Geriatrics

Question 1

Alzheimer’s disease Tx (2)

Answer 1

Acetylcholinesterase Inhibitors (AChEIs)

Memantine

Question 2

Mild to Moderate Alzheimer’s (MMSE 10–26)

Tx

Answer 2

AChE inhibitors

(Donepezil, Rivastigmine, Galantamine)

Question 3

Moderate-Severe Alzheimer’s (MMSE <10) OR when AChE inhibitors are not tolerated

Tx

Answer 3

Memantine

Question 4

patient on Donepezil is worsening but tolerating the medication

Tx

Answer 4

Add Memantine

Question 5

Mnemonic for Alzheimer’s Drug Treatment

Answer 5

💡 “Don’t Ruin Grandad’s Memory” (DRGM)

Donepezil → Mild

Rivastigmine / Galantamine → Moderate

Memantine → Severe

Question 6

Causes of Delirium

Mnemonic: I WATCH DEATH

Answer 6

Infection (UTI, pneumonia)

Withdrawal (alcohol, benzodiazepines)

Acute metabolic (electrolytes, glucose)

Toxins (medications, drugs)

CNS pathology (stroke, tumour)

Hypoxia (COPD, heart failure)

Deficiencies (B12, folate, thiamine)

Endocrine (thyroid, cortisol)

Acute vascular (MI, PE)

Trauma (head injury)

Heavy metals

Question 7

Delirium different to Dementia in 2 key aspects

Answer 7

Delirium is:

Acute

Hallucinations

Question 8

Delirium 1st Line Tx

Answer 8

Low-dose Haloperidol

(Avoid in Parkinson’s/Lewy Body Dementia → Use Lorazepam instead).