OPM - Frailty and Abnormal Presentations Flashcards
what is the classification of geriatric
65+
however some studies make it 75+
what is the definition of frailty
no definition
but is an agreed syndrome
an age-related condition characterised by a decline in physiological capacity across several organ systems, which results in a higher vulnerability to stressors and unfavourable outcomes
what is frailty
cascade from function to disability.
The inability to rebound after a stressor
what measure is used to scale frailty
USED ALOT IN OSCE AND EXAM
rockwood clinical frailty scale
what are the rockwood clinical frailty score classifications from 1-9
1 - fit
2 - well
3 - managing well
4 - vulnerable
5 - mildly frail
6 - moderately frail
7 - severely frail
8 - very severely frail
9 - terminally ill
normal is 2, 1 is excessive exercise and very fit
what are the 4 most common symptoms and signs of frailty
impairment of intellect
incontinence
immobility
instability (falls)
what common non-specific complaints would someone frail likely present with
Generalised weakness
Dyspnoea (Shortness of breath)
Pain (non specific)
Fatigue/ localised weakness
Speech disorder
Gait disorder
Loss of consciousness
what are common diagnosis for those classified as frail (think of 5 there are many more)
Pneumonia
Urinary tract infection
Stroke
Cancer
Dementia
Syncope
Pulmonary embolus
Subdural haematoma
Hypothyroidism
Diabetes
Medication poisoning
Alcoholism
Depression
what tool can be used to help assess geriatric primary care
CGA
comprehensive geriatric assessment
Often Exam qs
what are the 4 elements of the GCA
1) Physical assessment
2) Functional, social and environmental assessment
3)Psychological components
4)Medication review
who would be most vulnerable and are identified as patients at risk
- age 85+
- multiple medical conditions
- Multiple medications
- cognitive impairment
- residing in a care institution
Case 1
90yr F.
Dizzy and bp 80/50
fatigue and vivid dreaming overnight
ECG - ST elvation
angina-free MI is more common in older people
Case 2
86yr M
delirious, tachypnoea, dry cough
constipated for 4 days and off food
Abdo XR - sever blockage
acute abdomen more common to present without pain or major discomfort in the elderly
Case 3
F
malaise, shaking, fatigue, difficult to stand, no food for 2 days
urine dip - + for staph aureus
not necessarily a UTI
looking at feet - wound infected
what must you decide if you cant get hold of family of someone who lacks capacity and you fill out a DNACPR . is this illegal
no
you must try to contact the family
but its a medical decision. So you don’t need their permission, but you must try to contact them
