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Preventive Medicine 3 > LEC 1: Geriatric Care > Flashcards

LEC 1: Geriatric Care Flashcards

1
Q

What does the comprehensive geriatric assessment (CGA) cover?

A

Optimization of function and increase in life expectancy

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2
Q

What are the three geriatric syndromes that involve the mind? (Clue: 3 Ds)

A

Dementia, delirium, and depression

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3
Q

Which two geriatric syndromes involve mobility? (Clue: 2 Fs)

A

Function/ADLs and falls

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4
Q

Which type of dementia is most common, manifesting initially with memory problems, followed by problems with language, executive function, and personality?

A

Alzheimer’s Disease

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5
Q

Which type of dementia starts with a stroke, eventually manifesting as cognitive impairment,
problems with executive function, and personality issues?

A

Vascular dementia

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6
Q

Which type of dementia begins with disinhibition, followed by depression, apathy, and eventual cognitive impairment?

A

Fronto-temporal dementia

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7
Q

Which type of dementia begins with a naming problem, followed by aphasia (mutism) and memory issues?

A

Semantic dementia

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8
Q

Which type of dementia begins with Parkinsonism, followed by cognitive impairment and fluctuations, as well as visual hallucinations?

A

Dementia with Lewy Bodies

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9
Q

Which type of dementia begins with Parkinson’s disease, before manifesting cognitive impairment?

A

Parkinson’s dementia

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10
Q

Which factor has the strongest evidence of increasing the risk of dementia?

A

Traumatic brain injury

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11
Q

Which factor has the strongest evidence of decreasing the risk of dementia?

A

Years of formal education

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12
Q

Which three-item dementia screening questionnaire is used as an initial screening?

A

Mini-Cog

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13
Q

Which two fields does the Mini-Cog fail to measure?

A

Orientation and language

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14
Q

What is the cut-off score of the Montreal Cognitive Assessment Tool (MoCA)

A

24

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15
Q

Which two fields does the Mini-Mental State Examination (MMSE) fail to measure?

A

Semantic memory and executive function

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16
Q

What is the single cut-off score for the MMSE

A

24

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17
Q

Which field does the Clock Drawing Test (CDT) measure?

A

Executive function

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18
Q

Which pharmacologic treatment is given to patients with mild cognitive impairment or early dementia?

A

Cholinesterase inhibitors (Donepezil, Rivastigmine, Galantamine)

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19
Q

Which pharmacologic treatments are given to patients with moderate to severe dementia?

A

Cholinesterase inhibitor (Donepezil) + NMDA receptor antagonist (Memantine)

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20
Q

Which four non-pharmacologic treatments are used to prevent the progression of dementia?

A

Provide a predictable routine, break complex tasks into individual components, use distractions to divert patient’s attention, light therapy to reduce sundowning

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21
Q

What is the average lifespan for patients with Alzheimer’s disease?

A

4-8 years

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22
Q

What tests are used to screen for delirium?

A

Confusion Assessment Method (CAM) and 4AT

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23
Q

Which tool is commonly used in practice to screen for depression?

A

Geriatric depression scale

24
Q

How many points in the geriatric depression scale suggest depression?

25
How many points in the geriatric depression scale confirm depression?
10
26
Which questionnaire is used to test for depression when there is not enough time to use GDS?
PHQ-2 questionnaire
27
Which pharmacologic intervention for depression is potent and may cause bleeding as an adverse effect?
Fluoxetine
28
Which questionnaire is used to assess Activities of Daily Living (ADLs)?
Katz index
29
What is part of Activities of Daily Living (ADLs)?
Eating, bathing, dressing, toileting, walking, or moving around
30
What is part of the Instrumental Activities of Daily Living (IADLs)?
Shopping, cooking, cleaning, managing money and medications
31
Which test tests for functional mobility?
Timed up and go test
32
What is the cut-off time for the timed up and go (TUG) test?
12 seconds
33
In patients >60 years old, what are the benefits of Vitamin D?
Reduces fractures and overall mortality
34
Which diagnostic modality for incontinence has good predictive value?
Asking for symptoms: “Have you lost your urine and gotten wet over the past year?” and “Have you ever lost urine on six separate days?”
35
What non-pharmacologic interventions are used to manage incontinence?
Lifestyle changes, pelvic exercises (Kegel’s), timed voiding
36
Which pharmacologic treatment is used to relieve symptoms in men with BPH?
Alpha-receptor blockers (Tamsulosin, Terazosin)
37
Which pharmacologic treatment is used to decrease prostate size in men with BPH?
5-alpha-reductase inhibitors (Finasteride, Dutasteride)
38
Which pharmacologic treatment is used to treat incontinence in women?
Estrogen cream
39
What pharmacologic interventions are used to manage insomnia?
Melatonin and Zolpidem
40
Which pharmacologic intervention for constipation has the least adverse events?
Polyethylene glycol
41
What are the advantages of water supplementation for constipation?
Improves stool frequency if on a high-fiber diet
42
How much water should be supplemented in cases of constipation?
1.5-2 L/day
43
How much fiber should be ingested daily in cases of constipation?
20-35 g/day, slowly increased over several weeks to decrease adverse effects
44
Which screening tool is used to assess geriatric nutritional status?
Mini Nutritional Assessment (MNA)
45
How is the waist circumference measured?
Using the midpoint from the lowest rib and the iliac crest
46
What is the optimal cut-off of waist circumference for males?
109 cm (43 in)
47
What is the optimal cut-off of waist circumference for females?
98 cm (38 in)
48
Which calf circumference suggests protein energy malnutrition in the elderly?
<30.5 cm
49
Which mid-arm circumference suggests malnutrition in the elderly?
<23.4 cm
50
How to manage obesity in the elderly?
Decrease caloric intake by 500 calories, and perform moderate intensity exercises
51
Define obesity in the elderly
If BMI is 30 and above, or if BMI is 25-29 with comorbidities such as HPN, DM, and dyslipidemia
52
What is the daily protein requirement for an elderly patient with sarcopenia?
1 g/kg/day
53
What is the gold standard to screen patients for osteoporosis?
Bone Mineral Densitometry
54
Define polypharmacy
4 or more prescription medications, or 3 or more new prescription medications in 24 hours
55
Which questionnaire tests the caregiver’s experiences?
Modified Caregiver Strain Index (MCSI)
56
Which law gives a 20% discount and exemption from VAT to senior citizens?
RA 9994 (Expanded Senior Citizens Act 2010)

Preventive Medicine 3 (1 decks)

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