SMLE flashcards

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

CURB-65

Pneumonia severity score: confusion, urea >7 mmol/L, respiratory rate ≥30, low blood pressure, age ≥65. Each item scores one point; ≥2 suggests inpatient care.

Anion gap formula

Anion gap = Na+ − (Cl− + HCO3−), normally 8–12 mEq/L. Elevated gap indicates unmeasured anions such as ketones, lactate, uremia, or toxins.

Nephrotic syndrome criteria

Proteinuria greater than 3.5 g per day, hypoalbuminemia, edema, and hyperlipidemia. Minimal change disease is the commonest cause in children.

Parkland formula

Burn resuscitation: 4 mL of crystalloid × body weight in kg × percent total body surface area burned over 24 hours, with half given in the first 8 hours.

Alvarado score

Clinical appendicitis score using migration of pain, anorexia, nausea, right lower quadrant tenderness, rebound, fever, leukocytosis, and left shift; ≥7 supports surgery.

Hesselbach triangle

Boundaries are the inferior epigastric vessels laterally, inguinal ligament inferiorly, and rectus sheath medially. Direct hernias protrude through this triangle.

Holliday-Segar maintenance

Pediatric fluid maintenance: 100 mL/kg/day for first 10 kg, 50 mL/kg/day for next 10 kg, and 20 mL/kg/day thereafter.

Kawasaki disease criteria

Fever ≥5 days plus ≥4 of conjunctivitis, mucosal changes, rash, extremity changes, or cervical lymphadenopathy. Treat with IVIG and aspirin to prevent coronary aneurysms.

Simple febrile seizure

Generalized seizure lasting under 15 minutes occurring once in 24 hours in a child aged 6 months to 5 years with fever, without prior neurologic abnormality.

Preeclampsia definition

Blood pressure ≥140/90 after 20 weeks gestation with proteinuria or end-organ dysfunction. Delivery is definitive; magnesium sulfate prevents seizures.

Postpartum hemorrhage causes

The four T's: tone (uterine atony, commonest), trauma, tissue (retained placenta), and thrombin (coagulopathy). Atony is managed with massage and uterotonics.

Rh prophylaxis timing

Give anti-D immunoglobulin to unsensitized Rh-negative mothers at 28 weeks gestation and within 72 hours of delivering an Rh-positive infant.

Gestational diabetes thresholds

On a 75-g oral glucose tolerance test: fasting ≥92, one-hour ≥180, or two-hour ≥153 mg/dL. A single abnormal value establishes the diagnosis.

Metformin first-line

First-line pharmacotherapy for type 2 diabetes unless contraindicated by renal impairment or intolerance. SGLT2 inhibitors or GLP-1 agonists are added for cardiovascular or renal disease.

PHQ-9 use

Nine-item depression screening and severity tool; scores of 5, 10, 15, and 20 represent mild, moderate, moderately severe, and severe depression respectively.

Colorectal cancer screening

Average-risk adults begin screening around age 45–50 with colonoscopy every 10 years or annual fecal immunochemical testing, continuing to about age 75.

Serotonin syndrome features

Clonus, hyperreflexia, agitation, and hyperthermia after serotonergic drugs. Stop the offending agent; severe cases may receive cyproheptadine.

Neuroleptic malignant syndrome

Rigidity, fever, autonomic instability, and elevated creatine kinase after dopamine antagonists. Stop the drug and treat with dantrolene or bromocriptine.

Delirium definition

Acute, fluctuating disturbance of attention and awareness, often with disorientation. Identify and treat the underlying cause rather than relying on sedation.

Lithium therapeutic range

Target serum lithium 0.6–1.0 mEq/L, drawn 12 hours after the last dose. Toxicity causes tremor, ataxia, vomiting, and renal effects.

Anaphylaxis first-line drug

Intramuscular epinephrine 0.3–0.5 mg of 1:1000 solution into the lateral thigh, repeated every 5–15 minutes. Antihistamines and steroids are adjuncts only.

Sepsis bundle elements

Measure lactate, obtain blood cultures, give broad-spectrum antibiotics within one hour, and give 30 mL/kg crystalloid for hypotension or lactate ≥4 mmol/L.

Tension pneumothorax management

A clinical diagnosis requiring immediate needle decompression followed by tube thoracostomy. Do not delay treatment for chest imaging.

Organophosphate poisoning antidote

Atropine titrated until secretions dry, plus early pralidoxime. Features include salivation, lacrimation, urination, diarrhea, bronchospasm, and bradycardia.

Malignant hyperthermia treatment

Stop triggering volatile agents and succinylcholine, give dantrolene 2.5 mg/kg intravenously, and cool the patient while treating hyperkalemia and acidosis.

Local anesthetic systemic toxicity

Stop injection, secure the airway, and give 20% lipid emulsion 1.5 mL/kg bolus with infusion. Seizures and arrhythmias may follow inadvertent intravascular injection.

ARDS Berlin criteria

Acute onset within one week, bilateral opacities, no cardiac cause, and PaO2/FiO2 ≤300 on PEEP ≥5. Ventilate with low tidal volume of 6 mL/kg predicted body weight.

Septic shock vasopressor

Norepinephrine is first-line to maintain mean arterial pressure ≥65 mmHg. Add vasopressin or epinephrine for refractory shock.

Half-life equation

Half-life = 0.693 × volume of distribution divided by clearance. It determines the time to steady state, generally about four to five half-lives.

Frank-Starling relationship

Increasing ventricular preload increases stroke volume up to a physiologic limit. Beyond that point, further stretch reduces effective contraction.

Oxygen curve right shift

Increased 2,3-BPG, acidosis, hypercapnia, and fever reduce hemoglobin oxygen affinity, shifting the curve right and enhancing tissue oxygen unloading.

Staphylococcus aureus identification

Gram-positive cocci in clusters that are catalase and coagulase positive. Coagulase positivity distinguishes it from coagulase-negative staphylococci such as S. epidermidis.