketoacidosis treatment

Isotonic saline first, insulin infusion at 0.1 units/kg/h, and potassium replacement once potassium is below 5.2 mEq/L with adequate urine output.

ATLS sequence

Trauma assessment order: catastrophic hemorrhage control, airway, breathing, circulation, disability, and exposure. Permissive hypotension applies to uncontrolled hemorrhage before surgery.

Gestational diabetes screening

A 50 g glucose challenge at 24 to 28 weeks is followed by a 100 g three-hour oral glucose tolerance test if the screen is abnormal.

Croup treatment

Barking cough and inspiratory stridor in young children. A single dose of dexamethasone is first-line, with nebulized epinephrine added for severe cases.

Relative risk

Ratio of disease incidence in exposed versus unexposed groups, used in cohort studies. An odds ratio approximates it when the disease is rare.

Warfarin monitoring

Warfarin effect is monitored with the INR, while heparin is monitored with activated partial thromboplastin time or anti-Xa levels. Vitamin K reverses warfarin.

Tumor staging versus grading

Grading describes cellular differentiation, while staging describes anatomic extent of tumor spread. Staging generally predicts prognosis better than grading.

Cardiac output

Volume of blood pumped per minute, equal to heart rate multiplied by stroke volume. Normal resting output is about 5 liters per minute.