Browse topics
Geriatric medicine
26 notes, 80 questions and 225 flashcards.
Tier 1 is core knowledge expected of every trainee. Tier 2 is deeper or less common.
Presentations
- Behavioural and psychological symptoms of dementiaFree sampleFinding the cause of agitation, aggression and psychosis in dementia, the DICE approach, pain and delirium first, which symptoms antipsychotics help, risperidone and brexpiprazole rules, harms, deprescribing, and chemical restraint under the Aged Care Act 2024.Tier 1, approach to a presentation, 3 questions, 10 flashcards
- Deconditioning and functional decline after illnessWhy older inpatients lose function, the causes to exclude before calling it deconditioning, measuring ADLs and frailty, preventing hospital-associated disability, CGA and the Australian rehabilitation and aged care pathways.Tier 1, approach to a presentation, 3 questions, 8 flashcards
- Falls in older peopleSeparating syncope from mechanical falls, the World Falls Guidelines risk stratification, multifactorial assessment, fall-risk-increasing drugs, anticoagulation in fallers, the long lie, post-fall care in hospital and which prevention measures have evidence.Tier 1, approach to a presentation, 4 questions, 9 flashcards
- Fragility fractures and hip fracture careRecognising fragility fractures, hip fracture types and their operations, the 2023 Hip Fracture Clinical Care Standard (surgery within 36 hours, nerve block, orthogeriatric care, weight bearing day 1), anticoagulants before surgery, delirium, and starting bone protection before discharge.Tier 1, approach to a presentation, 4 questions, 10 flashcards
- Urinary and faecal incontinenceTransient versus established incontinence in older people, urge, stress, overflow and functional types, bladder diaries and post-void residuals, mirabegron over anticholinergics, the donepezil prescribing cascade, and faecal impaction with overflow.Tier 1, approach to a presentation, 3 questions, 9 flashcards
Key conditions
- Delirium and acute confusionRecognising acute confusion with the 4AT and CAM, hypoactive delirium, predisposing and precipitating factors, a targeted work-up, multicomponent prevention, why antipsychotics don't treat delirium, and follow-up for later dementia.Tier 1, approach to a presentation, 3 questions, 9 flashcards
- Orthostatic hypotensionClassic, initial and delayed orthostatic hypotension and postprandial hypotension in older people, how to measure it properly, drug culprits and prescribing cascades, the 2024 AHA position on antihypertensives, and a stepwise plan through to midodrine and fludrocortisone.Tier 1, condition, 3 questions, 9 flashcards
Dementia syndromes
- Alzheimer diseaseFree sampleAmyloid and tau pathology, the 2024 biological criteria, typical and atypical presentations, biomarkers including plasma p-tau217, cholinesterase inhibitors and memantine, anti-amyloid antibodies and their Australian status, and the course to advanced dementia.Tier 1, condition, 3 questions, 10 flashcards
- Dementia with Lewy bodiesThe 2017 DLB Consortium criteria (core features, indicative biomarkers, the one-year rule), DaT imaging, severe antipsychotic sensitivity, cholinesterase inhibitors, and managing parkinsonism, REM sleep behaviour disorder and autonomic failure in older people.Tier 1, condition, 3 questions, 8 flashcards
- Vascular dementiaVascular cognitive impairment by VICCCS, its subtypes (post-stroke, subcortical small vessel, multi-infarct, mixed), the imaging that supports it, CADASIL and cerebral amyloid angiopathy, and why vascular risk control rather than cholinesterase inhibitors is the main treatment.Tier 1, condition, 3 questions, 8 flashcards
- Frontotemporal dementiaRecognising behavioural variant FTD and the primary progressive aphasias, the Rascovsky criteria, why the MMSE and early MRI can be normal, separating FTD from late-onset psychiatric illness, the MND overlap, why cholinesterase inhibitors don't help, SSRIs and trazodone, and young-onset supports in Australia.Tier 2, condition, 3 questions, 10 flashcards
Less common or complex conditions
Investigations and procedures
- Assessment of decision-making capacityFree sampleHow to assess capacity for a specific decision (understand, retain, weigh, communicate), worked through a discharge refusal, and who decides when capacity is absent under Australian and NZ law, from advance care directives to the person responsible, tribunals and the doctrine of necessity.Tier 1, medical sciences concept, 3 questions, 9 flashcards
- Screening tools for depression, delirium and cognitionWhich bedside tool to use for attention, cognition and depression in an older person, the cut-offs (4AT, CAM, MMSE, MoCA, RUDAS, KICA-Cog, GDS-15, Cornell), how to read a score against education, culture and senses, and what a score can and can't decide.Tier 1, medical sciences concept, 4 questions, 8 flashcards
- Brain imaging and DXA reports in older patientsWhen an older person needs CT or MRI brain, how to read the report (atrophy pattern, white matter disease on the Fazekas scale, lacunes, microbleeds, subdurals, ventricles out of proportion), and how age-related spinal change distorts a DXA.Tier 2, medical sciences concept, 2 questions, 7 flashcards
Specific issues
Clinical issues
- Multimorbidity and non-specific presentations in older patientsWhy older people present with falls, confusion or "off legs" instead of textbook symptoms, how multimorbidity and frailty change the work-up, comprehensive geriatric assessment, the minimum criteria for treating UTI in residential care, and deciding which tests and treatments will change anything.Tier 1, topic overview, 3 questions, 8 flashcards
- Pain management in older patients and renal impairmentAssessing pain in older people including those with dementia (Abbey and PAINAD), paracetamol, NSAIDs and opioids adjusted for frailty and kidney function, which opioids to avoid in CKD and dialysis, gabapentinoid dose limits by creatinine clearance, Beers 2023 cautions, and worked dosing examples.Tier 1, medical sciences concept, 3 questions, 9 flashcards
- Perioperative assessment and care of older patientsPreoperative geriatric assessment (frailty, cognition, function, nutrition, goals), cardiac risk testing under ESC 2022, which medicines to stop or continue including SGLT2 inhibitors and the 2025 GLP-1 receptor agonist advice, postoperative delirium prevention, troponin surveillance for myocardial injury, and geriatric co-management, with a worked example.Tier 1, medical sciences concept, 3 questions, 9 flashcards
- Polypharmacy and deprescribingHow to run a medication review in an older person, the 2025 Australian deprescribing guideline, a worked review of a falls patient's list, drug-class rules for stopping, the trial evidence, and HMR, RMMR and on-site pharmacists.Tier 1, medical sciences concept, 3 questions, 9 flashcards
- Complications of acute illness and immobilisationThe system-by-system harms of bed rest and acute illness in older inpatients, their time course, the Australian hospital-acquired complications they map to, VTE prophylaxis doses, hypercalcaemia of immobilisation, and a worked day-7 ward review.Tier 2, medical sciences concept, 3 questions, 8 flashcards
- Non-surgical management of osteoporotic fracturesManaging vertebral, pelvic, rib, wrist and humeral fragility fractures without surgery, analgesia that lets an older person move, when vertebroplasty doesn't help, red flags for a pathological fracture, exercise after vertebral fracture, and starting bone protection.Tier 2, condition, 3 questions, 8 flashcards
- Rehabilitation and goal setting for older patientsChoosing who suits rehabilitation, the ICF framework, writing SMART goals, goal attainment scaling with a worked hip fracture example, FIM, Barthel and AN-SNAP, Australian rehabilitation and GEM settings, and when goals should turn palliative.Tier 2, medical sciences concept, 3 questions, 8 flashcards
- Residential aged care and discharge planningDeciding whether an older inpatient needs residential care, the Australian pathway under the Aged Care Act 2024 (single assessment, Support at Home, transition care, residential care funding and fees), the strengthened Quality Standards, and a practical discharge plan.Tier 2, topic overview, 3 questions, 7 flashcards