CPSP IMM Medicine flashcards

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

CURB-65 Components

Confusion, urea greater than 7 mmol/L, respiratory rate 30 or more, low blood pressure, and age 65 or older. Each scores one point; two or more points supports inpatient admission for pneumonia.

Sepsis-3 Definition

Sepsis is suspected infection plus an acute rise in SOFA score of at least two points. Septic shock adds vasopressor requirement for MAP 65 mmHg or higher and lactate above 2 mmol/L after fluids.

Anion Gap Formula

Sodium minus the sum of chloride and bicarbonate, normally 8 to 12 mEq/L. Add 2.5 mEq/L to the expected gap for every 1 g/dL decrease in serum albumin.

SIADH Diagnostic Criteria

Hypotonic hyponatremia with urine osmolality above 100 mOsm/kg and urine sodium usually above 30 mEq/L, while euvolemic. Hypothyroidism and adrenal insufficiency must be excluded first.

DRESS Syndrome Features

A drug hypersensitivity reaction occurring two to six weeks after exposure, with eosinophilia, transaminitis, facial edema, and rash. The culprit drug must be stopped promptly.

Mean Arterial Pressure Formula

Diastolic pressure plus one third of the pulse pressure, that is DBP plus (SBP minus DBP) divided by three. A target of 65 mmHg or higher guides vasopressor titration in shock.

Bazett Corrected QT

QT interval divided by the square root of the RR interval in seconds. A QTc above 500 ms or a rise greater than 60 ms increases torsades de pointes risk.

STEMI Reperfusion Times

Primary PCI is preferred if achievable within 120 minutes of first medical contact. Otherwise fibrinolysis should be given within 30 minutes of arrival when no contraindication exists.

HFrEF Quadruple Therapy

Four drug classes improve survival in reduced ejection fraction: ARNI or ACE inhibitor, evidence-based beta-blocker, mineralocorticoid receptor antagonist, and SGLT2 inhibitor.

CHA2DS2-VASc Threshold

Anticoagulation is recommended for atrial fibrillation when the score is 2 or higher in men or 3 or higher in women. A score of 1 in men warrants individualized consideration.

Severe Aortic Stenosis Criteria

Peak jet velocity of 4 m/s or more, mean gradient of 40 mmHg or more, or aortic valve area below 1.0 cm squared. Low-flow low-gradient cases need dobutamine stress assessment.

Cardiac Tamponade Triad

Beck triad consists of hypotension, distended neck veins, and muffled heart sounds. Echocardiography shows diastolic chamber collapse; treatment is fluid plus urgent pericardiocentesis.

Acute Respiratory Alkalosis Rule

In acute respiratory alkalosis, bicarbonate falls 2 mEq/L and PaCO2 falls 1.2 mmHg for each 1 mEq/L bicarbonate change. Chronic compensation reduces PaCO2 by 0.4 to 0.5 mmHg per mEq/L.

COPD GOLD Spirometry

A post-bronchodilator FEV1 to FVC ratio below 0.70 confirms persistent airflow obstruction. Severity grades use FEV1 percent predicted: 80 or higher, 50 to 79, 30 to 49, and below 30.

Light Criteria

Pleural fluid is exudative if any applies: protein ratio above 0.5, LDH ratio above 0.6, or pleural LDH above two thirds the upper normal serum limit.

PERC Rule Use

Eight criteria exclude pulmonary embolism only when all are absent and pretest probability is low. Any positive criterion means further testing such as D-dimer or CT angiography.

ARDS Berlin Definition

Onset within one week of a known insult, bilateral opacities not fully explained by effusion or collapse, no cardiac cause, and PaO2 to FiO2 ratio of 300 or less on PEEP of at least 5.

Glasgow-Blatchford Score

A score of 1 or less in upper gastrointestinal bleeding identifies very low risk, allowing consideration of outpatient management. It incorporates hemoglobin, urea, blood pressure, heart rate, and presentation.

Acute Pancreatitis Diagnosis

Two of three features are required: characteristic epigastric pain radiating to the back, lipase or amylase above three times the upper limit of normal, and cross-sectional imaging findings.

Hepatorenal Syndrome Type 1

Rapid creatinine rise in cirrhosis without shock, no improvement after albumin challenge, absence of nephrotoxins, and no structural kidney disease. Treatment uses terlipressin plus albumin.

Child-Pugh Components

Five variables: total bilirubin, serum albumin, INR, ascites, and encephalopathy. Class A indicates compensated disease, class B moderate impairment, and class C decompensation with poor prognosis.

Crohn Versus Ulcerative Colitis

Ulcerative colitis is continuous inflammation starting at the rectum and limited to mucosa. Crohn disease shows skip lesions, transmural inflammation, fistulae, and any part of the gastrointestinal tract.

Celiac Disease Testing

Check tissue transglutaminase IgA antibody together with total IgA, because IgA deficiency causes false negatives. Duodenal biopsy shows villous atrophy, crypt hyperplasia, and intraepithelial lymphocytosis.

Thyroid Storm Score

The Burch-Wartofsky score of 45 or higher is highly suggestive. Treatment combines beta-blockade, a thionamide, iodine given after the thionamide, and glucocorticoids.

DKA Diagnostic Criteria

Glucose usually above 250 mg/dL with pH below 7.3, bicarbonate below 18 mEq/L, and ketonemia. Total body potassium is depleted, so replace it once serum potassium is below 5.2 mEq/L.

Hyperosmolar Hyperglycemic State

Glucose often above 600 mg/dL with effective osmolality above 320 mOsm/kg, minimal ketosis, and severe dehydration. Mortality exceeds that of diabetic ketoacidosis, so fluid resuscitation comes first.

Estimated Average Glucose

Estimated average glucose in mg/dL equals 28.7 times HbA1c minus 46.7. HbA1c reflects mean glycemia over roughly three months because of red cell lifespan.

Aldosterone-Renin Ratio

Screening test for primary aldosteronism. Mineralocorticoid receptor antagonists are stopped four to six weeks beforehand, and hypokalemia is corrected, because both distort the ratio.

CKD-EPI 2021 Equation

A race-free creatinine-based equation for estimated glomerular filtration rate. CKD requires eGFR below 60 mL/min/1.73 m squared for at least three months or markers of kidney damage.

Fractional Excretion of Sodium

Urine sodium times plasma creatinine, divided by plasma sodium times urine creatinine, times 100. A value below 1 percent suggests prerenal azotemia, though diuretics reduce its reliability.

Fractional Excretion of Urea

Calculated like FENa but using urea. A value below 35 percent suggests prerenal azotemia and remains useful when diuretics have already raised urine sodium.

Hyponatremia Correction Limit

Correct sodium by no more than 8 mmol/L in 24 hours to prevent osmotic demyelination. Lower limits apply for chronic hyponatremia, malnutrition, alcohol use, and hypokalemia.