1. ADLs--- basic self-care activities done in the home, minimum for being able to live at home independently: bathing, dressing, toileting, continence, transferring from bed to chair, feeding self.

2. Instrumental ADLs-- things that don't need to be done every day, can have hired help to do them: telephone call, managing medications and finances, shopping, cooking, managing transportation. 

3. Vitamin E may be helpful in delaying the progression of Alzheimer's but it increases all-cause mortality. 

4. Well's criteria for determining risk of PE:
-Clinical signs of DVT - 3 pts
-DVT most likely - 3 pts
-Recent surgery (within 4 weeks) or recent immobilization > 3 days - 1.5 pts
-HR>100 - 1.5 pts
-Previous DVT or PE - 1.5 pts
-Malignancy within last 6 months - 1 pt
-Hemoptysis -1 pt
5 points or more: likely to be PE, go to CT
4 points or less: unlikely PE, d-dimer to r/o
5.Likelihood of CAD by sex, age, chest pain:

(source)

6. "Dizziness" is usually one of the following:
-Presyncope- feeling light-headed (cardiac, pulm, blood, vasovagal)
-Dysequilibrium- feeling off balance (cerebellum, DM neuropathy, Tabes dorsalis)
-Vertigo- room spinning (CNS pathology vs peripheral nerve)
7. Common causes of vertigo: 
-Vestibular neuritis: common after URI, affects peripheral nerve, may cause horizontal nystagmus that resolves with gaze fixation (bats in the direction of pathology), vertigo doesn't change with position. Inflammation of vestibular nerve.
-Labrynthitis: inflammation of both branches of CN VIII- vestibular and cochlear; causes hearing loss/tinnitus as well as vertigo.
-Benign paroxysmal positional vertigo: Episodic, acute onset episodes of vertigo triggered by position change and resolving minutes after the position change; may cause associated nausea, vomiting, hearing loss. Thought to be due to movement of calcium carbonate in the semicircular canals. (diagnose with dix-hallpike test; turn head 45 degrees to side, lie down fast, extend neck, nystagmus will bat towards the pathological side) (+ dix hallpike)
-Vestibular migraine: causes central vertigo +/- headache, patients usually report history of migraines.
-Menieres: episodes of unilateral tinnitus, hearing loss, vertigo.
-Otitis media: +fever, +findings on ear exam.
8. Central vs peripheral causes of nystagmus: 
-More likely peripheral: resolves with gaze fixation worsens with loss of fixation, unidirectional (horizontal or rotational), worsens with Frenzel glasses (prevent fixation)
-More likely central: does not resolve with gaze fixation, lasts longer (much more ominous- TIA/infarct, tumor)
9. Central vs peripheral vertigo: 
-Head thrust test: Ask them to look at your nose, then turn their head quickly to the side. Normally, they can still focus on you. If the lesion is peripheral, the vestibular-ocular reflex will fail, and you will see their eyes turn away suddenly, then saccade back when you turn the head to the affected side. A normal head-thrust test in the presence of vertigo suggests CNS pathology.
10. Treatment for peripheral vertigo:
-If its menieres disease, diuretics theoretically reduce endolymph pressure, but unclear evidence
-If its BPPV, epley maneuver (patient sits on table with head turned 45 deg to R. He patient quickly lies back with his head hanging over table. Once the nystagmus stops, turn the head 90 degrees to the left, hold for 30 seconds. Next, the patient rolls onto his left side, with his face at a 45 degree angle to the floor; hold 30 seconds. The patient returns to the sitting position with legs off the left edge of the table. After another 30 seconds, the patient can resume normal head position. Repeat on other side)
-Vestibular rehab (balance exercises)
-Vestibular suppressants- meclizine, diphenhydramine also help with nausea. Nonselective phenothiazine antiemetics (metoclopramide, promethazine) may help. All of these can cause sedation and some are anticholinergics, avoid in elderly.