Comprehensive Geriatric Assessment Flashcards
According to NICE which patients should receive a Comprehensive Geriatric Assessment (GCA)?
1 - >65
2 - >75
3 - >85
4 - >95
1 - >65
Which of the following are included in the Comprehensive Geriatric Assessment (GCA) that make up the frailty syndrome?
1 - Falls
2 - Immobility
3 - Delirium and dementia
4 - Polypharmacy
5 - Incontinence
6 - all of the above
6 - all of the above
Comprehensive Geriatric Assessments (GCA) are important for patients >65 years old who are at high risk of all of the following EXCEPT which one?
1 - Falls
2 - Hospital-acquired infection
3 - Immobility leading to reduced muscle mass
4 - Delirium
5 - Polypharmacy
6 - Functional decline
5 - Polypharmacy
- typically some medications could be stopped
- overall aim of the GCA id to reduce length of stay and avoid admission
Are comprehensive Geriatric Assessments (GCA) more beneficial if conducted in hospitals or in the community?
hospital
- reduce mortality and increase patient independence
- BUT in the community GCA reduce admissions and re-admissions
Which of the following is NOT part of a comprehensive Geriatric Assessments (GCA)?
1 - functional capacity of the patient
2 - nutritional intake of the patient
3 - psychology of the patient
4 - environment patient is living/will living in
5 - social support available to the patient
6 - medical management required for patient
2 - nutritional intake of the patient
- although important, it will come under environment, functional and social aspects
Is collateral history important when conducting a comprehensive Geriatric Assessments (GCA)?
- yes
- especially if patient has memory issues, or has had a fall and LOC
- electronic records can also be useful
Older patients are often prescribed a lot of medications and therefore polypharmacy. In addition due to altered pharmacokinetics (how drugs are metabolised, distributed etc.) of drugs, older patients are more susceptible to adverse events. What % of hospital admissions are suggested to be due to adverse events from medications?
1 - 1%
2 - 6.5%
3 - 30%
4 - 50%
2 - 6.5%
- tools such as STOPP/START can be useful
It is estimated that 6.5% of hospital admission are due to adverse effects of medications. Of the drugs below, which has the highest admission rates associated with adverse events?
1 - NSAIDs and aspirin
2 - diuretics
3 - warfarin
4 - all have equal hospital admissions
1 - NSAIDs and aspirin
- 30% of hospital admission due to AKI and upper GI bleeds
- diuretics = 27%, electrolyte imbalance
- warfarin = 10%, bleeding
As part of a Comprehensive Geriatric Assessments (GCA) we should assess function of the patient. Which 2 of the following are the most important aspects of this?
1 - muscle strength
2 - ability to perform ADLs
3 - gait and balance assessment
4 - reactions
2 - ability to perform ADLs
3 - gait and balance assessment
- report rockwood score
- this is what they need to be able to do at home
When assessing a patients psychological state as part of the Comprehensive Geriatric Assessments (GCA), we need to asses cognition and mood. Which of the following is NOT a tool used to assess cognition?
1 - Abbreviated mental test score (AMTS)
2 - Mini-mental state examination (MMSE) V
3 - Montreal Cognitive Assessment (MoCA)
4 - Geriatric depression scale (GDS)
4 - Geriatric depression scale (GDS)
- used to assess a patients mood, linked to depression
When performing a Comprehensive Geriatric Assessments (GCA) we need to perform an social assessment. Which of the following should be included in this?
1 - package of care
2 - meals on wheels
3 - family/friends support
4 - ability to cope with life
5 - all of the above
5 - all of the above
When performing a Comprehensive Geriatric Assessments (GCA) we need to perform an environmental assessment. Which of the following should be included in this?
1 - eligibility for care/financial support
2 - safety at home (stairs, ramps etc)
3 - need to supportive equipment (walking aids)
4 - all of the above
4 - all of the above
When performing a Comprehensive Geriatric Assessments (GCA) we should perform an advanced care plan. What is this?
1 - what help a patient needs at home
2 - what additional treatment they need while in hospital
3 - if the patient should undergo CPR if they go into cardiac arrest (DNAR discussion) or if they want to be admitted to ICU
4 - all of the above
3 - if the patient should undergo CPR if they go into cardiac arrest (DNAR discussion) or if they want to be admitted to ICU
- include relatives where appropriate
A problem list, which is a list of what is currently wrong with the patient is important for what reason (MAIN USE)?
1 - to notify family/carers
2 - identify suitable management plan
3 - estimate hospital stay
4 - all of the above
2 - identify suitable management plan
