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General Medicine > Classification > Flashcards

Classification Flashcards

1
Q

Classification - dyspoea in COPD

A

mMRC

0: dyspnoeic after strenous exercise
1: dyspnoeic when hurrying on level ground/ walking uphill
2: more dyspnoeic than same age/ takes breaks at own pace
3: 100 yards or a few mins
4: cannot leave the house, dyspnoeic when getting dressed

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2
Q

COPD Classification

A

GOLD Grading
A: mMRC (sx) < 2 + exacerbation (risk) < 2
B: mMRC (sx) > 2 + exacerbation (risk) < 2
C: mMRC (sx) < 2 + exacerbation (risk) > 2 or 1 admin
D: mMRC (sx) < 2 + exacerbation (risk) > 2 or 1 admin

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3
Q

Pneumonia Severity Score

A 
CURB-65
Confusion, Urea > 7mmol/L, RR>30, BP < 90/60
Mild - 1: Manage in Community
Moderate - 2: Admit 
Severe > 3: Admit + Consider ICU
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4
Q

Staging Criteria for Sarcoisodis?

A

Scadding Criteria

0: Normal CXR
1: Hilar or Mediastinal Enlargement only
2: Nodal Enlargement + Parenchymal Disease
3: Parenchymal Disease only
4: End-stage Lung Disease (Pulmonary Fibrosis)

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5
Q

Pleural Effussion Criteria?

A

Light’s Criteria

Transudate:
Protein (pleural/serum) < 0.5
LDH (pleural/serum) <0.6

Exudate:
Protein (pleural/serum) > 0.5
LDH (pleural/serum) > 0.6

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6
Q

Well’s Score PE

A 
Signs + Sx: 3
Most likely dx: 3 
TC >100bpm: 1.5
Immobilization >3d, recent surgery < 4 wks: 1.5
Hx. VTE: 1.5
Haemoptysis: 1 
Malignancy (tx < 6months): 1

PE
Likely > 4
Unlikely < 4

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7
Q

Well’s Score DVT

A 
Paralysis, Paresis, PLaster immobilization: 1 
Immobilization, Surgery < 12weeks: 1 
Malignancy: 1 
U/L pitting oedema: 1 
Localized Tenderness - distribution of deep venous system: 1 
Entire leg swollen: 1 
Collateral Superficial veins: 1 
Hx. DVT: 1 
Swelling > 3cm larger than C/L side: 1 
Other Dx more likely: - 2

DVT
Likely >2
Unlikely < 2

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8
Q

AKI Classification?

A

RIFLE

Severity:
Risk:
^ SCreat x1.5, GFR red 25%, UO < 0.5ml/kg/hr x 6hrs
Injury:
^ SCreat x2, GFR red 50%, UO < 0.5ml/kg/hr x 12hrs
Failure:
^ SCreat x3, GFR red 75%, UO < 0.3ml/kg/hr x 24hrs (oliguria) or anuria x 12hrs

Outcome:
Loss: Persistent ARF >4weeks
ESKD: >3months

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9
Q

AKI Staging?

A

KDIGO 2012 Classification

Stage 1: ^ SCreat x1.5, UO < 0.5ml/kg/hr x >6hrs

Stage 2: ^SCreat x2, UO < 0.5ml/kg/hr x >12hrs

Stage 3. ^SCreat x3, UO < 0.3ml/kg/hr >24hrs (oliguria) or anuria >12hrs

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10
Q

Thyroid FNA Cytology Classification?

A

British Thy System

Thy1: Non-diagnostic

Thy2: Non-neoplastic

Thy3a: Atypical fetaures present

Thy3f: Follicular neoplasm suspected

Thy4: Suspicious of malignancy

Thy5: Diagnostic of malignancy

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11
Q

Cirrhosis Classification?

A

Child-Pugh Score

Total Bilirubin (umol/L):
1 point <34, 2 points 34-50, 3 points >50
Serum Albumin (g/L):
1 point >35, 2 points 28-35, 3 points <28

PT INR:
1 point <1.7, 2 points 1.7 - 2.3, 3 points > 2.3

Ascites:
1 point None, 2 points Mild, 3 points Mod - Severe

Hepatic Encephalopathy:
1 point None, 2 points GI-GII, meds, 3 points GIII-GIV, Refractory

Class A: 5-6 100% 1-year survival
Class B: 7-9 80% 1-year survival
Class C: 10-15 45% 1-year survival

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12
Q

Scoring System for Wilson’s Disease

A

Liepzig Criteria

KF Rings
Neurological Sx
Serum Caeruloplasmin
Coombe’s -ive haemolytic anaemia

Liver Cu
Urinary Cu
Mutation Analysis (ATP7B)

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13
Q

Hepatic Encephalopathy

A

Grade 1: Changes in behaviour, mild confusion, slurred speech, disordered sleep

Grade 2: Lethargy, moderate confusion

Grade3: Marked confusion (stupor), incoherent speech, sleeping but arousable

Grade 4: Coma, Unresponsive to pain

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14
Q

Glascow Coma Score

A

E1: Unresponsive
E2: Pain
E3: Speech
E4: Spontaneously

V1: Unresponsive 
V2: Incomprehensible sounds 
V3: Inappropriate words
V4: Confused
V5: Orientated -time, person, place 
M1: No Response 
M2: Abnormal Extension (decerebrate)
M3: Abnormal Flexion (decorticate)
M4: Flexion withdrawl from pain 
M5: Moves to localized pain
M6: Obeys commands

3: Totally Unresponsive
<8: Comatose - protect airway?

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15
Q

Operative Morbidity + Mortality

A

P-POSSUM
Physiological + Operative Severity Score for enUmeration of Morbidity + Mortality

Parameters 
Age
Cardiac Signs 
Respiratory History
Systolic BP (mmHg)
Pulse
GCS
Hb
WCC
Urea 
Sodium
Potassium 
Echo
Operative Severity:
Multiple surgeries
Total Blood Loss
Peritoneal Soiling 
Malignancy 
Mode of Surgery
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16
Q

Classification of Hepato Renal Syndrome

A

Type 1: Cirrhois with rapidly progressive acute renal failure

Type 2: Cirrhosis with sub acute renal failure

Type 3: T1 or T2 HRS superimposed on CKD/AKI

Type 4: Fulminant liver failure with HRS

17
Q

Prognosis in Liver Failure/ Predict Survival following TIPS placement

A

MELD: Model for End Stage Liver Disease

3.78 x loge serum bilirubin (mg/dL) + 11.2 x loge INR + 9.57 x log e serum creatinine (mg/dL) + 6.43 (constant for liver disease aetiology)

18
Q

King’s College Hospital Criteria for Acute Liver Failure

Paracetamol

A 
pH <7.3 
or 
Arterial Lactate>3.5 (@4hrs) or >3 (@12hrs) 
or
PT > 100s (INR >6.5)

Serum Creatinine > 300
Grade 3 or 4 Encephalopathy

19
Q

King’s College Hospital Criteria for Acute Liver Failure

Non-Paracetamol

A

PT >100s (INR > 6.5), irrespective of encephalopathy
or
Any 3 of;
1. Age < 11 > 40
2. Aetiology of non-A/B hepatitis, halothane hepatitis, idiosyncratic drug use
3. Jaundice > 7d before onset of encephalopathy
4. PT > 50s (INR > 3.5)
5. Serum Bilirubin > 17mg/dL

20
Q

Aortic Stenosis Classification

A

Mild - Moderate - Severe

Moderate:
Jet Velocity 3-4 m/s
Transvalvular Gradient 20-40 mmHg
Valve Area 1 - 1.5 cm2

21
Q

Functional Classification of Heart Failure?

A

NYHA - New York Heart Ass.

1: No Limitation. Normal exercise - doesn’t cause fatigue or dyspnoea
2: Mild Limitation. Comfortable @ rest. Normal exercise - fatigue + dyspnoea
3: Marked Limitation. Comfortable @ rest. Less than normal exercise - fatigue + dyspnoea
4: Debilitated. Sx of HF @ rest

22
Q

Staging Classification for Heart Failure?

A

ACC - American College of Cardiology

A: At risk but no structural disease or symptoms
B: Structural Heart Disease. No Sx
C: Structural Heart Disease + Current/ Previous Sx
D: Refractory HF - req. specialist intervention

23
Q

Framingham Criteria

A

Dx of HF
2 major or 1major + 2 minor

Major:
S3 - Gallop Rhythm
Pulmonary Oedema 
Weight Loss > 4.5kgs - 5days when tx
Abdominojugular Reflux 
Distended Neck Veins 
Increased Cardiac Shadow - CXR 
Minor:
Hepatomegaly
B/L Effusions - CXR
B/L Peripheral Oedema 
TC > 120bpm
Dyspnoea - ordinary exertion
Nocturnal Cough
24
Q

Dx. Infective Endocarditis?

A

Modified Duke Criteria
2 major + 1 minor
1 major + 3 minor
5 minor

Major Criteria

Blood Cultures
2 +ive seperate Cultures - typical organisms
3 +ive cultures, persistently +ive >12 apart
1 +ive culture - coxiella burnetti

Endocardium Involvement
Echo - vegetation, abscess, pseudoaneurysm, dehiscence, prosthetic valve
PET CT - ^ Activity aroud prosthetic valve
Cardiac CT - Paravalvular Lesions

Minor Criteria 
Predisposition (IVDU, Cardiac Lesion)
Fever > 38degrees
Vascular Phenomenon 
Immunological Phenomenon 
\+ive blood culture that does not meet major criteria
25
Q

Risk Stratification - ACS

A

Killip Classification
30 day mortality

Class I: No clinical signs - HF (6%)
Class II: Crackles, S3, JVP (13%)
Class III: Acute Pulmonary Oedema - Flash (38%)
Class IV: Cardiogenic Shock (81%)

26
Q

Functional Dyspepsia

A

Rome Criteria

Continuous Dyspepsia 3/12 
Dx of Exclusion 
>/= 1 of 
Postprandial Fullness
Early Satiety 
Epigastric Pain
Burning 
No evidence structural disease
27
Q

Classification of SAH?

A

Hunt + Hess Scale

Grade 1: Asymptomatic or mild headache
Grade 2: Mod-Severe Headache, Occulomotor Palsy
Grade 3: Confusion, Drowsy or mild focal signs
Grade 4: Stupor (localizes to pain)
Grade 5: Coma (posturing or no motor response to pain)

28
Q

Stages of Clubbing

A

1: Normal appearace + angle but increased loss of fluctuancy of the nail bed
2: Loss of angle between nail + nailbed
3: Increase curvature of nail
4: Expansion of terminal phalynx - drumstick appearrance

29
Q

ARDS Definition?

A 
Berlin Criteria 
Acute Onset: within 1 week of insult/worsening resp sx
Hypoxia: 
Mild: P:F <300, PEEP/CPAP >/= 5
Mod: P:F <200, PEEP/CPAP >/= 5
Severe: P:F < 100, PEEP/CPAP >/= 5

Lung Water (inflammatory/pulmonary oedema): not fully explained by cardiac failure or fluid overload

Abnormal CXR: B/L opacities (not explained by effusion, collaspe, malignancy or nodules)

30
Q

Inflammatort Spinal Pain?

A

ASAS definition

spinal pain > 3 months +
>/=4 of

onset < 40yrs
insidious onset 
improves with exercise
no improvement with rest 
pain at night (improves on getting up)
31
Q

Criteria for Psoriatic Arthritis

A

CASPAR criteria
inflammatory articular disease, w/t >/= 3 of

Evidence of psoriasis: personal, past, FHx
Psoriatic Nail Dystrophy
-ive test for Rh Factor
Dactylitis: current or Hx
Radiological evidence of juxta articular new bone formation

32
Q

CKD Criteria

A

Either of the following > 3months

1+
Albuminuria - ACR > 30mg/g 
Urine Sediment Abnormalities 
Electrolyte or Other abnormalities
Histological Abnormalities
Structural Abnormalities detected by imaging 
Hx Kidney Transplant

GFR < 60mL/min/1.73m2

33
Q

Stages of CKD

A

KDIGO
G1: eGFR > 90 - normal
G2: eGFR < 90 - mildly decreased
G3a: eGFR < 60 - mild to mod decreased
G3b: eGFR < 45 - Moderately-severe decreased
G4: eGFR < 30 - severely decreased - nephrology F/U
G5: eGFR <15 - ESKD - dialysis

34
Q

Diabetic Nephropathy Characteristics

A

Clinical Syndrome

  1. Persistent Albuminuria > 300mg/day 2 occcasions 3-6/12 apart
  2. Progressive decline in eGFR
  3. Elevated arterial BP
35
Q

Stratifying Risk of Stroke following TIA

A 
ABCD2
Age > 60yrs (1)
BP > 140/90 (1)
Clinical Features: 
- U/L waekness (2)
- Slurred Speech without weakness (1)
Duration of Sx
- Sx > 1hr (2)
- Sx 10- 60mins (1)
Diabetes (1)

Score > 4 high risk - assessed within 24hrs

36
Q

Mortality in SAH

A 
I: None 
II: Neck Stiffness + CN Palsy - 11%
III: Drowsiness - 37%
IV: Drowsy with hemiplegia - 71%
V: Prolonged Coma - 100%
37
Q

Traumatic Brain Injury Classification

A

I: No visible intracranial injury
II: Cisterns present, Midline shift < 5mm, small, high or mixed density lesion < 25cc
III: Cisterns compressed or absent
IV: midline shift > 5mm

General Medicine (1 decks)

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