Flashcards in Geriatric medicine Deck (20):
what adverse effect of statins that can contribute to falls?
Statin- can cause myopathy or myalgias
why is a z score important for osteoporosis?
good for investigating a secondary cause for osteoporosi
Alzheimers disease- what is the decline in score for MMSE?
decline of approx 3 points each year
what is Romberg's actually measuring?
what are the consequences of "long lie" after a fall?
what do we mean by a 'hot fall"
acutely unwell but present with a fall as a nonspecific marker of ill health
what do we mean by a 'cold fall"
generally frail older people with multiple contributory factors
how can anticholinergics affect falls?
anticholinergics can cause cognitive defects
what are some key examinations you would want to perform if a patient presents with recurrent falls
• Neurological examination- balance, coordination, gait
• Joint examination
• Visual acuity
• Postural hypotension- take the blood pressure
• Examine injured limb
• Look for mobility aids, glasses
• Look for deformities like kyphosis or lordosis
• Romberg's test looking for impaired proprioreception
Dynamic and static balance testing with physiotherapist
what are some things you must ask a geriatric patient who presents with a fall
• Able to weight bear?
• What medications are you on?
• Mechanism of injury
• PMH of arrhythmias, neurological impairment
• Do you wear glasses/have visual impairment
• Do you use any gait aids such as a walking stick
• Do you have osteoporosis?
• Are you dizzy upon standing?
• Do you have stairs in the house?
• B12 deficient?
• Hx of alcohol drinking
transient, reversible cognitive dysfunction
what drugs do we need to consider in a patient who comes in with falls
ace inhibitors and other antihypertensive drugs
what are some management options for a patient with recurrent falls?
• Pain relief if injured
• Review medication
• Optometry review
• Physiotherapy for balance training
• Footwear review
-Consider environmental modification in the home
-consider pacemaker if required
why is a NOF # usually present as a shortened, and external rotated leg?
unopposed force from iliopsoas
how do we define frailty?
By Fried's criteria
1. unintentional weight loss
4. slow walking speed
5. low physical activity
greater than 3 = frailty
what is a comprehensive geriatric assessment?
a multidisciplinary assessment to determine the psychological, functional and medical capabilities of a frail person in order to integrate a plan for treatment and follow up
what is the CAM assessment tool for delirium?
1. acute onset and fluctuating course
3. disorganised thinking
4. reduced conscious state
a diagnosis of delirium via CAM tool is 1 and 2 with either 3 or 4
tell me the scoring system for MMSE for dementia?
mild cognitive impairment= 21-24
moderate cognitive impairment= 14-21
severe cognitive impairment= less than 13
What type of imaging can we do to ix amyloid dementia?
pittsburgh B scan