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Phase 3a - Geriatrics > MSK > Flashcards

MSK Flashcards

1
Q

What is the clinical definition of a fall?

A

An event where a person inadvertently comes to rest on a lower level, such as the ground or floor, without any external force involved.

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2
Q

What percentage of people over 65 experience at least one fall annually ?

A

Around 30%.

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3
Q

True/False: Falls are the most common cause of injury in people aged over 65.

A

true

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4
Q

Medical conditions like ______, stroke, and Parkinson’s disease increase fall risk.

A

Dementia

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5
Q

Name three intrinsic risk factors for falls.

A

Muscle weakness, poor vision, cognitive impairment.

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6
Q

What are two extrinsic risk factors for falls?

A

Poor lighting, loose rugs.

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7
Q

What is the primary tool used to assess fall risk in older adults?

A

The Timed Up and Go (TUG) test.

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8
Q

True/False: Gait and balance assessment are not part of the fall risk evaluation.

A

False

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9
Q

What are key components of a fall history?

A

Circumstances of the fall, preceding symptoms, and previous falls.

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10
Q

The ______ test evaluates visual acuity in fall-risk assessment.

A

Snellen

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11
Q

Name two major complications of falls.

A

Fractures (e.g., hip fractures) and traumatic brain injury.

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12
Q

True/False: Falls are associated with increased mortality in older adults.

A

true

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13
Q

What are three key aspects of managing falls in older adults?

A

Addressing medical conditions, physiotherapy, and home modifications.

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14
Q

______ therapy can be prescribed to improve muscle strength and balance.

A

Physiotherapy.

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15
Q

Name one medication class to avoid in fall-prone patients.

A

Benzodiazepines.

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16
Q

True/False: Vitamin D supplementation may help prevent falls in older adults.

A

true

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17
Q

List two environmental interventions to reduce fall risk.

A

Installing grab rails and removing trip hazards.

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18
Q

How does exercise reduce fall risk?

A

By improving strength, coordination, and balance.

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19
Q

What is frailty in geriatrics?

A

A clinical syndrome of decreased physiological reserve, increasing vulnerability to stressors and poor health outcomes.

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20
Q

Frailty is often described as a state of increased ______ and reduced resilience.

A

Vulnerability

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21
Q

Which age group is most commonly affected by frailty?

A

Adults aged 65 and older.

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22
Q

True/False: Frailty prevalence increases with age and affects women more than men.

A

true

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23
Q

What are the key biological processes contributing to frailty?

A

Chronic inflammation, sarcopenia, and dysregulation of multiple organ systems.

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24
Q

Frailty is closely associated with ______, the loss of muscle mass and strength.

A

Sarcopenia

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25
Q

What are the five criteria in Fried’s Frailty Phenotype?

A

Unintentional weight loss, self-reported exhaustion, weakness (grip strength), slow walking speed, and low physical activity.

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26
Q

True/False: Meeting three or more of Fried’s criteria defines frailty.

A

true

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27
Q

Name an alternative tool to diagnose frailty.

A

The Clinical Frailty Scale (CFS).

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28
Q

List common features of frailty.

A

Weakness, fatigue, slow mobility, unintentional weight loss, and cognitive decline.

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29
Q

Frail patients are at increased risk of ______ after acute illnesses or surgery.

A

Decompensation.

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30
Q

What is the primary goal of managing frailty?

A

To maintain or improve functional independence and quality of life.

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31
Q

True/False: Exercise, particularly resistance and balance training, is a key intervention for frailty.

A

true

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32
Q

Name two nutritional interventions for frailty.

A

Protein supplementation and addressing vitamin D deficiency.

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33
Q

Comprehensive ______ assessment (CGA) is essential in frailty management.

A

Geriatric

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34
Q

List two preventive strategies for frailty.

A

Regular physical activity and adequate nutrition.

35
Q

True/False: Early detection and intervention can prevent progression to severe frailty.

A

true

36
Q

Screening tools like the ______ can identify frailty in primary care.

A

Frailty Index.

37
Q

Name three complications of untreated frailty.

A

Increased falls, hospitalizations, and mortality.

38
Q

True/False: Frailty is reversible in its early stages with appropriate interventions.

A

true

39
Q

What is osteoporosis?

A

A condition characterized by low bone mineral density (BMD) and microarchitectural deterioration, leading to increased fracture risk.

40
Q

True/False: Osteoporosis is more common in men than women.

A

False. It is more common in postmenopausal women.

41
Q

Osteoporosis occurs due to an imbalance between bone ______ and bone ______.

A

Resorption; formation.

42
Q

Which two cells are involved in the regulation of bone turnover?

A

Osteoclasts (resorption) and osteoblasts (formation).

43
Q

True/False: Estrogen deficiency accelerates bone resorption.

A

true

44
Q

List five risk factors for osteoporosis.

A

Age, female gender, postmenopausal status, family history, and corticosteroid use.

45
Q

True/False: Smoking and alcohol consumption are modifiable risk factors for osteoporosis.

A

True.

46
Q

Long-term use of ______ (e.g., prednisolone) is a significant secondary cause of osteoporosis.

A

Glucocorticoids.

47
Q

What are the common clinical features of osteoporosis?

A

Fractures (vertebral, hip, wrist), loss of height, and kyphosis.

48
Q

True/False: Osteoporosis typically presents with pain even in the absence of fractures.

A

False. It is usually asymptomatic unless fractures occur.

49
Q

Vertebral fractures can lead to ______, characterized by a forward curvature of the spine.

A

Kyphosis.

50
Q

What investigation is the gold standard for diagnosing osteoporosis?

A

Dual-energy X-ray absorptiometry (DEXA) scan.

51
Q

A T-score of ______ or below indicates osteoporosis on a DEXA scan.

A

-2.5.

52
Q

True/False: Blood tests, including calcium, vitamin D, and thyroid function tests, are part of the workup to rule out secondary causes of osteoporosis.

A

true

53
Q

What is the first-line pharmacological treatment for osteoporosis?

A

Bisphosphonates (e.g., alendronate).

54
Q

True/False: Calcium and vitamin D supplementation is recommended for all patients with osteoporosis.

A

true

55
Q

______ is a monoclonal antibody that inhibits RANK ligand, reducing bone resorption.

A

Denosumab.

56
Q

Name two lifestyle modifications for osteoporosis management.

A

Weight-bearing exercise and smoking cessation.

57
Q

What is the most serious complication of osteoporosis?

A

Hip fractures, which are associated with high morbidity and mortality.

58
Q

Vertebral fractures can lead to chronic ______ and reduced quality of life.

A

Back pain.

59
Q

True/False: Patients with osteoporosis have a higher risk of falls.

A

true

60
Q

What are two preventive strategies for osteoporosis?

A

Adequate calcium and vitamin D intake, and regular weight-bearing exercise.

61
Q

True/False: Screening with a DEXA scan is recommended for all women over 50.

A

False. Screening is recommended for women over 65 or those with risk factors.

62
Q

Secondary prevention involves pharmacological treatment to prevent further ______.

A

Fractures.

63
Q

What is the most common cause of lower limb fractures in older adults?

A

The most common cause is falls, often due to reduced mobility, balance issues, or osteoporosis.

64
Q

What are the typical types of lower limb fractures seen in the elderly?

A

Common fractures include hip fractures (femoral neck or intertrochanteric), femoral shaft fractures, and distal femur fractures.

65
Q

Osteoporosis is a significant risk factor for lower limb fractures in older adults.

A

true

66
Q

The risk of lower limb fractures increases with increasing age.

A

true

67
Q

A ________ fracture is the most common type of hip fracture in older adults.

A

Femoral neck

68
Q

What are the clinical signs of a hip fracture in the elderly?

A

Clinical signs include pain in the hip or groin, inability to bear weight, shortened and externally rotated leg, and inability to move the affected leg.

69
Q

A fracture involving the femoral neck is most commonly caused by ________ in elderly patients.

A

falls

70
Q

What are the main complications associated with lower limb fractures in older adults?

A

Complications can include deep vein thrombosis (DVT), pulmonary embolism (PE), pressure ulcers, infection, loss of independence, and mortality.

71
Q

Fractures of the lower limb in older adults often require long-term rehabilitation and can lead to a significant decline in mobility.

A

true

72
Q

What is the initial management of lower limb fractures in elderly patients?

A

Initial management involves pain control, stabilization of the fracture, and early referral to orthopedic specialists. In some cases, surgical intervention may be necessary.

73
Q

Non-operative management is often preferred for hip fractures in older patients.

A

False (Surgical intervention is typically preferred for hip fractures in elderly patients.)

74
Q

________ is the primary surgical treatment for a femoral neck fracture.

A

Hip replacement (either partial or total)

75
Q

What are the types of surgical treatment for femoral fractures in the elderly?

A

Surgical options include hip replacement (partial or total), internal fixation (screws, nails, plates), and sometimes hemiarthroplasty.

76
Q

Older adults with lower limb fractures are at higher risk of mortality in the first year after the fracture.

A

true

77
Q

What factors influence the prognosis of lower limb fractures in elderly patients?

A

Prognostic factors include the patient’s age, comorbidities, functional status prior to the fracture, type of fracture, and timeliness of surgical intervention.

78
Q

The main goal in the management of lower limb fractures in older adults is to ________ and ________.

A

Restore mobility; prevent complications

79
Q

Physical therapy is often part of the rehabilitation process following a lower limb fracture in elderly patients.

A

true

80
Q

What role does osteoporosis play in the risk of lower limb fractures in the elderly?

A

Osteoporosis significantly weakens bones, increasing the likelihood of fractures, especially from low-impact trauma such as a fall.

81
Q

The use of ________ medications is important in the management of osteoporosis to prevent future fractures in elderly patients.

A

Bisphosphonates or other osteoporosis treatments

82
Q

A comprehensive geriatric assessment is important in managing elderly patients with lower limb fractures.

A

true

83
Q

What is the significance of early mobilization after a lower limb fracture in the elderly?

A

Early mobilization reduces the risk of complications such as deep vein thrombosis (DVT), pressure ulcers, and muscle atrophy, and it helps improve overall recovery.

Phase 3a - Geriatrics (8 decks)

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