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Aging Flashcards

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1
Q

What three parts are there to the definition of dementia?

A

Cognitive failiure
Deterioration of day to day function
Long term progression

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2
Q

Main feature of Alzheimer’s?

A

Early memory loss w gradual onset and progressive decline

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3
Q

Main 2 diagnostic feature of vascular dementia?

A

Step wise deterioration (with each infarct)

May have neurological symptoms eg. Hemianopia

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4
Q

Give 5 diagnostic features if leery body dementia

A 
Fluctuating cognition
Visual hallucinations
Disturbances in consciousness
Autonomic symptoms (eg falls and syncope)
Parkinsonism
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5
Q

Give two diagnostic features of frontotemporal dementia

A 
Memory preserved (in early stages)
Early decline in social/personal conduct
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6
Q

what is classic triad of Parkinsonism?

A

Tremor
Ridgidity
Brady/hypokineasia

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7
Q

What are the 2 first line treatments for osteoporosis?

A

Bisphosphonates (Alendronic Acid)

Calcium and Vitamin D supplementation

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8
Q

Give 4 conditions associted with low bone mass

A

Diabetes (esp Type 1)
Inflammatory rheumatic disease
Chronic liver disease
CKD

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9
Q

What do you give to supplement low Vit D

A

D3/cholecalciferol

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10
Q

Give 5 drugs used in Parkinsons

A 
L-Dopa
Muscarinic antagonists
Dopadecarboxylase inhibitors
D2 receptor agonists
MAO-B inhibitors
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11
Q

Why give Muscarinic antagonists in parkinsons?

A

Tremor
Excesive salivation
(counteracts the increased parasympathetic tone caused by increased Ach)

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12
Q

Why use MAO-B inhibitors in Parkinsons?

A

As an adjunct to L-DOPA.

Prevents MAO-B breaking down the dopamine

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13
Q 
What is the only disease modifying drug for dementia?
(Give the class and 3 examples)
A

Acetylcholineaterqse inhibitors

  • Rivastigmine
  • Donepezil
  • Galavitamide
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14
Q

What is the definition of osteoporosis?

A

Mineral density is <2.5 SD below normal as measured by DEXA scan

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15
Q

Give an example of a bisphosphonate

A

Alendronic acid

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16
Q

Give 3 pharmacological treatments for osteoporosis

A

Bisphosphonate
HRT (younger post menopausal women)
Testosterone replacement (hypogonadal men)

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17
Q

What is Paget’s disease of the bone?

A

Localised disorder or bone remodelling causing increased fracture risk and pain

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18
Q

Give the four radiographic hallmarks of an osteoarthritic joint

A

Loss of joint space
Joint line sclerosis
Osteophytes
Subcondral cysts

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19
Q

What is the pathological process of osteoarthritis?

A

Loss of joint cartilage (chondrocytes) resulting in loss of joint space

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20
Q

Give two symptoms of osteoarthritis

A

Pain (not worse in morning though!)

stiff joints after long rest period (inactivity gelling)

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21
Q

Give four examination findings in osteoarthritis

Study These Flashcards
A

Joint tenderness
Bony enlargement
Cool effusions
Crepitus (crackling when moving the joint)

22
Q

Give 3 pharmacological treatments for osteoarthritis

Study These Flashcards
A

NSAIDS
Topical steroid
Intraarticular ateroid

23
Q

How do you differentiate gout and calcium pyrophosphate disease by their biorefringence?

Study These Flashcards
A

Gout = -ve

Pseudo gout = +ve

24
Q

Give three main gout risk factors

Study These Flashcards
A

Male
High urate diet
CKD

25
What enzyme catalyses the conversion of purines (hypoxanthine) to Uric acid?
Xanthine Oxidase
26
Give five class of drug used to manage gout
``` Xanthine oxidase inhibitor eg. Allopurinol Recombinant uricase Uncosuric agent NSAID Steroid (prednisolone) ```
27
What is the real name for psudogout?
Calcium pyrophosphate disease
28
Which hand joints are classically affected in osteoarthritis and which are in RA?
Osteo: PIP and DIP joints RA: MCP joints
29
Apart from the classic parkinsonism triad, give five motor symptoms of parkinnsons
``` Micrographia Mask like face (with reduced blinking) Cogwheeling Freezing of gait Postural instability (shuffling, stooped gait wiht reduced arm swinging) ```
30
Give 2 MAO-B inhibitors used in Parkinsons?
Rasagiline, Selegiline
31
Give three D2 agonisttts used in parkinsons
Rotigatine, Pramipexole, Ropinirole
32
What 5 parkinson's symptoms is L-dopa good at correcting?
``` Bradykinesia Ridgidity Speech Facial expression Micrographia ```
33
What symptoms do muscarinic antagonists treat in parkinsons?
Tremor | Excessive salivation
34
Give two side effects of dopaminergic therapy in parkinson's
Nausea/vomiting | hypotension
35
How long does L-Dopa work for?
3-4 hours
36
What is the antimuscarinic used in parkinsons?
Trihexphenydyl
37
Give 5 side effects of muscarinic antagonist use in parkinson's?
``` Constipation Confusion Dry Mouth Mood changes Blurred vision ```
38
What drug must be given alongside L-Dopa?
Dopa decarboxylase inhibitor
39
What management can be performed on patients that L-Dopa wont work on?
Neuroablative surgury
40
What part of the brain is blocked in deep brain stimulation for parkinsons?
Subthalamic nucleus (part of the indirect pathway)
41
How does parkinson's tremor progress?
Starts unilaterally and progresses to bilateral with one side worse affected than the other
42
Give three prodromal symptoms of parkinsons
Hyposmia (loss of smell) REM sleep behavioral disturbance Constipation
43
What smell is used to test for early signs of hyposmia in parkinsons?
Oregano
44
Whats the first line drug for overactive bladder (urge incontinence)?
Oxybutanin
45
Whats management for stress incontinence
Pelvic floor exercises (8reps, 3 sets a day, 3 months) | Surgury
46
What gene mutation is the main genetic determinant of sporadic (non familial) alzheimers?
APOE
47
Give 3 gee mutations that may result in familial cases of alzheimers disease
Amyloid precursor protein (APP) PSEN1 PSEN2
48
When is the most common subtype of delerium
Hypoactive
49
Give the three criteria that must be fulfilled to diagnose delirium
Acute onset + fluctuating course Inattention disorganised thinking or altered consiousness
50
Give one difference in the pattern of pain in the morning in OA and RA
``` OA = lasts less than 30mins RA = lasts more than 30mins ```
51
Give three differences in the presentation of RA and OA
RA has morning pain lasting over 30 mins (OA <30 mins) OA affected PIP and DIP but RA only affects MCP joints OA may be asymetrical, RA is pretty much always symetrical

Aging (1 decks)

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