Risk scores

Question 1

Diabetes risk score: criteria

Answer 1

Age gender ethnicity
Waist measurement
BMI
HTN or taking meds for it
FHx of diabetes
Hyperglycaemia symptoms

Question 2

Hyperglycaemia symptoms

Answer 2

Toilet
Thirsty
Tired
Thinner
Thrush
-visual blurring

Question 3

0-6 diabetes risk score

Answer 3

Low

Question 4

7-15 diabetes risk score

Answer 4

Increased

Question 5

16-24 diabetes risk score

Answer 5

Moderate

Question 6

25-47 diabetes risk score

Answer 6

High

Question 7

Diabetes lifestyle advice

Answer 7

Regular meals
Portion size
Decrease salt, fat, sugar
Moderate alcohol
Exercise

Question 8

Diabetes exercise advice

Answer 8

150 minutes per week

Increase HR and RR

Question 9

What is the name of the score for assessing chance of diabetes

Answer 9

Diabetes risk score

Question 10

What is the name of the score for risk fo stroke in patients with Atrial Fibrillation

Answer 10

CHA2DS2VASc

Question 11

CHA2DS2VASc Criteria

Answer 11

Congestive heart failure
Hypertension
Age 75+
Diabetes
Stroke/ TIA
Vascular disease
Age 65-74
Sex- femlae

Question 12

CHA2DS2VASc score of 1 recommendation

Answer 12

Aspirin

Question 13

CHA2DS2VASc score of 2 recommendation

Answer 13

Warfarin

Question 14

CHA2DS2VASc score of 2 annual stroke risk

Answer 14

2%

Question 15

CHA2DS2VASc score of 5 annual stroke risk

Answer 15

5%

Question 16

CHA2DS2VASc score of 6-8 annual stroke risk

Answer 16

10%

Question 17

CHA2DS2VASc score of 9 annual stroke risk

Answer 17

15%

Question 18

CHA2DS2VASc advice to the patient

Answer 18

Manage bleeding risk factors
Manage HTN and diabetes
Warfarin advice

Question 19

What are modifiable risk factors for bleeding (HAS BLED)

Answer 19

Uncontrolled HTN
Aspirin
NSAIDs
Alcohol

Question 20

What is the score for risk of an osteoporotic fracture in untreated patients

Answer 20

FRAX

Question 21

FRAX criteria

Answer 21

Age, sex, weight, height
Previous fracture, parental hip fracture
Current smoking, >3 alcohol units a day
Glucocorticoids
Rheumatoid arthritis
Femoral neck BMD
Secondary osteoporosis

Question 22

Conditions which cause secondary osteoporosis

Answer 22

T1DM
Osteogenesis imperfecta
Long standing
-hyperthyroid
-hypogonadism
Menopause before 45
Malabsorption/ malnutrition
Chronic liver disease

Question 23

How do you measure BMD

Answer 23

T score compares reading to healthy 30 year old

Question 24

Advice to ALL FRAX score patients

Answer 24

Stop smoking
regular weight bearing exercise
falls reduction measures
Adcal-D3
Dairy, leafy vegetables

Question 25

Advice to those with a high FRAX score

Answer 25

Take a bisphosphonate- alendronic acid

Question 26

Which score assesses risk of stroke after a TIA

Answer 26

ABCD2

Question 27

ABCD2 criteria

Answer 27

``` Age >60 Blood pressure >140/90 Clinical features -unilateral weakness -speech w/o weakness Duration -60+ -10-59 -<10 Diabetes ```

Question 28

What is ABCD2 score 0-3

Answer 28

Low risk 1%

Question 29

What is ABCD2 score 4-5

Answer 29

Moderate risk 4%

Question 30

What is ABCD2 score 6+

Answer 30

High risk 8%

Question 31

What is the outcome of low risk ABCD2

Answer 31

7 day wait

Question 32

What is the outcome of a 4+ ABCD2

Answer 32

24hr wait

Question 33

ABCD2 medication advice

Answer 33

Aspirin and atorvastatin

Question 34

How does aspirin work

Answer 34

Inhibits COX

Question 35

How does clopidogrel work

Answer 35

P2Y12 inhibitor

Question 36

How do statins work

Answer 36

Inhibit HMGCoA reductase

Question 37

ABCD2 lifestyle advice

Answer 37

Diet- less fat and cholesterol Exercise Stop smoking Medication adherence

Question 38

Which score assesses the probability of developing DVT

Answer 38

Wells score

Question 39

Wells score criteria

Answer 39

``` Clinical symptoms Active cancer Recent 3 day immobilisation Previous DVT or PE Long haul flight Haemoptysis HRT or oral contraceptive ```

Question 40

Clinical symptoms of DVT

Answer 40

``` Paralysis, paresis or immobilisation of leg Localised tenderness Calf swelling Entire leg swollen One sided pitting oedema Collateral superficial veins ```

Question 41

Wells score 1 outcome

Answer 41

DVT unlikely- D dimer

Question 42

Wells score 2+ outcome

Answer 42

DVT likely - D dimer - Ultrasound

Question 43

What to do if ultrasound positive or gonna take more than 4 hours

Answer 43

Dalteparin (LMWH)

Question 44

How do LMWH work

Answer 44

Inhibit factor Xa

Question 45

What to do to all Wells score patients

Answer 45

Give warfarin

Question 46

Which score assesses the risk of having a heart attack or stroke in the next 10 years

Answer 46

QRISK2

Question 47

QRISK2 criteria categories

Answer 47

``` Personal information PMHx CARD DHx FHx SHx Direct measurements ```

Question 48

QRISK2 personal information

Answer 48

``` Age Sex Ethnicity BMI Postocde ```

Question 49

QRISK2 pmh

Answer 49

CKD AF RA DM

Question 50

QRISK2 dhx

Answer 50

Existing HTN treatment

Question 51

QRISK2 FHx

Answer 51

Angina or heart attack, <60yo first degree relative

Question 52

QRISK2 SHx

Answer 52

Smoking

Question 53

QRISK2 direct measurements

Answer 53

Cholesterol | Systolic bp

Question 54

What is QRISK2 <10%

Answer 54

Low

Question 55

What is QRISK2 10-20%

Answer 55

Moderate

Question 56

What is QRISK2 20+%

Answer 56

High

Question 57

QRISK2 less than 10% advice

Answer 57

``` Further reductions can be made Stop smoking exercise diet change weight loss disease control and medication adherence ```

Question 58

QRISK2 more than 10% advice

Answer 58

Lifestyle factors Disease control review Atorvastatin