Geriatric

Question 0

Pseudodementia. What is it and how to treat

Answer 0

Presence of apparent cognitive deficits in pts with major depression
Supportive psychotherapy. Community resources. Low dose SSRI

Question 1

Brain changes with normal aging

Answer 1

Decreased brain weight. Enlarged ventricles and sulci

Question 2

Which TCA has fewest anticholinergic side effects

Answer 2

Nortriptyline

Question 3

What is sundowning and when do you see it

Answer 3

Increased confusion at night. Seen with dementia but not pseudo

Question 4

How to determine the difference between dementia and pseudo dementia on questioning

Answer 4

Dementia pts will guess at answers, confabulate. Pseudo will say idk and will answer correctly if pressed

Question 5

Five stages of bereavement

Answer 5

Denial anger bargaining depression acceptance

Question 6

Time course of normal grief vs prolonged grief vs bereavement associated depression

Answer 6

Normal grief abates within six months
Complicated or prolonged grief lasts for at least six months and has other sx
Bereavement associated depression has hopelessness, helplessness, severe guilt and worthlessness, SI. treated for depression if pt has two straight weeks of depressive sx 6-8 weeks after the loss

Question 7

What do VH suggest in the elderly and how to treat?

Answer 7

Dementia with Lewy bodies. Treat with NO antipsychotics

Question 8

What sedatives are preferred for older pts with sleep disturbances

Answer 8

Hydroxyzine (vistaril) or trazodone

Question 9

Natural course of nursing home

Answer 9

Half stay permanently. Half discharged after only a Few months