NR 601 MIDTERM EXAM: PRIMARY CARE OF THE MATURING
AND AGED FAMILY LATEST 2024/ 2025 UPDATE
What is the treatment for osteoporosis? -Answer:-Aim to prevent those that
are at risk
Combine diet, exercise, meds
Dietary Ca/vit D
Wt-bearing/strength exercises
Bisphosphonates
Selective estrogen receptor modulators
Calcitonin
PTH
Denosumab
Fall prevention
How does chronic pain differ from acute pain? -Answer:-Chronic pain tends to
be more multifactorial, less amenable to cure, more influenced by
psychological/social factors.
Typically requires continuous long-term/multidisciplenary management.
Can be triggered with seemingly minor biologic stimulus or persist long after
injury is healed.
What is the principle goal of chronic pain treatment? -Answer:-Improvement
in QOL/function, rather than complete elimination of pain.
What is nociceptive pain? -Answer:-Pain from nociceptive fibers in periphery
triggered by actual or potential tissue damage.
,Typically attributed to specific anatomic location of tissue injury.
Pain is well-localized, stabbing, throbbing, achy.
What is neuropathic pain? -Answer:-Direct neuronal injury.
Burning, tingling, lancinating.
Often occurs in dermatomal pattern
What are treatments for nociceptive pain? -Answer:-Nonopioid (APAP,
ibuprofen)
Weak opioids (Tramadol, tapentadol)
Antidepressants (TCAs, SNRIs)
Opioids
What are treatments for neuropathic pain? -Answer:-Characteristically more
resistant to opioids and to pharm interventions in general than nociceptive
pain.
Antidepressants (TCAs, SNRIs)
Anticonvulsants (gabapentin, pregabalin, carbamazepine, oxcarbazepine)
Opioids
Topical agents
The percentage of the FVC expired in one second is: -Answer:-FEV1/FVC ratio
,The aging process causes what normal physiological changes in the heart? -
Answer:-The heart valve thickens and becomes rigid, secondary to fibrosis
and sclerosis.
A 55yo Caucasian male follows up after referral to cardiologist. He thinks his
med is causing a cough and sometimes he has difficulty breathing. Which med
was most likely prescribed? -Answer:-Lisinopril
JM is a 68yo man who presents for a physical. He has T2DM x5yrs, smokes 1/2
PPD, BMI is 30. No other previous medical dx, no current complaints.
According to the AHA/ACC guidelines, JM is stage A HF. Treatment goals for
him include: -Answer:-Heart healthy lifestyle
MJ presents with h/o structural damage with current s/s of HF. Treatment
will be based on his stage of HF, which is: -Answer:-Stage C
65yo Caucasian female presents with mitral valve stenosis, physical exam
unremarkable. You know her stage of HF is: -Answer:-B
DG, 65yo man, presents for eval of CP and L-sided shoulder pain, beginning
after strenuous activity, including walking. Pain is dull, aching, 8/10 during
activity, otherwise 0/10. Began few mo ago, intermittent, aggravated by
exercise, relieved by rest. Occasional nausea. Pain is retrosternal, radiating to
L shoulder, affects QOL by limiting activity. Pain is worse today, did not go
away after stopped walking. BP 120/80, HR 72 and regular. Normal heart
sounds, no murmur, S1, S2. Which differential dx would be most likely? -
Answer:-Coronary artery dz w/angina pectoris
, The best way to dx structural heart dz/dysfunction non-invasively is: -
Answer:-Echocardiogram
Chronic pain can have major impact on pt's ability to function and have
profound impact on overall QOL. Ongoing pain may be linked to: -Answer:-
Depression, sleep disturbance, decreased socialization
The Beers criteria are appropriate for use in evaluating use of certain meds in
pts: -Answer:->65yo
Pt presents with c/o increasing SOB, cough w/occasional white sputum,
fatigue. As part of the plan you order labs. You know the likelihood of HF is
low if the BNP is: -Answer:-<100
All of the following statements are true about lab values in older adults
except:
a. Normal ranges may not be applicable to older adults
b. Abnormal findings are often due to physiological aging
c. Reference ranges are preferable
d. References values are not necessarily acceptable values -Answer:-B
According to the 2017 ACC HTN guidelines, the recommended BP goal for a
65yo African American woman w/a h/o HTN and DM and no h/o CKD is: -
Answer:-<140/80
The pathophysiology of HF is due to: -Answer:-Inadequate cardiac output to
meet the metabolic and O2 demands of the body
AND AGED FAMILY LATEST 2024/ 2025 UPDATE
What is the treatment for osteoporosis? -Answer:-Aim to prevent those that
are at risk
Combine diet, exercise, meds
Dietary Ca/vit D
Wt-bearing/strength exercises
Bisphosphonates
Selective estrogen receptor modulators
Calcitonin
PTH
Denosumab
Fall prevention
How does chronic pain differ from acute pain? -Answer:-Chronic pain tends to
be more multifactorial, less amenable to cure, more influenced by
psychological/social factors.
Typically requires continuous long-term/multidisciplenary management.
Can be triggered with seemingly minor biologic stimulus or persist long after
injury is healed.
What is the principle goal of chronic pain treatment? -Answer:-Improvement
in QOL/function, rather than complete elimination of pain.
What is nociceptive pain? -Answer:-Pain from nociceptive fibers in periphery
triggered by actual or potential tissue damage.
,Typically attributed to specific anatomic location of tissue injury.
Pain is well-localized, stabbing, throbbing, achy.
What is neuropathic pain? -Answer:-Direct neuronal injury.
Burning, tingling, lancinating.
Often occurs in dermatomal pattern
What are treatments for nociceptive pain? -Answer:-Nonopioid (APAP,
ibuprofen)
Weak opioids (Tramadol, tapentadol)
Antidepressants (TCAs, SNRIs)
Opioids
What are treatments for neuropathic pain? -Answer:-Characteristically more
resistant to opioids and to pharm interventions in general than nociceptive
pain.
Antidepressants (TCAs, SNRIs)
Anticonvulsants (gabapentin, pregabalin, carbamazepine, oxcarbazepine)
Opioids
Topical agents
The percentage of the FVC expired in one second is: -Answer:-FEV1/FVC ratio
,The aging process causes what normal physiological changes in the heart? -
Answer:-The heart valve thickens and becomes rigid, secondary to fibrosis
and sclerosis.
A 55yo Caucasian male follows up after referral to cardiologist. He thinks his
med is causing a cough and sometimes he has difficulty breathing. Which med
was most likely prescribed? -Answer:-Lisinopril
JM is a 68yo man who presents for a physical. He has T2DM x5yrs, smokes 1/2
PPD, BMI is 30. No other previous medical dx, no current complaints.
According to the AHA/ACC guidelines, JM is stage A HF. Treatment goals for
him include: -Answer:-Heart healthy lifestyle
MJ presents with h/o structural damage with current s/s of HF. Treatment
will be based on his stage of HF, which is: -Answer:-Stage C
65yo Caucasian female presents with mitral valve stenosis, physical exam
unremarkable. You know her stage of HF is: -Answer:-B
DG, 65yo man, presents for eval of CP and L-sided shoulder pain, beginning
after strenuous activity, including walking. Pain is dull, aching, 8/10 during
activity, otherwise 0/10. Began few mo ago, intermittent, aggravated by
exercise, relieved by rest. Occasional nausea. Pain is retrosternal, radiating to
L shoulder, affects QOL by limiting activity. Pain is worse today, did not go
away after stopped walking. BP 120/80, HR 72 and regular. Normal heart
sounds, no murmur, S1, S2. Which differential dx would be most likely? -
Answer:-Coronary artery dz w/angina pectoris
, The best way to dx structural heart dz/dysfunction non-invasively is: -
Answer:-Echocardiogram
Chronic pain can have major impact on pt's ability to function and have
profound impact on overall QOL. Ongoing pain may be linked to: -Answer:-
Depression, sleep disturbance, decreased socialization
The Beers criteria are appropriate for use in evaluating use of certain meds in
pts: -Answer:->65yo
Pt presents with c/o increasing SOB, cough w/occasional white sputum,
fatigue. As part of the plan you order labs. You know the likelihood of HF is
low if the BNP is: -Answer:-<100
All of the following statements are true about lab values in older adults
except:
a. Normal ranges may not be applicable to older adults
b. Abnormal findings are often due to physiological aging
c. Reference ranges are preferable
d. References values are not necessarily acceptable values -Answer:-B
According to the 2017 ACC HTN guidelines, the recommended BP goal for a
65yo African American woman w/a h/o HTN and DM and no h/o CKD is: -
Answer:-<140/80
The pathophysiology of HF is due to: -Answer:-Inadequate cardiac output to
meet the metabolic and O2 demands of the body
