Geriatrics

Question 1

most heterogenous group in the population

Answer 1

geriatrics

Question 2

Tdap vaccine (if not previously vaccinated) followed by ?

Answer 2

tetanus and diphtheria toxoid (Td) booster every ten years

Question 3

dermatologic changes in aging
-loss of ? (intermittent regular protrusions of the epidermis layer), loss of ? fat, decrease in collagen and elastin, ? photo aging

Answer 3

rete pegs, subcutaneous, increased

Question 4

changes in aging

• CV- baroreceptor ?
• ? gastric acid, slight gallbladder duct ?
• ? in righting reflexes

Answer 4

• dysfunction
• decreased, dilation
• decline

Question 5

aging

• interstitial and skin perfusion ?
• ? absorption of topical preparations and sQ or IM injections

Answer 5

declines

slower

Question 6

bathing, grooming, dressing, mobility, toiling, eating, transferring

Answer 6

activities of daily living

Question 7

telephoning, meal preparation, shopping, finances, stairs, reading, laundry, housework, transportation, medications, employment

Answer 7

INSTRUMENTAL activities of daily living

Question 8

doses for drugs in regards to renal function should be based on ? because renal insufficiency may be present with normal serum creatinine levels

Answer 8

estimated creatinine clearance

Question 9

MC unintended negative medical events

Answer 9

adverse drug events

Question 10

any drug w/ anticholinergic properties likely to produce ? in elderly

Answer 10

confusion

Question 11

alternative therapies

• ? for prostatism
• ? for osteoarthritis

Answer 11

saw palmetto

glucosamine/chondroitin

Question 12

psychomotor retardation or agitation in delirium or dementia?

Answer 12

delirium

Question 13

delirium MC w/ surgical admissions, esp ? and ? procedures

Answer 13

orthopaedic, urologic

Question 14

screening procedures

• lipids?
• bone density?
• smoking cessation?
• exercise?
• aspirin?

Answer 14

q 5 years
F-65, M-70
q visit
q visit
81mg daily unless CI

Question 15

? is best predictor of outcome after stroke or serious fracture

Answer 15

premorbid function

Question 16

digoxin and verapamil or quinidine may result in ?

Answer 16

elevated digoxin levels

Question 17

warfarin + sulfa, quinolones, macrolides, NSAIDs may result in ?

Answer 17

increased effect

Question 18

in elderly MI may be felt as ? or ?

Answer 18

tightness, soreness

Question 19

? pain arises in somatic or visceral tissues and usually described as aching, stabbing, or intense pressure and pain

Answer 19

nociceptive

Question 20

? pain originates in central or peripheral nerves- electrical, burning, shooting, or stinging

Answer 20

neuropathic pain

Question 21

tx nociceptive

• mild pain w/ ?; avoid ?
• moderate to severe pain w/ ?

Answer 21

• acetaminophen or tramadol; NSAIDs (GI bleeding, renal toxicity)
• hydrocodone/acetaminophen, oxycodone, morphine, transdermal fentanyl, or methadone

Question 22

besides colace, ? is designed to reduce constipation from opioids

Answer 22

methylnatrexone bromide (Relistor)- opioid antagonist

Question 23

simple method to evaluate for fall risk?

Answer 23

arise from a chair w/out using arms

Question 24

incontinence - normal part of aging?

Answer 24

no

Question 25

med to tx urge incontinence that is not anticholinergic?

Answer 25

mirabegron (beta adrenergic agonist); associated with elevated BP and tachycardia

Question 26

impairment of cognition- normal part of aging?

Answer 26

no

Question 27

dementia inc risks - education level? - lifestyle? - history of ? or ?

Answer 27

lower sedentary diabetes/metabolic syndrome, htn

Question 28

? characterized by immobility, eating difficulties, and frequent infections

Answer 28

chronic dementia

Question 29

hallucinations - tx w/ ? | parkinson or lewy body dz - ? or ?

Answer 29

atypical antipsychotics | quetiapine, BZD

Question 30

unsteadiness; caused by vestibulopathies, visual, and MS d/o, and neuropathies or anxiety/depression d/o

Answer 30

disequilibrium

Question 31

caused by decreased cerebral perfusion b/c of OH or vaguely mediated cardiac events

Answer 31

presyncope

Question 32

often psychiatric; more vague sensation

Answer 32

light-headedness

Question 33

sudden, transient LOC not resulting from trauma?

Answer 33

syncope

Question 34

malnutrition - MC d/o ? - undernutrition cause most often ?

Answer 34

undernutrition | premouth

Question 35

problems with inability to shop for or prepare meals for inadequate assistance with feeding

Answer 35

premouth

Question 36

loss of or abnormal taste

Answer 36

dysgeusia

Question 37

water deficit is common because the elderly lack ?

Answer 37

a thirst response

Question 38

myalgias, arthralgias, sarcopenia, osteomalacia, hypoparathyroidism

Answer 38

vitamin D deficiency

Question 39

vertebral compression fractures usually in ?; complication include ? or ?

Answer 39

thoracic or lumbar spine; kyphosis, possible restrictive lung disease

Question 40

senile psychosis characterized by ? and ?; associated with isolation, sensory impairment, and dementia; agents of choice?

Answer 40

hallucinations and delusions; newer antipsychotic in low doses

Question 41

dysgeusia may be related to ? or ?, often is secondary to drugs

Answer 41

dental dz, sinusitis

Question 42

xerostomia associated with ? and ? in elderly

Answer 42

gingivitis/periodontitis

Question 43

dentures-harbor organisms, steroids, antibiotics, or diabetics may cause ?

Answer 43

oral candidiasis

Question 44

aspiration pneumonia risk increased with use of ?

Answer 44

PEG tube

Question 45

vague symptoms or confusion, difficult to distinguish from asymptomatic bacteriuria, delirium ?

Answer 45

UTI

Question 46

? characterized by SOB and bibasilar rales

Answer 46

fibrosis

Question 47

elderly presentation less specific, with confusion or arrhythmia or fever?

Answer 47

pulmonary embolus

Question 48

first choice for systolic hypertension?

Answer 48

thiazide diuretics

Question 49

sudden SOB and pulmonary edema seens in ?

Answer 49

CHF

Question 50

dx of CHF?

Answer 50

est clinically

Question 51

'gold standard' for CHF?

Answer 51

cardiac cath

Question 52

cardiac cath lessened in elderly for CHF due to ?

Answer 52

renal toxicity- contrast material

Question 53

elderly- PUD more likely to present with ? rather than dyspepsia or pain

Answer 53

nausea, FTT, melena

Question 54

ulcerations of the colon because of pressure and irritation from retained feces

Answer 54

stercoral ulcers

Question 55

tx for subdural hematomas (common in elderly, alcoholics)

Answer 55

surgery- burr holes

Question 56

competence- legal term determined by ?

Answer 56

judge

Question 57

decisional capacity determined by ?

Answer 57

physician

Question 58

nursing home care for subacute rehab is covered for up to ? after a 3-day qualifying hospital stay

Answer 58

100 days