Hill: Geriatric Psychiatry Flashcards

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1
Q

What is pseudodementia and why is it important to rule out?

A
  • Depression in geriatric pt’s can look like dementia!
  • Tx the depression and sx’s will improve!
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2
Q

What is most important in evaluation of dementia in the elderly?

A

H and P: what is the onset and character

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3
Q

Why is neuropsychological testing useful in evaluation of dementia in elderly pt?

A
  • Attempts to establish baseline (helpful early in disease)
  • Quantifies results of deficits
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4
Q

Which 2 drugs can be used to slow progression and increase patient functionality with dementia?

A
  • Donepezil (MOA: AChE inhibitor)
  • Memantine (MOA: NMDA antagonist)
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5
Q

What is a black-box warning for antipsychotic meds used for tx of psychosis with dementia?

A

Assoc. w/ an increased risk of mortality: most often due to heart-related events or infections

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6
Q

Psychosis due to delirium in elderly pt’s presents is characterized by what?

A

Thought disturbances w/ themes that tend to be from the current enviornment and situations, with poverty of thinking and irrationality, and with hallucinations (often visual)

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7
Q

What is the tx of choice for psychosis due to major depressive disorder in elderly?

A

ECT

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8
Q

What are the delusions most often like in elderly pt with psychosis due to alzheimer’s type dementia?

A
  • Often of paranoid nature:
  • Pt’s believe that items are being stolen from them
  • That they are being abandoned
  • That their spouse and children are being disloyal to them
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9
Q

What should you do in tx of substance abuse in older adults which will increase compliance?

A

INFORM YOUR PATIENTS!

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10
Q

What are the criteria for major depression in elderly?

A

Anhedonia or depressed mood for ≥2 weeks and 4 of the following:

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11
Q

Which TCA is a good choice for tx of depression in elderly pt’s; must use caution in which pt’s?

A

Nortriptyline; must use caution in cardiac pt’s

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12
Q

Which drug can be used in tx of depression in elderly and increases appetite?

A

Mirtazapine

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13
Q

Initial anti-depressant trial should be for how long when tx depression in elderly?

A

4-6 weeks

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14
Q

Treatment of substance abuse in older adults

A
  • Can’t go cold turkey w chronic alcohol abuse - possible delirium tremens and death
  • Taper meds like benzos
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15
Q

Which drugs to Rx depression and comorbid pain conditions?

A

Venlafaxine and Duloxetine

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16
Q

Which drug treats depression in elderly and promotes sleep?

A

Trazodone

17
Q

What is a contraindication in the treatment of elderly dementia and why?

A

Avoid anticholinergic meds bc they impair cognitive function

Ex: benadryl, hydroxyzine

18
Q

Best Rx for depression in the elderly

A

CBT: replace neg thoughts with positive ones

19
Q

Define Psychosis due to Delirium

A

Thought disturbance that tend to be from current environment with poverty of thinking, irrationality, and hallucinations.