Geriatric Screening Case with EBM Literature

Vanderbilt University School of Medicine

Product ID: 20345

Abstract:

An 88 year old female with a history of falls. Discussion questions included. EBM literature includes all types of geriatric screening and weighs the options and suggests modification indications.

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Educational objectives:

To determine: - If there are always benefits to initiating evidence based guidelines for CVD prevention - How to balance disease-based guidelines in the presence of other co-morbidities or limited life expectancy - Renal function despite normal Cr - Risks of polypharmacy - How to maximize outcomes

Date posted:

Thu, 02/26/2009

Date last updated:

Thu, 02/26/2009

CME credits available:

Has this product been peer reviewed?:

Geriatrics topic areas:

Aging Principles

Approach to the Geriatric Patient

Geriatric Syndromes

Chronic Illness

Models of Care

Communication

Geriatric Assessment

Geriatric Conditions, Diseases and Disorders

Discipline/specialty:

Physical Diagnosis

ACGME competency checklist:

Patient Care

Learning resource types:

Case-Study/Case Series

Exercise

Intended learner audience:

Medical Student Clinical

Resident

Minimum geriatric competencies:

1. Explain impact of age-related changes on drug selection and dose based on knowledge of age-related changes in renal and hepatic function, body composition, and Central Nervous System sensitivity.

2. Identify medications, including anticholinergic, psychoactive, anticoagulant, analgesic, hypoglycemic, and cardiovascular drugs that should be avoided or used with caution in older adults and explain the potential problems associated with each.

6. In an older patient with delirium, urgently initiate a diagnostic work-up to determine the root cause (etiology).

7. Perform and interpret a cognitive assessment in older patients for whom there are concerns regarding memory or function.

12. Ask all patients > 65 y.o., or their caregivers, about falls in the last year, watch the patient rise from a chair and walk (or transfer), then record and interpret the findings.

13. In a patient who has fallen, conduct a gait assessment and construct a differential diagnosis and evaluation plan that addresses the multiple etiologies identified by history, physical examination and functional assessment.

18. Generate a differential diagnosis based on recognition of the unique presentations of common conditions in older adults, including acute coronary syndrome, dehydration, urinary tract infection, acute abdomen, and pneumonia.

Authors:

Molly Cahall

Dr. Jim Powers

NLM Citation:

Cahall, M and Powers, J. Geriatric Screening Case with EBM Literature. POGOe - Portal of Geriatric Online Education; 2009 Available from: http://www.pogoe.org/productid/20345

APA Citation:

Cahall, M and Powers, J. (2009). Geriatric Screening Case with EBM Literature. POGOe - Portal of Geriatric Online Education. Retrieved February 10, 2012 from http://www.pogoe.org/productid/20345

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