Exam #1: Falls Flashcards
What are the intrinsic factors of falling?
These are age-related factors that predispose the patient to falling:
- Decreased vision
- Decreased contrast sensitivity
- Decreased hearing
- Gait changes
Also, all of the things that are related to the DEMENTIA mnemonic.
How can we address the intrinsic factors to prevent falling?
1) Increase light
2) Increase contrast
3) Exercise the prevent deconditioning & gait changes
What are the extrinsic factors of falling?
These are environmental factors that increase the risk of falls
- Loose rugs
- Slippery floors
- Uneven door thresholds
- Poor lighting
- Inappropriate bathroom fixtures & home furnishings
What drugs predispose a patient to falling?
Predominantly CNS affecting drugs
How should you consider a fall in the elderly?
Fall is a SYMPTOM, not a diagnosis; it deserves complete evaluation just as any other symptom
What are the major interventions that have been able to prevent falling?
1) Balance training
2) Lower extremity muscle strengthening
What is the most common/ serious consequence of falling?
Fracture
What can be done to prevent fractures s/p fall?
Addressing osteoporosis/ osteopenia
When do men & women need to have a DEXAscan?
Females= 60-65 Males= 70
Why is parathyroid hormone measured in relation to osteoporosis?
PTH= Ca++ balance
****Note that PTH causes Ca++ release from bone
What is a major cause of elevated PTH?
Vitamin D deficiency (normally, absorbs Ca++ from the gut–low absorption= mobilization from bone)
How much Ca++ should elderly patients have per day?
1,500 mg
How do you normalized Vitamin D?
Vitamin D3 supplementation
What medications can be used to build bone mass?
Antiresorptives= decrease osteoclast action on the bone–must stabilize PTH first*****
- Bisphosphanates–inconvenient/ poor compliance
- Prolia (better alternative, 1 IM injection Q6months)
- Forteo–best s/p fracture
What drug is recommended for long-term management of osteoporosis prevention?
Prolia
