Clinical Medicine Practice Flashcards

A comprehensive set of practice flashcards covering core concepts in geriatrics, infectious diseases, and pulmonology based on clinical case transcripts.

Initial management of severe hypercalcemia ($3.41\,mmol/L$)

Volume expansion with Intravenous 0.9% sodium chloride is the first step.

Fecal impaction with overflow diarrhea

A condition in chronic constipation where liquid stool bypasses impacted feces, appearing as watery diarrhea.

Sarcopenia prevention

Resistance training is the most effective exercise for improving muscle strength and preventing this condition.

Get-up-and-go test

A timed assessment used to evaluate mobility and fall risk in elderly patients.

Optimal pneumococcal vaccination in adults $\ge 65$ years

Sequential strategy of PCV13 followed by PPSV23.

Bacterial meningitis CSF profile

Cloudy fluid, low glucose, high protein, and a neutrophilic predominance ($70\%$ polymorphs).

Staphylococcus aureus food poisoning

Rapid onset of vomiting and watery diarrhea within 4 hours after eating, caused by preformed toxin.

Dengue fever

Classically presents with high fever, retro-orbital pain, and severe myalgia, also known as "breakbone fever."

Meningococcal prophylaxis for close contacts

Rifampicin or a single dose of Ciprofloxacin (specifically to reduce carriage in pilgrims from the African meningitis belt).

Giardiasis

Infection causing chronic diarrhea, weight loss, and malabsorption; diagnosed via trophozoites in duodenal aspirate and treated with Metronidazole.

Secondary syphilis

Presents with generalized lymphadenopathy and a rash on the palms and soles, following a painless genital ulcer; caused by Treponema pallidum.

Early prosthetic valve endocarditis

Infective endocarditis occurring 1 month after surgery, most commonly caused by Staphylococcus epidermidis.

Brucellosis

Zoonotic infection associated with animal exposure, fever, hepatosplenomegaly, and sacroiliac joint pain; diagnosed by the Tube agglutination test.

Neurobrucellosis treatment duration

Prolonged therapy required for $\ge 6$ months.

CNS toxoplasmosis

Opportunistic infection in HIV patients presenting with multiple brain lesions with mass effect; treated with Sulfadiazine and pyrimethamine.

Herpes encephalitis

Characterized by fever, confusion, and lesions classically affecting the temporal lobes on imaging; treated with Acyclovir.

Infectious mononucleosis

An EBV infection where a maculopapular rash typically develops after the administration of Amoxicillin.

Vibrio cholerae stool findings

Secretory diarrhea characterized by a low osmotic gap of approximately $30\,mOsm/kg$.

Goodpasture syndrome

A condition involving intermittent hemoptysis and hematuria, caused by anti-basement membrane antibodies.

Diagnostic thoracentesis site

Low in the midaxillary line, typically at the 9th intercostal space or between the 8th and 10th ribs.

FEV1/FVC ratio

A spirometric marker where a reduced ratio indicates obstructive lung disease (increased airway resistance) and a normal or increased ratio indicates restrictive disease.

Silicosis

A pneumoconiosis that impairs macrophage function, most strongly predisposing patients to tuberculosis.

COPD survival improvement

Long-term supplemental oxygen therapy is the intervention shown to improve survival in patients with severe chronic hypoxemia.

Acute hypercapnic COPD exacerbation management

Non-invasive positive pressure ventilation (NIPPV) is indicated when arterial pH is $7.3$ and distress persists despite bronchodilators.

Obstructive sleep apnea (OSA)

The most effective standard treatment for adults is Continuous Positive Airway Pressure (CPAP).

Spontaneous pneumothorax

Sudden pleuritic chest pain and dyspnea with absent lung markings on X-ray; smoking is the single most important modifiable risk factor for recurrence.

Parapneumonic effusion

A pleural effusion that develops following an incompletely resolved chest infection.

Malignant spinal cord compression

Emergency condition requiring immediate high-dose IV corticosteroids and MRI before neurologic deficits progress.

Humoral hypercalcemia of malignancy

Hypercalcemia caused by tumor secretion of PTH-related peptide (PTHrP), common in squamous cell carcinoma.

Isoniazid (INH) side effect

Peripheral neuropathy due to pyridoxine (Vitamin B6) deficiency.

Cor pulmonale

Right-sided heart failure resulting from chronic lung disease, characterized by raised JVP, loud P2, and bilateral leg edema.

Rheumatoid pleural effusion

Characterized by very low glucose levels, such as $1\,mmol/L$.

Aspiration lung abscess

Common in patients with poorly controlled epilepsy; characterized by foul-smelling sputum containing mixed aerobic and anaerobic organisms.

Sarcoidosis

Multisystem disease featuring non-caseating granulomas, bilateral hilar lymphadenopathy, and tender reddish nodules (erythema nodosum) over the shins.

Massive hemoptysis management

Positioning the patient on the lateral side of the bleeding lung to protect the contralateral lung.

Occupational asthma diagnosis

Confirmed by serial peak flow measurements demonstrating variation between the workplace and home.

Red man syndrome

A rate-related infusion reaction to vancomycin causing flushing and pruritus, managed by slowing the infusion rate.

Nitrofurantoin contraindication

Contraindicated in patients with renal impairment due to poor efficacy and potential toxicity.