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Year 4 TCDs > Ageing: SCTs > Flashcards

Ageing: SCTs Flashcards

1
Q

What are the components of a prescription review? (10)

A
  1. Case summary
  2. Medications prescribed (name, indication, dose, frequency, duration, route)
  3. Allergies/intolerance
  4. Demographics
  5. Medication indication
  6. Check medication dose, frequency, duration, route
  7. Check for drug interactions
  8. Check for relevant co-morbidities
  9. Check prescription is legible + complete
  10. Check how patient is taking their medication
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2
Q

What are the 3 drug causes for falling in the elderly?

A
  1. Sedation
  2. Hypotension (orthostatic, vasovagal, vasodepressor carotid sinus hypersensitivity)
  3. Bradycardia, tachycardia, periods of asystole
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3
Q

What is pharmacokinetics?

A

What the body does to the drug

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4
Q

What is pharmacodynamics?

A

What the drug does to the body

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5
Q

Name the 4 components of pharmacokinetics

A
  1. Absorption (little change in elderly)
  2. Distribution
  3. Metabolism (increased bioavailability of drugs)
  4. Excretion (decreased excretion)
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6
Q

What is polypharmacy?

A

The use of multiple medications by a patient, typically 5+

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7
Q

What is a prescribing cascade?

A

Occurs when a new medication is prescribed to treat an unrecognized adverse drug reaction or manifestation of a drug-drug interaction between existing medications

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8
Q

What are the 7 steps for medication review listed in the SIGN Polypharmacy Guidance?

A
  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 is at risk of ADRs?
  6. Is drug therapy cost-effective?
  7. Is the patient willing and able to take drug therapy as intended?
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9
Q

Mental capacity Act Legislation 2005 states that mental capacity is X and Y specific. What are X and Y?

A

Time specific

Decision specific

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10
Q

What 4 criteria must be met for someone to have capacity?

A
  1. Understand the information
  2. Retain the information
  3. Weigh up the information
  4. Communicate the decision back
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11
Q

What are the 2 stages of the Mental Capacity Act Legislation?

A
  1. Is there impairment/disturbance of function in a person’s brain or mind?
  2. Is the impairment sufficient to constitute loss of capacity?
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12
Q

What are 4 causes of malnutrition?

A
  1. Drugs
  2. Ageing process
  3. Medical conditions
  4. Environmental factors
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13
Q

What are the 3 categories of malnutrition?

A
  1. Increased needs
    - increased stress on body from illness/surgery
  2. Increased losses
    - diarrhea/vomiting; fever; wounds; burns
  3. Reduced intake
    - reduced appetite; cognitive/communicative issues; dysphagia; dislike of food
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14
Q

What are 7 consequences of malnutrition?

A
  1. Increased length of stay
  2. Impaired wound healing
  3. Impaired immune response
  4. Inability to mobilise
  5. Depression/reduced QOL
  6. Poor digestive function
  7. Increased costs of care
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15
Q

Name 8 conditions that can cause dysphagia?

A
  1. Motor neurone disease
  2. Multiple sclerosis
  3. Delirium
  4. PD
  5. Stroke
  6. Head/neck cancer
  7. Dementia
  8. Sepsis
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16
Q

What are the 5 categories of oropharyngeal dysphagia?

A
  1. Iatrogenic (i.e. medication)
  2. Neurological (i.e. stroke)
  3. Infectious (i.e. Lyme Disease)
  4. Structural (i.e. cricopharyngeal stricture)
  5. Myopathic (i.e. myasthenia gravis)
17
Q

What are the 3 categories of oesophageal dysphagia?

A
  1. Mechanical lesions
    - Intrinsic (i.e. benign tumours)
    - Extrinsic (i.e. mediastinal mass)
  2. Motility disorders (i.e. achalasia)
  3. Functional dysphagia
18
Q

Name 6 methods of artificial feeding

A
  1. Intravenous alimentation
  2. Nasoduodenal tube
  3. Nasogastric tube
  4. Nasojejunal tube
  5. Jejunostomy tube
  6. Gastrostomy tube
19
Q

List 5 indications for artificial feeding

A
  1. Mechanical dysphagia due to obstruction to the upper digestive tract (i.e. head/neck cancer)
  2. Neurological dysphagia, where there’s a prospect of recovery from underlying disease (i.e. stroke)
  3. Inability to eat due to global neurological damage, where there’s prospect of recovery from underlying disease (i.e. brain injury, reversible coma)
  4. Where nutritional requirements are increased due to malabsorption (i.e. CF, Crohn’s)
  5. For essential medication delivery (i.e. Anti-epileptics, PD meds)
20
Q

What is the SPIKES framework for breaking bad news?

A 
S-setting and listening skills
P-patient's perceptions
I-invitation
K-knowledge 
E-explore emotions/empathise
S-strategy/summary
21
Q

If you are confronted by an angry patient, what are 6 things you can do?

A
  1. Be at their eye level – try to sit down together
  2. Be polite and firm
  3. Acknowledge their feelings
  4. Be willing to talk and listen – open questions
  5. Create a calm atmosphere
  6. Verbally break the cycle of anger and aggression

Year 4 TCDs (16 decks)

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