COTE Flashcards
what is a posh name for postural drop?
Orthostatic hypotension
how is postural drop diagnosed?
drop of >20 from lying to standing
drop <90 when standing/regardless of drop
drop of 10 in diastolic with sx
which dementia associated with visual hallucinations?
DLB
If dementia sx within 1 year of PD Dx:
DLB
If dementia sx after 1 yr PD Dx:
PDD
which dementia presents with social inhibition and has strong FHx?
Frontotemporal dementia
which dementia best describes a young onset dementia, gradual progression, with memory and visuo-spacial awareness intact?
FTD
which class of drugs need stopping in the elderly as they can make the cognitive impacts of dementia worse?
Tricyclic ADs
amitriptyline
what class of drugs commonly used first-line in ALzheimer’s patients?
AchIs (anticholinesterase - inhibitors)
egs AChIs
Donepezil, Galantamine, Rivastigmine
what class of drug is memantine?
NMDA antagonist
contraindications of donepezil?
Bradycardia
insomnia
don’t give a delirious patient halloperidol if they have x disease?
parkinson’s - can lead to crisis
what can you give delirious parkinson’s patients to relieve agitation?
PO lorazepam
Non-pharma tx delirium:
reassurance environmental modification - clock on wall -consistent staffing -lights out night/on in day time
when should Abx be used in wound care tx in elderly?
Only if signs of infection: fever, hot to touch, exudate..
risk assessment score for pressure sores?
waterlow score
is Olanzapine contraindicated in delirium + PD?
No, but use lorazepam instead
what bloods form part of confusion screen?
TSH, folate, b12, glucose
Middle aged adult with insidious onset dementia and personality changes =
Pick’s disease
type of FTD
when would you see Pick’s bodies on FTD ix?
silver staining - tau protein spherical aggregations
what are the 5 geriatric giants (5Ms):
Mobility - falls and gait Mind - dementia, delirium, depression Medicines - polypharmacy, sfx Multicomplexity - comorbidity and BPS situation Matters most
FRAILTY: definition:
loss of in-built reserves, leaving vulnerable to dramatic, sudden changes in health triggered by seemingly small events (minor infection or change in meds or env). Group of older people who are at highest risk of adverse outcomes
intracapsular NOF# complication?
avascular necrosis
