Criteria Summary

The Criteria Summary section for Clinical Medicine Practice provides high-yield information with guidelines about specific diseases in medicine, which are essential as a medical student, resident, and practicing physicians.

Table Of Contents
1 Criteria Summary for Clinicians
2 Curb 65 (community-acquired pneumonia)
3 Centor Criteria (strep throat)
4 Dukes Criteria Modified (Bacterial Endocarditis)
5 Guiding decision for further imaging for adults/pediatric patients
6 Lights Criteria (Pleural fluid)
7 Modified Jones Criteria (Rheumatic Fever)
8 Ottawa Ankle Rule (Xray)
9 PERC rule (Pulmonary Embolism Rule-out Criteria)
10 Ranson’s Criteria (Acute Pancreatitis)
11 Wells Criteria (Pulmonary Embolism)
12 Popular Resources

Criteria Summary for Clinicians

Curb 65 (community-acquired pneumonia)

To estimate the prognosis for pts with community-acquired pneumonia

    • C – Confusion (new change in mental status)
    • U – Urea >7 mmol/L
    • R – Respiratory rate ³30
    • B – Blood pressure <90 systolic or £60 diastolic
    • 65 – Age 65

Centor Criteria (strep throat)

For Group A streptococcal (GAS) pharyngitis (strep throat)

    • C – Cough absent
    • E – Exudate
    • N – Nodes
    • T – Temperature (fever)
    • OR – young OR old modifier

Points: 

    • -1, 0 or 1 point(s) – No antibiotic or throat culture necessary 
    • 2 or 3 points – Throat culture and treat with an antibiotic if culture is positive 
    • 4 or 5 points – Rapid strep testing and/or culture. 

Dukes Criteria Modified (Bacterial Endocarditis)

 BE FIVE PM

    • Blood culture positive for IE
    • Endocardial involvement
    • Fever
    • Immunologic phenomena
    • Vascular phenomena
    • Echocardioraphy minor criteria (eliminated)
    • Predisposition
    • Microbiologic evidence

Definite Diagnosis from Clinical Criteria:

    • 2 (major) + 0 (minor) or
    • 1 (major) + 3 (minor) or
    • 0 (major) + 5 (minor)

Guiding decision for further imaging for adults/pediatric patients

  • SNOOPPPPY
    • – S = Systemic symptoms (e.g. fever, altered level of consciousness, anti-coagulation therapy, pregnancy, cancer, or HIV infection)
    • – N = Neurologic signs or symptoms (e.g. papilledema, abnormal cranial nerve function, motor function, cerebellar function, seizure)
    • – O = Onset recently (2 wks – 2 mons or suddenly)
    • – O = Occipital localization of pain
    • – P= Precipitated by Valsalva maneuver
    • – P = Positional
    • – P = Progressive
    • – P = Parent (i.e. lack of family history of headaches)
    • – Y = Years (i.e. age <6 yrs

Lights Criteria (Pleural fluid)

  • Pleural fluid is exudative if at least one of the following:
    • Pleural fluid protein / Serum protein >0.5.
    • Pleural fluid LDH / Serum LDH >0.6.
    • Pleural fluid LDH > 2/3 * Serum LDH Upper Limit of Normal
  • Exudative
    • Infections
    • Malignancy
    • Connective tissue disorders
    • Inflammatory disorders
    • CABG
    • Pulmonary Embolism
  • Transudative
    • CHF
    • Cirrhosis
    • Nephrotic Syndrome
    • Peritoneal dialysis

Modified Jones Criteria (Rheumatic Fever)

  • MAJOR Criteria
    • “CASES”
    • C- Carditis
    • A- Arthritis (not Arthralgias i.e polyarthritis)
    • S- Syndhem’s Chorea
    • E- Erythema Marginatum (not nodosum)
    • S- Subcutaneous Nodules
  • MINOR Criteria
    • “PEACH-Fever”
    • P- Prolonged PR interval
    • E- ESR raised
    • A- Arthralgias (not arthritis), 
    •      Acute phase reactants : leukocytosis, elevated sedimentation rate, and C -reactive protein
    • C- C-reactive protein increased
    • H- History of previous rheumatic fever, rheumatic heart disease
    • & Fever

Ottawa Ankle Rule (Xray)

Patients need an ankle X-ray only if:

Mnemonic: 44-55-66-PM

    • 4: Unable to do 4 steps immediately AND
    • 4: Unable to do 4 steps at Emergency Department
    • OR
    • 5: Has pain at the base of 5th metatarsal
    • 5: Has pain at the 5caphoid (Navicular)
    • OR
    • 6: Tenderness in 6 cm tip or Posterior edge of lateral Malleolus
    • 6: Tenderness in 6 cm tip or Posterior edge of medial Malleolus

PERC rule (Pulmonary Embolism Rule-out Criteria)

HAD CLOTS

    • H – Hormone (estrogen) use
    • A – Age > 50
    • D – DVT or PE history (have they HAD CLOTS?)
    • C – Coughing blood
    • L – Leg swelling disparity
    • O – O2 sats < 95%
    • T – Tachycardia (>100bpm)
    • S – Surgery or Trauma (recent)

Ranson’s Criteria (Acute Pancreatitis)

For prognosis and mortality risk of acute pancreatitis

  • GA LAW (on admission) and Ca&HOBBS (post-admission)
  • On Admission
    • Glucose > 10mmol/L
    • AST > 250 U/L
    • LDH > 350 U/L
    • Age > 55 years
    • WBC > 16 x 109 cells/L
  • 48 Hours Post-Admission
    • Calcium < 2.0 mmol/L
    • Hematocrit fall > 10%
    • O2 <60 mmHg
    • BUN increase from admission > 1.79 mmol/L
    • Base deficit > 4 mEq/L
    • Sequestrated fluids > 6L

Score of 3 or more indicates severe acute pancreatitis.

Wells Criteria (Pulmonary Embolism)

Don’t Die Tell The Team To Calculate Criteria

    • Don’t (DVT symptoms) 3 points
    • Die (Diagnosis most likely PE) 3 points
    • Tell (Tachycardia) 1.5 points
    • The Team (Three days [at least] of immobilization, or surgery in the past Thirty days) 1.5 points
    • To (Thromboembolism in the past [DVT or PE]) 1.5 points
    • Calculate (Coughing up blood [hemoptysis]) 1 point
    • Criteria (Cancer) 1 point

 Probability:

    • 6 High probability of PE
    • 2-6 Moderate probability of PE
    • < 2 Low probability of PE
    • The modified Wells Criteria is a bit simpler: > 4 PE is likely ≤ 4 PE is unlikely

Popular Resources