Virtual Elderly

Question 1

differential diagnosis for weight loss?

Answer 1

malignancy
coeliac
IBD
Peptic ulcers
Altered taste
Benign cause dysphagia
Hyperthyroidism
Addisons
T1D
MS, MND, PD, Dementia
HIV, TB, Depression alcohol dependence
COPD, CCF, CKD

Question 2

refeeding syndrome?

Answer 2

low K Ph, Mg and high insulin

Question 3

differential diagnosis for anaemia?

Answer 3

hb- less than 125 for women and less than 135 for men

microcytic-iron deficiency chronic blood loss, dietary, malabsorption

normocytic- acute blood loss, anaemia of chronic disease, haematological malignancies myeloma

macrocytic- b12 folate deficiency, hypothyroidism, alcohol excess, mydelodysplastic syndromes

Question 4

differential diagnosis dizziness?

Answer 4

light headed: cardiac, orthostatic, hypoglycaemia

unsteady: gait disturbance, visual, peripheral neuropathy, joint problems, fear of falling

vertigo: peripheral BPPV
Menieres disease
vestibular neuronitis
labyrinthitis
drug- aminoglycoside

cerebellar
stroke- stroke, haemorrhage TIA
MS
antiepileptics, phenytoin benzos, lithium alcohol
veterbrobasilar insufficiency

Question 5

menieres disease?

Answer 5

hearing loss, tinnitus, and vertigo

Question 6

cerebellar signs?

Answer 6

DANISH
dysdiadochokineasia
ataxia
nystangmus
intention tremor
slurred speech
hypotonia

Question 7

headache differential diagnosis?

Answer 7

secondary: cevicogenic
osteoarthritis
trigemnal neuralgia
calcium channel blockers
nitrates
dipyridadmole

primary: analgesic overuse
tension
migraine

red flag- subarachnoid
giant cell arteritis
malignant hypertesnion
subdural, extradural
raised intracranial pressure
infection
carbon monoxide poisoning
sinus venous thrombosis