Older people

Question 1

Comprehensive geriatric assessment:
- Definition
- Healthcare workers involved (7)
- What’s included in CGA (7)

Question 2

Polypharmacy:
- Definition
- Why is this bad
- Tool used
- What to ensure when you prescribe a drug (10)

Question 3

What other healthcare workers do geriatricians work with (6)

Question 4

Discharge planning:
- Who to consider alongside patient when discharging (3)
- What is a home first form
- Role of social worker upon discharge
- What does a discharge involve (7)
- Reasons for re-admission (5)

Question 5

Acutely unwell patient:
- 2 different symptoms in elderly
- Where can a patient be admitted to hospital from (7)

Question 6

Patients with chronic diseases:
- Define physiological frailty
- Define phenotypic frailty (4)
- Why is determining fragility useful
- Clinical fragility scale

Answer 6

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Question 7

Falls:
- Describe syncopal vs non-syncopal fall
- Risk factors (6)
- What examinations (4)

Question 8

Delirium:
- Definition
- Causes (7)
- Risk factors (3)
- Management

Answer 8

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Question 9

Dementia:
- Definition
- Symptoms
- Management
- DD

• Alzheimers pathophysiology
• Vascular
• Dementia with lewy body
• Frontotemporal
• Parkinsons disease with dementia

Question 10

Urinary incontinence:
- Types (4)
- What to ask in history (7)
- Examinations (6)
- Management

Question 11

Faecal incontinence:
- Causes
- Examination
- Complications
- Management

Chronic diarrhoea:
- Investigations (2)
- Management

Question 12

Palliative care:
- What are advanced directives
- Dying phase stages (4)
- Symptoms (8)
- Management

• Factors which define a good death
• Challenges to achieve a good death
• Psychological stages of dying

Answer 12

• Where they want to die, Agreed care plan such as DNAR/ReSPECT form, Avoid medicalisation (not have to prolong life pointlessly), Adequate symptom control and pain relief, Warn that death is coming and what can be expected, Dignity and privacy, Access to emotional support
• Death is a taboo subject, Can’t go home, Truthfulness with patients, Allowing time to prepare, Avoiding isolation, doctrine of double effect (permissible to cause harm as SE e.g. giving morphine but will cause renal impairment)
• Anger, denial, bargaining, depression, acceptance

Question 13

Death certificate:
- What does certifying after death involve (3)
- What’s included in certificate
- When does coroner get involved and their role

Answer 13

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Question 14

Transient ischaemic attack (TIA):
- Definition
- Risk assessment used and what does it include
- Investigations
- Management
- What is a crescendo TIA

Question 15

Stroke:
- Definition
- Toast classification (causes of infarct) (5)
- Causes of bleeds (5)
- Risk factors (8)
- Symptoms
- Types - Bamford classification (4)
- Investigations
- Management
- DD

Question 16

What to include in an older people history