An 88-year-old female patient of yours has multiple medical problems.
She takes aspirin, paracetamol, bisoprolol, ramipril, codeine, omeprazole and nifedipine. She says she tries to remember to take her tablets but she doesn’t attend for repeat prescriptions as often as she should. When compliant, she is stable and well.
Which one of the following regarding this lady’s treatment is correct?
You assess a new admission to the residential home you manage. Mary is an 84-year-old woman with moderate dementia. She appears to be pleasantly confused but tends to wander around and occasionally shouts that she wants to go home. The nursing staff have informed you that they have locked the entry door to the floor of the residential home to prevent her from leaving and getting lost. What would be the legally appropriate advice in this situation?
You are called to see a 77-year-old woman at home.
She is known to suffer with COPD and over the last one to two weeks has started coughing up purulent phlegm and feels more breathless than usual. She uses inhaled treatment only and is not on home oxygen. She lives alone, with no social support.
On examination, she is alert and oriented, oxygen saturations are 93% in air and she is mildly breathless. You diagnose an infective exacerbation of her COPD.
Which of the following factors in this patient’s history and examination should most strongly prompt consideration of admission to hospital?
You are working a morning session in a GP practice in the north of England.
Out of the six prescriptions you sign that morning, which one would be exempt from NHS prescription charges for a patient who is 65 years old?
A 75-year-old gentleman has just begun taking galantamine for his moderate dementia. He initially experienced a runny nose and dry cough. Presently, he is expressing concern about new mouth ulcers, a tender red rash on his trunk, and feeling generally unwell. When his skin is gently rubbed, blisters appear.
What is the MOST PROBABLE diagnosis?
At what age can the term ‘Old age’ be included on a death certificate?
An 80-year-old man who lives alone is evaluated. He has a history of dementia. His neighbors are becoming worried about his behavior as they frequently observe him wandering outside in a seemingly disoriented state. You believe he may require a care package or residential care, but he adamantly refuses to consider such an option. Which legal framework is the most suitable for addressing this matter?
A 73-year-old man comes in with painful lumps in his feet and is diagnosed with gout. After initial treatment with non-steroidal anti-inflammatory agents, he is prescribed allopurinol. What is the mechanism of action of allopurinol?
A 93-year-old patient of yours wants to make an advanced decision but his family are not sure that he fully understands what he is doing. You have to assess his competence.
Which of the following statements about competence is correct?
A 68-year old gentleman is seen for follow up. He has recently been diagnosed with heart failure. His echocardiogram shows a reduced ejection fraction. On reviewing his medications you can see that he has been taking atenolol going back many years for hypertension.
Which of the following beta blockers would you recommend he switches to in order to enhance his heart failure treatment?