Clinical scoring systems Flashcards

1
Q

What scoring systems can be used to asses GI bleeding?

A

Rockall score and the Blatchford score

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is Rockall score used for?

A

To predict the risk of death and risk of re-bleeding from an upper GI bleed
In other words - determines the severity of GI bleed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What parameters are involved in Rockall scoring system?

A

Age, Shock, co-morbidities, diagnosis, major stigmata of recent haemorrhage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is required to use the Rockall scoring system?

A

Need endoscopy findings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is Blatchford scoring system used for?

A

Will predict the need for intervention i.e blood transfusion or therapeutic endoscopy. Used to help decide if a patient needs admitting to hospital or not.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is MELD scoring system used for?

A

MELD = Model for End stage Liver Disease.

Used for patients with liver cirrhosis - ranks degree of illness to determine how urgently you will receive a donor liver/transplant procedure
Used to monitor complications in patients with cirrhosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is Maddrey’s score used for?

A

(Maddrey’s score is aka Maddrey’s disciminant function)

Predicts prognosis in alcohol-related hepatitis and identify patients suitable for treatment with steroids.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is (Modified) Glasgow score used to assess?

A

Severity of pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe criteria for Glasgow imrie score

A

Use PANCREAS
P - PaO2
A - Age >55
N - Neutrophils (WBC>15)
C - Calcium <2
R - uRea >16
E - Enzymes (LDH>600 or AST/ALT>200)
A - Albumin <32
S - Sugar (Glucose >10)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe Glasgow coma scale score

A

Eye opening:
4 - spontaneously
3 - to speech
2 - to pain
1 - no response

Verbal response
5 - orientated to time, person, place
4 - confused
3 - inappropriate words
2 - incomprehensible sounds
1 - no response

Motor response
6 - obeys command
5 - moves to localised pain
4 - flex to withdraw from pain
3 - abnormal flexion
2 - abnormal extension
1 - no response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe CURB-65 scoring system

A

Confusion
Urea >7mmol
Resp rate >30
Blood pressure <90 systolic
Over 65

CURB-65 score of 2+ = admit.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe Centor scoring system

A

Estimates probability that pharyngitis is streptococcal and suggests management course

Only to be used in patients with ≤3 day Hx of pharyngitis

Age
- 3-14yrs = 1 point
- 15-44 = 0 points
- 45+ = -1 point

Exudate or swelling on tonsils = yes (1 point) or no

Tender/swollen anterior cervical LN = Y/N

Temp >38C = Y/N

Cough = Present (0)/ absent (+1 point)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe FeverPAIN scoring system

A

Predicts likelihood of strep throat Yes = 1 point. No= 0 point. Total of 4+ points = abx. 2-4 points = delay abx script. 0-2 points = Strep throat unlikely

Questions asked:

Fever in past 24hrs
Absence of cough or coryza
Symptom onset ≤3 days
Purulent tonsils
Severe tonsil inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe CHA2DS2-VASc

A

Estimates stroke risk in pts with AFib

Congestive Heart failure
Hypertension
Age (1 point 65-74, 2 points 75+)
Diabetes
Stroke or TIA recently
Vascular disease
Sex category - female

Score above 1 = high risk
Score of 1 = moderate risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe BTS classification of asthma severity

A

Mild:
- no features severe asthma
- PEFR >75%

Moderate:
- no features of severe asthma
- PEFR 50-75%

Severe: if one of following present:
- Can’t complete sentences in one breath
- PEFR 33-50%
- RR >25
HR >110/min

Life threatening: if any one of following present:
- PEFR<33%
- Sats <92% or ABG pO2 <8kPa
- Cyanosis, poor respects effort, near or fully silent chest
- exhaustion, confusion, hypotension, arythmies
- normal pCO2

Near fatal:
- raised pCO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe MRC dyspnoea score

A

Grade of breathlessness related to activities.
Used in rest diseases, especially COPD

1 = not troubled by breathlessness expect on strenuous activity

2 = SOB when hurrying or walking up a slight hill

3 = walks slower than contemporaries on ground level

4 = stops for breath after walking about 100m or after a few mins on level ground

5 = too breathless to leave house, breathless on dressing/undressing

17
Q

Describe CKD classification

A

Stage 1 = eGFR >90
Stage 2 = 60-89
Stage 3a = 45-59
Stage 3b = 30-44
Stage 4 = 15-29
Stage 5 = eGFR <15

18
Q

Describe MRC grading of muscular power

A

0 = no contraction

1 = flicker or trace of contraction

2 = active movement, with gravity eliminated

3 = active movement against gravity

4 = active movement against gravity and resistance

5 = normal power

19
Q

What are parameters in Wells score?

A
  • Signs and symptoms of DVT
  • PE is number 1 Ddx
  • HR >100
  • Haemoptysis
  • Immobilisation in 3+ days or surgery in last 4 weeks
  • Previous DVT, VTE, PE
  • Malignancy with treatment within last 6 months or palliative
20
Q

What is ASA used for?

A

Classifies health of patients prior to surgery

21
Q

What is HAS-BLED used for?

A

Estimates risk of major bleeding for patients on anti-coag to assess risk-benefit in A.fib care

22
Q

What is Rockall used for?

A

Determines severity of GI bleeding, prior to endoscopy

23
Q

What is POSSUM used for?

A

Estimates morbidity and mortality for general surgery patients

24
Q

What is NELA used for?

A

Estimates risk of death within 30 days of emergency abdominal surgery

25
What is Ranson used for?
Estimates mortality of patients with pancreatitis, based on initial and 48hr lab values
26
What is ROME used for?
Criteria to diagnose IBS
27
What is PHQ-9 used for?
Patient health questionnaire-9. Used for degree of depression severity.
28
What is GAD-7 used for?
Generalised Anxiety Disorder. Measures severity of anxiety
29
What is FAST used for?
There are a few.. FAST for alcohol screening test FAST acronym for stroke FAST focused assessment with sonography for trauma - predicts presence of pericardial or intra-ado injury after penetrating or blunt trauma
30
What is GPCOG used for?
GP assessment of cognition A screening tool for dementia
31
What is STaRTBack used for?
Used to categorise patients into low, medium and high risk for back pain. Helps decision making and management of patient