Geriatrics

Question 1

Undernutrition, slowed motor performance, loss of muscle mass, or weakness suggests

Answer 1

frailty

Question 2

Kyphosis or abnormal gait

Answer 2

impairs balance & increases risk for falls

Question 3

Isolated systolic HTN (>140) after age 50

Answer 3

triples risk for CAD in men & increases risk of stroke

Question 4

Pulse pressure (PP) >60 is a risk factor for

Answer 4

Cardiovascular & renal disease; & stroke

Question 5

Lightheadedness, weakness, unsteadiness, visual blurring, & 20-30% of patients experience syncope

Answer 5

Symptoms of Orthostatic Hypotension

Question 6

Respiratory rate >25 breaths per minute indicates

Answer 6

lower respiratory infection

Question 7

translucent nodules that spreads & leaves a depressed center with firm elevated border

Answer 7

Basal Cell Carcinoma

Question 8

firm reddish-appearing lesion often emerging in a sun-exposed area

Answer 8

Squamous Cell Carcinoma

Question 9

dark raised asymmetric lesion with irregular borders may be

Answer 9

melanoma

Question 10

______ may develop from obliteration of arteriolar & capillary blood flow to skin or from shear forces during movement across sheets or when lifted upright incorrectly

Answer 10

Pressure sores

Question 11

world’s leading cause of blindness

Answer 11

cataracts

Question 12

Cataracts risk factors

Answer 12

cigarette smoking, exposure to UV B-light, high alcohol intake, DM, some meds, & trauma

Question 13

what disease is linked to cerebral microvascular changes & cognitive impairment

Answer 13

retinal microvascular disease

Question 14

increased cup-to-disc ratio

Answer 14

open angle glaucoma - caused by irreversible optic neuropathy

Question 15

causes poor central vision & blindness; drusen may be hard & sharply defined or soft & confluent with altered pigmentation

Answer 15

Macular Degeneration

Question 16

____ may arise from periodontal disease

Answer 16

gingivitis

Question 17

Increased tooth mobility from abscesses or advanced caries warrants

Answer 17

removal to prevent aspiration

Question 18

increased anteroposterior diameter, purse-lipped breathing, & dyspnea with talking or minimal exertion suggests

Answer 18

chronic obstructive pulmonary disease

Question 19

Isolated systolic HTN & widened pulse pressure are cardiac RF, prompting search for

Answer 19

Left Ventricular Hypertrophy (LVH)

Question 20

A ______ can raise pressure in the left jugular veins by impairing drainage into right atrium.

Answer 20

tortuous atherosclerotic aorta

Question 21

_____ can be hearted in aortic stenosis & carotid stenosis.

Answer 21

Carotid Bruits – Note: increased risk for ipsilateral stroke

Question 22

Sustained PMI is present in

Answer 22

LVH

Question 23

Diffuse PMI is present in

Answer 23

heart failure

Question 24

In older adults an S3 suggests

Answer 24

dilation of left ventricle from heart failure or cardiomyopathy

Question 25

S4 often accompanies

Answer 25

hypertension

Question 26

Delay between the brachial & radial pulses during simultaneous palpation denotes

Answer 26

aortic stenosis

Question 27

A harsh holosystolic murmur at apex that is common in older adults

Answer 27

mitral regurg.

Question 28

Widened aorta & pulsatile mass on abdomen

Answer 28

abdominal aortic aneurysm (AAA)

Question 29

if aortic width >3cm or with a pustule mass

Answer 29

Triple A (especially in older male smokers with coronary disease)

Question 30

Diminished or absent pulses may indicate

Answer 30

arterial occlusion

Question 31

<33% of patients with peripheral vascular disease have symptoms of

Answer 31

claudication

Question 32

erythema with satellite lesions during genital exam

Answer 32

infection with Candida

Question 33

Genital Exam: multifocal reddened lesions with white scaling plaques are seen in

Answer 33

extramammary Paget’s disease (an intraepithelial adenocarcinoma)

Question 34

Clitoral enlargement may accompany

Answer 34

androgen-producing tumors or use of androgen creams

Question 35

Mobility of cervix is restricted with

Answer 35

inflammation, malignancy, or surgical adhesion

Question 36

A uterus that is enlarged, fixed, or irregular may indicate

Answer 36

adhesions or possible malignancy

Question 37

Persistent blinking after glabellar tap & difficulty walking heel-to-toe

Answer 37

Parkinson’s disease