Ageing Formative

Question 1

side effects of steroids?

Answer 1

diabetes
osteoporosis
proximal myopathy
dyspepsia
candidiasis 
fluid retention
adrenal suppression
delirium
hypokalaemia
euphoria

Question 2

how are tendon reflexes affected in parkinsons?

Answer 2

normal (not affected)

Question 3

non-motor features of parkinsons?

Answer 3

problems with speech, swallow, bowel movement and sleep
masked facies
micrographia

Question 4

how can stopping steroids cause postural hypotension?

Answer 4

steroids suppress adrenals so stopping them suddenly means adrenals wont work to produce hormones to maintain BP

Question 5

bloods in osteomalacia?

Answer 5

low calcium
low phosphate
high alk phos
(usually have low vit D too)

Question 6

what drugs can cause low vit D?

Answer 6

phenytoin and other enzyme inducing drugs

• carbamazepine
• phenytoin
• oxcarbazepine
• topiramate
• phenobarbital
• primidone

Question 7

how does cerebellar disease affect tone and reflexes?

Answer 7

normal (or reduced) muscle tone

normal deep tendon reflexes

Question 8

rhombergs test in cerebellar disease?

Answer 8

negative

Question 9

definition of postural hypotension?

Answer 9

fall in systolic of >20mmHg or >10mmHg diastolic in a symptomatic patient when standing from sitting/lying down

Question 10

most common cause of postural hypotension?

Answer 10

drugs (eg diuretics, antihypertensives etc)

Question 11

first line treatment of delirium?

Answer 11

non-pharmacological (eg optimise environment etc)

Question 12

pharmacological treatment of delirium?

Answer 12

manage pain, constipation etc, treat any cause (eg UTI etc)

oral haloperidol used in small doses if sedation is needed

Question 13

why arent benzos used in delirium?

Answer 13

can make it worse

used in alcohol withdrawal though

Question 14

some common drugs which can cause delirium?

Answer 14

amitriptyline
codeine
benzodiazepines

Question 15

definition of hypothermia?

Answer 15

core temp <35 (oral and auricular temp not reliable)

Question 16

how can hypothermia affect reflexes?

Answer 16

can be absent

Question 17

ECG features of hypothermia?

Answer 17

bradycardia

J waves after QRS complexes

Question 18

drugs which cause tremor as a side effect?

Answer 18

sodium valproate
lithium
primidone
salbutamol

Question 19

features of essential tremor?

Answer 19

bilateral
postural in nature
can be caused by environmental factors
50-70% of people have a family history
improves with alcohol

Question 20

key clinical features of delirium?

Answer 20

acute onset
fluctuation in cognition
altered consciousness
inattention
disorganised thinking

Question 21

how do CCBs, ACEi and alpha blockers cause hypotension?

Answer 21

vasodilation

Question 22

can topical beta blocker eye drops cause hypotension?

Answer 22

yes as they can be systemically absorbed

Question 23

how does digoxin cause hypotension?

Answer 23

blocks conduction through AV node and causes bradycardia

Question 24

do NSAIDs cause fluid retention?

Answer 24

yes