@english.

enarm

Dr. Omar Rodríguez-Mendoza

Masterclass de
Inglés Médico
para el ENARM
 Contenido
Ginecología y
1. Introducción 5.
Obstetricia
2. Gramática
6. Cirugía y Soporte Vital
3. Historia clínica
7. Medicina Interna
4. Pediatría y Genética 8. Conclusiones

@english.enarm
Objetivos
1. Familiarizarse con la terminología médica más utilizada en
inglés.
2. Fortalecer la gramática para comprender y responder
preguntas del ENARM.
3. Dominar el vocabulario especializado aplicado en historia
clínica, laboratorio, y gabinete.
4. Practicar la resolución de casos clínicos en inglés para
mejorar la interpretación y respuesta de preguntas del
examen.

@english.enarm
Importancia del inglés
El porcentaje de preguntas en inglés puede variar, pero suele
estar en torno al 10-15% del total de preguntas.

Esto significa que, de las 280 preguntas, podrías esperar entre

28 y 42 preguntas en inglés.

@english.enarm
@english.enarm
Tener correctas las
preguntas en inglés
hace la diferencia entre
quedar (60%) y no
quedar (50%)

@english.enarm
 Esta clase incluye la primera edición del
Manual de Inglés Médico para el ENARM

@english.enarm
 Enfoque: Habilidades de lectura
HABILIDAD DESCRIPCIÓN

Pronunciation Articulación correcta de sonidos y palabras

Speaking Comunicación verbal efectiva en inglés

Writing Redacción clara y precisa en inglés

Listening Comprensión auditiva en conversaciones en inglés

Comprensión de textos y casos clínicos, así como

Reading
datos pivote de cada uno

@english.enarm
 rammar
G

@english.enarm
 Sujetos en Inglés
Sujeto en
Persona Ejemplos
Inglés

Tercera Persona Singular “It shows abnormal

It
(Neutral o Cosa) results in the test.”

“We discuss the

We Primera Persona Plural
treatment plan together.”

“You administer the

You (plural) Segunda Persona Plural
medication daily.”

“They review the

They Tercera Persona Plural
patient’s history.”
@english.enarm
 Sujetos en Inglés
Sujeto en
Persona Ejemplos
Inglés

Primera Persona “I prescribe medication

I
Singular for the patient.”

Segunda Persona “You monitor the

You
Singular patient’s vital signs.”

Tercera Persona “He diagnoses the

He
Singular (Masculino) patient with diabetes.”

Tercera Persona “She performs the

She
Singular (Femenino) surgery.”
@english.enarm
Tiempos verbales
Verbos irregluares conjugados en 3a persona (paciente).

• Presente Simple:
Usado para hechos generales o situaciones habituales.
Ejemplo: “The patient has a fever.”

• Pasado Simple:
Describe acciones completadas en el pasado.
Ejemplo: “The surgery was successful.”

• Futuro Simple:
Indica acciones que ocurrirán.
Ejemplo: “The patient will undergo treatment.”

@english.enarm
 Tiempos verbales
Pronoun Present simple + Past simple + Future simple -

I I treat patients I treated the patient I will treat the patient

You prescribed You will prescribe

You You prescribe medication
medication medication.

He diagnosed the He will diagnose the

He/She/It He diagnoses conditions
condition. condition.

We performed
We We perform surgeries We will perform surgery.
surgery.

They monitored vital

They They monitor vital signs They will monitor vital signs
signs
 Second Conditional (Would)
Uso: Plantear escenarios hipotéticos o poco probables en el presente o futuro. Es
útil para explorar qué acciones podrían tomarse en situaciones teóricas o bajo
condiciones específicas. Planes de tratamiento o resultados esperados.
Condición: Síntomas del paciente.
Pasado simple.
• If + pasado simple, would + verbo base. Resultado: Tratamiento.
Would + Verb.
Ejemplo:

“If the patient developed severe anemia, would you recommend a blood
transfusion?”

Si el paciente desarrollara anemia severa, ¿le recomendaría una transfusión

sanguinea?

@ENGLISH.ENARM
 Passive Voice in Present Tense
Uso: La voz pasiva en presente se utiliza para poner
énfasis en la acción o el tratamiento recibido, en lugar de
en quién realiza la acción. En medicina, es comúnmente
empleada para describir procedimientos o cuidados que el
paciente recibe, donde el paciente es el receptor de la
acción, no el ejecutor. Un participio pasado en verbos regulares
termina en -ed (similar al pasado simple),
mientras que en verbos irregulares cambia la
Estructura: forma (take -> taken; be -> been).

• Sujeto + verbo “to be” en presente (am/is/are) + verbo

principal en participio pasado + (by + agente opcional).

@english.enarm
 Passive Voice in Present Tense
Ejemplo:

• “The wound is cleaned daily.”

Análisis: Se sabe quién es el que

realiza la acción -> MIP
• Sujeto: “The wound”
• Verbo “to be” en presente: “is”
• Verbo principal en participio pasado: “cleaned”

(Agente opcional): No se especifica quién limpia la herida.

@english.enarm
 Passive Voice in Past Tense
Uso: La voz pasiva en pasado se utiliza para describir
acciones que ya se han completado, con el enfoque en
la acción realizada más que en quién la llevó a cabo.
Es comúnmente empleada en informes médicos o
discusiones sobre los resultados de tratamientos.

Estructura:

• Sujeto + verbo “to be” en pasado (was/were) + verbo

principal en participio pasado + (by + agente opcional).

@english.enarm
 Passive Voice in Past Tense
Ejemplo:

• “The surgery was performed successfully.”

Análisis: was -> pasado

is -> presente
• Sujeto: “The surgery”
• Verbo “to be” en pasado: “was”
• Verbo principal en participio pasado: “performed”
• (Agente opcional): No se especifica quién realizó la cirugía.

@english.enarm
@english.enarm
Inglés Español Ejemplo

What ¿Qué? ¿Cuál? What is the patient’s main symptom?

Wh- Questions Where ¿Dónde? Where is the pain located?

When ¿Cuándo? When did the symptoms begin?

Who ¿Quién? Who is the attending physician?

Why ¿Por qué? Why was this medication prescribed?

Which ¿Cuál? Which treatment is more effective?

How ¿Cómo? How does the patient feel after the surgery?
 What are connectors?
Los conectores (palabras de enlace o conjunciones) son palabras o
frases que se utilizan para unir ideas, oraciones o párrafos. Ayudan a
crear relaciones lógicas entre las diferentes partes de un texto,
haciendo que la escritura sea más clara y coherente.

Tipos
Causa y efecto (Cause and effect)
Contraste (Contrast)
Secuencia (Sequence)
Resultado (Result)
Adición (Addition)
Ejemplificación (Exemplification)

@english.enarm
 • Causa y efecto:
Connectors
because, therefore, thus
Ejemplo: “The patient has diabetes, therefore insulin therapy
is necessary.”

• Contraste:
although, however, but
Ejemplo: “The symptoms improved, however the infection
persisted.”

• Secuencia:
first, next, then
Ejemplo: “First, take the patient’s history, then perform a
physical exam.”

@english.enarm
 Uso de conectores
Conector Función Ejemplo

Because Causa The patient needs insulin because his blood sugar is high.

Therefore Resultado The diagnosis was confirmed, therefore treatment was initiated.

Although the symptoms improved, the patient still needs

Although Contraste
observation.

However Contraste The test was negative, however further investigation is needed.

@english.enarm
 Uso de conectores
Conector Función Ejemplo

In addition Adición The patient is on antibiotics, in addition, he requires rest.

The surgery was successful, moreover, the recovery is

Moreover Adición
progressing well.

The patient has typical symptoms of pneumonia, for example,

For example Ejemplificación
fever and cough.

First, take the patient’s history, then perform the physical

First / then Secuencia
exam.

@english.enarm
 Uso de conectores

Conector Función Ejemplo

The patient responded well to the treatment,

Thus Resultado
thus no further intervention is needed.

Despite the treatment, the infection did not

Despite Contraste
resolve.

@english.enarm
 Estructura de oraciones médicas
• Sujetos comunes:
“The patient,” “The study,” “The treatment”

• Verbos de acción:
exhibits, presents with, demonstrates
Ejemplo: “The patient presents with chest
pain.”

• Complementos:
Ejemplo: “The treatment includes antibiotics
and rest.”

@english.enarm
 Errores Comunes
• CONCORDANCIA DE SUJETO Y VERBO:
INCORRECTO: “THE PATIENT HAVE A FEVER.”
CORRECTO: “THE PATIENT HAS A FEVER.”

• USO CORRECTO DE ARTÍCULOS:

INCORRECTO: “HE HAS AN FLU.”
CORRECTO: “HE HAS THE FLU.”

• EVITAR TRADUCCIONES LITERALES:

EJEMPLO: “ELEVATED PRESSURE” EN LUGAR
DE “HIGH PRESSURE.”

@english.enarm
 ¿Cómo viene preguntado el inglés en el ENARM?

A 70-year-old man with a history of atrial fibrillation presents to the

emergency department with sudden-onset weakness in his right arm and
difficulty speaking. His vital signs show an irregular pulse and a blood
pressure of 150/90 mmHg. A stroke is suspected. If this patient were
diagnosed with an acute ischemic stroke, would you consider administering
thrombolytic therapy?

A) Yes, thrombolytic therapy should be administered immediately.

B) No, thrombolytic therapy is contraindicated in this case.

C) Yes, but only after performing a CT scan to rule out hemorrhage.

D) No, supportive care alone would be sufficient.

@english.enarm
 ¿Cómo viene preguntado el inglés en el ENARM?
Lugar donde se
Sociodemograficos Antecedentes
presenta

Padecimiento A 70-year-old man with a history of atrial fibrillation presents to the Signos Vitales
actual emergency department with sudden-onset weakness in his right arm
(Interrogatorio and difficulty speaking. His vital signs show an irregular pulse and a
y exploración blood pressure of 150/90 mmHg. A stroke is suspected. If this patient Sospecha
física) were diagnosed with an acute ischemic stroke, would you consider diagnóstica
administering thrombolytic therapy?

A) Yes, thrombolytic therapy should be administered immediately.

Pregunta
B) No, thrombolytic therapy is contraindicated in this case.
Respuesta
C) Yes, but only after performing a CT scan to rule out hemorrhage.

D) No, supportive care alone would be sufficient.

@english.enarm
Cambio de género en los casos clínicos
mal redacrados
A 45-year-old woman presents to
the emergency department with
Femenino Masculino sudden-onset severe headache,
nausea, and blurred vision. He has
a history of hypertension but is
She He currently not on any medication. On
physical examination, his blood
Her His pressure is 190/110 mmHg, and
fundoscopy reveals papilledema. An
intracranial hemorrhage is
Herself Himself suspected.
@english.enarm
P A T I E N T G R O U P S
Inglés Español Inglés Español

Adolescent / Teenager Adolescente Patient Paciente

Infant Infante Woman Mujer

Elderly Anciano Man Hombre

Pregnant woman Mujer embarazada Child Niño/Niña

Fetus Feto Newborn Neonato english.enarm

 COLORS
Inglés Español Ejemplo Disease

Red (Redness) Rojo Redness Erythema

Yellow Amarillo Yellow Sputum Pneumoniae

Green Verde Greenish discharge Trichomoniasis

White Blanco White discharge Yeast infection

Gray Gris Gray discharge Bacterial vaginosis

@english.enarm
 Adjetivos de importancia
Adjetivo Significado Adjetivo Significado

Worsen Empeorar Chronic Crónico

Improve Mejorar Increased Aumentado

Severe Grave Mild Leve

Acute Agudo

@english.enarm
Estrategias para abordar casos clínicos en inglés
1. Leer la pregunta final primero.
2. Descartar opciones irrelevantes.
3. Buscar palabras clave (datos
patognomónicos, colores, grupos
etarios, factores de riesgo).
4. Diseccionar el caso.
5. Correlacionar la información.
6. Considerar la fisiopatología.
7. No dejarse llevar por el apuro.
8. Revisar al final.

@english.enarm
 Medical History

@english.enarm
 Past Medical History
Inglés Español

Chronic Condition Enfermedades Crónicas

Allergies Alergias

Medications Medicamentos

Family History Antecedentes Familiares

Immunization History Historia de Vacunación

@english.enarm
Past Medical History
Inglés Español

Factores de Estilo de
Lifestyle Factors
Vida

Substance Use Uso de Sustancias

Enfermedades de la
Childhood Illnesses
Infancia

Surgeries Cirugías

Hospitalizations Hospitalizaciones

@english.enarm
 Vital Signs
Español Inglés

Frecuencia
Heart Rate (HR)
Cardíaca (FC)
Español Inglés
Frecuencia Respiratory Rate
Respiratoria (FR) (RR) Respiraciones por Breaths per
minuto (rpm) minute (brpm)
Presión Arterial
Blood Pressure (BP)
(PA) Latidos por Beats per minute
minuto (lpm) (bpm)
Saturation of
Saturación de
Peripheral Oxygen Índice de Masa Body Mass Index
Oxígeno (SatO2)
(SpO2) Corporal (IMC) (BMI)
 Fever
Inglés Español

Low grade fever

Fiebre de bajo
grado
Mild fever

High fever Fiebre alta

Sudoraciones
Night sweats
nocturnas

@english.enarm
Pain semiology
Tipo de dolor Type of pain Example

Dolor a la palpación Tenderness Tender abdomen

Indoloro Painless Painless ulcer

Dolor punzante
Stabbing pain Trigeminal neuralgia
(apuñalamiento)

Dolor agudo Acute pain Acute pancreatitis

@english.enarm
 Pain semiology
Tipo de dolor Type of pain Example

Dolor quemante Burning pain Herpes zoster

Dolor sordo Dull pain Abdominal distension

Dolor irradiado Radiating pain Lumbar radiculopathy

Dolor palpitante Throbbing pain Migraine

Dolor agudo (punzada) Sharp pain Gastric perforation

@english.enarm
 Anatomical quadrants
Letra Inglés Español

L Left Izquierdo

RUQ LUQ
R Right Derecho UIQ UOQ

U Upper Superior

RLQ LLQ LIQ LOQ

L Lower Inferior

O Outer Externo

I Inner Interno

@english.enarm Q Quadrant Cuadrante

 Eye Abbreviations
RE LE

OU

OD OI

OCULUS UTERQUE A patient presents

AMBOS OJOS
with progressive vision
@english.enarm loss in OU.
 Organs

ESPAÑOL INGLÉS ESPAÑOL INGLÉS

Riñón Kidney Pulmones Lungs

Hígado Liver Intestino delgado Small Bowel

Bazo Spleen Intestino grueso Large Bowel

Corazón Heart Vejiga Bladder

Vesícula biliar Gallbladder Cerebro Brain

Estómago Stomach
@english.enarm
 Laboratory tests
Español Inglés

BHC (Biometría Hemática

CBC (Complete Blood Count)
Completa)

Gasometría Arterial ABG (Arterial Blood Gases)

Gasometría Venosa VBG (Venous Blood Gases)

PFH (Pruebas de Función

LFTs (Liver Function Tests)
Hepática)

Urocultivo Urine Culture

Examen General de Orina Urianalysis

@english.enarm
 Laboratory tests
Español Inglés

Conteo Plaquetario Plt (Platelet Count)

GR (Glóbulos Rojos) RBC (Red Blood Cells)

GB (Glóbulos Blancos) WBC (White Blood Cells)

Proteína C Reactiva (PCR) CRP (C-Reactive Protein)

Hemocultivos Blood Cultures

@english.enarm
 Medical Imaging
Español Inglés

Radiografía de tórax CXR (Chest X-Ray)

CT scan (Computed
Tomografía computarizada
Tomography)

Vista lateral Lateral view

Campos pulmonares Lung fields

@ENGLISH.ENARM
 Healthcare Areas
Español Inglés

Departamento de Urgencias Emergency Department

Consulta Externa Clinic

Unidad Toco-quirúrgica Labor and Delivery Unit

Unidad de Cuidados Intensivos (UCI) Intensive Care Unit (ICU)

Quirófano Operating Room

Unidad de Cuidados Intensivos Neonatal Intensive Care Unit

Neonatales (UCIN) (NICU)

@english.enarm
 Pediatrics

@english.enarm
 Neonatology
A 38-week gestational age newborn presents with respiratory
distress at birth. On physical examination, the newborn shows
tachypnea, nasal flaring, and grunting. A chest X-ray reveals a
reticulogranular pattern with reduced lung volume. What is the
most likely diagnosis?

A) Neonatal pneumonia
B) Respiratory distress syndrome
C) Transient tachypnea of the newborn
D) Persistent pulmonary hypertension of the newborn

@english.enarm
 Neonatology
A 38-week gestational age newborn presents with respiratory
distress at birth. On physical examination, the newborn shows
tachypnea, nasal flaring, and grunting. A chest X-ray reveals a
reticulogranular pattern with reduced lung volume. What is the most
likely diagnosis?

A) Neonatal pneumonia
B) Respiratory distress syndrome
C) Transient tachypnea of the newborn
D) Persistent pulmonary hypertension of the newborn

@english.enarm
 Neonatology
**Correct answer: B) Respiratory distress syndrome (RDS)**
RDS is characteristic in newborns with pulmonary immaturity,
presenting with a reticulogranular pattern on chest X-ray and signs of
respiratory distress at birth. Neonatal pneumonia usually has other
associated signs and a different radiographic pattern. Transient
tachypnea of the newborn does not present the "ground-glass"
pattern and generally does not include severe respiratory distress.
Persistent pulmonary hypertension manifests with severe hypoxemia,
and the chest X-ray may appear normal.

@english.enarm
 Neonatology
Inglés Español

(RDS) Respiratory Distress (SDR) Síndrome de Dificultad

Syndrome Respiratoria

(TTN) Transient Tachypnea of (TTRN) Taquipnea Transitoria del

the Newborn Recién Nacido

(MAS) Meconium Aspiration (SAM) Síndrome de Aspiración de

Syndrome Meconio

(BPD) Bronchopulmonary
(DBP) Displasia broncopulmonar
dysplasia
 Growth and Development
A 2-year-old boy is brought to the pediatric clinic by his mother due to concerns about
his development. The mother reports that her son is not speaking in sentences yet,
only says a few words, and has difficulty following simple commands. She also notes
that he doesn't seem interested in playing with other children and prefers to play
alone. His birth history is unremarkable, and his immunizations are up to date. On
examination, the child has normal height and weight for his age, but he avoids eye contact
and does not respond to his name. What is the most likely diagnosis?

A) Language delay
B) Autism spectrum disorder
C) Attention deficit hyperactivity disorder (ADHD)
D) Global developmental delay

@english.enarm
 Growth and Development
A 2-year-old boy is brought to the pediatric clinic by his mother due to concerns about his
development. The mother reports that her son is not speaking in sentences yet, only says a
few words, and has difficulty following simple commands. She also notes that he doesn't
seem interested in playing with other children and prefers to play alone. His birth history is
unremarkable, and his immunizations are up to date. On examination, the child has normal
height and weight for his age, but he avoids eye contact and does not respond to his name.
What is the most likely diagnosis?

A) Language delay
B) Autism spectrum disorder
C) Attention deficit hyperactivity disorder (ADHD)
D) Global developmental delay

@english.enarm
 Growth and Development

Correct answer: B) Autism spectrum disorder (ASD)**

This case describes a 2-year-old boy with delayed speech, difficulty following commands,
lack of social interaction, and avoiding eye contact, all of which are hallmark features of
autism spectrum disorder (ASD). While language delay (option A) could explain his limited
vocabulary, the presence of social and communication deficits points more specifically to
ASD. ADHD (option C) typically presents with inattention and hyperactivity rather than
communication and social issues at this age. Global developmental delay (option D) would
be considered if multiple developmental domains were affected, but the case focuses
primarily on communication and social skills.

@english.enarm
 Growth and Development
Inglés Español

Developmental
Hitos del desarrollo
milestones

Growth chart Tabla de crecimiento

Habilidades motoras
Fine motor skills
finas

Habilidades motoras
Gross motor skills
gruesas

Diapers Pañales
@english.enarm
 Vaccination
An 18-month-old girl is brought to the clinic for her routine immunization visit. Her
vaccination record shows that she has received all of her scheduled vaccines except
for the second dose of the MMR vaccine (measles, mumps, rubella). Her mother
expresses concern about the safety of vaccines after hearing misinformation online.
The child is otherwise healthy, with no significant medical history. What is the most
appropriate next step in managing this patient?

A) Reassure the mother about the safety and efficacy of vaccines and administer the MMR
vaccine.
B) Delay the MMR vaccine until the mother feels more comfortable.
C) Administer only the measles component of the vaccine.
D) Advise the mother to consult with another healthcare provider before proceeding.

@english.enarm
 Vaccination
An 18-month-old girl is brought to the clinic for her routine immunization visit. Her
vaccination record shows that she has received all of her scheduled vaccines except for the
second dose of the MMR vaccine (measles, mumps, rubella). Her mother expresses concern
about the safety of vaccines after hearing misinformation online. The child is otherwise
healthy, with no significant medical history. What is the most appropriate next step in
managing this patient?

A) Reassure the mother about the safety and efficacy of vaccines and administer the
MMR vaccine.
B) Delay the MMR vaccine until the mother feels more comfortable.
C) Administer only the measles component of the vaccine.
D) Advise the mother to consult with another healthcare provider before proceeding.

@english.enarm
 Esquema
Nacional De
Vacunación

@english.enarm
 Vaccination
Correct answer: A) Reassure the mother about the safety and efficacy of vaccines and
administer the MMR vaccine.**

In this case, the child is due for the second dose of the MMR vaccine, which is crucial for
preventing measles, mumps, and rubella. It's common for parents to have concerns due to
misinformation, but it's important to provide reassurance based on scientific evidence.
Vaccines are safe and effective, and delaying the MMR vaccine could leave the child at risk for
these preventable diseases. Administering only the measles component (option C) is not
appropriate as the combined vaccine is necessary. Referring to another healthcare provider
(option D) or delaying the vaccine (option B) may further contribute to vaccine hesitancy. The
best approach is to address the mother's concerns and proceed with the scheduled
vaccination.

@english.enarm
 Vaccinations
Inglés Español

MMR vaccine (Measles, Vacuna triple viral (Sarampión,

Mumps, Rubella) Parotiditis, Rubéola)

DTaP vaccine (Diphtheria, Vacuna DTPa (Difteria, Tétanos, Tos

Tetanus, Pertussis) ferina)

IPV (Inactivated Poliovirus Vacuna antipoliomielítica inactivada

Vaccine) (IPV)

HPV vaccine (Human Vacuna contra el VPH (Virus del

Papillomavirus) Papiloma Humano)

@english.enarm
 Flu Vaccine
Initials Full Name

Live Attenuated Influenza

LAIV
Vaccine

IIV Inactivated Influenza Vaccine

RIV Recombinant Influenza Vaccine

Cell Culture-based Influenza

ccIIV
Vaccine

@english.enarm
 Exanthematous Diseases
A 5-year-old boy is brought to the clinic with a 3-day history of fever, runny nose,
cough, and a red rash that started on his face and has now spread to his entire body.
His mother reports that he has not been vaccinated according to the recommended
schedule. On examination, the child has small white spots on the buccal mucosa, and the
rash appears as maculopapular. What is the most likely diagnosis?

A) Varicella
B) Measles
C) Rubella
D) Scarlet fever

@english.enarm
 Exanthematous Diseases
A 5-year-old boy is brought to the clinic with a 3-day history of fever, runny nose, cough, and
a red rash that started on his face and has now spread to his entire body. His mother
reports that he has not been vaccinated according to the recommended schedule. On
examination, the child has small white spots on the buccal mucosa, and the rash appears as
maculopapular. What is the most likely diagnosis?

A) Varicella
B) Measles
C) Rubella
D) Scarlet fever

@english.enarm
 Exanthematous Diseases
Correct answer: B) Measles**

The clinical presentation of a 5-year-old with fever, runny nose, cough, and a maculopapular
rash that started on the face and spread to the body is highly suggestive of measles
(rubeola). The presence of small white spots on the buccal mucosa, known as Koplik spots, is
a hallmark sign of measles and helps differentiate it from other exanthematous diseases.
Varicella (option A) typically presents with a vesicular rash, not maculopapular. Rubella
(option C) also presents with a rash, but it usually starts on the face and is milder, without
Koplik spots. Scarlet fever (option D) presents with a rash that feels like sandpaper and is
associated with a "strawberry tongue," not with Koplik spots.

@english.enarm
 Exanthematous Diseases
ESPAÑOL ENFERMEDAD NOMBRE ALTERNATIVO

Sarampión Measles Rubeola (No confundir con Rubella)

Rubéola Rubella German Measles

Varicela Varicella Chickenpox

Quinta enfermedad Erythema infectiosum Slapped Cheek Disease / Fifth Disease

Exantema súbito Roseola Sixth Disease

Escarlatina Scarlet fever Scarlatina

Enfermedad de Kawasaki Kawasaki Disease -

@english.enarm
 Congenital Heart Disease
A 2-month-old infant is brought to the clinic for a routine check-up. The mother reports
that the baby becomes easily fatigued during feeding and sometimes turns blue around
the lips. On examination, the infant has a loud systolic murmur best heard at the left
upper sternal border and a palpable right ventricular heave. Oxygen saturation is 85%
on room air. A chest X-ray shows a "boot-shaped" heart. What is the most likely diagnosis?

A) Tetralogy of Fallot
B) Ventricular septal defect
C) Atrial septal defect
D) Patent ductus arteriosus

@english.enarm
 Congenital Heart Disease
A 2-month-old infant is brought to the clinic for a routine check-up. The mother reports that
the baby becomes easily fatigued during feeding and sometimes turns blue around the lips.
On examination, the infant has a loud systolic murmur best heard at the left upper sternal
border and a palpable right ventricular heave. Oxygen saturation is 85% on room air. A chest
X-ray shows a "boot-shaped" heart. What is the most likely diagnosis?

A) Tetralogy of Fallot
B) Ventricular septal defect
C) Atrial septal defect
D) Patent ductus arteriosus

@english.enarm
 Congenital Heart Disease
Correct answer: A) Tetralogy of Fallot**

Tetralogy of Fallot is characterized by four key features: ventricular septal defect (VSD),
pulmonary stenosis, right ventricular hypertrophy, and an overriding aorta. The clinical
presentation of this infant, including cyanosis (blue around the lips), a loud systolic murmur,
and a "boot-shaped" heart on chest X-ray, are classic findings for Tetralogy of Fallot. The
cyanosis occurs due to the right-to-left shunting of blood through the VSD, bypassing the
lungs. Ventricular septal defect (option B) and atrial septal defect (option C) generally
present with less severe symptoms and do not typically cause cyanosis. Patent ductus
arteriosus (option D) can cause a continuous murmur but is less likely to present with
cyanosis and a boot-shaped heart on imaging.

@english.enarm
 Congenital Heart Disease
Inglés Español Datos clave

Se caracteriza por cuatro anomalías: defecto del septo ventricular, estenosis

Tetralogy of Fallot Tetralogía de
pulmonar, hipertrofia del ventrículo derecho y aorta cabalgante. Suele causar
(TOF) Fallot
cianosis y el signo radiográfico de "corazón en forma de bota”.

Comunicación Es el defecto cardíaco congénito más común a nivel mundial. Causa un soplo
Ventricular septal
Interventricular pansistólico y puede llevar a insuficiencia cardíaca si es grande y no se cierra
defect (VSD)
(CIV) espontáneamente.

A menudo asintomático en la infancia, pero puede causar un soplo sistólico y

Atrial septal defect Defecto del septo
agrandamiento de la aurícula derecha y el ventrículo derecho en la edad adulta.
(ASD) auricular (DSA)

Conducto
Patent Ductus Persistencia del conducto arterioso abierto después del nacimiento. Más común
Arterioso
Arteriosus (PDA) en México.
Persistente (CAP)

@english.enarm
 Congenital Heart Disease
Inglés Español Datos clave

Estrechamiento de la válvula pulmonar que limita el flujo de sangre desde

Estenosis
Pulmonary stenosis (PS) el ventrículo derecho hacia los pulmones, causando un soplo sistólico y
pulmonar
potencial cianosis en casos graves.

Atresia Ausencia de la válvula tricúspide que impide el flujo de sangre del atrio
Tricuspid atresia (TA)
tricuspídea derecho al ventrículo derecho, causando cianosis grave y requiere cirugía.

Transposición de
Transposition of the great Las arterias principales están invertidas, lo que provoca cianosis grave al
los grandes
arteries (ToGA) nacer. Requiere intervención quirúrgica temprana para la supervivencia.
vasos

Doble salida del

Double Outlet Right Tanto la aorta como la arteria pulmonar salen del ventrículo derecho
ventrículo
Ventricle (DORV)
derecho

@english.enarm
 GENETICS @english.enarm

Genes Full Name Enfermedad Disease

EWSR1 Ewing Sarcoma Breakpoint Region Sarcoma de Ewing Ewing Sarcoma

Cáncer de mama, ovario,

BRCA 1-2 Breast Cancer 1,2 Breast Cancer
próstata

NF1 Neurofibromin 1 Neurofibromatosis Neurofibromatosis

FMR1 Fragile X Mental Retardation 1 Síndrome de X Frágil Fragile X Syndrome

Distrofia Muscular de Duchenne Muscular

DMD Dystrophin
Duchenne Dystrophy

Cystic Fibrosis Transmembrane

CFTR Fibrosis Quística Cystic Fibrosis
Conductance Regulator

KAL1 Anosmine 1 Síndrome de Kallman Kallman Syndrome

Mnemotecnias
en inglés y
escalas clínicas
PEDIATRÍA

@english.enarm
 @english.enarm

APGAR Mide la adaptación del recién nacido a la vida

extrauterina: Se evalúa al minuto y a los 5 minutos.
@english.enarm
 Conjunto de anomalías congénitas.Se diagnostica

VACTERL cuando el paciente presenta al menos 3 de estas

anomalías.

@english.enarm
CHARGE

@english.enarm
 Infecciones perinatales relacionadas con

TORCH enfermedades congénitas.

@english.enarm
 Gynaecology
and
Obstetrics
@english.enarm
 Cervical Intraepithelial Neoplasia
A 32-year-old woman presents to the gynecology clinic for a routine Pap smear. She
reports no significant medical history and is asymptomatic. Her sexual history
includes multiple partners over the past 5 years, and she has not received the HPV
vaccine. The Pap smear report shows the presence of koilocytes. Further testing
reveals that she is positive for high-risk HPV types. Based on the findings of
koilocytes in the Pap smear, what is the most likely diagnosis?

A) Cervical cancer
B) Cervical intraepithelial neoplasia (CIN)
C) Endometrial hyperplasia
D) Ovarian cyst

@english.enarm
 Cervical Intraepithelial Neoplasia
A 32-year-old woman presents to the gynecology clinic for a routine Pap smear. She
reports no significant medical history and is asymptomatic. Her sexual history includes
multiple partners over the past 5 years, and she has not received the HPV vaccine. The Pap
smear report shows the presence of koilocytes. Further testing reveals that she is positive
for high-risk HPV types. Based on the findings of koilocytes in the Pap smear, what is the
most likely diagnosis?

A) Cervical cancer
B) Cervical intraepithelial neoplasia (CIN)
C) Endometrial hyperplasia
D) Ovarian cyst

@english.enarm
 Cervical Intraepithelial Neoplasia
The presence of koilocytes is indicative of HPV infection and suggests the possibility of
Cervical Intraepithelial Neoplasia (CIN), a precursor lesion to cervical cancer. Koilocytes are
hallmark cells with perinuclear halos and nuclear abnormalities, often seen in patients
infected with high-risk HPV strains. This finding warrants close follow-up and management
to prevent progression to cervical cancer.

@english.enarm
Cervical Intraepithelial Neoplasia
INGLÉS ESPAÑOL

Intercourse Relaciones sexuales

Pap smear Citología exfoliativa

Sangrado leve fuera del

Vaginal spotting
periodo menstrual regular

Last Menstrual Period (LMP) Última menstruación (FUM)

Koilocytes Coilocitos

@english.enarm
 Preeclampsia
A 28-year-old woman, G2P1, at 34 weeks of gestation, presents to the emergency
department with a severe headache, visual disturbances, and swelling in her hands
and feet. Her blood pressure is 160/100 mmHg, and urinalysis reveals 4+ proteinuria.
She has no history of hypertension prior to pregnancy. Fetal monitoring shows a
reassuring heart rate pattern. What is the next best step in management?

A) Administer antihypertensive medication and plan for delivery at 37 weeks

B) Administer magnesium sulfate and proceed with immediate delivery
C) Monitor blood pressure and proteinuria, and reassess in 48 hours
D) Initiate bed rest and repeat urinalysis in 24 hours

@english.enarm
 Preeclampsia
A 28-year-old woman, G2P1, at 34 weeks of gestation, presents to the emergency
department with a severe headache, visual disturbances, and swelling in her hands and
feet. Her blood pressure is 160/100 mmHg, and urinalysis reveals 4+ proteinuria. She
has no history of hypertension prior to pregnancy. Fetal monitoring shows a reassuring
heart rate pattern. What is the next best step in management?

A) Administer antihypertensive medication and plan for delivery at 37 weeks

B) Administer magnesium sulfate and proceed with immediate delivery
C) Monitor blood pressure and proteinuria, and reassess in 48 hours
D) Initiate bed rest and repeat urinalysis in 24 hours

@english.enarm
 Preeclampsia
Correct answer: B) Administer magnesium sulfate and proceed with immediate delivery

This patient presents with severe preeclampsia, evidenced by her high blood pressure
(160/100 mmHg), significant proteinuria (4+), and symptoms such as headache and visual
disturbances. These findings indicate a high risk for complications like eclampsia or stroke.
The next best step is to stabilize the patient with magnesium sulfate to prevent seizures
and proceed with immediate delivery, as the only definitive treatment for preeclampsia is
delivery. Option A (delaying delivery until 37 weeks) is not appropriate due to the severity
of her condition. Monitoring (option C) and bed rest (option D) are insufficient in managing
severe preeclampsia and could lead to worsening outcomes for both mother and fetus.

@english.enarm
 Preeclampsia
INGLÉS ESPAÑOL

Fetal growth restriction Restricción del crecimiento fetal

Epidural analgesia Analgesia epidural

Monitoreo de la frecuencia
Fetal heart rate monitoring
cardíaca fetal

Preterm labor Trabajo de parto prematuro

Her water broke “Se le rompió la fuente”

@english.enarm
 Postpartum Hemorrhage
A 30-year-old woman, G3P2, vaginally delivers a healthy 3.8 kg baby after a
spontaneous labor. Shortly after delivery of the placenta, she experiences heavy
vaginal bleeding. On examination, her uterus feels boggy and is above the level of
the umbilicus. Vital signs reveal a blood pressure of 90/60 mmHg and a heart
rate of 110 bpm. Estimated blood loss is 800 mL. What is the most appropriate
next step in management?

A) Administer oxytocin and perform uterine massage

B) Start broad-spectrum antibiotics
C) Perform a D&C (dilation and curettage)
D) Prepare for emergency hysterectomy

@english.enarm
 Postpartum Hemorrhage
A 30-year-old woman, G3P2, vaginally delivers a healthy 3.8 kg baby after a
spontaneous labor. Shortly after delivery of the placenta, she experiences heavy
vaginal bleeding. On examination, her uterus feels boggy and is above the level of the
umbilicus. Vital signs reveal a blood pressure of 90/60 mmHg and a heart rate of 110
bpm. Estimated blood loss is 800 mL. What is the most appropriate next step in
management?

A) Administer oxytocin and perform uterine massage

B) Start broad-spectrum antibiotics
C) Perform a D&C (dilation and curettage)
D) Prepare for emergency hysterectomy

@english.enarm
 Postpartum Hemorrhage
Correct answer: A) Administer oxytocin and perform uterine massage

The most appropriate initial management for postpartum hemorrhage in this patient is to
administer oxytocin and perform uterine massage. The boggy uterus indicates uterine atony,
which is the most common cause of postpartum hemorrhage. Oxytocin helps to contract the
uterus, and uterine massage assists in this process. Broad-spectrum antibiotics (option B)
are not indicated unless there is suspicion of infection. A D&C (option C) is appropriate if
retained products of conception are suspected, but this is not the case here. An emergency
hysterectomy (option D) is a last resort when conservative measures fail, and the bleeding is
life-threatening.

@english.enarm
 Postpartum Hemorrhage
Inglés Español Datos clave

Falta de contracción del útero después del parto, la

Uterine atony Atonía uterina
causa más común de hemorragia postparto.

Retención de Parte o la totalidad de la placenta no es expulsada

Retained placenta
placenta después del parto, lo que puede causar hemorragia.

Bimanual Compresión Técnica en la que se aplica presión con ambas manos

compression bimanual sobre el útero para controlar la hemorragia postparto.

Procedimiento para remover restos placentarios en caso

D&C (Dilation and Dilatación y
de hemorragia postparto secundaria a retención de
Curettage) curetaje
productos.

@english.enarm
 Early Pregnancy Complications
A 26-year-old woman presents to the emergency department with severe lower abdominal
pain and vaginal spotting. She reports that her last menstrual period was 7 weeks ago. On
examination, she has tenderness in the RLQ, and a pelvic ultrasound shows an empty
uterus. Her serum β-hCG levels are 1500 mIU/mL. What is the most likely diagnosis?

A) Threatened miscarriage
B) Ectopic pregnancy
C) Ovarian cyst rupture
D) Pelvic inflammatory disease (PID)

@english.enarm
 Early Pregnancy Complications
A 26-year-old woman presents to the emergency department with severe lower abdominal
pain and vaginal spotting. She reports that her last menstrual period was 7 weeks ago. On
examination, she has tenderness in the right lower quadrant, and a pelvic ultrasound shows
an empty uterus. Her serum β-hCG levels are 1500 mIU/mL. What is the most likely
diagnosis?

A) Threatened miscarriage
B) Ectopic pregnancy
C) Ovarian cyst rupture
D) Pelvic inflammatory disease (PID)

@english.enarm
 Ectopic Pregnancy
Correct answer: B) Ectopic pregnancy

This patient presents with lower abdominal pain, vaginal spotting, and a history of 7 weeks
since her last menstrual period, all of which raise suspicion for an ectopic pregnancy. The
empty uterus on ultrasound combined with a serum β-hCG level of 1500 mIU/mL further
supports this diagnosis, as a normal intrauterine pregnancy should be visible on ultrasound
at this hCG level (typically >1500 mIU/mL). Threatened miscarriage (option A) would more
likely show an intrauterine gestational sac on ultrasound. Ovarian cyst rupture (option C) and
pelvic inflammatory disease (option D) can cause abdominal pain but are less likely given the
clinical context and hCG findings. Immediate management is crucial to prevent complications
such as rupture and hemorrhage.

@english.enarm
 Ectopic Pregnancy
Inglés Español

Ruptured ectopic
Embarazo ectópico roto
pregnancy

Empty uterus Útero vacío

Inestabilidad
Hemodynamic instability
hemodinámica

Expectant management Manejo expectante

Tubo-ovarian abscess Absceso tubo-ovárico

@english.enarm
 Third-trimester obstetric complications
A 32-year-old woman, G2P1, at 36 weeks of gestation, presents to the labor and delivery
unit with painless vaginal bleeding after spontaneous rupture of membranes. Fetal heart
rate monitoring reveals a severe bradycardia of 80 beats per minute. On examination, the
uterus is soft, and there is no evidence of uterine tenderness. The patient has no prior
history of placental abnormalities, and her prenatal care has been routine. What is the
most likely diagnosis?

A) Placenta previa
B) Uterine rupture
C) Vasa previa
D) Placental abruption

@english.enarm
Third-trimester obstetric complications
A 32-year-old woman, G2P1, at 36 weeks of gestation, presents to the labor
and delivery unit with painless vaginal bleeding after spontaneous rupture of
membranes. Fetal heart rate monitoring reveals a severe bradycardia of 80
beats per minute. On examination, the uterus is soft, and there is no evidence of
uterine tenderness. The patient has no prior history of placental abnormalities,
and her prenatal care has been routine. What is the most likely diagnosis?

A) Placenta previa
B) Uterine rupture
C) Vasa previa
D) Placental abruption

@english.enarm
 @english.enarm

Vasa Previa
Correct answer: C) Vasa previa

Vasa previa is a condition where fetal blood vessels cross or run near the internal os of the
uterus, unprotected by the placenta or umbilical cord. The classic presentation includes
painless vaginal bleeding after rupture of membranes and fetal distress, as indicated by
severe bradycardia (80 bpm). This condition is a true obstetric emergency because the fetal
vessels can rupture, leading to rapid fetal exsanguination. Placenta previa (option A) also
presents with painless bleeding, but it does not cause fetal bradycardia unless significant
blood loss occurs. Uterine rupture (option B) typically presents with sudden-onset
abdominal pain and a non-reassuring fetal heart rate, but the uterus would be tender, which
is not the case here. Placental abruption (option D) usually involves painful bleeding and
uterine tenderness, which are absent in this scenario. Immediate delivery via cesarean
section is the recommended management for vasa previa to prevent fetal demise.
 Vasa Previa
Inglés Español

Painless vaginal bleeding Sangrado vaginal indoloro

Umbilical cord insertion Inserción del cordón umbilical

Cervical os Orificio cervical

Exsanguination Exanguinación

Umbilical cord insertion Inserción del cordón umbilical

@ENGLISH.ENARM
 Chronic Pelvic Pain
A 30-year-old woman presents to the clinic with a 2-year history of progressively
worsening pelvic pain that is most severe during her menstrual periods. She also reports
dyspareunia and has been trying to conceive for the past year without success. Her
menstrual cycles are regular, and her physical exam reveals tenderness upon palpation of
the lower abdomen, especially in the adnexal regions. A pelvic ultrasound shows a 3 cm
ovarian endometrioma. What is the most likely diagnosis?

A) Pelvic inflammatory disease

B) Ovarian cyst
C) Endometriosis
D) Uterine fibroids

@english.enarm
 Chronic Pelvic Pain
A 30-year-old woman presents to the clinic with a 2-year history of progressively worsening
pelvic pain that is most severe during her menstrual periods. She also reports dyspareunia
and has been trying to conceive for the past year without success. Her menstrual cycles are
regular, and her physical exam reveals tenderness upon palpation of the lower abdomen,
especially in the adnexal regions. A pelvic ultrasound shows a 3 cm ovarian endometrioma.
What is the most likely diagnosis?

A) Pelvic inflammatory disease

B) Ovarian cyst
C) Endometriosis
D) Uterine fibroids

@english.enarm
 Endometriosis
Correct answer: C) Endometriosis

This patient presents with classic symptoms of endometriosis, including chronic pelvic pain,
dysmenorrhea (painful periods), dyspareunia (painful intercourse), and infertility. The
presence of an ovarian endometrioma on ultrasound further supports the diagnosis.
Endometriosis is characterized by the presence of endometrial tissue outside the uterus,
leading to inflammation, scarring, and cyst formation. Pelvic inflammatory disease (option A)
usually presents with more acute pain and signs of infection. An ovarian cyst (option B) may
cause pain but wouldn’t explain the chronic symptoms and infertility. Uterine fibroids
(option D) can cause pelvic pain and heavy menstrual bleeding but are less associated with
dyspareunia and infertility compared to endometriosis.

@english.enarm
 Endometriosis
Inglés Español Datos clave

Deep infiltrating Endometriosis Forma severa de endometriosis en la que el tejido endometrial invade
endometriosis infiltrante profunda profundamente los órganos pélvicos, causando síntomas más graves.

Ovarian Capacidad funcional de los ovarios para producir óvulos viables. La endometriosis
Reserva ovárica
reserve puede reducir la reserva ovárica.

Bowel Endometriosis Involucro del intestino por tejido endometrial, lo que puede causar síntomas
endometriosis intestinal gastrointestinales como dolor al defecar y sangrado rectal durante la menstruación.

Hormonal Tratamiento que incluye el uso de anticonceptivos hormonales, agonistas de

Terapia hormonal
therapy GnRH, o progestágenos para reducir los síntomas de la endometriosis.

@english.enarm
Mnemotecnias
en inglés y
escalas clínicas
GYNAECOLOGY AND OBSTETRICS

@english.enarm
 HELLP
syndrome

@english.enarm
 4T

Causas de
hemorragia
postparto

@english.enarm
 Ectopic
pregnancy

Factores de
Riesgo de
Embarazo
Ectópico

@english.enarm
 Surgery

@english.enarm
 Inguinal Hernia
A 45-year-old man presents to the clinic with a bulge in his right groin that has been
present for several months. He reports that the bulge becomes more noticeable when he
coughs or lifts heavy objects, and it reduces when he lies down. Over the past two days, he
has experienced increasing pain in the area, and the bulge has become irreducible. On
examination, a firm, tender mass is palpated in the right inguinal region. What is the most
appropriate next step in management?

A) Elective surgical repair

B) Observation and follow-up in 6 months
C) Urgent surgical consultation
D) Prescribe pain management and recommend activity restriction

@english.enarm
 Inguinal Hernia
A 45-year-old man presents to the clinic with a bulge in his right groin that has been
present for several months. He reports that the bulge becomes more noticeable when
he coughs or lifts heavy objects, and it reduces when he lies down. Over the past two
days, he has experienced increasing pain in the area, and the bulge has become
irreducible. On examination, a firm, tender mass is palpated in the right inguinal
region.

What is the most appropriate next step in management?

A) Elective surgical repair

B) Observation and follow-up in 6 months
C) Urgent surgical consultation
D) Prescribe pain management and recommend activity restriction

@english.enarm
 Inguinal Hernia
Correct answer: C) Urgent surgical consultation

This patient presents with an inguinal hernia that has progressed to incarceration, as
indicated by the irreducible bulge and increasing pain. Incarcerated hernias are at risk of
becoming strangulated, where the blood supply to the herniated tissue is compromised,
leading to tissue necrosis. Immediate surgical consultation is necessary to evaluate the need
for urgent surgical intervention. Elective repair (option A) is appropriate for reducible hernias
without complications, but not in this case. Observation (option B) and pain management
with activity restriction (option D) are not suitable for an incarcerated hernia, as delaying
treatment could lead to serious complications.

@english.enarm
 Inguinal Hernia
Inglés Español

Groin Ingle

Bulge Abultamiento

Tension-free Reparación
repair sin tensión

Saco
Hernia sac
herniario

Navel Ombligo

@english.enarm
 Biliary Pathology
A 45-year-old female presents to the emergency department with RUQ abdominal
pain that began 6 hours ago, radiating to her right shoulder. She describes the pain as
sharp and constant, worsening after eating a fatty meal. She has a history of obesity
and has had similar, milder episodes in the past. On physical examination, there is
tenderness in the right upper quadrant with a positive Murphy’s sign. Her vital signs
are stable. Based on the patient’s presentation, what is the most likely diagnosis?

A) Acute pancreatitis
B) Peptic ulcer disease
C) Acute cholecystitis
D) Hepatitis

@english.enarm
 Biliary Pathology
A 45-year-old female presents to the emergency department with RUQ abdominal pain
that began 6 hours ago, radiating to her right shoulder. She describes the pain as sharp and
constant, worsening after eating a fatty meal. She has a history of obesity and has had
similar, milder episodes in the past. On physical examination, there is tenderness in the right
upper quadrant with a positive Murphy’s sign. Her vital signs are stable. Based on the
patient’s presentation, what is the most likely diagnosis?

A) Acute pancreatitis
B) Peptic ulcer disease
C) Acute cholecystitis
D) Hepatitis

@english.enarm
 Acute Cholecystitis
The most likely diagnosis is acute cholecystitis due to the classic symptoms: right upper
quadrant pain radiating to the right shoulder, worsened after fatty meals, along with a
positive Murphy’s sign, which is a hallmark of this condition. Additionally, the patient has risk
factors such as obesity and a history of milder episodes, indicating possible underlying
gallstones (cholelithiasis). This rules out the other options: acute pancreatitis typically
presents with epigastric pain radiating to the back, not the shoulder; peptic ulcer disease
causes epigastric pain, but it’s not associated with right upper quadrant tenderness or a
positive Murphy’s sign; and hepatitis usually presents with more diffuse abdominal pain and
systemic symptoms like jaundice, which are absent in this case.

@english.enarm
 BILIARY PATHOLOGY
Inglés Español

Meal Comida

Gallbladder Vesícula biliar

Gallstones Calculos biliares

Pared de la
Gallbladder wall
vesícula biliar

@english.enarm
 Intestinal Obstruction
A 65-year-old man presents to the emergency department with a 2-day history of crampy
abdominal pain, vomiting, and abdominal distension. He reports no bowel movements or
passage of gas during this time. His medical history includes a prior abdominal surgery for
a perforated ulcer 5 years ago. On physical examination, his abdomen is distended with
hyperactive bowel sounds. An abdominal X-ray shows multiple dilated loops of small bowel
with air-fluid levels. What is the most likely diagnosis?

A) Paralytic ileus
B) Small bowel obstruction
C) Large bowel obstruction
D) Acute appendicitis

@english.enarm
 Intestinal Obstruction
A 65-year-old man presents to the emergency department with a 2-day history of crampy
abdominal pain, vomiting, and abdominal distension. He reports no bowel movements or
passage of gas during this time. His medical history includes a prior abdominal surgery for a
perforated ulcer 5 years ago. On physical examination, his abdomen is distended with
hyperactive bowel sounds. An abdominal X-ray shows multiple dilated loops of small bowel
with air-fluid levels. What is the most likely diagnosis?

A) Paralytic ileus
B) Small bowel obstruction
C) Large bowel obstruction
D) Acute appendicitis

@english.enarm
 Small Bowel Obstruction
Correct answer: B) Small bowel obstruction**

This patient presents with classic symptoms of small bowel obstruction, including crampy
abdominal pain, vomiting, abdominal distension, and the absence of bowel movements or gas
passage. His history of prior abdominal surgery increases the likelihood of adhesions, which are
the most common cause of small bowel obstruction. The physical exam findings of a distended
abdomen with hyperactive bowel sounds, along with the abdominal X-ray showing dilated loops
of small bowel and air-fluid levels, further support this diagnosis. Paralytic ileus (option A)
typically presents with a more generalized reduction in bowel activity, often following surgery or
severe illness, but without the same pattern of air-fluid levels. Large bowel obstruction (option
C) would present similarly but with more distal dilation, and acute appendicitis (option D) would
usually present with localized pain and no bowel obstruction signs on imaging.

@ENGLISH.ENARM
 Intestinal Obstruction
Inglés Español

Intestinal Obstruction Obstrucción intestinal

Obstrucción del intestino

Small bowel obstruction
delgado

Air-fluid levels Niveles hidroaéreos

Nasogastric tube Sonda nasogástrica

@ENGLISH.ENARM
 ATLS
A 35-year-old man is brought to the emergency department after a high-speed motor
vehicle collision. He is unresponsive with a Glasgow Coma Scale score of 6. His blood
pressure is 80/50 mmHg, and his heart rate is 120 bpm. On examination, he has decreased
breath sounds on the left side, and his trachea is deviated to the right. His abdomen is
distended, and there are multiple abrasions on his chest and abdomen. What is the most
appropriate next step in management?

A) Perform a chest X-ray

B) Administer intravenous fluids
C) Insert a chest tube
D) Initiate advanced airway management

@english.enarm
 ATLS
A 35-year-old man is brought to the emergency department after a high-speed motor vehicle
collision. He is unresponsive with a Glasgow Coma Scale score of 6. His blood pressure is 80/50
mmHg, and his heart rate is 120 bpm. On examination, he has decreased breath sounds on the
left side, and his trachea is deviated to the right. His abdomen is distended, and there are multiple
abrasions on his chest and abdomen. What is the most appropriate next step in management?

A) Perform a chest X-ray

B) Administer intravenous fluids
C) Insert a chest tube
D) Initiate advanced airway management

@english.enarm
 ATLS
Correct answer: C) Insert a chest tube**

The patient's presentation suggests a tension pneumothorax, evidenced by decreased

breath sounds on the left side, tracheal deviation to the right, and hypotension. In the
context of ATLS, the most immediate and life-saving intervention is to insert a chest tube
(thoracostomy) to relieve the pressure in the pleural space. A chest X-ray (option A) may
confirm the diagnosis but would delay the necessary treatment. Administering IV fluids
(option B) is important for addressing hypotension but does not address the primary
cause of the patient's instability. Advanced airway management (option D) may be
required if the patient's respiratory status deteriorates further, but in this case, addressing
the tension pneumothorax takes precedence to stabilize the patient.

@english.enarm
@english.enarm

ATLS
Inglés Español Definición

Evaluación Proceso inicial de evaluación en el manejo del trauma, que sigue el

Primary survey
primaria ABCDE.

Evaluación y manejo de la ventilación y oxigenación, incluyendo la

Breathing Respiración
identificación de neumotórax, hemotórax, o lesiones pulmonares.

Dispositivo utilizado para estabilizar fracturas pélvicas y reducir el

Pelvic binder Faja pélvica
sangrado en trauma pélvico.

Tubo torácico Dispositivo utilizado para drenar aire o líquido del espacio pleural,
Chest tube
(tubo pelural) común en el manejo de neumotórax.

Exposure and Exposición y Desvestir completamente al paciente para identificar todas las
environmental control control ambiental lesiones, mientras se evita la hipotermia.
 Acute Otitis Media
A 4-year-old boy is brought to the clinic by his mother due to ear pain and fever for the
past two days. The mother reports that the child has been irritable and tugging at his right
ear. On examination, the tympanic membrane is erythematous and bulging, with
decreased mobility on pneumatic otoscopy. His temperature is 38.5°C, and there is no
history of ear discharge. What is the most appropriate next step in management?

A) Observation and pain management

B) Immediate antibiotic therapy
C) Ear irrigation and removal of cerumen
D) Referral to an otolaryngologist

@english.enarm
 Acute Otitis Media
A 4-year-old boy is brought to the clinic by his mother due to ear pain and fever for the past
two days. The mother reports that the child has been irritable and tugging at his right ear.
On examination, the tympanic membrane is erythematous and bulging, with decreased
mobility on pneumatic otoscopy. His temperature is 38.5°C, and there is no history of ear
discharge. What is the most appropriate next step in management?

A) Observation and pain management

B) Immediate antibiotic therapy
C) Ear irrigation and removal of cerumen
D) Referral to an otolaryngologist

@english.enarm
 Acute Otitis Media
Correct answer: B) Immediate antibiotic therapy

The child presents with classic signs of acute otitis media (AOM), including ear pain, fever,
and a bulging, erythematous tympanic membrane. Immediate antibiotic therapy is
indicated in this case, especially given the presence of fever and the child’s young age
(under 6 years). Observation (option A) may be appropriate for older children with mild
symptoms, but this child requires prompt treatment. Ear irrigation and cerumen removal
(option C) are not indicated as there is no mention of cerumen impaction. Referral to an
otolaryngologist (option D) is unnecessary unless the child fails to respond to initial
treatment or has recurrent infections.

@english.enarm
 Acute Otitis Media

Inglés Español

Hearing loss Pérdida auditiva

(AOM) Acute Otitis Media (OMA) Otitis Media Aguda

Pneumatic otoscopy Otoscopia neumática

Tonsillitis Amigdalitis

@ENGLISH.ENARM
 Angiology
A 55-year-old woman presents to the clinic with swelling and pain in her left calf for
the past 3 days. She describes the pain as a constant ache that worsens when she
walks. She has a history of hypertension and recently underwent knee surgery 2
weeks ago. On physical examination, her left calf is swollen and tender to palpation,
with a circumference 3 cm larger than the right calf. Her vital signs are stable, and
she has no signs of shortness of breath. What is the most likely diagnosis?

A) Cellulitis
B) Deep vein thrombosis
C) Peripheral artery disease
D) Muscle strain

@english.enarm
 Deep Vein Thrombosis
A 55-year-old woman presents to the clinic with swelling and pain in her left calf for the
past 3 days. She describes the pain as a constant ache that worsens when she walks.
She has a history of hypertension and recently underwent knee surgery 2 weeks ago.
On physical examination, her left calf is swollen and tender to palpation, with a
circumference 3 cm larger than the right calf. Her vital signs are stable, and she has no
signs of shortness of breath. What is the most likely diagnosis?

A) Cellulitis
B) Deep vein thrombosis
C) Peripheral artery disease
D) Muscle strain

@english.enarm
 Deep Vein Thrombosis
Correct answer: B) Deep vein thrombosis

The patient’s presentation is highly suggestive of deep vein thrombosis (DVT),

particularly given the history of recent surgery, which is a significant risk factor for
venous thromboembolism. The swelling, pain, and increased calf circumference are
classic signs of DVT. Cellulitis (option A) can also cause swelling and pain, but it typically
presents with redness and warmth of the skin, which are not mentioned here.
Peripheral artery disease (option C) usually presents with claudication and diminished
pulses, not with swelling. Muscle strain (option D) could explain the pain, but it wouldn’t
typically cause the significant swelling and difference in calf circumference seen in this
patient.

@english.enarm
@english.enarm

Deep Vein Thrombosis

Inglés Español

(DVT) Deep Vein (TVP) Trombosis Venosa

Thrombosis Profunda

(PE) Pulmonary Embolism (EP) Embolia Pulmonar

Virchow’s triad Tríada de Virchow

Filtro de la Vena Cava

Inferior Vena Cava Filter
Inferior
 UR OLOG Y

Inglés Español Ejemplo

The patient reports a weak urinary

Stream Flujo urinario
stream.

The patient’s primary complaint is

Dificultad para
Hesitancy hesitancy, characterized by difficulty
iniciar la micción
initiating urination.

@english.enarm
 @english.enarm

Mnemotecnias
en inglés
CIRUGÍA
 Causas comunes de
Pancreatitis Aguda

I GET SMASHED
Me emborracho

@english.enarm
Primary Survey in
Trauma

@english.enarm
 Risk Factors for
Gallstone Disease

The traditional risk

factors for gallstone
disease are the four
“F’s: female, fat, forty,
and fertile.”

@english.enarm
 Mantrels Alvarado Score

@english.enarm
 @english.enarm

Internal
Medicine

@english.enarm
 Hypertensive Crisis
A 60-year-old woman with a history of hypertension presents to the emergency
department with a severe headache, blurred vision, and confusion. She reports missing
her antihypertensive medications for the past three days. On physical examination, her
blood pressure is 220/120 mmHg, and she has bilateral papilledema on fundoscopic
examination. Her neurological examination reveals mild weakness in her left arm. What
is the most appropriate next step in management?

A) Administer intravenous labetalol

B) Start oral antihypertensive therapy
C) Perform a head CT scan
D) Initiate immediate hemodialysis

@english.enarm
 Hypertensive Crisis
A 60-year-old woman with a history of hypertension presents to the emergency
department with a severe headache, blurred vision, and confusion. She reports missing
her antihypertensive medications for the past three days. On physical examination, her
blood pressure is 220/120 mmHg, and she has bilateral papilledema on fundoscopic
examination. Her neurological examination reveals mild weakness in her left arm. What
is the most appropriate next step in management?

A) Administer intravenous labetalol

B) Start oral antihypertensive therapy
C) Perform a head CT scan
D) Initiate immediate hemodialysis

@english.enarm
 Hypertensive Crisis
@english.enarm

Correct answer: A) Administer intravenous labetalol

This patient presents with signs and symptoms of hypertensive encephalopathy, a type of
hypertensive emergency characterized by severe hypertension (BP >180/120 mmHg) with
evidence of target organ damage (in this case, papilledema and confusion). The most appropriate
next step is to lower her blood pressure with intravenous labetalol, which is commonly used in
hypertensive emergencies because of its rapid onset and ability to reduce blood pressure
without causing significant reflex tachycardia.

Starting oral antihypertensive therapy (option B) would not be appropriate in a hypertensive

emergency where immediate BP reduction is necessary. Performing a head CT scan (option C)
could be considered if there were focal neurological deficits or suspicion of a stroke, but initial
management focuses on blood pressure control. Immediate hemodialysis (option D) is not
indicated unless there is acute renal failure with hyperkalemia or other severe electrolyte
disturbances.
 Hypertensive Crisis
INGLÉS ESPAÑOL

Neurological deficits Déficits neurológicos

Renal impairment Insuficiencia renal

Intravenous antihypertensive Terapia antihipertensiva

therapy intravenosa

Hypertensive crisis Crisis hipertensiva

@ENGLISH.ENARM
 Diabetic Ketoacidosis (DKA)
A 25-year-old woman with a history of type 1 diabetes mellitus presents to the
emergency department with abdominal pain, nausea, and vomiting for the past 24
hours. She reports that she has been feeling extremely thirsty and has been urinating
frequently. She admits to missing her insulin doses over the past two days due to a
lack of supplies. On examination, she is tachycardic, hypotensive, and has deep, rapid
breathing (Kussmaul respirations). Her blood glucose is 450 mg/dL, and her arterial
blood gas shows a pH of 7.15. Urinalysis is positive for ketones. What is the most
appropriate next step in management?

A) Administer intravenous fluids and insulin

B) Start oral hypoglycemic agents
C) Administer sodium bicarbonate immediately
D) Perform a CT scan of the abdomen

@english.enarm
 Diabetic Ketoacidosis (DKA)
A 25-year-old woman with a history of type 1 diabetes mellitus presents to the
emergency department with abdominal pain, nausea, and vomiting for the past 24
hours. She reports that she has been feeling extremely thirsty and has been urinating
frequently. She admits to missing her insulin doses over the past two days due to a lack
of supplies. On examination, she is tachycardic, hypotensive, and has deep, rapid
breathing (Kussmaul respirations). Her blood glucose is 450 mg/dL, and her arterial
blood gas shows a pH of 7.15. Urinalysis is positive for ketones. What is the most
appropriate next step in management?

A) Administer intravenous fluids and insulin

B) Start oral hypoglycemic agents
C) Administer sodium bicarbonate immediately
D) Perform a CT scan of the abdomen

@english.enarm
 Diabetic Ketoacidosis (DKA)
A) Administer intravenous fluids and insulin

This patient presents with classic signs of diabetic ketoacidosis (DKA), including
hyperglycemia, metabolic acidosis (low pH), and ketonuria. The first step in
management is to administer intravenous fluids to correct dehydration and electrolyte
imbalances, followed by intravenous insulin to reduce blood glucose levels and stop
ketogenesis.

Starting oral hypoglycemic agents (option B) is not appropriate in this acute setting, as
they are ineffective in type 1 diabetes and do not address the underlying ketoacidosis.
Sodium bicarbonate (option C) is generally not recommended unless the acidosis is
severe (pH < 6.9), as it can cause complications like hypokalemia. A CT scan of the
abdomen (option D) might be considered if there were concerns about another cause
of abdominal pain, but the immediate priority is to treat the DKA.
@english.enarm
 Diabetes Mellitus
Inglés Español

(DKA) Diabetic ketoacidosis (CAD) Cetoacidosis Diabética

(HHS) Hyperosmolar (EHH) Estado Hiperglucémico

Hyperglycemic State Hiperosmolar

(FBG) Fasting Blood

(GA) Glucosa en Ayuno
Glucose

(OGTT) Oral Glucose (PTGO) Prueba de Tolerancia

Tolerance Test a la Glucosa Oral

@english.enarm
 Anemia
A 35-year-old woman presents to the clinic with complaints of fatigue, weakness, and
shortness of breath on exertion for the past two months. She also reports headaches
and dizziness. Her menstrual periods have been heavy and prolonged for the last six
months. On physical examination, she is pale, and her conjunctivae are notably pale
as well. Her CBC shows a hemoglobin level of 9 g/dL, a MCV of 70 fL, and a serum
ferritin level of 8 ng/mL. What is the most likely diagnosis?

A) Vitamin B12 deficiency anemia

B) Anemia of chronic disease
C) Iron deficiency anemia
D) Thalassemia trait

@english.enarm
 Anemia
A 35-year-old woman presents to the clinic with complaints of fatigue, weakness, and
shortness of breath on exertion for the past two months. She also reports headaches and
dizziness. Her menstrual periods have been heavy and prolonged for the last six months.
On physical examination, she is pale, and her conjunctivae are notably pale as well. Her
complete blood count (CBC) shows a hemoglobin level of 9 g/dL, a mean corpuscular
volume (MCV) of 70 fL, and a serum ferritin level of 8 ng/mL. What is the most likely
diagnosis?

A) Vitamin B12 deficiency anemia

B) Anemia of chronic disease
C) Iron deficiency anemia
D) Thalassemia trait

@english.enarm
 Iron Deficiency Anemia
Correct answer: C) Iron deficiency anemia

The patient’s symptoms, heavy menstrual periods, and lab findings (low
hemoglobin, low MCV, and low serum ferritin) strongly suggest iron deficiency
anemia. The chronic blood loss from heavy periods is a common cause. Vitamin B12
deficiency and anemia of chronic disease would present differently, and thalassemia
trait wouldn’t show low ferritin. Treatment involves iron supplementation and
managing the menstrual bleeding.

The most appropriate treatment would include iron supplementation and

addressing the underlying cause of blood loss, such as managing the patient’s heavy
menstrual bleeding.

@english.enarm
 ANEMIAS
Inglés Español Inglés Español

Iron deficiency Anemia por Aplastic anemia Anemia aplásica

anemia deficiencia de hierro
Anemia de células
Megaloblastic Anemia Sickle cell anemia falciformes o
anemia megaloblástica drepanocítica

Pernicious anemia Anemia perniciosa Anemia de

Anemia of chronic
enfermedades
disease
Hemolytic anemia Anemia hemolítica crónicas

@english.enarm
 Community-Acquired Pneumonia (CAP)

A 70-year-old man with a history of chronic obstructive pulmonary disease (COPD) presents to the
emergency department with a 3-day history of fever, productive cough with greenish sputum, and
shortness of breath. He also reports pleuritic chest pain on the right side. On examination, his
temperature is 38.5°C, respiratory rate is 24 breaths per minute, and oxygen saturation is 88% on
room air. Auscultation reveals decreased breath sounds and crackles in the right lower lung field. A
chest X-ray shows a right lower lobe consolidation. What is the most appropriate next step in
management?

A) Start broad-spectrum intravenous antibiotics

B) Discharge with oral antibiotics and follow-up
C) Obtain a sputum culture and await results before starting antibiotics
D) Initiate corticosteroid therapy alone

@english.enarm
 Community-Acquired Pneumonia (CAP)

A 70-year-old man with a history of chronic obstructive pulmonary disease (COPD) presents to the
emergency department with a 3-day history of fever, productive cough with greenish sputum, and
shortness of breath. He also reports pleuritic chest pain on the right side. On examination, his
temperature is 38.5°C, respiratory rate is 24 breaths per minute, and oxygen saturation is 88% on
room air. Auscultation reveals decreased breath sounds and crackles in the right lower lung field. A
chest X-ray shows a right lower lobe consolidation. What is the most appropriate next step in
management?

A) Start broad-spectrum intravenous antibiotics

B) Discharge with oral antibiotics and follow-up
C) Obtain a sputum culture and await results before starting antibiotics
D) Initiate corticosteroid therapy alone

@english.enarm
 Community-Acquired Pneumonia (CAP)

Correct answer: A) Start broad-spectrum intravenous antibiotics

This patient presents with classic symptoms and signs of community-acquired pneumonia (CAP),
including fever, productive cough, pleuritic chest pain, and findings on chest X-ray consistent with
right lower lobe consolidation. Given his age, history of COPD, and oxygen saturation of 88% on
room air, he is at increased risk for complications and warrants hospitalization. The most
appropriate next step is to start broad-spectrum intravenous antibiotics to cover typical and atypical
pathogens.

Discharging the patient with oral antibiotics (option B) is not appropriate due to his severity of
symptoms and risk factors. While obtaining a sputum culture (option C) is useful, treatment should
not be delayed while awaiting results. Initiating corticosteroid therapy alone (option D) may be
helpful in managing COPD exacerbation but is not sufficient to treat the underlying pneumonia.

@english.enarm
 Pneumology
Inglés Español

Chronic Obstructive Enfermedad Pulmonar

Pulmonary Disease (COPD) Obstructiva Crónica (EPOC)

Pleural effusion Derrame Pleural

Crackles Estertores

Lung cancer Cáncer de Pulmón

Chest X-ray (CXR) Radiografía de tórax

@english.enarm
 Acute Viral Hepatitis
A 28-year-old man presents to the clinic with a 1-week history of fatigue, nausea, and a
decreased appetite. He also reports dark urine and jaundice over the past three days. He
denies any recent travel or use of illicit drugs but admits having multiple sexual partners
in the past year. On physical examination, he is icteric, and his liver is mildly tender on
palpation. His laboratory results show elevated liver enzymes (AST, ALT), total bilirubin of
4 mg/dL, and positive hepatitis surface antigen. What is the most likely diagnosis?

A) Hepatitis A
B) Hepatitis B
C) Hepatitis C
D) Alcoholic hepatitis

@english.enarm
 Acute Viral Hepatitis
A 28-year-old man presents to the clinic with a 1-week history of fatigue, nausea, and a
decreased appetite. He also reports dark urine and jaundice over the past three days. He denies
any recent travel or use of illicit drugs but admits to having multiple sexual partners in the past
year. On physical examination, he is icteric, and his liver is mildly tender on palpation. His
laboratory results show elevated liver enzymes (AST, ALT), total bilirubin of 4 mg/dL, and
positive hepatitis B surface antigen (HBsAg). What is the most likely diagnosis?

A) Hepatitis A
B) Hepatitis B
C) Hepatitis C
D) Alcoholic hepatitis

@english.enarm
 Acute Viral Hepatitis
B) Hepatitis B

The patient’s presentation with fatigue, nausea, jaundice, and dark urine, along with elevated liver
enzymes and a positive hepatitis B surface antigen (HBsAg), strongly suggests acute hepatitis B infection.
His history of multiple sexual partners is a known risk factor for hepatitis B transmission.

Hepatitis A (option A) typically presents with similar symptoms but is more commonly associated with
travel to endemic areas or contaminated food and water. Hepatitis C (option C) is usually chronic and
less likely to present acutely with jaundice and elevated bilirubin. Alcoholic hepatitis (option D) would be
considered if there were a significant history of alcohol use, and it typically presents with a different
pattern of liver enzyme elevation (AST > ALT).

The correct management involves supportive care and monitoring for potential complications, as most
cases of acute hepatitis B resolve spontaneously.

@english.enarm
 Acute Viral Hepatitis
INGLÉS ESPAÑOL

Jaundice Ictericia

Elevated liver enzymes Elevación de enzimas hepáticas

Cirrhosis Cirrosis

Viral load Carga viral

Hepatitis flare-up Reagudización de la hepatitis

@ENGLISH.ENARM
PRIMARY LESIONS Similares en español y
en inglés

Inglés Español

DIFERENTES en
Vesicle Vesícula
español y en inglés
Pustule Pústula
Inglés Español
Nodule Nódulo
Bulla Ampolla
Plaque Placa

Papule Pápula

Macule Mácula
@english.enarm
SECONDARY LESIONS

DIFERENTES en español y Similares en español y

en inglés en inglés

Inglés Español Inglés Español

Scar Cicatriz Erosion Erosión

Scale Escama Fissure Fisura

Crust Costra Eschar Escara

@english.enarm
 @english.enarm

Mnemotecnias
en inglés
INTERNAL MEDICINE
CHA2DS2VASC

Se usa para determinar

si un paciente con FA
debería recibir
anticoagulación para
reducir su riesgo de
sufrir un ACV.

@english.enarm
 MUDPILES /
GOLDMARK

@english.enarm
CHF CXR Findings

@english.enarm
 Concluding Remarks
En esta clase hemos cubierto los aspectos fundamentales del inglés
médico, incluyendo gramática, vocabulario especializado, y estrategias
para abordar casos clínicos. Es esencial que continúen practicando y
familiarizándose con estos conceptos, ya que son herramientas cruciales
para el éxito en el ENARM. La precisión en la interpretación de preguntas
en inglés puede marcar la diferencia en su desempeño.
Recuerda utilizar tu manual y resolver el examen simulacro.

¡Mucho éxito en el ENARM y en tu camino hacia la

especialidad!

@english.enarm
 @english.enarm

Inglés Médico para el ENARM

¡Mucho
éxito en el ENARM y
en tu camino hacia
la especialidad!
 Bibliografía @english.enarm

Gramática Inglesa:

• Hewings, M. (2013). Advanced Grammar in Use (3rd ed.). Cambridge University Press.
• Murphy, R. (2019). English Grammar in Use (5th ed.). Cambridge University Press.
• McCarthy, M., & O’Dell, F. (2017). English Vocabulary in Use: Advanced (3rd ed.). Cambridge University Press.

Medicina Interna:

• Jameson, J. L., Fauci, A. S., Kasper, D. L., Hauser, S. L., Longo, D. L., & Loscalzo, J. (2018). Harrison’s Principles
of Internal Medicine (20th ed.). McGraw-Hill Education.

Pediatría:

• Kliegman, R. M., St. Geme, J. W., Blum, N. J., Shah, S. S., Tasker, R. C., & Wilson, K. M. (2020). Nelson Textbook
of Pediatrics (21st ed.). Elsevier.

Ginecología y Obstetricia:

• Cunningham, F. G., Leveno, K. J., Bloom, S. L., Dashe, J. S., Hoffman, B. L., Casey, B. M., & Spong, C. Y. (2018).
Williams Obstetrics (25th ed.). McGraw-Hill Education.

Cirugía:

• Brunicardi, F. C., Andersen, D. K., Billiar, T. R., Dunn, D. L., Hunter, J. G., Matthews, J. B., & Pollock, R. E. (2019).
Schwartz’s Principles of Surgery (11th ed.). McGraw-Hill Education.
Inglés Médico para el ENARM