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Phase 3A > Passmed Geriatrics > Flashcards

Passmed Geriatrics Flashcards

1
Q

What medication is used to manage secretions in a palliative care setting?

A

Hyoscine hydrobromide

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2
Q

In palliative patients how much do you increase the morphine doses by?

A

30-50% if pain not controlled

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3
Q

What are the distinguishing features of Lewy Body dementia?

A

Hallucinations, progressive cognitive impairment, parkinsonism, fluctuating condition,

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4
Q

What drugs can be used to manage lewy body dementia?

A

Acetylcholinesterase inhibitors (donepezil and rivastigmine), memantine

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5
Q

Which types of tumours typically cause brain mets?

A

Lung, breast, kidney, melanoma and colorectal cancers

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6
Q

What is the typical presentation of parkinsonism?

A

rigidity, resting tremor, bradykinesia. Shuffling gait, mask-like face, micrographia, dementia

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7
Q

What are the clinical features of multiple system atrophy?

A

Parkinsonism, autonomic disturbance - erectile dysfunction, postural hypotension, atonic bladder, cerebellar signs

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8
Q

What is the first-line treatment of alzheimer’s disease?

A

Acetylcholinesterase inhibitors - donepezil, galantamine, rivastigmine

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9
Q

What is the second-line treatment for alzheimers?

A

memantine (NMDA antagonist)

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10
Q

What medication can be used in elderly patients with acute confusional state?

A

Haloperidol

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11
Q

Which symptom is suggestive of idiopathic parkinsons?

A

Asymmetrical symptoms

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12
Q

What pain medications should be used in patients with CKD?

A

Oxycodone in mild-moderate renal failure
Alfentanil, buprenorphine and fentanyl in severe renal failure

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13
Q

What index is used to measure ADLs in stroke patients?

A

Barthel Index

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14
Q

How do you convert oral morphine dose to IV?

A

Total daily dose should be divided by 3

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15
Q

What features are more typical of delirium over dementia?

A

acute onset
impairment of consciousness
fluctuation of symptoms: worse at night, periods of normality
abnormal perception (e.g. illusions and hallucinations)
agitation, fear
delusions

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16
Q

What is an example of overflow incontinence?

A

Prostate enlargement - bladder outflow obstruction

17
Q

What percentage of morphine dose should be prescribed for breakthrough pain?

A

1/6th of daily morphine dose

18
Q

Which opioids do you use in palliative patients with severe renal impairment?

A

Buprenorphine/fentanyl

19
Q

What are the symptoms of digoxin toxicity?

A

GI disturbance, dizziness, blurry/yellow vision, arrhythmias

20
Q

What are the side effects of amitriptyline?

A

Dry eyes, dry mouth, postural hypotension, delirium. Constipation, urinary retention, arrhythmias

21
Q

What is indapamide?

A

A thiazide-like diuretic (can make gout worse)

22
Q

Which medications cause postural hypotension?

A

nitrates, diuretics, anticholinergics (amitriptyline), antidepressants, beta-blockers, L-dopa, ACE-I (rampiril)

23
Q

What tests are used to assess patients at risk of falls?

A

FRAX and Turn 180 degrees test, timed up and go test

24
Q

What can be used for mouth pain in palliative patients?

A

Benzydamine hydrochloride mouthwash

25
Q

What is the equivalent dose of morphine to codeine?

A

Codeine to morphine - divide by 10

26
Q

What is the conversion of an oral morphine dose to a subcutaneous dose?

A

Divide by 2
(divide by 3 for subcut diamorphine)

27
Q

What can help with metastatic bone pain?

A

analgesia, bisphosphonates and radiotherapy

28
Q

How do you treat immunocompromised patients with first time chickenpox infection/exposure?

A

varicella zoster immunoglobulins

29
Q

What antiemetic is used in patients with chemo/radiotherapy caused nausea and vomiting?

A

Ondansetron - serotonin receptor antagonist and dexamethasone

30
Q

Which antiemetic should be used in vomiting due to gastric dysmotility?

A

Metoclopramide - but only for up to 5 days due to extrapyramidal effects

31
Q

What type of dementia is associated with motor neurone disease?

A

Fronto-temporal dementia

32
Q

What is charles-bonnet syndrome?

A

associated with macular degeneration - hallucinations that patient is aware are not real

33
Q

Which opioid can be used for neuropathic pain?

A

Tramadol - it is an opioid and a serotonin and noradrenaline reuptake inhibitor

34
Q
A

Phase 3A (14 decks)

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