Diabetes

Question 1

QRISK2 cardiovascular

Answer 1

Age 
Gender 
Ethnicity 
Smoking status 
Diabetes
Angina / heart attack in 1st degree relative 
Post code 
Cholesterol
Hypertension 
Sex 
Rheumatoid arthritis 
Diabetes
Family Hx 
Chronic kidney disease

Question 2

Wells score for DVT

Answer 2

Immobility of lower limb
Recently bed ridden / major surgery in past 4 weeks
Localised tenderness in deep vein system
Swelling of entire leg
Calf swelling 3cm greater then other leg
Pitting oedema greater in symptomatic leg
Collateral non varicose superficial veins
Active cancer treated within 6 months
Previous DVT
Alternative diagnosis more likely than DVT (Baker’s cyst (arthritis/meniscus tear) , cellulitis, muscle damage, superficial venous thrombosis, post phlebitic syndrome, inguinal lymphadenopathy, external venous compression) (-2 points)

Question 3

Osteoporosis FRAX

Answer 3

10 year risk for fracture 
Age
Gender 
Height 
Weight 
Exercise - and is it weight bearing 
Previous fracture 
Parent fractured hip 
Smoker
Steroids
Rheumatoid arthritis 
Alcohol 
Secondary osteoporosis 
Bone mineral density 
Throid / parathyroid disorders 
Intestinal disorders

Question 4

Risk of stroke post TIA ABCD2

Answer 4

ABCD2

Age over 60 1
Blood pressure over 140 1
Clinical features unilateral weakness with or without speech impairment 2
speech impaired but no weakness 1
Duration of TIA over 60min 2, 10 min to an hour 1
Diabetes 1

Question 5

Stroke risk assessment

CHADs2VASc

Answer 5

Congestive heart failure 
Hypertension above 140/90 
Age over 75 (2 points)
Diabetes mellitus 
Prior stroke TIA or thromboembolism (2 points)
Vascular disease (peripheral artery, MI, aortic plaque)
Age 65-74 
Sex (woman)

Question 6

Qrisk risk scores

Answer 6

Comes out as a percentage

>10% - statins

Question 7

Wells score meanings ?

Treatment ?

Answer 7

Used alongside a d dimer (if d dimer negative no DVT)

Question 8

Diabetes risk score

Answer 8

Smoking 
Age 
Sex 
Ethnicity (self defined) 
BMI
Family Hx 
Waist circumference 
Hx heart attack, stroke, mini stroke
Steroids 
Hypertension (with medication) 
Polycystic ovaries 
Baby over 10lb

Question 9

Diabetes score meanings

Answer 9

Low risk - lifestyle
Moderate risk - lifestyle
High risk - see GP, lifestyle

Question 10

Abcd2 score meanings

Answer 10

Low risk - don’t hospitalise unless new risk factor eg AF
Moderate risk 4-5 - hospitalise for observation
High risk 6-7 - hospitalise (antiplatelet - aspirin / clopidogrel )