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Stage 3: EJR - LTC > General LTC > Flashcards

General LTC Flashcards

1
Q

What bedside tests are done in a confusion screen in elderly

A
  • urine dipstick

- ECG

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2
Q

What blood tests are done in a confusion screen in elderly

A
  • TFTs (hypothyroidism)
  • LFTs (liver failure, alcoholism)
  • B12, folate
  • FBC
  • BM
  • U n Es (hyponatremia)
  • INR (check bleed risk if on warfarin)
  • Calcium (hypercalcaemia)
  • Digoxin toxicity
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3
Q

What imaging should be done in a confusion screen in elderly

A
  • CXR
  • AXR (constipation, bowel obstruction)
  • CT head
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4
Q

Target INRs for normal patients pre-surgery

A

less than 1.4

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5
Q

Target INRs for people with mechanical heart valves

A

3-4

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6
Q

Common complications from major surgery

A
  • DVT, PE
  • Urinary retention due to anaesthetic
  • Shock, wound infection, internal bleeding
  • Lung complications (due to lack of deep breathing within 48h of surgery)
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7
Q

In which groups of people is measuring eGFR inaccurate?

What should be used to assess kidney function instead?

A

Inaccurate in frail/ obese people (because eGFR is based off average body weight)

Should look at PLASMA CREATININE instead.

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8
Q

General history questions to ask if you suspect infection

A
  • fever
  • weight loss
  • change in urinary habits
  • palpitations
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9
Q

6 geriatric giants in older patients

A
  1. Immobility
  2. Instability
  3. Incontinence
  4. Intellectual impairment
  5. Iatrogenic eg poly pharmacy
  6. Pressure sores
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10
Q

Describe grade 1 pressure sores

A
  • Intact skin with non-blanchable erythema
  • localised area
  • usually over a bony prominence
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11
Q

Describe grade 2 pressure sores

A
  • Partial thickness skn loss
  • involves epidermis/ dermis
  • May present as intact/ open blister
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12
Q

Describe grade 3 pressure sores

A
  • Full thickness skin loss
  • Damage/ necrosis of subcutaneous tissues
  • Extends to, but not through underlying fascia, bone, tendon, joint capsule
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13
Q

Describe grade 4 pressure sores

A
  • Full thickness skin loss
  • Extensive destruction/ tissue necrosis/ damage to muscle, bone, tendon, joint capsule
  • Slough may be present
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14
Q

4 types of urinary incontinence

A
  1. stress
  2. urge
  3. overflow
  4. total
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15
Q

What is d-dimer used for, and when is it not as reliable?

A

To check for presence of PE/DVT

Would also be raised in sepsis so not so reliable.

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16
Q

How much should a breakthrough dose of morphine be

A

1/6 of total daily morphine dose within 24h

17
Q

Common side effects of morphine

A

Myoclonic jerks
Dry mouth
Rash

18
Q

What lab test to check if patient on statins complains of muscle pain

A 
Creatinine kinase
(product of muscle breakdown)
19
Q

What class of drugs should never be given with ACE inhibitors?

A

NSAIDs.

Combination is very nephrotoxic.

20
Q

Symptoms of a dying person

A 
"	Get sleepier and sleepier
"	Breathing slows down: Cheyne-Stokes pattern
"	Profound weakness
"	Gaunt appearance
"	Disorientation (possibly)
"	Diminished oral intake
"	Difficulty concentrating
"	Struggling with oral medication
"	Weaker pulses, low BP
"	Audible respiratory secretions
"	Skin gets colder from periphery inwards
"	Eventually all signs of cardiorespiratory function cease and the corneal reflex is lost
21
Q

Clopidogrel and warfarin are not usually given in combination.

In which group of patients is this an exception?

A

Patients who have had a stent

22
Q

4 features of metabolic syndrome

A
  1. Obesity
  2. High cholesterol
  3. Hypertension
  4. Diabetes mellitus
23
Q

Normal target INR range

A

2-3

24
Q

4 drugs given to palliative patients

A
  1. Anti-emetic
  2. Analgesia eg morphine
  3. Mood stabiliser eg midazolam
  4. Anti-secretion eg hyoscine

Stage 3: EJR - LTC (14 decks)

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