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32 cardsRevalida (Brazil Medical Diploma Revalidation Exam)

Revalida: Key Clinical Rules and Numbers

Thirty-two cards with the clinical rules, formulas and public health facts that are most often tested in the Brazilian medical validation exam.

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Diagnosis of diabetes
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1
Diagnosis of diabetes
Fasting glucose of 126 mg/dL or more, or HbA1c of 6.5% or more, on repeated testing.
2
First-line drug in type 2 diabetes
Metformin.
3
First step in diabetic ketoacidosis
Intravenous fluids, then insulin once potassium is known.
4
Primary hypothyroidism
High TSH, low free T4; treated with levothyroxine.
5
Initial treatment of STEMI
Aspirin and prompt reperfusion with primary PCI.
6
Heart failure with reduced ejection fraction
ACE inhibitor (or ARB), evidence-based beta-blocker and mineralocorticoid antagonist improve survival.
7
Stroke thrombolysis window
Up to 4.5 hours from symptom onset, after CT excludes bleeding.
8
Tuberculosis treatment in Brazil
Rifampicin, isoniazid, pyrazinamide and ethambutol for 2 months, then rifampicin and isoniazid for 4 months.
9
CURB-65
Confusion, urea above 7 mmol/L, respiratory rate 30 or more, low blood pressure and age 65 or over.
10
Hyperkalaemia with ECG changes
Intravenous calcium gluconate first, then insulin with glucose.
11
Spontaneous bacterial peritonitis
250 or more neutrophils/mm³ in ascitic fluid; ceftriaxone and albumin.
12
Hepatic encephalopathy
Lactulose.
13
Paracetamol overdose antidote
N-acetylcysteine.
14
Organophosphate poisoning antidote
Atropine, with pralidoxime.
15
Dengue without warning signs
Oral hydration and paracetamol; avoid aspirin and NSAIDs.
16
Primary survey in trauma (ATLS)
A airway with cervical spine protection, B breathing, C circulation, D disability, E exposure.
17
Tension pneumothorax
Clinical diagnosis; needle decompression at once.
18
Beck's triad
Hypotension, muffled heart sounds and distended neck veins: cardiac tamponade.
19
Parkland formula
4 mL x kg x % body surface burned in 24 hours; half in the first 8 hours.
20
Glasgow Coma Scale range
3 to 15.
21
APGAR score
Assessed at 1 and 5 minutes: heart rate, respiration, tone, reflexes, colour.
22
Exclusive breastfeeding
Until 6 months of age.
23
Newborn vaccines
BCG and hepatitis B.
24
Developmental milestones
Social smile at about 2 months; sits without support at about 6 months; walks alone at about 12 months.
25
4-2-1 rule
Maintenance fluids: 4 mL/kg/h for the first 10 kg, 2 for the next 10 kg and 1 for each kg above 20.
26
Naegele's rule
Add 7 days to the last menstrual period and subtract 3 months.
27
Preeclampsia
Blood pressure of 140/90 mmHg or more after 20 weeks with proteinuria or organ dysfunction; magnesium sulfate prevents seizures.
28
Screening in Brazil
Pap smear from 25 to 64 years; mammography every two years from 50 to 69.
29
SUS principles and guidelines
Universality, equity and integrality; decentralisation, regionalisation and community participation.
30
Laws of the SUS
Law 8.080/1990 organises the SUS; Law 8.142/1990 deals with social participation.
31
Prevention levels
Primary: before disease (vaccines). Secondary: early detection (screening). Tertiary: rehabilitation. Quaternary: avoiding excess intervention.
32
Epidemiological measures
Incidence: new cases at risk. Prevalence: existing cases. Case fatality: deaths among cases.

Revalida (Brazil Medical Diploma Revalidation Exam) in Brazil

In Brazil, Revalida (Brazil Medical Diploma Revalidation Exam) is part of: Medicine.

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