MedOrqis: Zero-Token Deterministic Medical AI Skills • Evidence-Grounded Decision Support
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Test real clinical scenarios, run deterministic mathematical engines, and inspect step-by-step mathematical derivations without token hallucination.

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Cardiology & Nephrology

Elderly Diabetic Patient with Atrial Fibrillation & CKD

72-year-old male presenting with palpitation and fatigue. Medical history includes hypertension, type 2 diabetes mellitus, and a remote TIA 3 years ago. Baseline serum creatinine is 1.4 mg/dL, weight 78 kg, height 175 cm.

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CHA2DS2-VA (ESC 2024 Guidelines)

2024
ESC 2024 / AHA: 65-74 = 1 pt, ≥ 75 = 2 pts
ESC 2024 Rule: Sex category (Sc) has been formally removed. Score range is 0 to 8 points.
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HIGH RISK 2024 ESC Guidelines for the management of atrial fibrillation (Van Gelder IC et al. Eur Heart J 2024) (2024)

CHA2DS2-VA (ESC 2024 Guidelines)

Applicable Population: Adults (>= 18 years) with non-valvular atrial fibrillation

Berechneter Score: 5 points
Clinical Interpretation
High Thromboembolic Risk (5 points)
Guideline-Directed Recommendation
Oral anticoagulation IS RECOMMENDED (Class I), preferably DOAC over VKA unless mechanical valve or moderate-severe mitral stenosis. Assess HAS-BLED bleeding risk.
Clinical Alerts & Safety Warnings
  • Always assess renal function (CrCl via Cockcroft-Gault) prior to DOAC dosing.

Deterministic Execution Trace

Zero-Token Arithmetic
Mathematical Formula \text{Score} = C + H + A_2 + D + S_2 + V \quad (\text{Range: } 0-8)
Step-by-Step Formula Progression:
1 +1: Hypertension history or anti-hypertensive therapy
2 +1: Age 65-74 years
3 +1: Diabetes Mellitus
4 +2: Prior Stroke, TIA, or systemic thromboembolism
5 NOTE: Biological sex category REMOVED in ESC 2024 guideline (score range 0-8).
Invariant Input Payload:
{
    "age_years": 72,
    "biological_sex": "MALE",
    "hx_heart_failure": false,
    "hx_hypertension": true,
    "hx_diabetes": true,
    "hx_stroke_tia_thromboembolism": true,
    "hx_vascular_disease": false,
    "serum_creatinine_mg_dl": 1.4,
    "weight_kg": 78,
    "height_cm": 175,
    "uncontrolled_hypertension_sbp_gt_160": false,
    "abnormal_renal_function": false,
    "abnormal_liver_function": false,
    "stroke_history": true,
    "prior_major_bleeding_or_predisposition": false,
    "labile_inr": false,
    "medications_antiplatelets_nsaids": false,
    "alcohol_excess": false
}
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