Geriatrics

Question 1

A 70 year old man is brought by his wife with forgetfulness. He is also noted to have a hcange in personality and socially inappropriate behaviour. What is the likely cause?

Answer 1

Frontal dementia

Question 2

A 70 year old man is brought by his wife with forgetfulness. He has been noted to be seeing things and talking to an empty space. He was also noted to have tremors and slow movement. He had fluctuation of the mental state on examination. What is the likely cause?

Answer 2

Lewy Body dementia

Question 3

A 70 year old man is brought by his wife with forgetfulness which began suddenly. He has had some facial weakness to the right. He has some microvascular changes on the CT head. What is the likely cause?

Answer 3

Vascular dementia

Question 4

All of the folowing are risk factors for dementia except

a) Family history
b) Late-onset depression
c) Hypothyroidism
d) Downs Syndrome
e) Diabetes mellitus
f) History of head injury
g) HIV/AIDS
h) Generalised atherosclerosis
i) Parkinsons disease

Answer 4

Answer e) Diabetes Mellitus

Question 5

All of the following are differential diagnosis of dementia in a 75 year old except

a) Drug abuse
b) Medical conditions such as anaemia, thyroid disorders, endocrine disorders
c) Normal cognitive impairment of ageing
d) Delirium
e) Major depression
f) Rheumatoid arthritis
g) Amnestic disorder

Answer 5

Answer f) Rheumatoid arthritis

Question 6

How do you best describe the benefit of cholinesterase inhibitors (donezepil, galantamine, rivastigmine) and aspartate antagonist (memantamine)?

a) Only modest improvement overall
b) Less improvememnt with higher doses
c) Higher doses not well tolerated
d) Long term efficacy is known and good
e) Clinical effectiveness in severe disease s well demonstrated

Answer 6

a) Only modest improvement overall