Elderly Medicine

Question 1

fluctuating cognition

Answer 1

Lewy body dementia

Question 2

Contralateral hemiparesis and sensory loss with the lower extremity being more affected than the upper

Answer 2

anterior cerebral artery

Question 3

Sudden onset vertigo and vomiting, ipsilateral facial paralysis and deafness

Answer 3

anterior inferior cerebellar artery

Question 4

tress incontinence who don’t respond to pelvic floor muscle exercises and decline surgical intervention

Answer 4

Duloxetine

Question 5

Visual hallucinations with dementia

Answer 5

Lewy body dementia

Question 6

Acute confusional state: if treating the underlying cause and environmental modification not working

Answer 6

haloperidol

Question 7

surgical management for intertrochanteric (extracapsular) proximal femoral fracture

Answer 7

Dynamic hip screws

Question 8

Contralateral hemiparesis and sensory loss with the upper extremity being more affected than the lower, contralateral homonymous hemianopia and aphasia

Answer 8

middle cerebral artery

Question 9

diagnostic of malnutrition

Answer 9

Unintentional weight loss greater than 10% within the last 3-6 months

Question 10

Bladder still palpable after urination

Answer 10

think retention with urinary overflow

Question 11

unilateral hemiparesis and/or hemisensory loss of the face, arm & leg
homonymous hemianopia
higher cognitive dysfunction e.g. dysphasia

Answer 11

Total anterior circulation infarcts

Question 12

Dominant hemisphere middle cerebral artery strokes

Answer 12

aphasia

Question 13

suffered troubling upper gastrointestinal side effects of alendronate?

Answer 13

Change alendronate to risedronate

Question 14

Following a fragility fracture in women ≥ 75 years,

Answer 14

a DEXA scan is not necessary to diagnose osteoporosis and hence commence a bisphosphonate

Question 15

widespread cerebral atrophy mainly involving the cortex and hippocampus

Answer 15

Alzheimer’s disease

Question 16

Osteoporosis is commonly associated with normal blood test values

Answer 16

normal ALP, normal calcium, normal phosphate, normal PTH

Question 17

Patients with heart failure with reduced LVEF

Answer 17

beta blocker and an ACE inhibitor

Question 18

Intracapsular fracture, displaced Independently mobile, does not use more than a stick

Answer 18

Total hip replacement

Question 19

Intracapsular fracture, displace
Not independently mobile

Answer 19

Hemiarthroplasty, cemented implants preferred

Question 20

Trochanteric fracture

Answer 20

Sliding hip screw

Question 21

Subtrochanteric fracture

Answer 21

Intramedullary nail

Question 22

Fluctuating confusion/consciousness?

Answer 22

Subdural haemorrhage/ haematoma

Question 23

neuroimaging findings: ventriculomegaly in the absence of, or out of proportion to, sulcal enlargement

Answer 23

Normal pressure hydrocephalus

Question 24

Stepwise progression of symptoms in dementia

Answer 24

think vascular dementia

Question 25

Urinary incontinence + gait abnormality + dementia

Answer 25

normal pressure hydrocephalus

Question 26

sweating, tremor, confusion and hyperreflexia

Answer 26

Serotonin syndrome

Question 27

first-line for mild-moderate Alzheimer’s disease

Answer 27

Acetylcholinesterase inhibitors such as donepezil