Old Age

Question 1

antipsychotic least likely to worsen parkinsons

Answer 1

clozapine
quetiapine

Question 2

post op delirium prophylaxis

Answer 2

haloperidol

Question 3

Memantine

Answer 3

NMDA receptor antagonist
blocks the effects of pathologically elevated levels of glutamate that may lead to neuronal dysfunction

Question 4

NICE recommendations dementia treatment

Answer 4

• acetylcholinesterase inhibitors recommended as options for mild-moderate AD or DLB (NOT for FTD or MS related cognitive impairment)
• memantine option for moderate AD (can be added to AChE-I)
• donepezil or rivastigmine for mild/mod/sev DLB - if not tolerated consider galantamine
• consider memantine for DLB if AChE-I not tolerated or contraindicated

Question 5

% of people with visual impairment that have charles bonnet syndrome

Answer 5

20%

Question 6

PSP symptoms

Answer 6

• supranuclear, primarily vertical gaze palsy
• extrapyramidal symptoms
• cognitive dysfunction
• dystonia

typically after 6th decade

Question 7

PSP on MRI

Answer 7

hummingbird sign - midbrain atrophy

Question 8

cortical dementias (4)

Answer 8

alzheimers
picks disease
CJD
Primary progressive aphasia

Question 9

subcortical dementias (6)

Answer 9

Binswanger’s disease
Huntington’s dementia
AIDS dementia
Parkinsons dementia
Wilson’s disease dementia
PSP dementia

Question 10

early symptoms of suncortical dementias (5)

Answer 10

• slowness of thought processes
• difficulty starting or stopping activities
• changes in personality and mood
• motor symptoms (tremor, rigidity, bradykinesia)
• memory retrieval problems, but recognition remains in tact

Question 11

early symptoms in cortical dementias

Answer 11

• aphasia
• agnosia
  apraxia
• memory impairment, especially recent memory

Question 12

estimated UK prevalence of dementia

Answer 12

1.3%