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Phase 2B OSCE > Risk assessment > Flashcards

Risk assessment Flashcards

1
Q

What is QRISK score?

A

Risk of having an MI or stroke in next 10 years (%)

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2
Q

What age group is QRISK used for?

A

35-74

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3
Q

What personal criteria does QRISK use?

A
  • Age
  • Sex
  • Ethnicity
  • BMI
  • Smoking history
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4
Q

What PMH does QRISK use?

A
  • CKD
  • AF
  • Rheumatoid arthritis
  • Diabetes
  • Migraines
  • SLE
  • Mental illnesses
  • Erectile dysfunction
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5
Q

What drug history does QRISK use?

A
  • Anti-hypertensives
  • Atypical antipsychotics
  • Steroids
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6
Q

What family history does QRISK use?

A
  • Angina/ MI in 1st degree relative < 60 y/o
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7
Q

What other information does QRISK use?

A
  • Cholesterol/ HDL ratio
  • Systolic BP
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8
Q

What medications may be started if QRISK is high?

A

Statins (atorvastatin)

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9
Q

What is low, medium and high QRISK scores?

A
  • Low = < 10%
  • Medium = 10-20%
  • High = > 20%
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10
Q

What is ABCD2 score?

A

Risk of having a stroke after a suspected TIA

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11
Q

What is asked about in ABCD2 score?

A
  • Age > 60
  • Blood pressure > 140/90
  • TIA with unilateral weakness = 2
  • TIA with speech disturbance = 1
  • Duration of symptoms (>60 = 2, 10-60 = 1)
  • Diabetes = 1
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12
Q

What medications can be used if ABCD2 is high?

A

Aspirin/ clopidogrel

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13
Q

What secondary prevention can be used for high ABCD2 risks?

A
  • Statins
  • Hypertension control
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14
Q

What is low, medium and high risk ABCD2 scores?

A
  • Low = 1-3
  • Medium = 4,5
  • High = 6,7
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15
Q

What information do those with a TIA need to be told?

A

Don’t drive for 1 month after TIA

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16
Q

What is wells score used for?

A

Probability of developing a DVT

17
Q

What criteria are used for wells score?

A
  • Active cancer/ treatment within 6 months
  • Immobilised, paralysis, paresis
  • Recent surgery
  • Calf more than 3cm swollen
  • Collateral veins
  • Entire leg swollen
  • Localised tenderness along veins
  • Pitting oedema
  • Previous DVT/PE
  • Pregnant/ HRT/ COCP
18
Q

What else is important to ask in those with suspected DVT?

A
  • Recent flights
  • Smoking/ drinking
  • OCP/ HRT
19
Q

How should DVT be investigated?

A
  • D-dimer if under 2
  • D-dimer + doppler if 2 or over
20
Q

What is low, moderate, high DVT risks?

A
  • Low = 0
  • Moderate = 1,2
  • High = 3+
21
Q

How is DVT treated?

A
  • LMWH
  • Other anticoagulants (apixaban, rivaroxaban)
22
Q

What is CHADSVaSc used for?

A

Risk of stroke in patients with AF

23
Q

What criteria are used for CHADSVaSc?

A
  • CHF
  • Hypertension
  • Age (65-74 or 75+)
  • Diabetes
  • Stroke/ TIA
  • Vascular disease (MI, PAD, aortic plaque)
  • Sex
24
Q

What scores are significant in CHADSVaSc?

A
  • 0 = no anticoagulation
  • 1 = consider anticoagulation
  • 3 = anticoagulation required
25
Q

What anticoagulants should be used if CHADSVaSc is high?

A
  • DOAC e.g. apixaban
  • … then warfarin if contraindicated
26
Q

What is does FRAX score calculate?

A

10 year risk of osteoporotic fracture if untreated

27
Q

What criteria are used for FRAX?

A
  • Age
  • Sex
  • Weight + Height (BMI)
  • RA
  • Previous fracture
  • Secondary osteoporosis (kidney failure, thyroid/ parathyroid problems, liver disease)
  • Parent has fractured hip
  • Smoke/ drink alcohol
  • Steroids
  • Femoral neck BMD
28
Q

What medications are given to someone with a high FRAX?

A

Bisphosphonates (alendronic acid)

29
Q

What criteria are used for diabetes risk score?

A
  • Age
  • Sex
  • Ethnicity
  • Relative with diabetes
  • Waist circumference
  • BMI (height/ weight)
  • Hypertension/ BP meds
30
Q

What are the different risk of developing diabetes?

A
  • 0-6 = low
  • 7-15 = increased
  • 16-24 = moderate
  • 25+ = high
    Out of 47
31
Q

What is also important to ask those at risk of diabetes?

A

Signs/ symptoms e.g.:
* Thirst
* Tired
* Increased urination
* Recurrent infections

Phase 2B OSCE (2 decks)

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