OPIC Flashcards
Frailty Assessments
Timed Up + Go (< 10s)
Gait Speed (4m/5s)
180 degree Turn Test (< 5 steps)
GP Assessment
PRISMA-7 Questionaire (> 3)
Self-reported
Polypharmacy (> 4)
Delirium Screening
CAM:
Acute-Onset, Fluctuating (2)
Inattention (2)
Disorganised Thinking (1)
Altered Consciousness (1)
Cog Impairment Screening + Assessment
AMT: (Screening)
Age, D.O.B, Year, Place
(Count backwards, Year of WWII, ID 2 people/objects, Recall Address)
Assessment:
AMT10,
MMSE,
Mini-Cog
TIA Scoring
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
Anti-Coag Scoring (CHADSVAS)
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)
Anti-Coag Scoring (HASBLED)
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)
LD Criteria + Assessment
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
Overflow Incontinence Mx
(Reduce Prostate)
Alpha blockers (Doxazocin, Tamsulosin), 5a Reductase Inhib (Finasteride)
Surg (TURP)
Faecal Impaction/Incontinence Mx
Laxatives
Enema
DRE (Assess Prostate)
(If Neuro Dysfunct: Urgent Referral)
T/PACS Features
Unilateral weakness/sensory loss
Contralateral Homonymous hemianopia
Cerebral dysfunction
POCS Features
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)
Lacunar Features
Motor/sensory/motor – sensory loss
Ataxic Hemiparesis
Diagnostic Overshadowing Def
Attributing Presenting symptom/s to learning disability rather than seeking alternative cause
Incontinence Mx (Conservative)
Lifestyle changes:
Reduce Caffeine/Alcohol
Reduce BMI
Stop Meds (Diuretics)
Stress Incontinence Mx
Pelvic floor exercises
Surg (mesh, stitches, bulking)
Duloxetine (SNRi AntiD)
Urge Incontinence Mx
Bladder retraining (Increase time btw voids)
Oxybutynin (Anti-muscarinic)
Mirabegron (Beta3 Agonist)
Malnutrition Assessment
Malnutrition Universal Screening Tool
Causes of Malnutrition
Reduced Intake
Malabsorption
Increased Losses
Altered Requirements/Increased Energy Expenditure (Hypermetabolism)
Consequences of Malnutrition
Reduced Muscle Mass/Strength Fatigue Impaired Cardio-respiratory function Vitamin/Mineral/Electrolyte Def Reduced Immunity + Poor Wound healing Psychosocial effects
5 Principles of MCA
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
5 preventable Risk Factors of Dementia
HT DM Smoking Alcohol Obesity, Sedentary lifestyle
