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FINALS revision - @medicbotanist > COTE > Flashcards

COTE Flashcards

1
Q

What is a 5Q pathway?

A

They are discharged from hospital to home but need a greater level of care.

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2
Q

What treatments can you refuse in an advanced directive?

A

You can withdraw anything that isn’t a basic care need.

Such as food + water.

You can refuse advanced care needs in an advanced directive

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3
Q

Describe what a PEG tube is?

A

Percutaneous endoscopic gastrostomy- a procedure where you get a flexible feeding tube placed through the abdomen wall into the stomach

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4
Q

What is the Court of Protection ?

A

This is a legal court set up to help patients who are unable to make decisions about their health, financial or welfare situation.

They appoint deputies to act on behalf of the patient

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5
Q

What is a court appointed deputy?

A

This is when a patient has already lost capacity for a lasting power of attorney.

They need to make decisions on the patients behalf

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6
Q

What is an independent mental capacity advocate?

A

This is needed when a patient has a serious decision to make ie long term move or a serious medical treatment

They lack capacity and do not have a Court Appointed Deputy to make their decisions.

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7
Q

How is a DoLS different to when someone is sectioned under the Mental Health Act?

A

DoLS is when a patient has no capacity but has no mental illness.

Decisions are made in their best interests. hence why it is used in Dementia patients.

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8
Q

What causes OAPs to be at an increased risk of postural hypotension?

A

In the elderly the blood vessels become less responsive to nerve stimuli as such you get the inability to respond to a rise and fall in BP.

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9
Q

Do the elderly have a higher or lower fat percentage than younger patients?

What about their renal clearance?

A

They have a higher fat percentage so be aware of this in fat soluble drugs.

Renal clearance: reduced. Reduce dose of regally excreted drugs accordingly

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10
Q

Give 5 RF for falls:

A
  1. Previous Fall
  2. Mobility issues
  3. Sensory impairment.
  4. Pain
  5. CVS, diabetes or urinary incontience
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11
Q

Give 5 tests you would want to do on someone that comes into hospital with a fall?

A

CT Head

BP + lying and standing BP

ECG

BMs , FBC, CRP, U&Es etc

Rule out sepsis: CXR, urine dip etc

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12
Q

What is dementia?

A

Dementia is a condition that describes the progressive decline in cognitive function affecting ADLs and the whole cortex

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13
Q

Is Alzheimer’s disease more common in females or males?

A

Females

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14
Q

How would dementia with Lewy Body’s present?

How is it different to Parkinson’s plus dementia ?

A

Dementia w/ Lewy body’s. Tends to present with inattention and appearance of hallucinations of small animals and children.

Other Parkinsonian Symptoms: REM, constipation and tremors tend to occur a couple of years later.

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15
Q

How does vascular dementia present?

A

Step wise degenerative changes.

RF previous vascular damage i.e. TIAs, HA and Stroke

Management: statins and BP control

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16
Q

What age range is fronto temporal dementia common in?

How does it present?

A

Common in 40-50s got a genetic link

Presents with a change in personality, social disinhibition and deterioration in intellect.

17
Q

How would Alzheimer’s present?

A

Insidious in onset.

Memory loss, Reduction in executive function
Apraxia and Agnosia 
Behaviour changes 
Decline in language 
Loss in insight
18
Q

What are the pathophysiological changes in Alzheimer’s Disease?

A

You get neurofibrillary tangles of Tau protein and beta amyloid plaque deposits

19
Q

What cognitive screening can you do on a patient with suspected dementia?

A

You need to rule out reversible causes: B12, thyroid, folate, iron deficiency, do they have pseudo dementia caused by depression?

Then you may want to do a MRI head.

Tests include: Addenbrooke’s cognitive examination, Montreal Cognitive Assessment and MMSE

20
Q

Give 5 RF of a fall ?

A

Poor mobility

Pain

Incontience (foecal or urine)

Sensory impairment

Drug use

21
Q

What are 4 investigations you would like to do in someone who just had a fall?

A

CT head

Lying and Standing BP

ECG

BM, urine dip etc

22
Q

What would you treat someone with Lewy body Dementia?

A

Donepezil

23
Q

How many months does Lewy Body Dementia develop pre Parkinson’s?

A

> 12 months

24
Q

What is the treatment for Alzheimer’s?

A
  1. Donepezil or Rivastigmine

2. Memantine

25
Q

What are some of the symptoms of Parkinson’s Disease pre motor symptoms?

A
  1. REM sleep
  2. Aches and Pains
  3. Anosmia
  4. Constipation
  5. Depression
26
Q

What are the three features of Parkinson’s ?

A

Rigidity

Resting Tremor

Bradykinesia

27
Q

How would you treat a benign essential tremor?

A

Propanol

28
Q

What is the 1st and 2nd line treatment of Parkinson’s Disease?

A
  1. Co carelodopa = de carboxylase inhibitor
  2. Dopamine Agonist: cabergoline
  3. MAO-B inhibitor oral rasagiline
29
Q

What criteria is used to score pressure sores?

A

Braden and Waterlow scores

30
Q

Does smoking increase the incidence of pressure sores?

A

YES

31
Q

What is the best diagnostic method for diagnosing PD?

A

Positive response to dopamine

Can also use a DAT imaging scan

32
Q

Give a definition of delirium

A

An acute onset fluctuation in consciousness that often involves perception and mood. Worse at night.

33
Q

What bloods would you like to do in a patient with suspected osteoporosis?

A

Alkaline Phosphatase

Phosphate

Calcium

Phosphate

34
Q

Give 5 different types of syncope?

A

Neurally mediated syncope: vasovagal

Orthostatic Hypotension: occurs on standing up

Autonomic Failure: common in DM or PD

Hypovolaemic: haemorrhage, dehydration, D + V

Cardiogenic: arrhythmias

Psychogenic

FINALS revision - @medicbotanist (20 decks)

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