Risk Assessment Station

Question 1

DIABETES RISK
4 personal information questions?

Answer 1

Age >50
Gender - male
Ethnicity - non-white
Relative with diabetes

Question 2

DIABETES RISK
Risk reduction advice

Answer 2

Regular meals
decrease portion size
decrease fat/sugar/salt
moderate alcohol
exercise 150 mins a week
weight loss

Question 3

DIABETES RISK
5 symptoms of diabetes

Answer 3

5Ts
Toilet
Thirsty
Tiredness
Tingling
Thinner - unintentional weight loss

Question 4

What does QRisk measure?

Answer 4

risk of developing CVD in next 10 years in those aged 35-74

Question 5

QRISK
5 bits of personal information

Answer 5

Age
Sex
Ethnicity
BMI - Height and weight
POST CODE

Question 6

QRISK
PMHx - 4 specific conditions to check for

Answer 6

CKD stage 4/5
AF
RhA
Diabetes

Question 7

QRISK
DHx

Answer 7

Antihypertensives

Question 8

QRISK
Family history

Answer 8

MI or Angina in 1st degree ralative under 60

Question 9

QRISK
2 direct measurements needed

Answer 9

Cholesterol/HDl ratio
Systolic BP

Question 10

QRISK
what counts as low risk?

Answer 10

<10%

Question 11

QRISK
What counts as high risk?

Answer 11

> 20%

Question 12

QRISK
Advice for lowering risk?

Answer 12

Stop smoking
exercise
diet change/ weight loss
disease control/medication adherence
Statins

Question 13

what is CHA2DS2-VASC for?

Answer 13

stroke risk with AF

Question 14

CHA2DS2-VASC
what does it stand for?

Answer 14

Congestive heart failure
HTN
Age >75 - +2 points
Age >65 - +1 point
Diabetes
Stroke/TIA - +2 points
Vascular disease
Sex Category

Question 15

what CHA2DS2-VASC score warrants anticoagulation?

Answer 15

> 1 maybe and >2 definitely

Question 16

CHA2DS2-VASC
life advice

Answer 16

Avoid alcohol
stop smoking
healthy diet
exercise

Question 17

warfarin advice

Answer 17

get INR checked
Teratogenic
Can interfere with other medications
increased bleeding risk
diet control
can be reversed w/ vitamin K

Question 18

DOAC advice

Answer 18

non-reversible
increased bleeding risk
expensive
caution in renal impairment/GI bleed Hx

Question 19

What is the FRAX SCORE?

Answer 19

10 year probability of spine/hip/shoulder/wrist fracture in 40-90 y/o

Question 20

FRAX SCORE
Personal info

Answer 20

age
sex
weight
height

Question 21

FRAX SCORE
PMHx

Answer 21

Dexa Scan + BMD
previous fracture
secondary osteoporosis
RhA

Question 22

What conditions can cause secondary osteoporosis?

Answer 22

Kidney failure
hyperthyroid
coeliac
T1DM
chronic liver disease
premature menopause

Question 23

FRAX SCORE
Drug Hx

Answer 23

Steroids
lithium

Question 24

FRAX SCORE
FHx

Answer 24

parental fractured hip

Question 25

FRAX SCORE SHx

Answer 25

smoking alcohol intake - >3 units/day

Question 26

FRAX SCORE low risk advice

Answer 26

more exercise quit smoking limit alcohol calcium + vitamin D rich diet grab bars in home good grip shoes

Question 27

FRAX SCORE high risk advice

Answer 27

low risk + DEXA scan if T-score <-2.5 = Tx w/ bisphosphonates

Question 28

what is ABCD2 for?

Answer 28

risk of stroke after TIA

Question 29

what does ABCD2 stand for?

Answer 29

Age >60 BP >140/90 Clinical features - unilateral weakness +2, speech no weak +1 Duration - 10-60 mins - +1, >60 mins +2 Diabetes

Question 30

ABCD2 advice

Answer 30

diet exercise stop smoking antithrombotics - Aspirin, clopidogrel control HTN Statin if high cholesterol

Question 31

WELLS SCORE HxPC questions (+1)

Answer 31

recent leg immobilisation or paralysis tenderness in deep venous system swollen whole leg calf swelling >3cm compared to other leg unilateral pitting oedema collateral superficial veins present

Question 32

WELLS SCORE PMHx questions

Answer 32

major surgery past 12 weeks active cancer previous DVT

Question 33

WELLS SCORE SHx Questions

Answer 33

long haul flight OCT/HRT smoking prothrombotic state

Question 34

WELLS SCORE DVT treatment

Answer 34

LMWH oral warfarin compression stockings seek/treat underlying cause diet, exercise, stop smoking

Question 35

what counts as a high risk frax score?

Answer 35

>50%

Question 36

what counts as a high risk wells score?

Answer 36

>3