Clinical Skills Flashcards
Choice of cognitive test for patient at primary care setting
AMTS - abbreviated mental test score
GPCOG - GP assessment of cognition
MINI COG
Choice of cognitive test for patient in memory clinics
Addenbrookes COG test
Montreal COG test
MMSE mini mental state exam
Choice of cognitive test for patient in acute care setting
AMTS
6CIT- 6-item cog impairment test
GPCOG
Choice of cognitive test for patient in care homes
AMTS
6CIT- 6-item
GPCOG
Montreal
What does the result of PHQ9 means?
0-10 points - unlikely to suffer from depression
10-27 - v likely
GPCOG can detect what condition
Dementia
What is GPCOG consist of
Cog test items + historical Qs
Why is 6CIT not very well known as a cog impairment test?
- newer test then AMTS
- more complex scoring system
AMT is a quick to use test but not used so much today.
This is bc
It can be confounded by intelligence. Age. Social class. Sensitivity of hearing. History of stoke.
What’s the easier and quicker to administer version of AMT
A 4 point AMT is easier than 10 point version
AMT for delirium and cog impairment has more validation in which setting, primary care or hospital
Hospital
Med rec plays an important role when pt
Is transferred from one healthcare setting to another
Hospital, home, ward, care home
Define med Rec (by institute for healthcare improvement)
The process of obtaining an up to date and accurate med list that has been compared to the most recently available information and has documented any - discrepancies - changes - deletions - additions Resulting a complete list of med
What are the 3C in med rec
Collecting
Checking
Communicating
MUR IS AN…. SERVICE
Advanced
An mur is... a full clinical review A chance to identify problematic se An agreement about changes to meds A way to reduce med wastage
2,4
Who can conduct an MUR
Pharmacist only
What are the MUR target group
High risk med (naproxen)
Respiratory
CVR
recent discharge from hospital
Examples of High risk meds
Naproxen - NSAID
Dalteparin - LMWH anticoagulant
Bendroflumethiazide- diuretics for CVD
Under what circumstance can’t you perform a MUR due to NMS?
- Can’t do MUR if NMS within 6M Unless discharged from hospital - if had MUR within 12m - if pt not used this pharmacy for longer than 3M - unless pt on more than 1 D Unless the only D is high risk med
What’s the issue with hypothyroidism patient taking calcium tablet
Levothyroxine x calcium
Take dose separately
Medicine optimisation for patients with aki
- medication that could exacerbate AKI
- Medications where doses need to be adjusted
- Educate patient before discharge about which med restart
- Communication with GP which medicine to restart and when
What are the medications to be stopped in acute kidney injury
CANDA
Contrast media, ace inhibitor, NASID, diuretics, ARB
Also. Metformin, spironolactone
What are the problems with epileptic meds
Carbamazepine and phenyltoin are enzyme inducer
Sodium valproate is enzyme inhibitor
Dose equivalence N conversion for Caffeine citrate to caffeine base
2 mg caffeine citrate = 1 mg caffeine base
Define preterm: term : post term neonate
<37w
37-42w
>=42w gestation
How to calculate corrected gestationalr age
Term (40w)- gestation (35) = 5 w of prematurity
Age since born 8w- 5w= 3w
