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Psych > Chapter 9 pt 1 > Flashcards

Chapter 9 pt 1 Flashcards

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1
Q

suicide rate of elderly (aged 85 or older) white men is what compared to national average

A

5x

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2
Q

what are common diagnoses in elderly patients

A

mood disorders
anxiety disorders
neurocognitive disorders
many mental disorders in this population remain underreported

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3
Q

what factors are associated with normal aging

A

decreased brain weight/enlarged ventricles and sulci
decreased muscle mass
increase in fat
impaired vision and hearing
minor forgetfulness (sometimes called age-associated memory impairment or benign senescent forgetfulness)

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4
Q

depression in the elderly is associated with what

A

poor physical health

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5
Q

new admits to nursing homes suffering from depression have

A

increased 1 year mortality rate

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6
Q

stroke patients who develop depression have

A

> 3x increase rate of death during the 10 years following stroke

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7
Q

post-MI patients who develop depression have

A

4x increased rate of death

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8
Q

what is pseudodementia

A

presence of apparent cognitive deficits in patients with major depression

symptoms of major depression in the elderly often include problems with memory and cognitive functioning

when mistaken for a neurocognitive disorder this term is used

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9
Q

how is pseudo dementia treated

A 
supportive psychotherapy
community resources (senior centers, senior services)
Low dose SSRI
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10
Q

what TCA is favored in elderly and why

A

nortriptyline

fewest anticholinergic side effects

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11
Q

how can one differentiate dementia and pseudodementia

A

onset:
dementia: insidious; pseudo: more acute
sundowning:
common in dementia; not common in pseudo
Answers:
dementia will confabulate (guess); pseudo will say “i dont know”
awareness:
dementia- unaware of problems; pseudo-aware
anti-depressant therapy
cognitive deficits will improve with antidepressant medication in pseudo

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12
Q

what is safe and effective in the elderly and can be used in place of antidepressants

A

ECT

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13
Q

whiter ether 5 stages of Grief

A 
Denial
Anger
Bargaining
Depression
Acceptance

-people may skip stages and go through them in different order

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14
Q

what is normal grief

A

intense feelings, including guilt and sadness, sleep disturbances, appetite changes, and illusions

generally abate by 6 MONTHS of the loss

patients ability to fiction appropriately in their life is preserved

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15
Q

what is bereavement-assoicated depression

A

major depression that began with a concrete death or loss in the patients life

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16
Q

how can one distinguish depression and grief

A

look for hopelessness, helplessness, severe guilt and worthlessness, neurovegetative symptoms (insomnia, appetite/weight changes, low energy), suicidal ideation

17
Q

treatment for depression that occurs in association with bereavement is recommended when

A

2 straight weeks of depressive symptoms

18
Q

what percentage of people 65+ drinks alcohol

A

40%

16% are heavy drinkers with adverse health effects due to the alcohol

19
Q

what are the age related effects of alcohol

A

decreased alcohol dehydrogenase- can lead to higher blood alcohol levels with fewer drinks

less water in the body with age resulting in higher percentage of alcohol in blood compared to younger person relatively

increase CNS sensitivity to alcohol

20
Q

what chronic medical conditions are worsened by alcohol

A 
liver diseases (cirrhosis, hepatitis)
GI diseases (bleeding, reflux, ulcer)
CVD (HTN, heart failure)
Metabolic/endocrine (gout, diabetes)
mental (depression, anxiety)
21
Q

what interaction does alcohol have with H2 blockers

A

higher blood alcohol levels

22
Q

what interaction does alcohol have with benzos, TCAs, narcotic, barbs, antihistamines

A

increase sedation

23
Q

what interaction does alcohol have with aspirin, NSAID

A

prolonged bleeding time, irritation of gastric lining

24
Q

what interaction does alcohol have with metronidazole, sulfonamides, long-acting hypoglycemics

A

nausea vomiting

25
Q

what interaction does alcohol have with Resperine, nitroglycerin, hydralazine

A

increase risk of hypotension

26
Q

what interaction does alcohol have with acetaminophen, isoniazid, phenylbutazone

A

increased hepatotoxicity

27
Q

what interaction does alcohol have with antihypertensives, anti diabetic, ulcer drugs, gout medications

A

worsen underlying disease

Psych (35 decks)

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