Geriatrics/Palliative Care/Oncology Flashcards
what does alzheimers cause in the brain
cerebral atrophy in the cortex and hippocampus
1st and 2nd line management for alzheimers
1st: AchE inhibitors e.g. donepezil and rivastigmine
2nd: NMDA antagonist (memantine)
dementia with visual hallucinations
lewy body
dementia with a stepwise progression
vascular
gradual onset dementia at a young age with preserved memory and visuospatial skills
frontotemporal
why should you check the FBC, U&E, LFT, TFT, Ca, Glucose, B12 and folate in dementia
to check for reversible causes
what medication increases mortality in dementia
antispychotics
behavioural change and dementia in middle age
picks disease
reduced conscious level and psychotic sx
delirium
name one cause of delirium
constipation
which score is used to assess frailty
PRISMA-7
1st and 2nd line management of acute confusional state
1st: treat underlying cause and environment
2nd: haloperidol
which two tools assess medication risk benefit
STOPP and START
which score assesses pressure ulcers
waterlow score
management of pressure ulcers
dressing
analgesia
nutritional assessment
abx only if infection
which medication worsens delirium
benzos e.g. lorazepam
GI disturbance, dizziness, confused, arrhythmias, blurred yellow vision precipitated by renal failure or low K
acute digoxin toxicity
which medication predisposes gout
thiazides e.g. indapamide
which sedating medication should you avoid in parkinsons
haloperidol - use lorazepam instead
if pain is uncontrolled, how much should you increase morphine by
30-50%
what is the breakthrough dose of morphine
1/6th the daily dose
converting from oral to SC morphine
divide by 2
converting from codeine to morphine
divide by 10
converting from oral morphine to diamorphine
divide by 3
which opioids should you use in CKD
bupenorphine, fentanyl
which opioid should you use in mild renal impairment
oxycodone
treatment of nausea caused by gastric dysmotility/statis
dopamine antagonist
treatment of intracranial nausea
cyclizine
treatment of headache caused by raised ICP
dexamethasone
treatment of hiccups
chlorpromazine / haloperidol
3 treatments for metastatic bone pain
analgesia, bisphosphonates, radiotherapy
treatment of a painful mouth
benzydamine hydrochloride mouthwash
treatment of respiratory secretions and bowel colic
muscarinic receptor antagonists e.g. hyoscine bromide
CA153
breast cancer
CA125
ovarian cancer
CA199
pancreatic cancer
CEA
colorectal cancer
AFP (2)
hepatocellular carcinoma
teratoma
PSA
prostate cancer
which other marker is associated with prostate cancer
BRAC2
S-100 (2)
melanoma
schwannoma
Bombesin (3)
SCLC
gastric cancer
neuroblastoma
FAP
gardners syndrome
HNPCC
lynch syndrome
what condition can you see sinus invertus
kartagener
management of neoplastic spinal cord compression
immediate oral dexamethasone
urgent MRI of whole spine
management of SVC obstruction
dexamethasone
where does SCLC metastasise to
spine
which lung cancer has the highest association with smoking
squamous cell
where does breast cancer metastasise to
bone
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