By G. S. Rai MD, MSc, MRCP, V. Pearce MB, BSc, MRCP (auth.)
The objective of those brief notes is to supply the newcomer to the speciality of geriatrics with a large even though now not exhaustive differential analysis of many of the generally encountered signs within the aged, and to attract specific recognition tothe universal and demanding problems. the typical motives of indicators and the typical dis eases in addition to definite good points that have particular significance to the drugs of the aged are emphasised. a last part on investigations (with brief notes) which one might hire within the perform of geriatric medication is incorporated besides an appendix of ordinary values for the aged. In our view this booklet doesn't convey how geriatric drugs is practised however it does offer an summary of medical points of medication (geriatrics), wisdom of that is necessary to the perform of ger iatrics. G.S.R. V.P. Foreword I take the view that if energy is lowered to the level that it interferes with lifestyles because the outdated individual would want to reside it, then a formal clinical evaluation may be made as a part of the final appraisal of that person's difficulties. the supply of a house aid or the nutrients on wheels carrier can't be anticipated to revitalize the individual being affected by hypothroidism or pernicious anaemia! within the occasion either scientific therapy and social aid will be wanted and to supply one with out the opposite will be part measures.
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Flapping or 'wing beating' - characteristic of liver failure but it can be present in respiratory or renal failure hysteria - can be fine or coarse 41 Visual Failure Lens cataract Cornea keratitis keratomalacia Iris uveitis Aqueous glaucoma Vitreous haemorrhage Optic nerve compression demyelinating disease Retina detachment optic neuritis retinal artery thrombosis retinal vein thrombosis papilloedema optic nerve atrophy macular degeneration temporal arteritis choroid retinitis Intracerebral pituitary tumours damage to chiasma at pituitary surgery intracranial tumours cerebrovascular accident intracerebral abscess raised intracranial pressure from any cause aneurysm Cranial trauma Paget's disease Orbital lesions Drugs chloroquine practolol 42 Common disorders Anaemia WHO definition: Hb < 13g/dl in men and < 12g/dl in women Occurs in 5-20% of elderly Iron deficiency anaemia aetiology poor nutrition poverty, immobility etc.
Suprabasal split heat worsens condition cold produces remission prognosis good Stevens-Johnson syndrome aetiology infection herpes simplex mycoplasma drugs sulphonamides barbiturates etc.
5% in clinical studies Aetiology - may develop following suppurative pneumonia following pneumonia complicating measles or whooping cough following obstruction of bronchus by carcinoma Clinical features chronic productive cough sputum +++ recurrent chest infections haemoptysis classical signs of finger clubbing, cyanosis, coarse crepitations are only rarely found diagnosis made on bronchography although plain chest X-rays may suggest its presence Complications severe haemoptysis leading to anaemia cerebral abscess empyema Treatment antibiotics for acute exacerbations of infections physiotherapy - postural drainage - very important transfusion if severe anaemia present on rare occasions surgery may help if bronchiectasis is localized and causing chronic ill-health.