Scoring Systems Flashcards
MRC Dyspnoea
Stage 1 - Fine, no ill effects
Stage 2 - Shortness of breath after mild exertion (hurrying on level, slight hill)
Stage 3 - Walk slower than peers, stop after 15 minutes
Stage 4 - Breathless on level ground, after 100 yards
Stage 5 - ADLs inhibited
CURB-65
Confusion - AMT <8 or new onset Urea >7.0 Resp rate >30 Blood pressure <90 or <60 >65
Asthma Severity
Life threatening PEFR <33% of best PaCO2 normal or high PaO2 <92% Silent chest, cyanosis, poor effort Exhaustion, altered conciousness
Severe acute PEFR 33-50% Pa02 92-96% HR - >110 Resp rate >25 Struggles to finish sentences
Moderate PEFR >50-75% Oxygen sats >92% Speech normal RR <25 breaths per minute Pulse <110
NYHA Classification
Stage 1 - Cardiac disease but no impact on life activities
Stage 2 - Some activity limitation
Stage 3 - Breathless with stairs, comfortable at rest
Stage 4 - Moribund, struggles with ADLs
WHO Cancer Score
(AKA WHO performance score)
0: able to carry out all normal activity without restriction
1: restricted in strenuous activity but ambulatory and able to carry out light work
2: ambulatory and capable of all self-care but unable to carry out any work activities; up and about more than 50% of waking hours
3: symptomatic and in a chair or in bed for greater than 50% of the day but not bedridden
4: completely disabled; cannot carry out any self-care; totally confined to bed or chair.
Duke’s Endocarditis
Infective endocarditis diagnosed if pathological criteria positive, or 2 major criteria, or 1 major and 3 minor criteria, or 5 minor criteria
Major criteria
Positive blood cultures
two positive blood cultures showing Streptococcus viridans and the HACEK group or three or more positive blood cultures where the pathogen is less specific such as Staph aureus and Staph epidermidis
Evidence of endocardial involvement
positive echocardiogram or
new valvular regurgitation
Minor criteria
1) predisposing heart condition or intravenous drug use
2) microbiological evidence does not meet major criteria
3) fever > 38ºC
4) vascular phenomena: major emboli, splenomegaly, clubbing, splinter haemorrhages, Janeway lesions, petechiae or purpura
5) immunological phenomena: glomerulonephritis, Osler’s nodes, Roth spots
Duke’s Cancer Staging
Dukes A Tumour confined to the mucosa (90%)
Dukes B Tumour invading bowel wall (70%)
Dukes C Lymph node metastases (45%)
Dukes D Distant metastases (6%)(20% if resectable)
CHADVASC
Congestive heart failure Hypertension Age >65 (1)/Age >75 (2) Diabetes Stroke/TIA in the past (2) Vascular disease Sex (female)
HASBLED
Hypertension Abnormal renal/liver Stroke Bleeding history Labile INRs Elderly Drugs predisposing to bleeding
Glasgow Coma Scale
Eyes Spontaneous Respond to voice Respond to pain Nothing
Voice Spotaneous Confused Words Noises Nothing
Movement Follows commands Localises pain Withdraws from pain Flexes (decorticate) Extends (decerebrate) No response
Glasgow Pancreatitis
Predicts severity of attack PANCREAS PaO2 <8kpa Age >55 Neutrophils >15 Calcium uRea Enzymes - LDH Album Sugar (glucose)
Gustilo Anderson
Type I
wound < 1 cm
Type II
1-10cm
Type III A
> 10 cm, high energy
adequate tissue for coverage
includes segmental / comminuted fractures even if wound <10cm
farm injuries are automatically Gustillo III
Type IIIB
extensive periosteal stripping and requires free soft tissue transfer
Type IIIC
vascular injury requiring vascular repair
Salter Harris
Type 1 - Slipped (through growth plate)
Type 2 - Above (fracture above & involving growth plate)
Type 3 - Lower (fracture below and involving growth plate)
Type 4 - Through (transverse - intra-articular)
Type 5 - Rammed
MRC Muscle Grading
Grade 5: Muscle contracts normally against full resistance.
Grade 4: Muscle strength is reduced but muscle contraction can still move joint against resistance.
Grade 3: Muscle strength is further reduced such that the joint can be moved only against gravity with the examiner’s resistance completely removed. As an example, the elbow can be moved from full extension to full flexion starting with the arm hanging down at the side.
Grade 2: Muscle can move only if the resistance of gravity is removed. As an example, the elbow can be fully flexed only if the arm is maintained in a horizontal plane.
Grade 1: Only a trace or flicker of movement is seen or felt in the muscle or fasciculations are observed in the muscle.
Grade 0: No movement is observed.
AKI
A rise in serum creatinine of 26 μmol/L or greater within 48 hours.
50% or greater increase in serum creatinine (1.5 fold from baseline) within the preceding seven days.
A fall in urine output to less than 0.5 mL/kg/hour for more than six hours.
