Falls

Question 1

what is vasovagal syncope

Answer 1

response due to a trigger due to dysfunction of the HR and BP regulating mechanism. When HR slows, BP decreases and lack of blood to brain causes fainting

Question 2

what are the typical triggers of vasovagal syncope

Answer 2

prolonged standing, emotional stress, pain, blood

Question 3

what is situational syncope

Answer 3

after or during micturition, straining for bowel movement, coughing, swallowing, lifting a heavy object

Question 4

what is the treatment of reflex syncope (vasovagal, and situational)

Answer 4

avoidance of triggers, prepare before triggers eg, move/cross legs to tighten muscles before injection, increase consumption of salt and fluids

Question 5

what is orthostatic hypotension

Answer 5

fall in SBP>20 or DBP>10 after 3 mins on standing

Question 6

what treatment is there for falls

Answer 6

strength and balance retraining, must be x3 week for minimum 12 weeks
footwear and footcare
vision optimization
patient education and treatment
review medications
start vitamin D, fracture assessment/osteoporosis treatment

Question 7

what does GDS stand for

Answer 7

geriatric depression score

Question 8

which antidepressants are associated with falls

Answer 8

anticholinergics and paroxetine/citalopram

Question 9

what are the 2 main models for measuring frailty

Answer 9

Rockford and Friel

Question 10

how is frailty assessed in Friel

Answer 10

weight loss
decrease in grip strength 
exhaustion 
decreased physical activity 
slow walking speed

Question 11

what are the criteria for frailty in Friel

Answer 11

0-non frail, 1-2=pre-frail, 3 or more=frail

Question 12

how is geriatric patients assessed

Answer 12

complex geriatric assessment

Question 13

what is included in complex geriatric assessment

Answer 13

medical-including co-morbidities, medication
social and environmental
psychological
functioning