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Geriatric Medicine


Normal physiological ageing | physical examination | laboratory values | presentation of disease | falls | cognitive impairment | delirium | pain | urinary and faecal incontinence | constipation | gait disorders | stroke disease | hypertension and hypotension | dementia | arthritis | osteoporosis | pressure ulcers | Parkinson's disease | drug treatment| psychiatric illness | functional assessment |complex multiple disabilities | aging and society| Rating scales | legal and ethics |aids| assessing competency | multidisciplinary team | community services | public health | care facilities

 

 

  • Normal physiological ageing: the effects of ageing on organ systems and reduced functional reserve.

Exam Questions

References

DHEA in Elderly Women and DHEA or Testosterone in Elderly Men
Nair K. S., Rizza R. A., O'Brien P., Dhatariya K., Short K. R., Nehra A., Vittone J. L., Klee G. G., Basu A., Basu R., Cobelli C., Toffolo G., Man C. D., Tindall D. J., Melton L. J. III, Smith G. E., Khosla S., Jensen M. D.
N Engl J Med 2006; 355:1647-1659, Oct 19, 2006. Original Articles

Aging and Fountain-of-Youth Hormones
Stewart P. M. N Engl J Med 2006; 355:1724-1726, Oct 19, 2006. Editorials

Mechanisms of Disease: Age-Related Macular Degeneration
de Jong P. T.V.M. N Engl J Med 2006; 355:1474-1485, Oct 5, 2006. Review Articles

 

 

  • The hazards of drug treatment in elderly people: pharmacokinetic and pharmacodynamic changes in drug handling with age and disease; the risks of multiple drug prescription; iatrogenic drug-induced diseases; compliance in the elderly.
  • The presentation and management of psychiatric illness in old age and its relationship to physical illness.

Clinical review Recent developments: Suicide in older people
Henry O'Connell, Ai-Vyrn Chin, Conal Cunningham, and Brian A Lawlor
BMJ 2004; 329: 895-899.

 


  • The importance of the functional assessment of elderly patients in terms of impairment; disability and handicap that also includes social, psychological and environmental dimensions.

exam questions

2002 paper one question 54 Habitual gait speed as an indicator of survival and future institutionalisation

  • Skill in managing elderly people with complex multiple disabilities.
  • An understanding of some of the physical, psychological and social changes that occur with age and attitudes of society towards ageing, and the importance in the face of illness and frailty of promoting older peoples' dignity and sense of identity.

exam questions

references

Mortality after the Hospitalization of a Spouse
Christakis N. A., Allison P. D.
N Engl J Med 2006; 354:719-730, Feb 16, 2006. Special Articles

 

  • The use of rating scales in particular clinical situations, for example a mental test score such as the Folstein MMSE, a geriatric depression scale and scoring of activities of daily living using a recognised scale.
  • Understanding of important ethical and legal issues in caring for elderly people.
  • Understanding the role of aids (including hearing aids) and appliances in the rehabilitation of elderly disabled people.
  • Knowledge and skill in assessing competency required for decision making and providing informed consent and knowledge of the legal standing of alternative decision makers.
  • Understanding of the medical role in a multidisciplinary team and understanding the role of each discipline in care of the elderly.
  • Knowledge of the community services available to support older people at home.
  • Importance of health education and health promotion for elderly people.
  • Knowledge of residential care facilities.