older adults

Question 1

components of functional domain

Answer 1

function
nutrition
vision
hearing

Question 2

safety and mobility assessment

Answer 2

performance-oriented mobility assessment
tinoetti balance and gait evaluation

Question 3

ASPEN malnutrition definition

Answer 3

2 of the following:

insufficient energy intake
loss of muscle mass
weight loss
loss of SQ fat
diminished functional status (handgrip strength)
localized or generalized fluid accumulation

Question 4

recommended vision screening

Answer 4

q 1-2 years

Question 5

psychologic domain assesments

Answer 5

cognitive assessment
affective assessment (depression screening tool)

Question 6

average life expectancy

Answer 6

78.79

Question 7

causes for underreporting illness

Answer 7

ageism
perception of unresponsive system for care (this is a normal thing of aging)
depression
dementia
denial (fear of consequences)

Question 8

body systems most often affected by age-related decline

Answer 8

neuro
CV
musculoskeleteal
lower urinary

Question 9

most common symptoms of illness

Answer 9

acute confusion
depression
falls
incontinence
syncope

Question 10

why are older adults vulnerable to geriatric syndromes?

Answer 10

decreased physiologic reserve

Question 11

delirium first line treatment

Answer 11

haldiol 0.5-1 mg BID

check QTc!

Question 12

2nd line delirium treatment options

Answer 12

olanzapine 2.5 mg BID
quetiapine 25 mg BID
risperidone 0.5 mg BID

lorazepam 0.5-1 mg q4h

trazodone 25-150 mg QHS

Question 13

agitation treatment

Answer 13

haldol

risperidone

Question 14

biggest risk factor for fall

Answer 14

previous fall

Question 15

causes of transient incontinence

Answer 15

DIAPPERS

delirium
infection
atrophic uretitis and vaginitis
pharmaceuticals
psychological factors
excess urinary output
restricted mobility
stool impaction

Question 16

established risk factors for incontinence

Answer 16

older age
female
increased BMI
dementia
DM
limited physical activity

Question 17

types of incontinence

Answer 17

urethral incompetence (stress)
detrusor overactivity (urge)
functional
high post void residual
detrusor under activity (overflow)
mixed

Question 18

incontinence workup

Answer 18

history
focused physical
UA with C/S
PVR
consider: BMP, renal US, urologic evaluation, urodynamic testing

Question 19

management for urethral (stress) incompetence

Answer 19

kegels, limit fluid and caffeine, bladder suspension

Question 20

management for detrusor overactivity/urge

Answer 20

bladder training, bladder relaxants (oxybutinin)

Question 21

management for functional incontinence

Answer 21

environmental manipulations, undergarments/pads, behavioral interventions

Question 22

management of high PVR

Answer 22

removal of obstruction, consider intermittent cath, long-term cath

Question 23

management of detrusor underactivity/overflow incontinence

Answer 23

bladder decompression with intermittent or indwelling Cath followed by initiation of alpha blocking agents (tamsulosin)

finasteride if enlarged prostate

Question 24

1 modifiable risk factor for falls

Answer 24

> 4 medications

Question 25

acute dizziness

Answer 25

<2 months

Question 26

chronic dizziness

Answer 26

> 2 months