additional components

Question 1

what is “MUST”

Answer 1

malnutrition, universal screening tool

Question 2

what does the “MUST” consist of?

Answer 2

5 step screening tool to identify adults who are;

• malnourished
• at risk of malnutrition
• obese

Question 3

outline the first 3 steps of the MUST criteria which are added up to equate to step 4 which is the overall risk of malnutrition

Answer 3

step 1 = BMI

step 2 = unplanned weight loss in past 3-6 months

step 3 = acute disease effect (if patient is acutely unwell ill and likely to have no nutritional intake for >5days

Question 4

name 2 essential members of MDT to involve in guiding decision making for a malnourished patient

Answer 4

• speech and language therapist

- dietician

Question 5

modified consistency category E

Answer 5

fork mashable

Question 6

modified consistency category D

Answer 6

Pre mashed

Question 7

modified consistency category C

Answer 7

puree

Question 8

4 components of medical ethics

Answer 8

1 autonomy
2 beneficience
3 non-maleficence
4 justice

Question 9

outline the first stage of assessment of mental capacity

Answer 9

Questioning whether the person has an impairment of their mind or brain whether as a result of alcohol, drug abuse, or illness

Question 10

outline the second stage of assessment of mental capacity

Answer 10

Does the impairment mean the person is unable to make a specific decision when they need to?

Question 11

Mental capacity act states that a person lacks capacity if they can’t; (4)

Answer 11

• understand the information relevant to the decision
• retain the information
• weigh up the decision
• communicate decision back

Question 12

what is a lasting power of attorney

Answer 12

arranging for someone else to legally be able to make decisions for you

Question 13

increased losses than can contribute to malnutrition

Answer 13

• fever
• diarrhoea
• wounds
• burns

Question 14

decreased intake that can contribute to malnutrition

Answer 14

• reduced appetite
• dysphagia
• disliking food
• communication issues
• reduced ability to self feed

Question 15

what can cause mechanical dysphagia due to obscturction to the upper digestive tract?

Answer 15

• head + neck cancer

Question 16

what can cause neurological dysphagia

Answer 16

acute strokes

Question 17

name 3 of 5 types of tubes that can deliver feed

Answer 17

• nasogastric
• PEG
• jejunostomy
• nasojejunal
• nasoduodenal

Question 18

name 3 medications that can contribute to risk of falls by causing hypotension

Answer 18

bendroflumethiazide, amlodopine, tamsulosin

Question 19

how can codeine contribute to falls

Answer 19

sedation

Question 20

how can amitriptyline contribute to risk of falls?

Answer 20

sedation

Question 21

a prescribing cascade is …

Answer 21

when a new medication is prescribed to treat an unrecognised adverse drug reaction or manifestations of a drug-drug interaction between existing medications

Question 22

what are the 7 steps for medication review listed in the SIGN polypharmacy guidance

Answer 22

1. identify objectives of drug therapy
2. identify essential drug therapy
3. does the patient take unnecessary drug therapy
4. are therapeutic objectives being achieved
5. does the patient have ADR or at risk of ADR?
6. is drug therapy cost-effective
7. is the patient willing and able to take drug therapy as intended

Question 23

definition of polypharmacy

Answer 23

more than 4 medications

Question 24

what does SPIKES stand for and what is this used for?

Answer 24

Breaking bad news.

S - Setting 
P - Patients perception 
I - Invitation 
K - Knowledge 
E - Explore emotions 
S - Strategy + summary