Midterm

Question 1

Your elderly patient complains of slight dizziness after performing Valsalva’s, this would most likely be due to

Answer 1

There may have been a drop in blood pressure

Question 2

Age affects the neurological system in as much that a geriatric patient may have a ____ without intiially demonstrating any neurological symptosm

Answer 2

Hemorrhage

Question 3

Changes affecting the stria vascularis define this type of presbycusis

Answer 3

Metabolic

Question 4

These protein fragments form hard insoluble plaques that accumulate between nerve cells in ALzheimer patients

Answer 4

Beta amyloid

Question 5

In an effort to improve your senior patient’s overall wellbeing you recommend some aerobic exercises. The patient complains that his heart beats hard and fast and that recovery at rest takes long. The mechanism for this slow recovery is likely to be from

Answer 5

Reduced Beta adrenergic response

Question 6

Demographers define baby boomers as those born between

Answer 6

1946 and 1964

Question 7

A deformity of this protein that stabilizes neuron microtubules, has been implicated in Alzheimer’s disease

Answer 7

Tau

Question 8

The normal hearing range occurs between

Answer 8

20 Hz and 20 KHz

Question 9

Metamorphosia, central scotoma and reduced visual acuity are associated with this type of presbyopia

Answer 9

Macular degeneration

Question 10

Geriatric patients often have an atrypical presentation to a disease process. As such, delirium might be the presenting sign of a patient who simply has a bad UTI

Answer 10

True

Question 11

The ability to taste __ adn ___ are altered in teh elderly

Answer 11

Sweet

Salty

Question 12

The default diagnosis of a patient who is known to be confused is ___ until another diagnosis can be found

Answer 12

Delirium

Question 13

A slight elevation of serum creatinin could signify

Answer 13

Reduced renal function

Question 14

As part of your evaluation fo a patient with suspected dementia, clock drawing and three item recall should be employed because they have an 80% degree of reliability in evaluating cognitive status

Answer 14

True

Question 15

The terminal end of the chromosome which determines replication is called

Answer 15

Telomere

Question 16

Low serum levels of ___ and/or ___ may be a sign of undernutrition

Answer 16

Albumin

Iron

Question 17

Altered color perception, sensitivity to glare and loss of contrast sensitivity are associated with this form of visual impairment

Answer 17

Cataract

Question 18

In our last lecture I explained that an objective of a patient care was the need to develop normative data. What was the study I was referred to that was an example of this

Answer 18

DEXA

Question 19

Developing normative data, making a diagnosis and reviewing treatment progress is a process that describes

Answer 19

Functional status measuresq

Question 20

Loss of this deep tendon reflex is often associated with aging and not a sign of neuro pathology

Answer 20

Achilles

Question 21

According to lecture, unilateral ankle edema may be a consequence of sciatic radiculopathy

Answer 21

True

Question 22

A major feature that distinguishes delirium from dementia and other causes of impaired cognitive function is a clouding of the state of consciousness evidenced by the patients difficulty in sustaining attention, a sensory misconception or fragmented thought

Answer 22

True

Question 23

According to lecture, statin drugs are known to deplete the cells of

Answer 23

CoQ-10

Question 24

Which one of the following is NOT considered a neurological change assocaited with aging

Answer 24

Increased incidence of pill rolling tremors

Question 25

The expression brown bagging it refers to

Answer 25

Addressing polypharmacy

Question 26

The get-up and go test is designed to evaluate

Answer 26

Risk for falling

Question 27

Female patient, 53, presents with pain and tenderness in the proximal muscles should be queried about concomitant

Answer 27

Temporal headaches

Question 28

Mr. James jackson is a 75yo new patient who presents to your office complaining of bilateral leg cramping. During your history you learn he has lumbar degeneration and high cholesterol for which he takes the statin drug Lipitor. He denies trauma and states that symptosm began gradually. He denies problems with bathroom or sleep. Differential would include all of the following except

Answer 28

Sciatic radiculopathy | Vascular claudication, neurological claudication, rhabdomyolysis

Question 29

You hear bruit in the carotid arteries of a 74 yo male who has come to you with complaint of neck pain. What shoukld your care plan entail

Answer 29

Order a doppler US and refer to his PCP

Question 30

An assessment of your pt reveals memory difficulties but no focal neurological signs, emotional stability, clear awareness but difficulty finding words. Your referral to the neurologist would include a suspected diagnosis of

Answer 30

Alzheimer dementia

Question 31

According to the reisburg scale, pre-clincal alzheimer’s dementia can be determined by

Answer 31

Observation of protein plaques on advanced imaging

Question 32

Apoptosis is programmed cell death without the influence of

Answer 32

Inflammation

Question 33

As we age there appears to be an increase in the appearance of autoimmune disease. One theory of aging postulates that increasing quantities of ___ is the culprit

Answer 33

Proinflammatory cytokiens

Question 34

Advanced glycation end products develop when a reducing sugar bonds with a protein causing the elimination of a

Answer 34

Water molecule

Question 35

Balance and mobility problems and an increased risk of motor vehicle accidents are related to

Answer 35

Loss of attentional visual field

Question 36

Life span is considered to be 65% heredity and 35% environment. T/F

Answer 36

False

Question 37

Where should skin turgor be checked when assessing pt for dehydration

Answer 37

Chest or abdomen

Question 38

In the absence of pulmonary dx and heart dx, crackles discerned during ausculatition of a senior patient, would make you suspicious of

Answer 38

Atelectasis

Question 39

Which one of the following would be considered an abnormal neurological change associated with aging

Answer 39

Increased incidence of pill rolling tremors

Question 40

A senior pt with irregular pulse

Answer 40

Seldom needs other treatment than chiropractic care

Question 41

The info gleaned from asking this question is most associated with determining the body system involved

Answer 41

Pain quality

Question 42

Which one of the following is not considered part of the key aspects of the mental status exam

Answer 42

General affect

Question 43

Reactive oxygen metabolites are theorized to cause sensorineural hearing loss by

Answer 43

MtDNA deletions

Question 44

What is the criterion for unexplained weight loss, which would warrant further evaluation for occult neoplasm Loss of ___%. Body weight within __ months or less

Answer 44

5 | 12

Question 45

Inabiilty to hear ___ or ____ Hz in either ear with the audioscope set at 40 decibels characterizes a person as having poor hearing

Answer 45

20 | 20,000

Question 46

What is the diagnostic criterior for urinary incontinecnce

Answer 46

Loss of urine continence 6 separate days within one year

Question 47

What makes a free radical a free radical

Answer 47

It has an unpaired electron in its outer shell

Question 48

This is a reversible form of cognitive impairment that is specifically caused by a thimain deficiency

Answer 48

Korsakoff syndrome

Question 49

Decline of CoQ-10 in mitochondria is associated with

Answer 49

Loss of energy

Question 50

In humans there appears to be a direct correlation between shortening telomere length and ___ aging

Answer 50

Vascular