Passmedicine Flashcards
What is the treatment for acute confusional state (delirium)?
1st line: Oral haloperidol
Parkinsons - benzodiazepine (like lorazepam)
What blood tests are performed as part of the confusion screen
TFT (hypothyroidism)
B12 (deficiency)
Folate (deficiency)
Glucose (hypoglycaemia)
Bone profile (hypercalcaemia)
Which part of the brain does Alzheimers affect?
The cortex and hippocampus
What are important points regarding levy body dementia?
Associated with Parkinson’s - If cognitive signs come first its LBD - Parkinson signs can develop within one year.
If parkinson signs come first, they’re usually present for a year before cognitive signs appear and its Parkinson’s.
- It is treated with rivastigmine or donepezil.
- Cognition is FLUCTUANT.
What is digoxin?
A cardiac glycoside - it decreases conduction through the AV node.
What is digoxin used for?
- Mainly used for rate control in AF.
- Also has positive inotropic properties for symptomatic relief in HF.
When should digoxin levels be measured?
Only if digoxin toxicity is suspected
Within 8-12 hours of the last dose
What are signs of digoxin toxicity?
Unwell
Lethargy
Nausea
Vomiting
Anorexia
Confusion
Yellow-green vision
Arrhythmias
Gynaecomastia
What can precipitate digoxin toxicity?
Hypokalaemia
Renal failure
MI
Amiodarone
Verapamil
What is the management of digoxin toxicity?
Digibind
Correct arrhythmias
Monitor potassium
Which questionnaire is used to determine frailty?
PRISMA-7
What is the treatment for mild-moderate Alzheimers disease?
the three acetylcholinesterase inhibitors (donepezil, galantamine and rivastigmine)
What is the second line treatment for Alzheimers?
memantine (an NMDA receptor antagonist)
Used when:
- moderate Alzheimer’s who are intolerant of, or have a contraindication to, acetylcholinesterase inhibitors
- as an add-on drug to acetylcholinesterase inhibitors for patients with moderate or severe Alzheimer’s
- monotherapy in severe Alzheimer’s
