Nokea
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.
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Which is a true statement about varicose veins?
- A. They are due to congenital valve deformities
- B. They are usually diagnosed on clinical presentation
- C. They are not affected by pregnancy
- D. They are more symptomatic during ovulation
Correct Answer: B
Rationale: The correct answer is B because varicose veins are usually diagnosed based on clinical presentation, such as visible, bulging veins and symptoms like pain or swelling. This is because varicose veins are often easily visible and cause noticeable symptoms.
A: Varicose veins are not typically due to congenital valve deformities but rather develop over time due to weakened vein walls and valves.
C: Varicose veins can be affected by pregnancy due to hormonal changes and increased pressure on the veins.
D: Varicose veins may not necessarily be more symptomatic during ovulation; symptoms can vary based on individual factors.
When examining the breast, the "tail of Spence" would be located:
- A. In the upper inner quadrant
- B. In the lower inner quadrant
- C. In the lower outer quadrant
- D. Laterally across the anterior axillary fold
Correct Answer: D
Rationale: The "tail of Spence" is an extension of breast tissue into the axilla. To locate it, visualize an imaginary line extending laterally from the breast towards the arm, crossing the anterior axillary fold. This is where the tail of Spence is found.
A: Incorrect. The upper inner quadrant is closer to the sternum.
B: Incorrect. The lower inner quadrant is below the nipple.
C: Incorrect. The lower outer quadrant is towards the armpit but not in the axilla like the tail of Spence.
Therefore, choice D is correct because the tail of Spence extends laterally across the anterior axillary fold.
Which of the following is a clinical identifier of metabolic syndrome?
- A. Waist circumference of 38 inches for a male
- B. Waist circumference of 34 inches for a female
- C. BP of 134/88 for a male
- D. BP of 128/84 for a female
Correct Answer: A
Rationale: The correct answer is A because a waist circumference of 38 inches for a male is a clinical identifier of metabolic syndrome. This measurement reflects abdominal obesity, a key component of metabolic syndrome. Excess abdominal fat is associated with insulin resistance, high blood pressure, and dyslipidemia, which are all features of metabolic syndrome.
Choice B is incorrect because a waist circumference of 34 inches for a female is not the correct measurement for identifying metabolic syndrome in females.
Choice C is incorrect because a blood pressure of 134/88 for a male, while elevated, is not a specific clinical identifier of metabolic syndrome.
Choice D is incorrect because a blood pressure of 128/84 for a female, although slightly elevated, is not a specific clinical identifier of metabolic syndrome.
The medication that blocks the transportation of glucose across the intestines into the bloodstream to target prandial blood glucose is:
- A. Metformin (Glucophage XR)
- B. Acarbose (Precose)
- C. Rosiglitazone (Avandia)
- D. Glipizide (Glucotrol XL)
Correct Answer: B
Rationale: The correct answer is B: Acarbose (Precose). Acarbose is an alpha-glucosidase inhibitor that blocks the breakdown of carbohydrates into glucose in the intestines, reducing glucose absorption and lowering postprandial blood glucose levels. Metformin (A) works by decreasing glucose production in the liver. Rosiglitazone (C) is a thiazolidinedione that improves insulin sensitivity. Glipizide (D) is a sulfonylurea that stimulates insulin release from the pancreas. Acarbose specifically targets postprandial blood glucose by blocking glucose absorption in the intestines.
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.