Geriatric Psychiatry

Question 1

Factors associated with normal aging

Answer 1

Decreased brain weight with enlarged ventricles and sulci

Decreased muscle mass, increased fat

Impaired vision and hearing

Minor forgetfullness

Question 2

Pseudodementia

Answer 2

Memory loss and decreased cognitive functioning due to major depressive symptoms

Question 3

Tx of Pseudodementia

Answer 3

SSRI
Psychotherapy
TCA (If using these use nortryptiline, less anti-cholinergic effect)
Mitrazipine can be used to increase appetite and
Methylphenidate can be used for patients with psychomotor retardation

Question 4

What are the 5 stages of Grief

Answer 4

Denial
Anger
Bargaining
Depression
Acceptance

Question 5

Normal Grief

Answer 5

Go through many of the same sx as depression. Usually lasts up to 6 months then subsides. Afterwards, patients ability to function appropriately in their life is preserved

Question 6

Complicated or prolonged grief

Answer 6

Lasts more than 6 months and contains 4 of the following:

Difficulty moving on
Numbness/Detachment
Bitterness
Feeling that life is empty without deceased
Trouble accepting loss
Agitation
Difficulty trusting others.

Question 7

Bereavement associated depression

Answer 7

Major Depression that began with death or loss in patients life. Basically the same otherwise . Treat if 2 straight weeks of depression 6-8 weeks after the loss.

Question 8

Sleep patterns of the elderly

Answer 8

Decreased REM latency and total REM

Increased amounts of Stage 1 and 2 sleep, Decreased amounts of stage 3-4 sleep

Decreased sleep efficiency

Decreased total sleep