MOE

Question 1

anaesthetics and diazepam are hydrophilic/lipophyllic drugs?

Answer 1

lipophyllic- half life often very increased in elderly patients!

Question 2

diazepam, morphine, and pethidine are acidic/basic drugs?

Answer 2

Basic

Question 3

How do you calculate the therapeutic index of a drug?

Answer 3

median lethal dose divided by median effective dose
or
minimum toxic concentration divided by minimum effective concentration

Question 4

in elderly patients, the Vd of lipophilic drugs is increased, resulting in shorter/longer half life?

Answer 4

longer- higher fat mass

Question 5

lithium and digoxin are hydrophilic/lipophyllic drugs?

Answer 5

hydrophillic

Question 6

one of the first areas of the brain to be affected in Alzheimers disease is ???

Answer 6

the nucleus basalis of meynert- main source of ACh for the cortex

Question 7

phenytoin, aspirin, and penicillins are acidic/basic drugs?

Answer 7

acidic- causes difficulty if patient being fed from PEG or patient has had previous GI surgery

Question 8

the plasma concentration of theophylline is increased/decreased? in smokers, and by alcohol consumption

Answer 8

decreased

Question 9

the plasma concentration of theophylline is increased/decreased? in heart failure, hepatic impairment, and in viral infections

Answer 9

increased

Question 10

the _____ test is similar to the MMSE but provides a more comprehensive neuropsychological assessment (and is free)

Answer 10

ACE-III

Question 11

the _____ test is a useful and rapid screening test for mild cognitive dysfunction

Answer 11

MoCA

Question 12

what anticoagulant has a notoriously narrow therapeutic index?

Answer 12

warfarin, of course

Question 13

what are the 4 components of the AMT-4 test?

Answer 13

age, DOB, current location, current year
confusingly, AMT4 (low points=more confused) is a component of the 4AT (high points= more confused)

Question 14

what are the steps of the GPCOG test that you can ask of the patients relative or carer

Answer 14

compared to how they used to be, does the patient have trouble:
remembering events
remembering conversations
finding words
managing money
managing medications
managing transport

score out of six; three or lower is definitely imapaired

Question 15

what is HMPAO-SPECT?

Answer 15

type of CT used to distinguish between dementia subtypes

Question 16

What is the cutoff score for ACE-III for raising flags when a patient has memory problems?

Answer 16

<88? dementia
<82 dementia!!!

Question 17

What is the cutoff score for the MMSE for raising flags that a patient has memory problems?

Answer 17

24/30

Question 18

What is the Hachinski ischaemic score used for?

Answer 18

to distinguish Alzheimers disease (low score) from vascular dementia (high score)

Question 19

what type of drug is memantine?

Answer 19

NMDA receptor antagonist
second-line therapy in Alzheimer’s

Question 20

You are interviewing a patient with memory problems. What specific areas of cognitive functioning should you ask about?

Answer 20

APPLE MO

attention and concentration ability
praxis- wether they can et dressed, lay a table etc
psychiatric features- depression, anxiety, psychotic symptoms
language function
executive function- problem solving etc
memory- short and long term
orientation- time, place, person

Question 21

You want to quickly screen a patient for memory problems. What’s the cheat’s version of the MMSE/MoCA, that doesn’t even need a paper questionnaire (just some scrap paper)?

Answer 21

if you can draw a clock showing 11:10 and recall at leas one of three words, then cognition looks to be grossly intact

Question 22

what plasma protein binds to acidic drugs?

Answer 22

albumin

Question 23

albumin binds to acidic/basic drugs?

Answer 23

acidic

Question 24

what plasma protein binds to basic drugs?

Answer 24

alpha-1 acid glycoprotein

Question 25

alpha-1 acid glycoprotein binds to acidic/basic drugs?

Answer 25

basic

Question 26

_________ amnesia refers to difficulty in acquiring new material and remembering events since the onset of the illness or injury

Answer 26

anterograde

Question 27

_______ is the most common neuropsychiatric complication of stroke

Answer 27

depression - affecting up to 30% of patients

Question 28

________ amnesia refers to difficulty in remembering information prior to onset of the illness or injury

Answer 28

retrograde