Assessment and Criteria Flashcards
modified dukes criteria
infective endocarditis if
- pathological criteria
- 2 major
- 1 major and 3 minor
- 5 minor
major criteria
- positive blood cultures with typical organisms; strep viridians or hacek group
- presistent bacteraemia
- positive serology
- positive molecular assays
- positive echo findings
- new valvular regurgitation
minor criteria
- predisposing heart condition or ivdu
- micro evidence does not meet major criteria
- fever greater than 38
- vascular phenomena; major emboli, splenomegaly, clubbing, splinter haemorrhages, janeway lesions, pettechiae or purpura
- immunological phenomena; glomerulonephritis, oselr’s nodes, roth spots
lights criteria
exudate = protein >2.9g/dL (inflammation and increased vascular permeability) transudate = protein <2.5 g/dL (increased hydrostatic pressure, decreased colloid osmotic pressure)
criteria for exudate
- fluid protein divided by serum protein >0.5
- fluid LDH divided by serum LDH >0.6
- fluid LDH >2/3 the upper limit of normal serum LDH
glasgow blatchford
assessing need for intervention in upper gi bleed
blood urea
- 6.5-8 = 2
- 8-10 = 3
- 10-25 = 4
- > 25 = 6
haemoglobin (men)
- 12.0-12.9 = 1
- 10.0-11.9 = 3
- <10 = 6
haemoglobin (women)
- 10.0-11.9 = 1
- <10.0 = 6
systolic blood pressure
- 100-109 = 1
- 90-99 = 2
- <90 = 3
other markers
- pulse >100 = 1
- presentation with melaena = 1
- presentation with syncope = 2
- hepatic disease = 2
- cardiac failure = 2
score or 6 or more equivalent to 50%, or higher, risk of intervention
rai criteria
staging of chronic lymphoid leukaemia
Rai stage 0
- low risk
- lymphocytosis: a high lymphocyte count defined as more than 15,000 lymphocytes per cubic millimeter (> 15,000/mm3)
Rai stage I
- intermediate risk
- lymphocytosis and lymphadenopathy
Rai stage II
- patients are also intermediate risk
- lymphocytosis plus an enlarged liver (hepatomegaly) or enlarged spleen (splenomegaly), with or without lymphadenopathy
Rai stage III
- patients are high-risk
- lymphocytosis plus anaemia with or without lymphadenopathy, hepatomegaly, or splenomegaly
Rai stage IV
- high-risk
- lymphocytosis + thrombocytopenia (< 100-103 /dL)
aki
stage 1 = 1.5-fold increase in the serum creatinine, or glomerular filtration rate (GFR) decrease by 25 percent, or urine output <0.5 mL/kg per hour for six hours
stage 2 = Two-fold increase in the serum creatinine, or GFR decrease by 50 percent, or urine output <0.5 mL/kg per hour for 12 hours
stage 3 = Three-fold increase in the serum creatinine, or GFR decrease by 75 percent, or urine output of <0.3 mL/kg per hour for 24 hours, or no urine output (anuria) for 12 hours
nephritic syndrome
- haematuria
- proteinuria
- hypertension
- oliguria
nephrotic syndrome
- proteinuria >3.5g/24hours
- hypoalbunimaemia <2.5g/L
- oedema
glasgow pancreas score
3 or more positive factors detected within 48 hours of onset suggests severe pancreatitis and should prompt transfer to itu/hdu
- Pa02 <8kpa
- Age >55
- Neutrophilia wbc >15
- Calcium <2
- Renal function, urea >16
- Enzymes, LDH >600, AST >200
- Albumin <32
- Sugar, blood glucose >10
kings college criteria
liver transplant
poor prognosis if arterial ph <7.3 or all of the following;
- INR greater than 6.5
- serum creatinine greater than 300
- presence of grade 3/4 encephalopathy
child-pugh score
prognosis of chronic liver disease (1,2,3 respectively)
- total bilirubin; <34, 35-50, >50
- serum albumin; >35, 28-35, <28
- prothrombin time; <4, 4-6, >6
- ascites; none, mild, moderate-severe
- encephalopathy; none, grade 1/2, grade 3/4
one year and two year survival respectively
child-pugh A (5-6) = 100%, 85%
child-pugh B (7-9) = 81%, 57%
child-pugh C (10-15) = 45%, 35%
nyha functional classification
class 1 = Cardiac disease, but no symptoms and no limitation in ordinary physical activity, e.g. no shortness of breath when walking, climbing stairs etc.
class 2 = Mild symptoms (mild shortness of breath and/or angina) and slight limitation during ordinary activity.
class 3 = Marked limitation in activity due to symptoms, even during less-than-ordinary activity, e.g. walking short distances (20–100 m), comfortable only at rest
class 4 = Severe limitations. Experiences symptoms even while at rest. Mostly bedbound patients.
ckd classification
based on glomerular filtration rate (ml/min/1.73m2)
stage 1 - >= 90 stage 2 - 60-89 stage 3a - 45-59 stage 3b - 30-44 stage 4 - 15-29 stage 5 - <15
curb 65
- C Confusion (abbreviated mental test score <= 8/10)
- U Urea >7 mmol/L
- R Respiration rate >= 30/min
- B Blood pressure: systolic <= 90 mmHg and/or diastolic <= 60 mmHg
- 65 Aged >= 65 years
- score of 0 should be managed in the community
- score of 1 should have their Sa02 assessed which should be >92% to be safely managed in the community and a CXR performed. If the CXR shows bilateral/multilobar shadowing hospital admission is advised.
- score of 2 or more should be managed in hospital as this represents a severe community acquired pneumonia.
- score of 4 approaching a 30% mortality rate at 30 days.
blood loss
class 1
- blood loss <750ml
- pulse <100bpm
- bp same
- pulse pressure same or increased
- respirations 14-20/min
- urine output >30ml/hour
- mental state slightly anxious
class 2
- blood loss 750-1500ml
- > 100bpm
- bp same
- pulse pressure decreased
- respirations 20-30/min
- urine output 20-30ml/hour
- mental state anxious
class 3
- blood loss 1500-2000ml
- pulse >120bpm
- bp decreased
- pulse pressure decreased
- respirations 30-40/min
- urine output 5-15ml/hour
- mental state confused
class 4
- blood loss >2000ml
- pulse >140bpm
- bp decreased
- pulse pressure decreased
- respirations >35/min
- urine output negligible
- mental state lethargic
centor criteria
sore throat antibiotic prescribing
- history of fever
- tender anterior cervical lymphadenopathy
- absence of cough
- tonsillar exudates
modified; +1 for under 15, -1 for over 44
- less than 2 = no antibiotic or throat culture
- 2-3 = throat culture and treat if culture positive
- 4-5 = consider rapid strep testing and/or culture, no empiric treatment based on symptomatology alone
