geriatrics Flashcards
which tool identifies medications where the risk outweighs the benefits ?
STOPP tool
which tool alerts doctors to the right treatment to commence in patients with multiple comorbidities
START
4 features of frontotemporal dementia
onset < 65
insidious onset
preserved memory and visuospatial skills
personality change and social conduct problems
what are the macroscopic changes seen in Picks disease
Atrophy of frontal and temporal lobes
what are the microscopic changes seen in Picks disease
Pick bodies
gliosis
neurofibrillary tangles
senile plaques
what is semantic dementia ?
Fluent progressive aphasia. Fluent speech which is empty and conveys little meaning
what are the precipitating factors of Delirium ?
PINCH ME
Pain
Infection
Nutrition
Constipation
Hydration
Medication
Environment
how do you treatment Delirium ( step by step)
Treat underlying cause
Modify environment
Haloperidol 0.5 mg
which medications should be avoided in Lewy body dementia and why
Anti-psychotics ( Haloperidol) as they may lead to irreversible parkinsonism, rigidity , immobility , falls etc
what is the first line investigation for dementia and what does it include ?
FBC, U+E, LFTs, Calcium, glucose, ESR/CRP, TFTs, vitamin B12, Folate
which factors favour delirium over dementia
acute onset
impairment of consciousness
fluctuation of symptoms ( worse at night, periods of normality)
abnormal perception ( illusions + hallucinations)
agitation and fear
delusions
which questionnaire can be used to assess fraility
PRISMA-7
what is the GPCOG tool used for
screening tool for dementia in GP
what is the pathalogical feature seen in lewy body dementia
Alpha-synuclein cytoplasmic inclusions in the substantia nigra, paralimbic and neocortical areas
what medications can be used in the management of Lewy body dementia
Acetylcholinesterase inhibitors ( Donepezil, Rivastigmine) and Memantine ( NDMA receptor antagonist)
what can trigger digoxin toxicity
renal failure and hypokalaemia
what are the features of digoxin toxicity
GI disturbance- nausea, vomiting, Abdo pain
dizziness
confusion
blurry / yellow vision
Arrythmias
what pathalogical feature is seen on CT in alzheimers disease
widespread cerebral atrophy mainly involving the cortex and hippocampus
characteristic feature of Vascular dementia
stepwise deterioration of cognitive function
which type of dementia most commonly presents with fluctuating cognition
Lewy Body dementia
name 4 factors that contribute to the development of pressure ulcers
Malnourishment
incontinence
lack of mobility
pain
which score is used to screen for patients at risk of developing pressure areas
Waterlow score
name 3 things that are recquired in the management of a non infected pressure ulcer
wound dressing
appropriate analgesia
nutritional assessment
what are the indications for antibiotic use in the management of pressure ulcers ?
Clinical evidence of systemic sepsis
spreading cellulitis
underlying osteomyelitis
in which cases is Memantine used in the management of Alzheimer’s disease
moderate Alzheimers who are intolerant to ACHE inhibitors
severe alzheimers disease
which type of dementia is characterised by visual hallucinations
Lewy body dementia
whats the difference between Parkinsons disease dementia and dementia w lewy bodies
PDD : motor symptoms come first
LBD : dementia comes first + overlapping symptoms
which parkinsons medications are most associated with inhibition disorders
dopamine receptor agonists such as ropinirole
