formative Flashcards
(18 cards)
medication for upset by lewy body hallucinations
Rivastigmine/donepezil
quetiapine off label
78 male with advanced dementia, stroke registrar thinks thrombolysis is in his best interests but his LPA says this is not what he would want. what should you do
urgently contact hospital advice team
donepezil ecg
bradycardia
vascular dementia initial pharmacological management
- falls, restlessness, poor sleep, reduced appetite, talking less
this is BPSD in vascular dementia, memantine/donepezil not used unless mixed dementia picture - this is pure vascular
Best initial pharmacological option for this presentation:
Low-dose mirtazapine
(Helps with sleep, appetite, mood, and social engagement, with relatively low fall risk)
fill out table for BPSD pharmacological mx
agnosia
can’t recognise
black report
most at risk of poverty
unemployed school leavers / long term sick
what is sick sinus syndrome
The SA node fails to generate impulses properly, causing bradyarrhythmias, pauses, or alternating fast and slow heart rhythms.
Often seen in older adults or people with underlying heart disease.
Can cause symptoms of syncope, dizziness, fatigue, palpitations.
management of 90M with fractured NOF for bones
DEXA scan is not essential before starting treatment in patients with fragility fractures; fracture itself is diagnostic of osteoporosis needing treatment.
He has a fragility fracture (NOF fracture) — this is a clear indication for anti-resorptive therapy like alendronic acid (a bisphosphonate) to reduce risk of future fractures. weekly.
Calcium and vitamin D supplementation support bone health and reduce risk of hypocalcemia with bisphosphonates. daily.
does memantine cause heart block
no - refer to cardiology
gold standard for osteomyelitis
MRI pelvis
medication to review in old lady with new onset kidney failure
n an 80-year-old woman with vomiting, urea 29, creatinine 230, and eGFR 20 (i.e., significant acute kidney injury or chronic kidney disease), the medication that needs urgent review is:
Digoxin
Why?
Digoxin is renally excreted and has a narrow therapeutic window.
Reduced renal function (eGFR 20) can lead to digoxin accumulation and toxicity, especially in the setting of vomiting (which may cause electrolyte disturbances like hypokalemia).
define health inequalities
Systematic, avoidable, and unfair differences in health status or in the distribution of health resources between different population groups, arising from social, economic, environmental, or demographic factors.
non healthcare factors contribute to health
Approximately 80-90% of health outcomes are determined by non-healthcare factors — that is, social determinants like socioeconomic status, education, environment, lifestyle, and behavior.
most likely cause of homelessness 2022
In 2022, the most common cause of homelessness in the UK was the end of a private rented tenancy, particularly due to rising rents and unaffordable housing costs.
homeless biggest cause of death
In 2022, the most common cause of death among homeless individuals in the UK was drug-related deaths, accounting for approximately 36% of all recorded fatalities. This category includes deaths from drug overdoses and substance misuse. Other significant contributors to mortality in this population were suicide (10%) and alcohol-related causes (9.6%).
