Brainscape's Knowledge GenomeTM

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


See full index

*Psychiatry > Old Aged Psychiatry > Flashcards

Old Aged Psychiatry Flashcards

1
Q

How does the prevalence of most mental health disorders vary in the community vs hospitals?

A

All are increased drastically except alcohol misuse and Schizophrenia

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

What are the ABCDs of Dementia syndrome?

A

A - Activities of Daily living

B - Behavioural and Psychiatric symptoms of Dementia (BPSD)

C - Cognitive impairment

D - Decline

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

What are the cognitive features of Dementia?

A

Memory loss

Functional decline (ADLs)

(Plus one of):

  • Dysphasia
  • Dyspraxia
  • Dysgnosia
  • Dysexecutive functioning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is Dysgnosa?

A

Not recognising objects

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

MMSE scores correlate with what?

A

Lower the score - worse the deterioration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the neuropsychiatric disturbances seen in dementia?

A

Psychosis

Depression

Altered circadian rhythms

Agitation

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

What are the Behavioural and Psychiatric symptoms of Dementia (BPSD)?

A

Paranoia

Hallucinations

Activity disturbances

Aggression

Diurnal rhythm

Affective disturbance

Anxiety

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

What are the causes of dementia? What is their prevalence?

A

ALZHEIMERS (50%)

Vascular dementia (25%)

Mixed Alz/Vasc (15%)

Lewy body (5%)

Other

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

What is the ‘course’ of dementia?

A

Symptoms - Diagnosis

Loss of independence

Behavioural problems

Nursing home placement

Death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How is Alzheimer’s diagnosed?

A

Case-finding then clinical assessment

Exclude delirium and depression

Specialist referral (Confirm with brain scanning and neuropsychology)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does dementia differ from delirium?

A

Dementia - slower onset with progression, with less prominent physiology, consciousness and psychomotor decline only late in illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does dementia differ from depression?

A

Dementia - insidious with no psych history Day to day mood fluctuation with stable cognitive loss

Depression - abrupt onset with fluctuations, mood correlates with memory loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What assessments are used for dementia?

A

MMSE

MOCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the criteria for Lewy Body Dementia?

A
  1. Dementia with deficits of:
  • Attention
  • Frontal executive
  • Visuospatial
  1. 2 probable, 1 possible
  2. Fluctuation
  3. Visual Hallucinations
  4. Parkinsons

3 - Suggestive, REM sleep disorder, antipsych sensitivity, DAT scan abnormal

  1. Falls, syncope, LoC, Psych symptoms
  2. Dx ess likely if stroke or comorbidities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What brain scan is used in Dementia with lewy bodies?

A

DAT Scan

85% sens/spec

Shows reuptake of dopamine transporters in caudate nucleus and putamen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does Frontotemporal dementia present?

A

Behavioural disorder
Personality change
Early emotional blunting
Can be early onset
Speech disorder

Frontal dysexecutive syndrome (memory, praxis not badly impaired)

Frontotemporal abnormalities in imaging

Neurological signs absent early, parkinsonism later

17
Q

What drugs are used in dementia?

A 
Acetylcholinersterase Inhibitors (Moderate Alzheimers)
Memantine (moderate - severe Alz)

Antipsychotics

Antidepressants

Hypnotics

Anticonvulsants

18
Q

What are the non-pharmacological approaches to dementia?

A

Avoid other causes of distress

ABC approach

Communication

Assess capacity

19
Q

What is the significance of assessing capacity in dementia?

A

Power of Attourney:

  • Finance
  • Welfare
  • Best interests
  • Misuse

(Or) Guardianship - lack capacity to grant PoA

20
Q

What is required for Guardianship?

A

Lack of capacity to grant PoA

2 Medical certificates

Detailed report from social worker (take into account the family)

21
Q

How common is depression in old age?

A

20-30%

More common in women

22
Q

How does depression present in old age?

A

(less low mood or suicidal wishes)

Insomnia

Hyperchondriasis

Suicide

Agitation

23
Q

What are the causes of depression in old age?

A

Loss of health, wealth, spouse, work, home

Genetic

24
Q

What is the management of depression in old age?

A

Antidepressants

CBT

ECT if severe

(most not treated)

25
Q

What are the abnormal symptoms of grief?

A

>2 months

Guilt

Thoughts of death

Worthlessness

Psychomotor retardation or marked impairment

Psychosis

26
Q

What are the triggers for suicide in the elderly?

A

Depression

Loneliness/widower

Ill health/chronic pain

Life events

27
Q

How does late onset schizophrenia like psychosis present?

A

Spectrum of psychotic symptoms

28
Q

What is the cause of late onset schizophrenia like psychosis?

A

Sensory loss

Social isolation

Genetic?

29
Q

How is late onset schizophrenia like psychosis managed?

A

Admission

Neuroleptics

Increased social contact

30
Q

How does dementia/organic brain syndrome impair fitness to drive?

A

Notice DVLA of diagnosis

License may be yearly

Poor short term memory, disorientation or lack of insight should not drive

*Psychiatry (18 decks)

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