GERIS

Question 1

meds to manage acute delerium

Answer 1

olanzapine/haloperidol

Question 2

inheritance pattern of alzheimers

Answer 2

5% of cases are inherited as an autosomal dominant trait

Question 3

macroscopic alzheimers changes

Answer 3

macroscopic:
widespread cerebral atrophy, particularly involving the cortex and hippocampus

Question 4

microscopic alzheimers changes

Answer 4

microscopic:
cortical plaques due to deposition of type A-Beta-amyloid protein and intraneuronal neurofibrillary tangles caused by abnormal aggregation of the tau protein

Question 5

medications to manage MILD-MOD Alzheimer’s disease

Answer 5

donepezil, galantamine and rivastigmine

Question 6

MOA donepezil, galantamine and rivastigmine

Answer 6

acetylcholinesterase inhibitors

Question 7

memantine when is it used

Answer 7

-moderate Alzheimer’s who are intolerant of, or have a contraindication to, acetylcholinesterase inhibitors
-dd-on drug to acetylcholinesterase inhibitors for patients with moderate or severe Alzheimer’s
-monotherapy for severe alzheimers

Question 8

which alzheimers med is contraindicated in bradycardia

Answer 8

donepezil

Question 9

which alzheimers med causes insomnia

Answer 9

donepezil

Question 10

Delirium vs. dementia

Answer 10

Factors favouring delirium over dementia
impairment of consciousness
fluctuation of symptoms: worse at night, periods of normality
abnormal perception (e.g. illusions and hallucinations)
agitation, fear
delusions

Question 11

types of dementia

Answer 11

• Alzheimers
• Vascular
• Lewy body
• fronto temporal

Question 12

A MMSE score of ??? suggests dementia

Answer 12

24 or less out of 30 suggests dementia

Question 13

Common features of frontotemporal lobar dementias

Answer 13

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

Question 14

what type of dementia causes personlaity change

Answer 14

fronto temporal

Question 15

pathological feature lewy body dementia

Answer 15

alpha-synuclein cytoplasmic inclusions (Lewy bodies) in the substantia nigra, paralimbic and neocortical areas.

Question 16

what type of dementia causes visual hallucinations

Answer 16

lewy body

Question 17

diagnosis imaging for lewy body dementia

Answer 17

SPECT) scan

Question 18

neuroleptics/antipsychotics should be avoided in which type of dementia- and why

Answer 18

lewy body
may develop irreversible parkinsonism

Questions may give a history of a patient who has deteriorated following the introduction of an antipsychotic agent

Question 19

Management lewy body dementia

Answer 19

both acetylcholinesterase inhibitors (e.g. donepezil, rivastigmine) and memantine can be used

Question 20

which type of scoring used for pressure sores

Answer 20

waterlow score

Question 21

The main subtypes of VD:

Answer 21

Stroke-related VD – multi-infarct or single-infarct dementia
Subcortical VD – caused by small vessel disease
Mixed dementia – the presence of both VD and Alzheimer’s disease

Question 22

rate of deterioration in vascular dementia

Answer 22

step wise

several years of a history of a sudden or stepwise deterioration of cognitive function.

Question 23

management vascular dementia

Answer 23

conservative - no pharmacological tx for just VD.

can give ACHEi’s etc if sus mixed dementia w alzheimers

Question 24

why only haloperidol given as sedation in the elderly

Answer 24

to reduce risk of CV event (associated with olanzapine, risperidone)

Question 25

frontal temporal dementia MX

Answer 25

PAROEXETINE