Geriatrics - Frailty, Sarcopenia, Nutrition, Swallowing, Drug use

Question 1

Define ageing

Answer 1

Ageing is a process that converts healthy adults into frail ones with diminished reserves in most physiologic systems and exponentially increasing vulnerability to most diseases and to death

Question 2

Consequences of ageing

Answer 2

Ageing is a multifactorial process involving multiple molecular/ genetic, biochemical and physiological factors which manifest clinically as slowness, weakness, weight loss, low activity, fatigue etc
* Frail brain: loss of neurons in most cortical regions esp. area w/ high metabolic demands e.g. Hippocampus (Amnesia)
* Frail endocrine system: Less GH, IGF-1, Sex hormones, Vit. D, more Cortisol
* Frail immune system: Less stem cells, Change T cells, B cells, Reduced phagocytic activity of Neutrophils, MQ, NK, Elevated pro inflammatory cytokines e.g. IL6, CRP
* Frail haematological system

Question 3

Clinical presentation of ageing

Answer 3

Question 4

Characteristics of elderly people and interaction with diseases

Answer 4

Question 5

Change in drug metabolism with age

Answer 5

Question 6

Drugs that should be used cautiously in elderly

Answer 6

Question 7

Define polypharmacy and prescription cascade

Answer 7

Question 8

Complications of polypharmacy

Answer 8

Question 9

Medication non compliance

Risk factors for non compliance
Protective factos against non-compliance

Answer 9

Question 10

Potential causes of non-compliance

Answer 10

Question 11

Management of non compliance to medication

Answer 11

Question 12

Define medication appropriateness index

Answer 12

7D 2E 1I
Drug - Drug interaction
Drug - Disease interaction
Dosage
Duration
Duplication
Direction correct
Direction practical
Expensive
Effective
Indicated

Question 13

Define Frailty

Answer 13

Question 14

Risk factors for frailty

Answer 14

Question 15

Pathogenesis of Frailty

Answer 15

Question 16

Biological causes of frailty

Answer 16

Question 17

List indicies to diagnose frailty

Answer 17

Fried or Hopkins Frailty Phenotype
FRAIL Scale
FRAIL Index
Rockwood Clinical Frailty Scale

Question 18

Fried/ Hopkins Frailty Phenotype

Items
Interpretation

Answer 18

Question 19

FRAIL Scale

Items
Interpretation

Answer 19

Question 20

Frailty index
Items
Interpretation

Answer 20

Question 21

Rockwood Clinical Frailty Scale

Items
Interpretation

Answer 21

Question 22

General management plan for frailty

Answer 22

Question 23

Exercise prescription for frailty

Answer 23

Question 24

Causes of non-compliance to exercise prescription in frail patients

Answer 24

Question 25

Causes of poor nutrition in frail patients

Answer 25

Question 26

Recommended nutritional supplement in frail patients

Answer 26

Question 27

Frailty prognosis

Answer 27

Question 28

Sarcopenia

Pathogenesis
Clinical presentation

Answer 28

Question 29

Sarcopenia

Diagnosis

Answer 29

Question 30

Sarcopenia

Management

Answer 30

Question 31

Effect of ageing on nutrition

Answer 31

Question 32

Nutritional requirement in elderly

Answer 32

Question 33

Tool for optimal nutrition

Answer 33

Question 34

Risk factors of malnutrition

Answer 34

Question 35

Complications of malnutrition

Answer 35

Question 36

Clinical indices to screen for malnutrition

Answer 36

Malnutrition Universal Screening Tool (MUST)
Mini Nutritional Assessment (MNA®)

Question 37

Malnutrition Universal Screening Tool

Items
Interpretation

Answer 37

Question 38

Mini nutritional Assessment

Items
Interpretation

Answer 38

Question 39

Swallowing

Clinical signs of aspiration

Answer 39

Question 40

Swallowing

Prediction of aspiration risk

Answer 40

Question 41

Management of feeding difficulties

Answer 41