OPIC

Question 1

Frailty Assessments

Answer 1

Timed Up + Go (< 10s)
Gait Speed (4m/5s)
180 degree Turn Test (< 5 steps)

GP Assessment
PRISMA-7 Questionaire (> 3)
Self-reported
Polypharmacy (> 4)

Question 2

Delirium Screening

Answer 2

CAM:

Acute-Onset, Fluctuating (2)
Inattention (2)
Disorganised Thinking (1)
Altered Consciousness (1)

Question 3

Cog Impairment Screening + Assessment

Answer 3

AMT: (Screening)
Age, D.O.B, Year, Place
(Count backwards, Year of WWII, ID 2 people/objects, Recall Address)

Assessment:
AMT10,
MMSE,
Mini-Cog

Question 4

TIA Scoring

Answer 4

ABCD2 (> 4 => Urgent TIA Clinic):

Age: > 60 
BP: S: > 140, D: > 90 
Clin: Unilat Weakness (2), Speech Diff (1) 
Duration: > 1hr (2), < 1hr (1) 
DM: On Insulin

Question 5

Anti-Coag Scoring (CHADSVAS)

Answer 5

CHADSVAS: (> 2: High-risk: Anti-Coag):

C: CCF 
H: HT 
A: Age (> 75: 2) 
D: DM (On Insulin)
S: Previous Stroke/TIA (2) 
V: Vasc D 
A: Age (> 65: 1) 
S: Sex (F)

Question 6

Anti-Coag Scoring (HASBLED)

Answer 6

HASBLED: (> 3: High-risk: No Anti-Coag):

H: HT 
A: Abnormal Liver/Renal Funct (2) 
S: Stroke 
B: Bleeding D 
L: Labile INR 
E: Elderly (> 65) 
D: Drugs/Alc (2)

Question 7

LD Criteria + Assessment

Answer 7

Major IQ Impairment (<69)
Major Adaptive Funct Impairment (Safety, Self-care, Relationships)
Childhood-Onset

If Adult: LD Screening Q
If Child: Child + Adolescent Intellectual Disability Screening Q

Question 8

Overflow Incontinence Mx

Answer 8

(Reduce Prostate)​

Alpha blockers (Doxazocin, Tamsulosin), 
5a Reductase Inhib (Finasteride)​

Surg (TURP)​

Question 9

Faecal Impaction/Incontinence Mx

Answer 9

Laxatives
Enema
DRE (Assess Prostate)
(If Neuro Dysfunct: Urgent Referral)

Question 10

T/PACS Features

Answer 10

Unilateral weakness/sensory loss​
Contralateral Homonymous hemianopia​
Cerebral dysfunction​

Question 11

POCS Features

Answer 11

Bilateral weakness/sensory loss​
Homonymous hemianopia with macula sparing​
Conjugate eye disorder (Weak Add, Nystagmus on Abd)​
Cranial nerve palsy with contralateral weakness/sensory loss​
Cerebellar dysfunction (DANISH)

Question 12

Lacunar Features

Answer 12

Motor/sensory/motor – sensory loss​

Ataxic Hemiparesis

Question 13

Diagnostic Overshadowing Def

Answer 13

Attributing Presenting symptom/s to learning disability rather than seeking alternative cause​

Question 14

Incontinence Mx (Conservative)

Answer 14

Lifestyle changes:
Reduce Caffeine/Alcohol
Reduce BMI
Stop Meds (Diuretics)

Question 15

Stress Incontinence Mx

Answer 15

Pelvic floor exercises
Surg (mesh, stitches, bulking)
Duloxetine (SNRi AntiD)

Question 16

Urge Incontinence Mx

Answer 16

Bladder retraining (Increase time btw voids)​
Oxybutynin (Anti-muscarinic)​
Mirabegron (Beta3 Agonist)​

Question 17

Malnutrition Assessment

Answer 17

Malnutrition Universal Screening Tool

Question 18

Causes of Malnutrition

Answer 18

Reduced Intake
Malabsorption
Increased Losses
Altered Requirements/Increased Energy Expenditure (Hypermetabolism)

Question 19

Consequences of Malnutrition

Answer 19

Reduced Muscle Mass/Strength
Fatigue
Impaired Cardio-respiratory function
Vitamin/Mineral/Electrolyte Def
Reduced Immunity + Poor Wound healing
Psychosocial effects

Question 20

5 Principles of MCA

Answer 20

Must presume capacity at all times
Patients should be supported to make independent decisions
Patients have the right to make an unwise decision
Any decision made on behalf of someone lacking capacity must be made in their best interests
Any decision made on behalf of someone lacking capacity must be the least restrictive option

Question 21

5 preventable Risk Factors of Dementia

Answer 21

HT
DM
Smoking
Alcohol
Obesity, Sedentary lifestyle