Deck 16: Psychological Disorders

Question 1

Of the following,which one is the most useful clinical evaluation tool to assist in the diagnosis of dementia?

A) Folstein's Mini-Mental Status Exam (MMSE)
B) St.Louis University Mental Status Exam (SLUMS)
C) Montreal Cognitive Assessment (MoCA)
D) Geriatric Depression Scale (GDS)

Answer 1

St.Louis University Mental Status Exam (SLUMS)

Question 2

The justification for ordering a CBC,TSH,and serum B12 for a patient you suspect may have clinical depression is:

A) To determine the cause of sadness
B) Because of overlapping symptoms with anemia,thyroid dysfunction,and nutritional deficiencies
C) To differentiate between depression and metabolic disorders
D) To rule out vascular disease

Answer 2

Because of overlapping symptoms with anemia,thyroid dysfunction,and nutritional deficiencies

Question 3

Symptoms of depression distinct to the elderly include:

A) Flat affect
B) Loss of pleasure in usual activities
C) Appetite and weight disturbances
D) Lack of emotions

Answer 3

Lack of emotions

Question 4

The comorbid psychiatric problem with the highest frequency in dementia is:

A) Anxiety
B) Depression
C) Agitation and aggression
D) Psychosis

Question 5

A consistent finding in delirium,regardless of cause,is:

A) Dopamine deficiency
B) Serotinergic toxicity
C) Acetylcholine deficiency
D) Reduction in regional cerebral perfusion

Question 6

The elderly are at high risk for delirium because of:

A) Multisensory declines
B) Polypharmacy
C) Multiple medical problems
D) All of the above

Question 7

The proposed mechanism by which diphenhydramine causes delirium is:

A) Serotinergic effects
B) Dopaminergic effects
C) Gabanergic effects
D) Anticholinergic effects

Question 8

The cornerstone of pharmacotherapy in treating Alzheimer's disease is:

A) Cholinesterase inhibitors
B) NMDA receptor antagonist
C) Psychotropic medications
D) Anxiolytics

Question 9

Older adults with dementia sometimes suffer from agnosia,which is defined as the inability to:

A) Use language
B) Understand language
C) Recognize objects
D) Remember events and places

Question 10

Which of the following is the most appropriate screening tool for delirium?

A) Lawton Scale of Instrumental Activities of Daily Living
B) Confusion Assessment Method
C) Folstein's Mini-Mental Status Examination
D) Montreal Cognitive Assessment

Question 11

The prevalence of depression in nursing home residents is greater than adults living in the community.

A) 1-2 times
B) 2-3 times
C) 3-4 times
D) 5 times

Question 12

One major difference that is useful in the differential diagnosis of dementia versus delirium is that:

A) Dementia develops slowly and delirium develops quickly
B) The initial symptoms of dementia are more severe than the symptoms of delirium
C) Dementia symptoms are not associated with underlying medical conditions and delirium symptoms usually result from underlying medical conditions
D) Symptoms of delirium involve memory and attention and symptoms of dementia involve only memory

Question 13

In late stages of dementia,a phenomenon called "sun downing" occurs,in which cognitive disturbances tend to:

A) Improve as the day goes on
B) Become worse toward the evening
C) Fluctuate during the course of the day
D) Peak mid-day

Question 14

The majority of depressed older adults remain untreated because of:

A) Misdiagnosis
B) Social stigma
C) Environmental barriers
D) All of the above

Question 15

When treating depression associated with dementia,which of the following would be a poor choice and should not be prescribed?

A) Fluoxetine
B) Desipramine
C) Amitriptyline
D) Mirtazapine