Classification System Flashcards
Aortic Dissection
Stanford A - involves ascending aorta with or without descending - surgical
Stanford B - descending, distal to left subclavian -> medical
DeBakey
Type I - ascending aorta
Type II - ascending aorta only
Type III - descending aorta after subclavian
Leventhal Criteria for MG
Duration > 6 years
Chronic lung disease
FVC < 2.9L
Dose pyridostigmine >750mg/d
Other predictive factors
- Bulbar symptoms
- Osserman III-IV
- Recent steroid use
- Major cavity surgery, long duration
MG Classification for severity
Osserman Classification
I - ocular only
IIa - mild, without resp/bulbar
IIb - mod, with bulbar
III - severe
IV - requires mechanical ventilation
ECG Contiguous leads
inferior - II, III, aVF
Anterior - V1-V4
Lateral - I, aVL, V5-V6
Posterior - look for reciprocal ST depression V1-V3
Sgarbossa criteria
Concordant ST elevation ≥1mm
Concordant ST depression ≥1mm
Discordant ST elevation ≥5mm
HAS-BLED score
Max score 9, ≥3 = high bleeding risk
Hypertension
Abnormal liver or renal function
Stroke
Bleeding history
Labile INR
Elderly >65
Drugs (anti platelet or anticoagulation )
New version of CHADSVASC?
Remove female gender as a risk factor
CCF
HTN
Age ≥75 (2 points)
DM
Stroke (2 points)
Vascular disease
Age 65-75 (1 point)
Max 9 points
STOPBANG
Snorning, tiredness, observed apnoea, pressure high
BMI >35
Age > 50
Neck > 40cm
Gender male
Infective endocarditis diagnosis?
Duke Criteria
Major - positive blood culture, positive echo
minor - IV drug use, fever≥38, septic emboli, immunological signs, microbiological signs
2 major or 1 major + 3 minor or 5 minor
Facial fracture classification
Le Fort
Class I - across maxilla above the teeth, horizontal
Class II - across mid face
Class III - separation of mid face from skull base
Subarachnoid classification
World federation of neurosurgical societies (WFNS) Grade
- Based on GCS and motor deficit.
- GCS 13, motor deficit = class III
- Range of 1-5
Fisher Grade for CT classification
- Grade 1-4
- Predicts risk of cerebral vasospasm based on amount of blood
- class 2 = diffuse blood <1mm thick
- class 3 = localised clot or layers of blood ≥1mm, highest risk of vasospasm
- class 4 = intraventricular or intraparenchymal haemorrhage
WHO criteria for pulmonary HTN?
Class I - pulmonary arterial HTN
Class II - cariogenic
Class III - respiratory
Class IV - chronic thromboembolism
Class V - miscellaneous causes, sarcoidosis, haematological
Lee’s Revised Cardiac Risk Index
Major cavity surgery
IHD
CCF
Cerebral vascular disease
Insulin dependent diabetes
CKD
≥3 = 11% of MACE in non-cardiac surgery
GOLD Criteria COPD
FEV1 predicted
Mild ≥80%
Mod 5070
Sev 30-50
Very severe <30%
ABCD grouping - number of exacerbation + shortness of breath
mMRC Dyspnoea Scale
0 - strenuous exercise
2 - walks slower than peers due to breathlessness
3 - stops for breath after ~100m
Grade 4 - too breathless to leave house
Three legs of the stool for thoracic surgery for pneumonectomy
Resp mechanics
- FEV1 >2L for pneumo, >1.5L for lobectomy. Not accounting for size, so no longer used.
- Predicted post-op FEV1 >40% (absolute FEV1 of 0.8L post resection)
Lung parenchymal
DLCO PPO >40%
Cardiopulmonary reserve
CPET VO2 max >15ml/kg/min
Calculation of predicted post-op FEV1
PPO = FEV1 x (1 - %lung resected)
So if taking out right lung - FEV1 x 0.5
Lung segments
Right lung
- Apical, posterior, anterior
- Medial and lateral
- Apical, anterior, posterior, medial, lateral
Left lung
- Apicalposterior, anterior
- Lingula: superior, inferior
- Apical, anterior, posterior, lateral
Restrictive lung disease stratification
FEV1
Mild >70%
Mod 60-70%
Mod Sev 50-59%
Severe 35-50%
Very severe <35%
DLCO < 40% =0.4 severe reduction
40-60% = mod
Stratify severity of pHTN based on
1) mPAP
2) RVSP
3) Echo features
mPAP - 20/40/55
RVSP - 30/45/60
Echo -
TAPSE <17mm
Tricuspid regurgitation
RA/RV dilation
SBP For TBI
110 for <50 and >70
100 for 50-70
