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Psychiatry pro +1700 > Geriatrics > Flashcards

Geriatrics Flashcards

1
Q

What is the “oldest old” segment of the population?

A

85+

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2
Q

What happens to cerebral blood flow with aging?

A

Decreases

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3
Q

What happens to the transport across the BBB with aging?

A

Increases

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4
Q

What is the major concern with increased fat with aging in terms of drug prescriptions?

A

More lipophilic drugs stay around longer–lower doses needed

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5
Q

IQ is stable until what age?

A

80

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6
Q

True or false: the verbal abilities of the elderly generally decline with age

A

False

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7
Q

True or false: simple recall declines with older age

A

True

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8
Q

True or false: Recognition is generally intact in the elderly

A

True

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9
Q

Does personality change much with age?

A

Thinking is no

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10
Q

What is the role of social activity in the elderly?

A

Socially active seniors are generally healthier, both physically and emotionally

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11
Q

What is the major issue with retirement in some older folk?

A

Loss of identity and self esteem

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12
Q

True or false: most people who retire voluntarily will not re-enter the workforce

A

False–will reenter the workforce in 2 years

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13
Q

What happens to sexuality with geriatrics?

A
  • Frequency of orgasms declines

- social/culture factors prevent them to realize their full sexual potential

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14
Q

The level of sexual activity in the elderly depends largely on what?

A

The presence of and health of the spouse

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15
Q

Who are the usual caregivers with the elderly?

A

Wives, daughters, and daughters-in-law

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16
Q

Do caregivers to the elderly usually have jobs outside the home?

A

Yes–more than 50%

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17
Q

What are the levels of care for the elderly?

A
  • Home care services
  • Assisted living
  • Nursing homes
  • Memory care units
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18
Q

True or false: there is a good correlation between physical health, and mental health in older patients

A

True

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19
Q

What is the major challenge with family dynamics in the elderly?

A

Maintaining appropriate boundaries, and ensuring that information is released appropriately

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20
Q

How hard is it to get durable power of attorney for healthcare?

A

Tough-ish (legal document must be signed)

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21
Q

What is the difference between a guardianship vs a conservatorship?

A

Conservatorship = Court ordered person to look over a specific aspect of a pt’s life (financial)

Guardianship = Personal and property interests of a person is given to another

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22
Q

True or false: a civil commitment can be filed by anyone

A

True–but need two

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23
Q

True or false: mental decline falls under the jurisdiction of civil commitment

A

True

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24
Q

Which is judge determined: competency vs capacity

A

Competency

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25
Q

Does self-abuse (e.g. no eating/drink etc) fall under the category of dependent adult abuse?

A

Yes

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26
Q

True or false: if it’s not your patient, then you do not have a legal requirement to report abuse

A

True

27
Q

What is the major issue with interviewing the a patient with their caretaker?

A

May not see abuse, or interfere with examination

28
Q

True or false: if you are determining capacity, you should not tell the patient that you are assessing them for it

A

False–should inform them

29
Q

What are the two major things that should be done with elderly patients on a regular basis?

A
  • Updated medication list

- Cognitive screening

30
Q

Personality changes in the elderly should be suspicious for what?

A

Neurocognitive disorder or dementia

31
Q

New onset psychosis in the elderly should be suspicious for what?

A

Dementia or neurocognitive disorder

32
Q

When is dividing doses appropriate in the elderly?

A

If they are in a nursing home, or have help with their medications

33
Q

What is the general rule of thumb for prescribing medication in the elderly?

A

Start low, go slow, sometimes say no

34
Q

True or false: prevalence of depressive disorders in the geriatric population is actually lower than younger people if they are in good health

A

True

35
Q

True or false: suicide rates are higher in elderly

A

True

36
Q

What is the common theme with depressive disorders in the elderly

A

Loss

37
Q

True or false: elderly patients may have quasi-psychotic experiences where they sense the presence of the deceased

A

True

38
Q

What type of drugs should be avoided with bereavement in the elderly?

A

Sedative hypnotics

39
Q

When do the psych symptoms of bereavement subside, usually?

A

Within a year

40
Q

What is the most common presentation of late life major depression?

A

Somatic complaints

41
Q

True or false; relapse rates of MDD in the elderly are generally low

A

False– high

42
Q

What happens to cognition with MDD later in life?

A

Blunted–pseudodementia

43
Q

Venlafaxine side effect = ?

A

HTN

44
Q

What is the major side effect of citalopram?

A

QT prolongation

45
Q

What is the major side effect of paroxetine?

A

anticholinergic effects

46
Q

What is the major side effect of duloxetine?

A

Bleeding risk

47
Q

What is the major side effect of mirtazapine?

A

Promotes sleep, increases appetite

48
Q

What is the major side effect of doxepin?

A

QT prolongation, sleep

49
Q

What is the major issues with Li in the elderly?

A

New neurological symptoms

50
Q

Should you discontinue treatment of Li in the elderly if they are responding well w/o side effects?

A

No

51
Q

How common are late life schizophrenia?

A

Very Rare

52
Q

What happens to late life schizophrenia, in terms of residual s/sx?

A

30% will enter a residual phase where negative symptoms are more prominent and positive symptoms fade

53
Q

What is the usual onset of late life delusional disorders?

A

40-55

54
Q

What should always be suspected with late life delusional disorder?

A

Neurocognitive disorders

55
Q

What is the most common type of anxiety disorder late in life? How do the s/sx of this compare to the same disorder earlier in life?

A

Phobias–less severe

56
Q

What specific treatment for late anxiety disorders might you not be able to use if the patient is cognitively impaired?

A

Psychotherapy–will not remember

57
Q

What are the major side effects of benzos in the elderly?

A
  • Impair gait

- Paradoxical excitation

58
Q

How does the pharmacological treatment for anxiety disorders in the elderly compare to the younger population?

A

Same meds, but more avoidance of benzos

59
Q

What are the issues with later life substance abuse? (2)

A
  • related injuries can be devastating

- new onset neurocognitive disorders

60
Q

What are the common approaches to late life sleep disorder?

A

Sleep hygiene:

  • Avoid EtOH and caffeine
  • Avoid hypnotics
  • CPAP PRN
61
Q

What is the major side effect of clozapine?

A

Agranulocytosis

62
Q

What is the antidepressant of choice for anorexic patients, or those with insomnia? Why?

A

Mirtazapine–promotes sleep and increases appetite

63
Q

How common are late life somatic symptoms disorders (e.g. hypochondriasis etc)?

A

Common

Psychiatry pro +1700 (28 decks)

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