100% Correct Anawers
What is the mini mental evaluation? - A tool that can be used to thoroughly assess mental status.
What areas does the mini mental exam assess? - It test five areas of cognitive function: orientation,
registration, attention and calculation, recall, and language.
What is the Montreal cognition? - A rapid screening assessment used for mild cognitive dysfunction.
What does the Montreal cognition test for? - Attention and concentration, executive functions,
memory, language, visuoconstructional skills, conceptual thinking, calculations, and orientation.
What is Delirium? - A sudden onset of clouded sensorium that can occur at any age associated with a
physical stressor.
What are the causes for Delirium? - Toxins, alcohol/drug abuse, trauma, Impactions in the elderly,
poor nutrition, electrolyte imbalances, anesthesia and septicemia.
What is the management of Delirium? - Treat the underlying cause
What is Dementia? - A chronic progressive cognitive impairment
What are the causes of Dementia? - Atherosclerosis, neurotransmitter deficits, cortical atrophy,
ventricular dilation, loss of brain cells, possible viral causes, Alzheimer's disease, Lewy body
dementia
What are the first line treatment drugs used to treat Alzheimer's? - Best in mild to moderate disease;
may be effective in Lewy body dementia.
Donepezil (Aricept): Start at 5 mg/day PO; may increase to 10 mg/day after 1 month, may increase to
23 mg/day after 3 months if needed. Orally disintegrating tablets; generic available. Caution with
digoxin or β-blockers (Donepezil may prolong PR interval.)
, Rivastigmine (Exelon): Start at 1.5 mg PO BID and increase by 1.5 mg BID every 2 weeks;
maintenance 6 to 12 mg/day total Capsule, solution, or patch (reduced side effects)
Galantamine (Razadyne): Start at 4 mg BID for 4 weeks and then increase by 4 mg BID every month
with goal of 16 to 24 mg/day dose.
Tablets, solution, extended-release (ER) capsule, and transdermal formulations
Vitamin E—2,000 IU/day supplementation was found to slow decline in one study.
Memantine, a N-methyl-d-aspartate (NMDA) receptor antagonist for moderate to severe AD
Monotherapy or in combination with acetylcholinesterase inhibitors, Memantine immediate release:
5 mg/day; titrate up to 10 mg BID, adding 5 mg/day every week PRN.
Memantine extended release: 7 mg/day up to 28 mg/day, adding 7 mg/day every week PRN
What type of inhibitors are used to treat Alzheimer's - Acetylcholinesterase Inhibitors (ChEIs)
What are the side effects of Alzheimer's drugs? - All have potential for GI and other side effects, such
as bradycardia/syncope.
Neuropsychiatric symptoms: assessment and treatment for delirium, environmental modification,
sleep hygiene, exercise, cognitive interventions, hearing/vision aids, and if necessary for moderate to
severe symptoms, consider second-line care
What are the second line drugs used to treat Alzheimer's? - For moderate to severe depression:
selective serotonin reuptake inhibitors (SSRIs) preferred
Insomnia: Medications have little efficacy for sleep in AD.
Avoid diphenhydramine and antihistamines in elderly due to negative side effects.
If using low-dose risperidone, trazodone, or sleep aid (e.g., zolpidem), use caution and lowest dose
possible in elderly.