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Yr3: GP > Scoring Systems & Emergency Drugs > Flashcards

Scoring Systems & Emergency Drugs Flashcards

1
Q

Describe the Glasgow coma scale (GCS) scoring system

A

Score is froom 3-5

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2
Q

Describe CHA2DS2VASc score

A
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3
Q

Describe BTS classification of asthma severity

A
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4
Q

Describe MRC dyspnoea score

A
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5
Q

Describe CKD classification

A
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6
Q

Describe MRC grading of muscle power

A
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7
Q

Describe CURB65 score

A
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8
Q

Describe Centor score

A
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9
Q

Describe FeverPAIN score

A
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10
Q

Must be able to complete a scoring chart (provided for you) and calculate Wells scoring for DVT and PE.

Whats cut off for likely DVT and likely PE?

A
  • Likely DVT =/>2
  • Likely PE >4
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11
Q

Must know how to record observations on EWS (NEWS2) chart and use it to calculte EWS score

A

Things to remember:

  • Diff SpO2 scales. Scale 1 has target saturations of =/>96%. Scale 2 for if saturations target 99-92%
  • If on oxygen record either L/min or % of O2 delivered
  • BP put systolic and diastolic with line/arrow between

Score of 3 or more in one category or total score >5 need a review.

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12
Q

What is the ASA score used for?

A

American Society of Anesthesiologists (ASA) grade is used to describe current fitness prior to undergoing anaesthesia and surgery and indicate the risk of post-operative complications and absolute mortality.

E= used in emergency operations

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13
Q

What is HAS-BLED score used for?

A

Estimate the 1-year risk for major bleeding in patients with atrial fibrillation

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14
Q

What is the Rockall score used for?

A

Estimate the risk of death or rebleeding in pts with upper GI bleed; have pre- and post-endoscopic score

Score 0-1 is low risk

Score 2-4 is intermeidate risk

Score =/> 5 is high risk

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15
Q

What is the POSSUM score used for?

Interpret the score

A

Assesses morbidity and mortality for surgery. It can be used for both emergency and elective surgery; consists of both physiological and operative score. Should not be used for trauma pts/surgery!

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16
Q

What is the NELA score?

A

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

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17
Q

What is the Ranson criteria?

Interpret the score

A

Used to assess severity and mortality of acute pancreatitis

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18
Q

What is the ROME IV criteria?

A

Used to diagnose functional Gastrointestinal Disorders. Different criteria for different problems e.g. IBS, gastrodudoenal disoders, anorectal disorders etc.. Also have criteria for children e.g. for functional diarrhoea.

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19
Q

Describe the ROME IV criteria for IBS

A
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20
Q

Describe the ROME IV criteria for constipation

A
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21
Q

What is the PHQ-9 score/questionnaire?

A

The PHQ-9 is a 9-question instrument given to patients in a primary care setting to screen for the presence and severity of depression- based on DSM 5 criteria for depression

22
Q

Give a rough indication as to what a high, medium and low score of PHQ-9 is

A
23
Q

What is the GAD-7 score/questionnaire used for?

A

For screening and assessing severity of generalized anxiety disorder (GAD).

24
Q

Give a rough indication as to what a low, medium and high GAD-7 score is

A
25
Q

What is the FAST score used for?

A

Screening tool used to assess a service users level of risk to alcohol harm.

26
Q

If pt scores 3 or more on FAST score, what should you do next?

A

AUDIT questionnaire

27
Q

Describe the AUDIT questionnaire

Interpret the score

A

● 0 to 7 indicates low risk

● 8 to 15 indicates increasing risk

● 16 to 19 indicates higher risk,

● 20 or more indicates possible dependence

Questions from FAST & those in image

28
Q

What is GPCOG used for?

A

The General Practitioner Assessment of Cognition (GPCOG) is a brief screening test for cognitive impairment.

Has two parts: patient section and informant section

29
Q

What is the STarTBack score used for?

A

Risk stratify patients with back pain into low, medium and high risk groups for ongoing disability

*Subscore looks at Q5-Q9 which are psychological qeustions

30
Q

What is the dose and administration route of adrenaline in anaphylaxis?

A
  • 0.5ml (or 500 micrograms) of 1:1000
  • IM

*1 in 1000 solution is 100ug in 0.1ml

31
Q

What is the dose and administration route of adrenaline in cardiac arrest?

A
  • 1mg of 1:10000 every 3-5 mins
  • IV injection

*1 in 10000 is 100ug/mL therefore 1mg would be 10ml??

32
Q

What is the dose and administration route of hydrocortisone in anaphylaxis?

A
  • 100-300mg
  • IV injection
33
Q

What is the dose and administration route of chlorphenamine in anaphylaxis?

A
  • 10mg (repeat dose if necessary up to 4 times in 24hrs)
  • IV injection or IM injection
34
Q
A
35
Q

What is the dose and administration route of atropine for treatment of post-MI bradycardia?

A
  • 500ug (0.5mg) every 3-5 minutes up to max of 3mg
  • IV injection
36
Q

What is the dose and administration route of aspirin in ACS?

A
  • 300mg
  • Chewable or dispersed in water
37
Q

What is the dose and administration of clopidogrel in ACS?

A
  • 300mg
  • PO
38
Q

What is the dose and administration of calcium gluconate in hyperkalaemia?

A
  • 10-20mL of 10%
  • Slow IV injection

Can be repeated as required or followed by continous infusion; initially 50 mL/hour, adjusted according to response, infusion to be administered using 100 mL of calcium gluconate 10% diluted in 1 litre of glucose 5% or sodium chloride 0.9%.

39
Q

What medication and route of administration should insulin be given during a hypo if pt is alert and can swallow?

A
  • Fast acting carbohydrate PO e.g. 10-20mg of glucose tablets, glucogel. Repeat afer 10-15 mins up to 3 times if required
  • Once blood sugar >4mmo/L provide with long acting carbohydrate e.g. slice of bread
40
Q

What medication, dose and route of administration should be given in a hypo if pt has decreased level of consciousness?

A
  • Glucagon 1mg
  • IM injection

If no response after 10 minutes give IV glucose:

  • 125mL of 20% dextrose
  • 250mL of 10% dextrose

**DO NOT GIVE 50% dextrose

41
Q

What medication, dose and route of administration should be used if pt is having hypo and is having seizures or is unconscioius?

A
  • 1mg glucagon
  • Im injection

If no response after 10 minutes give IV glucose:

  • 125mL of 20% dextrose
  • 250mL of 10% dextrose

**DO NOT GIVE 50% dextrose

42
Q

Who can you not give IM glucagon to in a hypo?

Why do we avoid 50% dextrose?

A
  • Chronic liver disease as have impaired hepatic gluconeogenesis. Glucagon may provoke reboudn hypoglycaemia secondary to insulin release
  • Hypertonic and has high viscosity and is irritant to venous system causing thrombophlebitis
43
Q

What dose of insulin and dextrose would you use to set up variable rate insulin infusion?

A
44
Q

What dose and route of administration of diazepam would you use for status epilepticus?

A
  • 10 mg
  • IV injection

….then 10 mg after 10 minutes if required, administered at a rate of 1 mL (5 mg) per minute.

45
Q

What dose and route of adminstration would you give lorazepam in status epilepticus?

A
  • 4mg
  • Slow IV injection

Can be repeated after 10 mins if required. To be administerd into large vein.

46
Q

What dose and route of administration would you give lorazepam in if pt has delerium tremens?

A
  • 2-4mg
  • PO
47
Q

What dose of salbutamol can be given via inhalation of aerosol during asthma attack?

A

2–10 puffs, each puff is to be inhaled separately, repeat every 10–20 minutes or when required, give via large volume spacer, each puff is equivalent to 100 micrograms.

48
Q

What dose of salbutamol can be given via nebuliser during asthma attack?

A

5 mg, repeat every 20–30 minutes or when required, give via oxygen-driven nebuliser if available

49
Q

What dose and route of administration should prednisolone be given in acute asthma attack?

A

40–50 mg PO daily for at least 5 days.

50
Q

What dose and route of administration should morphine be given during ACS?

A

For Adult

  • 5–10 mg, followed by 5–10 mg if required
  • Slow IV injection (rate of 1–2 mg/minute)

For Elderly **Use dose for elderly in frail patients.

  • 2.5–5 mg, followed by 2.5–5 mg if required
  • Slow IV injection at a rate of 1–2 mg/minute.
51
Q

For acute pain, what dose of morphine can adults have?

A

10mg every 4hrs (PO, SC or IM)

5mg every 4hrs (slow IV injection)

52
Q

What dose and route of administration is required for naloxone in opoid overdose?

A
  • IV injection
  • Initially 400 micrograms, then 800 micrograms for up to 2 doses at 1 minute intervals if no response to preceding dose, then increased to 2 mg for 1 dose if still no response (4 mg dose may be required in seriously poisoned patients),

Yr3: GP (21 decks)

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