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Home Scores

Medical Scores – G

Dr.NM Tamilmani by Dr.NM Tamilmani
February 1, 2022
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Medical Scores – G


GRAVES ORBITOPATHY:

  • Activity is easily measured by the clinical activity score (CAS). A CAS ≥3/7 is indicative of active GO. Severity is rated as mild, moderate to severe and sight threatening (or very severe)
  • Graves’ orbitopathy activity assessment according to CAS
    • 1 Spontaneous retrobulbar pain
    • 2 Pain on attempted upward or downward gaze
    • 3 Redness of eyelids
    • 4 Redness of conjunctiva
    • 5 Swelling of caruncle or plica
    • 6 Swelling of eyelids
    • 7 Swelling of conjunctiva (chemosis)
  • Inactive GO=CAS<3
  • Active GO=CAS≥3
  • CAS – Clinical activity score, GO – Graves’ orbitopathy, DON – Dysthyroid optic neuropathy.

GLASGOW COMA SCALE:

  • For use in trauma patients with decreased LOC; good indicator of severity of injury and neurosurgical prognosis
  • Most useful if repeated; change in GCS with time is more relevant than the absolute number
  • Less meaningful for metabolic coma
  • Patient with deteriorating GCS needs immediate attention
  • Prognosis based on best post-resuscitation GCS
  • Reported as a 3-part score: Eyes + Verbal + Motor = Total
  • If patient intubated, GCS score reported out of 10 + T (T = tubed, i.e. No verbal component)

TABLE 3. GLASGOW COMA SCALE:

Eyes Open   Best Verbal Response   Best Motor Response  
Spontaneously 4 Answers questions appropriately 5 Obeys commands 6
To voice 3 Confused, disoriented 4 Localizes to pain 5
To pain 2 Inappropriate words 3 Withdraws from pain 4
No response 1 Incomprehensible sounds 2 Decorticate (flexion) 3
No verbal response 1 Decerebrate (extension) 2
No response 1

13-15 = mild injury, 9-12 = moderate injury, ≤8 = severe injury


MODIFIED GLASGOW COMA SCORE:

Modified GCS

Modified GCS for Infants
Eye Opening Verbal Response Motor Response
Spontaneously 4 Coos, babbles 5 Normal, spontaneous movement 6
To speech 3 Irritable cry 4 Withdraws to touch 5
To pain 2 Cries to pain 3 Withdraws to pain 4
No response 1 Moans to pain 2 Decorticate flexion 3
No response 1 Decerebrate extension 2
No response 1
Modified GCS for Children <4 years
Eye Opening Verbal Response Motor Response
Spontaneously 4 Oriented, social, speaks, interacts 5 Normal, spontaneous movement 6
To speech 3 Confused speech, disoriented, consolable 4 Withdraws to touch 5
To pain 2 Inappropriate words, not consolable / aware 3 Withdraws to pain 4
No response 1 Incomprehensible, agitated, restless, not aware 2 Decorticate flexion 3
No response 1 Decerebrate extension 2
No response 1

 


MODIFIED CENTOR SCORE: APPROACH TO DIAGNOSIS AND MANAGEMENT OF GABHS:

POINTS
Cough absent? 1
History of fever >38ºC? 1
Tonsillar exudate? 1
Swollen, tender anterior nodes? 1
Age 3-14 1
Age 15-44 0
Age >45 -1

 


IN COMMUNITIES WITH MODERATE LEVELS OF STREP INFECTION (10-20% OF SORE THROATS):

Score 0 1 2 3 4 or More
Chance patient has strep 1-2.5% 5-10% 11-17% 28-35% 51-53%
Suggested action NO culture or antibiotic Culture all, treat with antibiotics only if culture is positive Culture all, treat with antibiotics on clinical grounds1, discontinue antibiotics if culture comes back negative

Clinical grounds include a high fever or other indicators that the patient is clinically unwell and is presenting early in the course of the illness Limitations:

*This score is not applicable to patients <3 yr of age.

*If an outbreak or epidemic of illness caused by GABHS is occurring in any community, the score is invalid and should not be used


WHO PROGNOSTIC SCORE FOR GTD (2011):

Score
Prognostic Factor 0 1 2 4
Maternal Age >40 40
Antecedent Pregnancy Mole Abortion Term
Interval (End of Antecedent Pregnancy to Chemotherapy in Months) <4 4-6 7-13 >13
HCG IU/1 <103 103-104 104-105 >105
Number of Metastases 0 1-4 5-8 >8
Site of Metastases Lung Spleen, kidney GI tract Brain, liver
Largest Tumour Mass 3-5 cm >5 cm
Prior Chemotherapy Single drug Two drug

 


GLEASON SCORE FOR PROSTATE CANCER:

  • Grade 1 – Small uniform glands
  • Grade 2- More space between glands and increase in stroma
  • Grade 3- Distinct infiltration of cell margin
  • Grade 4- Irregular masses of neoplastic cells
  • Grade 5 – Lack of glandular pattern
  • Old score- grade 1(well differentiated)-grade 5(poorly differentiated)
  • New Gleason score: Extends from grade 1 to grade 10
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Medical Scores – H, I

Dr.NM Tamilmani

Dr.NM Tamilmani

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