Geriatric

Question 1

Parkinson pt needing urgent mx of delirium

Answer 1

lorazepam

Question 2

side effects of donepezil (acetylocholinesterase inhibitor)

Answer 2

contraindicated if bradycardia
insomnia

Question 3

widespread cerebral atrophy particularly involving the cortex and hippocampus

Answer 3

alzheimers

Question 4

amyloid protein and neurofibrillary tangles due to aggregation of tau protein

Answer 4

alzheiemrs

Question 5

biochemically there is a deficit of what in Alzheimers

Answer 5

aceylcholine

Question 6

neurofibrillary tangles are made of what

Answer 6

tau

Question 7

assessment of demential recommended by NICE

Answer 7

10 point cognitive screener
6 item cognitive impairment test

Question 8

what is usually done first in dementia

Answer 8

blood screen to exclude reversible causes

Question 9

in secondary care what is done in dementia

Answer 9

neuroimaging to exclude subdural haematoma, normal pressure hydrocephalus

Question 10

Picks (type of frontotemporal dementia) disease affects

Answer 10

frontal and temporal lobes

Question 11

what part of near system involved with falls

Answer 11

basal ganglia

Question 12

meds associated with falls

Answer 12

nitrates, diuretics, antichol, antidepressants, bentos, antipsychotics

Question 13

test if fall history

Answer 13

Turn 180 degrees, Timed up and go test

Question 14

characteristic of picks disease

Answer 14

focal gyro atrophy with a knife blade appearance

Question 15

picks bodies are

Answer 15

spherical aggregations of tau protein (silver staining)

Question 16

mx of frontotemoral

Answer 16

NICE do NOT recommend ache inhibitor or memantien for people with frontotemporal

Question 17

other 2 types of frontotemporal dementia

Answer 17

progressive non fluent and semantic

Question 18

semantic dementia

Answer 18

speech conveys little meaning
unlike in Alzheimers memory is better for recent rather than remote events

Question 19

Lewy bodies are

Answer 19

alpha synuclein cytoplasmic inclusion

Question 20

Lewy body dementia

Answer 20

symptoms within one year of each other

Question 21

what dementia is known for having fluctuations in cognition

Answer 21

Lewy body

Question 22

in contrast to Alzheimer’s, early impairments in attention and executive function rather than just memory loss

Answer 22

Lewy body

Question 23

diagnosis of leeway body is usually clinical but what is a great scan that can be used

Answer 23

SPECT

Question 24

can classic Alzheimers meds be used for leeway body

Answer 24

yep

Question 25

what drugs should be avoided in Lewy body dementia and may develop irreversible Parkinsonism

Answer 25

first gen antipsychotics

Question 26

what 3 things should be used to assess frailty

Answer 26

- gait speed - self reported health status -PRISMA -7 questionnaire

Question 27

no benefit in taking what after 3 years

Answer 27

biphosphoante

Question 28

PPI may be started if on nsaids that can prevent formation of ulcers and therefore

Answer 28

reduce bleeding risk

Question 29

what meds should you consider stopping I peptic ulcer disease

Answer 29

Nsaids, warfarin and aspirin

Question 30

scoring for pressure sores

Answer 30

Waterlow

Question 31

mx of pressure sore

Answer 31

moist dressing - hydrocolloid or hydrogel - avoid soap as this will dry out wound wound swabs should not be done routinely as the vast majority of pressure ulcers are colonised with bacteria

Question 32

rare inherited of vascular dementia

Answer 32

CADASIL

Question 33

vascular dementia can also be fluctuating but has a stepwise progression

Question 34

NICE Recommends what criteria for vascular dementia

Answer 34

NINDS-AIREN

Question 35

do you give acei or memantine for suspected vascular dementia

Answer 35

only if also got Alzheimer, parkisnosn dementia, dementia with Lewy body