Pastest

Question 1

Most likely causes of renal failure in old people

Answer 1

Dehydration
Sepsis
Rhabdomyolysis

Question 2

Serum calcium and phosphate in Paget’s disease?

Answer 2

Serum calcium and phosphate are normal (bone is resorbed but it is also reformed)
(however long periods of immobilisation could lead to hypercalcemia)

Question 3

When does delirium tremens usually occur?

Answer 3

48-72 hours after the last drink.

Characterised by confusion, hallucinations, delusions, agitation, fear, autonomic overactivity and insomnia.

Question 4

Complications of giant cell arteritis (temporal arteritis)

Answer 4

Blindness and big risk of stroke

blindness due to ischaemic optic neuropathy/central retinal artery occlusion

Question 5

If you have transient visual loss (amaurosis fugax) in a TIA, which territory is affected?

Answer 5

The carotid territory has been affected

Question 6

Investigation of TIA

Answer 6

CT
Carotid ultrasound
Cardiac ultrasound

Question 7

Treatment of neurally mediated syncope?

Answer 7

Support stockings, SSRIs and fludrocortisone

Question 8

Triad of normal pressure encephalopathy

Answer 8

Gait disturbance
Urinary incontinence
Memory loss

Question 9

Treatment of normal pressure hydrocephalus

Answer 9

Lumbar puncture and therapeutic drainage of CSF

Question 10

Symptoms of scabies

Answer 10

Itching - worse at night and in warm conditions

Rash - superficial burrows and pimples in interdigital spaces, feet, wrists, elbows, buttocks and genitalia

Question 11

Treatment of scabies

Answer 11

Permethrin cream

Question 12

What dietary measure can help patients lose weight?

Answer 12

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

Question 13

How much sodium should you consume?

Answer 13

<2g of sodium daily

Question 14

How many alcoholic drinks should you have daily?

Answer 14

<2 alcoholic drinks

Question 15

Life threatening asthma mnemonic

Answer 15

CHEST
Confusion/coma/cyanosis
Hypotension
Exhaustion
Silent chest
Threatening PEF rate - <33% predicted

Question 16

What can cause osteoporotic wedge fractures in old people?

Answer 16

Osteoporotic fractures can occur from relatively minor traumatic episodes, such as coughing fits

Question 17

When would you not give metaclopramide

Answer 17

In parkinsons

Question 18

When you’re giving morphine, what should your breakthrough dose be?

Answer 18

Roughly 1/6th of your total daily dose

Question 19

How many medications can be mixed together in a syringe driver?

Answer 19

Up to three medications

Question 20

Difference between oral morphine and SC morphine

Answer 20

Subcutaneous morphine is twice as potent

Question 21

Which type of delirium has a higher mortality rate? Hyperactive or hypoactive?

Answer 21

Hypoactive

Question 22

Hyperactive dlirium

Answer 22

Agitated, aggressive, wandering –> easily recognised

Question 23

Hypoactive delirium

Answer 23

Withdrawn, apathetic, sleepy coma –> easily missed

Question 24

Which section is adults with incapacity?

Answer 24

Section 47

Question 25

Medication which may help improve muscle strength in old people

Answer 25

Allopurinol