FINAL- Geriatric Syndromes

Question 1

What are the main types of dizziness?

Answer 1

Vertigo, presyncope, disequilibrium, other (nonspecific), and mixed.

Question 2

What are common causes of vertigo in older adults?

Answer 2

BPPV (Benign paroxysmal positional vertigo), Ménière’s disease, vestibulopathy, acoustic neuroma, cerebrovascular disease.

Question 3

What conditions cause presyncope?

Answer 3

Orthostatic hypotension, postprandial hypotension, cerebral ischemia, vasovagal syncope.

Question 4

What are common causes of disequilibrium?

Answer 4

Vision loss, proprioceptive disorders, musculoskeletal/gait disorders.

Question 5

Which medications can cause dizziness?

Answer 5

Anxiolytics, antihypertensives, antidepressants, antipsychotics, aminoglycosides, NSAIDs, antihistamines, anticholinergics.

Question 6

What test is used to diagnose BPPV?

Answer 6

Dix-Hallpike maneuver.

Question 7

What is the first-line treatment for BPPV?

Answer 7

Epley maneuver.

Question 8

What are intrinsic fall risk factors?

Answer 8

Age-related decline in vision, vestibular system, BP regulation, cognitive impairment, low vitamin D, Parkinson’s, stroke, arthritis.

Question 9

What are extrinsic fall risk factors?

Answer 9

Poor lighting, rugs, thresholds, unsafe footwear, clutter, staff ratios.

Question 10

Which medications increase fall risk?

Answer 10

Antihypertensives, antidepressants, antipsychotics, benzodiazepines, opioids, insulin, muscle relaxants, Parkinson’s drugs.

Question 11

What is the CDC tool for fall risk assessment?

Answer 11

STEADI algorithm.

Question 12

What is frailty?

Answer 12

A chronic progressive syndrome of decreased physiologic reserve and increased vulnerability.

Question 13

What are the Fried frailty criteria?

Answer 13

Weight loss, exhaustion, weakness (grip strength), slowness (walking), low activity. ≥3 = frailty.

Question 14

What is sarcopenia?

Answer 14

Loss of lean muscle mass central to frailty.

Question 15

What are tools to measure frailty?

Answer 15

Fried phenotype, gait speed, SOF index, Frailty Index, Edmonton Frail Scale, Clinical Frailty Scale, FRAIL scale.

Question 16

What management approach improves frailty outcomes?

Answer 16

Comprehensive Geriatric Assessment (CGA).

Question 17

What is malnutrition?

Answer 17

Imbalance between intake and body needs leading to adverse outcomes.

Question 18

What is the daily energy requirement for older adults?

Answer 18

25–30 kcal/kg/day.

Question 19

What is the protein requirement for older adults?

Answer 19

0.8 g/kg/day (up to 1.5 g/kg under stress).

Question 20

What BMI indicates undernutrition?

Answer 20

BMI <18.5.

Question 21

Which labs are used to assess nutrition?

Answer 21

Albumin <3.5, prealbumin (short-term), cholesterol <160.

Question 22

What vitamin D and calcium intake is recommended?

Answer 22

Vitamin D 800 IU/day, Calcium 1000 mg/day.

Question 23

What is the gold standard test for dysphagia?

Answer 23

Videofluoroscopic swallow study (modified barium swallow).

Question 24

What are examples of swallow therapy?

Answer 24

Compensatory (head turn), indirect (strengthening), direct (multiple swallows per bolus).

Question 25

What are AGS Choosing Wisely recommendations for advanced dementia?

Answer 25

Avoid PEG; use assisted oral feeding.