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25 cardsNational Health Regulatory Authority Licensure Examination (NHRA Bahrain)
NHRA Bahrain Clinical Practice and Emergency Protocols
Essential clinical diagnostic criteria, acute emergency resuscitation algorithms, and management guidelines for NHRA medical licensure.
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First-Line Medical Therapy for Acute Anaphylaxis
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1
First-Line Medical Therapy for Acute Anaphylaxis
Intramuscular Epinephrine 1:1,000 (0.3 to 0.5 mg in adults, 0.01 mg/kg in children) injected into the anterolateral mid-thigh.
2
Immediate Dual Antiplatelet and Anticoagulation for STEMI
Aspirin 300 mg chewed plus a P2Y12 inhibitor (Ticagrelor 180 mg or Clopidogrel 600 mg) and unfractionated heparin prior to primary PCI.
3
Curbside qSOFA Sepsis Screening Criteria
1. Respiratory rate >= 22 breaths/min; 2. Altered mental status (GCS < 15); 3. Systolic blood pressure <= 100 mmHg. Positive score >= 2.
4
Initial Fluid Resuscitation for Septic Shock (Hour-1 Bundle)
30 mL/kg of intravenous balanced crystalloids (e.g., lactated Ringer's) within 3 hours, targeting MAP >= 65 mmHg.
5
Preferred First-Line Vasopressor for Septic Shock Refractory to Fluids
Norepinephrine infusion titrated to maintain mean arterial pressure (MAP) >= 65 mmHg.
6
Door-to-Balloon and Door-to-Needle Time Benchmarks in Acute MI
Door-to-balloon time for primary PCI <= 90 minutes; door-to-needle time for intravenous fibrinolysis <= 30 minutes.
7
Immediate Management of Hyperkalemia with ECG Changes
Intravenous Calcium Gluconate (10% 10 mL over 2-5 minutes) for immediate myocardial membrane stabilization, followed by insulin/dextrose.
8
Initial Pharmacotherapy for Status Epilepticus (Seizure > 5 Minutes)
Intravenous Lorazepam (0.1 mg/kg, typically 4 mg) or IV Diazepam 10 mg; intramuscular Midazolam 10 mg if IV access is unavailable.
9
Classic Charcot Triad and Reynolds Pentad of Acute Cholangitis
Charcot: Fever, right upper quadrant pain, jaundice. Reynolds pentad adds hypotension and altered mental status (indicating septic emergency).
10
Emergency Treatment of Tension Pneumothorax Before Chest Tube
Immediate needle decompression with a large-bore cannula (14-gauge) at the second intercostal space midclavicular line or 5th ICS anterior axillary line.
11
Diagnostic Triad of Diabetic Ketoacidosis (DKA)
Hyperglycemia (blood glucose > 250 mg/dL), metabolic acidosis (pH < 7.30 or serum bicarbonate < 18 mEq/L), and positive serum/urine ketones.
12
Potassium Replacement Threshold in Diabetic Ketoacidosis
Do not initiate IV insulin if serum potassium is < 3.3 mEq/L. Correct potassium first to prevent fatal cardiac arrhythmias.
13
CURB-65 Pneumonia Severity Score Components
C: Confusion, U: Urea > 7 mmol/L, R: Respiratory rate >= 30, B: BP < 90 systolic or <= 60 diastolic, Age >= 65 years. Score 2+ warrants admission.
14
First-Line Antihypertensive for Severe Preeclampsia / Eclampsia
Intravenous Hydralazine, intravenous Labetalol, or oral immediate-release Nifedipine to safely lower BP below 160/110 mmHg.
15
Seizure Prophylaxis and Treatment in Severe Preeclampsia / Eclampsia
Intravenous Magnesium Sulfate (4 to 6 g loading dose over 15-20 min, followed by 1 to 2 g/hour continuous maintenance infusion).
16
Antidote for Magnesium Sulfate Toxicity with Loss of Deep Tendon Reflexes
Intravenous Calcium Gluconate (10% 10 mL administered slowly over 5 to 10 minutes).
17
First-Line Pharmacotherapy for Postpartum Hemorrhage (PPH) from Uterine Atony
Intravenous Oxytocin (10 to 40 units in crystalloid infusion) combined with vigorous bimanual uterine fundal massage.
18
APGAR Score Assessment Parameters at 1 and 5 Minutes
Appearance (color), Pulse (heart rate), Grimace (reflex response), Activity (muscle tone), Respiration (effort). Max score = 10.
19
Classic Triad and Clinical Presentation of Intussusception in Infants
Intermittent colicky abdominal pain, sausage-shaped right upper quadrant abdominal mass, and 'currant jelly' bloody stools.
20
Diagnostic and Therapeutic Modality of Choice for Ileocolic Intussusception
Ultrasound-guided air or water-soluble contrast enema reduction in hemodynamically stable patients without bowel perforation.
21
Centor Criteria for Streptococcal Pharyngitis
1. Tonsillar exudates; 2. Tender anterior cervical lymphadenopathy; 3. History of fever; 4. Absence of cough. Score 3-4 warrants rapid test and antibiotics.
22
Pharmacological Treatment of Croup (Laryngotracheobronchitis)
Single dose of oral or intramuscular Dexamethasone (0.15 to 0.6 mg/kg); nebulized racemic epinephrine for moderate-to-severe stridor at rest.
23
Therapeutic Target and Window for IV Alteplase in Acute Ischemic Stroke
Administered within 4.5 hours of symptom onset after excluding intracranial hemorrhage by non-contrast head CT, with BP < 185/110 mmHg.
24
First-Line Maintenance Medication for Chronic Heart Failure with Reduced Ejection Fraction (HFrEF)
Four pillars: SGLT2 inhibitor, ARNI (Sacubitril/Valsartan) or ACEi/ARB, evidence-based beta-blocker, and Mineralocorticoid receptor antagonist.
25
Primary Medical Therapy for Acute Upper GI Bleeding from Peptic Ulcer
High-dose intravenous Proton Pump Inhibitor (e.g., Esomeprazole 80 mg IV bolus followed by 8 mg/hour infusion) and early endoscopy within 24 hours.
National Health Regulatory Authority Licensure Examination (NHRA Bahrain) in Bahrain
In Bahrain, National Health Regulatory Authority Licensure Examination (NHRA Bahrain) is part of: Health professions.
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