Falls Flashcards
Differentiate between the autonomic and neuroglycopaenic features of hypoglycaemia.
Autonomic: trembling, sweating, anxiety, hunger, palpitations, nausea, tingling
Neuroglycopaenic: confusion, weakness, drowsiness, visual change, difficulty speaking, headache, dizziness, tiredness, difficulty concentrating
What are the four questions involved in the AMT?
- What year is it?
- How old are you?
- What is your date of birth?
- Where are we?
Name some drugs which cause postural hypotension.
nitrates ACEi diuretics L-dopa tricyclics SSRIs
What are the typical clinical features of idiopathic Parkinson’s disease?
bradykinesia
rigidity
tremor
postural instability
What is idiopathic Parkinson’s disease?
neurodegenerative disease that affects predominantly dopaminergic neurons in the substantia nigra
What are the non-motor symtoms of PD?
neuropsychiatric: anxiety, depression, sleep disorders, cognitive changes, hallucinations
olfactory: altered sense of smell
GI: constipation
urinary: nocturia: urinary frequency, incontinence, ED
muscular pain
hyperhidrosis
How would you describe a typical PD tremor?
assymetrical, 4-6Hz enhanced by anxiety, occurs at rest
What does progressive supranuclear palsy cause?
axial imbalance, oculomotor disturbance, early bulbar involvement (speech and swallow difficulties)
What are some of the causes of falls?
D:rugs + alcohol
A:ge-related changes e.g. gait, balance, weakness, sensory impairment
M:edical e.g. CVD, PD
E:nvironmental e.g. obstacles, lighting
Name causes of gait abnormalities.
PD hemiplegic gait cerebellar disease sensory ataxia normal pressure hydrocephalus antalgic gait proximal myopathy foot drop
What are the risk factors for developing pressure sores?
poor mobility poor nutritional status neuropathy pain age and frailty cognitive impairment incontinence
What causes pressure ulcers?
interfacial pressure exceeding capillary pressure, which then leads to ischaemia
Describe the grading system used for pressure ulcers.
1: non-blanching erythema -
Intact skin with localised erythema, may differ in temperature to surrounding skin and be tender to touch
2. Partial thickness - superficial skin loss appears as shallow open ulcer without slough. May also be a blistered area without bruising
3. Full-thickness skin loss - Subcutaneous fat visible, may have sinus formation. No exposed tendon/ bone
4. Full-thickness tissue loss- Extends down to bone, tendon or fascia. Often accompanied by sinus formation
Discuss the management of pressure ulcers.
positional changes, mattress support, dressings, barrier creams, antibiotics, dietary support, debridement
