Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NP- Phase 3a Medicine > Geriatrics > Flashcards

Geriatrics Flashcards

(60 cards)

Start Studying
1
Q

what is delirium?

A

an acute state of fluctuating disturbance in attention, cognition and consciousness level, which can be precipitated by infection, drugs, dehydration or hypoxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the subtypes of delirium?

A
  • Hyperactive- patients will be agitated, disoriented, delusional and may experience hallucinations
  • Hypoactive- patients will appear subdued, confused, disoriented and apathetic
  • Mixed- fluctuating between the hyperactive and hypoactive states of delirium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

causes of delirium

A
  • Drug initiation- benzodiazepines, analgesic and anticholinergic medications are those associated most with delirium
  • Withdrawal
  • Vascular- stroke/ MI
  • Hypoxia- respiratory/ cardiac failure
  • Systemic infection- pneumonia, UTI, malaria, wounds, IV-line infection
  • Metabolic derangement- hypo/hypernatremia, hypoglycaemia, uraemia
  • Surgery
  • Pain
  • Stroke/ seizures
  • Systemic organ failure
  • Intracranial infection/ head injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are 3 differentials of delirium?

A

dementia, anxiety, epilepsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

investigations in delirium

A
  • Identify cause- do FBC, U&E, LFT, blood glucose, ABG, septic screen (urine dipstick, CXR, blood cultures), ECG, EEG, CT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how would you manage a patient with delirium?

A
  • Identify cause
  • Reorientate patient- clocks, calendars etc
  • Visits from friends and family
  • Manage fluid balance
  • Mobilize the patient
  • Remove anything invasive- catheters, IV;s etc
  • Review medications- discontinue any unnecessary agents
  • haloperiodol to regucy agitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how can you differentiate delirium from dementia?

A

Delirium- acute onset

Delirium- inattention, distractibility and disorganised thinking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the 4 subtypes of dementia?

A

Alzheimers
vascular
fronto-temporal
lewy body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is Alzheimers dementia?

A

progressive, global cognitive impairment- affects visuo-spatial skill, memory, verbal abilities and executive function (planning)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are some causes and risk factors of Alzheimers dementia?

A

Causes- environmental, genetic, accumulation of B-amyloid.

Risk factors- 1st degree FH, downs syndrome, depression, smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is vascular dementia?

A

cumulative effect of multiple small strokes, focal neurological signs, usually sudden onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is dementia?

A

neurodegenerative syndrome with a progressive decline in several cognitive domains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the key features of fronto-temporal dementia?

A

personality change! Plus socially inappropriate actions, disinhibition, poor judgement, decreased motivation. Memory is preserved until later stages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is Picks disease?

A

type of fronto-temporal dementia in which Pick inclusion bodies can be found on histology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the features of Lewy body dementia?

A

fluctuating cognitive impairment, detailed visual hallucinations, develops into Parkinsonism. Lew bodies (eosinophilic intracytoplasmic inclusion bodies) found in brainstem and neocortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how is Alzheimers diagnosed?

A

CT/ MRI- beta amyloid plaques, neurofibrillary tangles, atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how is frontotemporal dementia diagnosed?

A

CT-MRI- frontotemporal atrophy, Pick cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how is vascular dementia diagnosed?

A

imaging will show vascular infarcts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how is Lewy body dementia diagnosed?

A

imaging- lewy bodies in cortex of midbrain, generalised atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

how is Alzheimers dementia managed?

A

donepezil (acetylcholinesterase inhibitors), memantine, treat depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

how is lewy body dementia managed?

A

acetylcholinesterase inhibitors, memantine, levodopa, physiotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what medications must be avoided when treating dementia?

A

neuroleptics, sedatives, tricyclic antidepressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are some examples of acetylcholinesterase inhibitors (AChE)?

A

donepazil
rivastigmine
galantamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

give an example of an antiglutamatergic treatment of dementia

A

Memantine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what is the triad seen in Parkinsons?
extrapyramidal triad of: - pill rolling tremor hypertonia- cogwheel rigidity - bradykinesia- slow to initiate movements
26
what are causes of Parkinsons disease?
loss of dopaminergic neurons in the substantia nigra- associated with lewy bodies
27
what are some non-motor symptoms of parkinsons?
- autonomic dysfunction- postural hypotension, constipation, urinary frequency/urgency, dribbling - sleep disturbance reduced sense of smell
28
what are some neurophyschiatric symptoms of parkinsons?
depression dementia psychcosis
29
what is the risk with beginning levodopa treatment in parkinsons?
efficacy reduces over time- so stronger doses needed (resulting in worse side effects and reduced response)- so usually start late
30
what are pharmacological treatment options for parkinsons?
- levodopa - dopamine agonists- ropinirole - apomorphine - anticholinergics (orphenadrine) - MAO-B inhibitors (rasagilline, selegiline) - COMT inhibitors (entacapone, tolcapone)
31
what is the difference between 1st and 2nd degree osteoporosis?
1st- age related 2nd- related to another condition. medication
32
risk factors of osteoporosis
- female - over 50 - white/asian - post-menopausal - FH - alcoholism - RA - Steroid use (long-term prednisolone) - thin
33
how is osteoporosis investigated?
DEXA scan bloods- normal calcium, phosphate and ALP- rules out other metabolic bone diseases
34
what are the T score ranges from a DEXA scan
0 to -1= BMD is in the top 84%, no evience of osteoporosis -1 to -2.5= osteopenia- risk of later osteoporotic fracture worse than -2.5= osteoporosis
35
pharmacological management of osteoporosis
- bisphosphonates- alendronic acid (1st line) - calcium and vitamin D - HRT
36
causes of urinary incontinence in men
prostate enlargement urinary retention
37
causes of urinary incontinence in womenn
functional incontinence- immobility (unable to reach toilet etc) stress incontinence- coughing and laughing result in an increased intra-abdominal pressure, resulting in the loss of small, but frequent, amounts of urine urge incontinence- sudden urge to go to the toilet- caused by detrusor overactivity
38
oxford bamford classification- total anterior circulation stroke (large ACA/MCA stroke)
all 3 of: - unilateral weakness (and/or sensory deficit) of face, arm and leg - homonymous hemianopia - higher cerebral dysfunction (dysphasia, visuospatial disorder)
39
oxford Bamford classification- - partial anterior circulation stroke
2 of: - unilateral weakness (and/or sensory deficit) of face, arm and leg - homonymous hemianopia - higher cerebral dysfunction (dysphasia, visuospatial disorder)
40
Oxford bamford classification- posterior circulation stroke
one of: - cerebellar or brainstem syndromes - loss of consciousness - isolated homonymous hemianopia
41
Oxford bamford classification- lacunar syndrome (LACS) (subcortical- midbrain and internal capsule)
one of: - unilateral weakness (and/or sensory deficit) of face and arm, arm and leg or all 3 - pure sensory loss - ataxic hemiparesis (cerebellar and motor symptoms)
42
management of a stroke
- ABCDE - o2 sats greater than 95% - nill by mouth (risk of aspiration pneumonia) - thrombolysis- e.g. altepase within 4.5 hours - antiplatelet therapy- clopidogrel
43
what medications are associated with falls?
- benzodiazepines - antidepressants- SSRI's and tricyclics - antipsychotics - diuretics - ACE inhibitors - beta blockers
44
what is vasovagal syncope?
'simple faint' vagal stimulation (fright, pain, emotion) leads to hypotension and syncope
45
causes of postural hypotension
- drugs- vasodilators, diuretics - chronic hypertension - volume depletion (dehydration, haemorrhage) - sepsis- vasodilation
46
clinical features of cardiac syncope
- ecg abnormalities - chest pain - arrythmias - palpitations - hypotension - loss of conciousness
47
what is the sepsis 6?
3 in, 3 out: - IV fluids, IV antibiotics, 02 sats 94% - lactate, blood cultures, U&E's
48
what are the geriatric giants?
- immobility - instability - intellectual impairment - incontinence - iatrogenesis - inanition
49
clinical features of delirium
- marked memory deficit - acute - disordered and disorientated thinking - worsened concentration, slow responses - reduced mobility/ movement
50
what medications are associated with causing delirium
- opiates - benzodiazepines - zopiclone - anticholinergics - Dopimanergic meds
51
management of alcoholism
chlordiazepoxide
52
what is Korsakoff syndrome?
- hypothalamic damage and cerebral atrophy due to B1 deficiency - decreased ability to acquire new memories, confabulations, lack of insight and empathy
53
what triad is seen in Wernicke's encephalopathy?
- confusion - ataxia - opthalmoplegia
54
what is the sepsis 6?
- oxygen (target >94%) - blood cultures - IV Abx - fluid resus - serum lactate and Hb - catheterise
55
causes of faecal incontinence
- sphincter dysfunction- due to vaginal delivery, surgical trauma - impaired sensation- due to diabetes, MS, dementia, spinal cord problems - idiopathic
56
treatment and management of faecal incontinence
- treat cause - ensure toilet is easy to get to - pelvic floor rehab - loperamide - skin care - enemas
57
causes of urinary incontinence in men
prostate enlargement
58
causes of urinary incontinence in women
- functional incontinence - stress- incompetent sphincter (incontinence occurs with rise in intra abdominal pressure- coughing) - urge incontinence (precipitated by arriving home, cold, water running, caffeine- all due to detrusor overactivity)
59
management of stress incontinence
pelvic floor exercises - intravaginal electrical stimulation - duloxetine
60
what medications can prevent delirium?
- dexmedetomidine- sedative | - cholinesterase inhibitors- rivastigmine or donepezil

NP- Phase 3a Medicine (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions