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Phase 2b OSCE's > Risk > Flashcards

Risk Flashcards

1
Q

Q-Risk 2 assess…

A

The risk of CVD within ten years

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2
Q

Which demographics are used to calculate a Q-Risk score?

A

Age, Sex, BMI, Ethnicity, Post Code

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3
Q

When assessing Q-Risk, what in particular needs to be elicited from the past medical history?

A

C - Chronic kidney failure
A - Atrial fibrillation
R - Rheumatoid arthritis
D - Diabetic status

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4
Q

Which type of medication should be investigated while taking a drug history to elicit a Q-Risk score?

A

Hypertensive treatment

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5
Q

Which direct measurements should be recorded for a Q-Risk assessment?

A

Blood pressure and Cholesterol / HDL ratio

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6
Q

Which aspect of the social history should be investigated to establish a Q-Risk score?

A

Smoking status

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7
Q

What should be explored withing the family history to calculate a Q-Risk score?

A

Angina or heart attack in a first degree relative aged under 60 years

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7
Q

What should be explored withing the family history to calculate a Q-Risk score?

A

Angina or heart attack in a first degree relative of less than 60 years of ahe

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8
Q

Which factors make up the CHADSVAS Score?

A 
Congestive heart failure
Hypertension
Age >75
Diabetes
Stroke or TIA
Vascular disease
Age 65-74
Sex - Female
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9
Q

Which factors of the CHADVAS Score are worth two points

A

Stroke or TIA

Age >75

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10
Q

With a CHADVAS Score of 0, what management would be advised?

A

No treatment

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11
Q

With a CHADVAS Score of 1, what management would be advised?

A

Consider anticoagulation and start in those who are clinically at risk

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12
Q

With a CHADVAS Score of 2, what management would be advised?

A

Start anticoagulation

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13
Q

What is a CHADVAS Score a measure of?

A

The risk of stroke in patients with atrial fibrillation

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14
Q

What does FRAX assess the risk of?

A

Fracture

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15
Q

What personal information is used to calculate a FRAX score?

A

Age, Sex, Weight, Height, Femoral neck bone mineral density if known

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16
Q

What needs to be elicited from the patients past medical history to calculate a FRAX Score?

A

Previous Fracture, Rheumatoid arthritis and Causes of secondary osteoporosis - Kidney failure, Coeliac disease, Hyperthyroidism,,,

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17
Q

It is important to ask about which type of medication when calculating a FRAX Score?

A

Glucocorticoids

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18
Q

Which aspects of the social history are apart of the FRAX Score?

A

Smoking, 3+ Units of alcohol a day

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19
Q

What needs to be checked regards a patient’s family history to calculate a FRAX Score?

A

Parental hip fracture

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20
Q

In relation to the FRAX, what is a T-score?

A

Compares bone density to that of a healthy 30 year old adult

21
Q

A T-Score of -1 standard deviation and above is indicative of what?

A

Healthy bone tissue

22
Q

A T-Score of between -1 and -2.5 standard deviations is indicative of what?

A

Osteopenia - Consider starting bisphosphonates in light of certain risk factors

23
Q

A T-Score of -2.5 standard deviations and below is indicative of what?

A

Osteoporosis - Start bisphosphonates

24
Q

ABCD2 is a risk assessment tool used for what?

A

Calculating the risk of stroke following a TIA

25
Q

What contributing factors make up the ABCD2 score?

A

Age, Blood pressure (140/90), Clinical features (Unilateral weakness and Speech difficulty w/o weakness), Duration, Diabetes

26
Q

Which factors of ABCD2 score two pints?

A

Unilateral weakness, Duration of sixty minutes or more

27
Q

Which factor of ABCD2 scores zero points?

A

Duration of less than ten minutes

28
Q

What aspects of a patient’s past medical history should be investigated when working with the ABCD2 score?

A

Current AF and Previous TIAs and when they occurred

29
Q

What is the risk of stroke within two days in a patient scoring 0-3, 4-5 and 6+ respectively when using ABCD2?

A

1%, 4% and 8%

30
Q

When using ABCD2 how would a patient currently in AF be managed?

A

Immediate referral to a specialist

31
Q

When using ABCD2 how would a patient scoring 0-3 be managed?

A

Urgent referral - All patients with suspected TIA should be seen within one week by a specialist

32
Q

When Using ABCD2 how would a patient scoring 4-7 be managed?

A

Immediate referral - Should be seen be a specialist within 24 hours

33
Q

What lifestyle advice can be given to reduce the risk of stroke in those scoring on ABCD2?

A

Diet, Exercise, Smoking Cessation, Adherence to medication (diabetic and anti-hypertensive meds)

34
Q

Which types of medications can be used to reduce the risk of stroke in those scoring on ABCD2?

A

Anticoagulants (clopidogrel, aspirin) and Statins

35
Q

Wells Score is used to calculate the risk of what?

A

Probability if developing a DVT

36
Q

What information should be elicited from the patient’s presenting complaint to calculate their Wells Score?

A

Localised tenderness, Entire leg swelling, Calf swelling >3cm, Paralysis/Paresis/Immobility, Pitting oedema, Collateral superficial veins

37
Q

What aspects of the patient’s past medical history contribute to the Wells Score?

A

Previous DVT, Recent major surgery, Bedridden for more than 3 days, Active cancer treatment

38
Q

Which medications or therapies need to be asked about when working with Wells Score?

A

HRT and Oral contraceptives

39
Q

What needs to be asked when discussing a patient’s social history in regards Wells Score?

A

Smoking status and Recent long haul flights

40
Q

How would a Wells Score of 1 or less be managed?

A

DVT unlikely

D-dimer - if negative rule out DVT, if positive request USS

41
Q

How would a Wells score of 2 or greater be managed?

A

DVT likely
D-dimer and USS - if both negative rule out DVT, if USS positive treat as DVT, if D-dimer positive and USS negative repeat USS in a week

42
Q

What lifestyle advice would be given to someone scoring on Wells Criteria?

A

Diet, Exercise, Smoking cessation

43
Q

Which medications can be prescribed for those scoring on Wells Criteria?

A

LMWH and Anticoagulants

44
Q

Which risk factors are associated with diabetes?

A

Age, Sex, Ethnicity, Waist measurement, BMI, Hypertension, Family history

45
Q

When assessing diabetes risk which signs of hyperglycemia should be investigated?

A

Polyuria, Polydipsia, Weight loss, Fatigue, Genital thrush, Blurred Vision

46
Q

What levels of risk are associated with a diabetes risk score?

A

Low - 0-6%
Increased - 7-15%
Moderate - 15-24%
High - 24-47%

47
Q

What diet advice can be given to reduce the risk of diabetes?

A

Eat regular meals, Watch portion size, Reduce fat and salt, Limit sugar, Moderate alcohol

48
Q

What exercise advice can be given to reduce the risk of diabetes?

A

150 minutes of moderate intensity exercise which raises both heart rate and respiration rate per week

49
Q

Those at risk of diabetes should be helped to recognise the five T’s. What are the five T’s?

A

Thirst (polydipsia), Tiredness, Thrush, Toilet (polyuria), Thinning (weight loss)

Phase 2b OSCE's (1 decks)

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