geriatrics

Question 1

which tool identifies medications where the risk outweighs the benefits ?

Answer 1

STOPP tool

Question 2

which tool alerts doctors to the right treatment to commence in patients with multiple comorbidities

Answer 2

START

Question 3

4 features of frontotemporal dementia

Answer 3

onset < 65
insidious onset
preserved memory and visuospatial skills
personality change and social conduct problems

Question 4

what are the macroscopic changes seen in Picks disease

Answer 4

Atrophy of frontal and temporal lobes

Question 5

what are the microscopic changes seen in Picks disease

Answer 5

Pick bodies
gliosis
neurofibrillary tangles
senile plaques

Question 6

what is semantic dementia ?

Answer 6

Fluent progressive aphasia. Fluent speech which is empty and conveys little meaning

Question 7

what are the precipitating factors of Delirium ?

Answer 7

PINCH ME
Pain
Infection
Nutrition
Constipation
Hydration
Medication
Environment

Question 8

how do you treatment Delirium ( step by step)

Answer 8

Treat underlying cause
Modify environment
Haloperidol 0.5 mg

Question 9

which medications should be avoided in Lewy body dementia and why

Answer 9

Anti-psychotics ( Haloperidol) as they may lead to irreversible parkinsonism, rigidity , immobility , falls etc

Question 10

what is the first line investigation for dementia and what does it include ?

Answer 10

FBC, U+E, LFTs, Calcium, glucose, ESR/CRP, TFTs, vitamin B12, Folate

Question 11

which factors favour delirium over dementia

Answer 11

acute onset
impairment of consciousness
fluctuation of symptoms ( worse at night, periods of normality)
abnormal perception ( illusions + hallucinations)
agitation and fear
delusions

Question 12

which questionnaire can be used to assess fraility

Answer 12

PRISMA-7

Question 13

what is the GPCOG tool used for

Answer 13

screening tool for dementia in GP

Question 14

what is the pathalogical feature seen in lewy body dementia

Answer 14

Alpha-synuclein cytoplasmic inclusions in the substantia nigra, paralimbic and neocortical areas

Question 15

what medications can be used in the management of Lewy body dementia

Answer 15

Acetylcholinesterase inhibitors ( Donepezil, Rivastigmine) and Memantine ( NDMA receptor antagonist)

Question 16

what can trigger digoxin toxicity

Answer 16

renal failure and hypokalaemia

Question 17

what are the features of digoxin toxicity

Answer 17

GI disturbance- nausea, vomiting, Abdo pain
dizziness
confusion
blurry / yellow vision
Arrythmias

Question 18

what pathalogical feature is seen on CT in alzheimers disease

Answer 18

widespread cerebral atrophy mainly involving the cortex and hippocampus

Question 19

characteristic feature of Vascular dementia

Answer 19

stepwise deterioration of cognitive function

Question 20

which type of dementia most commonly presents with fluctuating cognition

Answer 20

Lewy Body dementia

Question 21

name 4 factors that contribute to the development of pressure ulcers

Answer 21

Malnourishment
incontinence
lack of mobility
pain

Question 22

which score is used to screen for patients at risk of developing pressure areas

Answer 22

Waterlow score

Question 23

name 3 things that are recquired in the management of a non infected pressure ulcer

Answer 23

wound dressing
appropriate analgesia
nutritional assessment

Question 24

what are the indications for antibiotic use in the management of pressure ulcers ?

Answer 24

Clinical evidence of systemic sepsis
spreading cellulitis
underlying osteomyelitis

Question 25

in which cases is Memantine used in the management of Alzheimer’s disease

Answer 25

moderate Alzheimers who are intolerant to ACHE inhibitors
severe alzheimers disease

Question 26

which type of dementia is characterised by visual hallucinations

Answer 26

Lewy body dementia

Question 27

whats the difference between Parkinsons disease dementia and dementia w lewy bodies

Answer 27

PDD : motor symptoms come first
LBD : dementia comes first + overlapping symptoms

Question 28

which parkinsons medications are most associated with inhibition disorders

Answer 28

dopamine receptor agonists such as ropinirole