geriatrics

Question 1

most common early sign of aging

Answer 1

difficulty staying up all night and working the next day

Question 2

most common cause of abdominal operations in elderly

Answer 2

biliary tract disease

Question 3

most common cause of acute pancreatitis in elderly

Answer 3

gallstones

Question 4

presentation of ruptured aaa

Answer 4

hypotension
abdominal pain
back pain
key finding is enlarged tender aorta

Question 5

activities of daily living

Answer 5

bathing
dressing
eating 
toileting
ambulating
transferring

Question 6

instrumental activities of daily living

Answer 6

making food
managing checkbook (money mngmnt)
using telephone 
shopping
transportation
ability to take meds
housekeeping
laundry

Question 7

most common primary psychiatric disorder in elderly

Answer 7

depression

Question 8

causes of delirium

Answer 8

i watch death
infections
withdrawal
acute metabolic
trauma
cns pathology
hypoxia
deficiencies (thiamine, b12, niacin)
endocrinopathies
acute vascular
toxins or drugs
heavy metals

Question 9

modifiable causes of dementia

Answer 9

meds
alcohol
metabolic (b12, thyroid, hyponatremia, hypercalcemia, hepatic and renal dysfucn)
depression
cns neoplasms/ chronic subdural hematoma
NPH

Question 10

sige caps

Answer 10

sleep
interest
guilt
energy
concentration
appetite
psychomotor
suicide

Question 11

most common cause of death from adverse drug rxn

Answer 11

gi bleed, intracranial bleed, renal failure

Question 12

drugs associated w/ adverse events

Answer 12

antithrombotics- bleeds
antidiabetics- hypoglycemia, renal failure
diuretics- electrolyte imbalance, dehydration
nsaids- ulcers, gi bleed, renal failure, heart failure

Question 13

drug metabolism different in elders

Answer 13

liver- hepatic blood flow decreases which decreases first pass metabolism (need less drug)
kidneys- renal perfusion decreaes
decreased lean body to fat ratio- distribution of drugs
decreased serum protein- drugs that are protein bound altered

Question 14

stopp

Answer 14

screening tool of older person potentially inappropriate prescription

Question 15

start

Answer 15

screening tool to alert prescribers to right treatment
most common drug omissions:
statins- atherosclerosis
warfarin- a fib
anti platelet tharpy- arterial dises
vitamin d/ calcium- osteoporosis

Question 16

first line for depression

Answer 16

behavioral therapy

Question 17

should you use meds to get a1c below 7.5 in adults >65

Answer 17

no

Question 18

should you treat elders w/ bacteriuria that are ASYMPTOMATIC

Answer 18

NO

Question 19

leading cause of irreversible blindness in world

Answer 19

glaucoma

Question 20

central vision loss

Answer 20

macular degeneration

Question 21

peripheral vision loss

Answer 21

glaucoma

Question 22

leading cause of reversible blindness in world

Answer 22

cataract

Question 23

indications for hospitalizations from pneumonia

Answer 23

curb 65
confusion
bun >20
respiratory >30
bp (systolic <60)
greater then 65 

score of 2 hospitalize
3-4 icu

Question 24

what 3 pain meds to not use

Answer 24

amitriptiline
propoxyphene
demerol

Question 25

goal for bp control

Answer 25

<140/90

Question 26

1 cause of sub arachnoid hemorrhage

Answer 26

aneurysm

Question 27

1 cause of intracerebral hemorrhage

Answer 27

hypertension

Question 28

how long after stroke can you give tpa

Answer 28

3 hours

Question 29

polymyalgia rheumatica

Answer 29

morning stiffness

pain in shoulders, neck, and pelvic girdles

Question 30

what virus has polymyalgia rheumatica been associated w/

Answer 30

respiratory syncitial virus (RSV)

Question 31

most useful lab for polymyalgia rheumatic

Answer 31

esr

Question 32

main tx for polymyalgia rheumatica

Answer 32

prednisone

Question 33

transient causes of incontince

Answer 33

diappers
delirium
infxn
atrophy
pharmceuticals
psychogenic
endocrine or excess urine output
restricted mobility
stool impaction