Internal med 4 final

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Questions and Answers

Disease presentation in the elderly is:

often atypical, especially in those >90 old; because of dicreased physiologic reserve, older patients often develop symptoms at an later stage of their disease; there are usually single abnormality amenable to treatment, and large improvements in each

often atypical, especially in those >65 old; because of dicreased physiologic reserve, older patients often develop symptoms at an later stage of their disease; there are usually single abnormality amenable to treatment, and large improvements in each

often atypical, especially in those over 70-80 years old: because of decreased physiologic reserve, older patients often develop symptoms at an earlier stage of their disease; there are usually multiple abnormalities amenable to treatment and small bowel improvements (correct)

often typical, especially in those >80 old; because of increased physiologic reserve, older patients often develop symptoms at an later stage of their disease; there are usually single abnormality amenable to treatment and large improvements in each

some select physiologic changes (or consequences)age related of important organs systems in respiratory:

increased cough reflex

increased chest wall stiffness

increased lung elasticity

increased microaspiration, aspiration pneumonia, dysponea, hypoxia (correct)

For several reasons, older pts are 2 or 3 times more likely to have adverse drug reactions. Why?

drug clearance is often markedly reduced, volume of distribution of drugs is also affected (correct)

serum albumin levels increase

increase in protein binding of some drugs

increase in total body water and relative decrease in body fat

Part of the eldery regularly use nonprescribed drugs, many of which cause significant symptoms and/or interact with other medication:

nearly three quarters Signup and view all the answers

HYVET study evidence. Impact of active AH therapy on total mortality in old patients (in age 80 years and more):

21% reduction of total mortality, 30% reduction of all stroke, 64% reduction of heart failure Signup and view all the answers

Potential drug interactions:

should be searched for at every visit Signup and view all the answers

Most important anatomic and functional changes CVS in old age:

number of pacemakers cells decrease, number of contractile cardiomyocytes dicrease Signup and view all the answers

Evaluation of the older patients (pt) can:

be time-consuming, even it is tailored to the problem Signup and view all the answers

Thus, adverse drug reactions and dosage errors are:

more likely to occur, especially if the patient has visual, hearing or memory deficit Signup and view all the answers

Some select physiologic changes (or consequences) age related of important organs, systems in hematologic/immune:

anemia, autoimmune disease Signup and view all the answers

The highest pre-operation risk in the eldery is represented by:

operations on big arteries Signup and view all the answers

3rd degree AV block in the eldery should be treated by:

implantation of a cardio stimulator Signup and view all the answers

serum keratinine in old people is:

is not a good index of renal function, however, when is elevated special care must be taken with the administration of drugs normally excreted by the kidney Signup and view all the answers

immobilization syndrome is associated with:

hypoventilation and developing pneumonia Signup and view all the answers

sleeping disorders in the eldery:

include hypersomnia Signup and view all the answers

changes in the blood circulation system of a geriatric patient are chracterized by:

worsening the left ventricle’s flexousity Signup and view all the answers

certain features of the examination should receive special attention, depending in part on clues from the history

pts who fall should not be observed standing up from a chair, bending down, reaching up, walking 3 m, turning, returning, and sitting again Signup and view all the answers

risk factors of immobility do NOT include:

uroinfection Signup and view all the answers

which are the most favourable antihypertensive drugs in the eldery?

calcium antagonists Signup and view all the answers

we refer to a geriatric patient as one at the age of:

65 and higher Signup and view all the answers

Typical history in the case of occupational asthma is:

exacerbation of symptoms at work with remission during weekend and vacation Signup and view all the answers

EU safety and health at work are include in:

directive Signup and view all the answers

occupational disease from long-term, overused and one-side load affect:

extremities Signup and view all the answers

the international agency for research on cancer categorizes agents, mixtures and exposures on basic of evidence of carcinogenity in:

4 groups Signup and view all the answers

Radon is:

alpha emitter Signup and view all the answers

Work exacerbated asthma is:

asthma that is made worse, but was not initially caused, by workplace conditions Signup and view all the answers

The first choice in pharmacological treatment of Raynauld syndrome are:

calcium channel blockers Signup and view all the answers

Early, localized infection of Lyme disease is characterized by:

erythema migrans Signup and view all the answers

Organophosphates intoxication is manifested by:

cholinergic, muscarinic syndrome Signup and view all the answers

Which occupational oncological disease often occurs due to the exposition to benzene?

leukaemia Signup and view all the answers

Tinel sign is present at:

carpal tunnel syndrome Signup and view all the answers

Pneumoconiosis is generally diagnosed using the following examination method:

a combination of: occupational history, clinical symptoms, a physical examination, pulmonary function tests, chest- X-ray, HRCT scan of the chest, in special case bronchoscopy and lung biopsy Signup and view all the answers

The most typical occupation with the high risk of vocal cords disorders is:

teacher Signup and view all the answers

pneumoconiosis cannot be caused by:

iron Signup and view all the answers

EU safety and health at work are include in:

directive Signup and view all the answers

X-ray shadows of small opacities (under 1 cm) accord to international labour office standardisaion are index:

p,q,r Signup and view all the answers

Typical chest X-ray signs of simple silicosis are:

generally pattern of small and round opacities (shadows with diameter less than 10mm) Signup and view all the answers

Into occupationl disease from long-term, overused and one-side load of upper extremities do not belong:

osteoarthrosis generalised Signup and view all the answers

Gold standard in the diagnostic algorithm of occupational asthma is:

specific bronchoconstriction test Signup and view all the answers

Raynauld phenomena is not component part of:

rheumatic fever Signup and view all the answers

Into definition of occupational health do not blongs:

genetic predisposition of some work aggraveted diseases Signup and view all the answers

occupational hygiene take care on:

occupational enviroment Signup and view all the answers

occupational diseases are regulated by EU as:

EU directives Signup and view all the answers

Most common risk at work is:

noise Signup and view all the answers

in case of loudness risk we can talk if there is average of noise at work over:

85dB Signup and view all the answers

Raynaud phenomena is not component part of:

reumatic fever Signup and view all the answers

Tinnel sign is present at:

carpal tunnel sy Signup and view all the answers

into occupational disease from longterm, overused and one-side load of upper extremities do not belong:

osteoartrosis generalizata Signup and view all the answers

occupational disease for longterm and one-side load affect:

extremities Signup and view all the answers

Typical X-Ray signs of complicate silicosis are:

along generalized nodulation presence of shadows with diameter higher than 10mm Signup and view all the answers

under the item of occupational disease’s list. Other disorders from work we can report:

low back pain Signup and view all the answers

pneumoconiosis are lung diseases following:

inhalation of mineral dust Signup and view all the answers

Between complications of pulmonary asbestosis do not belong:

lung abscess Signup and view all the answers

Chronic epicondylitis can be conclude by:

x-ray Signup and view all the answers

causal drug for treatment of silicosis is:

we don’t know causal drug Signup and view all the answers

to the most common occupational infection diseases belongs:

hepatitis A Signup and view all the answers

Which of the following intoxication occur most frequently:

alkohol intoxication Signup and view all the answers

Mehanism of plethyzmographic is in:

measurament of capillar volume changes Signup and view all the answers

Neer test is present during:

impingement sy. of upper extremitis Signup and view all the answers

among the typical occupational cancer belongs:

pleural mesothelioma Signup and view all the answers

Latent form of tubercolosis can not be excluded by:

blood count Signup and view all the answers

Which occupational oncological disease often occurs due to the exposition to benzene?

leukemia Signup and view all the answers

Typical etiological agent for cancer of the nose and paranasal sinuses is:

hard wood dust Signup and view all the answers

A typical feature of asthma is the daily variability of PEF:

20% Signup and view all the answers

Bronchodilatation test is positive, if FEV1 will increase:

12% Signup and view all the answers

Typical history is the case of occupational asthma is:

exacerbation of symptoms at work with remission during weekend and vacation Signup and view all the answers

The most common etiological factors of occupational rhinitis belongs:

flour Signup and view all the answers

Functional examination method of upper airways is:

rhinomanometry Signup and view all the answers

in non-specific bronchocostriction test and nasal provocation test we apply:

histamine Signup and view all the answers

X-ray shadows of small opacites (under 1cm) accord to International Labour Office Standardisation ILO are index:

p,q,r Signup and view all the answers

into definition of occupational health do not belongs:

genetic predisposition of some work aggravated diseases Signup and view all the answers

Occupational hygiene take care on:

occupational enviroment Signup and view all the answers

Occupational diseases are regulated by EU as:

EU directives Signup and view all the answers

In case of loudness risk we can talk if there is average of noise at worl over:

85db Signup and view all the answers

Psychosis (unadequate laugh, euphory, impulsive negotation, mixed-upness, agressivity, halucinations) occurs intoxication by:

Mn Signup and view all the answers

Kussmaul trias is clinical manifestation as:

stomatitis, eretizmus and tremor Signup and view all the answers

Mechanism of plethyzmographic:

measurement of capillar volume changes Signup and view all the answers

Among the occupational cancer belongs:

pleural mesothelioma Signup and view all the answers

Which metal is not neurotoxic:

Cr Signup and view all the answers

The most common ethiological factors of occupational rhinitis belongs:

flour Signup and view all the answers

In non-specific bronchoconstriction test and nasal provocation test we apply:

histamine Signup and view all the answers

X-ray shadows of small opacites (under 1 cm) accord to International Labour Office Standardisation are index

p,q,r Signup and view all the answers

Which form of hypertension is the most common in elderly population

Isolated systolic hypertension Signup and view all the answers

An acute state of confusion, which is relatively short and reversible is named

Deliriant state Signup and view all the answers

Decubities are parts of picture of

Immobilization syndrome Signup and view all the answers

Ageism means

Discrimination of seniors in the society Signup and view all the answers

Sleeping disorders in the elderly

Include hypersomnia Signup and view all the answers

Insomnia is

Somatic, not caused by pain Signup and view all the answers

Which are the most favourable antihypertensive drugs in the elderly

Calcium antagonists Signup and view all the answers

Hypertension crisis in the old age is a serious issue in which

BP has to be reduced, not necessarily brought to the normal Signup and view all the answers

3rd Degree AV Block in elderly should be treated by

Implantation of cardio stimulator Signup and view all the answers

Which tools are used to assess mental state of geriatric patient

MMSE Signup and view all the answers

Geriatrics main task as branch of medicine is to

Provide diagnostics and treatments of acute reversible illnesses with focus on restoring and retaining independence Signup and view all the answers

We refer to a geriatric patient as one at the age of

65 and higher Signup and view all the answers

Immune system of a geriatric patient is characterized by

Immune deficit due to malnutrition Signup and view all the answers

Changes in the blood circulation system of a geriatric patient are characterized by

Worsening left ventricle flexuosity Signup and view all the answers

Typical feature of geriatric patients illness development is

Absence of claudicational or anginous pain in patients with osteoarhrosis of lower Signup and view all the answers

Pharmacotherapy of geriatric patients is characterized by

Incidence of poly-pragma Signup and view all the answers

Immobilization syndrome is associated with

Hyperventilation and developing pneumonia Signup and view all the answers

Risk factors of immobility do NOT include

Uroinfection Signup and view all the answers

Prior to planned surgical operation it is not necessary to stop administering

LMWH / low weight molecular heparin Signup and view all the answers

In older patients

Digitales, procainamide and quinidine have prolonged half-lives, narrow therapeutic windows Signup and view all the answers

Many finding that are abnormal in younger patients are relatively:

Common in older people e.g. bacteriuria, premature ventricular contractions, low bone mineral density, impaired glucose tolerance, and uninhibited bladder c.. Signup and view all the answers

Fundamental pathophysiologic features of hypertension in the elderly

Structural changes of vessels (↑rigidity, ↓compliance) Signup and view all the answers

Most common occupational diseases are

Musculoskeletal diseases Signup and view all the answers

Raynaud's phenomenon is not component part of

Rheumatic fever Signup and view all the answers

To health chemical hazards at the work belongs

Gases Signup and view all the answers

To the most frequently reported occupational skin diseases belong

Contact allergic dermatitis Signup and view all the answers

The first choice in pharmacological treatment of raynaud syndrome are

Calcium channel blockers Signup and view all the answers

Part of the elderly regularly use non-prescribed drugs, many of which cause significant symptoms and/or interact with other medications

Nearly three-quarters Signup and view all the answers

Serum creatinine in old people is

Is not a good index of renal function, however, when is elevated, special care must be taken with the administration of drugs normally excreted by the kidney Signup and view all the answers

average life expectance is now:

11 years at age 75 Signup and view all the answers

Finally the older patients with multiple chronic condition:

is likely to be taking severant drugs, include nonprescribed agents Signup and view all the answers

Frequent of the eldery use nonsteroidal anti-inflammatory drugs which:

can hamper control of AH in addition to causing renal dysfunction and GI bleeding Signup and view all the answers

The most frequent ethiological factor of lung cancer in miner is:

ionizing radiation Signup and view all the answers

The most common occupational infection diseases belongs :

hepatitis A Signup and view all the answers

Nearly 3/4 of the eldery regularly use nonprescribed drugs, many of which cause significant symptoms and/or interact with other medications. Frequent ofenders include nonprescribed agents for insomnia and nonsteroidal antiinflammatory drugs NSAIDs:

which can hamper control of AH in addition to causing renal dysfunction and GI bleeding Signup and view all the answers

Deaths attributed by occupational risks is higher at:

middle income countries Signup and view all the answers

Kussmal trias is clinical manifestation as:

stomatitis, eretismus and tremor Signup and view all the answers

International labour Organization and World Health Organization definition of Occupational Health is:

the promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all occupations Signup and view all the answers

Methacholine bronchoconstriction test is positive, if FEV1 will fall minimally of its basal

20% Signup and view all the answers

Early localized infection of Lyme disease is characterized by:

erythema migrans Signup and view all the answers

Ethiological factor for liver angiosarcoma is:

polyvinyl chloride Signup and view all the answers

Thus advers drug reactions and dosage errors are:

more likely to occur, especially if the patient has visual, hearing or memories deficit Signup and view all the answers

Some select physiologic changes age ... (non si legge il continuo):

brain atrophy, decreased brain catachol synthesis, decreased brain dopaminergic synthesis Signup and view all the answers

If nonpharmacologic treatment of insomnia is unsuccessful, may be useful:

low-dose and short-term or intermittent use of a intermediate-acting whose metabolism is no affected by age Signup and view all the answers

Pharmacotherapy of geriatric patients is characterized by:

incidence of poly-pragma Signup and view all the answers

certain features of the examination shoulf receive special attention, depending in part on clues from the history:

weight and postural PB should be measured at most visits, vision and heating should be checked, the systolic murmur of aortic sclerosis is common and may be difficult to differentiate from aortic one Signup and view all the answers

Finally the older patients with multiple chronic condition:

is likely to be taking several drugs, include nonprescribed agents Signup and view all the answers

which pathogenic agent is able to cause an infection of Q fever?

coxiella burnetii Signup and view all the answers

one of the occupational disease that we can report:

herniation of lumbar disc with radicular syndrome Signup and view all the answers

An effective vaccination is available against:

Hepatitis B Signup and view all the answers

A typical feature of asthma is the daily variability of PEF more than:

20% Signup and view all the answers

hypersensitivity pneumonitis is caused by repeated inhalation of antigens:

organic dust particles Signup and view all the answers

Organophosphates intoxication is manifasted by:

cholinergic, muscarinic syndrome Signup and view all the answers

some select physiologic changes age related of importabt organs systems in gastrointestinal:

decrease gastric acidity Signup and view all the answers

average disability free remaining at men-women in 75-80 years is:

7/7 Signup and view all the answers

insomnia is:

somatic, not caused by pain Signup and view all the answers

Is recommended for prescription some pharmacological drugs:

Each of these agent should be avoided in the eldery: of the NSAIDs indomethacin is most likely to induce confusione fluid retention, and GI bleeding. Both propoxyphene and meperidine are not associated with a disproportionate risk of delirium Signup and view all the answers

Role and tasks of Occupational Health Services is not:

check up of workers specifically to risk factors of atherosclerosis Signup and view all the answers

Latent tubercolosis infection can be confirmed by:

tubercolin skin test and interferon gamma release assays test Signup and view all the answers

occupational lung cancer is the most frequently induced by:

asbestos Signup and view all the answers

in addition to impaired drug clearance, which alters pharmacokinetics, older patients have altered responses to similar serum drug levels. They are:

more sensitive to some drugs Signup and view all the answers

Even beyong age 85:

only 30% of people are impaired in any activity required for daily living and only 20% reside in a nursing home Signup and view all the answers

select physiologic changes age related of important organs systems in general:

increase body fat and decrease total body water Signup and view all the answers

some select physiological changes age related of importat organs systems in gastrointestinal:

cirrhosis, delayed metabolism of some drug, fecal impaction Signup and view all the answers

evidence. Impact of active AH therapy on totale mortality in old patients (in age 80 years and more):many finding that are abnormal in younger patients are relatively:

21% reduction of total mortality, 30% reduction of all stroke, 64% reduction of heart failure Signup and view all the answers

Study HYVET was prematurely ended . In spite of that HYVET demostrated

Tendency to reduce incidence of dementia cases by active therapy Signup and view all the answers

some select physiologic changes age related of important organ system in musculoskeletal:

functional impairment, osteopenia, hip fracture Signup and view all the answers

some select physiologic changes age related of important organ system in renal:

impaired excretion of some drugs, increase serum creatinine Signup and view all the answers

some select physiologic changes age related of important organ system in hematologic/immune:

anemia, autoimmune disease Signup and view all the answers

serume kreatinine in old people is:

is not a good index of renal function, however, when is elevated, special care must be taken with the administration of drugs normaly excreted by the kidney Signup and view all the answers

This statistic has important demographic and economic implications. And its impact on medical care is also substancial: of all people who have ever lived to age 65, more than .... are now alive:

half Signup and view all the answers

some select physiologic changes age related of important organ system in genitourinary:

vagina/urethral mucosal atrophy, prostatae enlargement Signup and view all the answers

Bysxssinosis (non si legge le lettere iniziali) is characteristic:

is an occupational respiratory disease associated with inhalation of cotton,flax or hernp dust Signup and view all the answers

Anaemia, neutropenia ,thrombocitopenia is typical for:

sistemic lupus erythematous Signup and view all the answers

Back pain can cause:

all the above mentioned Signup and view all the answers

Dermatomyositis is often associated with:

malignoma Signup and view all the answers

Elevated levels of kreatinphosphokinesis is typical for:

polymiositis/dermatomyositis Signup and view all the answers

For primary Sjogren syndrome is typical:

association wih HLA-B3, DR-3 Signup and view all the answers

For spondiloartheropaties is typical

positivity of HLA B27 Signup and view all the answers

Hyperuricaemia can be caused by:

all of the above metioned Signup and view all the answers

Osteoblasts:

are cells synthesizing bone Signup and view all the answers

Positivity of anti DNP antibodies is typical for:

systhematic lupus erythematosus Signup and view all the answers

risk factor that may not cause bone loss is:

adequate sport activities Signup and view all the answers

The typical result of synovial fluid examination in gout is:

presence of crystals Signup and view all the answers

we can measure the bone density in children by:

Z-score Signup and view all the answers

which of the following is not a risk factor for osteoarthritis:

hypolipidemia Signup and view all the answers

which symptom does not belong to the clinical picture of polyarteritis nodosa:

dryness of mouth Signup and view all the answers

RAIDS (reactive airway disfunction syndrome) is:

acute form of limitant occupational asthma Signup and view all the answers

which disorder of vocal cord is voice neurosis?

severe phonaesthesia Signup and view all the answers

Some select physiologic changes (or consequences) age related of important organs systems in hematologic/immune:

anemia, autoimmune diseases Signup and view all the answers

Objective of Study HYVET-COG was:

to determine whether treatment of arterial hypertension in patients ?80s would reduce the incidence both, Vascular dement Alzheimer ́s Disease Signup and view all the answers

Some select physiologic changes (or consequences) age related of important organs systems in renal:

impaired excrettion of some drugs, ↑ Serum creatinine Signup and view all the answers

Serum kreatinine in old people is:

is not a good index of renal function, however, when is elevated, special care must be taken with the administration of drugs excreted by the kidneys Signup and view all the answers

Certain features of the examination should receive special attention, depending in part on clues from the history:

weigt and postural BP should be measured at most visits; vison and hearing should by checked (cerumen!), the systolic multiple sclerosis is common and may be difficult to differentiate from aortic stenosis Signup and view all the answers

Pharmacotherapy of geriatric patients is characterized by:

incidence of poly-pragma Signup and view all the answers

In addition to impaired drug clearence, which alters pharmacokinetics, older patients (pts) have altered responses to similar ser levels (a phenomen knownas altered pharmacodynamics). They are:

more sensitive to some drugs (e.g., opiates, antikoagulans) and less sensitive to others (e.g., ß-adrenergic agents) Signup and view all the answers

Psychosis (inadequate laugh, euphoria, impulsive negotiation, mixed-upness, aggressively, hallucinations) occurs intoxication

Mn Signup and view all the answers

In the diagnosis of dermatosis it is possible to use (select the most appropriate claim):

all claims are correct Signup and view all the answers

Lead intoxication symptom is:

abdominal colics Signup and view all the answers

Carpal tunnel syndrome treatment include:

endoscopic surgery Signup and view all the answers

Raynaud syndrome is the present of:

hand arm vibration syndrome Signup and view all the answers

Gold standard in diagnosis of TBC is:

Quantiferon test Signup and view all the answers

Relative short latency period (often 3 – 5 years) between the exposition to carcinogen and manifestation of cancer we can see

leukaemia Signup and view all the answers

Most common musculoskeletal and neurological occupational diseases is:

carpal tunnel syndrome Signup and view all the answers

Immune System of a geriatric patient is characterized by:

immune-deficit due to malnutrition Signup and view all the answers

Some select physiologic changes (or consequencs) age related of important organs systems in cardiovascular

syncope, atrial fibrillation, heart block, heart failure Signup and view all the answers

Average disability-free remaining at men/women in 75-80

7/7 Signup and view all the answers

Some select physiologic changes (or consequences) age related of important organs systems in nervous:

brain atrophy, ↓ brain catechol synthesis, ↓ brain dopaminergic synthesis Signup and view all the answers

During nasal provocation test we evaluate:

symptom score and rhinomanometry together Signup and view all the answers

Mechanism of plethysmography is in:

measurement of capillary volume changes Signup and view all the answers

Etiological factor for liver angiosarcoma is:

polyvinyl chloride Signup and view all the answers

The higher EU-27 labour force works at domain:

services Signup and view all the answers

Typical X-ray signs of complicate silicosis are:

along generalised nodulation presence of shadows with diameter higher than 10 mm Signup and view all the answers

Is recommended for presciption some pharmacological drugs:

Cyclooxygenase 2 (COX-2) inhibitors are not safer than nonselective NSAIDs for older adults Signup and view all the answers

Fundamental pathophysiologic features of hypertension in the elderly:

structual changes of vessels ( ↑ rigidity, ↓ compiance) Signup and view all the answers

Some select physiologic changes (or consequences) age related of important organs systems in eyes and ears:

presbyopia, lens opacification Signup and view all the answers

impingement syndrome of shoulders cannot be diagnosed:

X-ray Signup and view all the answers

Caprolactam, according The International Agency for Research on Cancer (IARC), belongs to the

group 4 Signup and view all the answers

RADS (Reactive airway dysfunction syndrome) is

acute form of irritant occupational asthma Signup and view all the answers

Chronic obstructive pulmonary disease is characterised by:

partially reversible obstruction Signup and view all the answers

Study Notes

Geriatric Health

Elderly patients are 2-3 times more likely to experience adverse drug reactions due to age-related changes in organ function and metabolism, decreased kidney and liver function, and polypharmacy.
Polypharmacy in the elderly is common with many using non-prescribed medications which can have significant side effects and interact with other medications.
The HYVET study demonstrated a significant impact of ACE inhibitor treatment on total mortality in patients aged 80 years and older, suggesting potential benefits in managing hypertension.
Key cardiovascular changes in the elderly include decreased heart rate variability, increased stiffness of the aorta, and decreased baroreceptor sensitivity.
Evaluation of elderly patients should include assessing functional status, cognitive function, mood, nutritional status, and medication use, to help identify potential problems and optimize care.
Adverse drug reactions and dosage errors are more common in the elderly due to age-related changes in pharmacokinetics and pharmacodynamics, and polypharmacy.
Age-related hematologic changes include decreased bone marrow function, increased risk of anemia, and impaired immune function.
The highest pre-operative risk in elderly patients is associated with the presence of pre-existing conditions such as diabetes, heart disease, and chronic lung disease.
Third-degree AV block in the elderly should be treated by permanent pacemaker implantation.
Serum creatinine levels in older individuals are often elevated due to age-related decline in kidney function, but may not necessarily indicate kidney disease.
Immobilization syndrome, common among elderly patients, is associated with increased risks of falls, pressure ulcers, and pneumonia.
Sleeping disorders are prevalent in the elderly and include insomnia, restless leg syndrome, obstructive sleep apnea, and sleep-disordered breathing.
Blood circulation changes in geriatric patients include reduced blood vessel elasticity, decreased heart output, and increased risk of thrombosis.
Risk factors for immobility in elderly populations do not include age itself – but rather include factors such as underlying medical conditions, polypharmacy, and lack of physical activity.
Calcium channel blockers, ACE inhibitors, and diuretics are favored antihypertensive drugs for the elderly due to their favorable side effect profiles and effectiveness in lowering blood pressure.
A geriatric patient is typically defined as someone aged 65 years or older.

Occupational Health

Occupational asthma typically presents with a history of respiratory symptoms that are work-related, with symptoms improving outside of the work environment.
EU safety and health at work regulations include measures to prevent and protect workers from occupational hazards.
Occupational diseases from long-term, repetitive, and one-sided loading can affect the musculoskeletal system, causing conditions such as epicondylitis and carpal tunnel syndrome.
The International Agency for Research on Cancer (IARC) categorizes agents, mixtures, and exposures based on their available evidence of carcinogenicity.
Radon is a naturally occurring radioactive gas that is a significant risk factor for lung cancer, particularly among miners and workers in enclosed environments.
Work-exacerbated asthma is triggered by exposure to specific workplace substances, such as dusts, fumes, or chemicals.
Calcium channel blockers are the first-line pharmacological treatment for Raynaud's syndrome to improve blood flow in affected areas.
Early, localized Lyme disease is characterized by a distinctive skin rash called erythema migrans, often at the site of a tick bite.
Organophosphate intoxication manifests with symptoms including sweating, salivation, muscle weakness, and respiratory distress.
Occupational exposure to benzene is a significant risk factor for acute myeloid leukemia.
Tinel's sign, a tingling sensation in the fingers upon tapping the median nerve at the wrist, is commonly observed in carpal tunnel syndrome.
Pneumoconiosis is generally diagnosed using chest X-ray imaging to identify characteristic patterns of lung abnormalities.
Teachers and singers are among the most common occupations associated with a high risk of vocal cord disorders.
Pneumoconiosis cannot be caused by exposure to environmental pollutants – it is specifically caused by inhaling mineral dusts in various work settings.
X-ray shadows of small opacities (under 1 cm), according to the International Labour Office (ILO) standardisation, are graded using categories 0-3 based on their size, number, and distribution.
Typical chest X-ray signs of simple silicosis include small, rounded opacities in the upper lung fields.
De Quervain's tenosynovitis (a condition affecting the thumb side of the wrist), is not an occupational disease from long-term, overuse, and one-sided loading of the upper extremities.
The gold standard in the diagnostic algorithm for occupational asthma is to demonstrate a positive relationship between exposure to a workplace allergen and respiratory symptoms.
Raynaud's phenomenon is not a component of Dupuytren's contracture (a condition affecting the hand where the fingers curl inward), which mainly affects the palmar fascia.
Occupational health is a multidisciplinary field that focuses on the health and well-being of workers.
Occupational hygiene aims to prevent workplace hazards and promote safe and healthy working conditions.
The European Union (EU) regulates occupational diseases under specific directives and frameworks, ensuring worker protection and compensation for related illnesses.
The most common risk at work is the risk of musculoskeletal disorders, due to prolonged sitting, repetitive motions, and heavy lifting.
Loudness risk at work is defined when the average noise level over an eight-hour workday exceeds 85 decibels.
Raynaud’s phenomenon is not a component of systemic sclerosis (scleroderma) – it is a component of a systemic condition, and it is not a component of local, isolated symptoms.
Tinel’s sign is present at the wrist, when tapping the median nerve.
De Quervain's tenosynovitis (a condition affecting the thumb side of the wrist) is not an occupational disease from long-term, overuse, and one-sided loading of the upper extremities.
Occupational diseases caused from long-term, overuse, and one-sided loading typically affect the musculoskeletal system, such as the shoulders, elbows, wrists, and hands.
Characteristic X-ray patterns of complicated silicosis include larger opacities, irregular shapes, and evidence of fibrosis and lung lesions.
Other disorders from work that can be reported as occupational diseases include mental health conditions, such as stress, anxiety, and depression, as well as other exposure-related illnesses.
Pneumoconiosis are lung diseases caused by inhaling mineral dusts, which are often found in various industrial settings.
Pleural plaques and asbestos-related lung cancer are not complications of pulmonary asbestosis – they are associated with exposure to asbestos.
Chronic epicondylitis, a condition affecting the outside of the elbow, can be caused by repetitive activities that strain the tendons in that area.
There is no causal drug treatment for silicosis, as the condition is caused by irreversible lung scarring.
Occupational infection diseases include infections acquired through exposure to biological agents in specific work settings, such as healthcare, agriculture, and laboratory work.
Intoxications most frequently occur in workplaces with exposure to toxic substances, such as chemicals, aerosols, and fumes.
Plethysmography is a technique used to measure lung volumes and capacities, which are crucial in diagnosing and monitoring respiratory diseases.
Neer's test, a maneuver to assess for rotator cuff injuries, is present during examination if pain is elicited upon raising the arm to a specific position.
Occupational cancer is a significant public health concern and includes various types of cancer associated with specific workplace exposures.
Latent tubercolosis cannot be fully excluded by a negative tuberculin skin test, as the results can be falsely negative, especially in individuals with weakened immune systems.
Benzene exposure is a significant risk factor for acute myeloid leukemia, an aggressive type of blood cancer.
Cancer of the nose and paranasal sinuses, also known as nasopharyngeal cancer, can be caused by prolonged exposure to wood dust, chromates, and nickel compounds.
Asthma is characterized by the daily variability of peak expiratory flow (PEF), which measures the maximum rate of air expulsion from the lungs.
A bronchodilatation test is considered positive if the forced expiratory volume in 1 second (FEV1) increases by at least 12% after inhaling a bronchodilator medication, indicating a response to the medication.
Occupational asthma typically presents with a history of respiratory symptoms that are work-related, with symptoms improving outside of the work environment, and often with a clear trigger substance.
The most common etiological factors of occupational rhinitis (inflammation of the nasal lining) include exposure to dusts, chemicals, and allergens (e.g., pollen, mold spores).
Functional examination methods of the upper airways include measuring nasal airflow, assessing nasal patency, and examining the vocal cords.
Non-specific bronchoconstriction test and nasal provocation tests are applied to assess the airway's sensitivity to specific stimuli, such as cold air, exercise, or known allergen.
In ILO standardisation, X-ray shadows of small opacities (under 1 cm) are categorized into different groups based on their size, number, and distribution.
Occupational health is a diverse field focused on promoting the health of workers and ensuring their safety and well-being in the workplace.
Occupational hygiene aims to prevent workplace hazards and promote safe and healthy working conditions.
The EU regulates occupational diseases under specific directives and frameworks, ensuring worker protection and compensation for related illnesses.
A noise risk at work is defined when the average noise level over an eight-hour workday exceeds 85 decibels, although the acceptable limits can vary depending on the specific tasks and industries.
Psychosis – characterized by inadequate laughter, euphoria, impulsive negotiation, mixed-upness, aggression, and hallucinations – can occur as a result of intoxication by volatile organic compounds (VOCs), such as toluene, acetone, and other industrial solvents.
Kussmaul's triad is a clinical manifestation characterized by increased jugular venous pressure, muffled heart sounds, and distended neck veins.
Plethysmography is a technique used to measure changes in volume, often in the limbs, to assess blood flow and circulation, especially in conditions like Raynaud's phenomenon.
Among the occupational cancers, exposure to specific carcinogens like asbestos, benzene, and radon is associated with an increased risk of developing diseases involving lung, bladder, and blood cancers.
Although various metals are neurotoxic, Mercury is not typically considered to be neurotoxic. However, exposure to mercury can pose potential risks to neurological health, particularly in the brain and nervous system.
The most common etiological factors of occupational rhinitis include exposure to dusts, chemicals, and allergens (e.g., pollen, mold spores).
Non-specific bronchoconstriction tests and nasal provocation tests use substances that cause bronchoconstriction (narrowing of the airways), typically using a nebulizer or inhalation device.
X-ray shadows of small opacities (under 1 cm), following the International Labour Office Standardisation (ILO), are categorized into different groups based on their size, number, and distribution, providing valuable information in diagnosing pneumoconiosis.
Isolated systolic hypertension is the most common form of hypertension in the elderly population.
Delirium is the acute state of confusion, which is relatively short and reversible.
Decubitus ulcers are parts of immobility syndrome.
Ageism is the prejudice and discrimination against older people.
Sleeping disorders in the elderly include insomnia, restless leg syndrome, obstructive sleep apnea, and sleep-disordered breathing.
Insomnia is characterized by difficulties falling asleep or staying asleep.
Calcium channel blockers, ACE inhibitors, and diuretics are favored antihypertensive drugs for the elderly due to their favorable side effect profiles and effectiveness in lowering blood pressure.
Hypertension crisis in the old age is a serious issue in which very high blood pressure can lead to strokes, heart attacks, or other complications.
3rd Degree AV Block in elderly should be treated by Permanent Pacemaker implantation.
Mental state of geriatric patient can be assessed by Mini-Mental State Examination (MMSE).
Geriatrics main task as branch of medicine is to promote health and well-being of older adults.
We refer to a geriatric patient as one at the age of 65 years or older.
Immune system of a geriatric patient is characterized by decreased immune function with increased susceptibility to infections.
Changes in the blood circulation system of a geriatric patient are characterized by reduced blood vessel elasticity, decreased heart output, and increased risk of thrombosis (blood clots).
Typical feature of geriatric patients illness development is slower onset of symptoms.
Pharmacotherapy of geriatric patients is characterized by the increased risk of adverse drug reactions due to age-related changes in pharmacokinetics and pharmacodynamics, and polypharmacy.
Immobilization syndrome is associated with decreased mobility, muscle weakness, and increased risk of falls, pressure ulcers, and pneumonia.
Risk factors of immobility do NOT include age itself – but rather include factors such as underlying medical conditions, polypharmacy, and lack of physical activity.

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This quiz focuses on understanding how diseases manifest and present in elderly populations. Participants will explore unique symptoms, risks, and considerations relevant to aging individuals. Enhance your knowledge of geriatric health care and disease management.

Internal med 4 final

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Questions and Answers

Disease presentation in the elderly is:

some select physiologic changes (or consequences)age related of important organs systems in respiratory:

For several reasons, older pts are 2 or 3 times more likely to have adverse drug reactions. Why?

Part of the eldery regularly use nonprescribed drugs, many of which cause significant symptoms and/or interact with other medication:

HYVET study evidence. Impact of active AH therapy on total mortality in old patients (in age 80 years and more):

Potential drug interactions:

Most important anatomic and functional changes CVS in old age:

Evaluation of the older patients (pt) can:

Thus, adverse drug reactions and dosage errors are:

Some select physiologic changes (or consequences) age related of important organs, systems in hematologic/immune:

The highest pre-operation risk in the eldery is represented by:

3rd degree AV block in the eldery should be treated by:

serum keratinine in old people is:

immobilization syndrome is associated with:

sleeping disorders in the eldery:

changes in the blood circulation system of a geriatric patient are chracterized by:

certain features of the examination should receive special attention, depending in part on clues from the history

risk factors of immobility do NOT include:

which are the most favourable antihypertensive drugs in the eldery?

we refer to a geriatric patient as one at the age of:

Typical history in the case of occupational asthma is:

EU safety and health at work are include in:

occupational disease from long-term, overused and one-side load affect:

the international agency for research on cancer categorizes agents, mixtures and exposures on basic of evidence of carcinogenity in:

Radon is:

Work exacerbated asthma is:

The first choice in pharmacological treatment of Raynauld syndrome are:

Early, localized infection of Lyme disease is characterized by:

Organophosphates intoxication is manifested by:

Which occupational oncological disease often occurs due to the exposition to benzene?

Tinel sign is present at:

Pneumoconiosis is generally diagnosed using the following examination method:

The most typical occupation with the high risk of vocal cords disorders is:

pneumoconiosis cannot be caused by:

EU safety and health at work are include in:

X-ray shadows of small opacities (under 1 cm) accord to international labour office standardisaion are index:

Typical chest X-ray signs of simple silicosis are:

Into occupationl disease from long-term, overused and one-side load of upper extremities do not belong:

Gold standard in the diagnostic algorithm of occupational asthma is:

Raynauld phenomena is not component part of:

Into definition of occupational health do not blongs:

occupational hygiene take care on:

occupational diseases are regulated by EU as:

Most common risk at work is:

in case of loudness risk we can talk if there is average of noise at work over:

Raynaud phenomena is not component part of:

Tinnel sign is present at:

into occupational disease from longterm, overused and one-side load of upper extremities do not belong:

occupational disease for longterm and one-side load affect:

Typical X-Ray signs of complicate silicosis are:

under the item of occupational disease’s list. Other disorders from work we can report:

pneumoconiosis are lung diseases following:

Between complications of pulmonary asbestosis do not belong:

Chronic epicondylitis can be conclude by:

causal drug for treatment of silicosis is:

to the most common occupational infection diseases belongs:

Which of the following intoxication occur most frequently:

Mehanism of plethyzmographic is in:

Neer test is present during:

among the typical occupational cancer belongs:

Latent form of tubercolosis can not be excluded by:

Which occupational oncological disease often occurs due to the exposition to benzene?

Typical etiological agent for cancer of the nose and paranasal sinuses is:

A typical feature of asthma is the daily variability of PEF:

Bronchodilatation test is positive, if FEV1 will increase:

Typical history is the case of occupational asthma is:

The most common etiological factors of occupational rhinitis belongs:

Functional examination method of upper airways is:

in non-specific bronchocostriction test and nasal provocation test we apply:

X-ray shadows of small opacites (under 1cm) accord to International Labour Office Standardisation ILO are index:

into definition of occupational health do not belongs:

Occupational hygiene take care on:

Occupational diseases are regulated by EU as:

In case of loudness risk we can talk if there is average of noise at worl over:

Psychosis (unadequate laugh, euphory, impulsive negotation, mixed-upness, agressivity, halucinations) occurs intoxication by:

Kussmaul trias is clinical manifestation as: