Geriatrics Flashcards
How does FTD present?
Frontotemporal dementia presents with social disinhibition and often has a family history
Why do antipsychotics worsen symptoms of Parkinson’s disease?
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.
How do we distinguish between LBD and parkinsons?
Lewy Body = mind before body (symptoms affecting cognition start before symptoms involving body/mobility). Parkinson is opposite
Name a contraindication for donepezil
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.
What is memantine?
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.
How does Lewy Body Dementia present?
Lewy body dementia typically presents with fluctuating cognition in contrast to other forms of dementia
How does frontotemporal dementia present?
Frontotemporal dementia typically presents under the age of 65 with the main features of personality change and social conduct problems. Memory and visuospatial skills are relatively preserved.
When do we place a pt on a DOLS?
A patient must be placed on a DOLS if they are to be treated in hospital and they do not have capacity to consent for this. Often not done if agreeable to tx in practice as it takes a long time to put in place.
By law, how do we certify somebody blind/
In the UK, legal blindness is characterised as vision which is worse than 20/200. Only consultant ophthalmologists have the legal right to certify a patient as legally blind. They do this by filling out a Certificate of Vision Impairment (CVI). Macula degeneration does indeed predominantly affect the central visual field however is the leading cause of blindness in the UK.
