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CSI > falls > Flashcards

falls Flashcards

1
Q

what are the risk factors for falls in the elderly?

A

muscle weakness

low blood pressure

vision impairment

side effects of medication

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2
Q

why might someone have muscle weakness?

A

previous stroke

neurological conditions

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3
Q

what is the form of low blood pressure where it drops when going from a sitting to a standing position?

A

positral hypotension

can be caused by
- age
- drugs (e.g beta blockers, other medication that is used to lower blood pressure)
-

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4
Q

what are the environmental factors for falls in the elderly?

A

trip hazards

  • lighting
  • furniture
  • stairs
  • wet floors
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5
Q

what is syncope?

A

fainting

could be caused by positral hypotension

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6
Q

what are fragility fractures?

A

result from mechanical forces that wouldn’t ordinarily result in fracture (low level or low energy trauma)

forces are equivalent to a fall from standing height or less

some can happen without a fall (e.g vertebral)

  • bumping into something
  • coughing (affects spine)

major risk factor for fragility fracture is reduced BMD (such as in osteoporosis) but can occur in individuals without osteoporosis

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7
Q

what characterises osteoporosis?

A

low bone mass

microarchitectural disruption

skeletal fragility

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8
Q

how is osteoporosis diagnosed?

A

low BMD, measured on DEXA scan (T-score)

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9
Q

what does osteoporosis result in?

A

decreased bone strength

increased risk of (fragility) fracture

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10
Q

why are elderly females at particular risk of osteoporosis?

A

post menopausal

  • decreased levels of oestrogen
  • more resorption than bone formation (increases activity of osteoclasts, decreases activity of osteoblasts)
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11
Q

why are elderly people at risk of osteoporosis?

A

vitamin D deficiency

  • don’t go out as much
  • liver and kidney issues, needed for hydroxylation of vitamin D

stem cells in bone marrow may become adipocytes - leads to lack of osteoblast formation

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12
Q

how are muscle and bone weakness linked (mechanostat model)?

A

external forces influence mass and architecture of bone

more muscle puts more strain on bone

less muscle mass causes decrease in bone mass (resorption) - conservation of energy, weighs less

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13
Q

what is sarcopenia?

A

syndrome characterised by progressive and generalised loss of skeletal muscle mass and strength

correlated with physical disability, falls, low BMD, poor quality of life and death

linked with osteopenia/osteoporosis -affect same groups of people

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14
Q

what are the risk factors for sarcopenia?

A

age

gender

level of physical activity

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15
Q

what is sarcopenia correlated with?

A

physical disability

falls

low BMD

poor quality of life and death

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16
Q

what may cause death after a hip fracture?

A

(most common)
HAI
- infections post-op

heart failure

less common
co-morbidity - other diseases

poor mobility caused by fracture

  • could lead to blood clots etc
  • bed sores
17
Q

what does a fracture in the intracapsular region risk?

A

lack of blood supply to head of femur

tissue becomes necrotic

18
Q

why may a hemi-arthroplasty be used?

A

high risk during surgery

19
Q

what is teriparatide?

A

osteoporosis medication

competitive inhibitor of PTH to reduce bone resorption

20
Q

what is alendronic acid?

A

osteoporosis medication

bisphosphate

allows formation of calcium phosphate

oil - (first line defence)

21
Q

what is alendronic acid?

A

osteoporosis medication

bisphosphate

allows formation of calcium phosphate

contraindications by

oil - (first line defence)

22
Q

what is raloxifene?

A

selective oestrogen receptor modulator

23
Q

what is raloxifene?

A

selective oestrogen receptor modulator

24
Q

what is a falls clinic used for?

A

rehabilitation

run by geriatrics team

MDT

  • nurses
  • physio
  • occupational therapy
25
Q

falls may cause delirium - what are the symptoms?

A

fluctuations

change in mood and alertness

drowsiness

26
Q

what can cause delirium?

A

infection

medication

environment

dehydration

constipation

27
Q

what can cause/ trigger delirium?

A

infection

medication

environment

dehydration

constipation (can be caused by strong painkillers i.e opioids)

change in environment

pain

electrolyte/metabolic abnormalities (low blood sugar, low sodium, high calcium)

28
Q

underlying risk factors for delirium?

A

age

dementia

29
Q

how can delirium be combated in a hospital setting?

A

familiarise environment (photos, objects)

rehydration, laxatives

review meds

continuity of care

relatives

whiteboard, clock and calendar for time passage and to combat confusion

clear distinction between night and day due to confusion about time passage

meal-times - mood trays, mealtime buddies

30
Q

what are the neurological causes of falls?

A

confusion

cognitive impairment

depression

poor vision

poor balance

poor co ordination

31
Q

what are the unmodifiable causes of falls?

A

age

being female

history of falls

32
Q

what are the neurological causes of falls?

A

polypharmacy

particular drug culprits

alcohol

33
Q

what are the cardiovascular causes of falls?

A

orthostatic hypotension

arrythmia

syncope

34
Q

what are the neuromuscular causes of falls?

A

muscle weakness

gait disorders

  • Parkinson’s
  • hemiplegia
  • cerebellar disease
  • antalgic
  • normal pressure hydocephalus
  • proximal myopathy

peripheral neuropathy

  • sensory ataxia
  • foot drop

arthritis disorders

35
Q

what are the environmental causes of falls?

A

home hazards

inappropriate footwear

insufficient home modifications

36
Q

what are the 3 ‘other’ causes of falls?

A

fear of falling

incontinence

frailty syndrome

CSI (9 decks)

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