Geriatrics

Question 1

What bloods should a basic ‘dementia screen’ consist of at first presentation with cognitive impairment / dementia concerns?

Answer 1

FBC, U&Es, LFTs, Vitamin B12, Folate, Calcium, Glucose, Electrolytes

Question 2

With which dose of steroids should you offer osteoporosis prophylaxis (Alendronate 1st line + Ca + Vit D supplementation) for?

Answer 2

Anyone that is having the equivalent of 7.5mg Prednisolone daily for 3 months or more should be offered osteoporosis prophylaxis
(If starting someone on steroids where you know they will be on them for at least 3 months start bone protection from the off-set)

Question 3

Which primary care screening questionaire should be used to assess for frailty?

Answer 3

PRISMA-7

Question 4

What is the difference between a T-score and a Z-score on DEXA scan?

Answer 4

T score compares you bone mineral density to a healthy young person (25-35) of your ethnicity and gender.

Z score compares your bone mineral density to a AGE-MATCHED health person of you age, gender and ethnicity

Both are expressed as standard deviations around the mean.

Mean = 0 (50% of values will lie above, 50% will lie below)
+1 to -1 = normal
-1 to -2.5 = osteopenia
-2.5 or less = osteoporosis

Question 5

True or false - patients > 65 who have osteopenia and have already suffered a hip fracture should be offered zolendronic acid infusions every 18 months?

Answer 5

True

If over 65 with osteopenia and already suffered a hip fragility fracture then should have zolendronic acid every 18 months for 6 years