OSCE – RTS Referral Criteria Flashcards
What is the referral criteria for routine GP referral in constipation?
- Medication ADR
- Treatment failure
- 3rd trimester pregnancy
- Laxative dependence/ abuse
- N+V
- Passing mucous
- Signs of impaction
What is considered high blood pressure and referral criteria?
> 140/90mmHg
What is considered high random blood glucose and referral criteria?
> 11mmol/L
What is considered to be low random blood glucose and referral criteria?
<3.5mmol/L
What is considered to be high random blood cholesterol and referral criteria?
> 5mmol/L
When is GP referral appropriate for acute otitis media?
Recurrent infection, not resolving
What are symptoms for direct referral in chest pain?
Localised knifelike pain, worsened by breathing or coughing
What is the referral criteria for skin?
(1) Bleeding
(2) Weeping
(3) Infection
(4) Non-blanching rash
(5) Child
(6) On the face
What are the referral criteria for contact dermatitis?
(1) Non-blanching rash
(2) Failure of treatment
(3) Lesions on face
(4) Child
(5) Pregnant/ breast-feeding
(6) Broken skin/ weeping/ bleeding
(7) Widespread
(8) Infection
What are the referral criteria for psoriasis?
(1) Non-blanching rash
(2) Bleeding
(3) Lesions with malaise/ fever/ swollen glands
(4) Hairloss
(5) Abnormal lumps
(6) Pregnant/ breastfeeding
What are the referral criteria for chicken pox?
(1) Non-blanching rash
(2) Infected blisters
(3) Pregnant/ breastfeeding
(4) Immunosuppressed
What is the referral criteria for shingles?
(1) Antiviral treatment
(2) Non-blanching rash
(3) Severity of symptoms
(4) High risk of complications
What are the referral criteria for ringworm (tinea)?
(1) Large areas of the body
(2) Treatment failure
(3) Face
(4) Scalp
(5) Anogenital
(6) Pregnant/ breastfeeding
(7) Non-blanching rash
What is the referral criteria for bites and stings?
(1) Intense swelling
(2) Restriction to blood flow
(3) Bleeding
(4) Sting/ insect still present
(5) Anaphylaxis/ flu-like symptoms
What is the referral criteria for acne?
(1) Weeping
(2) Bleeding
(3) Infection
(4) Cracked/ broken skin
(5) Pain
(6) Treatment failure
(7) Nodules/ cysts present
What is the referral criteria for cold sores?
(1) Spread of infection
(2) Failure of treatment
(3) Dehydration
(4) Large numbers
(5) Babies/ infants
(6) Lasting >10 days
What is the referral criteria for athlete’s foot?
(1) Treatment failure
(2) Diabetic failure
(3) Signs of bacterial infection
(4) Nails affected
(5) Pregnant/ breastfeeding
(6) Severe + affecting other parts of the foot
What is the referral criteria for onchomycosis?
(1) Affecting more than 2 nails
(2) Failure of treatment
(3) Immunocompromised
(4) Pregnant/ breastfeeding
(5) Diabetic
What is the referral criteria for warts/ verrucas?
(1) Treatment failure - 12 weeks
(2) Multiple clusters
(3) Face
(4) Genitals
(5) Immunocompromised patients
(6) Diabetic patients
(7) Pregnant/ breastfeeding
(8) Affecting patient mobility
What is the referral criteria for corns and callouses?
(1) Treatment failure
(2) Diabetic patient
(3) Affecting walking
(4) Intense pain
(5) Affecting posture
What is the referral criteria for a sport-related injury?
(1) Severe/ prolonged
(2) Unable to bear weight
(3) Head injury
(4) Signs of infection
(5) Fevers/ chills/ malaise
(6) Joint instability
(7) Pins and needles
(8) Treatment failed
What is referral criteria for bruising?
(1) Unexplained
(2) Frequent
(3) Excessive
(4) Known clotting problems
(5) Hepatic impairment
(6) Taking warfarin/ NSAIDs/ steroids/ carbimazole
What is the referral criteria for back pain?
(1) Pain following major trauma
(2) Weight loss
(3) New pain in <20 or >50years
(4) Worst at rest + better after exercise
(5) Bladder/ bowel problems
(6) Widespread/ worsening weakness in legs
(7) Pain radiating down 1/2 legs
(8) Numbness/ tingling
(9) Fever
(10) Suspected OA/ OP
(11) No response to treatment
What is the referral criteria for headaches?
(1) Ongoing severe pain >4hrs
(2) Very sudden onset
(3) Suspected depression
(4) Signs of meningitis
(5) Recent trauma
(6) Cluster headaches
(7) Migraines occurring for 1st time >50yrs
(8) Eye strain/ severe eye pain
(9) Severe pain w/ N+V or confusion or malaise
(10) Failed treatment
What is the referral criteria for an issue regarding the eye?
(1) Pain in the eye
(2) Visual disturbances
(3) Unusual pupil appearance
(4) Upper eyelid drooping
(5) Treatment failure
(6) Eye/ head injury
(7) Photophobia
(8) Contact lens wearers, if eye drops unsuitable
What are the referral criteria for ear issues?
(1) Severe pain
(2) Discharge
(3) Deafness
(4) Bleeding
(5) Foreign body in ear
(6) Treatment failure
(7) Abnormal lesions
(8) Suspected vertigo/ otitis media/ perforated ear drum
When should a patient with a perforated ear drum be referred?
If symptoms persist with no improvement
What is the referral criteria for nausea and vomiting in children?
(1) Vomiting >24hrs
(2) Unable to keep fluids down for 8hrs
(3) Signs of dehydration
(4) Limp/ irritable/ change in character
(5) Refuse food
(6) Stick neck/ headache
(7) Severe tummy pain
What is the referral criteria for nausea and vomiting in adults?
(1) Vomiting >48hrs
(2) Unable to keep fluids down
(3) Vomit is green
(4) Signs of severe dehydration
(5) Loss of weight
(6) Regular occurrence
(7) Vomit with a faecal smell
What is the referral criteria in heartburn and indigestion?
(1) Treatment failure
(2) Child
(3) Pregnant/ breastfeeding
(4) >55yrs 1st presentation
(5) Medication adverse drug reaction
What is the referral criteria for routine GP referral in constipation?
- Medication ADR
- Treatment failure
- 3rd trimester pregnancy
- Laxative dependence/ abuse
- N+V
- Passing mucous
- Signs of impaction
What are the referral criteria for diarrhoea?
- Blood/ mucous in the stool
- Black stools
- Persistent vomiting
- Loss of weight
- Fever
- Recent discharge from hospital
- Recent course of ABx
- Pregnancy
- Severe abdominal pain
What type of dysmenorrhoea must be referred?
Secondary dysmenorrhoea
Most common in 30-45 years old
What is the referral criteria for dysmenorrhoea?
- Pain/ bleeding between periods/ after sex or urination
- Sudden severe pain
- Fever
- Unpleasant discharge from vagina
- Post-menopausal women
- IUD insertion
- Painkillers used for 3-4 cycles unsuccessfully
What is the red flag referral criteria for menorrhagia?
- Irregular bleeding
- Increase in blood loss
- Postcoital bleeding
- Pelvic pain/ discharge during intercourse
What are the red flag referral criteria for vulvovaginal candidiasis?
- First occurrence of symptoms
- <16 or >60yrs
- Pregnancy
- History of STD
- Vaginal discharge, yellow/ greenish
- Vulval/ vaginal sores/ ulcers/ blisters
- Abnormal/ irregular bleeding
- Pain during sex
- Failure of treatment
What is the referral criteria for cold/ flu?
- Chest pain
- Shortness of breathe
- Wheezing
- Sputum nature
- Severe pain on coughing
- Stiff neck/ non-blanching rash
- Treatment failure
What are the referral criteria for a sore throat?
- Babies/ infants
- Hoarseness
- Dysphagia
- White spots/ pus
- Coloured sputum
- Thrush in mouth area
- Treatment failure
- Recurrent infection
What is the referral criteria for a cough?
- > 3 weeks
- Presence of blood
- Yellow/ green mucous
- Chest pain
- Persistent night time coughing, in children
- Wheezing
- SOB
- Whooping cough/ croup
- Weight loss
- Failure of treatment
- Suspected ADRs
What are the red flag referral criteria for hayfever?
- Wheezing
- Shortness of breath
- Painful ear/ sinuses
- Purulent conjunctivitis
- Failed medication
