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OSCE Stations > Risk Assessments > Flashcards

Risk Assessments Flashcards

(46 cards)

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1
Q

What factors influence a DMT2 risk score ?

A

Gender, age, ethnicity, FHx, Waist size, BMI, PMHx (HTN)

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2
Q

What are the categories calculated in a DMT2 RS ? e.g. low-high ?

A

Low = 0 - 6
Increased = 7-15
Moderate = 16 - 24
High = 25 - 47

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3
Q

How does age impact a DMT2 score ?

A

49 or younger = 0
50-59 = 5
60-69 = 9
70+ = 13

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4
Q

How does gender impact a DMT2 score ?

A

Male = 1
Female = 0

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5
Q

How does ethnicity impact a DMT2 score ?

A

White European = 0
Other = 1

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6
Q

How does waist measurement impact a DMT2 score ?

A

Less than 90cm = 0
90-99.9 = 4
100-109.9 = 6
110 or above = 9

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7
Q

How does BMI impact DMT2 score ?

A

Less than 25 = 0
25-29.9 = 3
30-34 = 5
35 or above = 8

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8
Q

How does BP impact a DMT2 score ?

A

HTN = 5

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9
Q

What is the pathology of T2DM ?

A

Insulin resistance due to B-cell dysfunction
Hyperglycaemia results due to reduced insulin secretion

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10
Q

How does FHx impact the score ?

A

Yes = 5

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11
Q

What are normal HbA1c tests

A

<42 mmol/L

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12
Q

What are pre-diabetic HbA1c tests ?

A

42-47 mmol/L

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13
Q

What are diabetic HbA1c tests ?

A

> 47

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14
Q

What is first line treatment for T2DM ?

A

If the condition can be managed with lifestyle changes instead of medications, then it should be

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15
Q

What is second line treatment for T2DM ?

A

Metformin

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16
Q

What medications could be given in addition to metformin ?

A

Metformin +
Sulphonylurea
DDP4 inhibitor
Pioglitazone 2
SGLT-2i

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17
Q

What does a QRISK2 calculate ?

A

Risk of having an MI or stroke within the next 10 years

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18
Q

List the variables of a QRISK2 score ?

A

Age, sex ethnicity, Post-code, Smoko, DM, Angina or MI in first degree relative <60, CKD (stage 4 or 5), AF, HTN treatment, RA, Cholesterol/HDL ratio, Systolic BP, BMI

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19
Q

Which variables are modifiable in a QRISK2 ?

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A

Smoko, Cholesterol, BMI

20
Q

Which variables are non-modifiable in a QRISK2 ?

Study These Flashcards
A

Age, sex, ethnicity, DM, FHx, RA, HTN

21
Q

What should an ideal QRISK2 score be ?

22
Q

What does a CHAD2VASc calculate ?

Study These Flashcards
A

Risk of stroke for patient in AF

23
Q

What does CHADS2VASc stand for ?

Study These Flashcards
A

Congestive HF = 1
HTN = 1
Age = > 75 = 2
DM = 1
Stroke/TIA/Systemic embolism = 2
Vascular disease = 1
Age = 1
Sex = 1

24
Q

What are the different scores in a CHADS2VASc

Study These Flashcards
A

0 male or 1 female
Low risk
No anticoagulation
1 male
Moderate risk
Oral anticoagulant should be considered

2 or greater
High risk
Oral anticoagulant is recommended

25
Which factors are non-modifiable in a CHADS2VASc ?
Congestive HF Age DM Sex Stroke/TIA/Systemic embolism
26
CHADS2VASc -What factors impact stroke risk ?
Risk of stroke is 5 times higher in person with AF than normal sinus rhythm Severity of stroke is greater when associated with AF Anticoagulation treatment reduced the risk of stroke by about 2/3rds
27
What treatment could be provided for clot risk ?
Warfarin DOAC e.g. rivaroxaban or apixaban Both carry a risk of bleeding
28
What does a FRAX calculate ?
Used to calculate the risk of fracture in the next 10 years
29
What are the variables ?
Age, sex, weight, height, previous #, FHx of #,. smoko , GCs, RA, Secondary osteoporosis (T1DM, Hyperthyroidism, chronic liver disease), alcohol and bone mineral density (DEXA)
30
How are the results of a FRAX calculated ?
Results come out as a % A score of 5% or more for a hip facture at age 70+ suggests one should consider treatment alongside lifestyle changes
31
What is a DEXA scan ?
A scan which looks at the mineral density of your bones and compares it to scans from people of a similar age
32
What are the different scores from a FRAX ?
T score and Z score
33
What are the different T scores ?
Greater than -1 = normal -1 - -2.5 = Osteopenia <-2.5 = Osteoporosis
34
What does a Z score suggest ?
>-2 suggest that something other than ageing may be responsible for your bone mineral density
35
What is osteopenia ?
When your bone density scan shows lower bone density than the average for your age
36
What is osteoporosis ?
Significant loss of bone mineral density resulting in fragile bones which are a risk of breaking
37
What does ABCD2 stand for ?
Age > 60 Blood pressure > 140/90 Clinical features e.g. unilateral weakness (2) speech disturbances without weakness (1) Duration of symptoms e.g. 60 mins + = 2, 10-59 mins =1 DM = 1
38
What are the results for an ABCD2 score ?
0-3 = low risk ~3% chance of stroke of stroke in the next 90 days 4-5 = moderate risk ~10% chance of stroke in the next 90 days 6-7 = high risk ~18% chance of a stroke in the next 90 days
39
What treatment could you give for a TIA ?
Antiplatelets e.g. aspirin (instant), dipyridamole (2 weeks), clopidogrel Anticoagulants e.g. heparin or warfarin, long term statins e.g. simvastatin Control risk factors e.g. HTN
40
What treatment could you give for a stroke ?
Thrombolysis e.g. alteplase
41
What is a Well's DVT score
Tool to calculate the risk of developing a deep vein thrombosis (and PE)
42
What are the variables in a Wells score ?
Active cancer, bedridden > 3 days, major surgery within 12 weeks, Calf swelling > 3 days (unilateral), collateral superficial veins, entire leg swollen, localised tenderness confined to symptomatic leg, pitting edema, paralysis, paresis or plaster immobilisation, previous DVT, alternative diagnosis likely (-1)
43
What are the results of a Wells score ?
Moderate risk = 1-2 High risk = 3+
44
Signs and symptoms of DVT
Pulse is present Pain-aching cramping Skin pigmentation in galter area (medial and lateral malleolus) Thickened and tough may be reddish blue
45
What are the risks of a DVT ?
Develop into an ulcer Stroke MI
46
What treatment could be given for a DVT ?
D-dimer could exclude Heparin or warfarin

OSCE Stations (3 decks)

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