Disease diagnoses/staging/severity scales

Question 1

What are the 2 staging systems for colorectal cancer

Answer 1

Duke’s

TNM

Question 2

Duke’s A - explain

Answer 2

Limited to muscularis propria; nodes not involved

Question 3

Duke’s B - explain

Answer 3

Extending beyond muscularis propria; nodes not involved

Question 4

Duke’s C - explain

Answer 4

Tumour spread to lymph nodes

Question 5

Duke’s D - explain

Answer 5

Distant metastases

Question 6

TNM staging

What do T, N & M stand for

Answer 6

Tumour
Nodes
Metastases

Question 7

TNM staging

Explain T staging

Answer 7

T1 - Tumour in submucosa only
T2 - Tumour into muscle layer
T3 - Tumour through muscle layer
T4 - Tumour invaded adjacent structures

Question 8

TNM staging

Explain N staging

Answer 8

N0 - No lymph node involvement
N1 - ≤3 lymph nodes involved
N2 - >3 lymph nodes involved

Question 9

TNM staging

Explain M staging

Answer 9

M0 - No distant metastases

M1 - Distant metastases

Question 10

What is CURB 65 used for

Answer 10

Assessing the severity of Community-Acquired Pneumonia

Question 11

What CURB score would indicate mild CAP

Answer 11

0-2 = moderate- mild CAP

3 and more = severe CAP

Question 12

Explain CURB 65 fully

Answer 12

C - confusion
U - urea (>7mmol/L) 
R - resp rate (>30/min) 
B- bp (Systolic <90, Diastolic ≤60) 
65 - age 65 or over 

Each part scores 1 point

Question 13

What is the Rome III criteria used to diagnose

Answer 13

IBS (Irritable bowel syndrome)

Question 14

Explain the Rome III criteria fully

Answer 14

Recurrent abdo. pain for 3 days/month for 3 months
+ 2 or more of
1. Relief with defecation
2. Onset associated with change in stool frequency
3. Onset associated with change in stool form

Question 15

What is the CHA2DS2VASc score used for

Answer 15

To determine the risk of stroke in a patient with AF and thus the need to anti-coagulate them

Question 16

Explain the CHA2DS2VASc score components fully

Answer 16

C - Congestive HF = 1
H - Hypertension = 1
A - Age - ≥75 = 2 ; 65-74 = 1

D - Diabetes = 1
S - previous Stroke or TIA = 2

V - Vascular disease (IHD, PVD) = 1
S - Sex, Female = 1

Question 17

If someone has a CHA2DS2VASc score of 0, what is the outcome

Answer 17

No anticoagulation

Question 18

If someone has a CHA2DS2VASc score of 1, what is the outcome

Answer 18

If male - Consider anticoagulation

If female - No anticoagulation (1 point for gender)

Question 19

If someone has a CHA2DS2VASc score of 2 or more, what is the outcome

Answer 19

Offer anticoagulation

Question 20

Explain step 1 of the MUST score

Answer 20

BMI
<18.5 = 2
18.5 - 20 = 1
>20 = 0

Question 21

Explain step 2 of the MUST score

Answer 21

Unplanned weight loss in last 3-6months
<5% = 0
5-10% = 1
>10% = 2

Question 22

Explain step 3 of the MUST score

Answer 22

If the patient is acutely ill and
there has been or is likely
to be no nutritional
intake for >5 days = 2

Question 23

What scores correspond to Low, Medium and High risk on the MUST score

Answer 23

0 = Low-Risk  
1 = Medium Risk  
2 = or more High Risk