Ageing Formative Flashcards
side effects of steroids?
diabetes osteoporosis proximal myopathy dyspepsia candidiasis fluid retention adrenal suppression delirium hypokalaemia euphoria
how are tendon reflexes affected in parkinsons?
normal (not affected)
non-motor features of parkinsons?
problems with speech, swallow, bowel movement and sleep
masked facies
micrographia
how can stopping steroids cause postural hypotension?
steroids suppress adrenals so stopping them suddenly means adrenals wont work to produce hormones to maintain BP
bloods in osteomalacia?
low calcium
low phosphate
high alk phos
(usually have low vit D too)
what drugs can cause low vit D?
phenytoin and other enzyme inducing drugs
- carbamazepine
- phenytoin
- oxcarbazepine
- topiramate
- phenobarbital
- primidone
how does cerebellar disease affect tone and reflexes?
normal (or reduced) muscle tone
normal deep tendon reflexes
rhombergs test in cerebellar disease?
negative
definition of postural hypotension?
fall in systolic of >20mmHg or >10mmHg diastolic in a symptomatic patient when standing from sitting/lying down
most common cause of postural hypotension?
drugs (eg diuretics, antihypertensives etc)
first line treatment of delirium?
non-pharmacological (eg optimise environment etc)
pharmacological treatment of delirium?
manage pain, constipation etc, treat any cause (eg UTI etc)
oral haloperidol used in small doses if sedation is needed
why arent benzos used in delirium?
can make it worse
used in alcohol withdrawal though
some common drugs which can cause delirium?
amitriptyline
codeine
benzodiazepines
definition of hypothermia?
core temp <35 (oral and auricular temp not reliable)
how can hypothermia affect reflexes?
can be absent
ECG features of hypothermia?
bradycardia
J waves after QRS complexes
drugs which cause tremor as a side effect?
sodium valproate
lithium
primidone
salbutamol
features of essential tremor?
bilateral postural in nature can be caused by environmental factors 50-70% of people have a family history improves with alcohol
key clinical features of delirium?
acute onset fluctuation in cognition altered consciousness inattention disorganised thinking
how do CCBs, ACEi and alpha blockers cause hypotension?
vasodilation
can topical beta blocker eye drops cause hypotension?
yes as they can be systemically absorbed
how does digoxin cause hypotension?
blocks conduction through AV node and causes bradycardia
do NSAIDs cause fluid retention?
yes
