2016 zima

Question 1

Which of the following activities are not included in the scale Acitivities of Daily Living?

Answer 1

food preparation

Question 2

Which of the following has been shown to increase falls risk?

Answer 2

polypharmacy, 25-OH-D3 deficiency, proproception loss

Question 3

Dementia combined with gait disturbance, urinary incontinence, enlarged brain ventricles and normal, slightly elevated CSF pressure

Answer 3

normal-pressure hydrocephalus

Question 4

Sudden onset, definite beginning pont, greatly impaired attention, variably impaired level of consciousness and reversible course

Answer 4

delirium

Question 5

Nutritional recommendation for elderly should include all except

Answer 5

supplementation with selenium

Question 6

Older adults should avoid drugs with anticholinergic effects when possible. Adverce effects include:

Answer 6

confusion, othostatic hypotension, constipation, dry mouth, urinary retention, blurred vision

Question 7

79yrs man, acute cholecystitis, diabetes mellitus, mild dementia, deppresive disorder, recurrent falls. he fell twice last 3 mths. Delirious while hosp. Insulin twice a day, donepezil. How to reduce risk of falls

Answer 7

use a cane when walking

Question 8

84 yrs man, minimizing muscle loss, How to delay it?

Answer 8

advice regular physical activity of moderate intensity

Question 9

72 yrs man, he believes that he has undiagnosed cancer

Answer 9

major depressive disorder with psychotic feature

Question 10

88yrs woman, peripheral arterial disease, gangrene in 2 toes. BP 140/80, RR 16, HR 90, T=38. cefalosporyna, metro, pentoksyfilina, heparyna, morfina. acutely confused and inattentive, chaotic speech

Answer 10

delirium

Question 11

94 yrs nursing home with AD, screaming for help, making noise past 3 weeks

Answer 11

atypical neuroleptics

Question 12

81 yrs old woman, muscle weakness, fatigue, palpitations, weight loss, normal apetite, RR 160/65, HR 110

Answer 12

hyperthyroidism

Question 13

True statements

Answer 13

a test below 40 in the Barthel Index indicates that a geriatric patient qualifies for a long term care or institutionalising
to evaluate instrumental activities of daily living (IADL) the Lowton’s scale is used

Question 14

93 yrs old man, hypertension, diabetes, hip fracture, RR 165/90, glc 8,5, HB10.9% MMSE 21/30

Answer 14

operation urgently

Question 15

pneumonia in elderly - true

Answer 15

acute confusion, delirium, deterioration of baseline function

Question 16

hazard of immobility

Answer 16

constipation, atelectasis, pressure ulcers

Question 17

Parkinson’s disease - false

Answer 17

intentional tremor

Question 18

risks of hormone replacement therapy in older woman

Answer 18

^ of pulmonary emboli and ischemic strokes

Question 19

PCV-13 and PPSV-23

Answer 19

PPSV-23 in one year after PCV-13b (65+)
PCV-13 in more than one year after PPSV-23 (65+)
PPSV-23 before 65, than PCV-13 in more than one year and PPSV again in more than 5 yrs after

Question 20

true

Answer 20

increasing patients with multimorbidity - delivery of care built around single diseases

Question 21

assessment of PU risk in elderly

Answer 21

clinical state, functional, cognitive, nutritional status, skin assessment, screening test

Question 22

70 yrs old 3x6 sacral ulcer

Answer 22

sharp debridement of eschar

Question 23

PU stage II

Answer 23

shiny or dry shallow open ulcer

Question 24

HF in elderly

Answer 24

confusion, sacral area edema, nocturnal agitation

Question 25

risk of iatrogenic complications

Answer 25

multiple chronic diseases, multiple physicians, polypharmacy and inappropriate drugs, hospitalization

Question 26

reccurent pleural exudate - true

Answer 26

1. appears in 50% with malignant cancer
2. median survival time - 1 yr in breast, 6 months in lung
3. pleurodesis is a chosen method

Question 27

UTI symptoms

Answer 27

bladder spasm, self catheterization, acute retention

Question 28

anaphylactic shock after morphine - false

Answer 28

consequence of SINGLE administration of morphine

Question 29

haemoptysis - false

Answer 29

massive is not a medical emergency

Question 30

false

Answer 30

diarrhoea appears in 70% patients

Question 31

CYT P450 genetic polymorphism drug

Answer 31

codeine

Question 32

60 yrs woman, metastatic breast, dehydrated, lethargic, without focal neurological findings

Answer 32

hypercalcemia

Question 33

62 yrs old lung cancer, shortness of breath, facial swelling, distended neck veins

Answer 33

superior vena cava obstruction

Question 34

effective communication

Answer 34

language, experience, values, motions

Question 35

opioids cause nausea and vomiting by

Answer 35

stimularing the chemoreceptor zone

Question 36

false anorexia-cachexia

Answer 36

intensive nutrition prolong life, stops progress of cachexia

Question 37

OIH false

Answer 37

can be overcome by increasing dosage

Question 38

^risk of renal failure

Answer 38

enalapril + furosemid + ketoprofen

ketoprofen + torasemid

Question 39

very long half-life

Answer 39

methadon

Question 40

risk of thrombotic episodes

Answer 40

megestrol acetate

Question 41

constipation

Answer 41

morphine

Question 42

hyperglycemia, Cushing

Answer 42

dexamethasone

Question 43

Lymphangitis carcinomatosa

Answer 43

bad prognostic predictor

high dose GKS

Question 44

false

Answer 44

nephrostomy changed each 1-2 days

Question 45

reversible terminal sedation

Answer 45

relief of intractable pain or suffering

Question 46

terminally ill, awareness, decreased oral intake, not getting up out of bed

Answer 46

impending death