Geriatric Psychiatry — MCQs

Q: Which of the following is not a common symptom of Alzheimer's disease?

Cerebral infarcts. ***Cerebral infarcts*** - While **cerebral infarcts** (strokes) can cause cognitive impairment (vascular dementia), they are not a defining or common symptom of Alzheimer's disease itself. - Alzheimer's is characterized by distinct **neurodegenerative changes** (amyloid plaques, neurofibrillary tangles), not typically acute vascular events. *Memory loss* - **Memory loss**, particularly of recent events, is often the earliest and most prominent symptom of Alzheimer's disease, significantly impacting daily life. - This progressive decline in episodic memory is a core diagnostic criterion. *Delusions* - **Delusions**, such as paranoid thoughts or beliefs that things are being stolen, can occur in the moderate to late stages of Alzheimer's disease. - These psychotic symptoms are often a source of distress for both the patient and caregivers. *Apraxia and aphasia* - **Apraxia** (difficulty with learned movements despite normal motor function) and **aphasia** (language difficulties, including word-finding problems) are common cognitive deficits in Alzheimer's. - These symptoms reflect diffuse cortical dysfunction as the disease progresses beyond memory centers.

Q: Which of the following non-memory cognitive symptoms can be associated with Alzheimer's disease (AD)?

All of the options. ***All of the options*** - Alzheimer's disease is characterized by a decline in various cognitive domains, extending beyond memory impairment to include **aphasia**, **apraxia**, and **agnosia**. - These non-memory symptoms become increasingly prominent as the disease progresses and are essential for a comprehensive diagnostic evaluation. *Aphasia* - **Aphasia**, or difficulty with language production or comprehension, is a common non-memory cognitive symptom in AD. - Patients may struggle to find words, understand spoken or written language, or produce coherent sentences. *Apraxia* - **Apraxia**, the inability to perform learned motor movements despite intact motor function and comprehension, is frequently observed in AD. - This can manifest as difficulty with activities of daily living, such as dressing, eating, or using tools. *Agnosia* - **Agnosia**, the inability to recognize objects, people, sounds, shapes, or smells despite intact sensory function, is another non-memory cognitive deficit seen in AD. - Patients may not recognize familiar faces or common household items.

Q: What is the most common postoperative psychiatric complication?

Delirium. ***Delirium*** - **Delirium** is the most frequent postoperative psychiatric complication, especially in elderly patients and those undergoing major surgery. - It is an acute **neuropsychiatric syndrome** characterized by fluctuating attention, disorganized thinking, and altered level of consciousness. - Incidence ranges from **15-50% in elderly surgical patients** and **up to 80% in ICU settings**. *Depression* - Postoperative depression is common but typically emerges days to weeks after surgery, unlike the acute onset of **delirium**. - While it can significantly affect recovery, its incidence directly after surgery is lower than that of **delirium**. *Psychosis* - Postoperative psychosis is relatively rare and often linked to pre-existing psychiatric conditions, substance withdrawal, or severe medical complications. - It involves more severe thought disturbances and hallucinations than the more common **delirium**. *Anxiety* - Postoperative anxiety is common and can affect recovery, but it is typically **less severe** than delirium. - Unlike delirium, anxiety does not involve altered consciousness or acute cognitive impairment requiring immediate psychiatric intervention.

Practice by Chapter

Normal Aging Process

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Dementia: Alzheimer's Type

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Other Neurocognitive Disorders

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Delirium in the Elderly

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Late-Life Depression

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Anxiety Disorders in the Elderly

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Psychosis in the Elderly

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Sleep Disorders in the Elderly

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Pharmacotherapy Considerations in the Elderly

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Elder Abuse and Neglect

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End-of-Life Issues

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Long-term Care Issues

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