Comprehensive geriatric assessment and acute illness

Question 1

describe the geriatric process (5)

what is CGA?

Answer 1

• Comprehensive Geriatric Assessment
• Creation of a problem list (more than a just a list of differential diagnoses for one problem)
• Agree objectives of care
• Develop Individual Management Plan
• Regular Review

-comprehensive geriatric assessment

Question 2

What does a comprehensive geriatric assessment involve? (4)

Answer 2

Medical:

• Problem list
• Co-morbid conditions and disease severity
• Medication review
• Nutritional status

Psychological

• Mental status/cognitive function
• Mood/depression testing

Functioning

• Basic ADLs
• Extended ADLs
• Activity/exercise status
• Gait and balance

Social/ Environment

• Informal needs and assets
• Social circle
• Care resource eligibility & availability
• Safety

Question 3

Name the 7 common clinical problems in geriatric care

Answer 3

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

Question 4

state the differences between younger people and geriatric presentations (4)

Answer 4

• impaired immune system (reduced immune response)
• impaired physiology (blunted here rate/BP response
• Co-morbidities
• polypharmacy

Question 5

Why might beta blockers cause problems?

Answer 5

they prevent the tachychardic response when it is required

Question 6

Sepsis presentation in the elderly (6)

why should antibiotics be targeted?

Answer 6

• become hypotensive early (antihypertensive medication_
• low temp
• absent tachycardic response
• Delirium may be prominent feature
• CRP and WCC lower than expected
• Fluid balance may be hard

risk of C.diff higher