Diagnostic Criterias

Question 1

what diagnostic criteria is used for bacterial vaginosis?

Answer 1

Amsel’s:
1. homogenous, non-clumping vaginal dc
2. positive “whiff test”
3. clue cells (>20%) on microscopy
4. vaginal pH > 4.5

Question 2

what is the WHO metabolic syndrome criteria?

Answer 2

central abdominal adiposity ( M > 102 cm, F >88 cm)

PLUS ANY 2 OF THE FOLLOWING:
- triglycerides > 150
- HDL <40 (M) or <50 (F)
- BP > 130/80
- fasting glucose >100

Question 3

what diagnostic criteria is used for PCOS?

Answer 3

Rotterdam Criteria: need 2 out of 3

1. oligo- and/or an- ovulation
2. biochemical and/or clinical signs of hyperandrogenism (hirsutism, acne)
3. polycystic ovaries on TVUS

Question 4

what diagnostic criteria is used for IBS?

Answer 4

Rome criteria
1. reccurent abdominal pain >1 day per week in the past three months, with onset > 6 mo before dx

and with at least two of the follownig:
1. pain related to defacation
2. change in stool frequency
3. change in form of stool

Question 5

what diagnostic criteria is used for strep pharyngitis?

Answer 5

Centor criteria

• fever (+1)
• tonsillar exudate (+1)
• NO cough (+1)
• tender/swollen cervical lymph nodes (+1)
• age 3-14 (+1)
• age 15-44 (0)
• age >44 (-1)

4 = rapid antigen test, culture, tx empirically
3 = rapid antigen test, culture
0-2 = no test/tx

Question 6

what criteria is used to determine stroke risk? in which condition is this used?

Answer 6

Chads Score (CHA2DS-VASc) - used with Afib to determine if anticoagulation therapy should be used

CHA2DS-VASc

• congestive HF (+1)
• HTN (+1)
• age >75 (+1)
• diabetes (+1)
• (previous) stroke, TIA, thromboembolism (+2)
• vascular dz (+1)
• sex (female = +1)

1 = consider anticoag therapy
2+ = use anticoag therapy

Question 7

what criteria is used to assess mortality rate for community acquired pnemonia?

Answer 7

CURB-65

• confusion
• BUN > 30
• RR > 30
• BP (S<90/D<60)
• 65+

0 = home tx
1-2 = likely need hospital assessment
3-4 = urgent hospital admission

Question 8

what criteria is used to assess for risk of DVT?

Answer 8

wells score
- active cancer (tx in last 6 mo) (+1)
- immobilization >3 days, surgery last 12 wks (+1)
- calf swelling >3 cm other leg (+1)
- collateral (non varicose) superficial veins (+1)
- entire leg swollen (+1)
- localized tenderness along deep venous sys (+1)
- pitting edema in sx leg only (+1)
- recent immobilization/casting (+1)
- previous DVT (+1)
- alternative dx thats as/more likely (-2)

0 = low risk
1-2 = moderate risk
>3 = high risk

Question 9

what criteria is used to assess for risk of PE?

Answer 9

wells score
- clinical sx DVT (+3)
- PE = #1 dx or equally likely (+3)
- HR >100 (+1.5)
- immobilization >3 days, surgery last 4 wks (+1.5)
- previous PE or DVT (+1.5)
- hemoptysis (+1)
- malignancy with tx or palliation last 6 mo (+1)

Question 10

what components are assesed in the pnemonia severity index?

Answer 10

• males
• nursing home resident
• neoplastic dz
• liver dz hx
• CHF hx
• cerebrovascular dz hx
• renal disease hx
• altered mental state
• RR >30
• systolic BP >90
• temp <95 or >103.8
• HR >125
• pH <7.35
• BUN >30
• sodium <130
• glucose >250
• pleural effusion on CXR