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Risk Assessment Tools Flashcards

1
Q

What is the risk assessment score for osteoporotic fracture

A

FRAX Assessment tool

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2
Q

What does a 10% risk from FRAX assessment tool mean

A

High risk

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3
Q

What does a risk score close to but below 10% mean on FRAX assessment tool

A

Orange zone of risk chart

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4
Q

What does a risk score on FRAX assessment tool below 10% mean

A

Green risk chart

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5
Q

What is the risk threshold of FRAX assessment tool for arranging a DXA scan

A

Measures the bone density

10 year risk of 10%

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6
Q

What factors increase your risk of osteoporotic fractures

A

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

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7
Q

How much calcium intake is recommended in people with increased risk of fragility fracture

A

At least 1000 mg/day

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8
Q

When should vitamin D be given in fragility fracture

A

Aged over 65

Not exposed to unlight (wear clothes that cover the whole body or indoors for long period of time)

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9
Q

What is important to take in the history for use of FRAX assessment tool

A

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

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10
Q

What scoring tool is used in suspected DVT

A

Wells score

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11
Q

What are comments of the wells score that you must ask about

A

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

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12
Q

What should you do if a wells score is likely for a DVT

A

Offer proximal leg ultrasound scan with the results available after 4 hours

If cannot be carrier out - d-dimer test

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13
Q

What should be offered if there is a risk factor in wells of unlikely for DVT

A

Offer D-dimer results within 4 hours

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14
Q

What is the treatment for a DVT

A

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

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15
Q

What are the key questions to ask for a QRisk score

A

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

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16
Q

What does QRisk calculate

A

10-year risk of having a heart attack or stroke

17
Q

What does < 10% QRisk mean

A

1 in 10 chance of having a stroke of HA in the next 10 years

Low risk

18
Q

What does a 10-20% QRisk score mean

A

1 to 2 in 10 chance of having a stroke of HA in the next 10 years

Moderate risk

19
Q

What does > 20% QRisk mean

A

Have at least 2 in 10 chance of having a stroke or HA in the next 10 years

High risk

20
Q

At what % of QRisk score does treatment start

21
Q

At >/= 10% QRisk score what should be done

A

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

22
Q

What lifestyle changes can be done in QRisk score

A

Stop smoking
Healthy balanced diet
Reduced alcohol intake
Eye of weight BMI 20-25
Exercise regularly
Take medication to reduce HTN if needed

23
Q

After QRisk score is calculated when should it be investigated again

A

Can retest cholesterol in 6-12 months, measure weight and BP to recalculate risk

24
Q

What is the risk factor for stroke risk in Atrial fibrillation

A

CHADS2 VA2SC

25
Q

What does CHADS2 VA2SC

A

stroke risk in atrial fibrillation

26
Q

What is the mnemonic that is use to remember the FRAX score

A

FRAX SCORE

  • Fracture history
  • Rheumatoid arthritis
  • Age
  • X - Sex (gender)
  • Smoking (current)
  • Corticosteroids (glucocorticoids use)
  • Osteoporosis (secondary causes)
  • Relative (parental hip fracture)
  • Ethanol (alcohol consumption, 3 or more units/day)
27
Q

Name what is part of the FRAX score - you need to match

A

FRAX SCORE

  • Fracture history
  • Rheumatoid arthritis
  • Age
  • X - Sex (gender)
  • Smoking (current)
  • Corticosteroids (glucocorticoids use)
  • Osteoporosis (secondary causes)
  • Relative (parental hip fracture)
  • Ethanol (alcohol consumption, 3 or more units/day)

Phase 2B (15 decks)

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