Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MRCPsych - CASC > Old Age Psychiatry > Flashcards

Old Age Psychiatry Flashcards

1
Q

Psychosis in Old-Age (history)

A
  • Clarify HPC (onset, duration)
  • Explore auditory hallucinations (quality, content, number, 2nd/3rd person, commentary, commands, insight)
  • Hallucinations in other modalities
  • Delusional beliefs
  • Thought interference and passivity phenomena
  • Mood (mood, sleep, appetite, enjoyment)
  • Memory
  • Alcohol and drugs
  • Risk
  • Physical health (inc vision/hearing) and medications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Psychosis in Old-Age (explanation)

A
  • Clarify diagnosis
  • Explain causes (family history, personality traits, hearing impairment)
  • Explain treatment (inpatient/outpatient, MHA)
  • Explain medication (mechanism, side-effects, duration 6m)
  • Alternative treatments (CBT)
  • Long-term management (CPN, OT/PT, discharge location)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Stress/distress symptoms in dementia (history)

A
  • Clarify HPC (duration, triggers, aggression)
  • Psychiatric symptoms (diagnosis, follow-up, medications, mood, psychotic Sx)
  • Physical symptoms (medical history, temperature, falls, pain, elimination)
  • Environmental changes (space, people, activities)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Stress/distress symptoms in dementia (explanation)

A
  • Clarify concerns
  • Explain treatment rationale (symptoms, risk, failed management)
  • Explain side-effects (inc stroke risk, risk/benefit, low dose, duration)
  • Alternative treatments (orientation, reminiscent therapy, art therapy, pet therapy, doll therapy, activities, family involvement)
  • Questions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Risk factors for paraphrenia

A 
Female
Hearing/visual impairment 
Single, no children
CVAs
Social isolation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Side-effects of acetylcholinesterase inhibitors

A

GI upset, incontinence, loss of appetite, dizziness, drowsiness, bradycardia
CI in asthma/COPD (except rivastigmine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Side-effects of memantine

A

Constipation, headache, dizziness, drowsiness, high blood pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Alzheimer’s genetics

A

Parents - 3-4x higher risk

Familial dementia - more likely early onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Risk factors for Alzheimer’s disease

A 
History of diabetes
Repeated head injury
History of depression
Vascular risk factors (HTN, stroke, cholesterol)
Increasing age
Family history of dementia
Low educational attainment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Dementia (history)

A
  • Clarify HPC (onset, duration)
  • Explore memory difficulties (short-term, long-term)
  • Orientation (day/dates, confused, recognizing people)
  • Communication (word-finding, understanding, identify objects)
  • Functioning (dressing, washing, toileting, walking, money, shopping, food, transportation)
  • PMHx and risk factors (head injury, low mood)
  • Risk (wandering, getting lost, fire, flooding, exploitation, abuse, aggression, self-injury).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Dementia (medication)

A
  • Clarify understanding
  • Donepezil, rivastigmine, galantamine
  • Purpose and mechanism (increase ACh, slow down progression, improve QoL)
  • Duration and efficacy (40-50% respond, memory monitoring, 6m reviews)
  • Side-effects/CIs (dizziness, drowsiness, low of appetite, bradycardia, GI upset, incontinence)
  • Address other concerns and offer leaflets
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Vascular dementia (explanation)

A
  • Clarify diagnosis and aetiology
  • Progression and prognosis (mean survival 3 years)
  • Explain medication (AChIs not indicated, control RFs, treat depression etc)
  • Alternative treatment (lifestyle modification)
  • Address other concerns and offer leaflets
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Lewy Body Dementia (explanation)

A
  • Clarify diagnosis and aetiology (LBs affect chemicals)
  • Common symptoms (falls, fluctuating cognition and hallucinations)
  • Difference between LBD/PDD (1 year between Sx for PDD)
  • Explain medication options (avoid antipsychotics, rivastigmine, PD meds - neurology)
  • Alternative treatment (PT/OT)
  • Address other concerns and offer leaflets
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Lewy Body Dementia (behaviour management)

A
  • Clarify HPC (onset, duration)
  • Clarify possible causes (medication change, illness)
  • Explain medication options (increase current meds, add antipsychotic)
  • Alternative treatment (re-orientation, MDT involvement, light therapy/sleep hygiene)
  • Address other concerns
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Fronto-temporal dementia (history)

A
  • Clarify HPC (onset, duration)
  • Explore memory difficulties (short-term, long-term)
  • Orientation (day/dates, confused, recognizing people)
  • Communication (word-finding, understanding, identify objects)
  • Explore frontal lobe Sx (personality, sexual inappropriateness, plans, mood, impulsivity, repetitiveness)
  • Functioning (dressing, washing, toileting, walking, money, shopping, food, transportation)
  • Risk (wandering, getting lost, fire, flooding, exploitation, abuse, aggression, self-injury).
  • PMHx and risk factors (head injury, low mood)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Mini-ACE cognitive examination

A
  • Day/date/month/year (4)
  • Animals in 1 min (7 for >22)
  • Address x3 (7)
  • Clock drawing (5)
  • Address recall (7)
  • Cut-off of 21 or 25
17
Q

Mild Cognitive Impairment (explanation)

A
  • Clarify diagnosis and understanding
  • Explain course and prognosis (5-10% per year conversion to dementia)
  • Explain medication (no specific treatment, treat risk factors such as HTN/diabetes)
  • Alternative treatment (lifestyle modification - diet, exercise, smoking)
  • Address concerns and offer leaflet
18
Q

Delirium (history)

A
  • Clarify HPC (onset, duration, orientation TPP)
  • Clarify possible causes (PMHx, recent illness, medication change, constipation)
  • Explore co-morbid symptoms (mood, enjoyment, sleep, appetite, psychosis)
  • Risk (agitation, aggression, self-injury, wandering).
  • Assess for underlying memory impairment (normal memory, dates, recognition, functioning, finances, wandering, risk).
19
Q

Delirium (management)

A
  • Summarise case/formulation
  • Explain DDx and possible aetiology
  • Explain investigations (GP collateral, bloods, MSU)
  • Management (location, treat cause, re-orientation, consistent nursing care etc.)
  • Medications (haloperidol if QTc ok)
  • Explain prognosis (usually 2-3 weeks)
20
Q

Indications for CT head in delirium

A
  • new focal neurological signs
  • a reduced level of consciousness (not adequately explained by another cause)
  • a history of recent falls
  • a head injury (patients of any age)
  • anticoagulation therapy.
  • non-resolving delirium where no clear cause is identified
21
Q

Mania in elderly patient (history)

A
  • Clarify HPC (onset, duration)
  • Elicit core mania symptoms (elation, irritability, energy, sleep, appetite, racing thoughts)
  • Explore grandiose beliefs (special powers, challenge these)
  • Explore auditory hallucinations (quality, content, number, 2nd/3rd person, commentary, commands, insight)
  • Hallucinations in other modalities
  • Thought interference and passivity phenomena
  • Risk (Police, spending, disinhibition, suicidality)
  • Alcohol and drugs
  • Past psych Hx, PMHx, FHx, medications.
22
Q

Mania in elderly patient (explanation)

A
  • Clarify diagnosis, rationale and DDx
  • Clarify PPHx, PMHx, medication
  • Explain treatment (inpatient/outpatient, MHA)
  • Explain medication (mechanism, side-effects)
  • Long-term management (CPN, CMHT)
  • Address other concerns
23
Q

Frontal assessment battery

A
  • Ask about visual/hearing difficulties
  • Similarities (banana/orange, table/chair, tulip/rose/daisy)
  • Verbal fluency (S-words, over 9 for 3 points)
  • Programming (fist-edge-palm, x3 together then alone, 6 reps for 3 points)
  • Conflicting instructions (tapping once/twice, 10 times)
  • Inhibitory control (don’t tap when tap twice, 10 times)
  • “Do not take my hands” (stroke palms)
  • Cut off score of 12

MRCPsych - CASC (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions