B6.075 Formative Answers

Question 1

when a patient starts losing IADLs, what is the most important component of the functional assessment to check first?

Answer 1

everyday activities

I guess lol wtf

Question 2

order of loss of ADLs

Answer 2

opposite order that they are acquired as children (if lost due to frailty)

1. bathing
2. toileting

Question 3

only ADL a person can need help with but still live alone

Answer 3

hygiene
can get a bath aid 3-5 times per week
more predictable and can be scheduled unlike other ADLs

Question 4

reason for functional assessment

Answer 4

optimize independence and treat impairments early

maximize function

Question 5

biggest risk factors for future falls

Answer 5

1. history of falls

2. fear of falling

Question 6

gait associated with lumbar spinal stenosis

Answer 6

pain worsens with extension (up stairs) and improves with flexion

Question 7

symptoms associated with normal pressure hydrocephalus

Answer 7

wacky (confused)
wobbly (gait instability)
wet (incontinence)
festinating gait that is commonly associated with parkinsons

Question 8

gait associated with tardive dyskinesia

Answer 8

involuntary movements that are dyskinetic

Question 9

gait associated with progressive supranuclear palsy

Answer 9

postural instability

Question 10

factors that contribute to orthostatic hypotension

Answer 10

compensatory mechanism decline with age
venous insufficiency
chronic diuretic use (volume depletion)
B blckers

Question 11

tandem walk

Answer 11

adds challenges to gait performance to assess a gait that appears normal
can help predict falls

Question 12

modifiable risk factor for falling that can be treated w a multifactorial approach

Answer 12

balance impairment

• tai chi
• strength training
• flexibility

Question 13

SAFE SSRIs that older people can have

Answer 13

sertraline
citalopram
escitalopram

Question 14

SSRIs that increase fall risk

Answer 14

fluoxetine
paroxetine
have anticholinergic effects and multiple drug interactions

Question 15

lorazepam

Answer 15

benzo

increased fall risk

Question 16

zolpidem

Answer 16

sedative/hypnotic
used for insomnia
can increase fall risk

Question 17

diphenhydramine

Answer 17

strongly anti-cholinergic
notorious for effects on balance and cognition
never use in older adults

Question 18

3 interventions proven to decrease number of people who fall

Answer 18

tai chi / exercise
environmental modifications IF visually impaired
vit D supplementation

Question 19

management of trochanteric hip fracture (avulsion)

Answer 19

non weight bearing for 3-4 weeks
follow up with ortho for xrays
usually full activities in 3-4 months
NO SURGERY typically
early ambulation can displace bone, not recommended

Question 20

discharge meds following hip surgery

Answer 20

LWM heparin for 35 days

Question 21

most important med 1-2 hours before surg

Answer 21

Cefazolin

LMW hep given 12 hrs prior