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Geriatrics > Overview of falls and instability > Flashcards

Overview of falls and instability Flashcards

1
Q

Indicators for potentially having a fall

A

unstable balance on standing
use of > 4 meds
hip weakness

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2
Q

are falls a normal aspect of aging?

A

No

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3
Q

what is a good previous indicator of a fall

A

a previous fall

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4
Q

is someone has dysequilibrium what should you think

A

neuromuscular dz
stroke
cerebellar dz

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5
Q

if it is vertigo what should you suspect

A 
drugs
depression
vestibular neuronitis
benign positional vertigo
otitis media
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6
Q

what is fainting, lightheadedness, feeling that loss of consciousness is imminent

A

pre-syncope

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7
Q

difficulty initiating gait and festination

A

parkinson

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8
Q

foot drop indiactes what?

A

anterior tibialis weakness or reduced knee flexion

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9
Q

do you just tx a patient for osteoporosis?

A

Nope, make sure there isn’t a secondary cause

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10
Q

what is a potential screening for osteoporosis that is super cheap and has no radiation?

A

Quantitative ultrasonography of the calcaneus (if its positive must get a DEXA)

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11
Q

is osteoporosis reversible?

A

No, but you can stop the progression

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12
Q

ADRs of bisphosphonates

A

osteocencorsis on the jaw and atypical femur fractures

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13
Q

is hormone replacement therapy used for osteoporosis?

A

Nope

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14
Q

enlargement at DIP

A

Heberden’s nodes

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15
Q

enlargement at the PIP

A

Bouchard’s nodes

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16
Q

usually over age 50
Women 2x more than men
Morning stiffness > 1 hour
Shoulder and hip girdles

A

Polymyalgia rheumatica

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17
Q

tx for polymyalgia rheumatica

A

steroids

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18
Q

tx for temporal arteritis (giant cell arteritis)

A

temporal artery biopsy

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19
Q

do you wait for tx for giant cell arteritis?

A

never

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20
Q

Temporal HA, blindness

ESR, CRP highly elevated

A

giant cell arteritis

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21
Q

Tx for giant cell arteritis

A

Temporal artery biopsy

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22
Q

tx for giant cell arteritis?

A

steroids

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23
Q

what 2 conditions are highly associated

A

polymyalgia rheumatica

giant cell arteritis

24
Q

are wound surface cultures helpful?

A

No

25
Q

how many hip fractures remain in the nursing home 1 year after fracture?

A

30%

26
Q

how many people will develop a pressure ulcer after a hip fracture?

A

30%

27
Q

What are the 5 most common places for fractures following a fall?

A 
hip
femur
humerus
wrist
ribs
28
Q

What type of hematoma is a consequence of falls?

A

subdural hematoma

29
Q

What are 3 reasons falls are underreported?

A

Injury minimal
“normal” with aging
fear of restriction in activities or institutionalization

30
Q

What 3 drug levels should you get for a fall?

A

Digoxin, anticoags, ETOH

31
Q

What vitamin deficiency could play a part in a fall?

A

Vitamin D level

32
Q

If someone is dizzy, you should suspect what 5 things?

A

Vertigo (ear, drug toxicities, depression)
Dysequilibrium (neuromuscular disease, stroke, cerebellar dz)
Presyncope
Mixed dizziness
Nonspecific dizziness

33
Q

5 causes of presyncope

A 
Cerebral hypo-perfusion
Orthostatic HPOTN
Cardiac arrhythmias
CHF
Vasovagal episodes
34
Q

Sudden, transient loss of consciousness characterized by unresponsiveness and loss of postural control, followed by spontaneous and typically complete recovery

A

Syncope

35
Q

What test should you get if there is any LOC?

A

head CT

36
Q

If there is gait initiation failure, what do you suspect?

A

high level sensorimotor disorder (frontal lobe or white matter)

37
Q

Why would there be short step length?

A

fear of falling, neuro or MSS problem

38
Q

Pelvic muscle weakness or unable to bend the knee or hemiplegia causes what?

A

circumdunction

39
Q

A bone density between -1 to -2.5 means

A

osteopenia

40
Q

A bone density above >1.0 means

A

Normal Bone Mineral Density

41
Q

What bone density value means osteoporosis?

A

<-2.5

42
Q

Can men get osteoporosis?

A

yes

43
Q

What is type 1 and type 2 idiopathic osteoporosis?

A

type 1- postmenopausal

Type 2- age associated or senile

44
Q

4 endocrine disorders that are causes of osteoporosis

A

cushing, DM, hyperparathryoidism, hyperthyroidism

45
Q

When should men be screened for osteoporosis?

A

> 70 y/o

10% weight loss, physical inactivity, steroid use, androgen deprivation therapy, previous fragility fracture)

46
Q

What is the gold standard for osteoporosis diagnosis?

A

Dual-Energy X-ray Aborptiometry (Lumbar spine, hip, and proximal femur)

47
Q

Can any treatment reverse established osteoporosis?

A

No

48
Q

What should you supplement with if on corticosteroids?

A

Ca and Vit D

49
Q

First line Tx for osteoporosis

A

Bisphosphonates

50
Q

What should you treat with if bisphosphonates have failed?

A

PTH hormone

51
Q

ADRs of SERM

A

increased risk of DVT and hot flashes

52
Q

What’s the most common presentation of pain?

A

OA

53
Q

Stiffness after period of inactivity which is alleviated within 30 minutes of activity. Episodes of severe pain, tenderness of joints WITHOUT INFLAMMATION

A

OA

54
Q

Heberden’s and Bouchard’s nodes associated with what?

A

OA

55
Q

Morning stiffness > 1hour

A

polymyalgia rheumatica

Geriatrics (18 decks)

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