Risk assessments - broken down Flashcards
Diabetes risk score - sections (5)
Demographics
Lifestyle
Current symptoms
Complications
PMH/Drug/Family history
Diabetes risk score [1/5] - Demographics (5)
- Age
- Sex
- Ethnicity
- Weight/height/BMI
- Waist circumference
Diabetes risk score [2/5] - Lifestyle (4)
- Exercise
- Diet
- Sugar
- Fruit + veg - Smoking
- Alcohol
Diabetes risk score [3/5] - Current symptoms (4)
- Thirst - polydipsia
- Toilet - polyuria
- Tired - lethargy
- Thin - unintentional weight loss
Diabetes risk score [4/5] - Complications (12)
- Visual problems/changes
- Loss of peripheral sensation
- Vascular issues, ulcers
- Genital thrush
- UTIs
- Dysuria
- Incontinence
- Erectile dysfunction
- Angina/MI/stroke symptoms
- Palpitations
- Hypoglycaemia symptoms
- Footcare
Diabetes risk score [5/5] - PMH/Drug/Family history (4)
PMH
- High blood sugar
- Hypertension
Drug history
- Antihypertensives
Family history
- Diabetes
What does QRisk assess?
An individual’s 10-year risk of having a heart attack or stroke
QRisk3 score - sections (6)
Demographics
PMH
Drug history
Family history
Social history
Measurements
QRisk3 score [1/6] - Demographics (5)
- Age
- Sex
- Ethnicity
- BMI
- Postcode
QRisk3 score [2/6] - PMH (9)
- Hypertension
… - Chronic kidney disease (stage 3+)
- Atrial fibrillation
- Rheumatoid arthritis
- Diabetes (type 1/2)
- Systemic lupus erythematosus
- Migraines
- Erectile dysfunction
- Severe mental illness
QRisk3 score [3/6] - Drug history (3)
- Antihypertensives
- Regular corticosteroids
- Atypical antipsychotics
QRisk3 score [4/6] - Family history (1)
- Angina or MI in 1st degree relative aged <60
QRisk3 score [5/6] - Social history (2)
- Smoking
- Alcohol
QRisk3 score [6/6] - Measurements (2)
- Cholesterol:HDL ratio
- Systolic BP
What does CHA2DS2VASc assess?
Ischaemic stroke risk in patients with atrial fibrillation
CHA2DS2VASc score
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)
What does FRAX stand for?
Fracture Risk Assessment Tool
What does FRAX assess?
Estimates your risk of having a hip or other major fracture in the next 10 years
FRAX score - sections (5)
Demographics
Fracture history
Other PMH
Drug history
Social history
FRAX score [1/5] - Demographics (5)
- Age
- Sex
- Weight
- Height
–> BMI - Femoral neck bone mineral density (BMD)
FRAX score [2/5] - Fracture history (2)
- Fracture history (Y/N)
- Fracture hip in a parent (Y/N)
FRAX score [3/5] - Other PMH (2)
- Rheumatoid arthritis
- Secondary osteoporosis (9)
Causes of secondary osteoporosis (9)
- Type 1 diabetes
- Osteogenesis imperfecta
- Hyperthyroidism
- Premature menopause/hypogonadism
- Coeliac disease/malabsorption/malnutrition
- Chronic liver disease
- Kidney failure
- Multiple sclerosis
- Cushing’s syndrome
FRAX score [4/5] - Drug history (1)
- Glucocorticoids
Also: lithium, barbiturates
FRAX score [5/5] - Social history (2)
- Smoking
- Alcohol (3+ units/day)
Also: diet (calcium), sun exposure
Interpretation of DEXA scan
≥-1 - normal
-1 - -2.5 - osteopenia
≤-2.5 - osteoporosis
What does ABCD2 assess?
Risk of a stroke after a TIA
ABCD2 score
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
Well’s score - sections (7)
Current symptoms - leg
Current symptoms - other symptoms
Recent immobility
PMH
Drug history
Family history
Social history
Well’s score [1/7] - Leg symptoms (7)
- Tenderness - localised to along deep venous system
- Redness
- Hot to touch
- Leg swelling
- Entire leg swollen
- Pitting oedema
- Unilateral (>3cm) - Collateral veins
Well’s score [2/7] - Other symptoms (3)
- Breathlessness
- Fever/chills
- Haemoptysis
Well’s score [3/7] - Recent immobility (4)
- Long haul flights/travel
- Paralysis
- Plaster cast
- Bedridden
Well’s score [4/7] - PMH (3)
- Recent surgery
- Cancer diagnosis/chemotherapy
- Previous DVT diagnosis
Well’s score [5/7] - Drug history (2)
- Anticoagulants
- Use of COCP or HRT
Well’s score [6/7] - Family history (1)
- DVT diagnosis
Well’s score [7/7] - Social history (3)
- Smoking
- Alcohol
- Pregnant?