It's All in the Bones
What is the GFR cutoff for use of zoledronic acid?
GFR >35
The biochemical that accumulates in the brain the longer one stays awake, resulting in sleepiness
adenosine
True or False: Prevalence of positive urine cultures is increased in SNF residents with falls ???
False!
A resident has scratched her cheek. There is no evidence of infection. Should you order bacitracin?
No.
What medication is first-line for a hospitalized patient with COVID and now available in PMA?
Remdesivir
Use of bisphosphonates during acute fracture delays wound healing due to inhibition of osteoclasts. T or F
F. Inpatient bisphosphonates dec risk of secondary fracture.
Colorectal cancer screening confers a survival benefit after how many years?
10
Name of criteria that encourage urine culture in a SNF patient with Delirium and indwelling catheter but not in someone with Pyuria 50 WBC/ul/HPF and bacteriuria 50,000 CFU/ml but no symptoms
Loeb Criteria
What promotional slogan would you choose for LHH?
(points awarded)
Aprepetent (Emend) is an anti-emetic active at what receptor?
NK-1 receptor
Which 2 osteoporosis meds are available in non-PO formulations?
denosumab and zoledronic acid
Which prognostic index is available online for free and incorporates NH and ADL status?
What class of antibiotics are to be avoided as first choice empiric treatment of UTI in elderly patients because of risk of tendon rupture?
Fluoroquinolones
Your resident desires to go OOP but needs assistance to climb the hill. What time is the last shuttle from Forest Hill to LHH?
6pm
What is the dermatologist-recommended treatment for anogenital MASD?
Hydrocortisone cream 2.5% cream mixed with ketoconazole 2% cream, followed by zinc oxide paste.
If using the FRAX calculator to determine if someone should be on osteoporosis treatment, it is recommended to treat if 10-year risk of major osteoporotic fracture is greater than ____ and risk of hip fracture is greater than _____ %
20% and 3%
What acronym can you use to respond to difficult emotions?
NURSE: Name the emotion, Understand it, Respect, Support, Explore
Recovery from TBI is expected to plateau over what time period?
2 years
What does LPC stand for?
Laguna Premier Club
Which class of diabetes medications has been shown both to slow progression of CKD and to improve outcomes in CHF?
SGLT-2 inhibitors
The FRAX is an online tool to assess risk of fracture. What is the name of the calculator used to predict risk among nursing home residents?
FRAiL calculator (ifar-frail.hsl.harvard.edu) or INJURE-NH Short
What is a helpful 5-step mnemonic for breaking bad news?
REMAP: Reframe, Expect emotion, Map the goals, Align, and Plan
A patient's GCS score is 10. How would you characterize their TBI?
Moderate TBI (severe GCS 3-8, mod 9-12, mild 13-15)
What are 2 goals of extended barrier precautions?
To reduce transmission of multidrug-resistant organisms (MDROs) in nursing homes
While avoiding isolation of resident in their rooms
What is Laguna Honda's Mission Statement?
To provide a welcoming therapeutic and healing environment that promotes the individuals health and well-being.