ABFM CARE OF VULNERABLE
ELDERY EXAM WITH CORRECT
ANSWERS 2025
Acute Intestinal Ischemia ( Correct answers ) -Presents w/ significant pain
in absence
of physical
-Hx of cv disease - think widespread vascular
findings
-Elderly with low flow states due to cardiac events can have abd
involvement
pain due to
*nonocclusive* bowel
-Can be caused by vasoconstrictors - triptans, ergots, vasopressin,
ischemia
NE, underlying
-Tx cocaine condition first, if no improvement - Dx with
Arteriography
sepsis ( Correct answers ) SIRS due to confirmed
-mortality increases with
infection
age
prevalance of adrenal insufficiency in septic shock ( Correct
answers ) 50%
corticosteroids in septic shock ( Correct answers ) low-to-moderate quality
evidence
that corticosteroids reduce mortality from septic shock if given in
low dosages
equivalent to < 400 mg /day of
hydrocortisone.
-evidence best for 28 day
course
Causes of volume depletion in sepsis ( Correct answers ) Venodilation
and capillary
lea
k
-pts require large amounts of fluids in 1st 24 hours
of mgmt
Bicarb therapy in sepsis ( Correct answers ) Not rec for improving
hemodynamics
reducing vasopressor
or
requirements
Dopamine ( Correct answers ) increases MAP and CO by increasing stroke
volume and
heart
rate
Norepinephrine ( Correct answers ) increases MAP by vasoconstriction; little
effect
HR andonless effect than dopamine
on SV
Best test of pancreatitis ( Correct answers ) CT w/ contrast - distinguishes
from necrotizing pancratitis, 2-3 days of
interstitial
illness
Initial management of Pancreatitis ( Correct answers ) aggressive fluid
and improved delivery
resuscitation
of O2
-prevent necrosis and improve
survival
ALREADY
GRADED A+
, Gut feeding ( Correct answers ) better than TPN cause it stabilizes gut
barrier function
- thereby preventing infection
Medicare
-both mustPart D ( Correct answers ) for married couple to qualify
have
Part Amust be enrolled in
-both
part D must be < 150% of federal poverty level
-Income
foron
-If a couple
Medicaid, then automatically eligible - not required to file an
application
Peri-operative/post-operative
increases complications ( Correct answers ) -
risk of post-operative
Smoking
-Poor
pneumonia -
exercise tolerance increases risk of CV complications, neuro
complicaitons,
unexpected transfer
and to
-COPD - risk of post op
ICU
-DM - increased risk of peri op cv probs, risk for wound
pneumonia
-Controlled HTN NOT RISK FACTOR
infection
Elderly Abuse ( Correct answers ) -Neglect >
physical abuse
-increasing in recent
-< 25% reported from
years
physicians
-1/5 cases are
reported
-financial exploitation cases are even lower
Urinary Catheters in Elderly ( Correct answers ) -insert only when
necessary, and as
kept in as long
necessary
-Don't use soley for
convenience
-alternatives to foleys - condom cath drainage, suprapubic cath,
intermittent urethral
cat
-as of 2008, medicaid and medicare won't pay for cath associated UTI
h
infections
present at not
admission
Indwelling catheter ( Correct answers ) -should not be changed at
fixed intervals
-avoid irrigation unless
-intermittent irrigation if clot, mucus, or other causes of
obstrucion
-BID cleaning of urethral meatus with iodine solution and soap and water
obstruction
NOT
to shownCAUTI - so don't do it
reduce
Omnibus Budget Reconciliation Act (OBRA) ( Correct answers ) -
establishedand
guidelines training
minimum staff
requirements
-strengthened resident's rights - restraints usage and
psychoactive
-periodic meds
comprehensive assessment of all nursing home
residents
-decreased over all use of restraints and prevalance of
pressure ulcers
-However no significant improvement in QUALITY
of care
ALREADY
GRADED A+
ELDERY EXAM WITH CORRECT
ANSWERS 2025
Acute Intestinal Ischemia ( Correct answers ) -Presents w/ significant pain
in absence
of physical
-Hx of cv disease - think widespread vascular
findings
-Elderly with low flow states due to cardiac events can have abd
involvement
pain due to
*nonocclusive* bowel
-Can be caused by vasoconstrictors - triptans, ergots, vasopressin,
ischemia
NE, underlying
-Tx cocaine condition first, if no improvement - Dx with
Arteriography
sepsis ( Correct answers ) SIRS due to confirmed
-mortality increases with
infection
age
prevalance of adrenal insufficiency in septic shock ( Correct
answers ) 50%
corticosteroids in septic shock ( Correct answers ) low-to-moderate quality
evidence
that corticosteroids reduce mortality from septic shock if given in
low dosages
equivalent to < 400 mg /day of
hydrocortisone.
-evidence best for 28 day
course
Causes of volume depletion in sepsis ( Correct answers ) Venodilation
and capillary
lea
k
-pts require large amounts of fluids in 1st 24 hours
of mgmt
Bicarb therapy in sepsis ( Correct answers ) Not rec for improving
hemodynamics
reducing vasopressor
or
requirements
Dopamine ( Correct answers ) increases MAP and CO by increasing stroke
volume and
heart
rate
Norepinephrine ( Correct answers ) increases MAP by vasoconstriction; little
effect
HR andonless effect than dopamine
on SV
Best test of pancreatitis ( Correct answers ) CT w/ contrast - distinguishes
from necrotizing pancratitis, 2-3 days of
interstitial
illness
Initial management of Pancreatitis ( Correct answers ) aggressive fluid
and improved delivery
resuscitation
of O2
-prevent necrosis and improve
survival
ALREADY
GRADED A+
, Gut feeding ( Correct answers ) better than TPN cause it stabilizes gut
barrier function
- thereby preventing infection
Medicare
-both mustPart D ( Correct answers ) for married couple to qualify
have
Part Amust be enrolled in
-both
part D must be < 150% of federal poverty level
-Income
foron
-If a couple
Medicaid, then automatically eligible - not required to file an
application
Peri-operative/post-operative
increases complications ( Correct answers ) -
risk of post-operative
Smoking
-Poor
pneumonia -
exercise tolerance increases risk of CV complications, neuro
complicaitons,
unexpected transfer
and to
-COPD - risk of post op
ICU
-DM - increased risk of peri op cv probs, risk for wound
pneumonia
-Controlled HTN NOT RISK FACTOR
infection
Elderly Abuse ( Correct answers ) -Neglect >
physical abuse
-increasing in recent
-< 25% reported from
years
physicians
-1/5 cases are
reported
-financial exploitation cases are even lower
Urinary Catheters in Elderly ( Correct answers ) -insert only when
necessary, and as
kept in as long
necessary
-Don't use soley for
convenience
-alternatives to foleys - condom cath drainage, suprapubic cath,
intermittent urethral
cat
-as of 2008, medicaid and medicare won't pay for cath associated UTI
h
infections
present at not
admission
Indwelling catheter ( Correct answers ) -should not be changed at
fixed intervals
-avoid irrigation unless
-intermittent irrigation if clot, mucus, or other causes of
obstrucion
-BID cleaning of urethral meatus with iodine solution and soap and water
obstruction
NOT
to shownCAUTI - so don't do it
reduce
Omnibus Budget Reconciliation Act (OBRA) ( Correct answers ) -
establishedand
guidelines training
minimum staff
requirements
-strengthened resident's rights - restraints usage and
psychoactive
-periodic meds
comprehensive assessment of all nursing home
residents
-decreased over all use of restraints and prevalance of
pressure ulcers
-However no significant improvement in QUALITY
of care
ALREADY
GRADED A+
