Case 6- Falls Flashcards
What is orthostatic hypotension?
Fall in BP after standing
What is syncope?
Fainting due to low BP
What is a fragility fracture?
A fracture from a mechanical force that wouldnt usually cause a fracture
What is the main factor that increases risk of fragility fractures?
Reduced bone mineral density
What are the characteristics of osteoperosis?
Low bone mass, microarchitectural disruption and skeletal fragility
How is osteoporosis diagnosed?
By a low BMD
How is bone mineral density measured?
By a DEXA scan
On a scan what are some visible signs of osteoporosis?
Thinning of horizontal trabeculae and loss of continuity
Why do females have a higher risk of osteoporosis?
After menopause oestrogen levels fall and its an important hormone for bone health, so the drop can lead to reduced bone health
Why do older people have a higher risk of osteoporosis compared to young people?
Their osteoclast activity exceeds their osteoblast activity whereas in young kids the activities are equal
What do mechanostat thresholds conclude?
The regulatory mechanisms in bone sense changes in mechanical demands and stimulate adjustment in architecture
What is sarcopenia?
Progressive and generalised loss of skeletal muscle mass and strength
How are displaced intra capsular fractures treated?
Total hip replacement or hemi arthroplasty
How are non displaced intra capsular fractures treated?
With cannulated hip scews
How are extracapsular fractures treated?
Dynamic hip screw or intra medullary nail
What is a hemi arthroplasty?
The acetabulum is not replaced
What is the first line drug for osteoporosis?
Alendronic acid
How do bisphosphonates treat osteoporosis?
They slow down osteoclasts and give osteoblasts more time to work to reduce imbalance
How is alendronic acid given?
Orally
When is alendronic acid not given?
If the person has a hiatus hernia or reflux
What are some factors that contribute to delirium?
Shock, pain, new hospital environment, analgesia, medication, injury
What conditions should you rule out before diagnosing delirium?
Electrolyte/metabolic imbalance and intracerebral pathology
What is the difference between delirium and dementia?
Symptoms of delirium come on in a few hours compared to days/months in dementia
What are some factors asides osteoporosis that can cause falls?
UTIs
Pneumonia
Syncope
