Criteria

Question 1

What risk score is used to see the RISK of CVD in next 10 years

Answer 1

QRISK2
(Done in unstable angina)

Question 2

What estimates the risk of death or death/myocardial infarction (MI) in patients following an initial acute coronary syndrome (ACS)

Answer 2

The Global Registry of Acute Coronary Events (GRACE) score
The scores can be stratified between: In-hospital mortality and mortality/MI

Question 3

HF severity criteria

Answer 3

NY heart association: Class 1-4 of HF severity
1. no limit on physical activity
2. slight limit on moderate activity
3. marked limit on moderate activity + gentle activity
4. Symptoms even at rest!!!

Question 4

Fontaine Classification (stages 1-4)

Answer 4

Peripheral Arterial Disease
1. Asymptomatic
2. Intermittent claudication
a. Claudication after walking >200m
b. Claudication after walking <200m
3. Chronic limb ischemia = rest pain
4. Ischaemic ulceration or tissue loss (gangrene)

Question 5

Wells score

Answer 5

Predicts risk of a patient presenting with symptoms having a DVT or PE. Includes risk factors + clinical findings (calf swelling)

Question 6

TRUE LOVE + WITTS

Answer 6

Severity of flares in ulcerative colitis

Question 7

MARSH histological classification

Answer 7

Coeliacs

Question 8

CHA2DS2-VASc score

Answer 8

C = congestive heart failure/LV function
H = hypertension
A2 = Age > 75
D = diabetes mellitus
S2 = Stroke/TIA/thromboembolism
V = vascular disease
A = age = 65-74
S = sex (female)
Max score is 9
Verify risk of stroke in patients with A.fib

Question 9

ORBIT scores

Answer 9

Older age = 1
Reduced haemoglobin/ Hct/ anaemia = 2
Bleeding history = 2
Insufficient kidney function = 1
Treatment with anti platelets = 1

Estimates the risk of a major bleeding for patients on anticoagulants for A.fib

Question 10

Severity score of Mallory Weiss Tear

Answer 10

ROCKALL SCORE
- age, blood pressure, comorbidities, and endoscopic findings
- identify patients at risk of adverse outcomes following endoscopic treatment of an upper GI bleed

Question 11

Alvarado score

Answer 11

Predict the likelihood of appendicitis. A score of >7 is predictive of acute appendicitis
5-6 warrants an USS or CT

Question 12

TNM Classification

Answer 12

Oesophageal cancer
Gastric cancer
Colorectal polyps and cancer

Question 13

Criteria for a cute liver failure

Answer 13

West Haven Criteria Grade 1-4
Grade 1: Altered mood, sleep issues, sleep disturbances, dyspraxia
Grade 2: Lethargy, mild confusion, ASTERIXIS (liver flap)
Grade 3: Marked confusion, incoherent, restlessness, somnolent (v. quiet)
Grade 4: Comatose

Question 14

Treatment for ALD steroid consideration

Answer 14

Maddrey’s discriminant value = INR + serum bilirubin = 32+) + N-acetylcysteine (severe)

Question 15

Alcohol dependency questionnaire

Answer 15

ALD

CAGE:
should you CUT down
are people Annoyed by your drinking
feel Guilty about drinking
you drink in morning (Eye opening)
2 < dependant
AUDIT: 1st line = 10 questions = alcohol use disorder ID test

Question 16

NAFLD scoring system

Answer 16

Non invasive tool to assess the level of fibrosis, such as Fibrosis-4 (FIB-4) or NAFLD Fibrosis score. Patients with low score can be managed in primary care
> 2.67 = advanced

Question 17

Acute pancreatitis defined by 2+/3 out of the 3 criteria

Answer 17

Clinical features: consistent with pancreatitis
Elevation of serum amylase or serum lipase (3x)
Radiological features: inflammation on CT

Question 18

Acute pancreatitis scoring systems

Answer 18

MODIFIED GLASGOW SCORE: 3 points or more within the first 48 hours should be considered for referral to high-dependency care
P - pO2 <8kPa
A - Age > 55 years
N - Neutrophils - WCC > 15x109/L
C - Calcium <2mmol/L
R - Renal function = urea >16mmol/L
E - enzymes = AST >200U/L or LDH>600U/L
A - Albumin <32g/L
S - Sugar (Blood sugar >10mmol/L

Question 19

Rheumatoid Arthritis scoring systems

Answer 19

American College of Rheumatoid Arthritis (ACR) and European League Against Rheumatism (EULAR)

Question 20

FRAX SCORE

Answer 20

predicts the risk of a fragility fracture over the next 10 years

Question 21

PSORIATIC ARTHRITIS

Answer 21

CASPAR criteria state: scores > 2 points
- Psoriatic nail changes (2 points)
- Rheumatoid factor negative (1 point)
- History of dactylitis (1 point)
- Radiological evidence = juxta-articular periostitis (1 point)

Question 22

Risky stratifying tool to determine risk of future stroke

Answer 22

ABCD2
Age > 60 (1)
BP > 140/90 (1)
Clinical symptoms:
- unilateral weakness (2)
- slurred speech, no weakness (1)
DMT2 (1)
* Score > 6 refer to neurology asap, risk of stroke in a week -= 35.5% *

Question 23

Scoring system for SAH

Answer 23

Glasgow score scale
- out of 15
- Eyes =4
- Vertebral = 5
- Motor = 6

Question 24

Assessment tools for dementia

Answer 24

Mini-mental state (MMSE)
- 11 questions testing orientation, attention, memory, language and visual-spatial skills
Low risk > 25
Mild cognitive impairment: 20-24
Moderate: 13-20
Severe < 12

DSM-V
ICD-10

Question 25

Diagnostic criteria include two of front-temporal dementia

Answer 25

- Visual hallucinations - Parkinsonism - Fluctuating mental state

Question 26

Diagnostic criteria for epilepsy

Answer 26

At least 2 unprovoked seizures occurring more than 24 hours apart One unprovoked seizure and probability of future seizures (considered >60% risk in 10 years Diagnosis of an epileptic syndrome - eyes open - synchronised movements - can occur in sleep

Question 27

Scoring system for BPH

Answer 27

Intermittent prostate symptom score: tool for assessing severity of LUTS - 0-7 = mildly symptomatic - 8-19 = moderate symptomatic - 20-35 = severely symptomatic

Question 28

Prostate cancer scoring system

Answer 28

GLEASON SCORE Identifies two most common cell patterns + gives them both a score between 1-5 and add them together 1 = well differentiated 5 = poorly differentiated Low grade < 6 Intermediate grade 7 High grade 8-10

Question 29

Which scoring system is used to decided whether to offer possible prostate cancer patient a multi-parametric MRI influenced prostate biopsy

Answer 29

- Likert score > 3 = offer multi parametric MRI-influenced prostate biopsy - Likert score < 3 = discuss pros and cons of biopsy

Question 30

RCC STAGING

Answer 30

ROBSON STAGING 1-4

Question 31

VARICOCELE GRADING

Answer 31

Sub-clinical = no clinical abnormality only detected by Doppler USS Grade I (small) = only palpable with Valsalva Grade II (moderate) = palpable without Valsalva Grade III (large) = Varicocele is visible through scrotal skin

Question 32

Post natal depression

Answer 32

POST NATAL DEPRESSION ASSESSMENT TOOL: Patient health questionnaire (PHQ-9)

Question 33

HARK questions for abuse

Answer 33

humiliated, afraid, rape, kick

Question 34

GOLD CLASSIFICATION FOR COPD

Answer 34

Severity of airflow obstruction 1) Post-bronchodilator FEV1/FVC 2) FEV1 (% of predicted) Stage 1: Mild* 1) <0.70 2) ≥80% Stage 2: Moderate 1) <0.70 2) 50-79% Stage 3: Severe 1) <0.70 2) 30-49% Stage 4: Very severe 1) <0.70 2) <30%

Question 35

MRC dyspnoea scale for COPD

Answer 35

Grade 1 = Breathless on strenuous exercise Grade 2 = Breathless on walking up a hill Grade 3 = Breathless that shows on walking on flat Grade 4 = Stop to catch their breathe after walking 100 metres on flat Grade 5 = Unable to leave the house due to breathlessness

Question 36

CURB 65

Answer 36

MORTALITY PREDICTION CURB-65 Confusion Urea > 7 Resp Rate > 30/min Blood pressure < 90 systolic or < 60 diastolic (mmHg) 65 + 0-1 = Treat in primary care > 2 = hospital admissions > 3 = ICU

Question 37

Pleural effusions criteria

Answer 37

LIGHTS CRITERIA If the protein level is 25-35 g/L, Light’s criteria should be applied. Validated set of pleural fluid lab test findings used to distinguish between transudate and exudate effusions for borderline presentations. Light’s criteria state that an exudate is likely if one or more of the following criteria are met: - Pleural fluid protein divided by serum protein is > 0.5 - Pleural fluid LDH divided by serum LDH is > 0.6 - Pleural fluid LDH > 2/3 the upper limit of normal serum LDH

Question 38

Risk calculator for GI bleeds

Answer 38

Glasgow Blatchford bleeding score- GBS