OMSB Internal Medicine (OEIM) flashcards

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

Sepsis-3 definition

Sepsis is suspected infection plus an acute increase in SOFA score of at least 2 points; septic shock adds vasopressor need and lactate above 2 mmol/L despite fluids.

CURB-65 components

Confusion, urea above 7 mmol/L, respiratory rate 30 or more, low systolic or diastolic blood pressure, and age 65 or older; each scores one point.

CHA2DS2-VASc score

Scores heart failure, hypertension, age 75 or older, diabetes, prior stroke, vascular disease, age 65-74, and female sex; guides anticoagulation in atrial fibrillation.

Winter's formula

Expected PaCO2 equals 1.5 times serum bicarbonate plus 8, with a range of plus or minus 2; a measured value outside this range suggests a mixed acid-base disorder.

Anion gap formula

Sodium minus the sum of chloride and bicarbonate, normally 8-12 mmol/L; add 2.5 mmol/L for every 1 g/dL drop in albumin below normal.

Light criteria

Pleural fluid is exudative if protein ratio exceeds 0.5, LDH ratio exceeds 0.6, or pleural LDH exceeds two-thirds the upper normal serum value.

KDIGO AKI staging

Stage 1 is creatinine rise of 0.3 mg/dL or 1.5-fold; stage 2 is 2-fold; stage 3 is 3-fold or creatinine 4 mg/dL or dialysis initiation.

AEIOU dialysis indications

Acidosis, electrolyte disturbance such as refractory hyperkalemia, intoxication, fluid overload, and uremia with complications such as pericarditis or encephalopathy.

Diabetic ketoacidosis management

Give isotonic saline first; start insulin infusion only when potassium is at least 3.3 mmol/L; add dextrose when glucose falls below 11-14 mmol/L to clear ketones.

Corrected sodium formula

Measured sodium plus 0.024 times the glucose minus 5.5 mmol/L; hyperglycemia dilutes sodium and the correction estimates the true value.

Corrected calcium formula

Measured calcium plus 0.02 times 40 minus the albumin in g/L; hypoalbuminemia lowers total calcium without changing ionized calcium.

CHA2DS2-VASc thresholds

Anticoagulation is recommended when the score is 2 or more in men and 3 or more in women; a score of 1 in men warrants individualized consideration.

Heart failure four pillars

For reduced ejection fraction, combine an ARNI or ACE inhibitor or ARB, an evidence-based beta-blocker, a mineralocorticoid receptor antagonist, and an SGLT2 inhibitor.

Hyponatremia correction limit

Correct chronic hyponatremia by no more than 8-10 mmol/L in 24 hours to reduce the risk of osmotic demyelination syndrome.

Glasgow Coma Scale

Eye opening scores 1-4, verbal response 1-5, and motor response 1-6; a total of 8 or less indicates need for airway protection.

Status epilepticus sequence

Give a benzodiazepine first, then a second-line agent such as levetiracetam, valproate, or phenytoin; refractory cases require anesthetic infusion.

Stroke thrombolysis window

Intravenous thrombolysis is given within 4.5 hours of last known well; mechanical thrombectomy may extend to 24 hours in selected large-vessel occlusion.

Neutropenic fever definition

A single temperature of 38.3°C or higher, or 38.0°C sustained over one hour, in a patient with an absolute neutrophil count below 500 cells per microliter.

Tumor lysis syndrome criteria

Cairo-Bishop criteria require two or more abnormal values among uric acid, potassium, phosphate, and calcium within three days before or seven days after chemotherapy.

Heparin-induced thrombocytopenia

A platelet drop greater than 50 percent with thrombosis occurring 5-10 days after heparin exposure; stop heparin and start a non-heparin anticoagulant.

Multiple myeloma CRAB features

Calcium elevation, renal insufficiency, anemia, and bone lesions; diagnosis also requires marrow plasma cells of 10 percent or more or a biopsy-proven plasmacytoma.

Giant cell arteritis treatment

Start high-dose glucocorticoids immediately when suspected, without waiting for biopsy, and confirm with temporal artery biopsy within two weeks.

ANCA vasculitis associations

c-ANCA with proteinase-3 antibodies suggests granulomatosis with polyangiitis; p-ANCA with myeloperoxidase antibodies suggests microscopic polyangiitis.

Antiphospholipid syndrome criteria

Recurrent thrombosis or pregnancy loss with persistent lupus anticoagulant, anticardiolipin, or anti-beta-2 glycoprotein antibodies on two occasions 12 weeks apart.

Aortic dissection management

Beta-blockade to a heart rate below 60 and systolic blood pressure below 120 precedes surgery; CT angiography confirms the diagnosis.

Cardiac tamponade signs

Beck triad of hypotension, distended neck veins, and muffled heart sounds, often with electrical alternans; urgent pericardiocentesis is required.

Hypertrophic cardiomyopathy murmur

A systolic murmur that increases with Valsalva maneuver and decreases with squatting; vasodilators and dehydration can worsen obstruction.

Nephrotic syndrome definition

Proteinuria greater than 3.5 g per day with hypoalbuminemia and edema; adults require biopsy to identify minimal change, membranous, or focal segmental glomerulosclerosis.

Nephritic syndrome features

Hematuria with red cell casts, hypertension, and oliguria; post-streptococcal glomerulonephritis follows pharyngitis by 1-2 weeks and resolves with supportive care.

Thyroid storm treatment

Give a beta-blocker, a thionamide, iodine after the thionamide, and a glucocorticoid; the Burch-Wartofsky score supports the diagnosis.

Pheochromocytoma treatment order

Alpha-blockade must precede beta-blockade to avoid unopposed vasoconstriction and hypertensive crisis; plasma free metanephrines are the best initial test.

Tuberculosis standard regimen

Two months of isoniazid, rifampin, pyrazinamide, and ethambutol followed by four months of isoniazid and rifampin; adjust for resistance.