High-Yield Clinical Medicine and Surgery Review

Comprehensive vocabulary flashcards covering high-yield internal medicine, critical care, and surgical principles, including diagnostic criteria, emergency management, triads, and classic presentations.

Microcytic anemia differential (TAILS)

Thalassemia, Anemia of chronic disease, Iron deficiency, Lead poisoning, Sideroblastic.

Most specific lab test for Iron Deficiency Anemia (IDA)

Low Serum Ferritin level.

B12 vs Folate deficiency differentiation (clinical & lab)

B12 has neurological symptoms & elevated Methylmalonic Acid (MMA); Folate has normal MMA.

Treatment of choice for young patient with severe Aplastic Anemia

Allogeneic Hematopoietic Stem Cell Transplantation (HSCT).

Classic triad of Intravascular Hemolysis

Anemia, Jaundice, Hemoglobinuria (Dark urine).

First-line vasopressor of choice in Septic Shock

Norepinephrine.

Initial fluid resuscitation choice in hypovolemic and septic shock

Crystalloids (Normal Saline or Lactated Ringer's).

Cushing's Triad of increased Intracranial Pressure (ICP)

Hypertension (with wide pulse pressure), Bradycardia, Irregular Respirations.

GCS score threshold requiring Endotracheal Intubation ("Protect the airway")

GCS less than or equal to $8$.

First-line immediate treatment for Acute Anaphylactic Shock

IM Epinephrine ($1:1000$) in anterolateral thigh.

Most specific autoantibodies for Systemic Lupus Erythematosus (SLE)

Anti-dsDNA and Anti-Sm (Smith) antibodies.

First-line Disease-Modifying Anti-Rheumatic Drug (DMARD) in Rheumatoid Arthritis

Methotrexate.

Synovial fluid crystals in Acute Gout vs Pseudogout

Gout: Negatively birefringent needle-shaped crystals. Pseudogout: Positively birefringent rhomboid crystals.

Classic triad of Giant Cell (Temporal) Arteritis

Unilateral headache, Jaw claudication, Visual disturbances (with high ESR).

Immediate management for suspected Giant Cell Arteritis with visual symptoms

High-dose IV Corticosteroids immediately (before temporal artery biopsy).

Classic protein electrophoresis finding in Multiple Myeloma

M-protein spike (Monoclonal gammopathy) and Bence Jones light chains in urine.

Major complication of Rapid Chemotherapy in High-Burden Tumors

Tumor Lysis Syndrome (Hyperkalemia, Hyperphosphatemia, Hypocalcemia, Hyperuricemia).

First-line agent to prevent/treat Tumor Lysis Syndrome hyperuricemia

Rasburicase (or Allopurinol) + Vigorous IV Hydration.

First-line acute pharmacological management for Status Epilepticus

IV Lorazepam or IV Diazepam (Benzodiazepines).

CSF finding in Guillain-Barre9 Syndrome (GBS)

Albuminocytological dissociation (High protein, Normal WBC count).

Classic triad of Hemolytic Uremic Syndrome (HUS)

Microangiopathic Hemolytic Anemia, Thrombocytopenia, Acute Kidney Injury (AKI).

First-line resuscitation & drug therapy in Acute Upper GIT Bleeding

IV Fluid resuscitation, IV Proton Pump Inhibitor (PPI) infusion, Urgent Endoscopy.

Diagnostic criteria for Spontaneous Bacterial Peritonitis (SBP) on paracentesis

Ascitic fluid PMN (neutrophil) count $\ge 250\text{ cells/mm}^3$.

Emergency treatment for Acute Adrenal Crisis

High-dose IV Hydrocortisone + IV Normal Saline resuscitation.

Early ECG sign of Hyperkalemia vs Late ECG sign

Early: Peaked T waves. Late: QRS widening, Loss of P wave, Sine wave pattern.

Classic 6 Ps of Acute Limb Ischemia

Pain, Pallor, Pulselessness, Paresthesia, Paralysis, Poikilothermia.

Gold standard emergency procedure for acute embolic arterial occlusion

Emergency Surgical Embolectomy using Fogarty catheter.

Standard indication for elective repair of Abdominal Aortic Aneurysm (AAA)

AAA diameter $\ge 5.5\text{ cm}$ in men ($\ge 5.0\text{ cm}$ in women) or rapid growth ($> 0.5\text{ cm}$ in $6\text{ months}$).

Virchow's Triad (Classic triad of DVT risk factors)

Stasis, Hypercoagulability, Endothelial Injury.

Parkland Formula for Burn Fluid Resuscitation (24 hours)

$4\text{ mL} \times \text{Weight (kg)} \times \%\text{ TBSA burned}$ of Lactated Ringer's (give $1/2$ in first $8\text{ hours}$, $1/2$ in next $16\text{ hours}$).

First priority in initial assessment of severe burn patient

Airway assessment and maintenance (check for inhalation injury/facial burns).

Skin Graft vs Skin Flap (Fundamental difference)

Graft relies on host bed for blood supply (no native vascular supply); Flap carries its own blood supply.

Small Bowel Obstruction vs Large Bowel Obstruction (Most common causes)

Small Bowel: Post-operative Adhesions. Large Bowel: Colorectal Cancer.

Classic physical exam signs for Acute Appendicitis

McBurney's point tenderness, Rovsing sign, Psoas sign, Obturator sign.

Charcot's Triad in Acute Cholangitis

Fever, Jaundice, Right Upper Quadrant (RUQ) abdominal pain.

Reynold's Pentad in Suppurative Cholangitis

Charcot's Triad + Hypotension + Altered Mental Status.

Most sensitive diagnostic imaging for suspected Acute Cholecystitis

Abdominal Ultrasound (shows gallbladder wall thickening $> 4\text{ mm}$, pericholecystic fluid, sonographic Murphy sign).

Emergency management of Tension Pneumothorax

Immediate Needle Decompression ($2\text{nd}$ ICS mid-clavicular or $5\text{th}$ ICS mid-axillary) before chest X-ray, followed by Chest Tube.

Classic CT scan appearance of Epidural vs Subdural Hematoma

Epidural: Biconvex (lenticular), hyperdense, respects suture lines. Subdural: Crescent-shaped, crosses suture lines.

Classic presentation of Epidural Hematoma history

Head trauma followed by a "Lucid Interval" then rapid neurological deterioration (Middle Meningeal Artery tear).

Classic pain presentation of Acute Compartment Syndrome

Severe pain out of proportion to injury, exacerbated by passive stretch of muscles.

Definitive treatment for Acute Compartment Syndrome

Emergency Surgical Fasciotomy.

Classic clinical deformity in Femoral Neck Fracture

Shortened, Externally Rotated lower limb.

Monteggia vs Galeazzi fracture-dislocations distinction

Monteggia: Proximal Ulnar fracture + Radial head dislocation. Galeazzi: Distal Radial fracture + Distal Radioulnar joint dislocation.

Classic clinical presentation of Intestinal Ischemia (Mesenteric Ischemia)

Severe abdominal pain out of proportion to physical exam findings.

Initial drug treatment for Acute Anaphylaxis vs Acute Asthma Exacerbation

Anaphylaxis: IM Epinephrine. Asthma Exacerbation: Inhaled Short-Acting Beta-2 Agonist (Salbutamol/Albuterol) + Systemic Corticosteroids.

Classic diagnostic CSF pattern in Bacterial Meningitis

High PMN Neutrophils, High Protein, Low Glucose ($< 40\%$ of serum glucose).

Indication for placement of Chest Tube (Tube Thoracostomy) in Hemothorax

Initial drainage $\ge 1500\text{ mL}$ of blood OR ongoing bleeding $> 200\text{ mL/hour}$ for $2\text{--}4\text{ hours}$ requires Thoracotomy.

Direct vs Indirect Inguinal Hernia anatomical landmarks

Direct: Medial to Inferior Epigastric Vessels (through Hesselbach's triangle). Indirect: Lateral to Inferior Epigastric Vessels (through deep inguinal ring).

First-line management for suspected Acute Upper GIT Bleeding from Varices

Fluid resuscitation, IV Octreotide/Terlipressin, IV Antibiotic prophylaxis, Urgent Endoscopy (Banding).