Your FREE ABIM Flashcards 2026 – 250+ Cards

ABIM Flashcards

MONA for ACS

Morphine, Oxygen (if hypoxic), Nitrates, Aspirin — early measures in acute coronary syndrome; add a P2Y12 inhibitor and anticoagulation.

CHA₂DS₂-VASc

Stroke-risk score in atrial fibrillation; ≥2 (men) or ≥3 (women) generally warrants anticoagulation.

CURB-65

Pneumonia severity score: Confusion, Urea >7, Respiratory rate ≥30, BP low, age ≥65 — guides admission.

STEMI definition

ST-elevation MI: new ST elevation at the J point in ≥2 contiguous leads (or new LBBB) with ischemic symptoms — needs emergent reperfusion (PCI preferred).

NSTEMI vs unstable angina

Both lack ST elevation; NSTEMI has elevated troponin (myonecrosis), unstable angina does not.

First-line for STEMI reperfusion

Primary percutaneous coronary intervention (PCI) within 90 minutes; fibrinolysis if PCI not available in time.

HFrEF guideline therapy

The 4 pillars: ARNI/ACEi/ARB, beta-blocker, mineralocorticoid antagonist (MRA), and SGLT2 inhibitor.

HFpEF

Heart failure with preserved EF (≥50%); treat volume with diuretics, control BP/comorbidities; SGLT2 inhibitors now recommended.

BNP / NT-proBNP

Natriuretic peptides released by ventricular stretch; elevated in heart failure, helpful to rule out HF in dyspnea.

Atrial fibrillation management

Rate control (beta-blocker or non-DHP CCB) or rhythm control + anticoagulation by CHA₂DS₂-VASc.

Aortic stenosis triad

Angina, syncope, and heart failure; harsh crescendo–decrescendo systolic murmur radiating to carotids — replace the valve once symptomatic.

Mitral regurgitation murmur

Holosystolic murmur at the apex radiating to the axilla.

Aortic regurgitation

Early diastolic decrescendo murmur, wide pulse pressure, water-hammer pulse.

Hypertensive emergency

Severe BP elevation with acute target-organ damage; lower MAP ~10–20% in the first hour with IV agents.

Statin indications (ASCVD)

Clinical ASCVD, LDL ≥190, diabetes age 40–75, or elevated 10-year risk — high-intensity statin for most ASCVD.

Wells criteria

Pretest probability tool for DVT/PE that guides D-dimer vs imaging.

Long-QT danger

Predisposes to torsades de pointes; avoid QT-prolonging drugs and correct low K⁺/Mg²⁺/Ca²⁺.

Pericarditis ECG

Diffuse ST elevation with PR depression; pleuritic chest pain relieved by sitting forward, with a friction rub.

Cardiac tamponade (Beck triad)

Hypotension, muffled heart sounds, and jugular venous distension; pulsus paradoxus is a key clue.

Stable angina first-line

Beta-blocker and/or nitrates for symptoms, plus aspirin and a statin; PCI/CABG for refractory or high-risk disease.

Digoxin toxicity

Nausea, visual halos/yellow vision, arrhythmias; worsened by hypokalemia — treat with digoxin-specific Fab if severe.

Wolff-Parkinson-White

Accessory pathway (delta wave, short PR); avoid AV-nodal blockers in WPW with atrial fibrillation.

Acute decompensated HF treatment

IV loop diuretics for congestion; vasodilators if hypertensive; treat the precipitant.

Peripheral artery disease (ABI)

Ankle-brachial index ≤0.90 is diagnostic; treat with exercise, statin, antiplatelet, and risk-factor control.

COPD vs asthma reversibility

Asthma airflow obstruction is largely reversible with a bronchodilator; COPD is incompletely reversible (post-bronchodilator FEV1/FVC <0.70).

Asthma stepwise therapy

Inhaled corticosteroid is the controller cornerstone; add LABA, then escalate. SABA for rescue (or ICS-formoterol as both).

COPD exacerbation management

Bronchodilators, systemic corticosteroids, and antibiotics if increased sputum purulence; consider NIPPV for respiratory failure.

PE diagnosis

CT pulmonary angiography is the test of choice; D-dimer rules out if pretest probability is low/moderate.

Massive PE treatment

Hemodynamic instability → systemic thrombolysis (or embolectomy) plus anticoagulation.

Light's criteria

Distinguishes exudative from transudative pleural effusion (pleural/serum protein or LDH ratios, or pleural LDH).

ARDS

Acute hypoxemic respiratory failure with bilateral infiltrates not from cardiac edema; treat with low-tidal-volume (lung-protective) ventilation.

Sepsis bundle

Early lactate, blood cultures before antibiotics, broad-spectrum antibiotics within 1 hour, and 30 mL/kg crystalloid for hypotension/lactate ≥4.

Septic shock vasopressor

Norepinephrine is first-line after fluid resuscitation.

Idiopathic pulmonary fibrosis

Progressive restrictive ILD; honeycombing/UIP pattern on HRCT; antifibrotics (pirfenidone, nintedanib) slow decline.

Solitary pulmonary nodule

Risk-stratify by size, growth, and patient risk; compare with old films; biopsy/PET for intermediate-to-high risk.

Obstructive sleep apnea

Repetitive upper-airway collapse causing daytime sleepiness; diagnosed by polysomnography; treat with CPAP.

Pulmonary hypertension

Mean PA pressure ≥20 mmHg; right heart catheterization confirms; classify into 5 WHO groups.

Spontaneous pneumothorax

Sudden pleuritic dyspnea; tension pneumothorax (hypotension, tracheal deviation) needs immediate needle/finger decompression.

Restrictive vs obstructive PFTs

Obstructive: low FEV1/FVC. Restrictive: normal/high ratio with low total lung capacity.

Hospital-acquired pneumonia

Pneumonia ≥48 h after admission; cover Pseudomonas and MRSA per local risk/antibiogram.

GERD alarm features

Dysphagia, odynophagia, weight loss, bleeding, anemia, or age >60 with new symptoms → endoscopy.

Peptic ulcer cause

H. pylori and NSAIDs are the leading causes; test-and-treat H. pylori.

H. pylori triple therapy

A PPI plus clarithromycin and amoxicillin (or quadruple therapy with bismuth in high-resistance areas).

Upper vs lower GI bleed

Upper (proximal to ligament of Treitz): melena, high BUN/Cr ratio. Lower: hematochezia.

Ulcerative colitis vs Crohn

UC: continuous, mucosa-only, rectum-up, colon only. Crohn: skip lesions, transmural, mouth-to-anus, with fistulae/granulomas.

C. difficile treatment

Oral vancomycin or fidaxomicin first-line; stop the offending antibiotic; fecal transplant for recurrence.

Acute pancreatitis diagnosis

2 of 3: characteristic epigastric pain, lipase/amylase ≥3× upper limit, or imaging findings; gallstones and alcohol are top causes.

Cirrhosis complications

Varices, ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, and hepatorenal syndrome.

SBP diagnosis

Ascitic fluid neutrophils (PMNs) ≥250/µL; treat empirically with a third-generation cephalosporin.

Hepatic encephalopathy treatment

Lactulose (titrate to 2–3 stools/day) ± rifaximin; identify the precipitant.

Acute liver failure (acetaminophen)

N-acetylcysteine is the antidote; use the Rumack-Matthew nomogram to guide treatment.

Hemochromatosis

HFE iron overload; elevated transferrin saturation and ferritin; treat with phlebotomy.

Celiac disease

Gluten-sensitive enteropathy; anti-tissue-transglutaminase IgA screen, confirm with duodenal biopsy (villous atrophy).

Colorectal cancer screening

Begin at age 45 for average risk (colonoscopy or stool-based tests).

Diverticulitis

Left-lower-quadrant pain, fever; CT confirms; uncomplicated cases may be managed with or without antibiotics.

IBS diagnosis

Recurrent abdominal pain related to defecation with altered stool form/frequency; a clinical (Rome) diagnosis after excluding alarm features.

Community-acquired pneumonia outpatient

Amoxicillin or doxycycline (or a respiratory fluoroquinolone) for healthy outpatients without comorbidities.

Infective endocarditis (Duke criteria)

Combines positive blood cultures and echo vegetations with minor criteria to diagnose; get 3 blood-culture sets before antibiotics.

MRSA coverage

Vancomycin, linezolid, or daptomycin (not daptomycin for pneumonia — inactivated by surfactant).

Neutropenic fever

ANC <500 with fever; start empiric anti-pseudomonal beta-lactam (e.g., cefepime) immediately.

HIV when to start ART

Start antiretroviral therapy in everyone with HIV regardless of CD4 count.

PCP prophylaxis

TMP-SMX when CD4 <200 (or thrush/AIDS-defining illness).

Latent TB treatment

Positive IGRA/PPD with no active disease → isoniazid, rifampin, or combination short-course therapy.

Active TB regimen (RIPE)

Rifampin, Isoniazid, Pyrazinamide, Ethambutol for the initial 2-month phase.

Meningitis empiric therapy

Vancomycin + ceftriaxone; add ampicillin for Listeria if >50 or immunocompromised; dexamethasone for pneumococcal.

Pyelonephritis

Flank pain, fever, pyuria; treat with a fluoroquinolone or third-gen cephalosporin per local resistance.

Cellulitis vs necrotizing fasciitis

Necrotizing infection: pain out of proportion, rapid spread, crepitus, systemic toxicity — a surgical emergency.

Sepsis source control

Drain abscesses, remove infected lines/devices, debride necrotic tissue alongside antibiotics.

Hepatitis B serologies

HBsAg = infection; anti-HBs = immunity; anti-HBc IgM = acute; HBeAg = high infectivity.

Hepatitis C

Screen all adults once; direct-acting antivirals cure most patients.

Antibiotic stewardship

Narrow therapy once cultures return, use the shortest effective duration, and de-escalate to limit resistance.

Septic arthritis

Acute mono-arthritis; arthrocentesis (WBC often >50,000) before antibiotics; drain the joint.

Rheumatoid arthritis

Symmetric small-joint (MCP/PIP) inflammatory arthritis with morning stiffness >1 h; anti-CCP and RF positive.

RA first-line DMARD

Methotrexate is the anchor disease-modifying drug.

SLE diagnosis

Multisystem autoimmune disease; ANA is sensitive (screen), anti-dsDNA and anti-Smith are specific.

Lupus nephritis monitoring

Follow anti-dsDNA, complement (C3/C4 fall with flares), urinalysis; biopsy guides therapy.

Gout

Monosodium urate crystals — negatively birefringent, needle-shaped; acute treat with NSAIDs, colchicine, or steroids.

Gout urate-lowering

Allopurinol (xanthine oxidase inhibitor) for recurrent attacks/tophi; target urate <6 mg/dL.

Pseudogout (CPPD)

Calcium pyrophosphate crystals — positively birefringent, rhomboid; chondrocalcinosis on X-ray.

Giant cell arteritis

Headache, jaw claudication, vision loss, high ESR in age >50; start high-dose steroids immediately, then biopsy.

Polymyalgia rheumatica

Proximal shoulder/hip girdle pain and stiffness with high ESR; dramatic response to low-dose steroids; associated with GCA.

Seronegative spondyloarthritis

Ankylosing spondylitis, psoriatic, reactive, IBD-associated; HLA-B27, inflammatory back pain, enthesitis.

Ankylosing spondylitis

Young adult inflammatory low back pain improving with exercise; sacroiliitis; 'bamboo spine'.

Systemic sclerosis

Skin thickening, Raynaud, anti-Scl-70 (diffuse) or anti-centromere (limited/CREST); watch renal crisis and PAH.

Sjögren syndrome

Dry eyes and mouth; anti-Ro (SSA)/anti-La (SSB); increased lymphoma risk.

Osteoarthritis vs inflammatory

OA: worse with use, brief (<30 min) stiffness, no systemic signs; treat with exercise, weight loss, and analgesics.

ANCA-associated vasculitis

GPA (c-ANCA/PR3) and MPA (p-ANCA/MPO); pulmonary–renal syndrome; induce remission with steroids + rituximab/cyclophosphamide.

Fibromyalgia

Chronic widespread pain, fatigue, and unrefreshing sleep with normal labs; treat with exercise, sleep, and SNRIs/gabapentinoids.

Type 2 diabetes first-line

Metformin plus lifestyle; add GLP-1 RA or SGLT2 inhibitor (proven cardiorenal benefit) based on comorbidities.

Diagnosing diabetes

Fasting glucose ≥126, A1c ≥6.5%, 2-h OGTT ≥200, or random ≥200 with symptoms (confirm).

DKA management

IV fluids, insulin infusion, and potassium repletion; treat the precipitant; close the anion gap before stopping insulin.

HHS vs DKA

Hyperosmolar hyperglycemic state: very high glucose, high osmolality, minimal ketosis/acidosis — usually type 2.

Hypothyroidism

Fatigue, weight gain, cold intolerance; high TSH, low free T4; treat with levothyroxine.

Hyperthyroidism (Graves)

Low TSH, high free T4, TSI antibodies, diffuse goiter, orbitopathy; treat with methimazole, radioiodine, or surgery.

Thyroid storm

Life-threatening thyrotoxicosis; beta-blocker, thionamide, iodine (after thionamide), and steroids.

Adrenal insufficiency

Fatigue, hypotension, hyponatremia, hyperkalemia; low cortisol with high ACTH (primary); treat with hydrocortisone (stress-dose in illness).

Cushing syndrome workup

Confirm hypercortisolism (late-night salivary cortisol, 24-h urinary free cortisol, low-dose dexamethasone suppression), then localize.

Pheochromocytoma

Episodic headache, sweating, palpitations, hypertension; plasma/urine metanephrines; alpha-blockade before beta-blockade.

Primary hyperaldosteronism

Hypertension with hypokalemia; high aldosterone/renin ratio; the most common secondary HTN cause.

Hypercalcemia causes

Primary hyperparathyroidism (outpatient) and malignancy (inpatient) are the top two.

Osteoporosis treatment

Bisphosphonates are first-line; ensure calcium/vitamin D; T-score ≤ −2.5 or fragility fracture.

Diabetic kidney protection

ACEi/ARB and SGLT2 inhibitors slow progression of diabetic nephropathy with albuminuria.

SIADH

Euvolemic hyponatremia with concentrated urine and low serum osmolality; treat with fluid restriction (and the cause).

Hyperlipidemia in diabetes

Statin therapy for most adults with diabetes age 40–75 to reduce ASCVD risk.

AKI categories

Prerenal (low perfusion), intrinsic (ATN, GN), and postrenal (obstruction) — urine studies and FENa help differentiate.

Prerenal vs ATN

Prerenal: FENa <1%, high urine osmolality, bland sediment. ATN: FENa >2%, muddy-brown casts.

CKD staging

By GFR (G1–G5) and albuminuria (A1–A3); slow progression with BP control, ACEi/ARB, SGLT2i.

Hyperkalemia ECG/treatment

Peaked T waves → calcium gluconate (membrane stabilization), then insulin+glucose/albuterol to shift, then remove (diuresis, K-binders, dialysis).

Anion gap

Na⁺ − (Cl⁻ + HCO₃⁻); high gap acidosis mnemonic MUDPILES (methanol, uremia, DKA, etc.).

Metabolic acidosis compensation

Winter's formula: expected PCO₂ = 1.5 × HCO₃⁻ + 8 ± 2.

Nephrotic vs nephritic

Nephrotic: proteinuria >3.5 g/day, edema, hypoalbuminemia. Nephritic: hematuria, RBC casts, hypertension, mild proteinuria.

Nephrolithiasis

Calcium oxalate is the most common stone; non-contrast CT diagnoses; increase fluids, treat pain, may pass <5 mm spontaneously.

Renal artery stenosis

Secondary HTN; consider with a rise in creatinine after starting an ACEi/ARB or flash pulmonary edema.

Hyponatremia approach

Assess volume status and serum/urine osmolality; correct slowly (≤8 mEq/L per 24 h) to avoid osmotic demyelination.

Contrast-associated AKI

Risk in CKD/diabetes; hydrate; usually transient — true incidence is lower than once thought.

Indications for dialysis (AEIOU)

Acidosis, Electrolytes (refractory hyperkalemia), Intoxications, Overload (volume), Uremia (encephalopathy, pericarditis).

Iron-deficiency anemia

Microcytic, low ferritin, high TIBC; find the source (GI bleed in adults); replace iron.

Anemia of chronic disease

Normocytic/microcytic; normal-to-high ferritin, low TIBC; treat the underlying disease.

B12 vs folate deficiency

Both cause macrocytic anemia; only B12 deficiency causes neurologic deficits (check methylmalonic acid).

Hemolytic anemia clues

High LDH and indirect bilirubin, low haptoglobin, high reticulocytes; positive Coombs in autoimmune hemolysis.

Sickle cell crisis

Vaso-occlusive pain; hydrate, oxygenate, analgesia; hydroxyurea reduces frequency.

ITP

Isolated thrombocytopenia from antiplatelet antibodies; treat with steroids/IVIG if bleeding or very low counts.

TTP pentad

Thrombocytopenia, microangiopathic hemolysis, neuro changes, renal injury, fever; ADAMTS13 deficiency — urgent plasma exchange.

HIT

Heparin-induced thrombocytopenia: platelet drop ~5–10 days after heparin with thrombosis; stop all heparin, use a non-heparin anticoagulant.

DIC

Consumptive coagulopathy: low platelets/fibrinogen, high PT/PTT and D-dimer; treat the cause and support.

Von Willebrand disease

Most common inherited bleeding disorder; mucocutaneous bleeding, prolonged bleeding time; desmopressin for type 1.

Polycythemia vera

JAK2 mutation, high hematocrit, pruritus, thrombosis; phlebotomy and low-dose aspirin.

Warfarin reversal

Vitamin K for non-urgent; 4-factor PCC (plus vitamin K) for major bleeding.

Tumor lysis syndrome

After chemo of bulky tumors: high K⁺, phosphate, uric acid; low calcium — hydrate, allopurinol/rasburicase.

Febrile neutropenia (onc)

Oncologic emergency — empiric anti-pseudomonal antibiotics within an hour of fever.

Spinal cord compression

Back pain with neuro deficits in a cancer patient → emergent MRI and steroids, then radiation/surgery.

SVC syndrome

Facial/arm swelling, distended neck veins from tumor compression; often small-cell lung cancer or lymphoma.

Hypercalcemia of malignancy

PTHrP, bone metastases, or 1,25-vitamin D; treat with IV fluids and bisphosphonates.

Lung cancer types

Small-cell (central, paraneoplastic, rapid) vs non-small-cell (adeno most common); smoking is the major risk.

Breast cancer screening

Mammography for average-risk women, generally starting at 40–50 depending on guideline.

Prostate cancer screening

Shared decision-making about PSA, generally ages 55–69.

Cervical cancer screening

Pap ± HPV co-testing starting at 21; HPV-based screening at 25–30+ per guideline.

Lung cancer screening

Low-dose CT for adults 50–80 with a ≥20 pack-year history who currently smoke or quit within 15 years.

Paraneoplastic SIADH

Hyponatremia from ectopic ADH — classically small-cell lung cancer.

Lymphoma B symptoms

Fever, drenching night sweats, and weight loss >10% — adverse prognostic signs.

Ischemic stroke tPA window

IV thrombolysis within 4.5 hours of onset if no contraindication; thrombectomy for large-vessel occlusion in selected patients up to 24 h.

Stroke vs TIA

TIA has transient symptoms without infarction on imaging; both need urgent secondary-prevention workup.

Status epilepticus

Seizure >5 min or recurrent without recovery; benzodiazepine first, then a loading antiepileptic.

Bacterial meningitis signs

Fever, headache, neck stiffness, altered mental status; LP after imaging if indicated; do not delay antibiotics.

Subarachnoid hemorrhage

Thunderclap 'worst headache of life'; non-contrast CT, then LP (xanthochromia) if CT negative.

Parkinson disease

Resting tremor, bradykinesia, rigidity, postural instability; levodopa-carbidopa is most effective.

Multiple sclerosis

CNS demyelination disseminated in time and space; MRI lesions, oligoclonal bands; treat relapses with steroids.

Guillain-Barré

Ascending symmetric weakness with areflexia after infection; albuminocytologic dissociation; treat with IVIG or plasmapheresis; watch respiratory status.

Myasthenia gravis

Fatigable weakness (ptosis, diplopia); acetylcholine-receptor antibodies; treat with pyridostigmine and immunotherapy.

Migraine vs tension headache

Migraine: unilateral, throbbing, photophobia/phonophobia, nausea; treat acute with triptans, prevent if frequent.

Delirium vs dementia

Delirium is acute, fluctuating, with inattention (often reversible); dementia is chronic and progressive.

Normal pressure hydrocephalus

Triad: gait apraxia, urinary incontinence, dementia ('wet, wobbly, wacky'); may improve with shunting.

Major depressive disorder

≥5 SIG-E-CAPS symptoms for ≥2 weeks including depressed mood or anhedonia; first-line is an SSRI plus psychotherapy.

Serotonin syndrome

Agitation, clonus, hyperreflexia, hyperthermia from serotonergic drugs; stop the agent, supportive care, cyproheptadine.

Generalized anxiety disorder

Excessive worry most days for ≥6 months; SSRIs/SNRIs and CBT first-line.

Bipolar disorder caution

Avoid antidepressant monotherapy (can precipitate mania); use mood stabilizers (lithium, valproate) or atypical antipsychotics.

Lithium toxicity

Tremor, ataxia, confusion; narrow therapeutic index worsened by dehydration, NSAIDs, ACEi, and thiazides.

Alcohol withdrawal

Tremor, tachycardia, seizures, delirium tremens; treat with benzodiazepines and thiamine (before glucose).

Wernicke encephalopathy

Thiamine deficiency: confusion, ataxia, ophthalmoplegia; give IV thiamine before glucose.

Neuroleptic malignant syndrome

Fever, rigidity, autonomic instability, elevated CK from antipsychotics; stop the drug, cool, dantrolene/bromocriptine.

Opioid use disorder

Treat with buprenorphine or methadone; naloxone reverses overdose.

Capacity assessment

A patient has decision-making capacity if they can communicate a choice, understand, appreciate, and reason about it.

Stevens-Johnson / TEN

Drug-induced mucocutaneous necrosis with sloughing (positive Nikolsky); stop the drug, supportive care (often burn unit).

Melanoma ABCDE

Asymmetry, Border irregularity, Color variation, Diameter >6 mm, Evolving — biopsy suspicious lesions.

Erythema multiforme

Target lesions, often from HSV or drugs.

Psoriasis

Well-demarcated plaques with silvery scale on extensor surfaces; topical steroids/vitamin D, phototherapy, or biologics.

Cellulitis vs erysipelas

Erysipelas is superficial with a sharply demarcated raised border (often Strep); cellulitis is deeper and less well-defined.

Basal vs squamous cell carcinoma

BCC: pearly papule with telangiectasias (rarely metastasizes). SCC: scaly/ulcerated, can metastasize.

Drug reaction with eosinophilia (DRESS)

Fever, rash, eosinophilia, and organ involvement weeks after a drug; stop the agent, supportive/steroids.

Pemphigus vs pemphigoid

Pemphigus vulgaris: flaccid bullae, positive Nikolsky, intraepidermal. Bullous pemphigoid: tense bullae, negative Nikolsky, subepidermal.

Sensitivity vs specificity

Sensitivity = true-positive rate (negative test rules OUT, SnNout); specificity = true-negative rate (positive test rules IN, SpPin).

PPV depends on prevalence

Positive predictive value rises with disease prevalence; likelihood ratios do not depend on prevalence.

Number needed to treat

NNT = 1 ÷ absolute risk reduction; fewer patients needed means greater benefit.

Relative risk vs odds ratio

RR compares incidence between groups (cohorts/RCTs); OR is used in case-control studies and approximates RR for rare outcomes.

Confidence interval

A 95% CI that crosses 1 (for RR/OR) or 0 (for differences) indicates a non-significant result.

Preoperative cardiac risk

Assess functional capacity (METs) and surgical risk; routine testing is not needed for low-risk surgery or good functional status.

Adult immunizations

Annual influenza; Tdap then Td/Tdap boosters; pneumococcal and RSV per age; zoster (RZV) at ≥50.

Geriatric polypharmacy

Review with the Beers criteria; deprescribe high-risk drugs (anticholinergics, benzodiazepines) in older adults.

Falls in older adults

Multifactorial; review medications, vision, gait/balance, and home hazards; strength/balance exercise reduces risk.

Delirium prevention

Reorient, mobilize, restore sleep, treat pain, hydrate, and remove tethers; avoid deliriogenic drugs.

Palliative vs hospice

Palliative care can accompany curative treatment at any stage; hospice is for a prognosis ~6 months when curative care is stopped.

Advance directives

A living will states wishes; a healthcare proxy/durable power of attorney names a surrogate decision-maker.

USPSTF AAA screening

One-time ultrasound for men 65–75 who have ever smoked.

Osteoporosis screening

DEXA for women ≥65 (and younger high-risk) to assess fracture risk.

Smoking cessation

Combine counseling with pharmacotherapy (varenicline, bupropion, or nicotine replacement) — most effective together.

Diabetes prevention

Intensive lifestyle change (weight loss, activity) and metformin reduce progression from prediabetes.

Dressler syndrome

Autoimmune pericarditis weeks after MI — fever, pleuritic chest pain, pericardial effusion; treat with NSAIDs/colchicine.

Right ventricular MI

Inferior MI with hypotension and clear lungs; preload-dependent — give fluids, AVOID nitrates.

Hypertrophic cardiomyopathy murmur

Systolic murmur that INCREASES with Valsalva/standing (less preload); risk of sudden death in young athletes.

Mitral stenosis

Opening snap and diastolic rumble; usually rheumatic; causes left atrial enlargement and atrial fibrillation.

Endocarditis prophylaxis

Antibiotics before dental procedures only for highest-risk hearts (prosthetic valve, prior endocarditis, certain congenital disease).

DOAC vs warfarin in AF

Direct oral anticoagulants are preferred over warfarin in non-valvular atrial fibrillation; warfarin is required for mechanical valves and rheumatic MS.

Orthostatic hypotension

Drop ≥20 systolic or ≥10 diastolic on standing; review volume status and medications.

Cardiogenic shock

Pump failure with hypotension and end-organ hypoperfusion; revascularize the cause; vasopressors/inotropes/mechanical support.

Secondary prevention post-MI

Aspirin, P2Y12 inhibitor, high-intensity statin, beta-blocker, and ACEi/ARB; cardiac rehab.

Takotsubo cardiomyopathy

Stress-induced apical ballooning mimicking ACS with normal coronaries; usually recovers.

Sarcoidosis

Non-caseating granulomas; bilateral hilar adenopathy, elevated ACE/calcium; many resolve, steroids for organ involvement.

Asthma severity by control

Step up if symptoms/rescue use are frequent or there are exacerbations; reassess and step down when stable.

Alpha-1 antitrypsin deficiency

Early panacinar (basilar) emphysema in a young non-smoker, often with liver disease.

Obesity hypoventilation

Daytime hypercapnia in obesity without another cause; treat with weight loss and positive-airway-pressure therapy.

Exudative effusion causes

Infection (parapneumonic/empyema), malignancy, PE, and inflammatory disease.

Transudative effusion causes

Heart failure, cirrhosis, and nephrotic syndrome (low oncotic / high hydrostatic pressure).

Aspiration pneumonia

Right lower/middle lobe predilection; risk with impaired swallow/consciousness; cover anaerobes/oral flora.

Methacholine challenge

Provocation test for asthma when spirometry is normal but asthma is suspected.

Massive hemoptysis

Airway protection, position bleeding side down, and urgent bronchoscopy/bronchial artery embolization.

Zollinger-Ellison syndrome

Gastrinoma causing refractory/multiple peptic ulcers and diarrhea; check fasting gastrin.

Hepatocellular carcinoma surveillance

Ultrasound (± AFP) every 6 months in cirrhosis and chronic hepatitis B.

Wilson disease

Copper overload in young patients: liver disease, neuropsychiatric signs, Kayser-Fleischer rings, low ceruloplasmin.

Primary biliary cholangitis

Middle-aged women with pruritus and fatigue; high alkaline phosphatase, anti-mitochondrial antibody; treat with ursodiol.

Ascending cholangitis (Charcot triad)

Fever, jaundice, and RUQ pain; biliary obstruction with infection — antibiotics and urgent biliary drainage (ERCP).

Acute mesenteric ischemia

Severe pain out of proportion to exam in an at-risk patient; surgical emergency.

Microscopic colitis

Chronic watery diarrhea with normal-appearing colon; diagnosed on biopsy; often drug-associated.

NAFLD management

Weight loss, control diabetes/lipids; the leading chronic liver disease in the developed world.

Variceal bleed management

Octreotide, antibiotics (prophylaxis), and endoscopic band ligation; non-selective beta-blocker for prevention.

Syphilis stages

Primary chancre, secondary rash (palms/soles), latent, and tertiary (gummas, neuro, cardiovascular); treat with penicillin.

Lyme disease

Erythema migrans bull's-eye rash; doxycycline for early disease; can cause carditis/Bell palsy/arthritis.

Clostridial myonecrosis (gas gangrene)

Crepitus, severe pain, systemic toxicity — emergent debridement plus penicillin/clindamycin.

Osteomyelitis

Bone infection; MRI is most sensitive; bone biopsy/culture guides prolonged antibiotics.

Fever of unknown origin

Fever ≥3 weeks without diagnosis after workup; causes: infection, malignancy, and connective-tissue disease.

Catheter-related bloodstream infection

Remove the line; blood cultures from line and periphery; Staph aureus and Candida need source control.

Immune reconstitution syndrome

Paradoxical worsening of an infection after starting ART as immunity recovers.

Asymptomatic bacteriuria

Do NOT treat (except in pregnancy or before urologic procedures) to avoid resistance.

Influenza antiviral

Oseltamivir is most effective within 48 hours of symptom onset, especially in high-risk patients.

Antiphospholipid syndrome

Recurrent thrombosis and/or pregnancy loss with antiphospholipid antibodies; anticoagulate.

Polyarteritis nodosa

Medium-vessel vasculitis sparing the lungs; associated with hepatitis B; renal/GI/skin involvement.

Reactive arthritis

Post-infectious triad: arthritis, conjunctivitis, urethritis ('can't see, pee, or climb a tree'); HLA-B27.

Drug-induced lupus

Anti-histone antibodies; from hydralazine, procainamide, isoniazid; resolves after stopping the drug.

Dermatomyositis

Proximal weakness with Gottron papules and heliotrope rash; elevated CK; screen for underlying malignancy.

Adult-onset Still disease

Quotidian fevers, salmon-colored rash, arthritis, very high ferritin.

Septic vs gout joint

Always tap an acute hot joint; Gram stain/culture and crystal analysis — septic arthritis can coexist with crystals.

Methotrexate monitoring

Check CBC, liver enzymes, and creatinine; supplement folic acid; avoid in pregnancy.

Subclinical hypothyroidism

High TSH with normal free T4; treat if TSH >10, symptomatic, or pregnant/planning pregnancy.

Thyroid nodule workup

Ultrasound and TSH; fine-needle aspiration for suspicious features or size criteria.

Hypoglycemia (Whipple triad)

Low glucose, consistent symptoms, and relief with glucose; evaluate for insulinoma vs medication.

Diabetes monitoring target

A1c goal commonly <7% for most adults, individualized for frailty/hypoglycemia risk.

Acromegaly

Excess growth hormone (pituitary adenoma); check IGF-1, confirm with oral glucose tolerance test.

Prolactinoma

Most common pituitary tumor; galactorrhea, amenorrhea; first-line is a dopamine agonist (cabergoline).

Diabetic foot care

Annual monofilament exam; treat ulcers with offloading, debridement, and infection control.

Hyperparathyroidism

High calcium with high/inappropriately normal PTH; parathyroidectomy for symptoms or end-organ effects.

IgA nephropathy

Most common glomerulonephritis; hematuria days after an upper respiratory infection.

Diabetic nephropathy

Leading cause of ESRD; albuminuria; protect with ACEi/ARB and SGLT2 inhibitors.

Rhabdomyolysis

Muscle breakdown with very high CK, myoglobinuria, and AKI; aggressive IV fluids; watch potassium.

Renal tubular acidosis

Non-anion-gap metabolic acidosis; type 1 (distal), type 2 (proximal), type 4 (hyperkalemic, hypoaldosterone).

Hypernatremia

Free-water deficit; correct slowly (<10–12 mEq/L per day) to avoid cerebral edema.

Hypokalemia ECG

U waves, flat T waves, and risk of arrhythmia; replace potassium and correct magnesium.

Contrast nephropathy prevention

Use the lowest contrast volume and hydrate in at-risk patients.

Multiple myeloma (CRAB)

hyperCalcemia, Renal failure, Anemia, Bone lesions; M-spike, plasma cells in marrow.

Chronic lymphocytic leukemia

Most common adult leukemia; smudge cells; often indolent and found incidentally.

Acute promyelocytic leukemia

AML M3 with t(15;17); DIC risk; treat with all-trans retinoic acid (ATRA).

Hodgkin lymphoma

Reed-Sternberg cells; contiguous nodal spread; highly curable.

G6PD deficiency

Episodic hemolysis after oxidant stress (drugs, fava beans, infection); bite cells and Heinz bodies.

Thalassemia vs iron deficiency

Both microcytic; thalassemia has a normal/high RBC count and normal ferritin; check hemoglobin electrophoresis.

Hypercoagulable workup

Consider after unprovoked or recurrent VTE — factor V Leiden, prothrombin mutation, protein C/S, antithrombin, antiphospholipid.

Colorectal cancer follow-up

Surveillance colonoscopy and CEA monitoring after curative resection.

Testicular cancer markers

AFP, beta-hCG, and LDH; highly curable even when metastatic.

Prostate cancer staging

PSA, Gleason score, and imaging; options range from active surveillance to surgery/radiation/ADT.

Pancreatic cancer

Painless jaundice, weight loss, CA 19-9; poor prognosis; often unresectable at diagnosis.

Immunotherapy toxicity

Checkpoint inhibitors cause immune-related colitis, pneumonitis, hepatitis, and endocrinopathies — treat with steroids.

Cancer of unknown primary

Metastatic disease without an identified source; tailor workup by histology/immunostains.

Stroke secondary prevention

Antiplatelet (or anticoagulation for AF), high-intensity statin, BP control, and carotid evaluation.

Bell palsy

Acute peripheral (whole-face) CN VII palsy; treat with steroids ± antivirals.

Trigeminal neuralgia

Brief, severe lancinating facial pain; carbamazepine is first-line.

Essential tremor

Action/postural tremor improving with alcohol; treat with propranolol or primidone.

Carpal tunnel syndrome

Median nerve compression; nocturnal hand numbness; splinting, then steroid injection or surgery.

Cluster headache

Severe unilateral periorbital pain with autonomic features; high-flow oxygen and triptans abort.

Diabetic peripheral neuropathy

Distal symmetric 'stocking-glove' sensory loss; treat pain with SNRIs, gabapentinoids, or TCAs.

Suicide risk assessment

Assess ideation, plan, intent, access to means, and prior attempts; ensure safety.

PTSD

Re-experiencing, avoidance, hyperarousal, and negative cognition after trauma; SSRIs and trauma-focused therapy.

Panic disorder

Recurrent unexpected panic attacks with anticipatory anxiety; CBT and SSRIs.

Anorexia nervosa risks

Restriction with low body weight; watch refeeding syndrome (low phosphate) and bradycardia.

Benzodiazepine risks

Tolerance, dependence, falls, and cognitive impairment — avoid long-term use, especially in older adults.

Antidepressant onset

SSRIs take 4–6 weeks for full effect; continue 6–12 months after remission of a first episode.

Pityriasis rosea

Herald patch followed by a 'Christmas-tree' truncal eruption; self-limited.

Actinic keratosis

Rough scaly sun-damaged lesions; premalignant for squamous cell carcinoma.

Contact dermatitis

Type IV hypersensitivity in the distribution of the allergen; topical steroids and avoidance.

Acanthosis nigricans

Velvety hyperpigmented skin in folds; associated with insulin resistance (and rarely GI malignancy).

Dermatitis herpetiformis

Intensely pruritic vesicles on extensors; associated with celiac disease.

Type I vs type II error

Type I (alpha) = false positive (reject a true null); Type II (beta) = false negative; power = 1 − beta.

p-value meaning

The probability of results as extreme as observed if the null hypothesis were true; <0.05 is conventionally significant.

Lead-time vs length-time bias

Lead-time: earlier detection only seems to prolong survival; length-time: screening preferentially finds slow-growing disease.

Intention-to-treat analysis

Analyze participants in their assigned group regardless of adherence — preserves randomization and reduces bias.

Cohort vs case-control

Cohort follows exposure forward to outcome (gives incidence/RR); case-control starts from outcome backward (gives odds ratio).

Hospice eligibility

A prognosis of about 6 months or less if the disease runs its usual course, with a focus on comfort.

Pressure injury prevention

Reposition, offload, manage moisture, and optimize nutrition in immobile patients.

Urinary incontinence types

Stress (leak with cough), urge (overactive bladder), overflow (retention), and functional.

Perioperative anticoagulation

Balance bleeding vs thrombosis risk; bridge only high-risk patients; hold DOACs based on renal function and bleeding risk.

Vaccination in immunocompromised

Avoid live vaccines; give inactivated vaccines and pneumococcal series.

Hypertension diagnosis

Confirm with out-of-office (ambulatory/home) readings; stage 1 is ≥130/80 by current US guidelines.

Obesity pharmacotherapy

GLP-1 receptor agonists (semaglutide) and other agents added to lifestyle for BMI ≥30 (or ≥27 with comorbidity).