Geriatrics Module 2

According to a recent comprehensive meta-analysis on the use of Potentially Inappropriate Medications (PIM) in older outpatients, which of the following medications is MOST commonly prescribed as a PIM in this population?

An 88-year-old man with a 10-year history of dementia is brought in by his 85-year-old wife. They have been happily married for 55 years. The man has a history of falls, prostatism and postural hypotension. The wife describes her husband’s delusions and accusations over the last six months about her supposed infidelities with his brother who has been dead for 20 years. The wife is so distressed by the accusations that she is considering placing him in a nursing home.

The most appropriate initial pharmacological treatment for this man is:

Which clinical feature of delirium is most useful for differentiating it from dementia?

A son brings her 72-year-old mother to hospital with concerns about a change in his mother’s mental state over the preceding week. He tells you that her mother had been wandering around the house at night and has become uncharacteristically suspicious of her daughter-in-law, accusing her of stealing her belongings.

She also complained to her son of seeing thieves in her bedroom at night, but failed to prove of having anything stolen. There is no previous psychiatric history.

What would be the most likely diagnosis?

Which of the following is the most beneficial intervention for preventing the development of delirium in an elderly woman?

The Mini Mental State Examination (MMSE) is most appropriately used in detecting which condition?

Which one of the following is the first line treatment for a 65 year old woman with stress incontinence?

What is the most common cause of irreversible visual loss in Australia?

Which of the following medication is least likely to cause falls in the elderly population?

Dementia with Lewy bodies is characterized by progressive cognitive impairment among other features.

Which other clinical feature would be most consistent with this diagnosis?

In an elderly patient with a history of falls, which of the following intervention will most likely reduce the incidence of future falls?

A nursing home dietitian notifies you that an 85-year-old patient is gradually losing weight involuntarily. One year ago she weighed 59 kg, six months ago 55 kg and this month 51 kg, a loss of approximately 7% over six months and approximately 14% over one year.

Her current medical problems include osteoarthritis, Parkinson’s disease, probable Alzheimer’s disease, congestive heart failure and chronic constipation.

Her medications include digoxin 0.25 mg/day, levodopa/carbidopa 250/25 mg four times/day and ibuprofen 400 mg four times/day.

What is the least likely cause of her weight loss?

Which of the following medication is associated with weight loss in the elderly population?

Which of the following anti-depressant is associated with weight loss in the elderly population?

Maximal oxygen consumption (V.O2 maximum) is the best measure of aerobic capacity or cardiovascular fitness and declines with age.

In healthy ageing, the most important physiological change which contributes to this decline is a reduction in:

Which of the following are the most consistent changes in regional deposition of adipose tissue that occur with ageing?

Which of the following is most characteristic of healthy ageing muscle?

Which one of the following hormone shows the most consistent decline in blood levels (in both sexes) with ageing?

What is the main factor responsible for systolic hypertension in the elderly?

The most important reason for the higher incidence of adverse drug reactions in the elderly compared to young people is:

When comparing tricyclic antidepressants with selective serotonin reuptake inhibitors (SSRIs) as treatments for major depression in the elderly, which of the following side effects represents the most clinically significant difference between these drugs?

As part of a multicomponent intervention, which of the following measure is less likely to prevent delirium in an elderly hospitalized population?

Medication withdrawal is frequently undertaken in elderly patients with polypharmacy.

Which of the following medication can be stopped abruptly with minimal risk of a withdrawal syndrome in the elderly?

Which of the following cardiovascular parameter is unchanged in healthy aging during exercise?

Old age is associated with diminished pharmacodynamic response to beta adrenergic antagonists (beta blockers).

Which of the following mechanism best explains this phenomenon?

Which of the following lung function increases with healthy aging after maximum expiration?

Which of the following physiological changes in the kidney that increases with aging?

Which of the following hormone increase is responsible for nocturnal polyuria?

An 87-year-old man presents to the Accident and Emergency Department on a hot day complaining of feeling lightheaded.

Age related change in which one of the following is most likely to hinder blood pressure maintenance in this man?

Which of the following physiological changes in the bladder increases with age?

Which of the following organ system has the least significant functional change with age?