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Ageing and Complex Health > Falls > Flashcards

Falls Flashcards

1
Q

What are the causes of falls?

A

D - Drugs (polypharmacy, antihypertensives, sedatives, opioids, psychotropics)
A - Ageing ( Presbyopia, cognitive decline, gait issues, reduced muscle mass, slow reflexes)
M - Medical causes (cardiac, neurological, OA)
E - Environmental (walking aids, footwear, glasses, home hazards e.g. pets, rugs, tables)

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2
Q

What can make someone feel dizzy?

A
  1. Vertigo
  2. Presyncope
  3. Unsteadiness
  4. Psychogenic (feeling unconfident after a fall)
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3
Q

How do you assess lying and standing BP?

A
  1. Take BP after patient has been rested for a minimum of 5 minutes
  2. Take the standing BP at 1, 3 and 5 minutes after standing
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4
Q

What calculator can be used to assess fracture risk?

A

FRAX score

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5
Q

What is the suggested first line treatment for osteoporosis from the NOGG?

A
  1. Bisphosphonate

2. Vitamin D

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6
Q

What advice should be given to someone who is taking bisphosphonates?

A

They must be taken on an empty stomach in the mornings with water only. The patient must remain upright for 30-45 minutes after taking the medicine.

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7
Q

What is the correct BP equation?

A

BP=COxPVD

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8
Q

What is the correct Cardiac output equation?

A

CO=HRxSV

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9
Q

What age related changes occur in the following system; cardiovascular?

A
  1. Atherosclerotic changes
  2. Reduction in baroreceptor sensitivity
  3. Renin-Aldosterone system works less effectively
  4. Left ventricular diastolic dysfunction
  5. Conduction system disease
  6. Thickened heart valves
  7. Reduction in the limit of the heart rate
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10
Q

What age related changes occur in the following system; musculoskeletal?

A
  1. Skeletal muscle cell death and mass loss
  2. Hormonal losses contributing to reduced BMD
  3. Reduced bone mineral density
  4. Reduced cartilage
  5. Osteoarthritis
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11
Q

What age related changes occur in the following system; vision and hearing?

A
  1. Lens stiffness
  2. Lens density reduced
  3. Reduction in retina sensitivity
  4. Poor pupil reactions
  5. Presbyacusis
  6. Presbyopia
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12
Q

What age related changes occur in the following system; renal/GU?

A
  1. 30-40% reduction in number of nephrons
  2. Kidneys shrink
  3. Poor waste clearance
  4. BPH (men)
  5. Urinary incontinence (women)
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13
Q

What age related changes occur in the following system; nervous?

A
  1. Reduced cerebral blood flow
  2. 10% loss of brain mass
  3. More susceptible to damage
  4. Slowing of thought process’
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14
Q

What age related changes occur in the following system; immune?

A
  1. Immunosenesence
  2. Haemopoetic stem cells lost
  3. Less phagocytes
  4. Cell and humoral mediated immunity lost
  5. Increased risk of malignancy
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15
Q

What age related changes occur in the following system; GI?

A
  1. loss of taste buds
  2. Gum recession and lack of saliva production
  3. Gut transit time slower
  4. Loss of hepatic cells and reduced blood flow to the liver
  5. Constipation
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16
Q

What age related changes occur in the following system; endocrine?

A
  1. Less growth hormone
  2. Decreased insulin sensitivity
  3. Less adrenal hormones produced
  4. Female menopause
17
Q

What do osteoclasts do?

A

Break down old bone

18
Q

Which cells add new bones following osteoclastic activity?

A

Osteoblasts

19
Q

What is the tinetti test/score used for?

A

This is a tool for assessing gait and balance

20
Q

Which investigations should be performed routinely in patients presenting with falls?

A
  1. Blood glucose
  2. ECG
  3. Gait assessment
  4. Lying and standing BP
21
Q

What is a significant drop in systolic and diastolic BP to be classed as postural HTN?

A

20/10 mmHg

Ageing and Complex Health (6 decks)

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