Scoring

Question 1

What is involved in GCS?

Answer 1

Eye opening - 4
Verbal - 5
Motor - 6

Question 2

What are the points for eye opening in GCS?

Answer 2

Spontaneous - 4
Open in response to voice - 3
Open in response to pain - 2
Not opening - 1

Question 3

What are the points for verbal in GCS?

Answer 3

Oriented - 5
Confused conversation - 4
Inappropriate speech - 3
Incomprehensible sounds - 2
None - 1

Question 4

What are the points for motor in GCS?

Answer 4

Obeys commands - 6 
Localises to pain - 5 
Withdraws to pain - 4
Flexor response to pain - 3
Extensor response to pain - 2 
No response - 1

Question 5

What is the CURB65 score?

Answer 5

Prediction of mortality and guides tx in pneumonia

Confusion
Urea >8
Resps >25
BP <100 systolic 
65 yrs or older

Question 6

How does the CURB65 score guide tx?

Answer 6

1 => PO amoxicillin
2 => admit, amoxicillin/doxy + clarithromycin/erythromycin
3-5 => co-amoxiclav + clarithromycin/erythromycin

Question 7

What is the FeverPAIN score?

Answer 7

Fever during previous 24hrs
Purulent sputum on tonsils 
Attended within 3 days of onset 
Severely inflamed tonsils
No cough or coryza

Question 8

What is Centor criteria?

Answer 8

Tonsillar exudate
Tender anterior cervical lymphadenopathy
History of fever
Absence of cough

Question 9

What is included in CHADSVASC?

Answer 9

Congestive heart failure
Hypertension
Age 65-74
Diabetes
Stroke/TIA/VTE (2 points)
Vascular disease
Age >75 (2 points)
Sex - female

Question 10

What is Wells criteria for DVT?

Answer 10

• Active cancer, or cancer that’s been treated within last six months
• Paralysed leg/immobilisation
• Recently bedridden for more than three days or had major surgery within last four weeks
• Tenderness near a deep vein
• Swollen leg
• Calf swelling >3cm than other leg
• Pitting oedema in one leg
• Collateral veins
• Previous DVT or PE
• Other diagnosis more likely (-2 points)

Question 11

What is Wells criteria for PE?

Answer 11

• Clinical signs and symptoms of DVT = 3
• An alternative diagnosis is less likely than PE = 3
• Heart rate >100 = 1.5
• Immobilisation for 3 or more consecutive days or surgery in the previous 4 weeks = 1.5
• Previous PE or DVT = 1.5
• Haemoptysis = 1
• Malignancy (on treatment, treatment in last 6 months or palliative) = 1

Question 12

How is the score for Wells criteria for PE interpreted?

Answer 12

<4 unlikely - D-dimer

>4 likely - do CTPA