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10. nmsp exam 1 > Geriatric Psych (Hill) > Flashcards

Geriatric Psych (Hill) Flashcards

1
Q

DSM 5 name for dementia

A

Major neurocognitive disorder

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2
Q

Medications to slow progression of dementia and increase patient functionality

A

1) Donepezil (AChEsterase inhibitor)

2) Memantine (NMDA antagonist)

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3
Q

Medications to slow progression of dementia and increase patient functionality (2)

A

1) Donepezil (AChEsterase inhibitor)

2) Memantine (NMDA antagonist)

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4
Q

What medications should be avoided in the demented elderly?

A

those that can impair cognitive function:

  • Benadryl
  • hydroxyzine
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5
Q

Black box warning associated with treatment of psychosis in the elderly

A

antipsychotic medications are associated with increased mortality (Olanzapine, Aripiprazole, Risperidone, quetiapine). Increased risk of heart-related events and infection

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6
Q

workup for acute psychosis (5)

A
  • CBC
  • CMP
  • imaging: CT/MRI
  • B12/folate
  • mini mental status exam
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7
Q

DDx acute psychosis (6)

A
  • stroke
  • tumor
  • delirium
  • depression
  • endocrine: hypthyroidism, diabetes
  • dementia
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8
Q

third most common cause of psychosis in elderly outpatients

A

psychosis d/t delirium

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9
Q

describe delirium

A

thought disturbances with themes that tend to be from current environment and situations, with poverty of thinking and irrationality, and with hallucinations (often visual)

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10
Q

Causes of delirium

A

often 2/2 illness:

  • infection
  • drug reaction
  • hypoxemia
  • constipation, etc…
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11
Q

Causes of delirium

A

often 2/2 illness:

  • infection
  • drug reaction
  • stroke
  • hypoxemia
  • constipation, etc…
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12
Q

second most common cause of psychosis in elderly outpatients

A

psychosis d/t Major depressive disorder with psychotic features (somatic troubles, persecution, guilt, poor self-esteem)

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13
Q

most common diagnosis accounting for psychosis in elderly outpatients

A

psychosis d/t Alzheimer’s-type dementia (often paranoid delusions)

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14
Q

Why do physicians miss substance abuse in elderly? (3)

A
  • unaware of high prevalence rate
  • unaware of the increased impact some substances have on elderly
  • uncomfortable screening elderly patients
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15
Q

What medications should be avoided in the demented elderly?

A

those that can impair cognitive function:

  • Benadryl (diphenhydramine)
  • hydroxyzine
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16
Q

Consequences of substance of abuse in elderly (6)

A
  • cognition impairment
  • depression/mood impairment
  • sleep alteration
  • balance and vestibular problems
  • delirium
  • increased risk other medical problems
17
Q

Risks of going “cold turkey” with chronic alcohol abuse

A

possible delirium tremens and death

18
Q

Medication example for treatment of acute EtOH withdrawal

A

benzodiazepienes

19
Q

Risks of going “cold turkey” with chronic alcohol abuse

A

possible delirium tremens and death

20
Q

How to increase substance abuse treatment compliance in elderly adults

A

inform your patients

21
Q

primary causes of depression in the elderly (4)

A
  • deteriorating health
  • cognitive decline
  • loss of independence
  • loss of spouse and friends
22
Q

clinical tool used to diagnose depression in the elderly

A

geriatric depression scale

23
Q

What score on the geriatric depression scale is suggestive of depression

A

score > 5

24
Q

what score on the geriatric depression scale is almost always indicative of depression

A

score >10

25
Q

What does a score >5 on the geriatric depression scale warrant?

A

a follow up comprehensive assessment

26
Q

How do you differentiate between dementia and depression in the elderly population

A

mental status exam: look for INSIGHT

  • depressed patients WILL have insight
  • dementia patients have little/no insight
27
Q

Differential diagnosis with recent and abrupt onset depression in elderly with absence of social factors

A
  • dementia
  • normal bereavement
  • adjustment disorder w/ depressed mood
28
Q

First line treatment for major depressive disorder

A

1) CBT

2) SSRI

10. nmsp exam 1 (20 decks)

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