Which of the following cardiovascular changes is/are seen as body ages? -
ANSWER Increase in total peripheral resistance
With aging, blood pressure and total peripheral resistance increase, however, a
decrease in cardiac output is seen. A progressive decline in baroreceptor
sensitivity is a characteristic feature of human aging as is a decrease in Beta-
adrenergic receptor sensitivity.
According to the AGS updated Beers Criteria for Potentially Inappropriate
Medication Use in Older Adults which of the following statement is true
regarding anti-infective agent Nitrofurantoin? - ANSWER Use of
Nitrofurantoin is not recommended in older adult with creatinine clearance
<30ml/min.
Avoid Nitrofurantoin in patients with a CrCl< 60 mL/min was revised with the
2015 update. There is evidence that it can be used in patients with a CrCl of 30
mL/min or higher for short duration.
According to the AGS updated Beers Criteria for Potentially Inappropriate
Medication Use in Older Adults which of the following antihypertensive
medications should be avoided in older adults? - ANSWER Doxazosin is a
peripheral alpha blocker, which is considered a potentially inappropriate
medication (PIM) in the elderly. Nifedipine IR is also listed on the Beers
Criteria to be avoided in the elderly.
Which of the following medications can lower patient's seizure threshold? -
ANSWER Seizure threshold can be lowered by Bupropion, Chlorpromazine,
Clozapine, Maprotiline, Olanzapine, Thioridazine, Thiothixene, and Tramadol.
Which of the following pulmonary changes is/are seen as the body ages? -
ANSWER Expiratory flow rates decrease with aging and typically show
changes in the flow-volume curves. Other age-related changes that occur in the
, lungs include weakening of the respiratory muscles as well as a decrease in lung
measures of lung function such as vital capacity, which is the maximum amount
of air that can be breathed out following a maximum inhalation.
Which of the following medications should be avoided for constipation in
elderly patients? - ANSWER Mineral oil should not be administered orally in
the elderly due to the risk of aspiration. There are safer alternatives.
Which of the following medications should be avoided if a patient is on lithium
to avoid lithium toxicity? - ANSWER ACE-inhibitors (such as lisinopril) and
loop diuretics (furosemide) can both increase the risk of lithium toxicity.
Which of the following medications should be avoided with warfarin? -
ANSWER Amiodarone and NSAIDs can both interact with warfarin causing an
increased risk of bleeding. Amiodarone should be avoided when possible.
DR is a 81 year old female admitted in ICU with PNA, A Fib, CHF with
preserved left ventricular function. She weighs 76 kg. She has history of lung
cancer for which she is being treated with cyberknife and chemotherapy as
outpatient, history of hypertension, hyperlipidemia, hypothyroidism, COPD. On
admission her WBC is 1.0 K/uL, bands of 32% and segs of 42%. SR was started
on Vancomycin, Levofloxacin and Aztreonam for HAP. She is also on the
electrolyte replacement protocol. She is allergic to PCN/cephalosporin (rash).
For her A. Fib she was given Amiodarone 400mg orally BID and Diltiazem
10mg/hr. She also received few doses of furosemide for her CHF. What is DR's
ANC? - ANSWER ABSOLUTE NEUTROPHIL COUNT: ANC = WBC *
((Segs/100) + (Bands/100)) ANC = 1.0 k/uL x (0.32 + 0.42) = 740
DR is a 81 year old female admitted in ICU with PNA, A Fib, CHF with
preserved left ventricular function. She weighs 76 kg. She has history of lung
cancer for which she is being treated with cyberknife and chemotherapy as
outpatient, history of hypertension, hyperlipidemia, hypothyroidism, COPD. On
admission her WBC is 1.0 K/uL, bands of 32% and segs of 42%. SR was started
on Vancomycin, Levofloxacin and Aztreonam for HAP. She is also on the
electrolyte replacement protocol. She is allergic to PCN/cephalosporin (rash).
For her A. Fib she was given Amiodarone 400mg orally BID and Diltiazem
10mg/hr. She also received few doses of furosemide for her CHF. Physician
would like to treat DR's low ANC. Which of the following would be the
ANSWER Increase in total peripheral resistance
With aging, blood pressure and total peripheral resistance increase, however, a
decrease in cardiac output is seen. A progressive decline in baroreceptor
sensitivity is a characteristic feature of human aging as is a decrease in Beta-
adrenergic receptor sensitivity.
According to the AGS updated Beers Criteria for Potentially Inappropriate
Medication Use in Older Adults which of the following statement is true
regarding anti-infective agent Nitrofurantoin? - ANSWER Use of
Nitrofurantoin is not recommended in older adult with creatinine clearance
<30ml/min.
Avoid Nitrofurantoin in patients with a CrCl< 60 mL/min was revised with the
2015 update. There is evidence that it can be used in patients with a CrCl of 30
mL/min or higher for short duration.
According to the AGS updated Beers Criteria for Potentially Inappropriate
Medication Use in Older Adults which of the following antihypertensive
medications should be avoided in older adults? - ANSWER Doxazosin is a
peripheral alpha blocker, which is considered a potentially inappropriate
medication (PIM) in the elderly. Nifedipine IR is also listed on the Beers
Criteria to be avoided in the elderly.
Which of the following medications can lower patient's seizure threshold? -
ANSWER Seizure threshold can be lowered by Bupropion, Chlorpromazine,
Clozapine, Maprotiline, Olanzapine, Thioridazine, Thiothixene, and Tramadol.
Which of the following pulmonary changes is/are seen as the body ages? -
ANSWER Expiratory flow rates decrease with aging and typically show
changes in the flow-volume curves. Other age-related changes that occur in the
, lungs include weakening of the respiratory muscles as well as a decrease in lung
measures of lung function such as vital capacity, which is the maximum amount
of air that can be breathed out following a maximum inhalation.
Which of the following medications should be avoided for constipation in
elderly patients? - ANSWER Mineral oil should not be administered orally in
the elderly due to the risk of aspiration. There are safer alternatives.
Which of the following medications should be avoided if a patient is on lithium
to avoid lithium toxicity? - ANSWER ACE-inhibitors (such as lisinopril) and
loop diuretics (furosemide) can both increase the risk of lithium toxicity.
Which of the following medications should be avoided with warfarin? -
ANSWER Amiodarone and NSAIDs can both interact with warfarin causing an
increased risk of bleeding. Amiodarone should be avoided when possible.
DR is a 81 year old female admitted in ICU with PNA, A Fib, CHF with
preserved left ventricular function. She weighs 76 kg. She has history of lung
cancer for which she is being treated with cyberknife and chemotherapy as
outpatient, history of hypertension, hyperlipidemia, hypothyroidism, COPD. On
admission her WBC is 1.0 K/uL, bands of 32% and segs of 42%. SR was started
on Vancomycin, Levofloxacin and Aztreonam for HAP. She is also on the
electrolyte replacement protocol. She is allergic to PCN/cephalosporin (rash).
For her A. Fib she was given Amiodarone 400mg orally BID and Diltiazem
10mg/hr. She also received few doses of furosemide for her CHF. What is DR's
ANC? - ANSWER ABSOLUTE NEUTROPHIL COUNT: ANC = WBC *
((Segs/100) + (Bands/100)) ANC = 1.0 k/uL x (0.32 + 0.42) = 740
DR is a 81 year old female admitted in ICU with PNA, A Fib, CHF with
preserved left ventricular function. She weighs 76 kg. She has history of lung
cancer for which she is being treated with cyberknife and chemotherapy as
outpatient, history of hypertension, hyperlipidemia, hypothyroidism, COPD. On
admission her WBC is 1.0 K/uL, bands of 32% and segs of 42%. SR was started
on Vancomycin, Levofloxacin and Aztreonam for HAP. She is also on the
electrolyte replacement protocol. She is allergic to PCN/cephalosporin (rash).
For her A. Fib she was given Amiodarone 400mg orally BID and Diltiazem
10mg/hr. She also received few doses of furosemide for her CHF. Physician
would like to treat DR's low ANC. Which of the following would be the
