PRITE – GERIATRICS
STUDY SET
D. Frequent small sips of water - CORRECT CHOICE ✅✅A 91 year
old hospice patient with severe cachexia, end-stage dementia, renal
impairment has stopped eating and drinking. Which of the following
comfort measures would be most appropriate?
A. Total Parenteral nutrition
B. IV hydration
C. Nasogastric tube feeding
D. Frequent small sips of water
E. Appetite-inducing medications
A. Sex education - CORRECT CHOICE ✅✅A 75 year old man and
his 72 year old wife present requesting marital therapy. They
describe interesting conflict beginning about a decade ago when the
,wife began refusing sexual activity. The husband explains that he
still desires an intimate relationship and is frustrated and hurt that
his wife refuses him. She says that she does not see herself as
"sexy" and cannot understand how her husband could still desire
her. She has occasionally suggested he find "some younger woman."
He is insulted by these suggestions, saying that he would never
stray from the marriage. In treating this couple, the initial approach
should incorporate which of the following interventions?
A. Sex education
B. Sildenafil treatment
C. Sensate focus exercises
D. Testosterone replacement therapy
E. Cognitive Behavioral therapy
E. Information processing speed - CORRECT CHOICE ✅✅Which of
the following neurocognitive functions is most likely to show a
decline in people over age 65?
A. Attention span
B. Language
C. Long-term memory
D. Simple pattern recognition
E. Information processing speed
B. has a ceiling effect for well-educated persons - CORRECT
CHOICE ✅✅A 62 yea old patient is referred for complaints of
memory problems. The patient reports feeling more forgetful and
give example of "losing my keys, handbag, or forgetting the names
,of acquaintances." The patient denies any other neurocognitive
symptoms. Family member confirm the patient's report, and feel
that this has been a gradual change over the last year. Family
members report that the patient is a former history professor who
continues to enjoy intellectual activities, and they need to prepare if
the patient is going to lose these capabilities as a result of
dementia. The standard MMSE would be a relatively insensitive
instrument for this patient because it:
A. has not been validate in people of the same age
B. has a ceiling effect for well-educated persons
C. requires considerable training and is not practical in the clinical
setting
D. was designed to be a diagnostic tool rather than a general
cognitive assessment
E. focuses on attention and immediate recall, which are not the
primary complaints
A. Electrolytes - SSRI cause SIADH and hyponatremia, which
increase thirst drive and intake of hypotonic fluids, further
worsening hyponatremia. Check Na+ - CORRECT CHOICE ✅✅A 70
year old patient with mild early Alzheimer disease who lives with a
family member has recently been prescribed an SSRI for
depression. The patient also has HTN, adult onset DM and
rheumatoid arthritis, which have been stable and well-controlled
with medication. The patient develops acute confusion but no other
medical or psychiatric symptoms. Which of the follwoign tests
should be ordered first to determine the etiology of the patient's
confusion?
A. Electrolytes
, B. Cardiac enzymes
C. Liver function tests
D. Thyroid function tests
E. ESR
A. Changes in renal clearance make lithium problematic to use -
CORRECT CHOICE ✅✅Valproate is more commonly used than
Lithium for Bipolar Disorder in adults over age 65 and this
treatment preference is best justified by:
A. Changes in renal clearance make lithium problematic to use
B. Valproate appears to be superior to lithium in comparison to
trials
C. Lithium is more likely to interact with other drugs commonly
used
D. The half-life of valproate is less affected by the physiological
changes
E. Blood serum Valproate levels more accurately reflect the active
quantity available to the brain .
D. MDD with psychosis - CORRECT CHOICE ✅✅A 79 year old man
presents to the doctor c/o possibly having a "venereal disease",
explaining that he had an affair and these he contracted an STD.
The patient reports poor appetite, sleep, and energy for the last
month, but claims these are only because "I feel miserable and
guilty, and cannot stop thinking about it." The patient's spouse,
who is present, seems surprised by the patient's concerns, saying
that the affair the patient describes occurred many years ago and
the spouse has long since forgiven the patient. Physical exam shows
no evidence of infection. MSE is significant for sad affect, and
STUDY SET
D. Frequent small sips of water - CORRECT CHOICE ✅✅A 91 year
old hospice patient with severe cachexia, end-stage dementia, renal
impairment has stopped eating and drinking. Which of the following
comfort measures would be most appropriate?
A. Total Parenteral nutrition
B. IV hydration
C. Nasogastric tube feeding
D. Frequent small sips of water
E. Appetite-inducing medications
A. Sex education - CORRECT CHOICE ✅✅A 75 year old man and
his 72 year old wife present requesting marital therapy. They
describe interesting conflict beginning about a decade ago when the
,wife began refusing sexual activity. The husband explains that he
still desires an intimate relationship and is frustrated and hurt that
his wife refuses him. She says that she does not see herself as
"sexy" and cannot understand how her husband could still desire
her. She has occasionally suggested he find "some younger woman."
He is insulted by these suggestions, saying that he would never
stray from the marriage. In treating this couple, the initial approach
should incorporate which of the following interventions?
A. Sex education
B. Sildenafil treatment
C. Sensate focus exercises
D. Testosterone replacement therapy
E. Cognitive Behavioral therapy
E. Information processing speed - CORRECT CHOICE ✅✅Which of
the following neurocognitive functions is most likely to show a
decline in people over age 65?
A. Attention span
B. Language
C. Long-term memory
D. Simple pattern recognition
E. Information processing speed
B. has a ceiling effect for well-educated persons - CORRECT
CHOICE ✅✅A 62 yea old patient is referred for complaints of
memory problems. The patient reports feeling more forgetful and
give example of "losing my keys, handbag, or forgetting the names
,of acquaintances." The patient denies any other neurocognitive
symptoms. Family member confirm the patient's report, and feel
that this has been a gradual change over the last year. Family
members report that the patient is a former history professor who
continues to enjoy intellectual activities, and they need to prepare if
the patient is going to lose these capabilities as a result of
dementia. The standard MMSE would be a relatively insensitive
instrument for this patient because it:
A. has not been validate in people of the same age
B. has a ceiling effect for well-educated persons
C. requires considerable training and is not practical in the clinical
setting
D. was designed to be a diagnostic tool rather than a general
cognitive assessment
E. focuses on attention and immediate recall, which are not the
primary complaints
A. Electrolytes - SSRI cause SIADH and hyponatremia, which
increase thirst drive and intake of hypotonic fluids, further
worsening hyponatremia. Check Na+ - CORRECT CHOICE ✅✅A 70
year old patient with mild early Alzheimer disease who lives with a
family member has recently been prescribed an SSRI for
depression. The patient also has HTN, adult onset DM and
rheumatoid arthritis, which have been stable and well-controlled
with medication. The patient develops acute confusion but no other
medical or psychiatric symptoms. Which of the follwoign tests
should be ordered first to determine the etiology of the patient's
confusion?
A. Electrolytes
, B. Cardiac enzymes
C. Liver function tests
D. Thyroid function tests
E. ESR
A. Changes in renal clearance make lithium problematic to use -
CORRECT CHOICE ✅✅Valproate is more commonly used than
Lithium for Bipolar Disorder in adults over age 65 and this
treatment preference is best justified by:
A. Changes in renal clearance make lithium problematic to use
B. Valproate appears to be superior to lithium in comparison to
trials
C. Lithium is more likely to interact with other drugs commonly
used
D. The half-life of valproate is less affected by the physiological
changes
E. Blood serum Valproate levels more accurately reflect the active
quantity available to the brain .
D. MDD with psychosis - CORRECT CHOICE ✅✅A 79 year old man
presents to the doctor c/o possibly having a "venereal disease",
explaining that he had an affair and these he contracted an STD.
The patient reports poor appetite, sleep, and energy for the last
month, but claims these are only because "I feel miserable and
guilty, and cannot stop thinking about it." The patient's spouse,
who is present, seems surprised by the patient's concerns, saying
that the affair the patient describes occurred many years ago and
the spouse has long since forgiven the patient. Physical exam shows
no evidence of infection. MSE is significant for sad affect, and
