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25 cardsKuwait Medical Licensing Examination (KMLE / KIMS)

KMLE Clinical Practice, Therapeutics, and Emergency Protocols

25 flashcards to revise the key facts for the Kuwait Medical Licensing Examination. Study material written for practice, not the official exam.

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Adult Cardiac Arrest: Shockable vs Non-Shockable Rhythms
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1
Adult Cardiac Arrest: Shockable vs Non-Shockable Rhythms
Shockable: Ventricular Fibrillation (VF) and Pulseless Ventricular Tachycardia (pVT) -> Immediate defibrillation + CPR + Epinephrine 1 mg q3-5min + Amiodarone. Non-Shockable: Asystole and PEA -> CPR + Epinephrine, no shock.
2
Initial Vasopressor of Choice in Septic Shock
Norepinephrine (Noradrenaline) continuous IV infusion, titrated to maintain Mean Arterial Pressure (MAP) >= 65 mmHg after fluid resuscitation.
3
Four Pillars of Guideline-Directed Medical Therapy for HFrEF
1. SGLT2 Inhibitor (Dapagliflozin/Empagliflozin); 2. ARNI (Sacubitril/Valsartan) or ACEi/ARB; 3. Evidence-based Beta-blocker (Carvedilol, Metoprolol succinate, Bisoprolol); 4. Mineralocorticoid Receptor Antagonist (Spironolactone/Eplerenone).
4
Diagnostic Criteria for Diabetic Ketoacidosis (DKA)
Blood glucose > 250 mg/dL, arterial pH < 7.30, serum bicarbonate < 18 mEq/L, elevated anion gap (> 12), and positive serum/urine ketones.
5
Anaphylaxis First-Line Emergency Treatment and Route
Intramuscular Epinephrine (Adrenaline) 1:1,000 (1 mg/mL) injected into the anterolateral mid-thigh: 0.3 to 0.5 mg in adults (0.01 mg/kg in children up to 0.3 mg).
6
Acute Ischemic Stroke: IV Thrombolysis Eligibility Window
Intravenous Alteplase (tPA) or Tenecteplase administered within 4.5 hours of symptom onset after ruling out hemorrhage on non-contrast head CT and BP controlled < 185/110 mmHg.
7
Beck's Triad of Cardiac Tamponade
1. Hypotension; 2. Distended jugular veins (elevated JVP); 3. Muffled or distant heart sounds. Pulsus paradoxus is also characteristic.
8
Tension Pneumothorax Immediate Management
Immediate needle thoracocentesis (large-bore needle in 2nd intercostal space midclavicular line or 4th/5th intercostal space anterior axillary line) followed immediately by tube thoracostomy (chest drain).
9
Parkland Formula for Fluid Resuscitation in Major Burns
Total 24-hour Lactated Ringer's = 4 mL Weight (kg) % TBSA (2nd and 3rd degree burns). Give half in the first 8 hours from time of injury, and remaining half over the next 16 hours.
10
Charcot's Triad and Reynolds' Pentad for Acute Cholangitis
Charcot: Fever/chills + Jaundice + RUQ pain. Reynolds' Pentad adds: Hypotension (shock) + Altered mental status, indicating suppurative emergency requiring urgent biliary decompression (ERCP).
11
Neonatal Resuscitation: Indication for Chest Compressions
Heart rate remaining < 60 bpm despite at least 30 seconds of effective positive-pressure ventilation (PPV) with chest movement; compressions coordinated with PPV in 3:1 ratio with 100% O2.
12
Hypertrophic Pyloric Stenosis Classic Electrolyte Derangement
Hypochloremic, hypokalemic metabolic alkalosis with paradoxical aciduria, caused by persistent vomiting of gastric hydrochloric acid.
13
Intussusception Classic Triad and First-Line Treatment
Triad: Colicky abdominal pain, vomiting, and 'currant jelly' stool. In a stable child without peritonitis, treatment is air or hydrostatic contrast enema reduction under imaging guidance.
14
Kawasaki Disease Diagnostic Criteria and Key Morbidity
Fever >= 5 days plus 4 of 5 signs (bilateral conjunctivitis, oral strawberry tongue/lips, polymorphous rash, extremity erythema/edema, cervical lymphadenopathy). Complication prevented by IVIG + Aspirin: Coronary artery aneurysms.
15
Acute Chest Syndrome in Sickle Cell Anemia Definition
A new pulmonary infiltrate on chest radiograph accompanied by fever, respiratory symptoms (tachypnea, cough, hypoxemia), or chest pain. Managed with O2, antibiotics, analgesia, and simple/exchange transfusion.
16
Pediatric Severe Dehydration Emergency Fluid Bolus
20 mL/kg of isotonic crystalloid (0.9% Normal Saline or Ringer's Lactate) administered as a rapid IV bolus over 10-20 minutes, repeatable up to 60 mL/kg in shock.
17
Preeclampsia with Severe Features Definition and Seizure Prophylaxis
BP >= 160/110 mmHg with severe end-organ features (thrombocytopenia < 100k, elevated liver enzymes, severe headache, pulmonary edema). Prophylaxis: IV Magnesium Sulfate (4-6 g load, then 1-2 g/hr).
18
Primary Postpartum Hemorrhage: Most Common Cause and First-Line Drug
Uterine atony (causes > 70% of PPH). First-line management: vigorous bimanual uterine massage and intravenous Oxytocin infusion (10-40 IU in 1,000 mL crystalloid).
19
Placenta Previa Strict Contraindication
Digital vaginal examination of the cervix is strictly contraindicated prior to ultrasound confirmation, as finger insertion into placenta can precipitate catastrophic fatal hemorrhage.
20
Preterm PROM (< 34 Weeks) Key Pharmacological Triad
1. Antenatal Corticosteroids (Betamethasone) for fetal lung maturity; 2. Latency Antibiotics (Ampicillin + Erythromycin/Azithromycin); 3. Magnesium Sulfate for fetal neuroprotection if delivery < 32 weeks.
21
Shoulder Dystocia First-Line Maneuver
Call for help, execute McRoberts maneuver (hyperflexion and abduction of maternal hips) accompanied by downward suprapubic pressure; fundal pressure is strictly contraindicated.
22
Kuwait Childhood Immunization at Birth
BCG (Bacille Calmette-Guérin) vaccine intradermally and Hepatitis B vaccine intramuscularly, administered within 24 to 48 hours of birth.
23
The Emergency Doctrine (Implied Consent)
In an acute life-threatening emergency where a patient lacks decision-making capacity and no surrogate is available, physicians are legally and ethically authorized to perform emergency life-saving interventions.
24
Mandatory Breach of Medical Confidentiality under Kuwait Law
Mandated reporting of Group A notifiable communicable diseases (e.g., active pulmonary tuberculosis, cholera) to the MOH Preventive Medicine Department to protect public health.
25
Four Legal Elements of Civil Medical Negligence (The 4 Ds)
1. Duty of care owed; 2. Dereliction (breach of medical standard of care); 3. Direct causation linking breach to injury; 4. Damages (actual quantifiable physical, psychological, or financial harm).

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