Help
Options
Question
You are seeing an 81-year-old male in your clinic because of progressive memory loss and an increasing inability to do basic things around the house. His wife notes that he has stopped cleaning up after himself, has forgotten to pay their utility and rent
click to flip
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't know
Question
You are seeing a 79-year-old male in the office with worsening confusion and combativeness over the last few months. His wife states he has not seen a primary doctor in many years. His evaluation suggests advanced Parkinson’s disease. What is the best ini
Remaining cards (102)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
geriatrics EOR quiz
| Question | Answer |
|---|---|
| You are seeing an 81-year-old male in your clinic because of progressive memory loss and an increasing inability to do basic things around the house. His wife notes that he has stopped cleaning up after himself, has forgotten to pay their utility and rent | Mini–Mental State Examination (MMSE) |
| You are seeing a 79-year-old male in the office with worsening confusion and combativeness over the last few months. His wife states he has not seen a primary doctor in many years. His evaluation suggests advanced Parkinson’s disease. What is the best ini | Carbidopa/levodopa (Sinemet) |
| What are the recommended first-line agents for pharmacotherapy of psychotic symptoms in patients with dementia? | Atypical antipsychotics |
| An 88-year-old black female with peripheral arterial disease is admitted to the hospital because she has gangrene in 2 toes as well as a soft-tissue infection of her distal foot. She is a widow and lives alone; her daughter visits at least weekly. On admi | Delirium |
| How many of the 78 million “baby boomers” are predicted to develop Alzheimer’s disease in their lifetime? | 10 million (13%) |
| The Framingham Study of the Incidence of Dementia revealed a decrease over time in of all of the following except: | Prevalence of dementia |
| A 67-year-old male presents to the office with his family to obtain a second medical opinion. He has lost 18 kg (40 lb) in the past 6 months, is weak, spends most of his time in bed, no longer participates in family activities, and is no longer interested | Occult lung cancer |
| A 76-year-old female is transferred from a rehabilitation facility to the hospital after she falls and fractures her right hip. She was recovering from a recent hospitalization for pneumonia and exacerbation of COPD that left her profoundly deconditioned. | Obtain preoperative consultation with a geriatrician for a multifactorial risk-strategy |
| You are seeing a 75-year-old male in the office accompanied by his family after they express concern about his recent loss of interest in his usual activities. They believe he has become increasingly withdrawn since the death of his wife six months earlie | mirtazapine (Remeron) |
| Which of the following is NOT a common symptom of mild to moderate Alzheimer disease? | Seizures |
| An 80-year-old Hispanic female is admitted to your hospital after falling and suffering a hip fracture. She lives alone and has been self-sufficient. She has been able to drive, go to the grocery, and balance her own checkbook. She does well in the hospit | Delirium |
| Which of the following statement about dementia is NOT correct? | The US Preventive Services Task Force (USPSTF) has concluded that there is sufficient evidence to recommend routine screening for dementia in older adults > 65 years of age |
| You are seeing a 58-year old female with newly diagnosed Parkinson's Disease to discuss recommend treatment options. Which of the following is a common side effect of this patient's underlying disease and new medication regimen? | All of the above |
| You are seeing a 68-year old male in the office for because of a worsening tremor in his both arms and is present most of the day. He has a past medical history of type 2 diabetes mellitus, hypertension, and chronic kidney disease. Medications are insulin | Depression: Nortriptyline |
| A 75-year-old retired man is brought to the office by his daughter. Since his wife died 6 yr ago, he has lived alone in the suburban home that he has owned for 40 years. The patient has been increasingly forgetful and has neglected his appearance and hygi | Adult day healthcare on weekdays, with supervision by the family on nights and weekends(A) Adult day healthcare on weekdays, with supervision by the family on nights and weekends |
| You are seeing a 71-year old male in your neurology clinic with his wife. He has a past medical history of high blood pressure and BPH. He takes lisinopril and tamulosin. He was diagnosed with Alzheimer's dementia three years and his wife is asking about | Cognitive stimulation |
| You are evaluating a 72-year-old patient for possible dementia. Which of the following tests are routinely recommended by the American Academy of Neurology? | Measurement of vitamin B12 level and assessment of thyroid function. |
| What is the incidence of delirium in older adults after a high-risk procedure? | 50% |
| You are seeing a 68-year-old white male in the office for evaluation into a recently new tremor in his left hand that developed over the last few months. He notes that is becoming increasingly more difficult to perform fine motor activities and it appears | Parkinson disease |
| An 85-year-old woman is brought to the office by her daughter because she has been having visual hallucinations of children and small animals when she is alone in a room. At times she has been disturbed and agitated by these hallucinations. Her daughter a | Dementia with Lewy bodies |
| You are seeing 61-year-old black previously healthy black male for a routine well-care visit along with his wife. She is concerned that he has become quite apathetic and seems to have lost interest in his job and golfing. He has been accused of making sex | Frontotemporal dementia |
| Which of the following statements is true regarding a 72-year-old man who is diagnosed with a first episode of major depression associated with cognitive impairment? | The condition may predict the development of an irreversible dementia, such as Alzheimer's disease or vascular dementia. |
| Which of the following statements regarding psychosis in patients with dementia is true? | Agitation represents a cluster of physical manifestations that suggest emotional distress or motor restlessness |
| When evaluating a new disability in an older adult, it is important to identify contextual factors as they have especially important roles in the early and late stages of disability development. Which of the following is not part of this evaluation? | Medication adverse effects |
| A 75-year-old woman comes to the office for follow-up evaluation after an ischemic stroke 2 months earlier. Her past medical history includes hypertension and COPD. She had a transient ischemic attack 2 yr ago; after which she has taken aspirin 81 mg/d; S | Discontinue aspirin |
| An 81-year-old patient presents for an annual physical examination. She reports no symptoms except mild arthritis and uses only acetaminophen occasionally. In addition to asking about falls in the past year, the most useful test to determine her risk of f | The Get up and Go Test. |
| A 67-year-old woman presents to the office for advice regarding diet. She recently had a modified radical mastectomy for stage I breast cancer. She chose this approach because she wanted to avoid radiation and chemotherapy. She has always had a healthy li | Drink 4 cups of green tea daily. |
| An 80-year-old male is brought to the emergency department because worsening altered mental status. His family notes that his cognition is rapidly deteriorating, and now has a temperature of 39.4C (103F). Around 12 hours ago he developed upper abdominal p | Incentive spirometry |
| An 82-yr-old woman is brought to the office to establish care. She requires complete assistance with ADLs due to her underlying dementia. She has a past medical history of moderate vascular dementia, atrial fibrillation, and systolic heart failure. Her me | Location |
| A 79-year-old male comes to the office because he has increasing difficulty understanding conversations with his grandchildren. Which of the following is the most likely diagnosis? | Presbycusis |
| A 55-year-old male presents to his primary care office for a routine examination. He has a past medical history of heavy smoking (two packs per day for the last 15 years) and occasional alcohol use. He denies use of illegal drugs. His family history is no | No screening is recommended |
| A 62 year old female presents after she was found unresponsive by her family who then called EMS. EMS noted an initial blood glucose of 32 mg/dL. She has a history of Type II DM per family but not sure what medications she is on. According to the article | Chlorpropamide |
| Which of the following statements are true regarding muscle loss in the elderly? | Aged skeletal muscle cells are more likely than younger skeletal muscle cells to undergo apoptosis (cell death) as a result of physical inactivity. |
| Bladder training is most effective in functional incontinence. | FALSE |
| A 72-yr-old woman comes to the office for preoperative evaluation before left total-knee replacement. Despite the worsening pain in her left knee, she remains active, and gardens and plays golf 4 days per week. She has no known allergies and has never smo | Continue atenolol at the current dosage. |
| A 66-year old male with no past medical history presents to you with difficulty urinating over the last few months. He denies fever, chills, flank pain, or dysuria. His urine dipstick reveals no WBC's, RBC's, protein, or glucose. On physical exam his abdo | Schedule a transrectal ultrasound (TRUS)-guided prostate biopsy |
| Which of the following statements about smoking and older adults is true? | Older smoker who quit gain substantial health benefits. |
| A 75-year-old man with chronic hepatitis C complains of abdominal pain and swelling of his abdomen and legs for the last few days. At night when he sleeps, he has difficulty breathing and needs to sleep sitting up. Last year he had a ultrasound and liver | Paracentesis |
| What change in gait occurs as patients age? | All of the above |
| For patients over 75 years old, falls are the leading cause of hospitalization and injury-related death. | TRUE |
| A 70-year-old Chinese-American man presents to your office with a worsening rash. For 2 days before the rash, he had fever, odynophagia, and bilateral eye pain. Over the next few days, the rash evolved to extensive sloughing and peeling of the skin. His p | Toxic epidermal necrolysis |
| An 80-year-old man with diabetes and osteoporosis comes to the office for consultation regarding his pain regimen. He has severe pain related to diabetic neuropathy and back pain related to multiple compression fractures. He takes hydrocodone/acetaminophe | Methadone |
| An 80-year-old female is receiving a bone marrow transplant. She is receiving the transplant from a matched but unrelated donor. After receiving the transplant, she begins to develop a maculopapular rash on her neck, shoulders, palms of her hands, and sol | T cells present in the allograft |
| You are seeing a 76-year-old female in clinic for a routine evaluation. She lives alone you note that she has multiple bruises over her upper arms and chest. Abuse is suspected although the patient vehemently denies this. What is the next best step? | Report the possible abuse to the appropriate authorities. |
| You are seeing a 76 year-old male after a recent fall. Patient states that the fall occurred at night, and that he has difficulty with walking at night. On physical exam, there is reduced position and vibratory sensation in his extremities. When the patie | Sensory ataxia |
| To promote gait stability, older men should be counseled to select shoes with: | High mid-sole hardness and low mid-sole thickness. |
| Which of the following supplements is most beneficial for the older adult? | Vitamin C, vitamin E, carotene, and zinc to slow progression of age-related macular degeneration. |
| Which of the following statements regarding B-type natriuretic peptide (BNP) levels is true? | BNP levels vary with age and sex. |
| A 79-year-old man comes to the office for advice about treatment options for localized prostate cancer. The cancer was identified during transurethral resection of the prostate for presumed benign prostatic hyperplasia. His prostate-specific antigen level | Active surveillance would be as effective as radical prostatectomy |
| Xerostomia is the subjective sensation of drymouth caused by decreased saliva production and affects 29 to 57 percent of older persons. Which of the following is not a risk factor for the development of xerostomia? | Alcohol |
| A 79-year-old male comes to the office because he has increasing difficulty understanding conversations with his grandchildren. Which of the following is the most likely diagnosis? | Presbycusis |
| Which of the following statements about hospice referrals is/are true? | Nationwide, the median length of stay in hospice is 26 days |
| You are seeing a 78 year-old male in the clinic for loosening and loss of teeth. The patient was diagnosed with diabetes 15 years ago. When asked about taking medications regularly, the patient is unsure. Vitals are BP 145/90 mm Hg, HR 83/min, Temp 98.0 F | All of the above |
| Which of the following is a known patient and physician barrier to hospice referral? | All of the above |
| Which of the following statements about cancer screening is not recommended? | All statements are true and recommended |
| You are seeing a 60 year-old female for her annual wellness visit. Her last mammogram was 2 years ago and came back normal. Her last pap smear was done 5 years ago and was normal. The patient’s last colonoscopy was 6 years ago, but she does not remember t | All of the above |
| Which of the following is the most significant determinant for post-op survival in hip fractures? | Pre-injury mobility |
| You are seeing a 78-year old female in the ER after an apparent fall at home. She is complaining of right distal forearm pain. She has a past medical history of endometrial cancer that was treated with a hysterectomy 15 years ago as well as anxiety and de | Elder abuse |
| Gait velocity is a powerful indicator of function and prognosis after stroke. What velocity would lead a patient to full mobility in the community? | 0.3 m/s |
| With aging, the appearance and structure of teeth tend to change. Which of the following is NOT an Age-Related Oral Change? | Gingival recession |
| A 45-year-old white male consults you because of a painless, circular, 1-cm white spot inside his mouth, which he noticed 3 days ago. You are treating him with propranolol (Inderal) for hypertension, and you know him to be a heavy alcohol user. After a ca | perform a biopsy of the lesion |
| Osteoporotic bone loss can be caused or accelerated by prolonged use of which one of the following medications? | Phenytoin |
| Which of the following statements are true regarding hospice? | None of the above |
| You are seeing 64-year-old male in your clinic with worsening memory loss that seems to be getting worse. He teaches college English and notes that he occasionally has difficulty remembering the names of his students and colleagues, forgetting telephone n | Magnetic resonance imaging of the brain |
| Most oral cancers are basal cell carcinomas that arise from the oral mucosa. | FALSE |
| Cancer is the leading cause of death among patients 65 years and older. | FALSE |
| The daily intake of vitamins and minerals recommended by the Food and Nutrition Board and U.S. Preventive Services Task Force varies according to sex, age, and condition. What is the recommended daily allowance of vitamin D for a 71-year old white female | 800 IU/day |
| You are seeing a 65-year old male in your office because of persistent worsening bilateral hand pain over the last several months. Which of the following hand joints are required to be affected in the diagnosis of Osteoarthritis? | 1st MCP, and 2nd/3rd DIPs and PIPs |
| A 61-year-old white male presents to your office for a lesion that he noticed on his tongue about 3 months ago. You are treating him with lisinopril for hypertension, and you know him to be a oral tobacco user and a former alcoholic now sober. An image of | This lesion represents hyperplasia of the squamous epithelium |
| What is the systolic blood pressure goal for patients 60 – 80 years of age? | < 150 mm Hg |
| You are seeing an 82-year-old female for an annual checkup. She asks you if she should receive a zoster vaccine, because she heard from her friends that it is recommended. What information is necessary from this patient's history in order for you to answe | Previous vaccination against varicella |
| A 75-year-old male presents to the office because of a lesion on his tongue. He notes that that is not painful except when he eats acidic or spicy foods. He does not remember when he first noticed it. His notes his last dental examination was 2 yr ago. He | Refer for immediate biopsy of the lesion |
| Tobacco and alcohol use are thought to be responsible for up to 75 percent of oral cancers. Precancerous lesions and early oral cancer can be subtle and asymptomatic. Most oral and oropharyngeal cancers are squamous cell carcinomas that arise from the lin | lateral borders of the tongue |
| With aging, the appearance and structure of teeth tend to change. Which of the following is not an Age-Related Oral Change? | Reduced cementum |
| Which of the following is the most significant risk factor for urinary incontinence? | Pregnancy and Childbirth |
| Which of the following has been shown to be of benefit in reducing pressure ulcers in acute-care settings? | Standard nutritional supplements for older patients |
| Unintentional weight loss in persons older than 65 years is associated with increased morbidity and mortality. What is the single most commonly identified cause? | Malignancy |
| urge incontinence | involuntary loss of urine with a strong urinary urgency |
| stress incontinence | urethral sphincter pressure insufficient to hold urine |
| overflow incontinence | too high urethral resistance or insufficient bladder contractions |
| functional incontinence | chronic impairment of physical or cognitive function |
| What is the most common type of constipation in older adults? | normal transit constipation |
| When approaching a patient with urinary incontinence, which of the following is the most helpful aspect in the evaluation into determining the diagnosis and best treatment options? | History |
| Treatment of unintentional weight loss treatment should focus on the underlying cause. This often involves a multidisciplinary team, including dentists; dietitians; speech, occupational, or physical therapists; and social service workers. Common strategie | Human growth hormone |
| Outpatient surveys indicate that about what percentage of older adults with dementia are current drivers? | 30% |
| Which of the statements is true regarding Older Adult Drivers with Cognitive Impairment? | Driving cessation has been associated with depression and social isolation in older adults |
| You are seeing an 80 year-old male in the hospital. The patient came from a nursing home with a decubitus ulcer. On physical exam, you note a grade III decubitus ulcer on his L buttock. How much does a pressure-reducing surface lower ulcer incidence compa | 60% |
| A 74-year-old man presents to clinic with a complaint of numerous episodes of dizziness, and has lost consciousness on his most recent episode. There is no chest pain, headache, nausea, vomiting, or feeling that the room is spinning. His past medical hist | Electrocardiogram |
| What is the most common type of hearing loss in the geriatric population? | high frequencies |
| How many older adults with dementia are current drivers? | 30% |
| Which of the following has been related to a lower fatality rate among elderly drivers? | In-person license renewal |
| You are seeing a patient who is having issues with fecal incontinence. As part of your workup, you want to assess for any somatic dysfunctions that you could treat with OMM. Where would be the most reasonable place to look? | S2-4 |
| Which of the following Nonpharmacologic Interventions behavioral interventions for the treatment of constipation in the older adult is not TRUE? | The recommended daily fiber intake is 100 g per day and |
| An 83-year-old otherwise healthy woman is brought to the office by her daughter because the mother has become confused and forgetful since beginning treatment with extended-release oxybutynin 10 mg for urge urinary incontinence 6 months ago. The incontine | Discontinue extended-release oxybutynin 10 mg; implement behavioral therapy for incontinence. |
| Which of the following findings is not an indication to perform colonoscopy? | Acute change in stool consistency |
| Enemas and suppositories can be useful for fecal impaction or in patients who cannot tolerate oral preparations. Which of the following statements regarding their treatment is FALSE? | Phosphate enemas are considered first line treatment for older adults with constipation |
| You are seeing an 85 year-old male in the hospital. The patient came from a nursing home with a decubitus ulcer. On physical exam, you note a grade IV decubitus ulcer on his R heel. What test should be done to check for osteomyelitis and guide antibiotic | Needle biopsy of the bone |
| A 75-year-old woman comes to the office because she perceives hearing loss. On examination, both of her ears are impacted with cerumen. Which of the following types of hearing loss results from impacted cerumen? | Conductive |
| Studies suggest that a life expectancy of at least how many years is necessary to derive a survival benefit from screening for breast and colorectal cancers? | 10 years |
| An 82-year-old female is discharged to home after a 2-week hospital stay for pneumonia. The hospitalization was complicated by atrial fibrillation with a rapid ventricular response, delirium, and development of a 4-cm, state III sacral pressure ulcer. Pri | The Medicare home health agency is required to provide twice-daily dressing changes when ordered by a physician. |
| You are seeing a 76-year old female who is presenting with an unintentional weight loss of about 8% over the last 6 months. She has a past medical history of hypertension that is treated well with hydrochlorothiazide. Her Patient Health Questionnaire-2 (P | Mirtazapine (Remeron) |
| Which of these possible treatments for unintentional weight loss is associated with increased mortality? | Human growth hormone |
| Use of Quetiapine in delirium is associated with a low degree of sedation and low risk of extrapyramidal effects. | FALSE |
Created by:
mmmk24