25 cardsJordanian Medical Licensing Examination (JMLE)
JMLE Clinical Medicine and Surgery High-Yield Review
Essential diagnostic criteria, emergency management protocols, and clinical pearls for the Jordan Medical Council Licensing Examination.
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Acute STEMI Initial Emergency Pharmacotherapy
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1
Acute STEMI Initial Emergency Pharmacotherapy
Dual antiplatelet therapy (Aspirin 300 mg chewed + Ticagrelor/Clopidogrel), unfractionated heparin, sublingual nitroglycerin, and immediate primary PCI within 90 minutes.
2
Anaphylactic Shock First-Line Management
Intramuscular Epinephrine (Adrenaline) 1:1,000 (0.5 mg in adults, 0.01 mg/kg in children) injected into the anterolateral mid-thigh, high-flow oxygen, and IV crystalloids.
3
Acute Appendicitis Clinical Diagnosis and Signs
Migratory periumbilical pain shifting to RLQ (McBurney's point), accompanied by Rovsing's sign, Psoas sign, Obturator sign, anorexia, and leukocytosis.
4
Charcot's Triad and Reynolds' Pentad (Acute Cholangitis)
Triad: Fever + Jaundice + RUQ abdominal pain. Pentad (suppurative cholangitis): Triad + Hypotension (shock) + Altered mental status. Requires emergency biliary decompression.
5
Community-Acquired Pneumonia (CAP) CURB-65 Criteria
Confusion, Urea > 7 mmol/L, Respiratory rate >= 30/min, Blood pressure (SBP < 90 or DBP <= 60), Age >= 65. Score >= 2 warrants inpatient admission; >= 3 warrants ICU evaluation.
6
Diabetic Ketoacidosis (DKA) Diagnostic Triad and First Step
Hyperglycemia (> 250 mg/dL), metabolic acidosis (pH < 7.30, HCO3 < 18), and elevated serum/urine ketones. Priority first step: aggressive IV isotonic 0.9% saline hydration before insulin.
7
Status Epilepticus First-Line Emergency Drug
IV Lorazepam (0.1 mg/kg up to 4 mg) or IV Diazepam / IM Midazolam; follow immediately with IV Levetiracetam, Fosphenytoin, or Valproate if seizures persist beyond 5 minutes.
8
Tension Pneumothorax Immediate Management
Immediate emergency needle thoracostomy (decompression) at the 2nd intercostal space midclavicular line or 4th/5th ICS anterior axillary line, followed by tube thoracostomy.
9
Deep Vein Thrombosis (DVT) Wells Score and Initial Workup
Wells score <= 1 (unlikely): High-sensitivity D-dimer. Wells score >= 2 (likely): Compression duplex venous ultrasonography of the lower extremity.
10
Thyroid Storm Diagnostic Features and Management
Burch-Wartofsky score (hyperpyrexia, tachycardia, agitation, jaundice, CHF). Rx: Beta-blocker (Propranolol) + Antithyroid (PTU/Methimazole) + Iodine drops + Corticosteroid.
11
Acute Pancreatitis Diagnosis (Atlanta Criteria)
Requires 2 of 3: Characteristic epigastric pain radiating to back; Serum lipase or amylase > 3x upper limit of normal; Cross-sectional imaging (CT/MRI/US) consistent with pancreatitis.
12
Bacterial Meningitis CSF Profile in Lumbar Puncture
Markedly elevated opening pressure (> 200 mm H2O), neutrophilic pleocytosis (> 1,000 cells/uL), markedly elevated protein (> 100 mg/dL), and decreased CSF-to-serum glucose ratio (< 0.4).
13
Sepsis-3 Definition and qSOFA Bedside Score
Life-threatening organ dysfunction caused by dysregulated host response to infection (SOFA increase >= 2). qSOFA criteria (1 pt each): RR >= 22, Altered mentation (GCS < 15), SBP <= 100 mmHg.
14
Small Bowel Obstruction (SBO) Classic Signs and X-Ray
Colicky central abdominal pain, bilious vomiting, obstipation, abdominal distension, and high-pitched tinkling bowel sounds. X-ray: Multiple air-fluid levels and plicae circulares (string of pearls).
15
Preeclampsia Diagnostic Criteria after 20 Weeks Gestation
New-onset hypertension (SBP >= 140 or DBP >= 90 on 2 occasions 4 hrs apart) + Proteinuria (>= 300 mg/24h or PCR >= 0.3) OR signs of end-organ dysfunction (thrombocytopenia, renal/liver injury).
16
Eclampsia Seizure Prophylaxis and Treatment
Intravenous Magnesium Sulfate (loading dose 4-6 g IV over 15-20 min, followed by continuous infusion of 1-2 g/hr). Monitor deep tendon reflexes, respiratory rate, and urine output.
17
Pediatric Croup (Laryngotracheobronchitis) Presentation and Rx
Barking cough, inspiratory stridor, and hoarseness in young children (parainfluenza virus). Subglottic narrowing ('steeple sign') on neck X-ray. Rx: Single-dose oral/IM Dexamethasone + Nebulized Epinephrine.
18
Pediatric Acute Epiglottitis Pathogen and Key Sign
Haemophilus influenzae type b (Hib); high fever, tripod position, drooling, toxic appearance. Lateral neck X-ray reveals 'thumbprint sign'. Do NOT visualize pharynx with tongue depressor without airway team.
19
Pediatric Dehydration Assessment and Fluid Management
Mild-to-moderate: Oral Rehydration Salts (ORS) solution (50-100 mL/kg over 4 hours). Severe shock dehydration: 20 mL/kg bolus of IV isotonic 0.9% normal saline or Ringer's lactate.
20
Postpartum Hemorrhage (PPH) Definition and '4 Ts' Causes
Blood loss >= 500 mL after vaginal delivery or >= 1000 mL after cesarean. Etiologies (4 Ts): Tone (uterine atony, 70%), Tissue (retained placenta), Trauma (laceration/rupture), Thrombin (coagulopathy).
21
Ectopic Pregnancy Classic Triad and Ultrasound Finding
Amenorrhea, unilateral pelvic pain, and vaginal bleeding with positive serum beta-hCG. Transvaginal ultrasound demonstrates an empty uterine cavity with an adnexal mass ('ring of fire' sign).
22
Pulmonary Embolism (PE) Gold Standard Diagnostic Imaging
CT Pulmonary Angiography (CTPA) is the imaging modality of choice. In renal failure or severe contrast allergy, Ventilation-Perfusion (V/Q) lung scan is preferred.
23
Acute Gouty Arthritis First-Line Acute Treatment
Oral NSAIDs (e.g., Naproxen, Indomethacin) or oral Colchicine (within 36 hrs of onset). Corticosteroids (oral or intra-articular) when NSAIDs are contraindicated (e.g., renal failure).
24
Acute Glaucoma (Angle-Closure) Presentation and Signs
Sudden severe ocular pain, headache, nausea, colored halos around lights, mid-dilated fixed pupil, and cloudy 'steamy' cornea with intraocular pressure elevated above 40-50 mmHg.
25
Nephrotic Syndrome Diagnostic Tetrad
Heavy proteinuria (> 3.5 g/24h in adults or > 40 mg/m^2/h in children), Hypoalbuminemia (< 3.0 g/dL), Generalized peripheral edema, and Hyperlipidemia with lipiduria.
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