Elderly care Flashcards
Deficiency In B12 Results in what type of anaemia
Macrocyctic
Comment on this chest x-ray
Anterior posterior chest x-ray = hard to comment on any cardiomegaly
Multiple pleural plaques (calcified)
Sternotomy suture can be noted
Especially if they involve the diaphragmatic pleura
Multiple Bilateral Calcified pleural Plaques Indicate What exposure.
Asbestos exposure
Incidental findings of non-symptomatic pleural plaques require treatment?
Not really, no Follow-up needed unless the patient becomes symptomatic
Not COPD
The spectrum of asbestos-related thoracic disease include:
- Benign pleural effusion
- Pleural plaques
- Diffuse pleural thickening
- Atelectasis
- Asbestosis
- Mesothelioma
- Lung cancer
In women presenting with frailty fractures what is the age cut-off between further testing needed versus presumed osteoporosis
75
In a woman presenting with a Frailty fractureb Under the age of 75 What further investigations are indicated?
DEXA scan + calcium and vitamin D bloods
What is the T score needed to diagnose osteoporosis
-2.5
A patient post DEXA scanAs indicated to have mineral density suggestive of severe osteoporosis what additional investigations should be done
/Could be done
- Calcium + vitamin D
- Parathyroid hormone + thyroid
- Bone turnover markers
A myeloma screen (urine and plasma electrophoresis), immunoglobulins and liver function tests would be additional tests to consider
What are some important considerations when starting on alendronic acid
- Only taken once a week
- Contraindicated in peptic ulceration/significant swallowing difficulties
Taken 30 minutes before breakfast with a full glass of water and remaining upright/standing 30 minutes
For patients who are unable to swallow alendronic acid what is NICEs recommended alternative
Denosumab
What is the single best means of Distinguishing between delirium And pre-existing dimension
Collateral history from relatives
The PINCH ME pneumonic is useful for identifying causes of delirium.What are these causes?
Everyone loves a pneumonic (This one is a bad one)
- Pain
- INfection
- Constipation
- DeHydration
- Medication
- Environment
Is low lighting helpful in delirium
Not exactly, while it may seem soothing it can cause shadows which can be miss perceived
What would be first-line Drug treatment in managing a patient with delirium
Low dose lorazepam (0.55 mg orally)
Drug treatment should Always be a last resort
What would be first-line Drug treatment in managing a patient with delirium
Low dose lorazepam (0.55 mg orally)
Drug treatment should Always be a last resort
Salbutamol can cause what electrolyte imbalance
Hypokalaemia
Hyperparathyroidism does what you Serum calcium
Hypercalcaemia
Aminobisphosphonate =
Alendronic acid
What is the therapeutic concentration of Digoxin
1 to 2 Micrograms/mL
What are some common symptoms of digoxin toxicity
- Nausea and vomiting
- Diarrhoea
- Hallucinations
- Visual disturbance
- Drowsiness
What is important to consider when prescribing erythromycinIn a patient on Digitoxin
Erythromycin is a very potent hepatic enzyme inhibitor and will inhibit the metabolism of many drugs, This can result digoxin toxicity