Geriatrics

Question 1

First line medication for delirium
First line with Parkinson’s

Answer 1

Haloperidol 0.5 mg
Lorazepam or an atypical antipsychotic (e.g. quetiapine, clozapine)

Question 2

Alzheimer’s management

Answer 2

Acetylcholinesterase inhibitors (donepezil, galantamine and rivastigmine)
Memantine

Question 3

Donepazil contraindication and SE

Answer 3

Contraindicated in patients with bradycardia
Adverse effects include insomnia

Question 4

Delirium over dementia

Answer 4

acute onset
impairment of consciousness
fluctuation of symptoms: worse at night, periods of normality
abnormal perception (e.g. illusions and hallucinations)
agitation, fear
delusions

Question 5

Features of frontotemporal lobar dementias

Answer 5

Onset before 65
Insidious onset
Relatively preserved memory and visuospatial skills
Personality change and social conduct problems

Question 6

Lewy Body Dementia Features

Answer 6

Progressive cognitive impairment
(occurs before parkinsonism, but usually both features occur within a year of each other)
Early impairments in attention and executive function
Parkinsonism
Visual hallucinations (other features such as delusions and non-visual hallucinations may also be seen)