Geriatric Medicine

Question 1

Parkinson’s Disease

1. Classic triad
2. Other key features
3. Drugs to avoid

Answer 1

Parkinson’s Disease

1. Bradykinesia, rigidity, tremor
2. Dementia, psychosis, depression, REM sleep disturbance
3. Antipsychotics (risk of acute bradykinesia)

Question 2

Dementia Type
Tremor, bradykinesia, rigidity early
Dementia later

Answer 2

Parkinson’s

Question 3

Dementia Type

Early cognitive impairment, loss of executive function. Fluctuating cognition, visual hallucinations and Parkinsonism

Answer 3

Lewy Body Dementia

Question 4

Dementia Type

Step-wise deterioration

Answer 4

Vascular Dementia

Question 5

Dementia Type

Early memory loss, speech and orientation disturbance later

Answer 5

Alzheimer’s Disease

Question 6

Dementia Type

Primarily behavioural disturbance

Answer 6

Frontal Lobe Dementia

Question 7

Treatment of Alzheimer’s Disease

1. Non-pharmacological
2. Pharmacological: 1st-line
3. Pharmacological: 2nd-line
4. When is 2nd-line indicated?

Answer 7

1. Activities, cognition stimulation therapy
2. ACh Inhibitors e.g. Donepezil, Galantamine, Rivastigmine
3. NMDA Antagonist, e.g. Memantine
4. Intolerant of ACh inhibitor, severe Alzheimer’s

Question 8

Alzheimer’s Medication

Contra-indication of Donepezil

Answer 8

Bradycardia