Old Age Psych

Question 1

Late onset schizophrenia

Answer 1

Delusional thinking (persecutory or grandiose)
Inappropriate affect
Catatonic features
Hallucinations
Less negative symptoms than normal schizophrenia

Question 2

Other geriatric psych conditions

Answer 2

Psychotic depression.
Persistent Delusional disorder
Psychotic depression
Dementia

Question 3

Common cases of delirium

Answer 3

METABOLIC = hypoxia, hyponatraemia, hypoglycaemia, anaemia, B12 deficiency, folate deficiency, dehydration. INTRACRANIAL = meningitis, hepatic encephalopathy, space occupying lesion, head trauma, epilepsy (post-ictal), subarachnoid haemorrhage, subdural haematoma, encephalitis.
DRUGS = L-dopa, benzodiazepines, opiates, steroids, tricyclic antiDx, opiates. Alcohol withdrawal/delirium tremens.
Sleep deprivation
Heart failure
Post-operative.
Relocation in an elderly person

Question 4

Clinical features of delirium

Answer 4

COGNITIVE = poor memory, poor concentration, aphasia, disorientation.
Acute onset of confusion.
Inattention and distractible.
Disorganised thinking, rambling, unclear flow of ideas. Unable to hold conversation.
Altered perceptions e.g. delusions and hallucinations Altered level of consciousness.
Loss of appetite
Mood change e.g. agitation, apathy, anxiety.

Question 5

Difference between delirium and dementia

Answer 5

Delirium = acute onset, fluctuating course, altered level on consciousness, disrupted sleep-wake cycle, incoherent speech. 
Dementia = gradual onset, normal sleep-wake cycle, normal consciousness, difficulty finding words, progressive deterioration.