Nokea
An older woman who is cared for by a concerned family is particularly likely to suffer from which of the following complications after an episode of gastroenteritis?
- A. Immobility related to overconcern
- B. Continued vomiting caused by too-rapid feeding
- C. Diarrhea resulting from administration of milk products
- D. Constipation related to overtreatment of diarrhea
Correct Answer: D
Rationale: Overtreatment of diarrhea can lead to constipation, especially in older adults.
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A patient presents with an elongated head with bony prominence of the forehead, nose, and lower jaw. These facial features could be suggestive of:
- A. Nephrotic syndrome
- B. Acromegaly
- C. Cushing’s syndrome
- D. Parkinson’s disease
Correct Answer: B
Rationale: Acromegaly is characterized by enlargement of bones and soft tissues, leading to features like a prominent jaw and forehead.
Joyce Mitchell is a 73-year-old frail female with a history of frequent falls, presenting with nausea, vomiting, sweating, and horizontal nystagmus. She is diagnosed with vestibular neuritis. What is the best initial course of treatment?
- A. Vestibular rehabilitation
- B. Supportive care with anti-nausea and anti-vertigo medication
- C. Fluids
- D. Epley maneuver
Correct Answer: B
Rationale: Supportive care with anti-nausea and anti-vertigo medication is appropriate for vestibular neuritis.
Which of the following best describes the components included in a patient's Social History (SH)?
- A. A summary of the patient's medical history and family background
- B. Lifestyle factors, social habits, and living conditions
- C. The patient's current medications and allergies
- D. Details about the patient's physical examination findings
Correct Answer: B
Rationale: Social History (SH) includes lifestyle factors, social habits, and living conditions, which impact overall health.
The National Institute of Neurologic Disorders and Stroke (NINDS) criteria for PD require a confirmatory autopsy but would rate as “probable” if three of the four primary clinical features were present. Which of the following lists three primary clinical features of PD?
- A. Fatigue, postural instability, gait dysfunction
- B. Rigidity, resting tremor, urinary urgency
- C. Rigidity, bradykinesia, resting tremor
- D. Freezing, sleep disturbance, arthralgias
Correct Answer: C
Rationale: The three primary features of PD are rigidity, bradykinesia, and resting tremor.
An 80-year-old man is being evaluated for recent episodes of incontinence and confusion. His family states that he is usually independent with no altered mental issues but has become forgetful within the last 2 weeks. Which medication is most likely associated with these symptoms?
- A. Cimetidine (Tagamet)
- B. Warfarin (Coumadin)
- C. Ramipril (Altace)
- D. Vitamin B12
Correct Answer: A
Rationale: Cimetidine can cause confusion and altered mental status in the elderly.