PNEUMONIA - CURB-65 CRITERIA

Determines whether a patient requires hospitalization for pneumonia. The presence of each factor earns 1 point. A score of 2+ implies need for hospitalization.

• C: Confusion
• U: BUN > 19mg/dL
• R: Respiratory rate > 30/min
• B: Systolic BP < 90 or Diastolic BP < 60
• 65: Age > 65

PULMONARY EMBOLISM - WELL'S CRITERIA

Determines whether the presence of a pulmonary embolism is likely (> 4) or unlikely (≤ 4).

• 3 Points:
• Clinical DVT symptoms
• Other diagnoses less likely
• 1.5 Points:
• HR > 100/min
• Immobilization for 3+ days in past 4 weeks
• Previous DVT and/or PE
• 1 Point:
• Hemoptysis
• Malignancy

PLEURAL EFFUSION - LIGHT'S CRITERIA

Determine whether an effusion is transudative or exudative. It is exudative if one or more of the following criteria are present:

• Pleural protein/Serum protein: > 0.5
• Pleural LDH/Serum LDH: > 0.6
• Pleural LDH: > 2/3 upper limit of normal serum LDH

STREPTOCOCCAL PHARYNGITIS - CENTOR CRITERIA

Determine the probability of strep throat based on symptoms. Use rapid antigen test if ≥ 3.

• Fever? +1
• Tonsillar exudates? +1
• Tender anterior cervical lymph nodes? +1
• Absent cough? +1
• Age < 15? +1
• Age > 44? -1

COPD - GOLD CRITERIA

Determine treatment options for COPD based on symptoms and FEV1.

• FEV1 > 50% (GOLD I/II) + mild symptoms: Treat with SABA as needed
• FEV1 > 50% (GOLD I/II) + moderate/severe symptoms: Treat with LABA
• FEV1 < 50% (GOLD III/IV) + mild symptoms: Treat with LABA and inhaled steroids OR inhaled anticholinergic
• FEV1 < 50% (GOLD III/IV) + moderate symptoms: Treat with LABA, inhaled steroids, and inhaled anticholinergics

AFIB STROKE RISK - CHADSVASC CRITERIA

Determines risk of stroke in patients with atrial fibrillation. Patients with a score of 1 should be put on aspirin, and a score of 2+ requires anticoagulation.

• 2 Points
• Age > 75
• Prior stroke or TIA
• 1 Point
• CHF
• HTN
• DM
• Vascular disease
• Female
• 65 < Age < 75

ANKLE SPRAIN - OTTAWA ANKLE CRITERIA

Determine whether an X-ray is required for an ankle injury or whether it can be managed conservatively.

Patients must have malleolar pain and one of the following:

• Bone tenderness at the posterior edge OR tip of the lateral malleolus
• Bone tenderness at the posterior edge OR tip of the medial malleolus
• Inability to bear weight immediately after injury AND in the ED

RHEUMATIC FEVER - JONES CRITERIA

Determine whether patient has rheumatic fever. Patients must have presence of Group A Streptococcal infection via serology AND either 2+ major JONES OR 1+ MAJOR JONES plus 2+ minor JONES

• MAJOR:
• Migratory polyarthritis
• Endocarditis, Myocarditis, and/or Pericarditis
• Subcutaneous nodules
• Erythema marginatum (macular rash on trunk and arms)
• Sydenham's chorea
• MINOR:
• Fever
• Arthralgia (cannot use if migratory polyarthritis is present)
• Increased acute phase reactants (CRP, ESR)
• Prolonged PR on EKG

ENDOCARDITIS - DUKE CRITERIA

Determine whether a patient likely has endocarditis

• MAJOR:
• Sustained bacteremia
• Endocardial damage (new murmur, vegetations on echo)
• MINOR:
• Predisposing conditions: abnormal valves, IV drug use
• Fever
• Vascular manifestations: Janeway lesions, splinter hemorrhages, septic emboli
• Immune manifestations: Osler nodes, Roth spots, glomerulonephritis

SYSTEMIC INFLAMMATORY RESPONSE SYNDROME - SIRS CRITERIA

• Heart rate: > 90/min
• Temperature: < 36 OR > 38
• WBC: < 4000, > 12000, or ≥ 10% bands
• Respiratory: Rate > 20 or PaCO₂ < 32mmHg

PANCREATITIS - RANSON'S CRITERIA

Determine probability of mortality due to pancreatitis.

• CRITERIA ON ADMISSION
• Age: > 55
• WBC: > 16000
• Glucose: > 200mg/dL
• LDH: > 350
• AST: > 250
• CRITERIA AT 48 HOURS
• Fluid requirements: > 6L
• Calcium: < 8mg/dL
• Arterial pO₂: < 60mmHg
• Hematocrit: > 10% drop
• BUN: > 5mg/dL increase
• Base deficit: > 4mg/dL increase
• PROBABILITY OF MORTALITY
• 0-2: < 1%
• 3-4: 15%
• 5+: > 40%

SYSTEMIC LUPUS ERYTHEMATOSUS CRITERIA

Determine whether a patient can be diagnosed with lupus. At least 4 of the 11 criteria must be met.

• Malar rash
• Discoid rash
• Photosensitivity
• Oropharyngeal ulcerations
• Serositis (pleuritis, pericarditis, peritonitis)
• Arthritis (> 2 joints)
• Lupus nephritis
• Seizures and/or psychosis
• Anemia, leukopenia, and/or thrombocytopenia
• Positive ANA serology
• Positive anti-dsDNA, anti-Smith, and/or lupus anticoagulant

UNSTABLE ANGINA AND NSTEMI - TIMI SCORE

Determine probability of mortality or ischemic events in patients with unstable angina or NSTEMI. Give one point for each risk factor. Probability is 5% (0-1 risk factors), 8% (2), 13% (3), 20% (4), 26% (5), 41% (6-7).

• Age ≥ 65?
• 3+ CAD risk factors?
• ≥ 50% coronary stenosis?
• Aspirin use in past week?
• ≥ 2 anginal episodes in past 24hrs?
• ST elevation ≥ 0.5mm?
• Elevated cardiac markers?

PRIMARY BILIARY CHOLANGITIS CRITERIA

Determine whether a patient has PBC. At least two of the criteria must be met:

• Positive anti-mitochronidrial antibodies
• Elevated alkaline phosphatase
• Intrahepatic bile duct destruction on biopsy