Pre-disposing factors for infections in elderly

Components of CGA

A 71-year-old female with longstanding history of episodic non-bilious projectile vomiting (mostly undigested food and saliva) presented with worsening of her symptoms and food intolerance during the previous six months. Over that time frame, she noted a sensation of food becoming stuck in her throat and progressive difficulty swallowing. This difficulty was initially related to solids and then progressively to liquids, which severely limited her food intake. She lost 8 kg since the symptoms started to worsen. She stays alone and does not smoke or drink alcohol. Her family history is non-contributory. Evaluation of her upper Gl endoscopy showed dilated esophagus and pooling of saliva and a tight GE junction. The barium swallow demonstrated dilated mid-distal esophagus with "bird beaking" appearance.

Questions: What is the likely diagnosis? What test is needed to confirm the diagnosis? Outline the common modalities of management.

An elderly man is brought by his family to emergency room in semiconscious and disoriented state. He has been suffering from diarrhea for last 3 days. His comorbid illnesses are DM, hypertension. Of late his family has been observing some forgetfulness. How will you proceed for assessment of dehydration. What are the risk factors for dehydration in this patient?

Discuss the evaluation of chronic dysphagia in the elderly

Biological in management of Rheumatoid Arthritis

T scores versus Z scores

What is "Apathetic thyrotoxicosis"?

Indications and contraindications of Hormone replacement therapy (HRT)

List normal renal functions

A 65 years old gentleman, known case of diabetes since 30 years, on regular medications for the same, presented with complaints of pain, discharge and reduced hearing in the right ear since 10 days. He has been visiting the physician regularly for routine examinations and the laboratory examinations are in normal range for his age. He gives a past history of discharge from the same ear few years back which was relieved with medications. On examination there is mucoid discharge in the ear. After cleaning the discharge there is a central perforation of the tympanic membrane. Tuning fork tests reveal conductive type of hearing loss in the right ear and normal hearing in the left ear.

a. What is the provisional diagnosis?

b. What investigations would you order?

C. What Medications would you prescribe?

d. What will the further management plan?

e. What surgical intervention would you advise to the patient?

f. Write a short note on the management of the fungal infections- dermatophytes and candidiasis in the elderly.

A 63 year old male presents with a report of less than 0.01 mu/l. How will you processed next?

जीनोग्राम (Genogram)

चिकित्सा विमर्श कौशल (Attending Skills) 

मुक्त साहचर्य (Free Association) 

मनोशिक्षा (Psychoeducation) 

संकट हस्तक्षेप (Crisis Intervention) 

किशोरावस्था के दौरान विकासात्मक परिवर्तनों का वर्णन कीजिए। 

क्रीड़ा चिकित्सा के उपागमों का वर्णन कीजिए एवं क्रीड़ा चिकित्सा में कुछ तकनीकों का व्याख्या कीजिए। 

संज्ञानात्मक विकृतियां की व्याख्या कीजिए एवं बेक के द्वारा दिया गया संज्ञानात्मक विकृतियों का वर्णन कीजिए।