Deck 5: Symptoms and Syndromes

Question 1

Which of the following statements about fluid balance in the elderly is false?

A) Total body water decreases with age.
B) Thirst response decreases as a person ages.
C) African Americans have higher rates of dehydration than white Americans.
D) Assessment of skin turgor at the sternum is a reliable indicator of dehydration in the elderly.

Answer 1

Assessment of skin turgor at the sternum is a reliable indicator of dehydration in the elderly.

Question 2

Risk factors associated with the finding of a malignancy in a patient with hemoptysis include all of the following except:

A) Male sex
B) Smoking history
C) Over age 40
D) Childhood asthma

Answer 2

Childhood asthma

Question 3

Bordetella pertussis is best characterized by:

A) Sub-acute cough lasting greater than two weeks
B) Acute cough associated with a coryzal symptom
C) Chronic cough with post-nasal drip
D) Non-productive acute cough

Answer 3

Sub-acute cough lasting greater than two weeks

Question 4

Atypical presentation of acute coronary syndrome is:

A) Most common in Hispanic females
B) More common in men
C) Most common in African American men
D) More common in females

Question 5

Presbystasis is best described as:

A) Impairment in vestibular apparatus that causes dizziness
B) Age-related disequilibrium of unknown pathology characterized by a gradual onset of difficulty walking
C) The loss of high frequency tones with aging that can impair sensation
D) A disorder of the inner ear characterized by vertigo

Question 6

If dizziness has a predictable pattern associated with it,the clinician should first consider:

A) Hypoglycemia
B) Psychogenic etiology
C) Cardiovascular cause
D) Neurogenic cause

Question 7

The term "geriatric syndrome" is best described as:

A) A condition that has multiple underlying factors and involves multiple systems
B) A condition that has a discreet etiology that is difficult to pinpoint
C) Significant progress has been made in understanding geriatric syndromes,especially falls and delirium
D) Therapeutic management of a geriatric syndrome can be accomplished once a specific diagnosis is made

Question 8

The most cost-effective interventions used to prevent falls are:

A) Use of sitters
B) Use of alarms (bed,chair,monitors)
C) Tai Chi exercises
D) Home modifications and vitamin D supplements

Question 9

The routine testing of tuberculosis should occur in all of the following vulnerable populations except:

A) Nursing home residents
B) Prison inmates
C) Hospitalized elderly
D) Immune-compromised patients

Question 10

Thoracic aortic dissection presents typically as:

A) Sharp stabbing pain in the mid thorax
B) Pleuretic chest pain and dyspnea
C) Severe retrosternal chest pain that radiates to the back and both arms
D) Unilateral pleuretic chest pain and dyspnea

Question 11

Which form of headache is bilateral?

A) Cluster
B) Tension
C) Migraine
D) Acute angle closure glaucoma

Question 12

Recent weight loss is defined as:

A) loss of >10 pounds over the past 3-6 months
B) loss of >2 pounds a week
C) 5% weight loss in three months
D) 10% weight loss in one year

Question 13

The anal wink reflex is used to test:

A) Rectal prolapse
B) Sensation and pudental nerve function
C) Baseline and squeeze sphincter tone
D) Fissures and fistulas

Question 14

What disease can mimic and often co-exists with myocardial infarctions in elders with coronary artery disease?

A) Hypertension
B) Esophageal disease
C) Diabetic gastroparesis
D) Vascular disease

Question 15

Medications known to contribute to constipation include all of the following except:

A) Stimulant laxatives
B) Anticholinergic drugs
C) Broad-spectrum antibiotics
D) Iron

Question 16

Evidence shows that the most important predictor of a fall is:

A) Prior history of a fall
B) Cognitive impairment
C) Gait and balance disturbance
D) Proximal muscle weakness

Question 17

Distinguishing delirium from dementia can be problematic since they may co-exist.The primary consideration in the differential is:

A) Performance on the Mini Mental Status Exam
B) The Confusion Assessment is negative
C) Rapid change and fluctuating course of cognitive function
D) The presence of behavioral symptoms with cognitive impairment

Question 18

Microscopic hematuria is defined as:

A) Twenty or more RBCs on a urine sample
B) Three or more RBCs on a urine sample
C) Twenty or more RBCs on three or more samples of urine
D) Three or more RBCs on three or more samples of urine

Question 19

Chronic fatigue syndrome is best described as:

A) Fatigue that is constant,lasting more than three months
B) Fatigue lasting longer than six months and not relieved by rest
C) Fatigue that waxes and wanes over a period of three months
D) Total exhaustion with inability to get out of bed

Question 20

All of the following are considered as contributors to dysphagia except:

A) Anticholinergics
B) Drugs that increase reflux symptoms
C) Inadequate intake of fluids with medications and meals
D) Smooth muscle relaxants

Question 21

The most common cause of disability in the elderly is due to:

A) Diabetes
B) Arthritis
C) Heart disease
D) Chronic obstructive pulmonary disease

Question 22

Lipedema is best described as:

A) Bilateral accumulation of interstitial fluid
B) Bilateral distribution of fat in the lower extremities
C) Fluid retention caused by a compromised lymphatic system
D) Lipid molecules that break down and cause fluid retention

Question 23

Overflow incontinence is usually associated with:

A) Loss of urine that occurs with urgency
B) Cognitive impairment
C) Weak pelvic floor muscles
D) Bladder outlet obstruction

Question 24

All of the following statements about tremor are true except:

A) The most common tremor is the Parkinson tremor
B) Most individuals with tremor do not seek medical attention
C) Psychogenic tremor is uncommon
D) Tremor is more prevalent in whites than blacks

Question 25

Wandering is best described as:

A) Aimless excessive ambulatory behavior
B) Purposeful excessive ambulatory behavior
C) Risk-seeking behavior in the cognitively impaired
D) A result of boredom in those with dementia

Question 26

Drug-induced pruritus is distinguished because it:

A) Occurs soon after a new drug is taken
B) Usually is a generalized rash
C) May occur right after the drug is taken or months later
D) Usually involves localized circumscribed lesions

Question 27

A form of syncope that is more common in the elderly than younger adults is:

A) Vasovagal
B) Carotid sinus sensitivity
C) Orthostatic hypotension
D) Arrhythmias