Care of the Elderly Flashcards
3 main features of Parkinson’s
bradykinesia
cogwheel rigidity
pill-rolling tremor
Parkinson’s pathophysiology
degeneration of dopaminergic neurons in the substantia nigra
initial treatment in Parkinson’s
Levodopa
What is levodopa sometimes combined with?
decarboxylase inhibitor - carbidopa or benserazide
side effects of levodopa?
dyskinesia, ‘on-off’ effect, dry mouth, postural hypotension, psychosis, drowsiness
other treatments for Parkinson’s?
Dopamine receptor agonist - Ropinirole
Pathophysiology for Osteoporosis
decreased bone mineral density which increases bone fragility and therefore increases fracture risk
Define osteoporosis, osteopenia and normal T-scores
Normal >-1
Osteopenia -1>t>-2.5
Osteoporosis t
Osteoporosis risk factors
SHATTERED Steroids Hyperthyroidism Alcohol Thin BMI<22 Testosterone decreased Early menopause Renal or liver failure Erosive/inflammatory bowel disease Dietary intake (T1DM, malabsorption)
Conservative osteoporosis treatment
lifestyle changes
weight-bearing exercises
Medical osteoporosis treatment
Bisphosphates - Alendronate
Denosumab - Monoclonal
Define delirium
acute, transient, reversible state of fluctuating impairment of consciousness, cognition and perception
Define the two types of delirium
Hyperactive = agitation, inappropriate behaviour, hallucinations Hypoactive = lethargy, reduced concentration
Causes of delirium
Drug use - opioids, steroids, benzodiazipines, infection - UTI or pneumonia, constipation, alcohol, hypoxia, vitamin B12 deficiency, thiamine deficiency, epilepsy
Delirium screening
Bloods - FBC, U&Es, LFT, TFTs, Calcium, INR
Supportive delirium management
Have a clock available, have familiar objects from home around patients - glasses, walking aids, staff consistency, adequate lighting, sleep hygiene
Medical delirium management
Haloperidol
Benzodiazepine e.g. diazepam for delirium resulting from alcohol withdrawl (delirium tremens)
Define an ulcer
Break in the skin or mucous membrane which fails to heal
Define pressure ulcer
an ulcer caused by pressure or shear force over bony prominence
Pressure ulcer risk factors
immobility, poor nutrition, incontinence, comorbidities, smoking, dehydration, obesity, diabetes mellitus, old age
Define syncope
temporary loss of consciousness, characterised by fast onset, short duration, spontaneous recovery
Causes of falls
Stroke/TIA, syncope, drugs (alcohol, sedatives), Parkinson’s, visual impairment, hypoglycaemia, osteoarthritis of hip
