Risk Scores Flashcards
What to ask in diabetes risk score
-Gender
-Ethnicity
-Age
-Height and weight
-Prescribed antihypertensive medication
-Prescribed steroids
-Family history (first degree relatives)
-Smoking history
What to include in a QRisk score
-Age
-Sex
-Ethnicity
-Height and weight
-Smoker
-Diabetes status
-Angina or heart attack in first degree relative <60
-Chronic kidney disease
-PMH AF
-PMH migraines
-PMH rheumatoid arthritis
-PMH SLE
-PMH severe mental illness
-PMH erectile disfunction
-Blood pressure medication?
-Atypical antipsychotic medication?
-Regular steroid tablets?
What to include in a CHADsVASc score
-Age
-Sex
-PMH congestive heart failure
-PMH hypertension
-PMH stroke/TIA/thromboembolism
-PMH vascular disease
PMH diabetes
What to include in a FRAX score
-Age
-Sex
-Height and weight
-PMH previous fracture
-PMH rheumatoid arthritis
-PMH secondary hyperparathyroidism
-FH parent fractured hip
-Glucocorticoids
-Current smoker
-Alcohol 3 or more units a day
What can you ask for PMH secondary osteoporosis for a FRAX score?
-hyperparathyroidism
-multiple myeloma
-Cushing’s disease
-coeliac disease
-hyperthyroidism
What to include in an ABCD2 score
-Age (>60)
-BP (>140/90)
-Clinical features of the TIA (unilateral weakness, speech disturbance without weakness)
-Duration of symptoms
-History of diabetes
What to include in Well’s score
-Active cancer
-Bedridden recently >3 days
-Major surgery within 12 weeks
-Calf swelling >3cm compared to the other leg
-Collateral (non-varicose) superficial veins present
-Entire leg swollen
-Localised tenderness along deep venous system
-Pitting oedema, confined to symptomatic leg
-Paralysis, paresis, or recent plaster immobilization of the lower extremity
-Previously documented DVT
What is the next step for assessing someone with a high diabetes risk score?
A blood test (fasting plasma glucose or HbA1c) to confirm their level of risk
What advice/care would you give to a person with a low risk of diabetes?
-Discuss risk factors and how they could improve their lifestyle to reduce overall risk
-Offer encouragement and reassurance
What advice/care would you give to someone with a moderate risk of diabetes?
-Discuss their particular risk factors, identify which ones can be modified and discuss how they can achieve this by changing their lifestyle
-Offer them a brief intervention, such as walking programmes, swimming clubs etc.
-Discuss if they would like to join a structured weight loss programme
What advice/care would you give to someone with a high risk of diabetes?
-Discuss their particular risk factors, identify which ones can be modified and discuss how they can change this by changing their lifestyle
-Offer them a referral to an intensive lifestyle-change programme
How would you manage someone with a CVD risk of less than 10% (QRisk)?
-Offer advice on any relevant lifestyle factors that can be improved
-Consider reviewing any relevant comorbidities that may not be optimally treated
-Advise that a further risk assessment should be considered in 5 years
How would you manage people with a CVD risk of 10% or more (QRisk)?
-Discuss the benefit of lifestyle modifications and optimise the management of all other modifiable CVD risk factors
-Offer statin treatment after risk assessment if lifestyle modification is ineffective or inappropriate
What medication would you offer a patient with a CVD risk of over 10% (QRisk)?
Atorvastatin 20mg daily
How would you treat someone if their CHADsVASc score was 0-1?
Consider other stroke risk modifiers to determine whether or not to use oral anticoagulants
