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geriatric medicine practice questions
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practice questions- systems based approach(geriatric med)
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Geriatric Medicine1. Which of the following is NOT an 4. Diazepam is a lipophilic drug. Which of
appropriate step to prevent delirium in a the following is true about the metabolism
hospitalized elderly patient? of diazepam in an older adult compared
a) Regular mobilization to encourage to a younger adult?
strength a) Diazepam will have decreased
b) Bladder catheterization to reduce elimination leading to an increased
risk of falls when going to the half-life
bathroom b) Diazepam will have increased
c) Provide appropriate vision and elimination leading to a decreased
hearing aids half-life
d) Monitor sleep-wake cycles c) Diazepam will have a larger volume
of distribution leading to a reduced
2. You have been asked to see an 84 year- maximum concentration
old man with a history of hypertension, d) Diazepam will have a reduced
diabetes, dyslipidemia, benign prostatic volume of distribution leading to an
hyperplasia, and recent admission for increased maximum concentration
myocardial infarction about two months
ago. His medications on discharge 5. The cause of the greatest decrease in
include metformin, metoprolol, aspirin, quality of life in the elderly is:
simvastatin, amlodipine, ramipril, and a) Arthritis
Tamsulosin. Today, he tells you that he is b) Dementia
troubled by increased swelling in his legs, c) Heart disease
which is confirmed with 2+ pitting edema d) Stroke
bilaterally on physical exam. Remainder e) Hypertension
of physical exam is unremarkable. What
is the next best step for managing his 6. Which of the following is NOT an age
edema? related change?
a) Add furosemide to facilitate diuresis a) Impaired myocardial diastolic
b) Decrease dose of amlodipine dysfunction
c) Encourage the patient to ambulate b) Increased gastric acid secretion
frequently to prevent dependent leg c) Decreased drug clearance
edema d) Increased nocturnal sodium and
d) Reassure and follow-up in 1 year fluid excretion
e) Decreased baroreflex sensitivity
3. A 76 year-old male sees multiple
prescribers for the 10 different 7. Regarding the elderly patient, which of
medications used to treat his 6 comorbid the following apply?
conditions. Which of the following is NOT a) Vague symptoms
a risk factor for the development of an b) Atypical presentations
adverse drug reaction (ADR)? c) Loss of function
a) Age of 76 d) Polypharmacy
b) Multiple prescribers e) All of the above
c) Use of 10 medications
d) 6 comorbidities
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