Geriatric Medicine Questions and Answers

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Questions and Answers on Geriatric Medicine

1. Which of the following in an Extrinsic risk factor for pressure ulcer?
(1) Edema
(2) Malnutrition
(3) Smoking
(4) Moisture

2. Following is true of Renal function tests in normal elderly, except –
(1) GFR declines approximately 8.0 mL/min per 1.73m2 per decade from the middle of the fourth decade of life
(2) Decrease in GFR with age is not accompanied by elevations in serum creatinine levels
(3) Cystatin C, is a marker of reduced GFR in older adults with deranged creatinine levels
(4) Aging is associated with a progressive decrease in renal plasma flow

3. Examples of advance directives include all, except –
(1) Physician Orders for Life-Sustaining Treatment (POLST)
(2) MOLST (Medical Orders for Life-Sustaining Treatment)
(3) Do not resuscitate
(4) Health Insurance

4. The confusion assessment method consists of looking for four features.
(1) Acute onset and fluctuating course
(2) Inattention
(3) Disorganised thinking, and
(4) Altered level of consciousness.
The diagnosis of delirium requires the presence of the following features –
(1) Any two of them
(2) 1 and 2 and either 3 or 4
(3) All the four
(4) Either 1 or 2, and 3 and 4

5. A 68-year-old man with a history of myocardial infarction and congestive heart failure is comfortable at rest. However, when walking he develops dyspnea, fatigue, palpitations. The above symptoms relieve after rest. His New York Heart Association classification is which of the following?
(1) Class I
(2) Class II
(3) Class III
(4) Class IV

6. Infectious esophagitis is not commonly caused by…………..
(1) Herpes Simplex
(2) Candida
(3) Cytomegalovirus (CMV)
(4) H. Pylori

7. Who introduced the concept of physical frailty?
(1) Fried
(2) Rockwood
(3) Mitnitski
(4) Newman

8. Population Ageing depends upon –
(1) Decline in fertility, increase in life expectancy and migration
(2) Increase in fertility, increase in life expectancy and large birth cohort
(3) Decline in life expectancy, increase in fertility and migration
(4) Decline in life expectancy, decline in fertility and large birth cohort

9. Arginine Vasopressin (AVP) acts through which receptor on renal collecting duct?
(1) V1 receptor
(2) V2 receptor
(3) V3 receptor
(4) V4 receptor

10. Long-Stay Quality Measures include all, EXCEPT –
(1) One or more falls with major injury
(2) Urinary tract infection
(3) Weight Gain
(4) Administration of antipsychotic medication

11. Sleep in older adults can be improved first by –
(1) Encouraging sleep hygiene
(2) Counselling
(3) Adding sedatives
(4) None of the above

12. Adverse drug reactions in older people are more frequent due to all, EXCEPT –
(1) Pharmacokinetic ad pharmacodynamic changes
(2) Pharmacovigilance
(3) Polypharmacy
(4) Comorbidities

13. Geriatric Failure To Thrive (GFIT) is characterised by all, EXCEPT –
(1) Involuntary weight loss and failure to maintain functional capacity
(2) More common in females
(3) More common in males
(4) Increases with age

14. The timed-up and go test (TUG) is an indicator of –
(1) Mental ability
(2) Psychological preparedness
(3) Functional status
(4) Quality of life assessment

15. Sjogren’s syndrome with a plasma sodium 140 meq/L, chloride 112 meq/L, bicarbonate 15 med/L, and potassium 3.0 meq/L; urine showing a pH of 6.0, sodium of 14 meq/L, potassium of 12 meq/L, and chloride of 12meq/L. The most likely diagnosis is –
(1) Type I Renal Tubular Acidosis (RTA)
(2) Type II RTA
(3) Type III RTA
(4) Type IV RTA

16. Which is the first imaging test for Stroke?
(1) NCCT Brain
(2) MRI Brian
(3) PET Scan
(4) MR angiography

17. Sensitivity is –
(1) True Negative
(2) True Positive
(3) False Negative
(4) False Positive

18. External factors affecting immunosenescence are following, EXCEPT –
(1) Alcoholism
(2) Exercise
(3) Malnutrition
(4) Cognitive impairment

19. Modern “Geriatric Giants” are –
(1) Frailty, sarcopenia, constipation, and cognitive impairment.
(2) Frailty, CHF, the anorexia of aging, and cognitive impairment.
(3) Frailty, sarcopenia, the anorexia of aging and cognitive impairment.
(4) Frailty, CKD, the anorexia of aging, and cognitive impairment.

20. Potentially Inappropriate Prescribing (PIP) or PIP omissions criteria are –
(1) Beers criteria
(2) Screening Tool of Older Person’s Prescription (STOPP)
(3) Screening Tool to Alert to Right Treatment (START)
(4) All of the above

21. Prevention measures to decrease nosocomial pneumonia for hospitalized elderly in the non-ICU setting include all, EXCEPT-
(1) Avoid intubation in patients with respiratory failure/Promote the use of non-invasive ventilation
(2) Promote use to proton pump inhibitors
(3) Use antibiotics judiciously
(4) Maintain good oral hygiene

22. For management of Acute abdomen in older people, what is not correct –
(1) Physical signs may be deceptive
(2) Mesenteric ischemia is more common than younger patients
(3) Early CT abdomen may not help
(4) Surgical intervention should not be deferred

23. Myelodysplastic Syndrome (MDS), FAB classification includes the following, EXCEPT –
(1) Refractory anaemia (RA)
(2) Refractory Anaemia with Ring Sideroblasts (RARS)
(3) Refractory Anaemia with Excess Blasts in Transformation (RAEB-T)
(4) Chronic Monocytic Leukaemia (CML)

24. Advance care planning discussion leads to following outcomes, EXCEPT-
(1) Advance statements
(2) Advance directive
(3) Advance payment
(4) The nomination of a surrogate decision maker

25. Rash in a 55 year old male on scrapping of the lesions is viewed after a wet preparation with 10% potassium hydroxide solution
Both hyphal and spore forms present, giving the slide an appearance of “spaghetti and meatballs.”
In addition, the lesions fluoresce to a yellow-green appearance under a Wood’s lamp.
Which of the following microorganisms is responsible for his this skin infection?
(1) Malassezia furfur
(2) Penicillium marneffei
(3) Sporothrix schenckii
(4) Trichophyton rubrum

26. Which of the following statements regarding Alzheimer’s disease is true?
(1) Delusions are uncommon
(2) It accounts for over half of the cases of significant memory loss in patients over 70 years of age
(3) It typically presents with rapid (<6 months) significant memory loss
(4) Less than 5% of patients present with nonmemory complaints

27. A 75-year-old male with diabetes mellitus presents acute abdominal pain in the right upper abdomen, vomiting and fever. His plain abdominal film reveals gas within the gall bladder lumen and dissecting within the gallbladder wall to form a gaseous ring. What is the probable diagnosis?
(1) Acute Pancreatitis
(2) Acalculous Cholecystitis
(3) Intestinal Perforation
(4) Emphysematous Cholecystitis

28. 45-year-old male complains of tremors while working. He complains of lethargy and decreased interest in work. There is no change in his weight. On examination he has no tremors at rest but has fine tremors when the hands are outstretched. His resting pulse rate is 80/mt with normal neurological examination. What is the most probable diagnosis?
(1) Chronic Anxiety
(2) Benign essential tremors
(3) Parkinson’s disease
(4) Hyperthyroidism

29. Anorexia-cachexia syndrome frequently occurring in terminal illnesses could be treated with all, EXCEPT-
(1) Corticosteroids
(2) Vitamins
(3) Oxandrolone
(4) Ghrelin mimetics

30. What is false about Bortezomib used for treatment of multiple myeloma?
(1) Proteasome inhibitor
(2) Herpes Zoster prophylaxis needed
(3) Causes Neuropathy
(4) Deep Vein thrombosis prophylaxis needed

31. Which of the following statements is FALSE?
(1) Suicide is twice as frequent in the elderly population.
(2) Depression in more common in men than in women.
(3) Depression is more common in hospitalized patients than in those in the community.
(4) More patients avoid becoming depressed if they move to a safer environment.

32. A 63-year-old man with treatment naive AML-M4 admitted in ER with altered mental status. He is confused and somnolent. He has history of passage of excessive urine the precious night at home. Laboratory studies are notable for an absolute neutrophil count of 400, a platelet count of 35,000 and a serum sodium of 165. Treatment includes all, EXCEPT –
(1) Thiazides
(2) Desmopressin
(3) Lithtum
(4) NSAIDS

33. Advance directives are also called –
(1) Medical wills
(2) Living wills
(3) Management plans
(4) Management directions

34. The following are age related changes in eyes, except –
(1) Decreased lacrimal gland secretion
(2) Lens becomes rigid
(3) Dryness of endothelial cells of cornea
(4) Denaturation of lens protein

35. Following antibiotics is not effective against anaerobes –
(1) Clindamycin
(2) Ticarcillin-clavulanic acid
(3) Doxycycline
(4) Meropenem

36. Rapidly developing bilateral blindness in an older person could occur due to –
(1) Age related macular degeneration
(2) Giant cell arteritis
(3) Diabetic retinopathy
(4) Cataract

37. Choose the correct statement about Health Expectancy –
(1) Same as life expectancy
(2) Population health indicator combining information on the quantity of life (life expectancy) and quality of the remaining years (health)
(3) Population health indicator combining information on the quantity of life (life expectancy) and quality of the previous years (health)
(4) Incorporates both present and past health states of aging population

38. Joint family system is gradually eroding in India affecting the health care of older people. Which is not the cause for it?
(1) Urbanization
(2) Migration
(3) Economic participation of women
(4) Financial security

39. Trabecular bone is seen in all sites, except –
(1) Vertebra
(2) Hip
(3) End of long bones
(4) Shaft of long bones

40. Frailty Tools are all, except –
(1) SARE Frailty Indicator
(2) Groningen Frailty Indicator
(3) Tilburg Frailty Indicator
(4) Edmonton Frail Scale

41. All of the following statements are correct, except –
(1) Older women are more likely than men to be living with disability/morbidity
(2) Old men are more likely to die than old women
(3) Old men are more likely to have heart disease as compared to old women
(4) Most studies of older populations have a larger proportion of males as compared to females

42. The antifungal action of Echinocandins is that it –
(1) Inhibits fungal DNA synthesis
(2) Inhibits lanosterol 140-demethylase
(3) Inhibits squalene epoxidase
(4) Inhibits β-1,3-glucan synthase

43. Enhanced cytokine production in the “inflammaging” leads to –
(1) Splenomegaly
(2) Thymic atrophy
(3) Lymphopenia
(4) Anaemia

44. Which is not a Long-Term Care Facility (LTCFs)
(1) Day Care Centre
(2) Old age Home
(3) Nursing Home
(4) Assisted Living

45. Following statements are true about tinnitus associated with Age-Related Hearing Loss (ARHL), EXCEPT –
(1) 11% of adults suffering from ARHL experience permanent and persistent tinnitus
(2) Hearing impairment, increasing age, and male gender are the most relevant risk factors
(3) Hearing impairment, increasing age, and female gender are the most relevant risk factors
(4) Hearing impairment, increasing age, and either male or female gender are the most relevant risk factors