Geriatrics

Question 1

What are the first line medications for mild-moderate Alzheimer’s disease

Answer 1

Donepezil, galantamine and rivastigmine (ACTH inhibitors)

Question 2

What does visual hallucinations with dementia point to?

Answer 2

Lewy Body dementia

Question 3

What Activities of Daily living can you ask about?

Answer 3

• Bathing / showering
• Toileting
• Getting dressed / grooming
• Walking
• Eating meals / feeding
• Transferring / moving from bed to chair / standing from sitting

Question 4

What causes of Delirium can you ask about?

Answer 4

• Constipation
• Pain
• Infection / pneumonia / UTI / meningitis / encephalitis
• Poor Nutrition
• Dehydration
• Metabolic disturbance / hypoglycaemia / hypercalcaemia / hyponatraemia /
  hypercalcaemia
• Hypothermia
• Hypoxia
• Sleeplessness / insomnia
• Hepatic impairment
• Renal impairment
• Stroke
• Environmental changes / visual disturbance / hearing disturbance / new
  hospital admission
• Drugs / opioids / corticosteroids / anticholinergics / benzodiazepines
• Alcohol withdrawal
• Nicotine withdrawal
• Brain tumour / brain metastasis

Question 5

Name 1 non-pharmacological intervention used in the prevention and
treatment of delirium?

Answer 5

• Reduce polypharmacy
• Promote good sleep hygiene
• Promote nutrition / encourage eating
• Avoid dehydration
• Monitor for sensory deficits / hearing aids / glasses
• Encourage early mobilisation

Question 6

What document is legally binding to prevent giving CPR?

Answer 6

Advance decision to refuse treatment

Question 7

What are the 2 recommended tests from NICE to assess patients at risk of falls?

Answer 7

• Turn 180 test
• Timed up and go test