Geriatrics

Front 1

List the 4 key features of delirium.

Back 1

1. Disturbance of counciousness
2. Change in cognition/new perceptual distrubance
3. Develops over a short period of time- hours to days.
4. caused by medical condition, intoxication, medication

Front 2

What is the characteristic appearance of EEG in delirium?

Back 2

slowing of the dominant posterior alpha rhythm and the appearance of abnormal slow-wave activity

Front 3

Mental Health Act 2007
Briefly explain sections 2, 3, 17 and 117.

Back 3

Section 2. 28 days assessment.

Section 3. up to 6 months treatment - renewable

Section 17. 6 months residing in a specified address and/or receiving services - renewable.

Section 17. Aftercare: social care is free to those discharged from S3 or on CTO

Front 4

What is the characteristic appearance of EEG in delirium?

Back 4

slowing of the dominant posterior alpha rhythm and the appearance of abnormal slow-wave activity

Front 5

Broadly classify falls into 4 major categories?

Back 5

1. Accidental falls
2. Trips
3. Syncope (cardiogenic, neurogenic)
4. other drop attacks, including seizures

Front 6

List causes od dizziness.

Back 6

Vestibular (central, peripheral, BPPV)
•
Acute labyrinthitis
•
Uncompensated previous vestibular injury
•
Proprioceptive loss
•
Central vestibular / cerebrovascular
•
cardiovascular

Front 7

List 3 categories of the history/mental state examination that often require greater attention than in younger people.

Back 7

1. Past Medical History
2. Social History
3. cognitive testing

Front 8

3 sources of information (other than from the
patient) that aid the diagnostic process

Back 8

Caregiver/GP/family

Front 9

7 aspects of the social history relevant to older people
with mental disorders

Back 9

1. LIVING ARRANGEMENTS;
2.TYPICAL DAY;
3. PADLs;
4. IADLs;
5. MOBILITY
6. HEARING
7. EYESIGHT;
8. HOME CARE
9. DAY CARE
10. SOCIAL/FAMILY SUPPORT
11. FINANCES

Front 10

3 tests of frontal lobe function used in bedside testing

Back 10

1. Verbal fluency (animals in 1 minute)
2. Set shifting (A1 B2 C3 etc)
3. Response Inhibition (Go/No go tasks)
4. Similarities
5. Judgement
6. Sequencing (AKA executive function)

Front 11

2 techniques for introducing cognitive testing to
older people without upsetting or annoying them.

Back 11

‘I’d like to ask you some questions about your memory and concentration’
‘Some questions may seem very easy, but I ask everyone the same questions’
‘Some questions are more difficult than others’

Front 12

list the features that make up the syndrome of dementia

Back 12

Amnesia – antero (inability to make new memory) and retrograde (memory loss)
Aphasia
Apraxia – inability to replicate a learned motor action
Agnosia
Executive dysfunction – can not function well in social environment
Full alertness (different than delirium)

Front 13

Describe the common causes of dementia

Back 13

Alzheimer’s
Vascular dementia
Lewy body dementia
Head trauma
HIV
Parkinson’s / Huntington’s/MS
Substance abuse

Front 14

True or False
1. Dementia is a speeding up of the normal ageing process of the
brain.
2. 5% >65 have dementia.
3. Up to 90% of demented patients will have behavioural
problems.

Back 14

1. F Dementia is a pathological process.
2. T 5% of all people over 65 have dementia. The
prevalance doubles with each 5 year age increase.
3. T

Front 15

True or False:
4. Low dose Risperidone is a good choice for the
pharmacological management of behavioural problems in
dementia.
5. Benzodiazepines are a good class of drug for the management
of behavioural problems of dementia.
6. CBT is of proven benefit in management of BPSD.
7. Behavioural techniques are used in BPSD.

Back 15

4. F Risperidone (and Olanzapine) are now contraindicated
in dementia except in special cases.
5. Bad question T if used in short-term F for long-term.
6. F
7. T

Front 16

What is the prevalence of dementia over the ages of 65, 75 and 85?

Back 16

1 in 20 over age 65
1 in 10 over age 75
1 in 5 over age 85

Front 17

NON-DRUG TREATMENT for dementia?

Back 17

Explain diagnosis & prognosis
Promote function
Social help
Support groups
Help carers

Front 18

DRUG TREATMENT OF AD?

Back 18

• Anticholinesterases
• NMDA Receptor antagonists
• Antidepressants
• Neuroleptics

Front 19

MENTAL TEST SCORE
(MTS/AMT) ?

Back 19

Age
Date of birth
Year
Hour of day
Institution
Count back from
Address for recall
Monarch
First World War
202 people

Front 20

Define Dementia.

Back 20

Global Impairment of
– Memory
– Personality
– Cognition
– Executive function
• In clear consciousness
• Chronic and progressive

Front 21

Differentiating AD, VaD
and LBD?

Back 21

• AD - gradual progressive course with steady global
deterioration
• VaD - stepwise course with sudden deteriorations and
sporadic decline in different functions. May be
neurological signs and signs of arterial disease, and
risk factors for vascular disease
• LBD - marked fluctuation and early manifestations of
psychiatric symptomatology (e.g. visual
hallucinations). EPS may occur early on. Memory loss
is sometimes not as prominent a feature as it is in AD