Medical Criteria – A

Medical Criteria – A 

ADMINISTRATION OF TREATMENT FOR AN INCAPABLE PATIENT IN EMERGENCY SITUATIONS:

• The patient is experiencing extreme suffering
• The patient is at risk of sustaining serious bodily harm if treatment is not administered promptly (loss of life or limb)

ADMINISTRATION OF TREATMENT FOR AN INCAPABLE PATIENT IN NON-EMERGENCY SITUATIONS:

• An incapable patient can only be detained against their will to receive treatment if they meet the criteria for certi­fication under the Mental Health Act.

ANAPHYLAXIS AND ALLERGIC REACTION: DIAGNOSTIC CRITERIA

• Anaphylaxis is highly likely with any of:

1. 1. Acute onset of an illness (min to hrs) with involvement of the skin, mucosal tissue and at least one of

• • • Respiratory compromise (e.g., Dyspnoea, Wheeze, Stridor, Hypoxemia)
    • Hypotension/end-organ dysfunction (e.g., Hypotonia, Collapse, Syncope, Incontinence)

1. 2. Two or more of the following after exposure to a LIKELY allergen for that patient (min to hrs)

• • • Involvement of the skin-mucosal tissue
    • Respiratory compromise
    • Hypotension or associated symptoms
    • Persistent gastrointestinal symptoms (e.g., crampy abdominal pain, vomiting)

1. 3. Hypotension after exposure to a KNOWN allergen for that patient (min to h)

• • • Management is also appropriate in cases that do not fulfil criteria, but who have had previous episodes of anaphylaxis
    • Life-threatening differentials for anaphylaxis include asthma and septic shock
    • Angioedema may mimic anaphylaxis but tends not to improve with standard anaphylaxis treatment

ACUTE UPPER GASTROINTESTINAL BLEEDING TRANSFUSION STRATEGIES: EXCLUSION CRITERIA

• Included massive bleed, ACS, stroke/TIA or transfusion within previous 90 d; recent trauma/surgery; lower GI bleed.

AMSTERDAM CRITERIA (“3-2-1 RULE”) FOR DIAGNOSIS OF LYNCH SYNDROME/HEREDITARY NONPOLYPOSIS COLORECTAL CA (HNPCC)

• 3 or more relatives with Lynch syndrome-associated cancer,
• 2 or more generations affected
• 1 case diagnosed before age 50
  • FAP is excluded

APC GENETIC SCREENING:  REFERRAL CRITERIA

• To confirm the diagnosis of FAP (in patients with ≥100 colorectal adenomas)
• To provide pre-symptomatic testing for individuals at risk for FAP (1st-degree relatives who are ≥10 yr)
• To confirm the diagnosis of attenuated FAP (in patients with ≥20 colorectal adenomas)

ANTIPSYCHOTICS FOR TREATMENT OF DELIRIUM IN HOSPITALISED NON-ICU PATIENTS: SELECTION CRITERIA

• Types of studies included randomized trials with the concealed allocation of subjects.

ANTIPHOSPHOLIPID ANTIBODY SYNDROME (APS): DIAGNOSTIC CRITERIA

•  ≥1 clinical and ≥1 laboratory criteria
  • Clinical: arterial or venous thrombosis, recurrent (>3) early pregnancy losses <10 wk, one late foetal loss ≥10 wks. (morphologically normal), or premature birth before 34 wks. due to (pre)eclampsia or placental insufficiency

• • Laboratory (must be confirmed on two occasions, tested ≥12 wks. apart): anticardiolipin antibodies, anti-β2 glycoprotein-I antibody, or lupus anticoagulant

ANTIPHOSPHOLIPID ANTIBODY SYNDROME: CLASSIFICATION CRITERIA OF APLS

• 1 clinical and 1 laboratory criteria must be present.

ACUTE BACTERIAL CONJUNCTIVITIS CRITERIA FOR ANTIBIOTICS VS PLACEBO

• RCTs with any form of antibiotic treatment compared with placebo including topical, systemic or combined (e.g., antibiotics and steroids) antibiotic treatments.

ACUTE BACTERIAL RHINOSINUSITIS: DIAGNOSIS CRITERIA

• Along with clinical criteria, can confirm radiographically and/or endoscopically using antral puncture for bacterial cultures

AGORAPHOBIA: DSM-5 DIAGNOSTIC CRITERIA

1. 1. Marked fear or anxiety about two (or more) of the following ­ve situations:
      • Using public transportation
      • Being in open spaces
      • Being in enclosed places
      • Standing in line or being in a crowd
      • Being outside of the home alone
   2. The individual fears or avoids these situations because of thoughts that escape might be difficult or help might not be available in the event of developing panic-like symptoms or other incapacitating or embarrassing symptoms
   3. The agoraphobic situations almost always provoke fear or anxiety
   4. The agoraphobic situations are actively avoided, require the presence of a companion, or are endured with intense fear or anxiety
   5. The fear or anxiety is out of proportion to the actual danger posed by the agoraphobic situations and to the socio-cultural context
   6. The fear, anxiety, or avoidance is persistent, typically lasting ≥6 month
   7.  The fear, anxiety, or avoidance causes clinically signifi­cant distress or impairment in social, occupational, or other important areas of functioning
   8. If another medical condition is present, the fear, anxiety, or avoidance is clearly excessive
   9. The fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder and are not related exclusively to obsessions, perceived defects or flaws in physical appearance, reminders of traumatic events, or fear of separation

• • Note: Agoraphobia is diagnosed irrespective of the presence of panic disorder. If an individual’s presentation meets the criteria for panic disorder and agoraphobia, both diagnoses should be assigned.

ADJUSTMENT DISORDER: DSM-5 DIAGNOSTIC CRITERIA

A. The development of emotional or behavioural symptoms in response to an identi­fiable stressor(s) occurring within 3 months of the onset of the stressor(s)

B. These symptoms or behaviours are clinically signi­ficant as evidenced by either of the following:

• • Marked distress that is in excess of what would be expected from exposure to the stressor
  • Signi­ficant impairment in social or occupational functioning

C. The stress-related disturbance does not meet the criteria for another mental disorder and is not merely an exacerbation of a pre-existing mental disorder

D. The symptoms do not represent normal bereavement

E. Once the stressor (or its consequences) has terminated, the symptoms do not persist for more than an additional 6 months

• • Speci­fiers: with depressed mood, with anxiety, with mixed anxiety/depression, with conduct disturbance, with mixed disturbance of conduct/emotions, unspeci­fied

ANOREXIA NERVOSA: DSM-5 DIAGNOSTIC CRITERIA FOR ANOREXIA NERVOSA

1. 1. Intake and weight: restriction of energy intake relative to requirements, leading to a signi­ficantly low body weight in the context of age, sex, developmental trajectory, and physical health; signi­ficantly low weight is defi­ned as a weight that is less than minimally normal or, for children and adolescents, less than that minimally expected
   2. Fear or behaviour: intense fear of gaining weight or of becoming fat, or persistent behaviour that interferes with weight gain, even though at a signi­ficantly low weight
   3. Perception: disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight

• • • Speci­fiers: Partial remission, full remission, severity based on BMI (mild = BMI >17 kg/m2, moderate = BMI 16-16.99 kg/m2, severe = BMI 15-15.99 kg/m2, extreme = BMI <15 kg/m2), type (restricting = during last 3 months no episodes of binge-eating or purging vs. binge-eating

CRITERIA TO ADMIT TO THE MEDICAL WARD FOR HOSPITALIZATION:

• <65% of standard body weight (<85% of standard bodyweight for adolescents), hypovolemia requiring intravenous fluid, heart rate <40 bpm, abnormal serum chemistry, or if actively suicidal

ASTHMA: CRITERIA FOR DETERMINING IF ASTHMA IS WELL CONTROLLED

ACUTE RESPIRATORY DISTRESS SYNDROME: BERLIN CRITERIA

• Acute onset
  • Within 7 days of a defined event, such as sepsis, pneumonia, or patient noticing worsening of respiratory symptoms – usually occurs within 72 hrs of presumed trigger
  • Bilateral opacities consistent with pulmonary oedema on either CT or CXR
  • Not fully explained by cardiac failure/fluid overload, but a patient may have concurrent heart failure
  • Objective assessment of cardiac function (e.g., Echocardiogram) should be performed even if no clear risk factors

ASAS CLASSIFICATION CRITERIA FOR AXIAL SPONDYLOARTHRITIS

• For patients with ≥3 mo back pain and age at onset <45 yrs.

Also read:

1. Criteria in GPNotebook
2. Criteria in NICE
3. Criteria in Statpearls