Old Age Psychiatry Flashcards
What are the potential causes of memory problems or confusion?
- Trauma disassociation
- Depression
- Problems with senses
- Hippocampus problems
- Unclear information coming in
What is cognitive impairment?
What are the potential causes of confusion?
How to check for attention?
- Ask someone to do something backwards (numbers, months, word)
How to know if someone has language problems?
- Long pauses (latency) and word finding problems (hard to express themselves)
How to ask about Visio-spacial problems?
- Do you bump into things?
- Apraxias with individual tasks e.g. buttons, cutlery, reaching for things
Executive function problems check?
- Getting cold to talk to
- Problems with cooking, shopping, finances (forgetting pin, money)
What is the history taking in cognitive impairment?
What is the examination of cognitive impairment?
What are the investigations in cognitive impairment?
FBC - infection
TFT - hypothyroid
Calcium phosphate - function of the brain
CRP, ESR - inflammation
ECG - heart attack
Neuro imagine - any classic pattern of atrophy (with syndromes)
Copper and ceruloplasmin - for Wilson’s disease
What is delirium?
What is the confusion assessment method (CAM)?
What is a risk factor for delirium?
- Change in environment
- Age
- Fluid and electrolyte imbalances
- Constipation
- Pain
- Previous history of delirium
- Infection
- Medications (e.g. benzodiazepines as sedates them, tricyclic antidepressant - anti-cholinergic (as less acetylcholine neurotransmitter in the brain) medications)
What are the risk factors of delirium?
What are the common causes of delirium?
How to manage delirium patients?
What is dementia?
What is the aetiology behind dementia?
Name some differential diagnosis’ of dementia
Table fill in
Alzheimers history (tau and beta-amyloid involved) - gradual onset (history), forgetting simple things - gas, kettle, toaster, prosopagnosia (difficulty remembering faces), doing the same thing over and over again (repetition & hoarding), mood disturbances, word finding difficulties, aimless wondering (signs and symptoms)
Vascular dementia - history - post-stroke, stepwise memory loss,
Signs and symptoms - dependant on where the structural damage is
Lewy body dementia - history - stepwise memory loss
Signs and symptoms - visual hallucinations, REM sleep disorders, Parkinsonism (as Basal ganglia degeneration) often show cogwheel rigidity, postural hypotension, fluctuating attention, anosmia (poor smell)
Frontotemporal dementia
History - Change in personality
Signs and symptoms - angry, disinhibition
What are the potential risks in patients with cognitive impairment and dementia?
How to manage dementia management?
What medications do you use for Alzheimer’s?
- Memantine (NMDA - receptor antagonist works on glutamate)
- Rivastigmine
- Donepazil
- ONE MORE
How to treat vascular dementia?
- Decrease risk factors of strokes
How to treat Lewy Body dementia? (medication)
- Cholinesterase inhibitors
What medication to use in delirium?
- Anti-psychotics
What are some neuropsychiatric symptoms?
Why might psychotic presentations in older adults be different?
Explain psychotic disorder in older adults
Explain very late-onset schizophrenia-like psychosis
Partition delusions - delusions about the possibility of people walking through walls and coming into their house
What are the risk factors of depression in older adults?
Depressive symptoms
Explain bipolar affective disorder in older adults
Explain anxiety disorder in older adults
