Capsule: Geriatrics Flashcards
(21 cards)
What do you do w a pt w new unexplained confusion?
Always admit for further ix: Geriatric Admission Profile (GAPS), CXR and MSU for infection, ECG for arrhythmia, CT head for bleed
What is included in GAPS?
FBC, U+E, LFT, TFT, CRP, glucose, calcium, vit D, B12, folate, iron, ferritin, transferrin
What can the density of a subdural haematoma tell you?
It becomes less dense over time so it’ll appear mixed following a rebleed
What is the Bamford Stroke Classification for the four types?
Unilateral weakness +/or sensory deficit of the face, arm and leg PLUS homonymous hemianopia PLUS higher cerebral dysfunction
Partial Anterior Circulation Syndrome (PACS) - 2/3
Total Anterior Circulation Syndrome (TACS) - 3/3
Lacunar Stroke Syndrome (LACS) is defined as pure motor or pure sensory deficit.
Posterior Stroke Syndrome (POCS) presents differently to those describe above. It can have a varied clinical picture such with sx such as vertigo, dizziness, nystagmus and ataxia.
Which vasc territory is involved for a TACS?
MCA
When do you tx the HTN during the acute mx of an ischaemic stroke?
Hypertensive heart failure, MI, encephalopathy, nephropathy
Aortic Dissection
PET or Eclampsia
What are the potential underlying causes of delirium that can be addressed initially before more invasive tests?
Drugs / Dehydration
Electrolyte Imbalance
Level of Pain
Infection / Inflammation
Respiratory Failure
Impaction of Faeces
Urinary Retention
Metabolic Disorder / MI
Which drugs can be used to sedate a pt?
- Lorazepam 0.5mg PO
- Haloperidol 0.5mg PO
Why are these drugs PO > IV?
Risk of resp arrest
Why is haloperidol second > first line?
Risks of giving it to pts w Parkinson’s disease or Lewy body dementia
List drugs that cause hypoNa
Carbamazepine
Citalopram
Indapamide
Spironolactone
Bisacodyl
Omeprazole
Which electrolyte disturbance does salbutamol cause?
HypoK
List drugs that predispose to urinary retention
Amitriptyline
Oxybutinin
Codeine
Which CXR view can you tell there is definite cardiomegaly?
PA
What is a positive postural BP test?
A drop in SBP of >=20mmHg, DBP of >=10mmHg w sx or to below 90 mmHg on standing
Mx of postural hypotension
Conservative: withdraw offending meds, rise slowly, avoid prolonged standing, raise head of bed, exercise, inc salt and water intake
Pharmacological: fludrocortisone (fluid overload and electrolyte imbalance SEs)-> midodrine (cardiac SEs)
What’s the ECG finding in hypothermia?
J wave formation
Which core temp implies hypothermia?
<35°C
What is the recommended rate of rewarming?
0.5-2 degrees per hr
What might be the first sign of too rapid rewarming?
Falling BP
Comps of hypothermia
MI
DIC
Arrhythmia
Pneumonia
Renal Failure
