1
Q
Chest Pain—SDEC inclusion
A
Stable vitals; pain settled/controlled; non-diagnostic ECG (no STEMI/ongoing ischaemia); low–intermediate risk after 0/1-h or 0/2-h hs-troponin pathway; no high-risk alternate dx (PE, dissection, pneumothorax); safe home circumstances.
2
Q
Chest Pain—Red flags → admit/escalate
A
ST-elevation/new LBBB; dynamic ST/T changes with ongoing pain; haemodynamic compromise; arrhythmia; pulmonary oedema; syncope; suspected aortic dissection (tearing pain, neurological signs, pulse deficit, mediastinal widening).
3
Q
Chest Pain—Key history
A
Central/retrosternal pressure/tightness; radiation to jaw/arm; onset at rest or exertion; duration >20–30 min suggests ACS; diaphoresis, dyspnoea, nausea; risk factors: age, diabetes, hypertension, smoking, family history, prior CAD.
4
Q
Chest Pain—Exam (positive findings)
A
Pale/clammy; tachycardia; S3 or basal crackles (HF); hypotension (red flag). Chest wall tenderness suggests MSK but does not exclude ACS.
5
Q
Chest Pain—ECG/imaging findings
A
ECG: ST elevation/depression, new T-wave inversion, new LBBB, posterior pattern (V1–V3 ST↓ + tall R). CXR to support ddx: pulmonary oedema, pneumothorax, consolidation, widened mediastinum.
6
Q
Chest Pain—Biomarkers/labs
A
hs-troponin rise/fall; FBC, U&E, glucose; lipids non-urgent. Consider VBG if unwell.
7
Q
Chest Pain—First-hour actions
A
ABCDE; initial and repeat 12-lead ECG (especially during pain); start 0/1-h or 0/2-h hs-troponin algorithm; CXR if alternate dx suspected; consider HEART/EDACS per local policy.
8
Q
Chest Pain—Initial treatment
A
Aspirin 300 mg stat if ACS cannot be excluded (unless contraindicated); GTN for analgesia; further antiplatelet/anticoagulation only if ACS pathway confirmed by cardiology.
9
Q
Chest Pain—Discharge criteria
A
Serial ECGs non-ischaemic; troponin rule-out met; pain resolved; vitals stable; safe follow-up arranged.
10
Q
Chest Pain—Safety-net & follow-up
A
Return for recurrent/worsening chest pain, dyspnoea, syncope. GP/cardiology follow-up; CT coronary angiography if suspected stable angina.
11
Q
Chest Pain—Clinical pearls
A
Normal first ECG ≠ rule-out ACS—use serial ECGs + hs-troponin; posterior MI may present with anterior ST-depression and tall R waves.
12
Q
Chest Pain—Decision rules
A
HEART score (History, ECG, Age, Risk factors, Troponin: 0–10; 0–3 low, 4–6 intermediate, 7–10 high). Optional EDACS per local use. STEMI thresholds: V2–V3 ≥2.5 mm men <40, ≥2.0 mm men ≥40, ≥1.5 mm women; ≥1.0 mm in other contiguous leads.
13
Q
PE—SDEC inclusion
A
sPESI = 0 AND Hestia negative; stable haemodynamics; SpO₂ ≥94% (or at baseline); low bleeding risk; imaging accessible or reliable return; adequate home support.
14
Q
PE—Red flags → admit/escalate
A
Hypotension/shock; syncope with instability; SpO₂ <90% on air; RV strain with biomarker rise; pregnancy; active bleeding/high bleed risk; severe renal failure; social/medical reasons preventing outpatient care.
15
Q
PE—Key history
A
Pleuritic chest pain; acute dyspnoea; haemoptysis; syncope; DVT symptoms; recent surgery/immobilisation; oestrogen therapy; cancer; previous VTE.
16
Q
PE—Exam (positive findings)
A
Tachycardia; tachypnoea; hypoxaemia; unilateral leg swelling/tenderness; raised JVP or loud P2 (RV strain).
17
Q
PE—ECG/imaging findings
A
ECG: sinus tachycardia; new RBBB; right axis deviation; T inversion V1–V4; S1Q3T3 (low sensitivity). Imaging: CTPA diagnostic (V/Q if CTPA unsuitable). CXR often normal or with small effusion/atelectasis.
18
Q
PE—Biomarkers/labs
A
D-dimer (age-adjusted if ≥50); troponin/BNP may be elevated (risk stratification); baseline FBC, U&E, LFT, coagulation profile.
19
Q
PE—First-hour actions
A
Apply Wells PE. If ‘unlikely’ use PERC and/or age-adjusted D-dimer; if ‘likely’, arrange urgent CTPA and consider starting DOAC if no contraindication and imaging delay anticipated.
20
Q
PE—Initial treatment
A
Apixaban or rivaroxaban loading per formulary; LMWH preferred in cancer, pregnancy, or severe renal impairment; oxygen if hypoxic; analgesia.
21
Q
PE—Discharge criteria
A
sPESI 0; Hestia negative; first anticoagulant dose administered; patient education; written plan; follow-up arranged.
22
Q
PE—Safety-net & follow-up
A
Return for worsening dyspnoea, chest pain, haemoptysis, syncope. Anticoagulation review ~2 weeks; typical duration 3–6 months (longer if unprovoked/high risk).
23
Q
PE—Clinical pearls
A
Hestia is a practical outpatient checklist; elevated troponin/BNP indicates RV strain and higher risk but not necessarily admission if otherwise stable and criteria met.
24
Q
PE—Decision rules
A
Wells PE (≥4 likely, ≤4 unlikely); PERC (8 items—all must be true to skip D-dimer); Age-adjusted D-dimer (age×10 ng/mL FEU if ≥50); sPESI (0 = low risk); Hestia criteria (any ‘Yes’ → inpatient).
25
DVT—SDEC inclusion
Stable unilateral leg symptoms; imaging same/next day; low bleeding risk; safe home; no severe phlegmasia or sepsis.
26
DVT—Red flags → admit/escalate
Suspected phlegmasia; limb ischaemia; disproportionate pain; sepsis; extensive iliofemoral clot with severe symptoms; anticoagulation contraindicated with high embolic risk.
27
DVT—Key history
Unilateral calf/leg pain and swelling; recent surgery/immobilisation; cancer; prior DVT; pregnancy; OCP/HRT.
28
DVT—Exam (positive findings)
Calf swelling >3 cm vs other leg (10 cm below tibial tuberosity); tenderness along deep veins; pitting oedema confined to one leg; collateral superficial veins.
29
DVT—Imaging findings
Compression ultrasound (whole-leg preferred): non-compressible vein with intraluminal thrombus.
30
DVT—Biomarkers/labs
D-dimer if Wells ‘unlikely’; baseline FBC, U&E, LFT; pregnancy test if relevant.
31
DVT—First-hour actions
Calculate Wells DVT. If ‘likely’ start DOAC and arrange ultrasound ≤24 h; if ‘unlikely’ perform age-adjusted D-dimer—negative rules out.
32
DVT—Initial treatment
Apixaban/rivaroxaban loading regimen; LMWH if cancer/pregnancy/renal failure; analgesia; mobilisation as tolerated.
33
DVT—Discharge criteria
Anticoagulation commenced when indicated; scan done or booked; safety-net and follow-up clear.
34
DVT—Safety-net & follow-up
Return for worsening swelling, new chest pain or breathlessness (possible PE). Anticoagulation review 1–2 weeks; typical duration 3 months if provoked.
35
DVT—Clinical pearls
Do not delay first anticoagulant dose when Wells ‘likely’ and scan delayed; consider alternative dx (ruptured Baker cyst, cellulitis).
36
DVT—Decision rules
Wells DVT (≥2 likely; <2 unlikely). Age-adjusted D-dimer for ‘unlikely’ pathway.
37
AECOPD—SDEC inclusion
Mild–moderate exacerbation; RR <24; SpO₂ near baseline on controlled oxygen; no acidosis; able to manage at home; good support.
38
AECOPD—Red flags → admit/escalate
ABG/VBG acidosis (pH <7.35 with CO₂ retention); severe hypoxia; sepsis; new arrhythmia; pneumonia on CXR; altered mental state; inability to cope at home.
39
AECOPD—Key history
Increased breathlessness, sputum volume, sputum purulence; wheeze; triggers (viral, pollution); inhaler use/adherence; home oxygen baseline; prior exacerbations.
40
AECOPD—Exam (positive findings)
Tachypnoea; accessory muscle use; wheeze; cyanosis; peripheral oedema if cor pulmonale.
41
AECOPD—ECG/CXR findings
CXR: hyperinflation; exclude consolidation, pneumothorax, pulmonary oedema. ECG: AF or right heart strain may be present.
42
AECOPD—Biomarkers/ABG
VBG/ABG if concern; CRP (antibiotic guidance); FBC/U&E. Watch pH more than absolute CO₂ if chronic retainer.
43
AECOPD—First-hour actions
Nebulised salbutamol + ipratropium; controlled O₂ targeting 88–92%; steroids; assess infection and comorbidities; consider CXR and ABG/VBG.
44
AECOPD—Initial treatment
Prednisolone 30 mg PO daily for 5 days; antibiotics if Anthonisen criteria or consolidation (e.g., amoxicillin or doxycycline/clarithromycin per local policy); optimise inhalers/spacer; smoking cessation advice.
45
AECOPD—Discharge criteria
SpO₂ near baseline without high O₂ needs; symptomatic improvement after treatment; mobilising; oral meds tolerated; clear plan and review.
46
AECOPD—Safety-net & follow-up
Return if worsening dyspnoea, fever, confusion, sats drop, cyanosis. GP/COPD team review 48–72 h; consider pulmonary rehab; check vaccinations.
47
AECOPD—Clinical pearls
Over-oxygenation can precipitate CO₂ retention—target 88–92%. Judge by pH when interpreting gases in chronic retainers.
48
AECOPD—Decision rules
No universal outpatient score; (DECAF is inpatient). Use clinical criteria and ability to safely self-manage.
49
CAP—SDEC inclusion
CURB-65 ≤1; SpO₂ ≥92% (or at baseline); able to take PO; reliable follow-up.
50
CAP—Red flags → admit/escalate
CURB-65 ≥2; hypotension; RR ≥30; SpO₂ <92% on air; multilobar involvement/effusion; confusion; sepsis/lactate elevation.
51
CAP—Key history
Fever; productive cough; pleuritic chest pain; dyspnoea; aspiration risk; exposure/travel; vaccination status.
52
CAP—Exam (positive findings)
Focal crackles; bronchial breathing; increased vocal resonance; dullness to percussion (consolidation or effusion).
53
CAP—CXR/labs
CXR: new consolidation ± effusion. Labs: WCC/CRP elevated; Urea for CURB-65.
54
CAP—First-hour actions
ABCDE; CXR; bloods; score CURB-65; consider viral swabs; assess aspiration risk; fluids/antipyretics.
55
CAP—Initial treatment
Amoxicillin first-line (e.g., 500 mg–1 g TDS ×5 days). Penicillin allergy: doxycycline or clarithromycin. Add flucloxacillin if staph suspected (post-influenza).
56
CAP—Discharge criteria
Low risk; stable vitals; oral therapy tolerated; safety-net provided.
57
CAP—Safety-net & follow-up
Return if worsening breathlessness, chest pain, persistent fever >48–72 h, confusion. GP review 48–72 h. CXR at 6 weeks if ≥50 years/smoker/lobar collapse.
58
CAP—Clinical pearls
CRP decline lags behind clinical improvement—avoid unnecessary antibiotic prolongation if improving clinically.
59
CAP—Decision rules
CURB-65: Confusion; Urea >7.0 mmol/L; RR ≥30; BP (SBP <90 or DBP ≤60); Age ≥65. 0–1 outpatient, 2 close review, 3–5 severe.
60
Cellulitis—SDEC inclusion
Eron Class I: localised infection; no systemic toxicity; stable comorbidity; able to take PO or suitable for OPAT; safe home.
61
Cellulitis—Red flags → admit/escalate
Sepsis/systemic toxicity; rapidly progressive pain; disproportionate pain/crepitus (suspect nec fas); facial/periorbital involvement; immunosuppression; failure of PO; suspected DVT/abscess requiring theatre.
62
Cellulitis—Key history
Unilateral redness, heat, tenderness; portal of entry (tinea, wound, ulcer); speed of spread; systemic symptoms.
63
Cellulitis—Exam (positive findings)
Warm erythema with ill-defined margins (cellulitis) or sharply demarcated (erysipelas); lymphangitis; check for fluctuance (abscess). Mark borders.
64
Cellulitis—Imaging/labs
Ultrasound if abscess suspected; FBC/CRP; swab if portal present; consider glucose if diabetic.
65
Cellulitis—First-hour actions
Assess extent; mark edges; analgesia; start antibiotics promptly; elevation; treat portals (e.g., tinea).
66
Cellulitis—Initial treatment
Flucloxacillin 500 mg–1 g QDS 5–7 days (or doxycycline/clarithromycin if penicillin-allergic). OPAT IV (e.g., cefazolin/fluclox) if PO fails or comorbidity demands.
67
Cellulitis—Discharge criteria
Afebrile or improving; pain controlled; antibiotics supplied; 48-hour review plan in place.
68
Cellulitis—Safety-net & follow-up
Return if fever, systemic symptoms, or erythema spreads beyond the marked line after 24–48 h; OPAT/GP review in 48 h.
69
Cellulitis—Clinical pearls
Early enlargement can reflect inflammatory lag—judge trajectory by pain/systemic features; always inspect for entry points (tinea interdigital, ulcers).
70
Cellulitis—Decision rules
Eron classification: I outpatient; II–IV consider admission/escalation (systemic illness/comorbidity/limb-threatening).
71
Syncope—SDEC inclusion
Likely reflex or orthostatic syncope; normal ECG; no serious injury; low Canadian Syncope Risk Score (CSRS); stable vitals; safe follow-up.
72
Syncope—Red flags → admit/escalate
Abnormal ECG (heart block, VT, ischaemia, Brugada/long QT, WPW); exertional or supine syncope; family history of sudden death; severe anaemia/GI bleed; heart failure; persistent hypotension; focal neurology.
73
Syncope—Key history
Circumstances (standing, exertion, micturition/defecation); prodrome (nausea, warmth, diaphoresis); duration/recovery; cardiac history; medications; injuries sustained.
74
Syncope—Exam (positive findings)
Orthostatic hypotension: ≥20 mmHg systolic or ≥10 mmHg diastolic drop within 3 minutes with symptoms; new murmurs (AS/HCM); neurological exam.
75
Syncope—ECG/imaging
ECG is key: look for brady/AV block, VT, ischaemia, long QT, Brugada, pre-excitation. CXR/echo only if indicated by history/exam.
76
Syncope—Biomarkers/labs
Capillary glucose; Hb; troponin if cardiac features present.
77
Syncope—First-hour actions
12-lead ECG; lying/standing BP; search for causes (dehydration, medications); arrange ambulatory monitoring/echo if indicated.
78
Syncope—Initial management
Fluids; medication review (reduce hypotensives); compression stockings; teach counter-pressure manoeuvres; treat precipitating illness.
79
Syncope—Discharge criteria
Low CSRS; normal ECG; stable vitals; no red flags; clear follow-up/monitoring plan.
80
Syncope—Safety-net & follow-up
Return for recurrent episodes, chest pain, palpitations, injury, or syncope during exertion; GP/cardiology for Holter/event monitor; echo if structural disease suspected; tilt-table if recurrent reflex syncope.
81
Syncope—Clinical pearls
ECG is the highest-yield test—most dangerous causes are ECG-detectable; orthostatic hypotension must be symptomatic to explain syncope.
82
Syncope—Decision rules
Canadian Syncope Risk Score: vasovagal −1; heart disease +1; SBP <90 or >180 +2; elevated troponin +2; abnormal axis +1; QRS >130 ms +1; QTc >480 ms +2; shortness of breath +1; ED dx vasovagal −2 / cardiac +2.
83
AF—SDEC inclusion
Haemodynamically stable; HR <130 after simple measures; no ischaemia/HF; address reversible triggers; safe for home.
84
AF—Red flags → admit/escalate
Instability; ongoing ischaemia; pulmonary oedema; sepsis; AF with WPW (very fast, wide-complex irregular); failure of rate control; need for urgent cardioversion without ambulatory pathway.
85
AF—Key history
Palpitations, dyspnoea, chest discomfort, reduced exercise tolerance; onset (<48 h?); triggers (infection, alcohol binge, hyperthyroid).
86
AF—Exam (positive findings)
Irregularly irregular pulse; signs of HF or infection.
87
AF—ECG/imaging
ECG: absent P waves, fibrillatory baseline, irregular RR; exclude delta wave.
CXR if HF.
88
AF—Biomarkers/labs
U&E, Mg, TFTs; troponin if ischaemia.
89
AF—First-hour actions
Confirm AF + exclude pre-excitation; check duration; calculate CHA₂DS₂-VASc and HAS-BLED; choose rate vs rhythm strategy.
90
AF—Initial treatment
Rate control: β-blocker (e.g., bisoprolol) or diltiazem (don’t combine). Digoxin if sedentary/HF.
Anticoagulation: start DOAC if CHA₂DS₂-VASc indicates (balance HAS-BLED).
Consider early cardioversion pathway if onset <48 h and suitable.
91
AF—Discharge criteria
Rate controlled (≤100–110 at rest); anticoag plan documented; symptom control; follow-up arranged.
92
AF—Safety-net & follow-up
Worsening SOB, chest pain, syncope → ED.
AF clinic/GP in 1–2 weeks; request echo; anticoag review.
93
AF—Clinical pearls
Start anticoag early when indicated; echo is not a prerequisite unless specific concern.
94
AF—Decision rules
CHA₂DS₂-VASc (stroke risk).
HAS-BLED (bleeding risk; modify factors, not to deny AC).
95
HF—SDEC inclusion
Known HF with mild fluid overload; no resting hypoxia or hypotension; no AKI; mobilising; can self-manage medications; safe monitoring plan.
96
HF—Red flags → admit/escalate
Resting hypoxia; pulmonary oedema; hypotension; new chest pain/ACS; arrhythmia; AKI/hyperkalaemia; severe hyponatraemia; confusion; sepsis.
97
HF—Key history
Weight gain; ankle swelling; orthopnoea/PND; dietary/medication indiscretion; infection; AF/MI.
98
HF—Exam (positive findings)
Elevated JVP; basal crackles; peripheral oedema; S3; hepatomegaly.
99
HF—CXR/ECG findings
CXR: cardiomegaly, upper lobe diversion, Kerley B lines, pleural effusions. ECG: AF, ischaemia, LBBB.
100
HF—Biomarkers/labs
U&E, creatinine, potassium (for diuretic changes); troponin if chest pain; BNP helpful but not acute-decision-making in SDEC.
101
HF—First-hour actions
ABCDE; weight; ECG; CXR if chest symptoms; labs; review guideline-directed meds and adherence.
102
HF—Initial treatment
IV furosemide 40–80 mg (tailor to prior dose/renal function) or increase oral loop; aim net −0.5 to −1.5 L first day; oxygen if hypoxic; add thiazide-type only cautiously (often inpatient).
103
HF—Discharge criteria
Symptom improvement; no hypoxia; stable BP/renal function/potassium; written self-adjust diuretic plan; U&E recheck booked (48–72 h).
104
HF—Safety-net & follow-up
Daily weights; call if >2 kg gain in 3 days; worsening dyspnoea, dizziness, oliguria, palpitations; HF nurse/clinic ≤1 week; U&E recheck 48–72 h after dose change.
105
HF—Clinical pearls
Always pair diuretic changes with renal/potassium monitoring and a written self-adjust plan.
106
HF—Decision rules
No specific ambulatory score; NYHA is descriptive. Disposition is clinical plus monitoring capability.
107
TIA—SDEC inclusion
Resolved focal neurological deficit (<24 h); NIHSS 0; stable; rapid access to TIA clinic (≤24–72 h based on risk); safe home.
108
TIA—Red flags → admit/escalate
Persistent or fluctuating deficit; suspected stroke; anticoagulated with head trauma; crescendo TIAs; severe hypertension with symptoms; poor support.
109
TIA—Key history
Sudden focal neurological symptoms now resolved (weakness, speech/language, vision); carotid territory features (amaurosis fugax); duration; AF history; vascular risk factors.
110
TIA—Exam (positive findings)
Typically normal now; check pulse (AF), murmurs, and carotid bruits (low specificity).
111
TIA—ECG/imaging
ECG to detect AF; TIA pathway imaging: carotid ultrasound/CTA and MRI DWI as arranged by stroke/TIA clinic.
112
TIA—Biomarkers/labs
FBC, U&E, lipids, HbA1c; glucose; others per clinic protocol.
113
TIA—First-hour actions
Aspirin 300 mg stat if no contraindication; ECG; ABCD² score; book urgent TIA clinic; consider short-course DAPT per local stroke guidance.
114
TIA—Initial treatment
Antiplatelet therapy (aspirin ± short DAPT if indicated); initiate statin/BP control; anticoagulation if AF confirmed after imaging plan clarified by stroke team.
115
TIA—Discharge criteria
Symptoms resolved; TIA clinic booked; written safety-net provided.
116
TIA—Safety-net & follow-up
Any recurrence or new neurological deficit → 999/ED; stroke/TIA clinic completes imaging (MRI/carotids), echo, and rhythm monitoring; GP manages risk-factor optimisation.
117
TIA—Clinical pearls
Early antiplatelet plus rapid clinic access markedly reduces early stroke risk—set up before discharge.
118
TIA—Decision rules
ABCD²: Age ≥60 (1), BP ≥140/90 (1), Clinical features—weakness (2) or speech only (1), Duration ≥60 min (2) or 10–59 min (1), Diabetes (1). Guides urgency; follow local pathway.
119
CURB-65 — components
Confusion (AMT <8/new), Urea >7.0 mmol/L, RR ≥30/min, BP (SBP <90 or DBP ≤60), Age ≥65.
120
CURB-65 — risk interpretation
0–1 outpatient; 2 close review/short stay; 3–5 severe → consider admission/IV therapy.
121
Wells PE — components & weights (two-tier)
DVT signs 3.0; PE more likely 3.0; HR >100 1.5; immobilisation ≥3 days or surgery ≤4 weeks 1.5; previous DVT/PE 1.5; haemoptysis 1.0; cancer (active/≤6 months/palliative) 1.0.
122
Wells PE — interpretation & next steps
≥4.0 = “PE likely” → imaging (CTPA) ± start anticoag if delay/appropriate; ≤4.0 = “PE unlikely” → apply PERC and/or age-adjusted D-dimer.
123
PERC — when to use & rule-out criteria
Use only if low clinical suspicion. All must be true to skip D-dimer: Age <50; HR <100; SpO₂ ≥95% RA; no haemoptysis; no oestrogen use; no prior VTE; no unilateral leg swelling; no recent surgery/trauma requiring hospitalisation/intubation (≤4 weeks).
124
Age-adjusted D-dimer (FEU units)
If age ≥50: threshold = age × 10 ng/mL FEU (e.g., 70 years → 700 ng/mL).
125
sPESI — components & low-risk definition
1 point each: Age >80; cancer; chronic cardiopulmonary disease (CHF/COPD); HR ≥110; SBP <100; SpO₂ <90%. Score 0 = low risk (often ambulatory if other criteria met).
126
Hestia criteria — outpatient PE suitability
Any “Yes” = NOT outpatient. Key: haemodynamic instability (SBP <100/need lysis); SpO₂ <92% RA (or >2 L O₂ to maintain ≥92%); active bleeding/high bleed risk/platelets <75×10⁹/L; severe renal (CrCl <30) or hepatic failure; pregnancy; PE on anticoagulation; need for IV opioids >24 h/other inpatient care; social/medical barriers.
127
Wells DVT — components & weights
+1 each: active cancer; paralysis/paresis or recent limb immobilisation; bedridden >3 days or major surgery ≤12 weeks; localised deep-vein tenderness; entire leg swollen; calf swelling >3 cm (10 cm below tibial tuberosity) vs other leg; pitting oedema confined to symptomatic leg; collateral superficial (non-varicose) veins; previous DVT. Alternative diagnosis at least as likely: −2.
128
Wells DVT — interpretation
≥2 = “DVT likely” → ultrasound ≤24 h (start anticoag if delay/appropriate). <2 = “DVT unlikely” → age-adjusted D-dimer; negative rules out.
129
Canadian Syncope Risk Score (CSRS) — items & weights
Vasovagal predisposition −1; heart disease +1; SBP <90 or >180 +2; elevated troponin +2; abnormal QRS axis (<−30°/>100°) +1; QRS >130 ms +1; QTc >480 ms +2; shortness of breath +1; ED diagnosis: vasovagal −2 / cardiac +2. Range −3 to +11; higher = ↑30-day serious events.
130
ABCD² (TIA) — components & risk bands
Age ≥60 (1); BP ≥140/90 (1); Clinical: unilateral weakness (2) or speech only (1); Duration ≥60 min (2) or 10–59 min (1); Diabetes (1). 0–3 low; 4–5 moderate; 6–7 high (triage clinic speed per local pathway).
131
CHA₂DS₂-VASc (AF) — components & scoring
CHF/LV dysfunction 1; Hypertension 1; Age ≥75 = 2; Diabetes 1; Stroke/TIA/TE = 2; Vascular disease 1; Age 65–74 1; Sex female 1.
132
CHA₂DS₂-VASc — anticoagulation thresholds
Men: ≥1 consider, ≥2 recommend. Women: ≥2 consider, ≥3 recommend (account for sex-only point carefully).
133
HAS-BLED (AF bleeding risk) — components & interpretation
HTN (SBP >160) 1; Abnormal renal 1 and/or liver 1; Stroke 1; Bleeding history/predisposition 1; Labile INR 1; Elderly >65 1; Drugs (antiplatelets/NSAIDs) 1 and/or Alcohol ≥8 drinks/wk 1. ≥3 = high risk → correct modifiable factors; not a sole reason to withhold anticoagulation.
134
Eron (cellulitis) — classification & disposition
I: no systemic toxicity/comorbidity instability → outpatient/OPAT. II–IV: systemic illness/comorbidity/limb-threatening → admit/escalate.
135
HEART score (chest pain) — components & bins
Each 0–2: History (slight/moderate/high), ECG (normal/nonspecific/ST-depression), Age (<45/45–64/≥65), Risk factors (0 / 1–2 / ≥3 or known CAD), Troponin (normal / 1–3× / >3× URL). 0–3 low, 4–6 intermediate, 7–10 high risk.
136
ECG — features suggesting ACS
New ST elevation/depression; new T-wave inversions; new LBBB; posterior MI pattern (V1–V3 ST-depression with tall R waves).
137
ECG — features suggesting PE
Sinus tachycardia; new RBBB; right axis deviation; T-wave inversion V1–V4; S1Q3T3 (low sensitivity).
138
ECG — syncope red-flag findings
Brady/AV block; ventricular tachycardia; ischaemic changes; long QT; Brugada pattern; pre-excitation (WPW).
139
CXR — signs of heart failure
Cardiomegaly; upper-lobe diversion; Kerley B lines; pleural effusions; alveolar oedema (‘bat-wing’).
140
CXR — signs of pneumonia
New focal consolidation ± air bronchograms; silhouette sign(s); possible parapneumonic effusion.
141
CXR — COPD/complications
Hyperinflation (flattened diaphragms, increased retrosternal airspace); exclude pneumothorax; exclude superimposed consolidation.
142
CTKUB — renal stones (key positives)
Non-contrast CT shows radio-opaque calculus; hydronephrosis if obstructing; perinephric stranding may be present.
143
Venous ultrasound (leg) — DVT positive
Non-compressible vein; intraluminal thrombus; absent/abnormal flow on Doppler.
144
CTPA — pulmonary embolism positive
Intraluminal filling defect in pulmonary arteries; RV strain suggested by RV/LV ratio >1 (risk stratification).
Med Ed Revision
flashcards
Decks in class (13)
# Cards
-
SDEC Prep144
-
ABGs - CO230
-
SDEC Prep 284
-
SDEC Prep 3108
-
F1 Cardiac Arrest - Defib, Drugs, Access41
-
F2 Renal Teaching - Glomerular Disease59
-
Diabetes - OSCE Hx & Exam53
-
F2 Rheumatology Teaching38
-
Micro - Blood Culture (KMMS Y4)94
-
Interview Prep 214
-
Interview Prep 39
-
AMS Data Collection - Regimens16
