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Flashcards in Miscellaneous Deck (18):
1

What are 3 key considerations when a patient presents following a fall?

1. Injuries sustained
2. Circumstance of fall
3. Falls risk factors

2

What is a basic management plan for an elderly patient that has sustained a fall?

-Pain relief
-Review anti-hypertensive medication
-Optometry review
-Physiotherapy for balance training
-Footwear review
-Consider treating 'fear of falling'
-Consider environmental modification

3

What is a 'hot fall'?

Patient is acutely unwell but presents with a fall as a non-specific marker of ill-health

4

What is a 'cold fall'?

Generally occurs in older, frail people with multiple contributing factors

5

What are 3 common balance tests?

1. Romberg's test
2. Timed up and go
3. Sternal push or shoulder tug

6

What is the timed up and go test?

How long it takes a patient to stand up from a standard chair, walk 3 metres, turn around, walk back to chair & sit down

7

What is an average timed up and go speed for a 70 year old?

9 seconds

8

What are some differential diagnoses in a 23 year-old presenting with psychosis?

-Schizophrenia
-Drug-induced psychosis
-Schizoaffective disorder
-Delusional disorder
-Schizo-phreniform psychosis
-Brief psychotic disorders

9

What are some of the symptom clusters seen in schizophrenia?

-Positive symptoms
-Negative symptoms
-Cognitive symptoms
-Functional symptoms
-Impaired insight

10

What are the 2 main types of delirium?

-Hyperactive delirium
-Hypoactive delirium

11

What are features of hyperactive delirium?

-Repetitive behaviours
-Wandering
-Hallucinations
-Verbal or physical aggression

12

What are features of hypoactive delirium?

Patients appear quiet & withdrawn

13

What is the CAM diagnosis of delirium?

1. Acute onset & fluctuating course
2. Inattention
3. Disorganised thinking
4. Altered conscious state

Presence of 1 and 2 and either 3 or 4.

14

What are some clinical features of dementia?

-Agitation
-Psychosis
-Mood disorders
-Sexual disinhibition
-Eating problems
-Abnormal or inappropriate vocalisations

15

What is the differential diagnosis of dementia?

-Alzheimer's disease
-Dementia with Lewy bodies
-Vascular dementia
-Frontal lobe dementia

16

What are the giants of geriatric medicine (4 starting with I)?

-Instability
-Immobility
-Incontinence
-Intellectual decline

17

What is Fried's criteria of fraily?

1. Unintentional weight loss
2. Weakness
3. Exhaustion
4. Slow walking speed
5. Low physical activity

Frail is 3 or more criteria

18

Which patients will benefit from a comprehensive geriatric assessment (CGA)?

-Recent onset of physical and/or cognitive impairment
-Changing physical and/or cognitive status
-Multiple interacting problems that are amenable to treatment
-Patients with fragmented specialty medical care
-Disorders that require rehabilitation therapy
-Consideration of change in living situation
-Evaluating patient competency/capacity
-Dealing with medico-legal issues