AKT geriatric

An 80-year-old woman presented to her general practitioner with a 24-hour history of profuse diarrhoea and mild abdominal pain. Her diabetes had been treated with metformin for 10 years. Two days previously, she had been discharged from hospital following treatment for community-acquired pneumonia. Her medication comprise domeprazole 20 mg once daily and metformin 850 mg twice daily.What is the most likely explanation for her diarrhoea?

• constipation with overflow

• diverticulitis

• metformin

• Clostridium difficile toxin

A 73-year-old man presented with a shuffling gait and increasing forgetfulness, which had been of gradual onset. He had a longstanding history of hypertension and diabetes.He had had a myocardial infarction 3 years previously and a stroke 2 years previously.What is the most likely diagnosis?

• cerebrovascular disease

• Lewy body disease

• normal pressure hydrocephalus

• Parkinson’s disease

An 86-year-old man with significant disability following a cerebrovascular event6 months previously lived with his wife in a privately owned bungalow. He received assistance from home care services, and the occupational therapists had provided him with several aids and appliances. However, his wife contacted the general practitioner to say that she was exhausted, as she had to provide a significant amount of care for her husband, especially at night. She was otherwise well, and the patient’s condition had not recently changed.What is the most appropriate next step in management?

• admit the husband to hospital

• domiciliary visit from a geriatrician

• transfer husband to nursing home

• respite care for husband

You are concerned that a 76-year-old man may be frail.What of the following may suggest that old man is frail?

• Low albumin level

• weight gain

• Hearing impairment

• Slow gait speed

A 65-year-old man presents with right hand rest tremor and stiffness. He works as a carpenter and has trouble using his tools with his symptoms. He has a history of a gambling problem. On examination, he has hypomimia, asymmetric limb rigidity and bradykinesia and a resting tremor in his right hand. What would you start this patient on?

• Cabidopa/ Levodopa

• Ropinirole

• Amantadine

• Rasagiline

Which of the following statements is false?

• Insomnia is normal part of ageing in elderly

• Insomnia is more common amongst women than men

• In the treatment of insomnia, improving sleep hygiene is the first step

• short term of benzodiazepines is useful for insomnia

You followed the community team to a Senior Activity Centre . The team has started a frailty intervention program there for older adults. Besides an exercise program, what are the other factors that could help to prevent frailty?

• Prevention of depression

• Prevention of falls

• Prevention of polypharmacy

• Prevention of osteoporosis