geriatrics Flashcards

Question

what is a periprostethesis

Answer 1

Periprosthetic fractures (PF) are considered fractures associated with an orthopedic implant, whether a replacement or internal fixation device. fracture where already mended

Answer 2

folate B12 ferritin intrinsic factor

Answer 3

independent mental capacity act - hospital advocat - dosent really work in emergencies

Answer 4

procylizine hydrochloride as well as anticholinergics

Answer 5

decompensated alcoholic liver disease

Answer 6

levoburpracaine

Answer 7

obese anoxeria when young as a kid like 17 growing ages reduced mobility malabsoprtion of ca and vi d cealiac disease crohns long term steriods familial links falls height smokign and drinking rheumatoid bed bound condtions

Answer 8

osteonecorsis of jaw atrypical stress fractures - slows down bone turnover dont use in egfr below 35

Answer 9

Bulbar palsy is a set of conditions that can occur due to damage to the lower cranial nerves. Clinical features of bulbar palsy range from difficulty swallowing and a lack of a gag reflex to inability to articulate words and excessive drooling. Bulbar palsy is most commonly caused by a brainstem stroke or tumor

Answer 10

dalteparin

Answer 11

Electromyography (EMG) is a diagnostic procedure to assess the health of muscles and the nerve cells that control them (motor neurons).

Answer 12

laxative PPI - gastric stais and upper gi bleed dalteparin 28day painkilers PRN oxycodone anti sickness naloxone

Answer 13

Gastroparesis, or gastric stasis, is a disorder of delayed gastric emptying in the absence of mechanical obstruction. It is manifest clinically through a set of largely non-specific symptoms such as early satiety, bloating, nausea, anorexia, vomiting, abdominal pain, and weight loss.

Answer 14

Donepezil is an acetylcholinesterase inhibitor and therefore has cholinergic effects.

Answer 15

The effects of activating cholinergic receptors include muscle contraction, heart rate deceleration, constriction of the iris (miosis) and of the lens, mucus secretion and broncho-constriction

Answer 16

Correct. DoLS is a procedure in law used where it is necessary to deprive a patient of their liberty as they lack capacity to consent to treatment or care to keep them safe from harm. Therefore, assessing her capacity is the most important step before issuing a DoLS.

Answer 17

pseudodementia more like depression

Answer 18

A true Parkinson's tremor is typically unilateral or asymmetrical. In comparison, drug-induced Parkinsonism is more likely to present with a symmetrical tremor and bilateral.

Answer 19

According to the CAM diagnostic criteria, features of delirium include: 1) acute onset with fluctuating course, 2) inattention, 3) disorganised thinking, 4) altered level of consciousness. Level of consciousness would be expected to be normal in dementia.

Answer 20

D - Drugs and Alcohol (Anti-cholinergics, opiates, anti-convulsants, recreational) E - Eyes, ears and emotional L - Low Output state (MI, ARDS, PE, CHF, COPD) I - Infection R - Retention (of urine or stool) I - Ictal U - Under-hydration/Under-nutrition M - Metabolic (Electrolyte imbalance, thyroid, wernickes (S) - Subdural, Sleep deprivation

Answer 21

Hypotension Restlessness Gastrointestinal upset In rare cases, dopamine excess can result in psychiatric reactions including acute psychosis.

Answer 22

older patients hisotry of fall and on blood thinner

Answer 23

An advance statement is a record of someone's preferences and values regarding future care if they were to become unwell and unable to make or communicate decisions about their care. An advance statement can be made verbally. For example, a patient could explain their wishes and preferences to a friend or family member at a time when they have full mental capacity. However, patients should be advised to make a permanent record of this.

Answer 24

A lasting power of attorney (LPA) may be able to override an advance decision

Answer 25

Benserazide is a decarboxylase inhibitor which prevents the peripheral breakdown of levodopa. This means that levodopa is decarboxylated into dopamine in the brain, enabling the full therapeutic dose to take effect.

Answer 26

Correct. The 4AT is a tool to quickly assess whether a patient has delirium or not. A score of 4 and above is suggestive of possible delirum +/- cognitive impairment.

Answer 27

The four components of capacity are to be able (1) to understand, (2) to retain, (3) to be able to weigh up and (4) to be able to communicate a decision

Answer 28

subdural heamorrhage

Answer 29

Phosphate enemas are irritant and encourage the bowels to contract and expel the contents of the rectum. Whilst they can be very effective at treating constipation, in general, oral methods to treat constipation should be trialled before rectal methods.

Answer 30

Phosphate enemas are irritant and encourage the bowels to contract and expel the contents of the rectum. Whilst they can be very effective at treating constipation, in general, oral methods to treat constipation should be trialled before rectal methods. somotic laxatives like macrogol soften stool

Answer 31

apply for DOLS

Answer 32

Midodrine is an alpha-1-adrenergic receptor agonist. Activation of alpha-1-adrenergic receptors leads to an increase in vascular tone and an increase in blood pressure.

Answer 33

alzeihermers

Answer 34

overflow diarrhoea

Answer 35

frontomporal dementia

Answer 36

Short duration of dementia Equal effect on long and short term memory Amnesia concerning specific events (often events are emotionally charged) Often patient will very detailed complaint about memory disturbance Patient may highlight failures in answers to questions relating to memory Loss of social skills early in the illness Patient will often answer “don't know” to questions, as opposed to guessing close answers Patient may make little effort in performing tasks history of depression

Answer 37

If features of Parkinsonism precede dementia by more than one year, this is suggestive of Parkinson's disease with dementia rather than Lewy body dementia.

Answer 38

Incorrect. This would be an example of an advanced decision, not advanced statement. Advanced decisions focus upon the refusal of treatments which are life sustaining, including aspects such as giving CPR in a situation of cardiac arrest. Correct. An Advance Statement also known as a "Statement of Wishes and Care Preferences," allows an individual to make general statements about their wishes, beliefs, feelings and values and how these influence their preferences for their future care and treatment. This includes expressing wishes regarding food preferences, spiritual/religious beliefs, where they would want to be treated and who they would like to have with them during their final days.

Answer 39

Correct. According to NICE guidance, new onset constipation, especially in patients over 50 years of age, or accompanying symptoms such as anaemia, abdominal pain, weight loss, or overt or occult blood in the stool should provoke urgent investigation because of the risk of malignancy or other serious bowel disorder.

Answer 40

yes lasting power of attorney can make decisions There are 2 types of LPA: for health and welfare, and for property and financial affairs. An LPA who has attorney for health and welfare can make medical decisions on behalf of a patient who lacks capacity.

Answer 41

linked with alzeiherms

Answer 42

Charles Bonnet Syndrome (CBS) Correct. This patient is experiencing new visual hallucinations on a background of vision loss, particularly peripheral (suggested by glaucoma). These symptoms, combined with the insight of the hallucinations not being real and the absence of psychiatric disorders, suggests that CBS is the most likely diagnosis. In CBS, it is thought that damage to the visual system causes these hallucinations. It is not a psychiatric disorder.

Answer 43

less dense