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Year 4 > Medicine for the Elderly > Flashcards

Medicine for the Elderly Flashcards

1
Q

Problems resulting from constipation (4)

A

Overflow diarrhoea
Urinary retention
Delirium
Abdominal pain/nausea and vomiting

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2
Q

Examples of Osmotic Laxatives

A

Laxido - prepared in solution

Lactulose

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3
Q

Examples of Stimulant Laxatives

A

Senna

Biscodyl

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4
Q

Examples of Softener Laxatives

A

Docusate

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5
Q

Examples of PR solutions

A

Glycerine suppositories
Microenemas
Phosphate enemas

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6
Q

Groups of Drugs Causing Constipation (2)

A

Opiates
Anti-Cholinergics
Including Anti-Muscarinics, Anti-Psychotics and Sedating Anti-Histamines

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7
Q

Examples of Bulk Forming Agents

A

Husk

Have both stimulant and softening actions

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8
Q

Pain Medications avoided in MFE

A

NSAIDs - GI ulceration

Dihydrocodeine, tramadol - tramadol can cause dizziness

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9
Q

Side Effects of Anti-Cholinergics (6)

A 
Agitation 
Blurred Vision 
Constipation 
Confusion 
Dry Mouth 
Stasis of urine/inability to sweat
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10
Q

Examples of Anti-Cholinergics

A

Anti-Depressants - amitriptyline, imipramine
Anti-Psychotics - clozapine, quetiapine, risperidone, haloperidol
Anti-Emetics - metoclopramide, prochlorperazine
Anti-Spasmodics - oxybutynin
Anti-Allergic - cetirizine, loratadine
Anti-Parkinson’s Drugs - levodopa, procyclidine

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11
Q

Signs in Opioid Toxicity (3)

A

Jerking/twitching movements
Vivid hallucinations
Sedation (less specific)

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12
Q

If need to switch from morphine, what would be the next opioid choice?

A

Oxycodone

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13
Q

Managing Breathlessness at End of Life

A

Non-Pharmacological - breathing exercises, physiotherapy, relaxation
Pharmacological - oral low dose opioid, lorazepam (helps anxiety around SOB), long term oxygen

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14
Q

Contraindications to using laxatives (5)

A 
Intestinal obstruction or perforation 
Paralytic ileus 
Faecal impaction 
IBD 
Toxic megacolon
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15
Q

How do bulk forming laxatives work?

A

Contain fibre, act by keeping fluid in the stool to produce distension

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16
Q

How do osmotic laxatives work?

A

Increasing the amount of fluid in the large bowel producing distension

17
Q

How do stimulant laxatives work?

A

Causes peristalsis by stimulating colonic nerves

Biscodyl also stimulates rectal nerves

18
Q

Lactulose is also helpful in what other condition?

A

Hepatic encephalopathy

19
Q

Causes of post-operative hypoxia (4)

A

Infection
Pulmonary Embolism
Post-operative MI
Pulmonary Oedema

20
Q

Causes of hypothermia (2)

A

Long lie

Sepsis - worse prognosis as suggests derangement of physiology

21
Q

Causes of post-operative tachycardia

A

Infection
Pulmonary Embolism
Atrial Fibrillation

22
Q

What is overflow incontinence?

Management

A

Unable to fully empty the bladder which causes frequent leaking
Ix: bladder scanning and urology referral
Mx: relieve obstruction, instruct individuals in self catheterisation

23
Q

Investigations (and justification) in Falls

A 
Bloods 
- FBC = anaemia 
- U&Es = electrolyte imbalance 
- LFTs = alcohol 
- TFTs 
- B12 = peripheral neuropathy, cognitive 
- RBG = hypo or hyperglycaemia 
ECG
Echo 
Visual Assessment 
Appropriate X-Rays
24
Q

Osteoporosis and T-score

A 
<2.5 = osteoporosis 
1.5-2.5 = osteopenia
25
Q

Side Effects of Bisphosphonates

A

Gastritis/GORD symptoms

Osteonecrosis (of jaw)

26
Q

eGFR consideration bisphosphonates

A

<35 should NOT be given

27
Q

Criteria for CT in Acute Confusion (5)

A 
Focal neurological signs 
Anti-coagulation therapy 
History of recent falls 
Head injury 
Reduced level of consciousness
28
Q

1st Pharmacological Intervention in Delirium

A

Haloperidol

29
Q

Other options in delirium

A

Can use benzodiazepines if alcohol withdrawal is causing the delirium
Can also be used in Parkinson’s Disease
May worsen the delirium

30
Q

Electrolyte Disturbance caused by steroids

A

Hypokalaemia

31
Q

Presentation of Heart Failure - elderly

A

Often fatigue dominates

Reduced exercise tolerance + other ‘classical’ features

32
Q

Management of rate in AF

A

Digoxin 250mg

Can also use bisoprolol

33
Q

Transudate pleural effusion

Causes

A

<30

Causes: cardiac failure, hypoalbuminaemia, nephrotic syndrome

34
Q

Exudate pleural effusion

Causes

A

> 30

Causes: malignancy, empyema

Year 4 (27 decks)

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