cote

Question 1

how to treat delirium acutely?

Answer 1

haloperidol 0.5mg

nice says haloperidol or olanzipine

Question 2

would you use benzos in delirium?

Answer 2

no, make delirium worse

Question 3

what causes alzheimer’s

Answer 3

extracellular amyloid plaques in hippocampus, temporal and parietal lobesq

Question 4

what would you see on mri of alzheimers?

Answer 4

bilateral hippocampal and temporal lobe atrophy

Question 5

what would you see on ct/mri of vascular dementia?

Answer 5

areas of new/old infarct

widespread white matter change due to small infarcts

Question 6

what would frontotemporal dementia look like on mri?

Answer 6

asymmetrical atrophy of hippocampus, amygdala, temporal lobes

Question 7

what causes frontotemporal dementia

Answer 7

atrophy of frontal and anterior temporal lobes

pick bodies (tau)

Question 8

what causes lewy body dementia?

Answer 8

lewy bodies in substantia nigra and cerebral cortex

may also see some amyloid plaques

Question 9

how is lewy body dementia treated?

Answer 9

acetylcholinesterase inhibitors

donepezil
rivastigmine
galantamine

2nd line
memantine (NMDA)

Question 10

can you give antispsychotics in lewy body dementia?

Answer 10

no, rigidity and akinesia!

Question 11

what is the effect of dopamine agonists in lewy body?

Answer 11

psychiatric side effects such as confusion, hallucinations

Question 12

what is first line medication for alzheimers?

Answer 12

achesterase inhibitors

donepezil
rivastigmine
galantamine

Question 13

what side effects need to be monitored in achesterase inhibitors?

Answer 13

cholinergic side effects

Question 14

what is second line tx for az dementia

Answer 14

memantine

Question 15

how to treat behavioural/psych problems of dementia?

Answer 15

haloperidol
risperidone
antidepressants

Question 16

how is vascular dementia treated?

Answer 16

manage RFs
treat htn
statins
antiplatelets
smoking cessation

Question 17

how is lewy body dementia treated?

Answer 17

ach inhibitors then memantine like alzheimers

levodopa for movement dis

clonazepam for REM sleep

avoid using haloperidol as serious side effects

can use antidepressants

Question 18

how is frontotemporal dementia treated?

Answer 18

antidepressants

antipsychotics (rarely)

Question 19

what sort of therapy for dementias?

Answer 19

cognitive stimulation therapy to improve memory and problem solving skills

Question 20

why might you get AKI in a patient who has fallen?

Answer 20

fallen for a long time - muscle breakdown (rhabdomyolysis) causes AKI

check U&E

also pressure sores

Question 21

does advanced directive have to be written?

Answer 21

not unless life-sustaining treatment

Question 22

can patient request treatment on advanced directive?

Answer 22

no, can only refuse

Question 23

maximum dols?

Answer 23

12 months

Question 24

who needs to be present in dols?

Answer 24

imca

Question 25

what are amitriptylline sideeffects?

Answer 25

dry mouth
blurred vision
constipation
cognitive decline
drowsiness
confusion
weight gain
retention

Question 26

what are the side effects of aspirin?

Answer 26

gastric problems

Question 27

what are the side effects of amlodipine in elderly?

Answer 27

ankle oedema

Question 28

what are the side effects of statins?

Answer 28

muscle pain