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Flashcards in Scoring Systems Deck (24):
1

MRC Dyspnoea

Stage 1 - Fine, no ill effects
Stage 2 - Shortness of breath after mild exertion (hurrying on level, slight hill)
Stage 3 - Walk slower than peers, stop after 15 minutes
Stage 4 - Breathless on level ground, after 100 yards
Stage 5 - ADLs inhibited

2

CURB-65

Confusion - AMT <8 or new onset
Urea >7.0
Resp rate >30
Blood pressure <90 or <60
>65

3

Asthma Severity

Life threatening
PEFR <33% of best
PaCO2 normal or high
PaO2 <92%
Silent chest, cyanosis, poor effort
Exhaustion, altered conciousness

Severe acute
PEFR 33-50%
Pa02 92-96%
HR - >110
Resp rate >25
Struggles to finish sentences

Moderate
PEFR >50-75%
Oxygen sats >92%
Speech normal
RR <25 breaths per minute
Pulse <110

4

NYHA Classification

Stage 1 - Cardiac disease but no impact on life activities
Stage 2 - Some activity limitation
Stage 3 - Breathless with stairs, comfortable at rest
Stage 4 - Moribund, struggles with ADLs

5

WHO Cancer Score

(AKA WHO performance score)

0: able to carry out all normal activity without restriction
1: restricted in strenuous activity but ambulatory and able to carry out light work
2: ambulatory and capable of all self-care but unable to carry out any work activities; up and about more than 50% of waking hours
3: symptomatic and in a chair or in bed for greater than 50% of the day but not bedridden
4: completely disabled; cannot carry out any self-care; totally confined to bed or chair.

6

Duke's Endocarditis

Infective endocarditis diagnosed if
pathological criteria positive, or
2 major criteria, or
1 major and 3 minor criteria, or
5 minor criteria

Major criteria

Positive blood cultures
two positive blood cultures showing Streptococcus viridans and the HACEK group or three or more positive blood cultures where the pathogen is less specific such as Staph aureus and Staph epidermidis

Evidence of endocardial involvement
positive echocardiogram or
new valvular regurgitation

Minor criteria
1) predisposing heart condition or intravenous drug use
2) microbiological evidence does not meet major criteria
3) fever > 38ºC
4) vascular phenomena: major emboli, splenomegaly, clubbing, splinter haemorrhages, Janeway lesions, petechiae or purpura
5) immunological phenomena: glomerulonephritis, Osler's nodes, Roth spots

7

Duke's Cancer Staging

Dukes A Tumour confined to the mucosa (90%)
Dukes B Tumour invading bowel wall (70%)
Dukes C Lymph node metastases (45%)
Dukes D Distant metastases (6%)(20% if resectable)

8

CHADVASC

Congestive heart failure
Hypertension
Age >65 (1)/Age >75 (2)
Diabetes
Stroke/TIA in the past (2)
Vascular disease
Sex (female)

9

HASBLED

Hypertension
Abnormal renal/liver
Stroke
Bleeding history
Labile INRs
Elderly
Drugs predisposing to bleeding

10

Glasgow Coma Scale

Eyes
Spontaneous
Respond to voice
Respond to pain
Nothing

Voice
Spotaneous
Confused
Words
Noises
Nothing

Movement
Follows commands
Localises pain
Withdraws from pain
Flexes (decorticate)
Extends (decerebrate)
No response

11

Glasgow Pancreatitis

Predicts severity of attack
PANCREAS
PaO2 <8kpa
Age >55
Neutrophils >15
Calcium
uRea
Enzymes - LDH
Album
Sugar (glucose)

12

Gustilo Anderson

Type I
wound < 1 cm
Type II
1-10cm
Type III A
> 10 cm, high energy
adequate tissue for coverage
includes segmental / comminuted fractures even if wound <10cm
farm injuries are automatically Gustillo III
Type IIIB
extensive periosteal stripping and requires free soft tissue transfer
Type IIIC
vascular injury requiring vascular repair

13

Salter Harris

Type 1 - Slipped (through growth plate)
Type 2 - Above (fracture above & involving growth plate)
Type 3 - Lower (fracture below and involving growth plate)
Type 4 - Through (transverse - intra-articular)
Type 5 - Rammed

14

MRC Muscle Grading

Grade 5: Muscle contracts normally against full resistance.
Grade 4: Muscle strength is reduced but muscle contraction can still move joint against resistance.
Grade 3: Muscle strength is further reduced such that the joint can be moved only against gravity with the examiner's resistance completely removed. As an example, the elbow can be moved from full extension to full flexion starting with the arm hanging down at the side.
Grade 2: Muscle can move only if the resistance of gravity is removed. As an example, the elbow can be fully flexed only if the arm is maintained in a horizontal plane.
Grade 1: Only a trace or flicker of movement is seen or felt in the muscle or fasciculations are observed in the muscle.
Grade 0: No movement is observed.

15

AKI

A rise in serum creatinine of 26 μmol/L or greater within 48 hours.
50% or greater increase in serum creatinine (1.5 fold from baseline) within the preceding seven days.
A fall in urine output to less than 0.5 mL/kg/hour for more than six hours.

16

Pre-Diabetes/diabetes ranges

<6mmol/l - normal
<6mmol/l - 7mmol/l - prediabetes
>7 mmol/l - diabetes (double check with HbA1C if asymptomatic)

<6% HbA1C is healthy
>6.5% is diabetes

17

Centor Criteria

No cough
Cervical lymphadenopathy
Exudative tonsils
Fever >38

18

SIRS

qSOFA
- RR >25
- Confusion
- Hypotension <90/60

19

Child-Pugh Classification

Bilirubin
Albumin
Prothrombin time
Encephalopathy
Ascites

20

CKD

1 >90ml/min/1.73
2 60-90
3 30-60
4 15 - 30
5 <15

21

ASA Grading

1 - no systemic disease
2 - mild systemic disease
3 - modereate systemic disease with functional impairment
4 - severe systemic disease that is a constant threat to life
5 - moribund - will die without operation
E - suffix for emergency procedures

22

Mortality in Acute Pancreatitis

Glasgow-Imrie Score:
P - PO2 <8
A - Age >55
N - Neutrophils (WCC >15)
C - Calcium <2
R - Renal function (Urea >16)
E - Enzymes (ALT/AST >200, LDH >600)
A - Albumin <32
S - Sugar (glucose >10)

23

Mortality in UGI bleed

Rockall score
Before endoscopy:
Age
Shock?
Co-morbidity

After endoscopy:
Diagnosis
Evidence of bleeding

24

Safe to discharge a UGI bleed

Glasgow-Blatchford Score:

Urea
Hb
Systolic BP
Pulse
Presentation - melena or syncope
Hepatic disease
Cardiac failure