GERATOLOGY Flashcards

1
Q

medication classes that commonly cause constipation (3) and some examples of each

A
  1. opiates e.g. oxycodone, morphine
  2. CCBs e.g. nifedipine, amlodipine, felodipine
  3. antipsychotics e.g. clozapine, haloperidol, chlorpromazine
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2
Q

1st line management of delirium

A

antipsychotics e.g. haloperidol

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3
Q

1st line management of delirium if pt has background of parkinsons

A

lorazepam

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4
Q

causes of delirium (PINCH ME)

A

Pain
Infection
Nutrition
Constipation
Hydration

Medications - opioids, benzos
Environment

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5
Q

what makes a diagnosis of postural hypotension?

A

from sitting to standing within 10 minutes - systolic BP drops by =>20mmHg and/or diastolic BP drops by =>10mmHg

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6
Q

what drugs frequently cause postural hypotension?

A
  • antihypertensives e.g. ramipiril
  • diuretics
  • L-dopa
  • antidepressants
  • sedatives
  • alpha blockers e.g. sildenafil
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7
Q

non-pharm causes of postural hypotension

A
  1. hypovolemia
  2. autonomic dysfunction - diabetes, Parkinson’s
  3. alcohol
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8
Q

management of postural hypotension
a) non-pharm
b) pharm

A

a) compression stockings, high salt diet, advice on knowing the signs and standing slowly

b) stop/decrease causative med
or fludrocortisone (e.g. if not due to med)

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9
Q

list some neuropsychiatric causes of falls in the elderly

A
  1. visual impairment
  2. hearing impairment
  3. peripheral neuropathy
  4. gait issues e.g. PD
  5. cognitive impairment
  6. stroke/TIA
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10
Q

list some toxic/environmental causes of falls in the elderly

A
  1. meds - BBs, diabetic meds, antihypertensives, benzos, abx
  2. polypharmacy
  3. substance misuse e.g. alcohol
  4. environmental hazards e.g. loose rugs, uneven floors, living alone
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11
Q

list some cardiovasc causes of falls in the elderly

A
  1. syncope
  2. orthostatic/postural hypotension
  3. carotid sinus syndrome
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12
Q

list some MSK causes of falls in the elderly

A
  1. instability/poor mechanical mobility
  2. arthritis
  3. reduced muscle strength
  4. obesity
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13
Q

which tests can be done at the bedside to assess gait and balance abnormalities after a fall?

A

turn 180 test
timed up and go test

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14
Q

assessment tool for distinguishing between dementia and delirium in hospital

A

confusion assessment method (CAM)

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15
Q

define delirium

A

am acute, transient syndrome of clouding of consciousness, disorientation, perceptual impairment and changes in affect and behaviour

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16
Q

reversible causes of dementia (5)

A
  1. b12 deficiency
  2. thiamine deficiency
  3. hypoglycaemia
  4. normal pressure hydrocephalus
  5. hypothyroidism
17
Q

drugs causing urinary incontinence

A
  1. diuretics e.g. furosemide, bendroflumethiazide
  2. sedatives e.g. opiates, antipsychotics
18
Q

RFs for urinary incontinence (6)

A
  1. pregnancy
  2. childbirth
  3. obesity
  4. chronic constipation
  5. chronic cough
  6. post-menopause (reduced oestrogen)
19
Q

drugs causing urinary retention

A
  1. anticholinergics e.g. oxybutynin
  2. NSAIDs
20
Q

supportive measures for stress incontinence

A

pelvic floor exercises, avoid caffeine, avoid/stop smoking, lose weight

21
Q

mechanism of action of duloxetine in stress incontinence

A

SNRI - increased noradrenaline at synapse, this increases tone of internal urethral sphincter

22
Q

palliative care management - secretions

A

1st line = hyoscine hydrobromide or hyoscine butylbromide

can also use glycopyyronium bromide

23
Q

palliative care management - pain

A
  • oral modified-release morphine
  • immediate-release morphine for breakthrough pain
  • laxatives for SE
24
Q

palliative care management - breathlessness

A
  • OPIOIDS e.g. oramorph or morphine sulphate SC (if severe CKD, start at lowest dose, consider oxycodone 1st line)
  • if associated with anxiety give LORAZEPAM SL
25
palliative care management - agitation
benzos - lorazepam SL - diazepam PO - midazolam SC
26
opioid of choice in palliative patients with CKD
- if mild-moderate, oxycodone preferred - if severe, alfentanil/buprenorphine/fentanyl
27
palliative care management - hiccups
options are - chlorpromazine - haloperidol - gabapentin
28
non-medical management options for preventing future falls in the elderly (4)
1. strength and balance training 2. home hazard assessment 3. medication review 4. vision assessment
29
cause of brown-red urine in rhabdomyolysis
myoglobinuria
30
common osteoporotic facture locations
1. hip 2. distal radius 3. vertebrae 4. humerus
31
instructions for how to take bisphosphonates and some common SEs
instructions: - take with lots of water - take whole - stay upright for 30 mins after SEs: - abdo pain - dyspepsia - nausea - abdominal distension