Geriatrics Chapter Questions Exam I
Which one of the following is most true about the rule of fourths?
A. 1/4 of geriatric problems are iatrogenic.
B. Little can be done to prevent 3/4 of the problems of aging.
C. For every medical complaint a pt has, a careful assessment can identify 3 other
Dx's.
D. What used to be called normal aging can be largely explained by processes
that aren't normal.
E. A good way to conduct a geriatric assessment is to use 4 categories: mental,
physical, psychosocial, and environmental.
D.
Which one of the following is most true about aging changes?
A. Stage 3 and 4 sleep decreases.
B. Renal perfusion is not reduced, but renal function is reduced.
C. Hearing acuity declines beginning in middle age.
D. Prostatic enlargement occurs only in a minority of men.
A.
A 71-yo woman w/ HTN, DM, and ischemic cardiomyopathy visits your office after
a witnessed episode of syncope at a church gathering. She does not remember
the event, but her daughter describes her suddenly appearing pale while sitting
and then slumping over and hitting her head on the side of a table. After about
30s she came to on her own. She has a normal PE except for an abrasion on her
forehead and her only ECG abnormalities are the changes from her previous MI.
What type of syncope is most likely in your DDx? (Chap 22)
a. Neurologic
b. Neurally mediated
c. Cardiac
d. Orthostatic
e. Psychiatric
C
,All of the following evaluation methods are part of the routine workup for a first
episode of syncope except:
a. ECG
b. complete Hx and PE
c. CT scan of the brain
d. review of medication use
C
A positive response to carotid sinus massage indicates a high likelihood of which
one of the following types of syncope?
a. Neurally mediated
b. Cardiac
c. Neurologic
d. Orthostatic
e. Psychiatric
A
A 65-year-old female patient who is new to your practice presents after one
episode of syncope that was sudden and without prodromal symptoms. She has
hypertension, hypothyroidism, and depression, all controlled on medication per
her report. Her physical examination reveals an obese woman with 2+ pretibial
edema and a normal cardiovascular and neurologic exam. Her ECG shows left
ventricular hypertrophy. Which of the following would be reasonable as the next
step in determining the etiology of her syncope?
a. carotid dopplers
b. Transthoracic Echo
c. CT scan of head
d. Tilt table testing
B
A 67-year-old man with no significant medical problems passes out at a cookout
soon after standing up to go to the bathroom. He had recently finished his
barbecue dinner and admits to having consumed three beers. He denies any
previous syncopal episodes. His complete physical examination reveals a very
, healthy-appearing man with no abnormal findings. His ECG is normal. What
should you do?
a. Admit him to the hospital for telemetry monitoring.
b. Refer him to a cardiologist for intracardiac electro-
physiologic studies.
c. Schedule an exercise treadmill cardiac stress test.
d. Reassure him and follow up with him in clinic again later in the week.
D
A 75-year-old man visits your clinic accompanied by his wife who reports that he
is having hearing difficulties. He denies hearing loss and reports that people
around him "mumble too much." His ear canals are free of cerumen. Of the
following screening tests you might use to assess the patient's hearing loss,
which is the most reliable and valid?
a. Whisper test
b. Audioscopy using otoscope with built-in audiometer
c. Tuning fork test
d. Finger rub test
e. Weber and Rinne tests
B
A 67-year-old male with severe bilateral hearing loss comes to the clinic to
establish primary care. A nurse practitioner observes that he does not
understand what is said to him during his assessment. He has no hearing aids.
Which of the following actions is least likely to ease communication with the
patient?
a. Use a hard-wired voice amplification system such as a Pocket Talker.
b. Ensure that the speaker's face is in full view of the listener and speak clearly at
a slightly louder than normal intensity; avoid shouting.
c. When repetition is necessary, paraphrase the message or write key words.
Which one of the following is most true about the rule of fourths?
A. 1/4 of geriatric problems are iatrogenic.
B. Little can be done to prevent 3/4 of the problems of aging.
C. For every medical complaint a pt has, a careful assessment can identify 3 other
Dx's.
D. What used to be called normal aging can be largely explained by processes
that aren't normal.
E. A good way to conduct a geriatric assessment is to use 4 categories: mental,
physical, psychosocial, and environmental.
D.
Which one of the following is most true about aging changes?
A. Stage 3 and 4 sleep decreases.
B. Renal perfusion is not reduced, but renal function is reduced.
C. Hearing acuity declines beginning in middle age.
D. Prostatic enlargement occurs only in a minority of men.
A.
A 71-yo woman w/ HTN, DM, and ischemic cardiomyopathy visits your office after
a witnessed episode of syncope at a church gathering. She does not remember
the event, but her daughter describes her suddenly appearing pale while sitting
and then slumping over and hitting her head on the side of a table. After about
30s she came to on her own. She has a normal PE except for an abrasion on her
forehead and her only ECG abnormalities are the changes from her previous MI.
What type of syncope is most likely in your DDx? (Chap 22)
a. Neurologic
b. Neurally mediated
c. Cardiac
d. Orthostatic
e. Psychiatric
C
,All of the following evaluation methods are part of the routine workup for a first
episode of syncope except:
a. ECG
b. complete Hx and PE
c. CT scan of the brain
d. review of medication use
C
A positive response to carotid sinus massage indicates a high likelihood of which
one of the following types of syncope?
a. Neurally mediated
b. Cardiac
c. Neurologic
d. Orthostatic
e. Psychiatric
A
A 65-year-old female patient who is new to your practice presents after one
episode of syncope that was sudden and without prodromal symptoms. She has
hypertension, hypothyroidism, and depression, all controlled on medication per
her report. Her physical examination reveals an obese woman with 2+ pretibial
edema and a normal cardiovascular and neurologic exam. Her ECG shows left
ventricular hypertrophy. Which of the following would be reasonable as the next
step in determining the etiology of her syncope?
a. carotid dopplers
b. Transthoracic Echo
c. CT scan of head
d. Tilt table testing
B
A 67-year-old man with no significant medical problems passes out at a cookout
soon after standing up to go to the bathroom. He had recently finished his
barbecue dinner and admits to having consumed three beers. He denies any
previous syncopal episodes. His complete physical examination reveals a very
, healthy-appearing man with no abnormal findings. His ECG is normal. What
should you do?
a. Admit him to the hospital for telemetry monitoring.
b. Refer him to a cardiologist for intracardiac electro-
physiologic studies.
c. Schedule an exercise treadmill cardiac stress test.
d. Reassure him and follow up with him in clinic again later in the week.
D
A 75-year-old man visits your clinic accompanied by his wife who reports that he
is having hearing difficulties. He denies hearing loss and reports that people
around him "mumble too much." His ear canals are free of cerumen. Of the
following screening tests you might use to assess the patient's hearing loss,
which is the most reliable and valid?
a. Whisper test
b. Audioscopy using otoscope with built-in audiometer
c. Tuning fork test
d. Finger rub test
e. Weber and Rinne tests
B
A 67-year-old male with severe bilateral hearing loss comes to the clinic to
establish primary care. A nurse practitioner observes that he does not
understand what is said to him during his assessment. He has no hearing aids.
Which of the following actions is least likely to ease communication with the
patient?
a. Use a hard-wired voice amplification system such as a Pocket Talker.
b. Ensure that the speaker's face is in full view of the listener and speak clearly at
a slightly louder than normal intensity; avoid shouting.
c. When repetition is necessary, paraphrase the message or write key words.
