Palestinian Board Part I flashcards

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

Mean arterial pressure

Mean arterial pressure approximates diastolic pressure plus one third of the pulse pressure. It reflects average perfusion pressure across the cardiac cycle and guides management in shock and critical illness.

CURB-65

A pneumonia severity score using confusion, urea above 7 mmol/L, respiratory rate at least 30, low blood pressure, and age 65 or older. A score of 2 or more suggests inpatient care.

Parkland formula

A burn resuscitation formula giving 4 mL/kg per percent total body surface area of crystalloid in 24 hours, with half given in the first 8 hours from injury and the rest over 16 hours.

Alvarado score

A clinical score for appendicitis based on migratory pain, anorexia, nausea, right lower quadrant tenderness, rebound tenderness, fever, leukocytosis, and neutrophil shift. Higher scores support operative management.

Apgar score

A newborn assessment at 1 and 5 minutes scoring heart rate, respiratory effort, muscle tone, reflex irritability, and color from 0 to 2 each. A total of 0 to 3 indicates need for resuscitation.

Holliday-Segar method

A pediatric maintenance fluid rule giving 100 mL/kg/day for the first 10 kg, 50 mL/kg/day for the next 10 kg, and 20 mL/kg/day for each kilogram thereafter.

Naegele rule

A method to estimate delivery date by adding 7 days and subtracting 3 months from the first day of the last menstrual period, or by adding 280 days to that date.

Preeclampsia severe features

Blood pressure at least 160/110 mmHg, platelets below 100,000, doubled liver enzymes, pulmonary edema, or renal insufficiency occurring after 20 weeks of pregnancy with hypertension.

Erb palsy

Brachial plexus injury affecting C5 and C6 roots, producing weakness of shoulder abduction and external rotation with the arm internally rotated, often called waiter tip deformity.

Oxygen dissociation curve

A sigmoid curve describing hemoglobin oxygen saturation against partial pressure. It shifts right with increased carbon dioxide, decreased pH, increased temperature, and increased 2,3-DPG, reducing affinity.

Sensitivity

The proportion of people with disease who test positive, calculated as true positives divided by true positives plus false negatives. It is intrinsic to the test and independent of prevalence.

Herd immunity threshold

The proportion of a population that must be immune to interrupt transmission, calculated as 1 minus 1 divided by the basic reproduction number. It rises with more transmissible pathogens.

Relative risk

The ratio of disease incidence in exposed people to incidence in unexposed people. A value above 1 indicates increased risk; it is estimated directly in cohort studies.

Lead-time bias

Apparent longer survival after screening because disease is detected earlier, without any change in the time of death. Mortality, not survival time, evaluates screening benefit.

Informed consent

Agreement to treatment after adequate disclosure of risks, benefits, and alternatives, given by a patient with capacity, comprehension, and voluntariness. A competent adult may refuse treatment.

SPIKES framework

A six-step approach to breaking bad news covering setting, perception, invitation, knowledge, empathy, and strategy or summary. It structures difficult conversations in clinical practice.

Anaphylaxis treatment

Intramuscular adrenaline 0.5 mg of a 1:1000 solution into the anterolateral thigh, repeated every 5 minutes as needed. Antihistamines and steroids are adjuncts and never replace adrenaline.

Glasgow Coma Scale

A score from 3 to 15 combining eye opening, verbal response, and motor response. A score of 8 or below generally indicates need for airway protection.

SIADH

Euvolemic hyponatremia with low serum osmolality, inappropriately high urine osmolality, and urine sodium above 40 mEq/L. Treat with fluid restriction and, if severe, hypertonic saline.

Anion gap

Serum sodium minus chloride minus bicarbonate, normally about 8 to 12 mEq/L. A raised gap indicates unmeasured anions such as ketones, lactate, or toxins.

Hemorrhagic shock classes

Class I is up to 15 percent blood loss, class II is 15 to 30 percent with tachycardia, class III is 30 to 40 percent with hypotension, and class IV exceeds 40 percent with marked hypotension.

Abdominal compartment syndrome

Bladder pressure above 20 mmHg with new organ dysfunction. It requires decompression, usually by laparotomy, and is associated with high mortality if unrecognized.

Neonatal sepsis

A systemic infection in the first month of life, commonly caused by group B Streptococcus and Escherichia coli. Empiric treatment is ampicillin plus gentamicin.

Koplik spots

Small white spots on the buccal mucosa that appear before the measles rash. They are a classic early sign and the rash then spreads from the face downward.

Rhesus prophylaxis

Anti-D immunoglobulin given to an Rh-negative unsensitized mother at 28 weeks and within 72 hours of delivering an Rh-positive infant to prevent hemolytic disease of the newborn.

McRoberts maneuver

Hyperflexion of the maternal hips onto the abdomen to relieve shoulder dystocia. It is combined with suprapubic pressure, and fundal pressure should be avoided.

Rotterdam criteria

Diagnostic criteria for polycystic ovary syndrome requiring two of three findings: oligo-ovulation or anovulation, clinical or biochemical hyperandrogenism, and polycystic ovaries on ultrasound.

PALM-COEIN

A classification of abnormal uterine bleeding: polyp, adenomyosis, leiomyoma, malignancy or hyperplasia; coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, and not otherwise classified.

Henderson-Hasselbalch equation

pH equals 6.1 plus the logarithm of bicarbonate concentration divided by 0.03 times the partial pressure of carbon dioxide. It relates the components of acid-base balance.

Michaelis-Menten Km

The substrate concentration at half maximal enzyme velocity. A low Km indicates high enzyme affinity for substrate, while Vmax reflects the amount of active enzyme present.

Warfarin mechanism

Warfarin inhibits vitamin K epoxide reductase, reducing synthesis of clotting factors II, VII, IX, and X. Monitoring uses the INR, and major bleeding is reversed with vitamin K and prothrombin complex concentrate.

Aminoglycosides

Antibiotics that bind the 30S ribosomal subunit and inhibit protein synthesis. They are nephrotoxic and ototoxic, so levels and renal function must be monitored during treatment.

Case-control study

A study comparing past exposure between people with disease and controls without it. It estimates the odds ratio and is efficient for rare diseases.

Kaplan-Meier method

A statistical method estimating survival probability over time from censored data. The log-rank test compares survival curves between groups in clinical trials.

Substituted judgment

A standard for surrogate decisions based on what the patient would have chosen, using prior statements and values. Best interests applies when the patient's wishes are unknown.

Negligence elements

A malpractice claim requires a duty of care, a breach of that duty, causation linking the breach to harm, and damages. All four elements must be established.

Organophosphate poisoning

Acetylcholinesterase inhibition causing salivation, lacrimation, urination, diarrhea, bronchospasm, bradycardia, and miosis. Treat with atropine until secretions dry and with pralidoxime.

Tricyclic overdose

Sodium channel blockade causing QRS widening, arrhythmia, and seizures. Sodium bicarbonate is the treatment for cardiac toxicity, along with airway and circulatory support.

Malaria severe disease

Plasmodium falciparum infection with high parasitemia, cerebral involvement, hypoglycemia, or acidosis. Intravenous artesunate is the treatment of choice for severe cases.

Neutropenic fever

Fever in a patient with low neutrophils, requiring empiric broad-spectrum antibiotics within one hour. An antipseudomonal beta-lactam is the standard initial choice.

Acute pancreatitis diagnosis

Two of three criteria: characteristic epigastric pain, lipase or amylase above three times the upper limit, and imaging findings. Treatment is fluids, analgesia, and supportive care.

Acute limb ischemia

Sudden limb hypoperfusion with pain, pallor, pulselessness, paresthesia, paralysis, and poikilothermia. Treat with heparin and urgent revascularization to prevent limb loss.

Developmental milestones

Social smile at 6 weeks, head control at 3 months, sitting without support at 6 to 8 months, and walking at 12 to 15 months. Delays warrant developmental assessment.

HELLP syndrome

Hemolysis, elevated liver enzymes, and low platelets in pregnancy. It is a severe complication of preeclampsia, and delivery is the definitive treatment.

Health system building blocks

Service delivery, health workforce, health information, medical products and technologies, financing, and leadership and governance. These six components describe health system functions.

Universal health coverage

Access to needed health services without financial hardship. It is measured by service coverage and by the incidence of catastrophic health spending.

Attack rate

The number of new cases divided by the population at risk during an outbreak. It is used especially for point-source outbreaks with a single peak epidemic curve.

Number needed to treat

The reciprocal of the absolute risk reduction. It estimates how many patients must be treated for one additional beneficial outcome; a smaller value indicates greater benefit.

Delirium tremens

Severe alcohol withdrawal with confusion, hallucinations, tremor, and autonomic instability. It is treated with benzodiazepines, thiamine, and supportive care.

Duty to warn

A legal and ethical obligation to disclose confidential information when a patient poses a serious threat to an identifiable person, to protect that person from harm.

Aortic dissection

Sudden tearing chest pain radiating to the back with pulse deficits. Beta-blockers reduce heart rate and blood pressure before imaging and definitive management.

Acute severe asthma

A severe exacerbation treated with oxygen, inhaled salbutamol, ipratropium, and systemic corticosteroids. Magnesium sulfate may be added for refractory cases.

Child-Pugh score

A prognostic score in cirrhosis using bilirubin, albumin, INR, ascites, and encephalopathy. Higher scores indicate worse prognosis and guide transplantation referral.

Bacterial meningitis

A central nervous system infection requiring immediate empiric antibiotics and dexamethasone. Lumbar puncture should not delay antibiotics when the diagnosis is suspected.

Testicular torsion

Sudden severe testicular pain with a high-riding testis and absent cremasteric reflex. Surgical exploration within 6 hours is required to preserve the testis.

Compartment syndrome

Pain out of proportion to injury, tense compartment, and pain on passive stretch. Fasciotomy is required urgently to prevent muscle and nerve necrosis.

Tetralogy of Fallot

A congenital heart defect with ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy, and overriding aorta. Squatting increases systemic vascular resistance and relieves cyanosis.

Bronchiolitis

A lower respiratory infection in infants, usually caused by respiratory syncytial virus. Treatment is supportive with oxygen and hydration; bronchodilators are not routinely recommended.

Ovulation timing

A midcycle luteinizing hormone surge precedes ovulation by about 24 to 36 hours. Basal body temperature rises after ovulation because of progesterone.

Endometrial hyperplasia

Excessive endometrial proliferation from unopposed estrogen. Atypical hyperplasia carries a high risk of progression to endometrial cancer and usually requires hysterectomy.

Type I hypersensitivity

An immunoglobulin E mediated reaction with mast cell degranulation, causing urticaria, bronchospasm, and anaphylaxis. Adrenaline is the first-line treatment.

Trisomy 21

An autosomal aneuploidy with hypotonia, flat facies, and congenital heart defects such as ventricular septal defect. Risk increases with maternal age.

Chlorination

A water disinfection method effective against most bacterial and viral pathogens. Residual chlorine should be maintained in distribution systems to prevent recontamination.

Threshold limit value

An occupational exposure limit for airborne concentrations of a substance that most workers can be exposed to repeatedly without adverse health effects.

Basic reproduction number

The average number of secondary infections from one case in a fully susceptible population. An epidemic grows when it exceeds 1 and declines when it falls below 1.

Case fatality rate

Deaths divided by confirmed cases over a period. It can overestimate severity when mild cases are not detected and depends on testing and case definition.

SBAR handover

A structured communication tool covering situation, background, assessment, and recommendation. It improves handover accuracy and reduces errors in clinical teams.

Root cause analysis

A systematic method to identify underlying system failures that contributed to an adverse event. It focuses on prevention through system change rather than individual blame.

Neurogenic shock

Hypotension with bradycardia after spinal cord injury from loss of sympathetic tone. Treat with fluids and vasopressors and maintain spinal immobilization.

Heat stroke

Core temperature above 40 degrees Celsius with altered mental status. Rapid cooling by ice water immersion or evaporation is the priority treatment.

Gout crystals

Needle-shaped, negatively birefringent monosodium urate crystals in joint fluid. Pseudogout shows rhomboid, positively birefringent calcium pyrophosphate crystals.

Stevens-Johnson syndrome

A severe mucocutaneous drug reaction with epidermal detachment. Stop the offending drug and manage in a burn unit with supportive care.

Pediatric anaphylaxis

Intramuscular adrenaline 0.01 mg/kg up to 0.5 mg into the thigh, repeated every 5 minutes as needed. Antihistamines and steroids are adjuncts only.

Sudden infant death syndrome

Unexpected death of an infant under 1 year. Risk is reduced by back sleeping, a firm surface, no soft bedding, and avoiding bed sharing.