Geri

Question 1

Features of geriatric depression (2 features)

Answer 1

1. melancholic. 2. somatic complaints

Question 2

What does the Wisconsin Card Sorting Test test?

Answer 2

executive funx

Question 3

cut-off for MMSE

Answer 3

below 26 high specificity for dementia

Question 4

Is the moca more sensitive than mmse?

Answer 4

yes

Question 5

most common psych sx in Alz

Answer 5

apathy

Question 6

most common hallucination in Alz

Answer 6

visual

Question 7

Rivastigmine inhibits which two enzymes?

Answer 7

cholinesterase and butylcholinesterase

Question 8

How does memantine work

Answer 8

NMDA inhibitor

Question 9

Which memory med works only as cholinesterase inhibitor

Answer 9

1. donepezil (it’s selective and reversible)

Question 10

first choice treatment for LBD and PD dementia

Answer 10

rivastigmine

Question 11

which two things does galantamine work on

Answer 11

1. acetylcholinesterase 2. nicotine receptor

Question 12

most common reason for psychosis in the elderly

Answer 12

dementia

Question 13

What is Wernicke’s aphasia

Answer 13

Fluent speech, poor comprehension

Question 14

Broca’s aphasia?

Answer 14

Cannot express, but can understand

Question 15

Most common med responsible for delirium

Answer 15

anticholinergics

Question 16

What factor in pharmacodynamics is not affected by aging?

Answer 16

absorption

Question 17

Does late onset depression have more or less relapses

Answer 17

More

Question 18

percentage depressed in community dwelling elderly

Answer 18

1%

Question 19

percentage depressed of hospitalized elderly

Answer 19

10-15%

Question 20

least and most anticholinergic TCA

Answer 20

least- desipramine and nortriptyline most- tertiary amines: amytriptyline, imipramine

Question 21

What is the most common progression of episodes in bipolar as one ages

Answer 21

Increase in frequency and severity of both mania and depression.

Question 22

what happens to REM in the elderly?

Answer 22

more episodes but less total REM

Question 23

what happens to liver conjugation as we age

Answer 23

no change

Question 24

what are the two types of FTD variants?

Answer 24

1. behavioral 2. language

Question 25

periodic sharp wave discharged are suggestive of which disease

Answer 25

prion/ creutzfeld-jacob

Question 26

What is the main fnx of a cholinesterase inhibitor

Answer 26

slow cognitive decline (doesnt change function)

Question 27

which neuroanatomy structures are primarily affected in Alz

Answer 27

parietotemporal (therefore frontal atrophy is often seen last)

Question 28

percent of hospitalized patients that develop delirium

Answer 28

6-56%

Question 29

most common type of hallucination in alz

Answer 29

VH

Question 30

classic pathology found in Alz

Answer 30

amyloid plaques (white matter intensities) and tau tangles with gliosis and granulovaculoar degeneration

Question 31

best AP to use in someone with PD or LBD and psychosis?

Answer 31

clozapine (least EPS risk)

Question 32

what percent of individuals with a delirium will die within a year

Answer 32

40%

Question 33

what is the primary pathology found in the brains of LBD and PD

Answer 33

alpha synuclein misfolding/aggregation

Question 34

which dementia affects both cortical and subcortical?

Answer 34

vascular

Question 35

subcortical dementias are associated with what disorder

Answer 35

movement d/o (Huntington, PD, LBD)

Question 36

What does APO E4 increase the risk of

Answer 36

late onset Alz

Question 37

Which three genes are associated with early onset Alz

Answer 37

1. APP 2. presinilin 1 3. presinilin 2

Question 38

what's the risk of alz disease over age 65

Answer 38

5%, which doubles every 5 yrs

Question 39

which vitamin is associated with treatment for Alz

Answer 39

Vit E (but also high doses is not recommended as tx..)

Question 40

In which gender is Pick's more common

Answer 40

M

Question 41

Impairment to recall > recognition in which types of dementia

Answer 41

subcortical

Question 42

retrograde amnesia and agnosia are common in which types of dementia

Answer 42

cortical

Question 43

What part of the brain does Binswager's affect

Answer 43

white matter arterioles (subcortical specific)

Question 44

Where are argyrophilic intracellular inclusions found

Answer 44

Pick bodies

Question 45

what is the most common anxiety disorder in the elderly

Answer 45

phobias

Question 46

EEG characteristics of delirium

Answer 46

generalized increase in theta or delta activity

Question 47

best med tx for TBI related aggression

Answer 47

BB (propranolol)

Question 48

least likely anxiety disorder in elderly

Answer 48

panic disorder (1%)

Question 49

two key features of PSP

Answer 49

1. impaired walking/balance 2. slow/restricted eye mvt

Question 50

does levodopa work in LBD

Answer 50

no- can worsen psych sx

Question 51

only three recommendations for tx of dementia according to CMAJ article

Answer 51

1. exercise. 2. tx HTN. 3. cholinesterase inh + memantine

Question 52

late onset depression is more common in which gender

Answer 52

F

Question 53

prevalence of MDD in community dwelling elderly

Answer 53

1-5%

Question 54

what imbalance can PPIs cause

Answer 54

hyponatremia

Question 55

qtc max for the elderly

Answer 55

M= 440 F= 460

Question 56

First investigation for NPH

Answer 56

MRI head

Question 57

mechanism of action of AD induced hyponatremia

Answer 57

SIADH

Question 58

next intervention if patient does not respond to atypicals for BPSD

Answer 58

SSRI (citalopram)

Question 59

Which type of dementia is HIV

Answer 59

subcortical

Question 60

best tx for neurobehavioral sx of FTD (i.e. impulsivity)

Answer 60

1. SSRI. 2. trazodone

Question 61

imaging most consistent with LBD

Answer 61

medial temporal lobe sparing

Question 62

imaging most consistent with Alz

Answer 62

cerebral atrophy especially hippocampal and medial temporal lobes

Question 63

most common dementia

Answer 63

Alz (60-70%)

Question 64

what does the hummingbird sign on MRI indicate

Answer 64

PSP

Question 65

what's the one similarity between mini-cog and mmse

Answer 65

delayed recall of three words

Question 66

what is the relationship bw dementia and suicide

Answer 66

none

Question 67

which dementia has apathy without depression

Answer 67

FTD

Question 68

the first complaint of someone with MS

Answer 68

memory loss

Question 69

what is the porphyria triad

Answer 69

1. abdo pain 2. psychosis 3. neuropathy