Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

IV Geriatria > 18/19 lato > Flashcards

18/19 lato Flashcards

1
Q

Which of the following has been shown to increase drug adherence in the eldery

A

physycian explanation imho physician explanation bo wg prezki inne zmniejszaja
adherence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which of the following opioids are available in Poland in transdermal patch

A

1- fentanyl

3- buprenorphine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Long acting NSAIDs can have all of the following effects on the elderly except:

A

hypotension

ale:
kidney injure
b) gastrointestinal bleeding and peptic ulcer disease
d) fluid retention
e) hypertension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how long after applying a transdermal fentanyl patch can an analgesic effect be observed:

A

c) 12h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q 
Which of the following patients with break through pain should not be treated with
transmucosal fentanyl (TIRF):
A

40 yo patient with advanced lung cancer who has been treated with a
transdermal fentanyl patch (12,5ug/h) for the past 2 months - because he wa s the only
patient who received less than 60 mg of morfine per day for a week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

patient with lung cancer is experiencing severe pain resulting from infiltration of
the chest wall (NRS 7-8). Therapy is initiated and optimal pain relief is achieved with
the paitent receiving 40 mg of oxycodone in a controlled released tablet every 12
hours (6:00 and 18:00). Occasionally, the patient reports exacerbations of pain
reaching 9 on the NRS scale, lasting 20 minutes, without any clear cause. Please
determine the type of pain:

A

spontaneous breaktrough pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which of the following increases with age

A

gastric pH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

(Xddddddddd)
Please read the following excerpt of a conversation and choose the best ending

  • How did you sleep last night?
  • Poorly, I couldn’t fall asleep (blablabla)
  • Yes
  • What is it?
  • I am worried.
  • You’re worried?
  • Yes. I don’t know what will come next.
  • Did you talk about this with your doctor?
  • If only the doctor had been listening, I would have told him what i really feel :(
A

Why do you think the doctor wasn’t listening?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

72 yo man with hypertension controlled with 2,5mg indapamide had a 6-month history of
dyspnoea on walking his dog and when gardening. His echocardiogram showed mild
concentric hypertrophy of the left ventricular, RF of 40%. Which of the following would be the
most likely to improve his life expectancy:

A

ACEI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Secondary gastroparesis occurs due to all of the following except

A

generalized artherosclerosis

ale:
constipation
b) diabetes mellitus
c) intestinal obstruction
e) muscular dystrophy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

The drug of choice in the treatment of diarrhea due to Clostridium difficile infection

A

Vancomycin p.o.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

smooth and red surface of the tongue (atrophy of lingual papillae) with disturbances of
taste is characteristic for which form of mycosis

A

chronic atrophic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

The reason of an impaired communication with an older patient (hearing impairment) is
not:

A

hypersensitivity to the high frequency sounds

ale:
lack of understanding garbling speech (e.g. while talking on phone)
2) impaired sound location
3) phenomenon called cocktail party effect
5) hypersensitivity to the low frequency sounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

A 30yo patient with metastatic colon cancer asks his doctor “Am i dying?” What should
the doctor respond?

A

Please tell me, why are you asking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Multiple brain metastases most frequently occur in:

A

Small cell lung carcinoma (also: niggeroma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
  1. A feature of the clinical course supporting the differentiation between dementia with
    Lewy bodies and dementia in the course of Alzheimer’s disease is:
A

a) a fluctuating course of cognitive processes with variability of attention and wakefulness
b) hypersensitivity to neuroleptisc
c) visual hallucinations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q
  1. Which of the following statements regarding the use of opioids in the treatment of
    dyspnea is false:
A

c- opioids increase the sensitivity of the central respiratory zone to increased levels of CO2

ale:
a- opioids decrease the sensitivity of the central respiratory zone to increased levels of CO2
b- opioids decrease the respiratory rate to a level tolerated by the patient
d- opioids modulate the inflammatory process and healing through their actions on neuroendocrine cells of the lungs
e- opioids decrease anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

The most frequent cause of seizures in patients with advanced neoplasms:

A 
a) primary or secondary brain tumor
electrolyte disturbances (hyponatremia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

80- year- old woman with a history of hypertension and congestive heart failure
complaints of frequent episodes of incontinence. She says that these episodes happen
without warning, usually in the context of coughing or sneezing. Which of following
interventions is the most likely to help with her incontinence

A

pelvic muscle exercises

20
Q
  1. Choose the best answer of five major components of a comprehensive assessment of
    the older adult patient:
A

medical, cognitive, functional, nutritional, social aspects

21
Q
  1. Which of the following neoplasms most frequently cause recurrent pleural effusion
A

1- lung cancer

4- breast cancer

22
Q

Which of the following regarding spinal cord compression syndrome is false:

A

it occurs in the cervical spine in 70% of cases

ale:
it occurs in 5% of patients suffering from cancer
b) it most commonly occurs in the thoracic spine
c) it most commonly occurs in patients with lung, breast and prostate cancer
d) autonomic disturbances are late symptoms

23
Q

In differentiating Alzheimer’s disease with vascular dementia, vascular dementia is
indicated by:

A

jumping course of symptoms

5- prevalent numerous strokes

24
Q

The frequency of resting dyspnea in patients with advanced bronchial carcinoma is:

A

80%

25
Q

A 75-year-old woman with multiple health problems complains of having “no energy” and
feeling increasingly weak. She has had a 6kg loss over the last 3 months. Choose the other
components use to recognize frailty syndrome:

A

physical activity

b) muscle strenght
c) walk speed

26
Q

In 80% of patients with spinal cord compression of a few-weeks duration the first
symptom is

A

radicular pain

27
Q

78 y-o man presents to the primary care clinic with complaints of dryness of mouth,
constipation, increased heart rate, falls without obvious reason, confusion. Which of the
following types of drugs might be to blame

A

anticholinergics

28
Q

A patient with sarcoma of the left thigh complains of mixed pain (nociceptive-neuropathic)
localized in the region of the left thigh with radiation to the hip. The intensity of the pain NRS
8-9/10 and is worst when the patient is standing. Until now, the patient has been receiving
tramadol 400mg/d, paracetamol 3g/d and ketoprofen 200mg/d. Please choose the best
course of action:

A

withdraw tramadol; administer controlled- release morphine 40mg/d, immediaterelease
morphine as needed and pregabalin 75mg/ d; continue administration of paracetamol and ketoprofen

29
Q

Which of the following type of dressing will be optimal to apply for pressure ulcer in stage III with slough and complicated by local infection:

A

d) gase

30
Q

Which type of exercise would you advise to a person aged 65+ to improve endurance

A

nordic walking

31
Q

Which of the following drugs are most useful in the treatment of pain with a neuropathc
component:

A

2-valproic acid
3- gabapentin
4- pregabalin

32
Q

What pharmacodynamic changes are seen in the elderly with regard to ACE-inhibitors
and beta-blockers:

A

increased response ACE

and decreased B-blockers

33
Q

Pregabalin and gabapentin act by:

A

inhibiting the alpha-2-delta of voltage-dependent calcium channels

34
Q

Which of the following statements about tramadol is false

A

simultaneous administration of tramadol and paroxetine does not increase the risk of serotonin syndrome

ale:
40% of its activity is as a non-selective mi, kappa, delta agonist
b) 60% of its activity is as a serotonin and noradrenaline reuptake inhibitor
c) its active metabolite is O-desmetylotramadol, which is stronger than its parent drug
d) the maximal dose of tramadol is 400mg/24h

35
Q
  1. In the patient with cancer pain till now not having taken opioids, we decide to introduce the treatment of morphine. We start titration, administer intravenously 1 mg of morphine every 5 minutes and we obtain pain relief with a dose of 10 mg. Please indicate the daily \demand of the drug:
A

60 mg .v. daily

36
Q

75-y-o woman with osteoporosis presents to the primary care clinic with a urinary tract infection. She is currently taking alendronate, vit. D, and calcium. Which of the following drugs may be less effective, considering the drugs she is currently taking, especially calcium:

A

ciprofloxacin

37
Q

A 79 year old woman with dementia was recovering from a fall when she developed a left ileofemoral deep vein trombosis. The occupational therapist is considering the suitability for care services. Which of the following is NOT included in the Bartel Index:

A

cognition

ale;
bathing
b) dressing
d) toileting
e) transfers
38
Q

74 year old woman has pressure ulcer on heel stage III with slough and small exudate. No signs of local infection, indicate the optimal metod of debridement of the pressure ulcer:

A

hydrogel or hydrocoloid dressing

39
Q

70 year old man who lives in assisted living is admitted to hospital with several hand fractures related to fall. His family notes that he has 2-yr history of progressive memory impairment. On examination, the patient is phisically agitated and appears anxious. He is verbal but cannot recall where he is or why. His score on the MMSE is 15/30 and his attention span is normal. He sleeps poorly in the hospital at nights and tend to sleep during the day, but he is easily aroused. Physical examination, brain imaging and laboratory examinations do not identify reversible cause of his impairments. Which of the following is the most likely cause of this patient’s agitation

A

c) Alzheimer’s disease

40
Q
  1. In the patient with severe pain (NRS=9) after titration of morphine we obtained a pain relief with a 24 hour dose of 40 mg of this opioid given s.c. After laboratory tests the patient was diagnosed with renal failure. Taking into consideration coexisting pain and renal insufficiency the best choice of opioid in this case will be:
A

transdermal buprenorphine 35ug/ h

41
Q

Which of the following items is not a component of Mini Mental State

A

proverb interpretation

ale:
remembering words for a period of time
b) calculation
d) drawing intersecting pentagons
e) carrying out a three-stage command
42
Q

94-y-l nursing home resident with Alzheimer’s disease is evaluated because
she has been disturbing other patients by screaming for help and banging on the
nurse throughout a day for the past 4 weeks. Which of the following drug group is the
most likely to reduce the patient’s agitation

A

second generation antipsychotics

43
Q

Which of the following statements regarding megestrol acetate is false

A

it worsens appetite

ale;
it causes an increase in body mass by increasing the amount of adipose tissue
and retention of water through the stimulation of neuropeptide Y
d) it can cause the following side effects: hypertension, hyperglycemia,
thromboembolic events, edema, depression, aggression, changes in mood
e) it inhibits the adrenal cortex after extended use
a) it is a synthetic progesteron

44
Q

Polyuria is urination:

A

greater than 7 times per day and 2 times during the night

45
Q

Which of the following drugs act as anti-emetics by blocking D2 receptors in the
chemoreceptor trigger zone and may effectively decrease nausea and vomiting due
to hypercalcemia?

A

(D) Haloperidol

46
Q
  1. Side effect to expect from anticholinergic (parasympatholitic) agents include all of the
    following exept
A

a) increased sweating
c) diarrhea

ale:

b) dry mouth
d) tachycardia

47
Q
  1. Differences in the presentation of depression in elderly compared to the younger age
    groups include
A

a) more frequent psychotic symptoms
b) the difference in the expression of anxiety in the form of excessiwe worrying,
concentration disorders, memory impairment

IV Geriatria (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions