Passmed (Elderly)

Question 1

How do we diagnose postural hypotension?

Answer 1

Where their standing blood pressure falls by more (systolic) 20 or (asystolic) 10 after taking lying blood pressure

Question 2

Medical treatment for postural hypotension?

Answer 2

Fludrocortisone (retians fluid).
Midodrine or ephedrine. (sympathomimetics)

Monitor weight and beware if CCF or low albumin: oedema worsens.

Question 3

Three main categories for causes of orthostatic hypotension?

Answer 3

Hypovolemia (dehydration, haemorrhage, anaemia)
Disease ( addisons, diabetes, heart disease)
Medications (diuretics, anti-depressants)

Question 4

Apart from salt diet & hydration, how else can we manage postural hypotension?

Answer 4

Bed tilt, compression stockings

Question 5

list some medical problems that are risk factors for falls

Answer 5

cognitive impairment
eyes diseases reducing acuity e.g. glaucoma, cataracts, age-related macular degeneration
arthritis
increased reaction time 

Question 6

What are some common causes of delirium in the elderly?

Answer 6

PINCH ME

Pain
Infection
Nutrition
Constipation
Hydration

Medications (amitriptyline)
Environment

Question 7

What is first line for delirium with a parkinsons patient?

Answer 7

Lorazepam