Geriatrics

Question 1

What are some factors in a presentation that would favour delirium over dementia?

Answer 1

Impairment of consciousness
Fluctuation of symptoms
Abnormal perception (e.g illusions and hallucinations)
Agitation/fear
Delusions

Question 2

What type of drug is memantine?

Answer 2

NMDA antagonist

Question 3

What is a screening tool used to assess a patient’s risk of developing pressure sores?

Answer 3

Waterlow score

Question 4

If a patient with delirium is becoming aggressive and non-pharmacological methods have not calmed them down, what is the first line medication you would give? When would not give that, what would you give instead?

Answer 4

Haloperidol
Don’t give with Parkinson’s/Lewy body dementia as makes these conditions significantly worse
Give lorazepam instead

Question 5

What are some features which favour delirium over dementia?

Answer 5

Impairment of consciousness, fluctuation of symptoms, hallucinations, agitation/fear, delusions

Question 6

What is some conservative advice we give to patients with orthostatic hypotension?

Answer 6

Maintain hydration, don’t strain, limit alcohol, compression stockings