Geriatrics Final Key Points

Front 1

What should you order next if a patient is experiencing syncope?

Back 1

echo, because it's likely structural heart disease

Front 2

What med shows significant relief for dyspnea of advanced, decompensated heart failure?

Back 2

morphine 5 mg po q4h

Front 3

definition of orthostatic hypotension

Back 3

20/10 20

change of over 20 mm Hg systolic and 10 mum Hg diastolic

or 20 HR

Front 4

What is the usual treatment for BPH and symptoms of overactive bladder?

Back 4

alpha blockers like tamsulosin

Front 5

but what can you add to tamsulosin?

Back 5

tolterodine

Front 6

midline mass emanating from the suprapubic area that is dull to percussion.

Back 6

urinary retention- need to pass catheter

Front 7

most common causes of ED in men

Back 7

vascular diseases- atherosclerosis or diabetes etc.

Front 8

most effective treatments for stress incontinence

Back 8

pelvic floor surgery and CBT

Front 9

What drug is NOT very effective for stress incontinence?

Back 9

oxybutynin

Front 10

what drugs WORSEN symptoms of UI?

Back 10

estrogens

Front 11

is UI a normal part of aging?

Back 11

NO but it's thought to be by the general public

Front 12

What is the firstling treatment for OAB?

Back 12

behavioral therapy like bladder training because it's just as effective as meds like tolterodine

Front 13

What is best for a nursing home patient experiencing urinary incontinence?

Back 13

trial of scheduled voiding

Front 14

a nursing home patient has asymptomatic bacteriuria, should you treat it?

Back 14

no it's not recommended

Front 15

What is the next best step in a patient with high PSA and palpable nodules?

Back 15

should get a transrectal ultrasound biopsy if their life expectancy is BEYOND 5 YEARS

Front 16

best ways to assess post void residual volume?

Back 16

catheter pass or ultrasound imaging

Front 17

a standard drug given to most patients with end stage CKD because it is shown to improve Q of L?

Back 17

EPO

Front 18

When do you treat a patient with anemia of chronic disease with EPO?

Back 18

when their Hgb falls under 11

Front 19

most common cause of postmenopausal bleeding

Back 19

atrophic vaginitis

Front 20

other causes include

Back 20

polyps

endometrial hyperplasia or cancers

cervical cancer

Front 21

first test to order for a woman with a postmenopausal bleed

Back 21

endometrial biopsy

Front 22

what is the alternative if the patient cannot tolerate endometrial biopsy?

Back 22

you can get a TVUS and look at the width of the stripe

Front 23

best tx for vaginal atrophy

Back 23

local estrogen

Front 24

tx for mild COPD

Back 24

SABAs and ipratropium

these are short acting dilators

Front 25

moderate COPD tx

Back 25

add a LABA (salmeterol, formoterol) or tiotropium etc.

Front 26

severe cOPD calls for

Back 26

inhaled steroids (budesonide)

Front 27

Best test to measure the body's Vit D stores?

Back 27

25-OH Vitamin D

Front 28

Why are older patients less able to maintain normal blood glucose levels?

Back 28

because they are less sensitive to insulin and their insulin secretion declines with age as well

Front 29

so the OGTT and glucose challenges have greater

Back 29

positive predictive value

Front 30

What test for looking for vitamin B12 deficiency?

Back 30

Serum MMA and homocysteine levels

Front 31

most common electrolyte abnormality in older adults?

Back 31

hyponatremia

Front 32

features of SIADH

Back 32

euvolemic hyponatremia

urine osmolality is greatly increased

common in SCLC

Front 33

best way to prevent constipation and diverticular disease

Back 33

supplement with INSOLUBLE fiber, which functions to increase fecal bulk, soften feces, and shorten transit time

Front 34

What is the effect of soluble fiber?

Back 34

supposed to lower heart disease risk by preventing cholesterol reabsorption

Front 35

classic feature of lumbar spinal stenosis

Back 35

leg pain with standing and walking that is relieved when leaning forward or walking uphill

Front 36

pathogenesis of Parkinson's disease

Back 36

loss of dopaminergic neurons in the SNc

Front 37

most effective short term treatment for Parkinson's?

Back 37

levodopa/carbidopa

Front 38

benefit of a home visit by OT?

Back 38

patient is at lower risk for falls

Front 39

is there a supplement or medication that is shown to increase function in older men with sarcopenia?

Back 39

no, high dose T is probably risky

Front 40

features of Lewy Body dementia

Back 40

fluctuating features

visual hallucinations

Parkinsonian features

Front 41

most useful assessment for attention span?

Back 41

digit span

if under 5 then it is suggestive of delirium

Front 42

if a patient has upper motor neuron signs in the hands with lower motor neuron signs in the legs then it's

Back 42

cervical stenosis

Front 43

another picture of spinal stenosis

Back 43

gait disorder with urinary incontinenec or polyuria

Front 44

best study for dx of cervical spinal stenosis

Back 44

MRI

Front 45

definition of mild cognitive impairment

Back 45

you've demonstrated that they have decline in function in at least one domain but are maintaining normal baseline function

Front 46

MCI can be either

Back 46

amnestic or non amnestic

Front 47

what are the 2 main requirements for dx of dementia?

Back 47

memory impairment and functional deficits

Front 48

PMR abates quickly with

Back 48

prednisone for 4 to 6 wks before tapering