What's Lachman's test?
Test of the integrity of anterior cruciate ligaments (knee) -> done at 30o
*a variation of ' anterior drawer test' -> done at 90o
What's a McMurray test?
It's to determine meniscal injuries
- knee is flexed at 90o and lateral pressure applied to the joint + external rotation of lower leg
- pain or palpable crepitus = lateral meniscal injury
What's Simmond's test?
to assess the integrity of the Achilles tendon -> to check for rupture of Achilles tendon
What's a patellar apprehension test?
- used to asses dislocatability of the patella
- pressure is applied to the patella -> if a patient feels anxious that knee cap is going to 'pop out' - positive test
What's the name of the score used to grade the spread and prognosis of prostate cancer?
*the higher the score the worse prognosis
How to take/measure ankle-brachial-pressure index (ABPI)?
the greatest of systolic pressure in either posterior tibial a. or dorsalis pedis a.
brachial systolic pressure at the same side
Is the 1.3 or higher result normal on ABPI?
No, that can be a result that is abnormally raised by calcification of the artery e.g. in diabetic person → need to refer for further investigaiton
What would the following readings of ABPI mean:
- 0.5 - 1.0
- 0.3 - 0.5
- 0.2 and <
- 0.5 - 1.0 → intermittent claudication
- 0.3 - 0.5 → rest pain
- 0.2 and less → acutely ischaemic leg and gangrene
*1.0 is normal
What's Kantor/string sign?
- Presents stricture (area resulting from chronic inflammation and scarring) formation in e.g. Crohn's
- It is visible on small bowel enemas
- I Slipped → # across the physis with no other fragment
- II Above → # across the physis with metaphyseal fragment
- III Lower → # across the physis with epiphyseal fragment
- IV Through → # through the physis with epiphyseal + metaphyseal fragment
- V Rammed → rush injury to the physis
What scale is used to assess the extent of burns? (in adults)
Wallace's 'rule of nines'
- name the score
- grades and description
The Garden system
- Type I: Stable fracture with impaction in valgus.
- Type II: Complete fracture but undisplaced.
- Type III: Displaced fracture, usually rotated and angulated, but still has bony contact.
- Type IV: Complete bony disruption.
Serum 'triple test'
- what is it for?
- what are its (3) components?
-when in gestation is it available?
For: Spina Bifida and Down's syndrome
*triple test estimates the risk of Down Syndrome. if 1:250 (positive) then amniocentesis or Chorionic Villus Sampling is offered
- AFP (alpha-fetoprotein)
Available: 14-20 weeks gestation
Upper GI bleed and scores
- what to use before endoscopy
- what to use after endoscopy
- Blatchford →before endoscopy
- Rockfall →after endoscopy
What're Light's criteria?
- help to distinguish between transudate vs exudate
- exudates have a protein level of >30 g/L
- transudates have a protein level of <30 g/L
if the protein level is between 25-35 g/L, Light's criteria should be applied.
An exudate is likely if at least one of the following criteria are met:
pleural fluid protein divided by serum protein >0.5
pleural fluid LDH divided by serum LDH >0.6
pleural fluid LDH more than two-thirds the upper limits of normal serum LDH
What is Framingham risk score used for?
To estminate 10-years risk of hear attack
What's Kocher's criteria are used for and what the score mean?
Used to assess the possibility of septic arthritis in children (4 point criteria)
- Non-weight bearing - 1 point
- Fever >38.5ºC - 1 point
- WCC >12 * 109/L - 1 point
- ESR >40mm/hr
The probabilities are calculated thus:
- 0 points = very low risk
- 1 point = 3% probability of septic arthritis
- 2 points = 40% probability of septic arthritis
- 3 points = 93% probability of septic arthritis
- 4 points = 99% probability of septic arthritis
What's Modified-Glasgow Score is used for?
What are its components?
Use: to stratify patients by risk of severe pancreatitis.
A score of ≥3 suggests a significant increase in likelihood of severe pancreatitis. These patients may benefit from intensive care.
P - PaO2 <8kPa
A - Age >55-years-old
N - Neutrophilia: WCC >15x10(9)/L
C - Calcium <2 mmol/L
R - Renal function: Urea >16 mmol/L
E - Enzymes: LDH >600iu/L; AST >200iu/L
A - Albumin <32g/L (serum)
S - Sugar: blood glucose >10 mmol/L
The criteria used to diagnose rheumatic fever
- how many diagnostic
Modified Dukett Jones criteria
- Sydenham's chorea
- erythema marginatum
- subcutaneous nodules
- high ESR or WCC
- heart block
Diagnostic: evidence of streptococcal infetion (anti-streptolysisn-O titrates) + 2 major criteria OR + 2 minor and 1 major