medication 260 palliation 261 revascularization 260 risk factor reduction 260 acetylcholinesterase inhibitors 224 \200\2235 achalasia 363 acidosis and angiodysplasia 378 angiotensin receptor blockers 271 hyperkalaemia 394 ACTH stimulation (short Synacthen) test 411 ankle swelling actinic keratoses 602 activities of daily living nocturnal polyuria 301 peripheral oedema 300 (ADLs) 78 acute coronary anorexia 645 depression 248 anti-arrhythmics, pitfalls 275 syndromes 262 acute ischaemia 306 acute kidney injury 386 , 390 ageism 672 alcohol, confusion and anti-nuclear antibodies 69 anti-thyroid antibodies 441 antianginals 261 antidepressants 252 antidiuretic hormone, syndrome of inappropriate secretion 410 antiepileptics 439 antihyper tensives 309 complications 388 \202 uid challenge in AKI/ alcohol 244 alcohol dementia syndrome 244 alcohol withdrawal 244 alpha-adrenergic anuria 389 management 388 post-renal causes 387 pre-renal causes 386 renal causes 386 blockers 271 , 512 acute renal failure see acute prostatism and kidney injury acute services 14 , 16 acute surgical abdomen 380 Addison \200\231s disease 4 46 \200\2237 adenocarcinoma of hypertension 513 alpha-glucosidase inhibitors 427 comorbid conditions 271 5-alpha-reductase inhibitors (eg \201 nasteride) 512 alprostadil (prostaglandin antimicrobials 610 pneumonia 321 precribing 610 resistant organisms 610 , lung 335 adenosine 275 admission avoidance schemes 20 E1) 529 Alzheimer \200\231s disease 212 622 antivirals 316 anuria, \202 uid challenge in vs vascular dementia 213 adrenal incidentalomas 447 adrenal insuf \201 ciency, primary 446 adrenocorticotrophic amaurosis fugax 474 amiodarone 138 , 275 AKI 389 cautions 138 oral 138 and thyroid disease 139 , aortic sclerosis 299 aortic stenosis 299 arrhythmias 286 diagnosis 274 examination 273 inve stigations 273 management 274 precipitants 274 presentation 272 treatment 275 hormone, stimulation test 411 443 amlodipine 150 Amsler grid 578 anemia advance directives 664 \200\2235 adverse drug reactions 135 age-associated memory impairment (AAMI) 205 of chronic disease 458 investigations 453 of malignancy 631 iron de \201 ciency age-related macular degeneration 576 ageing effects 1 arterial leg ulcers 593 arti \201 cial nutrition see clinically assisted nutrition asbesto s-related disease 350 asbestosis 350 cardiovascular system 256 changes due/not due to 2 cognitive ageing 204 cumulative exposure to risk factors (extrinsic ageing) 256 anemia 454 , 456 kidney disease 394 macrocytic 457 megaloblastic 457 pernicious 457 unexplained 458 , 631 698 INDEX aspiration pneumonia/ housing bene \201 t 682 pension credits 682 Social Fund 682 travel assistance 683 bundle branch heart pneumonitis 332 , 358 , 365 block 286 risk, clinically assisted feeding 361 bunion 490 aspirin 309 assessment 51 , 70 asthma benign essential C calcium, oral 470 calcium channel blockers 271 Campbell de Morgan tremor 154 , 164 benign paroxysmal assessment 342 assisted ventilation 346 drug treatment 344 non-drug treatment 346 vs COPD 3 43 positional vertigo 559 , 561 benign prostatic hyperplasia 510 spots 604 assessment 510 examination 510 herbal preparations 512 international prostate symptom score (IPSS) 511 investigations 510 surgery 513 treatment 512 \200\22313 urinary cancer atherosclerosis, kidney and ageing 628 approach to disease 394 atrial \201 brillation 276 investigation 634 skin, and pre-cancers 602 treatment 632 see also malignancy cancer with u nknown primary 634 acute AF 277 assessment 276 chronic AF 277 complications 276 and hyperthyroidism 443 paroxy smal AF 277 rate/ rhythm control 277 risk of stroke 278 stroke prevention 278 warfarin 280 atrial \202 utter 276 atropine 275 attendance allowance 682 audiology 551 biopsy specimens 635 investigation catheterization 513 benign senescent approach 634 forgetfulness 205 prognosis 635 treatment 635 benzodiazepines delirium 243 epilepsy 168 insomnia 177 candidiasis mouth 355 oesophageal 363 thrush 591 vaginal 528 capacity 654 bereavement 640 \200\223 1 bereavement services 650 beta-blockers 150 , 271 hyperthyroidism 443 bicipital tendonitis 498 biguanides 426 bisphosphonates 470 , 481 blepharitis 582 blin d registration 570 cochlear implants 553 hearing aids 551 \200\2232 , 554 practical advice 551 \200\2232 speci alized hearing tests 551 advance directives 664 \200\2235 assessment 654 \200\2235 incompetent patients 658 independ ent mental capacity advocates 656 B B-type natriuretic peptide Mental Capacity bene \201 ts 570 Act (2005) 230 , 656 blistering diseases 600 (BNP) 290 back pain 496 bacteriuria, see also competency; lasting power of attorney (LPA) bullous pemphigoid 600 causes of blistered skin 601 blood, urine test 618 blood pressure asymptomatic 620 carbimazole 442 cardiac failure acute 291 assessment 288 \200\2239 chronic 292 diastolic 29 6 and renal failure 295 terminal care 294 balance and dysequilibrium 112 Bamford \200\231s classi \201 cation, British Hypertension Society de \201 nitions 269 stroke 181 measuring ABPI 305 Boutonniere deformity banned terms, history taking 57 492 Barrett \200\231s esophagus 362 Barthel Index 688 basal cell carcinoma 583 , 602 bed sores see pressure Bowen \200\231s disease 602 bradycardia 282 causes 282 management 282 pacemakers 284 presen tation 282 cardiac rehabilitation 266 cardiopulmonary resuscitation (CPR) 668 sores befriending 42 behavior disturbance decision making process 670 \200\2231 cardiovascular system 255 breaking bad news 638 \200\2239 breathlessness, dementia 228 depression 248 ageing 256 physical examination 64 multifactorial 313 bronchial carcinoma 334 , bene \201 ts 682 care homes 34 attendance allowance 682 blind registration 570 carer \200\231s allowance 683 council tax b ene \201 t 682 healthcare assistance 683 Care Standards Act (2000) 36 350 bronchitis, acute 314 bronchodilators 344 bullous pemphigoid 600 dementia patients 34 diabetic people 427 funding 36 INDEX 699 medicine 34 residential care 35 staf \201 ng 34 confusion, terminal illness 645 confusion and alcohol 244 skin changes 592 varicose veins 592 venous ulcers 592 alcohol dementia syndrome 244 alcohol withdrawal 244 Korsakoff \200\231s syndrome 244 Werni cke \200\231s careers in UK geriatric circadian rhythm disorders 178 medicine 48 consultant careers 48 Diploma in Geriatric cirrhosis 368 investigations 368 non-alcoholic fatty liver Medicine, (DGM) 49 non-consultant careers 48 non-European overseas encephalopathy 244 disease 368 Confusion Assessment Model (CAM) 692 CJD 218 claw toes 490 clinically assisted feeding aspiration risk 361 ethics of withdrawing treatment 360 \200\2231 initiating treatment 360 doctors 48 constipation 370 causes 370 diagnosis 370 prevention and primary care physicians 48 carer \200\231s allowance 683 carotid sinus massage 123 carotid sinus syndrome 122 carpal t unnel syndrome 493 cataract 572 \200\2233 catheters 538 treatment 371 treatment 544 , 644 consultation skills 52 \200\2233 contractures 485 coronar y artery bypass clock-drawing test 693 interpretation 694 clopidogrel 309 Clostridium dif \201 cile - associated diarrhea 614 \200\2236 cochlear imp lants 553 cognition, physical examination 64 cognitive ageing 204 cognitive impairment depr ession 248 without dementia 205 benign prostatic hyperplasia 513 complications 540 managing without 539 grafting 264 coronary syndromes 262 comorbidity 262 late presentation 262 pathology 262 cellulitis 589 cerebellar dysfunction 154 cervical spondylosis 486 Charles Bonnet Coroner 651 corticosteroids 476 syndrome 571 chemotherapy 632 chest medicine 311 chest pain 258 chronic cough 333 chronic d isease asthma 344 cortisol, serum 446 cough, chronic 333 CRP 472 , 474 , 609 , 630 cremation forms 649 crutch es 89 CURB score 320 Colles \200\231 fracture 471 colon imaging 373 colonic conditions 378 community hospitals 3 0 management 44 chronic kidney disease 392 , admissions 31 effectiveness/cost 394 D D-dimer 69 , 259 , 330 DatSCAN \204 159 day centers 42 acidosis and effectiveness 31 community nurse 58 community nurses 99 competency hyperkalaemia 394 anemia 394 atherosclerosis 394 glomerular \201 ltration delirium 240 incompetent vs day hospitals 43 rate 393 day hospitals 22 deafness 548 hyperlipidaemia 394 hypertension 394 nervous system 394 salt and water patients 658 see also capacity communication with deaf complete heart block 286 complex regional pain syndrome 493 people 549 conductive 549 sensoneural 549 death and dying 637 retention 394 secondary hyperpara- thyroidism 394 chronic lymphocytic leukemia 464 chronic obstructive compression bandaging 595 compression bereavement 640, 641 bereavement mononeuropathy 504 compulsory detention and services 650 treatment 230 breaking bad news 638 \200\2239 cause of death 6 Coroner 651 diagnosing dying 666 documenta tion afer death 648 estimating when pulmonary disease 342 Deprivation of Liberty Safeguards 231 Mental Capacity Act (2005) 230 drug treatment 344 non-drug treatment 346 vs asthma 343 chronic problem services 15 refusal of treatment 231 Section 2 of the Mental chronic renal failure see Health Act (1983) 230 treatment is without hope 666 chronic kidney disease chronic venous insuf \201 ciency Section 5 (2) of the Mental Health Act (1983) 230 grief 640 palliative care 642 postmortems 650 registrar 650 clinical changes 592 oedema 592 pathogenesis 592 conduction disorders 282 , 284 700 INDEX diastolic heart failure 296 dieticians 96 digoxin 277, 281 Diogenes (squalor) syndrome 245 Diploma in Geriatric Medicine 49 dipyridamole 309 disability 73 discharge planning 37 , physical examination 208 preventing death and dying (cont.) symptom control, terminal progression 226 illness 644 decision-making prevention 223 rehabilitation 82 risk of harm to patient or cardiopulmonary resuscitation (CPR) 670 \200\2231 to others 222 risk management and complex decisions 667 \201 nancial decisions 658 medical decisions 660 social decisions 6 62 dehydration 404 , 406 subcutaneous \202 uid abuse 222 social management 220 UK National Dementia 75 , 83 disease-speci \201 c scales 79 diuretics 271 , 295 diverticular disease 372 Strategy 206 vascular dementia 212 vasculitis 219 vs delirium 207 administration 406 , 646 abscess 372 complications 372 \201 stula 372 hemorrhage 372 symptoms and signs 404 terminal illness 645 volume status dementia patients, care homes 34 demographics 4 \200\2239 depression assessment 405 delayed discharge 37 delirium 234 , 236 , 238 , diverticulitis 372 Donepezil 224 \200\2235 domiciliary (home) visits 32 \200\2233 driving r egulations cerebrovascular disease 198 anorexia and weight loss 248 assessment 249 clinical features 248 dementia vs depressive 240 \200\2231 baseline investigations 239 causes 236 , 240 clinical assessment 238 competency 240 diagnos is 234 drug treatments 237 , 242 non-drug pseudodementia 247 dementia 221 epilepsy 167 drop attacks 116 drug history 130 , 132 \200\2233 drug treatments 252 electroconvulsive therapy (ECT) 250 measurement management 241 physical restraint 241 recovery phase 241 treatment issues 240 where to trea t 240 concordance 132 information sources 130 instruments 78 non-drug drugs 125 management 250 adverse reactions 135 rule breaking 150 sensitivity 134 presentation 246 sadness 248 specialist referral 250 dementia acetylcholinesterase inhibitors 224 dry eye 582 Dupuytren \200\231s Deprivation of Liberty Safeguards 231 , 657 Alzheimer \200\231s disease 212 Alzheimer \200\231s vs vascular dementia 213 Assessment 208 \200\22310 behavioral problems 228 comorbidity 212 , 218 compulsory detention and contracture 492 dermatomes 686 detention see compulsory dysphagia 364 causes 364 history 364 investigations 364 signs 364 treatment 365 detention and treatment DEXA scan 469 diabetes mellitus 422 in care homes 427 complications 430 diagnosis 423 emerg encies 432 insulin 428 leg ulcers 593 presentation 422 secondary diabetes 422 treatment 424 , 426 , 428 type 1 vs type 2 422 diabetic nephropathy 431 diabetic neuropathy 430 diabetic retinopathy 579 dialysis 396 \200\2237 diarrhea 376 acute 376 chronic 376 \200\2237 malabs orption 376 see also Clostridium treatment 230 dysphasia 184 dyspnoea, terminal illness 645 diagnosis 206 disclosure of diagnosis 209 drugs 223 \200\2234 , 226 drugs/toxins and 219 fr ontotemporal E early walking aids (EWAs) 89 dementia 218 general management 220 hospital patients 227 and infection 218 with Lewy bodies 214 lifesty le interventions 223 management 220 mental state assessment ears 547 audiology 551 deafness 548 diabetes mellitus 431 tinnitus 556 vertigo 558 209 non-drug echocardiography 289 ectropion 582 elder abuse 674 \200\2235 electroconvulsive therapy management 228 overview 206 and parkinsonism 214 Parkinson \200\231s disease 214 dif \201 cile -associated diarrhea (ECT) 250 INDEX 701 forgetfulness 205 fractures 494 blind registration 570 cataract 572 diabetes mellitus 431 drugs 580 eyelid disorders 582 gl aucoma 574 systemic disease 579 visual hallucinations 571 visual impairment 569 emergencies 432 diabetes 432 , 434 , 445 hyperthyroidism 445 myxoedema coma 445 thyroid function tests 435 thyroid storm 445 emergency department non-operative osteoporotic 471 frame, walking aid 88 frozen shoulder 498 frozen shoulder/adhesive (A&E) 16 capsulitis 498 fungal infections 591 endocrinology 419 enteral feeding 357 entropion 582 epilepsy 166 F facial pain 354 fecal incontinence after stroke 196 assessment 543 causes 542 management 544 \200\2235 G gait 63 gallbladder 353 gallstones 368 gangrene 306 dry 306 wet 306 diagnosis 166 driving regulations 167 drug treatment, acute 168 drug treatment, chronic 168 general management 166 investigations 166 and stroke 167 Epley \200\231s maneuver, falls clinics 124 falls/ \200\230funny turns \200\231 101 assessment 104 associated drugs 1 04 balance and gastro-oesophageal re \202 ux disease 362 Barrett \200\231s/columnar-lined esophagus 362 vertigo 562 , 563 , 564 \200\2235 erectile dysfunction 528 erysipelas 590 erythrocyte sedimentation hiatus hernia 362 treatment 362 dysequilibrium 112 banned terms 103 dizziness 114 drop attacks 116 fall frequency/severity gastro-oesophageal re \202 ux disease (GORD) 148 rate 452 , 630 ethics gastroenterology 351 gastrointestinal advance directives 664 \200\2235 ageism 672 capacity 654 cardiopulmonary factors 102 bleeding 366 gastroparesis 367 genitourinary medicine 507 fallers 102 interventions to prevent resuscitation (CPR) 668 falls 106 , 107 multifactorial 115 orthostatic (postural) hypotension 118 ageing changes 508 Geriatric Depression Deprivation of Liberty Safeguards 657 elder abuse 674 \200\2235 incompetent patients 658 la sting power of attorney 660 Scale 687 geriatric services 13 , 15 , 18 \200\22319 emergency department postprandial hypotension 120 (A&E) 16 geriatrics, careers 48 giant cell arteritis 474 steroid therapy 476 Glasgow Coma S cale 696 glaucoma 574 syncope and power of attorney 658 predicting outcome for presyncope 108 vertebrobasilar CPR 668 rationing 672 refusal of treatment 661 returning home against insuf \201 ciency 117 fatty liver disease, non-alcoholic 368 acute angle closure 575 de \201 nition 574 intraocular pressure 574 primary (chronic) open angle glaucoma 574 fertility 6 \201 nance 677 advice 663 signing an LPA 659 testamentary capacity 659 withdrawing treatment bene \201 ts 682 making a will 678 pensions 680 taxation 679 \201 nasteride 512 \201 r st degree heart block 286 \202 ecainide 275 \202 udrocortisone 150 \202 uid challenge 389 foot 490 screening 574 360 \200\2231 glenohumeral see also decision-making osteoarthritis 499 evolution of ageing 3 eyelid disorders dry eye 582 ectropion 582 entropion 582 herpes zoste r glomerular \201 ltration rate 384 , 393 glomerulonephritis 386 , 400 glucose metabolism 420 monitoring 434 bone/joint disease 490 care 491 circulation infection 583 gout 482 GP contract (UK 2004), primary care 47 Graves \200\231 disease 441 grief stages 64 0 Guillain \200\224 Barr ptosis 582 eyelid tumors 583 eyes impairment 491 diabetes mellitus 431 neuropathic 490 sensory impairment 491 skin/nails 420 , 490 \200\2231 age-related macular degeneration 576 ageing 567 syndrome 173 702 INDEX H hematology 451 hemoglobin 452 Haemophilus in \202 uenzae 319 hair changes 586 Hallpike m aneuver 561 haloperidol, delirium 243 hammer toes 490 handicap 73 hands 492 hormone replacement impaired glucose therapy 223 , 448 , 469 , 508 , 521 tolerance 420 , 423 impairment 73 impulse control disorder 163 inattention 185 incompetent patients 658 inconti nence 531 see also fecal hydrocephalus 216 hydroxocobalamin 457 hypercalcaemia 633 hyperglycaemia 432 , 434 , 445 hyperkalaemia 137 , 384 , 394 hyperlipidaemia 394 hypernatraemia 384 , 412 hyperosmolar non -ketotic incontinence; urinary incontinence carpal tunnel independent mental syndrome 493 complex regional pain syndrome 493 state 432 capacity advocates (IMCAs) 656 infection 606 , 608 diagnosis 609 hyperparathyroidism 394 , 633 hypersexuality 529 hypersomnolence 178 hypertension 268 asses sment 268 kidney disease 394 non-pharmacological measures 270 deformity 492 repetitive strain injury 493 in \202 ammatory bowel disease 374 health visitors 99 healthcare assistance 683 hearing aids 551 \200\2232 , 554 hearing asses sment 550 in \202 uenza 319 in \202 uenza vaccine 324 insomnia 176 \200\2237 insulin 428 \200\2239 integrated care 18 \200\22319 intensive care 17 intermediate care 26 intertrigo 590 intesti nal ischaemia 379 intraocular pressure 574 investigations 66 \200\2237 toleration 67 see al so speci \201 c conditions see also deafness hearing tests 551 heat-related illness 418 Heberden \200\231s nodes 492 H elicobacter pylori 366 hepatic metabolism, treatment 270 treatment thresholds and goals 268 hyperthyroidism atrial \201 brillation 443 diagnosis 440 drug treatment 442 investigation 441 life-threat ening pharmacology 127 hepatitis C 368 herbal medicines 149 hiatus hernia 362 hip fracture 494 hip pain 494 \200 \2235 causes 494 osteoarthritis 494 hip protectors 107 history taking 56 , 58 emergencies 445 non-drug treatment 444 radioiodine 131 I 444 subclinical 443 surgery 444 iron de \201 ciency anemia 454 , 456 diagnosis 454 enteral iron 456 investigations 454 \200\2235 parenteral iron 456 treatment 4 56 hypoalbuminaemia 633 hypoglycaemia 433 hyponatraemia banned terms 57 , 103 cognitive impairment 56 drug history 130 information sources 58 inter view 56 sensory impairment 56 HIV infection/AIDS 530 clinical features 530 prevalence 530 r easons for increase 530 risk factors 530 testing 530 irritable bowel assessment 413 treatment 408 \200\2239 syndrome 378 ischaemic colitis 379 itching see pruritus IVC \201 lter 331 hypotension postprandial hypotension 120 postural blood pressure 121 K kidney, ageing changes 384 kidney disease, see also acute kidney injury; chronic kidney d isease Kidney Disease Outcomes Quality Initiative 393 Korsakoff \200\231s syndrome 244 hypothermia diagnosis 414 management 416 prevention 416 temperature holiday support 42 Holter monitors 109 , 273 home care 38 monitoring 417 hypothyroidism diagnosis 436 disease \200\224 drug care packages, reported problems 39 community care interactions 439 L lacunar stroke (LACS) 181 lansoprazole 148 large cell carcinoma of long-term assessment (needs assessment) 38 management 438 treatment 438 costs 39 informal carers 40 respite care 41 home visits 32 \200\2233 , 92 homeostasis 403 h ormonal therapy 632 lung 335 I 131 I (radioiodine) 444 immune system, ageing 606 large intestine 353 imaging, diverticular disease 373 INDEX 703 lasting power of attorney motor neuron disease 170 malignancy 627 (LPA) cancer with unknown primary 634 capacity to complete an clinical picture 171 examination 170 history 170 investigations 170 treatment 171 mouth 352 , 354 candidiasis 355 examination 354 facial pain 354 general management 354 systemic mani festation of dental diseases 355 LPA 659 diagnosis 629 leg ulcers 593 in older people 628 performance status 628 presentation 631 sc reening for 631 symptomatic hypercalcaemia, enduring power of attorney 658 for health and welfare 660 for property and \201 nancial affairs 658 signing an LPA 659 laxatives 371 , 545 leg ulcers 593 arterial 593 clinical features 593 diabetic 593 general approach 593 limb elevation 594 malignant 593 management 594 oral agents 595 surgery 595 ve nous 593 \200\2234 management 633 malignant melanoma 603 mallet \201 nger 492 malnutrition universal screeni ng tool (MUST) 695 mouth ulcers 355 multidisciplinary team meetings 83 multiple myeloma 460 multiple pathology and measurement instruments 78 etiology 54 megaloblastic acute presentations 54 chronic stable anemia 457 memantine (Ebixa), dementia 226 M ni re \200\231s disease 559 menopause 448 Me ntal Capacity Act (2005) 230 , 656 conditions 54 muscle symptoms 478 Legionella pneumophila 319 lentigo maligna 602 leucocyte esterase 618 leukemia, chronic lym phocytic leukemia 464 lichen sclerosus 526 lichen simplex 598 life expectancy 4 grading muscle strength 479 musculoskeletal system 465 Mycoplasma Mental Health Act Section 2 (1983) 230 pneumoniae 319 Mental Health Act Section 5 myelodysplasia/ (2) (1983) 230 myelodysplastic syndrome 462 \200\2233 mental test, abbreviated 690 mesothelioma 350 metastases, with unknown myelopathy 486 myocardial infarction 266 expected further years of life 5 cardiac rehabilitation 266 and prevalence of morbidity 8 primary 634 myxoedema coma 445 methicillin-resistant Staph. aureus (MRSA) 611 \200\22312 liver and gallbladder 353 , 368 N nails colonization 611 contamination and abnormal liver function tests 369 cirrhosis 368 gallstones 368 transmission 611 feet 420 , 490 \200\2231 physical examination 64 control 613 management 612 problems 611 Liverpool care pathway 643 living will see advance nasogastric tubes 358 \200\2239 National Service Framework for Older People 28 directives microscopic colitis 378 Mini-Cog 693 Mini-Mental State lorazepam, delirium 243 lumbar puncture 216 lung cancers 334 non-small cell age discrimination, anti-ageism policies 28 Examination 691 falls 29 general hospital care 28 intermediate care 28 medicines and older minimal cognitive carcinoma 335 impairment (MCI) 205 Parkinson \200\231s disease 215 palliative interventions 335 small cell carcinoma 335 mitosis, Hay \202 ick limit 3 mitral regurgitation 299 mitral stenosis 299 mobility, measu rement instruments 78 monoamine oxidase inhibitors 253 people 29 mental health 29 person-centered care 28 promotion of health and lungs, breathlessness, multifactorial 313 active life 29 stroke 28 M macrocytic anemia 457 nausea and vomiting 644 , monoclonal gammopathy of undetermined signi \201 cance (MGUS) 459 646 persistent megaloblastic 457 pernicious 457 treatment 457 malabsorption 376 unexplained 367 necrotizing fasciitis 590 nephrotic syndrome 399 mononeuropathies 504 704 INDEX masquerading diseases 164 minimal cognitive oesophageal neuralgia 156 \200\2237 , 625 candidiasis 363 oesophageal motility disorders 363 esophagus 352 olanzapine, delirium 243 o meprazole 148 ophthalmic shingles 624 opioid analgesia 140 oral candidiasis 355 oral manife stations of systemic diseases/ drugs 355 orthogeriatrics 495 orthostatic post-herpetic impairment 215 presentation 158 , 165 problem symptoms 162 tremor 158 Parkinson \200\231s-p lus neuralgia 156 , 625 neurogenic fecal incontinence 544 neuroleptic malignant syndrome 169 neurology 164 syndrome 164 ageing brain and nervous parotitis 354 partial anterior circulation stroke (PACS) 181 system 152 circadian rhythm disorders 178 pemphigoid 600 pemphigus 600 pension credits 682 pensions 680 epilepsy 166 hypersomnolence 178 motor neuron disease 170 neuralgia 156 , 625 Parkinson \200\231s disease 165 peripheral hypotension 118 , 121 occupational 680 UK state 680 war pension 681 osteoarthritis 466 drug treatments 467 management 467 non-drug treatments 467 surgical treatment 467 peptic ulcer disease 366 \200\2237 neuropathies 172 REM sleep behavior disorder 178 treatment 366 percutaneous coronary intervention 264 percutaneous endoscopic osteomyelitis 488 restless legs complications 489 treatment 489 vertebral 488 syndrome 178 gastrostomy (PEG) 358 performance status 628 \200\2239 peripheral nervous system, physical examination 64 peripheral neuropathies 172 \200\2233 serotonin syndrome 169 sleep apnoea 178 sleep and insomnia 176 stroke 167 subdural haematom a 174 tremor 154 osteoporosis 142 , 468 clinical features 468 diagnosis 469 management 470 non-operative in diabates 432 peripheral oedema 300 peripheral vascular disease 304 neuropathic pain/neuralgia, trigeminal neuralgia 156 fractures 471 pathology 468 primary prevention 469 acute ischaemia 306 in diabates 432 gangrene 306 as marker of other NIH Stroke Scale 184 nocturnal polyuria, ankle otitis externa 489 oxygen therapy 348 \200\2239 swelling 301 normal pressure hydrocephalus 216 vascular disease 304 P pacemakers, assessment 216 lumbar puncture 216 neuroimaging 216 treatment 216 measuring ABPI 305 slowly progressive disease 306 bradycardia 284 Paget \200\231s disease 480 pain peritonitis 380 pernicious anemia 457 pet schemes 42 pharmacists 97 pharmacology 126 absorp tion 126 administration NSAIDs 140 , 467 , 482 nutrition 356 back pain 496 complex regional pain syndrome 493 pain management 141 , 644 palliative care 642 in diabetes 434 principle of double effect 643 subcutaneous measurement instruments 79 rehabilitation team 79 weight loss management 357 problems 126 distribution 126 hepatic metabolism 127 renal excretion 127 O obesity 382 impact 382 treatment 382 phosphodiesterase type \200\2235 infusions 646 inhibitors 529 pancreas 353 paracetamol 467 , 482 paraproteinaemias 459 parenteral feeding 359 parkinsonis m photosensitizing drugs 588 obstructed bowel 381 occupational therapists 91 oesophageal disease 362 physical examination 62 assess gait 63 general advice 62 systems 64 and dementia 214 dementia with Lewy bodies 214 achalasia 363 Barrett \200\231s/columnar-lined esophagus 362 gastro-oesophageal re \202 ux physical slowness, Parkinson \200\231s disease 160 , 165 depression 248 physiotherapists 86 pleural effusions 322 , 328 and dementia 214 management 160 \200\2231 disease 362 hiatus hernia 362 INDEX 705 prostatic cancer 514 assessment 514 Gleason score 514 late-stage 519 screening 514 tests 51 5 treatment 518 protein level, pleural effusions 328 REM sleep behavior disorder 178 chronic effusions 328 differentiating cause by protein level 328 renal artery stenosis 401 renal excretion, pleural plaques 350 pneumococcal vaccine 324 pneumonia 318 pharmacology 127 renal failure and cardiac failure 295 see also acute kidney injury; chronic renal failure CURB-65 score 320 failure of response to treatment 322 proton pump inhibitors 148 renal medicine 383 renal replacement therapy pathogens 319 postexposure antiviral prophylaxis 324 gastro-oesophageal re \202 ux 148 interactions 148 side effects 148 dialysis 396 transplantation 398 treatment 320 repetitive strain injury 493 residual volume 535 respiratory changes, ageing 312 polymyalgia pruritic conditions 598 pruritus rheumatica 472 \200\2233 population age structure 6 population pyramids 6 \200\2237 posteri or circulation stroke causes 596 treatment 597 pseudogout 484 pseudo-obstruction 381 psychiatry 203 psychologist 194 psychosis 232 causes 232 de \201 nition 232 treatment 232 respiratory infections 314 acute bronchitis 314 in \202 uenza 315 \200\22316 reducing vira l (POCS) 181 postmortems 650 postprandial transmission 315 upper respiratory tract infections 314 hypotension 120 postural blood pressure 121 power of attorney see lasting power of attorney presbyacusis 548 prescribing, antibiotic respite care 41 restless legs syndrome 178 resuscitation 668 decision making ptosis 582 pulmonary embolism 330 pulmonary \201 brosis 325 process 670 \200\2231 revascularization 264 use 610 prescribing rules 128 \200\2239 and angina 260 rhabdomyolysis 505 rib fractures 326 ringworm 591 Rinne \200\231s test 550 r isperidone, delirium 243 rotator cuff tear 498 rotator cuff tendonitis 498 R radioiodine 131 I 444 radiologically inserted gastrostomy 358 antibiotics 610 best drug 128 contraindications 128 impact assessment 129 indications 128 i nteractions 128 starting dose 129 time frame 129 pressure area risk radiotherapy 632 raloxifene 470 Ramsay Hunt syndrome 625 rashes, drug-induced 147 rationing 672 S sadness 248, 640 salt and water measurement 79 measurement and ageism 672 instruments 79 pressure injuries 501 pressure sores 502 refeeding syndrome 358 registrar 650 rehabilitation team 71 retention 394 scabies 599 seborrhoeic dermatitis 591 seborrhoeic warts 604 second degree heart grading 502 mechanisms 502 risk factors 502 aims and objectives 75 doctors 94 inpatient selection 80 \200\2231 measurement primary adrenal block 286 secondary hyper- insuf \201 ciency 446 \200\2237 instruments 76 , 78 multidisciplinary team meetings 83 primary care 46 parathyroidism 394 sedation, delirium 243 selective serotonin reuptake GP contract (UK 2004) 47 problem lists 60 \200\2231 propylthiouracil 442 prostate nurses 95 occupational inhibitors 252 therapists 91 self harm, depression 248 sensitivity transurethral resection of prostate (TURP) 409 see also benign prostatic pharmacists 97 physiotherapists 86 social work and care management 98 speech and language t herapists 96 adverse reactions 134 \200\2235 altered sensitivity 134 dose adjustment 134 serotonin antag onists 253 serotonin and noradrenaline hyperplasia prostate-speci \201 c antigen (PSA) 510 , 516 unlikely bene \201 ciaries 82 walking aids 88 , 90 reuptake inhibitors (SNRIs) 253 screening with PSA 516 using PSA 516 706 INDEX T T-score 469 tachy - brady serotonin syndrome 169 sexual function 528 shingles 624 shoulder dislocation 498 shoulder p ain 498 cautions 142 in the eye 580 in PMR 472 \200\2233 stopping treatment 143 syndrome 286 sticks/canes 88 stomach 352 Streptococcus taste 352 taxation 679 teeth 352 bicipital tendonitis 498 frozen shoulder/adhesive capsulitis 498 glenohumeral OA 499 rotator cuff tear 498 rotator cuff pneumoniae 319 stroke 28 , 167 , 192 diabetes mellitus 431 temperature 417 teriparatide 470 terminal illness acute management 188 \200\2239 Bamford \200\231s tendonitis 498 classi \201 cation 180 \200\2231 diabetes control 434 symptom control 644 sick euthyroid burden of illness 180 complications 196 de \201 nition 180 diagnosis 188 driving regulatio ns 198 epilepsy 167 estimating prognosis after syndrome 420 testosterone 508 theophylline, asthma 344 theories of ageing 3 thiazide diuretics 271 thiaz olidinediones 426 thioamides 442 Thomas \200\231 test 466 thromboembolism, stroke 197 throm bolysis 192 sick sinus syndrome 282 , 286 single assessment process 27 sinoatrial block 286 sinus bradycardia 286 skin 585 stroke 191 examination 184 , 186 follow up, checklist 199 history 184 inattention 185 investigations 1 86 longer term issues 198 medical interventions 188 multidisciplinary acute ageing 586 \200\2237 bacterial infections 589 \200\22390 chronic venous myocardial infarction 266 pulmonary embolism 331 stroke 192 insuf \201 ciency 592 of feet 490 fungal infections 591 lesions 604 photoageing 588 physical examination 64 thrush 591 thyroid function 420 input 188 radioisotope scanning 441 tests 441 see also hyperthyroidism; ongoing management 194 predisposing factors 182 prognosis 191 return to community 198 Strok e Association 198 thromboembolism 197 thrombolysis 192 transient ischaemic attack (TIA) cli nics 200 urinary incontinence 197 skin rashes, drug- induced 147 hypothyroidism thyroid storm 445 thyroxine, drug skin tags 604 sleep apnoea 178 sleep disturbance, depression 248 sleep and insomnia 176 interactions 439 Tinea spp (ringworm) 591 tinnitus 556 \200\2237 toes 490 tongue, sore 354 total anterior ci rculation stroke (TACS) 181 drugs 177 other sleep disorders 178 small bowel ischaemia 379 small intestine 352 social cl ubs 42 Social Fund 682 social impact of ageing 8 social worker stroke units 190 bene \201 ts 190 de \201 nition 190 rationale 190 transfusions 463 transient ischaemic attack (TIA) clinics 200 strontium ranelate 470 subcutaneous \202 uid ABCD2 score for TIA administration 406 , 646 201 function 200 outpatient care management 98 stroke 194 somatization, subcutaneous infusion pump 646 subdural haematoma 174 suicide and attempted assessment 200 depression 249 specialty clinics 14 , 24 speech/language therapists 96 structure 200 suicide 254 depression 248 sulphonylureas 426 sun protection 588 supraventricular ectopic transurethral resection of prostate (TURP) 409 , 513 stroke 195 travel assistance 683 tremor 154 \200\2235 squalor syndrome 245 squamous cell beats 286 Synacthen test 411 syncope and presyncope benign essential tremor 154 carcinoma 603 lung 335 cerebellar Staphylococcus aureus 319 causes 108 history 108 vs seizures 110 dysfunction 154 Parkinson \200\231s disease 158 tricyclic antidepressants 252 trifascicular block 286 MRSA 611 \200\22312 statins 309 steroids 142 syndrome of inappropriate ADH 410 in asthma and COPD 344 INDEX 707 vaginal bleeding 520 assessment 521 causes 520 treatment 521 vaginal infection 520 vaginal prolapse 522 trigeminal neuralgia 156 trigger \201 nger 492 troponin 69 , 259 tuberculin skin test, pe rforming and interpreting 339 tuberculosis 336 , 338 chest X-ray 16 . 1 extrapulmonary dise ase 336 volume status assessment 405 vulval cancer 527 vulval disorders 526 lichen sclerosus 526 malignant epithelial disorders 527 care of vaginal pessary 523 illustrations 524 valvular heart disease non-neoplastic epithelial disorders 526 squamous hyperplasia 527 298 \200\2239 pulmonary disease 336 sequelae of previous treatment 337 sputum for microscopy and culture 338 vulvitis 526 vulvodynia 526 varicella zoster 583 , 624 varicose veins 592 vascular complications, W walking aids 88 , 90 diabetes 431 vascular dementia 212 vascular secondary treatment 340 crutches 89 early walking aids (EWAs) 89 prevention 308 \200\2239 vasculitis, in dementia 219 venous leg ulcers U upper respiratory tract infections 314 frame 88 stick (or cane USA) 88 walkers or rollators 89 592 \200\2234 venous thromboembolism prevention 302 \200\2233 uric acid 482 urinary catheterization, benign prostatic hyperplasia 513 warfarin 144 , 280 cautions 144 initiation 146 raised INR, action 145 reassessment 144 side effects 144 target international normalized ratio (INR) 145 verapamil 275 vertebrobasilar insuf \201 ciency 117 urinary incontinence 532 , vertigo 558 534 \200\2235 assessment 560 causes 558 \200\2239 de \201 nition 558 Epley \200\231s maneuver 562 , assessment 535 causes 532 comorbidity 532 environmental factors 533 irreversible (but treat able) 563 , 564 \200\2235 examination 560 Hallpike maneuver 561 history 560 management 562 unders tanding 558 Weber \200\231s test 550 weight loss 357 , 630 Wernicke \200\231s factors 533 management 536 reversible factors 532 stroke 197 encephalopathy 244 WHO classi \201 cation, rehabilitation team 73 urinary nitrite 618 urinary tract infection 621 vestibular examination 561 vision, optimizing 570 visual hallucinations 571 will, making a will 678 testamentory recurrent 623 treatment 622 capacity 659 withdrawing treatment, Charles Bonnet urine sampling, for dipstick, syndrome 571 ethics 360 \200\2231 microscopy and culture 618 \200\22319 drugs 571 organic brain urine tests, near- patient 618 X xerostomia 355 disease 571 psychiatric disease 571 visual impairment 569 causes 569 interventions 569 volume depletion and dehydration 404 V vaccination, pneumonia and Y yeasts 591 in \202 uenza 324