45 NOTES TO PG

Dr. Ankit Yadavendra, M.B.B.S., Dr.V.M.G.M.C., Solapur

38-SCALE/SCORE/CRITERIA/GRADING/INDEX
a/c pancreatitis severity
Glasgow score3
Ranson score3
admission(BAWLA)
Bld glu>10mmol/l(200mg/dl)
Age>55y
WBC>16000/mm(1610^9/l)
LDH>700U/l
AST>250sigma Frankel U
<48h
bld urea N2>5mg%
hct>10%
PaO2<60mmHg
sr Ca<2mmol/l
base decit>4mmol/l
fluid sequestration>6l
CT severity index6(best)
Apache score8
sr K, sr Na, sr creatinine
CRP>150mg/L
Balthazar grade- of necrosis
Agatson score-coronary calcic MDCT
Ahlback radiological grade osteoarthritis knee
I-jt space narrowing(<3mm)
II-jt space absent
III-mild bone attrition(0-5mm)
IV-mod bone attrition(5-10mm)
V-severe bone attrition(>10mm)
Alvarado score-a/c Appendicitis(MANTRELS)
Migrating RIF pain=1
Anorexia=1
Nausea, vomiting=1
Tenderness RIF=2
Rebound tenderness=1
Elevated temperature=1
Leucocytosis=2
Shift to lt=1
Americal College Rheumatology(ACR) criteria-Dx SLE
1-malar rash(50%)

2-discoid rash(20%)
3-oral ulcer(30-40%)
4-photosensitivity(70%)
5-arthritis(60%)
6-polyserositis(pleuritis50%, pericarditis40%, peritonitis30%)
7-lupus nephritis
WHO grade(renal Bx)
I-normal
II-mesangial GN
III-focal GN<50%
IV-diffuse GN>50%
V-membranous GN-subepithelial
VI-end stage>90% glom
8-CNS-cognitive decline, headache,GTCS, focal neurological decit, psychosis
9-hematologic lupus-anem of c/c ds, PLT, hemolyt anem(Coomb+ve), TLC
10-AI marker-anti dsDNAAb(65%), anti phospholipidAb(30-40%), anti SmithAb(25%,
most sp)
11-ANA(98%)
Dx-4/11 criteria
American Society of Anaesthesiology grade-physical health of pt before Sx
I-norm healthy
II-mild systemic ds not limit activity
III-severe systemic ds limit activity
IV-incapacitating systemic ds life threatening
V-moribund, not able to survive>24h with/without Sx
VI-brain dead for organ donation
E-Emergency
Amsler criteria-Dx Gardenella vaginalis
pH>4.5
clue cell
white discharge
shy odour when mixed with 10%KOH
Amsterdam criteria, revised Bethesda criteria-Dx HNPCC
ankle brachial index=ankle BP/brachial BP
norm=1.0-1.3
PVD=0.9-0.5
crital ischem0.4
antiphospholipid Ab synd Dx
clinical
1-recur fetal loss(3fetal loss, <10w gest)
2-1FL, 10w
3-thrombosis-DVT>a thrombosis
4-1preterm delivery(<34w) sec to severe preeclampsia or uteroplacental
insufciency
lab

1-anticardiolipinAb(ACA)-IgM/IgG in medium to high titre on 2occasion 12w apart

2-anti2microglobulinAb
3-antilupus anticoagulantAb/antirussel viper venumAb(aPTT)
Dx-1clinical+2lab criteria
Apgar score
sign012
HR-absent-<100/min->100/min
Resp effort-absent-slow,gasping-good crying
M tone-limp/flaccid-some flexion extremity-active
Colour-blue,pale-pink body,blue extremity-all pink
Reflex irritabilit-no response-grimace-cough,sneeze
total score=10
severe depression=0-3
mild=4-6
norm=7-10
AshBury criteria-GB synd
ATP III(Adult Treatment Panel) criteria-metabolic synd
abd obesity-waist circumference
mal>102cm(>40inch)
fem>88cm(>35inch)
TG150mg/dL
HDL cholesterol
mal<40 mg/dL
fem<50 mg/dL
BP130/85 mm Hg
fasting pl glu110mg/dl
Beatuex index
Aedes aegypti index=(no. of house with breeding/total house)100
airport(<400m)=0
BIRADS(Breast Imaging Reporting And Database System) score-mammogram
0-assessm incomplete
1-norm
2-bn
3-probably bn
4-suspicious malign-Bx recommended
5-highly suspicious-Bx req
6-known malign
Bishop/preinduction score(DCPEStation)
1-cx Dilatation(MI)
2-cx Consistency
3-cx Position
4-cx Effacement/lth
5-Station of head
favourable9/13, unfavourable4/13

bispectral index-frontal EEG for depth/awareness during anaesth

adeq sedation=60-85
adeq anaesth=40-60
cortic depress<40
Bradford Hill/surgeon general criteria-causal association
temporal association
strength of association
specicity of association
consistency of association
biological plausibility
coherence of association
brainstem death criteria
Harvard criteria(best)
Minnesota criteria
Philadelphia criteria
Briquet/somatization synd
4 pain sympt
2 GI sympt
1 sexual sympt
1 pseudoneurologic sympt
CAD prognosis
high sensitivity-CRP>HDL>LDL
CASPAR criteria-Psoriatic ARthritis
CHADS2 score-Stroke
CHF
HTN
Age>75y
DM
Stroke=2
Chandler index=no. of Ankylostoma egg/g of soil
<200=not of much signicance
200-250=potential danger
250-300=minor public health problem
>300=major public health problem
Cheopis(flea) index(more sp)=no. of flea/no. of rat
>1-plague outbreak
CHEOPS(Children Hosp Eastern Ontario Pain Scale)-assessm pain child
cry, facial, verbal, torso, touch, leg
mod Child criteria-sec prophylaxis esoph varices(BAPAE)

Bilirubin
Albumin
PT
Ascitis
Encephalopathy
modif COrmack Lehane grade-LaryngosCOpe view
CURB65-indication for ICU admission in CAP
Confusion
Uraemia
RR>30/min
SBP<90mmHg
age>65y
Cystic Fibrosis(CF) Dx
typic c/f(resp, GIT, genitourinary) or
h/o CF in sibling or
+ve neonat screen test +
lab evidence of CFTR dysfn
sweat Cl conc on 2separate d or
2CF mutat or
abnorm nasal PD
Demeester score-24 h pH monitoring
GERD<14.7
dengue fever
I-+ve tourniquet test
II-blding diathesis(petechiae, epistaxis, hematemesis)
III-circulation failure(rapid weak pulse, cold clammy skin, hypotension)
IV-profound shock
dengue hgic shock-III,IV
diaphr hernia neonate progn-pulm HTN
Downe score-resp distress
characteristic012
grunting-none-audible with steth-aud without steth
retraction-absent-mild-mod
air entry-present--barely audible
cyanosis-absent-present in room air with <40%O2-present even with>40%O2
RR(/min)-(40-60)-(60-80)->80
resp distr4, resp fail7
Duke criteria-inf endocarditis Dx
major
1-bld culture(all+ve)-2 BC 12h aprt/3 BC 1h apart
2-evid of endocardial involvem(TTE/TEE)
minor

1-predisposing factor-k/c/o RHD,congHD,IV drug user,prosthetic valve

2-fever
3-vasc phenomenon-splinter hge nail, Janeway lesion(palm, sole), mycotic
aneurysm, thromboembolism
4-immunologic phenom-Roth spot(Retina), Osler node(tender, pulp nger), AGN,
RF+ve
5-bld culture+ve
(2maj)/(1maj+3min)/(5min)-Dx
endometrioma
<12cm
attached to lat pelvic wall/BL
contains tarry thick fluid
CA125>90
Feriman Gallway score-hirsutism
8-Dx
grade of larial lymphedema
I-edema pitting-complete relieve on rest
II-edema pitting-partially relieve on rest& elevation
III-edema nonpitting-skin involvem, subcutaneous thickening
IV-edema nonpitting-not relieve, warty projection, elephantiasis, lymphorrhoea
Foam stability index-Fetal lung maturity
Folstein MMSE(Mini Mental Status Examination)-RORAL
Registration
Orientation
Recall
Attention
Language
signif brain dysfn24/30
mild=18-23
severe=0-17
no moderate
drawback-biased to dominant lobe
Framingham criteria-CHF
major-PND, neck v distension, rales, S3 gallop, cardiomegaly, a/c pulm edema, v
press(>16cmH2O), +ve hepatojugular reflex
minor-extremity edema, night cough, HR, exertion dyspnea, hepatomegaly, pleural
effusion, VC
1maj+2min=CHF
GHENT citeria-Dx MarfaN synd
family history, cardinal sign, brillin mutation
Glassgow coma scale(GCS)(EVM-CAEF)
Eye opening

no response 1
to pain 2
to verbal stimuli 3
spontaneous 4
Verbal response
no response 1
inComprehensible sound 2
inAppropriate word 3
disoriented/confused 4
oriented, converse 5
Motor response
no response 1
Extension withdrawal 2
Flexion withdrawal 3
withdrawal to pain 4
localize pain 5
obey command 6
7-coma
Gleason score(2-10)-progn ca prostate
score-prognosis
score>7-poor prognosis
Gleason grade(1-5)
HAI criteria
>48h of hosp admission
<2w of discharge
<12mth of discharge for prosth implant
Hannin Rajka criteria-atopic dermatitis
Hunt Hess scale-SAH
hypersensitivity pneumonitis predictive criteria
1.exposure to known Ag
2.+ve predictive Ab to Ag
3.recur sympt
4.sympt develop after 4-8h of exposure
5.exp crackle
6.wt loss
Inslers cx score-cx mucus
12=good
10-11=satisfactory
<10=poor
IQ scale
WAIS(Weschler Adult Intelligence Scale)
IDEAS(Indian Disability Evaluation Assessm Scale)
BKT(Binet Kamat Test)

Jones criteria(2002-03)-RF Dx
major(CPCES)
Carditis(50-60%)
Polyarthritis(75%)
Chorea(<10%)(Dxtic)
Erythema marginatum(5%)
Subcutaneous nodule(5%)
minor
clinical-fever,arthralgia
ECG-PR interval
lab-ESR, TLC
(2major/1major+2minor)+evidence of recent grp A hemol Str(S pyogenes)
inf(ASLO+ve)>90%/throat swab Gram stain/culture+ve(30%)-Dx
Kawasaki ds
fever5d+4 of following
b/l nonpurulent bulbar conjunctivitis
injected pharynx, dry ssured lip, strawberry tongue
u/l cervic LNpathy>1.5cm
nonvesicular polymorphic trunkal rash
edema, erythema of hand,feet, periungual desquamation
Rx-2g/kg IVIgG+100mg/kg/d aspirin2w
Kurtzke Expanded/Extended Ds/Disability Scoring Scale(EDSS)-multiple sclerosis
LAP score(DCPPA)
-CML, PNH, Pernicious Anem
-inf, leukemoid rxn, polycythemia
Levenson criteria-cong cholesteatoma
white behind norm TM
norm pars flaccida, pars tensa
no h/o discharge, perforat, instrumentat, prior Sx, exclusion of canal atresia
Light criteria-exudate pleural effusion
pl fluid prot/sr prot>0.5
pl fluid LDH/sr LDH>0.6
pl fluid LDH>sr LDH
Mallampatti grade-size of tongue for laryngoscopy
I-faucial pillar, uvula tip
II-uvula without tip
III-soft palate
IV-no soft palate
diff ETT-III, IV
Mangled Extremity Severity Score(MESS) (SALE)-for preservation of limb
Shock
Age

Limb ischemia
Energy
Manning score-biophysical prole
nonstress test, fetal bod movem, resp activity
McDonald criteria-MRI Multiple sclerosis
MCHAT-screen tool for AuTism
MELD(Model for End stage Liver Ds)
Liver transplant
MentzoR index=MCV/RBC
Fe def anem>14(Fourteen)
Thalassemia min<12(Twelve)
borderline=12-14
MetAcARpAl index-MARfAn synd
Mirel criteria-prophylactic Mx of path lesion bone
>7-poor progn
Morris index
deep ve P wave in V1-LA enlargem(MS)
m strength grade
0(zero)-no contract
1(trace)-palpable contract only
2(poor)-move jt, not against gravity
3(fair)-move jt against gravity
4(good)-move jt against gravity&moderate resistance
5(norm)-norm strength
Myer COTTon grade-subglOTTic stenosis
Nadas criteria-Dx of congHD
major
systolic murmur3
diastolic murmur
central cyanosis
CHF
minor
systolic murmur2
abn S2
abn BP
abn CXR
abn ECG
Dx-1major+2minor

Nazer prognostic criteria-cystic brosis

Nazer score-Mx of Wilson ds cirrhosis
SGOT, PT, STB
modif New York criteria-Dx ankylosing spondilitis
b/l radiographic sacroiliitis+any 1
1-inflamm back pain
2-limited spine movem
3-limited chest expansion
Nugent criteria-Gram stain Dx bact vaginosis
0-3=norm
4-6=indeterminate
7-10=bact vaginosis
osteoporosis(bone mineral density)
T score-race, sex matched young person
Z score-age, race, sex matched person
Paalman&MCEllin criteria-CErvical preg
pain scale
CGI scale
COMFORT scale
FACES scale
McGill questionnaire
visual analogue scale
PEDS(Parent Evaluation of Development Status)-screen developm child<8y
RA Dx
jt-large(hip, knee, ankle, shoulder, elbow), small(1stIP, PIP, wrist, MCP, MTP)
1large=0
2-10large=1
1-3small=2
4-10small=3
>10 jt=5
subcutaneous nodule(30%)
ve=0
mild(1-3time)=2
strong(>3time)=3
ESR&CRP
both norm=0
either/both=1
duration
<6w=0
>6w=1
score6/10-Dx

Reid index=mucus thick/alveolar wall thickn

c/c bronchitis>0.4
Revised Trauma Score(RTS)
RR
SBP
GCS
ROME II criteria-IBS Dx
abd pain/discomfort3d/mth>3mth
+any
pain by defecation
onset a/w change in stool freq
onset a/w change in stool consistency
ROtterDam criteria-PCOD Dx
1-amenorrhoea>oligomenorrhoea
2-hyperandrogenemia(sr total testosterone= 70-150mg)& hyperandrogenism
3-USG>12follicle(cyst), <10mm, total ovary vol>10ml
criteria-provisional Dx
SCADDing grade CXR-SArCoiDosis
Silverman score-neonat resp distress
characteristic012
nasal flaring-none-mild-mod
grunting-none-audible with steth-aud without steth
upper chest movem-synchronous-mild insp lag-paradox(see-saw)
lower chest retract-none-mild-mod
xiphoid retract-none-mild-mod
resp distress4, resp fail7
Sjogrens synd Dx
1-ocular sympt-dryness
2-oral sympt-dryness
3-ocular sign-Schirmer test
4-sal gld Bx-CD4 Tcell inltration
5-sal gld dysfn
6-anti Ro/anti LaAb
Dx4/6
Sokolov&Lyon criteria
LVH-R(V5,V6)+S(V1)>35mm
Spigelberg criteria-ovary preg
1-gestational sac located in region of ovary
2-ectopic preg attached to uterus by ovarian lig
3-ovarian ts in wall of gestational sac proved histologically
4-FT on involved side intact

systolic murmur grade

I-very soft
II-soft
III-loud
IV-loud+thrill(palpable murmur)
V-rim stethoscope
VI-without stethoscope
T Berry Brazelton-neonat behaviour assessment scale(DLDQAC)
sleep state
1-Deep sleep
2-Light sleep
awake state
3-Drowsy
4-Quiescent alert
5-Active alert
6-Crying alert
TRaum Injury Severity Scale(TRISS)(MIRA)
Mechanism of injury
Injury severity score
Revised Trauma Score(RTS)
Age
visual analogue scale-assessm pain child
0-no pain, 100-worst imaginable pain
VUR grade(MCU)
I-reflux lower part non dilat ureter-abtc
II-reflux upto kidn non dilat ureter-abtc
III-dilatation of ureter-u/l-abtc, b/l-Sx
IV-grossly dilat ureter-u/l-abtc, b/l-Sx
V-no loss renal papill-0-1y-abt, >1y-abtc
Waterston criteria-trachesoph stula
wt>5.5lb+no pneum-single stage thoracotomy
wt=4-5.5lb+min pneum-made t by IV fluid Sx
wt<4lb/sever pneum-feeding gastrostomy after few w Sx
Wells criteria-pulm thromboembolism
West Havens grading-encephalopathy(ADSC)
I-Alter sleep cycle>Alter handwriting
II-Drowsy
III-Stuporous
IV-Coma
Wong Baker rating scale-assessm pain in child
Zatuchni Anderson score-breech delivery

0-4-CS
Abbreviations
a-artery, AA-amino acid, abtc-antibiotic, AI-autoimmune
bef-before, bel-below, b/l-bilateral, bld-blood, b/n-between, bn-benign, br-branch,
Bx-biopsy
ca-carcinoma, carb-carbohydrate, c/i-contraindication, c/l-contralateral,
conc-concentration, cong-congenital, Cx-cervix
d-day, def-deficient, ds-disease, d/t-due to, Dx-diagnosis
E-estrogen
fem-female, fr-from
gld-gland, glu-glucose
h-hormone
idiop-idiopathic, i/l-ipsilateral, inf-infection, inj-injury
lig-ligament, LL-lower limb, l/t-leading to
m-muscle, maj-major, mal-male, MC-most common, met-metastasis, min-minor,
mtx-methotrexate, Mx-management
n-nerve, norm-normal
P-progesterone, pl-plasma, prot-protein, pt-patient
Rx-treatment
SCC-squamous cell carcinoma, sr-serum, Sx-surgery, sz-seizure
tm-tumour, ts-tissue
UL-upper limb, u/l-unilateral
vag-vagina, VC-vocal cord, vel-velocity, vert-vertebra, vit-vitamin, vol-volume
w-week, wt-weight
Xr-X ray
y-year
#-fracture
-degree
-(N.B.-THESE NOTES ARE ONLY FOR THE PURPOSE OF GUIDANCE AND HELP
TO PG ASPIRANTS, NOT FOR COMMERCIAL OR OTHER PURPOSE. REFERENCE
HAS BEEN TAKEN FROM VARIOUS STANDARD TEXTBOOKS. FOR ANY
FEEDBACK/QUERY PLEASE CONTACT- ankit.yadavendra@facebook.com or
dr.ankityadavendra@gmail.com )