General Medicine Clinical Exam Revision Master Guide

Comprehensive vocabulary and definition flashcards covering clinical medicine topics including Acute MI, Rheumatic Fever, Atrial Fibrillation, JVP, UMN vs LMN lesions, and other diagnostic markers.

Acute ST-Elevation Myocardial Infarction (STEMI)

Transmural myocardial ischemia caused by acute thrombotic occlusion of a coronary artery following atherosclerotic plaque rupture or erosion.

Troponin I / T

Most specific and sensitive cardiac biomarkers for myocardial infarction; they rise in $3–4\,hrs$, peak in $18–24\,hrs$, and remain elevated for $7–14\,days$.

CK-MB

Cardiac biomarker that rises in $4–6\,hrs$, peaks in $24\,hrs$, and returns to baseline in $48–72\,hrs$; excellent for detecting early re-infarction.

MONA-BASH

Acronym for the emergency management of MI: Morphine (pain and preload), Oxygen (if $SpO2 < 90\%$), Nitrates (GTN for vasospasm), Aspirin ($150–300\,mg$ chewed), Beta-blockers, ACE inhibitors, Statins (high-intensity), and Heparin (anticoagulation).

Primary PCI

The preferred revascularization strategy for STEMI, with a door-to-balloon time goal of $< 90\,min$ (or $< 120\,min$ if transferred).

Thrombolysis / Fibrinolysis

Treatment used if PCI is unavailable within $120\,min$; the door-to-needle goal is $< 30\,min$ using agents like Tenecteplase, Alteplase, or Streptokinase.

Acute Rheumatic Fever (ARF)

An autoimmune systemic inflammatory disease occurring $2–3\,weeks$ after Group A $\beta$-hemolytic Streptococcal (Streptococcus pyogenes) pharyngitis, mediated by molecular mimicry between M protein and human cardiac tissues.

Jones Criteria (Major)

Diagnostic criteria for ARF including Carditis (Pancarditis), Polyarthritis (migratory/asymmetric), Sydenham Chorea, Erythema Marginatum (serpiginous rash), and Subcutaneous Nodules.

Atrial Fibrillation (AF)

A supraventricular tachyarrhythmia with uncoordinated atrial activation, irregularly irregular R-R intervals, and the absence of distinct P waves (replaced by fibrillatory f waves).

CHA2DS2-VASc score

A clinical tool used to determine the need for anticoagulation (using DOACs or Warfarin) to prevent stroke in patients with Atrial Fibrillation.

JVP a wave

The positive wave in the jugular venous pulse caused by Right Atrial Systole (active atrial contraction).

JVP v wave

The positive wave in the jugular venous pulse caused by passive venous filling of the RA during ventricular systole against a closed tricuspid valve.

Sokolow-Lyon index

A standard 12-lead ECG calculation used to evaluate the presence of Left Ventricular Hypertrophy (LVH) in hypertensive patients.

Middleton's Hooking technique

A clinical palpation method used during deep inspiration to examine the spleen for enlargement.

Spider Angiomas & Palmar Erythema

Clinical signs of chronic liver failure caused by hyperestrogenism due to failure of hepatic steroid metabolism and local vasodilation.

Asterixis (Flapping Tremor)

A sign of hepatic, uremic, or hypercapnic encephalopathy caused by hyperammonemia or altered neurotransmission.

Upper Motor Neuron (UMN) Lesion

A lesion involving the corticospinal/pyramidal tract characterized by increased muscle tone (spasticity), hyperreflexia, and an extensor plantar reflex (Babinski Sign Positive).

Lower Motor Neuron (LMN) Lesion

A lesion of the anterior horn cell or peripheral nerve characterized by decreased muscle tone (flaccidity), hyporeflexia, neurogenic atrophy, and the presence of fasciculations.

Mitral Stenosis (MS) Signs

Cardiac examination findings including a Malar Flush, Loud S1, Opening Snap (OS), and a Mid-Diastolic Murmur (MDM) best heard at the apex in the left lateral position.

Grade II Clubbing

A status defined by the loss of the normal Lovibond angle ($> 180^{\circ}$).

Corrigan's Pulse

A water-hammer pulse with rapid ascent and collapse, characteristic of severe Aortic Regurgitation (AR).

Knee (Patellar) Reflex

A deep tendon reflex tested via the femoral nerve with a spinal root value of $L3, L4$.

Ankle (Achilles) Reflex

A deep tendon reflex tested via the tibial nerve with a spinal root value of $S1, S2$.