2B Risk Scores

Question 1

What does the CHA2DS2-VASc score estimate?

Answer 1

The risk of stroke in patients with AF

Question 2

What does ‘CHAD-VASc’ stand for?

Answer 2

Congestive Heart Failure - 1 
Hypertension  - 1 
Age > 75 years - 2 
Diabetes Mellitus -1 
Stroke (previous stroke / TIA / thromboembolism) - 2
Vascular disease - 1
Age 65 - 74 years - 1
Sex category (Female = 1; Male = 0)

Question 3

Which score estimates the risk of stroke in patients with AF?

Answer 3

CHA2DS2-VASc score

Question 4

If you are a Male with low risk chad-vasc (0), what anti-coagulant therapy should you consider?

Answer 4

None

Question 5

If you are a female with low risk chad-vasc (1), what anti-coagulation therapy should you consider?

Answer 5

None

Question 6

If you are: 
- Male, chad-vasc (1) OR
- Female - chad-vasc (1)
What therapy should you consider?
What is your risk level?

Answer 6

CONSIDER Oral anti-coagulant therapy eg. Warfarin

Moderate risk

Question 7

If you score chad-vasc 2+, what therapy should you consider?

Answer 7

oral anti-coagulant therapy

Question 8

What is the ‘HAS-BLED’ score a measure of?

Answer 8

An assessment of 1 year risk of major bleeding in patients with AF.

Question 9

What does ‘HAS-BLED’ stand for?

Answer 9

Hypertension
Abnormal renal & liver function 
Stroke
Bleeding
Labile INR 
Elderly 
Drugs / Alcohol

Question 10

Which risk score is an assessment of the 1 year risk of major bleeding in patients with AF?

Answer 10

HAS-BLED

Question 11

What is the ABCD2 score?

Answer 11

Risk of stroke following a TIA

Question 12

What comprises the ABCD2 score?

Answer 12

Age:
<60 = 0
>60 = 1

Blood pressure
Normal = 0
Above 140/90 = 1

Clinical features:

• No speech disturbance & no unilateral weakness = 0
• Speech disturbance. No unilateral weakness = 1
• Unilateral weakness = 2

Duration of TIA

• Less than 10 minutes = 0
• 10 - 59 minutes = 1
• Greater than 60 minutes = 2

Diabetes
No = 0
Yes = 1

Question 13

What is the risk classification of the ABCD2 score?

Answer 13

1 - 3 = Low risk
4 - 5 = Moderate risk
6 - 7 = High risk

Question 14

What 7 factors contribute to one’s diabetes risk score?

Answer 14

Age 
Gender 
Ethnicity 
Relatives with Diabetes 
Waist Measurement 
BMI 
Hypertension

Question 15

What does ‘Q-risk’ assess?

Answer 15

The 10 year risk of developing cardiovascular disease.

A score of 10% or more indicates a need for further intervention to lower risk.

Question 16

What are the 3 steps to lowering someone’s Q-risk?

Answer 16

1. Lifestyle advice
   eg. Smoking, Diet, Alcohol, Exercise
2. Manage comorbidities
3. Medications
   eg. Atorvastatin 20mg OD
   - Take baseline bloods
   - Consider delaying treatment if patient is committed to lifestyle interventions.

Question 17

What is the Wells’ Score?

Answer 17

Assesses the clinical probability of a DVT

Question 18

What are the 3 factors which comprise the Wells’ Score?

Answer 18

1. History: Immobilisation / Surgery / Malignancy
2. Clinical findings: Calf / leg swelling / pitting oedema
3. Possible alternative diagnosis more likely than a DVT?

Question 19

According to the Wells’ score, what raw number would give a 75% chance that it’s a DVT?

Answer 19

3

Question 20

Which risk score is used to assess the clinical probability of a DVT?

Answer 20

Wells’ Score

Question 21

What does ‘FRAX’ stand for?

Answer 21

Fracture Risk Assessment Tool

Question 22

What is ‘FRAX’ used to assess?

Answer 22

10 year probability of a fracture in the spine, hip, shoulder or wrist for people aged between 40 and 90.
- Risk is expressed as a percentage.

Question 23

How is osteoporosis diagnosed?

Answer 23

With a bone density scan (DEXA or DXA)