25 cardsLebanese Medical Colloquium (Colloquium Liban)
Lebanese Medical Colloquium - Clinical Protocols and Core Concepts
25 review flashcards covering emergency algorithms, clinical diagnosis, internal medicine, surgery, pediatrics, and obstetrics.
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What is the immediate initial management for acute tension pneumothorax?
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1
What is the immediate initial management for acute tension pneumothorax?
Immediate needle decompression with a large-bore cannula in the 2nd intercostal space midclavicular line (or 4th/5th anterior axillary line), followed by tube thoracostomy.
2
What is the diagnostic triad of Beck for cardiac tamponade?
Hypotension, jugular venous distension (elevated JVP), and muffled or distant heart sounds.
3
What is the gold standard diagnostic test for pulmonary embolism in hemodynamically stable patients?
Computed tomography pulmonary angiography (CTPA).
4
What is the first-line medication for an acute anaphylactic reaction?
Intramuscular epinephrine (adrenaline) 1:1,000 (0.3 to 0.5 mg in adults) injected into the anterolateral mid-thigh.
5
What classic ECG findings define ST-segment elevation myocardial infarction (STEMI)?
New ST-segment elevation at the J-point in at least two contiguous leads: >=2 mm in men (>=1.5 mm in women) in V2-V3, or >=1 mm in other leads.
6
What is the primary resuscitation target in diabetic ketoacidosis (DKA) prior to insulin administration?
Isotonic saline fluid resuscitation to restore intravascular volume and verification that serum potassium is >=3.3 mEq/L before starting IV insulin.
7
What is the classic diagnostic triad of acute appendicitis presentation?
Periumbilical pain migrating to the right lower quadrant (McBurney point), anorexia/nausea, and low-grade fever with localized peritoneal irritation.
8
What criteria define systemic inflammatory response syndrome (SIRS)?
At least 2 of: temperature >38C or <36C; heart rate >90 bpm; respiratory rate >20/min or PaCO2 <32 mmHg; WBC >12,000, <4,000, or >10% bands.
9
What initial medical treatment is indicated for ectopic pregnancy in hemodynamically stable patients?
Intramuscular methotrexate, provided the gestational mass is unruptured, beta-hCG is <5,000 mIU/mL, and no fetal cardiac activity is detected.
10
What is the definition of preeclampsia in a previously normotensive pregnant woman?
New-onset systolic BP >=140 mmHg or diastolic BP >=90 mmHg after 20 weeks of gestation, accompanied by proteinuria (>=300 mg/24h) or signs of end-organ dysfunction.
11
What is the drug of choice for seizure prophylaxis and treatment in eclampsia?
Intravenous magnesium sulfate (loading dose of 4-6 g over 15-20 minutes, followed by 1-2 g/hour maintenance infusion).
12
What pathogen is the most common cause of community-acquired pneumonia in children over 5 years of age?
Mycoplasma pneumoniae and Streptococcus pneumoniae.
13
What clinical signs characterize neonatal respiratory distress syndrome (RDS)?
Tachypnea, expiratory grunting, intercostal and subcostal retractions, nasal flaring, and cyanosis in room air, primarily due to surfactant deficiency.
14
What is the primary diagnostic sign on abdominal ultrasound for infantile hypertrophic pyloric stenosis?
Pyloric muscle thickness >=3 mm and pyloric channel length >=14 mm, with the characteristic 'target' or 'donut' sign on transverse view.
15
What electrolyte abnormality is characteristically caused by loop diuretics like furosemide?
Hypokalemia, hypochloremic metabolic alkalosis, and hypomagnesemia.
16
What is the initial antidote for severe acetaminophen (paracetamol) overdose?
N-acetylcysteine (NAC), which replenishes hepatic glutathione stores.
17
What is the landmark for performing a lumbar puncture in an adult?
The L3-L4 or L4-L5 intervertebral space, located at the level of the intercristal line (Tuffier line connecting the iliac crests).
18
What criteria define nephrotic syndrome in adults?
Proteinuria >3.5 g/24h, hypoalbuminemia (<3.0 g/dL), peripheral edema, and hyperlipidemia.
19
What are the classic clinical signs of acute cholangitis (Charcot triad)?
Fever/chills, right upper quadrant abdominal pain, and jaundice.
20
What additions turn Charcot triad into Reynolds pentad in suppurative cholangitis?
Hypotension (septic shock) and altered mental status.
21
What is the first-line pharmacologic treatment for acute ischemic stroke within 4.5 hours of onset?
Intravenous recombinant tissue plasminogen activator (rtPA, alteplase or tenecteplase), after excluding hemorrhage on non-contrast head CT.
22
What antibody is highly specific for systemic lupus erythematosus (SLE) and tracks with disease activity?
Anti-double-stranded DNA (anti-dsDNA) antibodies.
23
What is the diagnostic hallmark of intussusception on abdominal ultrasound in young children?
The 'target' or 'bulls-eye' sign on transverse scan and the 'pseudo-kidney' sign on longitudinal scan.
24
What medication is first-line for terminating sustained supraventricular tachycardia (SVT)?
Intravenous adenosine (6 mg rapid push via large vein, followed by 12 mg if unsuccessful), after vagal maneuvers.
25
What is the definitive management of symptomatic full-thickness third-degree atrioventricular block?
Temporary transcutaneous/transvenous cardiac pacing followed by permanent pacemaker implantation.
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