Falls

Question 1

consequences of falls

Answer 1

injury
social isolation
confidence
use of NHS resources

Question 2

medical conditions that contribute to falls

Answer 2

diabetes (neuropathy and retinopathy)
arthritis
PD
stroke (gait)
incontinence (need to rush)

Question 3

how does reduced cognition cause increased risk of falls?

Answer 3

reduced reaction time

Question 4

what contributes to fall risk?

Answer 4

medical conditions
cognition
vision
hearing
age-related changes

Question 5

examples of age-related changes contributing to falls

Answer 5

gait
proprioception
muscle strength
fitness

Question 6

extrinsic factors contributing to falls

Answer 6

medications (diuretics, anti-hypertensives, sedatives)
environment
lighting

Question 7

what are the negative impacts of a cautious gait?

Answer 7

decreases stability with decreased speed and step length which causes reduced physical conditioning and balance skills

Question 8

polypharmacy side effects that risk falls

Answer 8

frequency/ nocturia
sedation
drowsiness
diuretics
psychotrophs have increased risk of falling

Question 9

what is a drop attack?

Answer 9

event when someone suddenly collapses

Question 10

diagnosis of orthostatic hypotension

Answer 10

lying/ standing BP

Question 11

causes of orthostatic hypotension

Answer 11

decreased autonomic capacity
medication
autonomic neuropathy
PD/DLB

Question 12

management of orthostatic hypotension

Answer 12

stop drug cause
avoid sudden changes in movement
water and salt loading
compression stockings, elevate legs, calf muscle exercises

Question 13

pharmacological management of orthostatic hypotension

Answer 13

fludrocortisone

midodrine

Question 14

what is the carotid sinus?

Answer 14

area of dilatation in the ICA which contains baroreceptors

Question 15

role of baroreceptors

Answer 15

vasodilation
reduce HR

(when it feels increased pressure)

Question 16

what is carotid sinus syndrome (CSS)?

Answer 16

abnormal activation of the carotid sinus causing cerebral hypoperfusion

Question 17

types of CSS

Answer 17

1. Cardio-inhibitory CSS= pause in HR >3 seconds
2. Vasodepressor CSS= drop in systolic BP of 50mmHg
3. Mixed CSS= both

Question 18

diagnosis of CSS

Answer 18

CSM (carotid sinus massage)

tilt table BP measurement

Question 19

when is CSM contra-indicated?

Answer 19

MI or CVA recently
VT
CAS

Question 20

risks in CSM

Answer 20

sensory disturbance

stroke

Question 21

management of falls

Answer 21

strength and balance training
home hazard interventions
vision assessment
medication review