Geriatric Medicine Quiz

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Quiz on Geriatric Medicine

1. During surgery older patients are prone for –
(1) Hypokalemia
(2) Hypothermia
(3) Hypothyroidism
(4) Hypertension

2. Following is true of Lung function tests in normal elderly, except –
(1) Both FEVI and FVC decreases with age
(2) Ratio of REV1 to FVC increases annually
(3) Total Lung Capacity does not change significantly with age
(4) Residual V and FRC increase

3. Reversible or partially reversible dementias include all of the following, EXCEPT –
(1) Wilson’s disease
(2) Hashimoto’s thyroiditis
(3) Lewy body dementia
(4) Normal pressure hydrocephalus

4. A 61-year-old patient of ulcerative colitis has five stools per day with mild fever. His disease severity according to Montreal Classification of Extent and severity of Ulcerative Colitis is –
(1) Clinical remission
(2) Mild
(3) Moderate disease activity
(4) Severe disease activity

5. Monkeypox virus infection causes which type of skin lesions?
(1) Vesiculopustular lesions
(2) Palpable purpura
(3) Maculopapular lesions
(4) Papulonodular lesions

6. All of the following immunization are mandatory for elderly population, except?
(1) Pneumococcus
(2) Annual influenza
(3) COVID 19 vaccination
(4) Hepatitis B

7. All are validated fall risk screening tools, except –
(1) TUG test
(2) STRATIFY
(3) CaHFRiS Screen
(4) 10-Stage Balance Test

8. Some landmark studies in geriatrics include all, except –
(1) U.S. HRS-AHEAD
(2) ELSA
(3) SHARE
(4) ILDA

9. Which is not an indication for renal biopsy in an older patient?
(1) Acute decline in GFR
(2) Obstructive Uropathy
(3) Nephrotic range proteinuria
(4) Active urinary sediment

10. Healthy Ageing is developing and maintaining the………………..that enables well-being in older age.
(1) Functional ability
(2) Physical and mental ability
(3) Environment
(4) Intrinsic capacity

11. A 76-year-old man is admitted from the emergency room with cellulitis of the right leg. He has been consuming alcohol in significant quantities in the last few years and he has limited calorie intake other than alcohol. Given his alcoholism and poor oral intake, he would be at risk of deficiency of all of the following vitamins, EXCEPT –
(1) Folate
(2) Thiamine
(3) Vitamin B12
(4) Vitamin E

12. Regarding Febrile neutropenia in older patient which is INCORRECT?
(1) High risk of developing it
(2) Invasive fungal infections could occur
(3) Prophylactic use of Granulocyte-ColonyStimulating Factor (G-CSF) not recommended
(4) Poor Prognosis

13. Commonest identified source of community-acquired bacteremia in older patients is –
(1) Lower respiratory tract
(2) Buliary tract
(3) Genitourinary system
(4) Skin and soft tissues

14. A 65-year-old male has CT calcium score on Agatston score is 250. He falls in which CAC category?
(1) Mild
(2) Moderate
(3) Sever
(4) Minimal

15. For “Compression of Morbidity” hypothesis all are true, except –
(1) As people approach the limit of their life, they must compress the time that they experience diseases that affect mortality towards the end.
(2) Centenarians generally exhibit this compression.
(3) Centenarians generally do not exhibit this compression.
(4) Compression of morbidity towards the end of life would implicate an overall exhaustion of organ reserve as the cause of death in these individuals.

16. Omalizumab, a monoclonal antibody is used to treat –
(1) Ulcerative Colitis
(2) Rheumatoid Arthritis
(3) Asthma
(4) Multiple Myeloma

17. Regarding Basal cell Carcinoma is FALSE –
(1) Progresses slowly
(2) Usually do not metastasize
(3) Treatment of choice is chemotherapy
(4) Common on face but can occur on all body sites

18. The therapeutic goal of HbAIC for a 82 year-old-woman with Diabetes Mellitus, Stroke and Dementia would be –
(1) 7-7.5%
(2) 7-8%
(3) 8-8.5%
(4) <7%

19. Which of the following risk factors has the highest odds ratio of causing Peripheral Arterial Disease?
(1) Hypercholesterolemia
(2) Cigarette smoking
(3) Diabetes mellitus
(4) Hypertension

20. Which drug does not cause generalized osteoporosis?
(1) Glucocorticoids
(2) Heparin
(3) Lithium
(4) Cephalosporins

21. The murmur of hypertrophic cardiomyopathy is enhanced by –
(1) Hand grip
(2) Leaning forward while sitting
(3) Lying left side down
(4) Valsalva maneuver

22. Which is not correct about Comprehensive Geriatric Assessment (CGA)?
(1) Tool to estimate prognosis of the functionally compromised and frail older subjects
(2) Social and environmental assessment is included
(3) Multidimensional, interdisciplinary
(4) Healthcare setting will not modify the effectiveness of CGA

23. Following is true of Male Breast Cancer, EXCEPT –
(1) Males usually present at a later stage
(2) Histologically, most lesions are infiltrating ductal carcinomas
(3) Frequency of estrogen receptor-positive lesions is 20% to 30%
(4) The results with systemic chemotherapy are similar to those in females

24. Drug used to treat “Off” periods in parkinsonism is –
(1) Pramipexole
(2) Selegiline
(3) Apomorphine
(4) Amantadine

25. The World Health Organization Integrated Care for Older People COPE) approach has how many steps?
(1) 3
(2) 5
(3) 6
(4) 4

26. Which type of bite represents a potential medical emergency in a febrile asplenic patient?
(1) Cat bite
(2) Dog bite
(3) Fish bite
(4) Human bite

27. Allis true about “Actinic Keratosis” in elderly, except –
(1) Premalignant precursor of basal cell carcinoma
(2) Sun exposed areas most affected (forehead, scalp, ears, lower lip, forearms and dorsal aspect of the hands)
(3) Painful, indurated, eroded and erythematous are more likely to become malignant
(4) Treatment for few and discrete AKs is best performed with cryosurgery (liquid nitrogen)

28. 46-Year-old presents with history of mucopurulent cough and has been diagnosed as a case of Bronchiectasis. Which of the following is unlikely to be the cause of Bronchiectasis?
(1) Cystic Fibrosis
(2) Kartagener’s syndrome
(3) Chronic Left Ventricular failure
(4) Pneumonia

29. Regarding Tuberculosis in the older patient, what is not True?
(1) Extra pulmonary tuberculosis is less common than younger age
(2) Cough and hemoptysis less common
(3) Adverse drig reactions to anti tubercular treatment more common
(4) Delayed diagnosis

30. Following is a putative cancer risk biomarker in older people –
(1) Senescence-associated secretory phenotype
(2) Senescence-associated gene p16INK4A
(3) ATM gene
(4) Functional exonuclease 1 promoter

31. Following is a potential side effect associated with bisphosphonate use –
(1) Hepatic dysfunction
(2) Atypical femoral fracture
(3) Hypercalcaemia
(4) Thyroid dysfunction

32. Which of the following about Rheumatoid Arthritis (RA) in elderly is incorrect?
(1) Less constitutional symptoms (fever, weight loss, fatigue)
(2) More shoulder involvement
(3) More acute onset of arthritis
(4) May have negative assay for Rheumatoid Factor (RF)

33. The fraction of exhaled nitric oxide (FeNO) is a test employed experimentally in –
(1) Lung Cancer
(2) Asthma
(3) Bronchiectasis
(4) Lung Abscess

34. Potential Advantages of Telemedicine Systems include all, EXCEPT –
(1) Access to health services in rural and remote communities
(2) Reduction in travel time, inconvenience, and expense for patients
(3) Reduction in travel time for health professionals
(4) Decreased autonomy for older patients and caregivers in accessing health care

35. SY, 75 years old male, living alone, retired, Hindu Nuclear Family, Lower Socioeconomic status, Urban background, was apparently maintaining well until 2019, which he gradually developed symptoms of anger outbursts, delusions of persecution, muttering and smiling to self, blunted affect, poor self-care, and would be incoherent in between. From 2020, he started having grandiose delusions of ability and identity. He continued voicing delusions of grandiosity and would be seen muttering and smiling to self in between. By the end 2021, patient developed constipation and would not take his meals even on repeated persuasions. His symptoms started worsening and he would have increased agitation and anger outburst, despite on Clozapine 350mg and with adequate adherence. Diagnosis —
(1) Schizophrenia
(2) Depression
(3) Anxiety
(4) Senile Dementia

36. Oxybutynin is used in treatment of –
(1) Urge incontinence
(2) Functional incontinence
(3) BPH
(4) Stress incontinence

37. Human Prion Diseases include A/E-
(1) Kuru
(2) Creutzfeldt Jakob Disease
(3) Scrapie
(4) Gerstmann Straussler Scheinker Disease

38. Clinical consequences of Skin ageing are the following, EXCEPT –
(1) Atrophy, xerosis, pruritus
(2) Actinic lentigines
(3) Bowen’s disease
(4) Dermatoporosis

39. Noninvasive test Fibrosis-4 (FIB-4) score to assess the severity of hepatic fibrosis in NASH utilizes which of the following clinical variables?
(1) Platelet Count
(2) Serum Bilirubin
(3) Lymphocyte Count
(4) Serum Triglyceride

40. American College of Sports Medicine (ACSM) recommends the following physical activity standards in elderly –
(1) 150 minutes of moderate-intensity activity or at least 75 minutes of vigorous-intensity activity, or an equivalent combination of moderate and vigorous activity
(2) 120 minutes of moderate-intensity activity or at least 60 minutes of vigorous-intensity activity, or an equivalent combination of moderate and vigorous activity
(3) 180 minutes of moderate-intensity activity or at least 90 minutes of vigorous-intensity activity, or an equivalent combination of moderate and vigorous activity
(4) 200 minutes of moderate-intensity activity or at least 75 minutes of vigorous-intensity activity, or an equivalent combination of moderate and vigorous activity

41. Screening for which disease in older people is not cost effective-
(1) Hypertension
(2) Diabetes Mellitus
(3) Cervical Cancer
(4) Lung Cancer

42. Electrocardiographic changes in hypokalemia are most marked when serum K+ is –
(1) <2.5 mmol/L
(2) <2.7 mmol/L
(3) <3.0 mmol/L
(4) <2.9 mmol/L

43. True about use of Bone-Anchored Hearing Aids in elderly are all, except –
(1) Used in older adults with single-sided deafness
(2) Implanted, contralateral to the side of deafness
(3) Implanted to the same side of deafness
(4) Maximal benefit in elderly with conductive hearing loss

44. The most important genetic risk factor for sporadic Alzheimer’s Disease is –
(1) ApoE ε4 allele
(2) ApoE ε 2.allele
(3) ApoE ε 3 allele
(4) ApoE ε 1 allele

45. 35-year-old female from Rajasthan, presents with complaints of transient blurring of vision which lasted for less than an hour. No history of fever, addictions or any comorbidities. On examination her blood pressure was 150/96 mmHg. Pulse 74/mt. Investigations reveal Haemoglobin of 16.0gm/dl, WBC of 8000/mm3, RBCs of 82×103 /l with platelet of 800×103 /I. PS shows normal differential counts. Which of the following is the most likely diagnosis?
(1) Polycythemia rubra vera
(2) Secondary Polycythemia
(3) Chronic Myeloid Leukemia
(4) Essential Thrombocytosis