Scoring Systems :)

Question 1

Glasgow coma scale motor response

Answer 1

1- None
2- extending to pain
3- abnormal flexion to pain 
4- withdraws from pain
5- localises to pain
6- obeys commands

Question 2

Verbal response GCS

Answer 2

1- None
2- Sounds
3- Words
4- Confused
5- Orientated

Question 3

GCS eye opening

Answer 3

1- None
2- To pain
3- To speech
4- Spontaneous

Question 4

GCS score

Answer 4

3 totally unresponsive
8 comatose
15 best response

Question 5

CURB65

Answer 5

Confusion MMT<8
Urea>7mmol/L
RR>30
BP <=90 systolic or <=60 diastolic 
Age >=65

Question 6

FeverPAIN

Answer 6

Fever> 38
Purulent (pharyngeal/tonsillar exudate)
Attend rapidly within 3 days
Inflamed tonsils 
No cough or coryza

Indicates likelihood of isolating streptococci

Question 7

CHA2DSVASc score

Answer 7

1 in males- consider
>2 in males or females- anticoagulate

CHF
HTN
>=75
DM
Stroke/TIA
Vascular disease (IHD, PAD)
Age>=65
Female

Question 8

Moderate asthma

Answer 8

PEF 50-75%
Speech normal
RR <25/min
Pulse <110bpm

Question 9

Severe asthma

Answer 9

PEFR 33-50%
Can’t complete sentences in one breath
RR >25
Pulse >110

Question 10

Life-threatening

Answer 10

PEFR <33%
SpO2 <92
Normal CO2
Silent chest, cyanosis, poor resp effort, bradycardia, dysrhythmia or hypotension, exhaustion, confusion or coma

Question 11

MRC dyspnoea scale

Answer 11

1- breathless with strenuous exercise
2- SoB when hurrying on the level or walking up a hill
3- walks slower than people of the same age on the level or stops for breathy while walking at own pace on the level
4- stops for breath after walking 100m
5- too breathless to leave the house or breathless when dressing

Question 12

CKD classification

Answer 12

1 eGFR >90ml/min

2: 60-90
3a: 45-59
3b: 30-44
4: 15-29
5: <15

Question 13

MRC muscle power

Answer 13

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: active movement against resistance

Question 14

Glasgow Blatchford score significance

Answer 14

Decided which patients with upper GI bleeding are candidates for outpatient management

Question 15

Rockall score

Answer 15

After endoscopy determines patients risk of rebleeding and mortality

Question 16

POSSUM score

Answer 16

Physiological and operative severity score for the enumeration of mortality and morbidity
Used to predict risk-adjusted mortality and morbidity rates in a wide variety of surgical procedures

Question 17

NELA

Answer 17

National emergency laparotomy audit

Provides an estimate of the risk of death within 30days of emergency abdominal surgery

Question 18

Ranson score

Answer 18

Used for acute pancreatitis Mortality

Question 19

Rome IV criteria

Answer 19

Used for diagnosis of IBS

Question 20

FAST score

Answer 20

Alcohol screening test

Question 21

GP- COG

Answer 21

GP screening tool for dementia

Question 22

STaRTBack

Answer 22

Used for back pain

Question 23

PHQ-9

Answer 23

Depression tool
0-4 none
5-9 mild
10-14 moderate
15-19 moderately severe
20-27 severe

Question 24

Atropine for post-MI bradycardia

Answer 24

500micrograms every 3-5minutes IV

Maximum 3mg per course

Question 25

Calcium gluconate in severe hyperkalaemia

Answer 25

30mL, calcium gluconate 10% over 10mins

Question 26

Insulin dextrose in hyperkalaemia

Answer 26

10units insulin into 50mL of 50% glucose Add mix to 100mL bag of 0.9% saline 15minutes

Question 27

Morphine in MI

Answer 27

Slow IV injection 5-10mg, then another 5-10mg if required 1-2mg/min

Question 28

Naloxone for opioid overdose

Answer 28

400micrograms, then 800micrograms for up to 2 doses at 1minutr intervals

Question 29

Diazepam in status epilepticus

Answer 29

10mg, then 10mg after 10minutes IV

Question 30

Lorazepam in epilepsy

Answer 30

4mg for 1 dose, then 4mg after 10minutes

Question 31

ABCD2 score

Answer 31

``` Predicts short term risk of a stroke after a TIA Age Blood pressure Clinical features Duration of symptoms Presence of diabetes >=4 is a higher risk ```

Question 32

How to manage TIA

Answer 32

300mg aspirin daily Blood tests Carotid Doppler CT/MRI

Question 33

Management of ischaemic stroke

Answer 33

Aspirin 300mg then continue for 2 weeks If <4.5hours alteplase If <6 hours thrombectomy

Question 34

Severe middle artery infarction

Answer 34

``` Risk of malignant MCA syndrome Decompressive hemicraniectomy within 48hours NIHSS>15 <60 Infarct of >50% MCA territory ```

Question 35

Secondary prevention of stroke

Answer 35

Clopidogrel and aspirin

Question 36

Death certificate

Answer 36

1a cause of death 1b condition leading to cause of death 1c additional condition leading to 1b 2 any contributing factors or conditions