General Flashcards
HIV Long term management
1) Aggressively Manage CVD risk
a. Smoking cessation
b. Lipid reduction (pravastatin less interactions)
c. Weight loss and exercise
2) Malignancy surveillance
3) Vaccinations
4) Sexual Health screening
5) Compliance with therapy and monitor for OI
6) Mental health and stigmatism
HIV OI Prophylaxis
- <200 -> Bactrim or pentamidine
- <50 -> Azithromycin
- Previous viral infection consider acyclovir
HIV pregnancy
- Continue on HAART
- If viral load >1000 in 3rd term delivery via C-section
- Intralabour Zidovudine
- Treatment with Zidovudine for baby first 6 weeks
Falls examination
- Timed up and GO: Time taken to stand up walk 3 meters then return. *Should be less than 10 seconds
- Postural blood pressure
- Abnormality of gait
- Rhombergs
- Visual acuity
- Cerebellar testing
Management of recurrent falls
- Review polypharmacy
- Correct electrolytes / hydration status
- Gait excercise / balance training including Tai Chi
- Vitamin D repletion
- Physiotherapy
- New spectacles / optometry review
- Assessment of house OT home visit with aids
- Explore consideration of syncope
- Check for a treat osteoporosis to reduce risk of complication fracture
Management of Obesity
1) Assess willingness to engage in weight loss:
a) Precontemplative
b) Contemplative
c) Prepared
d) Action
2) Food Diary
3) Exercise program
a) Pedometer, gymnasium, exercise class
b) Water aerobics if osteoarthritis
4) Calorie Restriction
- Reduction of food intake by 2000-4000Kj per day will cause 500g weight loss per week
- Normal kJ intake ~8000 per day
- Engage community dietitian
- Optifast if severely obese
5) Pharmacological
- Orlistat: inhibits pancreatic lipas
- Naltrexone
- GLP1 agonist (self funded if no diabetes)
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6) Bariatric surgery
- Gastric Bypass best evidence
- Criteria BMI >40 or >35 with complications
- * Must have acceptable surgical risk
