Risk Assessment Tools Flashcards
What is the risk assessment score for osteoporotic fracture
FRAX Assessment tool
What does a 10% risk from FRAX assessment tool mean
High risk
What does a risk score close to but below 10% mean on FRAX assessment tool
Orange zone of risk chart
What does a risk score on FRAX assessment tool below 10% mean
Green risk chart
What is the risk threshold of FRAX assessment tool for arranging a DXA scan
Measures the bone density
10 year risk of 10%
What factors increase your risk of osteoporotic fractures
High alcohol intake (> 3 units of alcohol per day)
Heavy smoking
Vitamin D if aged > 65 or not exposed to sunlight (wear clothes that cover the whole body or indoors for long periods of time)
Calcium intake - 100 mg/day recommended for people with increased risk of fragility fracture
Loose weight
Identify any risk of falls
How much calcium intake is recommended in people with increased risk of fragility fracture
At least 1000 mg/day
When should vitamin D be given in fragility fracture
Aged over 65
Not exposed to unlight (wear clothes that cover the whole body or indoors for long period of time)
What is important to take in the history for use of FRAX assessment tool
Exclude non-osteoporotic causes for fragility fractures e.g. metastatic bone disease, multiple myeloma, Osteomalacia, Paget’s disease
Exclude secondary causes - endocrine, rheumatological, GI, chronic liver disease, COPD
What scoring tool is used in suspected DVT
Wells score
What are comments of the wells score that you must ask about
Active cancer - treatment ongoing, within the last 6 months or palliative
Recent immobilisation of the legs
Bedridden for 3 days or more
Major surgery within the last 12 weeks
Local calf tenderness
Swollen calf
Pitting oedema in the calf
Previous history of DVT
What should you do if a wells score is likely for a DVT
Offer proximal leg ultrasound scan with the results available after 4 hours
If cannot be carrier out - d-dimer test
What should be offered if there is a risk factor in wells of unlikely for DVT
Offer D-dimer results within 4 hours
What is the treatment for a DVT
Warfarin = aim for international normalised ratio (INR) target of 2.5, keeping it within range of 2.0-3.0
OR
DOAC e.g. apixaban
What are the key questions to ask for a QRisk score
Smoking status
Ethnicity
Diabetes
Angina or HA in 1st degree relative < 60
CKD (3,4,5)
AF
HTN treatment
Migraines
RA
SLE
Severe mental illness - schizophrenia, bipolar disorder, moderate/severe depression
On atypical antipsychotic medicines
Regular steroid tablets
Diagnosis or treatment for erectile dysfunction
Height
Weight
What does QRisk calculate
10-year risk of having a heart attack or stroke
What does < 10% QRisk mean
1 in 10 chance of having a stroke of HA in the next 10 years
Low risk
What does a 10-20% QRisk score mean
1 to 2 in 10 chance of having a stroke of HA in the next 10 years
Moderate risk
What does > 20% QRisk mean
Have at least 2 in 10 chance of having a stroke or HA in the next 10 years
High risk
At what % of QRisk score does treatment start
> 10%
At >/= 10% QRisk score what should be done
Offer statin
Reduce cholesterol which in some cases can lower your risk of heart attack and stroke by up to 25%
Designed to be taken every night
What lifestyle changes can be done in QRisk score
Stop smoking
Healthy balanced diet
Reduced alcohol intake
Eye of weight BMI 20-25
Exercise regularly
Take medication to reduce HTN if needed
After QRisk score is calculated when should it be investigated again
Can retest cholesterol in 6-12 months, measure weight and BP to recalculate risk
What is the risk factor for stroke risk in Atrial fibrillation
CHADS2 VA2SC
