Scales n things

Question 1

Describe ABCD2 score

Answer 1

Used to determine risk of stroke after a TIA

A - age >60 = 1
B - BP >140/90 = 1
C - clinical features 
Unilateral weakness = 2
Speech problems = 1 
D - duration of symptoms
>1hr = 2 
10-59mins = 1 
Diabetes = 1 

> 6 strongly predicts stroke and requires specialist referral immedialtey, while >4 within 24hrs, everyone else within 7days.

Question 2

Qrisk score

Answer 2

Calculates a person’s risk of developing a heart attack of stroke over the next 10yrs.

Question 3

Define CHA2DS2-VASc

Answer 3

Calculate risk of stroke and thus need for anticoagulation in AF.

Question 4

What does each part of CHA2DS2-VASc stand for?

Answer 4

All worth 1 point, unless a 2 afterwards. 
C - Congestive heart failure
H - hypertension 
Age - greater/equal to 75 (2pts)
D - DM
S - stroke/TIA/Thromboembolism (2pts)
Vascular disease 
A - age 65-74
Sc - Sex category female. 

If score >1 then aspirin, if >2 then DOAC/NOAC

Question 5

Well’s score

Describe outcome too.

Answer 5

Used to determine risk of DVT or PE

For DVT, if 2 or more then do a duplex US, if 0 or 1 then do a d-dimer.

For PE, if <4 then d-dimer, if 4 or above the CTPA.

Question 6

CURB65 (and the criteria)

Answer 6

Assess mortality risk when diagnosed with CAP in hospital. 
1pt for each:
C - confusion
Urea >7mmol/L
Resp rate >30/min
BP (Sys<90, Dia<60)
Age >65

Question 7

Glasgow coma scale

Answer 7

Measures level of consciousness

Score adds to 15 (normal), <8 is comatose, <3 totally unresponsive

Question 8

Gleason score

Answer 8

In Prostate cancer, two grades will then be added together to determine your Gleason score

Question 9

What is the HAS-BLED score used for?

Answer 9

Determines the risk of bleeding when on anticoagulants.

HAS-BLED is a scoring system developed to assess 1-year risk of major bleeding in people taking anticoagulants for atrial fibrillation.

Question 10

What are the HASBLED criteria

Answer 10

Hypertension
Abnormal renal/liver function (2)
Stroke
Bleeding tendency
Labile INR
Elderly (>65)
Drugs (NSAIDs) or alcohol (2)

So it is out of 9.

Question 11

What is FRAX and what are used to calculate it?

Answer 11

FRAX is a diagnostic tool used to evaluate the 10-year probability of bone fracture risk.

RA, glucocorticoid use, smoking, age, sex, weight, height, previous fracture, parent fractured hip, 3+ alcoholic drinks per day, femoral neck BMD, secondary osteoporosis (conditions related to osteoporosis, such as T1DM, hyperthyroidism, chronic liver disease, premature menopause (<45), and other conditions.)