PANRE flashcards

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

CHA2DS2-VASc anticoagulation threshold

A score of 2 or more in men, or 3 or more in women, with atrial fibrillation warrants oral anticoagulation; lower scores generally need no antithrombotic therapy.

Aortic stenosis murmur features

Crescendo-decrescendo systolic murmur at the right upper sternal border radiating to the carotids, with a delayed diminished carotid upstroke and a soft second heart sound.

HOCM murmur dynamics

Harsh systolic murmur at the left lower sternal border that becomes louder with Valsalva and standing and softer with squatting, reflecting dynamic left ventricular outflow obstruction.

Pericarditis ECG findings

Diffuse concave ST-segment elevation and PR depression across leads, often with sharp positional pleuritic chest pain relieved by leaning forward; treat with NSAIDs plus colchicine.

COPD spirometric criterion

A post-bronchodilator FEV1/FVC ratio below 0.70 confirms persistent airflow obstruction and establishes the diagnosis of chronic obstructive pulmonary disease.

Light criteria exudate

Pleural fluid is exudative if fluid-to-serum protein exceeds 0.5, fluid-to-serum LDH exceeds 0.6, or fluid LDH exceeds two-thirds the serum upper limit of normal.

CURB-65 components

Confusion, urea above 7 mmol/L, respiratory rate 30 or more, low blood pressure, and age 65 or older; scores of 2 or more suggest inpatient admission.

Lipase in acute pancreatitis

Lipase elevated more than three times the upper limit of normal, with characteristic epigastric pain radiating to the back, is sufficient for diagnosis without imaging.

Child-Pugh score components

Bilirubin, albumin, INR, ascites, and encephalopathy are each scored to grade cirrhosis as class A, B, or C and to estimate prognosis.

Refeeding syndrome hallmark

Hypophosphatemia with low magnesium and potassium develops after rapid reintroduction of nutrition in malnourished patients; start feeding slowly and replete electrolytes.

Celiac disease confirmatory testing

IgA tissue transglutaminase with a total IgA level; duodenal biopsy showing villous blunting confirms the diagnosis, and patients must keep eating gluten before testing.

Septic arthritis synovial fluid

Synovial white count above 50,000 with more than 90 percent neutrophils suggests bacterial infection; Gram stain and culture guide therapy and urgent drainage is required.

Gout crystal appearance

Needle-shaped, negatively birefringent monosodium urate crystals under polarized light; pseudogout instead shows rhomboid, positively birefringent calcium pyrophosphate crystals.

Compartment syndrome pressure threshold

A delta pressure of less than 30 mmHg (diastolic pressure minus compartment pressure), or absolute compartment pressure above 30, with pain on passive stretch requires urgent fasciotomy.

Acute otitis media treatment

High-dose amoxicillin is first-line; observe 48 to 72 hours in children 6 to 23 months with nonsevere disease, but treat immediately if severe or in young infants.

HINTS exam for vertigo

Head impulse, nystagmus, and test of skew distinguish central from peripheral vertigo; a normal head impulse or direction-changing nystagmus suggests a central lesion.

Epiglottitis classic presentation

Fever, drooling, muffled voice, and tripod positioning in an unvaccinated child; avoid inspecting the throat with a tongue blade and secure the airway in the operating room.

Preeclampsia treatment medications

Labetalol, hydralazine, or nifedipine control severe hypertension; magnesium sulfate prevents and treats eclamptic seizures; the definitive management remains delivery.

Rhogam administration timing

Give anti-D immune globulin at 28 weeks gestation and within 72 hours after delivery of an Rh-positive infant, plus after sensitizing events such as amniocentesis or bleeding.

PCOS Rotterdam criteria

Diagnosis requires two of three: oligo-ovulation or anovulation, clinical or biochemical hyperandrogenism, and polycystic ovaries on ultrasound, after excluding other causes.

DKA diagnostic triad

Hyperglycemia usually above 250 mg/dL, arterial pH below 7.3 with bicarbonate under 18, and positive serum or urine ketones with an elevated anion gap.

Thyroid storm treatment order

Beta-blocker first, then a thionamide (PTU preferred), then iodine at least one hour after PTU, plus glucocorticoids with supportive cooling and fluids.

Primary hypothyroidism labs

Elevated TSH with a low free T4; subclinical disease shows a high TSH with normal free T4, and levothyroxine dosing is about 1.6 mcg/kg daily.

Thrombolysis window ischemic stroke

Intravenous alteplase or tenecteplase may be given within 4.5 hours of symptom onset when CT shows no hemorrhage and no contraindication exists.

Bacterial meningitis empiric therapy

Vancomycin plus ceftriaxone, adding ampicillin for patients over 50 or immunocompromised; give dexamethasone with or before the first antibiotic dose.

Status epilepticus first-line drug

A benzodiazepine such as lorazepam, midazolam, or diazepam is first-line; if seizures persist, give levetiracetam, fosphenytoin, or valproate.

Serotonin syndrome hallmark findings

Neuromuscular excitability with clonus, hyperreflexia, and agitation, plus autonomic instability and hyperthermia after serotonergic agents; treat with cyproheptadine and supportive care.

Alcohol withdrawal treatment

Benzodiazepines titrated to CIWA-Ar scores; give thiamine before glucose to prevent Wernicke encephalopathy, along with folate and fluid support.

Delirium versus dementia

Delirium has acute onset, fluctuating course, and inattention; dementia is chronic and progressive with attention preserved until late; the CAM screens for delirium.

KDIGO acute kidney injury criteria

Creatinine rise of 0.3 mg/dL or more within 48 hours, or 1.5 times baseline within 7 days, or urine output below 0.5 mL/kg/hour for 6 hours.

FeNa in prerenal azotemia

Fractional excretion of sodium below 1 percent suggests prerenal azotemia from hypoperfusion; values above 2 percent suggest intrinsic injury such as acute tubular necrosis.

Hyperkalemia with ECG changes

Give intravenous calcium gluconate or calcium chloride first to stabilize the myocardium, then insulin with glucose, albuterol, and sodium bicarbonate; dialyze refractory cases.