Podcast
Questions and Answers
Which factor is LEAST likely to contribute to acute falls in the geriatric population?
Which factor is LEAST likely to contribute to acute falls in the geriatric population?
- Chronic osteoarthritis (correct)
- Toxic exposure
- Metabolic imbalance
- Infectious disease
A patient's mobility assessment reveals a deviation from normal walking. Which of the following is least likely to be a contributing factor?
A patient's mobility assessment reveals a deviation from normal walking. Which of the following is least likely to be a contributing factor?
- Acute anxiety (correct)
- Gait disturbance
- Balance issues
- Postural abnormalities
Which of the following best describes delirium?
Which of the following best describes delirium?
- A slowly progressive cognitive decline
- A fluctuating state of disorganized thought (correct)
- A consistent inability to perform activities of daily living
- A fixed state of impaired memory
When evaluating a patient for delirium, which laboratory study is LEAST likely to be helpful in determining the underlying cause?
When evaluating a patient for delirium, which laboratory study is LEAST likely to be helpful in determining the underlying cause?
Which feature is MOST indicative of dementia rather than delirium?
Which feature is MOST indicative of dementia rather than delirium?
Which of the following is the most common cause of dementia?
Which of the following is the most common cause of dementia?
A patient presents with memory impairment, speech difficulties, and imbalance. Which of the following findings would most strongly suggest a diagnosis of vascular dementia?
A patient presents with memory impairment, speech difficulties, and imbalance. Which of the following findings would most strongly suggest a diagnosis of vascular dementia?
Which of the following is the most common mechanism of stroke?
Which of the following is the most common mechanism of stroke?
According to the World Health Organization (WHO), how long must neurological deficits last to be classified as a stroke rather than a transient ischemic attack (TIA)?
According to the World Health Organization (WHO), how long must neurological deficits last to be classified as a stroke rather than a transient ischemic attack (TIA)?
Which of the following is a modifiable risk factor for stroke?
Which of the following is a modifiable risk factor for stroke?
A patient presents with acute onset of right-sided weakness and speech difficulty. If no hemorrhage is seen on the initial head CT, what is the next step in management if the patient is NOT coagulopathic?
A patient presents with acute onset of right-sided weakness and speech difficulty. If no hemorrhage is seen on the initial head CT, what is the next step in management if the patient is NOT coagulopathic?
Which of the following is considered the gold standard diagnostic test for subarachnoid hemorrhage (SAH)?
Which of the following is considered the gold standard diagnostic test for subarachnoid hemorrhage (SAH)?
Which of the following is a key risk factor for intracerebral hemorrhage (ICH)?
Which of the following is a key risk factor for intracerebral hemorrhage (ICH)?
Which of the following is the most significant risk factor for subdural hematoma (SDH)?
Which of the following is the most significant risk factor for subdural hematoma (SDH)?
For a patient presenting with carotid stenosis, referral to a vascular surgeon is primarily for:
For a patient presenting with carotid stenosis, referral to a vascular surgeon is primarily for:
Which degree of carotid stenosis (or greater) in an asymptomatic patient is typically considered an indication for endarterectomy?
Which degree of carotid stenosis (or greater) in an asymptomatic patient is typically considered an indication for endarterectomy?
What is the classic definition of a transient ischemic attack (TIA)?
What is the classic definition of a transient ischemic attack (TIA)?
Which of the following is a common characteristic of Parkinson's Disease?
Which of the following is a common characteristic of Parkinson's Disease?
A patient with suspected Parkinson's disease is being assessed for motor symptoms. Which of the following is LEAST likely to be observed?
A patient with suspected Parkinson's disease is being assessed for motor symptoms. Which of the following is LEAST likely to be observed?
A patient with motor symptoms consistent with Parkinson's disease also reports visual hallucinations and cognitive fluctuations. This presentation is most suggestive of:
A patient with motor symptoms consistent with Parkinson's disease also reports visual hallucinations and cognitive fluctuations. This presentation is most suggestive of:
Which of the following will most likely exacerbate an essential tremor?
Which of the following will most likely exacerbate an essential tremor?
Which of the following is part of the "SNOOP" mnemonic used in headache evaluation?
Which of the following is part of the "SNOOP" mnemonic used in headache evaluation?
A patient presents with chronic, severe headaches, and transient visual disturbances. Which condition is of greatest concern?
A patient presents with chronic, severe headaches, and transient visual disturbances. Which condition is of greatest concern?
Which of the following is the most typical presentation of trigeminal neuralgia?
Which of the following is the most typical presentation of trigeminal neuralgia?
What is the treatment of choice for trigeminal neuralgia?
What is the treatment of choice for trigeminal neuralgia?
A patient presents with new-onset seizures, hemiparesis, and ataxia. These symptoms are most consistent with
A patient presents with new-onset seizures, hemiparesis, and ataxia. These symptoms are most consistent with
Which characteristic is LEAST likely to be associated with post-traumatic headaches?
Which characteristic is LEAST likely to be associated with post-traumatic headaches?
What is the classic triad of symptoms associated with normal pressure hydrocephalus (NPH)?
What is the classic triad of symptoms associated with normal pressure hydrocephalus (NPH)?
Which of the following is a typical symptom of insomnia related to sleep deprivation?
Which of the following is a typical symptom of insomnia related to sleep deprivation?
Which of the following is most commonly associated with insomnia?
Which of the following is most commonly associated with insomnia?
Which of the following is MOST indicative of obstructive sleep apnea?
Which of the following is MOST indicative of obstructive sleep apnea?
Which of the following factors differentiates central sleep apnea from obstructive sleep apnea?
Which of the following factors differentiates central sleep apnea from obstructive sleep apnea?
Among older adults, which assessment would directly evaluate social determinants of their health regarding neurological care?
Among older adults, which assessment would directly evaluate social determinants of their health regarding neurological care?
An 80-year-old patient with a history of falls is undergoing a Performance-Oriented Mobility Assessment (POMA). Which element of the assessment specifically evaluates immediate standing balance?
An 80-year-old patient with a history of falls is undergoing a Performance-Oriented Mobility Assessment (POMA). Which element of the assessment specifically evaluates immediate standing balance?
A 65-year-old patient is being evaluated for cognitive impairment. The patient's spouse reports that the patient's confusion started suddenly a couple of days ago, has periods of lucidity, and shows disorganized thinking. Which of the following conditions is the most likely cause of the patient's symptoms?
A 65-year-old patient is being evaluated for cognitive impairment. The patient's spouse reports that the patient's confusion started suddenly a couple of days ago, has periods of lucidity, and shows disorganized thinking. Which of the following conditions is the most likely cause of the patient's symptoms?
A 70-year-old male patient with a history of hypertension and hyperlipidemia presents with sudden onset of right-sided weakness and difficulty speaking. A non-contrast CT scan of the head rules out hemorrhage. According to current guidelines, what is the MOST appropriate intervention?
A 70-year-old male patient with a history of hypertension and hyperlipidemia presents with sudden onset of right-sided weakness and difficulty speaking. A non-contrast CT scan of the head rules out hemorrhage. According to current guidelines, what is the MOST appropriate intervention?
An elderly patient presents with symptoms suggestive of a stroke. Which of the following symptoms would be MOST indicative of a potential vertebrobasilar artery stroke?
An elderly patient presents with symptoms suggestive of a stroke. Which of the following symptoms would be MOST indicative of a potential vertebrobasilar artery stroke?
Which of the following is the MOST appropriate initial diagnostic test for a patient presenting with suspected subarachnoid hemorrhage (SAH)?
Which of the following is the MOST appropriate initial diagnostic test for a patient presenting with suspected subarachnoid hemorrhage (SAH)?
Which of the following is LEAST likely to be associated with intracerebral hemorrhage (ICH)?
Which of the following is LEAST likely to be associated with intracerebral hemorrhage (ICH)?
Which assessment finding is most consistent with normal pressure hydrocephalus (NPH)?
Which assessment finding is most consistent with normal pressure hydrocephalus (NPH)?
The classic definition of transient ischemic attack (TIA) includes which characteristic?
The classic definition of transient ischemic attack (TIA) includes which characteristic?
Which of the following is the gold standard for treatment in Parkinson's Disease?
Which of the following is the gold standard for treatment in Parkinson's Disease?
Which of the following would be the least likely effect of sleep deprivation symptoms?
Which of the following would be the least likely effect of sleep deprivation symptoms?
An 82-year-old patient is being evaluated after experiencing multiple falls at home. Which of the following acute conditions is LEAST likely to be considered as a contributing factor to their recent falls?
An 82-year-old patient is being evaluated after experiencing multiple falls at home. Which of the following acute conditions is LEAST likely to be considered as a contributing factor to their recent falls?
During a home safety assessment for an elderly patient with a history of falls, which of the following modifications would be MOST effective in reducing fall risk related to environmental hazards?
During a home safety assessment for an elderly patient with a history of falls, which of the following modifications would be MOST effective in reducing fall risk related to environmental hazards?
A 75-year-old patient presents with new onset confusion. Her daughter reports that the confusion started abruptly yesterday and fluctuates in severity throughout the day. The patient is also noted to be easily distractible and has disorganized thoughts. Which of the following is the MOST likely diagnosis?
A 75-year-old patient presents with new onset confusion. Her daughter reports that the confusion started abruptly yesterday and fluctuates in severity throughout the day. The patient is also noted to be easily distractible and has disorganized thoughts. Which of the following is the MOST likely diagnosis?
When differentiating between delirium and dementia, which of the following historical features is MOST suggestive of delirium?
When differentiating between delirium and dementia, which of the following historical features is MOST suggestive of delirium?
Which of the following laboratory findings is MOST likely to be associated with delirium in an elderly patient presenting with acute confusion?
Which of the following laboratory findings is MOST likely to be associated with delirium in an elderly patient presenting with acute confusion?
A 78-year-old patient is diagnosed with Alzheimer's disease. Which of the following medication classes is MOST commonly used to manage the cognitive symptoms associated with this condition?
A 78-year-old patient is diagnosed with Alzheimer's disease. Which of the following medication classes is MOST commonly used to manage the cognitive symptoms associated with this condition?
Vascular dementia is most directly associated with which pathophysiological process?
Vascular dementia is most directly associated with which pathophysiological process?
An 80-year-old patient with a history of hypertension, hyperlipidemia, and atrial fibrillation presents with sudden onset of left-sided weakness and expressive aphasia. This clinical presentation is MOST consistent with which type of cerebrovascular event?
An 80-year-old patient with a history of hypertension, hyperlipidemia, and atrial fibrillation presents with sudden onset of left-sided weakness and expressive aphasia. This clinical presentation is MOST consistent with which type of cerebrovascular event?
According to the World Health Organization's (WHO) definition of stroke, the minimum duration of neurological deficits to differentiate a stroke from a transient ischemic attack (TIA) is:
According to the World Health Organization's (WHO) definition of stroke, the minimum duration of neurological deficits to differentiate a stroke from a transient ischemic attack (TIA) is:
Which of the following is the MOST critical initial step in the management of a patient presenting with acute stroke symptoms?
Which of the following is the MOST critical initial step in the management of a patient presenting with acute stroke symptoms?
If a non-contrast CT scan of the head is negative for hemorrhage in a patient with acute stroke symptoms, and the patient is not coagulopathic, the MOST appropriate next step in management, within the first few hours of symptom onset, is:
If a non-contrast CT scan of the head is negative for hemorrhage in a patient with acute stroke symptoms, and the patient is not coagulopathic, the MOST appropriate next step in management, within the first few hours of symptom onset, is:
A lumbar puncture (LP) is considered the gold standard diagnostic test for which type of intracranial hemorrhage when CT findings are inconclusive?
A lumbar puncture (LP) is considered the gold standard diagnostic test for which type of intracranial hemorrhage when CT findings are inconclusive?
Uncontrolled hypertension is the MOST significant risk factor for which type of intracranial hemorrhage?
Uncontrolled hypertension is the MOST significant risk factor for which type of intracranial hemorrhage?
Which of the following patient populations is at HIGHEST risk for subdural hematoma (SDH)?
Which of the following patient populations is at HIGHEST risk for subdural hematoma (SDH)?
Referral to a vascular surgeon is MOST indicated for a patient diagnosed with carotid stenosis to primarily:
Referral to a vascular surgeon is MOST indicated for a patient diagnosed with carotid stenosis to primarily:
For an asymptomatic patient with carotid stenosis detected on ultrasound, surgical intervention (endarterectomy) is generally considered when the stenosis is what degree or greater?
For an asymptomatic patient with carotid stenosis detected on ultrasound, surgical intervention (endarterectomy) is generally considered when the stenosis is what degree or greater?
The classic definition of a transient ischemic attack (TIA) includes neurological deficits that resolve within:
The classic definition of a transient ischemic attack (TIA) includes neurological deficits that resolve within:
Which of the following motor symptoms is a hallmark characteristic of Parkinson's Disease?
Which of the following motor symptoms is a hallmark characteristic of Parkinson's Disease?
Which of the following findings is LEAST likely to be associated with Parkinson's disease motor symptoms?
Which of the following findings is LEAST likely to be associated with Parkinson's disease motor symptoms?
A patient with motor features of Parkinsonism also presents with prominent visual hallucinations and fluctuating cognition. This clinical presentation is MOST suggestive of:
A patient with motor features of Parkinsonism also presents with prominent visual hallucinations and fluctuating cognition. This clinical presentation is MOST suggestive of:
Which of the following factors is known to exacerbate essential tremor?
Which of the following factors is known to exacerbate essential tremor?
In the 'SNOOP' mnemonic used to evaluate headache patients for secondary causes, the 'S' stands for:
In the 'SNOOP' mnemonic used to evaluate headache patients for secondary causes, the 'S' stands for:
A 70-year-old patient presents with chronic, severe headaches, new onset transient visual disturbances, and scalp tenderness. Which of the following conditions is of GREATEST concern and requires urgent evaluation?
A 70-year-old patient presents with chronic, severe headaches, new onset transient visual disturbances, and scalp tenderness. Which of the following conditions is of GREATEST concern and requires urgent evaluation?
The pain associated with trigeminal neuralgia is BEST described as:
The pain associated with trigeminal neuralgia is BEST described as:
First-line pharmacological treatment for trigeminal neuralgia typically involves:
First-line pharmacological treatment for trigeminal neuralgia typically involves:
New-onset seizures, progressive hemiparesis, and ataxia in an elderly patient are MOST concerning for:
New-onset seizures, progressive hemiparesis, and ataxia in an elderly patient are MOST concerning for:
Which of the following characteristics is LEAST typical of post-traumatic headaches?
Which of the following characteristics is LEAST typical of post-traumatic headaches?
The classic triad of symptoms associated with normal pressure hydrocephalus (NPH) includes:
The classic triad of symptoms associated with normal pressure hydrocephalus (NPH) includes:
Which of the following symptoms is MOST indicative of insomnia related to sleep deprivation?
Which of the following symptoms is MOST indicative of insomnia related to sleep deprivation?
Which of the following conditions is MOST commonly associated with chronic insomnia in older adults?
Which of the following conditions is MOST commonly associated with chronic insomnia in older adults?
Loud snoring, witnessed apneas, and excessive daytime sleepiness are MOST suggestive of:
Loud snoring, witnessed apneas, and excessive daytime sleepiness are MOST suggestive of:
The primary differentiating factor between central sleep apnea and obstructive sleep apnea is:
The primary differentiating factor between central sleep apnea and obstructive sleep apnea is:
When assessing social determinants of health in an older adult with neurological concerns, which question would be MOST pertinent to their access to care?
When assessing social determinants of health in an older adult with neurological concerns, which question would be MOST pertinent to their access to care?
During a Performance-Oriented Mobility Assessment (POMA), which component specifically evaluates a patient's ability to maintain balance immediately after standing?
During a Performance-Oriented Mobility Assessment (POMA), which component specifically evaluates a patient's ability to maintain balance immediately after standing?
A 68-year-old patient presents with new onset cognitive impairment. Her family reports that her confusion started gradually over the past year and has been progressively worsening. Which of the following conditions is the MOST likely cause of her symptoms?
A 68-year-old patient presents with new onset cognitive impairment. Her family reports that her confusion started gradually over the past year and has been progressively worsening. Which of the following conditions is the MOST likely cause of her symptoms?
A 72-year-old male patient with a history of smoking and hypertension presents with sudden onset of right-sided weakness and difficulty speaking. A non-contrast CT scan of the head rules out hemorrhage. According to current guidelines, what is the MOST appropriate acute intervention?
A 72-year-old male patient with a history of smoking and hypertension presents with sudden onset of right-sided weakness and difficulty speaking. A non-contrast CT scan of the head rules out hemorrhage. According to current guidelines, what is the MOST appropriate acute intervention?
An elderly patient presents with acute onset of vertigo, diplopia, and bilateral weakness. These symptoms are MOST suggestive of a stroke affecting which vascular territory?
An elderly patient presents with acute onset of vertigo, diplopia, and bilateral weakness. These symptoms are MOST suggestive of a stroke affecting which vascular territory?
What is considered the MOST sensitive initial diagnostic test for a patient presenting with suspected subarachnoid hemorrhage (SAH)?
What is considered the MOST sensitive initial diagnostic test for a patient presenting with suspected subarachnoid hemorrhage (SAH)?
According to the classic definition, a transient ischemic attack (TIA) is characterized by:
According to the classic definition, a transient ischemic attack (TIA) is characterized by:
While medications like levodopa are used to manage symptoms, the gold standard surgical treatment for advanced Parkinson's Disease aimed at improving motor function is:
While medications like levodopa are used to manage symptoms, the gold standard surgical treatment for advanced Parkinson's Disease aimed at improving motor function is:
Which of the following is LEAST likely to be a direct effect of sleep deprivation symptoms?
Which of the following is LEAST likely to be a direct effect of sleep deprivation symptoms?
A 78-year-old man presents with progressive memory impairment and difficulty with spatial orientation. Which screening tool would be most appropriate to initially evaluate cognitive impairment?
A 78-year-old man presents with progressive memory impairment and difficulty with spatial orientation. Which screening tool would be most appropriate to initially evaluate cognitive impairment?
A 68-year-old woman with recent frequent falls is being evaluated. Which physical exam technique specifically assesses mobility and balance?
A 68-year-old woman with recent frequent falls is being evaluated. Which physical exam technique specifically assesses mobility and balance?
An 85-year-old woman presents with chronic headaches, scalp tenderness, and transient vision disturbances. What diagnostic test is considered gold standard to confirm the suspected diagnosis?
An 85-year-old woman presents with chronic headaches, scalp tenderness, and transient vision disturbances. What diagnostic test is considered gold standard to confirm the suspected diagnosis?
An elderly patient complains of brief, intense facial pain triggered by chewing and brushing teeth. Physical exam is normal. What is the treatment of choice for this disorder?
An elderly patient complains of brief, intense facial pain triggered by chewing and brushing teeth. Physical exam is normal. What is the treatment of choice for this disorder?
According to current geriatric recommendations, which of the following screening practices is routinely indicated for early detection of cerebrovascular disease?
According to current geriatric recommendations, which of the following screening practices is routinely indicated for early detection of cerebrovascular disease?
Which evaluation is critical when assessing an older adult with an acute fall and suspected neurologic deficit?
Which evaluation is critical when assessing an older adult with an acute fall and suspected neurologic deficit?
An 80-year-old patient with progressive cognitive decline undergoes evaluation. What is the most common cause of dementia in older adults?
An 80-year-old patient with progressive cognitive decline undergoes evaluation. What is the most common cause of dementia in older adults?
A 70-year-old woman presents with rapid onset confusion, altered consciousness, and disorganized thinking for the past 24 hours. What is the most likely diagnosis?
A 70-year-old woman presents with rapid onset confusion, altered consciousness, and disorganized thinking for the past 24 hours. What is the most likely diagnosis?
Which screening method is recommended for evaluating risk of falls and mobility impairment in elderly adults?
Which screening method is recommended for evaluating risk of falls and mobility impairment in elderly adults?
A 77-year-old woman has symptoms suggestive of Normal Pressure Hydrocephalus (NPH). Which of the following is part of the classic triad seen with NPH?
A 77-year-old woman has symptoms suggestive of Normal Pressure Hydrocephalus (NPH). Which of the following is part of the classic triad seen with NPH?
An 83-year-old woman reports frequent falls and impaired balance. Which test specifically evaluates immediate standing balance, turning, and sitting balance to assess fall risk?
An 83-year-old woman reports frequent falls and impaired balance. Which test specifically evaluates immediate standing balance, turning, and sitting balance to assess fall risk?
An 80-year-old patient is being evaluated for dementia. Which laboratory test should routinely be included in this patient's evaluation?
An 80-year-old patient is being evaluated for dementia. Which laboratory test should routinely be included in this patient's evaluation?
A patient presents with progressively worsening tremors in both hands, especially noticeable when holding a coffee cup or signing a check. Symptoms improve significantly after consuming a small amount of alcohol. Which diagnosis is most likely?
A patient presents with progressively worsening tremors in both hands, especially noticeable when holding a coffee cup or signing a check. Symptoms improve significantly after consuming a small amount of alcohol. Which diagnosis is most likely?
A 72-year-old man presents with slowly progressive resting tremor, decreased arm swing while walking, and reduced facial expressions. Which of the following conditions is the most likely diagnosis?
A 72-year-old man presents with slowly progressive resting tremor, decreased arm swing while walking, and reduced facial expressions. Which of the following conditions is the most likely diagnosis?
An elderly patient presents after a mild head injury complaining of headaches, confusion, and weakness that developed over two weeks after the incident. Which condition is most likely?
An elderly patient presents after a mild head injury complaining of headaches, confusion, and weakness that developed over two weeks after the incident. Which condition is most likely?
A 67-year-old male develops sudden-onset facial asymmetry, dysarthria, and unilateral weakness lasting more than 24 hours. No hemorrhage is seen on CT. What is the most appropriate immediate treatment?
A 67-year-old male develops sudden-onset facial asymmetry, dysarthria, and unilateral weakness lasting more than 24 hours. No hemorrhage is seen on CT. What is the most appropriate immediate treatment?
Which factor most strongly predisposes elderly patients to intracerebral hemorrhage?
Which factor most strongly predisposes elderly patients to intracerebral hemorrhage?
A 76-year-old patient presents with gradual cognitive impairment, difficulty walking, and recent episodes of urinary incontinence. Imaging shows enlarged cerebral ventricles. What is the most likely diagnosis?
A 76-year-old patient presents with gradual cognitive impairment, difficulty walking, and recent episodes of urinary incontinence. Imaging shows enlarged cerebral ventricles. What is the most likely diagnosis?
A 69-year-old patient presents with unilateral, sharp, electric shock-like facial pain triggered by chewing. Physical exam and imaging are normal. What is the first-line treatment?
A 69-year-old patient presents with unilateral, sharp, electric shock-like facial pain triggered by chewing. Physical exam and imaging are normal. What is the first-line treatment?
A 70-year-old patient experiences unilateral headache, jaw claudication, and transient visual loss. What diagnostic test confirms the suspected diagnosis?
A 70-year-old patient experiences unilateral headache, jaw claudication, and transient visual loss. What diagnostic test confirms the suspected diagnosis?
An elderly patient with a 30-pack-year smoking history and atrial fibrillation asks about stroke prevention. Which modifiable risk factor, if managed, would most significantly reduce stroke risk?
An elderly patient with a 30-pack-year smoking history and atrial fibrillation asks about stroke prevention. Which modifiable risk factor, if managed, would most significantly reduce stroke risk?
An elderly woman complains of impaired sleep, nocturnal awakenings, and daytime fatigue. She reports drinking alcohol nightly before bed. Which intervention is most likely to improve her sleep?
An elderly woman complains of impaired sleep, nocturnal awakenings, and daytime fatigue. She reports drinking alcohol nightly before bed. Which intervention is most likely to improve her sleep?
Flashcards
Mobility disorder?
Mobility disorder?
Deviation from normal ambulation involving balance or posture issues.
Confusion?
Confusion?
Lack of clear thinking, often caused by UTI in elderly patients.
Delirium?
Delirium?
Disorganized thinking developing over hours/weeks, often acute and fluctuating. Examples include Disorientation, ETOH withdrawal and Hepatic Failure
Dementia?
Dementia?
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Dementia evaluation?
Dementia evaluation?
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Dementia and Delirium lab studies?
Dementia and Delirium lab studies?
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CVA?
CVA?
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Stroke modifiable risk factors?
Stroke modifiable risk factors?
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Non-modifiable stroke risk factors?
Non-modifiable stroke risk factors?
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Disease processes related to stroke?
Disease processes related to stroke?
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CVA clinical presentation?
CVA clinical presentation?
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Acute stroke tx?
Acute stroke tx?
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Intracerebral hemorrhage?
Intracerebral hemorrhage?
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Subarachnoid Hemorrhage?
Subarachnoid Hemorrhage?
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SAH Diagnosis?
SAH Diagnosis?
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Intracerebral hemorrhage risk factors?
Intracerebral hemorrhage risk factors?
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Subdural hematoma?
Subdural hematoma?
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Transient Ischemic Attack (TIA)?
Transient Ischemic Attack (TIA)?
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Parkinson's disease?
Parkinson's disease?
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Parkinson's classic motor findings?
Parkinson's classic motor findings?
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Lewy Body Dementia?
Lewy Body Dementia?
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What is an Essential Tremor?
What is an Essential Tremor?
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"SNOOP" criteria for headache?
"SNOOP" criteria for headache?
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Secondary headache causes?
Secondary headache causes?
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Temporal arteritis?
Temporal arteritis?
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Trigeminal neuralgia?
Trigeminal neuralgia?
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Trigeminal Neuralgia findings?
Trigeminal Neuralgia findings?
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Trigeminal Neuralgia tx?
Trigeminal Neuralgia tx?
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Neoplasm characteristics?
Neoplasm characteristics?
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Normal Pressure Hydrocephalus (NPH)?
Normal Pressure Hydrocephalus (NPH)?
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Elderly sleep disorders?
Elderly sleep disorders?
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Define Insomnia?
Define Insomnia?
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Causes of insomnia?
Causes of insomnia?
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Obstructive sleep apnea sx?
Obstructive sleep apnea sx?
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What is a Mini-Cog?
What is a Mini-Cog?
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What does the Romberg test assess?
What does the Romberg test assess?
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Acute Fall Evaluation
Acute Fall Evaluation
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POMA assesses what?
POMA assesses what?
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Check Vitamin B12 in?
Check Vitamin B12 in?
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What worsens Essential tremors?
What worsens Essential tremors?
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What 3 features define parkinsonism?
What 3 features define parkinsonism?
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Common Subdural hematoma sx?
Common Subdural hematoma sx?
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Acute ischemic stroke symptoms?
Acute ischemic stroke symptoms?
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Modifiable stroke risk factors?
Modifiable stroke risk factors?
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Study Notes
Geriatric Cognitive Impairment Evaluation
- The Mini-Cog is commonly used for the initial screening of cognitive impairment and dementia in elderly patients.
- Dementia evaluation should include CBC, metabolic panel, thyroid function tests, vitamin B12, and syphilis serology.
- Ask the patient and family about cognitive, memory, and behavioral issues.
- Assess the patient's spatial orientation
- Evaluate for neurovascular risk factors.
Balance and Fall Risk Assessment
- The Romberg test assesses balance/proprioception, important in evaluating fall risk in elderly patients.
- The Timed Up and Go (TUG) test assesses mobility and fall risk; >20 seconds indicates significant fall risk in elderly.
- POMA evaluates sitting balance, standing, turning balance, and Romberg testing.
- POMA is used specifically to assess fall risk and mobility impairment in older adults.
Temporal Arteritis (Giant Cell Arteritis)
- This is common in the elderly that may cause blindness if untreated.
- This is definitively diagnosed via temporal artery biopsy.
- Presents with unilateral headache, jaw claudication, and transient visual loss.
Trigeminal Neuralgia
- Presents as brief, intense facial pain along the CN V distribution.
- First-line therapy is carbamazepine.
Cerebrovascular Disease Screening
- Routine carotid screening is not recommended unless symptomatic or high-risk.
- Carotid ultrasound is indicated in patients with suspected significant carotid artery disease.
Acute Falls With Neurologic Deficit
- These falls require immediate neurological evaluation and appropriate imaging.
- Exclude intracranial pathology (stroke, subdural hematoma).
Alzheimer's Disease
- This is the most common dementia.
- It is characterized by slow, progressive cognitive decline over years.
Delirium
- Presents with acute onset confusion and fluctuating course.
- Often secondary to infection, metabolic changes, or medications.
Normal Pressure Hydrocephalus (NPH)
- The classic triad includes dementia, gait disturbance, and urinary incontinence.
- Often treatable with ventricular shunting.
Stroke and Treatment
- Acute ischemic stroke—IV tPA is indicated within 3 hours of onset if no hemorrhage or contraindications are present.
- Hypertension is the most significant risk factor for intracerebral hemorrhage in the elderly.
- Modifiable stroke risk factors include smoking cessation, hypertension control, diabetes management, and managing atrial fibrillation.
Essential Tremor
- This is a postural tremor that worsens with stress and caffeine.
- It improves with alcohol and beta-blockers.
Subdural Hematoma
- Common in the elderly.
- Presents with delayed symptoms (days to weeks), confusion, headache, and weakness.
Sleep and Alcohol
- Alcohol exacerbates insomnia and disrupts sleep architecture in the elderly.
- Cessation improves sleep quality.
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