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Adult Gero > Atypical Presentation > Flashcards

Atypical Presentation Flashcards

1
Q

What is the major cause of death in adults aged 65 and older?
- A) Cancer
- B) Cardiovascular disease
- C) Infection
- D) Diabetes

A
  • C) Infection
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2
Q

Infections exacerbate which of the following in older adults?
- A) Mobility
- B) Multimorbidities
- C) Cognitive function
- D) Sensory loss

A
  • B) Multimorbidities
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3
Q

What is immune senescence?
- A) Increase in antibody production with age
- B) Decline in immune function with age
- C) Enhancement of immune response in the elderly
- D) Increase in T-cell function with age

A
  • B) Decline in immune function with age
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4
Q

The decline in which immune cell function is a key feature of immune senescence?
- A) Neutrophils
- B) Platelets
- C) T-cells
- D) Red blood cells

A
  • C) T-cells
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5
Q

Which of the following is a risk factor for atypical presentation of illness in older adults?
- A) Multimorbidities
- B) Cognitive impairment
- C) Polypharmacy
- D) All of the above

A
  • D) All of the above
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6
Q

Why are older adults at higher risk for infections?
- A) Increased nutrition
- B) Immune senescence
- C) Higher skin elasticity
- D) Enhanced immune function

A

B) Immune senescence

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7
Q

. Fever in older adults is typically defined as an oral temperature:
- A) Over 99°F
- B) Over 100°F
- C) Over 101°F
- D) Over 98.6°F

A
  • B) Over 100°F
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8
Q

. What percentage of older adults with serious infections may not present with a fever?
- A) 25%
- B) 50%
- C) 75%
- D) 90%

A
  • B) 50%
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9
Q

The most common organism causing community-acquired pneumonia (CAP) in older adults is:
- A) Haemophilus influenzae
- B) Moraxella catarrhalis
- C) Streptococcus pneumoniae
- D) Klebsiella pneumoniae

A
  • C) Streptococcus pneumoniae
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10
Q

. Which of the following is NOT a risk factor for pneumonia in older adults?
- A) Multimorbidity
- B) Age over 85
- C) Hypothermia
- D) High cholesterol

A

D) High cholesterol

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11
Q

Outpatient treatment guidelines for CAP in older adults typically recommend:
- A) Amoxicillin only
- B) Beta-lactam with a macrolide
- C) Penicillin alone
- D) Cephalosporin alone

A
  • B) Beta-lactam with a macrolide
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12
Q

Which of the following is an atypical presentation of pneumonia in older adults?
- A) Fever over 101°F
- B) Abdominal pain
- C) Shortness of breath
- D) Productive cough

A
  • B) Abdominal pain
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13
Q

. In older adults, the absence of which symptom is common in serious infections such as pneumonia?
- A) Fever
- B) Cough
- C) Shortness of breath
- D) Chest pain

A
  • A) Fever
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14
Q

Which of the following might indicate a serious illness in an older adult?
- A) Increased confusion
- B) Worsening incontinence
- C) Functional decline
- D) All of the above

A
  • D) All of the above
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15
Q

. An older adult presenting with confusion or delirium may be experiencing which of the following?
- A) Urinary tract infection (UTI)
- B) Pneumonia
- C) Sepsis
- D) All of the above

A
  • D) All of the above
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16
Q

What is an atypical presentation of UTI in older adults?
- A) Dysuria
- B) Fever
- C) Confusion or altered mental status
- D) Urgency

A

C) Confusion or altered mental status

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17
Q

Which of the following is a reason NOT to treat asymptomatic bacteriuria in older adults?
- A) It reduces antibiotic resistance
- B) There is no clinical benefit
- C) It increases the cost of healthcare
- D) It prevents C. difficile colitis

A
  • B) There is no clinical benefit
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18
Q

In older adults, T-cell function is typically:
- A) Increased
- B) Decreased
- C) Unchanged
- D) Enhanced with age

A
  • B) Decreased
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19
Q

How does aging affect B cells in the elderly?
- A) B-cells produce more antibodies
- B) B-cells produce fewer antibodies with lower affinity
- C) B-cell activity remains unchanged
- D) B-cells become hyperactive

A
  • B) B-cells produce fewer antibodies with lower affinity
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20
Q

What is the common cause of gastrointestinal infections in older adults?
- A) Inhalation of pathogens
- B) Bloodborne transmission
- C) Oral-fecal contamination
- D) Transmission through wounds

A
  • C) Oral-fecal contamination
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21
Q

Which of the following is commonly associated with GI infections in the elderly?
- A) Rotavirus
- B) Streptococcus pneumoniae
- C) Escherichia coli
- D) Mycobacterium tuberculosis

A
  • C) Escherichia coli
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22
Q

Which of the following increases the risk of GI infections in older adults?
- A) Hypochlorhydria
- B) Antibiotic overuse
- C) Achlorhydria
- D) All of the above

A
  • D) All of the above
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23
Q

Which antibiotic regimen is often recommended for treating CAP in older adults?
- A) Amoxicillin-clavulanate (Augmentin)
- B) Ciprofloxacin alone
- C) Macrolide with a beta-lactam
- D) Penicillin alone

A
  • C) Macrolide with a beta-lactam
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24
Q

What is the usual duration of antibiotic treatment for uncomplicated outpatient CAP in older adults?
- A) 3-5 days
- B) 7-14 days
- C) 14-21 days
- D) 1-2 days

A
  • C) 14-21 days
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25
Q

Fever of unknown origin in older adults is defined as:
- A) A temperature above 100°F for 3 days
- B) A fever lasting more than 3 weeks with no diagnosis after one week of medical evaluation
- C) A temperature above 99°F for more than 2 weeks
- D) A fever that resolves with antipyretics

A
  • B) A fever lasting more than 3 weeks with no diagnosis after one week of medical evaluation
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26
Q

Which of the following is a common cause of fever of unknown origin in older adults?
- A) Osteomyelitis
- B) Heart disease
- C) Chronic kidney disease
- D) Hypertension

A
  • A) Osteomyelitis
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27
Q

Which of the following must be considered when prescribing antibiotics to older adults?
- A) Renal function
- B) Drug metabolism
- C) Drug interactions with other medications
- D) All of the above

A
  • D) All of the above
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28
Q

What is a common reason for poor medication adherence in older adults?
- A) Cognitive impairment
- B) Financial constraints
- C) Polypharmacy
- D) All of the above

A
  • D) All of the above
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29
Q

What is the best strategy to prevent pneumonia in older adults?
- A) Annual flu vaccination
- B) Smoking cessation
- C) High-dose pneumonia vaccine
- D) All of the above

A
  • D) All of the above
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30
Q

High-dose flu vaccines are recommended for adults over:
- A) 50 years old
- B) 60 years old
- C) 65 years old
- D) 70 years old

A
  • C) 65 years old
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31
Q

The most common organism responsible for urinary tract infections (UTIs) in older adults is:
- A) Escherichia coli
- B) Klebsiella pneumoniae
- C) Pseudomonas aeruginosa
- D) Streptococcus pneumoniae

A

A) Escherichia coli

32
Q

Which of the following interventions can help prevent recurrent UTIs in postmenopausal women?
- A) Antibiotics daily
- B) Intravaginal estrogen
- C) Cranberry juice
- D) Both B and C

A
  • D) Both B and C
33
Q

What is the first-line treatment for suspected sepsis in an elderly patient?
- A) Immediate surgery
- B) Antibiotics and fluid resuscitation
- C) Pain management
- D) Antiviral medication

A
  • B) Antibiotics and fluid resuscitation
34
Q

Which of the following increases the risk of sepsis in older adults?
- A) Age over 85
- B) Multimorbidities
- C) Immune senescence
- D) All of the above

A
  • D) All of the above
35
Q

Why is it important to assess older adults for multimorbidities when evaluating atypical presentations of infections?
- A) Multimorbidities increase the complexity of diagnosis and treatment
- B) They increase the risk of infection
- C) Symptoms may be masked or atypical
- D) All of the above

A
  • D) All of the above
36
Q

Which of the following is a common atypical presentation of infection in older adults?
- A) High fever
- B) General malaise or confusion
- C) Rash
- D) Severe joint pain

A

B) General malaise or confusion

37
Q

What is the primary reason older adults may not present with typical symptoms of infection such as fever?
- A) Lower metabolic rate
- B) Reduced immune response (immune senescence)
- C) Increased hydration
- D) Enhanced B-cell activity

A
  • B) Reduced immune response (immune senescence)
38
Q

In the elderly, which of the following is a key symptom that may be absent in a pneumonia diagnosis?
- A) Cough
- B) Fever
- C) Fatigue
- D) Shortness of breath

A
  • B) Fever
39
Q

Which of the following is the most effective preventive measure for reducing community-acquired pneumonia in older adults?
- A) Regular use of antibiotics
- B) Annual vaccination
- C) Increased vitamin intake
- D) Use of antifungals

A
  • B) Annual vaccination
40
Q

Which symptom is often absent in older adults presenting with a urinary tract infection (UTI)?
- A) Dysuria
- B) Fever
- C) Confusion
- D) Increased frequency

A
  • B) Fever
41
Q

Which of the following organisms is most commonly responsible for urinary tract infections (UTIs) in older adults?
- A) Streptococcus pyogenes
- B) Staphylococcus aureus
- C) Escherichia coli
- D) Pseudomonas aeruginosa

A
  • C) Escherichia coli
42
Q

. In older adults, what is a common cause of sepsis related to gastrointestinal infections?
- A) Rotavirus
- B) Campylobacter
- C) Bacillus species
- D) Clostridium difficile

A
  • D) Clostridium difficile
43
Q

Why is it important to use antibiotics judiciously in older adults?
- A) To improve the speed of recovery
- B) To prevent the development of drug-resistant organisms
- C) To increase the efficacy of immunizations
- D) To ensure higher drug tolerance

A

B) To prevent the development of drug-resistant organisms

44
Q

Which of the following is an adverse effect of overusing antibiotics in older adults?
- A) Increased immune function
- B) Reduced kidney function
- C) Increased risk of developing Clostridium difficile infection
- D) Increased cognitive function

A
  • C) Increased risk of developing Clostridium difficile infection
45
Q
  1. What is the major cause of death in adults 65 years and older?
    o A) Cancer
    o B) Cardiovascular diseases
    o C) Infections
    o D) Accidents
A

C) Infections

46
Q
  1. Which of the following describes the age-related decline in immune function?
    o A) Immune senescence
    o B) Immune hypersensitivity
    o C) Immune modulation
    o D) Immune adaptation
A

A) Immune senescence

47
Q
  1. What is the primary cause of reduced immune function in older adults?
    o A) Overactive T-cells
    o B) Depressed T-cell and B-cell response
    o C) Enhanced macrophage activity
    o D) Increased antibody production
A

o B) Depressed T-cell and B-cell response

48
Q
  1. Which of the following organisms is predominantly found in community-acquired pneumonia (CAP) in older adults?
    o A) Staphylococcus aureus
    o B) Streptococcus pneumoniae
    o C) Klebsiella pneumoniae
    o D) Moraxella catarrhalis
A

B) Streptococcus pneumoniae

49
Q
  1. What percentage of older adults die from infections?
    o A) 10%
    o B) 25%
    o C) 40%
    o D) 50%
A

o C) 40%

50
Q
  1. What is a significant risk factor for developing pneumonia in older adults?
    o A) Physical exercise
    o B) Multimorbidity
    o C) High hydration
    o D) Regular flu vaccination
A

o B) Multimorbidity

51
Q
  1. Which of the following is a primary method of pneumonia prevention in older adults?
    o A) Regular use of broad-spectrum antibiotics
    o B) Immunizations
    o C) Strict bed rest
    o D) Using antifungal medications
A

B) Immunizations

52
Q
  1. What role does skin integrity play in infection susceptibility in older adults?
    o A) Thicker skin increases the risk of infection
    o B) Thinner skin increases susceptibility to infection
    o C) No effect on infection risk
    o D) Skin integrity enhances immunity
A

B) Thinner skin increases susceptibility to infection

53
Q
  1. What is the strongest independent predictor of mortality in older adults with pneumonia?
    o A) Smoking
    o B) Multimorbidity
    o C) Obesity
    o D) Dehydration
A

o B) Multimorbidity

54
Q
  1. What is the primary organism responsible for pneumonia in long-term care facilities?
    o A) Streptococcus pneumoniae
    o B) Gram-negative bacilli
    o C) Staphylococcus aureus
    o D) Respiratory viruses
A

o B) Gram-negative bacilli

55
Q
  1. How often do nursing home residents develop pneumonia within two years?
    o A) 10%
    o B) 20%
    o C) 30%
    o D) 50%
A

o C) 30%

55
Q
  1. Which of the following is a risk factor for urinary tract infections (UTI) in older adults?
    o A) Decreased kidney function
    o B) Increased protein intake
    o C) Frequent hydration
    o D) Regular exercise
A

A) Decreased kidney function

56
Q
  1. Which is the most common pathogen causing UTIs in older adults?
    o A) Klebsiella pneumoniae
    o B) Enterococcus species
    o C) Escherichia coli
    o D) Pseudomonas aeruginosa
A

C) Escherichia coli

57
Q
  1. Why is asymptomatic bacteriuria often left untreated in older adults?
    o A) It is a mild infection
    o B) No clinical benefit and potential adverse effects from treatment
    o C) It leads to faster recovery without treatment
    o D) Antibiotics cannot treat it effectively
A

B) No clinical benefit and potential adverse effects from treatment

58
Q
A
59
Q
  1. Which medication is contraindicated in older adults with chronic kidney disease when treating UTIs?
    o A) Bactrim
    o B) Nitrofurantoin
    o C) Amoxicillin
    o D) Cephalexin
A

o B) Nitrofurantoin

60
Q
  1. What percentage of older women in long-term care facilities are affected by asymptomatic bacteriuria?
    o A) 10% to 20%
    o B) 25% to 50%
    o C) 60% to 80%
    o D) Over 90%
A

o B) 25% to 50%

61
Q
  1. What is the recommended first-line treatment for uncomplicated cystitis in older adults?
    o A) Amoxicillin
    o B) Fluoroquinolones
    o C) Bactrim or Nitrofurantoin
    o D) Doxycycline
A

C) Bactrim or Nitrofurantoin

62
Q
  1. Which condition in older adults is often caused by oral fecal contamination?
    o A) Respiratory infections
    o B) Gastrointestinal infections
    o C) Skin infections
    o D) Bone infections
A

o B) Gastrointestinal infections

63
Q
  1. Which viral organism is commonly responsible for gastrointestinal infections in older adults?
    o A) Staphylococcus aureus
    o B) Bacillus species
    o C) Norwalk virus
    o D) Escherichia coli
A

C) Norwalk virus

64
Q
  1. Which gastrointestinal condition can result from antibiotic overuse in older adults?
    o A) Bacillus infection
    o B) C. difficile colitis
    o C) Rotavirus
    o D) Traveler’s diarrhea
A

B) C. difficile colitis

65
Q
  1. What is a significant factor leading to infections in long-term care facilities?
    o A) Dehydration
    o B) Overuse of antiviral medications
    o C) Poor staff compliance with infection control practices
    o D) Overnutrition
A

C) Poor staff compliance with infection control practices

66
Q
  1. What is the most effective preventive measure for reducing influenza infections in older adults?
    o A) Annual flu vaccination, especially with high-dose vaccines
    o B) Quarantine during flu season
    o C) Use of antivirals year-round
    o D) Increasing hydration levels
A

A) Annual flu vaccination, especially with high-dose vaccines

67
Q
  1. What is the most common side effect of Tamiflu (oseltamivir) in older adults?
    o A) Severe headache
    o B) Gastrointestinal issues, such as nausea and vomiting
    o C) Rash
    o D) Difficulty breathing
A

B) Gastrointestinal issues, such as nausea and vomiting

68
Q
  1. What percentage of deaths from influenza occur annually in the United States, especially among older adults?
    o A) 10,000
    o B) 20,000
    o C) 40,000
    o D) 60,000
A

o C) 40,000

69
Q
  1. What is the primary management strategy for sepsis in older adults?
    o A) Rapid administration of fluids and antibiotics
    o B) Immediate surgery
    o C) High-dose vitamin therapy
    o D) Pain management
A

A) Rapid administration of fluids and antibiotics

70
Q

o D) Pain management
26. Which of the following changes in the immune system is commonly observed in older adults?
o A) Increased production of T-cells
o B) Depressed T-cell and B-cell function
o C) Increased production of antibodies
o D) Enhanced macrophage response

A

o B) Depressed T-cell and B-cell function

71
Q
  1. What is a typical sign of upper urinary tract infection (pyelonephritis) in older adults?
    o A) Increased frequency of urination
    o B) Fever, chills, and flank pain
    o C) Abdominal distention
    o D) Dry cough
A

B) Fever, chills, and flank pain

72
Q
  1. What percentage of older adults suffer from under-nutrition on an outpatient basis?
    o A) 5%
    o B) 10%
    o C) 11%
    o D) 20%
A

o C) 11%

73
Q
  1. Which of the following is an important measure to reduce the risk of hospital-acquired pneumonia?
    o A) Giving all patients prophylactic antibiotics
    o B) Performing chest X-rays regularly
    o C) Keeping patients upright prior to feeding
    o D) Administering cough suppressants frequently
A

C) Keeping patients upright prior to feeding

74
Q
  1. What is the treatment for gastrointestinal infections caused by Clostridium difficile in older adults?
    o A) IV vancomycin
    o B) Oral vancomycin
    o C) Oral penicillin
    o D) Topical antibiotics
A

o B) Oral vancomycin

Adult Gero (10 decks)

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