Comprehensive Geriatric Assessment Flashcards
what falls under the “medical” section of CGA?
problem list
co-morbid conditions and disease severity
medication review
nutritional status
what falls under “functioning” section of CGA?
basic ADLs
extended ADLs
activity / exercise status
gait and balance
what falls under the “psychological” section of CGA?
mental status / cognitive function
mood / depression testing
what falls under “social / environment” section of CGA?
informal needs and assets
social circle
care resource eligibility and resources
safety
what is most common cause of older patients losing weight rapidly?
what are the consequences of this?
dehydration
complications - dizziness etc
what is difference in presentation of MI in young patient vs old?
young = chest pain
old = no chest pain in 1/3 (more collapse, delirium, dizziness, breathlessness)
what are some differences in the pathophysiology of sepsis in old people compared to young?
BP may drop early (esp on hypertensives)
temp low, not high
tachycardic response may be absent
delirium may be prominent (not enough blood getting to brain)
CRP and WCC may not rise
fluid balance may be hard
antibiotics should be targeted - c.diff risk
why do you need to be careful with fluids in elderly?
more likely to cause heart failure if you don’t titrate it properly
what investigations will both young and old people get in MI?
blood tests, ECGs and CXRs
what investigations take place in young?
angiogram straight away
normally do echo
what problems may arise in investigating MI in elderly?
may not be able to lie flat
may be confused and not able to tolerate angiogram
echo may be normal
what side effects of antiplatelets are a concern in older patients?
problematic haemorrhage / haemorrhagic stroke
what always has to happen before any new medications added?
review
why is iatrogenesis common in elderly?
they have little homeostatic reserve
why do you tend to give topical NSAIDs rather than oral in elderly?
oral higher dose so higher risk of GI bleed
