Geriatrics Final - Case Studies ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
exam with correct answers ||\\||\\ ||\\||\\ ||\\||\\
An 89-year-old man is brought to the outpatient clinic by
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
his daughter for a geriatric consultation
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
- The daughter is concerned because he has recently had
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
trouble remembering dates and recent events. ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
- The patient has no specific concerns but, in response to a
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
screening survey, rates his health as "poor."
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
History includes: ||\\||\\
- type 2 diabetes
||\\||\\ ||\\||\\ ||\\||\\
- Hypertension
||\\||\\
- COPD ||\\||\\
Comprehensive geriatric assessment confirms that the ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
patient is in poor health ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Which of the following patient characteristics is the best ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
predictor of increased risk of functional decline and ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
mortality?
A. History of diabetes, hypertension, and COPD
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
,B. Presence of memory lapses
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
C. Patient rating his own health as poor
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
D. Physician rating the patient's health as poor
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
C. Patient rating his own health as poor
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
An 85-year-old man is enrolled in a home-based medical
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
care program because he can no longer manage to get to
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
the outpatient clinic. ||\\||\\ ||\\||\\
- He lives alone in the community and has two children
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
who live nearby. ||\\||\\ ||\\||\\
- He is mostly confined to a wheelchair because he has
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
bilateral hip pain and worsening gait instability ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
- He requires assistance for bathing, dressing, and many
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
instrumental activities of daily living ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
History includes: ||\\||\\
- hypertension
||\\||\\
- severe osteoarthritis
||\\||\\ ||\\||\\
- mild dementia
||\\||\\ ||\\||\\
Which of the following individuals is most likely to be the ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
caregiver for this patient? ||\\||\\ ||\\||\\ ||\\||\\
A. The patient's son
||\\||\\ ||\\||\\ ||\\||\\
,B. The patient's daughter
||\\||\\ ||\\||\\ ||\\||\\
C. A neighbor
||\\||\\ ||\\||\\
D. A home health aide
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
B. The patient's daughter
||\\||\\ ||\\||\\ ||\\||\\
Biodemographers classify centenarians according to 3 age ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
groups:
- Centenarians, 100-104 years old
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
- Semi-supercentenarians, 105−109 years old
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
- Supercentenarians, ≥110 years old
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Which one of the following is more likely to be true of
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
supercentenarians than of centenarians? ||\\||\\ ||\\||\\ ||\\||\\
A. They delay or escape age-related diseases.
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
B. They spend a longer period of their lives with aging-
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
related diseases. ||\\||\\
C. They are more heterogeneous in terms of medical
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
history.
D. They spend a longer proportion of their lives with
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
impairment of ≥1 activity of daily living. ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
A. They delay or escape age-related diseases.
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
- A 75-year-old man is brought to the office by his wife
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
because he has had progressive cognitive and because he ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
, has had progressive cognitive and behavioral decline for
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
the last 3 years ||\\||\\ ||\\||\\ ||\\||\\
- The wife says that his memory, attention, and
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
organizational ability have declined, such that his daily ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
function is impaired ||\\||\\ ||\\||\\
- The patient says that his sense of smell has decreased
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
- He has had progressive weight loss
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
- He has acted out his dreams for many years
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
- More recently, he has behavioral disturbance that is
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
worse at night, with frequent delusions and intermittent ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
hallucinations
Which one of the following clinical features is most useful ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
for differentiating dementia with Lewy bodies from
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Alzheimer disease? ||\\||\\
A. psychosis ||\\||\\
B. hyposmia||\\||\\
C. memory impairment
||\\||\\ ||\\||\\
D. REM sleep behavior disorder
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
D. REM sleep behavior disorder
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
- An 82-year-old man is seen for his annual wellness visit
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
- His wife says that his thinking has slowed in the last 2-3
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
exam with correct answers ||\\||\\ ||\\||\\ ||\\||\\
An 89-year-old man is brought to the outpatient clinic by
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
his daughter for a geriatric consultation
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
- The daughter is concerned because he has recently had
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
trouble remembering dates and recent events. ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
- The patient has no specific concerns but, in response to a
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
screening survey, rates his health as "poor."
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
History includes: ||\\||\\
- type 2 diabetes
||\\||\\ ||\\||\\ ||\\||\\
- Hypertension
||\\||\\
- COPD ||\\||\\
Comprehensive geriatric assessment confirms that the ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
patient is in poor health ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Which of the following patient characteristics is the best ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
predictor of increased risk of functional decline and ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
mortality?
A. History of diabetes, hypertension, and COPD
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
,B. Presence of memory lapses
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
C. Patient rating his own health as poor
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
D. Physician rating the patient's health as poor
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
C. Patient rating his own health as poor
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
An 85-year-old man is enrolled in a home-based medical
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
care program because he can no longer manage to get to
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
the outpatient clinic. ||\\||\\ ||\\||\\
- He lives alone in the community and has two children
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
who live nearby. ||\\||\\ ||\\||\\
- He is mostly confined to a wheelchair because he has
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
bilateral hip pain and worsening gait instability ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
- He requires assistance for bathing, dressing, and many
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
instrumental activities of daily living ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
History includes: ||\\||\\
- hypertension
||\\||\\
- severe osteoarthritis
||\\||\\ ||\\||\\
- mild dementia
||\\||\\ ||\\||\\
Which of the following individuals is most likely to be the ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
caregiver for this patient? ||\\||\\ ||\\||\\ ||\\||\\
A. The patient's son
||\\||\\ ||\\||\\ ||\\||\\
,B. The patient's daughter
||\\||\\ ||\\||\\ ||\\||\\
C. A neighbor
||\\||\\ ||\\||\\
D. A home health aide
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
B. The patient's daughter
||\\||\\ ||\\||\\ ||\\||\\
Biodemographers classify centenarians according to 3 age ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
groups:
- Centenarians, 100-104 years old
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
- Semi-supercentenarians, 105−109 years old
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
- Supercentenarians, ≥110 years old
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Which one of the following is more likely to be true of
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
supercentenarians than of centenarians? ||\\||\\ ||\\||\\ ||\\||\\
A. They delay or escape age-related diseases.
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
B. They spend a longer period of their lives with aging-
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
related diseases. ||\\||\\
C. They are more heterogeneous in terms of medical
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
history.
D. They spend a longer proportion of their lives with
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
impairment of ≥1 activity of daily living. ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
A. They delay or escape age-related diseases.
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
- A 75-year-old man is brought to the office by his wife
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
because he has had progressive cognitive and because he ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
, has had progressive cognitive and behavioral decline for
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
the last 3 years ||\\||\\ ||\\||\\ ||\\||\\
- The wife says that his memory, attention, and
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
organizational ability have declined, such that his daily ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
function is impaired ||\\||\\ ||\\||\\
- The patient says that his sense of smell has decreased
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
- He has had progressive weight loss
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
- He has acted out his dreams for many years
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
- More recently, he has behavioral disturbance that is
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
worse at night, with frequent delusions and intermittent ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
hallucinations
Which one of the following clinical features is most useful ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
for differentiating dementia with Lewy bodies from
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Alzheimer disease? ||\\||\\
A. psychosis ||\\||\\
B. hyposmia||\\||\\
C. memory impairment
||\\||\\ ||\\||\\
D. REM sleep behavior disorder
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
D. REM sleep behavior disorder
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
- An 82-year-old man is seen for his annual wellness visit
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
- His wife says that his thinking has slowed in the last 2-3
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
