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Geriatrics > Geriatrics > Flashcards

Geriatrics Flashcards

1
Q

What is osteoporosis?

A

Low done density and subsequent susceptibility to fracture

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2
Q

What are the risk factors for osteoporosis?

A

SHATTERED
Steroid use
Hyperthyroidism
Thin (low BMI under 22)
Low testosterone
Erosive or inflammatory bone disease
Renal or liver failure
Dietary calcium low
Early menopause before 45 years

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3
Q

What is the presentation of osteoporosis?

A

Asymptomatic until fracture
Vertebral crush fracture
Thoracic fracture
Colle’s fracture of the wrist

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4
Q

What is the diagnosis of osteoporosis?

A

DEXA scan - taken at the hip is gold
T-score is comparison to a healthy young adult
Z-score is comparison to an age and sex matched individual

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5
Q

What is the interpretation of DEXA scan results?

A

More than -1 = normal
-1 to -2.5 = osteopenia
More than -2.5 = osteoporosis
More than -2.5 with a fracture = severe osteoporosis

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6
Q

What is the management of osteoporosis?

A

Bisphosphonates such as Alendronate
Monoclonal antibodies such as Denosumab

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7
Q

What is the risk scoring tool for osteoporosis?

A

FRAX - 10 year risk of fractures

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8
Q

What is the management for osteopenia?

A

Lifestyle advice and repeat DEXA scan in 2 years

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9
Q

What are some drugs that can increase the risk of falls?

A

Anticholinergics
ACE-i
L-DOPA
Benzodiazepines
Diuretics
Baclofen

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10
Q

What are some assessment tests for falls?

A

Turn 180 test
Timed up and go test

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11
Q

What is the criteria for constipation?

A

2 or more of the following for 3 months or more -
Straining or defecation
Incomplete evacuation
Less than 2 bowel movements per week
Lumpy or hard stools

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12
Q

Name an osmotic laxative

A

Magnesium hydroxide 15ml

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13
Q

Name a stimulant laxative

A

Senna

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14
Q

What is a side effect of long term stimulant laxative use?

A

Cathartic atonic colon - anatomical change to the colon

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15
Q

Give some presentations of constipation in the elderly

A

Confusion
Urinary retention
Abdominal pain
Overflow diarrhoea
Appetite loss
Nausea

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16
Q

Give some causes of constipation in the elderly

A

Anticholinergics, opioids, antidepressants
Immobility
Poor toilet access
Parkinsons
Diverticular disease

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17
Q

What is used for soft stool constipation?

A

bisacodyl suppositories

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18
Q

What is used for hard stool constipation?

A

Glycerin suppositories

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19
Q

What is used for faecal impaction?

A

Lubricant and high phosphate enema

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20
Q

What is the MUST score used for?

A

Detecting protein energy undernutrition

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21
Q

What are the 3 methods of tube feeding?

A

PEG
RIG
Fine bore NG

22
Q

What are pressure sores?

A

Areas of skin necrosis due to pressure induced ischaemia

23
Q

What are the mechanisms of a pressure sore?

A

Pressure
Shear
Friction
Moisture

24
Q

What is the risk assessment tool for pressure sores?

A

Waterlow score

25
Q

What is the prevention of pressure sores?

A

Barrier creams
Reposition
Limit sitting
Pressure redistribution

26
Q

What is the management of pressure sores?

A

Hydrocolloid dressings
Hydrogels
Surgical debridement
Antibiotics if any sign of infection

27
Q

What is a neck of femur fracture?

A

Break in the upper femur just below the ball and socket hip joint

28
Q

Which type of neck of femur fracture has a better outcome?

A

Extracapsular because intracapsular has a high risk of avascular necrosis due to disrupted blood supply to the femoral head

29
Q

What is the classification for degree of displacement for neck of femur fracture?

A

Garden classification

30
Q

What is the classification for angle of displacement for neck of femur fracture?

A

Pauwels classification

31
Q

What is a colles wrist fracture?

A

Fracture of the distal radius from FOOSH

32
Q

What is the visible deformity of a colles wrist fracture?

A

Dinner fork

33
Q

What are 2 complications of a colles wrist fracture?

A

Carpal tunnel syndrome
Median nerve injury

34
Q

Name some confusion screen bloods

A

FBC - infection, anaemia
U+E - hyponatraemia or hyper
LFT
Coagulation/ INR - bleeding
TFT - hypothyroidism
Calcium
B12 and folate
Glucose
Blood cultures - sepsis

35
Q

What are some causes of delirium in the elderly?

A

UTI
Infection and sepsis
Opiates
Hypoxia
Alcohol
Constipation
Change in environment

36
Q

What is the diagnosis of postural hypotension?

A

A fall of 20 mmHg or more in systolic pressure on standing or fall of 10 mmHg in diastolic pressure

37
Q

What is the definition of polypharmacy?

A

4 or more medications

38
Q

What tool is used to suggest medications?

39
Q

Used to assess which drugs can potentially be discontinued in elderly patients undergoing polypharmacy

A

STOPP tool

40
Q

What is the temperature of hypothermia?

A

Under 35 degrees

41
Q

What is the gold standard diagnosis of hypothermia?

A

Rectal temperature

42
Q

What does poikilothermic mean?

A

Older people are generally less able to manage their core body temperature which is prone to fluctuation

43
Q

What is the temperature of hyperthermia?

44
Q

What is miliaria and the treatment?

A

Prickly heat
Cool, wash and give antihistamines

45
Q

What are some presentations of heat exhaustion?

A

Collapse
Weakness
Vomiting
Dizziness
Headache

46
Q

What are some presentations of heat stroke?

A

Core temperature over 40
Mental state alteration
Absent sweating
Coma

47
Q

What is a squamous cell carcinoma?

A

2nd most common skin cancer
Malignant tumour of epidermal keratinocytes

48
Q

What is the presentation of SCC?

A

Hyperkeratotic and scaly
May ulcerate
Pain
Tenderness
Bleeding

49
Q

What is the diagnosis of SCC?

A

Excision biopsy with 4mm margins
Punch biopsy

50
Q

What is the management of SCC?

A

Removal with 5mm margins
Radiotherapy

Geriatrics (1 decks)

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