Ageing

Question 1

5 domains of the comprehensive geriatric assessment

Answer 1

1. Medical
2. Psychological
3. Functional
4. Social
5. Spiritual

Question 2

Tools for measuring frailty

Answer 2

Rockwood Score

• count no. of body systems
• count how many have a deficit
• deficits/no. of systems

Fried Score

• unintentional wt loss
• slow walking speed
• low grip strength
• low physical activity
• self-reported exhaustion

Question 3

sarcopenia definition

Answer 3

progressive and generalised loss of muscle mass and function related to age

Question 4

sarcopenia obesity definition

Answer 4

loss of muscle with increased fat

Question 5

5 symptoms of dying

Answer 5

1. pain
2. breathlessness
3. n +v
4. agitation
5. secretions

Question 6

Mx of pain in dying

Answer 6

morphine

Question 7

Mx of breathlessness in dying

Answer 7

morphine

Question 8

Mx of n + v in dying

Answer 8

haloperidol (chemical induced n+v)

metoclopramide (stimulates gut)

levomopromazine (broad spec)

Question 9

Mx of agitation in dying

Answer 9

midazolam

Question 10

Mx of secretions in dying

Answer 10

buscopan

Question 11

confusion assessment method

Answer 11

1. acute onset + fluctuating course

AND

2. inattention

AND EITHER OF

3. disorganised thinking

OR

4. altered level of consciousness

Question 12

gold standard for diagnosing delirium

Answer 12

4AT score

Question 13

components of the 4AT score

Answer 13

1. Alertness
2. AMT4 (age, DOB, place, current year)
3. Attention (months backwards)
4. Acute change or fluctuating course

4 or more = potential delirium

Question 14

drugs causing delirium

Answer 14

sedatives
hypnotics
anti-depressants
drugs with anti-cholinergic effects: 
codeine, digoxin, furosemide, oxybutinin

Question 15

Drug Mx of delirium

Answer 15

haloperidol

Question 16

Drug Mx of delirium in Parkinson’s/LBD

Answer 16

Quetiapine

Question 17

Mx of delirium if caused by alcohol or BZD withdrawal

Answer 17

Lorazepam

Question 18

Drugs causing falls

Answer 18

vasodilating drugs (amlodipine, perindopril, tamsulosin)

topical beta blockers

digoxin

Question 19

what disease do NSAIDs worsen

Answer 19

CHF

Question 20

what disease do TZD’s worsen

Answer 20

CHF

Question 21

what disease do anticholinergics worsen

Answer 21

BPH - can cause urinary retention

Question 22

what group of drugs worsen constipation

Answer 22

CCBs

Question 23

what drugs lower seizure threshold

Answer 23

neuroleptics
tramadol
quinolones

Question 24

what drugs worsen asthma and shouldnt be given

Answer 24

b-blockers

Question 25

aspirin + NSAIDs interaction

Answer 25

increase bleeding risk

Question 26

warfarin + clarithromycin interaction

Answer 26

clarithromycin increases the anticoagulation effect of warfarin

Question 27

statin and clarithromycin interaction

Answer 27

clarithromycin increases the effect of the stain, increases the risk of rhabdomyolysis

Question 28

donepezil + atenolol interaction

Answer 28

hypotension

Question 29

Tx constipation if stimulation is the issue

Answer 29

senna

Question 30

Tx constipation if hard stool is the isssue

Answer 30

laxido + lactulose

Question 31

what food does metronidazole interact with

Answer 31

alcohol

Question 32

what foods does warfarin interact with

Answer 32

leafy veg broccoli cranberry

Question 33

what drugs interact with K rich foods (e.g. bananas)

Answer 33

ACEi ARBs K sparing diuretics (spironolactone)

Question 34

what food do statins interact with

Answer 34

grapefruit juice

Question 35

what drugs interact with chicken, turkey, milk, soy and cheese

Answer 35

digoxin | diuretics

Question 36

drugs with tremor as a s/e

Answer 36

salbutamol lithium sodium valproate clonazepam