Russia Primary Medical Accreditation - General Medicine flashcards

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

CURB-65 score

Pneumonia severity tool scoring confusion, urea >7 mmol/L, respiratory rate ≥30/min, low systolic or diastolic pressure, and age ≥65; 0–1 supports outpatient care.

qSOFA criteria

Bedside sepsis screen: respiratory rate ≥22/min, altered mentation, and systolic blood pressure ≤100 mmHg; two or more criteria indicate high risk of poor outcome.

Anion gap formula

Anion gap equals sodium minus the sum of chloride and bicarbonate, normally 8–12 mmol/L; an elevated gap suggests ketoacidosis, lactic acidosis, renal failure, or toxin ingestion.

KDIGO acute kidney injury

AKI is a creatinine rise of at least 26.5 µmol/L within 48 hours, at least 1.5 times baseline within 7 days, or urine output below 0.5 mL/kg/h for 6 hours.

CHA2DS2-VASc score

Stroke risk score in atrial fibrillation; anticoagulation is generally recommended at ≥2 in men and ≥3 in women, weighing bleeding risk with HAS-BLED.

Heart failure four pillars

For reduced ejection fraction: ACE inhibitor, ARB, or ARNI; beta-blocker; mineralocorticoid receptor antagonist; and SGLT2 inhibitor, each shown to reduce mortality.

Light's criteria

Pleural fluid is an exudate if protein ratio >0.5, LDH ratio >0.6, or pleural LDH exceeds two-thirds the upper normal serum LDH; otherwise it is a transudate.

GOLD airflow limitation

COPD is confirmed by a post-bronchodilator FEV1/FVC ratio below 0.70; severity grading and exacerbation history guide inhaled therapy selection.

Serum-ascites albumin gradient

A gradient of 11 g/L or more between serum and ascitic albumin indicates portal hypertension, most often cirrhosis; lower values suggest peritoneal malignancy or tuberculosis.

Spontaneous bacterial peritonitis

Diagnosed when ascitic fluid polymorphonuclear cells reach 250/mm³ or more; treat with a third-generation cephalosporin and intravenous albumin.

Diabetic ketoacidosis management

Isotonic saline resuscitation, insulin infusion at 0.1 U/kg/h, and potassium replacement once potassium is below 5.5 mmol/L with adequate urine output.

Adrenal crisis treatment

In hypotension with hyponatremia, hyperkalemia, or hypoglycemia, draw cortisol and ACTH then give intravenous hydrocortisone 100 mg immediately without waiting for results.

Heparin-induced thrombocytopenia

A platelet fall exceeding 50% at 5–10 days after heparin, causing thrombosis rather than bleeding; stop heparin and start a non-heparin anticoagulant.

Multiple myeloma CRAB features

Hypercalcemia, renal insufficiency, anemia, and bone lesions define symptomatic myeloma; serum protein electrophoresis and free light chains support diagnosis.

Gout crystal identification

Negatively birefringent needle-shaped monosodium urate crystals in synovial fluid confirm gout; calcium pyrophosphate crystals are positively birefringent and rhomboid.

Giant cell arteritis

Age over 50 with headache, jaw claudication, and elevated ESR; give high-dose glucocorticoids immediately and confirm with temporal artery biopsy.

Tuberculosis standard regimen

Two months of isoniazid, rifampicin, pyrazinamide, and ethambutol followed by four months of isoniazid and rifampicin for drug-susceptible pulmonary disease.

Sepsis one-hour bundle

Measure lactate, obtain blood cultures, give broad-spectrum antibiotics, begin 30 mL/kg crystalloid for hypotension or lactate ≥4, and start vasopressors if needed.

High-quality chest compressions

Compress at 100–120 per minute to a depth of 5–6 cm, allow full chest recoil, minimize interruptions, and change compressor every two minutes.

Anaphylaxis first-line treatment

Intramuscular adrenaline 0.5 mg of 1 mg/mL solution into the anterolateral thigh, repeated every five minutes as needed, with fluids for hypotension.

Screening levels of prevention

Primary prevention reduces risk before disease, secondary prevention detects disease early, and tertiary prevention limits disability and complications after disease onset.

Hypertension diagnosis confirmation

Diagnose hypertension only after repeated elevated office readings, confirmed by home or ambulatory blood pressure monitoring to exclude white-coat elevation.

Primary care gatekeeping

First-contact, continuous, comprehensive, and coordinated care in which the primary physician manages referrals and coordinates specialist and hospital services.

Chronic disease register

A structured list of patients with a long-term condition used for planned reviews, recall, and multidisciplinary management to reduce avoidable hospital admissions.

Cardiac rehabilitation components

Exercise training, risk-factor modification, education, and psychosocial support after myocardial infarction or revascularization; it reduces mortality and improves function.

Barthel index

A scored assessment of activities of daily living such as feeding, bathing, mobility, and continence, used to track rehabilitation progress and dependency.

Drug half-life steady state

Steady-state plasma concentration is reached after about four to five half-lives; half-life also determines dosing interval and duration after stopping therapy.

CYP450 enzyme inhibition

Macrolides, azole antifungals, and grapefruit inhibit cytochrome P450 enzymes and raise concentrations of co-administered drugs, increasing toxicity risk.

ECG interpretation sequence

Assess rate, rhythm, axis, PR/QRS/QT intervals, hypertrophy, and ischemia or infarction, then compare with previous tracings before concluding.

Arterial blood gas analysis

Interpret pH, PaCO2, PaO2, and bicarbonate to classify respiratory or metabolic acidosis and alkalosis, then calculate the anion gap for metabolic acidosis.

Informed consent elements

Valid consent requires patient capacity, adequate disclosure of risks, benefits, and alternatives, and a voluntary decision, documented in the medical record.

Medical confidentiality exceptions

Confidentiality may be breached with patient consent or where law mandates notification, such as certain infectious diseases and gunshot wounds.