7. CBLE Geriatric Psychiatry

Geriatric Psychiatry

1. A 65-year old man presented with the complaints of forgetting of day-to-day events, cannot dress, do prayer properly, low concern of self since last 2 years. The problems are gradually deteriorating and very recently he is getting lost when out of home.
a) List the first line investigations and neuropsychiatric testing you need to perform for this case. 6
b) What will be the contents of your family psychoeducation including role of the family members? 4

2. A 67-year old man is brought to the outpatient department who recently suspects that his necessary items are stolen from house. He feels that frequently strangers enter into his home and tries to move them out angrily. Science last one year he forgets things and becomes tempered when asked about forgetting matters. He is euphoric and occasionally does silly behaviour that does not go with his him.
a) How will you proceed to assess this case keeping in mind differential diagnosis? 5
b) What investigations are required at this stage? 5

3. A 62-year old man has been brought to the outpatient department who recently sees that snakes are moving in around. Gradually he sees many known and unknown peoples sit and walk in front of him but others at home do not see. These types of visions extend to scenic manner. Gradually, he becomes fearful and suspicious that some group of peoples are trying to harm him. He is hypertensive and diabetic controlled with medication.
a) What are the areas you need to explore to reach the diagnosis? 5
b) What investigations you want to at this stage?  5

4. A 65 year old man appears in the psychiatry OPD referred by GP who easily forgets since last six months that is gradually aggravating. Recently, he cannot recognize his close relatives, cannot dress properly and perform prayer. Very recently, he has five fit attack in last 10 days. The patent is hypertensive since last 25 years. He appears jovial and disinherited.
a) Prepare a checklist of information you need to be gathered keeping in mind possible diagnoses. 5
b) List the first line investigation at this stage. 6

5. A 72-year old male presents with self-talking, incoherence, forgetfulness, lack of self-care and urinary incontinence. His wife died four months back. Since then he is increasingly sad and tearful. He is diabetic and hypertensive.
a) What could be possible diagnosis? 5
b) Make a checklist of assessing this case.   5

6. A 66 year-old man is presented is presented with gradual and marked increase of forgetfulness and inability to perform day-to-day activities.
a) Make a checklist of clinical information with the aim of aetiological formulation  5
b)What laboratory investigations would you consider as first line for this patient? 3
c) Mention necessary neuropsychological tests necessary for makings for making treatment plan?  2

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