Geriatrics Module 3

In the elderly nursing home population, which one of the following contributes least to constipation?

Hepatic drug clearance is reduced in old age. Which of the following ageing changes is currently believed to have the biggest impact on hepatic drug metabolism?

In an elderly patient with urinary incontinence secondary to detrusor instability, which of the following would be the most appropriate therapy?

Which one of the following drug is least likely to cause urinary incontinence in the elderly population?

A hospitalised patient is seen with a stage III pressure ulcer (full thickness skin loss and necrosis of subcutaneous tissue extending down to, but not through, underlying fascia) on the sacrum that measures 10 x 10 cm. There is extensive eschar adhering to the centre and to one side of the wound and a large amount of purulent drainage is expressible from under the eschar. There is no surrounding skin erythema. The patient is afebrile.

Which one of the following approaches would best control local infection?

A 91-year-old nursing home resident has end stage Alzheimer’s disease. She is bed bound, unable to speak, and incontinent of urine and faeces. Daily inspection of skin reveals non-blanching erythema of the heels and normal sacral skin. Which of the following is most likely to prevent a pressure ulcer in this patient?

An 87-year-old man is admitted to hospital with a dense left hemiplegia and is totally bedbound and immobile. Which of the following strategies is the most effective for reducing the risk of developing a pressure ulcer in this patient?

Which of the following intervention is least likely to prevent pressure sores in the elderly?

The timed stand up and go test is used in elderly patients to quantify which of the following parameters?

Which of the following medication should be avoided in the management of delirium?

Pramipexole is a dopamine agonist of the non-ergoline class indicated for treating early-stage Parkinson’s disease (PD) and restless legs syndrome (RLS).

However the use of this medication in the elderly may increase the risk of:

Which of the following drug class poses the highest risk of falling in the elderly population?

On presentation, certain forms of dementia can be difficult to differentiate from delirium.
Which form of dementia has similar features to that of a delirium?

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?

Which of the following is the strongest visual risk factor for falls in the elderly population?

In an elderly who has had a fall, which of the following is the strongest predictor of fall in the next 1 year?

Which of the following has the highest prediction of delirium?

A usually fit and well 74 year old man undergoes surgery following a hip fracture.
Which of the following intervention is most likely to reduce the risk of developing delirium in this patient?

Which of the following medication has been proven in the HYVET trial to reduce stroke and all cause mortality when given with or without perindopril to people over the age of 80 for the treatment of hypertension?

What is the strongest risk factor for development of Alzheimer’s dementia?

An 82-year-old female complains of a decline in short-term memory, specifically difficulty remembering some names and telephone numbers. She lives alone in her own home and has been independent in all activities of daily living and instrumental activities of daily living, since the death of her husband one year previously. Her mini-mental state examination (MMSE) score is 27 out of 30, with short-term recall of only one out of three items.

The most likely diagnosis is:

Which of the following is the main risk factor for the development of delirium in older people?

Which of the following is least likely to be beneficial in preventing delirium?

Cholinesterase inhibitors such as Donepezil is least likely to be useful in:

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?

Which class of drug has strong evidence for association with the risk of falling in older people?

Which of the following is the best treatment for mild cognitive impairment?

When administered to a 70 year old man, which of the following drugs 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?

What is the most common cause of blindness in the elderly population?

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?

Which of the following modifiable risk factor has the highest prevalence in the development of dementia in later life (age >65)?

Aripiprazole is a second generation anti-psychotic that is approved for the treatment of which condition?