Geriatrics

Question 1

First line heart failure management (and MOA)

Answer 1

ACE inhibitor
- (decreases RAAS overactivity, prevents excess salt and water accumulation)
Beta blocker
- (decreases HR, increases isovolumetric relaxation time)

Question 2

Causes of heart failure

Answer 2

Structural abnormality must be present 
- hypertension
- valvular heart disease 
- alcohol related 
etc

Question 3

In heart failure, the ECG will always be abnormal. True or false?

Answer 3

True

- it is

Question 4

What are the 4 just in case medications (and indications)

Answer 4

Pain/breathlessness - morphine
Nausea - levomepromazine
Secretions - hyoscine (buscapan)

Question 5

Microalbuminurea - what medication might be used?

Answer 5

ACE inhibitor

Question 6

Oxybutynin has which type of side effects?

Answer 6

Anti-cholinergic

• can’t see (blurred vision)
• can’t pee
• can’t spit (dry mouth)
• can’t shit (constipation)

Question 7

Psychiatric side effects of steroids?

Answer 7

Can precipitate a psychosis

Question 8

PPIs can increase risk of C. diff. True or false?

Answer 8

True

Question 9

Common electrolyte disturbance with PPI?

Answer 9

Hyponatraemia

Question 10

Key symptoms of opiate toxicity

Answer 10

Pinpoint pupils
resp depression
drowsy
myoclonic jerking

Question 11

MST long or short acting?

Answer 11

Long acting

Question 12

severe renal impairment - what drug do you prescribe for pain?

Answer 12

Fentanyl

Question 13

HAP treatment severe

Answer 13

Amoxicillin + Gentamicin

Question 14

Someone with alcohol withdrawal. What do you give?

Answer 14

Benzodiazepines

Question 15

Constipation treatment 2 categories

Answer 15

Hard stool issues

Stimulant issue

Question 16

What type of laxative is a senna?

• stimulant
• softener
• osmotic laxative

Answer 16

Stimulant

- speeds up gut transit

Question 17

What type of laxative is laxido?

• stimulant
• softener
• osmotic laxative

Answer 17

osmotic laxative

Question 18

What type of laxative is lactulose?

• stimulant
• softener
• osmotic laxative

Answer 18

osmotic laxative

Question 19

Laxido dosing

Answer 19

Up to 6 sachets per 24 hours

mix with 125ml water

Question 20

Senna dosing

Answer 20

15mg / day

Question 21

Power of attorney - what is it

Answer 21

Grant someone powers to make decisions on your behalf

Question 22

What is guardianship

Answer 22

Patient doesn’t have capacity when it is put in place