OMSB Physician Exam flashcards

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

Primary PCI window

Primary percutaneous coronary intervention is preferred for STEMI when it can be delivered within 120 minutes of first medical contact; otherwise fibrinolysis if within 12 hours of symptom onset.

CHA2DS2-VASc threshold

Anticoagulation is recommended for atrial fibrillation when the score is at least 2 in men or at least 3 in women, balancing stroke reduction against bleeding risk.

Severe aortic stenosis criteria

Severe aortic stenosis is defined by peak velocity at least 4 m/s, mean gradient at least 40 mmHg, or valve area at most 1.0 cm squared, usually with symptoms.

HCM murmur maneuver

In hypertrophic cardiomyopathy the systolic murmur increases with Valsalva and standing because reduced preload worsens obstruction, and decreases with squatting.

Malignant hyperthermia antidote

Dantrolene 2.5 mg/kg IV treats malignant hyperthermia triggered by volatile anesthetics or succinylcholine, alongside stopping the trigger and cooling.

Lipid emulsion dosing

For local anesthetic systemic toxicity, give 20% lipid emulsion 1.5 mL/kg bolus followed by infusion, and avoid vasopressin, beta-blockers, and calcium channel blockers.

Succinylcholine contraindications

Avoid succinylcholine in burns older than 24 to 48 hours, denervation injury, prolonged immobility, and crush injury because of life-threatening hyperkalemia risk.

Apfel PONV risk factors

Female sex, nonsmoking status, history of postoperative nausea and vomiting, and postoperative opioids are the four Apfel factors used to guide prophylaxis.

Glycolysis net ATP

Cytoplasmic glycolysis yields a net 2 ATP and 2 NADH per glucose molecule, producing 2 pyruvate that enter mitochondria for further oxidation.

Urea cycle rate-limiting enzyme

Carbamoyl phosphate synthetase I catalyzes the rate-limiting mitochondrial step of the urea cycle; deficiency causes hyperammonemia with low blood urea nitrogen.

Thiamine cofactor enzymes

Thiamine pyrophosphate is required by pyruvate dehydrogenase, alpha-ketoglutarate dehydrogenase, and transketolase; deficiency causes Wernicke encephalopathy and beriberi.

G6PD hemolysis triggers

Oxidative drugs such as primaquine, dapsone, and nitrofurantoin, plus fava beans and infection, precipitate Heinz body hemolysis in glucose-6-phosphate dehydrogenase deficiency.

Avulsed permanent tooth storage

Replant an avulsed permanent tooth immediately or store it in milk or saline, then splint flexibly for about two weeks and consider tetanus prophylaxis.

Endocarditis prophylaxis indication

Dental procedure prophylaxis is indicated for prosthetic heart valves, prior infective endocarditis, and certain congenital heart disease, not routine joint prostheses.

Psoriasis clinical signs

Psoriasis shows well-demarcated erythematous plaques with silvery scale on extensor surfaces, Auspitz sign on scale removal, and Koebner phenomenon at trauma sites.

Pemphigus vulgaris features

Pemphigus vulgaris causes flaccid intraepidermal bullae with a positive Nikolsky sign and IgG against desmoglein 1 and 3; treat with corticosteroids and rituximab.

Melanoma prognostic factor

Breslow thickness, measured in millimeters from the granular layer to the deepest tumor cell, is the strongest prognostic factor in cutaneous melanoma.

Anaphylaxis epinephrine dose

Give intramuscular epinephrine 0.3 to 0.5 mg of 1:1000 solution in the anterolateral thigh and repeat every 5 to 15 minutes as needed.

Sepsis initial bundle

Measure lactate, draw blood cultures before antibiotics, give broad-spectrum antibiotics within one hour for septic shock, and 30 mL/kg crystalloid for hypotension or lactate at least 4.

Status epilepticus sequence

Give a benzodiazepine first, such as lorazepam or intramuscular midazolam, then a second-line antiseizure drug such as levetiracetam, valproate, or fosphenytoin.

Diabetes first-line therapy

Metformin is first-line for type 2 diabetes unless contraindicated; add an SGLT2 inhibitor or GLP-1 receptor agonist when atherosclerotic cardiovascular disease, heart failure, or kidney disease is present.

Combined pill contraindications

Combined oral contraceptives are contraindicated with migraine with aura, smoking after age 35, and prior venous thromboembolism; choose progestin-only or nonhormonal methods instead.

Osteoporosis DEXA threshold

A DEXA T-score of at most minus 2.5 defines osteoporosis; treatment choice depends on fracture risk and includes bisphosphonates, denosumab, or anabolic agents.

Appendicitis classic presentation

Periumbilical pain migrating to the right lower quadrant with McBurney point tenderness suggests acute appendicitis; ultrasound or CT confirms and guides appendectomy.

Postoperative fever timeline

Fever within 48 hours suggests atelectasis; days 3 to 5 suggest urinary tract infection or pneumonia; days 5 to 7 suggest surgical site infection or anastomotic leak.

Thyroidectomy nerve complication

Recurrent laryngeal nerve injury after thyroidectomy causes hoarseness, while parathyroid injury causes hypocalcemia with perioral numbness and positive Chvostek or Trousseau signs.

Heparin-induced thrombocytopenia management

A platelet drop greater than 50 percent at 5 to 10 days with thrombosis risk indicates heparin-induced thrombocytopenia; stop heparin and start argatroban or another non-heparin anticoagulant.

Iron deficiency laboratory pattern

Iron deficiency anemia shows low ferritin, low serum iron, high total iron-binding capacity, and low transferrin saturation; treat the underlying cause plus oral iron.

Caseous necrosis association

Caseous necrosis has a friable cheesy appearance within granulomas and is classically associated with tuberculosis and fungal infections.

Carcinoma in situ definition

Severe dysplasia with full-thickness epithelial atypia but an intact basement membrane is carcinoma in situ, meaning no invasive growth has occurred.

DKA potassium rule

In diabetic ketoacidosis, replace potassium before starting insulin when serum potassium is below 3.3 mmol/L, because insulin drives potassium intracellularly and worsens hypokalemia.

Spontaneous bacterial peritonitis

Spontaneous bacterial peritonitis is diagnosed when ascitic fluid neutrophil count is at least 250 per cubic millimeter and treated with a third-generation cephalosporin.