20 cards

Question 1

time onset difference in Parkinsonism demetia and lewy body dementia

Answer 1

Lewy body dementia - dementia starts before or within 1 year of the onset of the parkinsonian symptoms
Parkinson dementia - dementia occurs 4-5 years after motor symptoms.

Question 2

Diagnosis of orthostatic hypotension

Answer 2

Drop in SBP >20mmHg
Drop to <90mmHg on standing even if the drop is less than 20mmHg
Drop in diastolic BP of 10mmHg with symptoms

Question 3

Risk factors for falling

Answer 3

Lower limb muscle weakness
Vision problems
Balance/gait disturbances (diabetes, rheumatoid arthritis and parkinson’s disease etc)
Polypharmacy (4+ medications)
Incontinence
>65
Have a fear of falling
Depression
Postural hypotension
Arthritis in lower limbs
Psychoactive drugs
Cognitive impairment

Question 4

medications associated with falls

Answer 4

Those that cause postural hypotension - nitrates, diuretics, anticholinergic meds, antidepressants, beta blockers, levodopa, ACE inhibitors
Meds associated with falls due to other mechanisms - benzos, antipsychotics, opiates, anticonvulsants, codeine, digoxin, other sedatives

Question 5

Examination and investigations for patient with a fall

Answer 5

Exam: A to E, all systems assessment
Bedsides: basic obs and postural BP, blood glucose, urine dip and ECG
Bloods: FBC, UEC, LFT, bone profile
Imaging: XR of chest and injured limbs, CT head and cardiac echo

Question 6

Types of frontotemporal lobar degeneration

Answer 6

Frontotemporal dementia/ Pick’s disease
Progressive non fluent aphasia/ chronic progressive aphasia
Semantic dementia

Question 7

Pick’s disease clin F

Answer 7

Personality changes, impaired social conduct
Hyperorality, disinhibition, increased appetite, perservation behaviouts

Question 8

How to calculate breakthrough dose

Answer 8

1/6th of daily morphine dose

Question 9

Which antiemetic is used in palliative care for N/V due to gastric dysmotility

Answer 9

Dopamine R antagonist - metoclopramide

Question 10

When is cyclizine used

Answer 10

H1 R antag
nausea in relation to motion sickness or vestibular disturbances or increased ICP

Question 11

When is dexamethasone used for nause

Answer 11

Increased ICP, chemotherapy, inflammation

Question 12

When is lorazepam used for nausea

Answer 12

Anxiety, anticipatory nausea