What core mechanism explains acute coronary syndrome?

Plaque disruption with superimposed coronary thrombosis causes most acute coronary syndromes. 2025 ACC/AHA Guideline for the Management of Patients With Acute Coronary Syndromes · reviewed 2026-08-26

When an adult patient with decision-making capacity refuses a recommended treatment, what is the clinician’s next step?

Confirm that the choice is informed and voluntary, explain material risks and alternatives, document the discussion, and respect the refusal. Informed Consent · reviewed 2026-08-26

In a child or adolescent, what core mechanism explains asthma?

Airway inflammation and hyperresponsiveness create variable, usually reversible airflow obstruction. 2026 GINA Strategy Report · reviewed 2026-08-26

What core mechanism explains upper gastrointestinal bleeding?

Bleeding proximal to the ligament of Treitz is altered by gastric acid and intestinal transit, producing hematemesis or melena. ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding · reviewed 2026-08-26

In a child or adolescent, what core mechanism explains septic arthritis?

Bacterial invasion of synovium triggers destructive inflammation that can rapidly damage cartilage. Guideline for Management of Septic Arthritis in Native Joints · reviewed 2026-08-26

What core mechanism explains acute ischemic stroke?

Arterial occlusion deprives brain tissue of oxygen, leaving a salvageable penumbra around the infarct core. 2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke · reviewed 2026-08-26

What core mechanism explains community-acquired pneumonia?

Alveolar infection fills air spaces with inflammatory exudate and impairs gas exchange. Diagnosis and Treatment of Adults with Community-acquired Pneumonia · reviewed 2026-08-26

What core mechanism explains ectopic pregnancy?

Implantation outside the endometrial cavity, usually in the tube, can erode vessels and rupture. Ectopic Pregnancy · reviewed 2026-08-26

In a child or adolescent, what core mechanism explains major depressive disorder?

Mood-network and stress-system dysregulation interacts with genetic and environmental vulnerability; no single neurotransmitter explains the disorder. Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Major and Persistent Depressive Disorders · reviewed 2026-08-26

What core mechanism explains type 2 diabetes mellitus?

Insulin resistance plus progressive beta-cell dysfunction produces chronic hyperglycemia. Standards of Care in Diabetes—2026 · reviewed 2026-08-26

What core mechanism explains acute angle-closure glaucoma?

Closure of the anterior-chamber angle blocks aqueous outflow and abruptly raises intraocular pressure. Management of Angle-Closure Glaucoma · reviewed 2026-08-26

What clinical clue should raise suspicion for aortic dissection?

Abrupt severe chest or back pain, pulse or blood-pressure asymmetry, and a new aortic regurgitation murmur are high-risk clues. 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease · reviewed 2026-08-26

What core mechanism explains chronic kidney disease?

Progressive nephron loss causes hyperfiltration in remaining nephrons, fibrosis, and multisystem toxin accumulation. 2024 CKD Evaluation and Management Guideline · reviewed 2026-08-26

What core mechanism explains iron-deficiency anemia?

Iron depletion limits heme synthesis, producing hypochromic microcytes and eventually tissue iron symptoms. British Society of Gastroenterology Guidelines for the Management of Iron Deficiency Anaemia in Adults · reviewed 2026-08-26

In an infant aged 1–23 months with a viral prodrome followed by cough, wheeze or crackles, tachypnea, and feeding difficulty, what is the most likely diagnosis?

Bronchiolitis. An infant with viral prodrome followed by cough, wheeze or crackles, tachypnea, and feeding difficulty likely has bronchiolitis. Bronchiolitis: Recommendations for Diagnosis, Monitoring and Management of Children One to 24 Months · reviewed 2026-08-26

In a child or adolescent, what core mechanism explains atopic dermatitis?

Skin-barrier dysfunction and type 2 inflammation increase transepidermal water loss and itch. Atopic Dermatitis Clinical Guidelines · reviewed 2026-08-26

What clinical clue should raise suspicion for acute pancreatitis?

Severe persistent epigastric pain radiating to the back with nausea and vomiting is typical. ACG Clinical Guideline: Management of Acute Pancreatitis · reviewed 2026-08-26

What core mechanism explains uncomplicated cystitis?

Ascending periurethral bacteria inflame the bladder mucosa without renal-parenchymal involvement. EAU Guidelines on Urological Infections · reviewed 2026-08-26

Which diagnosis causes symmetric synovitis of the MCP, PIP, or wrist joints with prolonged morning stiffness?

Rheumatoid arthritis. Symmetric inflammatory pain and prolonged morning stiffness in MCP, PIP, or wrist joints with synovitis suggest rheumatoid arthritis. Rheumatoid Arthritis · reviewed 2026-08-26

What abilities are assessed when determining decision-making capacity for a specific choice?

The patient must communicate a choice, understand relevant information, appreciate how it applies personally, and reason about the options. Informed Consent · reviewed 2026-08-26

Which diagnosis causes fluctuating, fatigable ptosis, diplopia, dysarthria, dysphagia, or proximal weakness that worsens with use?

Myasthenia gravis. Fluctuating fatigable ptosis, diplopia, dysarthria, dysphagia, or proximal weakness that worsens with use suggests myasthenia. International Consensus Guidance for Management of Myasthenia Gravis: 2020 Update · reviewed 2026-08-26

Which diagnosis best fits new clinically significant diarrhea after antibiotics or healthcare exposure, especially with abdominal pain or leukocytosis?

Clostridioides difficile infection. New clinically significant diarrhea after antibiotics or healthcare exposure, with abdominal pain or leukocytosis, suggests C. difficile. 2021 Focused Update Guidelines on Management of Clostridioides difficile Infection in Adults · reviewed 2026-08-26

For surgical decision-making, after delivery of the head, retraction against the perineum and failure of the shoulders to deliver indicate which obstetric emergency?

Shoulder dystocia. After delivery of the head, retraction against the perineum and failure of the shoulders to deliver indicates dystocia. Shoulder Dystocia · reviewed 2026-08-26

In a child or adolescent, which diagnosis causes persistent developmentally inappropriate inattention and/or hyperactivity-impulsivity in more than one setting with impairment?

Attention-deficit/hyperactivity disorder. Persistent developmentally inappropriate inattention and/or hyperactivity-impulsivity in more than one setting with impairment suggests ADHD. ADHD in Children and Youth: Part 1—Etiology, Diagnosis, and Comorbidity · reviewed 2026-08-26

Which diagnosis best fits sharp pleuritic chest pain that improves when sitting forward, a friction rub, and diffuse ST elevation?

Acute pericarditis. Sharp pleuritic chest pain that improves when sitting forward, a friction rub, and diffuse ST elevation support pericarditis. 2025 Concise Clinical Guidance: Diagnosis and Management of Pericarditis · reviewed 2026-08-26

Which next action matters most in acute respiratory distress syndrome?

Treat the cause, ventilate with low tidal volumes and limited pressures, and use prone positioning for severe hypoxemia. An Update on Management of Adult Patients with Acute Respiratory Distress Syndrome · reviewed 2026-08-26

For surgical decision-making, identify the condition from this pattern: Proximal weakness, easy bruising, facial plethora, wide violaceous striae, osteoporosis, or difficult diabetes and hypertension are discriminating clues.

Cushing syndrome. Proximal weakness, easy bruising, facial plethora, wide violaceous striae, osteoporosis, or difficult diabetes and hypertension are discriminating clues. Diagnosis of Cushing Syndrome: An Endocrine Society Clinical Practice Guideline · reviewed 2026-08-26

For surgical decision-making, identify the condition from this pattern: Severe unilateral sore throat, muffled voice, drooling, trismus, and uvular deviation suggest a peritonsillar collection.

Peritonsillar abscess. Severe unilateral sore throat, muffled voice, drooling, trismus, and uvular deviation suggest a peritonsillar collection. Tonsillitis and Peritonsillar Abscess · reviewed 2026-08-26

What clinical clue should raise suspicion for anterior cruciate ligament tear?

A noncontact pivot, audible pop, immediate swelling, and instability with a positive Lachman test suggest an ACL tear. Management of Anterior Cruciate Ligament Injuries: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26

Which diagnosis may be silent until edema, pruritus, anemia, hypertension, or abnormal urine testing appears?

Chronic kidney disease. CKD may be silent; edema, pruritus, anemia, hypertension, or abnormal urine testing often appears later. 2024 CKD Evaluation and Management Guideline · reviewed 2026-08-26

For surgical decision-making, which next action matters most in aortic dissection?

Start rapid heart-rate and blood-pressure control and obtain emergency surgical evaluation for ascending dissection. 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease · reviewed 2026-08-26

Identify the condition from this pattern: Fatigue, pica, restless legs, koilonychia, or chronic blood loss can accompany microcytic anemia.

Iron-deficiency anemia. Fatigue, pica, restless legs, koilonychia, or chronic blood loss can accompany microcytic anemia. British Society of Gastroenterology Guidelines for the Management of Iron Deficiency Anaemia in Adults · reviewed 2026-08-26

What clinical clue should raise suspicion for bacterial brain abscess?

Headache, fever, focal deficit, seizure, or signs of raised intracranial pressure after sinus, ear, dental, or bloodstream infection raise suspicion. ESCMID Guideline on Diagnosis and Treatment of Brain Abscess in Children and Adults · reviewed 2026-08-26

Which diagnosis best fits chronic diarrhea, abdominal pain, weight loss, perianal disease, and skip lesions?

Crohn disease. Chronic diarrhea, abdominal pain, weight loss, perianal disease, and skip lesions support Crohn disease. Updated 2025 ACG Guidelines for Crohn’s Disease · reviewed 2026-08-26

What clinical clue should raise suspicion for pulmonary tuberculosis?

Chronic cough, fever, night sweats, weight loss, hemoptysis, or epidemiologic exposure raises concern. Clinical Overview of Tuberculosis Disease · reviewed 2026-08-26

Which diagnosis causes well-demarcated erythematous plaques with silvery scale on extensor surfaces and nail pitting?

Plaque psoriasis. Well-demarcated erythematous plaques with silvery scale on extensor surfaces and nail pitting support psoriasis. Psoriasis Clinical Guidelines · reviewed 2026-08-26

What clinical clue should raise suspicion for endometriosis?

Cyclic pelvic pain, dysmenorrhea, deep dyspareunia, painful defecation, or infertility suggests endometriosis. Endometriosis · reviewed 2026-08-26

Identify the condition from this pattern: Fever, flank pain, costovertebral-angle tenderness, nausea, and urinary symptoms suggest renal infection.

Acute pyelonephritis. Fever, flank pain, costovertebral-angle tenderness, nausea, and urinary symptoms suggest renal infection. EAU Guidelines on Urological Infections · reviewed 2026-08-26

What clinical clue should raise suspicion for panic disorder?

Recurrent unexpected panic attacks plus persistent worry or maladaptive avoidance for at least a month suggests panic disorder. Panic Disorder: What You Need to Know · reviewed 2026-08-26

What drug class or regimen fits acute pericarditis?

Use an NSAID plus colchicine for uncomplicated acute pericarditis when not contraindicated. 2025 Concise Clinical Guidance: Diagnosis and Management of Pericarditis · reviewed 2026-08-26

What clinical clue should raise suspicion for tension pneumothorax?

Severe dyspnea, unilateral absent breath sounds, hypotension, distended neck veins, and obstructive shock suggest tension physiology. Thoracic Trauma WSES-AAST Guidelines · reviewed 2026-08-26

In a child or adolescent, which next action matters most in diabetic ketoacidosis?

Begin isotonic fluids, replace potassium according to the measured level, and start IV insulin once potassium is safe. Standards of Care in Diabetes—2026 · reviewed 2026-08-26

Who makes decisions when an adult patient lacks capacity and has no applicable advance directive?

Use the legally authorized surrogate and guide decisions by the patient’s known wishes or, if unknown, best interests. Decisions for Adult Patients Who Lack Capacity · reviewed 2026-08-26

For surgical decision-making, which next action matters most in retinal detachment?

Send the patient to an eye doctor or emergency department immediately for retinal evaluation and treatment. Early treatment helps prevent permanent vision loss. Retinal Detachment · reviewed 2026-08-26

What clinical clue should raise suspicion for acute deep-vein thrombosis?

Unilateral leg swelling, pain, warmth, and risk from immobility, surgery, cancer, estrogen, or prior VTE raise suspicion. ASH VTE Guidelines: Diagnosis of Venous Thromboembolism · reviewed 2026-08-26

Which next action matters most in Crohn disease?

Drain abscesses and involve surgery for obstruction, fistula complications, perforation, or refractory disease. Updated 2025 ACG Guidelines for Crohn’s Disease · reviewed 2026-08-26

Which next action matters most in rheumatoid arthritis?

Refer early and start disease-modifying therapy rather than relying on symptomatic treatment. 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis · reviewed 2026-08-26

What antimicrobial approach is appropriate for suspected or confirmed pleural infection?

Start empiric antibiotics before culture results, covering likely organisms including anaerobes, then narrow therapy to microbiology and clinical context. British Thoracic Society Guideline for Pleural Disease · reviewed 2026-08-26

In a child or adolescent, which next action matters most in nephritic syndrome?

Control pressure and volume, treat the cause, and obtain urgent nephrology input for rapidly progressive loss. KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases with 2024 Chapter Updates · reviewed 2026-08-26

Which prevention or risk-reduction step is important for acute coronary syndrome?

Treat tobacco use, hypertension, diabetes, and dyslipidemia to reduce atherosclerotic risk. 2025 ACC/AHA Guideline for the Management of Patients With Acute Coronary Syndromes · reviewed 2026-08-26

Which next action matters most in multiple sclerosis relapse?

Exclude infection or pseudo-relapse, then treat functionally significant relapse and reassess disease-modifying therapy. Multiple Sclerosis in Adults: Management · reviewed 2026-08-26

PANCE Flashcards: Blueprint-Aligned Diagnoses, Tests & Next Steps

Study diagnoses, tests, next steps and management with a source-linked PANCE deck organized by the January 2025 NCCPA blueprint.

من إعداد Flashcards Open Source App

حول هذه الرزمة

Reviewed for 2026, this 600-card English deck follows the January 2025 NCCPA PANCE blueprint. Its two public tag axes let you switch between medical-content systems and exam-task retrievals: discriminating history and examination cues, diagnosis, diagnostic-study choice, prevention, next-step intervention, pharmacotherapy, and selected foundations. Every answer links to a current first-party clinical guideline or authoritative public-health or professional body and records the 2026-08-26 review date. Official PANCE eligibility and certification requirements remain with NCCPA. No recalled or leaked exam questions, exam items, mark schemes, curriculum prose, commercial deck wording, logos, figures, or trade dress were copied. Educational review only. This deck isn't medical advice and isn't a substitute for current clinical guidance, supervision, local protocols, or patient-specific judgment. This independently written resource is unofficial and is not affiliated with or endorsed by NCCPA.

بطاقات هذه الرزمة

البطاقة ١
السؤال
What core mechanism explains acute coronary syndrome?
الإجابة
Plaque disruption with superimposed coronary thrombosis causes most acute coronary syndromes.

2025 ACC/AHA Guideline for the Management of Patients With Acute Coronary Syndromes · reviewed 2026-08-26
البطاقة ٢
السؤال
When an adult patient with decision-making capacity refuses a recommended treatment, what is the clinician’s next step?
الإجابة
Confirm that the choice is informed and voluntary, explain material risks and alternatives, document the discussion, and respect the refusal.

Informed Consent · reviewed 2026-08-26
البطاقة ٣
السؤال
In a child or adolescent, what core mechanism explains asthma?
الإجابة
Airway inflammation and hyperresponsiveness create variable, usually reversible airflow obstruction.

2026 GINA Strategy Report · reviewed 2026-08-26
البطاقة ٤
السؤال
What core mechanism explains upper gastrointestinal bleeding?
الإجابة
Bleeding proximal to the ligament of Treitz is altered by gastric acid and intestinal transit, producing hematemesis or melena.

ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding · reviewed 2026-08-26
البطاقة ٥
السؤال
In a child or adolescent, what core mechanism explains septic arthritis?
الإجابة
Bacterial invasion of synovium triggers destructive inflammation that can rapidly damage cartilage.

Guideline for Management of Septic Arthritis in Native Joints · reviewed 2026-08-26
البطاقة ٦
السؤال
What core mechanism explains acute ischemic stroke?
الإجابة
Arterial occlusion deprives brain tissue of oxygen, leaving a salvageable penumbra around the infarct core.

2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke · reviewed 2026-08-26
البطاقة ٧
السؤال
What core mechanism explains community-acquired pneumonia?
الإجابة
Alveolar infection fills air spaces with inflammatory exudate and impairs gas exchange.

Diagnosis and Treatment of Adults with Community-acquired Pneumonia · reviewed 2026-08-26
البطاقة ٨
السؤال
What core mechanism explains ectopic pregnancy?
الإجابة
Implantation outside the endometrial cavity, usually in the tube, can erode vessels and rupture.

Ectopic Pregnancy · reviewed 2026-08-26
البطاقة ٩
السؤال
In a child or adolescent, what core mechanism explains major depressive disorder?
الإجابة
Mood-network and stress-system dysregulation interacts with genetic and environmental vulnerability; no single neurotransmitter explains the disorder.

Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Major and Persistent Depressive Disorders · reviewed 2026-08-26
البطاقة ١٠
السؤال
What core mechanism explains type 2 diabetes mellitus?
الإجابة
Insulin resistance plus progressive beta-cell dysfunction produces chronic hyperglycemia.

Standards of Care in Diabetes—2026 · reviewed 2026-08-26
البطاقة ١١
السؤال
What core mechanism explains acute angle-closure glaucoma?
الإجابة
Closure of the anterior-chamber angle blocks aqueous outflow and abruptly raises intraocular pressure.

Management of Angle-Closure Glaucoma · reviewed 2026-08-26
البطاقة ١٢
السؤال
What clinical clue should raise suspicion for aortic dissection?
الإجابة
Abrupt severe chest or back pain, pulse or blood-pressure asymmetry, and a new aortic regurgitation murmur are high-risk clues.

2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease · reviewed 2026-08-26
البطاقة ١٣
السؤال
What core mechanism explains chronic kidney disease?
الإجابة
Progressive nephron loss causes hyperfiltration in remaining nephrons, fibrosis, and multisystem toxin accumulation.

2024 CKD Evaluation and Management Guideline · reviewed 2026-08-26
البطاقة ١٤
السؤال
What core mechanism explains iron-deficiency anemia?
الإجابة
Iron depletion limits heme synthesis, producing hypochromic microcytes and eventually tissue iron symptoms.

British Society of Gastroenterology Guidelines for the Management of Iron Deficiency Anaemia in Adults · reviewed 2026-08-26
البطاقة ١٥
السؤال
In an infant aged 1–23 months with a viral prodrome followed by cough, wheeze or crackles, tachypnea, and feeding difficulty, what is the most likely diagnosis?
الإجابة
Bronchiolitis. An infant with viral prodrome followed by cough, wheeze or crackles, tachypnea, and feeding difficulty likely has bronchiolitis.

Bronchiolitis: Recommendations for Diagnosis, Monitoring and Management of Children One to 24 Months · reviewed 2026-08-26
البطاقة ١٦
السؤال
In a child or adolescent, what core mechanism explains atopic dermatitis?
الإجابة
Skin-barrier dysfunction and type 2 inflammation increase transepidermal water loss and itch.

Atopic Dermatitis Clinical Guidelines · reviewed 2026-08-26
البطاقة ١٧
السؤال
What clinical clue should raise suspicion for acute pancreatitis?
الإجابة
Severe persistent epigastric pain radiating to the back with nausea and vomiting is typical.

ACG Clinical Guideline: Management of Acute Pancreatitis · reviewed 2026-08-26
البطاقة ١٨
السؤال
What core mechanism explains uncomplicated cystitis?
الإجابة
Ascending periurethral bacteria inflame the bladder mucosa without renal-parenchymal involvement.

EAU Guidelines on Urological Infections · reviewed 2026-08-26
البطاقة ١٩
السؤال
Which diagnosis causes symmetric synovitis of the MCP, PIP, or wrist joints with prolonged morning stiffness?
الإجابة
Rheumatoid arthritis. Symmetric inflammatory pain and prolonged morning stiffness in MCP, PIP, or wrist joints with synovitis suggest rheumatoid arthritis.

Rheumatoid Arthritis · reviewed 2026-08-26
البطاقة ٢٠
السؤال
What abilities are assessed when determining decision-making capacity for a specific choice?
الإجابة
The patient must communicate a choice, understand relevant information, appreciate how it applies personally, and reason about the options.

Informed Consent · reviewed 2026-08-26
البطاقة ٢١
السؤال
Which diagnosis causes fluctuating, fatigable ptosis, diplopia, dysarthria, dysphagia, or proximal weakness that worsens with use?
الإجابة
Myasthenia gravis. Fluctuating fatigable ptosis, diplopia, dysarthria, dysphagia, or proximal weakness that worsens with use suggests myasthenia.

International Consensus Guidance for Management of Myasthenia Gravis: 2020 Update · reviewed 2026-08-26
البطاقة ٢٢
السؤال
Which diagnosis best fits new clinically significant diarrhea after antibiotics or healthcare exposure, especially with abdominal pain or leukocytosis?
الإجابة
Clostridioides difficile infection. New clinically significant diarrhea after antibiotics or healthcare exposure, with abdominal pain or leukocytosis, suggests C. difficile.

2021 Focused Update Guidelines on Management of Clostridioides difficile Infection in Adults · reviewed 2026-08-26
البطاقة ٢٣
السؤال
For surgical decision-making, after delivery of the head, retraction against the perineum and failure of the shoulders to deliver indicate which obstetric emergency?
الإجابة
Shoulder dystocia. After delivery of the head, retraction against the perineum and failure of the shoulders to deliver indicates dystocia.

Shoulder Dystocia · reviewed 2026-08-26
البطاقة ٢٤
السؤال
In a child or adolescent, which diagnosis causes persistent developmentally inappropriate inattention and/or hyperactivity-impulsivity in more than one setting with impairment?
الإجابة
Attention-deficit/hyperactivity disorder. Persistent developmentally inappropriate inattention and/or hyperactivity-impulsivity in more than one setting with impairment suggests ADHD.

ADHD in Children and Youth: Part 1—Etiology, Diagnosis, and Comorbidity · reviewed 2026-08-26
البطاقة ٢٥
السؤال
Which diagnosis best fits sharp pleuritic chest pain that improves when sitting forward, a friction rub, and diffuse ST elevation?
الإجابة
Acute pericarditis. Sharp pleuritic chest pain that improves when sitting forward, a friction rub, and diffuse ST elevation support pericarditis.

2025 Concise Clinical Guidance: Diagnosis and Management of Pericarditis · reviewed 2026-08-26
البطاقة ٢٦
السؤال
Which next action matters most in acute respiratory distress syndrome?
الإجابة
Treat the cause, ventilate with low tidal volumes and limited pressures, and use prone positioning for severe hypoxemia.

An Update on Management of Adult Patients with Acute Respiratory Distress Syndrome · reviewed 2026-08-26
البطاقة ٢٧
السؤال
For surgical decision-making, identify the condition from this pattern: Proximal weakness, easy bruising, facial plethora, wide violaceous striae, osteoporosis, or difficult diabetes and hypertension are discriminating clues.
الإجابة
Cushing syndrome. Proximal weakness, easy bruising, facial plethora, wide violaceous striae, osteoporosis, or difficult diabetes and hypertension are discriminating clues.

Diagnosis of Cushing Syndrome: An Endocrine Society Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ٢٨
السؤال
For surgical decision-making, identify the condition from this pattern: Severe unilateral sore throat, muffled voice, drooling, trismus, and uvular deviation suggest a peritonsillar collection.
الإجابة
Peritonsillar abscess. Severe unilateral sore throat, muffled voice, drooling, trismus, and uvular deviation suggest a peritonsillar collection.

Tonsillitis and Peritonsillar Abscess · reviewed 2026-08-26
البطاقة ٢٩
السؤال
What clinical clue should raise suspicion for anterior cruciate ligament tear?
الإجابة
A noncontact pivot, audible pop, immediate swelling, and instability with a positive Lachman test suggest an ACL tear.

Management of Anterior Cruciate Ligament Injuries: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ٣٠
السؤال
Which diagnosis may be silent until edema, pruritus, anemia, hypertension, or abnormal urine testing appears?
الإجابة
Chronic kidney disease. CKD may be silent; edema, pruritus, anemia, hypertension, or abnormal urine testing often appears later.

2024 CKD Evaluation and Management Guideline · reviewed 2026-08-26
البطاقة ٣١
السؤال
For surgical decision-making, which next action matters most in aortic dissection?
الإجابة
Start rapid heart-rate and blood-pressure control and obtain emergency surgical evaluation for ascending dissection.

2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease · reviewed 2026-08-26
البطاقة ٣٢
السؤال
Identify the condition from this pattern: Fatigue, pica, restless legs, koilonychia, or chronic blood loss can accompany microcytic anemia.
الإجابة
Iron-deficiency anemia. Fatigue, pica, restless legs, koilonychia, or chronic blood loss can accompany microcytic anemia.

British Society of Gastroenterology Guidelines for the Management of Iron Deficiency Anaemia in Adults · reviewed 2026-08-26
البطاقة ٣٣
السؤال
What clinical clue should raise suspicion for bacterial brain abscess?
الإجابة
Headache, fever, focal deficit, seizure, or signs of raised intracranial pressure after sinus, ear, dental, or bloodstream infection raise suspicion.

ESCMID Guideline on Diagnosis and Treatment of Brain Abscess in Children and Adults · reviewed 2026-08-26
البطاقة ٣٤
السؤال
Which diagnosis best fits chronic diarrhea, abdominal pain, weight loss, perianal disease, and skip lesions?
الإجابة
Crohn disease. Chronic diarrhea, abdominal pain, weight loss, perianal disease, and skip lesions support Crohn disease.

Updated 2025 ACG Guidelines for Crohn’s Disease · reviewed 2026-08-26
البطاقة ٣٥
السؤال
What clinical clue should raise suspicion for pulmonary tuberculosis?
الإجابة
Chronic cough, fever, night sweats, weight loss, hemoptysis, or epidemiologic exposure raises concern.

Clinical Overview of Tuberculosis Disease · reviewed 2026-08-26
البطاقة ٣٦
السؤال
Which diagnosis causes well-demarcated erythematous plaques with silvery scale on extensor surfaces and nail pitting?
الإجابة
Plaque psoriasis. Well-demarcated erythematous plaques with silvery scale on extensor surfaces and nail pitting support psoriasis.

Psoriasis Clinical Guidelines · reviewed 2026-08-26
البطاقة ٣٧
السؤال
What clinical clue should raise suspicion for endometriosis?
الإجابة
Cyclic pelvic pain, dysmenorrhea, deep dyspareunia, painful defecation, or infertility suggests endometriosis.

Endometriosis · reviewed 2026-08-26
البطاقة ٣٨
السؤال
Identify the condition from this pattern: Fever, flank pain, costovertebral-angle tenderness, nausea, and urinary symptoms suggest renal infection.
الإجابة
Acute pyelonephritis. Fever, flank pain, costovertebral-angle tenderness, nausea, and urinary symptoms suggest renal infection.

EAU Guidelines on Urological Infections · reviewed 2026-08-26
البطاقة ٣٩
السؤال
What clinical clue should raise suspicion for panic disorder?
الإجابة
Recurrent unexpected panic attacks plus persistent worry or maladaptive avoidance for at least a month suggests panic disorder.

Panic Disorder: What You Need to Know · reviewed 2026-08-26
البطاقة ٤٠
السؤال
What drug class or regimen fits acute pericarditis?
الإجابة
Use an NSAID plus colchicine for uncomplicated acute pericarditis when not contraindicated.

2025 Concise Clinical Guidance: Diagnosis and Management of Pericarditis · reviewed 2026-08-26
البطاقة ٤١
السؤال
What clinical clue should raise suspicion for tension pneumothorax?
الإجابة
Severe dyspnea, unilateral absent breath sounds, hypotension, distended neck veins, and obstructive shock suggest tension physiology.

Thoracic Trauma WSES-AAST Guidelines · reviewed 2026-08-26
البطاقة ٤٢
السؤال
In a child or adolescent, which next action matters most in diabetic ketoacidosis?
الإجابة
Begin isotonic fluids, replace potassium according to the measured level, and start IV insulin once potassium is safe.

Standards of Care in Diabetes—2026 · reviewed 2026-08-26
البطاقة ٤٣
السؤال
Who makes decisions when an adult patient lacks capacity and has no applicable advance directive?
الإجابة
Use the legally authorized surrogate and guide decisions by the patient’s known wishes or, if unknown, best interests.

Decisions for Adult Patients Who Lack Capacity · reviewed 2026-08-26
البطاقة ٤٤
السؤال
For surgical decision-making, which next action matters most in retinal detachment?
الإجابة
Send the patient to an eye doctor or emergency department immediately for retinal evaluation and treatment. Early treatment helps prevent permanent vision loss.

Retinal Detachment · reviewed 2026-08-26
البطاقة ٤٥
السؤال
What clinical clue should raise suspicion for acute deep-vein thrombosis?
الإجابة
Unilateral leg swelling, pain, warmth, and risk from immobility, surgery, cancer, estrogen, or prior VTE raise suspicion.

ASH VTE Guidelines: Diagnosis of Venous Thromboembolism · reviewed 2026-08-26
البطاقة ٤٦
السؤال
Which next action matters most in Crohn disease?
الإجابة
Drain abscesses and involve surgery for obstruction, fistula complications, perforation, or refractory disease.

Updated 2025 ACG Guidelines for Crohn’s Disease · reviewed 2026-08-26
البطاقة ٤٧
السؤال
Which next action matters most in rheumatoid arthritis?
الإجابة
Refer early and start disease-modifying therapy rather than relying on symptomatic treatment.

2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis · reviewed 2026-08-26
البطاقة ٤٨
السؤال
What antimicrobial approach is appropriate for suspected or confirmed pleural infection?
الإجابة
Start empiric antibiotics before culture results, covering likely organisms including anaerobes, then narrow therapy to microbiology and clinical context.

British Thoracic Society Guideline for Pleural Disease · reviewed 2026-08-26
البطاقة ٤٩
السؤال
In a child or adolescent, which next action matters most in nephritic syndrome?
الإجابة
Control pressure and volume, treat the cause, and obtain urgent nephrology input for rapidly progressive loss.

KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases with 2024 Chapter Updates · reviewed 2026-08-26
البطاقة ٥٠
السؤال
Which prevention or risk-reduction step is important for acute coronary syndrome?
الإجابة
Treat tobacco use, hypertension, diabetes, and dyslipidemia to reduce atherosclerotic risk.

2025 ACC/AHA Guideline for the Management of Patients With Acute Coronary Syndromes · reviewed 2026-08-26
البطاقة ٥١
السؤال
Which next action matters most in multiple sclerosis relapse?
الإجابة
Exclude infection or pseudo-relapse, then treat functionally significant relapse and reassess disease-modifying therapy.

Multiple Sclerosis in Adults: Management · reviewed 2026-08-26
البطاقة ٥٢
السؤال
Which next action matters most in HIV infection?
الإجابة
Link a newly diagnosed patient rapidly to HIV care and begin antiretroviral therapy as soon as feasible.

Initiation of Antiretroviral Therapy · reviewed 2026-08-26
البطاقة ٥٣
السؤال
For surgical decision-making, which next action matters most in postpartum hemorrhage?
الإجابة
Call the hemorrhage team, massage an atonic uterus, give uterotonics, replace blood products, and control the cause procedurally if needed.

Postpartum Hemorrhage · reviewed 2026-08-26
البطاقة ٥٤
السؤال
Which next action matters most in delirium?
الإجابة
Treat the cause, protect the patient, and use nonpharmacologic measures first.

Delirium: Prevention, Diagnosis and Management · reviewed 2026-08-26
البطاقة ٥٥
السؤال
After successful endoscopic hemostasis of a high-risk bleeding peptic ulcer, what medication strategy is recommended?
الإجابة
Give high-dose proton-pump inhibitor therapy continuously or intermittently for 3 days.

ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding · reviewed 2026-08-26
البطاقة ٥٦
السؤال
What clinical clue should raise suspicion for thyroid storm?
الإجابة
Fever, marked tachycardia, agitation or delirium, gastrointestinal symptoms, and heart failure in thyrotoxicosis suggest storm.

2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis · reviewed 2026-08-26
البطاقة ٥٧
السؤال
In a child or adolescent, what drug class or regimen fits septic arthritis?
الإجابة
Cover likely gram-positive organisms initially, adding gram-negative coverage for relevant risk.

Guideline for Management of Septic Arthritis in Native Joints · reviewed 2026-08-26
البطاقة ٥٨
السؤال
What clinical clue should raise suspicion for acute bacterial rhinosinusitis?
الإجابة
Persistent symptoms beyond 10 days, severe fever with purulent drainage, or worsening after initial improvement are patterns that support bacterial disease.

Clinical Practice Guideline: Adult Sinusitis Update · reviewed 2026-08-26
البطاقة ٥٩
السؤال
How should a clinician respond when a patient asks not to hear serious diagnostic information?
الإجابة
Explore the request and preferences, confirm it is voluntary, and identify whether the patient wants information shared with a chosen surrogate.

Withholding Information from Patients · reviewed 2026-08-26
البطاقة ٦٠
السؤال
What is the key first diagnostic step for cardiac tamponade?
الإجابة
Bedside echocardiography can show effusion with chamber collapse and respiratory flow variation.

2025 Concise Clinical Guidance: Diagnosis and Management of Pericarditis · reviewed 2026-08-26
البطاقة ٦١
السؤال
In a child or adolescent, which next action matters most in atopic dermatitis?
الإجابة
Treat active inflammation and address infection, sleep disruption, and trigger exposure.

Atopic Dermatitis Clinical Guidelines · reviewed 2026-08-26
البطاقة ٦٢
السؤال
What is the key first diagnostic step for idiopathic pulmonary fibrosis?
الإجابة
High-resolution CT showing a usual interstitial pneumonia pattern can establish diagnosis in the right context; multidisciplinary review is key.

Idiopathic Pulmonary Fibrosis: An Update and Progressive Pulmonary Fibrosis in Adults · reviewed 2026-08-26
البطاقة ٦٣
السؤال
What drug class or regimen fits benign prostatic hyperplasia?
الإجابة
Alpha-1 blockers improve symptoms quickly; 5-alpha-reductase inhibitors reduce progression in appropriately enlarged prostates.

EAU Guidelines on the Management of Non-neurogenic Male Lower Urinary Tract Symptoms · reviewed 2026-08-26
البطاقة ٦٤
السؤال
In a child or adolescent, what clinical clue should raise suspicion for nephritic syndrome?
الإجابة
Hematuria with dysmorphic red cells or casts, hypertension, edema, and reduced kidney function suggests glomerular inflammation.

KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases with 2024 Chapter Updates · reviewed 2026-08-26
البطاقة ٦٥
السؤال
In a child or adolescent, which initial medication regimen is indicated for a convulsive seizure lasting at least five minutes or recurring without recovery?
الإجابة
A benzodiazepine is first-line for convulsive status epilepticus, followed by an appropriate longer-acting antiseizure medicine.

Treatment of Prolonged Seizures in Children and Adults · reviewed 2026-08-26
البطاقة ٦٦
السؤال
Which next action matters most in acute deep-vein thrombosis?
الإجابة
Start anticoagulation promptly after acute deep-vein thrombosis is confirmed, unless a contraindication changes the plan.

ASH VTE Guidelines: Treatment of Deep Vein Thrombosis and Pulmonary Embolism · reviewed 2026-08-26
البطاقة ٦٧
السؤال
What drug class or regimen fits sepsis?
الإجابة
Use broad therapy matched to source, host, and local resistance, then de-escalate from cultures and response.

2026 Surviving Sepsis Campaign Adult Guidelines · reviewed 2026-08-26
البطاقة ٦٨
السؤال
Which bedside pattern best points to infective endocarditis?
الإجابة
Fever plus a new or changing murmur, embolic findings, injection-drug use, or prosthetic material raises suspicion.

2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease · reviewed 2026-08-26
البطاقة ٦٩
السؤال
What drug class or regimen fits pelvic inflammatory disease?
الإجابة
Outpatient therapy commonly uses ceftriaxone plus doxycycline and metronidazole.

Pelvic Inflammatory Disease: STI Treatment Guidelines · reviewed 2026-08-26
البطاقة ٧٠
السؤال
Which prevention or risk-reduction step is important for acute pancreatitis?
الإجابة
Treat gallstones, avoid alcohol excess, and control severe hypertriglyceridemia to reduce recurrence.

ACG Clinical Guideline: Management of Acute Pancreatitis · reviewed 2026-08-26
البطاقة ٧١
السؤال
What drug class or regimen fits schizophrenia?
الإجابة
Use an antipsychotic through shared decision-making; clozapine is indicated for treatment resistance or persistent suicide risk under monitoring.

Management of First-Episode Psychosis and Schizophrenia · reviewed 2026-08-26
البطاقة ٧٢
السؤال
Which prevention or risk-reduction step is important for anterior cruciate ligament tear?
الإجابة
Neuromuscular warm-up and landing programs reduce noncontact ACL injuries in high-risk athletes.

Management of Anterior Cruciate Ligament Injuries: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ٧٣
السؤال
What is the key first diagnostic step for primary hypothyroidism?
الإجابة
Measure TSH first in most patients and free T4 to characterize overt disease.

Guidelines for the Treatment of Hypothyroidism · reviewed 2026-08-26
البطاقة ٧٤
السؤال
In an acutely ill hospitalized medical patient, what VTE prevention strategy is appropriate?
الإجابة
Assess VTE and bleeding risk, then use pharmacologic prophylaxis when indicated or mechanical prophylaxis when anticoagulation is unsuitable.

ASH VTE Guidelines: Prophylaxis for Medical Patients · reviewed 2026-08-26
البطاقة ٧٥
السؤال
In a child aged 6 months or older, what drug class or regimen fits acute otitis media?
الإجابة
Amoxicillin is first-line for most children who need an antibiotic, with alternatives guided by allergy and prior treatment.

Management of Acute Otitis Media in Children Six Months of Age and Older · reviewed 2026-08-26
البطاقة ٧٦
السؤال
What makes informed consent more than a signed form?
الإجابة
It is a communication process covering the nature, expected benefits, material risks, alternatives, and the option to decline, followed by a voluntary decision.

Informed Consent · reviewed 2026-08-26
البطاقة ٧٧
السؤال
What condition should be suspected from this finding: Severely elevated pressure with acute neurologic, cardiac, renal, retinal, or aortic injury defines an emergency.
الإجابة
Hypertensive emergency. Severely elevated pressure with acute neurologic, cardiac, renal, retinal, or aortic injury defines an emergency.

2025 High Blood Pressure Guideline · reviewed 2026-08-26
البطاقة ٧٨
السؤال
Which prevention or risk-reduction step is important for migraine with aura?
الإجابة
Regular sleep, meals, hydration, activity, trigger management, and limiting acute-medicine overuse reduce attacks.

AHS Consensus Statement: Integrating New Migraine Treatments into Clinical Practice · reviewed 2026-08-26
البطاقة ٧٩
السؤال
What is the key first diagnostic step for upper gastrointestinal bleeding?
الإجابة
Check hemodynamics, CBC, metabolic and coagulation studies, type and screen, then perform timely upper endoscopy after stabilization.

ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding · reviewed 2026-08-26
البطاقة ٨٠
السؤال
Which prevention or risk-reduction step is important for early syphilis?
الإجابة
Condom use, partner services, repeat testing for ongoing risk, and prenatal screening reduce transmission and congenital disease.

Primary and Secondary Syphilis: STI Treatment Guidelines · reviewed 2026-08-26
البطاقة ٨١
السؤال
In a child or adolescent, what is the key first diagnostic step for septic arthritis?
الإجابة
Perform urgent arthrocentesis for cell count, crystals, Gram stain, and culture; obtain blood cultures.

Guideline for Management of Septic Arthritis in Native Joints · reviewed 2026-08-26
البطاقة ٨٢
السؤال
Which prevention or risk-reduction step is important for abnormal uterine bleeding from anovulation?
الإجابة
Address reversible causes of ovulatory dysfunction, review medicines that worsen bleeding, and monitor for anemia.

Abnormal Uterine Bleeding · reviewed 2026-08-26
البطاقة ٨٣
السؤال
In a young child, which diagnosis best fits a barking cough, hoarseness, and inspiratory stridor after a viral prodrome?
الإجابة
Croup. Barking cough, hoarseness, and inspiratory stridor after a viral prodrome in a young child suggests croup.

Acute Management of Croup in the Emergency Department · reviewed 2026-08-26
البطاقة ٨٤
السؤال
Which intervention is recommended to reduce later PTSD in an adult diagnosed with acute stress disorder?
الإجابة
Offer individual trauma-focused cognitive behavioral psychotherapy with exposure and/or cognitive restructuring.

Management of Posttraumatic Stress Disorder and Acute Stress Disorder · reviewed 2026-08-26
البطاقة ٨٥
السؤال
What clinical clue should raise suspicion for cellulitis?
الإجابة
Unilateral expanding warmth, tenderness, erythema, and edema without a sharply raised border favor cellulitis.

Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections · reviewed 2026-08-26
البطاقة ٨٦
السؤال
How should a clinician initially manage infective endocarditis?
الإجابة
Start targeted IV antibiotics after cultures; seek early valve-team input for heart failure, uncontrolled infection, or major embolic risk.

2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease · reviewed 2026-08-26
البطاقة ٨٧
السؤال
What clinical clue should raise suspicion for benign prostatic hyperplasia?
الإجابة
Progressive weak stream, hesitancy, incomplete emptying, nocturia, and frequency suggest bladder-outlet symptoms.

EAU Guidelines on the Management of Non-neurogenic Male Lower Urinary Tract Symptoms · reviewed 2026-08-26
البطاقة ٨٨
السؤال
What drug class or regimen fits chronic kidney disease?
الإجابة
Use an ACE inhibitor or ARB for appropriate albuminuric CKD and an SGLT2 inhibitor for eligible patients.

2024 CKD Evaluation and Management Guideline · reviewed 2026-08-26
البطاقة ٨٩
السؤال
Which microbiologic test is essential when gonococcal conjunctivitis is suspected?
الإجابة
Obtain a conjunctival specimen for culture; add a locally validated nucleic-acid amplification test when available, and perform susceptibility testing on cultured isolates when indicated.

Gonococcal Infections Among Adolescents and Adults · reviewed 2026-08-26
البطاقة ٩٠
السؤال
What drug class or regimen fits iron-deficiency anemia?
الإجابة
Oral iron is first-line for many patients; IV iron is useful when absorption, tolerance, severity, or speed makes oral therapy unsuitable.

British Society of Gastroenterology Guidelines for the Management of Iron Deficiency Anaemia in Adults · reviewed 2026-08-26
البطاقة ٩١
السؤال
When may treatment proceed without prior consent in an emergency?
الإجابة
When urgent treatment is needed, the patient cannot participate, no surrogate is available, and delay threatens life or serious health; document the circumstances.

Informed Consent · reviewed 2026-08-26
البطاقة ٩٢
السؤال
What drug class or regimen fits primary adrenal insufficiency?
الإجابة
Replace glucocorticoid and usually mineralocorticoid in chronic primary disease.

Primary Adrenal Insufficiency Guideline Resources · reviewed 2026-08-26
البطاقة ٩٣
السؤال
What is the key first diagnostic step for subarachnoid hemorrhage?
الإجابة
Use immediate noncontrast CT; if negative but suspicion remains, follow the time-appropriate pathway with lumbar puncture or vascular imaging.

2023 Guideline for Aneurysmal Subarachnoid Hemorrhage · reviewed 2026-08-26
البطاقة ٩٤
السؤال
Which bedside pattern best points to celiac disease?
الإجابة
Chronic diarrhea, bloating, weight loss, iron deficiency, dermatitis herpetiformis, or unexplained osteoporosis can be the clue.

ACG Clinical Guidelines: Diagnosis and Management of Celiac Disease · reviewed 2026-08-26
البطاقة ٩٥
السؤال
In a child or adolescent, what is the key first diagnostic step for bacterial meningitis?
الإجابة
Obtain blood cultures and lumbar puncture when safe; perform head imaging first only for defined risk features.

WHO Guidelines on Meningitis Diagnosis, Treatment and Care · reviewed 2026-08-26
البطاقة ٩٦
السؤال
In a postmenopausal woman or man aged 50 or older, which diagnosis is established by a hip or vertebral fragility fracture?
الإجابة
Osteoporosis. A hip or vertebral fracture from low trauma establishes osteoporosis regardless of T-score.

The clinician’s guide to prevention and treatment of osteoporosis · reviewed 2026-08-26
البطاقة ٩٧
السؤال
What is the key first diagnostic step for preeclampsia with severe features?
الإجابة
Confirm pressure correctly and assess urine protein, CBC, creatinine, liver tests, fetal status, and symptoms.

Gestational Hypertension and Preeclampsia · reviewed 2026-08-26
البطاقة ٩٨
السؤال
In an infant aged 1–23 months, how should a clinician initially manage bronchiolitis?
الإجابة
Support oxygenation and hydration; use suction selectively and assess apnea or exhaustion.

Bronchiolitis: Recommendations for Diagnosis, Monitoring and Management of Children One to 24 Months · reviewed 2026-08-26
البطاقة ٩٩
السؤال
What is the key first diagnostic step for bipolar I mania?
الإجابة
Diagnosis is clinical; assess substances, thyroid disease, medicines, psychosis, and safety.

Management of Bipolar Disorder in Adults · reviewed 2026-08-26
البطاقة ١٠٠
السؤال
How should medication be used in hypertensive emergency?
الإجابة
Choose a titratable IV agent suited to the clinical syndrome; do not rapidly normalize pressure in most presentations.

2025 High Blood Pressure Guideline · reviewed 2026-08-26
البطاقة ١٠١
السؤال
Which bedside pattern best points to obstructive sleep apnea?
الإجابة
Loud snoring, witnessed apneas, gasping, daytime sleepiness, morning headache, or resistant hypertension suggests OSA.

Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea · reviewed 2026-08-26
البطاقة ١٠٢
السؤال
What counseling point helps reduce harm from heart failure with reduced ejection fraction?
الإجابة
Control blood pressure and coronary risk, and avoid medicines that worsen fluid retention.

2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure · reviewed 2026-08-26
البطاقة ١٠٣
السؤال
What condition should be suspected from this finding: Increasing abdominal girth, shifting dullness, edema, jaundice, or stigmata of portal hypertension suggest decompensation.
الإجابة
Cirrhosis with ascites. Increasing abdominal girth, shifting dullness, edema, jaundice, or stigmata of portal hypertension suggest decompensation.

Diagnosis, Evaluation, and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome · reviewed 2026-08-26
البطاقة ١٠٤
السؤال
Which bedside pattern best points to carpal tunnel syndrome?
الإجابة
Nocturnal numbness or tingling in the thumb, index, and middle fingers with thenar weakness suggests median-nerve compression.

Management of Carpal Tunnel Syndrome: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ١٠٥
السؤال
In a patient with prior demyelinating events, which diagnosis fits a new focal neurologic deficit evolving over hours to days and lasting more than 24 hours?
الإجابة
Multiple sclerosis relapse. A focal neurologic deficit evolving over hours to days and lasting over 24 hours, separated in time and space from prior events, suggests relapse.

Multiple Sclerosis in Adults: Management · reviewed 2026-08-26
البطاقة ١٠٦
السؤال
Which prevention or risk-reduction step is important for primary hyperparathyroidism?
الإجابة
Maintain hydration and avoid unnecessary calcium-raising medicines while monitoring patients who do not have surgery.

Evaluation and Management of Primary Hyperparathyroidism: Fifth International Workshop Guidelines · reviewed 2026-08-26
البطاقة ١٠٧
السؤال
What condition should be suspected from this finding: Acute retroviral illness can cause fever, rash, pharyngitis, lymphadenopathy, or no symptoms; chronic infection may remain silent.
الإجابة
HIV infection. Acute retroviral illness can cause fever, rash, pharyngitis, lymphadenopathy, or no symptoms; chronic infection may remain silent.

About HIV · reviewed 2026-08-26
البطاقة ١٠٨
السؤال
Which prevention or risk-reduction step is important for sudden sensorineural hearing loss?
الإجابة
Counsel patients to seek same-day care for sudden hearing change rather than waiting for spontaneous recovery.

Clinical Practice Guideline: Sudden Hearing Loss (Update) · reviewed 2026-08-26
البطاقة ١٠٩
السؤال
For surgical decision-making, what condition should be suspected from this finding: Heavy postpartum bleeding with uterine atony, retained tissue, trauma, or coagulopathy can rapidly cause shock.
الإجابة
Postpartum hemorrhage. Heavy postpartum bleeding with uterine atony, retained tissue, trauma, or coagulopathy can rapidly cause shock.

Postpartum Hemorrhage · reviewed 2026-08-26
البطاقة ١١٠
السؤال
What is the clinician’s duty after recognizing a significant medical error that harmed a patient?
الإجابة
Disclose the known facts honestly, explain the clinical impact and next care steps, express appropriate concern, and follow reporting processes.

Promoting Patient Safety · reviewed 2026-08-26
البطاقة ١١١
السؤال
Which diagnosis causes an acute, fluctuating disturbance of attention and awareness with disorganized thinking?
الإجابة
Delirium. An acute fluctuating disturbance of attention and awareness with disorganized thinking suggests delirium.

Delirium: Prevention, Diagnosis and Management · reviewed 2026-08-26
البطاقة ١١٢
السؤال
In a child or adolescent, what is the key first diagnostic step for nephritic syndrome?
الإجابة
Use urine microscopy, protein quantification, complement and serologic testing, and biopsy for severe or unclear disease.

KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases with 2024 Chapter Updates · reviewed 2026-08-26
البطاقة ١١٣
السؤال
Which next action matters most in uncomplicated cystitis?
الإجابة
Assess for pyelonephritis, pregnancy, obstruction, or sepsis before treating as uncomplicated disease.

EAU Guidelines on Urological Infections · reviewed 2026-08-26
البطاقة ١١٤
السؤال
What is the key first diagnostic step for acute deep-vein thrombosis?
الإجابة
Use pretest probability with D-dimer or compression ultrasonography rather than symptoms alone.

ASH VTE Guidelines: Diagnosis of Venous Thromboembolism · reviewed 2026-08-26
البطاقة ١١٥
السؤال
How should medication be used in idiopathic pulmonary fibrosis?
الإجابة
Nintedanib or pirfenidone can slow functional decline; neither reverses established fibrosis.

Idiopathic Pulmonary Fibrosis: An Update and Progressive Pulmonary Fibrosis in Adults · reviewed 2026-08-26
البطاقة ١١٦
السؤال
What diagnostic approach is most appropriate when stable chronic hypertension is suspected?
الإجابة
Confirm persistent elevation with standardized office technique and out-of-office monitoring when appropriate.

2025 High Blood Pressure Guideline · reviewed 2026-08-26
البطاقة ١١٧
السؤال
How should a clinician initially manage cirrhosis with ascites?
الإجابة
Restrict sodium, assess for infection, and perform large-volume paracentesis with albumin when tense ascites causes symptoms.

Diagnosis, Evaluation, and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome · reviewed 2026-08-26
البطاقة ١١٨
السؤال
What is the key first diagnostic step for herpes zoster?
الإجابة
Clinical diagnosis is typical; PCR from a lesion is most useful when confirmation matters.

Clinical Overview of Shingles (Herpes Zoster) · reviewed 2026-08-26
البطاقة ١١٩
السؤال
How should a clinician initially manage osteoporosis in a postmenopausal woman at high fracture risk?
الإجابة
Offer pharmacologic therapy after shared decision-making, then reassess adherence and fracture risk.

Pharmacological Management of Osteoporosis in Postmenopausal Women · reviewed 2026-08-26
البطاقة ١٢٠
السؤال
Which bedside pattern best points to migraine with aura?
الإجابة
Recurrent unilateral pulsating headache with nausea or sensory sensitivity, preceded by gradually spreading reversible visual or sensory symptoms, suggests migraine with aura.

ICHD-3: Migraine with Aura · reviewed 2026-08-26
البطاقة ١٢١
السؤال
What condition should be suspected from this finding: Polyuria, polydipsia, blurred vision, recurrent infections, or an asymptomatic high-risk patient may reveal hyperglycemia.
الإجابة
Type 2 diabetes mellitus. Polyuria, polydipsia, blurred vision, recurrent infections, or an asymptomatic high-risk patient may reveal hyperglycemia.

Standards of Care in Diabetes—2026 · reviewed 2026-08-26
البطاقة ١٢٢
السؤال
Which bedside pattern best points to early syphilis?
الإجابة
A painless chancre or a diffuse rash involving palms and soles with generalized lymphadenopathy suggests syphilis by stage.

Primary and Secondary Syphilis: STI Treatment Guidelines · reviewed 2026-08-26
البطاقة ١٢٣
السؤال
For surgical decision-making, what condition should be suspected from this finding: Sudden painful red eye, blurred vision with halos, headache, nausea, a fixed mid-dilated pupil, and a firm globe are classic.
الإجابة
Acute angle-closure glaucoma. Sudden painful red eye, blurred vision with halos, headache, nausea, a fixed mid-dilated pupil, and a firm globe are classic.

Management of Angle-Closure Glaucoma · reviewed 2026-08-26
البطاقة ١٢٤
السؤال
Which bedside pattern best points to abnormal uterine bleeding from anovulation?
الإجابة
Irregular unpredictable bleeding without cyclic ovulation is common at reproductive extremes or with endocrine disruption.

Abnormal Uterine Bleeding · reviewed 2026-08-26
البطاقة ١٢٥
السؤال
How should a clinician manage a boundary-crossing gift from a patient?
الإجابة
Assess its meaning, value, timing, and effect on care; decline gifts that exploit, obligate, or distort the professional relationship.

Gifts from Patients · reviewed 2026-08-26
البطاقة ١٢٦
السؤال
A clinician is considering symptomatic aortic stenosis. Which finding adds the most support?
الإجابة
Exertional dyspnea, angina, or syncope with a harsh crescendo-decrescendo systolic murmur radiating to the carotids is typical.

2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease · reviewed 2026-08-26
البطاقة ١٢٧
السؤال
Which bedside pattern best points to post-traumatic stress disorder?
الإجابة
Intrusion, avoidance, negative mood or cognition, and hyperarousal lasting over a month after trauma suggest PTSD.

Management of Posttraumatic Stress Disorder and Acute Stress Disorder · reviewed 2026-08-26
البطاقة ١٢٨
السؤال
In a child aged 6–11 years or an adolescent, what diagnostic approach is most appropriate when asthma is suspected?
الإجابة
Demonstrate variable expiratory airflow limitation with spirometry and bronchodilator response or an accepted alternative.

2026 GINA Strategy Report · reviewed 2026-08-26
البطاقة ١٢٩
السؤال
Which prevention or risk-reduction step is important for chronic kidney disease?
الإجابة
Control blood pressure, diabetes, tobacco use, and nephrotoxin exposure; vaccinate and reduce cardiovascular risk.

2024 CKD Evaluation and Management Guideline · reviewed 2026-08-26
البطاقة ١٣٠
السؤال
In a child or adolescent, how should medication be used in acute appendicitis?
الإجابة
Preoperative antibiotics should cover enteric gram-negative organisms and anaerobes.

Guideline for the Diagnosis and Treatment of Appendicitis · reviewed 2026-08-26
البطاقة ١٣١
السؤال
Which prevention or risk-reduction step is important for iron-deficiency anemia?
الإجابة
Adequate dietary iron and evaluation of menstrual or gastrointestinal blood loss prevent recurrence.

British Society of Gastroenterology Guidelines for the Management of Iron Deficiency Anaemia in Adults · reviewed 2026-08-26
البطاقة ١٣٢
السؤال
Which drug class is preferred before oral therapy for knee osteoarthritis pain when topical treatment is feasible?
الإجابة
Use a topical NSAID first; it provides local pain relief with less systemic exposure than an oral NSAID.

2019 ACR/Arthritis Foundation Guideline for Osteoarthritis · reviewed 2026-08-26
البطاقة ١٣٣
السؤال
A patient has this pattern: Exertional calf discomfort relieved by rest, diminished pulses, and nonhealing foot wounds suggest lower-extremity arterial disease. What is the most likely diagnosis?
الإجابة
Peripheral artery disease. Exertional calf discomfort relieved by rest, diminished pulses, and nonhealing foot wounds suggest lower-extremity arterial disease.

2024 ACC/AHA Guideline for Lower Extremity Peripheral Artery Disease: Key Points · reviewed 2026-08-26
البطاقة ١٣٤
السؤال
For surgical decision-making, how should a clinician initially manage acute ischemic stroke?
الإجابة
Activate a stroke pathway and evaluate immediately for IV thrombolysis and mechanical thrombectomy eligibility.

2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke · reviewed 2026-08-26
البطاقة ١٣٥
السؤال
Which prevention or risk-reduction step is important for melanoma?
الإجابة
Use sun protection and teach patients to report changing lesions rather than relying on routine self-treatment.

Melanoma Clinical Guidelines · reviewed 2026-08-26
البطاقة ١٣٦
السؤال
How should a clinician initially manage community-acquired pneumonia?
الإجابة
Stabilize oxygenation and sepsis, then choose outpatient or inpatient care using clinical judgment and a validated severity tool.

Diagnosis and Treatment of Adults with Community-acquired Pneumonia · reviewed 2026-08-26
البطاقة ١٣٧
السؤال
Which prevention or risk-reduction step is important for ureteral stone?
الإجابة
High fluid intake and stone-specific dietary changes based on metabolic evaluation reduce recurrence.

EAU Guidelines on Urolithiasis · reviewed 2026-08-26
البطاقة ١٣٨
السؤال
For surgical decision-making, how should a clinician initially manage ectopic pregnancy?
الإجابة
Hemodynamic instability or suspected rupture requires emergency surgery; stable management depends on imaging, hCG, size, and follow-up reliability.

Ectopic Pregnancy · reviewed 2026-08-26
البطاقة ١٣٩
السؤال
What counseling point helps reduce harm from tension pneumothorax?
الإجابة
After chest trauma or an invasive thoracic procedure, urgently reassess new dyspnea, hypotension, or unilateral breath-sound loss so tension physiology is decompressed without delay.

Thoracic Trauma WSES-AAST Guidelines · reviewed 2026-08-26
البطاقة ١٤٠
السؤال
In a child or adolescent, how should a clinician initially manage major depressive disorder?
الإجابة
Assess safety first, create an urgent plan for imminent risk, and use psychotherapy, medication, or both by severity and preference.

Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Major and Persistent Depressive Disorders · reviewed 2026-08-26
البطاقة ١٤١
السؤال
What should happen when a clinician’s personal belief conflicts with a requested legal service?
الإجابة
Disclose the limitation without judgment, protect urgent care, provide timely information or referral, and avoid abandoning the patient.

Physician Exercise of Conscience · reviewed 2026-08-26
البطاقة ١٤٢
السؤال
For surgical decision-making, what immediate plan is appropriate for symptomatic aortic stenosis?
الإجابة
Severe symptomatic aortic stenosis requires valve-replacement evaluation rather than medical therapy alone.

2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease · reviewed 2026-08-26
البطاقة ١٤٣
السؤال
What counseling point helps reduce harm from celiac disease?
الإجابة
Screen appropriate first-degree relatives and correct micronutrient deficits.

ACG Clinical Guidelines: Diagnosis and Management of Celiac Disease · reviewed 2026-08-26
البطاقة ١٤٤
السؤال
How should a clinician initially manage primary hypothyroidism?
الإجابة
Start replacement when indicated and recheck TSH after dose changes rather than adjusting from symptoms alone.

Guidelines for the Treatment of Hypothyroidism · reviewed 2026-08-26
البطاقة ١٤٥
السؤال
Which activity counseling can reduce carpal tunnel symptoms or slow progression?
الإجابة
Modify job or recreational activities that aggravate symptoms, especially prolonged wrist flexion or extension.

Carpal Tunnel Syndrome · reviewed 2026-08-26
البطاقة ١٤٦
السؤال
How should a clinician initially manage bacterial conjunctivitis?
الإجابة
Remove contact lenses and urgently assess pain, photophobia, vision loss, corneal opacity, or hyperacute discharge.

Clinical Overview of Pink Eye (Conjunctivitis) · reviewed 2026-08-26
البطاقة ١٤٧
السؤال
Which diagnosis is marked by a rising creatinine or falling urine output after illness, volume loss, nephrotoxin exposure, obstruction, or sepsis?
الإجابة
Acute kidney injury. A rising creatinine or falling urine output after illness, volume loss, nephrotoxin exposure, obstruction, or sepsis indicates AKI.

KDIGO Clinical Practice Guideline for Acute Kidney Injury · reviewed 2026-08-26
البطاقة ١٤٨
السؤال
How should medication be used in bacterial brain abscess?
الإجابة
Empiric therapy should cover likely streptococci, anaerobes, and staphylococci according to source, then narrow to cultures.

ESCMID Guideline on Diagnosis and Treatment of Brain Abscess in Children and Adults · reviewed 2026-08-26
البطاقة ١٤٩
السؤال
In a child or adolescent, what condition should be suspected from this finding: Isolated petechiae, bruising, or mucosal bleeding with thrombocytopenia and otherwise preserved cell lines suggests ITP.
الإجابة
Immune thrombocytopenia. Isolated petechiae, bruising, or mucosal bleeding with thrombocytopenia and otherwise preserved cell lines suggests ITP.

American Society of Hematology 2019 Guidelines for Immune Thrombocytopenia · reviewed 2026-08-26
البطاقة ١٥٠
السؤال
What medication strategy is appropriate for peripheral artery disease?
الإجابة
Antiplatelet and high-intensity statin therapy reduce cardiovascular risk in symptomatic disease.

2024 ACC/AHA Guideline for Lower Extremity Peripheral Artery Disease: Key Points · reviewed 2026-08-26
البطاقة ١٥١
السؤال
A patient has this pattern: Dyspnea with reduced breath sounds, dullness to percussion, and decreased tactile fremitus suggests pleural fluid. What is the most likely diagnosis?
الإجابة
Pleural effusion. Dyspnea with reduced breath sounds, dullness to percussion, and decreased tactile fremitus suggests pleural fluid.

British Thoracic Society Guideline for Pleural Disease · reviewed 2026-08-26
البطاقة ١٥٢
السؤال
How should medication be used in pulmonary tuberculosis?
الإجابة
Treat drug-susceptible disease with a multidrug regimen and adherence support; tailor to susceptibility and patient factors.

Treatment for Drug-Susceptible Tuberculosis Disease · reviewed 2026-08-26
البطاقة ١٥٣
السؤال
How should medication be used in endometriosis?
الإجابة
Combined hormonal contraceptives or progestins are common first-line suppressive therapies when pregnancy is not desired.

Endometriosis · reviewed 2026-08-26
البطاقة ١٥٤
السؤال
How should medication be used in panic disorder?
الإجابة
SSRIs or SNRIs are preferred long-term medicines; benzodiazepines carry dependence and safety risks.

Panic Disorder: What You Need to Know · reviewed 2026-08-26
البطاقة ١٥٥
السؤال
A clinician is considering ulcerative colitis. Which finding adds the most support?
الإجابة
Bloody diarrhea, urgency, tenesmus, and crampy abdominal pain with continuous colonic inflammation suggest ulcerative colitis.

Updated 2025 ACG Guidelines to Manage Adult Ulcerative Colitis Patients · reviewed 2026-08-26
البطاقة ١٥٦
السؤال
In a patient younger than 16, which diagnosis fits persistent joint swelling, limited motion, or morning stiffness after other causes are excluded?
الإجابة
Juvenile idiopathic arthritis. Persistent joint swelling, limited motion, or morning stiffness beginning before age 16, after excluding other causes, suggests JIA.

2026 Juvenile Idiopathic Arthritis Guidelines · reviewed 2026-08-26
البطاقة ١٥٧
السؤال
Which bedside pattern best points to primary adrenal insufficiency?
الإجابة
Weight loss, fatigue, hypotension, salt craving, hyperpigmentation, hyponatremia, and hyperkalemia suggest primary adrenal failure.

Primary Adrenal Insufficiency Guideline Resources · reviewed 2026-08-26
البطاقة ١٥٨
السؤال
When can confidential information be shared with another treating clinician without a separate HIPAA authorization?
الإجابة
HIPAA generally permits disclosure for treatment, using reasonable safeguards and only information relevant to care.

Uses and Disclosures for Treatment, Payment, and Health Care Operations · reviewed 2026-08-26
البطاقة ١٥٩
السؤال
In a child aged 6 months or older, which bedside pattern best points to acute otitis media?
الإجابة
A bulging tympanic membrane with acute ear pain or new otorrhea is more specific than redness alone.

Management of Acute Otitis Media in Children Six Months of Age and Older · reviewed 2026-08-26
البطاقة ١٦٠
السؤال
Which pathophysiologic process drives heart failure with reduced ejection fraction?
الإجابة
Reduced contractility activates sympathetic and renin-angiotensin-aldosterone pathways that drive maladaptive remodeling.

2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure · reviewed 2026-08-26
البطاقة ١٦١
السؤال
In a child, typically 6 months to 3 years, what immediate plan is appropriate for croup?
الإجابة
Keep the child calm, give dexamethasone, and add nebulized epinephrine for moderate or severe stridor.

Acute Management of Croup in the Emergency Department · reviewed 2026-08-26
البطاقة ١٦٢
السؤال
What drug class or regimen fits cellulitis?
الإجابة
Use an agent active against streptococci for nonpurulent disease; add MRSA coverage when risk or purulence warrants it.

Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections · reviewed 2026-08-26
البطاقة ١٦٣
السؤال
What is the key first diagnostic step for testicular torsion?
الإجابة
Make a clinical diagnosis and obtain urgent urologic assessment; use Doppler ultrasound only if the diagnosis is uncertain and imaging will not delay exploration.

Testicular Torsion · reviewed 2026-08-26
البطاقة ١٦٤
السؤال
What counseling point helps reduce harm from Parkinson disease?
الإجابة
Exercise, fall-risk reduction, medication review, and driving and swallowing assessment reduce complications.

Parkinson’s Disease in Adults · reviewed 2026-08-26
البطاقة ١٦٥
السؤال
How should a clinician initially manage hyperkalemia?
الإجابة
With ECG changes or severe elevation, stabilize the myocardium, shift potassium intracellularly, and remove it from the body.

Clinical Practice Guideline: Treatment of Acute Hyperkalaemia in Adults · reviewed 2026-08-26
البطاقة ١٦٦
السؤال
What counseling point helps reduce harm from gonococcal urethritis or cervicitis?
الإجابة
Condom use, routine screening by risk, and partner treatment reduce reinfection and complications.

Gonococcal Infections Among Adolescents and Adults · reviewed 2026-08-26
البطاقة ١٦٧
السؤال
Which history or examination finding most strongly supports acute pericarditis?
الإجابة
Sharp pleuritic chest pain that improves when sitting forward, a friction rub, and diffuse ST elevation support pericarditis.

2025 Concise Clinical Guidance: Diagnosis and Management of Pericarditis · reviewed 2026-08-26
البطاقة ١٦٨
السؤال
What counseling point helps reduce harm from menopause vasomotor symptoms?
الإجابة
Cooling strategies and avoiding individual triggers can reduce symptom burden; assess bone and cardiovascular risk separately.

The Menopause Years · reviewed 2026-08-26
البطاقة ١٦٩
السؤال
A patient has this pattern: Most chronic infections are asymptomatic; abnormal aminotransferases or risk-based screening may reveal disease. What is the most likely diagnosis?
الإجابة
Chronic hepatitis C. Most chronic infections are asymptomatic; abnormal aminotransferases or risk-based screening may reveal disease.

Viral Hepatitis Clinical Care · reviewed 2026-08-26
البطاقة ١٧٠
السؤال
What counseling point helps reduce harm from alcohol withdrawal?
الإجابة
Treat alcohol-use disorder, plan medically supported withdrawal for high-risk patients, and provide thiamine when nutrition is poor.

The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management · reviewed 2026-08-26
البطاقة ١٧١
السؤال
What diagnostic approach is most appropriate when acute compartment syndrome is suspected?
الإجابة
Diagnosis is clinical; compartment-pressure measurement helps when the examination is unreliable or equivocal.

Management of Acute Compartment Syndrome: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ١٧٢
السؤال
In a child or adolescent with sickle cell disease, which pain pattern supports an acute vaso-occlusive episode?
الإجابة
Acute severe extremity, back, or bone pain that matches the patient’s typical vaso-occlusive pattern and has no alternative cause supports an acute vaso-occlusive pain episode.

ASH 2020 Guidelines for Sickle Cell Disease: Management of Acute and Chronic Pain · reviewed 2026-08-26
البطاقة ١٧٣
السؤال
What diagnostic approach is most appropriate when thyroid storm is suspected?
الإجابة
Diagnosis is clinical; obtain thyroid tests and evaluate the trigger without delaying treatment.

2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis · reviewed 2026-08-26
البطاقة ١٧٤
السؤال
A clinician is considering acute respiratory distress syndrome. Which finding adds the most support?
الإجابة
Acute hypoxemic respiratory failure with bilateral opacities not fully explained by cardiac failure after a known insult suggests ARDS.

An Update on Management of Adult Patients with Acute Respiratory Distress Syndrome · reviewed 2026-08-26
البطاقة ١٧٥
السؤال
How should medication be used in sudden sensorineural hearing loss?
الإجابة
Offer corticosteroids within the treatment window when appropriate; intratympanic therapy is an option in selected cases.

Clinical Practice Guideline: Sudden Hearing Loss (Update) · reviewed 2026-08-26
البطاقة ١٧٦
السؤال
What is the HIPAA minimum-necessary rule?
الإجابة
For many uses and disclosures, limit protected information to what is reasonably needed for the purpose; the rule does not apply in the same way to disclosures for treatment.

Minimum Necessary Requirement · reviewed 2026-08-26
البطاقة ١٧٧
السؤال
For surgical decision-making, hypotension, elevated jugular venous pressure, tachycardia, muffled heart sounds, and pulsus paradoxus indicate which diagnosis?
الإجابة
Cardiac tamponade. Hypotension, elevated jugular venous pressure, tachycardia, muffled heart sounds, and pulsus paradoxus suggest tamponade physiology.

2025 Concise Clinical Guidance: Diagnosis and Management of Pericarditis · reviewed 2026-08-26
البطاقة ١٧٨
السؤال
In a child or adolescent, what diagnostic approach is most appropriate when acute appendicitis is suspected?
الإجابة
Use ultrasound as the initial imaging study in many children; use CT or MRI when ultrasound is nondiagnostic and suspicion persists, according to local expertise.

Guideline for the Diagnosis and Treatment of Appendicitis · reviewed 2026-08-26
البطاقة ١٧٩
السؤال
For surgical decision-making, sudden focal weakness, facial droop, speech change, gaze deviation, neglect, or ataxia indicate which time-critical diagnosis?
الإجابة
Acute ischemic stroke. Sudden focal weakness, facial droop, speech change, gaze deviation, neglect, or ataxia is stroke until proved otherwise.

2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke · reviewed 2026-08-26
البطاقة ١٨٠
السؤال
A clinician is considering gout flare. Which finding adds the most support?
الإجابة
Abrupt severe monoarthritis with erythema, often at the first metatarsophalangeal joint, suggests gout.

Gout · reviewed 2026-08-26
البطاقة ١٨١
السؤال
Which diagnosis best fits new cough, fever, dyspnea, pleuritic pain, and focal crackles when an infiltrate is confirmed?
الإجابة
Community-acquired pneumonia. New cough, fever, dyspnea, pleuritic pain, and focal crackles suggest pneumonia, but clinical findings alone are imperfect.

Diagnosis and Treatment of Adults with Community-acquired Pneumonia · reviewed 2026-08-26
البطاقة ١٨٢
السؤال
In a child aged 6–11 years or an adolescent, what medication strategy is appropriate for asthma?
الإجابة
For children 6–11 years and adolescents, use an age-appropriate inhaled corticosteroid-containing strategy rather than short-acting beta agonist-only treatment.

2026 GINA Strategy Report · reviewed 2026-08-26
البطاقة ١٨٣
السؤال
For surgical decision-making, a patient has this pattern: Unilateral pelvic pain or bleeding in early pregnancy, especially with syncope or shoulder pain, raises concern for ectopic implantation. What is the most likely diagnosis?
الإجابة
Ectopic pregnancy. Unilateral pelvic pain or bleeding in early pregnancy, especially with syncope or shoulder pain, raises concern for ectopic implantation.

Ectopic Pregnancy · reviewed 2026-08-26
البطاقة ١٨٤
السؤال
In a child or adolescent, which diagnosis requires at least two weeks of depressed mood or loss of interest with functional change and associated neurovegetative or cognitive symptoms?
الإجابة
Major depressive disorder. At least two weeks of depressed mood or loss of interest with functional change and associated neurovegetative or cognitive symptoms suggests major depression.

Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Major and Persistent Depressive Disorders · reviewed 2026-08-26
البطاقة ١٨٥
السؤال
Which preventive measure belongs in care for atrial fibrillation?
الإجابة
Address hypertension, obesity, sleep apnea, alcohol excess, and other modifiable drivers.

2023 ACC/AHA/ACCP/HRS Guideline for Atrial Fibrillation: Key Perspectives · reviewed 2026-08-26
البطاقة ١٨٦
السؤال
For surgical decision-making, what condition should be suspected from this finding: An evolving asymmetric pigmented lesion with border irregularity, color variation, or a concerning outlier pattern requires evaluation.
الإجابة
Melanoma. An evolving asymmetric pigmented lesion with border irregularity, color variation, or a concerning outlier pattern requires evaluation.

Melanoma Clinical Guidelines · reviewed 2026-08-26
البطاقة ١٨٧
السؤال
Which bedside pattern best points to hyperkalemia?
الإجابة
Weakness, paresthesias, bradycardia, or ECG changes can occur, but dangerous hyperkalemia may be asymptomatic.

Clinical Practice Guideline: Treatment of Acute Hyperkalaemia in Adults · reviewed 2026-08-26
البطاقة ١٨٨
السؤال
For surgical decision-making, what condition should be suspected from this finding: Sudden colicky flank pain radiating to the groin with hematuria and restlessness is typical.
الإجابة
Ureteral stone. Sudden colicky flank pain radiating to the groin with hematuria and restlessness is typical.

EAU Guidelines on Urolithiasis · reviewed 2026-08-26
البطاقة ١٨٩
السؤال
In a child or adolescent, how should a clinician initially manage sickle cell vaso-occlusive crisis?
الإجابة
Provide rapid individualized analgesia, assess oxygenation and hydration, and evaluate acute chest syndrome or infection.

ASH 2020 Guidelines for Sickle Cell Disease: Management of Acute and Chronic Pain · reviewed 2026-08-26
البطاقة ١٩٠
السؤال
How should medication be used in primary hyperparathyroidism?
الإجابة
Cinacalcet can lower calcium when surgery is not possible; antiresorptive therapy targets low bone density.

Evaluation and Management of Primary Hyperparathyroidism: Fifth International Workshop Guidelines · reviewed 2026-08-26
البطاقة ١٩١
السؤال
What diagnostic approach is most appropriate when acute bacterial rhinosinusitis is suspected?
الإجابة
Diagnosis is clinical; routine imaging is not needed unless a complication or alternative diagnosis is suspected.

Clinical Practice Guideline: Adult Sinusitis Update · reviewed 2026-08-26
البطاقة ١٩٢
السؤال
What should a clinician do before discussing a patient in a public or semipublic area?
الإجابة
Move to a private setting when practical and use reasonable safeguards so others do not overhear identifiable information.

Incidental Uses and Disclosures · reviewed 2026-08-26
البطاقة ١٩٣
السؤال
A clinician is considering Parkinson disease. Which finding adds the most support?
الإجابة
Bradykinesia plus rest tremor or rigidity, with reduced arm swing and shuffling gait, supports parkinsonism.

Parkinson’s Disease in Adults · reviewed 2026-08-26
البطاقة ١٩٤
السؤال
What immediate plan is appropriate for chronic hepatitis C?
الإجابة
Stage liver disease, review interactions, test for coinfections, and link every patient with active infection to curative treatment.

Viral Hepatitis Clinical Care · reviewed 2026-08-26
البطاقة ١٩٥
السؤال
A clinician is considering gonococcal urethritis or cervicitis. Which finding adds the most support?
الإجابة
Purulent urethral discharge, dysuria, cervicitis, pelvic pain, or exposure may indicate gonorrhea, but infection can be asymptomatic.

Gonococcal Infections Among Adolescents and Adults · reviewed 2026-08-26
البطاقة ١٩٦
السؤال
In a child or adolescent, what immediate plan is appropriate for juvenile idiopathic arthritis?
الإجابة
Refer to pediatric rheumatology early and treat to control inflammation and preserve function.

2026 Juvenile Idiopathic Arthritis Guidelines · reviewed 2026-08-26
البطاقة ١٩٧
السؤال
A clinician is considering menopause vasomotor symptoms. Which finding adds the most support?
الإجابة
Hot flashes, night sweats, sleep disruption, and menstrual transition at the expected age usually identify menopausal vasomotor symptoms.

The Menopause Years · reviewed 2026-08-26
البطاقة ١٩٨
السؤال
Which diagnosis best fits this presentation: Progressive exertional dyspnea, dry cough, bibasilar fine crackles, and clubbing in an older adult suggest fibrotic interstitial disease.
الإجابة
Idiopathic pulmonary fibrosis. Progressive exertional dyspnea, dry cough, bibasilar fine crackles, and clubbing in an older adult suggest fibrotic interstitial disease.

Idiopathic Pulmonary Fibrosis: An Update and Progressive Pulmonary Fibrosis in Adults · reviewed 2026-08-26
البطاقة ١٩٩
السؤال
A clinician is considering alcohol withdrawal. Which finding adds the most support?
الإجابة
Tremor, autonomic hyperactivity, insomnia, nausea, anxiety, hallucinations, or seizures after reducing heavy alcohol use suggests withdrawal.

The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management · reviewed 2026-08-26
البطاقة ٢٠٠
السؤال
What is the priority management step for acute pericarditis?
الإجابة
Assess immediately for tamponade or high-risk features that require admission.

2025 Concise Clinical Guidance: Diagnosis and Management of Pericarditis · reviewed 2026-08-26
البطاقة ٢٠١
السؤال
In complicated acute calculous cholecystitis, how should empiric antibiotics be selected?
الإجابة
Base the regimen on likely biliary pathogens and local resistance patterns, with enteric gram-negative aerobes and anaerobes among the common targets.

2020 World Society of Emergency Surgery Updated Guidelines for the Diagnosis and Treatment of Acute Calculous Cholecystitis · reviewed 2026-08-26
البطاقة ٢٠٢
السؤال
For surgical decision-making, what is the priority management step for pleural effusion?
الإجابة
Drain a large symptomatic effusion or complicated parapneumonic collection and treat the underlying disease.

British Thoracic Society Guideline for Pleural Disease · reviewed 2026-08-26
البطاقة ٢٠٣
السؤال
In acute decompensated heart failure with fluid overload, which drug class is used first to relieve congestion?
الإجابة
Give an intravenous loop diuretic and adjust it to urine output, symptoms, renal function, and electrolytes.

2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure · reviewed 2026-08-26
البطاقة ٢٠٤
السؤال
For surgical decision-making, what immediate plan is appropriate for subarachnoid hemorrhage?
الإجابة
Stabilize, control pressure carefully, give nimodipine, and obtain urgent neurovascular treatment of the aneurysm.

2023 Guideline for Aneurysmal Subarachnoid Hemorrhage · reviewed 2026-08-26
البطاقة ٢٠٥
السؤال
What medication strategy is appropriate for hip fracture?
الإجابة
Use multimodal analgesia and guideline-based VTE prophylaxis around surgery.

Management of Hip Fractures in Older Adults: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ٢٠٦
السؤال
In a child or adolescent, what immediate plan is appropriate for bacterial meningitis?
الإجابة
Give empiric antibiotics immediately; do not delay for imaging or lumbar puncture when delay is likely.

WHO Guidelines on Meningitis Diagnosis, Treatment and Care · reviewed 2026-08-26
البطاقة ٢٠٧
السؤال
In a child or adolescent, which diagnosis fits hyperglycemia with dehydration, abdominal pain, vomiting, Kussmaul respirations, or altered mental status?
الإجابة
Diabetic ketoacidosis. Hyperglycemia with dehydration, abdominal pain, vomiting, Kussmaul respirations, or altered mental status suggests ketoacidosis.

Standards of Care in Diabetes—2026 · reviewed 2026-08-26
البطاقة ٢٠٨
السؤال
For surgical decision-making, what immediate plan is appropriate for preeclampsia with severe features?
الإجابة
Stabilize the mother, prevent seizure, control persistent severe pressure, and plan delivery by gestational age and status.

Gestational Hypertension and Preeclampsia · reviewed 2026-08-26
البطاقة ٢٠٩
السؤال
For surgical decision-making, new flashes, floaters, and a curtain or shadow across the visual field indicate which diagnosis?
الإجابة
Retinal detachment. New flashes, floaters, and a curtain or shadow across the visual field suggest detachment.

Retinal Detachment · reviewed 2026-08-26
البطاقة ٢١٠
السؤال
What immediate plan is appropriate for bipolar I mania?
الإجابة
Hospitalize when danger, grave disability, or severe psychosis requires containment; stop antidepressant monotherapy.

Management of Bipolar Disorder in Adults · reviewed 2026-08-26
البطاقة ٢١١
السؤال
May a clinician leave appointment information in a voicemail?
الإجابة
Yes, with reasonable safeguards: keep the message limited and follow any confidential communication request the patient has made.

Incidental Uses and Disclosures · reviewed 2026-08-26
البطاقة ٢١٢
السؤال
When is a loop diuretic appropriate in acute kidney injury?
الإجابة
Use a loop diuretic only to manage volume overload; it does not reverse intrinsic kidney injury or improve renal recovery.

KDIGO Clinical Practice Guideline for Acute Kidney Injury · reviewed 2026-08-26
البطاقة ٢١٣
السؤال
How should a clinician initially manage plaque psoriasis?
الإجابة
Assess body-surface area, special-site involvement, symptoms, and joint disease before selecting therapy.

Psoriasis Clinical Guidelines · reviewed 2026-08-26
البطاقة ٢١٤
السؤال
In a child or adolescent, how should medication be used in immune thrombocytopenia?
الإجابة
Corticosteroids or IVIG are common initial treatments when therapy is needed; longer-term choices depend on response and duration.

American Society of Hematology 2019 Guidelines for Immune Thrombocytopenia · reviewed 2026-08-26
البطاقة ٢١٥
السؤال
Which test or testing sequence best evaluates suspected ventricular fibrillation cardiac arrest?
الإجابة
Use rhythm analysis during high-quality CPR without delaying compressions.

2025 American Heart Association Guidelines for CPR and ECC: Adult Advanced Life Support · reviewed 2026-08-26
البطاقة ٢١٦
السؤال
Which drug class is first-line for erectile dysfunction when no contraindication such as nitrate use exists?
الإجابة
Use a phosphodiesterase-5 inhibitor after reviewing cardiovascular fitness, interactions, and correct use; never combine it with nitrates.

Erectile Dysfunction Guideline · reviewed 2026-08-26
البطاقة ٢١٧
السؤال
Which pathophysiologic process drives COPD?
الإجابة
Small-airway disease and emphysematous parenchymal destruction cause persistent expiratory flow limitation.

2026 GOLD Report and Pocket Guide · reviewed 2026-08-26
البطاقة ٢١٨
السؤال
Which history or examination finding most strongly supports Crohn disease?
الإجابة
Chronic diarrhea, abdominal pain, weight loss, perianal disease, and skip lesions support Crohn disease.

Updated 2025 ACG Guidelines for Crohn’s Disease · reviewed 2026-08-26
البطاقة ٢١٩
السؤال
Which pathophysiologic process drives acute compartment syndrome?
الإجابة
Rising pressure within a closed fascial space compromises capillary perfusion and causes muscle and nerve ischemia.

Management of Acute Compartment Syndrome: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ٢٢٠
السؤال
What medication strategy is appropriate for migraine with aura?
الإجابة
Use an NSAID or triptan for many acute attacks; select preventive therapy around comorbidities and patient preference.

AHS Consensus Statement: Integrating New Migraine Treatments into Clinical Practice · reviewed 2026-08-26
البطاقة ٢٢١
السؤال
What clinical clue should raise suspicion for hypertensive emergency?
الإجابة
Severely elevated pressure with acute neurologic, cardiac, renal, retinal, or aortic injury defines an emergency.

2025 High Blood Pressure Guideline · reviewed 2026-08-26
البطاقة ٢٢٢
السؤال
What medication strategy is appropriate for early syphilis?
الإجابة
Benzathine penicillin G is preferred for early syphilis; penicillin is required in pregnancy.

Primary and Secondary Syphilis: STI Treatment Guidelines · reviewed 2026-08-26
البطاقة ٢٢٣
السؤال
What counseling point helps reduce harm from Cushing syndrome?
الإجابة
Limit avoidable exogenous glucocorticoid exposure and taper chronic therapy safely when appropriate.

Treatment of Cushing Syndrome: An Endocrine Society Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ٢٢٤
السؤال
What medication strategy is appropriate for abnormal uterine bleeding from anovulation?
الإجابة
Progestin or combined hormonal therapy can regulate bleeding; tranexamic acid reduces heavy bleeding in eligible patients.

Management of Acute Abnormal Uterine Bleeding in Nonpregnant Reproductive-Aged Women · reviewed 2026-08-26
البطاقة ٢٢٥
السؤال
What counseling point helps reduce harm from peritonsillar abscess?
الإجابة
Seek prompt care for worsening unilateral throat pain, drooling, muffled voice, trismus, or breathing difficulty so an abscess and airway risk are not missed.

Tonsillitis and Peritonsillar Abscess · reviewed 2026-08-26
البطاقة ٢٢٦
السؤال
What medication strategy is appropriate for post-traumatic stress disorder?
الإجابة
Sertraline, paroxetine, or venlafaxine can help; benzodiazepines are not recommended for PTSD treatment.

Management of Posttraumatic Stress Disorder and Acute Stress Disorder · reviewed 2026-08-26
البطاقة ٢٢٧
السؤال
When may protected health information be disclosed to prevent a serious threat?
الإجابة
HIPAA permits a good-faith disclosure consistent with law and ethical standards to someone reasonably able to prevent or lessen a serious and imminent threat.

HIPAA Disclosure to Prevent or Lessen a Serious and Imminent Threat · reviewed 2026-08-26
البطاقة ٢٢٨
السؤال
In an infant aged 1–23 months, which history or examination finding most strongly supports bronchiolitis?
الإجابة
An infant with viral prodrome followed by cough, wheeze or crackles, tachypnea, and feeding difficulty likely has bronchiolitis.

Bronchiolitis: Recommendations for Diagnosis, Monitoring and Management of Children One to 24 Months · reviewed 2026-08-26
البطاقة ٢٢٩
السؤال
Which diagnosis causes marked edema, heavy proteinuria, hypoalbuminemia, and hyperlipidemia?
الإجابة
Nephrotic syndrome. Marked edema, heavy proteinuria, hypoalbuminemia, and hyperlipidemia define a nephrotic pattern.

KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases with 2024 Chapter Updates · reviewed 2026-08-26
البطاقة ٢٣٠
السؤال
Which bedside pattern best points to herpes zoster?
الإجابة
A painful unilateral grouped-vesicle eruption in a dermatomal distribution is characteristic.

Clinical Overview of Shingles (Herpes Zoster) · reviewed 2026-08-26
البطاقة ٢٣١
السؤال
A patient has this pattern: Thrombocytopenia plus microangiopathic hemolytic anemia, often with neurologic, renal, or fever findings, is an emergency. What is the most likely diagnosis?
الإجابة
Thrombotic thrombocytopenic purpura. Thrombocytopenia plus microangiopathic hemolytic anemia, often with neurologic, renal, or fever findings, is an emergency.

ISTH Guidelines for the Diagnosis and Treatment of Thrombotic Thrombocytopenic Purpura · reviewed 2026-08-26
البطاقة ٢٣٢
السؤال
Which bedside pattern best points to testicular torsion?
الإجابة
Sudden severe unilateral testicular pain with nausea or vomiting, a high-riding transverse testis, and loss of the cremasteric reflex strongly suggests torsion.

Testicular Torsion · reviewed 2026-08-26
البطاقة ٢٣٣
السؤال
For surgical decision-making, which diagnosis best fits hematemesis, coffee-ground emesis, or melena with orthostasis?
الإجابة
Upper gastrointestinal bleeding. Hematemesis, coffee-ground emesis, or melena with orthostasis indicates an upper gastrointestinal source until shown otherwise.

ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding · reviewed 2026-08-26
البطاقة ٢٣٤
السؤال
In a child or adolescent, what diagnostic approach is most appropriate when generalized tonic-clonic seizure is suspected?
الإجابة
Check glucose and reversible causes; use EEG and brain imaging based on whether this is a first unprovoked event or known epilepsy.

Epilepsies in Children, Young People and Adults · reviewed 2026-08-26
البطاقة ٢٣٥
السؤال
Identify the condition from this pattern: Repeated properly measured elevated readings, usually without symptoms, establish the clinical pattern.
الإجابة
Stable chronic hypertension. Repeated properly measured elevated readings, usually without symptoms, establish the clinical pattern.

2025 High Blood Pressure Guideline · reviewed 2026-08-26
البطاقة ٢٣٦
السؤال
What diagnostic approach is most appropriate when sepsis is suspected?
الإجابة
Measure lactate, obtain cultures before antibiotics when this causes no meaningful delay, and evaluate the source.

2026 Surviving Sepsis Campaign Adult Guidelines · reviewed 2026-08-26
البطاقة ٢٣٧
السؤال
For surgical decision-making, in a child with acute severe monoarticular pain, restricted passive motion, fever, or bacteremia risk, which diagnosis must be excluded urgently?
الإجابة
Septic arthritis. Acute severe monoarticular pain, restricted passive motion, fever, or bacteremia risk is septic arthritis until excluded.

Guideline for Management of Septic Arthritis in Native Joints · reviewed 2026-08-26
البطاقة ٢٣٨
السؤال
What diagnostic approach is most appropriate when pelvic inflammatory disease is suspected?
الإجابة
Test for gonorrhea, chlamydia, HIV, and syphilis; use ultrasound when abscess or another diagnosis is possible.

Pelvic Inflammatory Disease: STI Treatment Guidelines · reviewed 2026-08-26
البطاقة ٢٣٩
السؤال
Which pharmacologic approach is preferred for COPD?
الإجابة
Long-acting bronchodilators are maintenance therapy; add inhaled corticosteroid for selected exacerbation-prone patients based on phenotype and eosinophils.

2026 GOLD Report and Pocket Guide · reviewed 2026-08-26
البطاقة ٢٤٠
السؤال
What diagnostic approach is most appropriate when schizophrenia is suspected?
الإجابة
Diagnosis is clinical with medical, neurologic, and substance evaluation for first-episode psychosis.

Management of First-Episode Psychosis and Schizophrenia · reviewed 2026-08-26
البطاقة ٢٤١
السؤال
Which next action matters most in hypertensive emergency?
الإجابة
Lower pressure with monitored IV therapy at a controlled rate tailored to the injured organ.

2025 High Blood Pressure Guideline · reviewed 2026-08-26
البطاقة ٢٤٢
السؤال
How should an interpreter be used for a patient with limited English proficiency?
الإجابة
Use a qualified medical interpreter, speak to the patient directly, pause in short segments, and avoid relying on children or untrained family for consequential decisions.

Limited English Proficiency Guidance · reviewed 2026-08-26
البطاقة ٢٤٣
السؤال
What immediate plan is appropriate for thyroid storm?
الإجابة
Give a beta-blocker, block hormone synthesis, then block hormone release, add glucocorticoid, cool supportively, and treat the trigger.

2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis · reviewed 2026-08-26
البطاقة ٢٤٤
السؤال
Which preventive measure belongs in care for ulcerative colitis?
الإجابة
Use effective maintenance therapy and monitor symptoms together with objective inflammatory activity to reduce relapse and complications.

Updated 2025 ACG Guidelines to Manage Adult Ulcerative Colitis Patients · reviewed 2026-08-26
البطاقة ٢٤٥
السؤال
What immediate plan is appropriate for acute bacterial rhinosinusitis?
الإجابة
Assess orbital or intracranial red flags and arrange urgent evaluation when present.

Clinical Practice Guideline: Adult Sinusitis Update · reviewed 2026-08-26
البطاقة ٢٤٦
السؤال
Which preventive measure belongs in care for gout flare?
الإجابة
Weight management, limiting excess alcohol, reviewing urate-raising medicines, and long-term urate control reduce flares.

Gout · reviewed 2026-08-26
البطاقة ٢٤٧
السؤال
What immediate plan is appropriate for hyponatremia due to SIADH?
الإجابة
Treat severe neurologic symptoms with carefully dosed hypertonic saline and avoid overly rapid correction.

Clinical Practice Guideline on Diagnosis and Treatment of Hyponatraemia · reviewed 2026-08-26
البطاقة ٢٤٨
السؤال
In a child or adolescent, which pathophysiologic process drives immune thrombocytopenia?
الإجابة
Autoantibodies accelerate platelet clearance and can impair platelet production.

American Society of Hematology 2019 Guidelines for Immune Thrombocytopenia · reviewed 2026-08-26
البطاقة ٢٤٩
السؤال
Which test or testing sequence best evaluates suspected COPD?
الإجابة
Post-bronchodilator spirometry confirms persistent airflow obstruction.

2026 GOLD Report and Pocket Guide · reviewed 2026-08-26
البطاقة ٢٥٠
السؤال
Why does atrial fibrillation produce its defining clinical pattern?
الإجابة
Chaotic atrial activation eliminates coordinated atrial contraction and creates irregular AV nodal conduction.

2023 ACC/AHA/ACCP/HRS Guideline for Atrial Fibrillation: Key Perspectives · reviewed 2026-08-26
البطاقة ٢٥١
السؤال
Which pathophysiologic process drives subarachnoid hemorrhage?
الإجابة
Arterial blood entering the subarachnoid space raises intracranial pressure and can trigger vasospasm.

2023 Guideline for Aneurysmal Subarachnoid Hemorrhage · reviewed 2026-08-26
البطاقة ٢٥٢
السؤال
In a child or adolescent, which pathophysiologic process drives bacterial meningitis?
الإجابة
Bacterial invasion of the subarachnoid space triggers intense inflammation, edema, and raised intracranial pressure.

WHO Guidelines on Meningitis Diagnosis, Treatment and Care · reviewed 2026-08-26
البطاقة ٢٥٣
السؤال
Which pathophysiologic process drives preeclampsia with severe features?
الإجابة
Abnormal placentation and systemic endothelial dysfunction produce vasoconstriction and multisystem injury.

Gestational Hypertension and Preeclampsia · reviewed 2026-08-26
البطاقة ٢٥٤
السؤال
Which clinical feature defines bipolar I disorder?
الإجابة
At least one manic episode defines bipolar I disorder; a major depressive episode is common but is not required for the diagnosis.

Management of Bipolar Disorder in Adults · reviewed 2026-08-26
البطاقة ٢٥٥
السؤال
For surgical decision-making, what is the priority management step for upper gastrointestinal bleeding?
الإجابة
Establish IV access, resuscitate, use a restrictive transfusion strategy for most patients, and arrange endoscopic hemostasis.

ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding · reviewed 2026-08-26
البطاقة ٢٥٦
السؤال
Which history or examination finding most strongly supports rheumatoid arthritis?
الإجابة
Symmetric inflammatory pain and prolonged morning stiffness in MCP, PIP, or wrist joints with synovitis suggest rheumatoid arthritis.

Rheumatoid Arthritis · reviewed 2026-08-26
البطاقة ٢٥٧
السؤال
What is teach-back?
الإجابة
Ask the patient to explain the plan in their own words so the clinician can find and correct communication gaps without testing or blaming the patient.

Use the Teach-Back Method · reviewed 2026-08-26
البطاقة ٢٥٨
السؤال
A clinician is considering primary hyperparathyroidism. Which finding adds the most support?
الإجابة
Often asymptomatic hypercalcemia, nephrolithiasis, bone loss, constipation, or neurocognitive symptoms can be the clue.

Evaluation and Management of Primary Hyperparathyroidism: Fifth International Workshop Guidelines · reviewed 2026-08-26
البطاقة ٢٥٩
السؤال
How can a clinician reduce avoidable harm related to aortic dissection?
الإجابة
Long-term blood-pressure control and surveillance imaging reduce later aortic complications.

2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease · reviewed 2026-08-26
البطاقة ٢٦٠
السؤال
A clinician is considering sudden sensorineural hearing loss. Which finding adds the most support?
الإجابة
A rapid unilateral hearing decrease, often noticed on waking and sometimes with tinnitus, is an otologic emergency.

Clinical Practice Guideline: Sudden Hearing Loss (Update) · reviewed 2026-08-26
البطاقة ٢٦١
السؤال
Which preventive measure belongs in care for obstructive sleep apnea?
الإجابة
Weight management, alcohol and sedative avoidance near bedtime, and treatment of nasal obstruction reduce severity.

Sleep Apnea Treatment · reviewed 2026-08-26
البطاقة ٢٦٢
السؤال
In a child or adolescent, what diagnostic approach is most appropriate when atopic dermatitis is suspected?
الإجابة
Diagnosis is clinical; testing is reserved for an alternative diagnosis or a specific suspected trigger.

Atopic Dermatitis Clinical Guidelines · reviewed 2026-08-26
البطاقة ٢٦٣
السؤال
How should a clinician initially manage acute pyelonephritis?
الإجابة
Give fluids and antibiotics, and admit patients with sepsis, inability to take oral therapy, pregnancy concerns, or obstruction.

EAU Guidelines on Urological Infections · reviewed 2026-08-26
البطاقة ٢٦٤
السؤال
For surgical decision-making, which diagnosis best fits this presentation: A sudden maximal-at-onset thunderclap headache, neck stiffness, vomiting, or brief loss of consciousness is concerning.
الإجابة
Subarachnoid hemorrhage. A sudden maximal-at-onset thunderclap headache, neck stiffness, vomiting, or brief loss of consciousness is concerning.

2023 Guideline for Aneurysmal Subarachnoid Hemorrhage · reviewed 2026-08-26
البطاقة ٢٦٥
السؤال
What diagnostic approach is most appropriate when hyperkalemia is suspected?
الإجابة
Repeat a possibly hemolyzed sample while obtaining an ECG; assess kidney function, acid-base status, and contributing medicines.

Clinical Practice Guideline: Treatment of Acute Hyperkalaemia in Adults · reviewed 2026-08-26
البطاقة ٢٦٦
السؤال
In a child or adolescent, which diagnosis best fits this presentation: Fever, headache, neck stiffness, altered mental status, or a nonblanching rash should trigger urgent evaluation.
الإجابة
Bacterial meningitis. Fever, headache, neck stiffness, altered mental status, or a nonblanching rash should trigger urgent evaluation.

WHO Guidelines on Meningitis Diagnosis, Treatment and Care · reviewed 2026-08-26
البطاقة ٢٦٧
السؤال
What drug class or regimen fits stable chronic hypertension?
الإجابة
First-line classes include thiazide-type diuretics, ACE inhibitors or ARBs, and long-acting dihydropyridine calcium-channel blockers.

2025 High Blood Pressure Guideline · reviewed 2026-08-26
البطاقة ٢٦٨
السؤال
For surgical decision-making, which diagnosis best fits this presentation: New hypertension after 20 weeks with end-organ findings such as severe pressure, thrombocytopenia, liver injury, kidney injury, pulmonary edema, or neurologic symptoms suggests severe disease.
الإجابة
Preeclampsia with severe features. New hypertension after 20 weeks with end-organ findings such as severe pressure, thrombocytopenia, liver injury, kidney injury, pulmonary edema, or neurologic symptoms suggests severe disease.

Gestational Hypertension and Preeclampsia · reviewed 2026-08-26
البطاقة ٢٦٩
السؤال
Which pharmacologic approach is preferred for acute pancreatitis?
الإجابة
Routine prophylactic antibiotics do not treat sterile pancreatitis; reserve antimicrobials for proven or strongly suspected infection.

ACG Clinical Guideline: Management of Acute Pancreatitis · reviewed 2026-08-26
البطاقة ٢٧٠
السؤال
Which diagnosis best fits this presentation: At least one week of elevated or irritable mood with increased energy, decreased sleep, pressured speech, grandiosity, and risky behavior suggests mania.
الإجابة
Bipolar I mania. At least one week of elevated or irritable mood with increased energy, decreased sleep, pressured speech, grandiosity, and risky behavior suggests mania.

Management of Bipolar Disorder in Adults · reviewed 2026-08-26
البطاقة ٢٧١
السؤال
For surgical decision-making, in a child or adolescent, what is the priority management step for septic arthritis?
الإجابة
Drain the joint promptly and start empiric antibiotics after cultures unless the patient is unstable.

Guideline for Management of Septic Arthritis in Native Joints · reviewed 2026-08-26
البطاقة ٢٧٢
السؤال
In a child or adolescent, what diagnostic approach is most appropriate when sickle cell vaso-occlusive crisis is suspected?
الإجابة
Use focused labs and imaging for the suspected complication; do not require a changed hemoglobin to validate pain.

ASH 2020 Guidelines for Sickle Cell Disease: Management of Acute and Chronic Pain · reviewed 2026-08-26
البطاقة ٢٧٣
السؤال
In a child or adolescent, which diagnosis causes variable wheeze, cough, chest tightness, or dyspnea that changes over time and with triggers?
الإجابة
Asthma. Variable wheeze, cough, chest tightness, or dyspnea that changes over time and with triggers suggests asthma.

2026 GINA Strategy Report · reviewed 2026-08-26
البطاقة ٢٧٤
السؤال
In a child or adolescent, which pathophysiologic process drives diabetic ketoacidosis?
الإجابة
Absolute or marked insulin deficiency drives lipolysis, ketogenesis, osmotic diuresis, and total-body potassium loss.

Standards of Care in Diabetes—2026 · reviewed 2026-08-26
البطاقة ٢٧٥
السؤال
How should a clinician respond to a patient requesting an unnecessary antibiotic?
الإجابة
Acknowledge the concern, explain why the antibiotic will not help and may harm, offer a clear alternative plan, and define return precautions.

Core Elements of Outpatient Antibiotic Stewardship · reviewed 2026-08-26
البطاقة ٢٧٦
السؤال
Which pathophysiologic process drives retinal detachment?
الإجابة
Fluid passing through a retinal break separates neurosensory retina from the pigment epithelium.

Retinal Detachment · reviewed 2026-08-26
البطاقة ٢٧٧
السؤال
Which bedside pattern best points to peripheral artery disease?
الإجابة
Exertional calf discomfort relieved by rest, diminished pulses, and nonhealing foot wounds suggest lower-extremity arterial disease.

2024 ACC/AHA Guideline for Lower Extremity Peripheral Artery Disease: Key Points · reviewed 2026-08-26
البطاقة ٢٧٨
السؤال
Which preventive measure belongs in care for myasthenia gravis?
الإجابة
Avoid medicines that worsen neuromuscular transmission and plan carefully for infection, surgery, and pregnancy.

International Consensus Guidance for Management of Myasthenia Gravis: 2020 Update · reviewed 2026-08-26
البطاقة ٢٧٩
السؤال
In a child or adolescent, which pathophysiologic process drives acute appendicitis?
الإجابة
Luminal obstruction causes distention, ischemia, bacterial overgrowth, and eventual perforation.

Guideline for the Diagnosis and Treatment of Appendicitis · reviewed 2026-08-26
البطاقة ٢٨٠
السؤال
Which preventive measure belongs in care for Clostridioides difficile infection?
الإجابة
Isolate suspected or confirmed CDI with contact precautions, use C. difficile sporicidal agents for daily and terminal cleaning, and engage antibiotic stewardship.

Clinical Guidance for C. diff Infection Prevention in Acute Care Facilities · reviewed 2026-08-26
البطاقة ٢٨١
السؤال
After an acute ACL tear, which nonprescription medicines may be used for symptom relief when safe?
الإجابة
Ibuprofen or naproxen can reduce pain and swelling; acetaminophen can reduce pain. Check comorbidities and contraindications before NSAID use.

Anterior cruciate ligament (ACL) injury - aftercare · reviewed 2026-08-26
البطاقة ٢٨٢
السؤال
Which preventive measure belongs in care for shoulder dystocia?
الإجابة
Team drills, clear communication, and avoiding fundal pressure reduce preventable harm.

Shoulder Dystocia · reviewed 2026-08-26
البطاقة ٢٨٣
السؤال
Which next action matters most in idiopathic pulmonary fibrosis?
الإجابة
Assess oxygen need, comorbidity, transplant eligibility, and goals while monitoring progression.

Idiopathic Pulmonary Fibrosis: An Update and Progressive Pulmonary Fibrosis in Adults · reviewed 2026-08-26
البطاقة ٢٨٤
السؤال
In a child or adolescent, which preventive measure belongs in care for attention-deficit/hyperactivity disorder?
الإجابة
Use an individualized multimodal plan with psychoeducation, parent and school interventions, and clear functional goals.

ADHD in Children and Youth: Part 2—Treatment · reviewed 2026-08-26
البطاقة ٢٨٥
السؤال
Which diagnosis best fits unilateral expanding warmth, tenderness, erythema, and edema without a sharply raised border?
الإجابة
Cellulitis. Unilateral expanding warmth, tenderness, erythema, and edema without a sharply raised border favor cellulitis.

Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections · reviewed 2026-08-26
البطاقة ٢٨٦
السؤال
A clinician is considering hyponatremia due to SIADH. Which finding adds the most support?
الإجابة
Nausea, confusion, gait change, seizure, or subtle cognitive symptoms with hypotonic euvolemic hyponatremia may reflect SIADH.

Clinical Practice Guideline on Diagnosis and Treatment of Hyponatraemia · reviewed 2026-08-26
البطاقة ٢٨٧
السؤال
During a pulseless arrest, the monitor shows chaotic ventricular activity without organized QRS complexes. Which arrest rhythm is present?
الإجابة
Ventricular fibrillation cardiac arrest. Sudden unresponsiveness with absent normal breathing and no pulse is cardiac arrest; the monitor may show chaotic ventricular activity.

2025 American Heart Association Guidelines for CPR and ECC: Adult Advanced Life Support · reviewed 2026-08-26
البطاقة ٢٨٨
السؤال
A clinician is considering neutropenic fever. Which finding adds the most support?
الإجابة
A single fever in a patient with severe chemotherapy-related neutropenia is an emergency even when examination is unrevealing.

Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy · reviewed 2026-08-26
البطاقة ٢٨٩
السؤال
A patient has this pattern: Progressive weak stream, hesitancy, incomplete emptying, nocturia, and frequency suggest bladder-outlet symptoms. What is the most likely diagnosis?
الإجابة
Benign prostatic hyperplasia. Progressive weak stream, hesitancy, incomplete emptying, nocturia, and frequency suggest bladder-outlet symptoms.

EAU Guidelines on the Management of Non-neurogenic Male Lower Urinary Tract Symptoms · reviewed 2026-08-26
البطاقة ٢٩٠
السؤال
Which test or testing sequence best evaluates suspected primary adrenal insufficiency?
الإجابة
Measure morning cortisol and ACTH, then confirm with cosyntropin testing when the patient is stable.

Primary Adrenal Insufficiency Guideline Resources · reviewed 2026-08-26
البطاقة ٢٩١
السؤال
What medication strategy is appropriate for peritonsillar abscess?
الإجابة
Use antibiotics covering group A streptococci and oral anaerobes after drainage.

Tonsillitis and Peritonsillar Abscess · reviewed 2026-08-26
البطاقة ٢٩٢
السؤال
What belongs in a safe handoff?
الإجابة
State illness severity, active problems, recent changes, pending results, contingency plans, and who owns each next action, then allow questions.

TeamSTEPPS Communication Module · reviewed 2026-08-26
البطاقة ٢٩٣
السؤال
Which history or examination finding most strongly supports myasthenia gravis?
الإجابة
Fluctuating fatigable ptosis, diplopia, dysarthria, dysphagia, or proximal weakness that worsens with use suggests myasthenia.

International Consensus Guidance for Management of Myasthenia Gravis: 2020 Update · reviewed 2026-08-26
البطاقة ٢٩٤
السؤال
For surgical decision-making, identify the condition from this pattern: Pain out of proportion, pain with passive stretch, tense swelling, and progressive neurologic deficits after injury are warning signs.
الإجابة
Acute compartment syndrome. Pain out of proportion, pain with passive stretch, tense swelling, and progressive neurologic deficits after injury are warning signs.

Management of Acute Compartment Syndrome: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ٢٩٥
السؤال
Which history or examination finding most strongly supports Clostridioides difficile infection?
الإجابة
New clinically significant diarrhea after antibiotics or healthcare exposure, with abdominal pain or leukocytosis, suggests C. difficile.

2021 Focused Update Guidelines on Management of Clostridioides difficile Infection in Adults · reviewed 2026-08-26
البطاقة ٢٩٦
السؤال
How should a clinician confirm or characterize acute coronary syndrome?
الإجابة
Obtain a 12-lead ECG within 10 minutes and measure serial high-sensitivity troponin.

2025 ACC/AHA Guideline for the Management of Patients With Acute Coronary Syndromes · reviewed 2026-08-26
البطاقة ٢٩٧
السؤال
Which history or examination finding most strongly supports shoulder dystocia?
الإجابة
After delivery of the head, retraction against the perineum and failure of the shoulders to deliver indicates dystocia.

Shoulder Dystocia · reviewed 2026-08-26
البطاقة ٢٩٨
السؤال
In a child or adolescent, which history or examination finding most strongly supports attention-deficit/hyperactivity disorder?
الإجابة
Persistent developmentally inappropriate inattention and/or hyperactivity-impulsivity in more than one setting with impairment suggests ADHD.

ADHD in Children and Youth: Part 1—Etiology, Diagnosis, and Comorbidity · reviewed 2026-08-26
البطاقة ٢٩٩
السؤال
What clinical clue should raise suspicion for cirrhosis with ascites?
الإجابة
Increasing abdominal girth, shifting dullness, edema, jaundice, or stigmata of portal hypertension suggest decompensation.

Diagnosis, Evaluation, and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome · reviewed 2026-08-26
البطاقة ٣٠٠
السؤال
In a child, typically 6 months to 3 years, what clinical clue should raise suspicion for croup?
الإجابة
Barking cough, hoarseness, and inspiratory stridor after a viral prodrome in a young child suggests croup.

Acute Management of Croup in the Emergency Department · reviewed 2026-08-26
٦٠٠ بطاقة
PANCE Flashcards: Blueprint-Aligned Diagnoses, Tests & Next Steps
ادرس هذه الرزمة مجانًا
سيفتح تطبيق Flashcards لتبدأ الدراسة.
البطاقة ٣٠١
السؤال
How should a clinician initially manage peripheral artery disease?
الإجابة
Use supervised or structured exercise; evaluate revascularization for lifestyle-limiting symptoms despite therapy or limb threat.

2024 ACC/AHA Guideline for Lower Extremity Peripheral Artery Disease: Key Points · reviewed 2026-08-26
البطاقة ٣٠٢
السؤال
What drug class or regimen fits pulmonary embolism?
الإجابة
Direct oral anticoagulants are preferred for many stable eligible patients; choose differently for pregnancy, severe renal disease, or specific cancer contexts.

ASH VTE Guidelines: Treatment of Deep Vein Thrombosis and Pulmonary Embolism · reviewed 2026-08-26
البطاقة ٣٠٣
السؤال
For surgical decision-making, in a child or adolescent, identify the condition from this pattern: Periumbilical pain migrating to the right lower quadrant with anorexia, nausea, fever, and focal tenderness is typical.
الإجابة
Acute appendicitis. Periumbilical pain migrating to the right lower quadrant with anorexia, nausea, fever, and focal tenderness is typical.

Guideline for the Diagnosis and Treatment of Appendicitis · reviewed 2026-08-26
البطاقة ٣٠٤
السؤال
Which test or testing sequence best evaluates suspected hip fracture?
الإجابة
Obtain hip and pelvis radiographs; MRI detects an occult fracture when suspicion remains high.

Management of Hip Fractures in Older Adults: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ٣٠٥
السؤال
In a child or adolescent, what is the priority management step for generalized tonic-clonic seizure?
الإجابة
Protect from injury, position for airway safety, time the event, and treat as status epilepticus when it persists.

Epilepsies in Children, Young People and Adults · reviewed 2026-08-26
البطاقة ٣٠٦
السؤال
Which diagnosis causes fatigue, cold intolerance, constipation, dry skin, bradycardia, and delayed reflex relaxation?
الإجابة
Primary hypothyroidism. Fatigue, cold intolerance, constipation, dry skin, bradycardia, and delayed reflex relaxation support hypothyroidism.

Guidelines for the Treatment of Hypothyroidism · reviewed 2026-08-26
البطاقة ٣٠٧
السؤال
What is the priority management step for sepsis?
الإجابة
Start rapid resuscitation, broad empiric antimicrobials, and urgent source control.

2026 Surviving Sepsis Campaign Adult Guidelines · reviewed 2026-08-26
البطاقة ٣٠٨
السؤال
Which diagnosis best fits diffuse conjunctival injection with mucopurulent discharge and eyelids stuck on waking?
الإجابة
Bacterial conjunctivitis. Diffuse conjunctival injection with mucopurulent discharge and eyelids stuck on waking supports bacterial conjunctivitis.

Clinical Overview of Pink Eye (Conjunctivitis) · reviewed 2026-08-26
البطاقة ٣٠٩
السؤال
What is the priority management step for pelvic inflammatory disease?
الإجابة
Start empiric treatment promptly; admit for pregnancy, severe illness, abscess, surgical emergency uncertainty, or failed outpatient care.

Pelvic Inflammatory Disease: STI Treatment Guidelines · reviewed 2026-08-26
البطاقة ٣١٠
السؤال
What is closed-loop communication during an emergency?
الإجابة
The receiver repeats the instruction, the sender confirms or corrects it, and completion is announced so the team shares the same state.

TeamSTEPPS Check-Back Tool · reviewed 2026-08-26
البطاقة ٣١١
السؤال
What is the priority management step for schizophrenia?
الإجابة
Assess danger, catatonia, and ability to care for self, then combine antipsychotic treatment with psychosocial support.

Management of First-Episode Psychosis and Schizophrenia · reviewed 2026-08-26
البطاقة ٣١٢
السؤال
What medication strategy is appropriate for nephrotic syndrome?
الإجابة
Use renin-angiotensin system blockade to reduce proteinuria when appropriate; disease-specific immunotherapy depends on pathology.

KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases with 2024 Chapter Updates · reviewed 2026-08-26
البطاقة ٣١٣
السؤال
What immediate plan is appropriate for neutropenic fever?
الإجابة
Give empiric antipseudomonal antibiotics rapidly and stratify for inpatient versus carefully selected outpatient care.

Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy · reviewed 2026-08-26
البطاقة ٣١٤
السؤال
What counseling point helps reduce harm from cellulitis?
الإجابة
Treat tinea pedis, edema, skin breaks, and other portals of entry to reduce recurrence.

Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections · reviewed 2026-08-26
البطاقة ٣١٥
السؤال
A clinician is considering cardiac tamponade. Which finding adds the most support?
الإجابة
Hypotension, elevated jugular venous pressure, tachycardia, muffled heart sounds, and pulsus paradoxus suggest tamponade physiology.

2025 Concise Clinical Guidance: Diagnosis and Management of Pericarditis · reviewed 2026-08-26
البطاقة ٣١٦
السؤال
What counseling point helps reduce harm from benign prostatic hyperplasia?
الإجابة
Review fluid timing and medicines that worsen retention, and monitor complications.

EAU Guidelines on the Management of Non-neurogenic Male Lower Urinary Tract Symptoms · reviewed 2026-08-26
البطاقة ٣١٧
السؤال
Which diagnosis best fits progressive exertional dyspnea, chronic cough or sputum, and exposure to tobacco, biomass, or occupational irritants?
الإجابة
COPD. Progressive exertional dyspnea, chronic cough or sputum, and exposure to tobacco, biomass, or occupational irritants suggest COPD.

2026 GOLD Report and Pocket Guide · reviewed 2026-08-26
البطاقة ٣١٨
السؤال
Which test or testing sequence best evaluates suspected acute cholecystitis?
الإجابة
Right-upper-quadrant ultrasound is first-line; a gallbladder nuclear-medicine scan (HIDA) is an appropriate next study when ultrasound is negative or equivocal and suspicion remains high.

ACR Appropriateness Criteria® Right Upper Quadrant Pain · reviewed 2026-08-26
البطاقة ٣١٩
السؤال
In a postmenopausal woman or man aged 50 or older, what clinical clue should raise suspicion for osteoporosis?
الإجابة
A fragility fracture, height loss, or kyphosis should prompt assessment for osteoporosis and vertebral fracture.

The clinician’s guide to prevention and treatment of osteoporosis · reviewed 2026-08-26
البطاقة ٣٢٠
السؤال
Which pharmacologic approach is preferred for Parkinson disease?
الإجابة
Levodopa provides the strongest motor benefit for many patients; dopamine agonists carry impulse-control and sleep risks.

Parkinson’s Disease in Adults · reviewed 2026-08-26
البطاقة ٣٢١
السؤال
A patient has this pattern: Pressure-like substernal pain with diaphoresis, nausea, or radiation to the arm or jaw is a classic ischemic pattern. What is the most likely diagnosis?
الإجابة
Acute coronary syndrome. Pressure-like substernal pain with diaphoresis, nausea, or radiation to the arm or jaw is a classic ischemic pattern.

2025 ACC/AHA Guideline for the Management of Patients With Acute Coronary Syndromes · reviewed 2026-08-26
البطاقة ٣٢٢
السؤال
Which pharmacologic approach is preferred for gonococcal urethritis or cervicitis?
الإجابة
Ceftriaxone is first-line for uncomplicated infection; add chlamydia treatment if it has not been excluded.

Gonococcal Infections Among Adolescents and Adults · reviewed 2026-08-26
البطاقة ٣٢٣
السؤال
In a child aged 6 months or older, which examination best evaluates suspected acute otitis media?
الإجابة
Use pneumatic otoscopy to confirm middle-ear effusion and assess for a bulging tympanic membrane; tympanometry is less reliable in young infants.

Management of Acute Otitis Media in Children Six Months of Age and Older · reviewed 2026-08-26
البطاقة ٣٢٤
السؤال
Which pharmacologic approach is preferred for menopause vasomotor symptoms?
الإجابة
Systemic menopausal hormone therapy is most effective for eligible patients; nonhormonal options include selected SSRIs, SNRIs, gabapentin, or fezolinetant.

Hormone Therapy for Menopause · reviewed 2026-08-26
البطاقة ٣٢٥
السؤال
How should a clinician handle an ambiguous verbal medication order?
الإجابة
Stop and clarify the drug, dose, route, timing, and patient; read it back and do not guess.

TeamSTEPPS Communication Module · reviewed 2026-08-26
البطاقة ٣٢٦
السؤال
Which pharmacologic approach is preferred for alcohol withdrawal?
الإجابة
Benzodiazepines are first-line for clinically significant withdrawal; phenobarbital requires experienced protocols and monitoring.

The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management · reviewed 2026-08-26
البطاقة ٣٢٧
السؤال
In a child or adolescent, how should a clinician initially manage asthma?
الإجابة
Assess severity during exacerbation, give repeated bronchodilator, systemic corticosteroid when indicated, oxygen, and escalate for fatigue or silent chest.

2026 GINA Strategy Report · reviewed 2026-08-26
البطاقة ٣٢٨
السؤال
What medication strategy is appropriate for Cushing syndrome?
الإجابة
Medical cortisol-lowering therapy can bridge or treat selected patients when definitive source control is delayed or unavailable.

Treatment of Cushing Syndrome: An Endocrine Society Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ٣٢٩
السؤال
What counseling point helps reduce harm from acute kidney injury?
الإجابة
Avoid unnecessary nephrotoxins, adjust medicine doses, maintain perfusion, and monitor high-risk patients.

KDIGO Clinical Practice Guideline for Acute Kidney Injury · reviewed 2026-08-26
البطاقة ٣٣٠
السؤال
What medication strategy is appropriate for thrombotic thrombocytopenic purpura?
الإجابة
Caplacizumab is added in many acute immune TTP protocols under specialist care.

ISTH Guidelines for the Diagnosis and Treatment of Thrombotic Thrombocytopenic Purpura · reviewed 2026-08-26
البطاقة ٣٣١
السؤال
For surgical decision-making, in a child or adolescent, which next action matters most in acute appendicitis?
الإجابة
Give fluids, analgesia, antibiotics, and obtain prompt surgical consultation.

Guideline for the Diagnosis and Treatment of Appendicitis · reviewed 2026-08-26
البطاقة ٣٣٢
السؤال
How should medication be used in ventricular fibrillation cardiac arrest?
الإجابة
Give epinephrine during the arrest algorithm and consider amiodarone or lidocaine for refractory shockable rhythms.

2025 American Heart Association Guidelines for CPR and ECC: Adult Advanced Life Support · reviewed 2026-08-26
البطاقة ٣٣٣
السؤال
For surgical decision-making, which next action matters most in acute compartment syndrome?
الإجابة
Remove constrictive material and obtain immediate surgical fasciotomy evaluation.

Management of Acute Compartment Syndrome: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ٣٣٤
السؤال
In a child or adolescent, which diagnosis fits sudden loss of consciousness with bilateral tonic then clonic movements followed by confusion?
الإجابة
Generalized tonic-clonic seizure. Sudden loss of consciousness with bilateral tonic then clonic movements followed by confusion supports a generalized convulsion.

Epilepsies in Children, Young People and Adults · reviewed 2026-08-26
البطاقة ٣٣٥
السؤال
How should medication be used in herpes zoster?
الإجابة
Start an oral antiviral early for eligible patients, especially with severe pain, older age, or high-risk sites.

Clinical Overview of Shingles (Herpes Zoster) · reviewed 2026-08-26
البطاقة ٣٣٦
السؤال
Which diagnosis is defined by suspected infection with acute organ dysfunction and may include altered mentation, hypotension, tachypnea, or poor perfusion?
الإجابة
Sepsis. Suspected infection with acute organ dysfunction, altered mentation, hypotension, tachypnea, or poor perfusion suggests sepsis.

2026 Surviving Sepsis Campaign Adult Guidelines · reviewed 2026-08-26
البطاقة ٣٣٧
السؤال
What medication strategy is appropriate for uncomplicated cystitis?
الإجابة
Nitrofurantoin, trimethoprim-sulfamethoxazole where appropriate, or fosfomycin are common first-line options guided by patient factors and resistance.

EAU Guidelines on Urological Infections · reviewed 2026-08-26
البطاقة ٣٣٨
السؤال
Which diagnosis warrants empiric treatment when lower abdominal pain occurs with cervical-motion, uterine, or adnexal tenderness in a patient at STI risk?
الإجابة
Pelvic inflammatory disease. Lower abdominal pain with cervical motion, uterine, or adnexal tenderness in a patient at STI risk supports empiric PID treatment.

Pelvic Inflammatory Disease: STI Treatment Guidelines · reviewed 2026-08-26
البطاقة ٣٣٩
السؤال
How should a clinician confirm or characterize pulmonary embolism?
الإجابة
Use pretest probability with PERC or D-dimer when appropriate and CT pulmonary angiography for indicated stable patients.

ASH VTE Guidelines: Diagnosis of Venous Thromboembolism · reviewed 2026-08-26
البطاقة ٣٤٠
السؤال
Which diagnosis requires at least six months of illness with psychosis and functional decline, including at least one month of active symptoms, after exclusions?
الإجابة
Schizophrenia. At least six months of illness with psychosis and functional decline, including at least one month of active symptoms, supports schizophrenia after exclusions.

Management of First-Episode Psychosis and Schizophrenia · reviewed 2026-08-26
البطاقة ٣٤١
السؤال
Which prevention or risk-reduction step is important for infective endocarditis?
الإجابة
Reserve antibiotic prophylaxis for defined high-risk cardiac conditions undergoing relevant dental procedures.

2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease · reviewed 2026-08-26
البطاقة ٣٤٢
السؤال
What is the priority management step for primary adrenal insufficiency?
الإجابة
Suspected adrenal crisis requires immediate glucocorticoid and isotonic fluid treatment before confirmatory results.

Primary Adrenal Insufficiency Guideline Resources · reviewed 2026-08-26
البطاقة ٣٤٣
السؤال
What is the safest response to a critical test result that arrives after a patient leaves?
الإجابة
Acknowledge it promptly, contact the patient or responsible team, document attempts and advice, and escalate until ownership is clear.

Quick Safety 52: Advancing Safety with Closed-loop Communication of Test Results · reviewed 2026-08-26
البطاقة ٣٤٤
السؤال
In a child aged 6 months or older, what is the priority management step for acute otitis media?
الإجابة
Provide analgesia; treat severe illness promptly with antibiotics and use 24–48 hours of watchful waiting only for selected mildly ill children with reliable follow-up.

Management of Acute Otitis Media in Children Six Months of Age and Older · reviewed 2026-08-26
البطاقة ٣٤٥
السؤال
When antibiotic susceptibility is unknown, which empiric regimen is preferred for most treatment-naive Helicobacter pylori infection?
الإجابة
Use 14-day optimized bismuth quadruple therapy: a proton-pump inhibitor, bismuth, tetracycline, and metronidazole.

ACG Clinical Guideline: Treatment of Helicobacter pylori Infection · reviewed 2026-08-26
البطاقة ٣٤٦
السؤال
In a child or adolescent, which diagnosis best fits this presentation: Hematuria with dysmorphic red cells or casts, hypertension, edema, and reduced kidney function suggests glomerular inflammation.
الإجابة
Nephritic syndrome. Hematuria with dysmorphic red cells or casts, hypertension, edema, and reduced kidney function suggests glomerular inflammation.

KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases with 2024 Chapter Updates · reviewed 2026-08-26
البطاقة ٣٤٧
السؤال
What drug class or regimen fits carpal tunnel syndrome?
الإجابة
A local corticosteroid injection can provide relief; oral medicines do not correct the compression.

Management of Carpal Tunnel Syndrome: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ٣٤٨
السؤال
In a child or adolescent, what counseling point helps reduce harm from immune thrombocytopenia?
الإجابة
Avoid platelet-impairing medicines and counsel on bleeding precautions when counts are low.

American Society of Hematology 2019 Guidelines for Immune Thrombocytopenia · reviewed 2026-08-26
البطاقة ٣٤٩
السؤال
Which test or testing sequence best evaluates suspected bacterial brain abscess?
الإجابة
Contrast-enhanced MRI is preferred; obtain blood cultures and avoid lumbar puncture when mass effect is possible.

ESCMID Guideline on Diagnosis and Treatment of Brain Abscess in Children and Adults · reviewed 2026-08-26
البطاقة ٣٥٠
السؤال
What physiologic disturbance underlies aortic dissection?
الإجابة
An intimal tear lets blood split the aortic media, creating a false lumen.

2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease · reviewed 2026-08-26
البطاقة ٣٥١
السؤال
How can a clinician reduce avoidable harm related to acute respiratory distress syndrome?
الإجابة
Use lung-protective ventilation in mechanically ventilated patients at risk for ARDS to reduce ventilator-induced injury.

An Update on Management of Adult Patients with Acute Respiratory Distress Syndrome · reviewed 2026-08-26
البطاقة ٣٥٢
السؤال
Which test or testing sequence best evaluates suspected pulmonary tuberculosis?
الإجابة
Obtain chest imaging and multiple respiratory specimens for nucleic-acid testing, smear, and culture with susceptibility testing.

Clinical and Laboratory Diagnosis for Tuberculosis · reviewed 2026-08-26
البطاقة ٣٥٣
السؤال
Which test or testing sequence best evaluates suspected endometriosis?
الإجابة
Diagnosis can be clinical with imaging for endometrioma or deep disease; laparoscopy is not mandatory before initial treatment.

Endometriosis · reviewed 2026-08-26
البطاقة ٣٥٤
السؤال
Which test or testing sequence best evaluates suspected panic disorder?
الإجابة
Diagnosis is clinical after considering cardiac, pulmonary, endocrine, neurologic, medication, and substance causes.

Panic Disorder: What You Need to Know · reviewed 2026-08-26
البطاقة ٣٥٥
السؤال
How can a clinician reduce avoidable harm related to Crohn disease?
الإجابة
Support smoking cessation and use effective maintenance therapy with objective monitoring to reduce relapse and complications.

Updated 2025 ACG Guidelines for Crohn’s Disease · reviewed 2026-08-26
البطاقة ٣٥٦
السؤال
Which history or examination finding most strongly supports Cushing syndrome?
الإجابة
Proximal weakness, easy bruising, facial plethora, wide violaceous striae, osteoporosis, or difficult diabetes and hypertension are discriminating clues.

Diagnosis of Cushing Syndrome: An Endocrine Society Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ٣٥٧
السؤال
How can a clinician reduce avoidable harm related to rheumatoid arthritis?
الإجابة
Keep indicated vaccines current and coordinate timing with immunosuppressive therapy to reduce preventable infection risk.

2022 American College of Rheumatology Guideline for Vaccinations in Patients With Rheumatic and Musculoskeletal Diseases · reviewed 2026-08-26
البطاقة ٣٥٨
السؤال
Which history or examination finding most strongly supports peritonsillar abscess?
الإجابة
Severe unilateral sore throat, muffled voice, drooling, trismus, and uvular deviation suggest a peritonsillar collection.

Tonsillitis and Peritonsillar Abscess · reviewed 2026-08-26
البطاقة ٣٥٩
السؤال
When should a safety event or near miss be reported?
الإجابة
Report it through the local safety system promptly, including near misses, so hazards can be corrected without waiting for patient harm.

Reporting Patient Safety Events · reviewed 2026-08-26
البطاقة ٣٦٠
السؤال
For surgical decision-making, what immediate plan is appropriate for cardiac tamponade?
الإجابة
Urgent pericardial drainage is the definitive step when tamponade causes hemodynamic compromise.

2025 Concise Clinical Guidance: Diagnosis and Management of Pericarditis · reviewed 2026-08-26
البطاقة ٣٦١
السؤال
Which bedside pattern best points to pleural effusion?
الإجابة
Dyspnea with reduced breath sounds, dullness to percussion, and decreased tactile fremitus suggests pleural fluid.

British Thoracic Society Guideline for Pleural Disease · reviewed 2026-08-26
البطاقة ٣٦٢
السؤال
For surgical decision-making, what immediate plan is appropriate for melanoma?
الإجابة
Prompt complete diagnostic excision and staging guide definitive surgical management.

Melanoma Clinical Guidelines · reviewed 2026-08-26
البطاقة ٣٦٣
السؤال
A clinician is considering uncomplicated cystitis. Which finding adds the most support?
الإجابة
Dysuria and frequency without vaginal symptoms strongly support lower urinary infection in an appropriate patient.

EAU Guidelines on Urological Infections · reviewed 2026-08-26
البطاقة ٣٦٤
السؤال
In a child or adolescent, which clinical sequence defines a generalized tonic-clonic seizure?
الإجابة
Loss of consciousness with bilateral tonic stiffening followed by clonic jerking and a postictal period defines the typical sequence.

Epilepsies in Children, Young People and Adults · reviewed 2026-08-26
البطاقة ٣٦٥
السؤال
What is the priority management step for chronic kidney disease?
الإجابة
Identify cause, quantify progression risk, treat complications, and refer for high-risk features or advanced disease.

2024 CKD Evaluation and Management Guideline · reviewed 2026-08-26
البطاقة ٣٦٦
السؤال
Why does sepsis produce its defining clinical pattern?
الإجابة
A dysregulated host response causes endothelial injury, vasodilation, capillary leak, and organ dysfunction.

2026 Surviving Sepsis Campaign Adult Guidelines · reviewed 2026-08-26
البطاقة ٣٦٧
السؤال
Which history or examination finding most strongly supports stable chronic hypertension?
الإجابة
Repeated properly measured elevated readings, usually without symptoms, establish the clinical pattern.

2025 High Blood Pressure Guideline · reviewed 2026-08-26
البطاقة ٣٦٨
السؤال
Why does pelvic inflammatory disease produce its defining clinical pattern?
الإجابة
Ascending polymicrobial infection inflames endometrium and tubes, causing scarring and future ectopic or infertility risk.

Pelvic Inflammatory Disease: STI Treatment Guidelines · reviewed 2026-08-26
البطاقة ٣٦٩
السؤال
Which bedside pattern best points to chronic hepatitis C?
الإجابة
Most chronic infections are asymptomatic; abnormal aminotransferases or risk-based screening may reveal disease.

Viral Hepatitis Clinical Care · reviewed 2026-08-26
البطاقة ٣٧٠
السؤال
Which symptom domains should a clinician assess in schizophrenia?
الإجابة
Assess positive, negative, cognitive, and mood symptoms together with substance use, functioning, and safety.

Management of First-Episode Psychosis and Schizophrenia · reviewed 2026-08-26
البطاقة ٣٧١
السؤال
For surgical decision-making, an older adult after a fall has groin pain, cannot bear weight, and holds a shortened, externally rotated leg. Which diagnosis is most likely?
الإجابة
Hip fracture. An older adult after a fall with groin pain, inability to bear weight, and a shortened externally rotated leg likely has a hip fracture.

Management of Hip Fractures in Older Adults: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ٣٧٢
السؤال
In pulmonary embolism with hemodynamic compromise and no prohibitive bleeding risk, which drug class should be considered for reperfusion?
الإجابة
Use systemic thrombolytic therapy followed by anticoagulation; weigh the immediate bleeding risk and activate an advanced-reperfusion pathway.

ASH 2020 Guidelines for Treatment of Deep Vein Thrombosis and Pulmonary Embolism · reviewed 2026-08-26
البطاقة ٣٧٣
السؤال
Which diagnosis best fits this presentation: Unilateral leg swelling, pain, warmth, and risk from immobility, surgery, cancer, estrogen, or prior VTE raise suspicion.
الإجابة
Acute deep-vein thrombosis. Unilateral leg swelling, pain, warmth, and risk from immobility, surgery, cancer, estrogen, or prior VTE raise suspicion.

ASH VTE Guidelines: Diagnosis of Venous Thromboembolism · reviewed 2026-08-26
البطاقة ٣٧٤
السؤال
Which preventive measure belongs in care for type 2 diabetes mellitus?
الإجابة
Weight-supportive nutrition, physical activity, tobacco avoidance, and cardiometabolic risk control prevent complications.

Standards of Care in Diabetes—2026 · reviewed 2026-08-26
البطاقة ٣٧٥
السؤال
What is the first response when a colleague appears impaired while providing care?
الإجابة
Protect patients immediately, remove the colleague from unsafe duties through the proper chain, and activate confidential professional-assistance procedures.

Physician Responsibilities to Colleagues with Illness, Disability or Impairment · reviewed 2026-08-26
البطاقة ٣٧٦
السؤال
Which preventive measure belongs in care for acute angle-closure glaucoma?
الإجابة
Definitive treatment of the fellow narrow-angle eye helps prevent a second attack.

Management of Angle-Closure Glaucoma · reviewed 2026-08-26
البطاقة ٣٧٧
السؤال
Exertional dyspnea, orthopnea, edema, elevated jugular venous pressure, an S3, and an echocardiographic LVEF of 35% indicate which heart-failure phenotype?
الإجابة
Heart failure with reduced ejection fraction (HFrEF). The congestion findings establish heart failure, and an LVEF of 40% or less identifies the reduced-EF phenotype.

2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure · reviewed 2026-08-26
البطاقة ٣٧٨
السؤال
What clinical clue should raise suspicion for multiple sclerosis relapse?
الإجابة
A focal neurologic deficit evolving over hours to days and lasting over 24 hours, separated in time and space from prior events, suggests relapse.

Multiple Sclerosis in Adults: Management · reviewed 2026-08-26
البطاقة ٣٧٩
السؤال
For surgical decision-making, which diagnosis best fits persistent right-upper-quadrant pain or tenderness, fever, leukocytosis, and a positive Murphy sign?
الإجابة
Acute calculous cholecystitis. The combined clinical and inflammatory findings support the diagnosis; confirm it with imaging.

2020 World Society of Emergency Surgery Updated Guidelines for the Diagnosis and Treatment of Acute Calculous Cholecystitis · reviewed 2026-08-26
البطاقة ٣٨٠
السؤال
What clinical clue should raise suspicion for HIV infection?
الإجابة
Acute retroviral illness can cause fever, rash, pharyngitis, lymphadenopathy, or no symptoms; chronic infection may remain silent.

About HIV · reviewed 2026-08-26
البطاقة ٣٨١
السؤال
Why does hip fracture produce its defining clinical pattern?
الإجابة
Osteoporotic bone can fail under low-energy load, and immobility rapidly adds medical risk.

Management of Hip Fractures in Older Adults: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ٣٨٢
السؤال
What clinical clue should raise suspicion for postpartum hemorrhage?
الإجابة
Heavy postpartum bleeding with uterine atony, retained tissue, trauma, or coagulopathy can rapidly cause shock.

Postpartum Hemorrhage · reviewed 2026-08-26
البطاقة ٣٨٣
السؤال
Why does pulmonary embolism produce its defining clinical pattern?
الإجابة
Pulmonary embolism is venous thromboembolism obstructing the pulmonary arteries, which increases right-ventricular afterload.

ASH VTE Guidelines: Treatment of Deep Vein Thrombosis and Pulmonary Embolism · reviewed 2026-08-26
البطاقة ٣٨٤
السؤال
What clinical clue should raise suspicion for delirium?
الإجابة
An acute fluctuating disturbance of attention and awareness with disorganized thinking suggests delirium.

Delirium: Prevention, Diagnosis and Management · reviewed 2026-08-26
البطاقة ٣٨٥
السؤال
For surgical decision-making, what immediate plan is appropriate for ureteral stone?
الإجابة
Provide analgesia, check for infection and kidney injury, and decompress urgently when obstruction is infected.

EAU Guidelines on Urolithiasis · reviewed 2026-08-26
البطاقة ٣٨٦
السؤال
What is the key first diagnostic step for heart failure with reduced ejection fraction?
الإجابة
Transthoracic echocardiography defines ejection fraction and structural disease.

2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure · reviewed 2026-08-26
البطاقة ٣٨٧
السؤال
In a child or adolescent, a clinician is considering atopic dermatitis. Which finding adds the most support?
الإجابة
Chronic pruritic eczematous patches with age-dependent flexural or facial distribution and a relapsing course are typical.

Atopic Dermatitis Clinical Guidelines · reviewed 2026-08-26
البطاقة ٣٨٨
السؤال
Which diagnosis causes fever, marked tachycardia, agitation or delirium, gastrointestinal symptoms, and heart failure in a patient with thyrotoxicosis?
الإجابة
Thyroid storm. Fever, marked tachycardia, agitation or delirium, gastrointestinal symptoms, and heart failure in thyrotoxicosis suggest storm.

2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis · reviewed 2026-08-26
البطاقة ٣٨٩
السؤال
Which history or examination finding most strongly supports chronic kidney disease?
الإجابة
CKD may be silent; edema, pruritus, anemia, hypertension, or abnormal urine testing often appears later.

2024 CKD Evaluation and Management Guideline · reviewed 2026-08-26
البطاقة ٣٩٠
السؤال
Identify the condition from this pattern: Persistent symptoms beyond 10 days, severe fever with purulent drainage, or worsening after initial improvement are patterns that support bacterial disease.
الإجابة
Acute bacterial rhinosinusitis. Persistent symptoms beyond 10 days, severe fever with purulent drainage, or worsening after initial improvement are patterns that support bacterial disease.

Clinical Practice Guideline: Adult Sinusitis Update · reviewed 2026-08-26
البطاقة ٣٩١
السؤال
Which history or examination finding most strongly supports iron-deficiency anemia?
الإجابة
Fatigue, pica, restless legs, koilonychia, or chronic blood loss can accompany microcytic anemia.

British Society of Gastroenterology Guidelines for the Management of Iron Deficiency Anaemia in Adults · reviewed 2026-08-26
البطاقة ٣٩٢
السؤال
How should a clinician respond to a patient’s prejudiced request or discriminatory behavior?
الإجابة
Address the behavior directly, explore its reasons, set limits that protect staff and other patients, and do not accommodate invidious discrimination; urgent care still takes priority.

Discrimination and Disruptive Behavior by Patients · reviewed 2026-08-26
البطاقة ٣٩٣
السؤال
For surgical decision-making, which next action matters most in bacterial brain abscess?
الإجابة
Start IV antibiotics and obtain urgent neurosurgical consultation for aspiration or drainage when indicated.

ESCMID Guideline on Diagnosis and Treatment of Brain Abscess in Children and Adults · reviewed 2026-08-26
البطاقة ٣٩٤
السؤال
How should a clinician confirm or characterize acute pancreatitis?
الإجابة
Diagnosis requires two of three: characteristic pain, lipase or amylase at least three times normal, or compatible imaging.

ACG Clinical Guideline: Management of Acute Pancreatitis · reviewed 2026-08-26
البطاقة ٣٩٥
السؤال
Which next action matters most in pulmonary tuberculosis?
الإجابة
Isolate suspected contagious disease and coordinate promptly with public health.

Tuberculosis Infection Control · reviewed 2026-08-26
البطاقة ٣٩٦
السؤال
How should a clinician confirm or characterize anterior cruciate ligament tear?
الإجابة
MRI confirms associated soft-tissue injury when it will guide management; radiographs assess fracture.

Management of Anterior Cruciate Ligament Injuries: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ٣٩٧
السؤال
For surgical decision-making, which next action matters most in endometriosis?
الإجابة
Offer empiric symptom treatment or surgery based on severity, fertility goals, masses, and response.

Endometriosis · reviewed 2026-08-26
البطاقة ٣٩٨
السؤال
A patient has this pattern: Sudden dyspnea, pleuritic pain, tachycardia, hypoxemia, hemoptysis, or syncope with VTE risk raises suspicion. What is the most likely diagnosis?
الإجابة
Pulmonary embolism. Sudden dyspnea, pleuritic pain, tachycardia, hypoxemia, hemoptysis, or syncope with VTE risk raises suspicion.

ASH VTE Guidelines: Diagnosis of Venous Thromboembolism · reviewed 2026-08-26
البطاقة ٣٩٩
السؤال
Which next action matters most in panic disorder?
الإجابة
During an attack, ensure safety and exclude an emergency; for ongoing disorder, offer cognitive behavioral therapy and/or medication.

Panic Disorder: What You Need to Know · reviewed 2026-08-26
البطاقة ٤٠٠
السؤال
What medication strategy is appropriate for acute coronary syndrome?
الإجابة
Use dual antiplatelet therapy after ACS when indicated, balancing ischemic benefit against bleeding risk.

2025 ACC/AHA Guideline for the Management of Patients With Acute Coronary Syndromes · reviewed 2026-08-26
البطاقة ٤٠١
السؤال
What immediate plan is appropriate for COPD?
الإجابة
For an exacerbation, increase short-acting bronchodilation, use systemic steroids, add antibiotics when indicated, and support ventilation.

2026 GOLD Report and Pocket Guide · reviewed 2026-08-26
البطاقة ٤٠٢
السؤال
In a child or adolescent, which bedside pattern best points to juvenile idiopathic arthritis?
الإجابة
Persistent joint swelling, limited motion, or morning stiffness beginning before age 16, after excluding other causes, suggests JIA.

2026 Juvenile Idiopathic Arthritis Guidelines · reviewed 2026-08-26
البطاقة ٤٠٣
السؤال
What is the priority management step for stable chronic hypertension?
الإجابة
Estimate cardiovascular risk, assess target-organ damage, and set an individualized treatment plan.

2025 High Blood Pressure Guideline · reviewed 2026-08-26
البطاقة ٤٠٤
السؤال
What drug class or regimen fits myasthenia gravis?
الإجابة
Pyridostigmine treats symptoms; corticosteroid or other immunotherapy controls autoimmune activity.

International Consensus Guidance for Management of Myasthenia Gravis: 2020 Update · reviewed 2026-08-26
البطاقة ٤٠٥
السؤال
For surgical decision-making, how should a fit patient with acute calculous cholecystitis be managed initially?
الإجابة
Give fluids and analgesia, prescribe antibiotics when indicated, and arrange early laparoscopic cholecystectomy as soon as possible.

2020 World Society of Emergency Surgery Updated Guidelines for the Diagnosis and Treatment of Acute Calculous Cholecystitis · reviewed 2026-08-26
البطاقة ٤٠٦
السؤال
What drug class or regimen fits Clostridioides difficile infection?
الإجابة
Oral fidaxomicin is preferred for many initial episodes; oral vancomycin remains an accepted alternative.

2021 Focused Update Guidelines on Management of Clostridioides difficile Infection in Adults · reviewed 2026-08-26
البطاقة ٤٠٧
السؤال
How should a clinician confirm or characterize primary hyperparathyroidism?
الإجابة
Confirm elevated albumin-corrected or ionized calcium with an inappropriately high PTH; assess kidneys and bone.

Evaluation and Management of Primary Hyperparathyroidism: Fifth International Workshop Guidelines · reviewed 2026-08-26
البطاقة ٤٠٨
السؤال
Which medication prevents seizures in preeclampsia with severe features?
الإجابة
Use magnesium sulfate for seizure prophylaxis while controlling severe hypertension and planning delivery according to maternal and fetal status.

Gestational Hypertension and Preeclampsia · reviewed 2026-08-26
البطاقة ٤٠٩
السؤال
What is shared decision-making?
الإجابة
The clinician presents reasonable options and evidence, elicits the patient’s goals and tradeoffs, and reaches a choice together when more than one path is reasonable.

The SHARE Approach · reviewed 2026-08-26
البطاقة ٤١٠
السؤال
In a child aged 6 years or older or an adolescent, what drug class or regimen fits attention-deficit/hyperactivity disorder?
الإجابة
Extended-release stimulants are first-line medication for most children and adolescents when combined with nonpharmacologic care and monitored for benefit and adverse effects.

ADHD in Children and Youth: Part 2—Treatment · reviewed 2026-08-26
البطاقة ٤١١
السؤال
What is the priority management step for iron-deficiency anemia?
الإجابة
Identify and control bleeding, then replace iron; investigate occult gastrointestinal loss when appropriate.

British Society of Gastroenterology Guidelines for the Management of Iron Deficiency Anaemia in Adults · reviewed 2026-08-26
البطاقة ٤١٢
السؤال
Which pharmacologic approach is preferred for acute angle-closure glaucoma?
الإجابة
Use pressure-lowering topical agents plus systemic acetazolamide when appropriate; pilocarpine is added after pressure begins to fall.

Management of Angle-Closure Glaucoma · reviewed 2026-08-26
البطاقة ٤١٣
السؤال
Which diagnosis best fits this presentation: A painful unilateral grouped-vesicle eruption in a dermatomal distribution is characteristic.
الإجابة
Herpes zoster. A painful unilateral grouped-vesicle eruption in a dermatomal distribution is characteristic.

Clinical Overview of Shingles (Herpes Zoster) · reviewed 2026-08-26
البطاقة ٤١٤
السؤال
In a child or adolescent, which pharmacologic approach is preferred for nephritic syndrome?
الإجابة
Immunosuppression is disease-specific and should follow a supported diagnosis rather than empiric routine use.

KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases with 2024 Chapter Updates · reviewed 2026-08-26
البطاقة ٤١٥
السؤال
What counseling point helps reduce harm from symptomatic aortic stenosis?
الإجابة
Teach patients to report exertional dyspnea, angina, presyncope, or syncope promptly; new symptoms require timely reassessment, and severe symptomatic AS warrants valve-team evaluation rather than surveillance alone.

2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease · reviewed 2026-08-26
البطاقة ٤١٦
السؤال
For surgical decision-making, which diagnosis best fits this presentation: Abrupt severe unilateral scrotal pain, a high-riding transverse testis, nausea, and an absent cremasteric reflex are concerning.
الإجابة
Testicular torsion. Sudden severe unilateral pain with nausea or vomiting, a high-riding transverse testis, and loss of the cremasteric reflex is the classic pattern.

Testicular Torsion · reviewed 2026-08-26
البطاقة ٤١٧
السؤال
A clinician is considering idiopathic pulmonary fibrosis. Which finding adds the most support?
الإجابة
Progressive exertional dyspnea, dry cough, bibasilar fine crackles, and clubbing in an older adult suggest fibrotic interstitial disease.

Idiopathic Pulmonary Fibrosis: An Update and Progressive Pulmonary Fibrosis in Adults · reviewed 2026-08-26
البطاقة ٤١٨
السؤال
How should medication be used in ulcerative colitis?
الإجابة
Use 5-aminosalicylates for many mild-to-moderate cases; advanced therapy is selected by severity and prior response.

Updated 2025 ACG Guidelines to Manage Adult Ulcerative Colitis Patients · reviewed 2026-08-26
البطاقة ٤١٩
السؤال
For surgical decision-making, how should a clinician initially manage hip fracture?
الإجابة
Provide analgesia, optimize medical issues, and arrange timely operative management for most displaced fractures.

Management of Hip Fractures in Older Adults: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ٤٢٠
السؤال
For surgical decision-making, what condition should be suspected from this finding: Headache, fever, focal deficit, seizure, or signs of raised intracranial pressure after sinus, ear, dental, or bloodstream infection raise suspicion.
الإجابة
Bacterial brain abscess. Headache, fever, focal deficit, seizure, or signs of raised intracranial pressure after sinus, ear, dental, or bloodstream infection raise suspicion.

ESCMID Guideline on Diagnosis and Treatment of Brain Abscess in Children and Adults · reviewed 2026-08-26
البطاقة ٤٢١
السؤال
What clinical clue should raise suspicion for ventricular fibrillation cardiac arrest?
الإجابة
Sudden unresponsiveness with absent normal breathing and no pulse is cardiac arrest; the monitor may show chaotic ventricular activity.

2025 American Heart Association Guidelines for CPR and ECC: Adult Advanced Life Support · reviewed 2026-08-26
البطاقة ٤٢٢
السؤال
What condition should be suspected from this finding: Chronic cough, fever, night sweats, weight loss, hemoptysis, or epidemiologic exposure raises concern.
الإجابة
Pulmonary tuberculosis. Chronic cough, fever, night sweats, weight loss, hemoptysis, or epidemiologic exposure raises concern.

Clinical Overview of Tuberculosis Disease · reviewed 2026-08-26
البطاقة ٤٢٣
السؤال
Which pharmacologic approach is preferred for type 2 diabetes mellitus?
الإجابة
Choose glucose-lowering therapy around comorbid ASCVD, heart failure, CKD, weight goals, hypoglycemia risk, and patient priorities; metformin remains appropriate for many.

Standards of Care in Diabetes—2026 · reviewed 2026-08-26
البطاقة ٤٢٤
السؤال
For surgical decision-making, which diagnosis best fits cyclic pelvic pain, dysmenorrhea, deep dyspareunia, painful defecation, or infertility?
الإجابة
Endometriosis. Cyclic pelvic pain, dysmenorrhea, deep dyspareunia, painful defecation, or infertility suggests endometriosis.

Endometriosis · reviewed 2026-08-26
البطاقة ٤٢٥
السؤال
How should a clinician confirm or characterize sudden sensorineural hearing loss?
الإجابة
Differentiate sensorineural from conductive loss with bedside testing and urgent audiometry.

Clinical Practice Guideline: Sudden Hearing Loss (Update) · reviewed 2026-08-26
البطاقة ٤٢٦
السؤال
Which diagnosis requires recurrent unexpected panic attacks plus persistent worry or maladaptive avoidance for at least one month?
الإجابة
Panic disorder. Recurrent unexpected panic attacks plus persistent worry or maladaptive avoidance for at least a month suggests panic disorder.

Panic Disorder: What You Need to Know · reviewed 2026-08-26
البطاقة ٤٢٧
السؤال
How should uncertainty be communicated?
الإجابة
Name what is known and unknown, explain the leading possibilities and why, state the plan to reduce uncertainty, and give specific follow-up or return precautions.

Why Does Clinical Uncertainty Matter? · reviewed 2026-08-26
البطاقة ٤٢٨
السؤال
Which medication is FDA-approved for moderate-to-severe obstructive sleep apnea in adults with obesity?
الإجابة
Tirzepatide is approved for adults with obesity and moderate-to-severe obstructive sleep apnea, used with a reduced-calorie diet and increased physical activity.

FDA Approves First Medication for Obstructive Sleep Apnea · reviewed 2026-08-26
البطاقة ٤٢٩
السؤال
Which pathophysiologic process drives acute kidney injury?
الإجابة
Abrupt loss of filtration disturbs volume, electrolytes, acid-base balance, and toxin clearance.

KDIGO Clinical Practice Guideline for Acute Kidney Injury · reviewed 2026-08-26
البطاقة ٤٣٠
السؤال
Which pharmacologic approach is preferred for acute deep-vein thrombosis?
الإجابة
A direct oral anticoagulant is preferred for many eligible patients; selection changes with pregnancy, cancer, renal function, and antiphospholipid syndrome.

ASH VTE Guidelines: Treatment of Deep Vein Thrombosis and Pulmonary Embolism · reviewed 2026-08-26
البطاقة ٤٣١
السؤال
A clinician is considering upper gastrointestinal bleeding. Which finding adds the most support?
الإجابة
Hematemesis, coffee-ground emesis, or melena with orthostasis indicates an upper gastrointestinal source until shown otherwise.

ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding · reviewed 2026-08-26
البطاقة ٤٣٢
السؤال
How should medication be used in gout flare?
الإجابة
Use an NSAID, colchicine, or glucocorticoid based on comorbidity and timing; allopurinol is preferred long-term urate lowering for most.

2020 American College of Rheumatology Guideline for the Management of Gout · reviewed 2026-08-26
البطاقة ٤٣٣
السؤال
Which diagnosis best fits an irregularly irregular pulse with palpitations, fatigue, or dyspnea?
الإجابة
Atrial fibrillation. An irregularly irregular pulse with palpitations, fatigue, or dyspnea suggests atrial fibrillation.

2023 ACC/AHA/ACCP/HRS Guideline for Atrial Fibrillation: Key Perspectives · reviewed 2026-08-26
البطاقة ٤٣٤
السؤال
Which treatment should not be offered solely to treat multiple sclerosis?
الإجابة
Do not offer vitamin D solely to treat multiple sclerosis.

Multiple Sclerosis in Adults: Management · reviewed 2026-08-26
البطاقة ٤٣٥
السؤال
Which pathophysiologic process drives plaque psoriasis?
الإجابة
IL-23 and Th17 pathway activation drives accelerated keratinocyte turnover.

Psoriasis Clinical Guidelines · reviewed 2026-08-26
البطاقة ٤٣٦
السؤال
How can a clinician reduce avoidable harm related to HIV infection?
الإجابة
PrEP, condoms, sterile injection equipment, perinatal treatment, and sustained viral suppression prevent transmission.

Preventing HIV · reviewed 2026-08-26
البطاقة ٤٣٧
السؤال
Which pathophysiologic process drives acute pyelonephritis?
الإجابة
Ascending infection reaches the renal pelvis and parenchyma, producing systemic illness.

EAU Guidelines on Urological Infections · reviewed 2026-08-26
البطاقة ٤٣٨
السؤال
How can a clinician reduce avoidable harm related to postpartum hemorrhage?
الإجابة
Antenatal anemia treatment, active management of the third stage, and hemorrhage protocols reduce morbidity.

Postpartum Hemorrhage · reviewed 2026-08-26
البطاقة ٤٣٩
السؤال
What is the key first diagnostic step for tension pneumothorax?
الإجابة
Diagnosis is clinical in an unstable patient; bedside ultrasound can support it but imaging must not delay decompression.

Thoracic Trauma WSES-AAST Guidelines · reviewed 2026-08-26
البطاقة ٤٤٠
السؤال
How can a clinician reduce avoidable harm related to delirium?
الإجابة
Orientation, mobility, sleep protection, hearing and vision aids, hydration, and medication review reduce hospital delirium.

Delirium: Prevention, Diagnosis and Management · reviewed 2026-08-26
البطاقة ٤٤١
السؤال
What core mechanism explains infective endocarditis?
الإجابة
Microbial adherence to damaged endocardium or prosthetic material produces infected vegetations.

2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease · reviewed 2026-08-26
البطاقة ٤٤٢
السؤال
For surgical decision-making, which next action matters most in primary hyperparathyroidism?
الإجابة
Refer for parathyroidectomy when symptomatic or when guideline thresholds for calcium, kidney, bone, or age are met.

Evaluation and Management of Primary Hyperparathyroidism: Fifth International Workshop Guidelines · reviewed 2026-08-26
البطاقة ٤٤٣
السؤال
What makes a useful return precaution?
الإجابة
It names concrete symptoms or changes, states how urgently to act, and tells the patient where to seek help.

IDEAL Discharge Planning Overview, Process, and Checklist · reviewed 2026-08-26
البطاقة ٤٤٤
السؤال
Which next action matters most in sudden sensorineural hearing loss?
الإجابة
Arrange urgent otolaryngology evaluation and assess for retrocochlear pathology.

Clinical Practice Guideline: Sudden Hearing Loss (Update) · reviewed 2026-08-26
البطاقة ٤٤٥
السؤال
A patient has this pattern: Severe persistent epigastric pain radiating to the back with nausea and vomiting is typical. What is the most likely diagnosis?
الإجابة
Acute pancreatitis. Severe persistent epigastric pain radiating to the back with nausea and vomiting is typical.

ACG Clinical Guideline: Management of Acute Pancreatitis · reviewed 2026-08-26
البطاقة ٤٤٦
السؤال
For surgical decision-making, a noncontact pivot causes an audible pop, immediate swelling, instability, and a positive Lachman test. What is the most likely diagnosis?
الإجابة
Anterior cruciate ligament tear. A noncontact pivot, audible pop, immediate swelling, and instability with a positive Lachman test suggest an ACL tear.

Management of Anterior Cruciate Ligament Injuries: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ٤٤٧
السؤال
Which bedside pattern best points to acute ischemic stroke?
الإجابة
Sudden focal weakness, facial droop, speech change, gaze deviation, neglect, or ataxia is stroke until proved otherwise.

2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke · reviewed 2026-08-26
البطاقة ٤٤٨
السؤال
Which electrolyte disorder may cause weakness, paresthesias, bradycardia, or ECG changes but can be dangerous even without symptoms?
الإجابة
Hyperkalemia. Weakness, paresthesias, bradycardia, or ECG changes can occur, but dangerous hyperkalemia may be asymptomatic.

Clinical Practice Guideline: Treatment of Acute Hyperkalaemia in Adults · reviewed 2026-08-26
البطاقة ٤٤٩
السؤال
Which bedside pattern best points to community-acquired pneumonia?
الإجابة
New cough, fever, dyspnea, pleuritic pain, and focal crackles suggest pneumonia, but clinical findings alone are imperfect.

Diagnosis and Treatment of Adults with Community-acquired Pneumonia · reviewed 2026-08-26
البطاقة ٤٥٠
السؤال
Which pharmacologic approach is preferred for heart failure with reduced ejection fraction?
الإجابة
Foundational chronic therapy includes an ARNI or ACE inhibitor/ARB, an evidence-based beta-blocker, an MRA, and an SGLT2 inhibitor when tolerated.

2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure · reviewed 2026-08-26
البطاقة ٤٥١
السؤال
For surgical decision-making, severe dyspnea, unilateral absent breath sounds, hypotension, distended neck veins, and obstructive shock indicate which diagnosis?
الإجابة
Tension pneumothorax. Severe dyspnea, unilateral absent breath sounds, hypotension, distended neck veins, and obstructive shock suggest tension physiology.

Thoracic Trauma WSES-AAST Guidelines · reviewed 2026-08-26
البطاقة ٤٥٢
السؤال
Which bedside pattern best points to ectopic pregnancy?
الإجابة
Unilateral pelvic pain or bleeding in early pregnancy, especially with syncope or shoulder pain, raises concern for ectopic implantation.

Ectopic Pregnancy · reviewed 2026-08-26
البطاقة ٤٥٣
السؤال
In a child with sickle cell disease, sudden severe limb or back pain matches prior vaso-occlusive episodes and no alternative cause is found. Which diagnosis best fits?
الإجابة
Acute sickle cell vaso-occlusive pain episode.

ASH 2020 Guidelines for Sickle Cell Disease: Management of Acute and Chronic Pain · reviewed 2026-08-26
البطاقة ٤٥٤
السؤال
In a child or adolescent, which bedside pattern best points to major depressive disorder?
الإجابة
At least two weeks of depressed mood or loss of interest with functional change and associated neurovegetative or cognitive symptoms suggests major depression.

Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Major and Persistent Depressive Disorders · reviewed 2026-08-26
البطاقة ٤٥٥
السؤال
Which prevention or risk-reduction step is important for cirrhosis with ascites?
الإجابة
Use sodium restriction, review medicines that can worsen kidney perfusion, and monitor weight, kidney function, and electrolytes.

Diagnosis, Evaluation, and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome · reviewed 2026-08-26
البطاقة ٤٥٦
السؤال
What clinical clue should raise suspicion for type 2 diabetes mellitus?
الإجابة
Polyuria, polydipsia, blurred vision, recurrent infections, or an asymptomatic high-risk patient may reveal hyperglycemia.

Standards of Care in Diabetes—2026 · reviewed 2026-08-26
البطاقة ٤٥٧
السؤال
In a postmenopausal woman or man aged 50 or older, which steps support bone health and reduce fracture risk?
الإجابة
Adequate calcium and vitamin D, weight-bearing and muscle-strengthening exercise, fall-risk reduction, tobacco cessation, and avoiding excess alcohol support bone health.

The clinician’s guide to prevention and treatment of osteoporosis · reviewed 2026-08-26
البطاقة ٤٥٨
السؤال
What clinical clue should raise suspicion for acute angle-closure glaucoma?
الإجابة
Sudden painful red eye, blurred vision with halos, headache, nausea, a fixed mid-dilated pupil, and a firm globe are classic.

Management of Angle-Closure Glaucoma · reviewed 2026-08-26
البطاقة ٤٥٩
السؤال
How should a clinician respond to an incidental finding outside the visit’s main problem?
الإجابة
Explain the finding and its uncertainty, recommend proportionate follow-up, assign ownership, and document the plan.

Catching Those Who Fall Through the Cracks: Follow-up for Incidental Radiologic Findings · reviewed 2026-08-26
البطاقة ٤٦٠
السؤال
Which next action matters most in ventricular fibrillation cardiac arrest?
الإجابة
Start high-quality CPR and defibrillate ventricular fibrillation or pulseless ventricular tachycardia as soon as possible.

2025 American Heart Association Guidelines for CPR and ECC: Adult Advanced Life Support · reviewed 2026-08-26
البطاقة ٤٦١
السؤال
Which test or testing sequence best evaluates suspected plaque psoriasis?
الإجابة
Diagnosis is usually clinical; biopsy is reserved for uncertain morphology.

Psoriasis Clinical Guidelines · reviewed 2026-08-26
البطاقة ٤٦٢
السؤال
What is the priority management step for pulmonary embolism?
الإجابة
Start anticoagulation for confirmed pulmonary embolism; consider thrombolysis for selected patients with hemodynamic compromise and acceptable bleeding risk.

ASH VTE Guidelines: Treatment of Deep Vein Thrombosis and Pulmonary Embolism · reviewed 2026-08-26
البطاقة ٤٦٣
السؤال
What diagnostic approach is most appropriate when uncomplicated cystitis is suspected?
الإجابة
Urinalysis supports the diagnosis; culture is important for complicated, recurrent, resistant, pregnant, or atypical cases.

EAU Guidelines on Urological Infections · reviewed 2026-08-26
البطاقة ٤٦٤
السؤال
How should a clinician initially manage migraine with aura?
الإجابة
Treat early with an effective acute medicine and choose prevention when frequency or disability justifies it.

AHS Consensus Statement: Integrating New Migraine Treatments into Clinical Practice · reviewed 2026-08-26
البطاقة ٤٦٥
السؤال
Why does thrombotic thrombocytopenic purpura produce its defining clinical pattern?
الإجابة
Severe ADAMTS13 deficiency permits ultra-large von Willebrand factor multimers to form platelet-rich microthrombi.

ISTH Guidelines for the Diagnosis and Treatment of Thrombotic Thrombocytopenic Purpura · reviewed 2026-08-26
البطاقة ٤٦٦
السؤال
How should a clinician initially manage early syphilis?
الإجابة
Treat the patient and ensure partner evaluation; urgent specialist evaluation is needed for ocular, otic, or neurologic disease.

Primary and Secondary Syphilis: STI Treatment Guidelines · reviewed 2026-08-26
البطاقة ٤٦٧
السؤال
What diagnostic approach is most appropriate when atrial fibrillation is suspected?
الإجابة
Confirm the rhythm with a 12-lead ECG and assess for structural disease and reversible triggers.

2023 ACC/AHA/ACCP/HRS Guideline for Atrial Fibrillation: Key Perspectives · reviewed 2026-08-26
البطاقة ٤٦٨
السؤال
How should a clinician initially manage abnormal uterine bleeding from anovulation?
الإجابة
Stabilize acute heavy bleeding first, then protect the endometrium and control ongoing blood loss.

Management of Acute Abnormal Uterine Bleeding in Nonpregnant Reproductive-Aged Women · reviewed 2026-08-26
البطاقة ٤٦٩
السؤال
Why does acute cholecystitis produce its defining clinical pattern?
الإجابة
A gallstone can block bile flow, causing gallbladder pain and swelling (inflammation).

Cholecystectomy · reviewed 2026-08-26
البطاقة ٤٧٠
السؤال
How should a clinician initially manage post-traumatic stress disorder?
الإجابة
Offer individual trauma-focused psychotherapy as first-line treatment when available and acceptable.

Management of Posttraumatic Stress Disorder and Acute Stress Disorder · reviewed 2026-08-26
البطاقة ٤٧١
السؤال
In a child or adolescent, a clinician is considering septic arthritis. Which finding adds the most support?
الإجابة
Acute severe monoarticular pain, restricted passive motion, fever, or bacteremia risk is septic arthritis until excluded.

Guideline for Management of Septic Arthritis in Native Joints · reviewed 2026-08-26
البطاقة ٤٧٢
السؤال
Which next action matters most in acute kidney injury?
الإجابة
Treat the cause, restore perfusion without overload, stop nephrotoxins, and relieve obstruction.

KDIGO Clinical Practice Guideline for Acute Kidney Injury · reviewed 2026-08-26
البطاقة ٤٧٣
السؤال
For an eligible infant or selected high-risk child aged 8–19 months, which immunization strategy reduces severe RSV disease?
الإجابة
Use either maternal RSV vaccination or a recommended long-acting RSV antibody to protect infants; give nirsevimab to eligible high-risk children aged 8–19 months entering a second RSV season.

RSV Immunization Guidance for Infants and Young Children · reviewed 2026-08-26
البطاقة ٤٧٤
السؤال
Which diagnosis causes weight loss, fatigue, hypotension, salt craving, hyperpigmentation, hyponatremia, and hyperkalemia?
الإجابة
Primary adrenal insufficiency. Weight loss, fatigue, hypotension, salt craving, hyperpigmentation, hyponatremia, and hyperkalemia suggest primary adrenal failure.

Primary Adrenal Insufficiency Guideline Resources · reviewed 2026-08-26
البطاقة ٤٧٥
السؤال
What is the ethical approach to a learner performing a procedure?
الإجابة
Tell the patient who will participate, describe supervision, obtain voluntary agreement, and ensure refusal does not compromise care.

Residents and Fellows: Patient Involvement in Self-Education · reviewed 2026-08-26
البطاقة ٤٧٦
السؤال
In a child aged 6 months or older, what condition should be suspected from a bulging tympanic membrane with acute ear pain or new otorrhea?
الإجابة
Acute otitis media. A bulging tympanic membrane with acute ear pain or new otorrhea is more specific than redness alone.

Management of Acute Otitis Media in Children Six Months of Age and Older · reviewed 2026-08-26
البطاقة ٤٧٧
السؤال
Which bedside pattern best points to acute coronary syndrome?
الإجابة
Pressure-like substernal pain with diaphoresis, nausea, or radiation to the arm or jaw is a classic ischemic pattern.

2025 ACC/AHA Guideline for the Management of Patients With Acute Coronary Syndromes · reviewed 2026-08-26
البطاقة ٤٧٨
السؤال
How should medication be used in multiple sclerosis relapse?
الإجابة
High-dose corticosteroids shorten a disabling relapse; they do not alter long-term progression by themselves.

Multiple Sclerosis in Adults: Management · reviewed 2026-08-26
البطاقة ٤٧٩
السؤال
What immediate plan is appropriate for acute pancreatitis?
الإجابة
Use early isotonic fluids guided by response, analgesia, and early oral feeding as tolerated; address the cause.

ACG Clinical Guideline: Management of Acute Pancreatitis · reviewed 2026-08-26
البطاقة ٤٨٠
السؤال
How should medication be used in HIV infection?
الإجابة
Use a recommended combination antiretroviral regimen selected for resistance, interactions, comorbidity, pregnancy potential, and patient preference.

What to Start: Initial Combination Antiretroviral Regimens · reviewed 2026-08-26
البطاقة ٤٨١
السؤال
For surgical decision-making, what immediate plan is appropriate for anterior cruciate ligament tear?
الإجابة
Control swelling, restore motion, begin rehabilitation, and individualize reconstruction by instability and activity goals.

Management of Anterior Cruciate Ligament Injuries: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ٤٨٢
السؤال
How should medication be used in postpartum hemorrhage?
الإجابة
Oxytocin is first-line for uterine atony; add other uterotonics according to contraindications and give tranexamic acid early when indicated.

Postpartum Hemorrhage · reviewed 2026-08-26
البطاقة ٤٨٣
السؤال
In a child or adolescent, which history or examination finding most strongly supports asthma?
الإجابة
Variable wheeze, cough, chest tightness, or dyspnea that changes over time and with triggers suggests asthma.

2026 GINA Strategy Report · reviewed 2026-08-26
البطاقة ٤٨٤
السؤال
How should medication be used in delirium?
الإجابة
Reserve short-term antipsychotic use for severe dangerous agitation after reversible causes and contraindications are addressed.

Delirium: Prevention, Diagnosis and Management · reviewed 2026-08-26
البطاقة ٤٨٥
السؤال
Which preventive measure belongs in care for herpes zoster?
الإجابة
Age-appropriate recombinant zoster vaccination lowers zoster and postherpetic-neuralgia risk.

Clinical Overview of Shingles (Herpes Zoster) · reviewed 2026-08-26
البطاقة ٤٨٦
السؤال
For surgical decision-making, what condition should be suspected from this finding: Abrupt severe chest or back pain, pulse or blood-pressure asymmetry, and a new aortic regurgitation murmur are high-risk clues.
الإجابة
Aortic dissection. Abrupt severe chest or back pain, pulse or blood-pressure asymmetry, and a new aortic regurgitation murmur are high-risk clues.

2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease · reviewed 2026-08-26
البطاقة ٤٨٧
السؤال
Which preventive step is required during surgery for viable testicular torsion?
الإجابة
Perform bilateral orchiopexy, fixing the affected and contralateral testes to reduce future torsion risk.

Testicular Torsion · reviewed 2026-08-26
البطاقة ٤٨٨
السؤال
Which test or testing sequence best evaluates suspected hyponatremia due to SIADH?
الإجابة
Confirm low serum osmolality with inappropriately concentrated urine and urine sodium after excluding thyroid, adrenal, renal, and diuretic causes.

Clinical Practice Guideline on Diagnosis and Treatment of Hyponatraemia · reviewed 2026-08-26
البطاقة ٤٨٩
السؤال
Why does primary hypothyroidism produce its defining clinical pattern?
الإجابة
Low thyroid hormone removes feedback inhibition, so TSH rises in primary gland failure.

Guidelines for the Treatment of Hypothyroidism · reviewed 2026-08-26
البطاقة ٤٩٠
السؤال
Which test or testing sequence best evaluates suspected neutropenic fever?
الإجابة
Obtain blood cultures and targeted cultures or imaging, but do not delay empiric antibiotics.

Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy · reviewed 2026-08-26
البطاقة ٤٩١
السؤال
Why does bacterial conjunctivitis produce its defining clinical pattern?
الإجابة
Bacterial infection of the conjunctiva commonly produces red eye with purulent discharge that mats the eyelids.

Clinical Overview of Pink Eye (Conjunctivitis) · reviewed 2026-08-26
البطاقة ٤٩٢
السؤال
When is a chaperone appropriate for an intimate examination?
الإجابة
Offer a trained chaperone, respect patient preferences when safety permits, explain the examination, obtain consent, and document who was present.

Use of Chaperones · reviewed 2026-08-26
البطاقة ٤٩٣
السؤال
Which diagnosis causes recurrent unilateral pulsating headache with nausea or sensory sensitivity, preceded by gradually spreading reversible visual or sensory symptoms?
الإجابة
Migraine with aura. Recurrent unilateral pulsating headache with nausea or sensory sensitivity, preceded by gradually spreading reversible visual or sensory symptoms, suggests migraine with aura.

ICHD-3: Migraine with Aura · reviewed 2026-08-26
البطاقة ٤٩٤
السؤال
What medication strategy is appropriate for Crohn disease?
الإجابة
Corticosteroids can induce remission but are not maintenance therapy; immunomodulator or biologic selection depends on risk and phenotype.

Updated 2025 ACG Guidelines for Crohn’s Disease · reviewed 2026-08-26
البطاقة ٤٩٥
السؤال
Which diagnosis best fits a painless chancre or a diffuse rash involving the palms and soles with generalized lymphadenopathy?
الإجابة
Early syphilis. A painless chancre or a diffuse rash involving palms and soles with generalized lymphadenopathy suggests syphilis by stage.

Primary and Secondary Syphilis: STI Treatment Guidelines · reviewed 2026-08-26
البطاقة ٤٩٦
السؤال
What medication strategy is appropriate for rheumatoid arthritis?
الإجابة
Methotrexate is a preferred anchor drug for many patients with moderate-to-high activity, with folate and safety monitoring.

2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis · reviewed 2026-08-26
البطاقة ٤٩٧
السؤال
Which diagnosis best fits irregular, unpredictable uterine bleeding at reproductive extremes or with endocrine disruption?
الإجابة
Abnormal uterine bleeding from anovulation. Irregular unpredictable bleeding without cyclic ovulation is common at reproductive extremes or with endocrine disruption.

Abnormal Uterine Bleeding · reviewed 2026-08-26
البطاقة ٤٩٨
السؤال
Which medication class does the 2024 SCCM focused update suggest for an adult with acute respiratory distress syndrome?
الإجابة
Use systemic corticosteroids in selected adults with ARDS; the guideline does not specify one best molecule, dose, or duration.

2024 Focused Update: Corticosteroids in Sepsis, ARDS, and Community-Acquired Pneumonia · reviewed 2026-08-26
البطاقة ٤٩٩
السؤال
Which diagnosis requires intrusion, avoidance, negative mood or cognition, and hyperarousal lasting more than one month after trauma?
الإجابة
Post-traumatic stress disorder. Intrusion, avoidance, negative mood or cognition, and hyperarousal lasting over a month after trauma suggest PTSD.

Management of Posttraumatic Stress Disorder and Acute Stress Disorder · reviewed 2026-08-26
البطاقة ٥٠٠
السؤال
Which preventive measure belongs in care for acute pericarditis?
الإجابة
Restrict strenuous activity until symptoms and inflammatory findings resolve.

2025 Concise Clinical Guidance: Diagnosis and Management of Pericarditis · reviewed 2026-08-26
البطاقة ٥٠١
السؤال
Which diagnosis best fits loud snoring, witnessed apneas, gasping, daytime sleepiness, morning headache, or resistant hypertension?
الإجابة
Obstructive sleep apnea. Loud snoring, witnessed apneas, gasping, daytime sleepiness, morning headache, or resistant hypertension suggests OSA.

Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea · reviewed 2026-08-26
البطاقة ٥٠٢
السؤال
What drug class or regimen fits atrial fibrillation?
الإجابة
Choose anticoagulation from validated thromboembolic-risk assessment; direct oral anticoagulants are preferred for most eligible patients without mechanical valves or moderate-to-severe rheumatic mitral stenosis.

2023 ACC/AHA/ACCP/HRS Guideline for Atrial Fibrillation: Key Perspectives · reviewed 2026-08-26
البطاقة ٥٠٣
السؤال
In a child or adolescent, which history or examination finding most strongly supports acute appendicitis?
الإجابة
Periumbilical pain migrating to the right lower quadrant with anorexia, nausea, fever, and focal tenderness is typical.

Guideline for the Diagnosis and Treatment of Appendicitis · reviewed 2026-08-26
البطاقة ٥٠٤
السؤال
Which diagnosis best fits this presentation: Nocturnal numbness or tingling in the thumb, index, and middle fingers with thenar weakness suggests median-nerve compression.
الإجابة
Carpal tunnel syndrome. Nocturnal numbness or tingling in the thumb, index, and middle fingers with thenar weakness suggests median-nerve compression.

Management of Carpal Tunnel Syndrome: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ٥٠٥
السؤال
In an adult with headaches consistent with migraine with aura and a normal neurologic examination, when is neuroimaging needed?
الإجابة
Routine neuroimaging is unnecessary; consider it when the aura is unusual, prolonged, or persistent or when other atypical or red-flag features are present.

Neuroimaging for Migraine: The American Headache Society Systematic Review and Evidence-Based Guideline · reviewed 2026-08-26
البطاقة ٥٠٦
السؤال
In a child or adolescent, how can a clinician reduce avoidable harm related to diabetic ketoacidosis?
الإجابة
Sick-day planning, continued basal insulin, ketone checks, and early contact for illness reduce recurrence.

Standards of Care in Diabetes—2026 · reviewed 2026-08-26
البطاقة ٥٠٧
السؤال
How should a clinician confirm or characterize early syphilis?
الإجابة
Use a nontreponemal test with a treponemal confirmatory test, or the reverse sequence; evaluate neurologic or ocular symptoms separately.

Primary and Secondary Syphilis: STI Treatment Guidelines · reviewed 2026-08-26
البطاقة ٥٠٨
السؤال
How can a clinician reduce avoidable harm related to retinal detachment?
الإجابة
Assess sudden new floaters, flashes, or a curtain immediately; early treatment can prevent permanent vision loss. Dilated examination can find a small tear or detachment before vision is affected.

Retinal Detachment · reviewed 2026-08-26
البطاقة ٥٠٩
السؤال
How should a clinician confirm or characterize abnormal uterine bleeding from anovulation?
الإجابة
Exclude pregnancy, assess anemia, review medicines and systemic causes, and sample endometrium when age or risk warrants.

Management of Acute Abnormal Uterine Bleeding in Nonpregnant Reproductive-Aged Women · reviewed 2026-08-26
البطاقة ٥١٠
السؤال
How should social media be handled when a clinical story seems de-identified?
الإجابة
Do not post patient material without proper authorization; combinations of details can identify a person even when names are removed.

Professionalism in the Use of Social Media · reviewed 2026-08-26
البطاقة ٥١١
السؤال
How should a clinician confirm or characterize post-traumatic stress disorder?
الإجابة
Use a trauma-informed clinical assessment and a validated symptom measure while checking safety and comorbidity.

Management of Posttraumatic Stress Disorder and Acute Stress Disorder · reviewed 2026-08-26
البطاقة ٥١٢
السؤال
Which preventive measure belongs in care for nephrotic syndrome?
الإجابة
Vaccination, thrombosis-risk assessment, infection prevention, and cardiovascular-risk control reduce complications.

KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases with 2024 Chapter Updates · reviewed 2026-08-26
البطاقة ٥١٣
السؤال
In a child or adolescent, what medication strategy is appropriate for atopic dermatitis?
الإجابة
Topical corticosteroids are first-line for most flares; steroid-sparing topical agents help at sensitive sites or with maintenance.

Atopic Dermatitis Clinical Guidelines · reviewed 2026-08-26
البطاقة ٥١٤
السؤال
Which preventive measure belongs in care for thrombotic thrombocytopenic purpura?
الإجابة
Recognize relapse symptoms early and maintain specialist follow-up after recovery.

ISTH Guidelines for the Diagnosis and Treatment of Thrombotic Thrombocytopenic Purpura · reviewed 2026-08-26
البطاقة ٥١٥
السؤال
How should a clinician initially manage acute coronary syndrome?
الإجابة
Give aspirin promptly when acute coronary syndrome is suspected and no contraindication exists; activate reperfusion pathways for STEMI.

2025 ACC/AHA Guideline for the Management of Patients With Acute Coronary Syndromes · reviewed 2026-08-26
البطاقة ٥١٦
السؤال
Which history or examination finding most strongly supports acute pyelonephritis?
الإجابة
Fever, flank pain, costovertebral-angle tenderness, nausea, and urinary symptoms suggest renal infection.

EAU Guidelines on Urological Infections · reviewed 2026-08-26
البطاقة ٥١٧
السؤال
For surgical decision-making, which next action matters most in tension pneumothorax?
الإجابة
Perform immediate decompression followed by tube thoracostomy.

Thoracic Trauma WSES-AAST Guidelines · reviewed 2026-08-26
البطاقة ٥١٨
السؤال
Which diagnosis best fits this presentation: Chronic diarrhea, bloating, weight loss, iron deficiency, dermatitis herpetiformis, or unexplained osteoporosis can be the clue.
الإجابة
Celiac disease. Chronic diarrhea, bloating, weight loss, iron deficiency, dermatitis herpetiformis, or unexplained osteoporosis can be the clue.

ACG Clinical Guidelines: Diagnosis and Management of Celiac Disease · reviewed 2026-08-26
البطاقة ٥١٩
السؤال
What physiologic disturbance underlies anterior cruciate ligament tear?
الإجابة
An ACL tear removes a primary restraint to anterior tibial translation and rotation, producing anterior and rotational instability.

The Management of Anterior Cruciate Ligament Injuries · reviewed 2026-08-26
البطاقة ٥٢٠
السؤال
A clinician is considering heart failure with reduced ejection fraction. Which finding adds the most support?
الإجابة
Exertional dyspnea, orthopnea, edema, elevated jugular venous pressure, and an S3 support volume-overloaded heart failure.

2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure · reviewed 2026-08-26
البطاقة ٥٢١
السؤال
What physiologic disturbance underlies bacterial brain abscess?
الإجابة
Localized infection produces cerebritis and a capsule with surrounding edema and mass effect.

ESCMID Guideline on Diagnosis and Treatment of Brain Abscess in Children and Adults · reviewed 2026-08-26
البطاقة ٥٢٢
السؤال
What is the key first diagnostic step for Cushing syndrome?
الإجابة
Use an accepted first-line screen such as late-night salivary cortisol, 24-hour urinary free cortisol, or overnight dexamethasone suppression.

Diagnosis of Cushing Syndrome: An Endocrine Society Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ٥٢٣
السؤال
What physiologic disturbance underlies pulmonary tuberculosis?
الإجابة
Mycobacteria survive in macrophages and drive granulomatous inflammation with latent or active disease.

Clinical Overview of Tuberculosis Disease · reviewed 2026-08-26
البطاقة ٥٢٤
السؤال
Which antibiotic is required for gonococcal conjunctivitis in an adult?
الإجابة
Give systemic ceftriaxone; consider one-time saline lavage and evaluate for chlamydial coinfection when it has not been excluded.

Gonococcal Infections Among Adolescents and Adults · reviewed 2026-08-26
البطاقة ٥٢٥
السؤال
What physiologic disturbance underlies endometriosis?
الإجابة
Estrogen-responsive ectopic endometrial-like tissue drives inflammation, fibrosis, and pain.

Endometriosis · reviewed 2026-08-26
البطاقة ٥٢٦
السؤال
What should a clinician do after sending protected information to the wrong recipient?
الإجابة
Act immediately to limit further disclosure, notify the organization’s privacy or security process, document facts, and follow breach assessment requirements.

Breach Notification Rule · reviewed 2026-08-26
البطاقة ٥٢٧
السؤال
Which clinical pattern defines a panic attack?
الإجابة
An abrupt surge of intense fear or discomfort with physical and cognitive symptoms that peaks within minutes defines a panic attack.

Panic Disorder: What You Need to Know · reviewed 2026-08-26
البطاقة ٥٢٨
السؤال
What clinical clue should raise suspicion for acute kidney injury?
الإجابة
A rising creatinine or falling urine output after illness, volume loss, nephrotoxin exposure, obstruction, or sepsis indicates AKI.

KDIGO Clinical Practice Guideline for Acute Kidney Injury · reviewed 2026-08-26
البطاقة ٥٢٩
السؤال
What physiologic disturbance underlies tension pneumothorax?
الإجابة
A one-way pleural air leak raises intrathoracic pressure, collapses the lung, and impairs venous return.

Thoracic Trauma WSES-AAST Guidelines · reviewed 2026-08-26
البطاقة ٥٣٠
السؤال
In a child or adolescent, what clinical clue should raise suspicion for immune thrombocytopenia?
الإجابة
Isolated petechiae, bruising, or mucosal bleeding with thrombocytopenia and otherwise preserved cell lines suggests ITP.

American Society of Hematology 2019 Guidelines for Immune Thrombocytopenia · reviewed 2026-08-26
البطاقة ٥٣١
السؤال
What is the key first diagnostic step for celiac disease?
الإجابة
Order tissue-transglutaminase IgA with total IgA while the patient is eating gluten; confirm as guideline-directed.

ACG Clinical Guidelines: Diagnosis and Management of Celiac Disease · reviewed 2026-08-26
البطاقة ٥٣٢
السؤال
A patient has this pattern: Fever plus a new or changing murmur, embolic findings, injection-drug use, or prosthetic material raises suspicion. What is the most likely diagnosis?
الإجابة
Infective endocarditis. Fever plus a new or changing murmur, embolic findings, injection-drug use, or prosthetic material raises suspicion.

2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease · reviewed 2026-08-26
البطاقة ٥٣٣
السؤال
What is the key first diagnostic step for carpal tunnel syndrome?
الإجابة
Diagnosis is often clinical; electrodiagnostic testing helps when severe, atypical, or before selected surgery.

Management of Carpal Tunnel Syndrome: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ٥٣٤
السؤال
Which prevention step is essential before oral intake in acute ischemic stroke?
الإجابة
Screen swallowing before food, fluids, or oral medication to reduce aspiration risk.

2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke · reviewed 2026-08-26
البطاقة ٥٣٥
السؤال
What is the priority management step for cellulitis?
الإجابة
Mark the margin, assess for abscess or necrotizing infection, and escalate care for systemic toxicity.

Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections · reviewed 2026-08-26
البطاقة ٥٣٦
السؤال
Which prevention or risk-reduction step is important for community-acquired pneumonia?
الإجابة
Keep age- and risk-appropriate pneumococcal vaccination current to reduce preventable pneumococcal pneumonia.

Pneumococcal Vaccine Recommendations · reviewed 2026-08-26
البطاقة ٥٣٧
السؤال
For surgical decision-making, what is the priority management step for benign prostatic hyperplasia?
الإجابة
Urgently catheterize acute urinary retention and evaluate infection, kidney injury, or severe hematuria.

EAU Guidelines on the Management of Non-neurogenic Male Lower Urinary Tract Symptoms · reviewed 2026-08-26
البطاقة ٥٣٨
السؤال
Which prevention or risk-reduction step is important for ectopic pregnancy?
الإجابة
Early testing after a missed period and prompt evaluation of pain or bleeding reduce rupture morbidity.

Ectopic Pregnancy · reviewed 2026-08-26
البطاقة ٥٣٩
السؤال
What diagnostic approach is most appropriate when obstructive sleep apnea is suspected?
الإجابة
Confirm with polysomnography or an appropriate home sleep-apnea test in selected uncomplicated adults.

Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea · reviewed 2026-08-26
البطاقة ٥٤٠
السؤال
In a child or adolescent, which prevention or risk-reduction step is important for major depressive disorder?
الإجابة
Monitor symptoms, suicidality, functioning, treatment adherence, and recurrence with a clear follow-up and safety plan.

Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Major and Persistent Depressive Disorders · reviewed 2026-08-26
البطاقة ٥٤١
السؤال
Which pathophysiologic process drives symptomatic aortic stenosis?
الإجابة
Calcific leaflet narrowing creates a fixed left-ventricular outflow obstruction and pressure overload.

2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease · reviewed 2026-08-26
البطاقة ٥٤٢
السؤال
In a child or adolescent, what drug class or regimen fits diabetic ketoacidosis?
الإجابة
Use continuous IV regular insulin; add dextrose as glucose falls so ketone clearance can continue.

Standards of Care in Diabetes—2026 · reviewed 2026-08-26
البطاقة ٥٤٣
السؤال
What is the key first diagnostic step for peritonsillar abscess?
الإجابة
Diagnosis is usually clinical; ultrasound or CT helps when the diagnosis or deep-space extension is uncertain.

Tonsillitis and Peritonsillar Abscess · reviewed 2026-08-26
البطاقة ٥٤٤
السؤال
What does continuity require before ending a clinician-patient relationship?
الإجابة
Give reasonable notice, provide urgent coverage during the transition, offer transfer resources, and make records available as permitted.

Terminating a Patient-Physician Relationship · reviewed 2026-08-26
البطاقة ٥٤٥
السؤال
What counseling point helps reduce harm from chronic hepatitis C?
الإجابة
Avoid blood exposure, do not share injection equipment, and screen all adults and each pregnancy as recommended.

Viral Hepatitis Clinical Care · reviewed 2026-08-26
البطاقة ٥٤٦
السؤال
What drug class or regimen fits hyperkalemia?
الإجابة
IV calcium protects the heart; insulin with glucose shifts potassium, while diuresis, binders, or dialysis remove it.

Clinical Practice Guideline: Treatment of Acute Hyperkalaemia in Adults · reviewed 2026-08-26
البطاقة ٥٤٧
السؤال
In a child or adolescent, what counseling point helps reduce harm from juvenile idiopathic arthritis?
الإجابة
Vaccination, eye screening, activity, and growth monitoring reduce preventable morbidity.

2026 Juvenile Idiopathic Arthritis Guidelines · reviewed 2026-08-26
البطاقة ٥٤٨
السؤال
In a child or adolescent, which next action matters most in immune thrombocytopenia?
الإجابة
Treat clinically important bleeding urgently; observation is appropriate for selected patients with minor symptoms.

American Society of Hematology 2019 Guidelines for Immune Thrombocytopenia · reviewed 2026-08-26
البطاقة ٥٤٩
السؤال
A clinician is considering subarachnoid hemorrhage. Which finding adds the most support?
الإجابة
A sudden maximal-at-onset thunderclap headache, neck stiffness, vomiting, or brief loss of consciousness is concerning.

2023 Guideline for Aneurysmal Subarachnoid Hemorrhage · reviewed 2026-08-26
البطاقة ٥٥٠
السؤال
Which test or testing sequence best evaluates suspected aortic dissection?
الإجابة
CT angiography is the usual rapid definitive study in a stable patient; transesophageal echocardiography is useful when unstable.

2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease · reviewed 2026-08-26
البطاقة ٥٥١
السؤال
In a child, typically 6 months to 3 years, what counseling point helps reduce harm from croup?
الإجابة
Caregivers should seek urgent assessment for stridor at rest, marked chest retractions, cyanosis, lethargy, or poor air entry.

Acute Management of Croup in the Emergency Department · reviewed 2026-08-26
البطاقة ٥٥٢
السؤال
In a child or adolescent, a clinician is considering bacterial meningitis. Which finding adds the most support?
الإجابة
Fever, headache, neck stiffness, altered mental status, or a nonblanching rash should trigger urgent evaluation.

WHO Guidelines on Meningitis Diagnosis, Treatment and Care · reviewed 2026-08-26
البطاقة ٥٥٣
السؤال
A clinician is considering preeclampsia with severe features. Which finding adds the most support?
الإجابة
New hypertension after 20 weeks with end-organ findings such as severe pressure, thrombocytopenia, liver injury, kidney injury, pulmonary edema, or neurologic symptoms suggests severe disease.

Gestational Hypertension and Preeclampsia · reviewed 2026-08-26
البطاقة ٥٥٤
السؤال
A clinician is considering bipolar I mania. Which finding adds the most support?
الإجابة
At least one week of elevated or irritable mood with increased energy, decreased sleep, pressured speech, grandiosity, and risky behavior suggests mania.

Management of Bipolar Disorder in Adults · reviewed 2026-08-26
البطاقة ٥٥٥
السؤال
What is the priority management step for celiac disease?
الإجابة
Do not start a gluten-free diet before completing diagnostic testing unless immediate clinical needs demand it.

ACG Clinical Guidelines: Diagnosis and Management of Celiac Disease · reviewed 2026-08-26
البطاقة ٥٥٦
السؤال
Which history or examination finding most strongly supports acute compartment syndrome?
الإجابة
Pain out of proportion, pain with passive stretch, tense swelling, and progressive neurologic deficits after injury are warning signs.

Management of Acute Compartment Syndrome: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ٥٥٧
السؤال
For surgical decision-making, how should a clinician initially manage Cushing syndrome?
الإجابة
Confirm hypercortisolism, identify whether it is ACTH dependent, and localize the source before definitive treatment.

Treatment of Cushing Syndrome: An Endocrine Society Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ٥٥٨
السؤال
Which bedside pattern best points to retinal detachment?
الإجابة
New flashes, floaters, and a curtain or shadow across the visual field suggest detachment.

Retinal Detachment · reviewed 2026-08-26
البطاقة ٥٥٩
السؤال
How should a clinician respond when requested to falsify a work note or record?
الإجابة
Decline, document objective facts accurately, explain what can truthfully be certified, and preserve the integrity of the record.

Management of Medical Records · reviewed 2026-08-26
البطاقة ٥٦٠
السؤال
How can a clinician reduce avoidable harm related to hypertensive emergency?
الإجابة
Accurate home monitoring and sustained treatment adherence reduce progression to crisis.

2025 High Blood Pressure Guideline · reviewed 2026-08-26
البطاقة ٥٦١
السؤال
What clinical clue should raise suspicion for COPD?
الإجابة
Progressive exertional dyspnea, chronic cough or sputum, and exposure to tobacco, biomass, or occupational irritants suggest COPD.

2026 GOLD Report and Pocket Guide · reviewed 2026-08-26
البطاقة ٥٦٢
السؤال
Which pharmacologic approach is preferred for acute pyelonephritis?
الإجابة
Select empiric therapy from local resistance and severity, then narrow to the culture.

EAU Guidelines on Urological Infections · reviewed 2026-08-26
البطاقة ٥٦٣
السؤال
Which history or examination finding most strongly supports plaque psoriasis?
الإجابة
Well-demarcated erythematous plaques with silvery scale on extensor surfaces and nail pitting support psoriasis.

Psoriasis Clinical Guidelines · reviewed 2026-08-26
البطاقة ٥٦٤
السؤال
What immediate plan is appropriate for Parkinson disease?
الإجابة
Start multidisciplinary care and choose symptomatic treatment by functional impact, age, cognition, and adverse-effect risk.

Parkinson’s Disease in Adults · reviewed 2026-08-26
البطاقة ٥٦٥
السؤال
Which diagnosis best fits hypotonic euvolemic hyponatremia with inappropriately concentrated urine after thyroid, adrenal, renal, and diuretic causes are excluded?
الإجابة
Hyponatremia due to SIADH. Nausea, confusion, gait change, seizure, or subtle cognitive symptoms with hypotonic euvolemic hyponatremia may reflect SIADH.

Clinical Practice Guideline on Diagnosis and Treatment of Hyponatraemia · reviewed 2026-08-26
البطاقة ٥٦٦
السؤال
What immediate plan is appropriate for gonococcal urethritis or cervicitis?
الإجابة
Treat promptly, test for other STIs, abstain until treatment criteria are met, and arrange partner services.

Gonococcal Infections Among Adolescents and Adults · reviewed 2026-08-26
البطاقة ٥٦٧
السؤال
How should medication be used in aortic dissection?
الإجابة
Use an IV beta-blocker first to reduce shear stress, then add a vasodilator if pressure remains high.

2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease · reviewed 2026-08-26
البطاقة ٥٦٨
السؤال
What immediate plan is appropriate for menopause vasomotor symptoms?
الإجابة
Match treatment to symptom burden, uterus status, contraindications, and patient preference.

Hormone Therapy for Menopause · reviewed 2026-08-26
البطاقة ٥٦٩
السؤال
Which pharmacologic approach is preferred for cirrhosis with ascites?
الإجابة
Spironolactone with furosemide is a common diuretic combination when renal function and electrolytes allow.

Diagnosis, Evaluation, and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome · reviewed 2026-08-26
البطاقة ٥٧٠
السؤال
What immediate plan is appropriate for alcohol withdrawal?
الإجابة
Stabilize, give thiamine, use symptom- or risk-guided withdrawal treatment, and admit high-risk patients.

The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management · reviewed 2026-08-26
البطاقة ٥٧١
السؤال
In a child or adolescent, what drug class or regimen fits sickle cell vaso-occlusive crisis?
الإجابة
Use rapid individualized analgesia, with nonsteroidal anti-inflammatory drugs for selected mild pain and opioids for severe pain, followed by frequent reassessment.

ASH 2020 Guidelines for Sickle Cell Disease: Management of Acute and Chronic Pain · reviewed 2026-08-26
البطاقة ٥٧٢
السؤال
For surgical decision-making, what is the priority management step for carpal tunnel syndrome?
الإجابة
Use neutral-position night splinting initially; refer for decompression with severe weakness, denervation, or persistent symptoms.

Management of Carpal Tunnel Syndrome: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
البطاقة ٥٧٣
السؤال
In an infant aged 1–23 months, what drug class or regimen fits bronchiolitis?
الإجابة
Routine salbutamol, corticosteroids, and antibiotics are not recommended; use antibiotics only when bacterial infection is evident or strongly suspected.

Bronchiolitis: Recommendations for Diagnosis, Monitoring and Management of Children One to 24 Months · reviewed 2026-08-26
البطاقة ٥٧٤
السؤال
In a child or adolescent, which bedside pattern best points to diabetic ketoacidosis?
الإجابة
Hyperglycemia with dehydration, abdominal pain, vomiting, Kussmaul respirations, or altered mental status suggests ketoacidosis.

Standards of Care in Diabetes—2026 · reviewed 2026-08-26
البطاقة ٥٧٥
السؤال
For surgical decision-making, how should a clinician initially manage peritonsillar abscess?
الإجابة
Assess the airway, drain the abscess, hydrate, and treat infection.

Tonsillitis and Peritonsillar Abscess · reviewed 2026-08-26
البطاقة ٥٧٦
السؤال
Which factors determine a PA’s scope of practice?
الإجابة
A PA’s education and experience, state law, practice-setting policy and credentialing, and the care team’s arrangements together define the services the PA may provide.

PA Scope of Practice · reviewed 2026-08-26
البطاقة ٥٧٧
السؤال
What immediate plan is appropriate for heart failure with reduced ejection fraction?
الإجابة
For acute pulmonary edema, support oxygenation and relieve congestion while identifying the trigger.

2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure · reviewed 2026-08-26
البطاقة ٥٧٨
السؤال
What medication strategy is appropriate for acute ischemic stroke?
الإجابة
Antiplatelet therapy is used after hemorrhage is excluded when thrombolysis timing and stroke mechanism allow.

2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke · reviewed 2026-08-26
البطاقة ٥٧٩
السؤال
What combination of findings should raise suspicion for acute calculous cholecystitis?
الإجابة
Right-upper-quadrant pain or tenderness, fever, leukocytosis, and a positive Murphy sign support the diagnosis when considered together.

2020 World Society of Emergency Surgery Updated Guidelines for the Diagnosis and Treatment of Acute Calculous Cholecystitis · reviewed 2026-08-26
البطاقة ٥٨٠
السؤال
What medication strategy is appropriate for community-acquired pneumonia?
الإجابة
Use guideline-concordant empiric antibiotics based on setting, comorbidity, and local resistance; narrow when microbiology permits.

Diagnosis and Treatment of Adults with Community-acquired Pneumonia · reviewed 2026-08-26
البطاقة ٥٨١
السؤال
Which diagnosis is defined by acute hypoxemic respiratory failure with bilateral opacities not fully explained by cardiac failure after a known insult?
الإجابة
Acute respiratory distress syndrome. Acute hypoxemic respiratory failure with bilateral opacities not fully explained by cardiac failure after a known insult suggests ARDS.

An Update on Management of Adult Patients with Acute Respiratory Distress Syndrome · reviewed 2026-08-26
البطاقة ٥٨٢
السؤال
What medication strategy is appropriate for ectopic pregnancy?
الإجابة
Methotrexate is an option for selected stable unruptured ectopic pregnancy without contraindications.

Ectopic Pregnancy · reviewed 2026-08-26
البطاقة ٥٨٣
السؤال
In a child or adolescent, what medication strategy is appropriate for major depressive disorder?
الإجابة
When medication is indicated for an adolescent, use an evidence-supported SSRI with close monitoring; combine it with psychotherapy according to severity and preference.

Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Major and Persistent Depressive Disorders · reviewed 2026-08-26
البطاقة ٥٨٤
السؤال
In a child or adolescent, identify the condition from this pattern: Chronic pruritic eczematous patches with age-dependent flexural or facial distribution and a relapsing course are typical.
الإجابة
Atopic dermatitis. Chronic pruritic eczematous patches with age-dependent flexural or facial distribution and a relapsing course are typical.

Atopic Dermatitis Clinical Guidelines · reviewed 2026-08-26
البطاقة ٥٨٥
السؤال
Which pharmacologic approach is preferred for a postmenopausal woman with osteoporosis at high fracture risk?
الإجابة
Bisphosphonates are first-line for many postmenopausal women at high fracture risk; consider anabolic therapy for very high risk.

Pharmacological Management of Osteoporosis in Postmenopausal Women · reviewed 2026-08-26
البطاقة ٥٨٦
السؤال
Which history or examination finding most strongly supports atrial fibrillation?
الإجابة
An irregularly irregular pulse with palpitations, fatigue, or dyspnea suggests atrial fibrillation.

2023 ACC/AHA/ACCP/HRS Guideline for Atrial Fibrillation: Key Perspectives · reviewed 2026-08-26
البطاقة ٥٨٧
السؤال
Which diagnosis best fits dysuria and frequency without vaginal symptoms in an otherwise appropriate patient?
الإجابة
Uncomplicated cystitis. Dysuria and frequency without vaginal symptoms strongly support lower urinary infection in an appropriate patient.

EAU Guidelines on Urological Infections · reviewed 2026-08-26
البطاقة ٥٨٨
السؤال
How should a clinician initially manage nephrotic syndrome?
الإجابة
Manage edema and cause, and urgently evaluate thrombosis, infection, or severe volume compromise.

KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases with 2024 Chapter Updates · reviewed 2026-08-26
البطاقة ٥٨٩
السؤال
What condition should be suspected from this finding: A single fever in a patient with severe chemotherapy-related neutropenia is an emergency even when examination is unrevealing.
الإجابة
Neutropenic fever. A single fever in a patient with severe chemotherapy-related neutropenia is an emergency even when examination is unrevealing.

Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy · reviewed 2026-08-26
البطاقة ٥٩٠
السؤال
What is the purpose of root cause analysis after a serious patient-safety event?
الإجابة
Identify active and latent system contributors, then design and track corrective actions that reduce recurrence rather than stopping at individual blame.

Root Cause Analysis · reviewed 2026-08-26
البطاقة ٥٩١
السؤال
For surgical decision-making, a patient has this pattern: Often asymptomatic hypercalcemia, nephrolithiasis, bone loss, constipation, or neurocognitive symptoms can be the clue. What is the most likely diagnosis?
الإجابة
Primary hyperparathyroidism. Often asymptomatic hypercalcemia, nephrolithiasis, bone loss, constipation, or neurocognitive symptoms can be the clue.

Evaluation and Management of Primary Hyperparathyroidism: Fifth International Workshop Guidelines · reviewed 2026-08-26
البطاقة ٥٩٢
السؤال
How should a clinician initially manage obstructive sleep apnea?
الإجابة
Offer positive airway pressure for obstructive sleep apnea with excessive sleepiness and consider it for impaired sleep-related quality of life or comorbid hypertension.

Clinical Practice Guideline for Treatment of Adult Obstructive Sleep Apnea with Positive Airway Pressure · reviewed 2026-08-26
البطاقة ٥٩٣
السؤال
A patient has this pattern: A rapid unilateral hearing decrease, often noticed on waking and sometimes with tinnitus, is an otologic emergency. What is the most likely diagnosis?
الإجابة
Sudden sensorineural hearing loss. A rapid unilateral hearing decrease, often noticed on waking and sometimes with tinnitus, is an otologic emergency.

Clinical Practice Guideline: Sudden Hearing Loss (Update) · reviewed 2026-08-26
البطاقة ٥٩٤
السؤال
Which diagnosis requires bradykinesia plus rest tremor or rigidity and often includes reduced arm swing or a shuffling gait?
الإجابة
Parkinson disease. Bradykinesia plus rest tremor or rigidity, with reduced arm swing and shuffling gait, supports parkinsonism.

Parkinson’s Disease in Adults · reviewed 2026-08-26
البطاقة ٥٩٥
السؤال
Which diagnosis best fits purulent urethral discharge, dysuria, cervicitis, pelvic pain, or a relevant sexual exposure, although infection may be asymptomatic?
الإجابة
Gonococcal urethritis or cervicitis. Purulent urethral discharge, dysuria, cervicitis, pelvic pain, or exposure may indicate gonorrhea, but infection can be asymptomatic.

Gonococcal Infections Among Adolescents and Adults · reviewed 2026-08-26
البطاقة ٥٩٦
السؤال
Which diagnosis best fits hot flashes, night sweats, sleep disruption, and menstrual transition at the expected age?
الإجابة
Menopause vasomotor symptoms. Hot flashes, night sweats, sleep disruption, and menstrual transition at the expected age usually identify menopausal vasomotor symptoms.

The Menopause Years · reviewed 2026-08-26
البطاقة ٥٩٧
السؤال
Which diagnosis causes tremor, autonomic hyperactivity, insomnia, nausea, anxiety, hallucinations, or seizures after reducing heavy alcohol use?
الإجابة
Alcohol withdrawal. Tremor, autonomic hyperactivity, insomnia, nausea, anxiety, hallucinations, or seizures after reducing heavy alcohol use suggests withdrawal.

The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management · reviewed 2026-08-26
البطاقة ٥٩٨
السؤال
Which diagnosis causes bloody diarrhea, urgency, tenesmus, and crampy abdominal pain with continuous colonic inflammation?
الإجابة
Ulcerative colitis. Bloody diarrhea, urgency, tenesmus, and crampy abdominal pain with continuous colonic inflammation suggest ulcerative colitis.

Updated 2025 ACG Guidelines to Manage Adult Ulcerative Colitis Patients · reviewed 2026-08-26
البطاقة ٥٩٩
السؤال
Which diagnosis best fits abrupt severe monoarthritis with erythema, often at the first metatarsophalangeal joint?
الإجابة
Gout flare. Abrupt severe monoarthritis with erythema, often at the first metatarsophalangeal joint, suggests gout.

Gout · reviewed 2026-08-26
البطاقة ٦٠٠
السؤال
For surgical decision-making, which diagnosis best fits this presentation: Exertional dyspnea, angina, or syncope with a harsh crescendo-decrescendo systolic murmur radiating to the carotids is typical.
الإجابة
Symptomatic aortic stenosis. Exertional dyspnea, angina, or syncope with a harsh crescendo-decrescendo systolic murmur radiating to the carotids is typical.

2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease · reviewed 2026-08-26

Illustrated clinical review desk with a stethoscope, ECG trace, lungs, brain, and study cards arranged around a clear central title-safe area.

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