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1

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

2

What's a McMurray test?

It's to determine meniscal injuries

  • knee is flexed at 90and lateral pressure applied to the joint + external rotation of lower leg
  • pain or palpable crepitus = lateral meniscal injury

3

What's Simmond's test?

to assess the integrity of the Achilles tendon -> to check for rupture of Achilles tendon

4

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

5

What's the name of the score used to grade the spread and prognosis of prostate cancer?

Gleason score 

 

*the higher the score the worse prognosis

6

How to take/measure ankle-brachial-pressure index (ABPI)? 

the greatest of systolic pressure in either posterior tibial a. or dorsalis pedis a. 

divide by

brachial systolic pressure at the same side

7

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

8

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

9

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

10

Salter-Harris classification

mnemonic: SALTeR

  • 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

11

What scale is used to assess the extent of burns? (in adults)

Wallace's 'rule of nines'

 

12

13

Hip fractures 

- 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.

14

15

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

 

Markers used: 

- AFP (alpha-fetoprotein)

- bHCG

- oestriadol

 

Available: 14-20 weeks gestation 

16

Upper GI bleed and scores 

  • what to use before endoscopy 
  • what to use after endoscopy

  • Blatchford →before endoscopy
  • Rockfall →after endoscopy 

17

18

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

19

20

What is Framingham risk score used for?

To estminate 10-years risk of hear attack

21

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

 

 

22

23

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.

 

Components:

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

 

24

The criteria used to diagnose rheumatic fever

- components 

- how many diagnostic

Modified Dukett Jones criteria 

Major: 

- pancarditis 

- polyarthritis

- Sydenham's chorea 

- erythema marginatum 

- subcutaneous nodules 

Minor: 

- fever

- arthralgia

- high ESR or WCC

- heart block 

 

Diagnostic: evidence of streptococcal infetion (anti-streptolysisn-O titrates) + 2 major criteria OR + 2 minor and 1 major