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It just you and me, Alex. Yeah. No way. And can you see my screen? Yeah. Are you see your health? Yeah. Yeah. Is it like full screen though? Yeah. Yeah. Yeah. Ok. Um, we'll wait for, give 15 minutes. No worries. I'm gonna pick on you for all the cross ana, how are you feeling fine? When is, uh, when are exams next Tuesday? Next Tuesday? Oh, ok. Yeah, almost there. Thank you so much for, like, even, like, taking up time to do this call because it's, it's always good to have some teaching, you know? Yeah. Yeah. No, not at all. Um, I'm gonna, once everyone's in, I do it's pretty information light. We'll just do some MCA and do a quick whistle stop tour. I'm not gonna keep everyone to all hours of the evening. Thank you. I think it's probably, I mean, I'd give it until, yeah, I got maybe five minutes but I can't imagine there's gonna be a massive turn out of exams or next week. No, I think, I think last Friday there was only like, four of us in the call. Oh, really? All right. Ok. Yes. Um. Oh, yeah. We have more, um, for everyone who's joined, I'm, I'm gonna give it to, by bypass just to see if, if more people flock in, then we'll get started. Right. I think we'll just make a start. Um, well done for showing up guys. Uh, I know exams are coming, um, very soon, um, by virtue of being here. Um, I'm, I'm confident that all of you are gonna do very well. It's a massive, hard overcome, but you will get there. Um, so my name is Patrick. Uh I'm an F one doctor in the Belfast Trust. Um, and I did my first rotation in geriatrics, which I think a lot of people are like, oh, that sounds horrible. But it's actually quite good. You get very good at, um, because it's quite difficult in older people. Um, and you have to look a lot of medications and a lot of the kind of social, social side of things. So, uh, we'll do a pretty much a whistle stop tour of all the M CQ father because I know there's different people from final year, fourth year and Ulster Uni. So I'm, I'm not gonna focus too much on, on boring you with all the, the M CQ facts. Uh You probably know them better than I do and I mean that genuinely, um, which is probably not what you wanna hear before I start a lecture, but you're all, uh you're all very good at knowing the information So we'll do a list of the information. Uh We'll do a couple of MC Qs and a couple of OSC and then uh general uh advice and if anyone has any questions, uh I'm more than happy to take those at the end and you can email me at any stage for, for literally anything. Um Does that sound good? Um I see everyone's needed so I'll just crack on um Oh, there we go. Is that moving forward for everyone? Yeah. Yeah. Yeah, perfect. Thanks guys. Um OK, so learning outcomes. Um This is taken from the UK MLA. Um This is medicine of older adults. Um I tried to make it initially that I ticked off everything in this list and it just became the most boring dry presentation and that I couldn't look out. So I have not covered it all, but I have covered the main parts of it that you'll, you'll, you'll need to know essentially. Um So, so, ok. Um First of all, I want to introduce you to my friend. Uh I think I'm gonna call him bre the bee. So you're gonna see him pop up the whole time. If you take nothing from this lecture, I wouldn't be desperate to be writing notes down or anything. Um It's more of a listening thing. Um But if you take anything from it anywhere you see re come up, uh that's, that's the buzzword, that's what you want to be thinking of or, or what should spark whenever you hear these kind of titles. So we'll talk about dementia. So definition, global impairment of higher cerebral function in absence of a reversible cause. Um So four main types, which is your Alzheimer's your vascular Lewy body. And I put Parkinson's in with that as well. We'll do the distinction and then frontotemporal um big tip for F one and kind of more acies and stuff. So when people ask for a dementia screen or kind of, they'll say dementia bloods, um it's really the same as uh like admission blood. So it's basically just everything. Um So an FBC uni LFT S bone profile, glucose, thyroid B12 folate. And to be honest with you, if you added anything else else in there that I've forgotten, it's probably fine for a dementia screen, right? Alzheimer's um So big big buzzword slides. So beta amyloid um which tends to be extracellular and neurofibrillary tangles, which is intraneuronal. So this is the diagnosis on histology, which is the gold standard for diagnosing, but it really is just a clinical um diagnosis and the hippocampus is affected first in the temporal lobe. That's a question that comes up all the time. Um And it's a progressive decline um to kind of deteriorate over time. Risk factors include your um elderly patients, family history and kind of repeated head traumas. Um There's a link and loads of studies going on with Alzheimer's if anyone is interested in this, but the APO E four gene is, is, is, seem to be a big genetic predisposition to developing Alzheimer's. Um, and there's also other smaller genes again, the AP or the pre one gene, but don't get too worried about that. Um, the test that you use to gauge severity is your, mm se, so that's your questions if you haven't seen this before, um, it's good to look up. You probably won't be expected to do one for a, it's more ot s that would do that, but certainly to be able to interpret it in terms of what the different scores mean. So kind of the cutoff would be like 2025. I always do it in five, but I think it's six. So 25 to 30 is ok, 2025 less. Ok. 15 to 20 even less and all that. And this is what guides your treatment. So your pharmacological management is first.