High Yield IM CRITERIAS Review for Step 2 CK & Shelf Exam

Summary

This educational video script covers various medical scoring systems for diagnoses and treatment decisions. It includes criteria for atrial fibrillation, strep pharyngitis, migraine, pneumonia, systemic inflammatory response syndrome, pleural effusion, pulmonary embolism, COPD, Glasgow Coma Scale, and more. The script serves as a mnemonic tool for healthcare professionals to differentiate conditions and determine appropriate treatments or further testing.

Takeaways

• 📝 The CHA2DS2-VASc score is used for atrial fibrillation treatment decisions, with a score of 2 or more indicating warfarin treatment and less than 2 suggesting aspirin.
• 👨‍⚕️ The Centor criteria for strep pharyngitis includes absence of coffee, presence of exudates, tender anterior cervical lymph nodes, fever, and age considerations, guiding antibiotic treatment.
• 🤒 The US-BOUND criteria for migraine diagnosis includes pulsatile headache, one-day duration, unilateral pain, and nausea, helping differentiate it from other types of headaches.
• 🏥 CURB-65 criteria for pneumonia involves confusion, uremia, tachypnea, low blood pressure, and age, with a score of 2 or more indicating hospitalization and specific antibiotic treatment.
• 🚑 The systemic inflammatory response syndrome (SIRS) criteria and its progression to sepsis, severe sepsis, and septic shock are outlined, emphasizing the importance of early identification and treatment.
• 💧 The LIGHT's criteria for pleural effusion differentiates between exudates and transudates by comparing pleural fluid to serum protein or LDH ratios, with specific cutoffs for diagnosis.
• 🔍 Wells criteria for pulmonary embolism (PE) helps determine the need for a CT angio or a D-dimer test based on a scoring system.
• 🌡️ Long-term oxygen therapy criteria for COPD include oxygen saturation levels below 88% or a PaO2 level below 55, indicating the need for home oxygen therapy.
• 🧠 The Glasgow Coma Scale is used to assess the severity of brain injury, with a score of 8 or less indicating the need for intubation.
• 🩺 Ascites analysis uses a score of 250 or more neutrophils to indicate infection, specifically in cirrhotic patients with chronic ascites.
• 📉 The serum-ascites albumin gradient (SAAG) measures the difference in albumin levels between serum and ascites to determine portal hypertension, with a cutoff of greater than 1.1.

Q & A

What is the CHA2DS2-VASc score used for?

The CHA2DS2-VASc score is used to assess the risk of stroke in patients with atrial fibrillation and to guide anticoagulant therapy decisions.

What are the components of the CHA2DS2-VASc score?

The CHA2DS2-VASc score includes Congestive heart failure, Hypertension, Age (>75 counts as two points), Diabetes, Stroke (counts as two points), Vascular disease, and Sex category (female).

When should warfarin be considered for treatment based on the CHA2DS2-VASc score?

Warfarin should be considered for treatment if the CHA2DS2-VASc score is two or more.

What does the Centor criteria assess for strep pharyngitis include?

The Centor criteria for strep pharyngitis includes the absence of a cough, the presence of exudates, tender anterior cervical lymph nodes, fever, and age (14 years old adds a point, over 44 subtracts a point).

When should a rapid strep test be considered based on the Centor criteria?

A rapid strep test should be considered if the Centor score is two to three, except in children where it is always recommended regardless of the score.

What is the CURB-65 criteria used for?

The CURB-65 criteria is used to assess the severity of pneumonia and to determine whether hospitalization is necessary.

What does the acronym CURB-65 stand for in pneumonia assessment?

CURB-65 stands for Confusion, Urea (uremia), Respiratory rate (tachypnea), Blood pressure (hypotensive), and Age (65 years old or more).

What is the significance of the LIGHT's criteria for pleural effusion?

LIGHT's criteria helps differentiate between exudative and transudative pleural effusions by comparing the protein or LDH levels in pleural fluid to serum.

What are the Wells criteria used for?

The Wells criteria are used to assess the likelihood of pulmonary embolism (PE) and guide the decision to perform a CT angiogram or a D-dimer test.

What does the acronym SIRS stand for and what is it used to identify?

SIRS stands for Systemic Inflammatory Response Syndrome and is used to identify the early signs of infection.

What is the significance of the serum-ascites albumin gradient (SAAG) in the diagnosis of ascites?

The SAAG is used to determine the cause of ascites, with a gradient greater than 1.1 indicating portal hypertension.

What is the TIMI score used for and what does it guide?

The TIMI score is used for patients with unstable angina or NSTEMI to determine the need for a stress test or direct cath lab referral based on the score.