Medical Scores – M, N

Medical Scores – M

DIAGNOSTIC SCORE OF MI:

A score of ≥ 3 has specificity of 98% for diagnosis of MI

METABOLIC BONE DISEASE:

• T-score: the number of standard deviations from the young adult mean, most clinically valuable
  • osteopenia: –5< T-score <–1
  • osteoporosis: T-score ≤–5
• Z-score: the number of standard deviations from the age-matched mean, helpful in diagnosing secondary osteoporosis

CONSIDER MONITORING ICP IN THE FOLLOWING SITUATIONS:

• Patients with an abnormal head CT (SAH, hematoma, contusion, basal cistern compression, swelling, and herniation), and GCS score ≤8 after CPR

Or

• Patients with a normal head CT and GCS score of ≤8 AND the presence of two or more of the following:
• >40 yr
• Unilateral or bilateral motor posturing
• sBP <90 mmHg
• Post-operative monitoring
• Investigation of NPH

COGNITIVE ASSESSMENT USE MMSE TO ASSESS:

Gross screen for cognitive dysfunction: Total score is out of 30; <26 abnormal, 20-26 mild, 10-19 moderate, <10 severe.

MELD: MODIFIED END LIVER DISEASE SCORING: BASED ON: “CBI”:

• • Creatinine
  • Bilirubin
  • INR

• • • Recently Waiting list for transplant is made on the basis of MELD score*
    • Initially MELD score was used to predict mortality after TIPSS
    • Values vary from 6-40*. Liver transplant is allowed only for MELD > 15**

Medical Scores – N

THE NATIONAL INSTITUTE OF HEALTH STROKE SCALE (NIHSS): is a standardized clinical examination that determines the severity of an acute stroke; it can also be used to monitor response to treatment over time

• The scale uses 11 items that evaluate:
  • Level of consciousness
  • Visual system
  • Motor system
  • Sensory system
  • Language abilities
• Scoring (x/42):

• • 0=no stroke
  • 1-4=mild stroke
  • 5-15=moderate stroke
  • 15-20=moderate to severe stroke
  • 21-42=severe stroke
• rtPA is typically considered if score ≥6, but some stroke neurologists will administer rtPA with lower NIH stroke scale scores.