Geris

Question 1

Give 3 tools for assessing frailty?

Answer 1

• Clinical frailty score
• PRISMA 7
• Gait speed test

Question 2

Give 4 risk factors for delirium

Answer 2

• Hip fracture
• > 65
• Dementia
• Severe illness

Question 3

Give 4 metabolic causes of delirium

Answer 3

• Raised calcium
• Low sodium
• Thyroid (hyper/hypo)
• LFTs - raised ammonia

Question 4

What medication increase osteoporosis risk?

Answer 4

• Corticosteriods
• SSRIs
• PPIs
• Anti-epileptics
• Anti-oestrogens

Question 5

What blood tests is a marker of nutritional status?

Answer 5

Serum albumin

Question 6

What type of dementia are people with Down’s syndrome more at risk of? Why?

Answer 6

• AD
• Already have temporal lobe atrophy

Question 7

What does the DSM-IV criteria say is required for a dx of dementia?

Answer 7

Clear evidence of cognitive decline (MMSE/MOCA) PLUS…
- One of; aphasia, apraxia, agnosia, reduced executive function
- Symptoms interfere with work/social functioning
- Gradual onset and decline
- Not delirium
- No organic cause
- Not due to MHC

Question 8

What parts of the brain are primarily affected in AD? What compensation occurs?

Answer 8

• Frontal and temporal lobes
• Compensatory dilation of lateral ventricles -> hydrocephalus

Question 9

What characteristic motor sign do you get in vascular dementia?

Answer 9

Marche a petits pas - shuffling gait with small steps
- Can be called atherosclerotic PD

Question 10

What is another name of frontotemporal dementia?

Answer 10

Picks disease

Question 11

Which other subtype of dementia can be managed like AD?

Answer 11

LBD

Question 12

What does a disimpaction regime involve?

Answer 12

Macrogol laxative (polyethylene glycol) and electrolytes

Question 13

What is example of a osmotic laxative?

Answer 13

Lactulose

Question 14

What is example of a stimulant laxative?

Answer 14

Senna

Question 15

When are bulk forming laxatives indicated?

Answer 15

If they have hard stools and fibre cannot be increased in the diet

Question 16

What is second line for faecal impaction?

Answer 16

Stimulant laxative

Question 17

What is indicated by dark brown urine following long lie?

Answer 17

Rhabdomyolysis

Question 18

What CSF results are seen in viral meningitis?

Answer 18

• Clear CSF
• Normal glucose
• Normal protein
• Raised lymphocytes

Question 19

What is Confusion Assessment Method (CAM) used to diagnose? What is required for diagnosis?

Answer 19

• Used to diagnose delirium
• Require points 1 and 2 and either 3/4
  1. Acute onset and fluctuating course
  2. Inattention
  3. Disorganised thinking
  4. Alteration in consciousness