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Flashcards in Clinical scoring systems Deck (31)
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1
Q

What scoring systems can be used to asses GI bleeding?

A

Rockall score and the Blatchford score

2
Q

What is Rockall score used for?

A

To predict the risk of death and risk of re-bleeding from an upper GI bleed
In other words - determines the severity of GI bleed.

3
Q

What parameters are involved in Rockall scoring system?

A

Age, Shock, co-morbidities, diagnosis, major stigmata of recent haemorrhage.

4
Q

What is required to use the Rockall scoring system?

A

Need endoscopy findings

5
Q

What is Blatchford scoring system used for?

A

Will predict the need for intervention i.e blood transfusion or therapeutic endoscopy. Used to help decide if a patient needs admitting to hospital or not.

6
Q

What is MELD scoring system used for?

A

MELD = Model for End stage Liver Disease.

Used for patients with liver cirrhosis - ranks degree of illness to determine how urgently you will receive a donor liver/transplant procedure
Used to monitor complications in patients with cirrhosis.

7
Q

What is Maddrey’s score used for?

A

(Maddrey’s score is aka Maddrey’s disciminant function)

Predicts prognosis in alcohol-related hepatitis and identify patients suitable for treatment with steroids.

8
Q

What is (Modified) Glasgow score used to assess?

A

Severity of pancreatitis

9
Q

Describe criteria for Glasgow imrie score

A
Use PANCREAS 
P - PaO2
A - Age >55
N - Neutrophils (WBC>15)
C - Calcium <2
R - uRea >16
E - Enzymes (LDH>600 or AST/ALT>200)
A - Albumin <32
S - Sugar (Glucose >10)
10
Q

Describe Glasgow coma scale score

A
Eye opening:
4 - spontaneously 
3 - to speech 
2 - to pain 
1 - no response 
Verbal response
5 - orientated to time, person, place
4 - confused 
3 - inappropriate words 
2 - incomprehensible sounds 
1 - no response 
Motor response 
6 - obeys command 
5 - moves to localised pain 
4 - flex to withdraw from pain 
3 - abnormal flexion 
2 - abnormal extension 
1 - no response
11
Q

Describe CURB-65 scoring system

A
Confusion 
Urea >7mmol
Resp rate >30
Blood pressure <90 systolic 
Over 65 

CURB-65 score of 2+ = admit.

12
Q

Describe Centor scoring system

A

Estimates probability that pharyngitis is streptococcal and suggests management course

Only to be used in patients with ≤3 day Hx of pharyngitis

Age

  • 3-14yrs = 1 point
  • 15-44 = 0 points
  • 45+ = -1 point

Exudate or swelling on tonsils = yes (1 point) or no

Tender/swollen anterior cervical LN = Y/N

Temp >38C = Y/N

Cough = Present (0)/ absent (+1 point)

13
Q

Describe FeverPAIN scoring system

A

Predicts likelihood of strep throat Yes = 1 point. No= 0 point. Total of 4+ points = abx. 2-4 points = delay abx script. 0-2 points = Strep throat unlikely

Questions asked:

Fever in past 24hrs 
Absence of cough or coryza 
Symptom onset ≤3 days 
Purulent tonsils 
Severe tonsil inflammation
14
Q

Describe CHA2DS2-VASc

A

Estimates stroke risk in pts with AFib

Congestive Heart failure 
Hypertension 
Age (1 point 65-74, 2 points 75+)
Diabetes 
Stroke or TIA recently 
Vascular disease 
Sex category - female 

Score above 1 = high risk
Score of 1 = moderate risk

15
Q

Describe BTS classification of asthma severity

A

Mild:

  • no features severe asthma
  • PEFR >75%

Moderate:

  • no features of severe asthma
  • PEFR 50-75%
Severe: if one of following present:
- Can't complete sentences in one breath 
- PEFR 33-50%
- RR >25 
HR >110/min

Life threatening: if any one of following present:

  • PEFR<33%
  • Sats <92% or ABG pO2 <8kPa
  • Cyanosis, poor respects effort, near or fully silent chest
  • exhaustion, confusion, hypotension, arythmies
  • normal pCO2

Near fatal:
- raised pCO2

16
Q

Describe MRC dyspnoea score

A

Grade of breathlessness related to activities.
Used in rest diseases, especially COPD

1 = not troubled by breathlessness expect on strenuous activity

2 = SOB when hurrying or walking up a slight hill

3 = walks slower than contemporaries on ground level

4 = stops for breath after walking about 100m or after a few mins on level ground

5 = too breathless to leave house, breathless on dressing/undressing

17
Q

Describe CKD classification

A
Stage 1 = eGFR >90 
Stage 2 = 60-89 
Stage 3a = 45-59
Stage 3b = 30-44
Stage 4 = 15-29 
Stage 5 = eGFR <15
18
Q

Describe MRC grading of muscular power

A

0 = no contraction

1 = flicker or trace of contraction

2 = active movement, with gravity eliminated

3 = active movement against gravity

4 = active movement against gravity and resistance

5 = normal power

19
Q

What are parameters in Wells score?

A
  • Signs and symptoms of DVT
  • PE is number 1 Ddx
  • HR >100
  • Haemoptysis
  • Immobilisation in 3+ days or surgery in last 4 weeks
  • Previous DVT, VTE, PE
  • Malignancy with treatment within last 6 months or palliative
20
Q

What is ASA used for?

A

Classifies health of patients prior to surgery

21
Q

What is HAS-BLED used for?

A

Estimates risk of major bleeding for patients on anti-coag to assess risk-benefit in A.fib care

22
Q

What is Rockall used for?

A

Determines severity of GI bleeding, prior to endoscopy

23
Q

What is POSSUM used for?

A

Estimates morbidity and mortality for general surgery patients

24
Q

What is NELA used for?

A

Estimates risk of death within 30 days of emergency abdominal surgery

25
Q

What is Ranson used for?

A

Estimates mortality of patients with pancreatitis, based on initial and 48hr lab values

26
Q

What is ROME used for?

A

Criteria to diagnose IBS

27
Q

What is PHQ-9 used for?

A

Patient health questionnaire-9.

Used for degree of depression severity.

28
Q

What is GAD-7 used for?

A

Generalised Anxiety Disorder.

Measures severity of anxiety

29
Q

What is FAST used for?

A

There are a few..

FAST for alcohol screening test

FAST acronym for stroke

FAST focused assessment with sonography for trauma - predicts presence of pericardial or intra-ado injury after penetrating or blunt trauma

30
Q

What is GPCOG used for?

A

GP assessment of cognition

A screening tool for dementia

31
Q

What is STaRTBack used for?

A

Used to categorise patients into low, medium and high risk for back pain. Helps decision making and management of patient

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