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Phase 3A content > Geriatrics > Flashcards

Geriatrics Flashcards

1
Q

What are the characteristic symptoms of lewy body dementia?

A

Extrapyramidal side effects
Visual hallucinations
REM sleep disturbance
Worse with time

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2
Q

Treatment for lewy body dementia?

A

Leva dopa
Antipsychotics

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3
Q

What is vascular dementia?

A

Caused by multiple mini infarcts

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4
Q

What are the risk factors for vascular dementia?

A

HTN
DM
Hyperlipidaemia

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5
Q

Investigations for vascular dementia?

A

MMSE
Carotid USS
CT/MRI head

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6
Q

What tool is used to assess frailty?

A

PRISMA-7

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7
Q

What are the risks for osteoporosis?

A

Age
Female
Low mobility
Low BMI
RA
Long term corticosteroids

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8
Q

What t-score indicates osteopaenia?

A

-1 - -2.5

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9
Q

How is osteoporosis managed?

A

Calcium and vit D supplements
Bisphosphonates
HRT in women

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10
Q

What is the mnemonic for remembering the features of alzheimers?

A

4A’s

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11
Q

What do the 4 A’s in alzheimers stand for?

A

Amnesia (recent memories lost first)
Aphasia (word finding problems, speech muddled and disjointed)
Agnosia (recognition problems)
Apraxia (Inability to carry out skilled tasks despite normal motor function)

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12
Q

How does delirium present?

A

Disorientation
Hallucinations
Inattention
Memory problems
Change in mood or personality
Disturbed sleep

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13
Q

Name some causes of delirium?

A

Drugs and alcohol
Infection
Retention or urine or stool
Dehydration
Electrolyte imbalances particularly hypercalcaemia

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14
Q

What are the components of a confusion screen?

A

Urinalysis (UTI or hyperglycaemia)
Sputum culture (chest infection)
FBC (infection or anaemia)
Folate and B12
U&E (to identify AKI and electrolyte disturbance)
HbA1c (Hyperglycaemia)
Calcium
LFT’s
Inflammatory markers
Drug levels
TFT’s
CXR
ECG

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15
Q

What can the family and friends do to help manage a person with delirium at home?

A

Try simple reorientation strategies, such as reminding the person who they are and where they are.
Make sure there are easily visible clocks and calendars.

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16
Q

If an elderly person with delirium develops challenging behaviour what is the next best step management?

A

Move them to a quieter environment
Use verbal de escalation techniques

17
Q

What short term pharmacological therapies can be used for patients with delirium, who do not respond to verbal de escalation?

A

Short term, low dose haloperidol.

18
Q

What are the symptoms of dementia with Lewy bodies?

A

Parkinsonism
Fluctuating cognition
Visual hallucinations

19
Q

What is a DOLS procedure?

A

Deprivation of liberty as the patient lacks capacity to consent to treatment or care to keep them safe from harm.

20
Q

What are the 4 criteria for capacity?

A

All patients are initially assumed to have capacity
Capacity is decision specific
Capacity can be impaired permanently, temporarily or fluctuate
Patients deemed to have capacity are freely able to make unwise decisions that the healthcare provider would not agree with.

21
Q

What is a power of attorney?

A

A legal document drawn up by a competent adult that nominates another person to make decisions on their behalf.

22
Q

What is an advance directive?

A

A medical decision made by a patient with capacity regarding their future wishes for treatment. It only comes into force if a patient subsequently lacks capacity.

23
Q

What is the difference between advanced decisions and an advanced statement?

A

Advanced decisions is a legally binding document that includes specific treatments which the patient wishes to refuse in the future.
Advanced statement, documents general wishes about their wishes, feelings and values to others. It is not legally binding but it must be taken into consideration when acting in a patients best interests.

24
Q

What pneumonic can be used to remember the risk factors for osteoporosis?

25
Q

What are the risk factors for osteoporosis as per the mneumonic shattered?

A

Steroid use
Hyperthyroidism
Alcohol and smoking
Thin (BMI <22)
Testosterone deficiency
Early menopause
Renal/liver failure
Erosive/inflammatory bone disease
Diabetes

26
Q

Which groups of people should have their FRAX score calculated?

A

All men over 75
All women over 65
All men and women over 50 if they have specific risk factors, such as:
Previous fragility fracture
Low BMI
Drink more than 4U alcohol a day
Were on steroids
Falls history
Family Hx of hip fracture

27
Q

What is the gold standard investigation for osteoporosis?

28
Q

What is the first line treatment for osteoporosis?

A

Bisphosphonates

29
Q

How should bisphosphonates be taken?

A

Sitting up for 30mins after taking it with water.

Phase 3A content (15 decks)

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