Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Phase 2 > Geriatrics > Flashcards

Geriatrics Flashcards

1
Q

Define a fall

A

Unintentional loss of balance resulting in coming to rest on the floor or an object below knee level
Not as a consequence of force, sudden onset paralysis, seizure or XS alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the biggest risk factor for falls?

A

Previous fall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What assessments help in falls risk assessment?

A

Timed up and go test

Turn 180 test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the causes of transient loss of consciousness?

A

Syncope

Epilepsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the potential causes of unconsciousness?

A

Trauma
Metabolic
Infection
Neuro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the potential causes of apparent unconsciousness?

A

Dizziness
Vestibular
Mechanical
Pseudo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What extrinsic factors may contribute to falls risk?

A 
Drugs
Footwear
Obstacles
Inappropriate walking aids
Gravity
Lighting conditions
Furniture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What intrinsic factors contribute to falls risk?

A 
BP
HR
Neurology
Muscle strength
Joint integrity
Vision
Vestibular dysfunction
Reflexes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the components of a falls clinic appt?

A 
History of falls, syncope, neuro, msk, cardiac, vestibular
Focused examination
Bone health/osteoporosis review
Drug / polypharmacy review
Investigations: bloods, ECG, X-rays etc
Physio and ot assessment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Define syncope

A 
Transient loss of consciousness
Loss of voluntary muscle tone
Rapid onset with spontaneous prompt recovery on lying down
Full recovery (no focal deficit)
Transient global cerebral hypoperfusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the causes of syncope?

A
  1. Neurally-mediated reflex: situational / vasovagal faint / carotid sinus syndrome
  2. Orthostatic hypotension
  3. Cardiac syncope
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What questions should you ask a witness to a ?syncopal episode?

A 
Posture just before
Appearance / colour
Any abnormal movement
Tongue biting or incontinence
Duration
Post-event confusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What factors make cardiac syncope the likely diagnosis?

A 
CHESS...
Congestive heart failure
Haematocrit <30%
ECG abnormality
Shortness of breath
Systolic BP <90 on triage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What investigations would you request for a patient with syncope related to a tachy or bradyarrhythmia?

A

24h tape or consider inpatient monitoring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do you investigate suspected orthostatic hypotension?

A

Postural drop in BP: lying/standing BP

Accompanied by increase in HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Define orthostatic hypotension

A

= postural hypotension
Systolic BP fall of more than 20 or diastolic fall more than 10
Within 10 minutes of standing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How do you measure lying/standing BPs?

A

Measure BP at 0, 3 and 5 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the potential underlying causes of orthostatic hypotension?

A 
Hypovolaemia
Autonomic failure eg PD or DM
Prolonged bed rest
Drugs eg anti-hypertensives
Alcohol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How do you manage orthostatic hypotension?

A

Treat underlying cause, recognise precipitating factors
Conservative: education, bed tilt, increase salt
Medical: fludrocortisone
Averting action: recognise pre-syncope and sit/lie down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Describe tilt table testing

A

Moving from supine to upright causes shift of 300-800ml blood to venous capacitance system within 10 seconds
Reduced venous return and cardiac filling which decreases stroke volume
Compensatory increase in HR not enough
Sympathetic increase in TPR is key
Failure of compensatory mechanism is the cause of vasovagal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the contraindications to carotid sinus massage?

A

Heterogenous plaque disease

Stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How do you manage carotid sinus sensitivity?

A

Dual chamber pacing if cardio-inhibitory

Vasodepressor: education, reassurance, drugs alteration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Define delirium

A

Global impairment of cognition and awareness / concentration

24
Q

What are the signs of delirium?

A 
Disordered thinking
Euphoric / depressed (labile mood)
Language impaired
Illusions, delusions, hallucinations
Reversal of sleep-awake cycle
Inattention
Unaware/disorientated
Memory deficits
25
What are the criteria required for delirium diagnosis?
Disturbance of consciousness Change in cognition Disturbance develops over a short period of time
26
What are the risk factors for delirium?
``` Older age Multiple comorbidities Dementia Physical frailty Renal impairment Sensory impairment ```
27
What are the common causes of delirium?
``` DIMES: Drugs Infection Metabolic Environmental Structural ```
28
What are the common investigations in a delirium screen?
FBC, U&E, LFT, BM, ABG Septic screen ECG AMT
29
What tests of cognition are commonly used for delirium?
AMTS: 10 Qs, if score less than 8 then proceed to CAM: confusion assessment method
30
How do you manage delirium?
``` Identify and treat underlying cause Reduce distress Mod.lit, quiet room with same staff Improve orientation: clock, daylight Hearing aids and glasses No physical restraints, catheters, IV lines etc Music, massage, muscle relaxation Minimise medication Haloperidol 0.5mg if required, only as last resort ```
31
What are the types of delirium?
Hypo active Hyperactive Mixed
32
What are the features of hypo active delirium?
Lethargy and reduced motor activity | Can be mistaken for depression
33
What are the features of hyperactive delirium?
Increased motor activity, agitation, hallucinations | More likely to be recognised
34
What is mixed delirium?
Fluctuations between hypo and hyperactive, often fluctuates during the day
35
What questions should you ask about in a history of incontinence?
``` Ability to stop midstream Soreness Prolapse LUTS: frequency, nocturia, urgency Stress Obstructive: hesitancy, stream, dribbling Bowels ```
36
What are obstructive urinary symptoms?
Hesitancy Straining Terminal dribbling Complete bladder emptying
37
Define overflow incontinence
Leakage of urine at greater than normal bladder capacity
38
What is the underlying mechanism of overflow incontinence?
Either incomplete bladder emptying impaired detrusor contractility bladder outlet obstruction
39
What are the causes of overflow incontinence?
Prostatic hyper trophy Faecal impaction Urinary retention Atonic bladder
40
Why do women get incontinence post-menopause?
``` Oestrogen deficiency leads to... Atrophic urethritis Decreased vascularity Decreased sphincter resistance Weakened skeletal muscle and pelvic floor Sensory urgency ```
41
At what ml do you get desire to void?
150-300
42
What is the normal bladder capacity?
400-600ml
43
What is the average void?
250-400ml
44
Describe parasympathetic control of the bladder
``` Pees Detrusor muscle S2-4 Pelvic splanchnic nerve ACh muscarinic ```
45
Describe sympathetic control of the bladder
``` Stores Bladder neck/upper urethra T10-L2 Hypgastric nerve Alpha receptors noradrenaline ```
46
How do you manage stress incontinence?
Pelvic floor exercises Duloxetine Surgery
47
How do you manage detrusor over activity?
Bladder retraining, regular toiletting regime | Anticholinergic drug: tolterodine, oxybutynin
48
How do you manage overflow incontinence?
Remove the obstruction | Catheterisation: intermittent or permanent
49
What are the different types of urodynamic studies?
Flow rate Cystometry Urethral pressure profile
50
What are the risk factors for incontinence?
``` Constipation Childbirth Surgery Obesity Pregnancy Activity level Post menopause Dietary irritants: caffeine, alcohol Meds: diuretics, Anticholinergics, antiDs, alpha blockers ```
51
What are the underlying causes of faecal incontinence?
``` Sphincter weakness Ano-rectal pathology Neurological disease Acute or chronic confusion Diarrhoea Constipation ```
52
What are the different categories of laxatives?
Bulking and softening Stimulant Faecal softeners Osmotic
53
Give an example of a bulking laxative
Ispaghula husk - fybogel
54
Give an example of a stimulant laxative
Senna | Sodium picosulfate
55
Give an example of a faecal softener
Arachis oil (enema)
56
Give an example of an osmotic laxative
Lactulose Movicol Phosphate enema
57
What lifestyle changes help with constipation?
Diet Fluid Exercise Comfort, privacy, relaxation

Phase 2 (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions