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Medicine (MD/DO)
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Internal Medicine
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Guidelines, Criteria & Classifications

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Internal Medicine | Medicine (MD/DO) School Study Aid

Guidelines, Criteria & Classifications
20 Picmonics to Learn | 49 mins
Thyroid Function Screening Tests
If TSH High
Free T4 (FT4)
If TSH Low
Free T4 (FT4) and T3 (Triiodothyronine)
Consider Serum Total T4 (Thyroxine)
Considerations
Only Total T4 Increases in Pregnancy
T4 is Converted to T3
Avoid for Inpatient Screening
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2 mins
Wells' Criteria for Pulmonary Embolism
Scoring
Clinical Symptoms of DVT (+3)
Pulmonary Embolism Most Likely Diagnosis (+3)
Tachycardia (+1.5)
Immobilization > 3 Days (+1.5)
Previous DVT or PE (+1.5)
Hemoptysis (+1)
Malignancy (+1)
Probability
> 6 = High
2-6 = Moderate
< 2 = Low
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3 mins
Light's Criteria
Use
Determines Transudative vs. Exudative Source of Pleural Effusion
Exudate if (At Least One of the Following):
Effusion/Serum Protein Ratio > 0.5
Effusion/Serum LDH Ratio > 0.6
Effusion LDH > Two-thirds Upper Serum LDH Range
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2 mins
Systemic Inflammatory Response Syndrome (SIRS) Criteria
Must have 2 or more of the following:
Temperature < 36C or > 38C
Pulse > 90 beats per minute
Respirations > 20/min or PCO2 < 32
WBC < 4,000 or > 12,000 or 10% bands
Mechanism
Subset of Cytokine Storm and Related to Sepsis
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2 mins
Duke Criteria for Infective Endocarditis
Major Criteria
Blood Culture Positive
Endocardial Involvement
Minor Criteria
Fever
Immunologic Phenomena
Vascular Phenomena
Predisposition
Microbiological Evidence
Diagnosis
Two Major Criteria, or
One Major and Three Minor Criteria, or
Five Minor Criteria
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4 mins
Lab and Diagnostic Tests During Pregnancy
Complete Blood Cell Count
Blood Typing
Rubella Titer
Hepatitis B
HIV Testing
Urinalysis
Diabetes
Pap Smears
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2 mins
Lab and Diagnostic Tests During Pregnancy (1st Visit)
Diagnosis
Complete Blood Count (CBC)
Blood Typing and Rh
Rubella
HIV
Hepatitis B
Tuberculosis Skin Mantoux Test (PPD)
Sexually Transmitted Infections
Chlamydia
Neisseria gonorrhoeae
Syphilis
Pap Smears
Urinalysis
Sickle Cell Screening (If Indicated)
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2 mins
Lab and Diagnostic Tests During Pregnancy (Other Visits)
Diagnosis
10-13 Weeks
Offer Chorionic Villus Sampling (CVS)
15-18 Weeks
Quad Screen
18-20 Weeks
Ultrasound
Anatomic Screening
24-28 Weeks
One-Hour Glucose Challenge Test
35-37 Weeks
Streptococcus Agalactiae
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3 mins
Quad Screen Results Interpretation
Markers
AFP
Estriol
hCG
Inhibin A
Associations
Increased hCG + Inhibin A (HIgh)
Down Syndrome
Decreased hCG + Estriol + AFP (Low HEAp)
Edward Syndrome
Increased AFP
Neural Tube Defects
Abdominal Wall Defects
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2 mins
TORCHeS Screening
TORCHES
Toxoplasmosis
Other
Rubella
Cytomegalovirus (CMV)
Herpes Simplex Virus (HSV)
Syphilis
Considerations
Diagnostic Testing
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3 mins
Cervical Cancer Screening
Women Aged 21-65 Years
Pap Smear Every 3 Years
Women Aged 30-65 Years
Can Opt for Co-testing (Pap Smear + HPV Testing) Every 5 Years
Identify Lesions
High grade lesions
Cryotherapy
Loop Excision
Cold Knife Conization
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2 mins
Breast Cancer Diagnosis
Mammography
Ultrasound
MRI for High Risk Patients
Confirmed with Biopsy
Considerations
Lymph Node Involvement
Receptor Positivity
Estrogen and Progesterone Receptors
HER-2
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2 mins
Salter-Harris Fracture Classification
SMACK
Slipped Across Physis (Type 1)
Metaphysis and Physis (Type 2)
Articular-Epiphyseal (Type 3)
Complete Metaphysis and Epiphysis (Type 4)
Krushed Physis (Type 5)
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2 mins
Blood Pressure Classification (JNC 7)
Classifications
Normal
Systolic (<120)
Diastolic (< 80)
Prehypertension
Systolic +20 (120-139)
Diastolic +10 (80-89)
Stage 1 Hypertension
Systolic +20 (140-159)
Diastolic +10 (90-99)
Stage 2 Hypertension
Systolic + > 20 (160)
Diastolic + > 10 (100)
Hypertensive Crisis
Systolic > 180
Diastolic > 110
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4 mins
Blood Pressure Classification (ACC/AHA 2017)
Classifications
Normal
Systolic Less than 120
Diastolic Less than 80
Elevated
Systolic +10 (120-129)
Diastolic Less than 80
Stage 1 Hypertension
Systolic +10 (130-139)
Diastolic +10 (80-89)
Stage 2 Hypertension
Systolic +40 (140-179)
Diastolic +30 (90-119)
Hypertensive Crisis
Systolic greater than or equal to 180
Diastolic greater than or equal to 120
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5 mins
Cancer Warning Signs (CAUTION)
CAUTION
Change in Bowel or Bladder Habits
A Sore That Does Not Heal
Unusual Bleeding or Discharge
Thickening or Lump in the Breast or Elsewhere
Dyspepsia (Indigestion)
Obvious Change to Warts or Moles
Nagging Cough
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1 min
Ranson's Criteria on Admission
Use
Mortality Predictor for Acute Pancreatitis
Criteria on Admission
GA LAW (Each is +1)
Glucose > 200 mg/dL
Age > 55 Years
LDH > 350 U/L
AST > 250 U/L
WBC Count > 16,000/mm3
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2 mins
Ransons Criteria During First 48 Hours
Use
Mortality Predictor for Acute Pancreatitis
Criteria Present at 48 Hours
C HOBBS (Each is +1)
Calcium < 8.0 mg/dL
Hematocrit Decreased by > 10%
Oxygen (PO2) < 60 mmHg
BUN Increased by Greater or Equal to 5 mg/dL
Base Deficit > 4 mEq/L
Sequestered Fluid > 6 L
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3 mins
Pulmonary Hypertension Classification (WHO)
Group 1
Pulmonary Arterial Hypertension
Idiopathic
Hereditary
BMPR2 Mutation
Group 2
Left Heart Disease
Group 3
Lung Diseases or Hypoxia
COPD
Obstructive Sleep Apnea
Group 4
Chronic Pulmonary Emboli
Group 5
Multifactorial
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2 mins
Types of Fractures
Nondisplaced
Displaced
Incomplete
Complete
Closed
Open
Direction of Fracture Line
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2 mins

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