Risk assessments

Question 1

Diabetes risk score

Answer 1

Demographics
* Age
* Sex
* Ethnicity
* Weight/height/BMI
* Waist circumference
…
Lifestyle
* Exercise
* Diet
- Sugar
- Fruit + veg
* Smoking
* Alcohol
…
Current symptoms
* Thirst - polydipsia
* Toilet - polyuria
* Tired - lethargy
* Thin - unintentional weight loss
…
Complications
* Visual problems/changes
* Loss of peripheral sensation
* Vascular issues, ulcers
* Genital thrush
* Palpitations
* Dysuria
* Incontinence
…
PMH
- High blood sugar
Drug history
- Antihypertensives
Family history
- Diabetes

Question 2

What does QRisk assess?

Answer 2

An individual’s 10-year risk of having a heart attack or stroke

Question 3

QRisk3 score

Answer 3

Demographics
* Age
* Sex
* Ethnicity
* BMI
* Postcode
…
PMH
* Chronic kidney disease (stage 3+)
* Atrial fibrillation
* Rheumatoid arthritis
* Diabetes (type 1/2)
* Systemic lupus erythematosus
* Migraines
* Erectile dysfunction
* Severe mental illness
…
Drug history
* Antihypertensives
* Regular corticosteroids
* Atypical antipsychotics
…
Family history
* Angina or MI in 1st degree relative aged <60
…
Social history
* Smoking
* Alcohol
…
Measurements
* Cholesterol:HDL ratio
* Systolic BP

Question 4

What does CHADs2VASc assess?

Answer 4

Ischaemic stroke risk in patients with atrial fibrillation

Question 5

CHADs2VASc score

Answer 5

C - Congestive heart failure
H - Hypertension (+management)
A2 - Age ≥75
D - Diabetes
S2 - Stroke/TIA history
V - Vascular disease (MI, angina, aortic plaque, peripheral artery disease)
A - Age 65-74
Sc - Sex (female)

Question 6

What does FRAX stand for?

Answer 6

Fracture Risk Assessment Tool

Question 7

What does FRAX assess?

Answer 7

Estimates your risk of having a hip or other major fracture in the next 10 years

Question 8

FRAX score

Answer 8

Demographics
1. Age
2. Sex
3. Weight
4. Height
–> BMI
5. Femoral neck bone mineral density (BMD)
…
Fracture history
6. Fracture history (Y/N)
7. Fracture hip in a parent (Y/N)
…
Other PMH
8. Rheumatoid arthritis
9. Secondary osteoporosis
- Type 1 diabetes
- Osteogenesis imperfecta
- Hyperthyroidism
- Premature menopause/hypogonadism
- Coeliac disease/malabsorption/malnutrition
- Chronic liver disease
- Kidney failure
- Multiple sclerosis
- Cushing’s syndrome
…
Drug history
10. Glucocorticoids
…
Social history
11. Smoking
12. Alcohol (3+ units/day)

Question 9

Interpretation of FRAX score

Answer 9

≥-1 - normal
-1 - -2.5 - osteopenia
≤-2.5 - osteoporosis

Question 10

What does ABCD2 assess?

Answer 10

Risk of a stroke after a TIA

Question 11

ABCD2 score

Answer 11

A - Age ≥60
B - Blood pressure ≥140/90 mmHg
C - Clinical features
- 2: unilateral weakness
- 1: speech impairment, no weakness
D - Duration of symptoms
- 2: ≥60 minutes
- 1: 10-59 minutes
D - Diabetes

Also: Atrial fibrillation

Question 12

Well’s score

Answer 12

Current symptoms - leg
* Tenderness - localised to along deep venous system
* Redness
* Hot to touch
* Leg swelling
- Entire leg swollen
- Pitting oedema
- Unilateral (>3cm)
* Collateral veins
…
Current symptoms - other symptoms
* Breathlessness
* Fever/chills
* Haemoptysis
…
Recent immobility
* Long haul flights/travel
* Paralysis
* Plaster cast
* Bedridden
…
PMH
* Recent surgery
* Cancer diagnosis/chemotherapy
* Previous DVT diagnosis
…
Drug history
* Anticoagulants
* Use of COCP or HRT
…
Family history
* DVT diagnosis
…
Social history
* Smoking
* Alcohol
* Pregnant?