Diagnostic Criteria

Question 1

Scenario: Amsel’s Criteria

Answer 1

Bacterial vaginosis

Question 2

Amsel’s Criteria

Answer 2

Homogenous vaginal d/c
Fishy odor when KOH is added
Presence of clue cells (>20%)
Vaginal pH >4.5

Question 3

How many of Amsel’s criteria must be met in order to diagnose BV?

Answer 3

3/4

Question 4

3 of 4 positive Amsel’s criteria establishes accurate BV diagnosis in __% of affected women.

Answer 4

90%

Question 5

How many clue cells are necessary to satisfy Amsel’s criteria?

Answer 5

> 20%

Question 6

Scenario: Centor Criteria

Answer 6

Strep throat

Question 7

Centor Criteria

Answer 7

Absence of cough
Cervical lymphadenopathy
Tonsillar exudate
History of fever (>100.4)

Question 8

How does age affect Centor Criteria score?

Answer 8

3-14 = +1
15-44 = 0
45 or older = -1

Question 9

Centor Scoring

Answer 9

-1, 0, 1 = No abx or throat culture
2-3 = Consider rapid strep and/or culture
4-5 = Rapid strep and/or culture

Question 10

Scenario: CHADS2 score

Answer 10

Assess risk of stroke w/ a-fib

Question 11

CHADS2 score

Answer 11

CHF
HTN
Age > 75 
DM
Stroke/TIA history

Question 12

CHADS2 score scoring

Answer 12

CHADS > 2: High risk (Warfarin w/ goal INR 2-3_
CHADS = 1: Mod risk (Warfarin or ASA)
CHADS = 0: Low risk (ASA 81-325 mg qd)

Question 13

Scenario: CRB65

Answer 13

Determine in- vs. out-patient tx for CAP

Question 14

CRB65

Answer 14

Confusion to O&Ax3
RR >/= 30
SBP > 90 mmHg or DBP = 60 mmHg
Age >/= 65

Question 15

CRB 65 Scoring

Answer 15

Score of 1 or more = inpatient

Question 16

Metabolic Syndrome Criteria

Answer 16

Insulin resistance plus 2 or more:
BMI >30 or WHR >0.85(F), >0.90(M)
HDL < 39(F), <35(M)
TG >/= 150
BP >/= 140/90 or use of HTN meds
Microalbuminuria > 20
Albumin/Creatinine ratio >/= 30

Question 17

Scenario: PHQ2

Answer 17

Screening for depression

Question 18

PHQ2

Answer 18

Over the past 2 weeks, how often have you:

1) Had little interest or pleasure in doing things
2) Felt down, depressed, or hopeless

Question 19

PHQ2 Scoring

Answer 19

Positive answer to either question -> PHQ9

Question 20

Scenario: Rotterdam Criteria

Answer 20

Diagnosis of PCOS

Question 21

Rotterdam Criteria

Answer 21

Requires 2 of:

1) Oligo- or anovulation
2) Clinical and/or biochemical signs of hyperandrogenism
3) Polycystic ovaries

HOP

Question 22

Scenario: Wells Score

Answer 22

Assess risk of DVT

Question 23

Wells Score

Answer 23

Active CA
Bedridden >/= 3 days or major surgery within 12 weeks
Unilateral calf swelling >3 cm compared to other leg
Collateral superficial veins present
Entire leg swollen
Localized tenderness along deep venous system
Unilateral pitting edema
Paralysis/paresis/immobilization of LE
Previous DVT
Alternative DX at least as likely (-2)

Question 24

Wells Score Scoring

Answer 24

> /= 2 indicates likely DVT