Risk Assessments Flashcards
what does the wells score assess?
likelihood of DVT
what clinical features make up a wells score? (9)
- active cancer
- immobilisation / paralysis of lower limb
- bedridden for 3 days< or surgery in past 12 weeks
- localised tenderness
- entire leg swollen
- calf swelling 3cm larger than symptomatic side
- pitting oedema on symptomatic leg
- collateral superficial veins
- previous DVT
wells score 2 points or more?
DVT likely
wells score 1 point or less?
DVT unlikely
what does QRISK assess?
person’s risk of developing a heart attack or stroke over the next 10 years
what clinical features make up a QRISK3 score? (14)
- age
- sex
- ethnicity
- postcode
- BMI
- smoking status
- FHx of CHD / angina <60 years
- systolic bp / HTN
- total cholesterol : HDL cholesterol
- diagnosis of a fib
- diagnosis of CKD,
- diagnosis of rheumatoid arthritis
- history of mental illness and / or atypical antipsychotics
- history of erectile dysfunction
what does CHA2DS2-VASc score calculate?
stroke risk for patients with atrial fibrillation
what clinical features make up a CHA2DS2-VASc score?
- Congestive HF Hx
- HTN
- Age (>75)
- Diabetes
- Stroke / TIA / thromboembolism Hx
- vascular disease history
- Age (65-74)
- Sex (female)
what does a CHA2DS2-VASc score of 0 for men 1 for women mean?
“low” risk and may not require anticoagulation
what does a CHA2DS2-VASc score of 1 for men 2 for women mean?
“low-moderate” risk and should consider antiplatelet or anticoagulation
what does a CHA2DS2-VASc score of >/2 for men >/3 for women mean?
“moderate-high” risk and should otherwise be an anticoagulation candidate
what does FRAX score calculate?
estimates the 10-year risk of fragility fracture
what age group is the FRAX score valid for?
40-90 years
what clinical features make up a FRAX score? (12)
- age, sex, weight, height
- previous fracture
- parental fracture
- current smoking
- glucocorticoids
- rheumatoid arthritis
- secondary osteoporosis
- alcohol intake
- bone mineral density
what score is low risk for FRAX?
<10%
what score is medium risk for FRAX?
10-20%
what score is high risk for FRAX?
> 20%
what does ABCD2 score calculate?
Estimates the risk of stroke after a suspected TIA
what clinical features make up an ABCD2 score?
- Age >/ 60
- BP >/ 140/90mmHg
- Clinical features of TIA (unilateral weakness, speech disturbance without weakness or other
- Duration of symptoms (<10 mins, 10-59 mins, >/60 mins)
- Diabetes Hx
what does an ABCD2 score of 0-3 points mean?
low risk of stroke
what does an ABCD2 score of 4-5 points mean?
moderate risk of stroke
what does an ABCD2 score of 6-7 points mean?
high risk of stroke
what is INR?
International normalised ratio - standardised version of the prothrombin time - time for the blood to clot via the extrinsic pathway
what is the target INR for someone on warfarin?
2-3
what is the target INR for someone being treated for mechanical heart valves?
2.5-3.5
what system in the liver metabolises warfarin?
cytochrome p450
what are the values for low, moderate and high risk in QRISK score?
<10% = low, 10-19% moderate, >20% high risk
Main score for sob?
MRC dyspnoea scale
What is target INR for the normal everyday person?
1
Sx of high INR?
Bleeds: headaches, easy bruising, abnormal bleeding eg. Urine, bleeding for longer than usual
Sx of low INR?
VTE and CVA: calf swelling, chest pain, unilateral weakness or slurred speech?
What is HBa1c?
Directly proportional measure of glycerated haemoglobin over 3 months
Lifestyle Management for >10% score of qrisk?
- healthy diet
- exercise
- weight loss
- smoking cessation
- adherence to meds
Lifestyle Management advice for chadsvasc?
- healthy diet
- exercise
- weight loss
- smoking cessation
