Board Vitals Geriatrics Flashcards
What is most likely to affect an older person’s ability to live independently?
Risk of falls
If a long list of medications is given in an older patient, what should you consider to be the cause of their symptoms?
Polypharmacy
What symptoms are older patients on multiple medications susceptible to?
Dizzziness and vertigo
Does vitamin D supplementation reduce fall risk?
No
Does vitamin D alone reduce fracture risk?
No
What reduces the fall risk in patients 65 years and older?
Exercise
Does vision correction reduce risk of falls?
No
Where does mild congitive impairment fall on a continuum from normal aging to dementia?
In the middle
Where does mild cognitive impairment fall in the continuum of normal aging to dementia?
In the middle
Is mild cognitive impairment a risk factor for development of dementia?
Yes
Patient has an impairment in declarative episodic memory; and has difficulty completing activities of daily living.
Diagnosis?
Alzheimer’s dementia
Patient has resting tremors, difficulty initiating movement, and rigidity; with associated symptoms of orthostatic hypotension, postural instability and cognitive impairment.
Diagnosis?
Parkinson’s disease
Patient presents with cognitive impairment, along with visual hallucinations, REM sleep behavior disorder, fluctuating alertness and attention, and some symptoms of Parkinson’s disease.
Diagnosis?
Lewy body dementia
Patient with cognitive impairment presents with progressive aphasia and behavioral changes.
Diagnosis?
Frontotemporal dementia
Which laxative can be used daily and is suitable for long term use?
Polyethylene glycol (MiraLAX)
Why is Milk of Magnesia not recommended for daily use?
It may cause diarrhea and electrolyte abnormalities.
How long can Sennoside be used for?
One week (stimulant laxative)
Should Bisacodyl suppositories be used daily?
No (stimulant laxative)
Can amitriptyline cause orthostatic hypotension in the elderly?
Yes
In hospitalized elderly patients with delirium should you try pharmacological or non-pharmacological treatments first?
Non-pharmacological treatment e.g. increasing daylight exposure.
How soon should surgery be performed for elderly patients with a fractured hip (if medically stable - meaning not crashing)?
Within 24 hours
Should hip fracture surgery be delayed if the patient has hyperglycemia?
No
What is the first line treatment for mild osteoarthritis?
- Weight loss
- Exercise
What is a major risk factor for future falls?
A previous fall
What is the next step after there is concern regarding a patient’s driving abilities due to mild cognitive impairment?
Formal driving evaluation
How soon should hip fractures be surgically repaired?
Within 24 hours
What bedside test has the highest sensitivity and specificity for assessing delirium?
Confusion Assessment Method
Is the Mini Mental Status Exam specific to delirium?
No
What is the treatment of opioid-induced constipation with ileus if laxatives aren’t working?
Methylnaltrexone
Naloxegol
