Atypical Presentation Flashcards by V costa

What is the major cause of death in adults aged 65 and older?
- A) Cancer
- B) Cardiovascular disease
- C) Infection
- D) Diabetes

C) Infection

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Infections exacerbate which of the following in older adults?
- A) Mobility
- B) Multimorbidities
- C) Cognitive function
- D) Sensory loss

B) Multimorbidities

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What is immune senescence?
- A) Increase in antibody production with age
- B) Decline in immune function with age
- C) Enhancement of immune response in the elderly
- D) Increase in T-cell function with age

B) Decline in immune function with age

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The decline in which immune cell function is a key feature of immune senescence?
- A) Neutrophils
- B) Platelets
- C) T-cells
- D) Red blood cells

C) T-cells

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Which of the following is a risk factor for atypical presentation of illness in older adults?
- A) Multimorbidities
- B) Cognitive impairment
- C) Polypharmacy
- D) All of the above

D) All of the above

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Why are older adults at higher risk for infections?
- A) Increased nutrition
- B) Immune senescence
- C) Higher skin elasticity
- D) Enhanced immune function

B) Immune senescence

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. Fever in older adults is typically defined as an oral temperature:
- A) Over 99°F
- B) Over 100°F
- C) Over 101°F
- D) Over 98.6°F

B) Over 100°F

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. What percentage of older adults with serious infections may not present with a fever?
- A) 25%
- B) 50%
- C) 75%
- D) 90%

B) 50%

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The most common organism causing community-acquired pneumonia (CAP) in older adults is:
- A) Haemophilus influenzae
- B) Moraxella catarrhalis
- C) Streptococcus pneumoniae
- D) Klebsiella pneumoniae

C) Streptococcus pneumoniae

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. Which of the following is NOT a risk factor for pneumonia in older adults?
- A) Multimorbidity
- B) Age over 85
- C) Hypothermia
- D) High cholesterol

D) High cholesterol

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Outpatient treatment guidelines for CAP in older adults typically recommend:
- A) Amoxicillin only
- B) Beta-lactam with a macrolide
- C) Penicillin alone
- D) Cephalosporin alone

B) Beta-lactam with a macrolide

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Which of the following is an atypical presentation of pneumonia in older adults?
- A) Fever over 101°F
- B) Abdominal pain
- C) Shortness of breath
- D) Productive cough

B) Abdominal pain

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. In older adults, the absence of which symptom is common in serious infections such as pneumonia?
- A) Fever
- B) Cough
- C) Shortness of breath
- D) Chest pain

A) Fever

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Which of the following might indicate a serious illness in an older adult?
- A) Increased confusion
- B) Worsening incontinence
- C) Functional decline
- D) All of the above

D) All of the above

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. An older adult presenting with confusion or delirium may be experiencing which of the following?
- A) Urinary tract infection (UTI)
- B) Pneumonia
- C) Sepsis
- D) All of the above

D) All of the above

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What is an atypical presentation of UTI in older adults?
- A) Dysuria
- B) Fever
- C) Confusion or altered mental status
- D) Urgency

C) Confusion or altered mental status

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Which of the following is a reason NOT to treat asymptomatic bacteriuria in older adults?
- A) It reduces antibiotic resistance
- B) There is no clinical benefit
- C) It increases the cost of healthcare
- D) It prevents C. difficile colitis

B) There is no clinical benefit

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In older adults, T-cell function is typically:
- A) Increased
- B) Decreased
- C) Unchanged
- D) Enhanced with age

B) Decreased

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How does aging affect B cells in the elderly?
- A) B-cells produce more antibodies
- B) B-cells produce fewer antibodies with lower affinity
- C) B-cell activity remains unchanged
- D) B-cells become hyperactive

B) B-cells produce fewer antibodies with lower affinity

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What is the common cause of gastrointestinal infections in older adults?
- A) Inhalation of pathogens
- B) Bloodborne transmission
- C) Oral-fecal contamination
- D) Transmission through wounds

C) Oral-fecal contamination

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Which of the following is commonly associated with GI infections in the elderly?
- A) Rotavirus
- B) Streptococcus pneumoniae
- C) Escherichia coli
- D) Mycobacterium tuberculosis

C) Escherichia coli

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Which of the following increases the risk of GI infections in older adults?
- A) Hypochlorhydria
- B) Antibiotic overuse
- C) Achlorhydria
- D) All of the above

D) All of the above

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Which antibiotic regimen is often recommended for treating CAP in older adults?
- A) Amoxicillin-clavulanate (Augmentin)
- B) Ciprofloxacin alone
- C) Macrolide with a beta-lactam
- D) Penicillin alone

C) Macrolide with a beta-lactam

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What is the usual duration of antibiotic treatment for uncomplicated outpatient CAP in older adults?
- A) 3-5 days
- B) 7-14 days
- C) 14-21 days
- D) 1-2 days

C) 14-21 days

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Fever of unknown origin in older adults is defined as: - A) A temperature above 100°F for 3 days - B) A fever lasting more than 3 weeks with no diagnosis after one week of medical evaluation - C) A temperature above 99°F for more than 2 weeks - D) A fever that resolves with antipyretics

- B) A fever lasting more than 3 weeks with no diagnosis after one week of medical evaluation

Which of the following is a common cause of fever of unknown origin in older adults? - A) Osteomyelitis - B) Heart disease - C) Chronic kidney disease - D) Hypertension

- A) Osteomyelitis

Which of the following must be considered when prescribing antibiotics to older adults? - A) Renal function - B) Drug metabolism - C) Drug interactions with other medications - D) All of the above

- D) All of the above

What is a common reason for poor medication adherence in older adults? - A) Cognitive impairment - B) Financial constraints - C) Polypharmacy - D) All of the above

- D) All of the above

What is the best strategy to prevent pneumonia in older adults? - A) Annual flu vaccination - B) Smoking cessation - C) High-dose pneumonia vaccine - D) All of the above

- D) All of the above

High-dose flu vaccines are recommended for adults over: - A) 50 years old - B) 60 years old - C) 65 years old - D) 70 years old

- C) 65 years old

The most common organism responsible for urinary tract infections (UTIs) in older adults is: - A) Escherichia coli - B) Klebsiella pneumoniae - C) Pseudomonas aeruginosa - D) Streptococcus pneumoniae

A) Escherichia coli

Which of the following interventions can help prevent recurrent UTIs in postmenopausal women? - A) Antibiotics daily - B) Intravaginal estrogen - C) Cranberry juice - D) Both B and C

- D) Both B and C

What is the first-line treatment for suspected sepsis in an elderly patient? - A) Immediate surgery - B) Antibiotics and fluid resuscitation - C) Pain management - D) Antiviral medication

- B) Antibiotics and fluid resuscitation

Which of the following increases the risk of sepsis in older adults? - A) Age over 85 - B) Multimorbidities - C) Immune senescence - D) All of the above

- D) All of the above

Why is it important to assess older adults for multimorbidities when evaluating atypical presentations of infections? - A) Multimorbidities increase the complexity of diagnosis and treatment - B) They increase the risk of infection - C) Symptoms may be masked or atypical - D) All of the above

- D) All of the above

Which of the following is a common atypical presentation of infection in older adults? - A) High fever - B) General malaise or confusion - C) Rash - D) Severe joint pain

B) General malaise or confusion

What is the primary reason older adults may not present with typical symptoms of infection such as fever? - A) Lower metabolic rate - B) Reduced immune response (immune senescence) - C) Increased hydration - D) Enhanced B-cell activity

- B) Reduced immune response (immune senescence)

In the elderly, which of the following is a key symptom that may be absent in a pneumonia diagnosis? - A) Cough - B) Fever - C) Fatigue - D) Shortness of breath

- B) Fever

Which of the following is the most effective preventive measure for reducing community-acquired pneumonia in older adults? - A) Regular use of antibiotics - B) Annual vaccination - C) Increased vitamin intake - D) Use of antifungals

- B) Annual vaccination

Which symptom is often absent in older adults presenting with a urinary tract infection (UTI)? - A) Dysuria - B) Fever - C) Confusion - D) Increased frequency

- B) Fever

Which of the following organisms is most commonly responsible for urinary tract infections (UTIs) in older adults? - A) Streptococcus pyogenes - B) Staphylococcus aureus - C) Escherichia coli - D) Pseudomonas aeruginosa

- C) Escherichia coli

. In older adults, what is a common cause of sepsis related to gastrointestinal infections? - A) Rotavirus - B) Campylobacter - C) Bacillus species - D) Clostridium difficile

- D) Clostridium difficile

Why is it important to use antibiotics judiciously in older adults? - A) To improve the speed of recovery - B) To prevent the development of drug-resistant organisms - C) To increase the efficacy of immunizations - D) To ensure higher drug tolerance

B) To prevent the development of drug-resistant organisms

Which of the following is an adverse effect of overusing antibiotics in older adults? - A) Increased immune function - B) Reduced kidney function - C) Increased risk of developing Clostridium difficile infection - D) Increased cognitive function

- C) Increased risk of developing Clostridium difficile infection

1. What is the major cause of death in adults 65 years and older? o A) Cancer o B) Cardiovascular diseases o C) Infections o D) Accidents

C) Infections

2. Which of the following describes the age-related decline in immune function? o A) Immune senescence o B) Immune hypersensitivity o C) Immune modulation o D) Immune adaptation

A) Immune senescence

3. What is the primary cause of reduced immune function in older adults? o A) Overactive T-cells o B) Depressed T-cell and B-cell response o C) Enhanced macrophage activity o D) Increased antibody production

o B) Depressed T-cell and B-cell response

4. Which of the following organisms is predominantly found in community-acquired pneumonia (CAP) in older adults? o A) Staphylococcus aureus o B) Streptococcus pneumoniae o C) Klebsiella pneumoniae o D) Moraxella catarrhalis

B) Streptococcus pneumoniae

5. What percentage of older adults die from infections? o A) 10% o B) 25% o C) 40% o D) 50%

o C) 40%

6. What is a significant risk factor for developing pneumonia in older adults? o A) Physical exercise o B) Multimorbidity o C) High hydration o D) Regular flu vaccination

o B) Multimorbidity

7. Which of the following is a primary method of pneumonia prevention in older adults? o A) Regular use of broad-spectrum antibiotics o B) Immunizations o C) Strict bed rest o D) Using antifungal medications

B) Immunizations

8. What role does skin integrity play in infection susceptibility in older adults? o A) Thicker skin increases the risk of infection o B) Thinner skin increases susceptibility to infection o C) No effect on infection risk o D) Skin integrity enhances immunity

B) Thinner skin increases susceptibility to infection

9. What is the strongest independent predictor of mortality in older adults with pneumonia? o A) Smoking o B) Multimorbidity o C) Obesity o D) Dehydration

o B) Multimorbidity

10. What is the primary organism responsible for pneumonia in long-term care facilities? o A) Streptococcus pneumoniae o B) Gram-negative bacilli o C) Staphylococcus aureus o D) Respiratory viruses

o B) Gram-negative bacilli

11. How often do nursing home residents develop pneumonia within two years? o A) 10% o B) 20% o C) 30% o D) 50%

o C) 30%

12. Which of the following is a risk factor for urinary tract infections (UTI) in older adults? o A) Decreased kidney function o B) Increased protein intake o C) Frequent hydration o D) Regular exercise

A) Decreased kidney function

13. Which is the most common pathogen causing UTIs in older adults? o A) Klebsiella pneumoniae o B) Enterococcus species o C) Escherichia coli o D) Pseudomonas aeruginosa

C) Escherichia coli

14. Why is asymptomatic bacteriuria often left untreated in older adults? o A) It is a mild infection o B) No clinical benefit and potential adverse effects from treatment o C) It leads to faster recovery without treatment o D) Antibiotics cannot treat it effectively

B) No clinical benefit and potential adverse effects from treatment

15. Which medication is contraindicated in older adults with chronic kidney disease when treating UTIs? o A) Bactrim o B) Nitrofurantoin o C) Amoxicillin o D) Cephalexin

o B) Nitrofurantoin

16. What percentage of older women in long-term care facilities are affected by asymptomatic bacteriuria? o A) 10% to 20% o B) 25% to 50% o C) 60% to 80% o D) Over 90%

o B) 25% to 50%

17. What is the recommended first-line treatment for uncomplicated cystitis in older adults? o A) Amoxicillin o B) Fluoroquinolones o C) Bactrim or Nitrofurantoin o D) Doxycycline

C) Bactrim or Nitrofurantoin

18. Which condition in older adults is often caused by oral fecal contamination? o A) Respiratory infections o B) Gastrointestinal infections o C) Skin infections o D) Bone infections

o B) Gastrointestinal infections

19. Which viral organism is commonly responsible for gastrointestinal infections in older adults? o A) Staphylococcus aureus o B) Bacillus species o C) Norwalk virus o D) Escherichia coli

C) Norwalk virus

20. Which gastrointestinal condition can result from antibiotic overuse in older adults? o A) Bacillus infection o B) C. difficile colitis o C) Rotavirus o D) Traveler’s diarrhea

B) C. difficile colitis

21. What is a significant factor leading to infections in long-term care facilities? o A) Dehydration o B) Overuse of antiviral medications o C) Poor staff compliance with infection control practices o D) Overnutrition

C) Poor staff compliance with infection control practices

22. What is the most effective preventive measure for reducing influenza infections in older adults? o A) Annual flu vaccination, especially with high-dose vaccines o B) Quarantine during flu season o C) Use of antivirals year-round o D) Increasing hydration levels

A) Annual flu vaccination, especially with high-dose vaccines

23. What is the most common side effect of Tamiflu (oseltamivir) in older adults? o A) Severe headache o B) Gastrointestinal issues, such as nausea and vomiting o C) Rash o D) Difficulty breathing

B) Gastrointestinal issues, such as nausea and vomiting

24. What percentage of deaths from influenza occur annually in the United States, especially among older adults? o A) 10,000 o B) 20,000 o C) 40,000 o D) 60,000

o C) 40,000

25. What is the primary management strategy for sepsis in older adults? o A) Rapid administration of fluids and antibiotics o B) Immediate surgery o C) High-dose vitamin therapy o D) Pain management

A) Rapid administration of fluids and antibiotics

o D) Pain management 26. Which of the following changes in the immune system is commonly observed in older adults? o A) Increased production of T-cells o B) Depressed T-cell and B-cell function o C) Increased production of antibodies o D) Enhanced macrophage response

o B) Depressed T-cell and B-cell function

27. What is a typical sign of upper urinary tract infection (pyelonephritis) in older adults? o A) Increased frequency of urination o B) Fever, chills, and flank pain o C) Abdominal distention o D) Dry cough

B) Fever, chills, and flank pain

28. What percentage of older adults suffer from under-nutrition on an outpatient basis? o A) 5% o B) 10% o C) 11% o D) 20%

o C) 11%

29. Which of the following is an important measure to reduce the risk of hospital-acquired pneumonia? o A) Giving all patients prophylactic antibiotics o B) Performing chest X-rays regularly o C) Keeping patients upright prior to feeding o D) Administering cough suppressants frequently

C) Keeping patients upright prior to feeding

30. What is the treatment for gastrointestinal infections caused by Clostridium difficile in older adults? o A) IV vancomycin o B) Oral vancomycin o C) Oral penicillin o D) Topical antibiotics

o B) Oral vancomycin