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2b OSCE > Risk Assessments > Flashcards

Risk Assessments Flashcards

1
Q

what does the wells score assess?

A

likelihood of DVT

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2
Q

what clinical features make up a wells score? (9)

A
  • 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
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3
Q

wells score 2 points or more?

A

DVT likely

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4
Q

wells score 1 point or less?

A

DVT unlikely

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5
Q

what does QRISK assess?

A

person’s risk of developing a heart attack or stroke over the next 10 years

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6
Q

what clinical features make up a QRISK3 score? (14)

A
  • 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
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7
Q

what does CHA2DS2-VASc score calculate?

A

stroke risk for patients with atrial fibrillation

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8
Q

what clinical features make up a CHA2DS2-VASc score?

A
  • Congestive HF Hx
  • HTN
  • Age (>75)
  • Diabetes
  • Stroke / TIA / thromboembolism Hx
  • vascular disease history
  • Age (65-74)
  • Sex (female)
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9
Q

what does a CHA2DS2-VASc score of 0 for men 1 for women mean?

A

“low” risk and may not require anticoagulation

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10
Q

what does a CHA2DS2-VASc score of 1 for men 2 for women mean?

A

“low-moderate” risk and should consider antiplatelet or anticoagulation

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10
Q

what does a CHA2DS2-VASc score of >/2 for men >/3 for women mean?

A

“moderate-high” risk and should otherwise be an anticoagulation candidate

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11
Q

what does FRAX score calculate?

A

estimates the 10-year risk of fragility fracture

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12
Q

what age group is the FRAX score valid for?

A

40-90 years

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13
Q

what clinical features make up a FRAX score? (12)

A
  • age, sex, weight, height
  • previous fracture
  • parental fracture
  • current smoking
  • glucocorticoids
  • rheumatoid arthritis
  • secondary osteoporosis
  • alcohol intake
  • bone mineral density
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14
Q

what score is low risk for FRAX?

A

<10%

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15
Q

what score is medium risk for FRAX?

A

10-20%

16
Q

what score is high risk for FRAX?

A

> 20%

17
Q

what does ABCD2 score calculate?

A

Estimates the risk of stroke after a suspected TIA

18
Q

what clinical features make up an ABCD2 score?

A
  • 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
19
Q

what does an ABCD2 score of 0-3 points mean?

A

low risk of stroke

20
Q

what does an ABCD2 score of 4-5 points mean?

A

moderate risk of stroke

21
Q

what does an ABCD2 score of 6-7 points mean?

A

high risk of stroke

22
Q

what is INR?

A

International normalised ratio - standardised version of the prothrombin time - time for the blood to clot via the extrinsic pathway

23
Q

what is the target INR for someone on warfarin?

A

2-3

24
Q

what is the target INR for someone being treated for mechanical heart valves?

A

2.5-3.5

25
Q

what system in the liver metabolises warfarin?

A

cytochrome p450

26
Q

what are the values for low, moderate and high risk in QRISK score?

A

<10% = low, 10-19% moderate, >20% high risk

27
Q

Main score for sob?

A

MRC dyspnoea scale

28
Q

What is target INR for the normal everyday person?

A

1

29
Q

Sx of high INR?

A

Bleeds: headaches, easy bruising, abnormal bleeding eg. Urine, bleeding for longer than usual

30
Q

Sx of low INR?

A

VTE and CVA: calf swelling, chest pain, unilateral weakness or slurred speech?

31
Q

What is HBa1c?

A

Directly proportional measure of glycerated haemoglobin over 3 months

32
Q

Lifestyle Management for >10% score of qrisk?

A
  • healthy diet
  • exercise
  • weight loss
  • smoking cessation
  • adherence to meds
33
Q

Lifestyle Management advice for chadsvasc?

A
  • healthy diet
  • exercise
  • weight loss
  • smoking cessation

2b OSCE (7 decks)

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