Geriatrics 1 Flashcards
What is Phase I and II reaction?
Phase I : CROH - Conjugation/reduction/oxidation/hydrolysis
Phase II - form lipophilic content and be excreted
Which benzodiazepines affected by ageing?
Diazepam
urethral closure at bladder neck mediated by what ?
A1 receptor
APOE4 role in Alzheimers?
Late onset Alzheimers
PSEN1 role in alzheimers?
Early autosomal dominant Alzheimers
PSEN1 role?
Regulatory role in production of amyloid precursor protein - b- amyloid and APP
Vascular dementia - bradykinesia more in where?
Lower limbs
Vascular dementia hallmark clinical features?
Executive function impairment + stepwise fashion decline
Key difference between Dementia and mild cognition impairment?
Functional status
Geriatric assessment best in what group of elderly people?
Elderly + disability with functional limitations
Dementia of lewy body MRI finding?
Diffuse cerebral atrophy with medial temporal lobe sparing
What toxin poisoning mimics Parkinson?
Manganese/ Cyanide/ CO
CAM (confusion assessment method) tool for diagnosing delirium?
High sensitivity and specificity
Most common cause of bladder overactivity?
Idiopathic
Neurogenic is 2nd most common!
Commonest cause of neurogenic bladder?
Stroke!
Difference btw Dementia and mild neurocognitive disorder ( previously mild cognitive impairment)
Dementia -Decline in 2 or more clinical domain \+ Affects personal activities No delirium Not entirely due to normal aging
Mild neurocognitive disorder
-Decline in 1 or more clinical domain
-Not affecting personal activities
Not entirely due to normal aging
What neurotransmitter is for learning and memory?
Glutamate
Fronto-temporal dementia has 2 variants
- Speech
- Behavioural
Name me 2 variants of speech FTD?
- PNFA - progressive non-fluent aphasia
- can’t form sentence properly - Sematic
- Normal fluency, grammar - impaired single-word comprehension
What is LATE in geriatrics?
Limbic-predominant Age-Related TDP-43 Encephalopathy
(LATE)
-deposition of TDP-43
Causing b-amyloid + alpha synuclein deposition
Agitation in Dementia ( not DLB) - long term meds?
SSRI = Citalopram!
LATE presentation?
Like Alzheimer’s - amnesia/memory but rapid decline linearly
What drugs in elderly commonly cause the following;
1.Sedation + Postural hypotension
- Sedation + postural hypotension = TCA
- Urinary retention + confusion = Anti-cholinergic
- Urinary retention + postural hypotension = Prazosin
What neurotransmitter is high in CSF and maintains delirium?
Cortisol
In elderly with falls - which muscle is activated first causing the falls?
Proximal before distal muscles
Timed up and go test is significant for falls if?
Takes > 13 seconds
Single lens glasses paradox for falls?
Reduce falls outdoors
Increase falls indoors
Those with severe osteoarthritis
use walking aid with?
Advance leg with?
Walking aid with GOOD HAND
Advance leg with BAD HIP/LEG
Psychotropic drugs withdrawal causes?
Reduce RATE of falls but not RISK
Hepatic blood flow in elderly?
Reduced so reduced 1st pass metabolism
- reduced p450 enzymes
- prodrug affected
Top 2 medications causing orthostatic hypotension in elderly?
Alpha blockers - prazosin, tamsulosin
Nitrates
Nuclei for micturition?
Onuf nuclei
Tau protein function
when tau protein causes issue?
Stabilise microtubules within neurons
Phosphorylation - accumulates the tau protein to form neurofibrillary tangles
Spinal cord lesion causes what bladder issue?
Somatic control lost - incontinence
Bladder reflex intact
