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Year 4 - OPIC > Frailty > Flashcards

Frailty Flashcards

1
Q

Feeding at risk

  • Foods
  • Drinks
A

Feeding at risk

  • Foods
    7. Regular
    6. Soft & bite-sized
    5. Minced and moist
    4. Pureed
    3. Liquidised
  • Drinks
    4. Extremely thick
    3. Moderately thick
    2. Mildly thick
    1. Slightly thick
    0. Thin
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2
Q

Continence Assessments
- Hx
- Ex
- Ix

A

Continence Assessments

Hx
1. Detailed history
2. Bladder and bowel diary

Ex
3. Abdo exam
4. PR
5. External genitalia
- atrophic vaginitis

Ix
6. Urine dip and MSU
7. Post-mic bladder scan

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3
Q

Incontinence
- Mx

A

Incontinence
- Mx

  1. Oral intake
    - Decaf
    - Improved food
  2. Bowel habits
    - Regular
    - Bladder retraining
  3. Pelvic floor ex
  4. Anticholinergics not good
    - eg oxybutynin
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4
Q

Care homes

  1. Nursing
  2. Residential
A

Care homes

  • Nursing
    1. Nurses and care assistants
  • Residential
    2. Trained staff, not nurses
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5
Q

Carer strain
- Effects

A

Carer strain
- Effects

  1. 3/4 mental health effects
  2. 60% physical health effect
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6
Q

Falls history
- Features

A

Falls history
- Features

  1. When
  2. Where
  3. What
    - before?
  4. Who saw?
  5. Black out?
    - “I must have tripped”
  6. Frequency?
    - 12 month history
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7
Q

Falls assessment
- Points

A

Falls assessment
- Points

  1. Hx and Ex
    - gait
  2. ECG
  3. Lying/standing BP
  4. Medication review
  5. Bone health review
  6. Functional assessment MDT
    - Exercise programme
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8
Q

CGA
- Components

A

Comprehensive Geriatric Assessment
- CGA Components

  1. Medical
  2. Functional
  3. Psychological
  4. Social
  5. Environmental
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9
Q

CGA
- Medical components

A

CGA
- Medical components

  1. Problem list
  2. Co-morbidities
    3 . Medication
  3. Nutrition
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10
Q

CGA
- Functional components

A

CGA
- Functional components

  1. Basic ADLs
  2. Instrumental ADLs
  3. Gait and balance
  4. Exercises/activity
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11
Q

Orthostatic hypotension
- Definition

A

Orthostatic BP
- Definition

  1. 20 systolic
  2. 10 diastolic
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12
Q

Lying and standing BP test
- Process

A

Lying and standing BP test
- Process

  1. 5 minutes lying down
    - measure BP
  2. Stand up
    - measure at 1 min
    - measure again at 3 mins
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13
Q

CGA
- Psychological components

A

CGA
- Psychological components

  1. Cognitive status
  2. Mood assessment
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14
Q

CGA
- Social components
- Environmental components

A

CGA

  • Social components
    1. Informal social support
  • Environmental assessment
    1. Care resource eligibility/finances
    2. Home safety
    3. Transport access
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15
Q

Clinical frailty score
- Scores

A

Clinical frailty score
- Scores

1 -2
- Very fit, well

3-4
- Managing well, vulnerable

5-6
Mildly frail - moderately frail

7-9
Severely frail, very severely frail, terminally ill

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16
Q

Power of Attorney

  1. When made?
  2. Powers?
  3. Office?
  4. Court of protection?
A

Power of Attorney

  1. When made?
    - When patient has capacity
  2. Powers?
    - Health and welfare
    - Property and financial affairs
  3. Office?
    - Public guardian
  4. Court of protection?
    - When not in best interests
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17
Q

Feeding at risk
- Definition

A

Feeding at risk
- Definition

  1. Continues to eat and drink
    - despite risk
  2. Quality of life is highest priority
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18
Q

Feeding at risk
- When used?

A

Feeding at risk
- When used?

  1. Advanced stage of illness
  2. Swallow safety not likely to improve
  3. Tube feeding declined or inappropriate
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19
Q

Fragility fracture
- Definition

A

Fragility fracture
- Definition

  1. Falling from standing height
    - or lower
  2. Walking speed
    - or slower
20
Q

Fragility fractures
- Most common sites

A

Fragility fractures
- Most common sites

  1. Spine
    -vertebrae
  2. Hip
    - proximal femur
  3. Wrist
    - distal radius

also
- Humerus, pelvis, ribs

21
Q

Osteoporosis
- Definition

A

Osteoporosis
- Definition

  1. Low bone mass syndrome
  2. Micro-architectural deterioration of tissue
  3. Increased risk of fractures
  4. Bloods normal
22
Q

Fragility fracture
- Risk factors

A

Fragility fracture
- Risk factors

  1. Age
    - F65, M 75
  2. Previous falls/ fractures
  3. Steroids
  4. Family Hx
  5. Low BMI
  6. Smoking & alcohol
23
Q

FRAX assessment
- Risk stratification

A

FRAX assessment
- Risk stratification

  1. 10 year probability of fracture
  2. Based on BMD
24
Q

Bisphosphonates

  1. Blood tests
  2. Drug choices
  3. Contraindications
A

Bisphosphonates

  1. Blood tests
    - Ca, D3, GFR
  2. Drug choices
    - Risedronate/alendronate
    - IV Zolendronate
    - Denosumab
  3. Contraindications
    - Achalasia/strictures
    - Ulcers
25
Q

IV Zolendronate

  • Indication
  • Dosing
A

IV Zolendronate

  • Indication
    1. Non-compliant to oral
  • Dosing
    1. 30 minutes, once yearly
    2. 3 year
26
Q

Denosumab

  • Indications
  • ADRs
A

Denosumab

  • Indications
    1. Unresponsive to IV bisphosphonate
    2. Low GFR
  • ADRs
    1. Skin infection
    2. Stress fractures
27
Q

Pressure sores
- Screening tools

A

Pressure sores
- Screening tools

  1. Bestshot
  2. Waterlow
28
Q

Pressure sores
- Sites

A

Pressure sores
- Sites

  1. Sacrum
  2. Ankles
  3. Head
  4. Ears
  5. Knees
29
Q

Pressure ulcers
- Risk Factors

A

Pressure ulcers
- Risk Factors

  1. Build
  2. Skin type
  3. MUST
  4. Continence
  5. Mobility
  6. Tissue malnutrition
  7. Neurological deficit
  8. Major surgery/trauma
30
Q

Pressure sores
- Grading

A

Pressure sores
- Grading

1 Skin
2 Deep skin
3 Fat
4 Bone

31
Q

Pressure sores
- Mx

A

Pressure sores
- Mx

  1. Prevention
  2. Wound
    - pain and tolerance
    - position
    - dressing change
  3. Friction reduction
  4. Nutrition
  5. Pressure redistibution
    - 2-hourly turns
    - air mattress
    - repose boots
  6. Antimicrobials
32
Q

IMCA
- Role

A

Independent mental capacity assessor

  1. Involved in ‘best interest’ decisions
33
Q

DOLS
- Role

A

Deprivation of liberty safeguard

  1. Protect rights of person
    - When they cannot consent
  2. Deprive them of their liberties
34
Q

Role of OT

A

Role of OT

  1. Support independence
  2. Minimise carer strain
  3. Reduce risk to self and others
35
Q

Cardiac drug
- Thyroid complications

A

Cardiac drug
- Thyroid complications

  1. Amiodarone
  2. Hyper(/hypo)
36
Q

Renal dialysis
Indications AEIOU

A

Renal dialysis
Indications

  1. Acidosis
    E
    I ntoxication
    Oedema
    Uraemia
37
Q

Hearing impairment
- Speaking to patients

A

Hearing impairment
- Speaking to patients

  1. Slow
  2. Consonants
    - beginning
    - ending
38
Q

CKD
- UTI drug

A

CKD
- UTI drug

  1. Trimethoprim can cause AKI
  2. Don’t give to CKD3 or below
39
Q

AKI
- Stop the DAMN drugs

A

AKI

D - iuretics
A - CE inhibitors
M - etformin
N - SAIDs

40
Q

Frailty
5 Phenotypes

A

Frailty
5 Phenotypes

  1. Weight loss
  2. Weakness
  3. Exhaustion
  4. Slowness
  5. Low physical activity
41
Q

Prisma 7 score

A

Prisma 7 score

  1. 85+
  2. Male
  3. Limited activities
  4. Regular carer available
  5. Regularly staying home for health
  6. Someone close for help
  7. Mobility aids
42
Q

Frailty
- TUG Test

A

TUG Test
- Timed up and go

1.

43
Q

Geriatric giants
- Five Is

A

Geriatric giants
- Five Is

  1. Immobility
  2. Instability
  3. Incontinence
  4. Impaired memory
  5. Iatrogenesis
44
Q

Phenotypic frailty
- Five Lows

A

Phenotypic frailty
- Five Lows

  1. Low grip
  2. Low energy
  3. sLowed walking
  4. Low physical activity
  5. Unintentional weight Loss
45
Q

Approaching end of life

  • Definition
A

Approaching end of life
- Definition

  1. Likely to die within 12 months
    - Including imminent
  2. Advanaced, progressive, incurable
  3. General frailty
  4. Existing conditions
    - Possible crisis
  5. Sudden catastrophic events

Year 4 - OPIC (5 decks)

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