Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Phase 2b Sheffield Medicine > Risk Assessments > Flashcards

Risk Assessments Flashcards

1
Q

What is ABCD2 score used for?

A

Used for calculating the risk of a stroke after a TIA.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the parameters used for ABCD2?

A

A - Age
B - Blood pressure
C - Clinical Features
D - Duration
D - Diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How would you score age in a ABCD2 score?

A

If the patient’s age is above (and including) 60 years old = 1 point.
Below 60 years old = 0 points.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How would you score blood pressure in a ABCD2 score?

A

If the patient has a blood pressure of above (and including) 140/90 = 1 point.
Anything below this = 0 points.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How would you score clinical features in a ABCD2 score?

A

Unilateral weakness following TIA = 2 points.
Speech disturbances without weakness = 1 point.
None of the above = 0 points.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How would you score duration in an ABCD2 score?

A

TIA is longer than (and including) 60 minutes = 2 points.
TIA was between (and including) 10 minutes to below 60 minutes = 1 point.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How would you score diabetes in an ABCD2 score?

A

If the patient has diabetes = 1 point. `

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

In total, how many points is an ABCD2 score out of?

A

7 points.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What else could be enquired about when performing an ABCD2 risk assessment?

A

Atrial fibrillation
Previous history of TIA exploration - how far apart they were.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What would an ABCD2 score of less than (and including) 3 indicate for referral?

A

See the patient within 7 days.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What would an ABCD2 score of 4 or 5 indicate for referral?

A

See a specialist within 24 hours.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What would an ABCD2 score of 6 or 7 indicate for referral?

A

Specialist referral needed immediately.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is some lifestyle advice that can be given following a TIA?

A

Diet lower in fats and cholesterol.
Exercise more.
Smoking cessation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What would the antithrombotic treatment be following a TIA?

A

STAT - 300mg Aspirin.
FIRST LINE - Continued clopidogrel 75mg OD.
Second line - Modified-release dipyridamole 200mg DB.
Third line - Aspirin 75mg OD.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is secondary prevention advice for patients for TIA?

A

Control of hypertension .
Statin for patients with high cholesterol.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What should a patient not do following a TIA and how long for?

A

Do not drive for at least one month following TIA.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What surgical procedure can be given to a patient if internal carotid artery occlusion is above 70%?

A

Carotid endarterectomy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is QRISK2 score used for?

A

Gives risk of a person developing CVD over the next 10 years in those aged 35–74.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What personal information is used for QRISK2 scoring?

A

Age
Sex
Ethnicity
BMI - Therefore height and weight.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What past medical history is used for QRISK2 scoring?

A

Chronic Kidney Disease (stage 4/5) present?
Atrial fibrillation
Rheumatoid arthritis
Diabetic status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What drug history is used for QRISK2 scoring?

A

Antihypertensives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What family history is used for QRISK2 scoring?

A

Angina or heart attack in a first degree relative <60 years old.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What social history is used for QRISK2 scoring?

A

Smoking status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What direct measurements are used in QRISK2 scoring?

A

Cholesterol / HDL ratio
Systolic blood pressure (mmHg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What can the results of a QRISK2 score be and what would they mean?

A

<10% = low risk.
10–20% = moderate risk.
>20% = high risk.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the management of an individual with a QRISK score of <10% (low risk)?

A

Advise that risk is low but further reductions in risk can often still be achieved.
Offer advice on relevant lifestyle factors that can be improved:
- Stop smoking if relevant
- Exercise
- Diet change / weight loss
- Disease control / medication adherence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the management of an individual with a QRISK score of >10% (medium-high risk)

A

Offer advice on any relevant lifestyle factors to reduce risk.
Consider reviewing any relevant comorbidities that may not be optimally controlled.
Discuss the benefits and risks of taking a lipid modification therapy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the CHA2DS2VaSc scoring system used for?

A

Calculates the risk of stroke in Atrial Fibrillation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the parameters used for a CHA2DS2VaSc score?

A

C - Congestive heart failure.
H - Hypertension
A - Age
D - Diabetes
S - Stroke / TIA
Va - Vascular disease
Sc - Sex Category

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How would you score congestive heart failure in a CHA2DS2VaSc score?

A

If the patient has congestive heart failure = 1 point.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How would you score hypertension in a CHA2DS2VaSc score?

A

If the patient has hypertension = 1 point.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

How would you score age in a CHA2DS2VaSc score?

A

Patient is above (and including) 75 years old = 2 points.
Patient is between the ages of (and including) 65 and 75 = 1 point.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How would you score diabetes in a CHA2DS2VaSc score?

A

If the patient has diabetes = 1 point.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

How would you score stroke / TIA in a CHA2DS2VaSc score?

A

If the patient has a history of stroke or TIA = 2 points.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

How would you score vascular disease in a CHA2DS2VaSc score?

A

If the patient has vascular disease = 1 point.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

How would you score sex category in a CHA2DS2VaSc score?

A

If the patient is female = 1 point.
Male = 0 points.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is a CHA2DS2VaSc score out of?

A

9 possible points.

38
Q

What would a CHA2DS2VaSc score of 0 indicate for treatment?

A

No anticoagulation required.

39
Q

What would a CHA2DS2VaSc score of 1 indicate for treatment?

A

Consider anticoagulation with vitamin K antagonist like warfarin within therapeutic range (INR 2–3) or a DOAC (rivaroxaban, apixaban), maybe aspirin.

40
Q

What would a CHA2DS2VaSc score of 2 or more indicate for treatment?

A

Anticoagulation required with vitamin K antagonist like warfarin within therapeutic range (INR 2–3) or a DOAC (rivaroxaban, apixaban).

41
Q

What would the treatment be for a patient that has a CHA2DS2VaSc of above 1 but is already on an anticoagulant?

A

Manage modifiable risk factors for bleeding (HAS BLED – uncontrolled HTN, renal/liver disease, labile INR, using NSAIDs/antiplatelets, alcohol consumption).

42
Q

What is general life advice for a high CHA2DS2VaSc score?

A

Avoid alcohol
Smoking cessation
Healthy diet
Exercise

43
Q

What is Warfarin advice after prescription?

A

Needs INR check.
Teratogenic.
Can interfere with other medications.
Increased bleeding risk.
Diet control.
Can be reversed with vitamin K.

44
Q

What is DOAC advice after prescription?

A

Non-reversible.
Increased bleeding risk.
Expensive.
C/I in renal impairment/Hx of GI bleed.

45
Q

What is FRAX score used for?

A

Gives 10 year probability of a fracture in the spine, hip, shoulder or wrist for people aged 40–90 years old.

46
Q

What personal information is used in the FRAX score calculation?

A

Age
Sex
Weight (Kg)
Height (cm)

47
Q

What past medical history is used in the FRAX score calculation?

A

Rheumatoid arthritis.
Previous fracture.
Secondary osteoporosis.
- Kidney failure
- Hyperthyroidism
- Coeliac disease
- Diabetes mellitus type 1
- Chronic liver disease
- Premature menopause
Femoral neck BMD from previous DEXA-T scan (g/cm2)

48
Q

What drug history is used in the FRAX score calculation?

A

Glucocorticoids
Lithium

49
Q

What family history is used in the FRAX score calculation?

A

Parental hip fracture.

50
Q

What social history is used in the FRAX score calculation?

A

Smoking.
Alcohol intake (≥3 alcoholic drinks a day)

51
Q

What does a T score indicate from a FRAX score?

A

A T-score shows how much your bone density is higher/lower than the bone density of a healthy 30-year old adult.

52
Q

What does a Z score indicate from a FRAX score?

A

A Z-score compares the condition of your bones with someone of your age/sex/weight/ethnicity.

53
Q

What does a T score of ≥ –1 indicate?

A

Normal bone density, no intervention.

54
Q

What does a T score of between -2.5 and -1 indicate?

A

Osteopenia, consider medication, lifestyle advice

55
Q

What does a T score of less than -2.5 indicate?

A

Osteoporosis, medication, lifestyle advice.

56
Q

What would the treatment be for an individual who has a low risk (≤10%) FRAX score?

A

Lifestyle - weight bearing exercise, quitting smoking, limiting alcohol
Diet - calcium, vitamin D
Home adaptations - wearing shoes with good grip, getting rid of rugs
Reassessment in 5 years

57
Q

What would the treatment be for an individual who has a intermediate (10 < % < 20) risk FRAX score?

A

DEXA scan to measure BMD

If T below -2.5 then Biphosphonates (alendronate 10mg OD)
or RANK-L (Denosumab)
or Teriparatide

58
Q

What would the treatment be for an individual who has a high risk (≥20%) FRAX score?

A

If T above -2.5 then modify risk factors.
Reassess in 2 years.

If T below -2.5 then Biphosphonates (alendronate 10mg OD)
or RANK-L (Denosumab)
or Teriparatide

59
Q

What is a QRISK2 score used for?

A

Gives risk of a person developing CVD over the next 10 years in those aged 35–74

60
Q

What personal information is used in a QRISK2 score calculation?

A

Age
Sex
Ethnicity
BMI and therefore Height and Weight

61
Q

What past medical history is used in a QRISK2 score calculation?

A

Chronic Kidney Disease stage 4/5.
Atrial Fibrillation
Rheumatoid arthritis
Diabetic status

62
Q

What drug history is used in a QRISK2 score calculation?

A

Antihypertensives.

63
Q

What family history is used in a QRISK2 score calculation?

A

Angina / Heart attack in first degree relative <60 years old.

64
Q

What social history is used in a QRISK2 score calculation?

A

Smoking status

65
Q

What direct measurements are used in a QRISK2 score calculation?

A

Cholesterol / HDL ratio
Systolic blood pressure (mmHg)

66
Q

What are the three outcomes for a QRISK2 score calculation?

A

<10% = low risk.
10–20% = moderate risk.
>20% = high risk.

67
Q

What is the management for a QRISK2 score of <10%?

A

Advise that risk is low but further reductions in risk can often still be achieved.
Stop smoking
Exercise
Diet change and weight loss
Disease control / medication adherence

68
Q

What is the management for a QRISK2 score of >10%?

A

Offer advice on any relevant lifestyle factors to reduce risk.
Consider reviewing co-morbidities that may not be optimally controlled.
Discuss the benefits and risks of taking lipid modification therapy.

69
Q

What is the diabetes risk score out of?

A

47

70
Q

What non-modifiable risk factors affect diabetes risk score?

A

Age
Gender
Ethnicity
Relative with diabetes

71
Q

What modifiable risk factors affect diabetes risk score?

A

Waist measurement
Height and weight
Hypertension

72
Q

What points are given for age in diabetes risk score?

A

50 ≤ age < 60 = 5 points.
60 ≤ age < 70 = 9 points.
≥70 = 13 points.

73
Q

What points are given for gender in diabetes risk score?

A

male = 1 point.
female = 0 points.

74
Q

What points are given for ethnicity in diabetes risk score?

A

Any other ethnicity other than white European = 6 points.

75
Q

What points are given for relative with diabetes in diabetes risk score?

A

Yes = 5 points.
No = 0 points.

76
Q

What points are given for waist measurement in a diabetes risk score?

A

90 ≤ cm < 100 = 4 points.
100 ≤ cm < 110 = 6 points.
≥110cm = 9 points.

77
Q

What points are given for BMI (weight and height) in a diabetes risk score?

A

25 ≤ kg/m2 < 30 = 3 points.
30 ≤ kg/m2 < 35 = 5 points.
≥35kg/m2 = 8 points.

78
Q

What points are given for hypertension in a diabetes risk score?

A

Yes = 5 points.
No = 0 points.

79
Q

What are the total score boundaries for diabetes risk score?

A

Low risk = 0 – 6 points
Increased risk = 7 - 15 points
Moderate risk = 16 - 24 points
High risk = 25 - 47 points.

80
Q

What do the relative risk boundaries indicate for chances of developing diabetes?

A

Low risk = 1 in 100
Increased risk = 1 in 35 risk
Moderate risk = 1 in 10 risk
High risk = 1 in 4 risk

81
Q

What are the 5 Ts for recognising diabetes?

A

Toilet (polyuria)
Thirsty (polydipsia)
Tiredness (more than usual)
Thrush (genital itching)
Thinner (unintentional)

82
Q

What is Well’s score used for?

A

The Wells’ Criteria for DVT Objectifies risk of deep vein thrombosis (DVT) based on clinical findings.

83
Q

What points are given for history of presenting complaint in a Well’s score?

A

Paralysis, paresis, or recent immobilisation = 1 point.
Localised tenderness along the deep venous system = 1 point.
Entire leg swollen = 1 point.
Calf swelling >3cm compared to other leg = 1 point.
Pitting oedema, confined to symptomatic leg = 1 point.
Collateral superficial veins present = 1 point.

84
Q

What points are given for past medical history in a Well’s score?

A

Bedridden recently >3 days or major surgery within 12 weeks = 1 point.
Active cancer (treatment within 6 months) = 1point.
Previous DVT = 1 point.

85
Q

What would you give negative points for in Well’s scoring?

A

-2 points for an alternative diagnosis being more likely.

86
Q

What additional questions can be asked about in Well’s scoring?

A

Long-haul flights.
Smoking
HRT/OCP if appropriate.

87
Q

What does a Well’s score of ≤0 indicate?

A

DVT unlikely, 5% prevalence.

88
Q

What does a Well’s score of 1-2 indicate?

A

DVT moderate risk, 17% prevalence

89
Q

What does a Well’s score of ≥3 indicate?

A

DVT likely, 17–53% prevalence

90
Q

What investigations would you use on someone with a suspected DVT?

A

D-Dimer - good for negative exclusion, high specificity, low sensitivity.
USS doppler veins if high risk
CTPA is gold standard for diagnosing PE.

91
Q

What are some options for DVT treatment?

A

LMWH
Oral Warfarin and maintain INR 2-3 or a DOAC
Compression stockings
Treat / seek underlying cause
Diet, exercise, smoking cessation.

Phase 2b Sheffield Medicine (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions