Geriatric and Adult-Gerontology Care Flashcards

According to the AGS Beers Criteria, which medication should generally be avoided in a 78-year-old patient with insomnia?

Answer: Diphenhydramine

First-generation antihistamines such as diphenhydramine are strongly anticholinergic. In older adults they raise the risk of confusion, urinary retention, constipation, and falls.

Which equation is preferred for estimating renal function when dosing renally cleared drugs in a frail older adult?

Answer: Cockcroft-Gault creatinine clearance

Older adults often have a normal serum creatinine despite reduced GFR because of low muscle mass. Cockcroft-Gault accounts for age, weight, and sex, and most drug dosing guidance is based on it.

An 82-year-old is brought in with new confusion over the past 2 days, fluctuating attention, and a urinary tract infection. What is the most likely diagnosis?

Answer: Delirium

Delirium is an acute change in attention and cognition that fluctuates and has a medical trigger such as infection. Dementia is gradual and progressive. The first step is to find and treat the underlying cause.

Which timed test is recommended in the CDC STEADI algorithm to screen for fall risk, and what result suggests increased risk?

Answer: Timed Up and Go, 12 seconds or longer

STEADI uses the Timed Up and Go (TUG), the 30-second chair stand, and the 4-stage balance test. A TUG of 12 seconds or more indicates fall risk.

Under USPSTF recommendations, at what age should women without risk factors begin routine osteoporosis screening with DXA?

Answer: 65 years

The USPSTF recommends screening with bone density testing in women 65 and older. It also recommends screening postmenopausal women younger than 65 who are at increased risk.

Presbycusis typically presents as which type of hearing loss?

Answer: Bilateral, symmetric high-frequency sensorineural loss

Age-related hearing loss is gradual, bilateral, and symmetric. It affects high frequencies first, so patients struggle to understand speech in noisy settings.