Family Practice Exam Geriatric Care 5

Question 1

A 73-year-old man with Parkinson's disease develops visual hallucinations after starting which of the following medications?

Accepted Answer

Pramipexole (a dopamine agonist)

Answer

Dopamine agonists like pramipexole and ropinirole are more likely to cause hallucinations, impulse control disorders, and psychosis than levodopa in Parkinson's disease.

Question 2

A 68-year-old woman presents with sudden painless vision loss in her right eye. Fundoscopic exam shows a 'blood and thunder' appearance with diffuse flame hemorrhages in all quadrants. What is the most likely diagnosis?

Accepted Answer

Central retinal vein occlusion

Answer

Central retinal vein occlusion (CRVO) classically presents with the 'blood and thunder' fundus appearance showing diffuse flame hemorrhages in all four quadrants.

Question 3

Which of the following best describes the appropriate use of the Confusion Assessment Method (CAM) in geriatric care?

Accepted Answer

Detecting delirium in hospitalized patients

Answer

The CAM is a validated, widely used bedside instrument specifically designed to detect delirium in hospitalized patients based on four key features.

Question 4

A 71-year-old woman presents with pain in both hips and shoulders for 3 months, morning stiffness lasting over 1 hour, and ESR of 72 mm/hr. CK is normal. She responds dramatically to prednisone 15 mg/day. What should now be monitored most closely?

Accepted Answer

Blood glucose, blood pressure, and bone density (for steroid side effects)

Answer

Long-term corticosteroid therapy for PMR requires monitoring for steroid-induced complications including hyperglycemia, hypertension, osteoporosis, and adrenal suppression.

Question 5

An 85-year-old man is being discharged after hip fracture repair. Which intervention has the strongest evidence for preventing delirium in postoperative elderly patients?

Accepted Answer

Early mobilization and reorientation protocols

Answer

Multicomponent non-pharmacologic interventions including early mobilization, reorientation, sleep hygiene, and hydration are the most evidence-based strategies for delirium prevention.

Family Practice Exam Practice Test

Family Practice Exam Practice Test

Family Practice Exam Geriatric Care 5