Common Geriatric Disorders

85 question-and-answer flashcards covering key geriatric, oncology, neurologic, musculoskeletal, ophthalmologic, and pharmacologic concepts from the lecture notes.

What skin lesion is a precursor to squamous cell carcinoma and appears as small, rough, scaly pink-to-reddish patches on sun-exposed skin?

Actinic keratosis

What is the preferred diagnostic method for confirming actinic keratosis?

Skin lesion biopsy

How are a small number of actinic keratoses usually treated?

Cryotherapy with liquid nitrogen

Which topical chemotherapeutic agent is used for widespread actinic keratoses?

5-fluorouracil cream

Sudden severe eye pain, halos around lights, mid-dilated non-reactive pupil and nausea in an older adult suggest what ophthalmic emergency?

Acute angle-closure glaucoma

When acute angle-closure glaucoma is suspected, what is the immediate management step?

Call 911/emergent ophthalmologic evaluation

Which bedside test measures elevated intraocular pressure in acute angle-closure glaucoma?

Tonometry

Define a cerebrovascular accident (CVA).

Sudden onset of neurologic dysfunction lasting >24 hrs due to brain infarction or hemorrhage (stroke)

How does a transient ischemic attack (TIA) differ from a stroke?

TIA causes temporary neurologic deficits without permanent infarction; symptoms resolve within 24 hrs

Name the two major categories of stroke.

Ischemic stroke and hemorrhagic stroke

List two classic bowel-related warning signs of colorectal cancer.

Hematochezia or melena and change in bowel habits (e.g., ribbon-like stools)

At what age should average-risk adults begin routine colorectal cancer screening?

45 years

Give one screening question used to detect elder abuse regarding home safety.

"Do you feel safe where you live?"

Bruises on breasts or unexplained vaginal/rectal bleeding in an elder may indicate what?

Sexual abuse

Unequal leg length with external rotation after a fall in an older adult is characteristic of what injury?

Hip fracture

Approximately what percentage of older adults die within a year of a hip fracture?

Up to 20 %

Unilateral temporal headache with jaw claudication and elevated ESR suggests which vasculitis?

Giant cell (temporal) arteritis

What procedure is definitive for diagnosing giant cell arteritis?

Temporal artery biopsy

Floaters, flashes of light, and a curtain over part of vision indicate what emergency?

Retinal detachment

Name two major risk factors for retinal detachment.

High myopia and prior cataract surgery

In older adults, acute confusion without fever may be the only sign of what?

Severe bacterial infection

What is the leading cause of death in persons >65 years?

Heart disease

Which cancer causes the highest number of deaths in the United States?

Lung and bronchial cancer

What environmental gas is the second-leading cause of lung cancer after smoking?

Radon

Which annual screening test is recommended for high-risk adults aged 50–80 with ≥20-pack-year history?

Low-dose CT scan of the chest

In multiple myeloma, what does the mnemonic CRAB stand for?

HyperCalcemia, Renal insufficiency, Anemia, Bone lesions

Which serum test detects monoclonal proteins in suspected multiple myeloma?

Serum protein electrophoresis with immunofixation

Which major cancer has an 11 % five-year survival rate, making it the most lethal?

Pancreatic cancer

Name the tumor marker often elevated in pancreatic cancer and used for prognosis.

CA 19-9

Absence of guarding and only mild leukocytosis in an older adult may still indicate what abdominal emergency?

Acute abdomen

List two atypical presentations of acute myocardial infarction in older adults.

Dyspnea without chest pain, or nausea/epigastric discomfort

Which organism remains the predominant cause of community-acquired pneumonia in elders?

Streptococcus pneumoniae

Name two drug classes that commonly cause constipation in older adults.

Iron supplements and opioids (others include CCBs, anticholinergics)

What daily dietary fiber intake is recommended for chronic constipation management?

25–35 g of fiber

Give one example of a bulk-forming laxative.

Psyllium (Metamucil)

Which scale uses six basic functions like bathing and feeding to measure independence?

Katz Index of ADLs

Name the bedside test that times a patient rising, walking, turning, and sitting to assess fall risk.

Get Up and Go (Timed Up and Go) test

Meeting three or more Fried criteria classifies an older adult as what?

Frail

A Mini-Mental State Examination score of 10–20 indicates what severity?

Moderate cognitive impairment/dementia

How many words are used in the recall portion of the Mini-Cog test?

Three words

What reversible syndrome presents with acute confusion often triggered by infection or medication?

Delirium

What term describes evening agitation and confusion seen in dementia?

Sundowning phenomenon

Which drug class is first-line for mild-to-moderate Alzheimer’s disease?

Cholinesterase inhibitors (e.g., donepezil)

Which NMDA receptor antagonist is added in moderate-to-severe Alzheimer’s disease?

Memantine

Name the four classic "A's" of Alzheimer’s disease.

Amnesia, Aphasia, Apraxia, Agnosia

An action tremor that improves with small amounts of alcohol most likely represents what diagnosis?

Essential tremor

Which non-selective beta-blocker is first-line therapy for essential tremor?

Propranolol

The USPSTF recommends routine osteoporosis screening for women beginning at what age?

65 years

What DEXA T-score defines osteoporosis?

−2.5 or lower

Give one key counseling point when prescribing oral bisphosphonates.

Take with full glass of water upon awakening and stay upright ≥30 min

Which selective estrogen receptor modulator treats osteoporosis and lowers breast cancer risk?

Raloxifene

The classic triad of Parkinson disease includes tremor, rigidity and what third feature?

Bradykinesia

What is the first-line pharmacotherapy for symptomatic Parkinson disease?

Carbidopa–levodopa (Sinemet)

Urine leakage with coughing or laughing is which type of incontinence?

Stress incontinence

Sudden strong urge followed by involuntary urine loss defines what incontinence type?

Urge incontinence (overactive bladder)

Frequent dribbling due to an over-filled bladder, often seen in BPH, represents which incontinence type?

Overflow incontinence

What non-pharmacologic therapy is first-line for all types of urinary incontinence?

Lifestyle modification plus pelvic floor (Kegel) exercises

Which SNRI can be prescribed for stress urinary incontinence?

Duloxetine

Name an anticholinergic medication used for overactive bladder.

Oxybutynin

Older adults often present with UTI as acute confusion even without what typical infection sign?

Fever

What document lists potentially inappropriate medications for older adults?

American Geriatrics Society Beers Criteria

Which antihypertensive class can increase falls in elders by causing orthostatic hypotension?

Alpha-blockers

List two geriatric syndromes that may be precipitated by anticholinergic drugs.

Constipation and delirium (also dizziness, urinary incontinence)

What is the most common infection overall in adults aged >65?

Urinary tract infection

Exposure to radon is associated with which cancer type?

Lung cancer

Which two inflammatory markers are usually elevated in giant cell arteritis?

Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)

What visual complication makes giant cell arteritis an ophthalmologic emergency?

Irreversible blindness from ischemic optic neuropathy

Which staging system is used for colorectal cancer?

TNM (Tumor-Node-Metastasis) staging

Which colon-cancer screening modality is recommended every 10 years for average-risk adults?

Colonoscopy

Low-dose CT lung screening should be discontinued when a former smoker has quit for how many years?

15 years

A Mini-Cog score of 0–2 suggests what diagnosis?

Dementia

What hallmark protein deposit is found in the brains of Alzheimer patients?

Beta-amyloid plaques

Give one lifestyle risk factor for osteoporosis.

Physical inactivity (others: low calcium, smoking, high alcohol/caffeine)

Name a weight-bearing exercise beneficial in osteoporosis management.

Walking (others: jogging, yoga, tai-chi, aerobic dance)

What daily supplementation is recommended for osteoporosis management?

Calcium 1,200 mg plus vitamin D 800 IU

Which parathyroid hormone analog has a black box warning for osteosarcoma in rats?

Teriparatide (Forteo)

Abrupt cessation of dopamine agonists in Parkinson patients may cause what syndrome?

Dopamine agonist withdrawal syndrome

What bladder-emptying technique can help overflow incontinence?

Double voiding

A Get Up and Go time significantly longer than 12–14 seconds indicates what?

Increased fall risk

What is the most common histologic type of lung cancer?

Non-small cell lung carcinoma

Pain or fatigue in the jaw while chewing in giant cell arteritis is called what?

Jaw claudication

Gait dysfunction, cognitive decline, and urinary incontinence due to excess CSF with normal pressure describe which condition?

Normal pressure hydrocephalus

Which brief 3-minute test combines three-word recall with clock drawing to screen cognition?

Mini-Cog test

Early visual hallucinations and marked sensitivity to antipsychotics are characteristic of which dementia type?

Dementia with Lewy bodies

The USPSTF lung-cancer screening age range for high-risk adults is what?

50–80 years

What staging imaging is most accurate for localizing and biopsying suspicious colorectal lesions?

Colonoscopy with biopsy