GERIATRIC

Question 1

what are the geriatric giants?

Answer 1

1. immobility and falls
2. confusion
3. incontinence
4. impaired homeostasis
5. breakdown in social circumstances

Question 2

what are signs of delirium?

Answer 2

• a change in cognitive function
• change in perception
• change in physical function
• withdrawal in social behaviour
• acute onset
• fluctuating

Question 3

what are common causes of delirium? use DELIRIUM

Answer 3

D- Drugs (opioids, sedatives, LDOPA, digoxin
E- eyes, ears and sensory deficit
L- low oxygen states, MI, stroke, PE
I- infection
R- retention
I- ictal
U- under hydration/ nutrition
M- metabolic; DM, post op, sodium, uraemia
S- subdural haemorrhage

Question 4

other than ‘DELIRIUM’ what are other causes of delirium?

Answer 4

hepatic encephalopathy

Question 5

what investigations take place in an elderly person with delirium?

Answer 5

-history
- cognitive screening
- FBC (infection, anaemia)
- folate and B12
- U and E
- HBAIC
- LFT
- urine dip
- sputum culture
- septic screen
ECG
TFT

Question 6

what is the CAM criteria?

Answer 6

• confusion that has developed suddenly and fluctuates, inattention and disorganised thinking, altered level of thinking

Question 7

what are symptoms and signs of dementia?

Answer 7

• insidious and progressive onset
• normal conscious level until later stages
• poor STM and attention
• often no hallucinations
• paranoid and fixed delusions