Week 1 part 1

Question 1

Give three factors in human ageing?

Answer 1

1. Random molecular damage during cell replication
2. Inactivity, poor diet, inflammation increase damage
3. Reduction in body’s adaptive reserve capacity

Question 2

What is the end part of each chromosome arm?

Answer 2

Telomere

Question 3

What happens when each telomere progressively shortens with each cell replication?

Answer 3

Senescence

Question 4

What can telomerase do?

Answer 4

Re-extend shortened telomeres - active in some cells like immune cells, stem cells

Question 5

What 4 main cellular responses does damage cause?

Answer 5

1. Repair
2. Apoptosis
3. Senescence
4. Malignant transformation

Question 6

What term is given to loss of homeostasis and resilience and increased vulnerability to decompensation after a stressor event?

Answer 6

Frailty

Question 7

What is sarcopenia?

Answer 7

Age related loss of muscle mass and function

Question 8

What are the three criteria for sarcopenia?

Answer 8

1. Low muscle mass
2. Low muscle strength
3. Low physical performance

Question 9

What is sarcopenic obesity?

Answer 9

Loss muscle mass with increased fat

Question 10

What can cause increased risk of cardiometabolic disorders such as insulin resistance, metabolic syndrome or cardiovascular disease?

Answer 10

Sarcopenic obesity

Question 11

How do you treat sarcopenia?

Answer 11

Exercise

Question 12

In palliative care what is the smoothest delivery of medicines?

Answer 12

Syringe driver

Question 13

At end of life what do you prescribe for pain/SOB?

Answer 13

Morphine

Question 14

At end of life what do you prescribe for distress?

Answer 14

Midazolam

Question 15

At end of life what do you prescribe for nausea/agitation?

Answer 15

Levomepromazinr

Question 16

At end of life what do you prescribe for respiratory secretions?

Answer 16

Buscopan

Question 17

Rapidly developing clinical symptoms and/or signs of focal, and at times global, loss of brain function, with symptoms lasting more than 24 hours or leading to death with no apparent cause other than that of vascular origin ?

Answer 17

Stroke

Question 18

What type of stroke is cardioembolic?

Answer 18

Fibrin dependent “red thrombus”

Question 19

What type of stroke is platelet dependent “white thrombus” (cf acute coronary syndrome)?

Answer 19

Atheroembolic

Question 20

What area of the brain controls personality, emotional response and social behaviour?

Answer 20

Frontal lobe

Question 21

What area of brain is affected when disinhibition, lack of initiative, antisocial behaviour, iompaired memory, incontinence, grasp reflexes and anosmia

Answer 21

Frontal love

Question 22

What area of the brain controls calculation, language, planned movement and appreciation of size, texture and weight?

Answer 22

Parietal lobe dominant side

Question 23

What area of brain is affected when dyscalculia, dysphasia, dyslexia, apraxia, agnosia?

Answer 23

Parietal lobe dominant side

Question 24

What area of brain controls spatial orientation, constructional skills?

Answer 24

Parietal love non domionant side

Question 25

What area of brain is affected when neglect of non dominant side, spatial disorienttin, constructional apraxia, dressing apraxia and homonymous hemianopia?

Answer 25

Parietal lobe non dominant side

Question 26

What area of the brain controls auditory perception. speech, language, verbal memory, smell?

Answer 26

Dominant side temporal lobe

Question 27

When investigation a stroke - how would you identify an infarct or haemorrhage?

Answer 27

CT scan, MRI scan

Question 28

How do you investigate the aetiology of a stroke?

Answer 28

Carotid scan, angiogram, ECG, echo

Question 29

How do you manage an acute stroke?

Answer 29

1. Thrombolysis 2. Imaging 3. Swallow assessment 4. Antiplatelets 5. Stroke unit care

Question 30

What is the only proven treatment for acute ischaemic stroke?

Answer 30

IV tissue plasminogen activator - dissolves clot (limited less than 4.5 hours from onset)

Question 31

Name some secondary prevention methods for stroke?

Answer 31

1. Anticoagulants if cardioembolic/af 2. Antiplatelets if not cardioembolic (first line clopidogrel) 3. Stop smoking 4. Statins 5 Manage BP

Question 32

What is disturbance in attention, change in cognition and develops over a short period while fluctuating?

Answer 32

Delerium

Question 33

What is different between the onset of dementia and delerium?

Answer 33

Slow for dementia. sudden for delerium

Question 34

What four things diagnose delerium?

Answer 34

1. Acute and fluctuating 2. Inattention 3. Altered level of consciousness 4. Disorganised thinking

Question 35

Give three factors of hyperactive delerium?

Answer 35

Agitated, aggressive, wandering

Question 36

What is first line medication for delerium?

Answer 36

Haloperidol - excpet parkinsons

Question 37

What medication is given for patients with delerium and parkinsons?

Answer 37

Quetiapine

Question 38

When should you use benzodiazepines for delerium?

Answer 38

When alcohol withdrawl

Question 39

High stepping gait | Rombergs positive

Answer 39

Cervical myelopathy

Question 40

Altered sensation | Gait wide based

Answer 40

Peripheral neuropathy

Question 41

Pain/paraesthesia legs | Gait wide-based

Answer 41

Lumbar stenosis

Question 42

Gait wide based | Cerebellar signs

Answer 42

Cerebella ataxia

Question 43

Parkinson's disease

Answer 43

Shuffling gait | Tremor, rigidity, bradykinesia

Question 44

Loss of executive function | Impaired risk awareness

Answer 44

Dementia

Question 45

What test can be done for falls?

Answer 45

Romberg test

Question 46

What environment do acidic drugs require for absoirption?

Answer 46

acidic e.g. phenytoin, aspirin and penicillins

Question 47

What environment do basic drugs require for absorption?

Answer 47

Diazepam, morphine, pethidine

Question 48

Do elderly have decreased hepatic metabolism?

Answer 48

Yes due to decreased size, blood flow and disease

Question 49

What medication doses are effective in elderly?

Answer 49

Low