32 cardsUKMLA Applied Knowledge Test (MSRA-style single best answer)
UKMLA Diagnostic Criteria, Scores and Definitions
32 flashcards on commonly tested clinical scores, diagnostic criteria and definitions for UK medical exams. Study material for exam revision, not clinical advice.
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CURB-65 score
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1
CURB-65 score
One point each for: new Confusion, Urea over 7 mmol/L, Respiratory rate 30 or more, low Blood pressure (systolic under 90 or diastolic 60 or less), and age 65 or over. Used to judge the severity of community-acquired pneumonia.
2
Sepsis Six
Three actions to give: oxygen if needed, intravenous antibiotics, intravenous fluids. Three to take or measure: blood cultures, serum lactate, urine output. Aim to complete within the first hour.
3
Beck's triad
Hypotension, raised jugular venous pressure and muffled heart sounds. Indicates cardiac tamponade.
4
Charcot's triad and Reynolds' pentad
Charcot's triad: fever, jaundice and right upper quadrant pain (ascending cholangitis). Reynolds' pentad adds hypotension and confusion, indicating severe cholangitis.
5
Virchow's triad
Stasis of blood flow, hypercoagulability and endothelial injury. The three factors that predispose to venous thrombosis.
6
Cushing's triad
Hypertension, bradycardia and irregular breathing. A late sign of raised intracranial pressure.
7
Diagnosis of acute pancreatitis
Two of three: typical epigastric pain radiating to the back, serum lipase or amylase more than three times the upper limit of normal, and characteristic imaging findings.
8
Kawasaki disease criteria
Fever for at least 5 days plus at least 4 of 5: bilateral non-purulent conjunctivitis, oral changes, polymorphous rash, changes of the hands and feet, and cervical lymphadenopathy. Treat early to reduce coronary aneurysms.
9
Pre-eclampsia
New hypertension (140/90 mmHg or more) after 20 weeks of pregnancy with proteinuria or other maternal organ dysfunction or uteroplacental dysfunction.
10
Gestational diabetes (NICE, 75 g OGTT)
Diagnosed if the fasting plasma glucose is 5.6 mmol/L or more, or the 2-hour glucose is 7.8 mmol/L or more. Either value alone is enough.
11
Acute kidney injury (NICE criteria, adults)
Any of: creatinine rise of 26 micromol/L or more within 48 hours; creatinine rise of 50 percent or more within 7 days; urine output below 0.5 mL/kg/hour for more than 6 hours.
12
KDIGO staging of AKI by creatinine
Stage 1: 1.5 to 1.9 times baseline (or a rise of 26 micromol/L or more). Stage 2: 2.0 to 2.9 times baseline. Stage 3: 3 or more times baseline, creatinine 354 micromol/L or more, or renal replacement therapy.
13
Definition of chronic kidney disease
Abnormal kidney structure or function, such as an eGFR below 60 mL/min/1.73 m2 or markers of kidney damage like albuminuria, present for more than 3 months.
14
Diabetic ketoacidosis (UK criteria)
Ketonaemia of 3.0 mmol/L or more (or significant ketonuria), glucose over 11 mmol/L or known diabetes, and pH below 7.3 or bicarbonate below 15 mmol/L.
15
CHA2DS2-VASc score
Congestive heart failure 1, Hypertension 1, Age 75 or over 2, Diabetes 1, prior Stroke/TIA/thromboembolism 2, Vascular disease 1, Age 65 to 74 1, Sex category female 1. NICE: offer anticoagulation at 2 or more, consider it in men at 1.
16
NICE hypertension stages
Stage 1: clinic 140/90 or more and ambulatory average 135/85 or more. Stage 2: clinic 160/100 or more and ambulatory 150/95 or more. Severe: clinic systolic 180 or more or diastolic 120 or more.
17
Light's criteria for an exudate
Pleural fluid is an exudate if any of: pleural-to-serum protein ratio above 0.5, pleural-to-serum LDH ratio above 0.6, or pleural LDH above two thirds of the upper limit of normal serum LDH.
18
Acute severe asthma
Any of: peak flow 33 to 50 percent of best or predicted, respiratory rate 25 or more, heart rate 110 or more, inability to complete sentences in one breath.
19
Life-threatening asthma
Any of: peak flow below 33 percent, silent chest, cyanosis, poor respiratory effort, arrhythmia, hypotension, exhaustion, confusion or altered consciousness.
20
Rotterdam criteria for polycystic ovary syndrome
Two of three: ovulatory dysfunction (oligo- or anovulation), clinical or biochemical hyperandrogenism, and polycystic ovaries on ultrasound, after excluding other causes.
21
Hepatitis B: HBsAg and anti-HBs
HBsAg positive means current infection (chronic if it persists beyond 6 months). Anti-HBs positive alone, with negative anti-HBc, means immunity from vaccination.
22
Hepatitis B: anti-HBc
Core antibody shows exposure to natural infection. IgM anti-HBc indicates recent or acute infection. Anti-HBc with anti-HBs and no HBsAg means resolved infection.
23
SIADH: key findings
Hyponatraemia with low plasma osmolality, inappropriately concentrated urine (osmolality above 100 mOsm/kg), urine sodium above 30 mmol/L, in a euvolaemic patient without diuretic use or adrenal, thyroid or renal disease.
24
Postural hypotension
A fall in systolic blood pressure of 20 mmHg or more, or in diastolic pressure of 10 mmHg or more, within 3 minutes of standing.
25
Anaphylaxis: diagnostic features
Sudden onset and rapid progression of airway and/or breathing and/or circulation problems, usually with skin or mucosal changes such as urticaria or angioedema.
26
Nephrotic syndrome
Heavy proteinuria, hypoalbuminaemia and oedema, often with hyperlipidaemia. Minimal change disease is the commonest cause in children.
27
Nephritic syndrome
Haematuria with red cell casts, hypertension, oedema and reduced urine output with a fall in glomerular filtration. Post-streptococcal glomerulonephritis is a classic cause.
28
Hypercalcaemia: PTH patterns
Primary hyperparathyroidism: high calcium with a raised or inappropriately normal PTH. Malignancy: high calcium with a suppressed PTH. Secondary hyperparathyroidism in CKD: low calcium with a raised PTH.
29
Karyotypes: Turner, Klinefelter and Down
Turner syndrome is 45,X. Klinefelter syndrome is 47,XXY. Down syndrome is usually trisomy 21 (47,XX,+21 or 47,XY,+21).
30
Rinne and Weber tests
Rinne positive: air conduction better than bone, which is normal or sensorineural loss. Rinne negative: bone better than air, which suggests conductive loss. In unilateral loss the Weber lateralises to the affected ear in conductive loss and to the better ear in sensorineural loss.
31
Hardy-Weinberg equation
p + q = 1 and p squared + 2pq + q squared = 1. For a recessive disease, q squared is the disease frequency and 2pq is the carrier frequency.
32
Faster Diagnosis Standard
In England, patients referred urgently with suspected cancer should be told within 28 days whether or not they have cancer.
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