Extra Information

Question 1

What is a key question to ask if someone presents with loss of consciousness

Answer 1

Before? During? After?

Question 2

What can be used to treat trigeminal neuralgia

Answer 2

Antiepileptics e.g. carbamazepine

Question 3

What is trigeminal neuralgia described as

Answer 3

Electric shock

Question 4

Name a test for confusion (dementia)

Answer 4

AMT

Question 5

Describe AMT

Answer 5

Abbreviated mental test score out of 10 - rapidly assess elderly patients for possible dementia

Question 6

What questions are asked as part of AMT

Answer 6

Age
Time (nearest hour)
Current year
Patients home address
What jobs do these people do (point to 2)
DOB
Year WW1 started
Current monarch
Count backwards 20 to 1
Recall address given earlier

Question 7

What are the key questions to ask to determine someone’s confusion

Answer 7

Time - year? to nearest hour?
Place - where do you live?
Person - what is my job?
Sequence - 20 to 1 backwards
Memory - name and address

Question 8

What is the 4 As test for

Answer 8

Determining delirium

Question 9

What is the AMT-4

Answer 9

Abbreviated mental test 4

Question 10

What is the AMT-4 used for

Answer 10

Assess mental impairment in elderly patients

Question 11

Describe the 4 As test

Answer 11

Alertness
AMT-4
Attention - months in reverse order
Acute change/fluctuating course of mental status

Question 12

Describe the AMT-4 test

Answer 12

Age
DOB
Place (name of hospital)
Current year

Question 13

Define postural hypotension

Answer 13

Drop > (or equal to) 20mmHg systolic

And/or

> (or equal to) 10mmHg diastolic

Occurs within 3 minutes of standing

Question 14

If someone is on beta blockers and presents to A&E and has a normal HR what might this mean

Answer 14

Beta blockers can mask tachycardia in response to stress (like normal - will not go up). Can be falsely reassuring

Question 15

What can hypoglycaemia mimic

Answer 15

Can mimic strokes

Question 16

Describe A-E assessment

Answer 16

Airways

Breathing
- lungs
- spO2
- RR

Circulation
- BP
- Heart sounds (aortic stenosis can be common in elderly)
- HR - pulse? Is it regular?
- Capillary refill

Disabilities
- AVPU - scale of alertness
- Glucose
- PERL (Pupils equal + responsive to light)

Everything else
- Temperature
- Look for other injuries - always look front and back
- General examination

Question 17

Describe AVPU score

Answer 17

Scale of how awake a patient is

Alert
Voice
Pain
Unresponsive

Work way up to which they are

Question 18

If someone is confused what should be checked

Answer 18

B12 and folate

Question 19

Name a side effect of carbamazepine

Answer 19

Electrolyte disturbances (hyponatraemia)

Question 20

Name a side effect of diuretics

Answer 20

Hyponatraemia