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4th Year Exam > Geriatric ILOs > Flashcards

Geriatric ILOs Flashcards

1
Q

Give 4 causes of immobility (DAME)

A

Drugs
Age
Medical conditions
Environmental

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2
Q

Give points to be asked in an immobility Hx using SPLATT

A 
Symptoms
Previous fall
Location
Activity
Time
Trauma?
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3
Q

Give 4 systems to examine when someone is immobile

A

CVS
Neurological
MSK
Vision

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4
Q

Give 4 causes of falls

A

Dementia
Frailty
Vision defect
Environment e.g. poor lighting

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5
Q

Give 3 investigations for falls

A

Systems examinations
AMT4
Medication review

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6
Q

Give 3 consequences of falls

A

Injury e.g. haemorrhage
Immobility e.g. muscle loss
Depression

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7
Q

Give 3 causes of faecal incontinence

A

Structural abnormality
Neurology e.g. MS
Overflow

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8
Q

Give 3 risks for faecal incontinence

A

Female
Age
Nursing home resident

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9
Q

Give 3 management options for faecal incontinence

A

Dietary advice
Laxatives
Irrigation

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10
Q

Give 3 causes of urinary incontinence

A

Stress (weak muscles)
Pelvic floor damage
Enlarged prostate

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11
Q

Give 3 risks of urinary incontinence

A

Age
Pregnancy
Obesity

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12
Q

Give 3 investigations for urinary incontinence

A

Urinalysis
Cystoscopy
Urodynamic tests

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13
Q

Give 3 treatment options for urinary incontinence

A

Alpha agonists
Pelvic floor exercise
Surgery

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14
Q

Define delirium

A

Acute, fluctuating change in mental status. Classed as hypoactive, hyperactive or mixed

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15
Q

Give 4 causes of delirium

A
  • Infection
  • Polypharmacy
  • Drugs
  • Electrolyte imbalance
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16
Q

Give 2 symptoms of hypoactive and hyperactive delirium

A

Hypo: lethargy, decreased motor activity

Hyper: restlessness, hallucinations

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17
Q

Give 2 non-pharmacological and 2 pharmacological Tx for delirium

A
  • Talk to pt. calmly
  • Ensure pt. has hearing aid/glasses
  • Haloperidol
  • Lorazepam
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18
Q

Define dementia

A

Deterioration in cognition = behavioural problems and impairment in activities of daily living

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19
Q

Give the functions of each of the 4 domains in the brain

A

Frontal: executive function/language

Parietal: visuospatial function

Temporal: memory/language

Occipital: visual processing

20
Q

In dementia, where are neurons usually lost from first?

A

Temporal lobe, then parietal and frontal

21
Q

Outline the cause of Alzheimer’s and give one treatment

A

Accumulation of beta-amyloid peptide = neurofibrillary tangles/amyloid plaque and loss of acetylcholine

Tx: Acetylcholinesterase inhibitor e.g. Donepezil

22
Q

What is vascular dementia?

A

Any dementia caused by cerebrovascular disease or impaired blood flow of sudden onset

23
Q

Give 3 symptoms of Lewy body dementia and how is it diagnosed

A
  • Visual hallucinations
  • Parkinsomism
  • Dysautonomia

Clinical Dx

24
Q

Give 2 causes and 2 symptoms of fronto-temporal dementia

A

Pick’s disease + HIV

Disinhibition + Apathy

25
Q

Define sarcopenia and give 2 causes

A

A major component of frailty, the loss of skeletal muscle mass and strength as a result of ageing

  • Motor neuron loss
  • Disuse e.g. immobility
26
Q

What is the gold standard test for muscle mass assessment in sarcopenia?

A

CT/MRI

27
Q

Give 2 management options for sarcopenia

A

Increased protein intake

Vitamin D supplement

28
Q

List the symptoms of depression using SIGECAPS

A 
Sleep disorder
Interest deficit 
Guilt 
Energy deficit 
Concentration deficit 
Appetite disorder
Psychomotor agitation
Suicidality
29
Q

What tool is used to diagnose depression in the elderly?

A

Geriatric depression score: 30 item self-reporting assessment tool

30
Q

Give 3 risks for depression

A
  • Recent bereavement
  • Social isolation
  • Stroke
31
Q

Give 2 drugs for depression and their MOA

A

Sertraline (generally 1st line SSRI)

Mirtazapine (an SNRL, an appetite stimulant and mild sedative)

32
Q

Define fragility fractures and give the 2 causative conditions

A

Fractures that result from mechanical forces that would not normally cause a fracture – due to abnormal bone

Osteopenia + osteoporosis

33
Q

Give 3 risks of fragility fractures

A
  • Female
  • Increasing age
  • Chronic alcohol excess
34
Q

What score determines 10 year risk of fractures?

A

FRAX or Q-fracture

35
Q

Give 3 drugs used in osteoporosis

A
  • Calcium supplement
  • Vitamin D supplement
  • Alendronic acid 70mg once week
36
Q

What is the MOA of bisphosphonates in osteoporosis?

A

Inhibit bone resorption by inhibiting key signalling pathways of osteoclasts

37
Q

Define pressure ulcers and give 2 causes

A

Localised injury to skin/underlying tissue as a result of pressure

Immobility + sensory impairment

38
Q

Give 3 symptoms of pressure ulcers

A
  • Non-blanching erythema
  • Open wound
  • Exudate
39
Q

Give 3 management options for pressure ulcers

A
  • Pressure reducing aid and re-positioning
  • Hygiene, cleansing and dressings
  • Analgesia
40
Q

Define elder abuse and give 2 risks

A

Failure of carer to provide basic needs and safety of an older person, resulting in harm or high likelihood of harm

Age >75 + dementia

41
Q

What should be done in cases of elder abuse?

A
  • Social services evaluation

- Report to authorities

42
Q

Outline the differences between conductive and sensorineural hearing loss

A

Conductive: external and middle ear by interfering with transmission

Sensorineural: inner ear and auditory nerve

43
Q

Give 3 causes of hearing loss

A
  • Mechanical obstruction (impacted wax)
  • Trauma (e.g. laceration)
  • Infection
44
Q

Outline Weber test

A

Turning fork in centre of forehead and pt. asked which side is louder:

  • Both equal = normal
  • Left louder = right sensorineural impairment
  • Right louder = left sensorineural impairment
45
Q

Outline Rinne test

A

Turning fork on mastoid bone (bone conduction) then next to external ear (air conduction)

  • air conduction louder than bone = positive test
  • bone conduction louder than air = negative test and indicates conductive hearing loss
46
Q

Give 2 causes of each acute and chronic vision loss

A

A: optic neuritis + retinal vascular occlusion

C: Glaucoma + diabetic retinopathy

4th Year Exam (20 decks)

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