Comprehensive Geriatric Assessment

Question 1

What is Comprehensive Geriatric Assessment?

Answer 1

Process that determines an older person’s medical, psychological and functional capability

Question 2

Who makes up the multi-disciplinary team?

Answer 2

Doctors
Nurses
Dietician
Physio
Pharmacist

Question 3

Give an example of a problem list

Answer 3

Off legs (poor mobility)
Falls
Confusion
Frailty
Continence issues
Polypharmacy

Question 4

Chest pain is not a symptom in 1/3rd of MIs. List symptoms of MI in the elderly

Answer 4

Collapse
Delirium
Dizziness
Breathlessness

Question 5

How would you investigate MI in the elderly?

Answer 5

CXR
ECG
Troponin
Older people struggle with echos and angiograms

Question 6

How would you manage MI in the elderly?

Answer 6

Statins
Anti-platelets (not recommended due to GI bleeds)
Morphine for pain
Anti-hypertensives (can contribute to falls)
Lifestyle changes

Question 7

How do the symptoms of sepsis differ in the elderly?

Answer 7

BP may drop early (vasodilating antihypertensives contribute)
Temp low not high
No tachycardic response
Delirium
CRP and WCC do not rise much

Question 8

How should the management of sepsis differ in the elderly?

Answer 8

Antibiotics should be targeted rather than broad spectrum as there is a higher risk of C. diff

Question 9

Why can medication be dangerous to the elderly?

Answer 9

Because older people have little homeostatic reserve, they are often delicately balanced