GP Vivas · older-person-s-health
Falls assessment and prevention — structured viva
Structured oral on falls: defending exercise as the anchor intervention with Cochrane numbers, medication withdrawal as treatment, syncope versus mechanical workup, targeting multifactorial programmes at the right patients, and the fear-of-falling cycle.
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Target exams
RACGP CCEFRACGP oralsMRCGP SCA
Prompt
The examiner opens: 'Your practice sends every faller for physio and calls it prevention. Justify that — or replace it.' The viva branches through the multifactorial assessment, exercise evidence, medication withdrawal, syncope discrimination and targeted prevention.
Stem
You are the GP. An 82-year-old woman has had two falls this month. Neither caused injury. Her daughter wants "something done properly this time". [4]
References5ShowHide
- [1]Sherrington C, Fairhall NJ, Wallbank GK, et al. Exercise for preventing falls in older people living in the community: an abridged Cochrane systematic review. British Journal of Sports Medicine, 2020.PMID 31792067
- [2]Campbell AJ, Robertson MC, Gardner MM, Norton RN, Buchner DM Psychotropic medication withdrawal and a home-based exercise program to prevent falls: a randomized, controlled trial. Journal of the American Geriatrics Society, 1999.PMID 10404930
- [3]Santesso N, Carrasco-Labra A, Brignardello-Petersen R Hip protectors for preventing hip fractures in older people. Cochrane Database of Systematic Reviews, 2014.PMID 24687239
- [4]Grossman DC, Curry SJ, Owens DK, et al. Interventions to Prevent Falls in Community-Dwelling Older Adults: US Preventive Services Task Force Recommendation Statement. JAMA, 2018.PMID 29710141
- [5]Harwood RH, Foss AJ, Osborn F, Gregson RM, Zaman A, Masud T Falls and health status in elderly women following first eye cataract surgery: a randomised controlled trial. British Journal of Ophthalmology, 2005.PMID 15615747