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THE EXAM > Geri > Flashcards

Geri Flashcards

1
Q

Features of geriatric depression (2 features)

A
  1. melancholic. 2. somatic complaints
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2
Q

What does the Wisconsin Card Sorting Test test?

A

executive funx

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3
Q

cut-off for MMSE

A

below 26 high specificity for dementia

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4
Q

Is the moca more sensitive than mmse?

A

yes

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5
Q

most common psych sx in Alz

A

apathy

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6
Q

most common hallucination in Alz

A

visual

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7
Q

Rivastigmine inhibits which two enzymes?

A

cholinesterase and butylcholinesterase

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8
Q

How does memantine work

A

NMDA inhibitor

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9
Q

Which memory med works only as cholinesterase inhibitor

A
  1. donepezil (it’s selective and reversible)
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10
Q

first choice treatment for LBD and PD dementia

A

rivastigmine

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11
Q

which two things does galantamine work on

A
  1. acetylcholinesterase 2. nicotine receptor
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12
Q

most common reason for psychosis in the elderly

A

dementia

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13
Q

What is Wernicke’s aphasia

A

Fluent speech, poor comprehension

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14
Q

Broca’s aphasia?

A

Cannot express, but can understand

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15
Q

Most common med responsible for delirium

A

anticholinergics

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16
Q

What factor in pharmacodynamics is not affected by aging?

A

absorption

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17
Q

Does late onset depression have more or less relapses

A

More

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18
Q

percentage depressed in community dwelling elderly

A

1%

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19
Q

percentage depressed of hospitalized elderly

A

10-15%

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20
Q

least and most anticholinergic TCA

A

least- desipramine and nortriptyline most- tertiary amines: amytriptyline, imipramine

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21
Q

What is the most common progression of episodes in bipolar as one ages

A

Increase in frequency and severity of both mania and depression.

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22
Q

what happens to REM in the elderly?

A

more episodes but less total REM

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23
Q

what happens to liver conjugation as we age

A

no change

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24
Q

what are the two types of FTD variants?

A
  1. behavioral 2. language
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25
Q

periodic sharp wave discharged are suggestive of which disease

A

prion/ creutzfeld-jacob

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26
Q

What is the main fnx of a cholinesterase inhibitor

A

slow cognitive decline (doesnt change function)

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27
Q

which neuroanatomy structures are primarily affected in Alz

A

parietotemporal (therefore frontal atrophy is often seen last)

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28
Q

percent of hospitalized patients that develop delirium

A

6-56%

29
Q

most common type of hallucination in alz

A

VH

30
Q

classic pathology found in Alz

A

amyloid plaques (white matter intensities) and tau tangles with gliosis and granulovaculoar degeneration

31
Q

best AP to use in someone with PD or LBD and psychosis?

A

clozapine (least EPS risk)

32
Q

what percent of individuals with a delirium will die within a year

A

40%

33
Q

what is the primary pathology found in the brains of LBD and PD

A

alpha synuclein misfolding/aggregation

34
Q

which dementia affects both cortical and subcortical?

A

vascular

35
Q

subcortical dementias are associated with what disorder

A

movement d/o (Huntington, PD, LBD)

36
Q

What does APO E4 increase the risk of

A

late onset Alz

37
Q

Which three genes are associated with early onset Alz

A
  1. APP 2. presinilin 1 3. presinilin 2
38
Q

what’s the risk of alz disease over age 65

A

5%, which doubles every 5 yrs

39
Q

which vitamin is associated with treatment for Alz

A

Vit E (but also high doses is not recommended as tx..)

40
Q

In which gender is Pick’s more common

A

M

41
Q

Impairment to recall > recognition in which types of dementia

A

subcortical

42
Q

retrograde amnesia and agnosia are common in which types of dementia

A

cortical

43
Q

What part of the brain does Binswager’s affect

A

white matter arterioles (subcortical specific)

44
Q

Where are argyrophilic intracellular inclusions found

A

Pick bodies

45
Q

what is the most common anxiety disorder in the elderly

A

phobias

46
Q

EEG characteristics of delirium

A

generalized increase in theta or delta activity

47
Q

best med tx for TBI related aggression

A

BB (propranolol)

48
Q

least likely anxiety disorder in elderly

A

panic disorder (1%)

49
Q

two key features of PSP

A
  1. impaired walking/balance 2. slow/restricted eye mvt
50
Q

does levodopa work in LBD

A

no- can worsen psych sx

51
Q

only three recommendations for tx of dementia according to CMAJ article

A
  1. exercise. 2. tx HTN. 3. cholinesterase inh + memantine
52
Q

late onset depression is more common in which gender

A

F

53
Q

prevalence of MDD in community dwelling elderly

A

1-5%

54
Q

what imbalance can PPIs cause

A

hyponatremia

55
Q

qtc max for the elderly

A

M= 440 F= 460

56
Q

First investigation for NPH

A

MRI head

57
Q

mechanism of action of AD induced hyponatremia

A

SIADH

58
Q

next intervention if patient does not respond to atypicals for BPSD

A

SSRI (citalopram)

59
Q

Which type of dementia is HIV

A

subcortical

60
Q

best tx for neurobehavioral sx of FTD (i.e. impulsivity)

A
  1. SSRI. 2. trazodone
61
Q

imaging most consistent with LBD

A

medial temporal lobe sparing

62
Q

imaging most consistent with Alz

A

cerebral atrophy especially hippocampal and medial temporal lobes

63
Q

most common dementia

A

Alz (60-70%)

64
Q

what does the hummingbird sign on MRI indicate

A

PSP

65
Q

what’s the one similarity between mini-cog and mmse

A

delayed recall of three words

66
Q

what is the relationship bw dementia and suicide

A

none

67
Q

which dementia has apathy without depression

A

FTD

68
Q

the first complaint of someone with MS

A

memory loss

69
Q

what is the porphyria triad

A
  1. abdo pain 2. psychosis 3. neuropathy

THE EXAM (19 decks)

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