Conditions

Question 1

Who is predisposed to developing delerium?

Answer 1

Dementia patients (40% develop)
Elderly and frail
Hearing and visually imapired
Post-operatively 
Opiate/ anticholinergics/ sedatives
Alcoholics

Question 2

What are some of the tools used to assess delerium?

Answer 2

4AT method
CAM method
TIME bundle

Question 3

What are the treatments for delirium?

Answer 3

Reorientation to the environment
Treatment of the underlying cause
If a danger to themselves or others then haloperidol (0.25mg max 5mg in 24 hrs)
Need follow up because increased risk of dementia

Question 4

What is sarcopenia?

Answer 4

Age related loss of muscle mass and function from inactivity

Question 5

What are some of the interventions for immobility

Answer 5

150 minutes of moderate exercise per week
Resistance exercises 2 days per week
Using SMART goals to aid compliance
These can be delivered by physio

Question 6

What are some of the assessment tools used to determine a persons immobility and cognitive impair?

Answer 6

Outcome measures  (walking tests, QUALY, strength and balance assessment)
Rivermead motor assessment scale 
Montreal cognitive assessment
6 item cognitive impairment testing
Tinetti balance and gait assessment
Lindop Parkinson’s assessment

Question 7

Man 70 years presents with his wife as just not being quite right. He has difficulty recalling peoples names and has been finding it difficult with his shoe laces. Wife thinks its been going on for a few years now but getting worse. He has been finding it more difficult to find his words. What is the likely diagnosis?

Answer 7

Dementia

Question 8

What are some of the medications that can predispose you to falls?

Answer 8

Benzodiazepines
Neuroleptics
Antihypertensives
Antidepressants
Anticholinergics
Class 1A anti-arrhythmics
Polypharmacy generally

Question 9

What are the parameters change in BP to diagnose orthostatic hypotension ?

Answer 9

Lying to standing a fall in SBP >20mmhg

OR

DBP>10mmhg after 3 minutes standing

Question 10

Name the pain management given for mild pain in palliative care

Answer 10

Paracetamol 1g 4tds
NSAID like naproxen 500mg 2tds
Can add other adjuvant

Question 11

Name the pain management given for moderate pain (step 2) in palliative care

Answer 11

Codeine 30-60mg 4tds

Other adjuvant

Question 12

Name the pain management given for severe pain in palliative care

Answer 12

Stop codeine from step 2 and start strong opioid (usually morphine)
Can use in conjunction with paracetamol/ nsaids/ adjuvants

Question 13

What is the treatment for opiod toxicity?

Answer 13

Naloxone but slowly given to avoid distress and sudden pain onset

Question 14

Man is in his end of life and is feeling very nauseated what do you prescirbe?

Answer 14

Levomeppromazine subcutaneously 2.5mg/hr

Question 15

Man in his end of life is very short of breath. What do you prescribe him?

Answer 15

Morphine 2mg/hr subcutaneously

Question 16

Man in his end of life is very distressed what do you prescribe?

Answer 16

Midazolam 2mg/hr subcutaneously

Question 17

What scoring system is used to determine likely hood of having a stroke?

Answer 17

Rosier score