Nokea
An elderly male with benign prostate hyperplasia (BPH) should be advised to avoid antihistamines. What is the reason for this?
- A. Urinary incontinence
- B. Constipation
- C. Orthostatic hypotension
- D. Urinary retention
Correct Answer: D
Rationale: Antihistamines can cause urinary retention, worsening BPH symptoms.
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When fluid accumulates between the visceral and parietal pleural spaces, the term used is:
- A. Pericardial effusion
- B. Pleural effusion
- C. Pleural empyema
- D. None of the above
Correct Answer: B
Rationale: Pleural effusion occurs when fluid collects in the pleural space.
A 27-year-old male patient presents with a painless chancre on the shaft of his penis and regional lymphadenopathy. He is diagnosed with primary syphilis. The best initial treatment is:
- A. Ceftriaxone (Rocephin)
- B. Clindamycin (Cleocin)
- C. Metronidazole (Flagyl)
- D. Benzathine penicillin G (Bicillin L.A)
Correct Answer: D
Rationale: Benzathine penicillin G is the first-line treatment for primary syphilis.
Which of the following is NOT a safety issue commonly faced by older adults?
- A. Falls
- B. Medication safety
- C. Cognitive impairment
- D. Increased physical activity
Correct Answer: D
Rationale: Older adults face safety issues related to falls, medication safety, and cognitive impairment, but increased physical activity is generally a benefit.
Two years later Mr. Hunter reports progression of his urinary symptoms and desires “a pill to make this better.” His current IPSS is 17, with a bother score of 3 indicating moderate voiding symptoms with moderate impact on his quality of life. On review of systems he notes that his vision has worsened, especially in his left eye. His ophthalmologist has recommended cataract surgery. For which of the following medications would initiation of therapy be delayed until after cataract surgery?
- A. Finasteride
- B. Tamsulosin
- C. Tadalafil
- D. Oxybutynin
Correct Answer: B
Rationale: Tamsulosin may cause intraoperative floppy iris syndrome, so it is often delayed until after cataract surgery.
Randall Johnson, an 80-year-old man with a history of high blood pressure and hypothyroidism, presents with ongoing dizziness. What is the most likely cause of his dizziness?
- A. Orthostatic hypotension
- B. Benign positional paroxysmal vertigo
- C. Overcontrol of thyroid
- D. Ménière disease
Correct Answer: A
Rationale: Orthostatic hypotension is the most likely cause of dizziness in this patient with high blood pressure and hypothyroidism.