geriatrics Flashcards

1
Q

which tool identifies medications where the risk outweighs the benefits ?

A

STOPP tool

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2
Q

which tool alerts doctors to the right treatment to commence in patients with multiple comorbidities

A

START

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3
Q

4 features of frontotemporal dementia

A

onset < 65
insidious onset
preserved memory and visuospatial skills
personality change and social conduct problems

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4
Q

what are the macroscopic changes seen in Picks disease

A

Atrophy of frontal and temporal lobes

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5
Q

what are the microscopic changes seen in Picks disease

A

Pick bodies
gliosis
neurofibrillary tangles
senile plaques

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6
Q

what is semantic dementia ?

A

Fluent progressive aphasia. Fluent speech which is empty and conveys little meaning

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7
Q

what are the precipitating factors of Delirium ?

A

PINCH ME
Pain
Infection
Nutrition
Constipation
Hydration
Medication
Environment

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8
Q

how do you treatment Delirium ( step by step)

A

Treat underlying cause
Modify environment
Haloperidol 0.5 mg

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9
Q

which medications should be avoided in Lewy body dementia and why

A

Anti-psychotics ( Haloperidol) as they may lead to irreversible parkinsonism, rigidity , immobility , falls etc

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10
Q

what is the first line investigation for dementia and what does it include ?

A

FBC, U+E, LFTs, Calcium, glucose, ESR/CRP, TFTs, vitamin B12, Folate

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11
Q

which factors favour delirium over dementia

A

acute onset
impairment of consciousness
fluctuation of symptoms ( worse at night, periods of normality)
abnormal perception ( illusions + hallucinations)
agitation and fear
delusions

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12
Q

which questionnaire can be used to assess fraility

A

PRISMA-7

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13
Q

what is the GPCOG tool used for

A

screening tool for dementia in GP

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14
Q

what is the pathalogical feature seen in lewy body dementia

A

Alpha-synuclein cytoplasmic inclusions in the substantia nigra, paralimbic and neocortical areas

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15
Q

what medications can be used in the management of Lewy body dementia

A

Acetylcholinesterase inhibitors ( Donepezil, Rivastigmine) and Memantine ( NDMA receptor antagonist)

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16
Q

what can trigger digoxin toxicity

A

renal failure and hypokalaemia

17
Q

what are the features of digoxin toxicity

A

GI disturbance- nausea, vomiting, Abdo pain
dizziness
confusion
blurry / yellow vision
Arrythmias

18
Q

what pathalogical feature is seen on CT in alzheimers disease

A

widespread cerebral atrophy mainly involving the cortex and hippocampus

19
Q

characteristic feature of Vascular dementia

A

stepwise deterioration of cognitive function

20
Q

which type of dementia most commonly presents with fluctuating cognition

A

Lewy Body dementia

21
Q

name 4 factors that contribute to the development of pressure ulcers

A

Malnourishment
incontinence
lack of mobility
pain

22
Q

which score is used to screen for patients at risk of developing pressure areas

A

Waterlow score

23
Q

name 3 things that are recquired in the management of a non infected pressure ulcer

A

wound dressing
appropriate analgesia
nutritional assessment

24
Q

what are the indications for antibiotic use in the management of pressure ulcers ?

A

Clinical evidence of systemic sepsis
spreading cellulitis
underlying osteomyelitis

25
in which cases is Memantine used in the management of Alzheimer's disease
moderate Alzheimers who are intolerant to ACHE inhibitors severe alzheimers disease
26
which type of dementia is characterised by visual hallucinations
Lewy body dementia
27
whats the difference between Parkinsons disease dementia and dementia w lewy bodies
PDD : motor symptoms come first LBD : dementia comes first + overlapping symptoms
28
which parkinsons medications are most associated with inhibition disorders
dopamine receptor agonists such as ropinirole
29