Geriatrics Flashcards
Geriatrics (25 cards)
TIA Mimics
- syncope
- migraine
- temporal arteritis
- hypoglycaemia
- seizures
- retinal hemorrhage or detachment
Complications of stroke
- Aspiration pneumonia
- Pressure ulcers
- DVT
- Speech problems
- Depression
- Visual problems
- Weakness
- Urinary retention
- Constipation
Acute stroke management
- ABCDE
- CT
- Aspirin 300mg for 2 weeks
- Thrombolysis within 4.5 hours after excluding bleed
Falls Differentials
- Vasovagal Syncope
- Postural hypotension
- Myocardial infarction
- Epilepsy
- Poor eyesight/mobility
FRAX domains
- age
- sex
- parent fractured hip
- weight
- height
- current smoker
- steroids
- rheumatoid arhtritis
- secondary osteoporosis (type 1 diabetes, premature menopause, malabsorption disease)
- more than 3 units of alcohol a day
- BMD
Side effects of bisphosphonates
- Heartburn
- Indigestion
- Jaw pain
- GI upset
Contraindications to bisphosphonates
- Oesophageal disease
- Gastric ulcers
Causes of delirium
- infection
- change in environment
- medication
- surgery/post GA
- alcohol withdrawal
- pain
- head injury
- liver/kidney failure
- hyponatraemia
- hypoglycaemia
- B12/folate deficiency
Drugs that cause delirium
- Opiates
- Levodopa
- Sedatives
Delirium differentials
- Dementia
- Alcohol withdrawal
- Mania
- If hyperactive - psychosis
- Depression
Tools for assessing confusion
- CAM
- 4AT
Investigations in delirium
- Obs: Temp, pulse, BP
- Bloods: FBC, U&Es, Glucose, LFTs, CRP, B12& folate
- CXR
- Bowel chart
- Fluid charts
- Urine dip
4 features of CAM
- Acute onset and fluctuating
- Inattention
- Disorganised thinking
- Altered level of consciousness (hypo or hyper alert)
4AT Test
- Alertness
- AMT4
- Attention
- Acute and fluctuating course
Causes of parkinsonism
- Parkinsons disease
- Drug induced
- Progressive supranuclear palsy
- Multi systems atrophy
- Vascular parkinsonism (lower limb parkinsonism)
- Dementia with lewy bodies
- Cotico basal degeneration
Core features of parkinsonism
- Resting tremor
- Hypertonia
- Bradykinesia
Features of progressive supranuclear palsy
- Vertical gaze palsy
- Early postural instability and falls
- Rigidity in the trunk
Features of multi systems atrophy
- Postural hypotension
- ## Bladder instability
Drugs that can cause parkinsonism
- Metoclopramide
- Prochlorperazine
- Typical antipsychotics
Differentials of a tremor
- Essential tremor
- Drug induced
- Parkinsonism
- Cerebellar tremor
- Hyperthyroidism
- Anxiety
Causes of malnutrition
- Increased needs: stress from surgery or illness
- Increased losses: diarrhoea/vomiting, wounds, burns
- Reduced intake: loss of appetitie, dysphagia, cognitive/communication issues
Consequences of malnutrition
- Increased length of stay
- Increased costs of care
- Impaired wound healing
- Depression/ reduced QOL
- Impaired immune response
- Poor digestive function
- Inability to mobilise
What tool is used to identify malnutrition?
MUST (Malnutrition Universal Screening Tool)
Management after calculating MUST score
LOW RISK - repeat screening (weekly in hospital, monthly in care homes, annually in GP)
MEDIUM RISK - Observe and document dietary intake for 3 days
HIGH RISK- refer to dietician, improve overall intake, monitor and review care plan
