[10] Falls History Flashcards
why is there 2 decks on falls?
first one had shit falls history and it could be in osce so important :)
What can the questions about the actual falls in a falls history be divided into?
- When
- Where
- What
- Why
- Who
- How
What needs to be asked about when in a falls history?
- What time of the day did they fall
- What were they doing at the time
Give 2 examples of when knowing what the patient was doing at the time may be helpful in falls history?
- Looking upwards may suggest vertebrobasilar insufficiency
- Getting up from bed may suggest postural hypotension
What needs to be asked about where in falls history?
In house, or outside?
What are the categories of questions when asking about what happened in a fall?
- Before
- During
- After
What needs to be asked about what happened before a fall?
- Was there any warning?
- Was there any dizziness/chest pain or palpitations
What needs to be asked about what happened during a fall?
- Any incontinence or tongue biting
- Loss of consiousness
- Pale/flushed
- Injuries
- Which part of body had first contact with floor
Why is it important to know if there was any incontinence or tongue biting during a fall?
Indicates seizure activity
What needs to be asked about what happened after a fall?
- Could they get themselves up, and how long did it take them
- Could they resume normal activities afterwards
- Was there any confusion after event
- Was there any weakness or speech difficulty
What might confusion after a fall indicate?
Head injury
What might weakness or speech difficulty after a fall suggest?
Stroke/TIA
Give 2 examples of why a patient might think they had fallen?
- Tripped over rug
- Started new medication
What ‘who’ question should be asked in a falls history?
Who has seen you fall
Why is it important to ask who has seen the patient fall?
Can provide collateral history
What ‘how’ question should you ask in a falls history?
How many times have you fallen over in last 6 months
Why is it important to know how many times the patient has fallen over in the past 6 months?
Allows you to gauge severity of the problem
What general PMH may be important in a falls history?
- Visual/hearing impairment
- Diabetes
- Anaemia
What cardiovascular PMH may be important in a falls history?
- Cardiovascular disease
- Arrhythmias
What respiratory PMH may be important in a falls history?
COPD
What neurological PMH may be important in a falls history?
- Parkinson’s disease
- Peripheral neuropathy
- Stroke
- Dementia
What genitourinary PMH may be important in a falls history?
- Recurrent urinary tract infections
- Incontinence
What gastrointestinal PMH may be important in a falls history?
- Diverticulitis
- Chronic diarrhoea
- Alcoholic liver disease
What MSK PMH may be important in falls history?
- Arthritis
- Chronic pain
- Fractures
What needs to be included in social history in falls history?
- Alcohol intake
- Support at home
- Mobility and aids
What medications are important in falls?
- Beta blockers
- Diabetic medications
- Anti-hypertensives
- Benzodiazepines
- Antibiotics
What needs to be asked in a general systems enquiry in falls history?
- Fatigue
- Weight loss
What needs to be asked in cardiovascular systems enquiry in falls history?
- Chest pain
- Palpitations
What needs to be asked in a respiratory systems enquiries in falls history?
- Shortness of breath
- Cough
What needs to be asked in a neurological systems enquiries in falls history?
- Loss of consciousness
- Seizures
- Motor or sensory disturbance
What needs to be asked in a genitourinary systems enquiry in falls history?
- Incontinence
- Urgency
- Dysuria
What needs to be asked in a gastrointestinal systems enquiry in falls history?
- Abdominal pain
- Diarrhoea
- Constipation
What needs to be asked in a MSK systems enquiry in falls history?
- Joint pain
- Muscle weakness
