Scales

Question 1

Classification of COPD severity (GOLD criteria)

Answer 1

Stage I, mild: chronic cough, none/ mild breathlessness, FEV1/FVC 80% predicted.

Stage II, moderate: breathless on exertion, FEV1/FVC

Question 2

Glasgow coma scale

Answer 2

BgThe GCS is scored between 3 and 15, 3 being the worst, and 15 the best. It is composed of three parameters : Best Eye Response, Best Verbal Response, Best Motor Response, as given below :

Best Eye Response. (4)
No eye opening.
Eye opening to pain.
Eye opening to verbal command.
Eyes open spontaneously.

Best Verbal Response. (5)
No verbal response
Incomprehensible sounds.
Inappropriate words.
Confused
Orientated

Best Motor Response. (6)

No motor response.
Extension to pain.
Flexion to pain.
Withdrawal from pain.
Localising pain.
Obeys Commands.

Question 3

MRC Dyspnoea scale

Answer 3

Grade Degree of breathlessness related to activity

1 Not troubled by breathless except on strenuous exercise

2 Short of breath when hurrying on a level or when walking up a slight hill

3 Walks slower than most people on the level, stops after a mile or so, or stops after 15 minutes walking at own pace

4 Stops for breath after walking 100 yards, or after a few minutes on level ground

5 Too breathless to leave the house, or breathless when dressing/undressing

Question 4

Grading of limb power

Answer 4

5 - Normal
4 - Reduced, able to move against resistance
3 - Able to move against gravity, unable to move against resistance
2 - Unable to move against gravity, able to move against gravity if eliminated
1 - Flicker of movement only
0 - No movement

Question 5

What scale can you use to assess pneumonia and whether the pt should be admitted?

Answer 5

CURB-65: 2 or more indicate admission

Confusion (recent onset)
Urea >7mmol/l
Respirations >30/min
Blood pressure - systolic

Question 6

Risk of stroke after TIA

Answer 6

ABCD2

Age > 60 years
Blood pressure > 140mmHg systolic or 90mmHg diastolic
Clinical features - unilateral weakness / speech disturbance without weakness
Durations of TIA >60mins/ 10-59mins
Presence of diabetes.

Question 7

Sepsis criteria

Answer 7

According to a revised consensus conference definition in 2001, SIRS is defined by the presence of 2 or more criteria from a collection of clinical signs and laboratory investigations as follows:

Temperature >38.3°C (101°F) or 90 bpm

Tachypnoea >20 breaths/minute

PCO2 6.66 mmol/L [120 mg/dL]) in absence of diabetes mellitus

Acutely altered mental status

WBC count >12×10^9/L (12,000/microlitre) or 10% immature forms.

Question 8

British hypertension society classification

Answer 8

Grade 1 (mild) 140-159/ 90-99

Grade 2 (moderate) 160-179/ 100-109

Grade 3 (severe) >180/ 110

Question 9

New York classification of heart failure

Answer 9

I - hear disease present but no undue dyspnoea from ordinary activity

II - comfortable at rest; dyspnoea on ordinary activity

III - less than ordinary activity causes dyspnoea

IV - dyspnoea present at rest; all activity causes discomfort

Question 10

ALARMS 55 - dyspepsia

Answer 10

Anaemia
Loss of weight
Anorexia
Recent onset
Malaena/ haematemesis 
Swallowing difficulties
>55

Question 11

Centor scoring system

Answer 11

Scoring system used to predict the chances of having a bacterial rather than viral infection. UHL guidelines recommend that a centor score of 3+ would mean that a short course of antibiotics is indicated. 1 point is awarded for each of the following: Lymphadenopathy, exudative tonsils, no cough and fever.

Question 12

Centor scoring system

Answer 12

Scoring system used to predict the chances of having a bacterial rather than viral infection. UHL guidelines recommend that a centor score of 3+ would mean that a short course of antibiotics is indicated. 1 point is awarded for each of the following: Lymphadenopathy, exudative tonsils, no cough and fever.