Geriatric Medicine Overview

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Questions and Answers

What is the primary characteristic of a septic joint infection?

Joint shows no signs of inflammation

Joint is red, warm, swollen, and tender (correct)

Joint exhibits mild swelling and stiffness

Movement of the joint is completely normal

Which test is used to assess the presence of shoulder impingement?

Straight Leg Raise Test

McMurray's Test

Hawkin's impingement sign (correct)

Femoral Stretch Test

In the context of gout, what is a significant diagnostic indicator?

Normal X-ray findings

Consistent joint tenderness only during rest

Joint pain exclusively in the hip

Presence of tophi and joint fluid showing crystals (correct)

Which condition is characterized by joint findings resembling rheumatoid arthritis in its chronic phase?

CPPD (Pseudogout) Signup and view all the answers

What underlying factor increases the likelihood of infecting a joint?

Previous joint interventions Signup and view all the answers

What developmental challenge may be suggested by the persistence of the Glabellar Reflex in older children?

Neurological concerns Signup and view all the answers

Which of the following is characteristic of Still's murmur?

Benign and musical Signup and view all the answers

At what age should the Asymmetric Tonic Neck Reflex typically disappear?

By 4–6 months Signup and view all the answers

Which of the following describes central cyanosis?

Systemic blue discoloration indicative of hypoxia Signup and view all the answers

What is a significant indicator of respiratory distress based on physical examination findings?

Subcostal retractions Signup and view all the answers

When examining a child's growth, which trend is noted to occur by age 1 regarding weight?

Weight triples Signup and view all the answers

Which of the following findings is most concerning for pathology when found during an eye examination?

Leukocoria in the pupil Signup and view all the answers

What growth trend regarding head circumference occurs after the first year of life?

Slows considerably after age 1 Signup and view all the answers

What is the primary benefit of early identification of congenital anomalies in newborn assessment?

It helps initiate immediate needs and informs follow-up care. Signup and view all the answers

Which of the following is NOT a key aspect of pediatric care for parents during follow-up visits?

Discuss educational curriculum choices. Signup and view all the answers

In assessing a pediatric patient, why is it important to adapt the examination approach based on the child's developmental stage?

It helps build trust and reduces anxiety. Signup and view all the answers

The Denver II Developmental Assessment is primarily used to screen for which of the following areas?

Developmental milestones. Signup and view all the answers

Which of the following components is essential when taking a pediatric history?

Immunization status according to CDC guidelines. Signup and view all the answers

During a physical examination of an infant, where is it generally preferable to perform the examination?

On the parent's lap. Signup and view all the answers

What does BMI percentiles indicate in pediatric patients?

Weight classification in relation to age and height. Signup and view all the answers

For which reason is observing child-parent interactions important during a pediatric examination?

To understand family dynamics and their potential impact on the child. Signup and view all the answers

What is the recommended screening age for colon cancer in adults without high-risk factors?

45-75 years Signup and view all the answers

How often should women aged 30-65 receive co-testing for cervical cancer?

Every 5 years Signup and view all the answers

Which population is at increased risk for Mental Health issues according to health disparities?

Transgender individuals Signup and view all the answers

What is the recommended frequency of DEXA scans for postmenopausal women with low bone density?

Every 2 years Signup and view all the answers

Men aged 55-69 are advised to undergo which type of testing for prostate cancer?

PSA testing Signup and view all the answers

What screening is recommended annually for adults aged 50-80 with a history of heavy smoking?

Low-dose CT screening Signup and view all the answers

Which health risk is particularly heightened among sexual minority women due to healthcare avoidance?

Delayed cancer screenings Signup and view all the answers

What is the primary principle of patient-centered care in LGBTQI health promotion?

Addressing the whole person Signup and view all the answers

What is the significance of a score between 8 and 10 on the Apgar scoring system?

Shows normal physiological status Signup and view all the answers

Which reflex is characterized by a newborn's startle response where arms extend and are then brought together?

Moro Reflex Signup and view all the answers

What does a positive Ortolani test indicate in a newborn?

Hip instability requiring assessment Signup and view all the answers

How is gestational age assessed in newborns using the Ballard scoring system?

Through neuromuscular and physical maturity observations Signup and view all the answers

What is the primary purpose of the Barlow test in newborn assessment?

To evaluate the ability to dislocate the hip Signup and view all the answers

Which treatment is often required for severe hyperbilirubinemia to prevent kernicterus?

Exchange transfusion or phototherapy Signup and view all the answers

What physiological mechanism primarily causes physiologic hyperbilirubinemia in newborns?

Immature liver function Signup and view all the answers

What does the presence of a positive Barlow test suggest about the hip status of a newborn?

The hip joint is likely dislocated Signup and view all the answers

Which factor is NOT considered a parental risk factor for childhood abuse and neglect?

Social support systems Signup and view all the answers

What type of abuse involves children participating in activities they cannot consent to or understand?

Sexual abuse Signup and view all the answers

Which of the following is a common challenge in engaging adolescents in discussions about their health?

Peer influences and pressures Signup and view all the answers

Which sign is considered a pathognomonic injury commonly associated with physical abuse?

Immersion burns Signup and view all the answers

What is an example of emotional abuse that is particularly difficult to measure?

Physical humiliation or ridicule Signup and view all the answers

Which type of neglect is often correlated with the term 'failure to thrive'?

Nutritional neglect Signup and view all the answers

Which of the following child factors increases the risk for childhood abuse and neglect?

Behavior issues like ADHD Signup and view all the answers

What approach is recommended for building trust with adolescents during healthcare discussions?

Establishing rapport through praise and open-ended questions Signup and view all the answers

Study Notes

Geriatric Medicine Study Notes

Dementia vs. Delirium: Dementia is a chronic, progressive decline in cognitive function, including memory loss and impaired reasoning. Delirium is an acute, reversible state of confusion, often caused by an underlying medical condition.
Dementia Assessment: Tools like the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) are used to evaluate cognitive function.
Delirium Triggers: Infections (e.g., UTI, pneumonia), electrolyte imbalances, medications, dehydration, and surgery are common triggers of delirium.
Geriatric Medical Concerns: Incontinence, insomnia, loss of function, depression, diet concerns, and mobility issues are common medical concerns affecting quality of life.
Improving Quality of Life: Physical therapy, occupational therapy, assistive devices, medication management, and nutritional counseling are used to improve quality of life for the elderly.
Medication Risks: Polypharmacy (taking multiple medications), polyprovider (being under care of many doctors), and inadequate medication management are risks for elderly patients.

LGBTQI Health Considerations

Mental Health: LGBTQI populations face higher rates of depression, anxiety, suicidal behavior, and eating disorders.
Substance Use: Increased tobacco, alcohol, and drug use are often observed in these populations as coping mechanisms.
STIs and HIV: MSM (men who have sex with men) and trans women are disproportionately affected by HIV and other STIs.
Cardiovascular Risks: Smoking, obesity, and disordered eating contribute to increased cardiovascular risks.
Violence and Trauma: LGBTQIA+ individuals experience elevated rates of hate crimes, sexual assault, and intimate partner violence.

Immunizations and Screening

Tdap: A single dose is recommended for adults if not previously received; boosters every 10 years.
Influenza Vaccine: Recommended annually for all adults. High-dose or adjuvanted vaccines are recommended for those aged 65+.
Pneumococcal Vaccines: Required for adults aged 65+ or younger with specific risk factors.
Zoster Vaccine: Two doses, 2-6 months apart, starting at age 50.
Hepatitis A & B: Two or three doses are recommended for adults at risk.
Colon Cancer: Annual screening (colonoscopy) is advised for adults ages 45-75 (or earlier for family history).
Breast Cancer: Biennial mammograms are recommended for women ages 40-74, starting at or before 50.
Lung Cancer: Annual low-dose CT (LDCT) screening is recommended for adults aged 50-80 with a history of heavy smoking.
Osteoporosis: DEXA scans are used for risk assessment of osteoporosis.
Cervical Cancer: Women aged 21-69 receive Pap smears.

Newborn Assessment

Recognize Terminology: Meconium, SGA, AGA, LGA, vernix, fontanelle, molding, perioral cyanosis, acrocyanosis, milia.
Goals of Assessment: Identify anomalies, reassure parents, determine health status, and plan appropriate action.
Physical Examination: Observation (positioning, tone, color). Cardiorespiratory (rate, rhythms, distress). Abdomen (masses). Extremities (digits, hips). Neuro -reflexes, tone and responsiveness).

Adolescent Medicine

Tanner Stages: Used to track physical development in adolescents.
Confidentiality and Informed Consent: Maintain confidentiality but recognize situations where a report to authorities is required.
Concerns: Establishing confidentiality to discuss sensitive issues like risky sexual behaviors, substance use, and mental health.

Child Abuse and Neglect

Parental Factors: Substance abuse, mental illness, and inexperience are risk factors.
Child Factors: Behaviours like ADHD, chronic medical issues, and being unwanted.
Environmental Factors: Poverty, lack of social support, domestic violence, and large family sizes.
Recognizing Abuse: Recognizing physical and behavioural indicators.

Rheumatologic Diseases

Localized/Systemic: Identifying if the condition is confined to specific joint regions or spreading to other systems.
Articular/Non-Articular: Determining if the condition affects the joints directly.
Inflammatory/Non-inflammatory: Determining the underlying cause of inflammation in the joints

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Description

This quiz covers essential concepts in geriatric medicine, including the differences between dementia and delirium, assessment tools, common triggers for delirium, and key medical concerns in elderly patients. It also explores strategies for improving the quality of life for older adults through various therapies and interventions.