Geriatrics Module 1

Which of the following intervention is most effective in reducing the risk of falls and hip fractures in elderly population?

Which of the following isnot part of the Confusion Assessment Method (CAM) criteria for the diagnosis of delirium?

The FINGER study recently demonstrated that a multi-domain intervention could improve or maintain cognitive functioning in at-risk elderly people.

Which of the following intervention was NOT actually included in this study?

An 80 year old man with dementia who lives at home with his wife is becoming increasingly difficult to manage. He is frequently aggressive and has recently been prescribed low dose antipsychotic medication.

He has been refusing to take his medication so his wife has been crushing the tablets and mixing them into his food.

Which ethical principle has been breached?

The most common cause of chronic incontinence in the elderly is:

An 82-year-old female complains of a decline in short-term memory, specifically difficulty remembering the names of her friends and also some telephone numbers. She lives alone in her own home and remains independent in all of her activities of daily living.

Her husband had passed away 2 years ago.

Her mini-mental state examination (MMSE) score is 27 out of 30, with short-term recall of only one out of three items.

What is the most likely  diagnosis?

Donepezil, a cholinesterase inhibitor that is used to improve cognitive function in Alzheimers disease is least likely to cause which of the following side effect?

Frailty is considered highly prevalent in old age and confers to the high risk for falls, disability, hospitalization, and mortality. In a recent study, frailty can phenotypically be characterized by the following features except?

Which of the following intervention is most likely to reduce frailty in old people?

With regards to treatment of hypertension in the elderly population, a recent trial had proven a significant reduction in stroke risk and all cause mortality when given to people over the age of 80.

Which medication was this trial referring to?

When administered to a 70 year old man, which of the following drug is most likely to cause urinary retention?

If a healthy and independent 80 year old person performs daily moderate exercise for 3 months, which one of the following would likely to improve?

An elderly man comes to see you complaining of having poor sleep quality.

Which one of the following age related factors is least likely to contribute to this man’s problem?

The following features are highly suggestive of Dementia with Lewy Bodies except?

A 75-year-old man is seen in the Memory clinic. His daughter reports that for the past 12 months he has become increasingly forgetful and has now started to wander around at night. His MMSE is 18 out of 30. Neurological examination is unremarkable. A full blood screen is also requested, all of which comes back as normal.

What is the most appropriate next step?

An 85 year old lady presents with mild memory impairment, difficulty in concentrating and apathy.

Which of the following would suggest depression is more likely rather than dementia?

The following features are highly suggestive of Alzheimer’s disease except?

Which one of the following is the most common side effect of anti dementia drug donepezil?

What is the mechanism of action of Memantine used in Alzheimer’s disease?

The following are benefits of using cholinesterase inhibitors and Memantine in Alzheimer’s except?

Which feature is least consistent with the diagnosis of vascular  dementia?

What is the strongest risk factor for developing vascular dementia?

The following features are consistent with CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy), Except?

The following are genetic factors for early onset Alzheimer’s disease except?

A deficit in which of these following biochemical is thought to be the basis of fluctuating cognition and visual hallucinations seen in patients with dementia with lewy bodies?

Which of the following feature is most suggestive of frontotemporal  dementia?

Which of the following medications have been shown to be the most efficacious in the treatment of psychotic symptom in Alzheimer’s disease and mixed dementia?

Which one of the following symptoms in a person with Alzheimer’s disease is most likely to respond to haloperidol?

A 75-year-old woman presents with a twelve-month history of deteriorating behaviour and memory and increasing social withdrawal. She has been tearful and emotional with poor quality sleep. A diagnosis of depression has been made by her general practitioner, and she has been commenced on Sertraline 50mg / day with a limited response over the last eight weeks. Neurological examination reveals normal tone and no pyramidal findings. She scores 21/30 on a minimental state examination. Thyroid stimulating hormone, full blood count, urea and electrolytes, calcium and liver function tests are normal. Cranial CT Scan shows age related involutional change. Her EEG demonstrates diffuse symmetrical slowing over both fronto- temporal head regions with an excess of delta activity.

The most likely diagnosis is: