We hope you have added to your knowledge skills and attitudes about Atypical Presentations of Disease in the Older ED Patient. Those vague complaints – weakness, confusion, increased falls, “just not right” – are a frequent component of geriatric presentations in the ED. We need to recognize them as a part of the job of looking after older patients. Though it is harder to develop algorithms for their management than “chest pain,” “head ache,” or “fever,” it is important to have an understanding of their basis and an approach to assessing them Be aware that these vague complaints usually are symptoms of serious disease. Early and accurate diagnosis will make a big difference in your patient’s life – and she’ll thank you for recognizing the importance of her atypical presentation!
Review the Learning Objectives before proceeding to the Knowledge Check.
At the end of this module you should be able to:
- Explain the link between non-specific symptoms (weakness, fatigue, “dizziness,” confusion, increased falls, functional decline) and life-threatening or treatable conditions
- Describe how adverse drug reactions, drug-drug interactions, and drug-disease interactions can present as “new” medical conditions
- Recognize normal age-related changes in anatomy, physiology, and lab investigations that influence symptom presentation
- List reasons that medical diagnoses in older patients can present with atypical symptoms (altered immune response, decreased adrenergic response, polypharmacy (one drug masks symptoms), cognitive impairment (inability to describe symptoms), decreased psycho-social support (no one around to monitor changes).