Risk scores Flashcards
Diabetes risk score: criteria
Age gender ethnicity Waist measurement BMI HTN or taking meds for it FHx of diabetes Hyperglycaemia symptoms
Hyperglycaemia symptoms
Toilet Thirsty Tired Thinner Thrush -visual blurring
0-6 diabetes risk score
Low
7-15 diabetes risk score
Increased
16-24 diabetes risk score
Moderate
25-47 diabetes risk score
High
Diabetes lifestyle advice
Regular meals Portion size Decrease salt, fat, sugar Moderate alcohol Exercise
Diabetes exercise advice
150 minutes per week
Increase HR and RR
What is the name of the score for assessing chance of diabetes
Diabetes risk score
What is the name of the score for risk fo stroke in patients with Atrial Fibrillation
CHA2DS2VASc
CHA2DS2VASc Criteria
Congestive heart failure Hypertension Age 75+ Diabetes Stroke/ TIA Vascular disease Age 65-74 Sex- femlae
CHA2DS2VASc score of 1 recommendation
Aspirin
CHA2DS2VASc score of 2 recommendation
Warfarin
CHA2DS2VASc score of 2 annual stroke risk
2%
CHA2DS2VASc score of 5 annual stroke risk
5%
CHA2DS2VASc score of 6-8 annual stroke risk
10%
CHA2DS2VASc score of 9 annual stroke risk
15%
CHA2DS2VASc advice to the patient
Manage bleeding risk factors
Manage HTN and diabetes
Warfarin advice
What are modifiable risk factors for bleeding (HAS BLED)
Uncontrolled HTN
Aspirin
NSAIDs
Alcohol
What is the score for risk of an osteoporotic fracture in untreated patients
FRAX
FRAX criteria
Age, sex, weight, height Previous fracture, parental hip fracture Current smoking, >3 alcohol units a day Glucocorticoids Rheumatoid arthritis Femoral neck BMD Secondary osteoporosis
Conditions which cause secondary osteoporosis
T1DM Osteogenesis imperfecta Long standing -hyperthyroid -hypogonadism Menopause before 45 Malabsorption/ malnutrition Chronic liver disease
How do you measure BMD
T score compares reading to healthy 30 year old
Advice to ALL FRAX score patients
Stop smoking regular weight bearing exercise falls reduction measures Adcal-D3 Dairy, leafy vegetables
Advice to those with a high FRAX score
Take a bisphosphonate- alendronic acid
Which score assesses risk of stroke after a TIA
ABCD2
ABCD2 criteria
Age >60 Blood pressure >140/90 Clinical features -unilateral weakness -speech w/o weakness Duration -60+ -10-59 -<10 Diabetes
What is ABCD2 score 0-3
Low risk 1%
What is ABCD2 score 4-5
Moderate risk 4%
What is ABCD2 score 6+
High risk 8%
What is the outcome of low risk ABCD2
7 day wait
What is the outcome of a 4+ ABCD2
24hr wait
ABCD2 medication advice
Aspirin and atorvastatin
How does aspirin work
Inhibits COX
How does clopidogrel work
P2Y12 inhibitor
How do statins work
Inhibit HMGCoA reductase
ABCD2 lifestyle advice
Diet- less fat and cholesterol
Exercise
Stop smoking
Medication adherence
Which score assesses the probability of developing DVT
Wells score
Wells score criteria
Clinical symptoms Active cancer Recent 3 day immobilisation Previous DVT or PE Long haul flight Haemoptysis HRT or oral contraceptive
Clinical symptoms of DVT
Paralysis, paresis or immobilisation of leg Localised tenderness Calf swelling Entire leg swollen One sided pitting oedema Collateral superficial veins
Wells score 1 outcome
DVT unlikely- D dimer
Wells score 2+ outcome
DVT likely
- D dimer
- Ultrasound
What to do if ultrasound positive or gonna take more than 4 hours
Dalteparin (LMWH)
How do LMWH work
Inhibit factor Xa
What to do to all Wells score patients
Give warfarin
Which score assesses the risk of having a heart attack or stroke in the next 10 years
QRISK2
QRISK2 criteria categories
Personal information PMHx CARD DHx FHx SHx Direct measurements
QRISK2 personal information
Age Sex Ethnicity BMI Postocde
QRISK2 pmh
CKD
AF
RA
DM
QRISK2 dhx
Existing HTN treatment
QRISK2 FHx
Angina or heart attack, <60yo first degree relative
QRISK2 SHx
Smoking
QRISK2 direct measurements
Cholesterol
Systolic bp
What is QRISK2 <10%
Low
What is QRISK2 10-20%
Moderate
What is QRISK2 20+%
High
QRISK2 less than 10% advice
Further reductions can be made Stop smoking exercise diet change weight loss disease control and medication adherence
QRISK2 more than 10% advice
Lifestyle factors
Disease control review
Atorvastatin