Diabetes Flashcards
QRISK2 cardiovascular
Age Gender Ethnicity Smoking status Diabetes Angina / heart attack in 1st degree relative
Wells score for DVT
Veins, cancer, DVT
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
On the contraceptive pill, pregnancy
Alternative diagnosis more likely than DVT (Baker’s cyst, cellulitis, muscle damage, superficial venous thrombosis, post phlebitic syndrome, inguinal lymphadenopathy, external venous compression) (-2 points)
Osteoporosis FRAX
10 year risk for fracture OP, PP, R, SS, T, bone density , intestinal Age Gender Height Weight Previous fracture Parent fractured hip Smoker Steroids Rheumatoid arthritis Alcohol Secondary osteoporosis Bone mineral density Thyroid / parathyroid disorders Intestinal disorders
Risk of stroke post TIA ABCD2
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
Stroke risk assessment
CHADs2VASc
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)
Chads2vasc scoring and risk
0 low risk no treatment
1 moderate risk - consider anti coagulation
2+ high risk - give anticoagulation
Chads2vasc anticoagulants
Vitamin k antagonists - warfarin
Non fit k antagonist - NOAC (new oral anticoagulation drugs)
Qrisk2 scoring
Risk of cv event in next 10 years
10 - high risk - lipid lowering drugs (statins)
Wells score - scoring
What is used with to rule out DVT
Treatment
D dimmer used to rule out
2+ high risk - ultrasound - anticoagulation with heparins
1 - moderate risk - ultrasound anticoagulation with heparinise
ABCD2 scoring
Risk
Treatment
1-3 low risk - observation may not be nessasary unless new risk such as AF
4-5 moderate - hospital observation is justified
>5 high risk - observe them
Long term antiplatelet therapy - aspirin + clopidogrel (thromboembolic stroke )
What is the FRAX score for?
What would you give
10 year risk of hip fracture
Risk over 3% are treated
Or risk of over 20% of osteoporotic fracture are treated
BisPhosphonates (alendronate) alendronic acid
Diabetes risk
Age Sex Ethnicity BMI Smoker Family history Hx of heart attack, stroke HTN Steroid use
