Geriatrics

Question 1

T or F: depression is a normal part of aging

Answer 1

FALSE

Question 2

what are the 2 questions as part of the PHQ-9?

Answer 2

Little interest or pleasure in doing things?

feeling down, depressed, hopeless?

Question 3

Hospice is used when life expectancy is < _____

Answer 3

6 months

Question 4

Palliative care is used when life expectancy is < ____

Answer 4

18 months

Question 5

T or F: clinician judgment tends to underestimate survival time

Answer 5

FALSE - overestimation is common due to long-standing clinician/patient relationships

Question 6

SPIKES mnemonic stands for:

Answer 6

S - set up interview
P - patient's PERCEPTION of disease
I - Invitation to discuss info
K - KNOWLEDGE
E - address emotions
S - Summarize/strategy for future

Question 7

What are ADLs, and some examples

Answer 7

Activities of daily living

-eating, dressing, toileting

Question 8

Transportation, shopping, cooking, managing money, taking meds are examples of what

Answer 8

Instrumental ADLS (IADLs)

Question 9

AADLs are what? and what are some examples?

Answer 9

Advances ADLs

- golf, fishing, playing cards

Question 10

You are assessing your patient’s functional status, and the Get up and Go test time was 14 seconds. What does this mean?

Answer 10

need further assessment for function - refer to PT/OT

Question 11

your patient scores 8 seconds on the get up and go test. What does this mean?

Answer 11

normal functional status

Question 12

what is the most important prevention for functional decline

Answer 12

Physical activity/ exercise

Question 13

screening for cognitive impairment is controversial; you should only screen when?

Answer 13

if concerns are raised by family or patient themselves

Question 14

T or F: frequent falls in the elderly can be due to vision impairment

Answer 14

True

Question 15

Should you obtain a weight of elderly patients at every visit?

Answer 15

yes

Question 16

Which type of diet should frail elderly be on? DASH, mediterannean?

Answer 16

NONE - no restrictive diets

Question 17

what are the 2 most common vitamin deficiencies in elderly?

Answer 17

Vit B12 and Vitamin D

Question 18

if there are no other comorbidities, what is the safe amount of alcohol for elderly to consume per day?

Answer 18

1 drink per day considered safe

Question 19

what is the most common cause for triggering misuse of alcohol or other drugs

Answer 19

Stress

Question 20

what is a common comorbidity with alcoholism in elderly?

Answer 20

depression

Question 21

The CAGE and AUDIT scores are good for screening alcoholism, but the test more specific to the elderly is the _____

Answer 21

SMAST-G score

2 or more positive answers yields a drinking problem

Question 22

T or F: it is useless to suggest treatment for alcoholism in the elderly, because it is not effective

Answer 22

FALSE - better effectiveness compared to younger population!

Question 23

Because STI’s are increasing in the elderly, you need to screen your patients 65 and older now.

Answer 23

FALSE - not necessary to resume PAP testing regardless of sexual activity at this age.

Question 24

you screen elderly patients for diabetes who have what other 2 comorbidities?

Answer 24

HTN and hyperlipidemia

Question 25

A1c goal for elderly?

Answer 25

<8

Question 26

How do you screen for AAA, and in what population?

Answer 26

screen with abdominal US -screen man aged 65+ who has ever smoked

Question 27

when to stop breast cancer screening (mammogram)

Answer 27

age 75

Question 28

when to stop colorectal screening

Answer 28

75-85

Question 29

Do NOT screen for colorectal cancer if life expectancy < ____

Answer 29

5 years

Question 30

there are no screening for which 2 types of cancers in elderly

Answer 30

ovarian or pancreatic

Question 31

How are the elderly immunized against pneumococcal?

Answer 31

PCV-13 (Prevnar) once at age 65 PPSV-23 (Pneumovax) given 6-12 months later

Question 32

which herpes zoster vaccine is preferred, Zostavax or shingrix?

Answer 32

Shingrix - more side effects but works better

Question 33

How is shingrix administered?

Answer 33

2 doses 2-6 months apart, starting at age 50

Question 34

Hepatitis ____ vaccine is recommended after age 65`

Answer 34

C

Question 35

What is the term used to describe conditions coexisting in the context of an index disease?

Answer 35

Comorbidity

Question 36

What is the term used to describe multiple chronic conditions that collectively have an adverse effect on health status

Answer 36

Multimorbidity

Question 37

Changes in ____________ affect duration effect and blood levels of medication

Answer 37

Kidney function

Question 38

use of multiple medications can lead to ______ and ______

Answer 38

interactions and side effects

Question 39

what is Beer's criteria?

Answer 39

a list of medications to avoid in the elderly population

Question 40

the definition of atypical presentation of illness is:

Answer 40

presentation of a disease state that is missing traditional core features of the illness