Insomnia/TIA, CVA, Parkinson's Overview Flashcards Preview

Geriatrics > Insomnia/TIA, CVA, Parkinson's Overview > Flashcards

Flashcards in Insomnia/TIA, CVA, Parkinson's Overview Deck (30):
1

what stages do elderly not spend as much time in later in life?

Stage 3 and 4

2

Do elderly get the same amount of sleep?

Yes, but have decreased sleep efficiency (time in bed increases)

3

Are insomnia or excessive daytime somnolence a normal part of aging?

No

4

what should you ask patient/ sleep partner about?

Night time coughing
unusual movement
snoring
SOB when supine/ awakens patient from sleep

5

will patients always know they are waking up?

No

6

If patients report excessive daytime sleepiness what should you do?

Still evaluate and get a sleep study
may have sleep apnea, etc.

7


2 main type of treatments for insomnia

Pharmocologic (best for primary)
Psychological

8

if insomnia is due to acute distress what should you start with?

pharmacologic

9

what can happen with benzos when they stop taking them?

rebound insomnia

10

falls and fractures are less likely with what types of benzos

short acting

11

episodes of either cessation or marked decreased airflow during sleep. Caused by upper airway obstruction or central (mor uncommon)

sleep apnea

12

risk factors of OSA

Obesity
large neck circumference
structural factors related to nasal obstruction
male
postmenopausal state
smoke

13

3 cardinal symptoms of OSA

snoring
sleepiness
noticed by bed partner

14

Diagnosis for OSA

polysomnography

15

should you treat a patient with OSA without symptoms?

Yes

16

treatment for OSA

weight loss
discontinue sedative- hypnotics
avoidance of alcohol/ sedative use
non-supine sleeping position
CPAP
Surgery

17

itchy, scratchy, crawly sensation of legs so they can't sleep

Restless leg syndrome

18

fall asleep and then do the "river dance", leg jerks around patients from sleep

PLMD

19

tx for RLS

dopamine agonists (pramipexole, ropinirole)
levodopa/ carbidopa
anticonvulsants

20

what are some types of embolisms

fats
amniotic fluid
air
valvular vegetation

21

most common places for a clot to get stucks

carotid
posterior circulation

22

contralateral hemiparesis/ leg, UI, confusion, poor judgement, mutism

ACA

23

contralateral hemiparesis/ arm and face, aphasia/dominant hemisphere or apraxia

MCA

24

monocular blindness (amaurosis)

ophthalmic (MCA branch)

25

U/L or B/L CN deficits (Nystamgus, vertigo, dysarthria, diploplia) ataxia, limbs, sensroya nd motor deficits, altereted consciousness

vertebrobasilar

26

motor hemiparesis, sensory hemianthestsia

lacunar infarcts

27

aneurysm found, will often present later 30s early 40s, will often present in coma

Barry's aneurysm

28

most people with TIAs will have a stroke within what time?

6 month to a year

29

presents with thunderclap HA w/ altered consciousness

SAH

30

what is the pathophys condition with parkinson's?

synucleinopathy