OMSB Family Medicine (OEFM) flashcards

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

Hypertension diagnostic threshold

In adults, office blood pressure at or above 140/90 mmHg on two separate occasions confirms hypertension; home or ambulatory readings at or above 135/85 mmHg also support the diagnosis.

Metformin first-line type 2

Metformin is first-line pharmacotherapy for most adults with type 2 diabetes unless contraindicated by severe renal impairment, acidosis, or intolerance; lifestyle change remains foundational and A1c targets are individualized.

COPD spirometry criterion

A post-bronchodilator FEV1/FVC ratio below 0.70 confirms persistent airflow limitation and supports a diagnosis of chronic obstructive pulmonary disease in a symptomatic adult with compatible exposure history.

Infant fever under three months

A rectal temperature of 38.0 degrees Celsius or higher in an infant younger than three months warrants urgent sepsis evaluation, blood and urine cultures, lumbar puncture unless contraindicated, and empiric intravenous antibiotics.

Bronchiolitis routine management

Bronchiolitis is managed supportively with hydration, nasal suction, and oxygen if saturation falls below 90 to 92 percent; routine bronchodilators, corticosteroids, and antibiotics are not recommended.

Acute otitis media antibiotics

Amoxicillin is first-line for acute otitis media in children; observation for 48 to 72 hours is reasonable for selected children aged two years or older with nonsevere illness and reliable follow-up.

Preconception folic acid

Women planning pregnancy should take 400 micrograms of folic acid daily before conception and through the first trimester; 5 milligrams daily is used when prior neural tube defect or high risk exists.

Preeclampsia diagnostic threshold

Preeclampsia is new hypertension at or above 140/90 mmHg after 20 weeks of gestation plus proteinuria or maternal organ dysfunction; severe features mandate earlier delivery regardless of gestational age.

Ectopic methotrexate criteria

Methotrexate may be offered for a stable, unruptured tubal ectopic pregnancy when hCG is below 5000 IU/L, mass is small, and follow-up with serial hCG monitoring is reliable.

Anaphylaxis first-line treatment

Intramuscular epinephrine 0.5 milligrams of 1:1000 solution into the anterolateral thigh is first-line for adult anaphylaxis; repeat every 5 to 15 minutes if needed, and do not delay for adjuncts.

Sepsis antibiotic timing

For suspected sepsis, obtain cultures and give broad-spectrum antibiotics within one hour; give 30 mL/kg crystalloid for hypotension or lactate at or above 4 mmol/L.

Status epilepticus second-line

After a benzodiazepine fails to stop status epilepticus, second-line options include levetiracetam, fosphenytoin, or valproate; airway, breathing, circulation, and glucose should be addressed simultaneously.

Ottawa ankle rules

Ankle radiography is indicated after injury if there is pain in the malleolar zone plus inability to bear weight for four steps or bone tenderness at the posterior malleolus or fibular tip.

Low back pain red flags

Red flags for low back pain include age over 50 with new pain, cancer history, unexplained weight loss, fever, intravenous drug use, trauma, progressive neurologic deficit, and bowel or bladder dysfunction.

Gout acute treatment

Acute gout is treated with an NSAID, colchicine, or systemic corticosteroid; urate-lowering therapy is usually started after the flare settles, with prophylaxis against further attacks.

Depression first-line options

For moderate to severe depression, psychotherapy or an SSRI is first-line; continue treatment for at least 6 to 12 months after remission and assess suicide risk at every visit.

Alcohol withdrawal treatment

Alcohol withdrawal is managed with benzodiazepines guided by a withdrawal scale; give thiamine before glucose, monitor for delirium tremens, and correct electrolytes and volume depletion.

Bipolar mania prescribing

Acute bipolar mania is treated with a mood stabilizer such as lithium or valproate, often plus an antipsychotic; antidepressant monotherapy can precipitate mania and is avoided.

Colorectal cancer screening age

Average-risk adults should begin colorectal cancer screening at age 45 and continue to age 75; options include colonoscopy every 10 years or annual fecal immunochemical testing.

Tuberculosis initial investigations

Suspected pulmonary tuberculosis is investigated with sputum smear and culture, chest radiography, and nucleic acid amplification; treatment uses multidrug directly observed therapy and isolation until smear-negative.

Notifiable disease examples

Suspected cholera, plague, yellow fever, diphtheria, poliomyelitis, measles, and viral hemorrhagic fever require immediate notification to public health authorities to enable rapid containment.

Melanoma ABCDE criteria

Melanoma warning signs include asymmetry, irregular border, color variation, diameter greater than 6 millimeters, and evolution in size, shape, or symptoms; evolving lesions are especially concerning.

Cellulitis initial antibiotic

Nonpurulent cellulitis is usually caused by streptococci or staphylococci and is treated with an oral beta-lactam such as cephalexin; mark the border, elevate the limb, and review response in 48 hours.

Scabies treatment regimen

Scabies is treated with topical permethrin 5 percent applied to the whole body and repeated after 7 days; close contacts should be treated simultaneously, and bedding washed hot.

Acute angle-closure glaucoma

Acute angle-closure glaucoma presents with severe eye pain, headache, halos, nausea, and a fixed mid-dilated pupil; it is an emergency requiring urgent intraocular pressure lowering and ophthalmology review.

Epiglottitis airway priority

Suspected epiglottitis with drooling, tripod posture, and stridor requires immediate airway expertise; avoid examining the throat or lying the patient flat because this can precipitate complete obstruction.

Strep pharyngitis treatment

Confirmed or strongly suspected group A streptococcal pharyngitis is treated with penicillin or amoxicillin for 10 days to prevent rheumatic fever and reduce transmission.

Delirium first steps

Delirium is acute fluctuating inattention and confusion; identify and treat precipitants such as infection, medications, pain, constipation, urinary retention, and metabolic derangement, and avoid physical restraints.

Falls assessment domains

Falls assessment covers gait and balance, vision, orthostatic blood pressure, medications, footwear, home hazards, and vitamin D status; exercise and multifactorial intervention reduce recurrence.

Palliative opioid bowel care

Patients starting regular opioids for cancer pain should receive a prophylactic bowel regimen such as a stimulant laxative plus stool softener, because constipation is common and does not resolve with continued use.

Sensitivity and specificity

Sensitivity is true positives divided by true positives plus false negatives; specificity is true negatives divided by true negatives plus false positives; predictive values depend on disease prevalence in the tested population.

Number needed to treat

Number needed to treat equals one divided by absolute risk reduction; absolute risk reduction equals control event rate minus treatment event rate, and a smaller number indicates greater clinical benefit.