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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?

A

5

25
Q

How many points in the geriatric depression scale confirm depression?

A

10

26
Q

Which questionnaire is used to test for depression when there is not enough time to use GDS?

A

PHQ-2 questionnaire

27
Q

Which pharmacologic intervention for depression is potent and may cause bleeding as an adverse effect?

A

Fluoxetine

28
Q

Which questionnaire is used to assess Activities of Daily Living (ADLs)?

A

Katz index

29
Q

What is part of Activities of Daily Living (ADLs)?

A

Eating, bathing, dressing, toileting, walking, or moving around

30
Q

What is part of the Instrumental Activities of Daily Living (IADLs)?

A

Shopping, cooking, cleaning, managing money and medications

31
Q

Which test tests for functional mobility?

A

Timed up and go test

32
Q

What is the cut-off time for the timed up and go (TUG) test?

A

12 seconds

33
Q

In patients >60 years old, what are the benefits of Vitamin D?

A

Reduces fractures and overall mortality

34
Q

Which diagnostic modality for incontinence has good predictive value?

A

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
Q

What non-pharmacologic interventions are used to manage incontinence?

A

Lifestyle changes, pelvic exercises (Kegel’s), timed voiding

36
Q

Which pharmacologic treatment is used to relieve symptoms in men with BPH?

A

Alpha-receptor blockers (Tamsulosin, Terazosin)

37
Q

Which pharmacologic treatment is used to decrease prostate size in men with BPH?

A

5-alpha-reductase inhibitors (Finasteride, Dutasteride)

38
Q

Which pharmacologic treatment is used to treat incontinence in women?

A

Estrogen cream

39
Q

What pharmacologic interventions are used to manage insomnia?

A

Melatonin and Zolpidem

40
Q

Which pharmacologic intervention for constipation has the least adverse events?

A

Polyethylene glycol

41
Q

What are the advantages of water supplementation for constipation?

A

Improves stool frequency if on a high-fiber diet

42
Q

How much water should be supplemented in cases of constipation?

A

1.5-2 L/day

43
Q

How much fiber should be ingested daily in cases of constipation?

A

20-35 g/day, slowly increased over several weeks to decrease adverse effects

44
Q

Which screening tool is used to assess geriatric nutritional status?

A

Mini Nutritional Assessment (MNA)

45
Q

How is the waist circumference measured?

A

Using the midpoint from the lowest rib and the iliac crest

46
Q

What is the optimal cut-off of waist circumference for males?

A

109 cm (43 in)

47
Q

What is the optimal cut-off of waist circumference for females?

A

98 cm (38 in)

48
Q

Which calf circumference suggests protein energy malnutrition in the elderly?

A

<30.5 cm

49
Q

Which mid-arm circumference suggests malnutrition in the elderly?

A

<23.4 cm

50
Q

How to manage obesity in the elderly?

A

Decrease caloric intake by 500 calories, and perform moderate intensity exercises

51
Q

Define obesity in the elderly

A

If BMI is 30 and above, or if BMI is 25-29 with comorbidities such as HPN, DM, and dyslipidemia

52
Q

What is the daily protein requirement for an elderly patient with sarcopenia?

A

1 g/kg/day

53
Q

What is the gold standard to screen patients for osteoporosis?

A

Bone Mineral Densitometry

54
Q

Define polypharmacy

A

4 or more prescription medications, or 3 or more new prescription medications in 24 hours

55
Q

Which questionnaire tests the caregiver’s experiences?

A

Modified Caregiver Strain Index (MCSI)

56
Q

Which law gives a 20% discount and exemption from VAT to senior citizens?

A

RA 9994 (Expanded Senior Citizens Act 2010)

Preventive Medicine 3 (1 decks)

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