Clinical Condition Scores Flashcards

1
Q

Modified Duke’s Criteria

A

Modified Duke’s Criteria for Infective Endocarditis

Pathological Criteria (if either positive, diagnosis of IE is definitive) = Micro-organisms in a vegetation OR pathological lesions

Major Clinical Criteria (if both are positive, diagnosis of IE is definitive) = Blood cultures positive for IE (typical organisms from 2 separate cultures or single positive for Coxiella Burnetii) AND Evidence of Endocardial Involvement (NEW echo signs)

Minor Clinical Criteria (if all are positive, diagnosis of IE is definitive) = Predisposing heart condition or IVDU AND Fever AND Vascular phenomena AND Immunologic phenomena AND Microbiological evidence

Possible IE = 1 major + 1 minor OR 3 minor - exercise clinical judgement

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2
Q

CPIS Score

A

Clinical Pulmonary Infection Score (CPIS) for Ventilator Associated Pneumonia (VAP)

A score of >=7 may indicate higher likelihood of VAP

Temperature
WCC
Tracheal Secretions
PaO2/FiO2
CXR
Culture of tracheal aspirate specimen
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3
Q

SOFA Score

A

The Sequential Organ Failure Assessment score SOFA incorporates the physiological derangement of six organ systems, where each organ system is given a score between 0 (normal function) and 4 (grossly abnormal) to give an overall score of 24. The worst value over 24 h is recorded.

An increase in SOFA score by 2 was associated with an approximate 10% increased mortality risk.

Variables are:

  1. Lowest PAO2/FIO2 ratio
  2. Platelets
  3. Highest bilirubin
  4. BP status
  5. GCS
  6. Highest creatinine concentration
  7. Total urine output
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4
Q

MELD Score

A

The MELD score is used to predict short term survival in cirrhosis patients and the urgency of need for liver transplantation.

It comprises bilirubin, INR and creatinine.

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5
Q

Lille Model

A

The Lille Model is used to predict 6 month survival in patients with alcoholic hepatitis.

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6
Q

Glasgow Alcoholic Hepatitis Score

A

The Glasgow Alcoholic Hepatitis Score is used to predict 28-day mortality (score >9) and is comprised of 5 variables - age, WCC, urea, INR and bilirubin

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7
Q

Child-Pugh Score

A

The Child-Pugh Score is used in chronic liver failure to prognosticate in patients with cirrhosis. It is ranked A to C predicting mortality at 1 year and comprises 5 variables - encephalopathy, ascites, bilirubin, albumin and PT

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8
Q

APACHE II

A

3 factors: Acute physiological score (comprising clinical and biochemical parameters), age, and previous health conditions

12 Acute physiological parameters includes: Rectal temperature, MAP, HR, RR, Alveolar/arterial gradient, Arterial pH, Serum sodium, potassium and creatinine, Haematocrit, leukocyte count and GCS.

Worst score in first 24h after ICU admission
Score 25 = 50% predicted mortality; >35 = 80%

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9
Q

What are the King’s College selection criteria for paracetamol toxicity?

A
1. pH <7.3
Or
2. All three of:
INR >6.5/ PT >100
Serum Cr >300
Grade 3 or 4 hepatic encephalopathy
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10
Q

What are the King’s College selection criteria for Non-paracetamol induced ALF?

A
1. INR >6.5 
Or
2. Any three of
i. Age <11 or >40
ii. Aetiology non-A,B or drug reaction
iii. Time from onset of jaundice to encephalopathy >7days (i.e. not hyper acute)
iv. Serum bilirubin >300
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11
Q

West Haven (grading of encephalopathy)

A
0 = sub clinical
1= Trivial lack of awareness eurphoria or anxiety, shortened attention span, impaired performance
2 = Lethargy or apathy, disorientation in time, personality change, inappropriate behaviour
3 = Somnolence to semi-stupor, confusion, gross disorientation
4 = Unresponsive to verbal stimulus
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12
Q

O’ Grady Classification for ALF

A
Hyper-acute = <7 days
Acute = 7-28 days
Sub-acute = 4 weeks - 3 months
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13
Q

How does salicylate poisoning present?

A
Fever
Tinnitus
Hypoglycaemia
Vertigo
Visual disturbance
Coagulopathy
Pulmonary oedema
Vomiting (activates CTZ)
Respiratory alkalosis
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14
Q

What scoring system is used to prognosticate in ruptured AAA?

A

Hardman Index

Age >76
Creatinine >190
Haemoglobin <90
Myocardial ischemia on ECG
H/O LOC
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15
Q

KDIGO Criteria for AKI

A

Stage 1 = >1.5x increase in Cr + <0.5ml/h UO for 6-12h

Stage 2 = >2x increase in Cr + <0.5ml/h UO for >12h

Stage 3 = >3x increase in Cr + Anuria for >12h

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