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MD > MD3 RAPP > Flashcards

MD3 RAPP Flashcards

1
Q

What defines a mild cognitive impairment over dementia?

A

Mild cognitive impairment does not impact function

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2
Q

mx for mild cognitive impairment?

A
  • improve CVD risk factors as these are same as dementia
  • medicolegal - will + POA
  • retest 12 months
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3
Q

What are the two medications that may be used to slow dementia?

A

donepezil and rivastigmine commonly.

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4
Q

irritability and change in sleep pattern on top of prior cognitive impairment should ring alarm bells for?

A

delirium

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5
Q

Define delirium.

A

An acute and fluctuating change in cognition often featuring inattention.

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6
Q

Screening tool for delirium?

A

4AT

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7
Q

Ix for delirium screen?

A

SCRUBS mnemonic
Scan brain (sometimes)
CXR
Rationalise meds
Urine
Bloods - FBE, UEC, CMP, LFT, TFT, CRP
Scan bladder

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8
Q

Why do LFTs in suspected delirium?

A

to rule out hepatic encephalopathy

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9
Q

What is the molecular pattern responsible for alzheimers?

A

Amyloid beta plaques and neurofibrillary tangles

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10
Q

Is memory impacted in vascular dementia?

A

It can be or it can be spared. More typical is slow info processing and personality change.

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11
Q

Mx for vascular dementia?

A

CVD management to prevent further strokes.

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12
Q

Lew Body dementia is unique due to what defining feature?

A

Visual hallucinations

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13
Q

2 main types of fronto-temporal dementia and their classic signs.

A

fronto - behavioural change
temporal - primary progressive aphasia

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14
Q

Do cholinesterase inhibitors work for front-temporal dementia?

A

no

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15
Q

Brain imaging can be useful in declines in cognition to rule out?

A

space occupying lesions and brain bleeds (subdural in oldies)

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16
Q

Key finding on MRI in Alzheimers?

A

Hippocampi atrophy

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17
Q

Key MRI finding in vascular dementia?

A

Microhemarrohages

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18
Q

Triad for normal pressure hydrocephalus?

A

falls
ataxia
incontinence

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19
Q

Key to venous ulcer management?

A

compression (check for PVD first by ABI)

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20
Q

Most important mx for falls?

A

exercise

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21
Q

NOF mx principles

A
  • operate early
  • mobilise early
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22
Q

key for mx for neuropathic ulcers?

A
  • remove pressure eg. orthotics
  • beware osteomyelitis
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23
Q

Mild traumatic brain injury is also known as?

A

concussion

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24
Q

Name two unique features of traumatic brain injury compared to other ABIs?

A
  • diffuse axonal injury (sheared axons)
  • post-traumatic amnesia !!!
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25
Q

Only sign you will see on initial CT of ischemic stroke?

A

hyperdense artery sign

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26
Q

All spinal patients should have what intervention?

A

IDC - risk of retention

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27
Q

All acute quadreplegics should have what intervention?

A

NGT - huge aspiration risk

28
Q

Which Ix and medication are used in many spinal patients with bladder issues?

A

urodynamics and oxybutynin

29
Q

Which bacteria causes bladder stones in spinal bladders?

A

proteus - need to treat always

30
Q

Virtually every spinal patient should on which medicines for their constipation?

A

coloxyl - morning
senna - night

31
Q

First line treatment for spasticity?

A

Baclofen

32
Q

Pain in spinal patients is typically treated with which agents?

A

= neuropathic pain
- amytriptyline
- pregabalin

33
Q

First step in managing geriatric depression?

A

rule out organic causes

34
Q

Safe anti-depressant option in geris?

A

Mirtazepine

35
Q

One reason why tricyclics are poor options for geris?

A

orthostatic hypotension
also QT elongation

36
Q

SSRIs may cause _____ or _____ in conjunction with other medications.

A

SIADH or serotonin syndrome

37
Q

Mx option for refractive geri depression?

A

ECT

38
Q

Main ECT side effect?

A

memory loss (short term)

39
Q

Pharm mx for serotonin syndrome?

A

benzos

40
Q

Dementia risk factors?

A
  • CVD risks
  • hearing/visual impairment
  • TBI
41
Q

What is the anti-psychotic of choice for Lewy Body Dementia?

A

Quetiapine

42
Q

‘incongruent affect’ is code for ?

A

psychotic disorders

43
Q

Immediate pharm mx for mass compressing spine?

A

dexamethasone

44
Q

Why are LFTs relevant to bone mets?

A

ALP up in bone mets

45
Q

Scan for PE?

A

CTPA

46
Q

Opioid breakthrough dose?

A

1/6th of regular.

47
Q

max paracetamol dose in adults?

A

4g in 24hrs

48
Q

Side effects of opioids?

A

constipation, confusion, sedation, nausea, dry mouth.

49
Q

Best opioid for renal disease?

A

fentanyl

50
Q

Cyclizine is great for N+V caused by?

A

vestibular n+v

51
Q

Switch from metaclopramide to donperidone if….

A

noticing EPSE caused by metaclopramide (or pre-exisiting EPSE)

52
Q

Convert oral morphine to subcut.

A

Subcut is 1/3 of dose of oral.

53
Q

3 steps following pt death.

A
  1. call death same day, get chosen funeral services involved.
  2. Report to GP
  3. Bereavement resources to family
54
Q

What is a pancoast tumour?

A

Apical lung tumour causing shoulder pain, radiculopathy and Horner’s syndrome.

55
Q

Which stroke type is typically sensory only?

A

thalamic

56
Q

The main risk of diuretics in geris?

A

dehydration

57
Q

Right parietal stroke causes what type of presentation?

A

hemineglect

58
Q

What is an antalgic gait?

A

weird gait due to pain

59
Q

2 main falls rehab goals:
2 main falls risks:

A

strength and balance
bleed and fracture

60
Q

serum osmolality is the key ix in which geriatric presentation?

A

HHS (hyperosmolar hyperglycemic syndrome)

61
Q

Which cognitive screen is best for non-english speakers?

A

RUDAS

62
Q

2 key features of Wernicke’s Korsakoff?

A

No new memory laying + ophthalmogplegia

63
Q

Slow release K+ tablet?

A

Clorvescent

64
Q

two med classes used for neuropathic pain?

A

Anti convulsants eg. pregabalin and gabapentin

Anti-depressants - duloxetine and amitryptaline

65
Q

post-void residual level that is classified as retention?

A

over 300ml

66
Q
A

MD (18 decks)

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