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OSCE prep > RISK SCORES > Flashcards

RISK SCORES Flashcards

1
Q

What does the QRISK2 calculate?

A

The % risk of MI or stroke in 10 years

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2
Q

What are the key risk factors included in a QRISK2 score?

A

Age, sex, ethnicity, BMI
PMH: CKD, Atrial fibrillation, rheumatoid arthritis, Diabetes
DH: On antihypertensives
Family history: Angina/ heart attack in first degree relative <60
SH: Smoking
Investigations: Cholesterol/ HDL ratio, BP

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3
Q

What percentages indicate low, moderate and high risk on a QRISK2 score?

A 
<10%= low risk
10-20%= moderate risk
>20%= high risk
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4
Q

What is the management for people on a low risk QRISK2 score?

A 
Lifestyle factors; 
Stop smoking
exercise
Diet change/ weight loss
Disease control/ medication adherence
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5
Q

What is the management for people with moderate-high QRISK2 score?

A

Advice on lifestyle factors
Review co-morbities for optimum control
Discuss benefits and risks of taking lipid modification therapy

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6
Q

What does the CHA2DS2VASc score calculate?

A

The risk of stroke with atrial fibrillation

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7
Q

What does each part of CHA2DS2VaSc stand for?

A 
Congestive heart failure
HTN
Age
Diabetes
Stroke/ TIA previous
Vascular disease (peripheral)
Sex
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8
Q

What should be offered if there is a CHA2DS2VaSc score of 2 or more

A

Anticoagulation such as warfarin or DOAC (apixaban, rivaroaxban)

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9
Q

What should be flagged to the patient if they are on/ starting warfarin?

A 
Be careful of eating leafy greens
Will need daily INR
Teratogenic
Can interfere with other medications
Increased bleeding risk
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10
Q

What is given for clotting in the arterial system vs the venous system?

A

Arterial: Anti-platelets (e.g. clopidogrel)
Venous: Anticoagulants (e.g. warfarin, apixaban)

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11
Q

What is the ABCD2 score used to assess?

A

Risk of stroke after TIA?

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12
Q

What risk factors does the ABCD2 score consider?

A 
Age
Blood pressure
Clinical features of TIA: 
-Unilateral weakness
-speech disturbance
Duration of symptoms (>60 mins) 
Diabetes

(Also ask if they’ve had any TIAs in the past)

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13
Q

What ABCD2 scores indicate low, moderate and high risks?

A 
<3 = low
3-5 = Moderate
>6 = high
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14
Q

What is the advice is the patient has a high ABCD2 score?

A

Lifestyle: diet, exercise, smoking, adherence to medication
Medication: Antiplatelets, statin
DO NOT DRIVE FOR AT LEAST 1 MONTH

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15
Q

What is the Well’s score used to calculate?

A

Risk of DVT

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16
Q

What factors does the Well’s score take into account?

A 
Immobility (bedridden)
Long haul flight
On oral contraceptive
pill
Previous surgery
Active cancer
History of DVT
Smoking
17
Q

What things would you expect to find on examination of DVT (and so should ask about)?

A 
Redness
Swelling (is it unilateral?)
Pitting oedema
Tenderness
Collateral veins
Neurological signs
18
Q

What Well’s score would indicate a DVT was likely?

A

> 3

19
Q

How would you investigate a suspected DVT?

A

D-dimer to exclude
USS doppler
CTPA

20
Q

How would you manage a suspected DVT?

A 
LMWH
Oral warfarin
Compression stockings
Treat underlying cause
Lifestyle modification
21
Q

What does the FRAX score calculate?

A

The % risk of fracture in 10 years

22
Q

What questions are included in a FRAX assessment? (10)

A 
Age
Gender
Weight/ height
Previous fracture
Parent fractures hip
Smoking
Alcohol intake (>3 drinks a day)
Glucocorticoid use (Steroids)
RA
Secondary osteoporosis
(DEXA scan)
23
Q

What medical conditions result in secondary osteoporosis?

A 
Kidney failure
Cushings
Coeliac
MS
Hyperparathyroidism
Hyperthyroidism
Diabetes
24
Q

What score is used to show how much a persons bone density is higher or lower than that of a healthy 30 year old?

A

T score

25
Q

What do the different T scores mean?

A
  • 1 and above= normal

- 1 to -2.5 = osteopenia

26
Q

How is osteoporosis managed?

A

Lifestyle advice (more weight bearing exercise. quit smoking and alcohol)
Home adaptations (remove trip hazards)
Dexa scan
Medication (bisphosphonates)

27
Q

What factors are considered in a diabetes risk score?

A 
Gender
Age
Ethnic background
Close relative with it
Waist circumference
Height 
Weight (BMI)
High blood pressure
28
Q

Advice for patients at risk of diabetes?

A

Lifestyle advice:
(regular meals, portion size, decrease fat/ salt/ sugar, moderate alcohol)
Excercise
Weight loss

29
Q

What waist measurements and BMI are high risk for diabetes?

A

Waist: 100-110cm or greater

BMI >30 or >35

30
Q

What are the 5 signs of diabetes you should make the patient aware of?

A 
Going to the toilet frequently
Being thirsty
Being more tired
Getting thrush
Unintentional weight loss
31
Q

What is the diabetes risk score out of and what level is high risk?

A

Out of 47, >25= high risk

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