Risk scores Flashcards
MI risk in patient with no cardiac PMH
QRISK3
6 month risk of repeat MI or mortality, and when would you do it
NSTEMI/Unstable angina
Grace score
If over 3%, PCI
1 year risk of stroke after AF
CHA2DS2-VASc
Congestive heart failure
Hypertension
Age >75 (2)
Diabetes Mellitus
Stroke/TIA/Thromboembolism (2)
Vascular disease (PAD, MI, Aortic plaque)
Age 65-74
Sex category - Female
0 low
1 moderate
2+ High - oral anticoagulation!
Major bleeding risk in those with Afib
Orbit (prev. HASBLED)
Low Hb (2)
Age>74
Bleeding history (2)
eGFR<60
Treatment with antiplatelet
DVT predictor
Wells score
- Pitting oedema
- Active cancer
- Distended superficial veins
- Previous DVT
- Recently bedridden
- Localised tenderness
(alternative diagnosis likely = -2)
DVT unlikely = D dimer, if positive duplex/doppler ultrasound
DVT likely (2 or above) = D dimer and doppler ultrasound
Pulmonary Embolism
2 level PE Wells score
>4 - likely - immediate CTPA and anticoagulation
<4 - unlikely - D Dimer with anticoagulation whilst waiting results
(DOACs usually, LMWH if antiphospholipid)
Heart failure severity
New York Heart Association classifications of heart failure
I (Mild) - No limitation on physical activity. Ordinary physical activity doesnt cause fatigue/palpitations/dyspnoea
II (Mild) - Slight limitation n physical activity. Comfortable at rest; dyspnoea on ordinary activity
III (Moderate) - Less than ordinary activity causes dyspnoea, which is limiting. Rest is fine.
IIII (Severe) - Symptoms present at rest, all activity causes discomfort
Rheumatic fever
Revised Jones criteria - Evidence of recent strep infection + 2 major signs or 1 major 2 minor (JONES-FEAR)
Evidence of recent infection: group A strep antigen test, positive throat culture, strep antibodies
Major: JONES
- Joint arthritis
- Organ inflammation (CARDITIS! + Murmurs)
- Nodules under skin
- Erythema marginatum rash - red raised edges, clear middle
- Sydenham’s chorea - involuntary semi purposeful movements
Minor: FEAR
- Fever
- ECG (prolonged PR)
- Athralgia without arthritis
- Raised CRP/ESR
Infective endocarditis
Modified Duke’s criteria.
2 major criteria. 1 major, 3 minor. 5 minor.
Major:
- Positive blood cultures from 2 separate cultures drawn >12 hours apart. OR all of 3 or majority of 4+ positive cultures with over an hour between first and last.
- Echocardiogram evidence of endocardial involvement (vegetation, abscess, prosthetic valve dehiscence, new valve regurgitation)
Minor:
- Predisposition (cardiac lesion, IV drug use)
- Fever >38C
-vascular/immunological signs (janeway lesions, conjunctival petechiae, septic embolism/ glomerulonephritis, osler nodes, roth spots, rheumatoid factor)
- Positive culture that doesnt meet major
- Positive echocardiogram that doesnt meet major
HTN diagnostic criteria
140/90 in clinic
135/85 ABPM!
Lymphoma staging
Ann arbor
Ulcerative colitis severity
Truelove and witts
Upper GI bleed
Glasgow blatchford - If patients with upper GI bleed need emergency blood transfusion or endoscopic intervention (5+ = 30 day risk of mortality)
Rockall score - After endoscopy. Risk stratify for adverse outcomes
Risk of disease in ICU patients
APACHE
Cancer staging
TNM
