Lectures Flashcards
def: birth rate
no. of live births per 1,000 women in age group 15-44
def: total fertility rate
expected no. of children born per woman in child-bearing years
def: replacement level
no. of children required to join population to replace each couple
def: perinatal mortality rate
no. stillbirths and deaths of infants under 1 wk per 1,000 live and stillbirths
def: expectation of life at birth
average no. years which new born baby can be expected to survive if current mortality rates continue
def: lying and standing BP postural hypotension
systolic drop >20mmHg
diastolic drop >10mmHg
causes of falls
- ↓vision
- ↓righting reflexes
- ↓balance
- ↓ muscle strngth
- ↓joint mobility
- impaired sensory sustems
- cVS system problems
- neurological disease
- peripeheral neuropathy
- cognitive decline
- postural hypotension
- non-compliance with walking aid
falls risk assessment
- assess gait, balance and mobility and muscle weakness
- assess osteoporosis risk
- assess perception of functional ability and fear of falling
- assess vision
- assess cognitive impaitment and neuro exam
- assess urinary incontinence
- assess home hazards
- CVS exam and meds review
falls injuries
- fractures
- had injuries
- laceration
- bleeding
- bruising
- LOC
risks with long lie
- hypothermia
- dehydration
- rhabdomyolysis
- pneumonia
- pressure ulcers
- delirium
management of falls
- focus on injuries an healing initially
- rrehabilitation - improve confidence, mobility and safety
- MDT input
- bone health
- falls education
what happens balance in ageing
loss of cilia insemicircular canals, utricle and saccule vestibular system
progressive decline in baroreceptor function
conditions increasign risk of falls
- acute infection/sepsis (UTI, GIT, chest)
- parkinson’s disease
- stroke
- MS
- meniere’s disease
- diabetes
- peripheral vascular disaese
- chronic disease of MSK
medication in falls
- psychotropic drugs
- analgesics
- CVS drugs
medicaiton in falls: psychotropic drugs
- sedatives
- hypnotics
- anxiolytics
- antidepressants
- anticonvulsants
medication in falls: analgesics
- codeine
- opioids
medication in falls: CVS
- alpha blockers
- beta blockers
- diuretics
- antihypertensives
- ACE/ARB
- Ca channel blockers
- nitrates
def: carotid sinus hypersensitivity
exaggerated response to carotid sinus baroreceptor stimulation - syncope may occur due to transient reduced cerebral perfusion
what is CSH associated with
hypertension
Lewy body dimentia
IHD
medication
what to ask in syncope history
driving hx and document in notes
def: BPpV
benign paroxismal positional vertigo
what test is used in BPPV
dix halpike and epley manouvre
tx: BPPV
physio - balance excercises and muscle stregthening
stop night sedation
adequate fluid intake
how to measure lying and standing blood pressure
- ensure pt lies in bed for 5 mins
- get them to stand and take blood pressure immediately
- repeat after 3 minutes
- should be first thing in morning
def: postural hypotension
systolic drop >20mmHg
diastolic drop >10mmHg