Geriatrics Final 2

Front 1

early onset and rapid progression of dementia signs and symptoms might indicate

Back 1

FTD or prion disease

Front 2

What does a patient that gets Alzheimer's disease before age 65 and a positive family hx indicate?

Back 2

it might be an AD version in 5% of patients

Front 3

4 basic tests to think about when working up dementia

Back 3

- TSH

- B12

- CT/MRI

- depression

Front 4

other tests

Back 4

CBC

serum chemistry

LFTs

Front 5

Are most dementias reversible?

Back 5

no

Front 6

features of progressive supra nuclear palsy

Back 6

shows progressive voluntary gaze impairment

as well as marked axial rigidity

rapid deterioration with lot of faalls

Front 7

what is a subtle sign that could indicate FTD?

Back 7

sleep behavior disorders and severe sensitvity to neuroleptics

Front 8

When would you call it Parkinson's dementia?

Back 8

if they have had a long, well-established hx of Parkinson's and then develop dementia.

Front 9

first step to assess risk of falls in a patient

Back 9

previous hx of falls

Front 10

another sign they could be at high risk of a fall

Back 10

if they have abnormal gait

Front 11

What is the firstling mgmt for agitated behavior in dementia?

Back 11

non-pharmacologic steps are taken like some kind of behavioral therapy

then you follow this with second gen antipsyhotics

Front 12

What is the next best step for a patient that develops statin myopathy?

Back 12

d/c the offending agent in favor of a lower dose of another statin

Front 13

What helps you decide when to initiate lipid-lowering agents?

Back 13

you have to examine their life expectancy because it usually takes about 4 years of statin therapy to have any survival benefit ayway

Front 14

What are the features of Alzheimer's psychosis?

Back 14

they don't really have bizarre delusions but they have a lot of VISUAL hallucinations and a absent prior hx of psychosis

Front 15

When will a patient with Lewy Body dementia present with movement symptoms

Back 15

they will usually manifest the dementia symptoms as well as movement problems within the same year

Front 16

what type of psychotic features can depression show?

Back 16

usually they show mood-congruent hallucinations like derogatory voices

Front 17

What are some symptoms of hip arthritis?

Back 17

not able to climb stairs or rise out of bed without having pain

Front 18

next best step if you suspect giant cell arteritis

Back 18

start prednisone with any suspicion of the disease and then get a temporal artery biopsy

Front 19

what dose ?

Back 19

high dose pred

Front 20

again, what meds are Lewy Body dementia patients sensitive to?

Back 20

neuroleptics

Front 21

And what is the effect of cholinesterase inhibitors on FTD?

Back 21

makes it worse

Front 22

3 risk factors for development of MDD in advanced age

Back 22

social isolation

caregiver status

bereavement

Front 23

best first steps for anxiety disorders

Back 23

SSRI or SNRI plus CBT

Front 24

When is a chemical restraint like an antipsychotic justified/

Back 24

if hospital staff are at risk of harm and the patient's behavior is interfering with lifesaving treatments

Front 25

one or more physical complaints lasting over 6 months and associated with significant distress or impairment in functioning, that cannot be explained by medical conditions or testing

Back 25

somatoform disorder

Front 26

when would bereavement likely be MDD

Back 26

when it sounds like SIG E CAPS for over 2 months

Front 27

what is complicated grief?

Back 27

persistent yearning for their loved one along with PTSD like symptoms

the symptoms have to persist at least 6 months and interfere with function

Front 28

intervention if you suspect complicated grief

Back 28

SSRI + therapy

Front 29

how common are personality disorders?

Back 29

occur in 5 to 10% of older adults

Front 30

what is the most common psych disorder in nursing home residents?

Back 30

depression

Front 31

what about the community?

Back 31

anxiety

Front 32

what population is the greatest risk for suicide?

Back 32

single white man over age 70

Front 33

Best step to take for a patient that shows inadequate nutrient intake

Back 33

institute an individualized feeding assistance program

Front 34

best way to assess nutritional risk?

Back 34

calorie counts

Front 35

what about status?

Back 35

albumin

Front 36

When will Medicare Part A actually pay for a nursing home?

Back 36

it will pay for the first 20 days of a NH admission after leaving the hospital

otherwise, it's just skilled nursing

Front 37

what has been shown to reduce mortality in young old adults who are at risk?

Back 37

comprehensive in-home geriatric assessments with multiple home visits

Front 38

What type of mattresses are covered by Medicare? What part?

Back 38

Part B covers pressure-relieving mattresses if there are non-healing ulcers present

Front 39

What in general does Medicare Part B cover?

Back 39

outpatient services as well as all doctor fees

Front 40

What percent of adults age 65 to 84 live in a nursing home?

Back 40

2%

and then 14% of adults over 85

Front 41

Are cochlear implants covered by Medicare?

Back 41

yes

but hearing aids aren't

Front 42

Does Part A cover hospice?

Back 42

yes if you have a signed thing from an MD saying life expectancy under 6 months

Front 43

when should a woman get a DEXA scan?

Back 43

all women at age 65

Front 44

Should we screen for carotid artery stenosis in the general population?

Back 44

no, it's not recommended

Front 45

What population undergoes AAA screening?

Back 45

65 to 75 year old men who have ever smoked in their lifetime

Front 46

What is the threshold for surgical repair of a AAA?

Back 46

5.5 cm

Front 47

What are the two main requirements that demonstrate that a patient should NOT be in a nursing home?

Back 47

if they are ambulatory and independent in all ADLs

Front 48

What % of adults report a functional limitation in an ADL or IADL?

Back 48

42

Front 49

Best option for increasing strength in frail old patients?

Back 49

resistance training

Front 50

it's also recommended for

Back 50

people that are recovering from hip fx

Front 51

When is a cochlear implant indicated?

Back 51

if hearing aids are no longer helping and their hearing loss is profoudn

Front 52

causes of conductive hearing loss

Back 52

impacted cerumen (common)

middle ear effusions

otosclerosis

eustacian tube dysfunction

tumors

Front 53

most common cause of blindness in the US

Back 53

MD

Front 54

most common cause of vision loss in the US

Back 54

cataracts

Front 55

early sign of MD

Back 55

central vision distortion

Front 56

how does glaucoma present

Back 56

with loss in the peripheral visual fields

Front 57

halos around lights

redness of the eye

eye pain

N/v

blurry vision

Back 57

angle closure glaucoma

Front 58

some early symptoms of cataracts

Back 58

blurred vision

light sensitivity and glare