Chronic conditions and pain

Question 1

What social conditions should you always look for in developmental disability

Answer 1

Communication issues
Neglect
Abuse

Question 2

What underdiagnosed medical conditons should you think about in developmental disabilities

Answer 2

Vision
Hearing
Dental

Question 3

List three things to think of when someone has a worsening of their chronic condition

Answer 3

Medication side effect
Disease getting worse
Exacerbation of disease
New condition

Ask biopsychosocial and function

Question 4

What dose of ibuprofen

Answer 4

200-400 mg

Question 5

What is the max of a new start for opioids

Answer 5

50 mg morpheine equivalents daily

Question 6

Max dose of opioids you should try to taper down to

Answer 6

90 morphine equivalents daily

Question 7

List five medications you should try before opioids

Answer 7

NSAIDS
TCAs
Nabilone 
Acetaminophen 
Pregabalin

Question 8

List four non medications you should try before opioids

Answer 8

CBT
Exercise
Physio
RICE

Question 9

How long should you give an opioid prescription for

Answer 9

3 days

Not more than 7

Question 10

HOw to taper opioids

Answer 10

5% drop every 2-8 weeks

Question 11

When can we use cannabis (other than for fun)

Answer 11

Neuropatinc pain
Palliative pain
Spasticity
Cheo induced Nausea and vomiting

Question 12

When can you smoke and drive

Answer 12

6 hours after inhalation and 8 hours after oral ingestion

Question 13

List Seven concerns specific for the elderly

Answer 13

Incontinence
Memory disturbance
Anorexia
Sarcopenia
Frailty 
Depression 
Falls
Delirium 
Immobility

Question 14

List the RISKS for being elderly

Answer 14

Roaming
Intermittent danger (falls and fire)
Self neglect
Kinship (and abuse) 
Safe driving and substance abuse

Question 15

List the activities of daily living

Answer 15

Dressing
Eating
Ambulating
Toileting 
Hygiene

Question 16

List the IADLs

Answer 16

Shopping 
Housework
Accounting 
Food and meds 
Telephone and transport

Question 17

List 5 non prescription ways you can change an olds life

Answer 17

Hearing aids
Dnetures
Glasses
Walker
Refer to occupational therapy or physio

Question 18

What two screening tools can we use to deprescribe in the elderly

Answer 18

BEERS

STOPP

Question 19

What medications should we try to deprescribe and why

Answer 19

1. Benzos-Increased falls, confusion and all cause mortality
2. Antipsychotics if on for over 3 months or if ineffective

Question 20

How much should an old be allowed to drink

Answer 20

Women: 1 per day no more than 5 per week
Men 1-2 per day no more and 7 per week

Start on THiamine 50 mg daily if they are heavy drinkers
Consider pre op taper

Question 21

Name five ways we can help with elder abuse

Answer 21

Optimize home care 
Identify alternate caregivers
Assess mental health 
Address care giver burn out 
Assist in care planning (financial)
Evaluate, treat and document physical abuse
Refer to police 
Consider safety plan