Geriatrics

Question 1

How does FTD present?

Answer 1

Frontotemporal dementia presents with social disinhibition and often has a family history

Question 2

Why do antipsychotics worsen symptoms of Parkinson’s disease?

Answer 2

Antipsychotics primarily work by blocking dopamine receptors. Parkinson’s disease is characterized by a dopamine deficiency. Thus, using antipsychotics in Parkinson’s patients can exacerbate dopamine depletion, leading to worsening motor symptoms.

Question 3

How do we distinguish between LBD and parkinsons?

Answer 3

Lewy Body = mind before body (symptoms affecting cognition start before symptoms involving body/mobility). Parkinson is opposite

Question 4

Name a contraindication for donepezil

Answer 4

Donepezil, a cholinesterase inhibitor, is commonly used in the management of Alzheimer’s disease. However, it can increase vagal tone and cause bradycardia. In patients with sick sinus syndrome - a group of heart rhythm disorders where the sinus node doesn’t work properly - this could lead to severe symptomatic bradycardia or even sinus arrest. Therefore, donepezil should be used with caution in these patients.

Question 5

What is memantine?

Answer 5

Memantine - NMDA receptor antagonist

This prevents the over-activation of glutamine receptors.

Alzheimer’s neurotoxicity is linked to the overactivation of the glutaminergic system so using a drug that antagonises the over-activation of this system is why memantine is used.