ABIM Geriatric Medicine 2

Question 1

A 79-year-old woman asks for an over-the-counter sleep aid. Which agent is listed in the AGS Beers Criteria as strongly anticholinergic and should be avoided?

Accepted Answer

Diphenhydramine

Answer

First-generation antihistamines like diphenhydramine are highly anticholinergic and raise the risk of confusion, constipation, urinary retention and falls in older adults.

Question 2

In the Confusion Assessment Method (CAM), which feature must be present, along with acute onset or fluctuating course, to diagnose delirium?

Accepted Answer

Inattention

Answer

CAM requires acute onset/fluctuating course plus inattention, plus either disorganized thinking or altered level of consciousness.

Question 3

Using the CDC STEADI approach, a Timed Up and Go test result of what duration indicates increased fall risk in an older adult?

Accepted Answer

12 seconds or more

Answer

STEADI uses a TUG time of 12 seconds or longer as a marker of increased fall risk.

Question 4

A nursing home resident has a sacral wound with full-thickness skin loss and visible subcutaneous fat, but no exposed bone, tendon, or muscle. What is the pressure injury stage?

Accepted Answer

Stage 3

Answer

Stage 3 involves full-thickness skin loss into adipose tissue without exposure of fascia, muscle, tendon, ligament, cartilage, or bone.

Question 5

In a patient with suspected normal pressure hydrocephalus, which feature of the classic triad is most likely to improve after ventriculoperitoneal shunting?

Accepted Answer

Gait disturbance

Answer

Gait disturbance is usually the earliest feature and the one most responsive to CSF diversion.

ABIM - American Board of Internal Medicine Practice Test

ABIM - American Board of Internal Medicine Practice Test

ABIM Geriatric Medicine 2