Geriatrics

Question 0

Delusions

Answer 0

May be part of psychotic depression

Question 1

Underestimated if symptoms misattributed to

Answer 1

Physical disorders
Normal aging
Cognitive impairment
Lack of age appropriate diagnostic criteria

Question 2

Delirium

Answer 2

Acute onset
Can be from illness, meds or sensory deprivation

Behaviors may fluctuate 
Psychomotor change
Change in loc
Disorientation
Short attention span 
May be mistaken for dementia so they may be mis treated

Question 3

Components of geriatric assessment

Answer 3

Interviewing
MSE 
behavior response
Functional abilities (ADLs, risk for falls, mobility)
Neuroimaging
Labs
Psychological functioning (nutrition, substance abuse)
Social support 
Sleep patterns
Nutrition intake
Relocation of stress
Caregiver strain
Social isolation

Question 4

Causes of depression

Answer 4

Physics illnesses (depression is secondary)

• thyroid disorders
• cancer
• Parkinson’s disease, stroke, dementia
• vascular depression from vascular brain lesions

Meds

Question 5

Substance abuse

Answer 5

Alcoholism

Prescription drugs

Question 6

Failure to thrive syndrome

Answer 6

• weight loss, poor nutrition, decreased appetite, inactivity, dehydration

Question 7

Suicide risk

Answer 7

Recent death
Physical illness, uncontrollable pain, fear of prolonged illness
Perceived poor health
Poor prognosis 
Social isolation
Major change in social roles

Question 8

Somatization

Answer 8

Sign of pts sense of deterioration
Decreased self worth
…

Question 9

Treatment for depression

Answer 9

Antidepressant meds, start slow, high risk of side effects
ECT
CBT
Reminiscence therapy
Brief psychodynamic therapy

Question 10

Medication side

Answer 10

Slow metabolism of drugs
"Start low and go slow" low dose and one at a time
Vulnerable to:
Sedation
Orthostatic hypotension (falls)
Agitation
EPS

Usually handle newer drugs better because they target neurotransmitters better