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My Phase 3a cards > Geriatrics > Flashcards

Geriatrics Flashcards

1
Q

Define Delirium

A

A state of mental confusion that develops quickly and fluctuates in intensity

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2
Q

What are the associated features of delirium?

A 
Disordered thinking/Delusions
Euphoria/depression/mood changes
Language impairment
Inattention
Reversal of sleep wake cycle
Illusions
Unawareness/disorientation
Memory defects
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3
Q

What is the most common, and most frequently misdiagnosed, type of delirium?

A

Hypoactive delirium

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4
Q

What would indicate an abnormal Abbreviated Mental Test Score? What is the next step?

A

<8

Confusion Assessment Method

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5
Q

What tool can diagnose delirium?

A

Confusion Assessment method

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6
Q

Name 5 1st line investigations in delirium:

A

FBC, glucose, CXR, TFT, LFT, U&E

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7
Q

What are the 4 fields of management for delirium?

A
  1. Find and treat underlying cause
  2. Manage symptoms
  3. Prevent complications
  4. Explain to family
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8
Q

Which sedative for delirium is contraindicated in parkinson’s?

A

Haloperidol - so lorazepam is used instead

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9
Q

Name a drug that causes overflow incontinence?

A

Amitriptyline

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10
Q

Name a simple investigation of incontinence

A

Frequency volume charts

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11
Q

What is it called if 1/3 of urine is excreted at night?

A

Nocturnal polyuria

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12
Q

How many mls a day is the maximum to urinate?

A

2500, any more is polyuria

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13
Q

What are the causes of incontinence? (DIAPPERS)

A 
Delirium
Infection
Atrophy
Psychological
Pharmacalogical
Excess urine out put
Restricted mobility
Stool impaction in constipation
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14
Q

What are the patient education methods of managing incontinence?

A

Smoking cessation and weight loss advice
Reduce caffeine and alcohol intake
Manage constipation

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15
Q

What drugs are used in overactive bladders?

A

Antimuscarinic drugs

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16
Q

Name 3 medical treatments of over active bladder?

A

Antimuscarinic drug
Botox
Intravaginal oestrogen

17
Q

Name 2 drugs used to treat BPH in men

A

Alpha 5 reductase inhibitors

Alpha blockers e.g. sdoxazocin

18
Q

Define falls

A

When a person comes inadvertantly to the floor or to a lower level

19
Q

Name some intrinsic risk factors to falls

A

Cataracts, muscle strength, CI

20
Q

Name some extrinsic risk factors to falls

A

Home hazards, medications, walking aids

21
Q

Name the 4 important factors in the medical assessment of falls:

A
  1. Medication review
  2. DEXA scan
  3. Find medical reason for falls
  4. Manage conditions which cause the falls
22
Q

Name an exercise which can reduce falls risk

A

Tai Chi

23
Q

Why are old people more likely to be inappropriately prescribed?

A
  • more chronic illness
  • more polypharmacy
  • physiological changes due to age
24
Q

How should you alter the dose of hepatic-route drugs in older patients?

A

Lower the dose, increase the dose interval

25
Q

What are the consequences of inappropriate prescribing?

A

Longer hosptal stays, death, drug reactions, poor compliance

26
Q

What are the 4 criteria for assessing a patient’s capacity?

A
  1. Are they able to understand the information needed to make the decision?
    1. Are they able to retain this information long enough to make the decision?
    2. Are they able to weigh up the pros and cons of a decision?
    3. Are they able to communicate their decision?
27
Q

If a patient lacks capacity, can they make any decisions?

A

Yes e.g. what to have for dinner

28
Q

When can you restrain someone who lacks capacity?

A

Only when not doing so would cause harm to the patient

29
Q

What is unusual about the presentation of depression in older adults?

A

Physical symptoms may be more prominent

May present as confusion and memory loss

30
Q

Give 3 medications that may worsen depression

A

beta blockers, parkinson’s medications and CCB

31
Q

Where are pressure ulcers most likely to occur?

A

Bony prominences e.g. buttocks, heels, between the shoulder blades

32
Q

What may predispose an ulcer?

A

Skin feeling warmer or cooler on one area, colour or texture change

33
Q

What are 3 risk factors for developing a pressure sore?

A

Immobility
Sensory loss
Vascular problems/insufficiency
poor nutrition and hydration

34
Q

What surgery can be used to treat a pressure ulcer?

A

Surgical flap reconstruction

35
Q

What is advanced care planning?

A

Discussing care plans for patients when they are still competent, about future treatment preferences when they lose the ability to make decisions

36
Q

What are the 2 ways of having an advanced care plan?

A
  1. Living will

2. Power of attorney

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