2,353+ evidence-based clinical calculators for cardiology, nephrology, neurology, oncology, and all major specialties.
Calculate your Body Mass Index (BMI) instantly. Understand healthy weight ranges, obesity classification, and personalized health insights.
Calculate creatinine clearance (CrCl) using the Cockcroft-Gault equation from age, weight, sex, and serum creatinine. Used for renal drug dosing.
Estimate 1, 2, and 3-year survival probability for heart failure patients using the Seattle Heart Failure Model.
Calculate stroke risk in atrial fibrillation using the CHA₂DS₂-VASc score. Guides anticoagulation therapy decisions.
Calculate the APACHE III score, an ICU severity-of-illness measure that sums acute physiology points across 17 variables, an age modifier, and chronic health/comorbidity flags. Total score ranges 0–299, with higher scores indicating greater physiologic derangement and higher predicted hospital mortality.
Calculate cardiac output (CO = HR × SV) to assess heart pumping efficiency in liters per minute.
Calculate stroke volume (SV = EDV - ESV) — the volume of blood ejected per heartbeat.
Calculate left ventricular ejection fraction (EF = SV/EDV × 100%) — the percentage of blood pumped per beat.
Calculate heart rate reserve (HRR = HRmax - HRrest) using the Karvonen method to set training target zones.
Calculate mean arterial pressure (MAP = DBP + 1/3 × (SBP - DBP)) — the average arterial pressure during a cardiac cycle.
Calculate pulse pressure (PP = SBP - DBP) — the difference between systolic and diastolic blood pressure.
Calculate SVR = (MAP - CVP) × 80 / CO — the resistance the heart must overcome to pump blood.
Calculate PVR = (mPAP - PCWP) × 80 / CO — resistance in the pulmonary circulation.
Calculate cardiac index (CI = CO / BSA) — cardiac output normalized to body surface area.
Calculate BSA using Mosteller formula (√(height×weight/3600)) and DuBois formula — essential for drug dosing.
Calculate GCS score (E+V+M, range 3-15) to assess consciousness level in head injury and neurological emergencies.
Calculate NIHSS score (0-42) to quantify stroke severity — guides thrombolysis and intervention decisions.
Calculate mRS (0-6) to quantify neurological disability after stroke — primary outcome measure in stroke trials.
Calculate Hunt-Hess grade (1-5) for subarachnoid hemorrhage severity — predicts surgical risk and outcome.
Calculate modified Fisher grade (0-4) from CT findings to predict vasospasm risk after subarachnoid hemorrhage.
Calculate ICH score (0-6) to predict 30-day mortality in intracerebral hemorrhage based on GCS, volume, IVH, age, and infratentorial location.
Calculate intracerebral hemorrhage volume using the ABC/2 formula from CT scan measurements.
Calculate ABCD2 score (0-7) to predict short-term stroke risk after TIA — guides admission and urgent workup decisions.
Calculate CHA₂DS₂-VASc score for stroke risk in atrial fibrillation — guides anticoagulation therapy decisions.
Calculate HAS-BLED score (0-9) to estimate 1-year major bleeding risk in anticoagulated AF patients.
Calculate 10-year cardiovascular disease risk using the Framingham Heart Study equation — guides statin therapy decisions.
Calculate 10-year atherosclerotic cardiovascular disease risk using ACC/AHA Pooled Cohort Equations — the current guideline-recommended risk assessment tool.
Calculate LDL cholesterol using the Friedewald equation: LDL = Total Cholesterol - HDL - (Triglycerides/5).
Calculate non-HDL cholesterol (Total Cholesterol - HDL) — a better predictor of cardiovascular risk than LDL alone.
Interpret serum ApoB levels to assess atherogenic particle burden — superior to LDL-C for CVD risk prediction.
Calculate body mass index (BMI = weight/height²) and WHO classification — underweight, normal, overweight, or obese.
Calculate ideal body weight using Devine formula (IBW = 50kg + 2.3kg per inch over 5ft for males) — used for ventilator tidal volume and drug dosing.
Calculate adjusted body weight (AdjBW = IBW + 0.4 × (actual weight - IBW)) for drug dosing in obese patients.
Calculate waist-to-hip ratio (WHR) to assess central obesity risk — predictor of cardiovascular and metabolic disease.
Estimate body fat percentage using the US Navy circumference method — waist, neck, and hip measurements.
Calculate lean body mass (LBM = total weight - fat mass) — essential for precise drug dosing and nutritional assessment.
Calculate creatinine clearance using the Cockcroft-Gault formula — standard for renal drug dosing adjustments.
Calculate estimated GFR using the 2021 CKD-EPI equation (race-free) — the current standard for CKD staging.
Calculate eGFR using the MDRD (Modification of Diet in Renal Disease) study equation — older formula still used in some clinical settings.
Determine CKD stage by GFR and albuminuria category using KDIGO 2012 guidelines for prognosis classification.
Stage acute kidney injury using KDIGO criteria based on serum creatinine rise and urine output.
Calculate FENa = (urine Na × plasma Cr) / (plasma Na × urine Cr) × 100 — differentiates pre-renal from intrinsic AKI.
Calculate FEUrea to differentiate pre-renal from intrinsic AKI — preferred over FENa when diuretics have been given.
Calculate serum osmolality = 2×Na + glucose/18 + BUN/2.8 — detects osmolal gap suggesting unmeasured osmoles.
Calculate anion gap (AG = Na - Cl - HCO3) with albumin correction — essential for metabolic acidosis differential.
Calculate delta-delta ratio to identify mixed acid-base disorders in elevated anion gap metabolic acidosis.
Interpret arterial blood gas results: pH, PaCO2, HCO3 — identifies primary disorder and compensation.
Calculate bicarbonate deficit for sodium bicarbonate dosing in severe metabolic acidosis (bicarb deficit = 0.4 × weight × (target HCO3 - actual HCO3)).
Calculate total body sodium deficit for hyponatremia correction (Na deficit = 0.6 × weight × (target Na - actual Na)).
Calculate free water deficit in hypernatremia (FWD = 0.6 × weight × (actual Na/140 - 1)) — guides fluid replacement rate.
Calculate safe sodium correction rate for hyponatremia or hypernatremia based on target and actual sodium levels.
Evaluate SIADH diagnostic criteria — serum hypo-osmolality, urine osmolality >100, urine Na >40 in euvolemic state.
Estimate total body potassium deficit from serum K+ — guides KCl replacement dosing and rate.
Estimate magnesium deficit and calculate IV magnesium sulfate replacement dose for hypomagnesemia.
Calculate corrected calcium for hypoalbuminemia: corrected Ca = measured Ca + 0.8 × (4 - albumin).
Estimate pediatric weight by age using APLS formula. Age 1-5yr: weight = 2x(age+4)kg; age 6-12yr: weight = 3xage+7kg.
Calculate pediatric body surface area using Mosteller formula (sqrt(HxW/3600)) for accurate drug dosing.
Interpret Apgar score (Appearance, Pulse, Grimace, Activity, Respiration) at 1 and 5 minutes after birth: 7-10 normal, 4-6 needs assistance, 0-3 requires resuscitation.
Estimate gestational age from Ballard score assessing neuromuscular maturity and physical maturity criteria (total score correlates to gestational age 20-44 weeks).
Calculate weight, length, and head circumference z-scores for preterm infants using Fenton 2013 growth chart reference values (22-50 weeks PMA).
Calculate weight-for-age z-score for children under 5 using WHO 2006 growth standards. Z-score <-2 = underweight, <-3 = severely underweight.
Determine head circumference percentile by age and sex using CDC growth charts. Microcephaly <3rd percentile, macrocephaly >97th percentile.
Apply PECARN validated prediction rule to identify children at very low risk for clinically important TBI, avoiding unnecessary CT radiation. Age <2yr: GCS <15, altered status, palpable skull fracture, scalp hematoma, LOC 5s+, non-frontal scalp hematoma.
Assess consciousness in children using age-modified GCS (verbal response modified for non-verbal children): infants/toddlers use cry/grimace/movement criteria instead of verbal.
Calculate PEWS to identify deteriorating children in hospital: behavior, cardiovascular, respiratory subscores (0-2 each); score 4+ triggers review, 6+ ICU assessment.
Determine blood pressure percentile by age, sex, and height percentile using AAP 2017 guidelines. Hypertension is BP at or above 95th percentile on 3 occasions.
Reference normal heart rate ranges by age: newborn 100-160, 1-12mo 80-140, 1-3yr 80-130, 3-5yr 80-120, 6-10yr 70-110, 11-14yr 60-100 bpm.
Reference normal respiratory rate by age: newborn 30-60, 6mo 25-40, 1yr 20-40, 3yr 20-30, 6yr 18-25, 10yr 15-20, 14yr 12-18 breaths/min.
Determine neonatal bilirubin risk zone (Low/Low-Intermediate/High-Intermediate/High) from gestational age and hours of life, guiding phototherapy and exchange transfusion decisions.
Determine phototherapy initiation threshold (total serum bilirubin in mg/dL) based on gestational age, hours of life, and neurotoxicity risk factors per AAP guidelines.
Estimate dehydration severity using Gorelick 10-point clinical score (capillary refill, skin turgor, abnormal respirations, absent tears, dry mucous membranes, sunken eyes/fontanelle, abnormal pulse, pulse rate): 0-2=mild, 3-5=moderate, 6-10=severe.
Calculate pediatric maintenance fluid rate using 4-2-1 rule: 4 mL/kg/hr for first 10kg + 2 mL/kg/hr for next 10kg + 1 mL/kg/hr for each kg above 20kg.
Calculate weight-based amoxicillin dose: standard 25 mg/kg/day in 2 divided doses; high dose for resistant pneumococcus 80-90 mg/kg/day divided BID (max 3g/day).
Calculate acetaminophen dose at 10-15 mg/kg per dose every 4-6 hours (max 5 doses in 24h, max 75 mg/kg/day or 4g/day whichever less).
Calculate ibuprofen dose at 5-10 mg/kg per dose every 6-8 hours (max 40 mg/kg/day or 2400 mg/day); use 10 mg/kg for fever. Not recommended under 6 months.
Estimate TBSA burned in pediatric patients using Lund-Browder chart which accounts for age-related body proportion differences (head larger proportion in infants).
Calculate fluid resuscitation for pediatric burns: 3 mL/kg/% TBSA burned of Lactated Ringers in 24h (not 4 mL/kg as in adults) + maintenance fluids.
Assess organ dysfunction in critically ill children using pediatric SOFA adapted with age-appropriate values for respiratory, coagulation, liver, cardiovascular, neurological, and renal domains.
Estimate pediatric weight from height using color-coded Broselow tape system, used for emergency drug dosing and equipment sizing when actual weight unavailable.
Assess pain using FLACC scale (Face, Legs, Activity, Cry, Consolability) 0-2 each, total 0-10: 0=relaxed/comfortable, 1-3=mild discomfort, 4-6=moderate pain, 7-10=severe pain.
Convert HbA1c to estimated average glucose using ADA formula: eAG (mg/dL) = 28.7 x HbA1c - 46.7. HbA1c 7% = eAG 154 mg/dL.
Calculate 8-item Finnish Diabetes Risk Score (FINDRISC): age, BMI, waist circumference, physical activity, daily vegetables, hypertension history, hyperglycemia history, family history. Score 12+ = high risk, 15+ = very high risk.
Calculate insulin resistance using HOMA-IR = (fasting insulin mU/L x fasting glucose mmol/L) / 22.5. Normal <2.0; insulin resistance 2.0-2.9; significant resistance 3.0+.
Estimate beta cell function using HOMA-B = (20 x fasting insulin) / (fasting glucose - 3.5) x 100%. Normal approximately 100%; decreased in type 2 diabetes.
Calculate Quantitative Insulin Sensitivity Check Index: QUICKI = 1/(log(fasting insulin) + log(fasting glucose)). Normal above 0.357; insulin resistant 0.303-0.357; type 2 diabetes below 0.303.
Calculate insulin-to-carb ratio for mealtime bolus dosing: typically 1 unit per 15g carbohydrates (range 1:8 to 1:20 depending on insulin sensitivity). Use 500/TDD rule for initial estimate.
The 1800 rule estimates how far one unit of rapid-acting insulin will drop blood glucose: divide 1800 by the total daily dose. This page computes the sensitivity factor and the correction dose for a current and target glucose.
Identify dawn phenomenon (BG rise from 3-8am) vs Somogyi effect (rebound hyperglycemia after nocturnal hypoglycemia) using 2am and fasting blood glucose comparison.
Convert CGM mean glucose to estimated HbA1c: GMI = 3.31 + 0.02392 x mean glucose (mg/dL). More accurate than eAG formula for CGM time-in-range assessment.
Classify BMI by WHO categories: <18.5 underweight, 18.5-24.9 normal, 25-29.9 overweight, 30-34.9 obese class I, 35-39.9 obese class II, 40+ obese class III. Asian cutoffs: overweight 23+.
Diagnose metabolic syndrome using IDF criteria: central obesity required (waist 94cm+ men, 80cm+ women Europeans) plus any 2 of 4: TG 150+, HDL below 40/50, BP 130/85+, fasting glucose 100+ mg/dL.
Interpret TSH levels: <0.4 mIU/L hyperthyroid (or over-replacement), 0.4-4.0 euthyroid (normal), 4.0-10.0 subclinical hypothyroid, >10.0 overt hypothyroid. Pregnancy targets 0.1-2.5 first trimester.
Calculate levothyroxine replacement dose: healthy adult hypothyroidism 1.6 mcg/kg/day; elderly or cardiac disease start 12.5-25 mcg/day; post-thyroidectomy may need 2.0 mcg/kg/day.
Estimate peripheral T4 to T3 conversion: approximately 80% of T3 comes from T4 deiodination. Calculate T3 equivalent: 1 mcg T4 = approximately 0.25-0.33 mcg T3. Useful for thyroid hormone replacement optimization.
Interpret AM cortisol levels: normal 5-25 mcg/dL (138-690 nmol/L). Below 3 mcg/dL highly suggests adrenal insufficiency. 3-14 mcg/dL indeterminate and requires ACTH stimulation test. Above 18 mcg/dL excludes primary AI.
Interpret overnight 1mg DST: normal cortisol below 1.8 mcg/dL excludes Cushings. Failure to suppress (above 1.8) requires further evaluation with 24h urinary cortisol or late-night salivary cortisol.
Estimate pre-test probability of Cushing syndrome based on clinical features: easy bruising (most specific), plethora, proximal myopathy, striae above 1cm, and hypertension in young patients.
Calculate ARR for primary hyperaldosteronism screening: ARR = aldosterone (ng/dL) / renin (ng/mL/hr). ARR above 30 with aldosterone above 15 ng/dL = suspicious, requires confirmatory testing.
Interpret PTH in context of serum calcium: high Ca + high PTH = primary hyperparathyroidism; high Ca + low PTH = non-PTH-mediated hypercalcemia; low Ca + high PTH = secondary hyperparathyroidism; low Ca + low PTH = hypoparathyroidism.
Classify vitamin D status by 25(OH)D level: deficient below 20 ng/mL (below 50 nmol/L), insufficient 20-29 ng/mL, sufficient 30-100 ng/mL, potential toxicity above 100 ng/mL. Replacement dose: 1000-2000 IU/day maintenance.
Estimate 10-year probability of major osteoporotic fracture and hip fracture using FRAX tool incorporating age, sex, BMI, clinical risk factors, and optionally femoral neck BMD T-score.
Calculate free testosterone from total testosterone, SHBG, and albumin using Vermeulen 1999 equation. Normal free T males 50-210 pg/mL; females 1-8.5 pg/mL.
Diagnose PCOS using Rotterdam 2003 criteria: diagnosis requires 2 of 3: (1) oligo/anovulation, (2) clinical/biochemical hyperandrogenism, (3) polycystic ovaries on ultrasound (12+ follicles or ovarian volume above 10 mL).
Interpret anti-Mullerian hormone for ovarian reserve: low below 1.0 ng/mL (poor reserve, low IVF response), optimal 1.0-3.5 ng/mL, high above 3.5 ng/mL (PCOS risk, hyperstimulation).
Calculate free androgen index (FAI = total testosterone x 100 / SHBG) for hyperandrogenism assessment. Elevated FAI in women above 5-10 suggests hyperandrogenism. SHBG affected by thyroid, insulin, estrogen, obesity.
Assess a cancer patient functional capacity on the Karnofsky 100-0 scale. 100 = normal, no complaints; 80 = normal activity with effort; 60 = requires occasional assistance; 40 = disabled; 20 = very sick; 0 = dead.
Grade a cancer patient functional status on the ECOG 0-4 scale: 0 = fully active; 1 = restricted strenuous activity; 2 = ambulatory >50% of waking hours; 3 = limited self-care; 4 = completely disabled.
Calculate carboplatin dose using the Calvert formula: Dose (mg) = AUC x (eGFR + 25). AUC target 5-7 for combination, 5-6 for relapsed. Uses Cockcroft-Gault or CKD-EPI eGFR in mL/min.
Calculate cisplatin dose from BSA. Standard dosing: 50-100 mg/m2 IV every 3-4 weeks for solid tumours, or 20 mg/m2 daily x 5 days. Requires prehydration and vigorous antiemetic prophylaxis.
Calculate cyclophosphamide dose based on body surface area. IV dosing: 500-1500 mg/m2 every 3-4 weeks for lymphomas and solid tumours; oral: 1-2 mg/kg/day for autoimmune indications. Use mesna >= 600 mg/m2 for uroprotection.
Track lifetime anthracycline exposure against the 550 mg/m2 doxorubicin ceiling, or 450 mg/m2 when mediastinal radiotherapy has been given. The risk of congestive heart failure climbs steeply once the threshold is crossed.
Track cumulative bleomycin exposure against the 400-unit lifetime pulmonary toxicity threshold. Risk of bleomycin-induced pneumonitis rises substantially above 400 units total. Age > 70 and renal impairment lower the safe threshold.
Calculate vincristine dose by BSA. Standard: 1.4 mg/m2 IV (typically capped at 2 mg absolute dose to limit neurotoxicity). Used in CHOP, MOPP, and other haematological malignancy regimens.
Calculate paclitaxel (Taxol) dose from BSA. Standard: 175 mg/m2 every 3 weeks, or 80 mg/m2 weekly for breast cancer. Requires premedication with dexamethasone, diphenhydramine, and H2 blocker to prevent hypersensitivity.
Calculate docetaxel (Taxotere) dose from BSA. Standard: 75-100 mg/m2 every 3 weeks for breast, lung, prostate. Premedicate with dexamethasone 8 mg BID x 3 days starting day before to reduce fluid retention and hypersensitivity.
Calculate bevacizumab (Avastin) dose based on actual body weight. Standard: 5 mg/kg every 2 weeks or 15 mg/kg every 3 weeks for colorectal cancer; 15 mg/kg every 3 weeks for NSCLC. Dose in mg/kg - no BSA used.
Calculate trastuzumab (Herceptin) doses. Loading: 8 mg/kg IV over 90 min; Maintenance: 6 mg/kg every 3 weeks or 2 mg/kg weekly. For subcutaneous formulation: fixed 600 mg every 3 weeks regardless of weight.
Calculate rituximab dose from BSA. Standard haematology dose: 375 mg/m2 IV weekly x 4 for follicular lymphoma induction; 375 mg/m2 day 1 of each R-CHOP cycle. RA dose: 1000 mg IV x 2 doses 2 weeks apart.
Calculate Biologically Effective Dose using BED = nd(1 + d/(a/b)), where n = number of fractions, d = dose per fraction (Gy), and a/b = tissue repair ratio (10 Gy for tumours, 3 Gy for late-reacting normal tissues).
Convert any fractionation schedule into the equivalent dose delivered in 2 Gy fractions, so a hypofractionated course and a conventional one can be compared on the same scale for both tumour control and late normal-tissue effects.
Calculate PSA doubling time using PSADT = ln(2) / slope of ln(PSA) vs time regression. PSADT < 3 months indicates aggressive biology; 3-12 months intermediate risk; > 12 months favourable prognosis after primary treatment.
Convert Gleason score to ISUP Grade Group. GS <= 6 = Grade Group 1; GS 3+4 = GG2; GS 4+3 = GG3; GS 8 = GG4; GS 9-10 = GG5. Higher grade groups correlate with worse prognosis and guide treatment intensity.
Classify localised prostate cancer as Low, Intermediate, or High risk using PSA, Gleason score, and clinical stage. Low: PSA < 10 + GS <= 6 + stage <= T2a. High: PSA > 20 or GS >= 8 or stage >= T2c.
Calculate UCSF CAPRA score (0-10) for prostate cancer prognosis using PSA, Gleason score, clinical stage, percent positive cores, and age at diagnosis. CAPRA 0-2 = low risk; 3-5 = intermediate; 6-10 = high risk.
Interpret ACR BI-RADS categories. 0 = incomplete; 1 = negative; 2 = benign; 3 = probably benign (<=2% malignancy); 4 = suspicious (2-95%); 4A/4B/4C subcategories; 5 = highly suggestive malignancy (>=95%); 6 = known biopsy-proven.
Calculate Nottingham histological grade (Grade 1-3) from three components scored 1-3 each: tubule formation, nuclear pleomorphism, and mitotic count per HPF. Total 3-5 = Grade 1; 6-7 = Grade 2; 8-9 = Grade 3.
Interpret Ki-67 labelling index in breast cancer and neuroendocrine tumours. Breast: low < 14%, intermediate 14-20%, high > 20%. NET grading: G1 < 3%, G2 3-20%, G3 > 20%. High Ki-67 correlates with higher grade and chemosensitivity.
Grade adverse events using the NCI Common Terminology Criteria for Adverse Events. Grade 0 = no toxicity; 1 = mild; 2 = moderate, limiting instrumental ADL; 3 = severe, limiting self-care ADL; 4 = life-threatening; 5 = death.
Calculate Cockcroft-Gault creatinine clearance for use in the Calvert carboplatin formula. CrCl = [(140 - age) x weight (kg)] / (72 x serum creatinine mg/dL) x 0.85 (if female). FDA recommends capping at 125 mL/min to avoid overdosing.
Interpret TNM staging system for solid tumours. T (primary tumour size/invasion): T0-T4. N (regional lymph node involvement): N0-N3. M (distant metastasis): M0 (none) or M1 (present). Combined into Stage I-IV groupings; Stage IV always indicates metastatic disease.
Determine airflow obstruction from spirometry. Post-bronchodilator FEV1/FVC < 0.70 defines COPD per GOLD criteria. FEV1/FVC < LLN (lower limit of normal) is preferred by ATS/ERS to avoid over-diagnosing obstruction in the elderly.
Calculate FEV1 % predicted using NHANES III reference equations for adults. Predicted FEV1 varies by age, height, sex, and race. FEV1 % predicted < 80% indicates below-normal expiratory flow and is used for GOLD COPD staging.
Stage COPD severity by post-bronchodilator FEV1 % predicted. GOLD 1 (≥80%) to GOLD 4 (<30%) with the fixed-ratio obstruction criterion.
Calculate COPD Assessment Test score (0-40) from 8 items rated 0-5: cough, phlegm, chest tightness, breathlessness on hills, activity limitation, confidence, sleep, and energy. CAT < 10 = low impact; 10-20 = medium; 21-30 = high; > 30 = very high.
Grade breathlessness with the modified Medical Research Council scale (0-4). From breathless only on exertion to too breathless to leave the house.
Calculate BODE index (0-10) from BMI, airflow Obstruction (FEV1 %), Dyspnoea (mMRC), and Exercise (6MWT metres). Score 0-2 = best prognosis; 7-10 = 4-year mortality approximately 80%. Outperforms FEV1 alone for predicting COPD mortality.
Predict in-hospital mortality from acute COPD exacerbation using DECAF score (0-6): Dyspnoea eMRCD 5a/5b, Eosinopaenia < 0.05 x10^9/L, Consolidation on CXR, Acidaemia pH < 7.30, Atrial Fibrillation. Score > 3 = high mortality (>25%).
Calculate PSI Pneumonia Severity Index (PORT score) to risk-stratify community-acquired pneumonia into 5 classes. Includes age, nursing home residence, comorbidities, physical exam findings, and lab values. Class I-II: outpatient; III: observation; IV-V: hospitalise.
Calculate CURB-65 score for community-acquired pneumonia. 1 point each for: Confusion (new), Urea > 7 mmol/L, Respiratory rate >= 30/min, Blood pressure < 90 systolic or <= 60 diastolic, Age >= 65. Score 0-1: low risk; 2: intermediate; 3-5: severe.
Identify severe community-acquired pneumonia requiring ICU admission using ATS/IDSA 2007 criteria. Major criteria (1 sufficient): invasive mechanical ventilation or septic shock. Minor criteria (>= 3 of 9): RR >= 30, PaO2/FiO2 <= 250, multilobar infiltrates, confusion, BUN >= 20, WBC < 4000, platelets < 100K, temp < 36 C, SBP < 90.
Assess pre-test probability for PE using Wells score. Clinical DVT signs: 3 pts; PE more likely than alternative: 3 pts; HR > 100: 1.5; immobilisation >= 3 days or surgery in 4 weeks: 1.5; prior DVT/PE: 1.5; haemoptysis: 1; malignancy: 1. Score <= 4 = PE unlikely; > 4 = PE likely.
Estimate PE pre-test probability using the revised Geneva score (all objective criteria): age > 65: 1; prior DVT/PE: 3; surgery or fracture in 1 month: 2; active malignancy: 2; unilateral leg pain: 3; haemoptysis: 2; HR 75-94: 3; HR >= 95: 5; pain on deep palpation + unilateral oedema: 4. Low 0-3, intermediate 4-10, high >= 11.
Calculate PESI score to risk-stratify confirmed PE. Base score = age in years. Add: male +10, cancer +30, heart failure +10, chronic lung disease +10, HR >= 110 +20, SBP < 100 +30, RR >= 30 +20, temp < 36 C +20, altered mentation +60, SpO2 < 90% +20. Class I <= 65 = very low 30-day mortality (1.6%).
Classify ARDS severity using Berlin Definition 2012. All four criteria required: (1) onset <= 1 week of known insult; (2) bilateral opacities on CXR/CT not fully explained by effusions; (3) respiratory failure not explained by cardiac failure; (4) P/F ratio on PEEP >= 5 cmH2O: mild 200-300, moderate 100-200, severe < 100.
Calculate P/F ratio (PaO2 / FiO2) to assess oxygenation impairment. Normal > 400-500 mmHg; P/F > 300 = no ARDS; 200-300 = mild ARDS; 100-200 = moderate ARDS; < 100 = severe ARDS. Monitor trends to guide ventilator management.
Calculate lung-protective tidal volume for ARDS mechanical ventilation: 6 mL/kg ideal body weight (IBW). IBW (males) = 50 + 0.91 x (height cm - 152.4); IBW (females) = 45.5 + 0.91 x (height cm - 152.4). Target plateau pressure <= 30 cmH2O.
Measure plateau pressure during an inspiratory hold (0.5-2 sec pause at end-inspiration) to assess alveolar overdistension risk. Goal <= 30 cmH2O per ARDSNet protocol. Values > 30 cmH2O require tidal volume reduction or other interventions.
Calculate driving pressure = plateau pressure - PEEP. Target driving pressure < 15 cmH2O for lung-protective ventilation. Higher driving pressure independently predicts mortality in ARDS. Titrate tidal volume and PEEP to minimise driving pressure while maintaining adequate oxygenation.
Calculate systemic oxygen delivery: DO2 = CO x CaO2 x 10. CaO2 = (Hb x 1.34 x SaO2) + (PaO2 x 0.0031). Normal DO2 = 950-1150 mL/min. CO in L/min, Hb in g/dL, SaO2 as fraction (0-1). Critical threshold: DO2 < 330 mL/min (anaerobic threshold).
Calculate A-a gradient = PAO2 - PaO2. PAO2 = (FiO2 x (Patm - 47)) - (PaCO2 / 0.8). Normal A-a gradient on room air: age/4 + 4 mmHg (up to approximately 25 mmHg). Elevated gradient indicates V/Q mismatch, shunt, or diffusion impairment.
Calculate APACHE II score (0-71) from 12 acute physiology variables, age, and chronic health points. Score assessed on worst values in first 24 hours of ICU admission. Score > 25 predicts approximate 50% hospital mortality; > 35 predicts > 80% mortality.
Calculate SOFA score (0-24) to quantify organ failure in ICU patients across 6 systems: respiratory (P/F ratio), coagulation (platelets), liver (bilirubin), cardiovascular (vasopressor dose), CNS (GCS), renal (creatinine/urine output). Sepsis = baseline SOFA + 2 points.
Screen for sepsis risk outside the ICU using qSOFA: 1 point each for altered mentation (GCS < 15), respiratory rate >= 22/min, and systolic BP <= 100 mmHg. qSOFA >= 2 predicts poor outcome and should prompt sepsis workup, blood cultures, and lactate measurement.
Assess asthma control using the validated 5-item ACT questionnaire. Each item scored 1-5 (daytime symptoms, activity limitation, nocturnal waking, rescue inhaler use, overall control self-rating). Total 5-25: >= 20 = well controlled; 16-19 = not well controlled; <= 15 = very poorly controlled.
Determine NIV eligibility for acute hypercapnic COPD exacerbation. Indications: pH 7.25-7.35 + PaCO2 > 45 mmHg + RR > 23 on optimised medical therapy. Absolute contraindications: inability to protect airway, facial trauma, haemodynamic instability, severe agitation.
Calculate Kt/V to assess hemodialysis adequacy. Target ≥1.2 per session per KDOQI guidelines. Uses Daugirdas second-generation formula.
Calculate the urea reduction ratio (URR) to assess hemodialysis adequacy. URR = (pre-BUN minus post-BUN) / pre-BUN x 100. Target > 65%.
Calculate CRRT effluent dose in mL/kg/h for continuous renal replacement therapy. Recommended dose: 25-35 mL/kg/h per KDIGO guidelines.
Calculate and interpret urine protein-to-creatinine ratio (UPCR). UPCR > 0.3 g/g (300 mg/g) indicates clinically significant proteinuria.
Interpret UACR for CKD staging: A1 < 30 mg/g (normal to mildly increased), A2 30-300 mg/g (moderately increased), A3 > 300 mg/g (severely increased).
Estimate GFR using serum cystatin C with the CKD-EPI cystatin C equation. Less affected by muscle mass than creatinine-based equations.
Calculate TTKG to assess renal potassium handling. Formula: (urine K / serum K) divided by (urine osmolality / serum osmolality). Normal > 8 during hyperkalemia indicates appropriate renal excretion.
Calculate urine osmolal gap (measured minus calculated) to estimate urinary ammonium excretion. Gap > 100 mOsm/kg suggests adequate NH4+ excretion in metabolic acidosis.
Calculate erythropoietin-stimulating agent (ESA) dosing for CKD-related anaemia. Initial dose: 50-100 units/kg SC 3x/week. Target Hgb 10-11.5 g/dL.
Guide IV iron dosing for CKD anaemia. Target ferritin 200-500 ng/mL and TSAT 20-50%. Use when ferritin < 500 or TSAT < 30% in ESA-treated patients.
Guide phosphate binder selection and dosing based on dietary phosphate load and serum phosphate target (3.5-5.5 mg/dL) in CKD/ESRD patients.
Calculate cinacalcet dosing for secondary hyperparathyroidism (sHPT) in dialysis patients. Starting dose 30 mg daily; titrate every 2-4 weeks to PTH target 150-300 pg/mL.
Calculate corrected serum calcium when albumin is abnormal. Formula: Corrected Ca (mg/dL) = Measured Ca + 0.8 x (4 minus albumin).
Calculate vancomycin AUC/MIC ratio for optimised dosing. Target AUC/MIC 400-600 mg*h/L per 2020 ASHP/IDSA/SIDP guidelines to maximise efficacy and minimise nephrotoxicity.
Calculate once-daily aminoglycoside dosing (gentamicin 5-7 mg/kg, tobramycin 5-7 mg/kg q24h). Hartford nomogram for monitoring and dose adjustment.
Estimate contrast-induced nephropathy (CIN) risk using the Mehran risk score. Identifies high-risk patients needing pre-hydration and iso-osmolar contrast.
Estimate phosphate deficit and oral replacement dose for hypophosphataemia. Mild (1-2.5 mg/dL): 1-5 mg/kg/day oral. Severe (< 1 mg/dL): IV replacement required.
Estimate the effect of pH on serum potassium. Serum K+ changes approximately 0.6 mEq/L per 0.1 unit change in pH (inverse relationship).
Guide drug dose adjustments based on GFR categories (G1-G5). Covers common antibiotics, anticoagulants, antidiabetics, and analgesics requiring renal dose modification.
Calculate the Oxford MEST-C classification for IgA nephropathy: Mesangial hypercellularity (M), Endocapillary proliferation (E), Segmental glomerulosclerosis (S), Tubular atrophy/interstitial fibrosis (T), Crescents (C).
Classify lupus nephritis by ISN/RPS 2003 criteria: Class I-VI based on renal biopsy findings. Guides immunosuppressive treatment selection.
Stage diabetic nephropathy using Mogensen classification (Stages 1-5) based on GFR trajectory, albuminuria, and blood pressure to guide intervention.
Estimate CKD progression risk in hypertensive nephrosclerosis based on blood pressure control, GFR, albuminuria, and comorbidities using KDIGO heat map categories.
Stage acute kidney injury using AKIN criteria: Stage 1 (Cr x1.5-1.9 or +0.3 mg/dL, UO < 0.5 mL/kg/h for 6h+), Stage 2 (Cr x2-2.9, UO x12h), Stage 3 (Cr x3 or RRT, UO x24h/anuria).
Classify AKI using RIFLE criteria: Risk (Cr x1.5 or GFR -25%), Injury (Cr x2 or GFR -50%), Failure (Cr x3 or GFR -75%), Loss (complete loss > 4 weeks), ESKD (> 3 months).
Calculate Child-Pugh score to assess cirrhosis severity. Class A (5-6): well-compensated; Class B (7-9): significant dysfunction; Class C (10-15): decompensated, 1-2 year survival 35-80%.
Calculate MELD score for liver disease severity and transplant prioritisation. Formula: 6.43 + 9.57 x ln(Cr) + 3.78 x ln(Tbili) + 11.2 x ln(INR). MELD >= 15 favours transplant over medical management.
Calculate MELD-Na incorporating serum sodium for more accurate transplant waitlist mortality prediction. MELD-Na = MELD - Na - (0.025 x MELD x (140 - Na)) + 140.
Apply Baveno VI criteria to identify compensated cirrhosis patients who can safely avoid screening endoscopy: LSM < 20 kPa AND platelet count > 150,000/uL.
Grade hepatic encephalopathy using West Haven criteria (Grades 0-4). Guides treatment intensity: Grade 1-2: lactulose; Grade 3-4: ICU, consider rifaximin.
Calculate Maddrey Discriminant Function (mDF) for alcoholic hepatitis severity. mDF = 4.6 x (PT minus control PT) + serum bilirubin (mg/dL). Score > 32 indicates severe disease warranting corticosteroid therapy.
The Glasgow alcoholic hepatitis score (Forrest et al., 2005) combines age, white cell count, urea, prothrombin ratio and bilirubin into a 5-12 point scale. A score of 9 or more identifies the patients whose 28-day mortality falls with corticosteroids.
Calculate Lille score at Day 7 of corticosteroid therapy to predict 6-month mortality. Score >= 0.45 indicates non-response; discontinue steroids to avoid side effects.
Calculate CDAI for Crohn's disease activity: remission < 150, mild 150-219, moderate 220-450, severe > 450. Uses 8 clinical parameters over 7 days.
Simplified Crohn's activity index: <= 4 = remission, 5-7 = mild, 8-16 = moderate, > 16 = severe. Uses 5 clinical parameters without the 7-day diary requirement.
Calculate Mayo score for UC activity (0-12): remission < 2, mild 3-5, moderate 6-10, severe 11-12. Includes stool frequency, rectal bleeding, endoscopy, and physician assessment.
Classify UC severity using Truelove-Witts criteria: mild (<= 4 BM/day, no systemic features), moderate (between mild and severe), severe (>= 6 BM/day + systemic features). Severe UC requires hospitalisation.
Calculate BISAP score for acute pancreatitis: BUN > 25, Impaired mentation, SIRS, Age > 60, Pleural effusion. Score 0-5; score >= 3 predicts organ failure and mortality.
Assess pancreatitis severity using Ranson criteria: 5 at admission + 6 at 48h. Score 0-2: mild (1% mortality); 3-4: moderate (15%); 5-6: severe (40%); >= 7: critical (nearly 100%).
Classify acute pancreatitis severity per Revised Atlanta 2012: Mild (no organ failure, no local complications), Moderately severe (transient OF < 48h or local complications), Severe (persistent OF >= 48h).
Calculate Marshall organ failure score in acute pancreatitis. Assesses respiratory (PaO2/FiO2), renal (creatinine), and cardiovascular (systolic BP) dysfunction. Score >= 2 in any system = organ failure.
Calculate Glasgow-Blatchford score to identify low-risk upper GI bleed patients safe for outpatient management. Score 0 = < 1% risk of intervention needed; safe to discharge.
Calculate post-endoscopy Rockall score to predict rebleeding and mortality after upper GI bleeding. Score >= 5 = high risk (rebleed 24%, mortality 11%).
Calculate AIMS65 score for upper GI bleeding. Score > 2 = high risk, inpatient mortality 10-26%. Five variables: Albumin < 3, INR > 1.5, Altered mental status, SBP <= 90, Age >= 65.
Screen for nutritional risk in hospitalised patients using NRS 2002. Score >= 3 indicates at-risk status requiring nutritional support plan. Includes nutritional status + disease severity + age adjustment.
Screen for malnutrition in community and hospital using MUST (Malnutrition Universal Screening Tool). Combines BMI, weight loss, and acute disease effect. Score 0: low risk; 1: medium risk; >= 2: high risk.
Classify nutritional status using SGA: Category A (well-nourished), B (mildly-moderately malnourished), C (severely malnourished). Based on history and physical exam.
Calculate resting energy expenditure (REE) using Harris-Benedict equations. Male: 88.4 + 13.4xW + 4.8xH - 5.68xA. Female: 447.6 + 9.25xW + 3.1xH - 4.33xA. Multiply by activity factor for TDEE.
Calculate resting metabolic rate (RMR) using Mifflin-St Jeor equation. Male: 10xW + 6.25xH - 5xA + 5. Female: 10xW + 6.25xH - 5xA - 161. More accurate than Harris-Benedict in non-obese adults.
Guide branched-chain amino acid (BCAA)-enriched formula use for hepatic encephalopathy. Target Fischer ratio (BCAA:AAA) > 3. BCAA supplements address low BCAA:AAA ratio in cirrhosis.
Calculates the International Society on Thrombosis and Haemostasis (ISTH) overt DIC score using platelet count, fibrin markers, PT prolongation, and fibrinogen level. Score ≥5 indicates overt disseminated intravascular coagulation.
Calculates the 4Ts pretest probability score for heparin-induced thrombocytopenia (HIT) based on thrombocytopenia severity and timing, thrombosis or other sequelae, and other causes of thrombocytopenia. Score 0–8; ≥4 warrants investigation.
Calculates the 4-factor prothrombin complex concentrate (4F-PCC) dose for urgent warfarin reversal based on INR and body weight. High-intensity anticoagulation with life-threatening bleeding requires 50 units/kg IV.
Provides INR target ranges by clinical indication and interprets INR values relative to therapeutic goals. Includes ranges for atrial fibrillation (2–3), mechanical heart valves (2.5–3.5), DVT/PE (2–3), and antiphospholipid syndrome (2.5–3.5).
Interprets low-molecular-weight heparin (LMWH) anti-Xa levels for prophylactic (0.2–0.4 IU/mL) and therapeutic (0.6–1.0 IU/mL) dosing, drawn 4 hours post-dose. Used in renal impairment, obesity, pregnancy, and pediatric patients.
Stage multiple myeloma by tumour mass with the original Durie-Salmon system, using haemoglobin, calcium, skeletal survey, and paraprotein levels, then add the A or B renal subclass. Stage III with B carries the worst outlook.
Calculates the International Staging System (ISS) stage for multiple myeloma using serum β2-microglobulin and albumin. Stage I: β2M <3.5 mg/L + albumin ≥3.5 g/dL; Stage III: β2M ≥5.5 mg/L; Stage II: all others.
Calculates the International Prognostic Index (IPI) for aggressive non-Hodgkin lymphoma. Five risk factors scored 0–1 each: age >60, Ann Arbor stage III–IV, >1 extranodal site, ECOG performance status ≥2, and elevated LDH. Total score determines low, low-intermediate, high-intermediate, or high risk.
Calculates the Follicular Lymphoma International Prognostic Index (FLIPI) using 5 adverse factors: age >60, Ann Arbor stage III–IV, hemoglobin <12 g/dL, >4 nodal areas involved, and elevated LDH. Scores 0–5 define low (0–1), intermediate (2), or poor (3–5) risk.
Calculates the Sokal prognostic score for CML using age, spleen size, platelet count, and blast percentage. Formula: exp(0.0116×(age−43.4) + 0.0345×(spleen−7.51) + 0.188×((platelet/700)²−0.563) + 0.0887×(blasts−2.10)). Low <0.8, Intermediate 0.8–1.2, High >1.2.
Evaluates Camitta criteria for severe aplastic anemia (SAA): hypocellular bone marrow (<25% cellularity) PLUS at least 2 of: absolute neutrophil count <500/µL, platelets <20,000/µL, and reticulocytes <60,000/µL (or corrected reticulocyte count <1%). Very severe: ANC <200/µL.
Calculates the Reticulocyte Production Index (RPI) to assess bone marrow response to anemia. RPI = Reticulocyte % × (Patient Hct / Normal Hct) / Maturation Factor. RPI <2 indicates hypoproliferative anemia; RPI >3 indicates adequate bone marrow response.
Calculates the corrected reticulocyte count (CRC) to adjust for degree of anemia: CRC = Reticulocyte% × (Patient Hematocrit / 45). A CRC >2% indicates appropriate marrow response; <2% suggests hypoproliferative anemia.
Evaluates laboratory criteria for iron deficiency anemia: serum iron <60 µg/dL, TIBC >360 µg/dL, transferrin saturation <16%, and serum ferritin <20 ng/mL (or <30 ng/mL with inflammation). Includes interpretation in chronic disease states.
Evaluates laboratory markers of hemolysis: elevated LDH, low haptoglobin (<25 mg/dL), elevated indirect (unconjugated) bilirubin, elevated plasma free hemoglobin, and hemoglobinuria. Helps classify intravascular vs extravascular hemolysis.
Interprets the Direct Antiglobulin Test (DAT/Coombs test) results for autoimmune and alloimmune hemolytic anemia. IgG+C3d: warm AIHA; C3d alone: cold agglutinin disease; IgG alone: drug-induced or warm AIHA. Includes indirect Coombs (IAT) interpretation for pre-transfusion testing.
Determines evidence-based hemoglobin transfusion thresholds by clinical context: ICU/stable patients <7 g/dL (restrictive), cardiac surgery <8 g/dL, symptomatic cardiovascular disease <8 g/dL, and CNS/orthopedic surgery <8–9 g/dL. Based on TRICC, TRACS, and TRICS-III trials.
Provides evidence-based platelet transfusion thresholds: prophylactic <10,000/µL (stable), <20,000/µL (with risk factors), <50,000/µL (invasive procedures/surgery), <100,000/µL (CNS surgery, ocular surgery, epidural placement). Includes dose and expected increment calculations.
Calculates blood product ratios for massive transfusion protocol (MTP): 1:1:1 ratio of packed red blood cells (pRBC) : fresh frozen plasma (FFP) : apheresis platelets. Includes activation criteria (>10 units pRBC in 24h, or shock index >1 with ongoing hemorrhage) and TXA dosing.
Calculates the cryoprecipitate dose required to achieve target fibrinogen levels. Each unit of cryoprecipitate raises fibrinogen by approximately 50–70 mg/dL in a 70 kg adult. Target fibrinogen ≥150–200 mg/dL in active hemorrhage; ≥200 mg/dL in obstetric hemorrhage.
Calculates andexanet alfa dose for reversal of apixaban, rivaroxaban, and edoxaban in life-threatening bleeding. Low dose (400 mg IV bolus + 480 mg infusion over 2h): last apixaban ≤5 mg or rivaroxaban ≤10 mg, >8h since last dose. High dose (800 mg bolus + 960 mg infusion): all others.
Provides idarucizumab dosing for urgent dabigatran reversal: 5 g IV (2 × 2.5 g vials administered consecutively) for life-threatening bleeding or urgent surgery. Reversal is complete within minutes and sustained for at least 24 hours in most patients (RE-VERSE AD trial).
Assesses the severity of sickle cell vaso-occlusive crisis (VOC) using pain intensity (NRS 0–10), location and number of sites, baseline opioid use, recent hospitalizations, and functional impairment. Guides analgesic ladder escalation and hospitalization decision.
Calculates hydroxyurea starting dose for sickle cell disease: 15–20 mg/kg/day orally (round to nearest 500 mg capsule). Escalate by 5 mg/kg/day every 8–12 weeks to maximum tolerated dose (MTD), targeting HbF ≥20% and MCV increase while monitoring CBC for myelosuppression.
Calculates the HEART score for early risk stratification of chest pain in the ED: History (2/1/0), ECG (2/1/0), Age (≥65=2, 45–64=1, <45=0), Risk factors (2/1/0), Troponin (2/1/0). Score 0–3: low risk (1.7% MACE); 4–6: moderate (12%); 7–10: high (65%).
Calculates the TIMI (Thrombolysis in Myocardial Infarction) risk score for NSTEMI and unstable angina (0–7 points): age ≥65, ≥3 CAD risk factors, known CAD (stenosis ≥50%), ST deviation, ≥2 anginal events in 24h, aspirin use in past 7 days, elevated cardiac markers.
Calculates the GRACE (Global Registry of Acute Coronary Events) score for in-hospital and 6-month mortality risk in ACS. Variables: age, heart rate, systolic BP, creatinine, cardiac arrest at admission, ST deviation, elevated cardiac markers, Killip class. Guides invasive vs conservative strategy.
Classifies heart failure severity in acute MI: Class I (no heart failure, no crackles, no S3 — 30-day mortality ~6%), Class II (mild HF, crackles <50% lung fields or S3 — 17%), Class III (pulmonary edema — 38%), Class IV (cardiogenic shock, SBP <90 + hypoperfusion — 67–81%).
Explains the SYNTAX score system for quantifying coronary artery disease complexity based on anatomical features: dominance, number of lesions, bifurcation involvement, calcification, tortuosity, thrombus, diffuse disease. Low ≤22 (PCI preferred), intermediate 23–32, high ≥33 (CABG preferred).
Calculates aortic valve area (AVA) using the Gorlin formula: AVA = CO / (HR × SEP × 44.3 × √ΔP), where CO = cardiac output (L/min), HR = heart rate (beats/min), SEP = systolic ejection period (sec/beat), and ΔP = mean aortic valve pressure gradient (mmHg).
Calculates mitral valve area (MVA) by echocardiographic pressure half-time method: MVA = 220 / PHT (ms), where PHT is the time for the peak diastolic pressure gradient to decrease by half. Normal MVA 4–6 cm²; severe mitral stenosis <1.0 cm².
Classifies aortic stenosis severity by echocardiographic criteria: Mild AS: AVA >1.5 cm², mean gradient <25 mmHg, Vmax <3.0 m/s. Moderate AS: AVA 1.0–1.5 cm², mean gradient 25–40 mmHg. Severe AS: AVA <1.0 cm², mean gradient >40 mmHg, Vmax >4.0 m/s.
Evaluates Framingham criteria for heart failure diagnosis requiring ≥2 major OR 1 major + 2 minor criteria. Major: PND, orthopnea, elevated JVP, S3 gallop, cardiomegaly, pulmonary edema, hepatojugular reflux, weight loss >4.5 kg in 5 days. Minor: bilateral leg edema, nocturnal cough, dyspnea on exertion, hepatomegaly, pleural effusion, tachycardia >120.
Interprets NT-proBNP levels for heart failure diagnosis and rule-out. Age-stratified cutoffs: <75 years: 125 pg/mL (rule-out), 450 pg/mL (rule-in); ≥75 years: 450 pg/mL (rule-out), 1800 pg/mL (rule-in). BNP cutoffs: <100 pg/mL rule-out, >400 pg/mL rule-in. Includes effect of obesity and renal failure.
Calculates the LACE index predicting 30-day readmission or death: L=Length of stay (1–7pts), A=Acuity (emergent admission=3pts), C=Comorbidity (Charlson index, 0–5pts), E=ED visits in prior 6 months (1–4pts). Total 0–19; score ≥10 indicates high readmission risk.
Calculates the Berg Balance Scale (BBS) total score (0–56) across 14 balance tasks scored 0–4. Score <45 indicates significant fall risk. Interpretation: 41–56 = low fall risk; 21–40 = medium risk with assistive device; 0–20 = high fall risk, wheelchair dependent.
Calculates the Barthel Index of ADL performance (0–100 points): assesses 10 ADLs — feeding, bathing, grooming, dressing, bowel control, bladder control, toileting, transfers, mobility, and stair climbing. Score 0–20: total dependence; 21–60: severe; 61–90: moderate; 91–99: mild; 100: full independence.
Calculates the Functional Independence Measure (FIM) total score (18–126) across 18 items in 6 domains: self-care (6 items), sphincter control (2), transfers (3), locomotion (2), communication (2), and social cognition (3). Each item scored 1–7 (1=total assist, 7=complete independence).
Interprets Mini-Mental State Examination (MMSE) scores (0–30): 24–30 = normal/no cognitive impairment; 18–23 = mild cognitive impairment; 12–17 = moderate impairment; <11 = severe cognitive impairment. Includes orientation, registration, attention, recall, language, and visuospatial construction domains.
Interprets the Montreal Cognitive Assessment (MoCA) score: ≥26/30 = normal cognition; 18–25 = mild cognitive impairment; 10–17 = moderate impairment; <10 = severe impairment. Adds 1 point for ≤12 years of education. Tests executive function, visuospatial, attention, language, memory, and orientation.
Calculates the Patient Health Questionnaire-9 (PHQ-9) depression severity over the past 2 weeks: 0–4 = minimal/none; 5–9 = mild; 10–14 = moderate; 15–19 = moderately severe; 20–27 = severe. Question 9 (suicidal ideation) scored separately regardless of total.
Calculates the Generalized Anxiety Disorder 7-item (GAD-7) scale: 0–4 = minimal anxiety; 5–9 = mild; 10–14 = moderate; 15–21 = severe. Each of 7 items scored 0–3 (not at all/several days/more than half/nearly every day) over the past 2 weeks.
Calculates the Pittsburgh Sleep Quality Index (PSQI) global score (0–21) from 7 component scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. PSQI >5 indicates poor sleep quality.
Calculates Epworth Sleepiness Scale (ESS) score: 8 scenarios rated 0–3 for likelihood of dozing (sitting and reading, watching TV, sitting inactive in public, passenger in a car, lying down resting, sitting and talking, sitting quietly after lunch, in a car stopped in traffic). Score 0–10 normal; 11–24 excessive daytime sleepiness.
Evaluates the MDS-UPDRS Part III (motor examination) for Parkinson disease: 33 items scored 0–4 assessing speech, facial expression, rigidity (5 body segments), finger tapping, hand movements, pronation-supination, toe tapping, leg agility, gait, freezing, postural stability, posture, global spontaneity, tremor at rest, action tremor, and dyskinesias.
Calculates the Expanded Disability Status Scale (EDSS) for MS severity (0–10): 0 = normal neurological exam; 1.0–1.5 = no disability, minimal signs; 2.0–2.5 = minimal disability; 3.0–4.5 = moderate disability, fully ambulatory; 5.0–5.5 = ambulatory ~200m without aid; 6.0 = unilateral aid to walk 100m; 6.5 = bilateral aid; 7.0–7.5 = wheelchair; 8.0–8.5 = restricted to bed; 9.0–9.5 = bedridden helpless; 10 = death due to MS.
Evaluates the modified Rankin Scale (mRS) for disability after stroke and neurological events: 0=no symptoms; 1=no significant disability; 2=slight disability (independent in basic ADLs); 3=moderate disability (requires some help, walks without assistance); 4=moderately severe (unable to walk or attend to own bodily needs without assistance); 5=severe disability; 6=death.
Calculates the ABCD2I score (ABCD2 + imaging) for 2-day and 7-day stroke risk after TIA: Age ≥60 (1pt), BP ≥140/90 (1pt), Clinical features — unilateral weakness (2pt)/speech without weakness (1pt), Duration 10–59min (1pt)/≥60min (2pt), Diabetes (1pt), plus DWI infarction (+2pt). Total 0–9; score ≥4 = high risk.
Calculates the NIH Stroke Scale (NIHSS) neurological deficit score (0–42) across 11 items: level of consciousness (0–3), gaze (0–2), visual fields (0–3), facial palsy (0–3), arm motor (0–4 each), leg motor (0–4 each), limb ataxia (0–2), sensory (0–2), language/aphasia (0–3), dysarthria (0–2), extinction/inattention (0–2). Guides thrombolysis eligibility and outcomes prediction.
Calculates and compares Hunt-Hess and WFNS (World Federation of Neurosurgical Societies) grading for aneurysmal subarachnoid hemorrhage. Hunt-Hess uses clinical symptoms (Grade I–V). WFNS uses GCS and motor deficit (Grade I–V). Both predict mortality and guide timing of aneurysm treatment.
Calculates the original CHADS2 score for atrial fibrillation stroke risk. Assigns 1 point each for Congestive heart failure, Hypertension, Age ≥75, Diabetes mellitus, and 2 points for prior Stroke/TIA. Score 0 = low risk; 1 = intermediate; ≥2 = high risk requiring anticoagulation.
Calculates the ATRIA stroke risk score for atrial fibrillation. Assigns points: prior stroke 6pts, age ≥85 yrs 3pts, age 75–84 yrs 2pts, age 65–74 yrs 1pt, diabetes 1pt, female sex 1pt, CHF 1pt, proteinuria 1pt, eGFR <45 mL/min/1.73m² 1pt. Score 0–5 = low risk; 6 = intermediate; 7–15 = high risk.
Estimates 10-year cardiovascular risk in women by adding high-sensitivity CRP (hsCRP) and family history of premature MI to traditional Framingham variables (age, systolic BP, total cholesterol, HDL-C, smoking). Reclassifies ~40–50% of intermediate-risk women compared to Framingham alone.
Calculates non-HDL cholesterol (Total Cholesterol − HDL) and compares to risk-based targets. Non-HDL goal is 30 mg/dL above the corresponding LDL-C target: <130 mg/dL (general), <100 mg/dL (high-risk), <85 mg/dL (very high-risk ASCVD). Non-HDL captures atherogenic lipoproteins including VLDL and IDL.
Identifies discordance between LDL particle number (LDL-P) and LDL cholesterol (LDL-C). LDL-P >1000 nmol/L indicates high cardiovascular risk regardless of LDL-C level. Discordance is especially prevalent in insulin resistance, metabolic syndrome, and hypertriglyceridemia where LDL-C may underestimate atherogenic particle burden.
Evaluates Lp(a) level as an independent cardiovascular risk factor. Lp(a) >50 mg/dL (or >125 nmol/L) constitutes an independent CV risk factor. Lp(a) is genetically determined (~90% heritability), not substantially reduced by statins, and elevated in 20–25% of the global population. Informs eligibility for PCSK9 inhibitors and emerging Lp(a)-lowering therapies.
Classifies statin regimens by LDL-C reduction intensity per ACC/AHA guidelines. High-intensity statins reduce LDL-C by ≥50% (atorvastatin 40–80 mg, rosuvastatin 20–40 mg). Moderate-intensity statins reduce by 30–49%. Low-intensity statins reduce by <30%. Guides selection based on baseline risk and LDL target.
Evaluates aspirin use for primary vs secondary cardiovascular prevention. Secondary prevention: clear benefit in all patients with established CVD. Primary prevention: benefit outweighs harm only in patients aged 40–70 with high CVD risk (≥10% 10-year risk) and low bleeding risk. USPSTF recommends against initiating aspirin in adults ≥60 for primary prevention.
Determines eligibility for PCSK9 inhibitor therapy (evolocumab, alirocumab). Indicated for very high-risk patients with clinical ASCVD and LDL-C ≥70 mg/dL on maximally tolerated statin therapy (with or without ezetimibe). Also indicated for heterozygous or homozygous familial hypercholesterolemia. PCSK9 inhibitors reduce LDL-C by 50–65% and reduce MACE by 15–20%.
Interprets coronary artery calcium (CAC) Agatston score for cardiovascular risk reclassification. CAC = 0: very low risk, consider withholding statin in intermediate-risk patients. CAC 1–99: borderline-to-intermediate risk, statin therapy reasonable. CAC ≥100 or ≥75th percentile: intermediate-to-high risk, high-intensity statin recommended. CAC >400: high risk.
Calculates vancomycin dosing to achieve target AUC/MIC ratio of 400–600 mg·h/L per 2020 ASHP/IDSA/SIDP guidelines. AUC-guided dosing replaces trough-only monitoring to reduce nephrotoxicity (risk increases when AUC >600 mg·h/L). Uses two-level Bayesian estimation or first-order equations with weight-based initial dosing.
Calculates once-daily aminoglycoside dosing and monitoring interval using the Hartford nomogram. Gentamicin/tobramycin: 5–7 mg/kg; amikacin: 15–20 mg/kg IV. Draw serum level at 6–14 hours post-dose; plot on Hartford nomogram to select dosing interval (every 24h, 36h, or 48h). Excludes: CrCl <20, ascites, pregnancy, burns >20%, hemodialysis.
Calculates digoxin dosing for atrial fibrillation rate control (0.125–0.25 mg/day) and rapid digitalization for heart failure (loading: 0.25 mg IV/PO q6h × 4 doses). Goal trough level: 0.5–0.9 ng/mL for heart failure. Check levels 6–8 hours after last dose. Adjust for renal function, weight, and age. Narrow therapeutic index requires close monitoring.
Calculates unfractionated heparin dosing by indication. DVT/PE: bolus 80 units/kg + infusion 18 units/kg/h. ACS (NSTEMI/UA): bolus 60 units/kg (max 4,000 units) + infusion 12 units/kg/h (max 1,000 units/h). Target aPTT 60–100 seconds (1.5–2.5× normal). Adjust per institutional aPTT-based titration nomogram.
Calculates argatroban dosing for heparin-induced thrombocytopenia (HIT). Standard initial dose: 2 mcg/kg/min IV infusion. Reduce to 0.5 mcg/kg/min with hepatic impairment (elevated bilirubin or liver failure). Target aPTT 1.5–3× baseline (typically 45–90 seconds). Check aPTT 2 hours after initiation and each dose adjustment.
Calculates bivalirudin dosing for percutaneous coronary intervention (PCI). Bolus: 0.75 mg/kg IV, then infusion 1.75 mg/kg/h during the procedure. Post-PCI infusion (optional): reduce to 0.25 mg/kg/h for up to 4 hours. Reduce infusion by 20% if CrCl 10–29 mL/min; reduce to 0.1 mg/kg/h on hemodialysis.
Guides warfarin initiation and early dose adjustment. Starting dose: 5 mg/day for healthy adults <60; 2.5–5 mg/day for elderly, frail, or nutritionally compromised patients. Check INR at day 3–4 and adjust to target INR 2.0–3.0 (most indications) or 2.5–3.5 (mechanical mitral valve, recurrent VTE). Bridging with heparin required if thromboembolic risk is high.
Determines renal dose adjustments for NOACs. Apixaban: reduce to 2.5 mg BID if ≥2 of: age ≥80, weight ≤60 kg, creatinine ≥1.5 mg/dL. Rivaroxaban: avoid if CrCl <15 mL/min (AF); use with caution CrCl 15–30. Dabigatran: avoid if CrCl <30; reduce to 75 mg BID if CrCl 15–30 (US label). Edoxaban: 30 mg daily if CrCl 15–50 mL/min.
Calculates IV phenytoin or fosphenytoin loading dose for seizures and status epilepticus. Phenytoin: 20 mg/kg IV at ≤50 mg/min in NS (NEVER D5W — precipitates). Fosphenytoin: 20 mg PE/kg at up to 150 mg PE/min — preferred for IV use due to better tolerability. Monitor for hypotension, cardiac arrhythmias, and purple glove syndrome during infusion.
Calculates IV levetiracetam for status epilepticus and seizure treatment. Status epilepticus: 60 mg/kg (max 4,500 mg) IV over 15 minutes. Maintenance: 500–1,500 mg IV/PO twice daily. Dose reduction required for CrCl <50 mL/min. Preferred over phenytoin in many protocols due to favorable pharmacokinetics and safety profile.
Calculates IV valproate sodium (valproic acid) dosing for status epilepticus and seizure management. Loading dose: 15–45 mg/kg IV at 3–6 mg/kg/min (max rate 200 mg/min). Maintenance: 10–15 mg/kg/day divided q6–8h. Monitor for thrombocytopenia, hepatotoxicity, and hyperammonemia. Contraindicated in urea cycle disorders and mitochondrial disease.
Calculates IV labetalol dosing for hypertensive emergencies. Bolus: 20 mg IV over 2 minutes; may repeat 40–80 mg boluses q10 minutes; maximum cumulative bolus dose 300 mg. Maintenance infusion: 0.5–2 mg/min (mix 200 mg in 160 mL, run at 2 mL/min). Avoid in decompensated HF, asthma/COPD, cocaine hypertension, and bradycardia.
Calculates nicardipine IV infusion for hypertensive emergencies. Initial: 5 mg/h; increase by 2.5 mg/h every 5–15 minutes; maximum 15 mg/h. Preferred for ischemic stroke, hypertensive encephalopathy, perioperative hypertension, and when beta-blockers are contraindicated. Smooth, predictable BP reduction with easy titration.
Calculates IV hydralazine dosing for severe hypertension in pregnancy (preeclampsia/eclampsia). Dose: 5–10 mg IV over 2 minutes; repeat every 20–30 minutes as needed; maximum 20–30 mg per episode. Onset 10–20 minutes; duration 3–8 hours. Monitor fetal heart rate. Many centers now prefer IV labetalol or nicardipine due to hydralazine's unpredictable response.
Calculates dexamethasone dosing for vasogenic cerebral edema from brain tumors or abscesses. Standard: 4–10 mg IV/IM every 6 hours (16–40 mg/day). Loading dose: 10 mg IV. NOT effective for cytotoxic edema (ischemic stroke, TBI). Monitor blood glucose (steroid-induced hyperglycemia), psychiatric effects, and GI toxicity with prolonged use.
Calculates mannitol dosing for elevated intracranial pressure (ICP). Dose: 0.25–1 g/kg IV over 20 minutes; repeat every 4–6 hours as needed. Hold if serum osmolality >320 mOsm/kg or serum sodium >155 mEq/L (risk of renal failure and rebound ICP). Use 20% or 25% mannitol solution. Foley catheter required. Monitor serum electrolytes and osmolality every 4–6 hours.
Calculates patient-controlled analgesia (PCA) settings for IV morphine. Basal rate: 0.5–3 mg/h (use caution in opioid-naive patients). Bolus: 0.5–2.5 mg with lockout interval 6–10 minutes. Set 4-hour limit per institutional protocol. Requires nursing assessment at minimum every 4 hours. Titrate based on pain scores, respiratory rate, and sedation level.
Calculates fentanyl dosing for ICU analgesia. Continuous infusion: 25–200 mcg/h (0.5–2 mcg/kg/h). Bolus for acute pain: 25–50 mcg IV, onset 1–2 minutes, duration 30–60 minutes. Half-life is short (~30–60 min) with single doses but becomes prolonged (>10 hours) with continuous infusion due to adipose and muscle tissue accumulation. Daily sedation interruptions improve outcomes.
Calculates propofol infusion for ICU sedation targeting RASS −2 to 0. Typical range: 0.3–4 mg/kg/h (5–67 mcg/kg/min). Higher-dose threshold for PRIS: monitor when >5 mg/kg/h or duration >48 hours. Implement daily spontaneous awakening trials. Monitor: serum triglycerides, lactate (PRIS), urine color, and creatine kinase.
Assesses level of sedation/agitation in ICU patients using the Richmond Agitation-Sedation Scale (RASS). Range: +4 (combative) to −5 (unarousable). Target RASS −1 to 0 for most mechanically ventilated patients (light sedation). RASS −2 acceptable for procedure tolerance. RASS −3 to −5 only for specific indications (ARDS prone, severe ICP, status epilepticus). Validated tool used to guide sedation titration.
Converts between opioid medications using equianalgesic ratios. Key conversions (oral morphine equivalents): morphine oral 30 mg = IV 10 mg; oxycodone oral 20 mg; hydromorphone oral 7.5 mg or IV 1.5 mg; fentanyl transdermal patch 25 mcg/h ≈ oral morphine 60 mg/day; methadone conversion is non-linear and requires specialist guidance. Reduce dose 25–50% when switching opioids (incomplete cross-tolerance).
Calculates the Acute Physiology and Chronic Health Evaluation II (APACHE II) score for ICU mortality prediction. Comprises 12 acute physiology variables (temperature, MAP, HR, RR, oxygenation, pH, Na, K, creatinine, hematocrit, WBC, GCS) + age points + chronic health points. Total range 0–71. Each 5-point increase correlates with approximately 4% increase in predicted ICU mortality.
Calculates SOFA score across six organ systems: Respiratory (PaO2/FiO2 ratio), Coagulation (platelets), Liver (bilirubin), Cardiovascular (MAP/vasopressor dose), CNS (GCS), Renal (creatinine). Each domain scored 0–4; total 0–24. Acute increase of ≥2 points from baseline defines sepsis-related organ dysfunction per Sepsis-3 criteria.
Calculates qSOFA for rapid identification of patients at risk for sepsis-related organ dysfunction outside the ICU. Components: respiratory rate ≥22/min (1 pt), altered mentation — GCS <15 (1 pt), systolic BP ≤100 mmHg (1 pt). Score ≥2 predicts poor outcomes: sensitivity ~47%, specificity ~91% for organ dysfunction. Used as a screening prompt to assess SOFA.
Applies Sepsis-3 definitions to determine if criteria for sepsis or septic shock are met. Sepsis: suspected or confirmed infection + acute increase in SOFA score ≥2 points above baseline. Septic shock: sepsis + vasopressor requirement to maintain MAP ≥65 mmHg + serum lactate >2 mmol/L despite adequate fluid resuscitation. Replaces SIRS-based sepsis definitions.
Calculates lactate clearance rate and evaluates treatment response in sepsis. Formula: [(initial lactate − repeat lactate) / initial lactate] × 100%. Clearance ≥10% at 2 hours is associated with improved outcomes and similar mortality benefit to ScvO2 monitoring. Target lactate <2 mmol/L. Reassess every 2 hours in septic shock. Persistently elevated lactate indicates inadequate resuscitation or tissue hypoperfusion.
Calculates initial fluid resuscitation volume for sepsis-induced tissue hypoperfusion. Recommendation: 30 mL/kg IV crystalloid (normal saline or lactated Ringer's) within 3 hours of sepsis recognition. After initial bolus, reassess with dynamic measures (pulse pressure variation, passive leg raise, point-of-care echo) to guide further fluid administration and avoid fluid overload.
Provides evidence-based MAP targets and vasopressor dosing guidance for septic shock. Standard MAP target: ≥65 mmHg. Consider 80–85 mmHg if chronic hypertension (SEPSISPAM trial). Avoid targeting >75 mmHg in non-hypertensive patients — may increase atrial fibrillation. Target organ perfusion markers (urine output, lactate, mentation) alongside MAP.
Guides vasopressor selection and dosing in septic shock. First-line: norepinephrine 0.01–3 mcg/kg/min IV. Add vasopressin 0.03 units/min (fixed dose) to spare norepinephrine and reduce dose when NE >0.25 mcg/kg/min. Second-line for refractory shock: epinephrine. Phenylephrine preferred when tachyarrhythmia precludes other vasopressors. Dopamine is not recommended as first-line.
Determines when hydrocortisone should be initiated in septic shock. Indication: hemodynamic instability despite adequate fluid resuscitation AND vasopressor therapy. Dose: hydrocortisone 200 mg/day IV (50 mg q6h or 200 mg/day continuous infusion). Taper over 5–7 days when vasopressors are discontinued. Do not use low-dose hydrocortisone in patients who are NOT vasopressor-dependent.
Classifies ARDS severity per 2012 Berlin Definition. All categories require: bilateral infiltrates, respiratory failure within 1 week of clinical insult, not fully explained by cardiac failure/fluid overload, and PEEP/CPAP ≥5 cmH2O. Mild ARDS: PaO2/FiO2 200–300 mmHg. Moderate: 100–200 mmHg. Severe: <100 mmHg. Predicted mortality: mild 27%, moderate 32%, severe 45%.
Calculates ARDSnet lung-protective ventilation parameters for ARDS. Tidal volume: 6 mL/kg ideal body weight (IBW); may reduce to 4 mL/kg if needed. Plateau pressure goal: ≤30 cmH2O. Driving pressure (plateau − PEEP): target ≤15 cmH2O. Respiratory rate: 6–35/min to achieve pH 7.30–7.45. PEEP selected per high or low PEEP-FiO2 table. FiO2 goal: SpO2 88–95%.
Determines eligibility for prone positioning in ARDS and calculates session parameters. Indicated for severe ARDS with PaO2/FiO2 <150 mmHg on FiO2 ≥0.6, PEEP ≥5 cmH2O, and TV 6 mL/kg IBW after ≥12 hours of optimization. Sessions: minimum 16 hours. PROSEVA trial: 28-day mortality 16% (prone) vs 32.8% (supine) in severe ARDS. Continue daily sessions until PF consistently >150 after resupination.
Calculates cisatracurium dosing for neuromuscular blockade (NMB) in ARDS. Cisatracurium: 15 mg IV bolus then 37.5 mg/h (0–21 mcg/kg/min) continuous infusion for 48 hours. Indicated when PaO2/FiO2 <150 with significant ventilator dyssynchrony. ACURASYS trial showed 90-day mortality benefit; ROSE trial showed no benefit with NMB for all moderate-severe ARDS. Current guidelines: consider in severe dyssynchrony.
Evaluates safety criteria for spontaneous awakening trials (SAT) in mechanically ventilated ICU patients. Safety screen PASS criteria: off sedation or low infusion, no agitation (RASS ≤2), SpO2 >88%, RR <35/min, pH >7.25, FiO2 ≤0.70, PEEP ≤10 cmH2O. FAIL criteria: active seizures, alcohol withdrawal, elevated ICP, open abdomen, ongoing NMB. SAT followed by SBT improves extubation rates and reduces ICU LOS.
Assesses spontaneous breathing trial (SBT) success or failure for extubation readiness. Trial method: CPAP 5 cmH2O or T-piece for 30–120 minutes. PASS criteria: RR <35/min, SpO2 >90%, HR and RR within 20% of baseline, no use of accessory muscles, no diaphoresis, no agitation or distress. FAIL: any of the above violated. Consider RSBI (RR/Vt) <105 as additional predictor.
Calculates the Rapid Shallow Breathing Index (RSBI) for predicting extubation success. Formula: RSBI = Respiratory Rate (breaths/min) / Tidal Volume (liters). RSBI <105 predicts successful extubation with ~78–80% sensitivity and specificity. RSBI <80 is a stronger predictor. RSBI >105 predicts extubation failure. Measure during T-piece or low-pressure support trial.
Guides enteral nutrition (EN) initiation timing and route selection in critically ill patients. Start EN within 24–48 hours of ICU admission when hemodynamically stable (not on escalating vasopressors). Gastric EN is first-line; post-pyloric (jejunal) EN for gastroparesis, high GRV, or aspiration risk. EN is preferred over parenteral nutrition (PN) — lower infection rates, lower cost, preserves gut integrity.
Calculates caloric targets for critically ill patients by phase. Acute phase (days 1–3): 20–25 kcal/kg/day (permissive underfeeding avoids hyperglycemia and overfeeding complications). Stable/recovery phase (day 4+): 25–30 kcal/kg/day. Avoid overfeeding (>35 kcal/kg): increases CO2 production, hepatic steatosis, and infection risk. Use actual body weight for non-obese; adjusted weight for BMI >30.
Calculates protein targets for critically ill patients. Standard critically ill: 1.2–2 g/kg/day. Burns >20% BSA or major trauma: 2–2.5 g/kg/day. Severe AKI not on RRT: may reduce to 0.8–1.0 g/kg to reduce BUN. CRRT: increase to 1.5–2.5 g/kg to replace dialysis losses. Hepatic encephalopathy: not a reason to restrict protein — use 1.2–1.5 g/kg standard amino acids.
Stratifies community-acquired pneumonia patients into five risk classes (I–V) using demographic factors, comorbidities, physical exam findings, and laboratory values to guide inpatient vs. outpatient management.
Predicts 30-day mortality in community-acquired pneumonia using Confusion, Urea >7 mmol/L, Respiratory rate ≥30, low Blood pressure, and age ≥65. Score 0–1 = low risk (outpatient); 2 = moderate (consider admission); 3–5 = high risk (hospital required).
Clinical prediction rule to determine whether lumbar puncture is indicated in suspected bacterial meningitis, incorporating fever, neck stiffness, altered mental status, and skin petechiae to estimate pre-test probability.
Identifies Systemic Inflammatory Response Syndrome (SIRS) requiring ≥2 of: temperature >38°C or <36°C, heart rate >90 bpm, respiratory rate >20/min or PaCO₂ <32 mmHg, WBC >12,000/µL or <4,000/µL or >10% bands.
Interprets serum procalcitonin levels: <0.1 ng/mL = no infection; 0.1–0.5 = possible local infection; >0.5 = bacterial infection likely; >2 = severe sepsis; >10 ng/mL = septic shock. Guides antibiotic initiation and de-escalation.
Interprets serum CRP levels: <1 mg/L = low cardiovascular risk; 1–3 = intermediate CV risk; 3–10 = mild to moderate inflammation; 10–100 = significant inflammation or infection; >100 mg/L = severe bacterial infection, burn, or trauma.
Determines ART initiation threshold: start ART for all HIV-positive individuals regardless of CD4 count (current guidelines); historically CD4 <350 cells/µL was the threshold. Undetectable viral load (<200 copies/mL) confirms treatment success and prevents transmission.
Guides ARV regimen selection based on resistance testing, prior therapy, HLA-B*5701 status, and renal function. Preferred first-line: bictegravir/tenofovir AF/emtricitabine or dolutegravir + tenofovir/emtricitabine.
Determines antiviral therapy for chronic HBV: HBeAg-positive with HBV DNA >20,000 IU/mL and elevated ALT; HBeAg-negative with HBV DNA >2,000 IU/mL and elevated ALT or significant fibrosis on biopsy.
Determines HCV treatment regimen and duration by genotype: Genotype 1a/1b — sofosbuvir/ledipasvir 8–12 weeks (treatment-naive, no cirrhosis) or 12–24 weeks (cirrhosis). Genotype 2 — sofosbuvir/velpatasvir 12 weeks. Genotype 3 — 12–24 weeks depending on cirrhosis.
Diagnoses infective endocarditis using major criteria (≥2 positive blood cultures with typical organisms, new valvular regurgitation or echo vegetation) and minor criteria (predisposing heart condition, IV drug use, fever >38°C, vascular phenomena, immunologic phenomena). Definite: 2 major OR 1 major+3 minor OR 5 minor.
Guides oseltamivir (Tamiflu) and baloxavir timing: most effective when started within 48 hours of symptom onset. Reduces duration by 1–2 days and risk of complications. Recommended for high-risk patients (age >65, pregnancy, immunosuppression) regardless of symptom duration.
WHO 2015 criteria for severe P. falciparum malaria: impaired consciousness/coma (cerebral malaria), prostration, multiple convulsions, respiratory distress, pulmonary oedema, abnormal bleeding, jaundice + other organ dysfunction, hyperparasitaemia (>10%), hypoglycaemia (<2.2 mmol/L), severe anaemia (Hb <70 g/L), renal failure, circulatory collapse.
Classifies Lyme disease into three stages: (1) Early localized — erythema migrans, single lesion, 3–30 days post-tick bite; (2) Early disseminated — multiple EM, carditis, facial palsy, meningitis, days to weeks post-bite; (3) Late disseminated — Lyme arthritis, encephalopathy, months to years post-bite.
Standard DOTS regimen for drug-sensitive pulmonary TB: Intensive phase — isoniazid (H) + rifampicin (R) + pyrazinamide (Z) + ethambutol (E) × 2 months. Continuation phase — isoniazid + rifampicin × 4 months. Total: 6 months. MDR-TB requires second-line agents for ≥20 months.
Classifies CDI severity per IDSA/SHEA 2021: Non-severe — WBC ≤15,000/µL and serum creatinine <1.5 mg/dL. Severe — WBC >15,000/µL or creatinine ≥1.5 mg/dL. Fulminant — hypotension, shock, ileus, or toxic megacolon.
Guides empiric antibiotic therapy: CAP — amoxicillin ± macrolide (outpatient), β-lactam + macrolide or respiratory FQ (inpatient). HAP/VAP — piperacillin-tazobactam + vancomycin ± aminoglycoside. UTI (uncomplicated) — nitrofurantoin or TMP-SMX. Skin/soft tissue — cephalexin (mild), vancomycin (MRSA risk). Intra-abdominal — piperacillin-tazobactam or cefoxitin.
Classifies surgical risk: ASA I (healthy patient), ASA II (mild systemic disease), ASA III (severe systemic disease), ASA IV (severe disease — constant threat to life), ASA V (moribund, not expected to survive without surgery), ASA VI (brain-dead, organ donation).
Predicts intubation difficulty by visualizing oropharynx with mouth open and tongue protruded: Class I — soft palate, uvula, fauces, pillars fully visible; Class II — soft palate, uvula visible; Class III — soft palate, base of uvula; Class IV — only hard palate visible.
Estimates MACE risk for non-cardiac surgery using 6 predictors (1 point each): high-risk surgery, ischemic heart disease, CHF, cerebrovascular disease, insulin-dependent diabetes, pre-operative creatinine >2.0 mg/dL. Score 0: <1%; 1: 1%; 2: 2.4%; ≥3: 5.4% risk of major cardiac events.
Portsmouth-POSSUM predicts 30-day morbidity and mortality from 12 physiological variables (age, cardiac/respiratory signs, systolic BP, pulse, GCS, Hb, WBC, urea, Na, K, ECG) and 6 operative variables (magnitude, number of procedures, blood loss, peritoneal soiling, malignancy, urgency).
Estimate patient-specific odds of death, any complication, surgical site infection, and prolonged length of stay using the ACS NSQIP model, which pairs a CPT procedure code with twenty preoperative variables drawn from over five million operations.
Estimates surgical blood loss: weighing sponges (1 g ≈ 1 mL blood), canister volume minus irrigation, visual estimation by procedure type. Typical blood loss: appendectomy 50–100 mL, cholecystectomy 100–200 mL, bowel resection 200–500 mL, hip replacement 200–500 mL, Whipple 500–1500 mL.
Calculates intraoperative fluid requirements: crystalloid replacement = 3 mL per 1 mL estimated blood loss (EBL). Total fluids = maintenance rate (4-2-1 rule) × hours + third space losses (2–8 mL/kg/hr by surgical trauma level) + 3:1 crystalloid:blood replacement for EBL.
Confusion Assessment Method for the ICU (CAM-ICU) diagnoses delirium in intubated/non-verbal patients using 4 features: (1) Acute onset or fluctuating course; (2) Inattention; (3) Altered level of consciousness (RASS ≠ 0); (4) Disorganized thinking. Positive if features 1+2+3 OR 1+2+4.
Stratifies VTE risk in surgical patients: Low (score 0–1) — early ambulation; Moderate (2) — pharmacologic prophylaxis (LMWH or UFH); High (3–4) — LMWH + mechanical; Highest (≥5) — LMWH + mechanical ± extended prophylaxis for 28 days. Weighted factors include age, surgery duration, BMI, prior DVT/PE, thrombophilia.
Pre-test probability for DVT: score <0 = DVT unlikely (0.6%); 1–2 = moderate (17%); ≥3 = DVT likely (75%). Points awarded for active cancer, paralysis/plaster cast, bedridden >3 days/major surgery within 12 weeks, localized tenderness, entire leg swelling, calf swelling >3 cm, pitting oedema, collateral veins. Subtract 2 if alternative diagnosis as likely.
Estimates PE pre-test probability: ≤4 points = PE unlikely (12.1% prevalence); >4 = PE likely (37%). Points: clinical signs of DVT (3), no alternative diagnosis (3), heart rate >100 (1.5), immobilization/surgery in past 4 weeks (1.5), prior DVT/PE (1.5), haemoptysis (1), malignancy (1).
Estimates time to emergence by anesthetic agent: Desflurane (context-sensitive half-life ~5 min) — fastest emergence; Sevoflurane (~10–15 min); Isoflurane (~20–30 min); Propofol TIVA (~5–10 min); Ketamine (~15–20 min after dissociative dose). Influenced by duration, depth, patient age, BMI, and opioid co-administration.
Calculates propofol induction dose: standard adult 1.5–2.5 mg/kg IV (titrated to effect). Reduced doses for elderly (0.5–1.5 mg/kg), ASA III–IV (1.0–1.5 mg/kg), or with opioid co-induction (1.0–1.5 mg/kg). Inject slowly (10 mg every 10 seconds) to minimize apnea and hypotension.
Calculates ketamine for dissociative anesthesia or procedural sedation: IV induction 1–2 mg/kg (onset 30–60 sec, duration 10–15 min); IM 4–6 mg/kg (onset 3–5 min); sub-dissociative analgesia 0.1–0.3 mg/kg IV. Maintain airway reflexes; consider pre-treating with midazolam to reduce emergence delirium.
Calculates succinylcholine for rapid sequence intubation: 1.5 mg/kg IV (maximum 200 mg), onset 45–60 seconds, duration 10–12 minutes. Paediatric dose 2 mg/kg. Contraindicated in: >24h post-burn/crush/denervation (hyperkalemia risk), known pseudocholinesterase deficiency, personal/family history of malignant hyperthermia, myopathy.
Calculates rocuronium for RSI: 1.2 mg/kg IV (3× ED95), onset 60 seconds, duration 45–60 minutes. Standard intubating dose: 0.6 mg/kg (onset 90–120 sec). Fully reversed by sugammadex 16 mg/kg at 1.2 mg/kg RSI dose. Preferred alternative when succinylcholine is contraindicated.
Grades laryngoscopic view: Grade I — full glottis visible; Grade II — posterior glottis and arytenoids visible; Grade IIb — only arytenoids visible; Grade III — only epiglottis seen; Grade IV — epiglottis not visible. Grades III–IV indicate difficult intubation; video laryngoscopy or awake fibreoptic intubation should be prepared.
Calculates estimated gestational age and due date using Naegele's Rule: EDD = LMP + 280 days (40 weeks). Alternatively: EDD = LMP + 1 year − 3 months + 7 days. Gestational age in weeks = (today − LMP) ÷ 7. Crown-rump length ultrasound is most accurate before 14 weeks.
Estimates gestational age from symphysis-fundal height (SFH): fundal height in centimetres approximately equals weeks of gestation ± 3 cm between 20–36 weeks. SFH <3rd percentile for gestational age or lagging by ≥4 cm suggests fetal growth restriction; SFH >3 cm above dates suggests macrosomia or polyhydramnios.
Assesses cervical favourability for labour induction: Dilation (0–3 points), Effacement (0–3), Station (0–3), Consistency (firm/medium/soft, 0–2), Position (posterior/mid/anterior, 0–2). Total score 0–13. Score ≥8 = favourable cervix, high induction success. Score <6 = unfavourable, cervical ripening recommended.
Intrapartum GBS prophylaxis is indicated for: positive rectovaginal GBS culture at 35–37 weeks; GBS bacteriuria this pregnancy; prior infant with GBS disease; unknown GBS status with risk factors (delivery <37 weeks, ROM ≥18 hours, intrapartum fever ≥38°C, intrapartum NAAT positive). Penicillin G 5 million units IV then 2.5–3 million units q4h until delivery.
Preeclampsia: BP ≥140/90 mmHg on 2 occasions ≥4 hours apart after 20 weeks, PLUS proteinuria (≥300 mg/24h, PCR ≥0.3, or dipstick ≥2+), OR severe features without proteinuria (thrombocytopenia <100k, renal insufficiency Cr >1.1 mg/dL, impaired liver function LFTs ×2 normal, pulmonary oedema, headache, visual disturbances).
HELLP syndrome diagnosis: Hemolysis (abnormal peripheral smear or LDH ≥600 IU/L or bilirubin ≥1.2 mg/dL); Elevated Liver enzymes (AST/ALT ≥2× upper normal); Low Platelets (<100,000/µL). Tennessee classification: Class 1 (<50k), Class 2 (50–100k), Class 3 (100–150k). All classes require delivery.
Seizure prophylaxis in severe preeclampsia: Loading dose 4 g IV over 15–20 minutes, then maintenance 1–2 g/hr continuous infusion. Monitor for toxicity: loss of patellar reflexes (8–12 mg/dL) → respiratory depression (12–16 mg/dL) → cardiac arrest (>15 mg/dL). Antidote: calcium gluconate 1 g IV.
Antenatal corticosteroids for preterm birth <34 weeks: Betamethasone 12 mg IM × 2 doses, 24 hours apart (or dexamethasone 6 mg IM q12h × 4 doses). Benefit window: 24–34 weeks (strongest evidence); consider at 22–23 weeks for periviable infants. Peak effect: 48 hours–7 days after first dose. Reduces RDS, IVH, NEC, and neonatal mortality by ~40%.
Two-step approach (ACOG): 1-hour 50g GCT ≥140 mg/dL is positive screen; 3-hour 100g OGTT diagnoses GDM if ≥2 values exceed: fasting ≥95, 1hr ≥180, 2hr ≥155, 3hr ≥140 mg/dL. One-step approach (ADA): 75g OGTT diagnoses GDM if any value exceeds fasting ≥92, 1hr ≥180, or 2hr ≥153 mg/dL.
ACOG/ADA glycemic targets for gestational diabetes: Fasting <95 mg/dL (5.3 mmol/L); 1-hour postprandial <140 mg/dL (7.8 mmol/L); 2-hour postprandial <120 mg/dL (6.7 mmol/L). HbA1c goal <6% in GDM. Initiate insulin if dietary targets not met after 1–2 weeks of MNT.
Antenatal corticosteroids reduce neonatal morbidity and mortality when given for threatened preterm birth. Strongest benefit: 24–34 weeks. Benefit at 34–36+6 weeks (late preterm): reduces RDS and NICU admission. Periviable (22–23 weeks): consider with neonatal team. No benefit at ≥37 weeks. Administer both doses before delivery for maximum effect.
Predicts likelihood of vaginal delivery following labour induction based on Bishop score: ≥8 = high success rate (~95%), similar to spontaneous labour; 6–7 = moderate (70–80%); 4–5 = fair (50–70%); <4 = low (<50%), cervical ripening strongly recommended. Nulliparity and post-dates reduce success at any given score.
Assesses neonatal condition at 1 and 5 minutes: Appearance (skin colour), Pulse (HR), Grimace (reflex irritability), Activity (muscle tone), Respiration — each scored 0–2. Total 0–10. 7–10 = normal; 4–6 = moderate depression (stimulation, O₂); 0–3 = severe depression (resuscitation required). Repeat at 5 min and every 5 min until ≥7 if <7 at 5 min.
PPH defined as: blood loss >500 mL after vaginal delivery or >1,000 mL after cesarean delivery (ACOG), or any blood loss causing hemodynamic instability. Primary PPH occurs within 24 hours; secondary PPH at 24 hours to 12 weeks. Management: uterotonic agents (oxytocin, ergometrine, carboprost, misoprostol), bimanual compression, intrauterine balloon, surgical (B-Lynch, hysterectomy).
Low-dose oxytocin induction: start 0.5–2 mU/min, increase by 1–2 mU/min every 15–40 minutes until adequate contractions (3–5 per 10 min, 40–60 sec duration). Maximum dose typically 20–40 mU/min. High-dose protocol: start 4–6 mU/min, increase every 15–20 min. Monitor for tachysystole (>5 contractions/10 min).
Active labor begins at 6 cm dilation (contemporary Friedman curve). Expected dilation rate: ≥1 cm/hr in active phase (≥6 cm) for nulliparas and multiparas. Arrest of active phase: no cervical change in ≥4 hours with adequate contractions, or ≥6 hours with inadequate contractions. Latent phase prolongation: >20 hours nulliparas, >14 hours multiparas.
Calculates the Psoriasis Area and Severity Index (PASI) across four body regions (head, trunk, upper limbs, lower limbs). Scores range 0–72; mild <7, moderate 7–12, severe ≥12. Used to assess psoriasis severity and guide biologic therapy decisions.
Calculates the Disease Activity Score in 28 joints (DAS28) using tender joint count, swollen joint count, ESR or CRP, and patient global assessment. Remission <2.6, low activity <3.2, moderate 3.2–5.1, high ≥5.1.
Calculates the Simplified Disease Activity Index (SDAI) for RA using tender joint count (28), swollen joint count (28), patient global assessment, physician global assessment, and CRP (mg/dL). Remission ≤3.3, low ≤11, moderate ≤26, high >26.
Calculates the Clinical Disease Activity Index (CDAI) for RA without laboratory tests. Uses tender joint count (28), swollen joint count (28), patient global (0–10), and physician global (0–10). Remission ≤2.8, low ≤10, moderate ≤22, high >22.
Scores the 2010 ACR/EULAR rheumatoid arthritis classification criteria across four domains: joint involvement (0–5), serology (0–3), acute-phase reactants (0–1), and symptom duration (0–1). Score ≥6 out of 10 classifies as definite RA.
Applies the 2012 SLICC criteria for systemic lupus erythematosus (SLE) classification. Diagnosis requires ≥4 of 11 clinical criteria plus ≥1 immunological criteria, or biopsy-proven lupus nephritis plus ANA or anti-dsDNA.
Calculates the SLE Disease Activity Index 2000 (SLEDAI-2K), a weighted 24-item score assessing SLE disease activity across neurological, vascular, renal, musculoskeletal, serosal, skin, immunological, and constitutional domains. Scores >20 indicate very high activity.
Scores the 2015 ACR/EULAR gout classification criteria. Step 1 entry criterion: at least one episode of peripheral joint/bursa swelling/pain. Step 2: if MSU crystals identified = classified as gout. Step 3: scored domains (clinical, lab, imaging) — score ≥8 classifies as gout.
Evaluates serum uric acid levels against treatment thresholds. Treatment is indicated when uric acid >6 mg/dL with confirmed gout or urate-lowering therapy history. Target for most gout patients is <6 mg/dL; for tophaceous gout, <5 mg/dL.
Calculates the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) from 6 questions covering fatigue, spinal pain, joint pain, peripheral enthesitis, morning stiffness intensity, and morning stiffness duration. Score 0–10; ≥4 indicates high disease activity warranting therapy change.
Calculates the Disease Activity in PSoriatic Arthritis (DAPSA) score using tender joint count (68 joints), swollen joint count (66 joints), patient global assessment (0–10 VAS), patient pain VAS (0–10), and CRP (mg/dL). Remission ≤4, low ≤14, moderate ≤28, high >28.
Applies the 2010 ACR fibromyalgia diagnostic criteria using the Widespread Pain Index (WPI, 0–19) and Symptom Severity Scale (SS, 0–12). Fibromyalgia is diagnosed if: WPI ≥7 and SS ≥5, OR WPI 3–6 and SS ≥9. Symptoms must be present for ≥3 months.
Evaluates skin lesions using the ABCDE criteria for melanoma: Asymmetry, Border irregularity, Color variation, Diameter >6 mm, and Evolution (change over time). Each positive criterion raises concern; 3+ criteria warrant dermatology referral or biopsy.
Scores dermoscopic lesion asymmetry (0–2) and border abruptness (0–8 segments) as part of the ABSI (Asymmetry, Border, Structure, Irregularity) system. Higher scores indicate greater concern for malignancy. Used alongside full ABCD rule in dermatoscopy.
Evaluates probability of erythema migrans being due to Lyme disease based on lesion characteristics: expanding erythema, central clearing (bull's-eye pattern), tick exposure history, lesion size ≥5 cm, and days since tick bite (3–30 days). Guides empiric antibiotic initiation.
Assesses completeness of the reactive arthritis (ReA) classical triad: arthritis, urethritis/cervicitis, and conjunctivitis/uveitis following a triggering infection. Complete triad present in ~33% of cases; incomplete triad (≥2 components post-infection) is more common.
Calculates the modified Wells clinical prediction score for deep vein thrombosis (DVT) probability, particularly relevant in rheumatic disease patients who have elevated baseline clot risk. Score ≥2: high probability (75% DVT); 1: moderate (17%); ≤0: low (3%). Guides D-dimer and duplex ultrasound decision-making.
Converts Snellen visual acuity fractions (20/20, 20/40, 20/200, etc.) to decimal notation and LogMAR values. 20/20 = 1.0 decimal = 0.0 LogMAR; 20/40 = 0.5 = 0.3 LogMAR; 20/200 = 0.1 = 1.0 LogMAR. Used to standardize acuity reporting across international systems.
Interprets intraocular pressure (IOP) measurements in the context of glaucoma risk. Normal IOP: 10–21 mmHg. Ocular hypertension: >21 mmHg. Confirmed glaucomatous range: typically >25 mmHg with optic nerve changes. Low-tension glaucoma can occur at normal IOP.
Calculates the cup-to-disc ratio (CDR) from optic nerve head measurements. Normal CDR <0.6; suspicious >0.6–0.7; high glaucoma risk >0.8. Asymmetry ≥0.2 between eyes is also a red flag. Used alongside IOP and visual field testing for glaucoma assessment.
Classifies diabetic retinopathy severity by the International Clinical Diabetic Retinopathy scale: No DR, Mild NPDR (microaneurysms only), Moderate NPDR (more than mild, less than severe), Severe NPDR (4-2-1 rule), Proliferative DR (PDR). Guides follow-up intervals and treatment urgency.
Classifies AMD severity by AREDS2 categories based on drusen size and pigmentary changes: Category 1 (no AMD), Category 2 (early AMD — small drusen), Category 3 (intermediate AMD — medium/large drusen or geographic atrophy <1 disc area), Category 4 (advanced AMD — geographic atrophy or neovascular AMD).
Calculates intraocular lens (IOL) power for cataract surgery using the SRK-T formula: P = A − 0.9K − 2.5L, where A is the lens constant, K is average keratometry (diopters), and L is axial length (mm). The SRK-T formula is preferred for eyes with axial length >24.5 mm.
Calculates spherical equivalent (SE = sphere + cylinder/2) from spectacle prescription components. Converts between plus and minus cylinder notation. Classifies refractive error: myopia (negative SE), hyperopia (positive SE), astigmatism (cylinder ≠0), and emmetropia (SE ≈ 0).
Interprets Humphrey visual field mean deviation (MD) values for glaucoma staging. MD 0 to −2 dB: normal/borderline. MD −2 to −6 dB: mild loss. MD −6 to −12 dB: moderate loss. MD < −12 dB: severe loss. Used to classify glaucoma severity and guide surgical decisions.
Grades palatine tonsil size on the standard 0–4 scale: Grade 0 (tonsillectomy/absent), Grade 1 (<25% of oropharyngeal width), Grade 2 (25–50%), Grade 3 (50–75%), Grade 4 (>75%, "kissing tonsils"). Guides surgical decision-making for pediatric sleep apnea and recurrent tonsillitis.
Calculates the Nasal Obstruction Symptom Evaluation (NOSE) scale score from 5 items: nasal congestion, nasal blockage, trouble breathing through nose, trouble sleeping, and inability to get enough air during exercise. Each item scored 0–4 (×5 = 0–100). Mild <25, moderate 25–49, severe 50–74, extreme 75–100.
Screens for obstructive sleep apnea (OSA) risk using the 8-item STOP-BANG questionnaire: Snoring, Tired, Observed apneas, Pressure (hypertension), BMI >35, Age >50, Neck >40 cm, Gender (male). Score 0–2: low risk; 3–4: intermediate risk; ≥5: high risk for moderate-to-severe OSA.
Calculates the pure tone average (PTA) hearing threshold from audiogram values at 500 Hz, 1000 Hz, and 2000 Hz. PTA = (threshold 500 Hz + threshold 1000 Hz + threshold 2000 Hz) / 3. Normal ≤25 dB HL; mild loss 26–40; moderate 41–55; moderately severe 56–70; severe 71–90; profound >90 dB HL.
Assesses speech reception threshold in noise (SRTN) using the Hearing in Noise Test (HINT). Measures the signal-to-noise ratio (SNR) at which a listener correctly repeats 50% of sentences. Normal HINT score approximately 0 dB SNR. Higher (more positive) scores indicate worse performance in noise.
Calculates the Dizziness Handicap Inventory (DHI) from 25 items across functional (9 items), emotional (9 items), and physical (7 items) subscales. Each item: Yes=4, Sometimes=2, No=0. Total 0–100; 0–30 mild handicap, 31–60 moderate, 61–100 severe vestibular handicap.
Interprets corneal topography keratometry (K) readings. Normal flat K: 40–47 D; normal steep K: 40–47 D. Astigmatism = K steep − K flat. Average K > 48 D suggests corneal steepening (keratoconus screening). K < 40 D suggests flat cornea. Mean K guides IOL selection and contact lens fitting.
Compares IOP measurements from Goldmann applanation tonometry (GAT, gold standard) versus non-contact tonometry (NCT/air puff). NCT readings are typically 1–3 mmHg higher than GAT. Adjusts NCT readings based on published correlation data to estimate GAT-equivalent IOP.
Calculates the modified Wells clinical prediction score for DVT, incorporating bilateral leg swelling as a key clinical feature. Bilateral non-pitting edema is common in ocular/ENT-related conditions with systemic venous compromise. Score ≥2: high probability; 1: moderate; ≤0: low probability. Guides ultrasound and D-dimer testing.
Calculates the Harris Hip Score (HHS) from four domains: pain (44 points), function (47 points), absence of deformity (4 points), and range of motion (5 points). Total 0–100. Excellent ≥90, good 80–89, fair 70–79, poor <70. Standard outcome measure for hip arthroplasty.
Calculates the Knee Osteoarthritis Outcome Score (KOOS) across five subscales: Symptoms, Pain, Activities of Daily Living (ADL), Sport/Recreation, and Quality of Life. Each subscale scored 0–100 (100 = no problems). Used to assess knee OA and surgical outcomes.
Calculates the WOMAC arthritis index from three subscales: Pain (5 items), Stiffness (2 items), and Physical Function (17 items). Likert version: 0–4 per item. Higher scores = worse function. Total score 0–96 (Likert) or 0–240mm (VAS). Used in hip and knee OA.
Rates a patient's activity level from 0 to 10: Level 0 (sick leave or disability pension due to knee), Level 5 (recreational sports), Level 6 (recreational football twice/week), up to Level 10 (national or international elite competitive sport). Used before and after ACL reconstruction.
Calculates the Lysholm Knee Score (0–100) from 8 domains: limp (5 pts), support (5 pts), locking (15 pts), instability (25 pts), pain (25 pts), swelling (10 pts), stair climbing (10 pts), and squatting (5 pts). Excellent ≥95, good 84–94, fair 65–83, poor <65.
Calculates pain intensity using the Visual Analog Scale (VAS), a 100mm line anchored at "no pain" (0 mm) and "worst imaginable pain" (100 mm). Mild pain: 0–30 mm; moderate: 31–70 mm; severe: 71–100 mm. VAS is used in clinical trials and chronic pain monitoring.
Assesses pain using the Numeric Rating Scale (NRS), an 11-point integer scale from 0 (no pain) to 10 (worst imaginable pain). Mild pain: 1–3; moderate: 4–6; severe: 7–10. NRS is the most widely used clinical pain scale due to ease of verbal and written administration.
Calculates the Oswestry Disability Index (ODI) from 10 sections (pain intensity, personal care, lifting, walking, sitting, standing, sleeping, social life, traveling, and changing degree of pain), each scored 0–5. ODI % = (sum / 50) × 100. Minimal disability 0–20%, moderate 21–40%, severe 41–60%, crippled 61–80%, bed-bound 81–100%.
Calculates the Roland-Morris Disability Questionnaire (RMDQ) score from 24 yes/no items describing limitations due to low back pain. Score 0–24; higher = greater disability. Score >14 indicates severe disability. More sensitive than ODI for mild-to-moderate back pain.
Calculates the Neck Disability Index (NDI) from 10 sections (pain intensity, personal care, lifting, reading, headaches, concentration, work, driving, sleeping, recreation), each scored 0–5. Total 0–50. Mild disability 0–8 (0–16%), moderate 10–28 (20–56%), severe 30–38 (60–76%), complete 40–50 (80–100%).
Calculates the Disabilities of Arm, Shoulder and Hand (DASH) questionnaire score from 30 items covering physical function (21 items), symptoms (6 items), social function (1 item), work (1 item), and sleep (1 item). Score 0–100; 0 = no disability, 100 = most severe disability.
Grades muscle spasticity using the Modified Ashworth Scale (MAS): Grade 0 (no increase in tone), Grade 1 (slight increase, catch-and-release), Grade 1+ (catch followed by minimal resistance throughout ≤half of ROM), Grade 2 (marked increase, moved easily), Grade 3 (considerable increase, passive movement difficult), Grade 4 (affected part rigid in flexion or extension).
Classifies stroke motor recovery into 6 stages: Stage 1 (flaccidity, no voluntary movement), Stage 2 (spasticity appears, basic limb synergies emerge), Stage 3 (spasticity peaks, voluntary synergy control), Stage 4 (spasticity decreases, movements deviating from synergy possible), Stage 5 (complex combinations possible), Stage 6 (near-normal, coordination and speed deficits only).
Overview of the Fugl-Meyer Assessment (FMA) for post-stroke motor recovery. Upper extremity (UE): 0–66 points; lower extremity (LE): 0–34 points. Total motor: 0–100. Severe impairment: <50 UE; mild: >50 UE. Also includes balance (14), sensation (24), passive joint motion (44), and joint pain (44).
Classifies walking ability using the Functional Ambulation Categories (FAC), a 6-level scale: 0 (non-ambulatory/complete assistance needed), 1 (continuous manual support), 2 (intermittent support or guarding), 3 (supervision only), 4 (independent on level surfaces), 5 (fully independent including stairs, inclines, and uneven terrain).
Overview of the SF-36 Physical Component Summary (PCS) calculation. The PCS is derived from 8 SF-36 subscales using factor scoring: Physical Functioning (PF), Role-Physical (RP), Bodily Pain (BP), and General Health (GH) load most heavily on PCS. Norm-based score: mean 50, SD 10 in the US general population.
Score the 9-item PHQ-9 to screen and monitor depression severity. Scores 0-4 minimal, 5-9 mild, 10-14 moderate, 15-19 moderately severe, 20+ severe depression.
Calculate GAD-7 score for generalized anxiety disorder screening. Scores 0-4 minimal, 5-9 mild, 10-14 moderate, 15-21 severe anxiety.
Screen for bipolar spectrum disorder using the MDQ. A positive screen requires 7 or more symptom responses plus functional impairment from those symptoms occurring in the same time period.
WHO 10-item AUDIT screen for hazardous and harmful alcohol use. Scores 0-7 low risk, 8-15 hazardous drinking, 16-19 harmful use, 20+ probable alcohol dependence.
Brief 4-item CAGE questionnaire to screen for alcohol use disorder. A score of 2 or more indicates significant concern for alcohol dependence and warrants further assessment.
Interpret the 10-item DAST-10 for drug abuse severity. Scores: 0 no risk, 1-2 low, 3-5 moderate, 6-8 substantial, 9-10 severe drug-related problems.
Score the PCL-5 for PTSD symptom severity in adults. A total score of 31-33 or higher suggests probable PTSD diagnosis. Covers intrusion, avoidance, negative cognitions, and hyperarousal clusters per DSM-5.
Assess suicidal ideation intensity and behavior using the C-SSRS. Captures passive ideation, active ideation with or without intent, plan, and preparatory behaviors to stratify suicide risk.
Quantify functional impairment across three life domains: work/school, social life, and family/home responsibilities. Each domain scored 0-10; total 0-30 with higher scores indicating greater disability.
Measure OCD severity with Y-BOCS. Scores 0-7 subclinical, 8-15 mild, 16-23 moderate, 24-31 severe, 32-40 extreme OCD. Assesses obsession and compulsion subscales separately.
Assess sleep quality over the past month using PSQI. Global score above 5 identifies poor sleepers with sensitivity 89.6% and specificity 86.5%. Covers 7 components including latency, duration, and efficiency.
Score the ISI to quantify insomnia severity. Total scores 0-7 no clinically significant insomnia, 8-14 subthreshold, 15-21 moderate clinical insomnia, 22-28 severe clinical insomnia.
Screen for eating disorders with the 5-item SCOFF questionnaire. A score of 2 or more positive responses indicates a likely case of anorexia nervosa or bulimia nervosa requiring further evaluation.
Score the BDI-II 21-item self-report depression measure. Scores 0-13 minimal depression, 14-19 mild, 20-28 moderate, 29-63 severe depression. Aligned with DSM-IV depressive symptoms.
Clinician-rated HAM-A for anxiety severity. Scores 0-14 mild anxiety, 15-19 mild to moderate, 20-24 moderate, 25-30 moderate to severe, 31 and above severe anxiety. Assesses 14 psychic and somatic items.
Score AIMS to assess tardive dyskinesia severity in patients on antipsychotics. Items 1-7 rate specific body regions (0-4 each), items 8-10 rate global severity, with maximum total of 28 for the movement subscale.
Score the Liebowitz Social Anxiety Scale (0-144). Scores 55-64 moderate, 65-79 marked, 80-94 severe, 95 and above very severe social anxiety. Separately rates fear and avoidance across 24 social and performance situations.
Score PCDAI for pediatric Crohn's disease activity. Scores below 10 indicate remission, 10-27.5 mild, 30-37.5 moderate, 40 or above severe disease. Includes abdominal pain, stool frequency, physician global assessment, weight, and labs.
Grade ulcerative colitis activity in children with the six-item PUCAI, a purely clinical index that needs no blood work or endoscopy. Remission is under 10 points, mild 10 to 34, moderate 35 to 64, and severe 65 or more.
Calculate growth velocity percentile (cm/year) by sex and age using WHO reference data. Growth velocity below the 3rd percentile may indicate growth failure and warrants investigation for underlying conditions.
Determine Tanner stage (1-5) based on breast development in females or testicular volume and pubic hair in males. Stage 1 is prepubertal and Stage 5 represents adult maturity. Links staging to typical age ranges.
Predict menarche age using maternal age at menarche and estimate adult height from mid-parental height or bone age radiograph. Girls typically reach menarche 2-3 years after breast budding.
Calculate BMI percentile for children ages 2-19 using CDC growth charts. BMI 85th to below 95th percentile = overweight; 95th percentile or above = obese; 120% or above of the 95th percentile = severe obesity.
Interpret Ages and Stages Questionnaire cut-off scores for developmental surveillance across communication, gross motor, fine motor, problem-solving, and personal-social domains. Below cutoff triggers referral.
Determine autism risk level using M-CHAT-R at 16-30 months. Scores 0-2 low risk (routine monitoring), 3-7 medium risk (follow-up interview), 8-20 high risk (immediate developmental evaluation).
Interpret Vanderbilt Assessment Scale for ADHD based on DSM-5 criteria. Requires 6 or more inattention or 6 or more hyperactivity/impulsivity symptoms rated often or very often plus functional impairment in one or more settings.
Classify pediatric asthma control per GINA guidelines: well-controlled (daytime symptoms 2 or fewer per week, no limitation, no nocturnal symptoms, SABA use 2 or fewer days per week), partly controlled (1-2 features), or uncontrolled (3 or more features).
Estimate breast milk caloric content and infant formula caloric dilution. Standard breast milk averages 20 kcal/oz (67 kcal/100 mL); term formula standard dilution also 20 kcal/oz. Preterm fortification increases to 22-24 kcal/oz.
Calculate pediatric resting energy expenditure using the Schofield equation by age group, sex, and weight. Multiply by activity and stress factors for total energy requirements in hospitalized or healthy children.
Calculate phenobarbital loading dose for neonatal seizures: standard 20 mg/kg IV. Additional doses of 5-10 mg/kg may be given every 15-30 minutes up to maximum 40 mg/kg. Infuse at 1 mg/kg/min or slower.
Calculate levetiracetam dose for pediatric status epilepticus: 60 mg/kg IV (maximum 3000 mg per dose). Infuse over 5-10 minutes. Second-line after benzodiazepines. Preferred for weight-based dosing up to 3000 mg cap.
Score RSV bronchiolitis severity using the Wang clinical score (0-12). Assesses respiratory rate, wheeze, I:E ratio, and accessory muscle use. Scores 0-3 mild, 4-8 moderate, 9-12 severe bronchiolitis.
Calculate infant formula caloric density by preparation method. Standard dilution (1 scoop per 2 oz water) = 20 kcal/oz. Concentrated formula preparations for higher caloric density (22-27 kcal/oz) require precise water-to-powder ratios.
Determine colorectal cancer screening eligibility per USPSTF 2021 guidelines. Colonoscopy recommended for ages 45-75. Ages 76-85 individualized decision. Alternatives include FIT annually, FIT-DNA every 1-3 years, or CT colonography every 5 years.
Compare mammography screening recommendations across guidelines. USPSTF 2024: biennial screening ages 40-74. ACR/SBI: annual from age 40. ACS: option from 40, recommended annually from 45-54, biennial from 55 onward.
Determine eligibility for annual low-dose CT lung cancer screening per USPSTF 2021. Criteria: age 50-80 years, 20 or more pack-year smoking history, and currently smoking or quit within the past 15 years.
Calculate cervical cancer screening intervals per USPSTF/ASCCP. Ages 21-29: Pap smear every 3 years. Ages 30-65: Pap every 3 years OR co-testing (Pap+HPV) every 5 years OR primary HPV test every 5 years.
Guide shared decision-making for PSA prostate cancer screening. USPSTF recommends individualized discussion for ages 55-69 (Grade C). Ages below 40 and 70 or above: generally not recommended. Incorporates risk factors including family history and race.
Determine AAA screening eligibility per USPSTF. One-time abdominal ultrasound for men aged 65-75 who have ever smoked (100 or more cigarettes lifetime). Grade B recommendation with significant mortality benefit.
Determine DEXA screening eligibility. USPSTF recommends screening for women 65 or older, postmenopausal women under 65 with increased risk, and men 70 or older or younger men with risk factors. FRAX without BMD used to identify younger high-risk women.
Determine lipid screening start age per USPSTF/ACC/AHA. Fasting lipid panel for men 35 or older, women 45 or older with no CVD risk factors. For any adult 20 or older with CVD risk factors (DM, hypertension, smoking, obesity, family history), screen earlier.
Determine diabetes and prediabetes screening eligibility. USPSTF recommends screening adults aged 35-70 who are overweight or obese. ADA recommends screening any adult 35 or older, or any age with BMI 25 or above plus one risk factor.
Blood pressure screening intervals per USPSTF. Screen every year for adults 40 or older and those at increased risk. Screen every 2 years for adults 18-39 with normal BP (below 130/85). Confirm elevated readings with ambulatory or home monitoring.
Annual depression screening for all adults per USPSTF Grade B. PHQ-2 is a 2-item first-step screen; score of 3 or more prompts full PHQ-9. Perinatal women should be screened with Edinburgh Postnatal Depression Scale (EPDS).
Fecal immunochemical test (FIT) performed annually is an accepted non-invasive colorectal cancer screening strategy. One positive FIT requires follow-up colonoscopy within 3-6 months regardless of prior negative tests.
Adult tetanus-diphtheria (Td) booster every 10 years, or Tdap once to include pertussis coverage (previously unvaccinated adults). Tdap also recommended during each pregnancy at 27-36 weeks gestational age.
Pneumococcal vaccination schedule for adults. PCV20 (20-valent conjugate) at age 65 or older as a single dose preferred by ACIP 2022. Alternatively PCV15 followed by PPSV23 one or more year later. Earlier for immunocompromised and high-risk conditions.
Recombinant zoster vaccine (RZV/Shingrix) two-dose series for adults 50 or older. First dose at age 50, second dose 2-6 months later. Over 90% efficacy against herpes zoster. Also recommended for immunocompromised adults 19 or older.
Annual influenza vaccination recommended for all persons 6 months or older by ACIP. Adults 65 or older should receive high-dose or adjuvanted influenza vaccine (HD-IIV4 or aIIV3) preferentially. Optimal timing: by end of October each year.
Calculate 10-year fracture probability using FRAX without BMD. NOF/NOGG intervention threshold: 10-year hip fracture risk of 3% or more or major osteoporotic fracture risk of 20% or more (US thresholds) warrants pharmacological treatment consideration.
Assess aspirin benefit vs. harm for primary cardiovascular prevention. USPSTF 2022: initiate low-dose aspirin for adults 40-59 with 10% or more 10-year CVD risk (Grade C, shared decision). Adults 60 or older: do not initiate (Grade D) due to increased bleeding outweighing benefit.
Screen for combined alcohol and drug use disorders with CAGE-AID. Adapts CAGE questions to include illicit drug use. Score of 2 or more indicates significant concern for substance use disorder requiring further assessment.
Calculate PSA velocity (PSAV) as the rate of change in PSA over time. A PSAV >0.75 ng/mL/year is suspicious for prostate cancer even when absolute PSA is in the normal range. Requires at least 2 PSA measurements over 18 months.
Calculate PSA density (PSAD) by dividing serum PSA by prostate volume measured on transrectal ultrasound (TRUS). PSAD >0.15 ng/mL/cc is suspicious for prostate cancer and helps distinguish cancer from benign prostatic hyperplasia.
Interpret prostate cancer Gleason score grading. The Gleason score sums the primary and secondary architectural pattern grades (each 1-5), yielding a total score from 2-10. Higher scores indicate more aggressive disease. Grade groups 1-5 correspond to Gleason scores 6, 3+4=7, 4+3=7, 8, and 9-10.
Calculate the International Prostate Symptom Score (IPSS) to assess lower urinary tract symptom severity in men with BPH. Seven questions score 0-5 each (total 0-35). Scores 0-7 = mild, 8-19 = moderate, 20-35 = severe symptoms. An 8th quality-of-life question assesses bother.
Determine functional bladder capacity from a 3-day voiding diary. Functional capacity is the maximum single void volume recorded. Normal functional bladder capacity is 300-500 mL. Reduced capacity below 200 mL suggests detrusor overactivity, bladder fibrosis, or interstitial cystitis.
Interpret post-void residual urine volume measured by bladder ultrasound or catheterization. PVR below 50 mL is normal. PVR 50-100 mL is borderline and warrants monitoring. PVR above 200 mL indicates significant retention due to bladder outlet obstruction or neurogenic bladder.
Interpret 24-hour urine calcium excretion to diagnose hypercalciuria. Normal values: below 250 mg/day in women, below 300 mg/day in men (or less than 4 mg/kg/day). Hypercalciuria is the most common metabolic abnormality in calcium kidney stone formers, present in 30-60% of patients.
Interpret 24-hour urinary oxalate excretion. Normal excretion is below 40 mg/day. Hyperoxaluria (above 40 mg/day) significantly increases calcium oxalate stone risk. Mild hyperoxaluria (40-80 mg/day) is often dietary; primary hyperoxaluria causes values above 80-100 mg/day.
Interpret 24-hour urinary uric acid excretion. Hyperuricosuria is defined as above 750 mg/day in women or above 800 mg/day in men. It promotes both uric acid and calcium oxalate stone formation. Urine pH is critical: uric acid stones form predominantly at pH below 5.5.
Assess kidney stone composition risk factors to guide metabolic workup and prevention. Calcium oxalate (75-80% of stones) is associated with hypercalciuria, hyperoxaluria, hypocitraturia. Uric acid (5-10%) with low urine pH and gout. Struvite (5-15%) with urease-producing organisms. Cystine (under 1%) with cystinuria.
Apply the STONE score to predict the likelihood of nephrolithiasis and guide CT imaging in patients with suspected renal colic. Variables: Sex, Timing of pain onset, Origin (non-black race), Nausea/vomiting, Erythrocytes on urinalysis. Score 0-13; low (0-5), moderate (6-9), high (10-13) probability of stone.
Apply the modified Ottawa/Flexner kidney stone rule to identify low-risk patients who do not require immediate CT imaging. Low-risk criteria include: age below 75, no prior renal stones requiring intervention, no fever, and limited pain on arrival. High-risk features warrant immediate CT KUB.
Score urinary incontinence severity using the Sandvik Severity Index, combining frequency of leakage (1-4) and amount of leakage (1-3). Severity index = frequency multiplied by amount: 1-2 slight, 3-6 moderate, 8-9 severe, 12 very severe. Helps differentiate and quantify stress versus urgency incontinence.
Estimate intracerebral hemorrhage (ICH) expansion risk using CT-angiography spot sign and clinical factors. The spot sign (contrast extravasation within hematoma on CTA) is the strongest predictor of hematoma expansion, associated with 3-6x higher expansion risk and worse outcomes. Guides hyperacute hemostatic therapy decisions.
Grade subarachnoid hemorrhage severity using the World Federation of Neurological Surgeons (WFNS) scale. Grade I: GCS 15, no motor deficit. Grade II: GCS 13-14, no motor deficit. Grade III: GCS 13-14 with motor deficit. Grade IV: GCS 7-12. Grade V: GCS 3-6. Predicts surgical risk and outcome.
Calculate the ABCD2 score to predict 2-day stroke risk after TIA. Components: Age 60 or older (1), Blood pressure 140/90 or higher (1), Clinical features - unilateral weakness (2) or speech disturbance without weakness (1), Duration 60 min or longer (2) or 10-59 min (1), Diabetes (1). Maximum 7; score 4 or higher = high risk.
Calculate the National Early Warning Score 2 (NEWS2) for acute deterioration detection. Scores six physiologic parameters: respiratory rate, SpO2 (with scale 1 or 2 for hypercapnic patients), systolic BP, pulse, consciousness (ACVPU), and temperature. Total 0-20. Score 7 or higher = high clinical risk requiring urgent response.
Overview of the APACHE III (Acute Physiology and Chronic Health Evaluation III) ICU mortality prediction system. Scores 20 physiologic variables during the first 24 hours plus chronic health items and diagnostic category. Score range 0-299. Higher scores correlate with increased predicted hospital mortality, ranging from below 5% at low scores to above 80% at scores above 100.
Calculate the Modified Early Warning Score (MEWS) to identify patients at risk for clinical deterioration. Five parameters: systolic BP (0-3), heart rate (0-3), respiratory rate (0-3), temperature (0-2), and AVPU consciousness level (0-3). Total 0-14; score 5 or higher associated with increased risk of ICU admission or death.
Screen for cauda equina syndrome (CES) using red flag symptom checklist. Classic features: saddle anesthesia/paresthesia, bilateral leg weakness, bladder dysfunction (retention most common, overflow incontinence), bowel dysfunction, sexual dysfunction. CES is a surgical emergency requiring urgent MRI and decompression within 24-48 hours.
Classify spinal cord injury severity using the Frankel scale (A-E). Grade A: complete loss of motor and sensory function below injury. Grade B: sensory preserved but no motor. Grade C: motor preserved but non-functional (grade below 3). Grade D: motor functional (grade 3 or above). Grade E: normal motor and sensory function.
Grade spinal cord injury using the American Spinal Injury Association (ASIA) Impairment Scale. Grade A: complete (no sensory/motor in S4-S5). Grade B: sensory incomplete. Grade C: motor incomplete, majority key muscles below grade 3. Grade D: motor incomplete, majority key muscles grade 3 or above. Grade E: normal. Neurological level is the most caudal segment with normal function.
Apply NEXUS low-risk criteria to clear the cervical spine without imaging. All five criteria must be met: no focal neurological deficit, no midline posterior cervical tenderness, normal level of alertness, no evidence of intoxication, no distracting injury. If all met, C-spine injury probability below 0.1% (sensitivity 99.6%).
Apply the Canadian C-Spine Rule to decide imaging in alert, stable blunt trauma patients. Step 1: Any high-risk factor (age 65 or older, dangerous mechanism, paresthesias)? Imaging required. Step 2: Any low-risk factor allowing safe ROM assessment? Proceed to Step 3. Step 3: Can patient actively rotate neck 45 degrees left and right? No imaging needed. Sensitivity 100%, specificity 42%.
Assess severity of ossification of the posterior longitudinal ligament (OPLL) using the occupancy ratio (ossification cross-sectional area divided by spinal canal area, multiplied by 100%). Occupancy above 60% correlates with high risk of myelopathy. Type classification: segmental, continuous, mixed, circumscribed. Mixed type has worst prognosis.
Diagnose cardiogenic shock using hemodynamic and clinical criteria. Diagnostic criteria: SBP below 90 mmHg for 30 minutes or longer (or vasopressors/inotropes required to maintain SBP at or above 90), plus signs of hypoperfusion (urine output below 30 mL/hr, cool extremities, altered mentation, lactic acidosis 2 mmol/L or higher, cardiac index at or below 2.2 L/min/m2).
Assess intra-aortic balloon pump timing using arterial waveform analysis. Correct inflation: at dicrotic notch (aortic valve closure), creating diastolic augmentation. Correct deflation: just before systole, reducing end-diastolic pressure (afterload reduction). Mistimed IABP reduces efficacy and can cause harm.
Interpret hemodynamic profiles from pulmonary artery (Swan-Ganz) catheterization. Warm-Wet (high PCWP, normal CI): decompensated HF without shock. Cold-Wet (high PCWP, low CI): cardiogenic shock. Cold-Dry (normal/low PCWP, low CI): hypovolemia or RV failure. Warm-Dry (normal PCWP, normal CI): compensated.
Interpret pulmonary capillary wedge pressure (PCWP) as an estimate of left atrial pressure and LVEDP. Normal: 6-12 mmHg. Mild heart failure: 12-18 mmHg. Moderate failure: 19-25 mmHg. Severe failure: above 25 mmHg. Cardiogenic pulmonary edema typically occurs at PCWP above 25 mmHg.
Interpret mixed venous oxygen saturation (SvO2) from pulmonary artery blood. Normal SvO2: 65-75%. Values below 65-70% indicate increased oxygen extraction (high demand or low cardiac output in heart failure, hypovolemic or cardiogenic shock). Values above 80% suggest sepsis (maldistribution), hepatic failure, or pulmonary shunting.
Interpret serum lactate in the context of shock and tissue hypoperfusion. Normal: below 2 mmol/L. Mild elevation: 2-4 mmol/L (indicates tissue hypoperfusion, requires evaluation). Severe: above 4 mmol/L (associated with significantly increased mortality - 28-day mortality approximately 28-39% in sepsis). Serial lactate clearance above 10% per 2 hours is a treatment target.
Apply high-sensitivity troponin (hs-cTn) kinetics to diagnose acute MI using 0/1-hour or 0/2-hour algorithms. Rise of 20% or more absolute change over 1-3 hours from a detectable baseline = acute MI pattern. ESC 0h/1h algorithm: Rule-in at 0h if hs-cTnT is 52 ng/L or higher or rise of 5 ng/L or more at 1h; Rule-out if 0h is below 5 ng/L and rise is below 2 ng/L.
Calculate CK-MB fraction as a percentage of total CK. CK-MB/total CK above 6% suggests myocardial origin of CK elevation, as skeletal muscle CK-MB is typically below 2-3%. Useful when troponin is equivocal or to confirm cardiac vs. skeletal muscle source of CK elevation.
Interpret NT-proBNP for heart failure diagnosis using age-stratified thresholds. Age below 50: rule-out below 300 pg/mL, rule-in at or above 450 pg/mL. Age 50-75: rule-out below 300 pg/mL, rule-in at or above 900 pg/mL. Age above 75: rule-out below 300 pg/mL, rule-in at or above 1800 pg/mL. Values above rule-in thresholds support acute HF with high specificity.
Interpret B-type natriuretic peptide (BNP) for heart failure evaluation. BNP below 100 pg/mL: HF unlikely. BNP 100-500 pg/mL: heart failure possible, consider other causes. BNP above 500 pg/mL: heart failure highly likely. BNP is secreted by ventricular myocytes in response to increased wall stress from volume or pressure overload.
Classify hemodynamic status in acute MI using Killip classification. Class I: no signs of heart failure (in-hospital mortality approximately 6%). Class II: S3 gallop or basal crackles less than 50% of lung fields (approximately 17% mortality). Class III: acute pulmonary edema (approximately 38% mortality). Class IV: cardiogenic shock, SBP below 90 (approximately 81% mortality in original series).
Interpret complete hemodynamic profiles from PA catheter data. Cardiogenic shock: high PCWP (above 18), low CO (below 4), high SVR (above 1200). Distributive/septic shock: low/normal PCWP, high CO, low SVR (below 800). Hypovolemic shock: low PCWP, low CO, high SVR. RV failure: high CVP/RAP, low PCWP, low CO, high PVR.
Calculate cardiac output using the Fick principle: CO = VO2 divided by (CaO2 minus CvO2) multiplied by 10. Where VO2 = oxygen consumption in mL/min, CaO2 = arterial O2 content, CvO2 = mixed venous O2 content. O2 content = Hgb x 1.34 x SaO2 + (0.0031 x PaO2). Assumed VO2 of 125 mL/min/m2 is used when direct measurement is unavailable.
Calculate resting energy expenditure (REE) using the Mifflin-St Jeor equation, the most accurate predictive equation for non-ventilated patients. Men: REE = (10 x weight kg) + (6.25 x height cm) minus (5 x age) + 5. Women: REE = (10 x weight kg) + (6.25 x height cm) minus (5 x age) minus 161. Accuracy within 10% of indirect calorimetry in most patients.
Calculate total daily energy expenditure (TDEE) by multiplying REE by an activity factor. Sedentary (little/no exercise): REE x 1.2. Lightly active (1-3 days/week): REE x 1.375. Moderately active (3-5 days/week): REE x 1.55. Very active (6-7 days/week): REE x 1.725. Extra active (physical job + hard exercise): REE x 1.9.
Calculate daily protein requirements for critically ill patients. Standard ICU patients: 1.2-2.0 g/kg/day of actual body weight. Severe burns (above 30% TBSA): 2.0-2.5 g/kg/day. Major trauma/multitrauma: 2.0-2.5 g/kg/day. Acute kidney injury (no RRT): 1.2-1.5 g/kg/day. AKI on CRRT: 1.5-2.5 g/kg/day due to protein losses in filtrate.
Determine appropriate nutrition route using indication criteria. Enteral nutrition (EN) is preferred whenever the GI tract is functional: start within 24-48 hours of ICU admission. Parenteral nutrition (PN) indicated when: GI tract non-functional (ileus, SBO, mesenteric ischemia), EN contraindicated (GI fistula without distal access), or EN fails to meet 60% or more of caloric targets after 3-5 days.
Assess refeeding syndrome risk before initiating nutrition in at-risk patients. High-risk features (any 2 minor or 1 major): BMI below 16, unintentional weight loss above 15% in 3-6 months, minimal intake above 10 days, low baseline phosphate/potassium/magnesium. High risk requires thiamine supplementation, electrolyte monitoring, and slow caloric advancement (10-20 kcal/kg/day initially).
Monitor and correct phosphate in refeeding syndrome. Target serum phosphate above 0.8 mmol/L during refeeding. If phosphate drops to 0.5-0.8 mmol/L, use oral sodium phosphate supplementation and slow caloric advancement. If phosphate falls below 0.5 mmol/L (severe hypophosphatemia), use IV phosphate replacement and caloric restriction until above 0.8 mmol/L.
Assess thiamine (vitamin B1) deficiency risk. High-risk groups: chronic alcoholism (most common), prolonged inadequate nutrition or starvation above 2 weeks, malabsorption syndromes (Crohn disease, celiac), bariatric surgery (especially Roux-en-Y), persistent vomiting (hyperemesis gravidarum), and refeeding syndrome. Thiamine supplementation should precede glucose/carbohydrate administration in all high-risk patients.
Interpret serum vitamin B12 levels. Deficient: below 200 pg/mL (requires supplementation). Borderline/grey zone: 200-300 pg/mL (check methylmalonic acid and homocysteine for functional deficiency). Normal: above 300 pg/mL. Causes: pernicious anemia, gastric atrophy, strict veganism, metformin use, gastric bypass, H. pylori infection.
Assess folate status using serum and RBC folate measurements. Deficient: serum folate below 2.0 ng/mL, RBC folate below 140 ng/mL. Borderline: serum folate 2.0-3.0 ng/mL. RBC folate better reflects tissue stores. Causes: poor dietary intake, alcohol, malabsorption (celiac), medications (methotrexate, trimethoprim, phenytoin, sulfasalazine), pregnancy (increased demand).
Assess zinc status using serum zinc levels and clinical indicators. Deficient: serum zinc below 70 mcg/dL (below 10.7 micromol/L). Normal: 70-120 mcg/dL. Clinical features: acrodermatitis enteropathica (perioral/perianal rash), delayed wound healing, hypogeusia/anosmia, growth retardation, immune dysfunction, hypogonadism. Serum zinc poorly reflects body zinc stores due to acute phase reaction.
Diagnose malnutrition using the Global Leadership Initiative on Malnutrition (GLIM) criteria (2018). Requires at least 1 phenotypic criterion AND at least 1 etiologic criterion. Phenotypic: unintentional weight loss (above 5% in 6 months or above 10% in more than 6 months), low BMI (below 20 if under 70 years, below 22 if 70 or older), or reduced muscle mass. Etiologic: reduced food intake/absorption, or inflammation/disease burden.
Screen for malnutrition risk using the Malnutrition Universal Screening Tool (MUST). Step 1: BMI score (above 20 = 0, 18.5-20 = 1, below 18.5 = 2). Step 2: weight loss score (0-5% = 0, 5-10% = 1, above 10% = 2). Step 3: acute disease effect (if acutely ill and no nutrition for more than 5 days, add 2). Total 2 or higher = high risk; 1 = medium risk; 0 = low risk.
Estimate maximal oxygen uptake (VO2 max) from resting heart rate using the heart rate ratio method for a non-exercise cardiorespiratory fitness assessment.
Calculate heart rate and pace training zones from VO2 max percentage thresholds (Zone 1–5) for structured endurance training periodization.
Calculate aerobic threshold (AeT) heart rate — the intensity at which lactate begins to accumulate — from VO2 max or field test data for base training.
Calculate anaerobic threshold (lactate threshold 2) heart rate — the maximal sustainable exercise intensity — from field tests or percentage of maximal heart rate.
Calculate training readiness from morning HRV measurements, comparing current reading to rolling 7-day baseline to guide training load decisions.
Calculate root mean square of successive differences (RMSSD) from R-R interval data to assess parasympathetic nervous system activity and recovery status.
Assess autonomic nervous system function from the orthostatic heart rate response — the change in HR when moving from lying to standing position.
Calculate exercise readiness and recommended training intensity from wearable sleep score, sleep duration, and HRV data using a composite readiness algorithm.
Convert Borg RPE scale (6–20) or CR10 scale ratings to estimated percentage of VO2 max and heart rate equivalent for exercise prescription.
Look up or calculate MET values for hundreds of physical activities and use them to estimate energy expenditure per hour relative to resting metabolic rate.
Calculate calories burned during exercise from MET value, body weight, and duration for accurate energy balance tracking and weight management.
Calculate physical activity level (PAL) as a multiplier of BMR to estimate total daily energy expenditure (TDEE) for nutrition planning and weight management.
Calculate whether your weekly physical activity meets WHO guidelines (150–300 min moderate or 75–150 min vigorous) and estimate health risk reduction from meeting targets.
Estimate health risks from sedentary behavior based on daily sitting hours, light activity breaks, sleep duration, and occupational vs leisure sitting patterns.
Calculate and interpret Functional Movement Screen (FMS) composite score from 7 movement pattern scores (0–3 each) to identify asymmetries and injury risk.
Compare your sit-and-reach flexibility score against age and sex norms to determine percentile ranking for overall musculoskeletal health assessment.
Compare single-leg stance balance time against age and sex normative data to assess fall risk, proprioception, and neuromuscular function.
Compare grip strength measurement (kg or lbs) against age and sex normative data and assess its relationship to overall muscle mass and longevity.
Classify muscular endurance fitness level from push-up test count against age and sex normative data from ACSM fitness testing standards.
Convert sit-and-reach distance to age and sex fitness percentile using ACSM normative tables for hamstring and lower back flexibility assessment.
Calculate cardiovascular fitness score from post-exercise heart rate recovery after a 3-minute step test using YMCA or Harvard Step Test protocols.
Estimate VO2 max from the 12-minute Cooper running test distance using the Cooper equation for field-based cardiorespiratory fitness assessment.
Convert multi-stage fitness test (beep test / bleep test) level and shuttle number to estimated VO2 max using Leger et al. prediction equations.
Calculate Harvard Step Test Physical Fitness Index (PFI) from post-exercise pulse counts after a 5-minute, 20-inch step test to assess cardiovascular fitness.
Compare 6-minute walk test distance against age and sex reference values and interpret results for exercise capacity, COPD, and heart failure monitoring.
Estimate VO2 max from Bruce treadmill stress test duration using standard and modified Bruce protocol prediction equations.
Classify cardiorespiratory fitness level (very poor, poor, fair, good, excellent, superior) from VO2 max using ACSM age and sex normative tables.
Interpret spirometry results including FEV1/FVC ratio, FEV1% predicted, and FVC% predicted to assess obstructive vs restrictive lung function patterns.
Calculate predicted peak expiratory flow rate (PEFR) from age and height using Nunn-Gregg or NHANESIII equations and interpret asthma management zones.
Estimate expected blood oxygen saturation (SpO2) at altitude, safe ascent rates, and acclimatization timelines based on altitude, prior acclimatization, and individual factors.
Interpret Air Quality Index (AQI) values and estimate health impacts on different population groups from fine particulate matter (PM2.5) and ozone levels.
Estimate allergy symptom severity from pollen count levels, sensitization type, and medication use to guide outdoor activity timing and treatment decisions.
Calculate minutes of sun exposure needed to synthesize adequate vitamin D based on skin type, UV index, latitude, season, and body surface area exposed.
Estimate melatonin suppression duration from evening screen exposure based on device type, brightness, distance, exposure duration, and use of blue light filters.
Calculate jet lag recovery time and light exposure protocol to reset circadian rhythm based on number of time zones crossed, direction of travel, and chronotype.
Calculate composite sleep quality score from wearable-derived metrics including total sleep time, sleep efficiency, REM%, deep sleep%, and wake events.
Calculate sleep efficiency (time asleep ÷ time in bed × 100%) and interpret results against clinical thresholds for insomnia diagnosis and treatment.
Calculate recommended REM sleep duration by age, interpret percentage targets, and assess the impact of REM deprivation on memory and emotional regulation.
Calculate target deep sleep (slow-wave sleep) percentage and duration by age, and assess factors that impair deep sleep quality.
Estimate cognitive performance impairment (reaction time, attention, working memory) from cumulative sleep debt using validated psychomotor vigilance task (PVT) models.
Estimate expected HRV improvement from consistent meditation practice based on session frequency, duration, and meditation type using meta-analysis data.
Estimate physiological stress level from proxy indicators including resting heart rate elevation, HRV suppression, sleep disruption, and subjective stress score.
Score the effectiveness of a mindfulness practice from frequency, duration, type, and self-reported outcomes using standardized mindfulness scale items.
Calculate safe cold water immersion or cold shower exposure duration based on water temperature, individual cold tolerance, and target physiological adaptation.
Estimate cumulative cardiovascular benefit from sauna frequency and duration based on Finnish cohort epidemiological data linking sauna use to mortality reduction.
Calculate hours of fasting needed to deplete hepatic glycogen and transition to fat-burning (ketosis) based on activity level, recent carbohydrate intake, and metabolic rate.
Calculate the effective caloric restriction achieved through various intermittent fasting protocols (16:8, 5:2, OMAD) compared to standard caloric restriction.
Estimate metabolic benefits from time-restricted eating (TRE) window based on eating window duration, alignment with circadian biology, and individual metabolic status.
Calculate a composite longevity score from eight modifiable lifestyle factors including exercise, sleep, diet quality, stress, smoking, alcohol, social connection, and purpose.
Estimate biological age from VO2 max, grip strength, resting heart rate, flexibility, blood pressure, BMI, and sleep quality using validated aging biomarker algorithms.
Calculate optimal protein, carbohydrate, and fat macro split for a caloric deficit to maximize fat loss while preserving lean muscle mass.
Calculate caloric surplus and protein, carbohydrate, fat macro split to maximize muscle protein synthesis and hypertrophy during a lean bulk.
Calculate carbohydrate, protein, and fat targets for endurance athletes based on training volume, intensity, and race fueling demands.
Compare daily micronutrient intake against Dietary Reference Intakes (DRI) including RDA, AI, EAR, and UL values for vitamins and minerals.
Calculate effective iron absorption from a meal based on enhancers (vitamin C, meat factor) and inhibitors (phytates, tannins, calcium) for anemia prevention.
Calculate and optimize the dietary calcium-to-magnesium ratio for bone health, cardiovascular function, and neuromuscular performance.
Calculate dietary omega-3 to omega-6 ratio from food intake and estimate anti-inflammatory potential versus pro-inflammatory eicosanoid production.
Calculate therapeutic omega-3 (EPA+DHA) dose for inflammation, triglyceride reduction, and cardiovascular risk based on body weight and target blood levels.
Estimate serum 25(OH)D blood level change from supplemental vitamin D dose in IU using population pharmacokinetic models.
Estimate effective vitamin B12 absorption from dietary and supplemental sources based on intrinsic factor availability, age-related atrophic gastritis risk, and dose.
Calculate estimated absorbed zinc from diet considering phytate content, protein source (animal vs plant), and zinc:phytate molar ratio.
Calculate daily iodine requirement for thyroid hormone synthesis based on age, sex, pregnancy status, and thyroid function.
Calculate selenium intake needed for glutathione peroxidase saturation and cardiovascular protection, balancing benefit and toxicity risk.
Calculate expected blood pressure reduction from increased dietary potassium intake based on baseline BP, sodium intake, and current potassium consumption.
Estimate blood pressure reduction from sodium restriction based on baseline sodium intake, current blood pressure, and salt sensitivity status.
Calculate DASH diet sodium targets, food group servings, and caloric needs for blood pressure management at standard (2,300 mg) and reduced (1,500 mg) sodium levels.
Calculate PREDIMED or MEDAS Mediterranean diet adherence score from dietary questionnaire responses to quantify adherence and cardiovascular risk reduction.
Calculate glycemic load (GL) for individual meals from food glycemic index values and carbohydrate portion sizes to manage post-meal blood glucose response.
Compare food insulin index (FII) to glycemic index for assessing insulin demand and optimizing blood glucose and insulin response in metabolic health management.
Estimate relative reduction in colorectal cancer risk from increased dietary fiber intake based on meta-analysis dose-response relationships.
Calculate effective dosing ranges for prebiotic fiber (inulin, FOS, GOS) and probiotic CFU counts based on target health outcomes and individual tolerance.
Score dietary diversity for gut microbiome richness based on plant variety, fiber types, fermented foods, and polyphenol intake using validated diet diversity metrics.
Calculate the Dietary Inflammatory Index (DII) score from food and nutrient intake to quantify the inflammatory potential of the diet.
Track symptom severity during elimination and reintroduction phases of an elimination diet to identify food sensitivities and intolerances.
Guide the low-FODMAP elimination and reintroduction protocol for IBS symptom management with serving size thresholds and reintroduction timing.
Calculate daily phosphorus limit for chronic kidney disease patients based on GFR stage, serum phosphorus, and PTH levels.
Calculate protein requirements for hemodialysis and peritoneal dialysis patients to prevent protein-energy wasting while managing uremia and dialysate losses.
Calculate sodium restriction target for cirrhosis patients with ascites, and estimate fluid restriction needs based on serum sodium and disease severity.
Calculate DASH diet food group servings and calorie targets for hypertension management at multiple calorie levels (1,600–3,100 kcal/day).
Calculate carbohydrate servings per meal for type 1 and type 2 diabetes management, and estimate insulin-to-carb ratio for mealtime insulin dosing.
Calculate blood glucose targets, carbohydrate distribution, and weight gain goals for gestational diabetes management by trimester.
Calculate age-appropriate calorie and macronutrient needs for children and adolescents from 1–18 years using DRI and WHO growth-based equations.
Calculate additional calorie and protein requirements during breastfeeding based on milk production volume, infant age, and maternal nutritional status.
Calculate recommended prenatal supplement doses for folate, iron, DHA, vitamin D, iodine, and choline by trimester based on current evidence and guidelines.
Calculate nutrient repletion needs for iron, omega-3, vitamin D, choline, and iodine in the postpartum period based on blood loss, breastfeeding status, and depletion risk.
Calculate calcium and vitamin D requirements during perimenopause and post-menopause to prevent accelerated bone loss and fracture risk.
Calculate 10-year major osteoporotic fracture probability and hip fracture probability using FRAX clinical risk factors with or without BMD.
Calculate protein intake and distribution needed to prevent age-related muscle loss (sarcopenia) based on age, weight, and physical activity level.
Calculate DHA dose for cognitive function support, brain volume maintenance, and dementia risk reduction based on age, ApoE4 status, and baseline DHA levels.
Score dietary adequacy of nutrients supporting Phase I and Phase II liver detoxification pathways including B vitamins, sulfur compounds, and antioxidants.
Calculate daily oxalate limit and calcium intake needed to reduce calcium oxalate kidney stone recurrence risk, including high-oxalate food substitutions.
Assess total purine content of a meal and identify high-purine foods that raise uric acid, with gout-safe substitutions.
Calculate safe daily gluten exposure threshold for celiac disease and non-celiac gluten sensitivity, including cross-contamination risk from shared equipment.
Calculate protein, calorie, vitamin, and mineral requirements for the first year after Roux-en-Y gastric bypass, sleeve gastrectomy, or LAGB bariatric surgery.
Calculate therapeutic iron supplementation dose and duration for sports-related iron deficiency anemia based on ferritin level, Hgb, and athletic training load.
Calculate target hemoglobin and hematocrit values for altitude training camps, and estimate performance benefit from erythropoietic response to hypoxic exposure.
Calculate fluid and electrolyte (sodium, potassium, magnesium) replacement needs during heat acclimatization periods based on sweat rate, sweat sodium, and exercise duration.
Calculate protein and calorie targets for optimal tissue repair after sports injuries, surgery, or immobilization to prevent muscle atrophy and support healing.
Calculate therapeutic zinc and vitamin C doses for immune function support, cold duration reduction, and respiratory illness prevention based on clinical trial data.
Guide a structured food sensitivity elimination and reintroduction schedule to identify specific trigger foods causing delayed hypersensitivity reactions (IgG-mediated or non-immune).
Interpret ceruloplasmin levels in the context of Wilson's disease diagnosis. Low ceruloplasmin (<20 mg/dL) with KF rings and elevated urinary copper supports diagnosis.
Quantify neuropathic pain severity in Fabry disease using the Brief Pain Inventory adapted for acroparesthesias, burning pain, and episodic crises.
Calculate the Severity Score Index for Gaucher disease type 1, integrating bone, visceral, and hematologic involvement to guide enzyme replacement therapy decisions.
Determine diagnostic GAA enzyme activity thresholds for Pompe disease using dried blood spot or leukocyte assay, distinguishing classic infantile from late-onset forms.
Calculate the NPC suspicion score using clinical features including vertical supranuclear gaze palsy, gelastic cataplexy, ataxia, and cognitive decline to identify patients needing workup.
Estimate age of onset and disease progression in Huntington disease based on CAG repeat length in the HTT gene. Longer repeats correlate with earlier onset.
Estimate annual progression rate of spinocerebellar ataxia using SARA scale change per year, stratified by SCA subtype and CAG repeat length.
Score organ involvement in systemic amyloidosis (AL, ATTR, AA) using biomarkers and clinical criteria to stratify prognosis and guide treatment intensity.
Interpret serum ACE levels for sarcoidosis diagnosis and activity monitoring. Elevated ACE reflects granuloma burden but has limited sensitivity and specificity as a standalone marker.
Apply International Study Group criteria for Behçet's disease diagnosis, requiring recurrent oral ulcers plus 2 of 4 criteria: genital ulcers, eye lesions, skin lesions, pathergy test.
Calculate the modified Rodnan skin score (mRSS) for systemic sclerosis by assessing skin thickness across 17 body areas on a 0–3 scale (total 0–51).
Interpret CK elevation in dermatomyositis and polymyositis to assess muscle inflammation severity and guide immunosuppressive therapy intensity.
Apply ESR and CRP thresholds in the ACR/EULAR 2012 PMR classification criteria, integrated with clinical features for definite, probable, or possible PMR diagnosis.
Apply Yamaguchi criteria to diagnose adult-onset Still's disease: requires 5+ criteria (≥2 major) after excluding infections, malignancies, and rheumatic diseases.
Measure Takayasu arteritis disease activity using ITAS2010, incorporating constitutional, vascular, and laboratory features to guide treatment decisions.
Estimate ANCA positivity probability in EGPA (Churg-Strauss) and stratify vasculitic vs eosinophilic phenotype based on clinical features and eosinophil count.
Assess laboratory criteria for antiphospholipid syndrome: lupus anticoagulant, anticardiolipin IgG/IgM, and anti-β2-glycoprotein I IgG/IgM, requiring persistence on 2 tests ≥12 weeks apart.
Score mixed cryoglobulinemia severity (type II/III) using the Italian Multicenter Research Group criteria, integrating purpura, arthralgia, weakness, neuropathy, and renal involvement.
Calculate the HScore to estimate probability of reactive hemophagocytic lymphohistiocytosis using 9 variables including temperature, organomegaly, cytopenia, ferritin, fibrinogen, and bone marrow findings.
Apply 2016 ACR/EULAR/PRINTO classification criteria for MAS complicating systemic juvenile idiopathic arthritis using ferritin, platelet count, AST, triglycerides, and fibrinogen.
Calculate the RegiSCAR score for DRESS/DIHS to classify cases as no case, possible, probable, or definite, integrating fever, lymphadenopathy, skin involvement, organ involvement, and eosinophilia.
Calculate SCORTEN to predict mortality in Stevens-Johnson syndrome and toxic epidermal necrolysis. Seven variables scored at 24 hours predict in-hospital mortality risk.
Apply SCORTEN in toxic epidermal necrolysis (BSA detachment >30%) to stratify mortality risk and determine need for burn unit transfer, IVIG, or cyclosporine therapy.
Assess severity of erythroderma (>90% BSA erythema) by scoring systemic involvement including thermoregulatory failure, cardiac burden, hypoalbuminemia, and lymphadenopathy.
Calculate PDAI for pemphigus vulgaris/foliaceus by scoring active lesions (0–120) and damage/post-inflammatory changes across skin and mucosal surfaces to guide immunosuppressive treatment.
Apply the Bullous Pemphigoid Disease Area Index (BPDAI) scoring blisters, erosions, urticarial/erythematous lesions, and pruritus to assess disease severity and monitor treatment response.
Calculate the Ichthyosis Severity Index for congenital ichthyosis subtypes (ARCI, EI) scoring scaling, erythema, pruritus, restriction of movement, body surface area involvement, and QoL impact.
Assess mast cell burden in systemic mastocytosis using serum tryptase level, bone marrow mast cell percentage, and WHO B and C findings to classify indolent vs advanced disease.
Score hereditary angioedema attack severity by location (laryngeal, abdominal, peripheral), duration, pain intensity, and impact on daily activities to guide on-demand therapy selection.
Assess end-organ damage in hypereosinophilic syndrome across cardiac, neurologic, pulmonary, GI, and dermatologic systems to stratify treatment urgency with corticosteroids or mepolizumab.
Calculate the Eosinophilic Esophagitis Activity Index (EEsAI) scoring dysphagia frequency, dietary modification, and avoidance behaviors to measure treatment response and disease activity.
Apply the 10 warning signs of primary immunodeficiency (Jeffrey Modell Foundation criteria) to identify patients requiring immunologic evaluation including immunoglobulin levels, lymphocyte subsets, and genetic testing.
Apply ESID/PAGID diagnostic criteria for CVID: markedly reduced IgG + reduced IgA or IgM, impaired vaccine responses, age >4 years, exclusion of other causes.
Stratify cardiac defect risk in DiGeorge syndrome (22q11.2 deletion), where 74% have congenital heart disease, most commonly conotruncal defects including tetralogy of Fallot and interrupted aortic arch.
Apply the Zhu severity score for Wiskott-Aldrich syndrome grading thrombocytopenia, eczema, infections, autoimmunity, and malignancy to stratify patients for hematopoietic stem cell transplantation.
Apply diagnostic criteria for X-linked agammaglobulinemia: absent/very low B cells, severe panhypogammaglobulinemia, onset before age 5, mutations in BTK gene, or absent BTK protein by flow cytometry.
Estimate clinical expression probability in HFE C282Y homozygous hereditary hemochromatosis using transferrin saturation, ferritin, age, and sex to predict who requires phlebotomy therapy.
Assess severity of acute hepatic porphyria attacks (AHP) including abdominal pain, neurological features, hyponatremia, and SIADH to guide heme arginate or givosiran therapy decisions.
Apply MGFA clinical classification (Classes I–V) for myasthenia gravis to stratify disease severity from ocular-only to myasthenic crisis requiring ventilatory support.
Estimate probability of Lambert-Eaton myasthenic syndrome and malignancy (SCLC) using clinical features, VGCC antibody titer, and DELTA-P paraneoplastic score.
Estimate probability of AQP4-IgG seropositivity in suspected NMOSD based on clinical phenotype: optic neuritis, transverse myelitis, area postrema syndrome, and area involvement patterns.
Score NMOSD relapse severity using visual acuity, EDSS change, nadir EDSS, lesion length on MRI, and time to peak deficit to guide IV methylprednisolone vs plasma exchange therapy.
Assess disability in acute transverse myelitis using motor, sensory, and bladder/bowel function across levels to predict recovery trajectory and differentiate complete from partial TM.
Quantify plexiform neurofibroma burden in NF1 using volumetric MRI measurements to assess eligibility for selumetinib and monitor treatment response in pediatric and adult patients.
Assess mTOR pathway disease burden in tuberous sclerosis complex by integrating lesion types and sizes: SEGAs, cortical tubers, subependymal nodules, renal AMLs, and pulmonary LAM score.
Estimate risk of VHL-associated lesions (hemangioblastomas, ccRCC, pheochromocytoma, pancreatic NETs) based on mutation type classification (VHL type 1, 2A, 2B, 2C) and age.
Estimate probability of MEN1-associated tumors (parathyroid adenoma, gastrinoma, insulinoma, pituitary adenoma) by age and mutation status to guide biochemical and imaging surveillance.
Interpret basal and stimulated calcitonin thresholds in MEN2A (RET proto-oncogene mutation) to detect MTC at presymptomatic stage and time prophylactic or therapeutic thyroidectomy.
Assess cardiac myxoma risk in Carney complex (PRKAR1A mutation) using annual echocardiography findings, spotty pigmentation extent, and endocrine tumor screening results.
Apply mandatory and major criteria for POEMS syndrome diagnosis: polyneuropathy, monoclonal plasma cell disorder, plus additional major (VEGF, sclerotic bone lesions, Castleman disease) and minor criteria.
Calculate vancomycin dose and interval using AUC/MIC-guided dosing (target AUC 400–600 mg·h/L). Requires 2-point Bayesian PK estimation with trough and peak or two trough levels.
Interpret vancomycin trough levels by indication (MRSA bacteremia, endocarditis, MRSA pneumonia vs skin/soft tissue) and adjust dosing to achieve target range.
Calculate gentamicin or tobramycin extended-interval (once-daily) dose using weight-based dosing (5–7 mg/kg) with Hartford nomogram for subsequent dose interval adjustment.
Use the Hartford nomogram to determine gentamicin/tobramycin dosing interval (q24h, q36h, or q48h) based on a single post-distribution level drawn 6–14 hours after dose administration.
Correct measured total phenytoin level for hypoalbuminemia or renal failure using Winter-Tozer equation to estimate free phenytoin and avoid dose adjustment errors.
Interpret valproic acid levels by clinical indication: epilepsy (50–100 mg/L), bipolar disorder (50–99 mg/L), migraine prophylaxis (50–75 mg/L), and status epilepticus IV loading targets.
Assess lithium toxicity risk based on serum level (12h post-dose), renal function, dehydration, NSAID/ACE inhibitor co-prescription, and clinical symptoms of intoxication.
Assess theophylline toxicity risk and predict seizure/cardiac arrhythmia threshold based on serum level, rate of level rise (acute vs chronic), patient age, and comorbidities.
Interpret digoxin serum levels corrected for renal function, timing post-dose, and electrolyte status (K+, Mg2+) to distinguish therapeutic from toxic levels in heart failure and AF management.
Calculate warfarin dose adjustment based on current INR, target INR range, and VKORC1/CYP2C9 genotype to achieve and maintain anticoagulation targets safely.
Calculate HAS-BLED score for major bleeding risk on anticoagulation in atrial fibrillation: hypertension, renal/liver dysfunction, stroke, prior bleeding, labile INR, elderly, drugs/alcohol.
Interpret anti-Xa levels for IV unfractionated heparin therapy, targeting 0.3–0.7 IU/mL for VTE treatment (drawn 6 hours after infusion rate change) or 0.1–0.4 IU/mL for prophylaxis.
Calculate enoxaparin, dalteparin, or tinzaparin dose for DVT/PE treatment based on actual body weight, renal function, and indication (treatment vs prophylaxis vs bridging).
Calculate bivalirudin infusion rate adjustments for PCI and HIT anticoagulation based on activated clotting time (ACT) targets: 300–350 seconds during PCI, or aPTT 1.5–2.5× normal for HIT.
Calculate argatroban infusion rate for HIT treatment based on patient weight, hepatic function, and target aPTT (1.5–3.0× baseline). Reduce dose 75% in hepatic impairment.
Calculate fondaparinux dose for VTE treatment (weight-based) and prophylaxis (2.5 mg fixed) with contraindication screening for renal impairment (CrCl <30 mL/min contraindicated).
The apixaban label reduces the AF dose to 2.5 mg twice daily when two of three criteria are met — age 80 or older, weight 60 kg or less, creatinine 1.5 mg/dL or higher. This page applies the rule and flags the cases where it does not apply.
Determine appropriate rivaroxaban dosing for AF and VTE indications based on creatinine clearance, body weight, and indication-specific thresholds for dose reduction or avoidance.
Determine idarucizumab (Praxbind) dosing threshold for emergency dabigatran reversal based on dTT, ecarin clotting time, or anti-IIa activity, and indication (life-threatening bleeding or urgent surgery).
Apply edoxaban dose reduction criteria for VTE treatment (60 mg to 30 mg daily) and AF: CrCl 15–50 mL/min, body weight ≤60 kg, or concomitant P-gp inhibitors. Unique: better at higher CrCl than lower.
Identify high on-treatment platelet reactivity (HTPR) to clopidogrel using VerifyNow P2Y12 reaction units (PRU >208) or platelet aggregometry, and evaluate escalation to prasugrel or ticagrelor.
Determine optimal aspirin dose for antiplatelet effect by indication: 75–100 mg for secondary CVD prevention and DAPT with PCI, 81 mg for primary prevention in selected patients, 325 mg for ACS acute loading.
Score risk of NSAID-induced acute kidney injury using baseline eGFR, diuretic/ACE/ARB co-prescription, volume depletion, heart failure, age, and duration of NSAID use.
Apply the Rumack-Matthew nomogram to determine N-acetylcysteine treatment necessity in acetaminophen overdose based on 4-hour post-ingestion plasma level and time since ingestion.
Convert between oral and parenteral opioid doses using equianalgesic tables: morphine, oxycodone, hydromorphone, fentanyl, tramadol, codeine, and buprenorphine, with route-specific adjustments.
Understand and calculate the respiratory depression ceiling effect of buprenorphine (partial agonist) and determine maximum analgesic dose vs OUD treatment dose thresholds.
Stratify QTc prolongation and torsades de pointes risk for methadone therapy based on dose, ECG QTc interval, electrolytes, concomitant QT-prolonging drugs, and cardiac history.
Convert between benzodiazepines on a diazepam-equivalent basis for tapering and cross-tolerance work. The table follows the Ashton equivalence chart and covers lorazepam, clonazepam, alprazolam, temazepam, oxazepam and chlordiazepoxide.
Interpret clozapine trough plasma levels (12h post-dose) targeting 350–600 ng/mL for treatment-resistant schizophrenia, with seizure threshold above 700 ng/mL and toxicity above 1000 ng/mL.
Estimate lithium renal clearance from creatinine clearance and calculate appropriate lithium dose and frequency based on GFR to maintain therapeutic levels (0.6–1.2 mmol/L for maintenance).
Interpret cyclosporine 2-hour post-dose (C2) levels for absorption monitoring in transplant recipients, targeting C2 400–800 ng/mL (renal), 600–1000 ng/mL (liver), 900–1400 ng/mL (heart) in early post-transplant period.
Interpret tacrolimus trough levels by transplant type, time post-transplant, and risk stratification to optimize immunosuppression while minimizing nephrotoxicity and opportunistic infection risk.
Calculate MPA (mycophenolic acid) AUC target for mycophenolate mofetil or enteric-coated mycophenolate in transplantation, targeting MPA AUC0-12h of 30–60 mg·h/L to balance efficacy and toxicity.
Interpret sirolimus trough levels by indication: transplant (target 4–12 ng/mL when combined with CNI, 12–20 ng/mL CNI-free), LAM (5–15 ng/mL), and TSC (target 5–15 ng/mL).
Adjust everolimus dose for hepatic impairment in oncology and transplant settings: mild (Child-Pugh A), moderate (B), and severe (C) with specific dose reduction recommendations.
Calculate imatinib dose for CML, GIST, and pediatric ALL by weight, indication, phase, and response milestones. Standard adult CML: 400 mg/day; accelerated phase/blast crisis: 600–800 mg/day.
Assess hepatotoxicity risk with sunitinib based on baseline liver function, prior hepatitis exposure, DILI susceptibility factors, and guide dose modification or discontinuation decisions.
Grade EGFR inhibitor-associated acneiform rash using CTCAE criteria and apply management algorithms: topical antibiotics for Grade 1–2, dose reduction and systemic doxycycline for Grade 3.
Grade pembrolizumab and other PD-1/PD-L1 inhibitor immune-related adverse events by organ system using CTCAE v5, with NCCN/SITC-aligned management (hold, high-dose steroids, infliximab, hospitalization).
Estimate nivolumab (PD-1 inhibitor) response probability using PD-L1 TPS/CPS, tumor mutational burden (TMB), MSI-H status, and tumor type for treatment decision support.
Assess KRAS/NRAS/BRAF mutation status impact on cetuximab and panitumumab response in metastatic colorectal cancer. RAS-mutated tumors do not benefit from EGFR antibodies.
Assess and grade bevacizumab-induced hypertension (class effect of VEGF inhibitors) using baseline BP, risk factors, and CTCAE grading to guide antihypertensive prophylaxis and dose modification.
Determine LVEF monitoring frequency and trastuzumab hold/discontinuation thresholds for HER2+ breast cancer treatment based on baseline LVEF, prior anthracycline exposure, and cardiac risk factors.
Estimate duration of B-cell depletion after rituximab therapy and timing for revaccination, pregnancy planning, and infection risk assessment based on dose and number of cycles.
Interpret infliximab trough levels for Crohn's disease and ulcerative colitis: target ≥3–5 mg/L for remission, ≥7 mg/L for mucosal healing. Differentiate pharmacokinetic failure from pharmacodynamic failure.
Interpret adalimumab anti-drug antibody (ADA) levels in the context of drug trough levels to distinguish immunogenic failure from pharmacokinetic failure and guide treatment optimization.
Determine etanercept dose for rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, plaque psoriasis, and juvenile idiopathic arthritis (weight-based pediatric dosing).
Estimate tocilizumab response probability in RA, giant cell arteritis, CRS, and COVID-19 based on IL-6 pathway biomarkers and clinical disease characteristics.
Calculate EASI (Eczema Area and Severity Index) to qualify patients for dupilumab therapy (moderate-severe atopic dermatitis) and monitor treatment response. Target ≥50% EASI reduction (EASI-50).
Calculate PASI score and determine secukinumab dosing (300 mg vs 150 mg) for moderate-severe plaque psoriasis, monitoring PASI-75, PASI-90, and PASI-100 response milestones.
Calculate APACHE II (Acute Physiology and Chronic Health Evaluation II) score using 12 physiologic variables plus age and chronic health points to predict ICU mortality risk.
Calculate APACHE IV mortality prediction using 142 variables across physiology, diagnosis, chronic conditions, and ICU admission source for superior discrimination over APACHE II.
Calculate the Simplified Acute Physiology Score II using 17 variables (worst in 24h) to estimate in-hospital mortality probability in ICU patients without surgery-specific or diagnosis-specific adjustments.
Calculate SAPS III using pre-admission status, admission circumstances, and physiology at ICU admission (not 24h worst values), providing real-time mortality risk estimate upon admission.
Calculate daily SOFA score assessing 6 organ systems (respiratory, coagulation, liver, cardiovascular, CNS, renal) to quantify organ dysfunction, predict ICU mortality, and monitor treatment response.
Calculate and interpret delta SOFA (change in SOFA score from baseline over 48 to 72h) to distinguish patients with improving vs deteriorating organ function and predict 28-day ICU mortality.
Calculate qSOFA (RR >=22, altered mentation, SBP <=100 mmHg) as a rapid bedside sepsis screening tool for patients outside the ICU. Score >=2 warrants urgent assessment for organ dysfunction.
Apply 2016 Sepsis-3 definitions: sepsis (life-threatening organ dysfunction from infection = SOFA >=2 increase), and septic shock (vasopressor need + lactate >2 mmol/L despite adequate fluids).
Calculate lactate clearance percentage from serial measurements to assess resuscitation adequacy in septic shock. Target >=10% clearance per 2 hours; lactate <2 mmol/L within 6 hours associated with improved survival.
Calculate the NUTRIC score to identify ICU patients at high nutritional risk who benefit most from early optimized nutrition therapy. Score uses age, APACHE II, SOFA, comorbidities, days from hospital to ICU, and IL-6.
Perform Subjective Global Assessment for malnutrition screening integrating weight change, dietary intake changes, GI symptoms, functional capacity, and physical examination (fat/muscle stores).
Estimate risk of Post-Intensive Care Syndrome across cognitive, psychological, and physical domains based on ICU stay length, mechanical ventilation duration, sedation exposure, and severity scores.
Assess likelihood of ICU-acquired weakness (ICUAW) using MRC sum score of 6 bilateral muscle groups and identify modifiable risk factors including duration of immobility, corticosteroids, and hyperglycemia.
Apply RASS scale (-5 to +4) to target and communicate sedation depth in ICU patients, guide sedation titration, assess delirium readiness (CAM-ICU requires RASS >=-3), and facilitate daily sedation interruption.
Apply the Critical-Care Pain Observation Tool (CPOT) to assess pain in non-communicative ICU patients using 4 behavioral indicators: facial expression, body movements, muscle tension, and ventilator compliance.
Interpret Bispectral Index (BIS) values (0 to 100) for sedation depth monitoring in ICU and operating room: target BIS 40 to 60 for general anesthesia, 60 to 80 for ICU moderate sedation.
Calculate propofol infusion rate (mcg/kg/min) required to achieve target RASS or BIS, with safety thresholds for propofol infusion syndrome monitoring (>4 mg/kg/h for >48h increases PRIS risk).
Calculate dexmedetomidine infusion rate (0.2 to 1.5 mcg/kg/h) for ICU sedation and procedural use, with titration guidance based on RASS target and monitoring for bradycardia and hypotension.
Calculate fentanyl continuous infusion rates equivalent to other opioids for ICU analgesia, with dose titration based on CPOT/NRS scores and conversion between IV morphine, hydromorphone, and fentanyl patch.
Calculate remifentanil infusion rates by ventilation mode and target analgesia level: 0.05 to 0.2 mcg/kg/min for spontaneous/pressure support, 0.1 to 0.4 mcg/kg/min for controlled ventilation.
Assess cisatracurium reversal readiness using train-of-four (TOF) ratio and guide neostigmine or sugammadex dosing for ICU patients post-neuromuscular blockade for ARDS or status asthmaticus.
Assess rocuronium train-of-four (TOF) ratio to determine adequacy of reversal and residual neuromuscular blockade risk. TOF ratio <0.9 indicates clinically significant residual blockade.
Calculate neostigmine dose (0.03 to 0.07 mg/kg IV, max 5 mg) for reversal of non-depolarizing NMB at adequate block depth (TOF >=2 twitches), always given with glycopyrrolate or atropine.
Calculate expected PaO2/FiO2 ratio improvement and predict prone positioning response in moderate-severe ARDS using pre-prone P/F ratio and initial oxygenation response at 1 hour of proning.
Determine optimal PEEP setting for ARDS using ARDSnet PEEP/FiO2 tables (lower vs higher PEEP strategy) based on P/F ratio severity and lung recruitability assessment.
Calculate driving pressure (plateau pressure minus PEEP) and target <=14 to 15 cmH2O to minimize ventilator-induced lung injury in ARDS. Adjust tidal volume and PEEP to achieve target driving pressure.
Calculate and target plateau pressure <=30 cmH2O in volume-controlled ventilation for ARDS and at-risk mechanically ventilated patients to prevent barotrauma and ventilator-induced lung injury.
Calculate FiO2 adjustments to achieve target PaO2 (55 to 80 mmHg in ARDS, 95 to 100% SpO2 in general care) using current A-a gradient estimation and ARDSnet FiO2/PEEP tables.
Calculate PaO2/FiO2 (P/F) ratio and classify ARDS severity: mild (200 to 300 mmHg), moderate (100 to 200 mmHg), severe (<100 mmHg) per Berlin definition, with PEEP correction requirement.
Apply 2012 Berlin definition for ARDS: acute onset within 1 week, bilateral infiltrates not fully explained by cardiac failure, and P/F <300 on PEEP >=5 cmH2O, classified into mild/moderate/severe severity.
Calculate the Murray Lung Injury Score using 4 components (chest X-ray, PaO2/FiO2, PEEP level, static compliance) to quantify ALI/ARDS severity for ECMO referral decisions (score >2.5).
Assess risk of ventilator-induced lung injury integrating tidal volume (mL/kg IBW), driving pressure, plateau pressure, respiratory rate, and mechanical power to guide lung-protective ventilation adjustments.
Assess readiness for spontaneous breathing trial using standardized criteria: adequate oxygenation, hemodynamic stability, absence of vasopressor need, adequate mentation, and passing spontaneous awakening trial.
Calculate cuff leak volume (inspired VT minus expired VT with cuff deflated) to predict post-extubation laryngeal edema. Leak <110 mL or <12% of VT is associated with post-extubation stridor risk.
Calculate risk of post-extubation laryngeal edema requiring reintubation based on cuff leak volume, intubation duration, age, sex, and tube-to-trachea size ratio.
Apply clinical criteria (SQuID score, clinical prediction models) to determine early vs late tracheostomy timing in mechanically ventilated ICU patients to minimize laryngeal injury and facilitate weaning.
Calculate continuous renal replacement therapy dose prescription in mL/kg/h targeting 20 to 25 mL/kg/h effluent flow rate per KDIGO AKI guidelines, adjusting for pre-dilution, anticoagulation, and circuit downtime.
Plan sustained low-efficiency daily dialysis (SLEDD) sessions: 6 to 12 hour sessions at 200 to 300 mL/min blood flow and 150 to 250 mL/min dialysate flow as a hybrid approach between IHD and CRRT for hemodynamically unstable AKI.
Calculate plasma exchange volume (1 to 1.5x estimated plasma volume) for TTP, myasthenia gravis crisis, Guillain-Barre, anti-GBM disease, and other indications with replacement fluid selection.
Calculate total plasma exchange cycles needed by indication: TTP (daily until remission), MG crisis (5 exchanges), GBS (4 to 6 exchanges), FSGS recurrence (intensive), anti-GBM (14 sessions).
Calculate IVIG dose for primary immunodeficiency (400 to 600 mg/kg), ITP (1 g/kg x2), CIDP (2 g/kg loading), Kawasaki disease (2 g/kg single dose), GBS (2 g/kg x5 days), and other indications.
Work out the grams of albumin to give after draining ascites, using the 6 to 8 g per litre rule for taps over 5 litres. The aim is to blunt post-paracentesis circulatory dysfunction and the drop in effective circulating volume.
Calculate vasopressin dose ranges for septic shock (0.03 to 0.04 U/min), vasodilatory shock post-cardiac surgery, and bleeding varices (0.2 to 0.4 U/min), with titration and weaning guidance.
Calculate norepinephrine infusion rate (mcg/kg/min) required to achieve target MAP (>=65 mmHg in septic shock) and compare vasopressor potency equivalents between norepinephrine, dopamine, epinephrine, and phenylephrine.
Calculate epinephrine doses for adult cardiac arrest (1 mg IV/IO every 3 to 5 min), anaphylaxis (0.3 to 0.5 mg IM), and septic shock (0.1 to 0.5 mcg/kg/min infusion) with timing and route guidance.
Estimate probability of atropine response in symptomatic bradycardia based on rhythm type (sinus vs AV block degree), mechanism (vagal vs intrinsic), and presence of hemodynamic instability.
Convert between calcium chloride and calcium gluconate doses: 1 g CaCl2 = 272 mg elemental Ca = 3 g calcium gluconate = 93 mg elemental Ca. Guide selection for cardiac arrest vs CRRT hypocalcemia vs hyperkalemia.
Calculate magnesium sulfate loading dose (4 to 6 g IV over 15 to 20 min) and maintenance infusion (1 to 2 g/h) for eclampsia seizure prevention and treatment, with toxicity monitoring and calcium gluconate antidote.
Stratify ARDS severity using Berlin 2012 P/F ratio thresholds combined with PEEP requirement and clinical trajectory to determine escalation to prone positioning, ECMO referral, and paralytic agent use.
Determine sodium bicarbonate dose and pH threshold for administration in metabolic acidosis: typically reserved for pH <7.10 to 7.15 (lactic acidosis, DKA adjunct, RTA, toxin ingestion) with calculation of bicarbonate deficit.
Calculate and interpret the 1-minute Apgar score assessing neonatal adaptation at birth across five parameters: heart rate, respiratory effort, muscle tone, reflex irritability, and color.
Evaluate the 5-minute Apgar score to assess neonatal recovery and guide ongoing resuscitation. Persistent scores below 7 at 5 minutes warrant extended monitoring and neurologic follow-up.
Estimate gestational age from neuromuscular and physical maturity criteria using the New Ballard Score. Applicable from 20 to 44 weeks when last menstrual period is unknown.
Plot birth weight against gestational age to classify newborns as small for gestational age (SGA <10th percentile), appropriate (AGA 10–90th), or large for gestational age (LGA >90th).
Calculate z-scores for weight, length, and head circumference in preterm infants from 22 to 50 weeks postmenstrual age using the Fenton 2013 growth reference.
Calculate percentage postnatal weight loss from birth weight and assess whether it falls within acceptable ranges for term, late-preterm, and preterm neonates.
Determine phototherapy initiation threshold for neonatal jaundice based on total serum bilirubin, postnatal age in hours, and gestational age risk category using the Bhutani hour-specific nomogram.
Identify the total serum bilirubin level at which double-volume exchange transfusion is indicated based on gestational age risk stratification per AAP 2022 guidelines.
Calculate surfactant dosing for respiratory distress syndrome in preterm neonates based on body weight, gestational age, and surfactant preparation (poractant alfa, beractant, calfactant).
Calculate caffeine citrate loading and maintenance doses for apnea of prematurity in preterm neonates based on body weight, with monitoring parameters for toxicity.
Calculate indomethacin dosing regimen for pharmacologic closure of patent ductus arteriosus in preterm neonates, with age-stratified dosing and renal monitoring intervals.
Determine glucose intervention thresholds in neonates by age category and risk stratification, differentiating between at-risk asymptomatic and symptomatic hypoglycemia management protocols.
Stage necrotizing enterocolitis severity using modified Bell criteria across systemic, intestinal, and radiologic findings to guide medical versus surgical management decisions.
Identify retinopathy of prematurity stages and zones meeting threshold and pre-threshold criteria for laser photocoagulation or anti-VEGF treatment to prevent retinal detachment.
Score neonatal respiratory distress severity across five criteria: upper chest retraction, lower chest retraction, xiphoid retraction, nares dilation, and expiratory grunt, each scored 0–2.
Calculate the Score for Neonatal Acute Physiology II (SNAP-II) using mean blood pressure, lowest temperature, PaO2/FiO2 ratio, serum pH, multiple seizures, and urine output to predict NICU mortality.
Calculate pediatric daily and hourly maintenance fluid requirements using the Holliday-Segar method: 100 mL/kg for first 10 kg, 50 mL/kg for next 10 kg, 20 mL/kg thereafter.
Compute hourly IV fluid rate using the 4-2-1 rule for pediatric maintenance: 4 mL/kg/hr for first 10 kg, plus 2 mL/kg/hr for next 10 kg, plus 1 mL/kg/hr for remaining weight.
Calculate first 24-hour Ringer's lactate requirement for pediatric burns using the modified Parkland formula (3–4 mL/kg/% TBSA) plus daily maintenance fluids, with Lund-Browder TBSA assessment.
Calculate PALS defibrillation energy dose (2 J/kg initial, 4 J/kg subsequent) and cardioversion dose (0.5–1 J/kg) based on pediatric body weight for VF, pulseless VT, and SVT.
Calculate epinephrine dose for pediatric cardiac arrest (0.01 mg/kg IV/IO, 0.1 mg/kg ETT) and anaphylaxis (0.01 mg/kg IM) with maximum dose caps and repeat interval guidance.
Calculate atropine dose for symptomatic bradycardia in children: 0.02 mg/kg IV/IO, minimum 0.1 mg to avoid paradoxical bradycardia, maximum 0.5 mg per dose in children.
Calculate adenosine dose for pediatric SVT conversion: 0.1 mg/kg (maximum 6 mg) first dose, 0.2 mg/kg (maximum 12 mg) second dose, administered by rapid IV push followed by saline flush.
Calculate amiodarone loading dose for refractory VF/pulseless VT (5 mg/kg IV/IO bolus) and perfusing VT/SVT (5 mg/kg IV over 20–60 min) in pediatric patients.
Calculate weight-based amoxicillin dose for common pediatric infections: standard AOM (80–90 mg/kg/day), streptococcal pharyngitis (50 mg/kg/day), and UTI prophylaxis (10–15 mg/kg/day).
Calculate age- and weight-appropriate acetaminophen doses for children: oral/rectal 10–15 mg/kg every 4–6 hours, maximum 75 mg/kg/day or 5 doses in 24 hours.
Calculate weight-based ibuprofen dose for children aged 6 months and older: 5–10 mg/kg per dose every 6–8 hours for pain or fever, maximum 40 mg/kg/day or 2.4 g/day.
Estimate pediatric body weight from height/length using Broselow tape color zones for emergency drug dosing and equipment sizing when actual weight is unavailable.
Estimate pediatric GFR using the Schwartz formula: GFR = k x height (cm) / serum creatinine (mg/dL), where k is 0.413 for bedside CKiD version applicable to children 1–18 years.
Calculate vancomycin dosing interval and dose by postmenstrual age (PMA) and weight for neonatal sepsis, with AUC/MIC target-based dosing and trough monitoring guidance.
Calculate phenobarbital loading dose for neonatal or pediatric seizures: 20 mg/kg IV loading dose, with supplemental dosing of 5–10 mg/kg if seizures persist, up to 40 mg/kg total.
Calculate weight-based levetiracetam loading (40–60 mg/kg IV) and maintenance dosing (20–60 mg/kg/day) for pediatric epilepsy and status epilepticus by age and renal function.
Calculate phenytoin or fosphenytoin loading dose (15–20 mg PE/kg) for pediatric seizures, with IV rate limits to prevent cardiac arrhythmia and hypotension.
Calculate sepsis fluid resuscitation bolus for pediatric patients: 10–20 mL/kg isotonic crystalloid over 5–20 minutes, reassess after each bolus, titrate to perfusion endpoints per Surviving Sepsis guidelines.
Calculate Pediatric Risk of Mortality III (PRISM III) score using 17 physiologic variables collected in the first 12 PICU hours to predict risk-adjusted hospital mortality.
Calculate pediatric Sequential Organ Failure Assessment (pSOFA) score using age-specific thresholds for respiratory, cardiovascular, hepatic, coagulation, renal, and neurologic dysfunction.
Calculate Pediatric Index of Mortality 3 (PIM3) using 8 admission variables to predict probability of death in PICU patients for quality benchmarking and research stratification.
Score PICU sedation and distress using the COMFORT scale across alertness, calmness, respiratory distress, movement, blood pressure, heart rate, and muscle tone to guide analgesic titration.
Assess pain in pre-verbal children aged 2 months to 7 years using the FLACC scale: Face, Legs, Activity, Cry, and Consolability, each scored 0–2 for a total of 0–10.
Use the Wong-Baker FACES Pain Rating Scale to self-report pain in children aged 3 years and older using six facial expressions corresponding to pain scores 0, 2, 4, 6, 8, and 10.
Reference typical developmental milestone acquisition age ranges across gross motor, fine motor, language, social-emotional, and cognitive domains for children 0–5 years per CDC 2022 milestones.
Calculate and interpret BMI percentile for children and adolescents aged 2–20 years using CDC growth charts, classifying underweight, healthy weight, overweight, and obese categories.
Calculate WHO weight-for-length z-score for children under 5 years to classify acute malnutrition: severe acute malnutrition (<-3 SD), moderate acute malnutrition (-3 to -2 SD).
Identify Denver II developmental screening test failure criteria: 2 or more delays (failure of item passed by 90% of children at younger age) in one sector or one delay plus one caution across sectors.
Interpret Modified Checklist for Autism in Toddlers Revised (M-CHAT-R) scores to identify toddlers at risk for autism spectrum disorder at the 18-month and 24-month well-child visit.
Compare Vanderbilt ADHD Rating Scale scores from parent and teacher reports to identify ADHD subtype (predominantly inattentive, hyperactive-impulsive, or combined) and comorbid conditions.
Score the Childhood Autism Rating Scale across 15 behavioral domains to classify autism severity: non-autistic (below 30), mild-to-moderate (30–36.5), and severe autism (37–60).
Calculate the Conners Index score from parent or teacher Conners Rating Scale to identify clinically significant ADHD symptoms using T-score threshold of 65 or above for referral.
Calculate height velocity standard deviation score over a 6–12 month interval to identify growth faltering, growth hormone deficiency, or catch-up growth requiring endocrine evaluation.
Assess catch-up growth adequacy in SGA or post-illness children by evaluating centile crossing toward mid-parental height target range within expected timeframes.
Interpret bone age delay from Greulich-Pyle atlas against chronological age to differentiate constitutional growth delay from pathologic causes including hypothyroidism and growth hormone deficiency.
Calculate body surface area using the DuBois formula: BSA = 0.007184 x height(cm)^0.725 x weight(kg)^0.425, used as the primary dosing basis for chemotherapy agents.
Calculate carboplatin dose using the Calvert formula: Dose (mg) = Target AUC x (GFR + 25), using measured or estimated GFR. Target AUC varies by regimen from 2 to 7.5 mg/mL/min.
Adjust cisplatin dose based on creatinine clearance, holding for CrCl below 60 mL/min, and calculating dose reduction for CrCl 60–90 mL/min to minimize nephrotoxicity.
Calculate cumulative doxorubicin dose and compare against cardiotoxicity threshold (450–550 mg/m2), accounting for risk factors including prior mediastinal radiation and cardiac disease.
Estimate lifetime risk of anthracycline-induced cardiomyopathy using cumulative dose equivalent, patient age, cardiac risk factors, and whether echocardiographic surveillance has been initiated.
Calculate mesna prophylaxis dose (20% of cyclophosphamide dose at 0, 4, 8 hours) and IV fluid hydration requirements to prevent hemorrhagic cystitis from acrolein metabolite accumulation.
Determine leucovorin rescue timing and dose after high-dose methotrexate (HDMTX) based on serum MTX levels at 24, 48, and 72 hours using standard rescue nomograms.
Guide 5-fluorouracil dose modification based on CTCAE toxicity grade for mucositis, diarrhea, hand-foot syndrome, and myelosuppression: grade 2 delay, grade 3 reduce, grade 4 discontinue.
Determine capecitabine dose modification based on hand-foot syndrome (palmar-plantar erythrodysesthesia) grade: grade 1 maintain dose, grade 2 interrupt, grade 3 interrupt and reduce by 25%.
Calculate gemcitabine dose based on ANC and platelet count: full dose if ANC above 1000 and platelets above 100K; 75% dose if ANC 500–1000 or platelets 50–100K; hold if below these levels.
Assess peripheral neuropathy risk from cumulative paclitaxel exposure, with dose modification thresholds: grade 2 neuropathy warrants 20% dose reduction; grade 3 neuropathy requires treatment hold.
Grade docetaxel-related fluid retention syndrome and guide dose modification: dexamethasone premedication reduces severity, grade 3 edema requires treatment interruption.
Monitor cumulative vincristine dose relative to peripheral neuropathy risk, with dose capping at 2 mg per dose to prevent severe CIPN and autonomic neuropathy.
Adjust etoposide dose based on hepatic function: reduce by 50% for bilirubin 1.5–3 mg/dL or AST above 3x ULN; hold for bilirubin above 5 mg/dL or severe hepatic impairment.
Track cumulative bleomycin dose against pulmonary toxicity threshold (400 units total), with risk stratification for age above 70, renal impairment, smoking history, and high supplemental oxygen exposure.
Assess R-CHOP cycle intensity maintenance by calculating dose intensity ratios for each component and overall regimen relative dose intensity (RDI) versus planned doses across cycles.
Calculate International Prognostic Index (IPI) for DLBCL from age over 60, LDH elevation, ECOG PS 2+, Ann Arbor Stage III/IV, and extranodal sites over 1 to predict 5-year OS.
Calculate FLIPI score from age over 60, Ann Arbor Stage III/IV, hemoglobin below 12 g/dL, more than 4 nodal areas, and LDH elevation to classify 3 risk groups for follicular lymphoma.
Calculate the Mantle Cell Lymphoma International Prognostic Index (MIPI) from age, ECOG performance status, LDH, and WBC count to classify low, intermediate, and high-risk disease.
Classify multiple myeloma stage using International Staging System (ISS): serum beta-2 microglobulin and albumin levels determine Stage I, II, or III with corresponding median OS estimates.
Apply Revised ISS (R-ISS) for multiple myeloma staging combining ISS, FISH cytogenetics (del17p, t(4;14), t(14;16)), and LDH to classify Stage I, II, or III with updated survival data.
Apply criteria to distinguish smoldering multiple myeloma (serum M-protein 3 g/dL or above, or bone marrow plasma cells 10–60%) from MGUS and symptomatic MM requiring treatment.
Interpret serum free light chain kappa/lambda ratio: normal range 0.26–1.65, values outside this range in the context of plasma cell disorders support MGUS, SMM, or MM diagnosis.
Estimate annual and 20-year risk of MGUS progressing to myeloma or related disorder using the Mayo risk stratification model based on M-protein size, type, and FLC ratio.
Stage chronic lymphocytic leukemia using Rai staging (0–IV) based on lymphocytosis, lymphadenopathy, splenomegaly/hepatomegaly, anemia, and thrombocytopenia with median OS estimates.
Classify CLL using Binet staging system: Stage A (less than 3 involved areas, no anemia/thrombocytopenia), Stage B (3 or more areas), Stage C (anemia or thrombocytopenia present).
Calculate Cumulative Illness Rating Scale (CIRS) score to determine CLL patient fitness for intensive chemoimmunotherapy vs. reduced-intensity or targeted agent regimens.
Calculate the Sokal score for chronic myeloid leukemia using age, spleen size, platelet count, and blast percentage to classify low, intermediate, or high risk for TKI therapy planning.
Apply the EUTOS (European Treatment and Outcome Study) score using basophil percentage and spleen size to identify CML patients unlikely to achieve complete cytogenetic remission with imatinib.
Assess imatinib TKI response using ELN 2020 milestones: BCR-ABL1 IS below 10% at 3 months, below 1% at 6 months, and below 0.1% (MMR) at 12 months as optimal response benchmarks.
Calculate the Revised IPSS (IPSS-R) for myelodysplastic syndrome using cytogenetics, blast percentage, hemoglobin, platelets, and ANC to determine risk category and median OS.
Determine whether bone marrow blast percentage meets WHO AML threshold: 20% or more blasts required for AML diagnosis (with exceptions for AML-defining cytogenetics at any blast count).
Classify AML risk per European Leukemia Net 2022 criteria into favorable, intermediate, or adverse categories based on cytogenetics and molecular mutations to guide induction and consolidation decisions.
Interpret FLT3-ITD allelic ratio: high allelic ratio (above 0.5) without NPM1 mutation confers adverse risk in AML; lower ratios with co-occurring NPM1 mutation shift to intermediate or favorable risk.
Estimate complete remission probability from standard 7+3 induction (cytarabine x7 days + daunorubicin x3 days) based on age, ELN risk, secondary AML, and prior MDS/therapy.
Assess acute promyelocytic leukemia differentiation syndrome risk based on presenting white blood cell count, with prophylactic dexamethasone protocol for high-risk presentations (WBC above 10K).
Assess the prognostic impact of Philadelphia chromosome (BCR-ABL1) positivity in acute lymphoblastic leukemia and the treatment implications of TKI addition to chemotherapy.
Interpret MRD (minimal residual disease) negativity thresholds: below 0.01% (10^-4) by flow cytometry or below 10^-5 by PCR as optimal response benchmarks in AML and ALL.
Apply the 5-point Deauville scale to PET-CT scans in lymphoma: scores 1–2 indicate complete metabolic response, 3 is equivocal, 4–5 indicates residual disease, guiding response-adapted therapy.
Apply Lugano 2014 classification for Hodgkin and non-Hodgkin lymphoma staging using PET-CT, replacing Ann Arbor staging for response assessment and incorporating Deauville criteria.
Classify lymphoma using Ann Arbor staging (I–IV) with E (extranodal), S (spleen), A/B (constitutional symptoms), and X (bulky disease) modifiers for treatment planning.
Quantify the impact of ECOG performance status on median overall survival in solid tumors and hematologic malignancies, with each point increase associated with significantly reduced treatment tolerance and survival.
Convert Karnofsky Performance Scale score (0–100) to ECOG equivalent and estimate median survival for cancer patients, with KPS below 50 indicating median OS below 2 months in many solid tumors.
Apply RECIST 1.1 criteria to measure solid tumor response: CR (disappearance), PR (30% decrease), PD (20% increase plus 5 mm absolute), SD (neither PR nor PD) from sum of target lesion diameters.
Apply iRECIST criteria for immunotherapy response assessment, accounting for pseudo-progression with unconfirmed PD (iUPD) requiring confirmation at 4–8 weeks before declaring confirmed PD (iCPD).
Identify CTCAE v5.0 adverse event grade thresholds that trigger dose reduction or treatment discontinuation: grade 3 typically requires dose delay/reduction, grade 4 typically requires discontinuation.
Calculate Charlson Comorbidity Index from 19 weighted conditions to estimate 1-year all-cause mortality risk and guide oncologic treatment intensity, surgical fitness, and clinical trial eligibility.
Apply the Lee Index or revised cardiac risk index to assess functional capacity in oncology patients undergoing major surgery to stratify perioperative cardiac event risk.
Correlate ECOG performance status with chemotherapy toxicity risk, dose intensity maintenance, and survival benefit to guide treatment decision-making in borderline PS 2–3 oncology patients.
Determine G-CSF primary prophylaxis eligibility based on febrile neutropenia risk from regimen plus patient factors: ASCO/ESMO recommend G-CSF when overall FN risk exceeds 20%.
Calculate MELD-Na score incorporating serum sodium for liver transplant prioritization. MELD-Na = MELD + 1.32 × (137 − Na) − [0.033 × MELD × (137 − Na)]. Used by UNOS for organ allocation.
Calculate MELD 3.0, the updated liver disease severity score incorporating female sex, albumin, and creatinine. Approved by UNOS in 2022 to reduce sex-based disparities in transplant access.
Calculate Child-Turcotte-Pugh score for liver cirrhosis severity. Score 5 variables: bilirubin, albumin, PT/INR, ascites, encephalopathy. Class A (5–6): good function; Class C (10–15): severe dysfunction.
Interpret hepatic venous pressure gradient (HVPG) measurements for portal hypertension staging. HVPG normal: <5mmHg; subclinical: 5–9; clinically significant: ≥10; severe: ≥12 (variceal bleeding risk).
Calculate FIB-4 index for non-invasive liver fibrosis staging. FIB-4 = (Age × AST) / (Platelet Count × √ALT). Low risk: <1.30; Indeterminate: 1.30–2.67; High risk: >2.67 (significant fibrosis).
Calculate AST-to-Platelet Ratio Index (APRI) for liver fibrosis and cirrhosis assessment. APRI = (AST/ULN) × 100 / Platelet Count. APRI >2 suggests cirrhosis; <0.5 predicts no significant fibrosis.
Calculate NAFLD Fibrosis Score using age, BMI, hyperglycemia, AST/ALT ratio, platelets, and albumin. Distinguishes NAFLD patients with and without advanced fibrosis.
Calculate FAST score combining liver stiffness (FibroScan), controlled attenuation parameter (CAP), and AST to identify patients with NASH with significant fibrosis (≥F2) requiring treatment.
Apply King's College Hospital criteria to predict need for liver transplant in acute liver failure. Separate criteria for acetaminophen-induced and non-acetaminophen etiologies.
Stage liver cirrhosis according to EASL clinical practice guidelines using compensated vs decompensated status, HVPG, presence of varices, and history of decompensation events.
Estimate post-TIPS mortality risk using pre-procedural MELD score, Child-Pugh class, and indication (variceal hemorrhage vs refractory ascites). MELD >18 doubles procedural mortality risk.
Grade hepatic encephalopathy using West Haven criteria: Grade 0 (minimal/covert), Grade I (trivial lack of awareness), Grade II (disorientation), Grade III (somnolence), Grade IV (coma).
Calculate probability of spontaneous bacterial peritonitis (SBP) from ascitic fluid PMN count. Diagnosis: PMN ≥250 cells/mm3. Assess 1-year SBP recurrence risk and prophylaxis indication.
Apply Acute Kidney Injury Network (AKIN) criteria to diagnose and stage hepatorenal syndrome (HRS). HRS-AKI: creatinine rise ≥0.3 mg/dL in 48h or ≥50% rise. HRS-CKD: GFR <60 ml/min for 3+ months.
Calculate PELD score for children under 12 years awaiting liver transplant. Variables: bilirubin, INR, albumin, growth failure, age <1 year. Predicts 90-day mortality on pediatric transplant waitlist.
Estimate total liver volume (TLV) and remnant liver volume (RLV) for living donor liver transplant evaluation. TLV = -794.41 + 1267.28 × BSA. Minimum donor RLV >30% required for safe donation.
Calculate expected split liver graft volumes for pediatric (segment II/III) and adult (right trisegment) recipients from deceased donor. Estimate functional graft volume based on donor body surface area.
Estimate portal venous pressure from HVPG measurements and clinical parameters. Normal portal pressure 5–10 mmHg; portal hypertension >10 mmHg; clinically significant >12 mmHg.
Calculate hepatic artery resistance index (RI) from Doppler waveform: RI = (Peak Systolic Velocity − End Diastolic Velocity) / Peak Systolic Velocity. Normal 0.55–0.75. Post-transplant monitoring tool.
Classify biliary strictures using the Bismuth-Corlette system for hilar cholangiocarcinoma and bile duct injuries. Types I–IV based on location and involvement of biliary confluence.
Assess acute cholangitis severity using Tokyo Guidelines. Mild (Grade I): responds to medical treatment. Moderate (Grade II): end-organ impairment absent. Severe (Grade III): organ dysfunction present.
Classify Mirizzi syndrome using McSherry or Csendes system based on degree of bile duct involvement. Type I: external compression. Types II–IV: cholecystocholedochal fistula with increasing bile duct destruction.
Grade postoperative pancreatic fistula (POPF) using International Study Group on Pancreatic Fistula (ISGPF) 2016 definition. Grade A (biochemical leak), Grade B (clinical impact), Grade C (life-threatening).
Calculate Ranson's criteria score for acute pancreatitis prognosis. 5 admission criteria + 6 criteria at 48 hours. Score ≥3 predicts severe acute pancreatitis; ≥7 approaches 100% mortality.
Calculate modified Glasgow (Imrie) score for acute pancreatitis. 8 variables measured at 48 hours. Score ≥3 predicts severe pancreatitis with sensitivity 61–80% and specificity 73–82%.
Calculate BISAP score at 24 hours: BUN >25, Impaired mental status, SIRS criteria ≥2, Age >60, Pleural effusion. Score ≥3 predicts severe pancreatitis with mortality 5–20%.
Calculate Balthazar CT Severity Index combining CT grade (A–E, 0–4 points) and necrosis percentage (0–6 points). CTSI 0–3: mild; 4–6: moderate; 7–10: severe (17% mortality, 92% complication rate).
Interpret pancreatic main duct diameter in context of age and imaging findings. MPD ≥5mm warrants investigation. ≥10mm with mural nodule: high risk for IPMN malignancy requiring surgery.
Assign an ERCP to one of four ASGE complexity grades using the intended procedure, the patient's anatomy, and any comorbidity that raises sedation or access risk. Grade 3 and 4 cases belong in high-volume advanced endoscopy units.
Calculate ASGE risk stratification for choledocholithiasis: high risk (>50% probability: stone on imaging, cholangitis, bilirubin >4), intermediate, or low risk (<10%). Guides pre-op ERCP vs IOC decision.
Classify choledochal cysts using Todani modification of Alonso-Lej system. Types I–V based on location and morphology. Type I (fusiform CBD dilation) most common (80–90%). Type IV/V have highest malignancy risk.
Estimate annual progression risk from Barrett's esophagus to esophageal adenocarcinoma. Non-dysplastic: 0.1–0.3%/year. Low-grade dysplasia: 0.5–1.0%/year. High-grade: 5–8%/year.
Estimate H. pylori eradication probability based on regimen choice, clarithromycin resistance rates in region, compliance, and prior treatment history. First-line quadruple therapy achieves 85–95% in low-resistance areas.
Estimate diagnostic yield of small bowel capsule endoscopy by indication. Obscure GI bleeding: 45–70%. Iron deficiency anemia: 28–50%. Suspected Crohn's: 43–71%. Polyposis: 75–90%.
Estimate depth of insertion for push and device-assisted enteroscopy (single-balloon, double-balloon). Antegrade DBE reaches median 240–360cm past pylorus; retrograde reaches terminal ileum 100–160cm.
Interpret colonic transit scintigraphy results by calculating geometric center at 24, 48, and 72 hours. Geometric center <1.5 at 48h = delayed. >3.5 at 48h = normal. Guides constipation subtype diagnosis.
Apply Rome IV diagnostic criteria for IBS: recurrent abdominal pain ≥1 day/week for 3+ months, onset ≥6 months, with ≥2 of: related to defecation, associated with stool frequency change, stool form change.
Interpret Bristol Stool Form Scale types 1–7 for clinical implication. Types 1–2: constipation (>30 hour transit). Types 3–4: normal. Types 5–7: diarrhea (<10 hour transit). Used in IBS subtyping.
Interpret fecal calprotectin level for decision to proceed to colonoscopy. <50 μg/g: low organic disease probability. 50–200: borderline (repeat/other testing). >200: high probability of IBD or significant mucosal disease.
Interpret fecal tumor M2-pyruvate kinase (M2-PK) for colorectal cancer screening. Cut-off 4 U/mL: sensitivity 85% for CRC, 57% for advanced adenoma. Used alongside FIT in multi-marker protocols.
Calculate FIT (fecal immunochemical test) false positive rate and positive predictive value based on population CRC prevalence and cutoff threshold. Standard cutoff 20 μg Hb/g feces: PPV 3–5% in average risk.
Calculate endoscopist adenoma detection rate (ADR): percent of colonoscopies with at least one adenoma detected. Target ADR ≥25% (men ≥30%, women ≥20%). Higher ADR predicts lower post-colonoscopy CRC rates.
Estimate post-polypectomy bleeding and perforation risk based on polyp size, location, morphology, and technique. Large sessile polyps (>20mm) have 1–5% complication rate. Piecemeal EMR up to 8%.
Estimate colorectal cancer survival by Dukes/Modified Astler-Coller (MAC) stage. Dukes A (mucosa): 5-year OS >95%. Dukes B: 60–80%. Dukes C (lymph node positive): 35–55%. Dukes D (metastatic): 5–10%.
Estimate immunotherapy response probability in MSI-H/dMMR colorectal cancer. Pembrolizumab first-line: ORR 45%, PFS2 advantage vs chemotherapy. MMR status guides checkpoint inhibitor eligibility.
Estimate Lynch syndrome probability using MMR immunohistochemistry, MSI status, MLH1 promoter methylation, BRAF V600E, and family history. Positive MLH1 IHC loss without methylation = ~40% Lynch syndrome probability.
Apply Amsterdam II criteria for clinical Lynch syndrome diagnosis: ≥3 relatives with Lynch-associated cancers (CRC, endometrial, small bowel, ureter, renal pelvis), spanning 2 generations, ≤1 diagnosed <50 years.
Estimate probability of positive video capsule endoscopy (VCE) finding in obscure GI bleeding based on hemoglobin drop, transfusion requirement, and time since last bleed. Overt active bleed: 70-90% yield.
Calculate CDAI for Crohn's disease activity assessment over 7 days. Score <150: remission. 150-220: mild. 220-450: moderate. >450: severe. Endpoint in clinical trials and treatment escalation decisions.
Compute the four-part Mayo score for ulcerative colitis and its three-part partial version. Remission is 0 to 2, mild 3 to 5, moderate 6 to 10, and severe 11 to 12, with the endoscopic subscore reported separately.
Adjust warfarin dose based on CYP2C9 metabolizer phenotype. *1/*1 normal, *1/*2 or *1/*3 reduce by 10-25%, *2/*3 or *3/*3 reduce by 40-70%.
Estimate warfarin sensitivity from VKORC1 haplotype. -1639A/A haplotype confers high sensitivity; reduce dose 30-50% vs G/G.
Estimate clopidogrel antiplatelet failure risk from CYP2C19 loss-of-function alleles. *2/*2 homozygous gives 3x higher MACE risk.
Compare clopidogrel vs prasugrel antiplatelet efficacy based on CYP2C19 phenotype for ACS patients.
Assess risk of codeine toxicity in CYP2D6 ultra-rapid metabolizers. Gene duplication converts codeine to morphine at 2-3x normal rate.
Calculate tramadol O-desmethyltramadol accumulation risk by CYP2D6 phenotype. Ultra-rapid metabolizers have elevated seizure and serotonin syndrome risk.
Assess tamoxifen conversion to active endoxifen by CYP2D6 phenotype. Poor metabolizers have 75% lower endoxifen levels and reduced breast cancer protection.
Adjust atomoxetine dose for ADHD by CYP2D6 phenotype. Poor metabolizers require 40-50% dose reduction to avoid cardiovascular side effects.
Calculate fluoxetine's potent CYP2D6 inhibition effect on co-medications. Reduces CYP2D6 clearance by 60-90% creating phenoconversion to poor metabolizer.
Score interaction severity between paroxetine and CYP2D6 substrate co-medications. Paroxetine is the strongest CYP2D6 inhibitor among SSRIs.
Adjust sertraline dose by CYP2C19 phenotype. Ultra-rapid metabolizers may need 50% higher dose; poor metabolizers risk adverse effects at standard doses.
Assess escitalopram QTc prolongation and adverse event risk in CYP2C19 poor metabolizers. AUC 3-fold higher requiring dose cap at 10mg/day.
Calculate venlafaxine O-desmethylvenlafaxine ratio by CYP2D6 phenotype affecting SNRI blood pressure and efficacy.
Adjust bupropion dose by CYP2B6 metabolizer phenotype for smoking cessation and depression. Slow metabolizers accumulate drug and risk seizures.
Predict efavirenz CNS toxicity and virologic failure probability from CYP2B6 *6 allele status in HIV treatment.
Determine tacrolimus starting dose by CYP3A5 expressers vs non-expressers in solid organ transplant. Expressers require 1.5-2x higher initial dose.
Estimate cyclosporine AUC change from CYP3A4 inhibitors or inducers co-prescribed in transplant patients.
Calculate sirolimus dose adjustment needed when CYP3A4 inhibitors or inducers are added to regimen.
Determine everolimus dose escalation when CYP3A4 inducers like rifampin or carbamazepine are co-prescribed.
Predict irinotecan grade 3-4 diarrhea and neutropenia severity from UGT1A1 *28 promoter polymorphism status.
Calculate irinotecan dose reduction for UGT1A1 *28/*28 homozygous patients per FDA label guidance.
Assess life-threatening fluoropyrimidine toxicity risk from DPYD variants. Complete deficiency (*2A/*2A) is a contraindication to capecitabine.
Adjust 5-fluorouracil dose by DPYD activity score. Activity score 1.0 requires 50% dose reduction; 1.5 requires 25% reduction.
Predict azathioprine and 6-mercaptopurine myelosuppression severity from TPMT enzyme activity phenotype.
Calculate azathioprine dose by NUDT15 genotype especially relevant in Asian populations where *3 allele is more prevalent.
Determine abacavir hypersensitivity reaction risk from HLA-B*5701 status. Positive genotype: contraindication with 55% HSR risk.
Screen Asian patients for HLA-B*1502 before carbamazepine to prevent Stevens-Johnson syndrome. Variant present in 6-8% of Han Chinese.
Determine severe cutaneous adverse reaction risk from allopurinol based on HLA-B*5801 status and renal function.
Calculate flucloxacillin cholestatic hepatitis risk from HLA-B*5701 carrier status.
Estimate statin-induced myopathy risk from SLCO1B1 *5 variant. C allele carriers have 4.5x higher myopathy risk on high-dose simvastatin.
Calculate simvastatin myopathy risk when CYP3A4 inhibitors are co-prescribed. Azole antifungals contraindicated with simvastatin >10mg.
Adjust atorvastatin dose based on SLCO1B1 transport variant status to minimize myopathy while maintaining LDL target achievement.
Estimate rosuvastatin AUC increase from ABCG2 421C>A variant. Homozygous AA genotype doubles rosuvastatin exposure.
Assess metformin hepatic uptake and glucose-lowering efficacy from SLC22A1 (OCT1) loss-of-function variant status.
Determine metformin safety and dosing by eGFR: continue at G3a, halve dose G3b, discontinue at G4-G5.
Estimate digoxin level increase when P-glycoprotein inhibitors like amiodarone, clarithromycin or verapamil are co-prescribed.
Calculate fexofenadine bioavailability change from ABCB1/P-gp polymorphisms and grapefruit juice inhibition.
Adjust dabigatran dose when P-gp inhibitors (ketoconazole, dronedarone, rifampin) are co-prescribed in AF or VTE treatment.
Determine apixaban dose adjustment for strong dual CYP3A4/P-gp inhibitors or inducers based on current indication.
Calculate rivaroxaban bioavailability change from food intake timing and CYP3A4/P-gp interacting drugs.
Estimate lithium levels and toxicity risk from renal function changes, NSAIDs, thiazides, and ACE inhibitor co-prescription.
Assess valproate hepatotoxicity risk from CYP2C9 metabolizer status, age under 2 years, and polypharmacy with enzyme inducers.
Predict phenytoin saturation and toxicity threshold shift in CYP2C9 *2/*3 carriers. Target level must be lowered by 20-30%.
Quantify phenobarbital CYP2C9 induction effect on co-administered drugs including warfarin, phenytoin, and oral contraceptives.
Model carbamazepine CYP3A4 autoinduction causing 25-50% level drop over 4-6 weeks requiring dose escalation.
Calculate lamotrigine dose adjustment when enzyme inducers or valproate alter UGT glucuronidation. Valproate doubles; CBZ halves lamotrigine levels.
Calculate levetiracetam dose by eGFR. Normal: 500-1500mg BID; eGFR 30-50: 250-750mg BID; eGFR <30: 250-500mg BID.
Assess additive metabolic acidosis risk from topiramate and hydrochlorothiazide dual carbonic anhydrase inhibition.
Estimate zonisamide use safety in patients with sulfonamide allergy history. Cross-reactivity is low but monitoring required.
Estimate rifampin's pan-CYP induction effect on all co-administered medications. Reduces levels of CYP3A4 substrates by 50-80%.
Score ICU ABCDEF bundle compliance: Awakening, Breathing, Coordination, Delirium, Early Mobility, Family. Higher compliance correlates with reduced mortality.
Assess ICU delirium using Confusion Assessment Method-ICU: altered mental status, inattention, disorganized thinking, altered LOC.
Screen for ICU delirium using Intensive Care Delirium Screening Checklist. Score 4+ indicates delirium; 1-3 indicates subsyndromal delirium.
Set RASS sedation target for ICU patients. Light sedation (RASS -1 to 0) associated with shorter ventilator duration vs deep sedation.
Use Critical-Care Pain Observation Tool to assess and titrate analgesia in non-verbal ICU patients. Score 0-8; >2 indicates pain requiring treatment.
Score sedation level using Sedation-Agitation Scale (1-7). SAS 3-4 indicates calm target; SAS 5-7 escalating agitation requiring intervention.
Select optimal ICU sedation strategy per SCCM PAD/PADIS guidelines based on diagnosis, ventilator mode, and delirium risk factors.
Determine readiness for SAT in mechanically ventilated patients. Safety screen must pass before interrupting sedation infusions.
Screen ICU patients for SAT safety using ABCDEF bundle criteria before reducing or stopping sedation infusions.
Predict spontaneous breathing trial success using RSBI, P0.1 occlusion pressure, and integrated breathing index prior to extubation.
Calculate post-extubation laryngeal edema risk from intubation duration, female sex, tube size, and traumatic intubation history.
Predict post-extubation failure requiring reintubation within 48-72 hours using HACOR score components.
Score HACOR (Heart rate, Acidosis, Consciousness, Oxygenation, Respiratory rate) to predict NIV failure risk within 1-2 hours of initiation.
Convert HFNC flow rate and FiO2 setting to effective FiO2 delivered and expected SpO2 for clinical monitoring.
Guide HFNC vs NIV selection in hypoxemic respiratory failure based on etiology, ROX index, and work of breathing.
Determine acceptable mask leak thresholds for NIV efficacy. Leak >24 L/min impairs ventilation and CO2 clearance in standard BiPAP.
Choose between CPAP and BiPAP for respiratory support based on work of breathing, CO2, and underlying diagnosis.
Screen ARDS patients for prone positioning contraindications: spinal instability, elevated ICP, hemodynamic instability, tracheostomy complications.
Calculate neuromuscular blockade dosing for prone positioning in severe ARDS. TOF monitoring targets 1-2 twitches during procedure.
Guide incremental PEEP recruitment maneuver steps in ARDS. Assess compliance and oxygenation response at each PEEP level.
Calculate optimal PEEP for open lung strategy balancing recruitment vs overdistension using driving pressure and compliance.
Detect lung overdistension or recruitment from pressure-time curve shape during constant-flow ventilation. Index >1.1 indicates overdistension.
Estimate patient self-inflicted lung injury risk during spontaneous breathing in ARDS. Strong effort with high negative P0.1 increases VILI risk.
Use HACOR score to predict NIV treatment failure in hypoxemic and hypercapnic respiratory failure patients.
Score CLABSI prevention bundle adherence: hand hygiene, chlorhexidine, maximal barrier precautions, optimal site, removal assessment.
Score catheter-associated UTI prevention bundle: catheter necessity, aseptic insertion, maintenance, and daily removal assessment.
Score ventilator-associated pneumonia prevention bundle: HOB elevation, oral care, peptic ulcer prophylaxis, DVT prophylaxis, spontaneous awakening/breathing.
Estimate attributable mortality from CLABSI episode based on organism, patient comorbidity, and time to appropriate antibiotics.
Select anticoagulation intensity and duration for PE based on ACCP/ESC guidelines: provoked vs unprovoked, risk factors, bleeding risk.
Calculate heparin-induced thrombocytopenia pretest probability using 4T score: Thrombocytopenia degree, Timing, Thrombosis, other causes.
Interpret HIT functional assay (serotonin release assay or heparin-induced platelet activation) results in context of 4T pretest probability.
Calculate argatroban or bivalirudin dosing for immune-mediated HIT treatment with hepatic and renal adjustment.
Weigh risk-benefit of systemic thrombolysis in submassive PE based on RV dysfunction, troponin, BNP, bleeding risk, and hemodynamic trajectory.
Determine candidacy and dose for catheter-directed thrombolysis in massive PE. EKOS 24mg alteplase reduces bleeding vs systemic thrombolysis.
Score operative mortality risk for massive PE surgical embolectomy based on age, hemodynamics, cardiac arrest, and RV function.
Determine treatment escalation threshold in pulmonary arterial hypertension based on mPAP, PVR, and NYHA functional class.
Select milrinone vs dobutamine for acute RV failure based on SVR, PA coupling, and systemic blood pressure.
Interpret TAPSE (tricuspid annular plane systolic excursion) for RV systolic dysfunction. TAPSE < 17mm indicates impaired RV function.
Grade diastolic dysfunction and estimate filling pressures using E/e' ratio. E/e' > 14 indicates elevated LVEDP.
Predict fluid responsiveness from IVC collapsibility index in spontaneously breathing patients. >50% collapse predicts response.
Predict fluid responsiveness from passive leg raise CO increase. >10% increase in pulse pressure or cardiac output predicts responder.
Use PPV >13% to predict fluid responsiveness in mechanically ventilated patients with sinus rhythm and no spontaneous effort.
Optimize fluid management using SVV target <10-13% for goal-directed therapy in surgical and ICU patients.
Set global end-diastolic volume index target for transpulmonary thermodilution (PiCCO/LiDCO) guided fluid therapy.
Use ScvO2 >70% as resuscitation endpoint in septic shock. ScvO2 <65% indicates inadequate oxygen delivery or increased demand.
Monitor lactate clearance as resuscitation endpoint. ≥10% clearance per hour or >2 mmol/L absolute decrease at 2 hours predicts survival.
Calculate damping coefficient and natural frequency from fast-flush test to determine if arterial waveform is underdamped or overdamped.
Interpret PA catheter measurements: PCWP reflects LVEDP in absence of mitral valve disease; CVP reflects RV preload.
Assess RV-pulmonary arterial coupling using Ees/Ea elastance ratio. Ratio < 0.8 indicates uncoupling and poor prognosis.
Diagnose cardiac tamponade from echo findings: RA collapse, RV diastolic collapse, respiratory IVC variation, and Doppler respiratory variation >25%.
Determine PCI vs medical therapy using FFR threshold. FFR ≤0.80 indicates hemodynamically significant stenosis warranting revascularization.
Use iFR ≤0.89 to determine PCI indication without adenosine. iFR matches FFR outcomes in DEFINE-FLAIR and iFR-SWEDEHEART trials.
Calculate SYNTAX score for multivessel or left main CAD to guide PCI vs CABG decision. Low ≤22, intermediate 23-32, high ≥33.
Calculate predicted operative mortality for cardiac surgery using EuroSCORE II logistic model incorporating 18 risk variables.
Estimate morbidity and mortality risk for CABG, valve, and combined cardiac surgery using Society of Thoracic Surgeons risk model.
Classify TAVR patient as low, intermediate, or high surgical risk using STS-PROM score for aortic valve replacement.
Size TAVR prosthesis from CT aortic annulus area and perimeter. Annulus area-derived diameter guides valve selection and sizing.
Calculate aortic valve area using Gorlin equation from cardiac catheterization data: cardiac output, gradient, and heart rate.
Differentiate true severe from pseudo-severe aortic stenosis using dobutamine stress echo. True severe: AVA remains <1.0 cm² with flow normalization.
Modified Simpson biplane ejection fraction is the default echo measure of systolic function. This page takes end-diastolic and end-systolic areas and lengths from the A4C and A2C views and returns the biplane EF.
Average LV volumes from 5-chamber and 2-chamber views using biplane disc summation to improve EF accuracy.
Grade diastolic dysfunction from E/A ratio: Grade I (impaired relaxation E/A<1), Grade II (pseudonormal), Grade III (restrictive E/A>2).
Calculate left atrial volume index (LAVI) from biplane method. LAVI > 34 mL/m² indicates LA enlargement and chronic elevated filling pressures.
Noninvasively estimate LVEDP using E/e' ratio. LVEDP = 11.4 + (1.24 x average E/e') per validated regression equations.
Assess subclinical LV dysfunction using GLS. GLS worse than -18% suggests subclinical dysfunction even with preserved EF.
Calculate peak systolic strain rate from speckle-tracking echocardiography as a load-independent marker of myocardial contractility.
Measure and interpret TAPSE for RV systolic function. Normal TAPSE ≥17mm; values 11-16mm mild-moderate impairment; <11mm severe.
Estimate RV systolic pressure non-invasively from TAPSE/PASP ratio (TPAPE). Ratio <0.32 predicts 5-fold higher mortality in heart failure.
Estimate RVSP from tricuspid regurgitation velocity using modified Bernoulli equation plus estimated RAP.
Calculate pulmonary to systemic flow ratio from oxygen saturations to quantify intracardiac shunt magnitude in ASD and VSD.
Grade AR severity by continuous wave Doppler pressure half-time. PHT < 250ms indicates severe AR with rapid equalization.
Grade mitral regurgitation severity by vena contracta width. VC ≥7mm indicates severe MR requiring surgical or catheter-based intervention.
Calculate tricuspid valve area using continuity equation or PISA method to grade tricuspid stenosis severity.
Calculate mitral valve area by planimetry and PHT, scored by Wilkins score to guide PBMV candidacy. Score ≤8 favors PBMV.
Calculate effective regurgitant orifice area and regurgitant volume using PISA method for mitral or tricuspid regurgitation quantification.
Quantify effective regurgitant orifice area from PISA for classification of MR severity. ERO ≥40mm² = severe primary MR.
Calculate mitral regurgitant volume (RVol = ERO x VTI-MR). RVol ≥60 mL/beat defines severe primary MR.
Calculate abdominal aortic aneurysm annual rupture risk by diameter. Risk <1%/yr at 5cm, 10-15%/yr at 6cm, 30-50%/yr at 7+cm.
Estimate Type A aortic dissection mortality risk with time. Untreated: 1-2%/hour for first 48 hours; 50% at 48hrs without surgery.
Determine TEVAR indication for Type B aortic dissection based on aortic diameter, malperfusion, pain persistence, and false lumen expansion.
Calculate NASCET carotid stenosis percentage from angiography measurements. CEA beneficial if symptomatic stenosis ≥70% or asymptomatic ≥80%.
Estimate in-stent restenosis risk after carotid artery stenting based on lesion characteristics, stent type, and patient risk factors.
Classify peripheral artery disease severity by ankle-brachial index. ABI <0.90 diagnoses PAD; <0.40 indicates critical ischemia.
Stage critical limb ischemia using WIfI (Wound, Ischemia, Foot Infection) classification to predict amputation risk and revascularization benefit.
Reclassify ASCVD risk using coronary artery calcium (CAC) score. CAC=0 downclassifies; CAC>300 substantially upclassifies statin decision.
Guide PCI decision from coronary CTA-derived FFR-CT. FFR-CT ≤0.80 identifies lesion-specific ischemia noninvasively.
Compare CT-derived FFR accuracy, sensitivity, and specificity against invasive wire-based FFR for PCI decision.
Predict EF recovery after revascularization from cardiac MRI late gadolinium enhancement transmural extent in ischemic cardiomyopathy.
Assess myocardial viability from LGE transmurality. <25% transmural LGE: high viability; 26-50% intermediate; >50% non-viable.
Grade PET myocardial perfusion defect severity: summed stress score 0-3 normal, 4-7 mild, 8-12 moderate, ≥13 severe ischemia.
Interpret peak VO2 for heart failure prognosis and transplant listing. Peak VO2 <12 mL/kg/min predicts 1-year mortality >50%.
Interpret 6-minute walk test distance for NYHA class correlation and prognosis in heart failure. <300m indicates poor prognosis.
Determine transplant listing candidacy from peak VO2. Beta-blocked patients: VO2 <12 mL/kg/min; not beta-blocked: VO2 <14 mL/kg/min.
Classify advanced heart failure severity using INTERMACS profiles 1-7 to guide LVAD implant timing and predict outcomes.
Estimate 1-year survival after HeartMate 3 LVAD implantation based on age, INTERMACS profile, BUN, and albumin.
Predict post-LVAD right ventricular failure risk using EUROMACS score incorporating pre-implant echo and hemodynamic variables.
Determine CRT eligibility based on QRS duration and morphology. LBBB with QRS ≥150ms: Class IA; QRS 120-149ms LBBB: Class IIa.
Determine ICD primary prevention indication by LVEF: EF ≤35% with NYHA II-III on optimal therapy for ≥3 months is Class I indication.
Stage peripheral artery disease severity using Rutherford classification (0-6). Category 3: disabling claudication; 4-6: critical limb ischemia.
Assess myocardial viability using low-dose dobutamine stress echocardiography. Biphasic response (improvement then worsening) indicates viability.
Predict 3-month functional outcome from NIHSS score at admission. NIHSS <8 predicts favorable outcome; >25 predicts severe disability.
Quantify absolute benefit of IV tPA versus placebo from NNT data stratified by baseline NIHSS and time-to-treatment.
Determine tPA eligibility considering standard 3-hour window, extended 4.5-hour criteria, and wake-up stroke MRI selection.
Predict symptomatic intracranial hemorrhage probability after IV tPA using SITS-MOST registry predictors.
Use ASPECTS score for thrombectomy patient selection. ASPECTS ≥6 associated with favorable thrombectomy outcome in large vessel occlusion.
Apply DAWN trial selection criteria for thrombectomy in 6-24 hour window using DWI volume and NIHSS clinical mismatch.
Calculate MRI or CT perfusion-diffusion mismatch ratio for thrombectomy eligibility in 6-16 hour window per DEFUSE 3 criteria.
Score all 10 ASPECTS regions individually to guide prognosis. Caudate and internal capsule involvement most predict poor functional outcome.
Estimate salvageable penumbral tissue from CT perfusion Tmax>6s volume minus DWI or rCBF<30% core volume.
Predict probability of mRS 0-2 (independent function) at 90 days from baseline characteristics and treatment.
Grade SAH severity using Hunt-Hess scale (1-5). Grade 1-2: good prognosis; grade 4-5: high mortality and disability.
Grade SAH using World Federation of Neurosurgical Societies scale based on GCS and motor deficit. WFNS 1: GCS 15; WFNS 5: GCS 3-6.
Predict cerebral vasospasm risk from SAH CT using Fisher scale (1-4). Grade 3 (thick clot) has highest vasospasm and DCI risk.
Calculate 5-year rupture risk of unruptured intracranial aneurysm using PHASES score: Population, Hypertension, Age, Size, Earlier SAH, Site.
Calculate UIATS score weighing aneurysm and patient factors to recommend treatment vs observation for unruptured intracranial aneurysm.
Estimate cumulative rebleed risk for unclipped/uncoiled aneurysm after initial SAH. 20-30% in first 2 weeks without treatment.
Use TCD MCA mean velocity to predict cerebral vasospasm after SAH. MCA > 120 cm/s mild, >180 cm/s severe vasospasm.
Estimate DIND probability from Fisher grade, SAH onset severity, and day 3-14 clinical window.
Assess expected benefit from hypertension, hypervolemia, hemodilution for SAH-related vasospasm. Current evidence favors euvolemia + induced hypertension.
Quantify nimodipine NNT for favorable outcome in SAH. NNT = 7 for mRS 0-2; NNT = 11 to prevent death based on systematic review.
Set EVD drainage threshold for ICP management. ICP target <20-25 mmHg; drain at ICP >20 for >5 minutes per BTF guidelines.
Calculate cerebral perfusion pressure target range for TBI management. CPP target 60-70 mmHg; avoid CPP <50 and >70 mmHg with aggressive fluids.
Assess cerebral autoregulation integrity from MAP-ICP correlation (PRx). PRx >0.2 indicates impaired autoregulation requiring individualized CPP targeting.
Predict 6-month mortality from GCS at presentation in traumatic brain injury. GCS 3: 70% mortality; GCS 13-15: <5% mortality.
Grade pupillary light reactivity from +3 (brisk) to -1 (absent) for prognostication in coma, TBI, and herniation assessment.
Score TBI rehabilitation outcome using Disability Rating Scale (0-29). DRS tracks arousability, cognitive ability, and function for TBI.
Rate TBI outcome using Glasgow Outcome Scale Extended (1-8). GOSE 5-8 indicates upper good recovery to full recovery.
Assess disorders of consciousness using Coma Recovery Scale-Revised (0-23). Scores differentiate vegetative from minimally conscious state.
Grade epilepsy surgical outcome using Engel classification. Class I: seizure-free; Class IV: no worthwhile improvement.
Estimate seizure freedom probability after anterior temporal lobectomy, lesionectomy, or extratemporal resection based on pre-surgical evaluation.
Predict status epilepticus in-hospital mortality using STESS score. Score 0-1: mortality 1%; score 2-4: 17%; score 5-6: 39%.
Predict status epilepticus mortality using EMSE incorporating etiology, comorbidity, age, and EEG findings.
Apply Treiman criteria for refractory status epilepticus treatment escalation to anesthetic agents after stage 1-2 failure.
Score likelihood of non-convulsive status epilepticus using Salzburg criteria applied to continuous EEG in altered mental status.
Systematically verify brain death prerequisites and clinical criteria: coma, absent brainstem reflexes, apnea test per AAN 2010 guidelines.
Calculate optimal organ retrieval timing after withdrawal of life-sustaining treatment in DCD donation.
Calculate EDSS (0-10) from functional system scores in MS. EDSS 6.0: intermittent or constant unilateral aid required to walk 100m.
Apply McDonald 2017 criteria for MS diagnosis: dissemination in space, dissemination in time, and CSF OCBs in CIS patients.
Calculate NEDA-3 (relapses, EDSS progression, MRI activity) and NEDA-4 (adding brain volume loss) for MS treatment monitoring.
Assess cognitive processing speed in MS using Symbol Digit Modalities Test. Decline of 4 points from baseline indicates meaningful worsening.
Measure physical and psychological impact of MS using MSIS-29 patient-reported outcome. Scores 0-100; higher scores indicate worse health status.
Calculate ALSFRS-R score (0-48) and monthly decline rate to predict survival and ventilation timing in ALS.
Stage ALS by King's staging (1-4) or MiToS (0-5) and assess FTD probability from cognitive and behavioral changes.
Score Parkinson's disease motor function using MDS-UPDRS Part III (0-132). Score ON vs OFF medication to assess levodopa response.
Stage Parkinson's disease severity using modified Hoehn-Yahr (1-5). Stage 3: bilateral disease with postural instability; stage 5: wheelchair or bedridden.
Score DBS candidacy for Parkinson's disease from levodopa response, cognition, age, tremor dominance, and motor complication severity.
Convert MMSE score to approximate CDR stage for clinical dementia staging. MMSE 21-26: CDR 0.5-1; MMSE <10: CDR 3 (severe dementia).
Determine care level requirement from ADL and IADL deficits. Loss of IADLs first (CDR 0.5-1); ADL loss indicates need for supervised or full care.
Estimate annual conversion rate from MCI to Alzheimer's dementia based on amyloid biomarker status, APOE4, and memory performance.
Determine NIV initiation threshold from vital capacity in neuromuscular disease. NIV indicated at VC <50% predicted or with orthopnea symptoms.
Classify COPD severity using GOLD spirometric grades 1-4 based on post-bronchodilator FEV1 percentage of predicted.
Grade dyspnea severity using modified Medical Research Council scale (0-4) for COPD ABCD group classification.
Calculate COPD Assessment Test score (0-40) for symptom impact. CAT ≥10 indicates high symptom burden for GOLD group classification.
Predict COPD survival using BODE index: BMI, Obstruction (FEV1%), Dyspnea (mMRC), Exercise capacity (6MWT). Score 0-10.
Calculate DOSE index (Dyspnea, Obstruction, Smoking, Exacerbation) to predict future COPD exacerbation risk and hospitalization.
Predict in-hospital mortality for acute COPD exacerbations using DECAF score: Dyspnea, Eosinopenia, Consolidation, Acidemia, Atrial Fibrillation.
Apply Anthonisen criteria to determine antibiotic indication in COPD exacerbation. Type I (3 criteria) or Type II (2 criteria) benefit from antibiotics.
Stratify CAP severity using CURB-65 to guide antibiotic selection and admission decision. Score 0-1: home; 2: hospital; 3-5: ICU consideration.
Calculate Pneumonia Severity Index for CAP risk stratification. Class I-II: outpatient; III: observation; IV-V: inpatient with possible ICU.
Apply A-DROP criteria for CAP severity in Japanese guideline: Age, Dehydration, Respiratory failure, Orientation, low Pressure.
Predict need for intensive respiratory or vasopressor support in CAP using SMART-COP score. Score 3-4: 3x higher IRVS risk.
Apply IDSA/ATS minor criteria for ICU admission in severe CAP. 3 of 9 minor criteria or 1 major criterion (septic shock, mechanical ventilation) warrants ICU.
Calculate Clinical Pulmonary Infection Score (0-12) to guide antibiotic decision in hospital-acquired and ventilator-associated pneumonia.
Predict Candida infection probability in ICU using Candida score: total parenteral nutrition (0.908), multifocal colonization (1.112), surgery (0.997), severe sepsis (2.038).
Interpret galactomannan index for invasive pulmonary aspergillosis diagnosis. Serum index ≥0.5, BAL index ≥1.0 considered positive per ESCMID guidelines.
Classify pleural effusion as exudate or transudate using Light's criteria: pleural/serum LDH ratio, absolute LDH, and protein ratio.
Calculate TB pleuritis probability from pleural ADA level. ADA >40 U/L in lymphocyte-predominant exudate has 93% sensitivity for TB pleuritis.
Predict 3-month mortality in pleural infection using RAPID score: Renal, Age, Purulence, Infection source, Dietary status.
Stratify pleural effusion management using BTS guidelines based on size, biochemistry, cytology, and clinical features.
Predict 1, 2, 3-year mortality in IPF using GAP model: Gender, Age, Physiology (FVC, DLCO). GAP index 0-8.
Score ILD severity using TORVAN (Total Physiologic Score for Chronic Fibrotic ILD) for prognosis and transplant listing.
Quantify dyspnea impact in IPF using UCSD shortness of breath questionnaire (0-120). Score correlates with 6MWT distance and FVC.
Calculate CPI = 91.0 - (0.65 x DLCO%) - (0.53 x FVC%) + (0.34 x FEV1%) for IPF extent quantification.
Estimate UIP pattern probability on HRCT in connective tissue disease-associated ILD to guide treatment decisions.
Assess likelihood of organ involvement in sarcoidosis using WASOG criteria for lung, skin, eye, liver, heart, and neurological manifestations.
Stage pulmonary sarcoidosis using Scadding classification (0-IV) from chest radiograph findings.
Correct DLCO percent predicted for hemoglobin level. Anemia artificially lowers DLCO; correction = (predicted DLCO x 1.7) / (Hb + 10.22).
Differentiate restrictive from obstructive lung disease using TLC. TLC < 80% predicted confirms restriction regardless of FEV1/FVC ratio.
Calculate RV/TLC ratio to quantify gas trapping in obstructive lung disease. RV/TLC > 40% indicates significant gas trapping in COPD/asthma.
Determine clinical significance of isolated DLCO reduction. Isolated DLCO <70% suggests pulmonary vascular disease, early ILD, or emphysema.
Interpret exertional SpO2 desaturation during 6MWT. Nadir SpO2 <88% indicates significant desaturation requiring supplemental oxygen prescription.
Estimate peak VO2 from incremental shuttle walk test distance for COPD and ILD patients. VO2 peak (mL/kg/min) = 4.19 + (0.025 x ISWT metres).
Detect and quantify exercise oscillatory ventilation amplitude as marker of heart failure severity and poor prognosis in CPET.
Calculate physiological dead space fraction using Bohr equation: Vd/Vt = (PaCO2 - PeCO2) / PaCO2. High Vd/Vt indicates inefficient ventilation.
Estimate work of breathing from pressure-rate product (PRP = P0.1 x RR). PRP > 300 cmH2O/min indicates excessive work of breathing.
Assess respiratory muscle strength from negative inspiratory force (NIF). NIF more negative than -20 to -25 cmH2O required for successful extubation.
Define acceptable residual AHI on CPAP therapy. Treatment success: residual AHI <5/hour; acceptable <10/hour in device download data.
Compare HSAT (home sleep apnea test) AHI to PSG AHI. HSAT typically underestimates AHI by 10-30% due to lack of sleep staging.
Distinguish RDI from AHI: RDI includes hypopneas with flow limitation and RERA events not meeting full AHI criteria.
Screen for obstructive sleep apnea using STOP-BANG questionnaire. Score 5-8: high probability; score 3-4: intermediate risk.
Interpret overnight oximetry T90 (time spent at SpO2 <90%) for OSA and sleep hypoventilation. T90 >1-2% is abnormal; >10% suggests nocturnal hypoventilation.
Quantify daytime sleepiness using Epworth Sleepiness Scale (0-24). Score >10 indicates excessive daytime somnolence requiring evaluation.
Calculate BiPAP pressure settings: EPAP addresses obstructive events; pressure support (IPAP-EPAP) targets hypoventilation. Target SpO2 >90% and EtCO2 <45.
Diagnose obesity hypoventilation syndrome using criteria: BMI >30, awake PaCO2 >45 mmHg, and excluded other causes of hypoventilation.
Determine PAP therapy compliance using CMS 4-hour/night threshold for 70% of nights in 30-day period.
Predict SpO2 at altitude from elevation using barometric pressure model. SpO2 at 3000m: ~90%; at 5000m: ~82%.
Calculate hypoxic ventilatory response slope (VE vs SpO2) as measure of peripheral chemoreceptor sensitivity to hypoxia.
Calculate ventilatory reserve at peak exercise: (MVV - peak VE) / MVV x 100. Normal >15-20%; <15% indicates ventilatory limitation.
Interpret forced oscillation technique (FOT/IOS) results for small airway disease and resistance. Reactance (Xrs) at 5Hz sensitive to peripheral obstruction.
Determine significant bronchodilator response: FEV1 or FVC increase ≥12% AND ≥200 mL from baseline per ATS/ERS 2022 criteria.
Calculate eGFR using race-free CKD-EPI 2021 creatinine equation recommended by NKF/ASN task force for more equitable staging.
Calculate eGFR from cystatin C using CKD-EPI cystatin C equation; unaffected by muscle mass making it useful in sarcopenic patients.
Calculate eGFR using combined creatinine-cystatin C CKD-EPI equation. More accurate than either single biomarker for GFR estimation.
Calculate eGFR using MDRD4 equation. Less accurate than CKD-EPI but still used in some labs. Underestimates GFR >60 mL/min.
Calculate pediatric GFR using bedside Schwartz formula: eGFR = 0.413 x height(cm) / creatinine (mg/dL) for children 1-18 years.
Classify albuminuria severity from UACR: A1 (<30 mg/g normal to mildly increased), A2 (30-300 moderately increased), A3 (>300 severely increased).
Calculate urine protein-to-creatinine ratio as surrogate for 24-hour urine protein. PCR >2000 mg/g equivalent to nephrotic-range proteinuria.
Grade albuminuria per KDIGO using UACR and clinical categories: A1 normal/mild, A2 moderate, A3 severe. Combined with GFR stages risk.
Stage chronic kidney disease using KDIGO G1-G5 GFR categories combined with A1-A3 albuminuria categories for comprehensive risk assessment.
Determine phosphate management targets and binder dosing by CKD stage. Phosphate >1.46 mmol/L in G3-5 requires intervention.
Set PTH targets by CKD stage: G3-G4: aim for normal range; G5D dialysis: 2-9x upper limit of normal per KDIGO 2017.
Calculate calcium-phosphate product to assess vascular calcification risk. Ca x PO4 > 55 mg²/dL² indicates high calcification risk.
Titrate cinacalcet dose from 30mg to 180mg daily based on PTH level and calcium monitoring for secondary hyperparathyroidism in dialysis.
Calculate sevelamer carbonate starting dose from serum phosphate: phosphate 1.8-2.4: 800mg TID; 2.4-2.9: 1600mg TID; >2.9: 2400mg TID.
Determine paricalcitol IV dose for dialysis patients: dose (mcg) = iPTH (pg/mL) / 80. Administer 3x weekly with monitoring.
Calculate ESA (erythropoietin/darbepoetin) dose for CKD anemia. Target hemoglobin 10-11.5 g/dL; avoid >13 g/dL due to cardiovascular risk.
Calculate total iron replacement dose using TDI formula: body weight x (target Hb - actual Hb) x 2.4 + 500mg stores.
Calculate single-pool Kt/V from pre- and post-dialysis BUN to assess hemodialysis adequacy. Target spKt/V ≥1.4 per session.
Calculate urea reduction ratio (URR = 1 - Ct/C0) x 100 for hemodialysis adequacy. URR target ≥70% for 3x weekly HD.
Calculate normalized protein catabolic rate as protein intake marker in dialysis patients. nPCR target 1.0-1.2 g/kg/day.
Calculate equilibrated Kt/V (eKt/V) from single-pool Kt/V using Daugirdas rebound correction for more accurate dialysis dose measurement.
Compare DOPPS benchmarks for delivered vs prescribed dialysis dose, time, and flow rates in hemodialysis centers.
Classify peritoneal transport status from D/P creatinine at 4 hours: high transporter >0.81, high-average 0.65-0.81, low-average 0.50-0.64, low <0.50.
Adjust CAPD prescription based on peritoneal transport type. High transporters: reduce dwell times; low transporters: use longer dwells with icodextrin.
Grade PD catheter exit site infection severity using Twardowski exit site score to guide topical vs systemic antibiotic therapy.
Identify urgent RRT indications per KDIGO: refractory fluid overload, hyperkalemia K+ >6.5, acidosis pH <7.1, uremic complications.
Calculate regional citrate anticoagulation dose for CRRT: citrate 3-4 mmol/L blood flow, calcium replacement to maintain ionized calcium >1.1 mmol/L.
Calculate CRRT effluent dose in mL/kg/hr. Target 20-25 mL/kg/hr (KDIGO minimum); prescribe 25-30 mL/kg/hr to account for downtime.
Calculate sustained low-efficiency daily dialysis (SLEDD) dose. Target Kt/V 1.0-1.4 per session with 6-8 hour duration.
Model IHD session duration to achieve target Kt/V from blood flow, dialyzer clearance, volume of distribution of urea, and patient weight.
Correct for post-dialysis urea rebound to calculate equilibrated Kt/V. Rebound typically 15-20% in 30-60 minutes post-HD.
Classify DKA severity: mild (pH 7.25-7.30, HCO3 15-18), moderate (pH 7.00-7.24, HCO3 10-15), severe (pH <7.00, HCO3 <10 mEq/L).
Calculate corrected anion gap in DKA: AG = Na - (Cl + HCO3); correct for albumin: AC-AG = AG + 2.5 x (4 - albumin g/dL).
Estimate total body water deficit in DKA: average 3-6L in adults; replace with 0.9% NaCl at 250-500 mL/hr, transitioning to 0.45% once glucose <250 mg/dL.
Calculate insulin infusion for DKA: 0.1 unit/kg/hr; glucose target decrease 50-75 mg/dL/hr; switch to SQ when AG normal and glucose <200 mg/dL.
Calculate effective osmolarity in HHS: 2x Na + glucose (mg/dL)/18. HHS diagnosis: osmolarity > 320 mOsm/kg, glucose > 600 mg/dL.
Estimate HHS total water deficit: average 8-12L. Replace 50% in first 12 hours; use 0.45% NaCl to correct hypernatremia gently.
Score thyroid storm probability using Burch-Wartofsky criteria: temperature, CNS effects, cardiovascular, GI/hepatic, precipitant. Score >45: thyroid storm.
Score myxedema coma severity and guide treatment urgency. Score >60: very high mortality requiring IV T4 + T3 combination with stress-dose steroids.
Assess adrenal insufficiency likelihood from random cortisol: <3 mcg/dL confirms, >18 mcg/dL excludes; 3-18 mcg/dL requires stimulation testing.
Interpret insulin tolerance test for GH and ACTH deficiency. Adequate cortisol response: peak cortisol >18-20 mcg/dL at glucose <40 mg/dL.
Interpret 250 mcg cosyntropin stimulation test: cortisol ≥18-20 mcg/dL at 30-60 minutes is normal. Values below indicate adrenal insufficiency.
Interpret 1mg overnight dexamethasone suppression test. 8am cortisol <1.8 mcg/dL (50 nmol/L) excludes Cushing's syndrome with 95% sensitivity.
Screen for Cushing's syndrome using late-night salivary cortisol. Two elevated samples (>1.5 to 2.0 nmol/L) required for positive screen.
Interpret 24-hour urine free cortisol for Cushing's diagnosis. Values >3-4x upper normal limit are specific; borderline results require repeat or other tests.
Use CRH stimulation test to differentiate pituitary from ectopic ACTH source. Pituitary: ACTH rises >35%; ectopic: minimal or no response.
Calculate inferior petrosal sinus sampling ACTH ratio for Cushing's disease lateralization. Basal IPS:peripheral >2:1 or post-CRH >3:1 confirms pituitary source.
Assess acromegaly control using age- and sex-adjusted IGF-1 levels. Nadir GH <1 ng/mL on OGTT and normal age-adjusted IGF-1 define remission.
Monitor acromegaly treatment response: target IGF-1 in age-adjusted normal range and GH nadir <1 ng/mL on glucose loading.
Correlate prolactin level with tumor size: microprolactinoma typically <200 ng/mL; macroadenoma often 1000-5000 ng/mL. Hook effect at very high levels.
Interpret anti-Mullerian hormone level for ovarian reserve assessment and IVF response prediction. AMH <1.0 ng/mL indicates diminished ovarian reserve.
Interpret antral follicle count (AFC) by age for ovarian reserve assessment. AFC <5-7 total indicates diminished reserve; >15 raises OHSS concern.
Compare measured resting energy expenditure from indirect calorimetry with predicted equations to guide clinical nutrition support.
Calculate resting energy expenditure using the Weir equation from oxygen consumption and carbon dioxide production measured by indirect calorimetry.
Determine respiratory quotient (RQ) based on metabolic substrate being oxidized to assess nutritional status and overfeeding risk.
Calculate optimal dextrose to fat ratio in parenteral nutrition to minimize metabolic complications and optimize substrate utilization.
Determine appropriate amino acid dosing in total parenteral nutrition for critically ill patients based on weight, renal function, and metabolic stress.
Calculate the minimum linoleic acid requirement to prevent essential fatty acid deficiency in patients receiving fat-free parenteral nutrition.
Calculate intravenous omega-3 fatty acid (fish oil) emulsion dosing for critically ill patients to modulate inflammation and improve outcomes.
Assess risk of carnitine depletion and propofol infusion syndrome in critically ill patients on high-dose propofol sedation.
Determine selenium supplementation dose for critically ill patients to support antioxidant defense systems and thyroid function.
Calculate zinc supplementation dose to accelerate wound healing and support immune function in zinc-deficient or critically ill patients.
Assess neurological risk from copper deficiency, including myelopathy and neuropathy, particularly after gastric bypass or excessive zinc intake.
Evaluate chromium picolinate supplementation dosing for insulin resistance and type 2 diabetes management based on clinical evidence.
Assess molybdenum requirements for cofactor-dependent enzymes (xanthine oxidase, sulfite oxidase) and clinical implications of deficiency.
Assess iodine fortification program adequacy using urinary iodine concentration and household iodized salt coverage metrics.
Calculate WHO-recommended vitamin A supplementation dose for children with measles to reduce complications and mortality.
Calculate vitamin D loading (stoss) dose regimen to rapidly correct deficiency and achieve target serum 25-hydroxyvitamin D levels.
Compare bioavailability and clinical effects of vitamin K2 menaquinone-4 (MK-4) versus menaquinone-7 (MK-7) for bone and cardiovascular health.
Compare bioavailability, antioxidant activity, and anti-inflammatory properties of gamma-tocopherol versus alpha-tocopherol vitamin E forms.
Calculate high-dose intravenous ascorbate (vitamin C) dosing protocols used in integrative oncology and critical care settings.
Compare hydroxocobalamin and cyanocobalamin dosing for B12 deficiency treatment, including retention, conversion, and clinical considerations.
Calculate periconceptional folic acid dose for neural tube defect prevention, including high-risk dosing for previous NTD pregnancies.
Calculate riboflavin (vitamin B2) supplementation dose for migraine prophylaxis based on clinical trial evidence and mitochondrial dysfunction hypothesis.
Determine niacin dosing for dyslipidemia management with strategies to minimize prostaglandin-mediated flushing side effects.
Assess adequate intake of pantothenic acid (vitamin B5) for coenzyme A synthesis and its role in fatty acid metabolism and energy production.
Determine biotin supplementation requirements in parenteral nutrition to prevent deficiency and support carboxylase enzyme function.
Calculate adequate choline intake during pregnancy for fetal brain development and prevention of neural tube defects.
Calculate myo-inositol and D-chiro-inositol supplementation dosing for polycystic ovary syndrome management and insulin sensitization.
Assess taurine supplementation requirements for preterm neonates receiving parenteral nutrition to support retinal and brain development.
Calculate creatine monohydrate loading and maintenance dosing protocols for ergogenic benefit in sports and therapeutic applications.
Evaluate HMB supplementation dosing for sarcopenia prevention and muscle protein synthesis augmentation in older adults and clinical populations.
Determine leucine dose threshold required to maximally stimulate mTORC1 signaling and muscle protein synthesis in young and elderly populations.
Calculate optimal leucine:isoleucine:valine ratio in BCAA supplementation for muscle protein synthesis and hepatic encephalopathy management.
Compare digestion kinetics, amino acid peak plasma appearance, and muscle protein synthesis outcomes between whey and casein protein sources.
Identify limiting amino acids in common plant protein sources and calculate complementary protein combinations to achieve complete amino acid profiles.
Calculate Protein Digestibility Corrected Amino Acid Score (PDCAAS) to assess protein quality relative to human amino acid requirements.
Compare Digestible Indispensable Amino Acid Score (DIAAS) across protein sources using ileal digestibility coefficients for more accurate protein quality assessment.
Differentiate glycemic index from glycemic load and calculate GL to assess real-world postprandial blood glucose impact of portion sizes.
Compare food insulinemic index with glycemic index and assess the insulin demand of protein-rich and mixed foods not predicted by GI alone.
Estimate short-chain fatty acid (butyrate, propionate, acetate) production from dietary fiber fermentation by gut microbiota.
Assess optimal soluble to insoluble fiber ratio for cholesterol reduction, glycemic control, bowel regularity, and gut microbiome diversity.
Calculate prebiotic supplementation dose (inulin, FOS, GOS) required to significantly increase gut microbiome diversity and Bifidobacterium abundance.
Determine minimum probiotic colony-forming unit (CFU) count and strain specificity needed for clinical efficacy in various gastrointestinal conditions.
Evaluate whether synbiotic combinations (probiotic + prebiotic) provide additive or synergistic effects beyond individual components for gut health outcomes.
Estimate FMT success probability for recurrent Clostridioides difficile infection based on donor microbiome diversity, route, and patient factors.
Calculate PREDIMED Mediterranean diet adherence score (0–14) and estimate cardiovascular disease risk reduction based on dietary patterns.
Calculate DASH diet adherence score and estimate expected systolic blood pressure reduction based on dietary compliance level.
Calculate ketogenic diet macronutrient ratios required to achieve therapeutic blood beta-hydroxybutyrate levels for epilepsy and metabolic applications.
Estimate vitamin B12 absorption adequacy in strict vegans without supplementation and calculate time to clinical deficiency development.
Assess caloric adequacy and micronutrient risk in raw food diets compared to conventional cooking for complete nutritional planning.
Analyze the effect of different intermittent fasting windows (16:8, 5:2, OMAD) on LDL cholesterol and atherogenic lipid profiles.
Calculate 10-year cardiovascular disease risk using the Framingham Risk Score including coronary heart disease, stroke, and peripheral artery disease endpoints.
Calculate 10-year atherosclerotic cardiovascular disease risk using the ACC/AHA Pooled Cohort Equations for statin therapy initiation decisions.
Calculate QRISK3 cardiovascular risk score incorporating ethnicity, deprivation, and clinical conditions specific to UK populations for primary prevention.
Calculate SCORE2 and SCORE2-OP 10-year fatal and non-fatal CVD event risk for European patients using ESC 2021 guidelines.
Calculate cardiovascular heart age and lifetime risk using the JBS3 tool to communicate risk to patients in an intuitive manner.
Calculate number needed to treat (NNT) derived from JUPITER trial data for rosuvastatin in elevated hs-CRP primary prevention population.
Calculate statin benefit-to-harm ratio using NNT for cardiovascular prevention versus NNH for myopathy, diabetes, and other adverse effects.
Evaluate current guideline recommendations on aspirin for primary CVD prevention including bleeding risk NNH versus cardiovascular benefit NNT.
Determine appropriate colonoscopy surveillance interval based on polyp histology, size, number, and presence of high-grade dysplasia per ACG guidelines.
Calculate FIT test sensitivity, specificity, and predictive values for colorectal cancer and advanced adenoma detection in screening populations.
Determine eligibility for low-dose CT lung cancer screening based on NLST and USPSTF criteria including age, smoking pack-year history.
Compare mammography screening sensitivity and specificity by age group and density, and calculate false positive and false negative rates.
Compare HPV primary testing, Pap cytology alone, and cotesting strategies for cervical cancer screening by sensitivity, specificity, and interval.
Evaluate PSA screening benefit-harm tradeoffs for prostate cancer detection including overdiagnosis, overtreatment, and mortality reduction evidence.
Interpret USPSTF recommendation grades A through D and I statements and their clinical implications for preventive service coverage decisions.
Apply the ABCDE criteria for melanoma detection and calculate sensitivity and specificity of dermoscopy versus naked-eye examination.
Interpret DEXA bone mineral density T-scores and Z-scores to classify osteoporosis, osteopenia, and guide treatment thresholds.
Calculate FRAX 10-year probability of major osteoporotic and hip fracture and determine country-specific intervention thresholds for treatment.
Model the interactive effect of calcium and vitamin D supplementation on bone mineral density and fracture reduction in postmenopausal women.
Calculate optimal exercise prescription for osteoporosis management including resistance, balance, and impact loading to improve bone density and reduce fracture risk.
Calculate evidence-based resistance training volume, intensity, and frequency recommendations for older adults to prevent sarcopenia and maintain functional independence.
Quantify fall risk reduction from balance and functional training programs in older adults and calculate number needed to treat.
Calculate number needed to treat with proprioceptive training to prevent one fall in older adults with balance deficits or peripheral neuropathy.
Assess frailty using the Fried phenotype (unintentional weight loss, exhaustion, weakness, slow gait, low activity) and predict adverse outcomes.
Apply the Clinical Frailty Scale (1-9) to assess frailty severity and guide clinical decision-making including ICU admission and surgical risk.
Diagnose sarcopenia using EWGSOP2 criteria including muscle strength, muscle mass (ALMI), and physical performance thresholds.
Calculate expected grip strength decline by decade and identify clinically significant weakness thresholds for sarcopenia and disability prediction.
Score the 30-second chair stand test and compare to age- and sex-specific normative data to assess lower extremity strength and fall risk.
Assess usual and maximum walking speed thresholds associated with functional decline, disability, hospitalization, and mortality in older adults.
Use gait speed as a clinical vital sign to predict 5-year and 10-year mortality risk in community-dwelling older adults.
Measure the dual-task cost on gait (speed and variability) during cognitive loading and interpret its significance for fall risk and dementia prediction.
Estimate cognitive reserve using years of education as a proxy and assess its protective effect against Alzheimer's disease symptom onset.
Evaluate the U-shaped relationship between sleep duration and all-cause mortality and identify optimal sleep duration ranges for health outcomes.
Calculate cumulative cognitive impairment from chronic sleep restriction and predict performance equivalence to total sleep deprivation.
Assess health risks of circadian misalignment from shift work including metabolic syndrome, cardiovascular disease, and cancer risk quantification.
Calculate expected erythropoietic and performance benefits from altitude training or live-high-train-low protocols for competitive athletes.
Compare high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) for VO2max improvements and cardiovascular risk factor reduction.
Predict peak DOMS timing, magnitude of CK elevation, and recovery timeline after unaccustomed eccentric exercise for training load management.
Calculate target ground contact time for plyometric training progressions to optimize reactive strength index and neuromuscular performance.
Estimate the rate of strength, aerobic capacity, and neuromuscular performance loss per week of detraining to plan return-to-training protocols.
Apply evidence-based return-to-sport criteria including functional tests, strength symmetry, and psychological readiness for safe athletic return after injury.
Calculate limb symmetry index (LSI) for quadriceps strength and functional tests after ACL reconstruction to guide return-to-sport decision.
Prescribe rotator cuff and scapular stabilizer strengthening protocols for subacromial impingement syndrome with evidence-based sets, reps, and resistance.
Compare outcomes of corticosteroid injection versus physiotherapy versus wait-and-see for lateral epicondylopathy with NNT and time-course data.
Calculate NNT for extracorporeal shockwave therapy in plantar fasciitis compared to conservative management and corticosteroid injection.
Calculate training load modification parameters for patellofemoral pain syndrome including pain-guided activity levels and return-to-running protocols.
Design a progressive loading protocol for Achilles tendinopathy using the Alfredson and ISAAC protocols with individualized progression criteria.
Classify bone stress injuries along the continuum from periosteal reaction to stress fracture and guide return-to-sport timelines by anatomical risk level.
Calculate energy availability in athletes and assess relative energy deficiency in sport (RED-S) risk using the energy availability threshold of 30 kcal/kg FFM/day.
Apply the Sport Concussion Assessment Tool 5 (SCAT5) to assess concussion severity and guide return-to-play protocol initiation.
Determine required frequency of metabolic monitoring (weight, glucose, lipids) for patients on clozapine therapy to detect and manage metabolic syndrome.
Determine clozapine continuation, interruption, and discontinuation thresholds based on absolute neutrophil count (ANC) per REMS program guidelines.
Interpret clozapine and norclozapine plasma concentrations and determine therapeutic window for efficacy and seizure risk threshold.
Calculate required renal monitoring frequency for lithium-treated patients based on therapy duration and GFR to detect chronic kidney disease progression.
Identify urine output thresholds for lithium-induced nephrogenic diabetes insipidus and guide management with amiloride or dose adjustment.
Quantify valproate teratogenicity risks including neural tube defects and neurodevelopmental outcomes for counseling women of childbearing potential.
Assess carbamazepine Stevens-Johnson syndrome and toxic epidermal necrolysis risk using HLA-B*1502 and HLA-A*3101 genotyping before prescribing.
Calculate lamotrigine titration schedule to minimize serious skin rash (SJS/TEN) risk based on co-medications and indication.
Determine screening frequency and parameters for metabolic syndrome in patients receiving quetiapine for psychiatric indications.
Estimate probability and magnitude of weight gain with olanzapine therapy and identify risk factors for clinically significant weight gain.
Predict prolactin elevation magnitude with risperidone and assess clinical consequences including sexual dysfunction and bone density loss.
Select optimal aripiprazole augmentation dose for treatment-resistant depression and antipsychotic-induced weight gain and prolactin elevation mitigation.
Compare receptor binding profiles of brexpiprazole and aripiprazole and their clinical implications for efficacy, side effects, and tolerability.
Explain cariprazine's preferential D3 over D2 receptor selectivity and its clinical implications for negative symptoms and cognitive function in schizophrenia.
Explain lumateperone's multimodal mechanism involving serotonin, dopamine, and glutamate systems and its clinical profile versus typical antipsychotics.
Explain pimavanserin's selective 5-HT2A/2C inverse agonism mechanism and its role in Parkinson's disease psychosis without worsening motor symptoms.
Compare ultra-low dose amisulpride (10-50 mg/day) for depression versus standard antipsychotic doses (400-800 mg/day) and their different D2/D3 receptor occupancy profiles.
Calculate haloperidol decanoate long-acting injection dose from oral haloperidol equivalent for schizophrenia long-term maintenance therapy.
Calculate paliperidone palmitate 1-monthly (Invega Sustenna) and 3-monthly (Invega Trinza) dosing from oral equivalent and loading doses for schizophrenia.
Apply 1-day initiation regimen for aripiprazole lauroxil (Aristada Initio) to eliminate the need for 21-day oral aripiprazole lead-in period.
Evaluate evidence base for amisulpride augmentation of clozapine in treatment-resistant schizophrenia and assess QTc risk of the combination.
Calculate ECT stimulus dose using titration method to determine seizure threshold and set therapeutic dose above threshold for efficacy.
Compare efficacy and cognitive side effect profiles of bitemporal, bifrontal, and right unilateral ECT electrode placements for treatment-resistant depression.
Differentiate high-frequency (excitatory) and low-frequency (inhibitory) TMS protocols for depression and their evidence-based response rates.
Compare deep TMS H-coil penetration depth with standard figure-8 coil and assess clinical advantages for treatment of depression and OCD.
Apply the standard 0.5 mg/kg IV ketamine infusion protocol for treatment-resistant depression including session frequency, monitoring, and response tracking.
Determine Spravato (esketamine) nasal spray induction and maintenance dosing schedule for treatment-resistant depression and active suicidal ideation.
Evaluate clinical trial psilocybin dosing for treatment-resistant depression and PTSD with safety monitoring and psychological support requirements.
Outline MAPS MDMA-assisted psychotherapy protocol for PTSD including dose escalation, session structure, and integration therapy requirements.
Evaluate evidence-based components of cognitive behavioral therapy for insomnia (CBT-I) and their relative efficacy for sleep onset and maintenance insomnia.
Determine optimal session frequency and duration for prolonged exposure therapy in PTSD for efficient treatment completion and outcomes.
Compare prolonged exposure therapy and EMDR for PTSD treatment outcomes, dropout rates, mechanism of action, and clinical utility.
Determine DBT skills training module completion requirements and evidence-based outcomes for borderline personality disorder and emotion dysregulation.
Measure psychological flexibility using ACT-relevant measures (AAQ-II, CompACT) and assess treatment response to Acceptance and Commitment Therapy.
Identify DARN-C change talk (Desire, Ability, Reason, Need, Commitment) in motivational interviewing to assess readiness for behavior change.
Apply the SDM-Q-9 questionnaire to measure shared decision making quality from the patient perspective in clinical encounters.
Assess legal status of psychiatric advance directives by jurisdiction and evaluate their effectiveness in honoring patient treatment preferences during incapacity.
Apply criteria for involuntary psychiatric hold (5150 in California, equivalents in other states) including danger to self, others, or grave disability.
Apply the least restrictive alternative principle to psychiatric treatment planning including outpatient, partial hospitalization, and inpatient level of care criteria.
Guide Wellness Recovery Action Plan (WRAP) development and evaluate recovery-oriented mental health practice effectiveness outcomes.
Quantify clinical and functional outcomes attributable to peer support specialists in mental health recovery and compare to traditional clinician delivery.
Evaluate employment and social functioning outcomes of the psychiatric Clubhouse model compared to traditional mental health day programs.
Assess Individual Placement and Support (IPS) supported employment program fidelity using the IPS Fidelity Scale to predict competitive employment outcomes.
Calculate Assertive Community Treatment (ACT) team staffing ratios, caseload limits, and TMACT fidelity scale components for high-need psychiatric populations.
Compare psychiatric crisis stabilization unit outcomes versus emergency department management for mental health crises including cost, hospitalization diversion, and satisfaction.
Guide medication-assisted treatment initiation decisions for opioid use disorder including buprenorphine, methadone, and naltrexone selection criteria.
Assess risk of precipitated withdrawal during buprenorphine induction using COWS score and timing criteria for safe initiation from different opioid substrates.
Guide methadone dose titration with QTc monitoring thresholds to prevent torsades de pointes in opioid use disorder and pain management.
Assess factors affecting extended-release naltrexone (Vivitrol) adherence for opioid and alcohol use disorder and compare to daily oral naltrexone.
Apply AUDIT-C scoring to screen for hazardous alcohol use and determine thresholds for brief intervention versus specialist referral.
Stratify coronary artery disease risk by Agatston calcium score category: 0 (very low), 1-99 (mild), 100-399 (moderate), 400+ (severe).
Calculate 10-year coronary heart disease risk using the MESA model, which incorporates traditional risk factors plus coronary artery calcium score for improved reclassification.
Estimate net reclassification improvement (NRI) from adding coronary artery calcium score to traditional risk models for cardiovascular risk stratification.
Score coronary CT angiography (CCTA) plaque burden using semi-quantitative methods: segment involvement score, plaque composition, and stenosis grade.
Apply the fractional flow reserve derived from CT (FFR-CT) threshold of <=0.80 to identify hemodynamically significant coronary lesions and guide revascularization decisions.
Compare resting Pd/Pa (distal coronary to aortic pressure ratio) against hyperemic FFR to assess lesion significance without adenosine administration.
Evaluate diastolic dysfunction with exercise stress echocardiography using E/e' ratio. A peak stress E/e' >15 identifies exercise-induced diastolic dysfunction and elevated filling pressures.
Assess the clinical significance of a left ventricular ejection fraction (LVEF) change less than 5% during exercise stress echocardiography as a marker of reduced contractile reserve.
Calculate RV-PA coupling using the TAPSE/PAPS ratio. A ratio <0.55 mm/mmHg indicates uncoupling and predicts worse outcomes in pulmonary hypertension and right heart failure.
Identify restrictive diastolic filling pattern by E-wave deceleration time <140ms on Doppler echocardiography, indicating elevated filling pressures and adverse prognosis.
Assess LV longitudinal systolic dysfunction using mitral annular S-wave velocity by tissue Doppler imaging. Lateral S' <8 cm/s or septal S' <7 cm/s indicates systolic dysfunction.
Measure LV diastolic function using color M-mode flow propagation velocity (Vp). Vp <45 cm/s indicates impaired relaxation and elevated filling pressures.
Grade diastolic dysfunction using isovolumic relaxation time (IVRT). Normal IVRT 70-90ms; prolonged IVRT >100ms indicates impaired relaxation; shortened IVRT <60ms indicates elevated filling pressures.
Calculate the myocardial performance index (Tei index = IVCT+IVRT/ET) as a global measure of LV function. Normal <0.40 by pulsed Doppler; >0.40 indicates global dysfunction.
Classify LV geometry as normal, concentric remodeling, concentric hypertrophy, or eccentric hypertrophy using LV mass index and relative wall thickness (RWT).
Calculate relative wall thickness (RWT = 2 x posterior wall thickness / LVEDD) to distinguish concentric remodeling from hypertrophy. RWT >=0.42 indicates concentric pattern.
Assess the clinical significance of borderline reduced LVEF (50-54%), an intermediate zone between HFmrEF and HFpEF, with distinct prognosis and treatment implications.
Estimate the timeline and probability of LVEF recovery from <=35% to >=50% on guideline-directed medical therapy (GDMT) in non-ischemic dilated cardiomyopathy.
Differentiate ischemic from non-ischemic cardiomyopathy using late gadolinium enhancement (LGE) patterns on cardiac MRI: subendocardial/transmural (ischemic) vs mid-wall/epicardial (non-ischemic).
Assess sudden cardiac death risk from mid-wall fibrosis detected by LGE-CMR in hypertrophic cardiomyopathy. LGE >=15% of LV mass is a major SCD risk modifier.
Compare ASE and ESC risk stratification models for sudden cardiac death in hypertrophic cardiomyopathy. ESC uses continuous HCM Risk-SCD score; ASE uses major/modifier risk factor counting.
Calculate the ESC HCM Risk-SCD 5-year sudden cardiac death probability using age, family history, unexplained syncope, max LV wall thickness, LA diameter, LVOT gradient, and NSVT.
Compare prognosis between sarcomere-positive HCM (MYH7, MYBPC3) and genotype-negative HCM in terms of SCD risk, phenotypic expression, and family screening implications.
Estimate the genetic testing yield in dilated cardiomyopathy (DCM) for familial vs sporadic cases and guide cascade family testing based on index case genetic result.
Score ARVC/ARLD using 2010 revised Task Force Criteria: structural, histological, repolarization, depolarization, arrhythmia, and family history/genetic criteria weighted as major/minor.
Classify PKP2 (plakophilin-2) variants using ACMG criteria for pathogenicity in ARVC. Frameshift and nonsense variants are typically pathogenic; missense variants require extensive evidence.
Distinguish Brugada type 1 (coved pattern, diagnostic) from type 2 (saddle-back) ECG pattern and determine when sodium channel blocker challenge is indicated.
Stratify arrhythmic risk in Brugada syndrome based on SCN5A variant status, clinical presentation, electrophysiology study results, and spontaneous vs induced Type 1 ECG pattern.
Assess QTc-based arrhythmic risk stratification in long QT syndrome by genotype: LQT1 (KCNQ1), LQT2 (KCNH2), LQT3 (SCN5A) have distinct triggers and risk thresholds.
Calculate the Schwartz score for congenital long QT syndrome diagnosis using ECG features, clinical history, and family history. Score >=3.5 indicates high probability of LQTS.
Determine catecholaminergic polymorphic VT (CPVT) diagnosis and arrhythmia threshold heart rate during exercise stress testing. Bidirectional VT at <130 bpm is highly diagnostic.
Identify Andersen-Tawil syndrome (LQT7) by characteristic prolonged QU interval, prominent U-waves, bidirectional VT, periodic paralysis, and dysmorphic features.
Assess the diagnostic and prognostic significance of short QT interval (QTc <330ms) for short QT syndrome, which confers risk of AF, VF, and sudden death.
Assess WPW arrhythmic risk using shortest pre-excited RR interval during AF. Shortest R-R <250ms is a high-risk feature associated with potential VF via accessory pathway.
Assess Ebstein anomaly severity using cardiothoracic ratio (CTR) on chest X-ray. CTR >0.65 indicates severe cardiomegaly from massive RA/atrialized RV enlargement.
Monitor hepatic venous pressure and Fontan circuit pressure in single-ventricle patients to detect Fontan-associated liver disease (FALD) and optimize hemodynamics.
Define acceptable oxygen saturation targets after bidirectional Glenn anastomosis (superior cavopulmonary connection). Expected SaO2 75-85% reflects bidirectional mixing physiology.
Interpret post-operative chest X-ray findings after truncus arteriosus repair, including expected cardiac silhouette changes, RV-PA conduit position, and signs of residual pulmonary hypertension.
Assess residual pulmonary regurgitation (PR) and residual VSD after tetralogy of Fallot repair. Pulmonary regurgitation fraction >40% and residual VSD Qp/Qs >1.5 indicate re-intervention thresholds.
Estimate reoperation risk and timeline after Ross procedure (autograft aortic valve replacement with pulmonary homograft) based on autograft dilation rate and homograft dysfunction.
Apply modified Duke criteria for infective endocarditis diagnosis in prosthetic valve patients, where echocardiographic criteria are more difficult and PET-CT adds diagnostic value.
Apply updated 2023 ESC Duke-Li criteria for infective endocarditis with new major criteria including PET-CT, CT angiography, and whole-body CT for embolic events.
Estimate perioperative mortality for infective endocarditis surgery using EuroSCORE II or IE-specific risk models incorporating active infection, renal failure, and hemodynamic status.
Determine optimal timing for infective endocarditis surgery using ESC/ACC/AHA indication classes. Emergency (<24h), urgent (<7 days), or elective (>7 days) timing based on complications.
Determine drainage threshold for pericardial effusion in infective pericarditis. Large effusion (>20mm echo-free space), tamponade features, or purulent etiology mandate pericardiocentesis.
Estimate LVEF recovery probability in peripartum cardiomyopathy. 50-80% of patients recover LVEF >=50% within 6-12 months; predictors include higher baseline LVEF and non-Black race.
Assess Takotsubo cardiomyopathy severity by LV ballooning pattern (apical, mid-ventricular, basal, focal) and acute LVEF nadir. LVEF typically recovers to >50% within 4-8 weeks.
Estimate endomyocardial biopsy sensitivity for giant cell myocarditis (GCM). Sensitivity is 82-85% with sampling error due to patchy disease; multiple biopsies improve yield.
Diagnose and risk-stratify eosinophilic myocarditis using peripheral blood eosinophil count. Hypereosinophilia (>1500/uL x6 weeks or >1500/uL with organ damage) is diagnostic threshold.
Calculates the resting and provoked LVOT gradient in hypertrophic obstructive cardiomyopathy (HOCM) using Doppler measurements. Helps determine treatment eligibility for septal reduction therapy.
Stratify CKD progression risk using urine albumin-creatinine ratio (UACR): normal <30 mg/g, moderately increased 30-300 mg/g, severely increased >300 mg/g.
Compare cystatin C-based eGFR with creatinine-based eGFR and combined CKD-EPI creatinine-cystatin C equation for improved GFR estimation accuracy.
Use kidney injury molecule-1 (KIM-1) urine concentration to identify proximal tubular injury, predict AKI progression, and differentiate ATN from prerenal AKI.
Apply urine NGAL as an early AKI biomarker. NGAL rises within 2-12 hours of injury, 12-24 hours before creatinine elevation, with sensitivity 80-82% for AKI prediction.
Calculate the [TIMP-2] x [IGFBP7] product (NephroCheck) for AKI risk assessment. Value >0.3 (ng/mL)^2/1000 predicts moderate-severe AKI within 12 hours with AUC 0.80.
Apply KDIGO 2012 AKI staging and differentiate ATN from prerenal causes using FENa, FEUrea, urine sodium, and tubular injury biomarkers.
Use furosemide stress test (FST) to assess tubular integrity in AKI. Urine output <200 mL in first 2 hours after furosemide 1 mg/kg predicts KDIGO stage 3 AKI progression.
Estimate risk of AKI-to-CKD transition based on AKI severity, duration, and baseline kidney function. KDIGO stage 3 AKI carries 30-40% risk of new CKD at 3 months.
Score the probability of renal function recovery at 90 days after hospital-acquired AKI using clinical features: baseline eGFR, AKI stage, sepsis, oliguria, and vasopressor requirement.
Compare early/liberal vs delayed/conservative RRT initiation strategies in AKI. STARRT-AKI and IDEAL-ICU trials support conservative strategy without mortality benefit of early initiation.
Calculate major adverse kidney events (MAKE) composite: death, dialysis dependence, or 25% sustained eGFR reduction from baseline, used as primary endpoint in AKI clinical trials.
Estimate hospital and 90-day mortality risk for dialysis-requiring AKI (AKI-D). ICU-acquired AKI-D carries 50-70% hospital mortality; septic AKI-D carries higher risk.
Stage acute-on-chronic kidney failure (ACKF) using ADQI 2021 consensus: Stage 1 (creatinine rise 1.5-1.9x baseline), Stage 2 (2-2.9x), Stage 3 (>=3x or new RRT) in CKD patients.
Determine renal biopsy indication vs safe deferral using clinical features: proteinuria >1 g/day, active urine sediment, unexplained eGFR decline, or systemic disease requiring diagnosis.
Stage lupus nephritis by ISN/RPS 2018 classification (Class I-VI) and estimate renal prognosis and treatment intensity required per class.
Differentiate primary FSGS (immune-mediated, nephrotic syndrome) from secondary FSGS (adaptive, HIV, drugs, obesity) using clinical, histological, and genetic features.
Read an IgA nephropathy biopsy through the Oxford MEST-C criteria: mesangial hypercellularity, endocapillary hypercellularity, segmental sclerosis, tubular atrophy or interstitial fibrosis, and crescents. The T lesion drives most of the prognostic weight.
Calculate IgA nephropathy clinical risk score using proteinuria, blood pressure, eGFR, and histology to predict 5-year ESRD/50% eGFR loss risk.
Evaluate C3 glomerulopathy using complement profile: low C3, normal C4, elevated C3 nephritic factor, and anti-CFH antibodies to guide eculizumab eligibility.
Differentiate MPGN histological pattern (Type 1 immune complex, Type 2 C3G/DDD, Type 3 immune complex subepithelial) and map to underlying etiology for targeted treatment.
Estimate podocyte depletion from renal biopsy morphometry using podocyte number per glomerulus and podocyte density, which predicts FSGS development and CKD progression.
Determine clinically significant eGFR decline rate. Loss >3 mL/min/1.73m2/year or 40% eGFR decline over 2 years is a validated surrogate endpoint predicting ESRD risk.
Estimate probability of hypertensive nephrosclerosis vs other CKD causes in patients using APOL1 genotype and histological H-FSGS pattern for risk stratification.
Apply CORAL trial findings to guide renal artery stenting decisions in atherosclerotic renovascular hypertension. Stenting showed no benefit over medical therapy for most patients.
Use aldosterone-to-renin ratio (ARR) for primary hyperaldosteronism (PA) screening and adrenal vein sampling (AVS) lateralization index >=4 to guide adrenalectomy vs medical management.
Diagnose and manage fibromuscular dysplasia (FMD) of the renal artery. Characteristic string-of-beads pattern on imaging. PTA without stenting is treatment of choice for medial FMD.
Calculate height-adjusted total kidney volume (htTKV) in ADPKD for Mayo Imaging Classification and tolvaptan eligibility (htTKV >600 mL/m with rapid growth >=5%/year).
Classify ADPKD progression risk using Mayo Imaging Classification 1A-1E based on age and htTKV. Class 1C-1E indicates rapidly progressive disease with likely ESRD before age 58.
Determine tolvaptan eligibility for ADPKD: Mayo Class 1C-1E or htTKV >600 mL/m, age <55, eGFR >25 mL/min/1.73m2, and evidence of rapid progression without contraindications.
Calculate Mayo SSIGN score for renal cell carcinoma: stage, size, grade, necrosis to predict 1, 3, 5, 7, and 10-year cancer-specific survival and metastasis risk.
Evaluate 24-hour urine collection parameters for nephrolithiasis risk: calcium, oxalate, uric acid, citrate, pH, and volume to guide prevention therapy.
Calculate Tiselius activity product ratio (APR) for calcium oxalate stone formation from 24h urine parameters. APR >1 indicates supersaturation and active lithogenic risk.
Predict ESWL success using stone size, location, skin-to-stone distance, and stone density (HU) on CT. Success rate drops with HU >1000 or stone >15mm.
Predict ureteroscopy (URS) stone-free rate and procedural risk based on stone burden (total size), location, and stone composition for renal and ureteral calculi.
Determine PCNL approach: single vs staged session based on stone burden, residual stone, patient factors, and Guys Stone Score.
Determine optimal ureteral stent dwell time based on indication (post-URS, post-pyeloplasty, ureteral injury), ureteral size, and complication risk with prolonged indwelling.
Assess overactive bladder severity using ICIQ-OAB questionnaire: urgency, frequency, nocturia, and urgency incontinence scored 0-16. Score >=8 indicates moderate-severe OAB.
Use the Q-tip test (urethral axis test) to diagnose urethrovesical junction hypermobility in stress urinary incontinence. Deflection >=30 degrees indicates hypermobility.
Stage pelvic organ prolapse using POP-Q system: 9 measurement points referenced to hymen. Stage 0 (no prolapse) through Stage IV (complete vault eversion) with quantitative precision.
Assess interstitial cystitis/bladder pain syndrome (IC/BPS) severity using O'Leary-Sant Symptom Index (ICSI) and Problem Index (ICPI). Total score >=12 indicates significant disease.
Calculate PSA density (PSA / prostate volume in mL). PSA density >=0.15 ng/mL/mL suggests clinically significant prostate cancer rather than benign prostatic hyperplasia.
Calculate IPSS for benign prostatic hyperplasia (BPH): 7 symptom questions scored 0-35 plus quality of life item. Score >=20 indicates severe LUTS warranting surgical consideration.
Analyze 24-hour voiding diary: frequency (normal <=8/day), nocturia (normal <=1/night), functional bladder capacity, and voided volume variation for LUTS assessment.
Interpret post-void residual (PVR) urine volume significance. PVR >300 mL correlates with increased UTI risk and detrusor dysfunction; PVR >400 mL warrants intervention evaluation.
Apply BPH/BPE treatment algorithm: watchful waiting (mild IPSS), medical therapy (moderate), or surgery (severe/refractory) based on IPSS, prostate volume, PSA, and PVR.
Grade erectile dysfunction severity using IIEF-5 (International Index of Erectile Function-5). Score 5-21: severe (5-7), moderate (8-11), mild-moderate (12-16), mild (17-21).
Classify Peyronie's disease using Lue/Jordan classification by plaque characteristics and deformity type to guide surgical approach: plication vs grafting vs prosthesis.
Evaluate male factor infertility using WHO 2021 semen analysis reference limits: volume >=1.4 mL, total motility >=42%, progressive motility >=30%, morphology (Kruger) >=4%.
Assess varicocele grade (I-III by palpation or Dubin-Amelar) and its impact on male fertility and testosterone. Grade II-III clinical varicocele with impaired semen parameters supports repair.
Diagnose testosterone deficiency using total testosterone (<300 ng/dL) and free testosterone (<65 pg/mL) thresholds. SHBG influences free testosterone calculation and clinical relevance.
Calculate the Psoriasis Area and Severity Index (PASI) across four body regions (head, trunk, upper, lower extremities): erythema, induration, desquamation (0-4 each) x area (0-6 each). Range 0-72.
Assess dermatology-related quality of life using DLQI (10 questions, 0-30). Score >10 indicates significant impact on quality of life and supports eligibility for advanced therapy.
Grade psoriasis severity using IGA (0-4 scale): 0 (clear), 1 (almost clear), 2 (mild), 3 (moderate), 4 (severe). IGA 0/1 response is the standard biologic trial endpoint.
Calculate SCORAD for atopic dermatitis: extent (0-100) x 0.2 + intensity (0-18) x 0.7 + symptoms (0-20) x 0.5. Mild <25, Moderate 25-50, Severe >50.
Calculate EASI for atopic dermatitis: area (0-6) x intensity (0-3 for each of 4 signs) x body region weight. Severe EASI >=21; EASI 50/75/90/100 are standard trial endpoints.
Assess overall atopic dermatitis severity using IGA 0-4 scale. IGA 0 (clear) or 1 (almost clear) with >=2 grade improvement from baseline is the standard biologic trial co-primary endpoint.
Use the Three-Item Severity (TIS) score for rapid atopic dermatitis assessment: erythema, edema, and excoriation each scored 0-3. Range 0-9; quick clinical and phone-based assessment.
Assess prurigo nodularis (PN) severity using IGA 0-4 scale. IGA 0/1 response with >=2 grade improvement is the primary endpoint for dupilumab (LIBERTY-PN PRIME) and nemolizumab.
Stage hidradenitis suppurativa (HS) using Hurley classification: Stage I (abscess formation, no sinus tracts), Stage II (recurrent with sinus tracts), Stage III (diffuse with widespread tracts and scarring).
Calculate IHS4 (International Hidradenitis Suppurativa Severity Score System) from nodule count x1, abscess count x2, and draining tunnels x4. Score >=11 indicates severe HS.
Score pemphigus vulgaris activity using PDAI (Pemphigus Disease Area Index): skin activity (0-250), scalp activity (0-10), mucous membrane activity (0-40). Severe >45.
Calculate BPDAI (Bullous Pemphigoid Disease Area Index): skin blistering activity (0-120), urticaria/erythema activity (0-120), and mucous membrane activity (0-120) to guide treatment decisions.
Assess epidermolysis bullosa severity using EBDASI (EB Disease Activity and Scarring Index) or EB-IQ for patient-reported outcomes: blistering, pain, pruritus, and functional impairment.
Calculate modified Severity Weighted Assessment Tool (mSWAT) for mycosis fungoides/CTCL: patch, plaque, and tumor lesion areas x body region weights. Used with TNMB staging for response assessment.
Stage mycosis fungoides using TNMB classification. Stage IA (T1N0M0B0) carries 95% 10-year survival; Stage IV (T4/N3/M1/B2) carries <20% 5-year survival.
Classify blood involvement in Sezary syndrome: B0 (<5% atypical lymphocytes), B1 (>5% or Sezary cells by morphology), B2 (>=1000/uL Sezary cells or CD4:CD8 >=10 or CD4+CD26- >=30%).
Assess basosquamous carcinoma (metatypical BCC) excision adequacy and recurrence risk. Positive surgical margins require re-excision; Mohs micrographic surgery recommended for primary high-risk sites.
Compare BCC subtypes: nodular (most common, low risk), superficial (low risk), morpheaform/infiltrative (high risk), and ulcus rodens (deeply infiltrative/ulcerated, very high risk) for recurrence and treatment approach.
Predict cutaneous SCC metastasis risk using Brigham and Women's Hospital staging: T1 (0 risk factors), T2a (1 risk factor), T2b (2-3 risk factors), T3 (>3 risk factors or bone invasion).
Determine melanoma T-stage from Breslow depth: T1 (<=1.0mm), T2 (1.01-2.0mm), T3 (2.01-4.0mm), T4 (>4.0mm), with ulceration and mitotic rate as upstaging factors per AJCC 8th.
Assess melanoma anatomical invasion level using Clark classification: Level I (epidermis), II (papillary dermis), III (papillary-reticular junction), IV (reticular dermis), V (subcutaneous fat).
Apply AJCC 8th edition melanoma TNM staging from T (Breslow + ulceration), N (nodal number + microsatellitosis), and M (distant metastasis LDH) categories.
Estimate sentinel lymph node positivity probability in melanoma. Breslow >0.8mm with ulceration or >1.0mm any melanoma has >5% SLNB positive rate warranting biopsy per NCCN/MSLT-I.
Compare Mohs surgery cure rates by tumor location and type: BCC nose 99% (primary), SCC ear 97%, vs standard excision BCC recurrence rates of 5-10% for high-risk sites.
Grade acne vulgaris severity using IGA 0-4: 0 (clear), 1 (almost clear), 2 (mild: few comedones/papules), 3 (moderate: many lesions), 4 (severe: extensive inflammatory lesions/nodules).
Count closed (whiteheads) and open (blackheads) comedones separately in acne assessment. Comedonal-predominant acne responds best to retinoids; mixed inflammatory/comedonal acne requires combined therapy.
Apply Global Evaluation Acne (GEA) scale for European clinical practice: 0-5 scale considering total lesion count, inflammatory severity, and scarring. Standard for biologic acne trial endpoints in Europe.
Classify rosacea by phenotype and IGA: erythematotelangiectatic (ETR), papulopustular (PPR), phymatous, and ocular subtypes, with IGA 0-4 for PPR guiding therapy decisions.
Classify skin type using Fitzpatrick scale (I-VI) based on constitutive pigmentation and UV tanning response to guide phototherapy dosing, skin cancer risk counseling, and laser parameter selection.
Calculate melanin index (MI) from narrow-band reflectance spectrophotometry at 660/880nm to objectively quantify skin pigmentation, monitor vitiligo response, and assess tanning dose-response.
Measure TEWL (transepidermal water loss, normal <10 g/m2/h on forearm) as a skin barrier function biomarker. Elevated TEWL (>20 g/m2/h) indicates impaired barrier in atopic dermatitis and ichthyosis.
Assess glaucoma progression using mean deviation (MD) rate of change on Humphrey visual field (HVF). MD worsening >-1.0 dB/year indicates rapid progression requiring treatment intensification.
Calculate AGIS visual field defect score (0-20) from Humphrey 24-2 SITA visual field to assess advanced glaucoma severity. Score 0 (no defect) to 20 (end-stage vision).
Assess glaucomatous optic nerve damage using vertical cup-to-disc ratio (CDR). CDR >=0.7 or asymmetry >0.2 between eyes warrants glaucoma evaluation. Correlate with RNFL thickness and VF.
Assess retinal nerve fiber layer (RNFL) thinning rate and pattern on OCT. Global RNFL <80 microns or superior/inferior sector loss indicates glaucomatous damage. Rate >1 micron/year is significant.
Assess intraocular pressure (IOP) diurnal variation and peak IOP from Goldmann applanation tonometry. Normal IOP 10-21 mmHg; diurnal fluctuation >5-6 mmHg correlates with glaucoma progression risk.
Measure corneal hysteresis (CH) using Ocular Response Analyzer (ORA) to assess biomechanical corneal properties. CH <9.4 mmHg identifies eyes at higher risk of glaucoma progression independent of IOP.
Correct Goldmann applanation tonometry IOP for central corneal thickness (CCT). Standard CCT is 520-540 microns; thin corneas underestimate true IOP; thick corneas overestimate IOP.
Diagnose aqueous-deficient dry eye using Schirmer test. Wetting <5mm in 5 minutes (without anesthesia) indicates severe aqueous deficiency; 5-10mm is borderline; >10mm is normal.
Assess dry eye disease severity using TFOS DEWS II framework: SPEED/OSDI symptoms, TBUT <10s, corneal fluorescein staining >=5 Oxford spots, Schirmer, and MMP-9 positivity for grading 1-4.
Calculate SPEED (Standardized Patient Evaluation of Eye Dryness) questionnaire score (0-28). Score >=6 is consistent with dry eye disease; >=13 indicates severe symptomatic dry eye.
Grade anterior chamber angle by gonioscopy using Shaffer system: Grade 4 (wide open, 35-45°), Grade 3 (30°, closure improbable), Grade 2 (20°, possible closure), Grade 1-0 (closure likely/closed).
Assess intraocular pressure risk in pigment dispersion syndrome (PDS). 25-50% of PDS converts to pigmentary glaucoma over 10 years; IOP spikes during exercise or pupil dilation are characteristic.
Assess pseudoexfoliation glaucoma (PXFG) progression risk. PXFG has higher IOP, greater diurnal fluctuation, worse VF loss, and faster progression than POAG; prostaglandin analogues are first-line.
Calculate AREDS risk score (0-4) for AMD progression to advanced AMD: large drusen >=125 microns (1pt/eye), pigment abnormalities (1pt/eye). Score predicts 5-year advanced AMD risk.
Optimize anti-VEGF injection intervals for neovascular AMD using treat-and-extend (T&E) or pro-re-nata (PRN) protocols. Extend by 2-week intervals when OCT shows dry macula for 2 consecutive visits.
Grade diabetic retinopathy severity using ETDRS scale: mild NPDR (level 20), moderate NPDR (43-47), severe NPDR (53), PDR (61-71), and advanced PDR (81-85) for treatment decision thresholds.
Identify high-risk proliferative diabetic retinopathy (PDR) characteristics from DRS and ETDRS: NVD >=1/4 disc area OR any NVD with vitreous hemorrhage OR NVE >=1/2 disc area with vitreous hemorrhage.
Assess choroidal neovascularization membrane (CNVM) size and type in neovascular AMD. Classic CNVM >=4 disc areas or occult CNVM with recent progression are key treatment thresholds.
Estimate visual acuity prognosis after central retinal artery occlusion (CRAO). Without treatment, final VA is typically counting fingers or worse in 66%; within 4-6h window, IV tPA may improve outcomes.
Calculate the DAS28-CRP composite disease activity score for rheumatoid arthritis using tender/swollen joint counts, CRP, and patient global assessment to guide treat-to-target therapy.
Calculate Simplified Disease Activity Index (SDAI) and Clinical Disease Activity Index (CDAI) for rheumatoid arthritis. CDAI requires no lab values, making it useful in clinic without waiting for results.
Calculate RAPID3 (Routine Assessment of Patient Index Data 3) for rheumatoid arthritis—a three-item patient-reported outcome measuring function, pain, and global status. Enables rapid clinic assessment without formal joint counts.
Apply the 2010 ACR/EULAR classification criteria for rheumatoid arthritis. A score ≥6/10 classifies definite RA. Incorporates joint involvement, serology, acute-phase reactants, and duration of symptoms.
Calculate ASDAS (Ankylosing Spondylitis Disease Activity Score) using CRP or ESR for axial spondyloarthritis. Stratifies disease activity and guides biologic therapy initiation in AS/nr-axSpA.
Calculate the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), a validated patient-reported tool measuring fatigue, axial pain, peripheral joint pain, enthesitis, morning stiffness duration and severity.
Calculate the Bath Ankylosing Spondylitis Functional Index (BASFI), a 10-item patient-reported outcome measuring functional ability in activities of daily living for ankylosing spondylitis and axial SpA.
Calculate SLEDAI-2K for systemic lupus erythematosus. Scores 24 clinical and laboratory features weighted by clinical importance. Used to monitor disease activity, guide treatment escalation, and assess flares.
Apply the BILAG-2004 index to assess lupus disease activity across nine organ systems. Uses A-E grading per organ to guide therapeutic decisions, particularly for clinical trial enrollment.
Calculate the SLICC/ACR Damage Index (SDI) for SLE, measuring cumulative irreversible organ damage in 12 systems. Damage items must be present ≥6 months and not attributable to active inflammation.
Calculate ESSPRI (EULAR Sjögren Syndrome Patient Reported Index) for primary Sjögren's syndrome. Assesses dryness, fatigue, and musculoskeletal pain—the three most bothersome patient symptoms.
Calculate ESSDAI (EULAR Sjögren Syndrome Disease Activity Index), the gold-standard physician-rated activity score for primary Sjögren's syndrome across 12 organ domains.
Guide biologic DMARD selection in rheumatoid arthritis and other inflammatory arthritides. Weighs disease features, comorbidities (cardiovascular risk, VTE risk, malignancy), and drug contraindications against JAKi and TNFi profiles.
Interpret complement C3 and C4 levels to differentiate lupus activity, cryoglobulinemia, APLS, and hereditary angioedema. Low C3+C4 suggests immune complex consumption (SLE, hepatitis C cryoglobulinemia), isolated low C4 suggests C4 deficiency or angioedema.
Interpret ANA titer, pattern (homogeneous, speckled, nucleolar, centromere), and clinical context to calculate pre-test probability of specific autoimmune diseases including SLE, MCTD, SSc, primary Sjögren's, and inflammatory myopathy.
Interpret ANCA pattern (pANCA/MPO vs cANCA/PR3) to classify ANCA-associated vasculitis: granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), or eosinophilic GPA (EGPA). Guides immunosuppression strategy.
Calculate BVAS (Birmingham Vasculitis Activity Score v3) for ANCA-associated vasculitis and other systemic vasculitides. Scores activity across 9 organ systems to guide treatment initiation, escalation, and trial eligibility.
Calculate the Five Factor Score (FFS) for polyarteritis nodosa, eosinophilic GPA, and MPA. Predicts 5-year mortality and guides cyclophosphamide use: FFS ≥1 justifies immunosuppressive therapy.
Estimate end-stage renal disease (ESRD) risk at diagnosis of microscopic polyangiitis (MPA) and other ANCA-associated vasculitides using baseline serum creatinine, percentage normal glomeruli, and clinical features.
Calculate the IgG4-Related Disease Responder Index (IgG4-RD RI) to measure disease activity and treatment response across 26 organs in IgG4-related disease. Used in trials and as treat-to-target outcome.
Calculate flare risk reduction by achieving serum urate targets with urate-lowering therapy (ULT). Demonstrates benefit of serum urate <6 mg/dL vs <5 mg/dL vs no treatment for tophaceous and non-tophaceous gout.
Calculate DAPSA (Disease Activity index for PSoriatic Arthritis) for peripheral psoriatic arthritis. Scores tender/swollen joint counts, patient global, pain, and CRP to guide treat-to-target management.
Calculate PASI (Psoriasis Area and Severity Index) for plaque psoriasis. Assesses erythema, induration, and scaling in head, trunk, upper and lower limbs weighted by body surface area involvement. Standard biologic therapy endpoint.
Calculate DLQI (Dermatology Life Quality Index), the most widely used patient-reported outcome for skin disease impact. Required alongside PASI for biologic therapy authorization in most psoriasis guidelines.
Apply the 2012 EULAR/ACR classification criteria for polymyalgia rheumatica. Scores clinical, laboratory, and ultrasound features to distinguish PMR from mimics including RA, GCA, and inflammatory myopathy.
Estimate temporal artery biopsy (TAB) sensitivity for giant cell arteritis (GCA). Sensitivity is 75-80% for cranial GCA and lower for large-vessel GCA. Segment length, skip lesions, and pre-biopsy steroids affect yield.
Apply diagnostic criteria for reactive arthritis (formerly Reiter's syndrome). Assesses preceding infection, asymmetric arthritis, enthesitis, urogenital/ocular features, and HLA-B27 status to establish diagnosis and predict chronicity.
Calculate the Myositis Disease Activity Assessment (MDAA) score for inflammatory myopathies (dermatomyositis, polymyositis, inclusion body myositis). Assesses muscle strength, skin disease, pulmonary, cardiovascular, and GI involvement.
Apply the revised Sapporo (Sydney 2006) classification criteria for antiphospholipid syndrome (APS). Requires ≥1 clinical criterion (thrombosis or pregnancy morbidity) plus ≥1 laboratory criterion (anticardiolipin, anti-β2GPI, or lupus anticoagulant).
Calculate the Health Assessment Questionnaire Disability Index (HAQ-DI) for rheumatoid arthritis. The 20-item functional capacity assessment predicts work disability, total joint replacement, and mortality in RA.
Calculate the modified Rodnan Skin Score (mRSS) for systemic sclerosis. Measures skin thickness in 17 areas scored 0-3. mRSS is the primary endpoint in diffuse cutaneous SSc clinical trials and predicts renal crisis risk.
Calculate the REVEAL 2.0 risk score for pulmonary arterial hypertension (PAH). Uses 12 variables to stratify 1-year survival risk: low (<5%), intermediate (5-20%), and high (>20%) mortality risk.
Apply ACR 2016 fibromyalgia diagnostic criteria using Widespread Pain Index (WPI) and Symptom Severity Scale (SSS). No tender point exam required. Identifies fibromyalgia as a spectrum condition independent of other diagnoses.
Calculate FRAX 10-year probability of major osteoporotic fracture and hip fracture. Integrates clinical risk factors with or without femoral neck BMD. Country-specific intervention thresholds guide bisphosphonate therapy.
Calculate fracture risk for glucocorticoid-induced osteoporosis (GIOP). ACR 2022 guidelines adjust FRAX upward for chronic glucocorticoid use and recommend early bisphosphonate initiation for medium-to-high risk patients.
Apply Yamaguchi criteria for Adult-Onset Still's Disease (AOSD). Requires ≥5 criteria with ≥2 major, after exclusion of infections, malignancy, and other rheumatic diseases. Ferritin >1000 µg/L is highly characteristic.
Calculate SASDAS (Skin and Arthritis Disease Activity Score), combining DAPSA for joint disease with PASI for skin disease in psoriatic arthritis. Provides a single composite score for comprehensive PsA management.
Estimate Larsen radiographic damage score for rheumatoid arthritis. Measures erosion, joint space narrowing, and bone destruction in 32 joints. Compared serially to assess radiographic progression and therapy efficacy.
Stage and risk-stratify SSc-ILD (systemic sclerosis interstitial lung disease) using FVC% predicted, HRCT extent, and anti-Scl-70 status. Identifies limited vs extensive ILD and guides nintedanib or mycophenolate initiation.
Calculate the Vasculitis Damage Index (VDI) for ANCA-associated and other systemic vasculitides. Measures cumulative irreversible damage across 11 organ systems independent of current disease activity.
Classify IBD-related arthropathy: Type 1 (pauciarticular, correlates with gut activity), Type 2 (polyarticular, independent of gut), and axial disease (sacroiliitis/SpA). Guides rheumatology-gastroenterology co-management.
Interpret serum and fecal calprotectin levels as biomarkers of inflammation in rheumatoid arthritis and IBD overlap. Serum calprotectin (S100A8/A9) reflects joint macrophage activation; fecal calprotectin indicates gut inflammation.
Stratify pregnancy risk in women with rheumatic diseases including SLE, RA, SSc, APS, and inflammatory arthritis. Identifies high-risk features (active nephritis, antiphospholipid antibodies, anti-Ro/SSA, pulmonary hypertension) requiring specialist co-management.
Calculate pre- and post-test probability of rheumatoid arthritis using anti-CCP and rheumatoid factor results. Anti-CCP has 95% specificity; high-positive anti-CCP (>3× ULN) with high-titer RF indicates high RA likelihood and radiographic progression risk.
Calculate the focus score from minor salivary gland (labial) biopsy for primary Sjögren's syndrome diagnosis. A focus score ≥1 (≥50 lymphocytes per 4mm² gland area) combined with positive anti-SSA/Ro meets ACR/EULAR diagnostic criteria.
Estimate the probability and timeline of UCTD evolution to a defined connective tissue disease (CTD) using clinical features, autoantibody profile, and disease duration. 30-40% of UCTD evolves within 5 years.
Apply Sharp diagnostic criteria for mixed connective tissue disease (MCTD). Characterized by features of SLE, SSc, polymyositis, and RA with high-titer anti-U1-RNP antibodies. Distinguishes MCTD from overlap syndromes.
Apply EULAR-recommended cardiovascular risk adjustment for rheumatoid arthritis. Multiply SCORE or Framingham risk by 1.5× if RA criteria met (disease duration >10 years, RF/anti-CCP positive, extra-articular disease). Guides statin initiation.
Interpret autoantibody profile to distinguish connective tissue diseases. Maps anti-dsDNA, anti-Sm, anti-Ro/La, anti-RNP, anti-Scl-70, anti-centromere, anti-Jo-1, and ANCA patterns to likely CTD diagnoses with sensitivity/specificity data.
Apply McAdam diagnostic criteria for relapsing polychondritis (RP). Diagnosis requires ≥3 of 6 features: bilateral auricular chondritis, non-erosive seronegative polyarthritis, nasal chondritis, ocular inflammation, respiratory chondritis, and cochlear/vestibular damage.
Calculate estimated fetal weight (EFW) using Hadlock formula from biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL). Maps EFW to gestational age-specific percentile.
Calculate the Biophysical Profile (BPP) score for fetal surveillance. Five parameters (NST, breathing movements, body movement, tone, amniotic fluid) each scored 0 or 2. Score 8-10 = normal; 6 = equivocal; ≤4 = abnormal requiring delivery consideration.
Calculate AFI (sum of four-quadrant deepest pockets) and deepest vertical pocket (DVP). AFI <5 cm = oligohydramnios; >24 cm = polyhydramnios. DVP <2 cm = oligohydramnios; >8 cm = polyhydramnios.
Calculate umbilical artery pulsatility index (PI), systolic/diastolic (S/D) ratio, and resistance index (RI) from waveform measurements. Interprets absent or reversed end-diastolic flow (AEDF/REDF) in fetal growth restriction.
Calculate MCA peak systolic velocity (PSV) to screen for fetal anemia and cerebroplacental ratio (CPR = MCA-PI/UA-PI). MCA-PSV >1.5 MoM is the threshold for fetal blood sampling. Low CPR predicts adverse perinatal outcome in late FGR.
Calculate ductus venosus pulsatility index (DV-PIV) and classify A-wave (positive, absent, reversed) in severe FGR and hydrops. Absent or reversed DV A-wave indicates imminent fetal decompensation and guides delivery timing.
Interpret uterine artery Doppler pulsatility index (PI) and bilateral notching at 20-24 weeks for preeclampsia, FGR, and placental abruption risk. Mean PI >95th percentile plus bilateral notching has highest positive predictive value.
Calculate preterm birth risk from mid-trimester cervical length measurement. CL <25 mm at 18-24 weeks in singleton or CL <35 mm in twins increases preterm birth risk. Guides progesterone supplementation and cerclage decisions.
Interpret fetal fibronectin (fFN) result with cervical length for preterm birth prediction in symptomatic women 22-34 weeks. Negative fFN (<50 ng/mL) has >95% negative predictive value for delivery within 7-14 days.
Calculate Bishop score to assess cervical ripeness before labor induction. Scores dilation, effacement, station, consistency, and position. Score ≥8 predicts successful induction comparable to spontaneous labor onset.
Estimate probability of vaginal birth after cesarean (VBAC) using the Grobman nomogram. Inputs include age, BMI, prior vaginal delivery, prior VBAC, prior cesarean indication, cervical exam, and ethnicity.
Classify placenta previa by placental edge distance from the internal cervical os on transvaginal ultrasound. Distance <20 mm with posterior low-lying placenta or complete previa requires cesarean. Guides delivery planning.
Calculate placenta accreta spectrum (PAS) risk using prior cesarean count, placenta previa, prior uterine surgery, and ultrasound findings. PAS risk rises to 40-67% with anterior previa and 3+ prior cesareans.
Calculate first-trimester preeclampsia risk using the FMF ASPRE algorithm: MAP, uterine artery PI, PlGF, PAPP-A, and uterine history. Screen-positive women benefit from 150 mg aspirin started before 16 weeks to reduce early preeclampsia by 62%.
Diagnose and classify HELLP syndrome using Sibai criteria and Mississippi classification. Platelet count Class 1 (<50,000), Class 2 (50,000-100,000), Class 3 (100,000-150,000). Complete HELLP requires all three: hemolysis, elevated liver enzymes, low platelets.
Apply Swansea criteria for acute fatty liver of pregnancy (AFLP) diagnosis. Six or more of 14 criteria required. Immediate delivery is the only treatment. Untreated AFLP has >80% maternal mortality; treated, <1%.
Interpret 50g GCT and 100g 3-hour OGTT (Carpenter-Coustan or NDDG criteria) or 75g 2-hour OGTT (IADPSG/WHO criteria) for gestational diabetes mellitus (GDM) diagnosis. Two abnormal values on OGTT or any one value on IADPSG criteria.
Predict IVF oocyte retrieval number from antral follicle count (AFC) and anti-Müllerian hormone (AMH). AFC <5 or AMH <0.5 ng/mL indicates poor ovarian response; AFC >15 or AMH >3.5 ng/mL indicates high response risk for OHSS.
Apply 2003 Rotterdam PCOS criteria (2 of 3 required: oligo/anovulation, clinical/biochemical hyperandrogenism, polycystic ovaries) and calculate Free Androgen Index (FAI = total testosterone/SHBG × 100) to phenotype severity.
Diagnose premature ovarian insufficiency (POI, formerly premature menopause) using elevated FSH threshold. FSH >25 IU/L on two occasions ≥4 weeks apart before age 40 establishes diagnosis. Guides HRT and fertility counseling.
Calculate the revised American Society for Reproductive Medicine (rASRM) endometriosis classification score from laparoscopy findings. Stages I-IV (minimal-severe). Points for peritoneal/ovarian endometriosis size, adhesions, and cul-de-sac obliteration.
Calculate PUQE (Pregnancy-Unique Quantification of Emesis) score to assess severity of nausea and vomiting of pregnancy (NVP). Scores retching, vomiting, and nausea duration. Guides antiemetic and IV rehydration decisions.
Quantify intrapartum blood loss (QBL) and calculate postpartum hemorrhage (PPH) risk score. PPH defined as QBL ≥1000 mL or blood loss with signs of hemodynamic instability. Risk factors: uterine atony, placenta previa/accreta, coagulopathy.
Calculate fetal lung maturity from lecithin/sphingomyelin (L/S) ratio and phosphatidylglycerol (PG) status in amniotic fluid. L/S ≥2.0 and PG present indicates maturity with <1% risk of RDS in term infants.
Interpret umbilical arterial (UA) and venous (UV) cord blood gas values at birth. UA pH <7.0 with BD >12 mmol/L defines metabolic acidosis associated with HIE. Differentiates acute vs chronic hypoxia from pattern of UA vs UV discordance.
Calculate ectopic pregnancy risk using serum β-hCG trend, progesterone, and ultrasound findings. Discriminatory β-hCG zone (1,500-3,500 IU/L) with absent intrauterine gestational sac increases ectopic probability. Guides methotrexate eligibility.
Calculate UFS-QOL (Uterine Fibroid Symptom and Quality of Life) questionnaire score for symptomatic uterine fibroids. Symptom severity subscale (8 items) and HRQL subscale (29 items) guide treatment decision between myomectomy, embolization, and medical therapy.
Diagnose and manage preterm premature rupture of membranes (PPROM) at 18-36+6 weeks. Pooling + ferning + nitrazine confirms diagnosis. Estimate latency period: median 5-7 days at 28-31 weeks; delivery within 1 week of PPROM in 50% of cases.
Grade ovarian hyperstimulation syndrome (OHSS) severity using Golan classification (1-5) or RCOG/ASRM classification. Grade 3-4 (moderate-severe) with ascites and ovarian enlargement guides hospitalization and GnRH antagonist freeze-all strategy.
Estimate LVEF recovery timeline in peripartum cardiomyopathy (PPCM). LVEF >50% at 6 months in 45-70% of patients. LVEF <30% at onset, QRS >120 ms, non-white race, and delayed diagnosis predict poor recovery.
Calculate age-specific risk of trisomy 21, 18, 13, and sex chromosome aneuploidies from maternal age. Includes first-trimester combined screening adjustment (NT + PAPP-A + beta-hCG) to produce patient-specific risk.
Apply CDC/ACOG 2020 guidelines for group B Streptococcus (GBS) intrapartum antibiotic prophylaxis (IAP) decision. Culture-based approach: positive GBS culture, bacteriuria, or prior affected infant mandates penicillin G prophylaxis.
Calculate recommended gestational weight gain using 2009 IOM guidelines based on pre-pregnancy BMI. Underweight (<18.5): 28-40 lb; normal weight (18.5-24.9): 25-35 lb; overweight (25-29.9): 15-25 lb; obese (≥30): 11-20 lb.
Calculate the external cephalic version (ECV) success probability score. Factors: parity, engagement, amniotic fluid, placental location, and estimated fetal weight. Higher score predicts greater success for ECV at 36-37 weeks.
Calculate oxytocin dosing for labor induction and augmentation. Low-dose (starting 0.5-2 mU/min, increments q15-40 min) vs high-dose (starting 4-6 mU/min, increments q15 min) protocols with uterine contraction monitoring targets.
Apply the Creasy-Herron scoring system to identify high-risk patients for spontaneous preterm birth. Incorporates socioeconomic factors, past obstetric history, current pregnancy symptoms, and work/activity exposures to calculate preterm birth risk score.
Calculate optimal antenatal corticosteroid (betamethasone) timing and expected neonatal benefit. Maximum benefit 24h after first dose to 7 days. Reduces neonatal RDS by 40-50%, IVH by 50%, NEC by 50% in preterm infants 24-33+6 weeks.
Apply NICHD 2008 classification for intrapartum electronic fetal monitoring (EFM): Category I (normal, no action required), II (indeterminate, surveillance), III (abnormal, delivery expedited). Classifies baseline rate, variability, accelerations, and decelerations.
Apply FIGO 2018 cervical cancer staging, which now incorporates imaging and pathologic findings (pelvic lymph node metastasis upstages to IIIC1). Guides surgical vs chemoradiation treatment approach based on stage I-IV classification.
Classify endometrial cancer risk (low, intermediate, high-intermediate, high, advanced) per 2021 ESMO/ESGO/ESTRO guidelines incorporating FIGO stage, histology (endometrioid vs non-endometrioid), grade, LVSI, MMR/MSI status, and POLE mutation.
Estimate obstetric complication risk from pre-pregnancy BMI. Quantifies adjusted odds ratios for gestational diabetes, preeclampsia, cesarean, shoulder dystocia, macrosomia, postpartum hemorrhage, and VTE for BMI 30-50+.
Interpret CA-125 levels with Risk of Ovarian Malignancy Algorithm (ROMA) incorporating HE4 and menopausal status. Identify BRCA1/BRCA2 mutation carriers for genetic counseling and risk-reducing salpingo-oophorectomy.
Calculate risk of obstetric anal sphincter injury (OASI, 3rd/4th degree tears) using OASI Care Bundle risk factors: nulliparity, Asian ethnicity, birth weight >4 kg, instrumental delivery. Risk 0.25-10% depending on factors.
Stage fetal growth restriction (FGR) severity using Doppler parameters and BPP to guide delivery timing. Stage 1-4 framework: from EFW below 10th percentile with normal Doppler (Stage 1) to reversed DV A-wave or abnormal BPP (Stage 4).
Calculate stillbirth and neonatal risk from bile acid levels in intrahepatic cholestasis of pregnancy (ICP). Bile acids 40+ umol/L associated with 3-5x increased stillbirth risk. Guides ursodeoxycholic acid dosing and delivery timing.
Assess preeclampsia risk before pregnancy using clinical risk factors. High-risk factors (prior PE, antiphospholipid syndrome, chronic hypertension, CKD, diabetes, multiple gestation) predict risk above 8% and justify aspirin prophylaxis planning.
Calculate the Edinburgh Postnatal Depression Scale (EPDS) for perinatal depression screening. 10-item self-report scale scored 0-30. EPDS 10-13 indicates possible depression requiring follow-up; EPDS 13+ = probable major depression.
Calculate macrosomia-based shoulder dystocia risk and apply systematic maneuver sequence: McRoberts + suprapubic pressure, Rubin II, Woods screw, posterior arm delivery, Zavanelli. Higher EFW and maternal diabetes increase risk.
Assess VTE risk and calculate LMWH (enoxaparin/dalteparin) prophylactic and therapeutic dosing for pregnant and postpartum women using RCOG/ACCP thromboprophylaxis guidelines and weight-based dosing adjustments.
Assess risk of planned vaginal breech delivery vs cesarean using Term Breech Trial criteria and subsequent PREMODA study data. Identifies candidates for vaginal breech birth at experienced centers: frank breech, adequate pelvis, no hyperextension, experienced operator.
Estimate spontaneous recovery probability for sudden sensorineural hearing loss (SSNHL). Factors include severity of initial hearing loss (mild-profound), audiogram configuration, vertigo presence, and time to treatment. 65% overall spontaneous recovery rate.
Calculate the Tinnitus Handicap Inventory (THI) to quantify tinnitus impact. 25-item questionnaire scoring functional, emotional, and catastrophic subscales. THI 0-100: slight (<16), mild (16-36), moderate (38-56), severe (58-76), catastrophic (78-100).
Diagnose benign paroxysmal positional vertigo (BPPV) and identify the affected canal (posterior, anterior, horizontal) from Dix-Hallpike and supine roll test results. Guides Epley, Semont, or BBQ roll canalith repositioning procedure.
Apply 2015 Barany Society/AAO-HNS classification for Meniere disease. Definite criteria: 2+ spontaneous vertigo attacks 20 min-12h, low-to-medium frequency SNHL, ipsilateral aural symptoms, not explained otherwise. Probable: same features without documented hearing loss.
Calculate STOP-BANG score for obstructive sleep apnea (OSA) risk stratification. 8 dichotomous items (0-8): Snoring, Tiredness, Observed apnea, Pressure (hypertension), BMI, Age, Neck, Gender. Score 5-8 = high risk.
Calculate SNOT-22 (Sino-Nasal Outcome Test) for chronic rhinosinusitis (CRS) symptom assessment. 22-item validated measure scoring nasal, extranasal, sleep, and psychological symptoms 0-5. Total 0-110, MCID 8.9 points.
Calculate the Lund-Mackay CT staging score for chronic rhinosinusitis. Each of 10 sinus units scored 0 (normal), 1 (partial opacification), 2 (complete opacification). Maximum score 24. Score > 4-5 correlates with significant CRS disease burden.
Calculate the Voice Handicap Index (VHI, 30 items) or abbreviated VHI-10 for voice disorder impact. Scores functional, physical, and emotional subscales. VHI-10 >11 indicates significant voice-related quality of life impairment.
Calculate GRBAS perceptual voice quality rating: Grade, Roughness, Breathiness, Asthenia, Strain. Each scored 0-3 by trained listener. Grade (overall severity) is the primary subscale for clinical reporting.
Calculate WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) for hip and knee osteoarthritis. Three subscales: pain (5 items), stiffness (2 items), physical function (17 items). Total 0-96; higher = worse. Primary endpoint in THA/TKA and knee OA trials.
Calculate KOOS (Knee Injury and Osteoarthritis Outcome Score) for knee conditions including OA, ACL injury, and meniscus tears. Five subscales: symptoms, pain, ADL function, sport/recreation, quality of life. Profiles functional status across age groups.
Calculate HOOS (Hip Disability and Osteoarthritis Outcome Score) for hip OA, FAI, acetabular dysplasia, and THA outcomes. Five subscales mirroring KOOS: pain, symptoms, ADL, sport/recreation, quality of life.
Calculate the IKDC (International Knee Documentation Committee) subjective knee evaluation form for ligament injuries, meniscus tears, and OA. 18 items covering symptoms, sport activity level, and function. Scored 0-100 (100 = no limitations).
Calculate the Lysholm knee scoring scale for ligament and meniscus injuries. 8 items covering limping, support, locking, instability, pain, swelling, stair climbing, and squatting. Scores 0-100: excellent (95-100), good (84-94), fair (65-83), poor (<65).
Calculate ASES (American Shoulder and Elbow Surgeons) score and Constant-Murley Score for shoulder conditions. ASES: pain (50%) + function (50%). Constant: pain, activities of daily living, range of motion, strength. Used for rotator cuff repair, arthroplasty, and instability outcomes.
Calculate the Neck Disability Index (NDI) for cervical spine pathology including radiculopathy, myelopathy, and whiplash. 10 items each scored 0-5. Total 0-50 (or percentage 0-100%). Score >28 (>56%) indicates severe/complete disability.
Calculate the Oswestry Low Back Pain Disability Index (ODI). 10 items (pain intensity, personal care, lifting, walking, sitting, standing, sleeping, social life, travelling, employment) each scored 0-5. Total percentage = disability: 0-20% minimal, 41-60% severe.
Calculate the Lower Extremity Functional Scale (LEFS) for hip, knee, ankle, and foot conditions. 20 items scored 0-4 each. Total 0-80; higher = better. MCID = 9 points. Used for physiotherapy, post-surgical, and sports injury rehabilitation tracking.
Calculate the FAAM (Foot and Ankle Ability Measure) for Achilles tendon, ankle ligament, hindfoot, and forefoot conditions. ADL subscale (21 items) and Sports subscale (8 items). Each scored 0-4; higher = better. Primary outcome in Achilles tendinopathy and ankle instability.
Calculate the AOFAS (American Orthopaedic Foot and Ankle Society) ankle-hindfoot score. Three subscales: pain (40 points), function (50 points), alignment (10 points). Total 0-100; score 75-100 = excellent-good.
Calculate the Thoracolumbar Injury Classification and Severity Score (TLICS) for thoracic and lumbar spine fractures. Scores morphology, posterior ligamentous complex integrity, and neurological status. TLICS > 4 = surgical; 4 = may be either; < 4 = non-operative.
Grade cervical spondylotic myelopathy (CSM) severity using Nurick grade (0-5) and modified Japanese Orthopaedic Association (mJOA) score (0-18). mJOA grades functional impairment in upper limb, lower limb, bladder, and sensation. Guides surgical timing.
Calculate composite return-to-sport (RTS) readiness after ACL reconstruction using limb symmetry index (LSI) for strength (quadriceps/hamstrings), hop tests (single-leg, triple hop, cross-over hop), and psychological readiness (ACL-RSI). LSI >90% threshold for clearance.
Calculate the DASH (Disabilities of the Arm, Shoulder and Hand) questionnaire for upper extremity conditions. 30-item disability subscale + 2 optional modules (sport/music, work). Total 0-100; 0 = no disability. Used for carpal tunnel, rotator cuff, elbow, and hand surgery outcomes.
Assess Tegner activity level (0-10 scale) for knee ligament injuries and meniscal conditions. Measures sporting and occupational activity. Used alongside Lysholm and IKDC scores. Return to pre-injury Tegner level is the primary return-to-sport endpoint in ACL studies.
Calculate lateral center-edge angle (LCEA, Wiberg angle) and anterior center-edge angle (ACEA) from hip radiographs to grade acetabular dysplasia. LCEA <20 degrees = dysplasia, 20-25 = borderline, >25 = normal.
Classify rotator cuff tears by size (small <1 cm, medium 1-3 cm, large 3-5 cm, massive >5 cm) and fatty infiltration (Goutallier grade 0-4) to predict repair integrity and functional outcome. Massive tears with Goutallier 3-4 have poor repair prognosis.
Calculate the Boston Carpal Tunnel Questionnaire (BCTQ) with Symptom Severity Scale (SSS, 11 items) and Functional Status Scale (FSS, 8 items). Each item scored 1-5. SSS and FSS each reported as mean score. BCTQ is the most widely used CTS outcome measure.
Calculate the Harris Hip Score (HHS) for hip conditions and total hip arthroplasty outcomes. Pain (44 pts), function (47 pts), absence of deformity (4 pts), range of motion (5 pts). Total 0-100: poor <70, fair 70-79, good 80-89, excellent 90-100.
Calculate the Oxford Hip Score (OHS) or Oxford Knee Score (OKS) for arthroplasty outcomes. 12 items each scored 0-4. Total 0-48; higher = better. OHS/OKS are mandatory patient-reported outcome measures in UK National Joint Registry and many European registries.
Apply McGowan grading for cubital tunnel syndrome (ulnar nerve neuropathy at elbow). Grade 1 (subjective only, no wasting), Grade 2 (intrinsic weakness, hypothenar wasting), Grade 3 (severe intrinsic wasting and paralysis). Guides conservative vs surgical decompression.
Calculate the alpha angle from MRI/CT/radiograph for cam-type femoroacetabular impingement (FAI) diagnosis. Alpha angle >55 degrees (Clohisy) or >60 degrees (Netzli) indicates pathological cam morphology. Crossover sign detects pincer morphology.
Calculate Beighton hypermobility score (0-9) to assess generalized joint hypermobility. Evaluate patellar instability risk from MPFL deficiency, trochlear dysplasia, and high TT-TG distance. Guides MPFL reconstruction vs tibial tubercle transfer decision.
Apply Schatzker classification (Types I-VI) to tibial plateau fractures. Types I-III involve lateral plateau; IV involves medial; V and VI are bicondylar. Higher type predicts greater articular damage, neurovascular injury risk, and post-traumatic OA development.
Calculate distal radius fracture radiographic parameters: radial inclination, radial height, volar tilt, ulnar variance, intra-articular step-off. Parameters outside acceptable thresholds predict poor functional outcome and guide operative vs conservative management.
Apply MSIS/ICM 2018 periprosthetic joint infection (PJI) major and minor criteria. One major criterion (draining sinus/fistula, 2 cultures same organism) or 3 minor serology/synovial criteria (>4 points) establishes PJI diagnosis.
Calculate VTE risk and select pharmacological prophylaxis for orthopedic surgery (THA, TKA, hip fracture, spine). ACCP 2012 recommends extended-duration LMWH, warfarin, or DOACs for 10-35 days post-arthroplasty. Balances VTE risk against surgical bleeding risk.
Apply Tile/AO classification (Type A, B, C) for pelvic ring fractures based on stability: A = stable, B = rotationally unstable, C = rotationally and vertically unstable. Guides resuscitation priority, angioembolization, and surgical fixation.
Apply Sunderland (1-5) and Seddon (neuropraxia, axonotmesis, neurotmesis) classification for peripheral nerve injuries. Guides prognosis for spontaneous recovery vs surgical nerve repair or grafting. Sunderland Grade 5 = complete transection, requires repair.
Calculate delta pressure (diastolic BP minus intracompartmental pressure) for acute compartment syndrome diagnosis. Delta pressure <30 mmHg is the threshold for emergent fasciotomy. Intracompartmental pressure >30 mmHg alone is a supporting finding.
Calculate orthopedic surgical site infection (SSI) risk from patient factors: BMI, diabetes, tobacco use, immunosuppression, malnutrition, prior SSI, and procedure type. Identifies candidates for preoperative optimization before elective arthroplasty.
Classify snapping hip syndrome: external (IT band over greater trochanter), internal (iliopsoas over iliopectineal eminence), and intra-articular (labral tear, loose body). Internal and external types respond to stretching; intra-articular requires hip arthroscopy.
Classify meniscus tears (radial, longitudinal, bucket-handle, horizontal, complex) and estimate repair vs partial meniscectomy outcome. Meniscus repair success rate 70-85% for vascular zone tears in younger patients. Partial meniscectomy increases OA risk at 5-10 years.
Apply ASIA Impairment Scale (AIS) to classify spinal cord injury: A (complete, no motor/sensory below injury level), B (sensory incomplete), C (motor incomplete, most key muscles <3/5), D (motor incomplete, most key muscles 3/5+), E (normal). Predicts functional recovery.
Apply Eaton-Littler-Melone classification (Stages I-IV) for thumb carpometacarpal (CMC/basal joint) osteoarthritis. Stage I = normal joint space, synovitis only. Stage IV = complete joint space loss with radial subluxation and STT involvement. Guides injection, splinting, and surgery.
Diagnose de Quervain tenosynovitis using Finkelstein test and Eichhoff maneuver. Wrist pain over first dorsal compartment (abductor pollicis longus + extensor pollicis brevis) with ulnar deviation. Guides ultrasound-guided steroid injection vs first dorsal compartment release.
Calculate the Cumberland Ankle Instability Tool (CAIT) score for chronic ankle instability. 9 items, total 0-30 (30 = no instability). Score <24 = chronic ankle instability. Used to measure rehabilitation response and ATFL/CFL ligament reconstruction outcomes.
Apply Herbert classification (Types A-D) for scaphoid fractures. Type A: stable acute (do not treat operatively). Type B: unstable acute (waist, proximal, comminuted). Type C: delayed union. Type D: established non-union. Types B2-D require ORIF with Herbert screw.
Calculate the VISA-A score for Achilles tendinopathy severity and treatment response. 8 items scoring pain and function during exercise. Score 0-100: 100 = asymptomatic, fully active elite athlete. Scores >80 = mild tendinopathy; <50 = severe. Primary outcome in Achilles tendon rehabilitation trials.
Calculate Cobb angle for scoliosis measurement and classify severity: mild <20 degrees, moderate 20-40 degrees, severe >40 degrees. Risser stage and growth potential determine bracing vs surgical thresholds. Adolescent idiopathic scoliosis (AIS) Cobb >45-50 degrees warrants fusion.
Calculates the Mainz Severity Score Index (MSSI) for Fabry disease to assess organ involvement and disease burden across cardiac, renal, neurological, and general domains.
Calculates the Gaucher Disease Severity Score (DS3) to assess disease burden including bone involvement, splenomegaly, hepatomegaly, and hematological parameters.
Calculates the Leipzig scoring system for Wilson disease diagnosis, incorporating Kayser-Fleischer rings, neurological symptoms, serum ceruloplasmin, Coombs-negative hemolytic anemia, liver copper, and genetic testing results.
Evaluates Pompe disease (glycogen storage disease type II) progression using respiratory function (FVC% predicted), muscle strength testing, and walking distance to guide enzyme replacement therapy decisions.
Calculates dietary phenylalanine tolerance, target blood phe levels by age, and sapropterin (BH4) responsiveness assessment for phenylketonuria management.
Calculates the Huntington disease burden of pathology using CAG repeat length and age, estimating when symptoms will likely onset and disease progression stage using the unified Huntington disease rating scale components.
Calculates the ALS Functional Rating Scale-Revised score to assess disease progression in amyotrophic lateral sclerosis, covering speech, swallowing, handwriting, cutting food, dressing, turning in bed, walking, climbing stairs, dyspnea, orthopnea, and respiratory insufficiency.
Comprehensive assessment for rare inborn errors of metabolism including homocystinuria, organic acidemias, urea cycle disorders, and fatty acid oxidation defects using biochemical markers and clinical features.
Calculates the Niemann-Pick disease type C Suspicion Index (NPC-SI) to identify patients who should undergo diagnostic testing, based on neurological, psychiatric, and visceral findings with age-weighted scoring.
Evaluates disease severity in MPS Type I (Hurler syndrome) including somatic features, neurological involvement, cardiac disease, airway disease, and skeletal dysplasia to guide transplantation and enzyme replacement therapy decisions.
Assesses metabolic stability and renal function in methylmalonic acidemia using plasma methylmalonate, homocysteine, GFR, and clinical markers to guide protein restriction and supplementation strategies.
Monitors propionic acidemia metabolic control using plasma propionylcarnitine, ammonia, bicarbonate, and ketones with recommendations for biotin and carnitine supplementation and cardiac surveillance.
Assesses isovaleric acidemia severity using isovalerylcarnitine (C5), isovalerylglycine, and ammonia levels, with glycine supplementation dosing recommendation to enhance detoxification.
Monitors leucine, isoleucine, and valine levels in maple syrup urine disease with branched-chain amino acid tolerance calculation and crisis intervention thresholds.
Assesses treatment response in homocystinuria (CBS deficiency) by calculating total plasma homocysteine normalization, pyridoxine responsiveness, and thrombosis risk reduction targets.
Monitors metabolic stability in Glycogen Storage Disease Type I using glucose, lactate, uric acid, triglycerides, and liver size, with cornstarch dosing optimization.
Calculates BMI percentile, weight-for-height z-score, and pancreatic enzyme replacement dosing for cystic fibrosis patients, with fat-soluble vitamin supplementation recommendations.
Assesses Hunter syndrome (MPS II) disease activity through uGAG levels, neurocognitive function, 6-minute walk test, joint range of motion, and cardiac valve status for enzyme replacement therapy monitoring.
Monitors biotinidase deficiency treatment response with biotin supplementation dosing, plasma biotin levels, and assessment of neurological, auditory, visual, and dermatological complications.
Calculates fetal risk in maternal phenylketonuria based on maternal blood phenylalanine levels, timing of metabolic control, and gestational age, estimating risk of microcephaly, CHD, and intellectual disability.
Calculates age- and BSA-adjusted aortic root Z-score for Marfan syndrome using Roman nomogram to determine surgical urgency and monitor growth rate.
Predicts adult height in Turner syndrome using parental height formula (MPH - 13 cm) and growth hormone response parameters, with karyotype-adjusted bone age analysis.
Scores sickle cell disease pain crisis severity, calculates annual pain crisis rate, hydroxyurea dosing (15-35 mg/kg/day), and fetal hemoglobin (HbF) response to guide disease-modifying therapy.
Calculates transfusion iron loading rate, liver iron concentration from MRI T2*, cardiac iron from MRI T2*, and deferasirox/deferoxamine chelation adequacy index.
Calculates the Pettersson radiological score for hemophilic arthropathy, annual bleeding rate on prophylaxis, and factor activity trough level targets for severe hemophilia A and B.
Calculates the ISTH Bleeding Assessment Tool score to identify patients with significant mucocutaneous bleeding for von Willebrand disease screening, with DDAVP response prediction by VWD type.
Estimates liver iron concentration and calculates phlebotomy frequency required to achieve ferritin target in hereditary haemochromatosis (HFE C282Y homozygote) using serum ferritin and transferrin saturation.
Assesses Fragile X syndrome severity using CGG repeat expansion size, intellectual disability domain scoring, ASD features (ADOS-2 calibrated scores), ADHD severity, and anxiety management planning.
Calculates the Rett Syndrome Severity Scale for MECP2-related Rett syndrome using motor function, hand function, breathing pattern, ambulation, scoliosis, and seizure burden across the four clinical stages.
Assesses Angelman syndrome severity using UBE3A genetic mechanism (deletion vs UPD vs ImprintingCentreMutation vs UBE3A mutation), seizure burden, motor/language milestones, and EEG pattern scoring.
Calculates obesity risk trajectory in Prader-Willi syndrome using genotype (deletion vs UPD), age at hyperphagia onset, BMI trajectory, and growth hormone therapy response monitoring.
Assesses cardiovascular risk in Williams syndrome including supravalvular aortic stenosis severity by gradient, peripheral pulmonary stenosis, hypertension frequency, and sudden cardiac death risk stratification.
Assesses Noonan syndrome features including pulmonary stenosis severity, HCM risk, bleeding disorder (von Willebrand, platelet dysfunction), short stature SDS, and MEK/RAS pathway mutation for trametinib eligibility.
Calculates initial and maintenance levothyroxine dosing for congenital hypothyroidism by age/weight (10-15 mcg/kg/day neonate), with TSH and fT4 targets to optimize neurodevelopmental outcomes.
Assesses Beckwith-Wiedemann syndrome hypoglycemia severity and treatment needs, Wilms tumor/hepatoblastoma surveillance schedule by molecular subtype, and macroglossia severity for tongue reduction criteria.
Scores Silver-Russell syndrome severity using Netchine-Harbison clinical criteria, fasting hypoglycemia risk, growth hormone treatment response, and caloric requirement calculation to prevent fasting in SRS infants.
Assesses Sotos syndrome using the three cardinal features (facial gestalt, learning disability, overgrowth), NSD1 deletion vs mutation genotype-phenotype correlation, and tumor surveillance requirements.
Scores CHARGE syndrome diagnosis using Blake criteria (major: coloboma, CHD, choanal atresia, growth retardation, GU anomalies, ear anomalies; minor: TE fistula, lip/palate, SCSC, distinctive face) for CHD7 testing guidance.
Assesses Pallister-Killian syndrome (tetrasomy 12p) severity using intellectual disability level, epilepsy burden, structural heart disease, and skin pigmentation pattern to guide multidisciplinary management.
Scores VACTERL association (Vertebral, Anal atresia, Cardiac, Tracheo-Esophageal fistula, Renal, Limb) features for severity and guides surgical prioritization for neonatal interventions.
Generates age-specific Down syndrome health surveillance checklist covering cardiac monitoring, thyroid function, atlantoaxial instability screening, hearing/vision, Alzheimer dementia onset, and leukemia risk by age.
Calculates the Oxford MEST-C pathological classification (Mesangial hypercellularity, Endocapillary hypercellularity, Segmental glomerulosclerosis, Tubular atrophy, Crescents) for IgA nephropathy prognosis and sparsentan/budesonide eligibility.
Classifies nephrotic syndrome response to steroid therapy (steroid-sensitive vs resistant, frequently relapsing, steroid-dependent), calculates proteinuria remission criteria, and guides rituximab/calcineurin inhibitor initiation.
Calculates skin cancer risk in xeroderma pigmentosum by complementation group (XPA-XPG), sun protection compliance score, cumulative UV exposure estimate, and neurological involvement frequency.
Assesses hyperekplexia severity by startle response intensity, fall frequency, brainstem startle reflex latency, GLRA1/GLRB genotype, and clonazepam dosing response for startle suppression.
Monitors CSF glucose:plasma glucose ratio in GLUT1 deficiency, ketogenic diet adequacy (serum beta-hydroxybutyrate), seizure control response, and identifies movement disorder phenotypes requiring dietary vs cannabis-based therapy.
Assesses alkaptonuria disease burden using urinary homogentisic acid excretion, ochronotic deposition severity, joint involvement, and cardiac valve disease to monitor nitisinone therapy response.
Monitors hereditary tyrosinemia type 1 treatment response with plasma succinylacetone levels, AFP, liver function, and renal tubular function on nitisinone therapy.
Assesses primary carnitine deficiency severity using plasma free carnitine, acylcarnitine ratio, cardiac function, hypoglycemia episodes, and L-carnitine supplementation dosing requirements.
Assesses risk of metabolic crisis in fatty acid oxidation disorders (MCAD, LCHAD, VLCAD) based on acylcarnitine profile, fasting duration, illness severity, and provides safe fasting duration guidelines.
Classifies cobalamin (Vitamin B12) metabolism disorders (cblA-cblG, MMA, MTHFR) using methylmalonate, homocysteine, and clinical features, guiding hydroxocobalamin dosing and supplementation.
Calculates ammonia scavenger dosing (sodium benzoate, sodium phenylacetate/phenylbutyrate) and emergency glucose infusion rates for urea cycle disorder hyperammonemic crises based on weight and severity.
Composite severity assessment for alpha-1 antitrypsin deficiency using Pi typing, serum A1AT level, FEV1 percent predicted, DLCO, and liver fibrosis markers to guide augmentation therapy decisions.
Assesses lysosomal acid lipase deficiency severity (Wolman disease in infants; CESD in older patients) using liver function tests, lipid profile, liver ultrasound/biopsy findings, and sebilapase alfa dosing.
Calculates systemic oxalate burden in primary hyperoxaluria types 1-3 using 24-hour urinary oxalate, plasma oxalate, GFR, and estimates crystallization risk and lumasiran/oxalate lowering therapy response.
Monitors classic galactosemia (GALT deficiency) on dietary galactose restriction, assessing RBC GALT activity, galactose-1-phosphate levels, developmental outcomes, and ovarian insufficiency in females.
Evaluates succinic semialdehyde dehydrogenase (SSADH) deficiency severity using CSF and urine 4-hydroxybutyric acid (GHB), EEG abnormalities, and neuropsychiatric features to guide vigabatrin response assessment.
Calculates neonatal hyperammonemia severity using peak ammonia level, duration of hyperammonemia, and neurological examination findings to predict neurodevelopmental outcomes and guide CVVH/dialysis decisions.
Evaluates dopa-responsive dystonia and BH4 (tetrahydrobiopterin) synthesis defects through CSF neurotransmitter metabolites, BH4 loading test, and L-DOPA dosing calculator.
Calculates ATTR amyloidosis progression using the Neuropathy Impairment Score (NIS), FAS composite, polyneuropathy disability score, and cardiac biomarkers (NT-proBNP, troponin) to guide patisiran/inotersen dosing.
Calculates the Loes MRI severity score for X-linked adrenoleukodystrophy to guide stem cell transplantation eligibility, assessing cerebral demyelination extent and location.
Scores CDG syndrome severity across neurological, hepatic, coagulation, growth, and endocrine domains using the CDG-specific clinical severity score to assess treatment response and MPI-CDG mannose therapy.
Assesses pyruvate dehydrogenase complex (PDHc) deficiency severity using plasma lactate/pyruvate ratio, CSF lactate, brain MRI findings, and ketogenic diet adequacy monitoring.
Calculates clinical severity of mitochondrial respiratory chain deficiency using the NMDAS (Newcastle Mitochondrial Disease Adult Scale) or Newcastle Pediatric Mitochondrial Disease Scale, with mitochondrial disease criteria.
Assesses alpha-mannosidosis severity using intellectual disability degree, hearing impairment, immune deficiency (recurrent infections), ataxia, and psychiatric features to guide laronidase and HSCT decisions.
Calculates the 28-joint Disease Activity Score using CRP (DAS28-CRP) for rheumatoid arthritis to determine disease activity state (remission/low/moderate/high) and guide biologic therapy initiation.
Calculates CDAI for rheumatoid arthritis using swollen and tender joint counts plus patient and physician global assessments, without requiring laboratory tests for rapid clinical assessment.
Calculates SDAI for rheumatoid arthritis by summing swollen joint count, tender joint count, patient global, physician global, and CRP (mg/dL), with ACR/EULAR remission criteria comparison.
Evaluates ACR/EULAR Boolean remission criteria for rheumatoid arthritis requiring tender joint count ≤1, swollen joint count ≤1, CRP ≤1 mg/dL, and patient global assessment ≤2 cm simultaneously.
Calculates BASDAI from 6 patient-reported questions on fatigue, spinal pain, peripheral joint pain/swelling, enthesitis, morning stiffness duration and intensity in axial spondyloarthritis.
Calculates ASDAS-CRP for axial spondyloarthritis using back pain (Q2+Q3), peripheral joint pain, enthesitis, morning stiffness, and CRP to assess disease activity state and treatment response.
Calculates BASFI functional disability in ankylosing spondylitis using 10 patient-reported physical function questions on daily activities and ability to cope, tracking functional response to biologic therapy.
Calculates the Stanford HAQ Disability Index across 8 functional domains (dressing, arising, eating, walking, hygiene, reach, grip, activities) to assess functional impairment in RA, SSc, and other rheumatic diseases.
Calculates serum urate flare risk at different urate levels, allopurinol/febuxostat dose titration schedule to achieve <360 µmol/L target, and renal dose adjustment for urate-lowering therapy.
Calculates 10-year probability of major osteoporotic fracture (hip, spine, wrist, humerus) and hip fracture specifically using FRAX clinical risk factors with or without BMD, with country-specific intervention thresholds.
Calculates modified Rodnan Skin Score (mRSS) for systemic sclerosis, EUSTAR-derived early mortality risk, pulmonary hypertension screening parameters, and ILD progression risk stratification.
Calculates DAPSA for psoriatic arthritis using tender joint count, swollen joint count, patient pain VAS, patient global VAS, and CRP, with remission threshold for biologic tapering decisions.
Assesses lupus nephritis renal activity using UACR, urine red cell casts, eGFR trend, anti-dsDNA, complement C3/C4, and classifies renal response (complete/partial remission) per ACR 2024 criteria.
Assesses reactive arthritis severity, likelihood of chronicity (HLA-B27, causative organism, joint count), and antibiotic selection for trigger organism eradication including Chlamydial reactive arthritis.
Calculates EULAR Sjögren Syndrome Disease Activity Index (ESSDAI) across 12 organ domains, Schirmer test dry eye grading, and minor salivary gland biopsy focus score for diagnosis and biological therapy eligibility.
Calculates BVAS v3 for ANCA-associated vasculitis (GPA/MPA/eGPA) across 9 organ systems to assess disease activity and guide rituximab/cyclophosphamide induction and maintenance therapy decisions.
Calculates 2012 ACR/EULAR provisional classification criteria score for polymyalgia rheumatica, CRP/ESR flare frequency, and steroid tapering schedule with GCA vigilance assessment.
Assesses inflammatory myopathy (DM/PM/IBM/ASyS) disease activity using MMT8 manual muscle testing, MDAAT, skin VAS, CK levels, and IIM-specific autoantibody-guided prognosis (anti-MDA5, anti-Jo-1).
Scores Raynaud phenomenon severity using RCS (Raynaud Condition Score), attack frequency, digital ulcer burden, and distinguishes primary from secondary RP with SSc digital vasculopathy management.
Calculates Global APS Score (GAPSS) for thrombotic risk in antiphospholipid syndrome, identifies triple-positive criteria patients, and guides anticoagulation intensity (INR 2-3 vs 3-4 vs direct oral anticoagulants).
Calculates the Quantitative Myasthenia Gravis Score (QMGS) across 13 test items, myasthenic crisis risk assessment (FVC <1L threshold), pyridostigmine dose optimization, and thymectomy eligibility by AChR antibody status.
Assesses Lambert-Eaton myasthenic syndrome (LEMS) severity using the QMG-LEMS score, VGCC antibody titer, paraneoplastic SCLC screening priority score, and 3,4-diaminopyridine dosing.
Assesses stiff person syndrome severity using STIFF scale, anti-GAD65 antibody titer, co-existing type 1 DM and cerebellar ataxia features, and baclofen/diazepam dosing adequacy for muscle rigidity control.
Calculates pyridoxine-dependent epilepsy (PDE) diagnostic biomarkers (plasma/urine alpha-aminoadipic semialdehyde), pyridoxine dose response, lysine restriction protocol, and long-term neurodevelopmental outcome prediction.
Stages neuronal ceroid lipofuscinosis (CLN1-14) using HAMBURGS unified Batten disease rating scale, PPT1/TPP1 enzyme activity confirmation, and cerliponase alfa (CLN2) dosing and infusion monitoring.
Monitors key urine organic acid markers for various organic acidurias (3-hydroxypropionic acid, methylcitrate, ethylmalonic acid, suberylglycine) with metabolic control target ranges and crisis threshold values.
Calculates the Hammersmith Functional Motor Scale Expanded (HFMSE) for spinal muscular atrophy types 2-3, assessing motor milestones and tracking response to nusinersen, risdiplam, or onasemnogene therapy.
Stages Friedreich ataxia disability using the SARA (Scale for Assessment and Rating of Ataxia) and Functional Disability Scale, assessing cerebellar, cardiac (hypertrophic cardiomyopathy), and metabolic (diabetes) complications.
Assesses tuberous sclerosis complex disease burden across CNS (tubers, SEGA, SEH), pulmonary (LAM), renal (AML, cysts), cardiac (rhabdomyomas), and dermatological manifestations to guide everolimus/sirolimus therapy.
Calculates NF1 disease burden including plexiform neurofibroma tumor volume, MPNST risk assessment, optic glioma monitoring parameters, and selumetinib eligibility criteria.
Calculates the Epistaxis Severity Score (ESS) for hereditary hemorrhagic telangiectasia to guide treatment intensity and assess iron deficiency anemia requiring IV iron or transfusion.
Assesses Fanconi anemia bone marrow failure severity using blood counts, cytogenetics for clonal evolution, and FANCA/FANCB/FANCC complementation group for transplant eligibility and cancer surveillance scheduling.
Calculates acute hepatic porphyria (AIP/VP/HCP) attack severity using urinary ALA/PBG, pain score, neurological deficits, hyponatremia, and tachycardia to guide hemin therapy initiation and givosiran dosing.
Assesses primary immunodeficiency severity across B-cell (agammaglobulinemia, CVID), T-cell (SCID, DiGeorge), combined, and phagocyte defects to guide IVIG dosing, HSCT timing, and prophylactic antimicrobial regimens.
Calculates HAE-QoL score and attack frequency to guide choice between on-demand and long-term prophylaxis (lanadelumab, C1-INH concentrate), including kallikrein inhibitor dosing.
Calculates mastocytosis symptom severity using the Mastocytosis Activity Score (MAS) and baseline tryptase for skin, mediator release, bone marrow burden, and anaphylaxis risk to guide treatment escalation.
Classifies autoinflammatory periodic fever syndromes (FMF, TRAPS, CAPS, MKD, PFAPA) using fever episode characteristics, duration, associated features, serum amyloid A, and genetic testing results.
Calculates the SLICC/ACR Damage Index for systemic lupus erythematosus to assess irreversible organ damage across 12 domains, correlate with mortality risk, and guide treatment intensity decisions.
Monitors 21-hydroxylase deficiency CAH treatment adequacy using 17-OHP, androstenedione, renin/aldosterone ratio, and growth parameters to optimize hydrocortisone and fludrocortisone dosing.
Estimates CVD risk in familial hypercholesterolemia using the SAFEHEART score (FH-specific), Dutch Lipid Clinic Network score for FH diagnosis, and LDL reduction targets with PCSK9 inhibitor dosing.
Calculates the Charcot-Marie-Tooth Neuropathy Score Version 2 (CMTNSv2) to track CMT disease progression, nerve conduction velocity classification, and ankle-foot orthosis prescription criteria.
Calculates aortic dissection risk in Marfan syndrome using aortic root Z-score (age/BSA-indexed diameter), family history of dissection, and rate of aortic growth to determine surgical threshold.
Scores the 2017 hEDS diagnostic criteria including Beighton hypermobility score, systemic features, family history, and musculoskeletal complications to guide physiotherapy and autonomic management.
Calculates fracture risk in osteogenesis imperfecta using Sillence classification type, annual fracture rate, DXA Z-score, and pamidronate/zoledronic acid treatment response monitoring.
Evaluates skeletal dysplasia severity in SED using thoracic kyphoscoliosis degree, odontoid hypoplasia risk, hip dysplasia severity, and final height prediction using SED-specific growth charts.
Calculates the Richmond Agitation-Sedation Scale score (-5 to +4) to assess sedation and agitation levels in ICU patients, guiding propofol/midazolam/dexmedetomidine titration to target RASS -2 to 0.
Applies the Confusion Assessment Method for the ICU (CAM-ICU) four-feature assessment to diagnose delirium in non-verbal mechanically ventilated patients, distinguishing hyperactive and hypoactive subtypes.
Calculates APACHE II (Acute Physiology and Chronic Health Evaluation) score from 12 acute physiology variables, age, and chronic health points to estimate ICU mortality probability.
Calculates the SOFA score across six organ systems (respiratory, coagulation, hepatic, cardiovascular, CNS, renal) to assess organ failure severity and predict mortality in ICU and sepsis patients.
Applies the quick SOFA (qSOFA) criteria to identify patients outside the ICU with suspected infection at high risk of sepsis complications: respiratory rate ≥22, altered mentation, and systolic BP ≤100 mmHg.
Evaluates SIRS criteria (temperature, heart rate, respiratory rate, white blood cell count) for identification of systemic inflammatory response and sepsis risk stratification in context of suspected infection.
Calculates mean arterial pressure (MAP = DBP + 1/3 pulse pressure), cerebral perfusion pressure (CPP = MAP - ICP), and coronary perfusion pressure from blood pressure and ICP measurements for critical care management.
Applies Berlin ARDS criteria (PaO2/FiO2 with PEEP ≥5 cmH2O, bilateral infiltrates, non-cardiac origin), calculates predicted body weight for 6 mL/kg tidal volume, driving pressure, and plateau pressure targets.
Calculates norepinephrine, vasopressin, phenylephrine, epinephrine, and dopamine doses in mcg/kg/min from infusion rates, with vasopressor equivalence table and weaning guidance for septic shock.
Calculates ICU net fluid balance, cumulative fluid overload percentage (>10% BW associated with worse outcomes), and fluid responsiveness prediction from pulse pressure variation (PPV) and passive leg raise.
Stages acute kidney injury per KDIGO 2012 criteria using serum creatinine rise and urine output, calculates RRT initiation thresholds (STARRT-AKI, AKIKI criteria), and estimates creatinine kinetics.
Calculates ICU caloric and protein requirements using ESPEN/ASPEN guidelines, ideal body weight corrections, protein dosing in CRRT, and timing of transition from early trophic to full enteral nutrition.
Applies restrictive (Hb <7 g/dL) vs liberal (Hb <10 g/dL) transfusion thresholds for ICU patients, calculates PRBC units needed, and identifies higher-threshold scenarios (ACS, septic shock, cardiac surgery).
Interprets TEG and ROTEM parameters (R/CT, K/CFT, angle/alpha, MA/MCF, LY30/LI30) to identify coagulation defects and calculates FFP, cryoprecipitate, and platelet dosing for viscoelastic-guided resuscitation.
Calculates predicted DLCO using GLI 2017 reference equations, interprets percent predicted severity categories, adjusts for hemoglobin, carboxyhemoglobin, and altitude, and guides ILD/pulmonary hypertension assessment.
Calculates GLI 2012 predicted FEV1, FVC, FEV1/FVC ratio, and FEF25-75 by age, height, sex, and ethnicity, with GOLD COPD staging and ATS/ERS obstruction/restriction classification.
Calculates COPD exacerbation severity (Anthonisen criteria), antibiotic eligibility (3 cardinal symptoms: increased dyspnea, sputum, purulence), and guides amoxicillin-clavulanate vs respiratory FQ therapy and NIV threshold.
Calculates the Wells clinical prediction score for PE probability, integrates with D-dimer (PERC, YEARS algorithm) to stratify patients for CTPA need, and guides anticoagulation vs thrombolysis vs CDT threshold.
Calculates the Wells DVT probability score to guide D-dimer testing and lower limb compression ultrasound ordering for suspected deep vein thrombosis, with treatment duration guidance for provoked vs unprovoked DVT.
Checks SSC Hour-1 bundle compliance (blood cultures, lactate, antibiotics, fluids, vasopressors), calculates antibiotic time-to-administration delay penalty, and guides empirical antibiotic selection by suspected source.
Calculates optimal central venous catheter insertion length by site (internal jugular, subclavian, femoral) based on patient height and CXR verification criteria for superior vena cava tip positioning.
Calculates TTM target temperature (33-36°C), rewarming rate (0.25°C/hour), hemodynamic targets during cooling, and EEG/neurology outcome prediction using post-arrest NIHSS equivalent assessment.
Calculates magnesium sulphate loading dose (4-6g IV) and maintenance infusion (1-2g/hour) for eclampsia seizure prophylaxis and treatment, with toxicity thresholds and calcium gluconate antidote dosing.
Calculates Hunt-Hess clinical grade and modified Fisher CT grade for subarachnoid haemorrhage to predict surgical risk, vasospasm risk, and outcomes, with nimodipine dosing for cerebral vasospasm prevention.
Calculates Glasgow Coma Scale (adult GCS: eye 1-4, verbal 1-5, motor 1-6) and pediatric GCS with age-appropriate verbal response criteria, intubation indicator (GCS ≤8), and brain injury severity classification.
Calculates ICP treatment thresholds, osmotherapy dosing (mannitol/hypertonic saline), CPP targets, and guides decompressive craniectomy criteria in severe TBI and malignant MCA stroke.
Calculates time-based status epilepticus treatment algorithm: benzodiazepine phase (lorazepam/diazepam), second-line AED (levetiracetam/valproate/lacosamide), and refractory SE (propofol/midazolam/thiopentone) dosing by weight.
Predicts adult height in achondroplasia using achondroplasia-specific growth charts, annual height velocity on vosoritide therapy, and foramen magnum stenosis risk scoring.
Monitors GSD type III (debranching enzyme deficiency) using fasting glucose, liver aminotransferases, muscle CK, and fiber type ratio to guide high-protein diet and avoid fasting in hepatic and muscle GSD IIIa/IIIb.
Assesses glycogen storage disease types VI (liver phosphorylase) and IX (phosphorylase kinase) severity using hypoglycemia frequency, ketosis, growth, and liver function for dietary management guidance.
Assesses McArdle disease (myophosphorylase deficiency) severity using ischemic forearm test surrogate, exercise intolerance grade, myoglobinuria history, and CK baseline to guide safe exercise protocols and sucrose pre-exercise supplementation.
Assesses Danon disease severity using hypertrophic cardiomyopathy degree (wall thickness), left ventricular function, arrhythmia burden (WPW), and retinal disease to guide ICD implantation and transplant listing.
Assesses GSD type VII (phosphofructokinase deficiency / Tarui disease) using exercise intolerance score, hemolytic anemia severity (indirect bilirubin, reticulocyte count), and muscle CK during exertion.
Calculates thrombosis risk in MTHFR C677T and A1298C variants, homocysteine target levels, and optimal folate/B12 supplementation dosing for mild hyperhomocysteinemia management.
Guides confirmation testing for short-chain acyl-CoA dehydrogenase (SCAD) deficiency detected by newborn screening, using plasma butyrylcarnitine (C4) levels, ACADS gene variant pathogenicity, and clinical correlation.
Stratifies risk in very-long-chain acyl-CoA dehydrogenase (VLCAD) deficiency using C14:1 carnitine levels, cardiac involvement, exercise-induced rhabdomyolysis history, and MCT supplementation adequacy.
Calculates rhabdomyolysis risk in carnitine palmitoyltransferase II (CPT2) deficiency based on exercise type, fasting duration, fever, and cold exposure, with CK monitoring thresholds for AKI prevention.
Calculates safe fasting duration and carnitine dosing in carnitine palmitoyltransferase I (CPT1A) deficiency, with special consideration for the Arctic/Inuit CPT1A c.1436C>A variant and hypoketotic hypoglycemia risk.
Evaluates neurological severity in Gaucher disease types 2 and 3 using horizontal saccadic eye movement velocity, cognitive function, myoclonic epilepsy burden, and response to substrate reduction therapy (eliglustat/miglustat).
Classifies hypophosphatasia severity (perinatal/infantile/childhood/adult/odontohypophosphatasia) using ALP levels, phosphoethanolamine, PPi, TNSALP gene mutations, and asfotase alfa dosing by weight and phenotype.
Assesses FOP episodic flare severity using warmth, swelling, pain, and ROM restriction, estimates new heterotopic ossification volume from MRI, and guides palovarotene dosing for flare prevention.
Assesses lipoid proteinosis severity using laryngeal involvement (hoarseness grade), skin manifestation extent, eyelid beading score, neurological features, and guides CO2 laser treatment planning.
Evaluates Canavan disease (aspartoacylase deficiency) severity using urine N-acetylaspartate levels, developmental milestone assessment, MRI white matter signal score, and macrocephaly percentile.
Stages Alexander disease using MRI white matter abnormality severity score, Rosenthal fiber distribution, bulbar/brainstem dysfunction severity, and seizure burden to guide supportive care planning.
Stages Krabbe disease (globoid cell leukodystrophy) using psychosine levels, nerve conduction velocity, MRI severity, and disease stage to guide hematopoietic stem cell transplant eligibility (pre-symptomatic window).
Assesses Menkes disease severity using copper and ceruloplasmin levels, neurological development score, connective tissue findings, and subcutaneous copper histidinate response in mutation-specific outcome prediction.
Converts between visual acuity notation formats: Snellen fraction (20/x), decimal fraction, LogMAR, and ETDRS letter count, with near vision equivalents and legal blindness thresholds.
Corrects Goldmann applanation tonometry IOP for central corneal thickness (CCT) using the Ehlers and DIGS correction formulas, and calculates glaucoma target IOP based on stage and baseline IOP.
Assesses cup-to-disc ratio for glaucoma risk stratification using vertical CDR, ISNT rule compliance, neuroretinal rim analysis, and peripapillary nerve fiber layer thickness guidance.
Calculates 5-year risk of progression to advanced AMD using AREDS categories, drusen size and area, pigment abnormalities, and AREDS2 supplementation (AREDS2 = Vit C 500mg, Vit E 400IU, Lutein 10mg, Zeaxanthin 2mg, Zinc 80mg).
Grades diabetic retinopathy severity using ETDRS International Classification (mild/moderate/severe NPDR, PDR), calculates 1-year progression risk, and guides panretinal photocoagulation and anti-VEGF injection thresholds.
Calculates treatment threshold for diabetic macular oedema using central macular thickness (CMT >300-320 μm), BCVA, and anti-VEGF injection interval optimization using treat-and-extend protocol.
Calculates visual field mean deviation progression rate (dB/year) using linear regression of serial Humphrey VF tests, estimates time to functional blindness, and guides IOP lowering intervention urgency.
Calculates the Psoriasis Area and Severity Index (PASI) across four body regions (head, trunk, upper limbs, lower limbs), scoring erythema, induration, and scaling weighted by body surface area involvement.
Calculates SCORAD for atopic dermatitis using body surface area involvement, intensity of 6 lesional signs, and subjective symptoms (pruritus and sleep disturbance) to guide dupilumab/tralokinumab eligibility.
Calculates melanoma AJCC 8th edition T-stage from Breslow thickness and ulceration, estimates sentinel lymph node biopsy yield, and 5/10-year survival by stage with adjuvant immunotherapy eligibility.
Calculates the IGA static global assessment (0-4 scale) and body surface area for psoriasis and atopic dermatitis with treatment eligibility composite scoring for phase III clinical trial interpretation.
Classifies skin phototype (I-VI) based on genetic background, sun exposure reaction history, and tanning ability to guide UV therapy dosing (NB-UVB MED), laser parameter selection, and melanoma/NMSC risk counseling.
Calculates starting narrowband UVB dose based on Fitzpatrick skin type and MED testing, dose escalation schedule for psoriasis and vitiligo phototherapy, and cumulative lifetime UVB dose monitoring.
Calculates PDAI (Pemphigus Disease Area Index) for skin and mucous membranes, anti-desmoglein 1 and 3 titers for disease monitoring, and guides rituximab vs azathioprine steroid-sparing strategy.
Classifies rosacea by subtype (ETR, PPR, phymatous, ocular) and IGA score, guides topical ivermectin/brimonidine, oral doxycycline 40 mg modified-release, and IPL/laser therapy selection by subtype.
Grades acne severity using the Leeds revised acne grading and Global Evaluation of Acne (GEA) scales, guides topical retinoid/benzoyl peroxide/antibiotic combination selection, and oral antibiotic duration limitation.
Calculates NAPSI score for all 20 nails, scoring nail matrix (pitting, leukonychia, red spots in lunula, crumbling) and nail bed (onycholysis, subungual hyperkeratosis, oil spots, splinter hemorrhages) features.
Stages keratoconus using ABCD grading (anterior/posterior elevation, thinnest point, BSCVA) on Pentacam, assesses CXL eligibility (progression ≥1 D/year), and calculates topography-guided ablation suitability.
Estimates penetrating keratoplasty (PK) and DSAEK/DMEK graft survival by diagnosis, recipient risk factors (neovascularization, prior rejection, glaucoma), HLA matching, and topical steroid adherence requirement.
Applies updated WHO/EUROCJD diagnostic criteria for sporadic CJD (sCJD), classifies as possible/probable/definite, scores CSF 14-3-3 protein, MRI DWI/FLAIR, EEG PSWC, and RT-QuIC biomarker support.
Classifies orbital cellulitis using Chandler classification (I-V), guides CT orbital findings interpretation, indicates IV antibiotic selection, and determines subperiosteal abscess drainage criteria in pediatric/adult patients.
Calculates the Clinical Activity Score (CAS) for thyroid eye disease, EUGOGO severity classification (mild/moderate-severe/sight-threatening), teprotumumab eligibility criteria, and orbital decompression timing.
Calculates rhegmatogenous retinal detachment risk from myopia degree, lattice degeneration extent, prior surgery, and macula status, guiding choice between pneumatic retinopexy, scleral buckle, and pars plana vitrectomy.
Calculates vancomycin dosing using AUC/MIC target attainment methodology per 2020 ASHP/IDSA/SIDP consensus guidelines, integrating Cockcroft-Gault CrCl, patient weight, and target AUC 400-600 mg·h/L.
Calculates gentamicin/tobramycin/amikacin extended-interval dosing using the Hartford nomogram, renal function-adjusted interval, and draws for peak-trough monitoring in conventional dosing.
Calculates lithium dosing based on creatinine clearance, serum level at steady state, target therapeutic window (0.6-1.0 mEq/L for maintenance), and acute intoxication management thresholds.
Adjusts phenytoin levels for hypoalbuminemia and renal failure using the Sheiner-Tozer equation, calculates phenytoin-equivalent doses for fosphenytoin conversion, and loading dose calculations.
Guides warfarin dose adjustment based on current INR, target INR range, time in therapeutic range (TTR), and CYP2C9/VKORC1 pharmacogenomics to optimize anticoagulation with bleeding risk assessment.
Calculates leucovorin rescue dosing for high-dose methotrexate based on serum MTX levels at 24h/48h/72h, renal function decline, and delayed clearance criteria per standardized MTX elimination protocols.
Adjusts doses for 25+ commonly renally cleared medications including carbapenems, beta-lactams, antivirals (acyclovir, valacyclovir), gabapentin, pregabalin, and allopurinol based on CrCl using Cockcroft-Gault equation.
Calculates weight-based pediatric doses for 30+ common medications (antibiotics, analgesics, antipyretics, emergency drugs) using actual weight, adjusted weight, and maximum dose caps with age-specific formulations.
Calculates one-compartment pharmacokinetic parameters including volume of distribution, elimination rate constant, half-life, and area under the curve from drug concentration-time data.
Monitors cyclosporine C0 and C2 levels and tacrolimus trough levels in solid organ transplantation, calculates dose adjustments based on target troughs by time post-transplant and organ type.
Calculates fluoroquinolone pharmacodynamic target attainment using AUC/MIC ratio (target ≥125 for Gram-negatives, ≥30 for respiratory pathogens), with renal and hepatic dose adjustments.
Calculates optimal beta-lactam dosing using %T>MIC target attainment for piperacillin-tazobactam, meropenem, and cefepime extended or continuous infusions in severe infections with resistant organisms.
Predicts initial tacrolimus dose based on CYP3A5 genotype (*1 expressers vs *3 non-expressers), kidney vs liver transplant, and race-based metabolizer status to reduce time to therapeutic range.
Calculates weight-based unfractionated heparin infusion dosing per Raschke nomogram, aPTT-guided dose adjustments, and anti-Xa target monitoring for DVT/PE treatment and ACS.
Calculates enoxaparin dosing for VTE treatment (1 mg/kg q12h or 1.5 mg/kg q24h), prophylaxis (40 mg q24h), and ACS (1 mg/kg q12h), with anti-Xa monitoring thresholds for obesity, pregnancy, and renal failure.
Calculates idarucizumab (Praxbind) dosing for dabigatran reversal and andexanet alfa (Andexxa) dosing for apixaban/rivaroxaban/edoxaban reversal based on drug dose, last intake timing, and renal function.
Calculates digoxin loading dose, maintenance dose based on lean body weight and CrCl, target serum level by indication (AF rate control vs HFrEF), and Fab fragment antidote dosing for toxicity.
Applies the Rumack-Matthew nomogram to determine N-acetylcysteine (NAC) treatment necessity based on serum acetaminophen level and hours post-ingestion, with NAC dosing protocol for IV and oral routes.
Calculates salicylate toxicity severity using Done nomogram and clinical features, required urinary alkalinization parameters, and hemodialysis threshold criteria for salicylate poisoning management.
Calculates theophylline loading dose and maintenance infusion for acute severe asthma, target serum levels, dose adjustments for hepatic failure and drug interactions, and toxicity management thresholds.
Calculates cyclosporine doses for dermatological indications (psoriasis: 2.5-5 mg/kg/day, atopic dermatitis: 2-5 mg/kg/day), intermittent vs continuous dosing schedules, and renal function monitoring thresholds.
Calculates mycophenolate mofetil (MMF) dosing for transplant immunosuppression, lupus nephritis, and autoimmune indications, with MPA AUC monitoring and dose adjustments for GI intolerance.
Assesses hemolysis risk with dapsone therapy using G6PD enzyme activity level, starting dose, methemoglobin monitoring schedule, and CBC surveillance protocol for dermatological and PCP prophylaxis indications.
Calculates isotretinoin cumulative target dose (120-150 mg/kg) for severe nodular acne treatment, monthly CBC/lipid/LFT monitoring schedule, and iPLEDGE pregnancy prevention program compliance requirements.
Calculates colchicine dosing for acute gout attack (0.5-1.2 mg/hour protocol), gout prophylaxis (0.5-1 mg/day), acute pericarditis (0.5 mg BD), and familial Mediterranean fever (1-3 mg/day) with renal adjustment.
Calculates maximum safe hydroxychloroquine dose (≤5 mg/kg/day actual body weight), cumulative dose thresholds for retinal toxicity (>1000 g), and 5-year screening intervals based on ACR 2016 ophthalmology screening guidelines.
Calculates azathioprine/mercaptopurine dose based on TPMT and NUDT15 genotype per CPIC guidelines, starting dose for IBD (2-2.5 mg/kg/day) and autoimmune disease, and thiopurine metabolite monitoring.
Calculates mesalazine (5-ASA) induction and maintenance dosing for ulcerative colitis (oral + rectal combination), Crohn’s disease, and compliance threshold for remission maintenance with renal dose adjustment.
Calculates PPI dosing for GERD grades A-D (Los Angeles classification), H. pylori triple/quadruple therapy regimens, stress ulcer prophylaxis in ICU, and CYP2C19 pharmacogenomics impact on omeprazole/lansoprazole efficacy.
Calculates NSAID/COX-2 inhibitor cardiovascular (MACE risk), GI bleeding risk, and renal impairment risk using patient-specific factors, recommending lowest effective dose and GI protection with misoprostol or PPI.
Calculates stress dose glucocorticoid regimen (hydrocortisone 50-100 mg/m²/day) for adrenal insufficiency during illness, surgery, and procedures, with equivalent potency conversion between steroid formulations.
Calculates bivalirudin dosing for PCI/ACS and argatroban dosing for HIT (heparin-induced thrombocytopenia), with renal/hepatic dose adjustment and aPTT target monitoring (1.5-3x baseline).
Calculates fondaparinux dosing for VTE treatment (5-10 mg/day weight-based), prophylaxis (2.5 mg/day), and NSTEMI/ACS (2.5 mg/day), with renal contraindication threshold (CrCl <30 mL/min).
Calculates liposomal amphotericin B (L-AmB) and amphotericin B lipid complex (ABLC) dosing for invasive fungal infections, pre-medication protocol, infusion-related reaction management, and nephrotoxicity threshold.
Calculates voriconazole loading and maintenance doses with CYP2C19 genotype consideration, posaconazole tablet vs solution dosing, and plasma trough level targets for invasive Aspergillosis and prophylaxis.
Calculates caspofungin loading dose (70 mg/70 kg), micafungin (100-150 mg/day), and anidulafungin dosing for candidemia, esophageal candidiasis, and empirical antifungal therapy in neutropenic fever.
Adjusts antiretroviral dosing for renal impairment (tenofovir alafenamide vs TDF), hepatic impairment (atazanavir/darunavir modification), and drug interaction screening for CYP3A4/P-glycoprotein interactions.
Converts between corticosteroid formulations using relative anti-inflammatory potency, mineralocorticoid activity, biological half-life, and calculates equivalent prednisolone dose for systemic glucocorticoid therapy.
Calculates the modified SNAP (Simplified N-Acetylcysteine Protocol) for acetaminophen toxicity with lower anaphylactoid reaction rate, and standard 21-hour Prescott protocol comparison with weight-capped dosing.
Identifies toxidrome pattern (cholinergic/muscarinic, sympathomimetic, opioid, anticholinergic, serotonin syndrome, neuroleptic malignant syndrome) from vital signs and clinical features, with specific antidote dosing.
Calculates optimal blood sampling times for TDM of major narrow therapeutic index drugs (vancomycin, aminoglycosides, phenytoin, digoxin, lithium, tacrolimus, cyclosporine, theophylline) relative to dose administration.
Calculates loading doses to rapidly achieve target plasma concentration using Vd and bioavailability parameters for multiple drugs requiring loading (digoxin, phenytoin, vancomycin, aminophylline, chloroquine), with weight adjustment.
Calculates polypharmacy risk score from total medication count, assesses anticholinergic burden (ACB scale), Beers criteria inappropriate medication identification in elderly, and scores drug-drug interaction severity.
Converts drug infusion rates between mL/h and mcg/kg/min for ICU drugs (vasopressors, sedatives, insulin, heparin), calculates drug concentration, and verifies programmed infusion parameters against ordered dose.
Assesses level of sedation and agitation in ICU patients using the Richmond Agitation-Sedation Scale from -5 (unarousable) to +4 (combative), with target RASS range for different patient categories and sedation protocol titration.
Calculates SOFA score to assess organ dysfunction and predict ICU mortality based on respiratory (PaO2/FiO2), coagulation (platelets), liver (bilirubin), cardiovascular (MAP/vasopressors), CNS (GCS), and renal (creatinine) parameters.
Calculates APACHE II score from 12 acute physiology parameters, age points, and chronic health points to predict ICU mortality probability with diagnosis-specific risk adjustments.
Applies Sepsis-3 criteria to identify sepsis (SOFA ≥2 acute increase from infection) and septic shock (vasopressor + lactate >2 mmol/L), with qSOFA bedside screening tool.
Assesses readiness for spontaneous breathing trial (SBT) using the RSBI (rapid shallow breathing index), P/F ratio, and weaning criteria checklist per ACCP evidence-based guidelines for ventilator liberation.
Assesses fluid responsiveness using pulse pressure variation (PPV), stroke volume variation (SVV), passive leg raise CO response, and end-expiratory occlusion test to guide fluid resuscitation in mechanically ventilated patients.
Determines optimal MAP target in septic shock based on chronic hypertension, CKD stage, and age, with calculation of vasopressor doses (norepinephrine, vasopressin, phenylephrine) needed to achieve target MAP.
Calculates infusion rates for norepinephrine, epinephrine, dopamine, dobutamine, milrinone, and phenylephrine based on patient weight, desired dose, and drug concentration, with conversion between dose units.
Applies the Confusion Assessment Method for the ICU (CAM-ICU) to diagnose delirium in mechanically ventilated patients using four features: acute onset and fluctuating course, inattention, altered level of consciousness, and disorganized thinking.
Classifies ARDS severity per Berlin definition (mild/moderate/severe by P/F ratio) and calculates lung protective ventilation targets: TV 4-6 mL/kg IBW, plateau pressure ≤30 cmH2O, optimal PEEP from ARDSnet tables.
Interprets arterial blood gas results identifying primary acid-base disorders and expected compensation (Winter formula, 1.5 rule), calculates anion gap, delta-delta ratio, and identifies mixed disorders.
Calculates CRRT dose (effluent volume 20-25 mL/kg/h for AKI, up to 35 mL/kg/h for sepsis), citrate anticoagulation infusion rates, and phosphorus/bicarbonate replacement protocols.
Calculates cerebral perfusion pressure (MAP - ICP), ICP tier treatment algorithm triggers, and osmotherapy dosing (mannitol, hypertonic saline) for elevated ICP management in TBI and neurocritical care.
Calculates enteral nutrition goals using Mifflin-St Jeor and Penn State equations for ICU patients, protein requirements (1.2-2.0 g/kg), and ICU-specific modifications for ARDS, TBI, and post-surgical patients.
Calculates initial fluid resuscitation volume using the Parkland formula (4 mL × kg × %TBSA), modified Brooke formula, urine output targets, and escharotomy criteria for major burns.
Classifies accidental hypothermia severity (HT I-IV), calculates ECMO/CPB rewarming eligibility based on core temperature, serum potassium, and cardiac arrest status using the Swiss hypothermia score.
Stratifies ICU stress ulcer prophylaxis risk using Targownik criteria (mechanical ventilation >48h, coagulopathy) and modified ASHP risk factors to guide PPI vs H2RA selection and de-escalation timing.
Calculates CPOT score for pain assessment in non-verbal ICU patients using facial expression, body movements, muscle tension, and ventilator compliance/vocalization, with analgesia titration guidance.
Assigns ASA physical status class (I-VI) based on patient comorbidities and calculates estimated perioperative mortality risk, with emergency case modifier and 30-day NSQIP risk calculator integration.
Calculates Glasgow Coma Scale score (eye opening 1-4, verbal response 1-5, motor response 1-6) with TBI severity classification, intubation modifier (GCS-T), and outcome prediction for traumatic brain injury.
Calculates Injury Severity Score from AIS (Abbreviated Injury Scale) for six body regions, predicts mortality and ICU need, with RTS (Revised Trauma Score) and TRISS combined scoring.
Calculates MTP activation score using ABC score (4 parameters) and defines balanced resuscitation ratios (pRBC:FFP:platelets 1:1:1), fibrinogen replacement, and tranexamic acid dosing for hemorrhagic shock.
Calculates cardiac output by Fick principle and thermodilution, systemic/pulmonary vascular resistance, and cardiac power output from invasive hemodynamic parameters for ICU hemodynamic profiling.
Applies King's College criteria to identify acute liver failure patients requiring urgent liver transplant listing, with separate criteria for acetaminophen-induced and non-acetaminophen causes.
Calculates acute pancreatitis severity using Modified Marshall Score (respiratory/renal/cardiovascular), BISAP bedside index, and Revised Atlanta Classification to predict necrotizing pancreatitis and mortality.
Guides targeted temperature management protocol after cardiac arrest with temperature target (33°C vs 36°C), cooling duration, and neuroprognostication timeline based on TTM1 and TTM2 trials.
Applies ESC 0h/1h or 0h/2h high-sensitivity troponin algorithm to rule in or rule out NSTEMI, incorporating absolute values and delta changes per ESC 2020 NSTEMI guidelines.
Estimates pericardial effusion size from echocardiographic diastolic echo-free space, calculates hemodynamic tamponade risk using Beck triad and respiratory variation, and indicates pericardiocentesis urgency.
Calculates Wells score for pulmonary embolism pre-test probability with integration of PERC rule for low-risk patients, Geneva score alternative, and D-dimer age-adjusted threshold guidance.
Calculates the Aortic Dissection Detection Risk Score (ADD-RS) using high-risk conditions, high-risk pain features, and high-risk exam findings to guide D-dimer testing and CT-aorta ordering.
Calculates REVEAL 2.0 risk score for pulmonary arterial hypertension using 12 clinical parameters including 6MWT, NYHA class, RHC measurements, NT-proBNP, and echocardiographic parameters to guide treatment escalation.
Assesses tracheostomy candidacy and optimal timing using ICU-TracMAn criteria, Passy-Muir valve readiness, and decannulation protocol milestones for mechanically ventilated patients.
Determines prone positioning eligibility based on PROSEVA trial criteria (P/F<150, PEEP≥5, FiO2≥0.6) and provides contraindication checklist, expected P/F improvement calculation, and safe proning protocol.
Calculates the ICU Mobility Scale (0-10) and SOMS safety checklist to guide progressive early mobility in mechanically ventilated ICU patients, including criteria for sitting, standing, and ambulation readiness.
Differentiates blood culture contamination from true bacteremia using organism identity, number of positive bottles, time to positivity, and clinical context to guide antibiotic decisions in ICU and inpatient settings.
Diagnoses central line-associated bloodstream infection (CLABSI) using differential time to positivity criteria, organism-specific management, and catheter removal vs antibiotic lock therapy decision algorithm.
Calculates the Clinical Pulmonary Infection Score (CPIS) for VAP diagnosis using temperature, WBC, tracheal secretions, PaO2/FiO2, chest X-ray, and culture results, with antibiotic selection guidance.
Classifies C. difficile infection (CDI) severity per IDSA/SHEA 2021 guidelines using WBC, creatinine, and clinical features to guide treatment choice (vancomycin vs fidaxomicin vs bezlotoxumab) and fecal microbiota transplant eligibility.
Calculates Candida Score for non-neutropenic ICU patients to guide empiric antifungal therapy, and determines echinocandin dosing and step-down azole criteria based on Candida species identification.
Implements evidence-based glucose control (140-180 mg/dL target per NICE-SUGAR) in ICU patients with insulin infusion titration, hypoglycemia risk stratification, and continuous glucose monitoring integration.
Stratifies VTE risk and prophylaxis method in ICU patients using Padua score, contraindications to pharmacological prophylaxis, and enoxaparin/UFH dosing for medical and surgical ICU patients.
Calculates Burch-Wartofsky Point Scale for thyroid storm severity, integrating temperature, cardiovascular dysfunction, CNS effects, GI manifestations, and precipitating event to guide PTU/methimazole, iodine, and beta-blocker dosing.
Calculates emergency hydrocortisone dosing for adrenal crisis based on weight, severity, and patient type (primary vs secondary adrenal insufficiency), with stress dosing protocol for procedures and illness.
Calculates free water deficit, osmolality, and insulin/potassium replacement protocol for hyperosmolar hyperglycemic state (HHS) using glucose, sodium, BUN, and osmolality measurements.
Calculates the Clinical Institute Withdrawal Assessment for Alcohol scale revised (CIWA-Ar) with benzodiazepine PRN dosing thresholds, phenobarbital adjunct criteria, and ICU admission indications for severe alcohol withdrawal.
Calculates Braden Scale score (sensory perception, moisture, activity, mobility, nutrition, friction/shear) to stratify pressure injury risk and guide prevention protocol intensity for critically ill patients.
Converts visual acuity between Snellen (20/20), LogMAR, decimal fraction, and ETDRS letter score formats used in clinical ophthalmology, research, and FDA visual acuity endpoints.
Calculates cup-to-disc ratio (CDR) from optic disc and cup measurements, assesses glaucoma risk based on asymmetry, neuroretinal rim thinning, and ISNT rule compliance.
Calculates individualized IOP target for glaucoma based on baseline IOP, stage of disease (Hodapp-Parrish-Anderson VF classification), risk factors for progression, and central corneal thickness correction.
Calculates AREDS2 5-year AMD progression risk based on drusen size, pigment changes, and pseudodrusen, and determines AREDS2 supplement eligibility (antioxidants + zinc, lutein, zeaxanthin, omega-3).
Grades diabetic retinopathy severity using the International Clinical DR Disease Severity Scale, calculates risk of progression to PDR, and determines anti-VEGF and pan-retinal photocoagulation treatment thresholds.
Assesses CRVO and BRVO visual prognosis using BCVA, macular edema on OCT, and ischemia index (nonperfusion on FA/OCTA), with anti-VEGF treatment loading dose criteria.
Calculates PASI score for psoriasis severity across four body regions (head, trunk, upper extremities, lower extremities) using erythema, induration, desquamation, and area scores, with PASI 75/90/100 response thresholds for biologic therapy.
Calculates SCORAD (SCORing Atopic Dermatitis) index using extent of affected area (Rule of 9), six objective signs severity, and subjective symptoms (itch, sleep disturbance) for clinical trial and treatment monitoring.
Calculates melanoma T-stage by Breslow thickness and ulceration per AJCC 8th edition, sentinel lymph node biopsy eligibility criteria, and excision margin recommendations.
Calculates Dermatology Life Quality Index (DLQI) to assess impact of skin disease on quality of life across symptoms/feelings, daily activities, leisure, work/school, personal relationships, and treatment domains.
Grades acne severity (comedonal/papulopustular/nodular/nodulocystic) using IGA scale and lesion count, with treatment algorithm from topical retinoids through isotretinoin, considering antibiotic stewardship.
Calculates the 7-day Urticaria Activity Score (UAS7) from daily wheal and itch scores to assess chronic spontaneous urticaria severity and monitor response to antihistamine and omalizumab treatment.
Calculates the Severity of Alopecia Tool (SALT) score for alopecia areata scalp hair loss extent, and monitors response to ritlecitinib/baricitinib JAK inhibitor therapy with SALT50/75 thresholds.
Calculates the Nail Psoriasis Severity Index for all 20 nails assessing nail bed (onycholysis, subungual hyperkeratosis, oil drops, splinter hemorrhages) and nail matrix (pits, leukonychia, red spots, crumbling) features.
Classifies hidradenitis suppurativa severity using Hurley staging (I-III) and IHS4 score, determining adalimumab/secukinumab eligibility and defining surgical management thresholds.
Calculates DAS28 (CRP or ESR variant) for rheumatoid arthritis disease activity assessment, classifying remission (<2.6), low disease activity (2.6-3.2), moderate (3.2-5.1), and high (>5.1), with treat-to-target implications.
Calculates CDAI for rapid bedside RA assessment without laboratory values, integrating tender joint count, swollen joint count, patient global assessment, and evaluator global assessment.
Applies 2011 ACR/EULAR Boolean remission criteria for rheumatoid arthritis (TJC28 ≤1, SJC28 ≤1, CRP ≤1 mg/dL, PGA ≤20 mm) and calculates SDAI remission as an alternative index-based definition.
Calculates DAPSA (Disease Activity index for PSoriatic Arthritis) from TJC68/SJC66, patient global assessment, pain VAS, and CRP to guide treat-to-target management in psoriatic arthritis.
Calculates BASDAI for axial spondyloarthritis disease activity using six questions about fatigue, spinal/peripheral joint pain, localized tenderness, and morning stiffness to guide biologic treatment initiation.
Applies the Janssen (2010) gout diagnosis scoring system for probability of acute gout without joint aspiration, calculates urate-lowering therapy dose for serum urate <6.0 mg/dL target, and evaluates prophylaxis adequacy.
Calculates EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI) across 12 domains to assess systemic involvement and eligibility for hydroxychloroquine, rituximab, or belimumab therapy.
Calculates the Medsger Severity Scale for systemic sclerosis across general, peripheral vascular (Raynaud, digital ulcers), skin (mRSS), joint/tendon, muscle, GI, pulmonary, cardiac, and renal domains.
Calculates PMR-AS for polymyalgia rheumatica disease activity monitoring during steroid tapering, incorporating CRP, ESR, shoulder/hip girdle pain, and morning stiffness duration.
Calculates eGFR using the 4-variable MDRD Study Equation: 175 × (SCr)^-1.154 × age^-0.203 × 0.742 (females) × 1.212 (Black race), with CKD staging and implications for drug dosing.
Calculates eGFR using the 2021 CKD-EPI Creatinine equation (race-free) and optionally adds cystatin C (CKD-EPI Creatinine-Cystatin) for improved accuracy in edge cases.
Calculates urine anion gap (UAG = uNa + uK - uCl) to differentiate distal renal tubular acidosis from GI bicarbonate loss in patients with hyperchloremic non-anion gap metabolic acidosis.
Calculates fractional excretion of sodium (FeNa) and urea (FeUrea) to differentiate prerenal from intrinsic renal AKI, with interpretation adjustments for loop diuretics and CKD background.
Assess pharmacokinetic and pharmacodynamic drug interaction risk for medication combinations. Cytochrome P450 enzyme interaction checker with severity grading.
Calculate polypharmacy risk score based on number of medications, age, renal function, and Beers Criteria drugs. Identifies inappropriate prescribing in elderly patients.
Calculate weight-based medication doses for adults and pediatrics. Includes common antimicrobials, analgesics, and anticoagulants with renal/hepatic adjustment flags.
Calculate medication dose adjustments based on GFR/CrCl for renally cleared drugs. Supports 200+ medications with dose reduction, interval extension, or avoidance recommendations.
Calculate APACHE II (Acute Physiology and Chronic Health Evaluation) score for ICU patients. Predicts in-hospital mortality from 12 physiological parameters.
Calculate Sequential Organ Failure Assessment (SOFA) score for sepsis severity. Scores respiratory, coagulation, liver, cardiovascular, CNS, and renal function.
Calculate qSOFA (quick SOFA) at the bedside for rapid sepsis identification outside the ICU. Uses RR, altered mentation, and systolic BP criteria.
Calculate NEWS2 for acutely ill hospital patients. Triggers clinical review and escalation based on 7 physiological parameters including supplemental oxygen flag.
Calculate fall risk using Morse Fall Scale or STRATIFY tool for hospitalized patients. Identifies high-risk patients requiring fall prevention protocols.
Calculate pediatric doses by weight and age for common medications: antibiotics, analgesics, antipyretics, antiemetics, and emergency resuscitation drugs.
Calculate total parenteral nutrition (TPN) requirements: calories (dextrose, lipid), protein (amino acids), fluid, electrolytes, and micronutrients by weight and clinical state.
Calculate enteral feeding goals: caloric requirements (Harris-Benedict, Penn State equations), protein needs, and tube feed formula rate based on clinical indication.
Score antibiotic prescribing appropriateness based on indication, spectrum, duration, and culture-directed therapy. Includes de-escalation recommendation.
Determine transfusion triggers for pRBC, FFP, platelets, and cryoprecipitate based on clinical context: hemoglobin, PT/INR, platelet count, and fibrinogen levels.
Calculate CHA₂DS₂-VASc score for atrial fibrillation patients to determine anticoagulation benefit. Annual stroke risk percentage by score with DOAC recommendation.
Calculate HAS-BLED score for major bleeding risk in anticoagulated AF patients. Used alongside CHA₂DS₂-VASc to assess net clinical benefit of anticoagulation.
Calculate AF burden percentage from ambulatory monitoring data. Correlate with stroke risk and determine rhythm vs. rate control strategy appropriateness.
Calculate 10-year cardiovascular event risk using Framingham Heart Study equations. Includes hard coronary events, total CVD events, and heart age calculation.
Calculate 10-year ASCVD (Atherosclerotic Cardiovascular Disease) risk using 2013 ACC/AHA Pooled Cohort Equations. Guides statin therapy initiation.
Determine hypertension stage, drug class recommendation, and BP target based on ACC/AHA 2017 guidelines. Accounts for comorbidities (diabetes, CKD, CAD, heart failure).
Calculate estimated GFR using CKD-EPI 2021 (race-free), MDRD, and Cockcroft-Gault equations. Classify CKD stage and provide medication dosing guidance.
Calculate Clinical Frailty Scale (CFS) score for older adults. Predicts perioperative mortality, ICU outcomes, and long-term care needs from functional and clinical descriptors.
Estimate acute and chronic rejection risk for kidney, liver, and heart transplants based on HLA mismatch, PRA, donor-specific antibodies, and immunosuppression adherence.
Calculate SAPS II (Simplified Acute Physiology Score) for ICU mortality prediction. Scores 17 variables collected in first 24 hours to predict in-hospital mortality.
Determine if NEWS2 or vital sign changes meet rapid response team (RRT) or medical emergency team (MET) activation thresholds. Standardized criteria by hospital tier.
Calculate initial mechanical ventilator settings: tidal volume (6-8 mL/kg IBW), PEEP, FiO2, and respiratory rate for ARDS and standard ICU ventilation.
Calculate FiO2 delivery at different flow rates via nasal cannula, simple mask, Venturi mask, and non-rebreather mask. Estimates oxygen consumption and tank duration.
Calculate intravenous fluid resuscitation volumes: 4-2-1 maintenance rule, Parkland formula for burns, and sepsis 30 mL/kg resuscitation bolus target.
Calculate hemodialysis adequacy (Kt/V) using Daugirdas second generation formula. Target single-pool Kt/V ≥1.2 per session for thrice-weekly HD.
Calculate RCRI (Revised Cardiac Risk Index) for non-cardiac surgery. Predicts risk of major adverse cardiac events (MACE) based on 6 independent risk factors.
Calculate NIH Stroke Scale score from 11 neurological items. Guides thrombolysis eligibility, intervention planning, and stroke severity classification.
Calculate child height, weight, and BMI percentiles using CDC 2000 and WHO 2006/2007 growth charts. Flags growth failure, overweight, and obese categories.
Calculate pediatric body surface area (BSA) using Mosteller, DuBois, and Haycock formulas. Used for chemotherapy dosing, fluid calculations, and cardiac index.
Calculate pediatric fluid resuscitation: maintenance (Holliday-Segar method), deficit replacement for dehydration degree, and sepsis 20 mL/kg bolus protocol.
Look up 5-year relative survival rates by cancer type and SEER stage (localized, regional, distant). Data from SEER database. Covers 30+ cancer types.
Determine recommended cancer screening start age by risk factors. Covers breast (mammography), colon (colonoscopy), cervical (Pap/HPV), lung (LDCT), and prostate (PSA).
Apply Confusion Assessment Method (CAM) to screen for delirium in hospitalized patients. CAM-ICU version for intubated patients also included.
Convert between pain assessment scales: NRS (0-10), VAS, CPOT (critical care pain observational tool), FLACC for children, and BPS for intubated patients.
Calculate Braden Scale score for pressure injury risk in hospitalized patients. Scores 6 subscales to identify high-risk patients requiring prevention protocols.
Calculate MUST (Malnutrition Universal Screening Tool) score from BMI, unintentional weight loss, and acute disease effect. Guides nutrition intervention urgency.
Calculate Wells Score for pre-test probability of deep vein thrombosis. Guides D-dimer testing and compression ultrasound ordering in suspected DVT.
Calculate Wells Score for pulmonary embolism pre-test probability. Guides CT-PA ordering, D-dimer utility, and anticoagulation initiation strategy.
Calculate FIB-4 index for non-invasive liver fibrosis assessment in NAFLD and chronic hepatitis B/C. Distinguishes mild from advanced fibrosis using routine blood tests.
Calculate the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) to assess disease activity in SLE patients across 24 clinical and laboratory variables.
Assess cumulative organ damage in systemic lupus erythematosus using the SLICC/ACR Damage Index (SDI), covering 12 organ systems with irreversible damage present for at least 6 months.
Classify myasthenia gravis severity using the Myasthenia Gravis Foundation of America (MGFA) clinical classification system from Class I (ocular) to Class V (intubation required).
Calculate the Quantitative Myasthenia Gravis (QMG) score to objectively assess the degree of neuromuscular dysfunction across 13 items including ocular, bulbar, and limb function.
Calculate the Vasculitis Damage Index (VDI) to quantify permanent damage in patients with systemic vasculitis, covering 64 damage items across 11 organ systems.
Assess disease activity in systemic vasculitis using the Birmingham Vasculitis Activity Score (BVAS v3), covering 9 organ systems with 66 clinical features scored for new or worse disease.
Measure skin thickness in systemic sclerosis (scleroderma) using the Modified Rodnan Skin Score (MRSS), assessing 17 body areas on a 0–3 scale with a maximum total score of 51.
Measure patient-reported symptoms in primary Sjögren's syndrome using the ESSPRI (EULAR Sjögren's Syndrome Patient Reported Index), assessing dryness, fatigue, and pain on a 0–10 scale.
Assess systemic disease activity in primary Sjögren's syndrome using the ESSDAI (EULAR Sjögren's Syndrome Disease Activity Index) across 12 organ-specific domains.
Calculate the DAPSA score for psoriatic arthritis from joint counts, pain, global, and CRP. See if you're in remission, low, moderate, or high.
Calculate the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) to measure disease activity in ankylosing spondylitis using 6 patient-reported questions on fatigue, pain, and stiffness.
Assess functional ability in ankylosing spondylitis using the Bath Ankylosing Spondylitis Functional Index (BASFI), evaluating 10 activities of daily living on a 0–10 VAS scale.
Calculate the Disease Activity Score-28 (DAS28) for rheumatoid arthritis using tender joint count, swollen joint count, ESR or CRP, and patient global assessment.
Calculate the Clinical Disease Activity Index (CDAI) for rheumatoid arthritis — a simple score requiring no laboratory tests, using TJC28, SJC28, evaluator global, and patient global assessments.
Calculate the Simplified Disease Activity Index (SDAI) for rheumatoid arthritis, combining TJC28, SJC28, evaluator global, patient global, and CRP into a single activity score.
Assess remission in rheumatoid arthritis using the 2011 ACR/EULAR Boolean remission criteria requiring TJC ≤1, SJC ≤1, CRP ≤1 mg/dL, and patient global ≤1 on a 0–10 scale.
Estimate the risk of gout flare based on serum urate levels, prior flare frequency, comorbidities, and medication history. Guides prophylaxis decisions during urate-lowering therapy initiation.
Determine the appropriate serum urate target for gout management based on disease severity, presence of tophi, and renal function per ACR and EULAR guidelines.
Stratify thrombotic risk in antiphospholipid syndrome (APS) using the global APS score (GAPSS) or simplified APS risk stratification based on antibody profile and clinical history.
Determine if a patient meets the Sapporo (revised Sydney) classification criteria for antiphospholipid syndrome based on clinical and laboratory criteria.
Assess current disease activity in Behçet's disease using the BDCAF (Behçet's Disease Current Activity Form), evaluating manifestations in the preceding 4 weeks across all organ systems.
Quantify cumulative organ damage in Behçet's disease using the Behçet's Disease Damage Index (BDI), capturing irreversible damage across ocular, neurological, vascular, and other organ systems.
Record the Physician Global Assessment (PGA) of disease activity on a visual analogue or Likert scale, used across rheumatology, dermatology, and gastroenterology to capture overall clinical impression.
Calculate the Birmingham Vasculitis Activity Score specifically optimized for ANCA-associated vasculitis (GPA, MPA, EGPA), distinguishing new/worse disease from persistent activity for treatment decisions.
Calculate the revised Five-Factor Score (FFS 2009) for systemic necrotizing vasculitis (EGPA, MPA, PAN) to predict 5-year mortality risk based on clinical and laboratory features.
Estimate the risk of renal function decline in IgA nephropathy using the International IgA Nephropathy Prediction Tool, incorporating clinical and pathological MEST-C features.
Assess lupus nephritis activity and chronicity using the Austin modification of the NIH Activity Index and Chronicity Index for renal biopsy specimens in systemic lupus erythematosus.
Quantify overall disease severity in systemic sclerosis using the Systemic Sclerosis Severity Index (SSI), integrating organ involvement across skin, vascular, pulmonary, cardiac, renal, and GI domains.
Calculate the predicted DLCO (diffusing capacity of the lung for carbon monoxide) and percent predicted using GLI-2017 reference equations based on age, height, sex, and ethnicity.
Grade breathlessness severity using the Medical Research Council (MRC) Dyspnoea Scale from Grade 1 (breathless with strenuous exercise) to Grade 5 (too breathless to leave the house).
Calculate the Polymyalgia Rheumatica Disease Activity Score (PMR-DAS) to assess disease activity in polymyalgia rheumatica, combining pain VAS, morning stiffness, physician global, and ESR/CRP.
Estimate the pre-test probability of giant cell arteritis (temporal arteritis) using clinical features including age, sex, headache type, scalp tenderness, jaw claudication, and ESR/CRP.
Assess functional disability in rheumatoid arthritis using the Health Assessment Questionnaire Disability Index (HAQ-DI), covering 8 functional domains on a 0–3 scale.
Calculate the SF-36 Physical Component Summary (PCS) score from the SF-36 Health Survey, aggregating physical functioning, role-physical, bodily pain, and general health scales.
Calculate the SF-36 Mental Component Summary (MCS) score from the SF-36 Health Survey, aggregating vitality, social functioning, role-emotional, and mental health scales.
Calculate the Routine Assessment of Patient Index Data 3 (RAPID3) — a validated 3-item patient self-report measure of functional status, pain, and patient global estimate in rheumatoid arthritis.
Assess enthesitis severity in spondyloarthritis using the Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), examining 13 entheseal sites for tenderness on direct palpation.
Calculate the Spondyloarthritis Research Consortium of Canada (SPARCC) Enthesitis Index, evaluating 16 entheseal sites for tenderness in psoriatic arthritis and ankylosing spondylitis.
Evaluate enthesitis in psoriatic arthritis using the Leeds Enthesitis Index (LEI), a validated 6-site scoring tool assessing lateral epicondyles, Achilles insertions, and medial condyles of the femur.
Calculate the Psoriasis Area and Severity Index (PASI) — the gold standard for assessing psoriasis severity — by scoring erythema, induration, and scaling across four body regions weighted by area.
Estimate the body surface area affected by psoriasis using the palm method (patient's palm ≈ 1% BSA) to quickly quantify disease extent for treatment decision making.
Assess the impact of skin disease on quality of life using the Dermatology Life Quality Index (DLQI), a 10-question validated tool covering symptoms, activities, leisure, work, relationships, and treatment effects.
Score nail involvement in psoriasis using the Nail Psoriasis Severity Index (NAPSI), evaluating nail matrix (pitting, leukonychia, crumbling, red spots) and nail bed disease in each fingernail.
Assess disease severity in ichthyosis vulgaris and related ichthyoses using the Ichthyosis Severity Scale (IHS), evaluating extent, scale severity, erythema, and quality of life impact.
Calculate the SCORing Atopic Dermatitis (SCORAD) index by combining body surface area involvement, lesion severity, and subjective symptoms to provide a validated composite atopic dermatitis severity score.
Calculate the Eczema Area and Severity Index (EASI) by scoring four body regions for area and four disease signs (erythema, edema/papulation, excoriation, lichenification) in atopic dermatitis.
Assess overall atopic dermatitis severity using the Investigator's Global Assessment (IGA) 5-point scale from 0 (clear) to 4 (severe), used as a regulatory endpoint for biologic and JAK inhibitor trials.
Measure patient-reported atopic dermatitis severity using the Patient-Oriented Eczema Measure (POEM), a 7-question weekly diary covering itch, sleep, bleeding, weeping, cracking, flaking, and dryness.
Assess disease activity in inflammatory myopathies (dermatomyositis, polymyositis, IBM) using the Myositis Disease Activity Assessment Tool (MDAAT), covering extramuscular and muscular activity.
Apply the International Myositis Assessment and Clinical Studies (IMACS) core set measures for inflammatory myopathy, integrating physician global, patient global, HAQ, muscle enzymes, MMT, and extramuscular activity.
Calculate the SOFA score to assess severity of organ dysfunction in ICU patients across six organ systems: respiratory, coagulation, liver, cardiovascular, CNS, and renal.
Calculate the APACHE II score using acute physiology, age, and chronic health points to estimate ICU mortality risk within the first 24 hours of admission.
Estimate ICU mortality probability using the APACHE IV model, which incorporates admission diagnosis, acute physiology variables, ventilation status, and chronic conditions.
Calculate the Simplified Acute Physiology Score II (SAPS II) using 17 variables to estimate in-hospital mortality for ICU patients without reference to primary diagnosis.
Predict ICU mortality at the time of admission using SAPS 3, which evaluates patient characteristics, comorbidities, and acute illness severity gathered within one hour of ICU arrival.
Estimate ICU mortality probability at admission and at 24, 48, and 72 hours using the Mortality Probability Model II (MPM II), which uses binary predictor variables.
Calculate the Clinical Pulmonary Infection Score to diagnose ventilator-associated pneumonia (VAP) and guide antibiotic decision-making in mechanically ventilated ICU patients.
Classify ARDS severity (mild, moderate, severe) using the 2012 Berlin Definition based on onset timing, oxygenation, PEEP requirements, bilateral infiltrates, and exclusion of cardiac origin.
Score the severity of acute lung injury using the Murray Lung Injury Score, which evaluates consolidation on chest X-ray, hypoxemia, PEEP level, and respiratory compliance.
Calculate the Oxygenation Index (OI = FiO2 × Mean Airway Pressure × 100 / PaO2) to assess respiratory failure severity and guide ECMO or inhaled nitric oxide candidacy.
Calculate the PaO2/FiO2 ratio to quantify oxygenation impairment and classify ARDS severity according to the Berlin Definition. Normal P/F ratio is ≥400.
Calculate the Rapid Shallow Breathing Index (respiratory rate ÷ tidal volume in liters) to predict successful weaning from mechanical ventilation. RSBI <105 breaths/min/L predicts success.
Assess readiness for a spontaneous breathing trial (SBT) using standard ICU criteria: hemodynamic stability, oxygenation, mental status, and resolution of acute illness.
Calculate ventilator driving pressure (plateau pressure minus PEEP) as a key marker of lung stress in ARDS. Driving pressure ≤15 cmH2O is associated with improved survival.
Calculate static and dynamic respiratory system compliance to assess lung mechanics, guide tidal volume selection, and monitor response to prone positioning or PEEP optimization.
Guide PEEP titration in ARDS using ARDSnet PEEP/FiO2 tables, driving pressure minimization, or stress index principles to balance recruitment and overdistension.
Calculate and titrate the fraction of inspired oxygen (FiO2) to achieve target SpO2 or PaO2 in ICU patients, using ARDSnet tables or oxygen toxicity risk-based guidelines.
Calculate systemic oxygen delivery (DO2 = CO × CaO2 × 10) from cardiac output and arterial oxygen content to assess adequacy of oxygen transport to tissues.
Calculate systemic oxygen consumption (VO2 = CO × (CaO2 − CvO2) × 10) using the Fick principle to assess metabolic demand and oxygen utilization in critically ill patients.
Calculate oxygen extraction ratio (O2ER = VO2/DO2) to assess the balance between oxygen delivery and consumption, with normal O2ER of 20–30% rising during circulatory shock.
Calculate the physiological dead space fraction (Vd/Vt) using the Enghoff modification of the Bohr equation. Elevated dead space >0.60 in ARDS is associated with increased mortality.
Assess depth of sedation using the Ramsay Sedation Scale (1–6) in ICU patients. Target level 2–3 (cooperative, oriented, and tranquil, or responds to commands only).
Score agitation and sedation depth using the RASS (-5 to +4). Target RASS -1 to 0 for most ICU patients to reduce ventilator days, delirium, and ICU-acquired weakness.
Screen for ICU delirium using the Confusion Assessment Method for ICU (CAM-ICU), assessing acute onset, inattention, altered level of consciousness, and disorganized thinking.
Assess pain in non-communicative ICU patients using the Behavioral Pain Scale, scoring facial expression, upper limb movements, and compliance with mechanical ventilation (3–12).
Assess pain in non-verbal ICU patients using the CPOT, which scores facial expression, body movements, muscle tension, vocalization, and ventilator compliance (0–8).
Calculate the NEWS2 (National Early Warning Score 2) from respiratory rate, SpO2, supplemental oxygen, systolic BP, heart rate, consciousness, and temperature to identify deteriorating patients.
Calculate MEWS from systolic BP, heart rate, respiratory rate, temperature, and AVPU score to identify patients at risk of clinical deterioration requiring urgent review.
Calculate the Pediatric Early Warning Score using behavior, cardiovascular, and respiratory domain scores to identify children at risk of clinical deterioration requiring urgent intervention.
Screen for sepsis risk outside the ICU using qSOFA: altered mentation (GCS <15), respiratory rate ≥22, and systolic BP ≤100. Score ≥2 predicts poor outcomes.
Calculate lactate clearance percentage over 2–6 hours in sepsis and shock resuscitation. ≥10% clearance at 2 hours is a validated target equivalent to ScvO2 normalization.
Assess adequacy of oxygen delivery relative to consumption using central venous oxygen saturation (ScvO2). Normal ScvO2 ≥70%; <70% indicates increased oxygen extraction and potential tissue hypoperfusion.
Predict fluid responsiveness in mechanically ventilated ICU patients using pulse pressure variation (PPV), stroke volume variation (SVV), or passive leg raise response to guide resuscitation.
Assess fluid responsiveness using the passive leg raise (PLR) maneuver: a ≥10% increase in cardiac output or pulse pressure after leg elevation to 45° predicts volume responsiveness.
Calculate pulse pressure variation (PPV) from arterial line waveform to predict fluid responsiveness in controlled mechanical ventilation. PPV >13% predicts positive response.
Calculate stroke volume variation (SVV) over the respiratory cycle to assess preload dependence and fluid responsiveness. SVV >13% indicates likely benefit from fluid administration.
Calculate cardiac output using the thermodilution method from pulmonary artery catheter data (injectate temperature, blood temperature change, and injectate volume) via the Stewart-Hamilton equation.
Calculate systemic vascular resistance using SVR = (MAP − CVP) × 80 / CO to assess afterload, guide vasopressor/vasodilator therapy, and differentiate shock states.
Calculate mean arterial pressure (MAP = DBP + 1/3 × pulse pressure, or MAP = (SBP + 2×DBP) / 3) to assess perfusion pressure. Target MAP ≥65 mmHg in septic shock.
Calculate cerebral perfusion pressure (CPP = MAP − ICP) to guide management in traumatic brain injury and subarachnoid hemorrhage. Target CPP 60–70 mmHg per BTF guidelines.
Calculate CPP from ICP and MAP, convert ICP units (mmHg/cmH2O), and assess ICP thresholds for intervention in traumatic brain injury, hydrocephalus, and idiopathic intracranial hypertension.
Assess diagnostic criteria for hepatorenal syndrome (HRS-AKI and HRS-NAKI) in cirrhotic patients, distinguishing HRS from pre-renal AKI and intrinsic renal disease.
Classify cirrhosis severity using the Child-Pugh score (A/B/C) based on bilirubin, albumin, PT/INR, ascites, and hepatic encephalopathy to estimate surgical risk and 1-year survival.
Calculate MELD-Na score incorporating serum sodium for liver transplant prioritization and 90-day mortality prediction in patients with end-stage liver disease.
Grade ACLF severity (Grade 1, 2, 3) using the EASL-CLIF Consortium Organ Failure Score, which assesses renal, hepatic, cerebral, coagulation, circulatory, and pulmonary failure.
Stage acute kidney injury using the RIFLE criteria (Risk, Injury, Failure, Loss, End-stage) based on serum creatinine rise, GFR reduction, and urine output to guide nephrology consultation.
Stage acute kidney injury using the KDIGO 2012 criteria based on serum creatinine rise (absolute and relative) and urine output to guide management and nephrology involvement.
Calculate continuous renal replacement therapy (CRRT) dose (effluent rate in mL/kg/h) for patients with acute kidney injury requiring continuous dialysis in the ICU.
Calculate caloric and protein targets for ICU patients using ASPEN/ESPEN guidelines, including adjustments for obesity, malnutrition, renal replacement therapy, and mechanical ventilation.
Calculate the Abbreviated Burn Severity Index to predict burn mortality from age, sex, presence of inhalation injury, full-thickness burn, and total body surface area burned.
Assess disease stage and severity in Progressive Supranuclear Palsy using validated motor, cognitive, and bulbar domain scoring.
Quantify disease severity in Multiple System Atrophy across autonomic, cerebellar, and parkinsonian domains using the UMSARS-based scoring.
Evaluate clinical features of Corticobasal Syndrome including alien limb, cortical sensory loss, apraxia, and asymmetric rigidity to support diagnosis.
Stage frontotemporal dementia severity using behavioral, language, and executive function domains based on the CDR-FTD framework.
Estimate probability of Dementia with Lewy Bodies using core, supportive, and biomarker features from the 2017 McKeith consensus criteria.
Assess disability in Neuromyelitis Optica Spectrum Disorder using visual, motor, and sphincter domain scoring aligned with EDSS adaptation.
Score disease severity in anti-NMDA receptor encephalitis across psychiatric, movement, autonomic, and consciousness domains to guide treatment intensity.
Apply the Clinical Assessment Scale in Autoimmune Encephalitis (CASE) to quantify severity across seizure, memory, consciousness, and movement domains.
Estimate probability of paraneoplastic encephalitis based on clinical syndrome, antibody profile, and tumor search findings.
Evaluate likelihood of Stiff-Person Syndrome using axial rigidity, episodic spasms, anti-GAD antibody status, and trigger sensitivity criteria.
Measure Huntington disease severity and progression using the Unified Huntington's Disease Rating Scale covering motor, cognitive, behavioral, and functional domains.
Quantify Friedreich's Ataxia severity using the Friedreich Ataxia Rating Scale across neurological examination and activities of daily living subscores.
Score ataxia severity using the Scale for the Assessment and Rating of Ataxia (SARA) across gait, stance, sitting, speech, finger chase, nose-finger, and heel-shin tests.
Assess disease severity in Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-like Episodes (MELAS) across neurological, systemic, and biochemical domains.
Estimate likelihood of Fabry disease using neuropathic pain, acroparesthesias, angiokeratoma, cornea verticillata, and family history criteria.
Calculate the Severity Score Index (SSI) for Gaucher disease based on bone, visceral, and hematological involvement to guide treatment decisions.
Stage Niemann-Pick Disease Type C using neurological severity domains including vertical supranuclear gaze palsy, ataxia, dystonia, and cognitive decline.
Stage CADASIL severity using white matter lesion load, lacunar infarcts, cognitive impairment, and disability scores in NOTCH3 mutation carriers.
Score neurological severity in Leigh syndrome (subacute necrotizing encephalopathy) based on brainstem, movement, respiratory, and developmental domain impairment.
Measure Rett syndrome severity using the Rett Syndrome Behavior Questionnaire (RSBQ) across breathing dysfunction, hand stereotypies, mood, and body rocking domains.
Assess functional motor abilities in Spinal Muscular Atrophy using the Hammersmith Functional Motor Scale or CHOP-INTEND for infants and young children.
Measure functional decline in Amyotrophic Lateral Sclerosis using the Revised ALS Functional Rating Scale across speech, swallowing, handwriting, walking, and respiratory domains.
Correlate CTG repeat length with phenotype severity in Myotonic Dystrophy Type 1, from asymptomatic to congenital DM1 presentation.
Assess functional ability in Duchenne Muscular Dystrophy using the North Star Ambulatory Assessment (NSAA) and upper limb functional scales.
Evaluate Becker Muscular Dystrophy severity based on age of symptom onset, ambulation status, cardiac involvement, and serum CK levels.
Measure Charcot-Marie-Tooth disease severity using the CMT Neuropathy Score covering symptoms, sensory testing, motor nerve conduction, and strength.
Assess disability in Hereditary Spastic Paraplegia using the Spastic Paraplegia Rating Scale (SPRS) across walking, stair climbing, and lower limb spasticity.
Classify spinal cord injury severity using the ASIA Impairment Scale (AIS) from A (complete) to E (normal), with neurological level and motor/sensory scores.
Estimate 6-month outcome probability after Traumatic Brain Injury using the IMPACT model incorporating GCS, pupil reactivity, CT findings, and age.
Classify functional outcome after brain injury using the 8-level Glasgow Outcome Scale Extended from Death (1) to Upper Good Recovery (8).
Assign functional disability grade after stroke or neurological illness using the 6-level Modified Rankin Scale, the global standard outcome measure in stroke trials.
Quantify stroke severity using the National Institutes of Health Stroke Scale across 11 domains including consciousness, gaze, visual fields, facial palsy, motor, and language.
Calculate ASPECTS (Alberta Stroke Program Early CT Score) to quantify early ischemic change in the MCA territory for stroke treatment triage.
Grade clinical severity of subarachnoid hemorrhage using the Hunt-Hess scale to predict surgical risk and outcome.
Classify subarachnoid hemorrhage severity using the World Federation of Neurosurgical Societies scale based on GCS and motor deficits.
Classify subarachnoid hemorrhage blood volume on CT using the Fisher grade to predict vasospasm risk.
Calculate 30-day mortality risk in intracerebral hemorrhage using the ICH Score incorporating GCS, volume, infratentorial location, IVH, and age.
Predict 3-month functional outcome after IV tPA in ischemic stroke using the DRAGON score incorporating glucose, onset-to-treat time, NIHSS, and CT findings.
Estimate functional outcome after ischemic stroke with or without treatment using THRIVE (Totaled Health Risks In Vascular Events) score.
Predict symptomatic intracranial hemorrhage risk after IV thrombolysis using the SEDAN score based on glucose, NIHSS, early ischemic changes, and dense artery sign.
Assess imminent risk of transtentorial or tonsillar brain herniation based on clinical signs, ICP trends, and imaging findings.
Quantify cerebral edema severity using clinical, radiological, and ICP-based criteria to guide osmotherapy and surgical decompression decisions.
Calculate Cerebral Perfusion Pressure (CPP = MAP - ICP) and assess adequacy against CPP targets for TBI and neurocritical care management.
Classify ICP waveforms into Lundberg A, B, and C waves to identify pathological patterns indicating impaired intracranial compliance.
Classify seizure semiology using standardized ILAE terminology to localize seizure onset zone and guide epilepsy surgery evaluation.
Estimate probability of drug-resistant epilepsy based on seizure type, frequency, MRI findings, and number of failed AEDs per ILAE criteria.
Assess Dravet syndrome severity based on seizure frequency, prolonged seizure episodes, developmental trajectory, and SCN1A mutation status.
Quantify Lennox-Gastaut Syndrome severity based on seizure drop attack frequency, EEG slow spike-wave burden, intellectual disability degree, and AED failures.
Estimate neurodevelopmental prognosis in West Syndrome (infantile spasms) based on etiology, spasm onset age, hypsarrhythmia pattern, and treatment response.
Estimate febrile seizure recurrence risk using age at first seizure, family history, fever height, and complex features of the index seizure.
Calculate the EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI) across 12 organ domains to assess systemic disease activity and guide treatment decisions in primary Sjögren's syndrome.
Compute the EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI) combining dryness, fatigue, and pain scores to quantify patient-experienced symptom burden in primary Sjögren's syndrome.
Evaluate disease activity in inflammatory myopathies (dermatomyositis, polymyositis, inclusion body myositis) using the Myositis Disease Activity Assessment Tool across extramuscular and muscle activity domains.
Calculate the Birmingham Vasculitis Activity Score (BVAS v3) across 9 organ systems to assess disease activity in ANCA-associated and other systemic vasculitides.
Measure skin thickening in systemic sclerosis using the Modified Rodnan Skin Score (mRSS) across 17 body areas to assess disease extent and monitor treatment response.
Estimate lifetime breast and ovarian cancer risk for BRCA1 and BRCA2 pathogenic variant carriers using age-specific penetrance tables from the CIMBA meta-analysis and EMBRACE study data.
Calculate cumulative lifetime cancer risks for Lynch syndrome (HNPCC) based on pathogenic variant in MLH1, MSH2, MSH6, or PMS2, incorporating sex and age-specific penetrance data from prospective studies.
Assess pre-test probability and phenotype severity for hereditary cardiomyopathies (HCM, DCM, ARVC) based on gene variant type (sarcomere, desmosome, cytoskeletal), family history, and phenotype features.
Calculate the Gaucher Disease Severity Score Index assessing skeletal, visceral, hematological, and neurological involvement to stage disease and monitor enzyme replacement therapy response.
Score organ involvement in Fabry disease (alpha-galactosidase A deficiency) across cardiac, renal, neurological, and cerebrovascular domains to guide enzyme replacement therapy initiation and monitoring.
Assess neurological severity in Niemann-Pick Disease type C (NPC) using the NPC Severity Scale covering ambulation, manipulation, language, swallowing, and eye movement (VSGP) domains.
Administer the ALS Functional Rating Scale-Revised (ALSFRS-R) to assess functional status in amyotrophic lateral sclerosis across 12 items covering speech, swallowing, handwriting, cutting food, dressing, turning in bed, walking, climbing stairs, dyspnea, orthopnea, and respiratory insufficiency.
Calculate the Huntington Disease CAG-Age Product (CAP) score to estimate disease burden, predict age of motor onset, and stratify pre-manifest HD participants for clinical trial enrichment.
Assess cerebellar ataxia severity in Friedreich's ataxia and spinocerebellar ataxias using the Scale for the Assessment and Rating of Ataxia (SARA) across gait, stance, sitting, speech, finger chase, nose-finger test, fast alternating movements, and heel-shin slide.
Rate non-ataxia features in spinocerebellar ataxias including brainstem dysfunction, oculomotor involvement, pyramidal signs, extrapyramidal features, and cognitive impairment using the SCA Functional Index and inventory.
Calculate daily phenylalanine tolerance, protein equivalent from medical formula, and natural protein allowance for phenylketonuria (PKU) management based on weight, age, metabolic control target, and residual PAH activity.
Assess metabolic decompensation risk and calculate emergency regimen (glucose infusion rate, protein restriction, carnitine dosing) for organic acidemias including propionic acidemia, methylmalonic acidemia, and isovaleric acidemia.
Calculate safe protein intake, nitrogen scavenger dosing (sodium benzoate, sodium phenylacetate, glycerol phenylbutyrate), and emergency ammonia clearance regimen for urea cycle disorders including OTC deficiency, CPS1, AS, AL, and ARG deficiencies.
Calculate the Multiple Sclerosis Severity Score (MSSS) to compare disability progression between patients by relating EDSS to disease duration, using the global MSSS database of 9892 patients.
Calculate the Expanded Disability Status Scale (EDSS) for multiple sclerosis by scoring 8 functional systems (pyramidal, cerebellar, brainstem, sensory, bowel/bladder, visual, cerebral, other) to derive the overall disability grade.
Estimate the probability of transitioning from relapsing-remitting to secondary progressive multiple sclerosis using age, EDSS at diagnosis, relapse rate, and incomplete recovery variables from the MSBase registry.
Score Charcot-Marie-Tooth disease severity using the CMT Neuropathy Score (CMTNS-v2) covering symptoms, signs, and nerve conduction studies across upper and lower extremity domains.
Assess functional motor abilities in spinal muscular atrophy (SMA) using the Hammersmith Functional Motor Scale Expanded (HFMSE), covering 33 functional activities scored 0–2 each.
Score the North Star Ambulatory Assessment (NSAA) in ambulatory Duchenne muscular dystrophy patients across 17 functional items to assess disease severity and monitor exon-skipping therapy response.
Assess disease severity in mucopolysaccharidosis type I (Hurler, Hurler-Scheie, Scheie phenotypes) across cognitive, skeletal, cardiac, airway, and corneal domains to guide haematopoietic stem cell transplantation and enzyme replacement timing.
Track disease progression and enzyme replacement therapy response in Pompe disease (glycogen storage disease type II) using the 6-minute walk test, MRC muscle score, and respiratory function calculators including FVC supine/sitting.
Evaluate clinical severity and treatment response in MPS II (Hunter syndrome, iduronate-2-sulfatase deficiency) across neurocognitive, skeletal, cardiac, and airway domains.
Calculate sudden cardiac death risk in LMNA (lamin A/C) cardiomyopathy using the validated 5-year SCD risk model incorporating non-sustained VT, LVEF, sex, and prior cardiac arrest to guide ICD implantation decisions.
Apply the 2010 Revised Task Force Criteria for ARVC/D (arrhythmogenic right ventricular cardiomyopathy) across structural, histological, repolarisation, depolarisation, arrhythmia, and family history criteria to derive major/minor diagnosis.
Estimate Parkinson disease risk and progression rate for GBA pathogenic variant carriers, distinguishing mild (N370S, L444P) from severe (biallelic) mutations and their impact on cognitive decline and motor progression.
Interpret lyso-glucosylsphingosine (lyso-Gb1) plasma levels for Gaucher disease diagnosis, activity monitoring, and treatment response assessment using validated reference ranges and therapeutic targets.
Assess pre-test probability of RASopathy (Noonan syndrome, LEOPARD syndrome, Costello syndrome, cardiofaciocutaneous syndrome) based on phenotypic features and guide targeted gene panel selection.
Score Rett syndrome clinical severity using the Rett Syndrome Severity Scale across hand use, ambulation, communication, seizure frequency, and breathing abnormalities to classify disease stage and monitor natural history.
Classify seizure types and calculate seizure frequency in Angelman syndrome based on genotype (deletion, UPD, ICD, point mutation), EEG pattern, and anti-seizure medication response.
Interpret FMR1 CGG repeat lengths (normal, intermediate, premutation, full mutation) and calculate risk of fragile X syndrome, FXTAS, FXPOI, and transmitting expansion to offspring based on sex and repeat length.
Score phenotypic severity and multisystem involvement in 22q11.2 deletion syndrome (DiGeorge/velocardiofacial syndrome) across cardiac, immunological, palatal, endocrine, neuropsychiatric, and learning domains.
Apply the Wilson Disease Severity Score (Leipzig score, New Wilson Index, NAC score) to guide diagnosis and liver transplant listing in acute Wilson disease with hepatic failure.
Calculate iron overload risk, clinical penetrance, and phlebotomy requirement estimates for HFE haemochromatosis genotypes (C282Y/C282Y, C282Y/H63D, H63D/H63D) based on sex, transferrin saturation, and ferritin level.
Classify alpha-1 antitrypsin (SERPINA1) phenotype/genotype (PiZZ, PiSZ, PiMZ, PiSS) and estimate cumulative COPD, liver disease, and bronchiectasis risk based on smoking history and serum A1AT level.
Classify cystic fibrosis CFTR mutations by class (I–VI), predict phenotypic severity (lung, pancreatic, fertility), and determine eligibility for CFTR modulator therapy (ivacaftor, lumacaftor/ivacaftor, elexacaftor/tezacaftor/ivacaftor).
Calculate PNH clone size from flow cytometry (FLAER/CD59/CD55 on granulocytes and monocytes), estimate thrombosis and haemolysis risk, and determine eculizumab/ravulizumab treatment threshold.
Calculate MELD improvement probability after antiviral therapy for HCV (DAA), HBV (nucleoside analogue), and HDV (peginterferon/bulevirtide), and estimate time to MELD improvement with treatment response data.
Assess functional severity in hereditary spastic paraplegia (HSP) using the Spastic Paraplegia Rating Scale (SPRS) across upper and lower extremity spasticity, gait, bladder function, and pain domains.
Assess functional disability in stiff person syndrome (SPS) and correlate anti-GAD65 antibody titers with disease severity, fall risk, and response to IVIG, diazepam, baclofen, and rituximab therapy.
Score neurofibromatosis type 1 clinical severity across cutaneous neurofibromas, plexiform neurofibromas, Lisch nodules, café-au-lait spots, bone dysplasia, learning disability, and cardiovascular complications.
Score tuberous sclerosis complex (TSC) organ involvement across SEGA, angiomyolipomata, pulmonary LAM, epilepsy severity, and neurodevelopmental domains to guide everolimus/sirolimus (mTORC1 inhibitor) therapy.
Calculate cumulative pancreatitis, exocrine insufficiency, diabetes, and pancreatic cancer risk for PRSS1 (cationic trypsinogen) and SPINK1 (N34S) mutation carriers using age-specific penetrance data from EUROPAC.
Estimate penetrance and screening interval for VHL gene mutation carriers across CNS haemangioblastomas, clear cell RCC, phaeochromocytoma, pancreatic NETs, and retinal angiomas based on VHL mutation type (type 1, 2A, 2B, 2C).
Predict myotonic dystrophy type 1 (DM1) phenotypic class (congenital, childhood, adult, late-onset) and anticipation risk from parental CTG repeat size, anticipation in maternal vs paternal transmission, and degree of somatic mosaicism.
Calculate cumulative colorectal, gastric, small bowel, breast, gynaecological, and pancreatic cancer risks for STK11 (LKB1) mutation carriers with Peutz-Jeghers syndrome using age-specific penetrance data.
Calculate the Simplified Acute Physiology Score III (SAPS III) at ICU admission to estimate in-hospital mortality probability. Uses 20 physiological and chronic health variables collected within one hour of ICU admission.
Calculate the Mortality Probability Model II at time zero (admission) to estimate the probability of in-hospital death based on 15 variables present at ICU admission.
Calculate the Mortality Probability Model II at 24 hours after ICU admission to re-estimate in-hospital mortality probability incorporating updated clinical trajectory information.
Calculate the Logistic Organ Dysfunction System (LODS) score to quantify the degree of organ dysfunction across six organs — neurological, cardiovascular, renal, pulmonary, hematological, and hepatic.
Calculate the Organ Dysfunctions and Infections (ODIN) score to estimate ICU mortality based on the presence of organ failures and infectious complications on ICU day one.
Calculate the Multiple Organ Dysfunction Score (MODS) to quantify dysfunction across six organ systems: respiratory, renal, hepatic, cardiovascular, hematologic, and neurological.
Calculate the hepatic component of the SOFA score using serum bilirubin levels to assess liver dysfunction severity in critically ill patients as part of daily organ function monitoring.
Calculate the coagulation component of the SOFA score using platelet count to assess coagulopathy severity in ICU patients as part of daily sequential organ failure assessment.
Calculate the neurological component of the SOFA score using the Glasgow Coma Scale to quantify central nervous system dysfunction in critically ill and sedated ICU patients.
Calculate the cardiovascular component of the SOFA score based on mean arterial pressure and vasopressor requirements to assess circulatory failure severity in ICU patients.
Calculate Systemic Vascular Resistance (SVR) using the formula SVR = 80 × (MAP − CVP) / CO to assess afterload and guide vasopressor and vasodilator therapy in hemodynamically unstable patients.
Calculate Pulmonary Vascular Resistance (PVR) using PVR = 80 × (mPAP − PCWP) / CO to assess right ventricular afterload and guide therapy in pulmonary hypertension and right heart failure.
Interpret central venous oxygen saturation (ScvO2) measured from the superior vena cava to assess oxygen supply-demand balance and guide early goal-directed therapy in sepsis and shock.
Calculate systemic oxygen delivery (DO2) using the formula DO2 = CO × CaO2 × 10 to assess the amount of oxygen transported to tissues per minute in critically ill patients.
Calculate oxygen consumption (VO2) using the Fick principle: VO2 = CO × (CaO2 − CvO2) × 10, to assess tissue oxygen utilization and guide resuscitation in critically ill patients.
Calculate Cardiac Power Output (CPO) using the formula CPO = MAP × CO / 451 to assess global cardiac work capacity, with CPO <0.6 W being the strongest predictor of in-hospital mortality in cardiogenic shock.
Calculate the dead space fraction (Vd/Vt) using the Bohr-Enghoff equation: Vd/Vt = (PaCO2 − PETCO2) / PaCO2 to assess ventilation efficiency and pulmonary embolism risk.
Assess the risk of Patient Self-Inflicted Lung Injury (P-SILI) during spontaneous breathing by evaluating respiratory drive, effort, and transpulmonary pressure swings in patients with acute respiratory failure.
Calculate ventilator driving pressure (ΔP = Pplateau − PEEP) to assess lung stress in mechanically ventilated patients, with ΔP >15 cmH2O associated with increased ARDS mortality.
Calculate mechanical power (MP) transferred to the respiratory system per breath cycle to assess ventilator-induced lung injury (VILI) risk using the simplified formula incorporating RR, Vt, PEEP, and peak pressure.
Determine optimal PEEP level by identifying the PEEP value that maximizes static respiratory system compliance on a decremental PEEP trial, balancing alveolar recruitment against overdistension.
Convert noradrenaline (norepinephrine) infusion dose from mcg/kg/min to mL/hr based on patient weight, concentration, and syringe volume to ensure accurate vasopressor delivery in ICU patients.
Calculate dopamine infusion rate (mL/hr) from prescribed dose (mcg/kg/min) and determine receptor activity range: renal (1-3), beta (3-10), alpha (>10 mcg/kg/min) for ICU hemodynamic management.
Calculate vasopressin infusion rate for ICU patients, converting units/min or units/hour to mL/hr based on concentration, for use as a catecholamine-sparing vasopressor in septic shock.
Calculate the National Early Warning Score 2 (NEWS2) using respiratory rate, SpO2, supplemental oxygen, systolic BP, pulse rate, consciousness, and temperature to detect clinical deterioration in hospital patients.
Calculate the quick SOFA (qSOFA) score using three bedside criteria — respiratory rate ≥22, altered mentation, and systolic BP ≤100 mmHg — to identify patients with suspected infection at high risk of sepsis.
Apply the Sepsis-3 definitions to identify sepsis (suspected infection + SOFA increase ≥2) and septic shock (vasopressors needed for MAP ≥65 with lactate >2 mmol/L) for early intervention.
Calculate Pulse Pressure Variation (PPV = (PPmax − PPmin) / PPmean × 100) from arterial line waveform analysis to predict fluid responsiveness in mechanically ventilated patients.
Calculate Stroke Volume Variation (SVV) from advanced hemodynamic monitoring to predict fluid responsiveness in mechanically ventilated ICU patients as an alternative to PPV.
Predict fluid responsiveness using the passive leg raise (PLR) maneuver by assessing cardiac output or pulse pressure increase of ≥10% when legs are raised from 45° to horizontal position.
Calculate burn fluid resuscitation requirements using the Parkland Formula: 4 mL/kg/%TBSA in the first 24 hours, with half given in the first 8 hours and the remainder over the next 16 hours.
Calculate the Abbreviated Burn Severity Index (ABSI) to estimate burn survival probability based on age, sex, presence of inhalation injury, full-thickness burns, and percent TBSA burned.
Assess the mortality impact of inhalation injury in burn patients, applying the standard adjustment that inhalation injury increases predicted mortality by an additional 20–40% above burn surface area alone.
Calculate the Baux Score (age + percent TBSA burned) and Revised Baux Score (age + %TBSA + 17 if inhalation injury) to quickly estimate burn mortality probability at the bedside.
Estimate total body surface area (TBSA) burned using the Rule of Nines for adults and the Lund-Browder chart for pediatric patients to guide fluid resuscitation and transfer decisions.
Calculate Cardiac Index (CI = CO / BSA) to normalize cardiac output for patient size, enabling comparison of cardiac function between patients of different body habitus in ICU and cardiac care settings.
Calculate the PaO2/FiO2 (P/F ratio) to classify ARDS severity: mild (200–300), moderate (100–200), and severe (<100 mmHg) according to the Berlin Definition, and guide ventilator management decisions.
Calculate the Acute Physiology and Chronic Health Evaluation II (APACHE II) score using 12 acute physiologic variables, age, and chronic health status to predict ICU and hospital mortality.
Calculate the Rapid Shallow Breathing Index (RSBI = RR / Vt in liters) to predict successful extubation, with RSBI <105 predicting successful weaning from mechanical ventilation.
Calculate the Full Outline of UnResponsiveness (FOUR) score assessing eye response, motor response, brainstem reflexes, and respiration to grade coma severity as a validated alternative to GCS.
Calculate the Sequential Organ Failure Assessment (SOFA) score daily in ICU patients to quantify organ dysfunction across respiratory, coagulation, hepatic, cardiovascular, neurological, and renal systems.
Calculate Mean Arterial Pressure (MAP) using MAP = DBP + 1/3(SBP − DBP) or MAP = (SBP + 2×DBP) / 3, the driving pressure for organ perfusion and a key resuscitation target in shock.
Calculate the ISTH Disseminated Intravascular Coagulation (DIC) score using platelet count, D-dimer, PT prolongation, and fibrinogen to diagnose overt DIC (score ≥5) in critically ill patients.
Calculate the Glasgow Coma Scale (GCS) score from eye opening (E), verbal response (V), and motor response (M) to objectively assess level of consciousness in trauma and critical care patients.
Interpret Thromboelastography (TEG) and Rotational Thromboelastometry (ROTEM) parameters to characterize coagulopathy type and guide targeted hemostatic therapy in trauma, surgery, and ICU patients.
Calculate blood product requirements for massive transfusion protocols (MTP) using 1:1:1 ratio (RBC:FFP:Platelets) targeting damage control resuscitation in hemorrhagic shock and trauma.
Score sedation and agitation level using the Richmond Agitation-Sedation Scale (RASS) from +4 (combative) to −5 (unarousable) to guide analgo-sedation titration in ICU patients.
Apply the Confusion Assessment Method for the ICU (CAM-ICU) to diagnose delirium in mechanically ventilated patients using four features: acute onset, inattention, altered consciousness, and disorganized thinking.
Assess compliance with the ABCDEF bundle (Awakening and Breathing Coordination, Delirium monitoring, Early mobility, and Family engagement) to reduce ICU-acquired weakness and cognitive dysfunction.
Stage acute kidney injury (AKI) using KDIGO criteria based on serum creatinine rise (1.5–1.9× baseline = Stage 1, 2.0–2.9× = Stage 2, ≥3× = Stage 3) and urine output criteria.
Calculate the FIB-4 Index using age, AST, ALT, and platelet count to non-invasively stage liver fibrosis and distinguish significant fibrosis (F2+) from minimal fibrosis in chronic liver disease.
Calculate the AST-to-Platelet Ratio Index (APRI = (AST/ULN) / Platelet × 100) to non-invasively predict liver fibrosis and cirrhosis, particularly in chronic hepatitis B and C.
Calculate the NAFLD Fibrosis Score using age, BMI, hyperglycemia, platelet count, albumin, and AST/ALT ratio to predict advanced fibrosis in non-alcoholic fatty liver disease.
Apply the King's College Hospital criteria for acetaminophen (paracetamol)-induced acute liver failure to identify patients requiring urgent liver transplantation evaluation based on pH, lactate, coagulopathy, creatinine, and encephalopathy.
Apply the King's College Hospital criteria for non-acetaminophen acute liver failure to identify patients requiring urgent transplant evaluation based on INR, age, etiology, and bilirubin.
Calculate the UK End-stage Liver Disease (UKELD) score combining INR, creatinine, bilirubin, and sodium to determine liver transplant eligibility in the United Kingdom, with listing threshold UKELD ≥49.
Calculate Maddrey's Discriminant Function (4.6 × (PT − control PT) + bilirubin mg/dL) to identify severe alcoholic hepatitis (DF ≥32) where corticosteroid therapy may improve 30-day survival.
Calculate the Child-Pugh Score for liver cirrhosis severity using bilirubin, albumin, PT/INR, ascites, and encephalopathy to classify patients into Class A (5-6), B (7-9), or C (10-15).
Calculate the MELD-Na score incorporating serum sodium into the Model for End-Stage Liver Disease to improve 90-day mortality prediction and optimize organ allocation priority for liver transplantation.
Calculate the Lille Model score at day 7 of prednisolone therapy to assess treatment response in severe alcoholic hepatitis, with Lille >0.45 predicting non-response and 6-month mortality >75%.
Calculate the BARD Score using BMI, AST/ALT ratio, and diabetes to predict advanced hepatic fibrosis in non-alcoholic fatty liver disease as a simple clinical bedside tool.
Calculate the Lok Index using platelet count, PT ratio, and AST/ALT ratio to predict cirrhosis probability in chronic hepatitis C patients, with Lok >0.5 predicting cirrhosis.
Calculate the Disease Activity Score 28 using ESR (DAS28-ESR) to assess rheumatoid arthritis disease activity across 28 joints, guiding treat-to-target strategies and biologic therapy escalation.
Calculate the Disease Activity Score 28 using CRP (DAS28-CRP) to quantify rheumatoid arthritis disease activity, preferred in patients with chronically elevated ESR due to non-inflammatory causes.
Calculate the Clinical Disease Activity Index (CDAI = SJC + TJC + PtGA + PhGA) without laboratory tests to assess rheumatoid arthritis activity quickly at the point of care.
Calculate the Simplified Disease Activity Index (SDAI = SJC + TJC + PtGA + PhGA + CRP) for rheumatoid arthritis, requiring only a single CRP laboratory value alongside clinical assessments.
Calculate the Health Assessment Questionnaire Disability Index (HAQ-DI) from eight functional domains to assess physical disability in rheumatoid arthritis and predict work disability, mortality, and treatment response.
Calculate the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) across 24 clinical and laboratory items to quantify lupus disease activity and guide treatment decisions.
Calculate the SLICC/ACR Damage Index to quantify accumulated irreversible organ damage in systemic lupus erythematosus across 12 organ systems as a prognostic tool for mortality and morbidity.
Calculate the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) using six questions about fatigue, spinal and joint pain, localized tenderness, and morning stiffness to assess axial spondyloarthritis activity.
Calculate the Gender-Age-Physiology (GAP) index for idiopathic pulmonary fibrosis to estimate 1, 2, and 3-year mortality probability based on sex, age, FVC, and DLCO.
Assess interstitial lung disease severity using composite clinical, physiological, and radiological parameters to stage disease progression and determine intervention urgency.
Calculate the DECAF (Dyspnoea, Eosinopenia, Consolidation, Acidaemia, Atrial Fibrillation) score to predict in-hospital mortality in patients admitted with acute exacerbation of COPD.
Correct the measured DLCO (diffusing capacity of the lung for carbon monoxide) for haemoglobin concentration to avoid misinterpreting anemia-related reductions as true diffusion impairment.
Calculate and interpret the KCO (DLCO/VA, carbon monoxide transfer coefficient per unit alveolar volume) to distinguish intrinsic lung disease from reduced lung volume in diffusion impairment.
Calculate estimated GFR using the 2021 CKD-EPI creatinine equation without race variable, recommended by KDIGO and NKF for CKD staging and cardiovascular risk assessment in all adult patients.
Calculate estimated GFR using the 4-variable MDRD equation (creatinine, age, sex, race) for CKD staging, drug dosing adjustment, and research where MDRD-4 was the original study equation.
Calculate single-pool Kt/V dialysis adequacy using the Daugirdas second-generation formula from pre- and post-dialysis BUN, dialysis time, and ultrafiltration volume, targeting Kt/V ≥1.2 per session.
Calculate the Urea Reduction Ratio (URR = (preBUN - postBUN) / preBUN × 100) as a simple measure of hemodialysis adequacy, targeting URR ≥65% in thrice-weekly HD patients.
Calculate Protein Catabolic Rate (PCR) and normalized PCR (nPCR) in hemodialysis patients from interdialytic BUN change and urine urea excretion to assess protein intake and nutritional status.
Calculate the Renal Resistive Index (RRI = (Peak Systolic Velocity − End-Diastolic Velocity) / Peak Systolic Velocity) from renal Doppler ultrasound to assess renal vascular resistance and predict AKI reversibility.
Classify CKD risk using the Urine Albumin-to-Creatinine Ratio (UACR) into KDIGO albuminuria categories: A1 (<30), A2 (30–300), A3 (>300 mg/g) combined with GFR for comprehensive kidney disease risk staging.
Assess the prognostic significance of elevated FGF-23 levels in CKD for predicting disease progression, cardiovascular events, and all-cause mortality beyond traditional GFR and albuminuria staging.
Calculate clinical probability of MEN1 syndrome based on the presence and combination of primary hyperparathyroidism, enteropancreatic tumors, and anterior pituitary adenomas to guide genetic testing.
Calculate the Amended Insulin-to-Glucose Ratio (AIGR = insulin IU/mL × 100 / (glucose mg/dL − 30)) during a 72-hour fast to assess inappropriate insulin secretion in suspected insulinoma.
Assess adrenal incidentaloma malignancy risk using CT Hounsfield Units (HU), size, and imaging characteristics to determine whether surgical resection or follow-up imaging is indicated.
Convert Snellen visual acuity (e.g., 6/6, 20/20, 20/200) to decimal notation and logMAR values for standardized documentation, research reporting, and cross-referencing visual impairment classification systems.
Calculate Pure-Tone Average (PTA = average of 500, 1000, 2000, and 4000 Hz thresholds) to classify hearing loss severity and determine hearing aid candidacy per WHO hearing impairment grading.
Classify tympanogram type (A, As, Ad, B, C) from peak compliance and pressure measurements to diagnose middle ear pathology including otitis media with effusion, ossicular discontinuity, and Eustachian tube dysfunction.
Interpret cervical Vestibular Evoked Myogenic Potential (cVEMP) thresholds and amplitude asymmetry ratio to assess saccular function and differentiate vestibular disorders including superior canal dehiscence.
Score Amsler grid results to quantify central visual field distortion (metamorphopsia) and scotoma size as a monitoring tool for age-related macular degeneration, diabetic maculopathy, and epiretinal membrane.
Estimate Farnsworth-Munsell 100-Hue test total error score interpretation for colour vision deficiency classification and differentiation of congenital versus acquired dyschromatopsia.
Interpret Humphrey visual field perimetry Mean Deviation (MD) to classify glaucoma severity and rate of progression using established Hodapp-Parrish-Anderson criteria and trend analysis.
Calculate the NIH Stroke Scale (NIHSS) across 11 neurological domains to quantify acute stroke severity, determine thrombolysis eligibility, guide thrombectomy decisions, and predict functional outcomes.
Calculate the HAS-BLED score (Hypertension, Abnormal renal/liver function, Stroke, Bleeding, Labile INR, Elderly, Drugs/alcohol) to estimate annual major bleeding risk in atrial fibrillation patients on anticoagulation.
Calculate the CHA₂DS₂-VASc score for atrial fibrillation to estimate annual stroke risk and see if anticoagulation is recommended per ESC guidelines.
Calculate the TIMI Risk Score for NSTEMI/UA using seven variables to stratify 14-day risk of all-cause mortality, MI, or urgent revascularization and guide early invasive versus conservative management.
Calculate the GRACE 2.0 score for acute coronary syndrome to predict in-hospital and 6-month post-discharge mortality, guiding timing of coronary angiography and discharge planning.
Calculate the CURB-65 score (Confusion, Urea >7 mmol/L, Respiratory rate ≥30, BP <90/60, Age ≥65) to assess community-acquired pneumonia severity and determine outpatient versus hospital versus ICU management.
Calculate the Pneumonia Severity Index (PORT) using 20 clinical and laboratory variables to classify CAP patients into five risk classes (I-V), guiding safe outpatient management for low-risk patients.
Calculate the apparent volume of distribution (Vd = Dose / Cp) for a one-compartment pharmacokinetic model to understand how extensively a drug distributes into body tissues versus remaining in plasma.
Calculate the distribution (alpha) phase half-life (t½α) in a two-compartment pharmacokinetic model to characterize rapid drug distribution from central to peripheral compartments after IV bolus dosing.
Calculate the Area Under the Concentration-Time Curve (AUC) using the linear trapezoidal rule from serial drug concentration measurements to quantify total drug exposure for pharmacokinetic analysis.
Calculate total plasma drug clearance (CL = Dose / AUC) to quantify the volume of plasma cleared of drug per unit time, a fundamental pharmacokinetic parameter for dose individualization.
Calculate absolute oral bioavailability (F = AUCpo / AUCiv) by comparing the AUC after oral and intravenous administration of the same dose, correcting for any dose differences between routes.
Calculate the unbound drug fraction (fu = free concentration / total concentration) to assess clinically relevant drug exposure, adjust therapeutic drug monitoring interpretation, and identify displacement interactions.
Calculate the terminal elimination half-life (t½ = 0.693 / ke = 0.693 × Vd / CL) for first-order pharmacokinetic processes to determine time to steady state and drug washout after discontinuation.
Calculate the optimal dosing interval (τ = ln(Cmax/Cmin) / ke) for a drug using target peak and trough concentrations and the elimination rate constant to individualize dosing schedules.
Calculate vancomycin initial dosing to achieve target AUC24/MIC of 400–600 mg·h/L for MRSA infections using 2020 ASHP/IDSA/SIDP consensus guidelines and patient-specific pharmacokinetic parameters.
Adjust vancomycin dosing in renal impairment using Bayesian pharmacokinetic principles and estimated creatinine clearance to maintain therapeutic AUC24 targets while preventing nephrotoxicity in CKD and AKI patients.
Use vancomycin trough-based dosing nomogram to adjust dose and interval based on measured trough concentrations, acknowledging limitations compared to AUC-guided monitoring per 2020 consensus guidelines.
Calculate and interpret vancomycin AUC24/MIC ratio for MRSA bacteremia management, targeting 400–600 mg·h/L for therapeutic efficacy while minimizing nephrotoxicity risk in critically ill patients.
Apply the Hartford Nomogram for once-daily gentamicin dosing (7 mg/kg) with 6-14 hour post-dose level monitoring to guide dose interval selection (q24h, q36h, or q48h) based on renal function.
Calculate gentamicin conventional multiple-daily dosing with target peak 5–10 mg/L and trough <1 mg/L to minimize nephrotoxicity and ototoxicity while maintaining bactericidal efficacy.
Calculate tobramycin extended-interval dosing (5-7 mg/kg q24-48h) based on creatinine clearance to maximize peak bactericidal activity while minimizing cumulative nephrotoxicity in gram-negative infections.
Calculate amikacin dosing targeting peak 20–30 mg/L (once-daily) or peak 20–30 / trough <5 mg/L (conventional) for serious gram-negative infections, multidrug-resistant organisms, and Mycobacterium infections.
Use the Cooper lithium nomogram to predict steady-state lithium levels from a 24-hour test dose level, enabling initial dose selection without waiting for actual steady-state measurements.
Assess lithium toxicity risk based on serum level and clinical signs, classifying mild (1.5-2.0 mEq/L), moderate (2.0-2.5 mEq/L), and severe (>2.5 mEq/L) toxicity requiring emergency management.
Calculate lithium renal clearance as a percentage of GFR to assess tubular reabsorption efficiency and predict lithium accumulation risk in patients with chronic kidney disease.
Calculate corrected (adjusted) phenytoin level for hypoalbuminemia or renal failure using the Sheiner-Tozer equation to avoid under- or overdosing based on misleading total phenytoin concentrations.
Calculate phenytoin maintenance dose using Michaelis-Menten (Vmax/Km) nonlinear pharmacokinetic equations to account for saturable metabolism and avoid the disproportionate level rises with small dose increases.
Calculate paediatric drug dose using Clark's Rule (paediatric dose = weight(lb) / 150 × adult dose) as a historical weight-based dosing method for estimating approximate doses in children.
Calculate paediatric drug dose using Young's Rule (paediatric dose = age / (age + 12) × adult dose) as an age-based dosing approximation, noting limitations compared to weight-based approaches.
Calculate paediatric body surface area using the Mosteller formula (BSA = √(height(cm) × weight(kg) / 3600)) to determine BSA-based drug doses for chemotherapy and medications where dose/m² is specified.
Calculate weight-based drug doses in neonates accounting for gestational age (GA) and postnatal age (PNA) effects on pharmacokinetic maturation, including GFR, hepatic enzyme activity, and volume of distribution.
Calculate neonatal vancomycin extended-interval dosing based on gestational age, postnatal age, and weight, using maturation-based pharmacokinetic parameters to achieve therapeutic AUC targets in NICU patients.
Calculate amoxicillin dose adjustment for renal impairment using the fraction eliminated renally (fe) and kidney function ratio (KF) method: DR = 1 - fe×(1-KF), to prevent accumulation in CKD patients.
Adjust ciprofloxacin dose for renal impairment using CrCl-based dose reduction tables and the DR = 1 - fe×(1-KF) formula to prevent tendon and CNS toxicity from accumulation in CKD patients.
Determine metformin dose adjustment or contraindication based on eGFR to prevent metformin-associated lactic acidosis (MALA) in type 2 diabetes patients with renal impairment per KDIGO and FDA recommendations.
Adjust gabapentin dosing for renal impairment based on creatinine clearance to prevent CNS toxicity, excessive sedation, and respiratory depression from accumulation of this 100% renally excreted drug.
Calculate digoxin maintenance dose adjustment for renal impairment using CrCl-corrected clearance estimation to prevent life-threatening digoxin toxicity in heart failure and atrial fibrillation patients with CKD.
Adjust lisinopril starting dose and maximum dose based on eGFR/CrCl to safely initiate ACE inhibitor therapy in CKD and heart failure patients while monitoring for hyperkalemia and acute creatinine rise.
Adjust atenolol dose and frequency for renal impairment to prevent bradycardia and hypotension from drug accumulation, as atenolol is 85-100% renally excreted with no hepatic metabolism.
Adjust fluconazole dose for renal impairment using CrCl-based dosing, reducing by 50% when CrCl <50 mL/min and providing supplemental doses after hemodialysis sessions for antifungal therapy.
Calculate trimethoprim (TMP and TMP-SMX) dose adjustment for renal impairment, noting that trimethoprim competitively inhibits tubular creatinine secretion, causing apparent creatinine rises without true GFR change.
Calculate acyclovir dose adjustment for renal impairment using CrCl thresholds to prevent crystalline nephropathy and neurological toxicity (agitation, tremor, seizure) from drug accumulation.
Assess nitrofurantoin use in renal impairment: the drug is contraindicated at CrCl <30-45 mL/min due to inadequate urinary drug concentration for efficacy and risk of peripheral neuropathy from systemic accumulation.
Adjust allopurinol dose based on CrCl for gout management in CKD, avoiding doses >100 mg/day when CrCl <20 mL/min due to oxypurinol accumulation and severe allopurinol hypersensitivity syndrome risk.
Adjust colchicine dose for renal impairment to prevent colchicine toxicity (myopathy, neuropathy, bone marrow suppression) in CKD patients with gout or pericarditis requiring anti-inflammatory therapy.
Assess dabigatran dosing and contraindication thresholds based on CrCl for atrial fibrillation stroke prevention and VTE treatment, noting 80% renal elimination requiring dose reduction and avoidance in severe CKD.
Adjust rivaroxaban dosing for renal impairment in atrial fibrillation and VTE, reducing dose from 20 mg to 15 mg OD for AF at CrCl 15-49 and assessing contraindication thresholds below CrCl 15 mL/min.
Calculate creatinine clearance using the Cockcroft-Gault formula, the standard for drug dose adjustment calculations, as most renal dosing tables and pharmacokinetic studies were derived using this equation.
Use Child-Pugh classification to guide dose adjustment for hepatically metabolized drugs, reducing doses of high-extraction drugs in Class B/C cirrhosis where hepatic first-pass and enzymatic clearance are significantly impaired.
Calculate time required to reach any desired residual drug concentration or functional washout (>95%, >99%, >99.9%) after discontinuation based on the drug's elimination half-life.
Calculate drug loading dose (LD = target Cp × Vd / F) to rapidly achieve therapeutic steady-state concentrations without waiting 4-5 half-lives, used for drugs with long half-lives or time-critical indications.
Calculate expected average steady-state drug concentration (Css = F × Dose / (CL × τ)) to predict therapeutic levels, optimize maintenance dosing, and adjust for patient-specific pharmacokinetic parameters.
Calculate apparent volume of distribution using two measured drug concentrations after IV bolus dosing to individualize pharmacokinetic parameters for dose optimization in patients with altered distribution.
Estimate the expected magnitude of CYP450 drug-drug interactions based on inhibitor potency (weak/moderate/strong) and substrate sensitivity to predict fold-increases in AUC for dose adjustment guidance.
Calculate and interpret trough-to-MIC ratios for time-dependent antibiotics (beta-lactams, carbapenems) to optimize pharmacodynamic target attainment and predict clinical success in serious gram-negative infections.
Determine whether to use Total Body Weight (TBW), Ideal Body Weight (IBW), or Adjusted Body Weight (AdjBW = IBW + 0.4(TBW-IBW)) for drug dose calculations in obese patients to optimize efficacy and minimize toxicity.
Calculate the Wells score to estimate the pre-test probability of deep vein thrombosis (DVT) or pulmonary embolism (PE). The score guides whether further imaging such as D-dimer or ultrasound is warranted.
Estimate total body potassium deficit from serum potassium and calculate the KCl replacement dose for hypokalemia. Includes IV and oral replacement guidance with safe infusion rates.
Add up the gluten in a day's food and compare the total against the 10 to 50 mg per day range that the literature associates with mucosal safety in celiac disease. Built for dietitian review and gluten-free diet monitoring.