geriatrics-non-self study

Question 1

how do older patients present with atypical presentation

Answer 1

with less mood symptoms, more somatic (pain, weight loss, insomnia), more irritability, decreased function, social isolation and poor grooming

Question 2

what age does the brain peak

Answer 2

25

Question 3

true or false: mental disorders are normal part of normal aging

Answer 3

FALSE

Question 4

at what age does ability to hear higher frequency decrease

Answer 4

30

Question 5

what is the term for hearing loss ascribed by aging effects

Answer 5

presbycusis

Question 6

why is cardiac output impaired with age

Answer 6

decreased beta adrenergic response

Question 7

why is HTN/stroke increased with age

Answer 7

decreased compliance

Question 8

why is CHF increased with age

Answer 8

increased heart thickness

Question 9

why are dysrhythmias more common with age

Answer 9

increased left atrium, SA node dysfunction

Question 10

what is the largest group of immunocompromised individuals

Answer 10

older adults

Question 11

what is the most frequently missed diagnosis on autopsy

Answer 11

pneumonia

Question 12

how does pneumonia typically present in older adults

Answer 12

nausea and vomiting or diarrhea in up to 20%; new cardiac arrhythmias, myocardial ischemia, or an actual infraction in 10%

Question 13

where is TB most likely in older adults

Answer 13

middle or lower lobe infiltrate is more likely than classic upper lobe

Question 14

define disability

Answer 14

difficulty or dependency in carrying out activities essential for independent living

Question 15

what state has the greatest percentage of its citizens over the age 65

Answer 15

florida

Question 16

what state has the greatest number of seniors

Answer 16

california

Question 17

what race is the greatest proportion of racial/ethnic senior citizens

Answer 17

african americans

Question 18

what things are not covered under medicare

Answer 18

custodial care, dental care, eye exams, dentures, cosmetics, acupuncture, hearing aids, foot care

Question 19

what does an organisms reaction to stressors involve

Answer 19

cellular responses of apoptosis, senescence, and repairs

Question 20

why is the hay flick limit with senescence

Answer 20

between 40-60 cell divisions (before senescence)

Question 21

why are antipsychotics to be avoided as first line treatment of delirium

Answer 21

because of conflicting evidence on their effectiveness and the potential for adverse drug effects

Question 22

what is the most consistent risk factor for adverse drug reactions

Answer 22

number of prescriptions

Question 23

what are the most common body regions for pressure sulcers

Answer 23

sacrum, heels, ischial tuberosities, greater trochanters, and lateral malleoli

Question 24

when should urgent sharp debridement be preformed

Answer 24

if advancing cellulitis or sepsis occurs

Question 25

who are systemic antibiotics used in

Answer 25

patients with advancing cellulitis, osteomyelitis, or systemic infection

Question 26

what is the main risk factor for delirium

Answer 26

medications (ie: diphenhydramine)

Question 27

what allele has increased risk for dementia

Answer 27

APOE4

Question 28

what secondary amine TCAs are most appropriate for older patients

Answer 28

nortriptyline and desipramine

Question 29

what is HELP focused on

Answer 29

preventing delirium and functional decline

Question 30

what opioid analgesic is used for respiratory depression and sedation

Answer 30

naloxone hydrochloride

Question 31

what are the 2 major components of the pathophysiology of frailty

Answer 31

accelerated decrease in physiological reserve and failing homeostatic mechanisms

Question 32

what is the term for age-related loss of muscle mass and strength

Answer 32

sarcopenia

Question 33

what are the criteria for frailty and how many do you need

Answer 33

3; slow walking speed, poor hand grip, exhaustion, weight loss, low energy expenditure

Question 34

what is the exclusion criteria for SOF

Answer 34

inability to walk without the assistance of another person

Question 35

what must be effectively ruled out before diagnosing dementia

Answer 35

delirium and depression

Question 36

what is the most common type of dementia

Answer 36

alzheimer's disease

Question 37

describe the disinhibition associated with frontotemporal dementia

Answer 37

public urination, flatulence without concern, inappropriate grasps. offensive remarks or invade other's personal space

Question 38

what are the cardinal motor features associated with parkinson disease with dementia

Answer 38

bradykinesia and akinesia, rigidity, resting tremor, and postural instability

Question 39

what symptoms do individuals with depression usually describe

Answer 39

symptoms of hypothyroidism

Question 40

describe homeostenosis

Answer 40

reduced capacity to adjust to stressors; increase susceptibility to illness; physiologic decline plus disease results in excess morbidity and disability

Question 41

at what age does creativity peak

Answer 41

30

Question 42

how long is intellect maintained

Answer 42

until at least age 80

Question 43

What is the term for hearing loss ascribed to aging effects

Answer 43

presbycusis

Question 44

at what age does strength and coordination peak

Answer 44

19

Question 45

at what age is the body most flexible

Answer 45

age 20

Question 46

what is the term for a state of sudden confusion that can last days, weeks, or even months

Answer 46

delirium

Question 47

what is the most reliable sign for geriatric depression

Answer 47

anhedonia

Question 48

why should benzodiazepines be avoided in geriatrics

Answer 48

rebound insomnia, sedati o into the daytime, tolerance and withdrawal

Question 49

how many chronic primary diseases must be present for geriatric syndrome multimorbidity

Answer 49

3 or more

Question 50

what is typically the first presentation of disease

Answer 50

functional loss

Question 51

Which drug should be used with symptom profile of apathy, retardation

Answer 51

Bupropion

Question 52

What drug should be used with symptom profile of insomnia, anxiety, anorexia

Answer 52

Mirtazapine

Question 53

What drug should be used for symptom profile of pain

Answer 53

Duloxetine

Question 54

What drug should be used with symptom profile of atypical, melancholic, anxious

Answer 54

Venlafaxine