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4th year OSCE > Geries > Flashcards

Geries Flashcards

1
Q

DDx for falls

A

Vasovagal, micturition, orthostatic hypotension, epilepsy, arrythmia, hypoglycaemia, loss of balance (PD, alzeihmers, peripheral neuropathy), vertigo, muscle weakness, OA, visual, depression, drugs

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2
Q

Important Qs to ask in falls assessment

A

Start off asking to describe event
Loss of consciousness?
Warning signs? loss of vision, dizziness
Trigger for fall? sitting, micturition, hungry
After the fall- get up quickly?, injury? bladder incontinence? confusion?
Past history of falls- 2 falls in past 6 months? usual type of fall?

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3
Q

Important meds for falls

A

Antihypertensives, anti-psychotics, anti-depressants, Benzos, diuretics, anti-convulsants, beta blockers

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4
Q

Physical exam for falls

A

Heart, legs, neuro (eyes, balance, power), postural BP

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5
Q

Organic causes and Ix for fall

A

FBC (infection, anaemia), UEC (volume status), Glucose, Calcium (delerium), TFT, Urinalysis, Echo, CXR, CT head, Bone density

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6
Q

Mx for fall

A

review meds, pressure stocking for orthostatic hypotension, OT assessment, physio, personal alarm, regular exercise

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7
Q

Hemiplegic gait key

A

Arm flexion, circumduction of leg

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8
Q

Diplegic gait key

A

hip and knee flexion, circumduction leg, no arm involve

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9
Q

Myopathic gait key

A

pelvis drop to non-weight side

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10
Q

Parkinsonian gait key

A

shuffling, festination, bradykinesia, turning by numbers, small steps, stooped posture

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11
Q

Cerebellar gait key

A

Drunken sailor! wide base, unsteady, uncertain

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12
Q

Sensory ataxic gait key

A

slamming of foot

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13
Q

Timed up and Go

A

From sitting, walk 3m and sit again (>20s= impaired) normal= 10s

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14
Q

Other exams for Gait assess

A

Cardio, neuro, MSK, vision, falls risk assessment

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15
Q

DDx hemiplegic gait

A

stroke, infective, neoplastic, MS, cerebal palsy

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16
Q

Neuropathic gait Ddx

A

Peripheral neuropathy, charcot marie tooth, compression peroneal nerve, L5 radiculopathy

17
Q

Myopathic gait Ddx

A

muscular dystrophy, hip dislocation

18
Q

Continence Hx

A 
When was first time, how many/day
When does it usually occur, any precipitating (cough, laugh, lift)
Do you feel a sudden urge?
Dripping afterward?
Difficulty getting there?
Difficulty starting the flow, change in size of stream, desire to pass again straight away? (urinary obstruction)
Feeling thirsty (DM, kidney failure)
Change in appearance of urine (UTI)
Coffee, alcohol drinking
Med Hx- strokes, back injury
19
Q

Meds cause incontinence

A

Diuretics, prsozin, benzo, anti-psychotic

20
Q

Cause of stress incontinence

A

age, preganncy, post-prostate, weak pelvic floor

21
Q

Causes urge incontinence

A

stroke, prostate, bladder infection, parkinsons

22
Q

Causes of overflow incontinence

A

prostate

23
Q

Functional incontinence cause

A

immobility, memory, coordination

24
Q

Ix for incontinence

A

Urinalysis, FBC,
US bladder and ureter
Urodynamic testing- PVR, EMG (sphincter strength)

25
Q

Mx Incontinence

A

Pelvic muscle exercise
Avoid alcohol, coffee, lose weight, quit smoking
pads, catheter
prostate surgery

26
Q

Rx for urge incontinence

A

Oxybutinin (anticholinergic)

27
Q

Prostate Rx

A 
Alpha blockers (prasozin)
5-alpha reductase inhib: finasteride
28
Q

Cognitive assessment

A

Ask about memory, writing, reading, speaking, attention, depression, daily activities
PMHx- stroke, head injury, meds
Fhx- parkos, alzheimers
Smoking/alcohol

29
Q

MMSE

A

1) Day, date, month, year, season (5)
2) Where are we? name of hospital? floor? country? state? suburb? (5)
3) Pencil, Table, Apple. Repeat and remember (3)
4) Serial 7s (5)
5) Recall objects (3)
6) Point to watch and pencil, name (2)
7) No ifs, ands or buts (1)
8) Take paper in right hand, fold in half, put on floor (3)
9) Obey written command ‘close eyes’ (1)
10) write a sentence (1)
11) draw intersecting pentagons (1)

30
Q

MMSE scores

A

10-24 mild impair. <10 severe impair

31
Q

Clock drawing

A

Draw clok and set time 10 minutes past 11

32
Q

Frontal assessment battery

A

Words beginning with S, similarities between bannana and orange, repeat hand tapping movements

33
Q

ADLs

A

DEATTH

Dressing, eating, ambulation, toilet, hygeine,

34
Q

Instrumental activities of daily living

A

SHAFT

Shopping, housework, accounting , food, transport

35
Q

Barthel index

A

Measure of function /100

36
Q

Assessments to ask for in geries

A

FBC, UEC, LFT, TFT, Urinalysis, CXR, CT head, Calcium, Cognitive assessment, MMSE< Frontal assesment battery
Physical exams
ACAT assess, OT, Physio, Geriatrician, Dietician, social work (power of attorney, guardian)

37
Q

Nursing home requirement is…

A

assistance with transfers

4th year OSCE (7 decks)

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