Clinical Calculators

Question 1

what is SOFA and what is the evidence for it?

Answer 1

sequential organ failure assessment released by Sepsis-3 consortium, pub JAMA in Feb 2016

mortality and prognostic scoring & determination for the degree of organ failure

calculate on admission to ITU and every 24 hours thereafter

Question 2

what does the Rockall score do?

Answer 2

determine the mortality risk of an upper GI bleed once the endoscopy has been performed, based on the endoscopic findings

Question 3

what are the pancreatitis clinical scores and what are they used for?

Answer 3

• Modified Glasgow Imrie Severity Criteria - prognostic
• Marshall score - prognostic
• BISAP score - disease severity
• Ranson’s criteria - estimate mortality

Question 4

what does the Child Pugh score tell you?

Answer 4

estimates the degree of severity of liver cirrhosis

give - Child Pugh score, estimated perioperative mortality for abdominal surgery, and whether they should be considered for transplant

Question 5

what are the items of qSOFA?

Answer 5

SBP < 100 mmHg

RR > 22/min

altered conscioussness

Question 6

what score is helpful in determining management of acute upper GI bleed?

Answer 6

Blatchford score - doesn’t need the results of an endoscopy in order to calculate it, so usually more applicable than Rockall

Question 7

what is the ASCVD?

Answer 7

atherosclerotic cardiovascular disease risk calculator developed by the AHA/ACC

use for calculating the risk of a patient suffering CVD related to atherosclerosis, and decide whether to start statins or not

Question 8

what score helps estimate prognosis and suggest management of CAP?

what are the items

Answer 8

CURB-65

• confusion
• uraemia > 7
• resp rate >30
• systolic blood pressure < 90
• age > 65 years old

Question 9

what information do you get from a PESI score?

what are the limitations?

Answer 9

PESI = pulmonary embolus severity index

not a diagnostic tool! gives advice on management setting

• *I & II** - outpatient managment
• *III, IV & V** - high level of care, i.e. ITU admission

limitaiton: patient with renal failure and severe comorbidities were excluded from the original investigation cohorts so PESI is not applicable

Question 10

what calculator is useful in a patient with STEMI/NSTEMI to determine risk of mortality?

Answer 10

GRACE, TIMI or Killip scores

Question 11

what is the calculator for the probability of PE being present before blood tests or imaging are ordered?

what is used to determine likely outcomes from PE?

Answer 11

PE clinical probability

PESI (pulmonary embolus severity index) - 30-day outcomes

Question 12

what are the items for the ABCD² score?

when is this used?

Answer 12

• age > 60
• BP > 140/90
• clinical features
• duration of symptoms
• diabetic status

a management tool to identify if admission is required following TIA from primary care

Question 13

when should the dosing weight be calculated?

Answer 13

when weight > 1.25 x ideal body weight

Question 14

what are the items in the Child-Pugh score?

Answer 14

bilirubin, albumin, encephalopathic status, INR and acities status

Question 15

what is the calculator for the probability of a DVT before any blood tests are ordered?

Answer 15

Well’s score

Question 16

GCS

Answer 16

M 6 V 5 E 4

• movement
  
  • obey commands, localising to pain, withdrawing from pain, flexor from pain, extensor from pain, nothing
• voice
  
  • talking spontaneously, incoherent speech, words, sounds, nothing
• eyes
  
  • open and spontaneous movement, open to voice, open to pain, none

Question 17

what score helps assess suicide risk in depressed patients in the emergency setting?

Answer 17

SAD PERSONS

should always screen for risk to others & access to firearms/weapons in the house

Question 18

where is qSOFA applicable?

what are the actions of positive score?

Answer 18

out-of-hospital, adult inpatients, A&E

if >1, take lactate level and calculate a full SOFA score. Sepsis-6