Falls Flashcards Preview

Y3 AGEING > Falls > Flashcards

Flashcards in Falls Deck (18)
Loading flashcards...
1

List some causes of falling related to ageing

Reduced reactions
Visual impairment - smaller pupils, lens thickening
Sarcopenia
Poor sensory awareness
Decreased exercise (less fitness)

2

List some cardiovascular causes of falls and syncope

Neurogenic (vasovagal)
Orthostatic hypotension
Arrhythmias
Valve disease (aortic stenosis)
Carotid sinus hypersensitivity

3

List some musculoskeletal cause of falls

Joint pain
Arthritis
Sarcopenia

4

List common drugs that increase the risk of falls

Benzodiazepines
Neuroleptics
Anti-hypertensives
Anti-cholinergics
Anti-depressants
Anti-arrhythmias (digoxin)
Opiates
Parkinsons meds
ALCOHOL

5

What management has the strongest evidence for reducing falls risk?

Strength and balance training 3x a week for 12 weeks

6

List some implications of falls

Hypothermia
Dehydration
Pressure sores
Rhabdomyolysis (lead to AKI)
VTE
Bronchopneumonia
Muscular deconditioning

7

What is the definition of orthostatic hypotension?

Skeletal muscle pumps less effectively = less venous return
Reduced systolic BP by >20mmHg or diastolic BP >10mmHg after 3 minutes of standing

8

What distinguishes syncope from falls?

Transient loss of consciousness

9

List some neurological disorders that can contribute to falls

Cervical myelopathy (high stepping gait, romberg's +)
Cerebellar ataxia (wide-based gait, cerebellar signs)
Peripheral neuropathy (altered sensation, wide-based gait)
Parkinsons disease (shuffling gait, tremor, rigidity, bradykinesia, orthostatic hypotension)
Lumbar stenosis (pain/paraesthesia legs, gait wide-based)
Stroke disease

10

What is the most common type of vestibular disease contributing to falls? How is it diagnosed and treated?

BPPV
Halpike manoeuvre (+ if latency of onset, rotational nystagmus - fast phase to affected side)
Epley manoeuvre

11

What is vertigo? What must you always clarify with the patient?

Feels like your at sea, room is swimming, rotational
Clarify what they mean by dizzy

12

What questions should you ask a patient regarding syncope?

Chest pain/ SOB (aortic stenosis)
Any prodromal symptoms (should be -)
How do they feel sitting vs. standing?

13

How should you approach a falls history?

PREVENTION - screen for falls - 2 or more in last year? Acute fall? Problems with walking or balance?
FULL HISTORY - before and after fall? Impact/consequence of fall? Witness account? Accurate medication list?

14

What investigations should be considered in falls?

Gait, balance, joints
Neurological (vestibular, cerebellar, peripheral, rombergs, extrapyramidal, cortical)
CVS (pulse, murmurs, lying and standing BP)
Visual acuity (Snellen chart)
Feet and footwear
Incontinence assessment

15

What assessment tools can be used in falls?

Timed up and go test
Berg balance scale
Tinetti score

16

What should always be assessed in falls with elderly patients?

Fracture assessment (Q fracture)
Vit D deficiency
Fragility fracture e.g. wrist (osteoporosis)

17

A patient on > _ medications is a risk for falls?

4

18

What is some management options in postural hypotension?

Increased salt
TED stockings