Geri's Passmed

Question 1

What screening tool is used to identify medications where risk outweighs benefit?

Answer 1

STOPP (screening tool of older person’s prescriptions)

Question 2

What screening tool is used to identify individuals at risk of malnutrition?

Answer 2

MUST (malnutrition universal screening tool)

Question 3

Which type of dementia can present with fluctuations in cognitive impairment?

Answer 3

Lewybody dementia

Question 4

What is an example of objective test of memory?

Answer 4

AMT 10

Question 5

What does blurry/yellow vision suggest?

Answer 5

Digoxin toxicity

Question 6

What are possible complications of a long lie (after a fall)?

Answer 6

Pressure ulcers, dehydration, rhabdomyolysis, hypothermia

Question 7

What medications can can be associated with postural hypotension?

Answer 7

Nitrates, diuretics, anticholinergics, antidepressants, beta blockers, levo-dopa, ACEIs

Question 8

What is the criteria for postural hypotension?

Answer 8

A drop in systolic BP of 20 mmHg or more (with or without symptoms).

Question 9

What physical test could you do after a fall, to check mobility?

Answer 9

‘Turn 180 degree test’ or ‘Timed up and Go test’

Question 10

What is the definition of frailty?

Answer 10

State of increased vulnerability resulting from ageing-associated decline in functional reserve, across multiple physiological systems, resulting in compromised ability to cope with everyday or acute stressors

Question 11

What DEXA scan score indicates osteoporosis?

Answer 11

<-2.5

Question 12

What scoring system can assess risk of pressure sores?

Answer 12

Waterlow score

Question 13

What are risk factors for falling?

Answer 13

Lower limb muscle weakness, vision problems, balance/gait disturbances, polypharmacy, incontinence, >65 years, fear of falling, depression, postural hypotension, arthritis in lower limbs, psychoactive drugs, cognitive impairment

Question 14

What is polypharmacy?

Answer 14

> 4 drugs

Question 15

After a fall, who should have a multidisciplinary assessment by a qualified clinician?

Answer 15

• > 65 years
• fall requiring medical treatment
• poor performance or failure to complete the ‘turn 180 degrees test’ or the ‘timed up and go’ test
• > 2 falls in the last 12 months

Question 16

What is the definition of multimorbidity?

Answer 16

2 or more long term health conditions

Question 17

How should frailty be assessed?

Answer 17

Gait speed, self reported health status, or the PRISMA-7 questionnaire

Question 18

What are risk factors for multimorbidity?

Answer 18

Increasing age, female sex, low socio economic status, tobacco and alcohol usage, lack of physical activity, poor nutrition and obesity

Question 19

What are risk factors for pressure ulcers?

Answer 19

Malnourishment, incontinence, lack of mobility, pain (which can lead to lack of mobility)

Question 20

What is the grading system for pressure ulcers?

Answer 20

1: non blanching erythema of intact skin
2: partial thickness skin loss
3: full thickness loss involving damage to or necrosis of subcutaneous fascia
4: extensive destruction, tissue necrosis, damage to muscle/bone

Question 21

Should systemic antibiotics be taken by all patients with pressure ulcers?

Answer 21

No: needs to be a decision made on a clinical basis

Question 22

What should be done to encourage ulcer healing in pressure ulcers?

Answer 22

Moist wound environment. Hydrocolloid dressings or hydrogels may be used

Question 23

What is lasting power of attorney?

Answer 23

A document which a person can nominate someone else to make a certain decision on their behalf. Must be registered with the office of the public guardian

Question 24

When are refusals of treatment legally binding?

Answer 24

The person is an adult, competent and fully informed making the decision, the decision is clearly applicable to current circumstances, there is no reason to believe they have since changed their mind