Mksap 16 General Im 04 Geriatric Medicine

Front 1

timed “Up & Go” (TUG) test. The patient is asked to rise from a chair, walk 10 feet, turn around, walk back, and sit down again in the same chair

Back 1

The average healthy adult can complete the task in less than 10 seconds; those completing the task in more than 14 seconds are considered to be at high risk for subsequent falls

Front 2

The Institute of Medicine recommends a vitamin D intake of

Back 2

600 units/d for all men and women aged 51 to 70 years old and 800 units/d for men and women older than 70 years.

Front 3

The Mini–Mental State Examination (MMSE) has been the standard screening instrument for cognitive function, with a sensitivity of 76% and specificity of 88% for detecting cognitive impairment.

Back 3

Scores of 24 to 25 out of 30 suggest mild impairment, scores of 19 to 24 suggest mild dementia, and scores of 10 to 19 suggest moderate dementia

Front 4

Medical conditions associated with depression

Back 4

hypothyroidism, hyperthyroidism (“apathetic hyperthyroidism”), chronic pain, Parkinson disease, cancer, diabetes mellitus, vitamin B12 deficiency, alcohol abuse, and use of corticosteroids or interferon

Front 5

The most common cause of hearing loss

Back 5

presbycusis, or age-related hearing loss. Presbycusis results in high-frequency hearing loss, which typically impairs sound localization and hearing the spoken voice (particularly in noisy environments).

Front 6

Among the available screening tests, the whispered voice test,

Back 6

(examiner stands 2 feet behind a seated patient and assesses the ability of the patient to repeat a whispered combination of numbers and letters), or a single question about whether the patient has hearing difficulty seem to be nearly as accurate as hand-held audiometry or a detailed hearing loss questionnaire

Front 7

The most common causes of visual impairment in older persons

Back 7

refractive errors, cataracts, and age-related macular degeneration (AMD)

Front 8

The American Academy of Ophthalmology recommends comprehensive eye examinations

Back 8

every 1 to 2 years for persons 65 years or older who have no risk factors

Front 9

four medications were responsible for two thirds of emergency hospitalizations for adverse drug events.

Back 9

Hospitalizations involving three of them (warfarin, insulin, and oral hypoglycemic agents) were related to unintentional overdose. Warfarin was implicated most frequently, accounting for one third of emergency hospitalizations. The fourth class of drugs, oral antiplatelet agents, were implicated by acting alone or by interacting with warfarin

Front 10

Urinary incontinence is categorized as

Back 10

(1) urge incontinence (loss of urine accompanied by sense of urgency; caused by detrusor overreactivity); (2) stress incontinence (loss of urine with effort, coughing, or sneezing; caused by sphincter incompetence); (3) mixed urge and stress incontinence; and (4) overflow incontinence (caused by outlet obstruction).

Front 11

Functional incontinence

Back 11

not getting to the toilet quickly enough

Front 12

the two most effective behavioral therapies for incontinence

Back 12

Pelvic floor muscle training (PFMT, or Kegel exercises) and bladder training/urge suppression techniques are

Front 13

considered first-line therapy for patients with stress incontinence and is of likely benefit in patients with mixed urge and stress incontinence.

Back 13

pelvic floor muscle traiing

Front 14

effective in elderly nursing home residents with functional incontinence.

Back 14

Prompted voiding (periodically asking the patient about incontinence, reminding and assisting the patient to go to the toilet, and providing positive reinforcement for continence)

Front 15

In patients with stress incontinence for whom PFMT has not been successful, what is another option

Back 15

duloxetine a serotonin and norepinephrine reuptake inhibitor

Front 16

first line therapy for urge incontinence

Back 16

anticholinergic antimuscarinic medications are first-line therapy. Options include oxybutynin, tolterodine, fesoterodine, darifenacin, solifenacin, and trospium.

Front 17

Medications that have been found to be ineffective for incontinence

Back 17

pseudoephedrine (an α-agonist), oral estrogens (may worsen incontinence), and transdermal and vaginal estrogens

Front 18

Stage I ulcers treatment

Back 18

can generally be treated with transparent films and do not require debriding

Front 19

Stage II ulcers treatment

Back 19

occlusive dressing to keep the area moist. Wet-to-dry dressings should be avoided because debridement is usually unnecessary at this stage.

Front 20

Stage III and IV ulcers treatment

Back 20

generally require surgical or nonsurgical debridement, treatment of wound infection, and appropriate dressings based on the wound environment

Front 21

For nonhealing wounds that are stage III or higher

Back 21

imaging to rule out underlying osteomyelitis is indicated