Geriatric Medicine Flashcards
Donepezil
(Treatment - Mild to Moderate Dementia)
Selective Acetylcholinesterase Inhibitor.
N-Methyl D- Aspartate Receptor Antagonist
Memantine
(Treatment - Moderate AD)
Chorea
Caudate Nucleus.
(Low Mood, Poor Coordination, Chorea)
Allopurinol
Reduces Urate Production,
- Xanthine Oxidase Inhibitor
- Inhibits conversion of Hypoxanthine to Xanthine
Tardive Dyskinesia
-Movement disorder associated with the long-term use of Antipsychotics. -Cause a
wide range of involuntary, sudden movements:
lip-smacking
chewing
tongue protrusion
choreiform
hand movements
pelvic thrusting.
-Exacerbated by stress.
Beta Blocker Contraindicated in ——
Complete Heart Block.
- Exacerbates bradycardia.
Tonsillar Herniation/Coning
- Increased pressure on the midbrain.
-Increase in blood pressure and a fall in pulse rate.
-SAH or Cerebral Oedema or both.
-Hyperventilation and Mannitol reduce intracerebral pressure acutely. Poor Prognosis.
Competitive Inhibition of Creatinine secretion.
-Creatinine is a cation in the physiologic pH range and is secreted by the organic cation secretory pump, and this can be inhibited by other organic cations.
-A number of commonly used drugs can interfere with creatinine secretion leading to a self-limiting and reversible rise in serum creatinine without changing the true GFR, for
example, trimethoprim and cimetidine.
CLL (IOC for Dx)
Immunophenotyping/ Flow Cytometry.
Thiazides
-High Ca.
-Low Na, K, Cl, Mg.
-Worsens Glucose tolerance
-Increased risk of T2DM.
Flecainide
Avoided in patients with h/o IHD
Metastatic Prostatic Carcinoma
with Bony Metastasis - Standard blood film
-Leucoerythroblastic blood picture.
-Early red
blood cell precursors will be nucleated red blood cells; the early white blood cell precursors will include
promyelocytes, myelocytes and band cells.
Weber Syndrome
-Third nerve palsy and contralateral hemiparesis.
-Lesion is localised to the
Midbrain at the level of the Third nerve nucleus.
-Supplied by Paramedian branches of the Basilar
Artery or by branches of the Posterior Cerebral Artery.
Common Early features of Alzheimer’s disease
Progressive memory loss and Temporoparietal cortical
deficits such as Apraxia, Aphasia, Acalculia and Visuospatial dysfunction.
Lewy Body Dementia
Dementia, Persistent Visual Hallucinations and Spontaneous Parkinsonism.
Unique feature: Extreme reaction to Neuroleptics leading to severe deterioration of movements.
QT Prolongation
Clarithromycin, Ciprofloxacin.
Asymptomatic carrier of MRSA
Topical
Decolonisation
Stroke prophylaxis
over the long term?
Clopidogrel
Carotid Endarterectomy
Carotid Stenosis > 50% + Symptomatic.
If <50% then no benefit.
UTI + Treatment failure + Long term catheter
Biofilm Formation.
Vascular Dementia
Stepwise deterioration of cognition.
Cortical Blindness
-Anton Syndrome
-Bilateral Occipital Lobe
Infarcts.
-Site: Posterior Cerebral Arteries, formed from the Basilar Artery
Parietal and Temporal lobe infarcts
Middle Cerebral Artery Stroke, leading to Quadrantanopic visual field loss.
Nitrate Tolerance
Chronic Nitrate Therapy may increase vascular oxidative stress, which results in enhanced degradation of nitric oxide (NO) and reduced bioavailability. Resulting reactive oxygen and reactive nitrate species then lead to inhibition of the bioactivation of exogenously administered
nitrate.
