risk scores Flashcards
what risk score is used to assess probability of DVT
wells score
list the key things you need to ask about in a wells score history
CUTE BAPS
explain a DVT in patient friendly language
.
how would manage the different Wells score outcomes?
high - USS
moderate - USS
low - D-dimer
how would you manage a patient with a DVT
- LMWH
- anticoag
- compression stockings
- treat underlying cause
- diet / exercise / smoking cessation
what is FRAX used to assess?
% risk of fracture in 10 years
what key things do you need to know to calculate FRAX?
GRAB PASSS
what medical conditions can result in secondary osteoporosis?
- kidney failure
- cushings
- coeliac
- ms
- hyperparathyroidism
- hyperthyroidism
- diabetes
what is a T score?
comparison of a persons bone density to a healthy 30 year old
how would you manage a low FRAX score?
- FRAX is <10%
- reassess in 5 years
- lifestyle –> quit smoking & limit alcohol
- calcium and vit D rich diet
name some osteoporosis medications?
- bisphosphonates (alendronate)
- denosumab (RANK-L)
what FRAX score is considered high risk?
> 20%
you need to assess the risk of a patient having a stoke or MI in the next 10 years - what risk score do you use?
QRISK-2
what do you need to ask about for a QRISK-2 assessment
(check notes)
what are the % QRISK 2 boundaries?
<10% = low risk 10-20% = moderate risk >20% = high risk
what advice would you give someone to reduced their risk (based on QRISK2)?
LIFESTYLE
- stop smoking
- diet change / weight loss
- exercise
- disease control + medication adherence
you have be asked to calculate the stroke risk of a patient with AF - what risk score would you use?
CHA2DS2-VASc
what do you need to ask about in a CHA2DS2-VASc assessment?
see notes
what would a CHA2DS2-VASc score of > 2 mean?
patient is high risk
how would you advise a low risk CHA2DS2-VASc patient?
- consider anticoagulants
- lifestyle advice!!
how would you manage a high risk CHA2DS2-VASc patient?
anticoagulant/antiplatelet therapy
- lifestyle advice
don’t need to know BUT what are potential modifiable risk factors for bleeding?
HAS BLED
explain why you would use anticoagulants vs anti platelets
- clotting in arterial system mainly platelet driven (activated by contact with damaged endothelium/atheroma) –> antiplatelets
- clotting in venous system/AF due to blood stasis & is mostly clotting factor driven
what key things does a patient need to know about starting warfarin?
- needs INR checks
- teratogenic
- increased bleeding risk
- diet control
- can interfere with other medications
- reversible with vitamin K
what key things do you need to know about DOACs?
- non reversible
- increased bleeding risk
- contraindicated in those with renal impairment and/0r history of a GI bleed
- (expensive)
what is ABCD2 used to calculate?
risk of stroke after TIA (scored out of 7)
what things do you need to ask about in an ABCD2 assessment?
see notes
outline the risk boundaries for ABCD2 scores and how you would manage them
>6 = high risk --> specialist within 24 hours 4-6 = moderate risk <3 = low risk
management for abcd2 risk assessment?
- lifestyle advice
- antithrombotic treatment?
what would you ask about when assessing someone’s diabetes risk?
see notes
what are some key signs of diabetes?
- polyuria
- polydipsia
- tiredness
- thrush
- blurred vision
- thinner
what advice would you give someone to help lower their diabetes risk?
- diet advice
- exercise 150mins/week
- weight loss
