Geriatrics Flashcards
(21 cards)
Dementia
Acquired, persistent, progressive intellectual impairment
Compromise of memory and at least ONE other: aphasia, apraxia, agnosia, executive function
Common concomitant of early dementia
Depression
mini cog
3 item recall and a clock
No need for clock if they can remember all 3 items or 0 items
Montreal cognitive assessment
30 point test
Treatment of AD
Acetylcholinesterase inhibitors: donepezil, galantamine, rivastigmine
Memantine (NMDA antagonist)
First choice for behavioral sx of AD
Atypical antipsychotics: riseperidone, olanzapine, quetiapine, aripiprazole
Use with caution if CV risk factors due to risk of stroke
Older patients with depression complain of
somatic complaints, less likely to report depressed mood and more likely to experience psychotic features
Most poorly tolerated SSRI
Paroxetine and Fluoxetine
Delirium
Pathophysiologic consequence of an underlying general medical condition–such as infection, coronary ischemia, hypoxemia, or metabolic derangement
Medications particularly likely to increase risk of delirium
Sedative/hypnotics, anticholinergics, opioids, benzos, H1 and H2 blockers
Evaluation of patient with delirium
CBC, BUN, Electrolytes, Cr, Glucose, Ca, albumin, liver function, UA, ECG
Delirium
Pathophysiologic consequence of an underlying general medical condition–such as infection, coronary ischemia, hypoxemia, or metabolic derangement
Medications particularly likely to increase risk of delirium
Sedative/hypnotics, anticholinergics, opioids, benzos, H1 and H2 blockers
Evaluation of patient with delirium
CBC, BUN, Electrolytes, Cr, Glucose, Ca, albumin, liver function, UA, ECG
Leading cause of death from injury for people >65
Complications of falls
Medications most likely associated with falling
Sedatives, antidepressants, benzos
Most common fractures resulting from falls
Wrist, hip, vertebrae
Stress incontinence
Leakage of urine due to coughing sneezing, standing
Tx: pelvic floor exercises, limit caffeine and fluid, no medications
Urge incontinence
Urgency and inability to delay urination Due to detrusor overactivity BPH also Tx: bladder training, weight loss, caffeine reduction, antimuscarinic (tolterodine and oxybutynin) Alt tx is botox injection
Overflow incontinence
Variable presentation
Least common
Can be due to lower motor nerve dysfunction causing detrusor underactivity
Transient causes of incontinence
DIAPPERS
Delirium, infection, atrophic vaginitis, pharmaceuticals, psychological factors, excessive urinary output, restricted mobility, stool impaction
