Pastest Flashcards
Most likely causes of renal failure in old people
Dehydration
Sepsis
Rhabdomyolysis
Serum calcium and phosphate in Paget’s disease?
Serum calcium and phosphate are normal (bone is resorbed but it is also reformed)
(however long periods of immobilisation could lead to hypercalcemia)
When does delirium tremens usually occur?
48-72 hours after the last drink.
Characterised by confusion, hallucinations, delusions, agitation, fear, autonomic overactivity and insomnia.
Complications of giant cell arteritis (temporal arteritis)
Blindness and big risk of stroke
blindness due to ischaemic optic neuropathy/central retinal artery occlusion
If you have transient visual loss (amaurosis fugax) in a TIA, which territory is affected?
The carotid territory has been affected
Investigation of TIA
CT
Carotid ultrasound
Cardiac ultrasound
Treatment of neurally mediated syncope?
Support stockings, SSRIs and fludrocortisone
Triad of normal pressure encephalopathy
Gait disturbance
Urinary incontinence
Memory loss
Treatment of normal pressure hydrocephalus
Lumbar puncture and therapeutic drainage of CSF
Symptoms of scabies
Itching - worse at night and in warm conditions
Rash - superficial burrows and pimples in interdigital spaces, feet, wrists, elbows, buttocks and genitalia
Treatment of scabies
Permethrin cream
What dietary measure can help patients lose weight?
Eating a diet rich in fruit and vegetables can reduce blood pressure by 2-8mmHg in hypertensive patients.
It can also direct weight loss, which will further aid in lowering risk of hypertension
How much sodium should you consume?
<2g of sodium daily
How many alcoholic drinks should you have daily?
<2 alcoholic drinks
Life threatening asthma mnemonic
CHEST Confusion/coma/cyanosis Hypotension Exhaustion Silent chest Threatening PEF rate - <33% predicted
What can cause osteoporotic wedge fractures in old people?
Osteoporotic fractures can occur from relatively minor traumatic episodes, such as coughing fits
When would you not give metaclopramide
In parkinsons
When you’re giving morphine, what should your breakthrough dose be?
Roughly 1/6th of your total daily dose
How many medications can be mixed together in a syringe driver?
Up to three medications
Difference between oral morphine and SC morphine
Subcutaneous morphine is twice as potent
Which type of delirium has a higher mortality rate? Hyperactive or hypoactive?
Hypoactive
Hyperactive dlirium
Agitated, aggressive, wandering –> easily recognised
Hypoactive delirium
Withdrawn, apathetic, sleepy coma –> easily missed
Which section is adults with incapacity?
Section 47
Medication which may help improve muscle strength in old people
Allopurinol
