Ageing - General Flashcards
what is delirium?
change in attention and cognition
develops over a short period of time (acute)
is fluctuating
risk factors for delirium?
age dementia co morbidities malnutrition polypharmacy sensory impairment DM
features of HYPER active delirium?
agitated restless fluctuating emotioms illusions hallucinations delusions
features of HYPO active delirium?
sleepy
slow
what is the 4AT? what score indicates delirium?
Alertness
AMT4 (age, DOB, hospital, year)
Attention (months backwards)
Acute or fluctuating course
> 4 probable delirium
Ix for delirium?
FBC, U+Es, LFTs, CRP blood culture ABGs B12, folate, thiamine TFTs urinalysis ECG imaging (if indicated)
causes of delirium?
infection constipation/retention BM drugs hypoxia # heart attack dehydrated
Tx for delirium?
reverse cause appropriate environment hydrate haloperidol 0.5mg (/lorazepam if alcohol/seizure/parkinsons)
risk factors for falls?
>4 medicines Hx of fall age visual impairment cognitive impairment urinary incontinent
what are the red flags in a falls history?
incontinence
loss of consciousness
tongue biting
what exams should be done in a fall assessment?
CVS CNS MSK DM lying and standing BP feet exam ECG visual acuity
what should be done for falls prevention?
physio
OT
med rec
Vit D/bone protection
Ix for overflow incontinence?
bladder scan
Ix for urge incontinence?
PVR
Tx for overflow incontinence?
alpha blocker (doxasozin) 5-alpha reductase (finasteride)
