Barry, aged 80, has recently been diagnosed with Alzheimer’s dementia. He saw the geriatrician, who prescribed donepezil. Peter and his son would like some more information about the side effects of this medication before they decide whether to fill the script.
What would you advise Barry regarding the most common side effects to expect?(Click on an answer:)
- Transient worsening of cognition before it begins to improve.
- Nausea, vomiting and diarrhoea
- Weight gain and increased appetite
- Agitation and aggression
- Visual and auditory hallucinations
Anticholinesterase medications such as Donepezil can be associated with a small improvement in cognitive function in some patients with Alzheimer's disease, but they are often limited by prominent GI effects. Read more here or on eTG.
Anatomy of an AKT
- 150 items in SBA or modified extended matching. 3 hours exam but given 4 hours to complete.
- Each question has a stem, a lead in statement and a set of answer options.
- Questions must be able to be answered without looking at the possible answer choices – this is known as the cover test.
Generic types of AKT questions:
- Diagnosis questions: What is the most likely diagnosis / cause? Which of the following is the most common cause of X in adults?
- History questions: Which of the following is a recognised risk factor for X? Which of these would be a red flag feature? Which of the following medications is the most likely cause / associated with X?
- Investigation questions: Which of the following would be the most appropriate initial investigation? Which is the most appropriate investigation that would diagnose the condition? Test results are most likely to show which of the following changes?
- Management questions: What is the most appropriate recommendation/ advice / treatment to give? Which of the following would be appropriate / would you recommend? What is the most appropriate management at this stage? Which of the following is the most appropriate first line treatment / management? What would be your next step in management? Specialist referral is most appropriate for which of the following patients?
You can use these lead-in statements to write your own questions. Note that there are NO LONGER any negative questions, i.e. Which of the following is not a risk factor / common cause / symptom / complication/ contraindication…