RAHBAR
RAHBAR MBBSMedicine & Allied • Third Year Deep Learning Master
 ← Year 03 Subjects
YEAR 03 • MEDICINE & ALLIED • 20-MODULE • FULL CHAPTER MASTER

Medicine & Allied Learning Material

20 learning units covering clinical assessment, common medical presentations, urgent warning signs and allied specialties. Read the chapters, revise the key distinctions, then attempt 10 explained questions per unit in practice or assessment mode.

Academic scope: Original RAHBAR notes for the Year 3 clinical transition, informed by PM&DC medicine and allied domains. Institutional sequencing may differ. Examples are educational; clinical decisions and procedures require appropriate supervision and current local protocols. Sources & further reading ↓
MA
● MODULE 18 / 20

Geriatrics, Frailty & Palliative Care

Assess function, cognition and treatment burden and build care around the person’s goals.

Quick revision ↓ Medical Dictionary

FULL CHAPTER EXPLANATION

Deep Learning — Module 18

Connect symptoms and examination findings to a differential, targeted investigations, initial priorities and reassessment.

01

Comprehensive assessment

Older adults may present with falls, reduced mobility, confusion or loss of function rather than a single organ-specific complaint. Assess medical problems, medicines, cognition, mood, nutrition, mobility, daily activities and social support. Frailty describes reduced reserve and vulnerability, not simply age or disability. Establish the previous baseline and recent change using the patient’s account and appropriate collateral history. Reversible illness can coexist with longstanding impairment.

02

Delirium and dementia

Delirium typically develops acutely with fluctuating attention and awareness, while dementia usually has a more chronic trajectory; both can coexist. Hypoactive delirium may look like quiet withdrawal and is easily missed. Search for causes such as infection, pain, retention, constipation, medicines or metabolic disturbance. Support orientation, sleep, hydration, sensory aids and mobility as appropriate. Sedation is not a substitute for identifying and treating the cause.

03

Falls and medication burden

Falls assessment considers circumstances, loss of consciousness, postural symptoms, gait, vision, footwear, environment and medicines. A fall can reveal an acute illness or arrhythmia rather than simple clumsiness. Polypharmacy assessment reviews indication, benefit, interactions, dose and the patient’s ability to manage treatment. Deprescribing is a planned, monitored process, not abrupt withdrawal of every medicine. Decisions should respect goals and avoid using age alone to deny beneficial care.

04

Function and discharge

Assess whether the person can eat, mobilize, toilet and manage medicines safely, and identify the support actually available. Involve rehabilitation, nursing, pharmacy and social services as needed. A medically stable laboratory result does not prove a safe discharge environment. Communicate changes and follow-up to the receiving team, and include caregivers with consent and appropriate authority. Clear responsibility helps prevent falls, missed treatment and avoidable readmission.

05

Palliative principles

Palliative care addresses physical symptoms, psychological, social and spiritual needs alongside appropriate disease-directed care. Discuss goals, uncertainty and preferences sensitively and review them as circumstances change. Decisions about resuscitation and other treatments require individualized discussion and local processes; a decision about CPR does not mean stopping all care. Symptom treatment needs assessment of cause, benefit and adverse effects, and support extends to families and caregivers.

High-Yield Revision

  • Frailty is not synonymous with chronological age.
  • Quiet withdrawal can be hypoactive delirium.
  • Discharge safety includes function and real support.

Common Exam & Concept Pitfalls

  • Do not treat acute confusion as inevitable ageing.
  • Do not interpret a CPR decision as withdrawal of all treatment.

Sources & Further Reading

Curriculum and reference review: 24 September 2026. These original notes teach clinical reasoning and recognition, not standalone prescribing or procedure protocols. International guidance supports the principles below; local pathways, resources and authorized supervision govern patient care. Faculty review is pending.

RAHBAR study structure: presentation → examination → differential → investigation → care priorities → reassessment. Use institutional curriculum and faculty guidance for supervised clinical skills and assessment requirements.