GER310 Gerontology
Midterm Exam Review
(Questions & Solutions)
2025
©2025
, Question 1 (Multiple Choice):
A 76-year-old patient with a history of hypertension and diabetes
presents with mild cognitive impairment and subtle gait disturbances.
The interdisciplinary team suspects early signs of vascular dementia.
Which of the following imaging findings is most likely to be present in this
patient?
a) Diffuse cortical atrophy
b) Multiple white matter hyperintensities
c) Unilateral basal ganglia calcification
d) Single lacunar infarct in the cerebellum
Correct ANS: b) Multiple white matter hyperintensities
Rationale: Vascular dementia is frequently linked to chronic small
vessel ischemic changes that appear as multiple white matter
hyperintensities on MRI. This correlates with a history of vascular risk
factors such as hypertension and diabetes.
---
Question 2 (Multiple Choice):
A geriatric patient with advanced heart failure is experiencing episodes
of orthostatic hypotension. In the context of polypharmacy, which class
of medications is most likely contributing to these symptoms?
a) Beta-blockers
b) ACE inhibitors
c) Diuretics
d) Calcium channel blockers
Correct ANS: c) Diuretics
Rationale: Diuretics can reduce circulating blood volume, thereby
exacerbating orthostatic hypotension in older adults—particularly when
combined with other antihypertensive agents.
©2025
,---
Question 3 (Multiple Choice):
In a geriatric patient with osteoporosis and a recent vertebral fracture,
which of the following biochemical markers is most indicative of bone
resorption?
a) Alkaline phosphatase
b) Osteocalcin
c) C-terminal telopeptide (CTX)
d) Parathyroid hormone (PTH)
Correct ANS: c) C-terminal telopeptide (CTX)
Rationale: CTX is a specific marker for bone resorption because it
quantifies the breakdown products of type I collagen, which is
particularly useful in monitoring osteoporotic activity in the elderly.
---
Question 4 (Multiple Choice):
A 79-year-old patient with Alzheimer’s disease exhibits increased
agitation shortly after initiating risperidone therapy. What is the most
significant risk associated with atypical antipsychotic use in elderly
dementia patients?
a) Increased cerebrovascular events
b) Enhanced memory retention
c) Rapid stabilization of dementia symptoms
d) Reduced risk of falls
Correct ANS: a) Increased cerebrovascular events
Rationale: Atypical antipsychotics have been associated with an
increased risk of cerebrovascular events—including stroke—in patients
with dementia; thus, their use requires particularly careful monitoring in
the elderly.
---
©2025
, Question 5 (Multiple Choice):
An 82-year-old patient presents with unintentional weight loss and
decreased appetite. Which assessment tool is most appropriate to
evaluate nutritional status in older adults?
a) Body Mass Index (BMI)
b) Mini Nutritional Assessment (MNA)
c) Serum albumin level
d) Comprehensive Geriatric Scale (CGS)
Correct ANS: b) Mini Nutritional Assessment (MNA)
Rationale: The MNA is a multidimensional tool that evaluates dietary
intake, weight loss, and functional status, making it especially suited for
nutritional assessment in the elderly rather than relying solely on one
parameter like BMI.
---
Question 6 (Multiple Choice):
In the context of normal pressure hydrocephalus (NPH) in an elderly
patient, which clinical triad is most typical?
a) Memory loss, visual hallucinations, and tremors
b) Gait disturbance, urinary incontinence, and cognitive impairment
c) Seizures, headache, and confusion
d) Muscle rigidity, bradykinesia, and postural instability
Correct ANS: b) Gait disturbance, urinary incontinence, and cognitive
impairment
Rationale: The classic clinical triad for NPH comprises gait disturbance,
urinary incontinence, and cognitive impairment, a set of findings that
helps distinguish NPH from other neurodegenerative disorders.
---
Question 7 (Multiple Choice):
©2025
Midterm Exam Review
(Questions & Solutions)
2025
©2025
, Question 1 (Multiple Choice):
A 76-year-old patient with a history of hypertension and diabetes
presents with mild cognitive impairment and subtle gait disturbances.
The interdisciplinary team suspects early signs of vascular dementia.
Which of the following imaging findings is most likely to be present in this
patient?
a) Diffuse cortical atrophy
b) Multiple white matter hyperintensities
c) Unilateral basal ganglia calcification
d) Single lacunar infarct in the cerebellum
Correct ANS: b) Multiple white matter hyperintensities
Rationale: Vascular dementia is frequently linked to chronic small
vessel ischemic changes that appear as multiple white matter
hyperintensities on MRI. This correlates with a history of vascular risk
factors such as hypertension and diabetes.
---
Question 2 (Multiple Choice):
A geriatric patient with advanced heart failure is experiencing episodes
of orthostatic hypotension. In the context of polypharmacy, which class
of medications is most likely contributing to these symptoms?
a) Beta-blockers
b) ACE inhibitors
c) Diuretics
d) Calcium channel blockers
Correct ANS: c) Diuretics
Rationale: Diuretics can reduce circulating blood volume, thereby
exacerbating orthostatic hypotension in older adults—particularly when
combined with other antihypertensive agents.
©2025
,---
Question 3 (Multiple Choice):
In a geriatric patient with osteoporosis and a recent vertebral fracture,
which of the following biochemical markers is most indicative of bone
resorption?
a) Alkaline phosphatase
b) Osteocalcin
c) C-terminal telopeptide (CTX)
d) Parathyroid hormone (PTH)
Correct ANS: c) C-terminal telopeptide (CTX)
Rationale: CTX is a specific marker for bone resorption because it
quantifies the breakdown products of type I collagen, which is
particularly useful in monitoring osteoporotic activity in the elderly.
---
Question 4 (Multiple Choice):
A 79-year-old patient with Alzheimer’s disease exhibits increased
agitation shortly after initiating risperidone therapy. What is the most
significant risk associated with atypical antipsychotic use in elderly
dementia patients?
a) Increased cerebrovascular events
b) Enhanced memory retention
c) Rapid stabilization of dementia symptoms
d) Reduced risk of falls
Correct ANS: a) Increased cerebrovascular events
Rationale: Atypical antipsychotics have been associated with an
increased risk of cerebrovascular events—including stroke—in patients
with dementia; thus, their use requires particularly careful monitoring in
the elderly.
---
©2025
, Question 5 (Multiple Choice):
An 82-year-old patient presents with unintentional weight loss and
decreased appetite. Which assessment tool is most appropriate to
evaluate nutritional status in older adults?
a) Body Mass Index (BMI)
b) Mini Nutritional Assessment (MNA)
c) Serum albumin level
d) Comprehensive Geriatric Scale (CGS)
Correct ANS: b) Mini Nutritional Assessment (MNA)
Rationale: The MNA is a multidimensional tool that evaluates dietary
intake, weight loss, and functional status, making it especially suited for
nutritional assessment in the elderly rather than relying solely on one
parameter like BMI.
---
Question 6 (Multiple Choice):
In the context of normal pressure hydrocephalus (NPH) in an elderly
patient, which clinical triad is most typical?
a) Memory loss, visual hallucinations, and tremors
b) Gait disturbance, urinary incontinence, and cognitive impairment
c) Seizures, headache, and confusion
d) Muscle rigidity, bradykinesia, and postural instability
Correct ANS: b) Gait disturbance, urinary incontinence, and cognitive
impairment
Rationale: The classic clinical triad for NPH comprises gait disturbance,
urinary incontinence, and cognitive impairment, a set of findings that
helps distinguish NPH from other neurodegenerative disorders.
---
Question 7 (Multiple Choice):
©2025
