Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Geriatrics > Y4 - Lecture Notes > Flashcards

Y4 - Lecture Notes Flashcards

1
Q

State some reasons why the population is getting older

A 
Better sanitation 
Improvements in housing, education and nutrition 
Smaller family size
Higher incomes
Vaccination 
Increased life expectancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

State some impacts of an ageing population

A

Affects:
Retirement age
Pensions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Name some social aspects of ageing

A

Health loss due to increasing pathology
Wealth loss
Companionship loss due to bereavement
Loss of independence due to disabilities
Loss of homeostasis due to impairments of body systems
Loss of status following retirement and loss of independence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How much exercise is recommended in the elderly?

A

30m moderate intensity on most days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What % of older adults report a limiting longstanding sickness or disability?

A

65-74y: 1/3rd

>75y: 1/2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe sheltered housing

A

Group of small flats with communal facilities for meals/social activities
Provided by local authority/voluntary sector
Buzzer system to allow residents help
Assistive devices etc. but patients usually able to mobilise/do personal care independently

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When should an elderly patient be institutionalised (put in a nursing home)?

A

When they are no longer able to supported at home within the resources available, due to severe physical disability, immobility, severe mental disability req. constant supervision, unpredictable and frequent care needs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Give a few examples of institutions?

A

Long stay hospitals

Care homes providing nursing or personal care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How might an elderly person prevent themselves from getting influenza?

A

Annual flu jab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How might an elderly person prevent themselves from getting pneumonia?

A

5 yearly vaccination for pneumococcal pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How might an elderly person prevent themselves from getting dementia/having a stroke?

A

Treat high BP

Anticoagulation for AF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How might an elderly person prevent themselves from getting osteoporosis?

A

Achieving good peak bone mass in adult life and continuing to exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How might an elderly person prevent themselves from getting ischaemic heart disease?

A

Avoid tobacco

Exercise and healthy diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How might an elderly person prevent themselves from getting alcoholic dementia, heart failure, pancreatitis, cirrhosis?

A

Safe drinking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How might an elderly person prevent themselves from getting type 2 diabetes?

A

Exercise and maintaining ideal body weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How might an elderly person prevent themselves from getting COPD and lung cancer?

A

Not smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What must you be very careful of when prescribing antibiotics to the elderly?

A

Avoiding C. diff

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the cut off to go to old age psychiatry?

A

65+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

For patients that stay in their own home, what types of care can be provided?

A 
Twenty four hour care
Regular visits for care
Meals on wheels/frozen meals service
Lucheon clubs
Day centres
Respite care
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Who do the vast majority of strokes occur in?

A

> 55s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Define stroke

A

Rapidly developing clinical signs of focal disturbance of cerebral function lasting 24h or longer or leading to death, with no apparent cause other than of vascular origin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Define TIA

A

Ischaemic (usually embolic) neurological event with symptoms lasting less than 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What causes a stroke? What are the two kinds of stroke?

A

Interruption of the blood supply to the brain
Due to:
Infarction
Haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is an infarct?

A

Area of ischaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What can cause an infarct in the brain?
Thrombosis in situ Embolus from the carotids or heart Low BP
26
What things may cause a haemorrhage in the brain?
Arterial aneurysm | Most infarcts and bleeds are due to vessels being damaged by atheroma and HTN
27
What are the risk factors for stroke and how can these be combated?
Increased age HTN - diet, exercise, medical Rx Heart disease AF - CHA2DS2Vasc risk and Mx appropriately Sticky platelets - aspirin (75-300mg) or clopidogrel Carotid stenosis - surgery, antiplatelets Smoking Unhealthy diet Obesity Excess alcohol Adverse lipid profile - diet, exercise, wt loss, 2ndary prevention - start simvastatin 40mg DM Lack of exercise Previous TIA
28
What tool is used to assess risk of stroke in AF patients?
CHA2DS2-Vasc ``` C - CHF/LVEF 40% or less - 1 H - Hypertension - 1 A - Age 75+ - 2 D - Diabetes - 1 S - Stroke/TIA/TE - 2 V - Vascular disease - 1 A - Age 65-74 - 1 SC - Sex Category: Female - 1 ```
29
How should you manage patients to reduce their stroke risk based on their CHA2DS2-Vasc score?
``` 0 = nothing 1 = aspirin 2+ = anticoagulant (e.g. elderly patients consider warfarin, alternatives may be rivaroxaban and apixiban) ```
30
What are SEs of using warfarin in older patients?
Recurrent falls | Dementia
31
How do rivaroxaban and apixaban work?
Factor Xa inhibitors
32
What is the typical presentation of stroke?
Onset is abrupt
33
If the onset of stroke like symptoms occurs over weeks/days, what should you consider?
Tumour | Subdural haematoma
34
What are common stroke mimics?
``` Hypoglycaemia Partial seizures Todd's paralysis after a partial seizure Hemiplegic migraine Metabolic disturbances ```
35
In which situations may a stroke present with a coma?
Brain stem infarct Large cortical infarct with brain stem compression Seizure after stroke
36
When should you be cautious giving a patient aspirin?
History of asthma or GI haemorrhage
37
In stroke the patient looks away/towards the lesion. In brain tumours, the patient looks away/towards the lesion.
Stroke - towards | Tumour - away
38
What tends to cause TIAs?
Platelet emboli from an atheromatous plaque or ulcer in the aorta or carotids or red cell emboli from the heart
39
A TIA in the internal carotid region may lead to what signs?
Monocular loss of vision Hemiparesis or monoparesis Dysphasia Unilateral sensory loss
40
How should TIAs be managed?
300mg aspirin straight away (unless CI or on warfarin) Refer to rapid access TIA clinic Complete ABCD2 score If confident about diagnosis start statin and antihypertensives straight away
41
What ABCD2 score indicates a high risk of subsequent stroke after TIA?
4 or more
42
What is the ABCD2 score?
Used for assessing risk of stroke after a TIA ``` A - age 60+ - 1 B - BP at assessment 140/90+ - 1 C - clinical features (unilateral weakness, speech disturbance) - 2 (if no weakness = 1) D - duration >60m - 2 D - diabetes - 1 ```
43
What patients will have their cartoids scanned and how is this done?
After anterior circulation TIA or acute non-disabling stroke if patient suitable for carotid endarectomy Doppler duplex imaging/MRA
44
What patients should have a carotid endarectomy?
if there is between 70-90/99% stenosis of the cartotids | NB - carotid endarectomy is preferred over cartoid stenting in 70+
45
What are the major clinical problems following stroke?
``` Dysphasia Delirium Dysphasia Dysarthria Dyspraxia Sensory neglect Visuospatial perception Executive function loss Sensory loss Weakness of limbs Depression Shoulder pain Thalamic pain ```
46
What is dysphagia?
Poor swallow
47
What is dysphasia?
Disorder of language
48
Who does dysphasia tend to affect?
Right handed patients with left hemisphere lesions
49
What is dysarthria?
Disrupted articulation but normal content of speech
50
What is dyspraxia?
Inability to perform purposeful movement despite adequate comprehension and motor function
51
What are the kinds of sensory neglect?
Visual | Tactile
52
How can you treat depression after stroke?
Antidepressants
53
When is depression post stroke most common?
After dominant hemisphere lesion
54
Give examples of symptoms/signs of a cerebellar stroke
``` Vertigo Vascular RF often present Severe ataxia Difficulty walking Nystagmus Focal neurological signs ```
55
What are the symptoms of spinal stroke?
Paraplegia/quadriplegia Intermittent sharp or burning back pain Loss of pain and temperature sensation Incontinence
56
What are the symptoms of spinal cord ischaemia?
Aching pain down legs (neurogenic claudication)
57
What is a subarachnoid haemorrhage?
Bleeding where the brain blood vessels lie between the pia and arachnoid mater
58
What can cause a SAH?
Vascular malformation Aneurysm Bleed from cerebral BV
59
What is the typical presentation of SAH?
Thunderclap headache Vomiting Often without neurological signs
60
If someone presents with suspected SAH what should you do?
Urgent CT | If CT negative - LP to check for xanthochromia
61
How should you manage a confirmed SAH?
Oral nimodipine 60mg 4 hourly Analgesia, e.g. codeine Neurosurgery - e.g. after MRA/CT angiography, aneurysms may be clipped/clamped/blocked with endovascular coil
62
How do you manage stroke?
Protect airway Ensure normal BG, BP (only if risk of hypertensive emergency, e.g. encephalopathy, aortic dissection) Nil by mouth until swallow assessment CT/MRI w.i. 1h Once haemorrhagic stroke ruled out - give 300mg aspirin for 2 weeks, then give 75mg thereafter If symptom onset <4.5h ago, give alteplase (rt-PA) - delay aspirin for 24h if do this Consider thrombectomy
63
What is the penumbra?
In stroke, there is a central area of irreversibly damaged cells, but around this is a 'penumbra' of ischaemic but potentially salvageable cells
64
What are the threats facing the penumbra?
Oedema Glutamate, lactate, aspartate Influx of Ca ions
65
What is involved in the management of haemorrhagic stroke?
Vitamin K and pro-thrombin Lowering BP Mannitol (to maintain cerebral perfusion)
66
How long can patients who have had a stroke not drive for?
1 month Must inform insurance If no residual deficit may drive again after 1m If deficit, must inform DVLA and be re-assessed
67
What is involved in primary prevention of stroke?
``` Treat HTN, DM Lower lipids Rx cardiac dx Quit smoking Exercise Life long anticoagulation in AF/prosthetic heart valves ```
68
What is involved in secondary prevention of stroke?
Controlling RFs Aspirin 300mg for 2 weeks, then switch to long term clopidogrel/low dose aspirin if this is CI Check for AF and Rx Carotid doppler/MRA - ?carotid endarectomy
69
Name some cardiac causes of stroke
``` AF Cardioversion Prosthetic valves Acute MI with large left ventricular wall motion abnormalities on ECG Patent foramen ovale/septal defects Cardiac surgery Infective endocarditis ```
70
How does your eye sight change as you get older?
Reduced visual acuity Reduced contrast sensitivity Slower dark adaptation
71
Why does your balance become impaired as you age?
Loss of labyrinth hair cells reducing vestibular input
72
Define sarcopenia
Loss of muscle mass and therefore strength
73
How is reaction time affected by age?
Reduced
74
How does walking change as you age?
Reduced walking speed Shorter broad based, or more irregular gait pattern Less effective heel strike More time spent in double support (both feet on the ground)
75
How common are falls?
1/3rd of 65yo+ 1/2 of 80yo+ Fall every year
76
What is a useful pneumonia for remembering the causes of falls?
DAME Drugs (polypharmacy, alcohol) Age-related changes (e.g. gait, balance, sarcopenia, sensory impairment) Medical (stroke, heart disease, PD) Environmental (lighting, obstacles, footwear)
77
Vertigo in relation to someone having a fall may suggest what two things?
If its only a few minutes after changing position - benign paroxysmal vertigo Longer history may be suggestive of vestibular neuronitis
78
What drugs are associated with a high risk of falling?
``` Antihypertensives (diuretics, CCBs, beta blockers) Opiates (drowsiness) Long-acting hypoglycaemics Antipsychotics (EPS) Hypnotics (benzos - drowsiness) Antidepressants e.g. TCAs Anti-epileptics (dizziness) Digoxin (arrhythmias) Alcohol ```

Geriatrics (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions