Geriatrics 1

Question 1

What is Phase I and II reaction?

Answer 1

Phase I : CROH - Conjugation/reduction/oxidation/hydrolysis

Phase II - form lipophilic content and be excreted

Question 2

Which benzodiazepines affected by ageing?

Answer 2

Diazepam

Question 3

urethral closure at bladder neck mediated by what ?

Answer 3

A1 receptor

Question 4

APOE4 role in Alzheimers?

Answer 4

Late onset Alzheimers

Question 5

PSEN1 role in alzheimers?

Answer 5

Early autosomal dominant Alzheimers

Question 6

PSEN1 role?

Answer 6

Regulatory role in production of amyloid precursor protein - b- amyloid and APP

Question 7

Vascular dementia - bradykinesia more in where?

Answer 7

Lower limbs

Question 8

Vascular dementia hallmark clinical features?

Answer 8

Executive function impairment + stepwise fashion decline

Question 9

Key difference between Dementia and mild cognition impairment?

Answer 9

Functional status

Question 10

Geriatric assessment best in what group of elderly people?

Answer 10

Elderly + disability with functional limitations

Question 11

Dementia of lewy body MRI finding?

Answer 11

Diffuse cerebral atrophy with medial temporal lobe sparing

Question 12

What toxin poisoning mimics Parkinson?

Answer 12

Manganese/ Cyanide/ CO

Question 13

CAM (confusion assessment method) tool for diagnosing delirium?

Answer 13

High sensitivity and specificity

Question 14

Most common cause of bladder overactivity?

Answer 14

Idiopathic

Neurogenic is 2nd most common!

Question 15

Commonest cause of neurogenic bladder?

Answer 15

Stroke!

Question 16

Difference btw Dementia and mild neurocognitive disorder ( previously mild cognitive impairment)

Answer 16

Dementia
-Decline in 2 or more clinical domain
\+ Affects personal activities
No delirium
Not entirely due to normal aging

Mild neurocognitive disorder
-Decline in 1 or more clinical domain
-Not affecting personal activities
Not entirely due to normal aging

Question 17

What neurotransmitter is for learning and memory?

Answer 17

Glutamate

Question 18

Fronto-temporal dementia has 2 variants

• Speech
• Behavioural

Name me 2 variants of speech FTD?

Answer 18

1. PNFA - progressive non-fluent aphasia
   - can’t form sentence properly
2. Sematic
   - Normal fluency, grammar - impaired single-word comprehension

Question 19

What is LATE in geriatrics?

Answer 19

Limbic-predominant Age-Related TDP-43 Encephalopathy
(LATE)
-deposition of TDP-43

Causing b-amyloid + alpha synuclein deposition

Question 20

Agitation in Dementia ( not DLB) - long term meds?

Answer 20

SSRI = Citalopram!

Question 21

LATE presentation?

Answer 21

Like Alzheimer’s - amnesia/memory but rapid decline linearly

Question 22

What drugs in elderly commonly cause the following;

1.Sedation + Postural hypotension

Answer 22

1. Sedation + postural hypotension = TCA
2. Urinary retention + confusion = Anti-cholinergic
3. Urinary retention + postural hypotension = Prazosin

Question 23

What neurotransmitter is high in CSF and maintains delirium?

Answer 23

Cortisol

Question 24

In elderly with falls - which muscle is activated first causing the falls?

Answer 24

Proximal before distal muscles

Question 25

Timed up and go test is significant for falls if?

Answer 25

Takes > 13 seconds

Question 26

Single lens glasses paradox for falls?

Answer 26

Reduce falls outdoors

Increase falls indoors

Question 27

Those with severe osteoarthritis
use walking aid with?
Advance leg with?

Answer 27

Walking aid with GOOD HAND

Advance leg with BAD HIP/LEG

Question 28

Psychotropic drugs withdrawal causes?

Answer 28

Reduce RATE of falls but not RISK

Question 29

Hepatic blood flow in elderly?

Answer 29

Reduced so reduced 1st pass metabolism

• reduced p450 enzymes
• prodrug affected

Question 30

Top 2 medications causing orthostatic hypotension in elderly?

Answer 30

Alpha blockers - prazosin, tamsulosin

Nitrates

Question 31

Nuclei for micturition?

Answer 31

Onuf nuclei

Question 32

Tau protein function

when tau protein causes issue?

Answer 32

Stabilise microtubules within neurons

Phosphorylation - accumulates the tau protein to form neurofibrillary tangles

Question 33

Spinal cord lesion causes what bladder issue?

Answer 33

Somatic control lost - incontinence

Bladder reflex intact