Geriatric Psychiatry

Question 1

Factors Associated with normal aging:
Brain Weight?
Ventricles and sulci?
Muscle mass? Fat?

Answer 1

Brain Weight decreases
Ventricles and sulci enlarge
Muscle Mass decreases, Fat increases

Question 2

When an elderly patient presents with memory loss and nonspecific physical complaints, what Psych condition should you work them up for?

Answer 2

Major Depression

Question 3

Presence of apparent cognitive deficits in patients with major depression

Answer 3

Pseudodementia

Question 4

Tx for pseudodementia

Answer 4

Supportive psychotherapy, low dose antidepressant meds

Question 5

Elderly patients are very sensitive to side effects of antidepressant meds but which class in particular are they most sensitive to?

Answer 5

Anticholinergics

Question 6

When is treatment appropriate for Bereavement-associated depression?

Answer 6

When a patient has 2 straight weeks of depressive sx 6-8 weeks after the precipitating loss

Question 7

Visual hallucinations early in dementia suggest a diagnosis of ? and what should you not give these pts?

Answer 7

Dementia with Lewy Bodies and do NOT give them antipsychotics

Question 8

In the setting of dementia, most hallucinations are of what type?

Answer 8

Visual

Question 9

What are the normal sleep changes in Geriatric Patients?

What happens to REM, Stage 1 ,2,3,4, sleep efficiency, amount of sleep, and sleep cycle?

Answer 9

REM latency and total REM decrease
Stages 1 and 2 increase, stages 3 and 4 (deep sleep) decrease
Sleep Efficiency decreases,amount of sleep decreases and sleep cycle advances (earlier to bed, earlier to rise)