geriatrics

Question 1

management of pressure ulcer

Answer 1

nutritional assessment
analgesia
dressing
(abx only if evidence of sepsis, osteoyelitis or cellulitis)

Question 2

grading of pressure ulcers

Answer 2

grade 1- non-blanchable erythema of intact skin
2- partial thickness
3- ull thickness skin loss involving damage to or necrosis of subcutaneous tissue
4- Extensive destruction, tissue necrosis, or damage to muscle, bone or
supporting structures

Question 3

blood tests in consusion screen

Answer 3

B12/folate: macrocytic anaemias, B12/folate deficiency worsen confusion
TFTs: confusion is more commonly seen in hypothyroidism
Glucose: hypoglycaemia can commonly cause confusion
Bone Profile (Calcium): hypercalcaemia can cause confusion

Question 4

STOPP-START Criteria

Answer 4

medications that should consider withdrawing in the elderly

eg. tricyclic antidepressants in patients with dementia, due to the risk of worsening cognitive impairment.

Question 5

management of alzheimers

Answer 5

acetylcholinesterase inhibitors (donepezil, galantamine and rivastigmine) as options for managing mild to moderate Alzheimer's disease
memantine (an NMDA receptor antagonist) is in simple terms the 'second-line' treatment for Alzheimer's

Question 6

features of lewy body dementia

Answer 6

parkinsonism

visual hallucinations

Question 7

picks disease

Answer 7

frontotemporal dementia

Question 8

acutely confused parkinsons patient

Answer 8

Anti-psychotics should be avoided in delirious patients with a background of Parkinson’s disease