MCPS Family Medicine flashcards

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

First-line hypertension in Black adults

Thiazide diuretic or calcium channel blocker is preferred initial therapy for Black adults without CKD, because ACE inhibitors and ARBs are less effective and carry higher angioedema risk.

Four pillars of HFrEF therapy

ARNI or ACEi/ARB, evidence-based beta-blocker, mineralocorticoid receptor antagonist, and SGLT2 inhibitor each reduce mortality in heart failure with reduced ejection fraction and should be combined.

CURB-65 components

Confusion, Urea >7 mmol/L, Respiratory rate ≥30/min, Blood pressure <90 systolic or ≤60 diastolic, and age ≥65; score 0–1 supports outpatient care, 2 short admission, ≥3 ICU evaluation.

KDIGO AKI criteria

AKI is a creatinine rise ≥0.3 mg/dL within 48 hours, a rise to ≥1.5 times baseline within 7 days, or urine output <0.5 mL/kg/h for 6 hours.

Simple febrile seizure definition

A generalized seizure lasting under 15 minutes, occurring once in 24 hours, in a child aged 6 months to 5 years with fever and no prior neurologic abnormality; no routine EEG or imaging.

Kawasaki disease diagnostic criteria

Fever for at least 5 days plus 4 of 5 features: bilateral conjunctivitis, oral mucosal changes, polymorphous rash, extremity changes, and cervical lymphadenopathy; treat with IVIG and aspirin.

Bronchiolitis management

RSV bronchiolitis in infants is managed supportively with oxygen and hydration; routine bronchodilators, corticosteroids, and antibiotics are not recommended because they do not improve outcomes.

Pediatric dehydration ORS volumes

For mild dehydration give oral rehydration solution 50 mL/kg over 4 hours; for moderate dehydration give 100 mL/kg over 4 hours; severe dehydration requires isotonic IV fluids.

Gestational diabetes screening thresholds

Screen at 24–28 weeks with a 50-g glucose challenge; if ≥140 mg/dL, perform 100-g OGTT. Carpenter-Coustan thresholds are 95, 180, 155, and 140 mg/dL, with two or more abnormal values diagnostic.

Preeclampsia severe features

Blood pressure ≥160/110, platelets <100,000, AST/ALT >2 times normal, creatinine >1.1 mg/dL, pulmonary edema, or cerebral/visual symptoms define severe preeclampsia; delivery is definitive treatment.

Postpartum hemorrhage first steps

Uterine atony is the most common cause; give oxytocin 10 IU IM/IV, perform uterine massage, then add carboprost, methylergonovine (avoid in hypertension), or misoprostol, and tranexamic acid within 3 hours.

Cervical cancer screening intervals

Start at age 21; cytology every 3 years ages 21–29; ages 30–65 cytology every 3 years, HPV testing every 5 years, or co-testing every 5 years; stop at 65 after adequate negative screening.

Alvarado score components

Migration of pain, anorexia, nausea/vomiting, right lower quadrant tenderness, rebound tenderness, fever, leukocytosis, and left shift; score ≥7 suggests appendicitis and supports surgical evaluation.

Bowel obstruction surgery indications

Operate for signs of strangulation or perforation: fever, tachycardia, peritoneal signs, rising lactate, or worsening pain; otherwise initial management is NPO, nasogastric decompression, and IV fluids.

Revised Cardiac Risk Index

Predicts perioperative major cardiac events using ischemic heart disease, heart failure, cerebrovascular disease, insulin-dependent diabetes, creatinine >2 mg/dL, and high-risk surgery.

Ottawa ankle rules

Order ankle X-ray if there is malleolar pain plus bone tenderness at the posterior edge of the distal 6 cm of the tibia or fibula, or inability to bear weight four steps immediately and in the ED.

Septic arthritis synovial fluid

Synovial fluid white count >50,000/mm³ with >90% polymorphonuclear cells suggests septic arthritis until culture excludes it; immediate arthrocentesis and empiric antibiotics are indicated.

Compartment syndrome pressure threshold

Compartment pressure greater than 30 mmHg, or within 30 mmHg of diastolic pressure, with pain out of proportion and pain on passive stretch, indicates fasciotomy to prevent muscle and nerve necrosis.

Salter-Harris fracture types

SALTR: Slipped (I), Above (II), Lower (III), Through (IV), cRush (V); types III–V cross the physis and carry higher risk of growth disturbance.

Major depressive episode criteria

At least five of nine symptoms for two weeks, including depressed mood or anhedonia, plus sleep, appetite, energy, concentration, psychomotor, guilt, or suicidal symptoms; assess suicide risk.

Acute mania treatment

Treat acute mania with a mood stabilizer such as lithium or valproate plus an atypical antipsychotic; avoid antidepressant monotherapy because it can trigger mania or rapid cycling.

Alcohol withdrawal treatment

Use benzodiazepines for alcohol withdrawal; give thiamine before glucose to prevent Wernicke encephalopathy; monitor for seizures and delirium tremens, which carry significant mortality.

Delirium Confusion Assessment Method

Delirium is diagnosed by acute onset and fluctuating course, inattention, and either disorganized thinking or altered consciousness; it is a medical emergency requiring cause identification.

Lead-time bias

Screening appears to prolong survival because diagnosis occurs earlier, even if death occurs at the same age; mortality, not survival time, is the valid measure of screening benefit.

Case-control study measure

Case-control studies estimate the odds ratio, comparing exposure odds in cases versus controls; they are efficient for rare diseases but cannot directly measure incidence.

Sensitivity and specificity formulas

Sensitivity = true positives/(true positives + false negatives); specificity = true negatives/(true negatives + false positives); positive predictive value depends on disease prevalence.

CYP3A4 inhibitors and inducers

CYP3A4 inhibitors include grapefruit, ketoconazole, macrolides, and ritonavir; inducers include rifampin, carbamazepine, phenytoin, and St. John's wort; interactions alter drug levels significantly.

Warfarin reversal

For major warfarin bleeding, give 4-factor prothrombin complex concentrate plus vitamin K; for elevated INR without bleeding, hold warfarin and give vitamin K if bleeding risk is high.

Narrow therapeutic index drugs

Digoxin, lithium, warfarin, phenytoin, theophylline, and aminoglycosides require serum level monitoring; digoxin toxicity is worsened by hypokalemia and renal impairment.

Anion gap formula

Anion gap = Na − (Cl + HCO3), normal 8–12 mEq/L; elevated gap suggests MUDPILES causes; the delta-delta ratio helps identify mixed acid-base disorders.

Troponin kinetics

Troponin rises 3–6 hours after myocardial injury, peaks at 12–24 hours, and remains elevated 7–14 days; serial measurements with delta criteria improve acute myocardial infarction detection.

Tarasoff duty to warn

Clinicians may breach confidentiality to protect an identifiable person from serious imminent harm by a patient; this duty varies by jurisdiction and requires documenting risk assessment and actions.