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29 Cards in this Set
- Front
- Back
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In Lewy Body Dementia a patient being treated with an antipsychotic is at risk of developing a Seratonin Syndrome
T/F |
F - Serotonin Syndrome is mainly caused by combining antidepressants (MAOIs and TCA particularly)
Lewy Body dementia patients particularly sensitive to antipsychotics leading to Parkinsonian Crisis |
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Rivestagmine is an acetycholinesterase inhibitor
T/F |
T
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Early decline of normal conduct/social skills with preservation of cognitive function is indicative of which category of dementia?
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Frontotemporal + Pick's
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Fluctuation in cognitive function from day to day is indicative of which dementia category?
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Lewy Body
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The dementia with poorest life expectancy following diagnosis is...?
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Lewy Body dementia (1-2yrs)
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Alzheimer's can be treated with Donepazil?
T/F |
T - an acetylcholinesterase inhibitor.
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Parkinson's is generally thought be due to a reduced level of DA in the substantia nigra of the basal ganglia
T/F |
T
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Parkinson's can be due to vascular damage...
T/F |
T - Aterio-sclerotic Parkinsons
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Parkinsonian tremor generally stops after movement but continues during sleep.
T/F |
F - stops through sleep AND normally stops immediately after movement.
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Name as many causes of falls in the elderly as you can...
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1) Carotid sinus hypersensitivity
2) Drop attack (low muscle tone) 3) Epilepsy 4) Panic attack 5) Vertebrobasilar insufficiency 6) Cervical spondylosis 7) Positional vertigo 8) Cough syncope 9) Micturition syncope |
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Name 2 risk factors for Stress incontinence
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1. poor pelvic floor mm tone
2. low oestrogen |
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Name 3 non-surgical treatments for stress incontinence
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1. Pelvic floor exercises
2. Cones 3. Behavioural techniques |
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In urge incontinence the residual volume is high
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F - low in uncomplicated cases
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In urge incontinence an increase in intra-abdominal pressure will produce a "leak"
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F - that's stress incontinence numpty
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Overflow incontinence is secondary to retention.
T/F |
T
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List 3 causes of urge incontinence.
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1. Stroke
2. MS 3. UTI 4. Bladder trauma |
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Treat urge incontinence with oxybutinoin
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T - oxybutinoin (anticholinergic - think SE = blurred vision, dry mouth, constipation and maybe even retention)
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You see a confused elderly patient in A&E and notice that her GP says she's taking oxybutinoin. What's the probable diagnosis?
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Diagnosis = Urinary Retention
(SE of oxybutinin (anticholinergic)) |
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Name the two biggest causes of overflow incontinence...
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1. Neuro = SE of anticholinergic / TCA reducing bladder contraction
2. Obstruction = BPH / stricture |
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A patient doesn't seem to get the urge to want to go the loo but seems to be wet between the trousers a lot... diagnosis?
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Functional incontinence
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A patient is on the ward with a right hemiplegia, right hemianopia and is unable to communicate by speech though seems able to write. A bright eyed nurse student flashes her eye lashes at you and asks which sub-type of stroke the patient had suffered and what the chances of him making it through the year?
TACS/PACS/POCS/LACS |
You can't help but smile at the nurse, you knew those nights with your HCE textbook would pay off one day. TACS - 1yr survival = 40%
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A patient on the stroke ward has just one symptom from his attack - he can't talk. What subtype of stroke has he had?
TACS/PACS/POCS/LACS |
PACS - any disturbance of higher cortical function must be anterior circulation.
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A patient has an isolated left sided hemianopia... which stroke subtype?
TACS/PACS/POCS/LACS |
POCS
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A patient has lost movement in both her left and right arms... what sort of stroke has she had?
TACS/PACS/POCS/LACS |
POCS - both sides means likely to be posterior
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A consultant tells you that a patient with motor and sensory deficits in her right arm and leg has a Lacunar Syndrome due to a single vessel disease. Is she talking out of her well-tailored trouserlinings?
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NO - it is possible to have a deficit such as this from a single vessel vascular event.
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A stroke involving the Broca's area might make the patient unable to pass his grammer test?
T/F |
T - Broca's aphasia is an expressive aphasia.
"Yes... ah... Monday... er... Dad and Peter H... (his own name), and Dad.... er... hospital... and ah... Wednesday... Wednesday, nine o'clock... and oh... Thursday... ten o'clock, ah doctors... two... an' doctors... and er... teeth... yah" |
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Broca's area is in the temporal lobe
T/F |
F - Frontal
(Wernicke's is in the Temporal) |
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You might struggle to explain why you're giving paracetamol to a patient with a Wernicke's aphasia?
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T - they have difficulty understanding language.
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Aricept can be used to treat alzheimer's?
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T - Aricept is aka Donepezil, a Cholinesterase inhibitor
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