Nokea
Which of the following is an early sign of dehydration in older adults?
- A. Weight gain
- B. Dry mouth and skin
- C. Decreased urine output
- D. Increased thirst
Correct Answer: B
Rationale: The correct answer is B: Dry mouth and skin. Dehydration in older adults can lead to dry mouth and skin due to the lack of proper hydration. This is an early sign as the body starts to lose water. Weight gain (A) is not indicative of dehydration, as it typically occurs with fluid retention. Decreased urine output (C) is a later sign of dehydration, as the body conserves water. Increased thirst (D) is a response to dehydration but not an early sign. Therefore, dry mouth and skin are the most relevant early indicators of dehydration in older adults.
You may also like to solve these questions
A 12-year-old presents to the clinic with his father for evaluation of a painful lump in the left eye. It started this morning. He denies any trauma or injury. There is no visual disturbance. Upon physical examination, there is a red raised area at the margin of the eyelid that is tender to palpation; no tearing occurs with palpation of the lesion. Based on this description, what is the most likely diagnosis?
- A. Dacryocystitis
- B. Chalazion
- C. Hordeolum
- D. Xanthelasma
Correct Answer: C
Rationale: The correct answer is C: Hordeolum. A hordeolum, also known as a stye, presents as a red raised tender area at the margin of the eyelid. In this case, the absence of tearing upon palpation of the lesion suggests it is localized to the eyelid itself. Dacryocystitis (choice A) involves the lacrimal sac and would present with tearing. A chalazion (choice B) is a painless nodule on the eyelid, unlike the tender lesion described here. Xanthelasma (choice D) is characterized by yellowish plaques on the eyelids, not a red raised tender area.
A patient with bulimia is likely to be:
- A. Very overweight
- B. Very underweight
- C. Of average weight
- D. Not concerned with weight
Correct Answer: C
Rationale: The correct answer is C: Of average weight. Patients with bulimia often maintain a normal weight or fluctuate between weight extremes due to their binge-eating and compensatory behaviors. They may engage in purging to counteract the effects of binge eating, preventing significant weight gain. Choice A is incorrect as bulimia is not typically associated with being very overweight. Choice B is incorrect as individuals with bulimia can have a normal or slightly underweight body weight. Choice D is incorrect as individuals with bulimia are often preoccupied with weight and body image.
Which one of the following is most true about the rule of fourths?
- A. One-fourth of geriatric problems are iatrogenic.
- B. Little can be done to prevent three-fourths of the problems of aging.
- C. For every medical complaint a patient presents with, a careful assessment can identify three other diagnoses.
- D. What used to be called normal aging can be largely explained by processes that are not normal.
Correct Answer: A
Rationale: Step 1: The rule of fourths states that one-fourth of geriatric problems are iatrogenic, meaning they are caused by medical treatment.
Step 2: This statement is true because iatrogenic problems in the elderly are common due to multiple medications, procedures, etc.
Step 3: A careful assessment can indeed identify iatrogenic issues, making this statement accurate.
Summary:
A is correct because it aligns with the concept of iatrogenic problems in the elderly.
B is incorrect because interventions can help prevent many problems of aging.
C is incorrect as it does not specifically address iatrogenic problems.
D is incorrect as it does not focus on the iatrogenic aspect of geriatric problems.
In which of the following patients is chemical or surgical castration likely to prolong survival?
- A. A 78-year-old man with advanced dementia and prostate cancer metastatic to the bone.
- B. A 78-year-old man who had a radical prostatectomy 10 years earlier and now has a PSA level of 5.7 ng/mL. A year ago it was 0.1 ng/mL. A bone scan is negative and an abdomen-pelvis computed tomography (CT) is negative.
- C. A 78-year-old man who had a radical prostatectomy and external beam radiation therapy 10 years earlier now has a PSA level of 24.5 ng/mL. A CT scan of the pelvis shows an enlarged pelvic lymph node, and a bone scan is positive in the pelvis.
- D. A 78-year-old man with prostate cancer limited to the prostate with a Gleason score of 6.
Correct Answer: C
Rationale: The correct answer is C. In this scenario, the patient had a radical prostatectomy and external beam radiation therapy, indicating aggressive treatment. Despite this, the PSA level is high (24.5 ng/mL), suggesting biochemical recurrence and possible metastasis. The positive bone scan and enlarged pelvic lymph node indicate disease progression beyond the prostate. Chemical or surgical castration, such as androgen deprivation therapy, can help delay disease progression and prolong survival by reducing the levels of testosterone that fuel prostate cancer growth.
Summary:
A: In advanced dementia and metastatic bone disease, castration is unlikely to impact survival as the disease is already advanced.
B: A rising PSA level post-radical prostatectomy with negative imaging indicates biochemical recurrence, but without evidence of metastasis, making castration less beneficial.
D: Prostate cancer limited to the prostate with a Gleason score of 6 is low risk and may not benefit significantly from castration as it is less likely to progress rapidly.
Unilateral rhinitis could be caused by all of the following except:
- A. A foreign body in the nasal canal
- B. A nasal polyp
- C. Drug-induced rhinitis
- D. A deviated septum
Correct Answer: D
Rationale: The correct answer is D: A deviated septum. Unilateral rhinitis typically refers to inflammation in one nostril. A deviated septum is a physical obstruction in the nasal passage that affects both nostrils, not just one. Choices A, B, and C can all cause unilateral rhinitis as they specifically affect one side of the nasal passage. A foreign body in the nasal canal, a nasal polyp, and drug-induced rhinitis can all lead to inflammation and symptoms in one nostril.