Podcast
Questions and Answers
An 80-year-old patient is admitted with pneumonia. Which of the following is most indicative of a bacterial infection in this age group, considering atypical presentations?
An 80-year-old patient is admitted with pneumonia. Which of the following is most indicative of a bacterial infection in this age group, considering atypical presentations?
- Productive cough with green sputum
- High fever (above 102°F)
- Elevated white blood cell count with marked leukocytosis
- Sudden onset of confusion (correct)
Which factor most significantly contributes to the increased morbidity and mortality associated with infections in older adults?
Which factor most significantly contributes to the increased morbidity and mortality associated with infections in older adults?
- Higher rates of smoking compared to younger adults
- Increased exposure to pathogens in crowded living facilities
- Poor adherence to prescribed antibiotic regimens
- Decline in both B- and T-cell immunity (correct)
An 85-year-old nursing home resident is evaluated for possible pneumonia. Which atypical presentation is vital when assessing for pneumonia?
An 85-year-old nursing home resident is evaluated for possible pneumonia. Which atypical presentation is vital when assessing for pneumonia?
- High fever and productive cough
- Confusion and tachypnea (correct)
- Fatigue and reduced appetite
- Sharp chest pain exacerbated by breathing
In an elderly patient presenting with a urinary tract infection (UTI), what is the most crucial consideration regarding antibiotic treatment?
In an elderly patient presenting with a urinary tract infection (UTI), what is the most crucial consideration regarding antibiotic treatment?
What is the recommended approach to managing asymptomatic bacteriuria in an elderly female patient?
What is the recommended approach to managing asymptomatic bacteriuria in an elderly female patient?
Which of the following is the strongest risk factor for developing postherpetic neuralgia (PHN) after a herpes zoster (HZ) infection in an older adult?
Which of the following is the strongest risk factor for developing postherpetic neuralgia (PHN) after a herpes zoster (HZ) infection in an older adult?
An 82-year-old patient has a herpes zoster infection. When should antiviral treatment be initiated to most effectively reduce acute pain and chronic pain?
An 82-year-old patient has a herpes zoster infection. When should antiviral treatment be initiated to most effectively reduce acute pain and chronic pain?
An 70-year-old is due for several vaccinations. According to current guidelines, which vaccination is recommended at age 60 years or older?
An 70-year-old is due for several vaccinations. According to current guidelines, which vaccination is recommended at age 60 years or older?
An 68-year-old patient with a history of COPD is being vaccinated. What is the correct sequence for administering pneumococcal vaccines?
An 68-year-old patient with a history of COPD is being vaccinated. What is the correct sequence for administering pneumococcal vaccines?
Which of the following cardiovascular conditions is a common underlying cause of infective endocarditis (IE) in older adults?
Which of the following cardiovascular conditions is a common underlying cause of infective endocarditis (IE) in older adults?
What is the most common pathogen causing septic arthritis in older adults?
What is the most common pathogen causing septic arthritis in older adults?
When evaluating older residents in long-term care facilities (LTCFs) for possible infections, what should clinicians recognize regarding fever?
When evaluating older residents in long-term care facilities (LTCFs) for possible infections, what should clinicians recognize regarding fever?
An 88-year-old resident of a long-term care facility presents with a decline in functional status and increased confusion. What should be the initial step?
An 88-year-old resident of a long-term care facility presents with a decline in functional status and increased confusion. What should be the initial step?
An 75 year old new LTCF resident with an indwelling urinary catheter develops a fever. What is the next step?
An 75 year old new LTCF resident with an indwelling urinary catheter develops a fever. What is the next step?
Which of the following is an important consideration when evaluating a long-term care facility resident for a respiratory viral infection outbreak?
Which of the following is an important consideration when evaluating a long-term care facility resident for a respiratory viral infection outbreak?
What is the most important factor to consider when screening older adults for cancer?
What is the most important factor to consider when screening older adults for cancer?
According to the USPSTF, what is the upper age limit for recommending routine screening for colorectal cancer?
According to the USPSTF, what is the upper age limit for recommending routine screening for colorectal cancer?
A 78-year-old man asks about prostate cancer screening. According to the USPSTF, what is generally recommended regarding PSA screening in men of this age?
A 78-year-old man asks about prostate cancer screening. According to the USPSTF, what is generally recommended regarding PSA screening in men of this age?
Which of the following is a major diagnostic criterion for multiple myeloma (MM)?
Which of the following is a major diagnostic criterion for multiple myeloma (MM)?
What is the typical RBC morphology seen in anemia of chronic disease (ACD)?
What is the typical RBC morphology seen in anemia of chronic disease (ACD)?
A 72-year-old male is newly diagnosed with Vitamin B12 deficiency. What is the best treatment choice for this patient?
A 72-year-old male is newly diagnosed with Vitamin B12 deficiency. What is the best treatment choice for this patient?
What is the classic triad seen in multiple myeloma?
What is the classic triad seen in multiple myeloma?
What is the most common leukemia in the Western world?
What is the most common leukemia in the Western world?
What is the classic treatment for polycythemia vera?
What is the classic treatment for polycythemia vera?
Q1: A 70-year-old female presents to her primary care office for a yearly check-up. She has a history of DM and HTN both of which are managed with oral therapy. She is chronically fatigued but has no other specific complaints. PE discloses several 1-to 2 cm nodes on both sides of the anterior neck and in the axilla. Routine CBC reveals that her WBC is 98,000 mainly due to preponderance of mature-appearing lymphocytes (see below). Her hematocrit is 38.2% and her platelet count is 250,000/uL. Except for a mildly elevated LDH her serum chemistries are normal. Serum protein electrophoresis reveals mild hypogammaglobulinemia. A CT scan of the chest, abdomen, and the pelvis discloses multiple 1-2 cm lymph nodes in the peri-aortic area. What is the most likely diagnosis in this woman?
Q1: A 70-year-old female presents to her primary care office for a yearly check-up. She has a history of DM and HTN both of which are managed with oral therapy. She is chronically fatigued but has no other specific complaints. PE discloses several 1-to 2 cm nodes on both sides of the anterior neck and in the axilla. Routine CBC reveals that her WBC is 98,000 mainly due to preponderance of mature-appearing lymphocytes (see below). Her hematocrit is 38.2% and her platelet count is 250,000/uL. Except for a mildly elevated LDH her serum chemistries are normal. Serum protein electrophoresis reveals mild hypogammaglobulinemia. A CT scan of the chest, abdomen, and the pelvis discloses multiple 1-2 cm lymph nodes in the peri-aortic area. What is the most likely diagnosis in this woman?
Q2: A figure skater who won gold medals at the 1928, 1932, and 1936 Winter Olympic games became progressively fatigued her late 50's, leading to a workup that revealed a CBC with Hgb 10.1 g/dL, Hct 30.5%, MCV 90 fL, platelet count 89,000/uL, and WBC count 31,300/uL. From the peripheral blood picture shown here, the most likely diagnosis is:
Q2: A figure skater who won gold medals at the 1928, 1932, and 1936 Winter Olympic games became progressively fatigued her late 50's, leading to a workup that revealed a CBC with Hgb 10.1 g/dL, Hct 30.5%, MCV 90 fL, platelet count 89,000/uL, and WBC count 31,300/uL. From the peripheral blood picture shown here, the most likely diagnosis is:
Q 3: A 55-year-old man presents with bone pain that is aggravated by movement or weight bearing. Physical examination is remarkable for pale conjunctiva. Laboratory results show a normocytic anemia and an increased serum globulin level. Peripheral blood smear is seen here. Osteolytic bone lesions are seen on a radiograph of the pelvis. Bone scanning is normal. Which of the following is the most likely diagnosis?
Q 3: A 55-year-old man presents with bone pain that is aggravated by movement or weight bearing. Physical examination is remarkable for pale conjunctiva. Laboratory results show a normocytic anemia and an increased serum globulin level. Peripheral blood smear is seen here. Osteolytic bone lesions are seen on a radiograph of the pelvis. Bone scanning is normal. Which of the following is the most likely diagnosis?
Q 4: Which of the following statements concerning screening for colorectal cancer is correct?
Q 4: Which of the following statements concerning screening for colorectal cancer is correct?
Q 5: Which of the following statements about fecal occult blood testing is correct?
Q 5: Which of the following statements about fecal occult blood testing is correct?
Q6: Screening for prostate cancer with Prostate-specific antigen (PSA) is controversial because:
Q6: Screening for prostate cancer with Prostate-specific antigen (PSA) is controversial because:
Q7: Which of the following statements concerning catheter-associated urinary infections is common
Q7: Which of the following statements concerning catheter-associated urinary infections is common
Q 8: A 69-year-old PA was well until 3 weeks ago when she developed a urinary tract infection. She was treated with ampicillin for 10 days, taking her last dose 7 days ago. Four days ago, she developed abdominal pain, fever, and bloody diarrhea. On examination, she appears acutely ill; her temperature is 101 F and her abdomen is diffusely tender. Sigmoidoscopy demonstrates a hyperemic mucosa studded with plaque-like lesions. The most likely diagnosis is
Q 8: A 69-year-old PA was well until 3 weeks ago when she developed a urinary tract infection. She was treated with ampicillin for 10 days, taking her last dose 7 days ago. Four days ago, she developed abdominal pain, fever, and bloody diarrhea. On examination, she appears acutely ill; her temperature is 101 F and her abdomen is diffusely tender. Sigmoidoscopy demonstrates a hyperemic mucosa studded with plaque-like lesions. The most likely diagnosis is
Q 9: A 75-year-old woman has had increasing fatigue with a 3 kg weight loss over the past 7 months. Her hands become purple and painful upon exposure to cold. On physical examination, she has a palpable spleen tip. Laboratory studies show Hgb 10.5 g/dL, Hct 31.7%, MCV 99 fL, platelet count 193,600/microliter, and WBC count 5390/microliter. The direct Coombs test is positive at 4 C and negative at 37 C. Which of the following underlying diseases is this woman most likely to have?
Q 9: A 75-year-old woman has had increasing fatigue with a 3 kg weight loss over the past 7 months. Her hands become purple and painful upon exposure to cold. On physical examination, she has a palpable spleen tip. Laboratory studies show Hgb 10.5 g/dL, Hct 31.7%, MCV 99 fL, platelet count 193,600/microliter, and WBC count 5390/microliter. The direct Coombs test is positive at 4 C and negative at 37 C. Which of the following underlying diseases is this woman most likely to have?
Q10: A 72-year-old man presents for his annual health maintenance visit. The review of systems is positive for occasional fatigue and headache. The patient admits to generalized pruitis following a warm bath or shower. He has plethora and engorgement of the retinal veins. A spleen is palpable on abdominal examination. The patient's hematocrit is 63% and he has a leucocytes and thrombocytosis. Peripheral blood smear is normal. The patient does not smoke. Which of the following is the most likely diagnosis?
Q10: A 72-year-old man presents for his annual health maintenance visit. The review of systems is positive for occasional fatigue and headache. The patient admits to generalized pruitis following a warm bath or shower. He has plethora and engorgement of the retinal veins. A spleen is palpable on abdominal examination. The patient's hematocrit is 63% and he has a leucocytes and thrombocytosis. Peripheral blood smear is normal. The patient does not smoke. Which of the following is the most likely diagnosis?
In older adults, what distinguishes a lower hemoglobin concentration as a sign of disease, mortality, and hospitalization?
In older adults, what distinguishes a lower hemoglobin concentration as a sign of disease, mortality, and hospitalization?
What anemia is the most common with a known etiology in older adults?
What anemia is the most common with a known etiology in older adults?
What are the signs and symptoms of Anemia in an older adult?
What are the signs and symptoms of Anemia in an older adult?
Which cause of anemia must have have a dietary evaluation done, regardless if they have had poor nutrition?
Which cause of anemia must have have a dietary evaluation done, regardless if they have had poor nutrition?
Which of the following physiological changes in older adults is MOST likely to contribute to an increased susceptibility to infections?
Which of the following physiological changes in older adults is MOST likely to contribute to an increased susceptibility to infections?
An 80-year-old patient in a long-term care facility is suspected of having an infection. Which clinical finding, while common in younger adults, is LEAST reliable as an indicator of infection in this older adult population?
An 80-year-old patient in a long-term care facility is suspected of having an infection. Which clinical finding, while common in younger adults, is LEAST reliable as an indicator of infection in this older adult population?
A 75-year-old patient is diagnosed with pneumonia. Compared to younger adults with pneumonia, older adults are MORE likely to present with:
A 75-year-old patient is diagnosed with pneumonia. Compared to younger adults with pneumonia, older adults are MORE likely to present with:
Which of the following pathogens is MORE frequently associated with pneumonia in older adults, particularly in long-term care facilities, compared to community-acquired pneumonia in younger adults?
Which of the following pathogens is MORE frequently associated with pneumonia in older adults, particularly in long-term care facilities, compared to community-acquired pneumonia in younger adults?
An 82-year-old female resident in a nursing home presents with new onset confusion and increased falls. She has no fever. Which of the following should be the INITIAL diagnostic consideration?
An 82-year-old female resident in a nursing home presents with new onset confusion and increased falls. She has no fever. Which of the following should be the INITIAL diagnostic consideration?
What is the MOST appropriate management approach for asymptomatic bacteriuria discovered during routine urinalysis in an 85-year-old woman residing in assisted living?
What is the MOST appropriate management approach for asymptomatic bacteriuria discovered during routine urinalysis in an 85-year-old woman residing in assisted living?
Which of the following is the STRONGEST risk factor for the development of postherpetic neuralgia (PHN) following a herpes zoster infection in an older adult?
Which of the following is the STRONGEST risk factor for the development of postherpetic neuralgia (PHN) following a herpes zoster infection in an older adult?
An 80-year-old patient presents with herpes zoster. To MOST effectively reduce the duration and severity of acute pain and the risk of PHN, antiviral treatment should be initiated within how many hours of rash onset?
An 80-year-old patient presents with herpes zoster. To MOST effectively reduce the duration and severity of acute pain and the risk of PHN, antiviral treatment should be initiated within how many hours of rash onset?
According to current guidelines, which vaccination is routinely recommended for adults aged 60 years or older to prevent herpes zoster and its complications?
According to current guidelines, which vaccination is routinely recommended for adults aged 60 years or older to prevent herpes zoster and its complications?
A 70-year-old patient with a history of COPD is due for pneumococcal vaccinations. What is the CORRECT recommended sequence for administering pneumococcal vaccines in this patient?
A 70-year-old patient with a history of COPD is due for pneumococcal vaccinations. What is the CORRECT recommended sequence for administering pneumococcal vaccines in this patient?
Which of the following cardiovascular conditions is a COMMON underlying risk factor for infective endocarditis (IE) in older adults?
Which of the following cardiovascular conditions is a COMMON underlying risk factor for infective endocarditis (IE) in older adults?
What is the MOST common causative pathogen of septic arthritis in older adults?
What is the MOST common causative pathogen of septic arthritis in older adults?
When evaluating a resident in a long-term care facility for a possible infection, a temperature of what value should be considered a fever, warranting further investigation?
When evaluating a resident in a long-term care facility for a possible infection, a temperature of what value should be considered a fever, warranting further investigation?
An 88-year-old long-term care facility resident presents with a sudden decline in functional status and increased confusion. What is the MOST appropriate INITIAL step in evaluating this patient?
An 88-year-old long-term care facility resident presents with a sudden decline in functional status and increased confusion. What is the MOST appropriate INITIAL step in evaluating this patient?
A 75-year-old new resident of a long-term care facility with an indwelling urinary catheter develops a fever. What is the NEXT BEST step in management?
A 75-year-old new resident of a long-term care facility with an indwelling urinary catheter develops a fever. What is the NEXT BEST step in management?
During a respiratory viral infection outbreak in a long-term care facility, what is the MOST important specimen to obtain from residents with suspected infection for diagnostic purposes?
During a respiratory viral infection outbreak in a long-term care facility, what is the MOST important specimen to obtain from residents with suspected infection for diagnostic purposes?
What is the MOST significant risk factor for cancer overall?
What is the MOST significant risk factor for cancer overall?
According to the USPSTF guidelines for colorectal cancer screening, routine screening is generally recommended to continue until what age in average-risk individuals?
According to the USPSTF guidelines for colorectal cancer screening, routine screening is generally recommended to continue until what age in average-risk individuals?
A 78-year-old man asks about prostate cancer screening. According to USPSTF recommendations, what is the general guidance regarding PSA screening in men of this age?
A 78-year-old man asks about prostate cancer screening. According to USPSTF recommendations, what is the general guidance regarding PSA screening in men of this age?
What is the typical red blood cell (RBC) morphology observed in anemia of chronic disease (ACD)?
What is the typical red blood cell (RBC) morphology observed in anemia of chronic disease (ACD)?
A 72-year-old male is newly diagnosed with Vitamin B12 deficiency. Assuming no neurological symptoms, what is the MOST appropriate initial treatment?
A 72-year-old male is newly diagnosed with Vitamin B12 deficiency. Assuming no neurological symptoms, what is the MOST appropriate initial treatment?
What is the classic triad of findings associated with multiple myeloma (MM)?
What is the classic triad of findings associated with multiple myeloma (MM)?
Which type of leukemia is the MOST common in the Western world?
Which type of leukemia is the MOST common in the Western world?
What is the cornerstone of initial treatment for polycythemia vera to reduce the risk of thrombotic complications?
What is the cornerstone of initial treatment for polycythemia vera to reduce the risk of thrombotic complications?
In older adults, a lower hemoglobin concentration is more likely to be indicative of disease, increased mortality, and hospitalization when it is associated with:
In older adults, a lower hemoglobin concentration is more likely to be indicative of disease, increased mortality, and hospitalization when it is associated with:
Which type of anemia is the MOST common anemia with a known etiology in older adults?
Which type of anemia is the MOST common anemia with a known etiology in older adults?
Which of the following is an IMPORTANT sign or symptom of anemia in older adults that may be easily overlooked or attributed to other age-related conditions?
Which of the following is an IMPORTANT sign or symptom of anemia in older adults that may be easily overlooked or attributed to other age-related conditions?
In an older adult diagnosed with iron deficiency anemia, even in the presence of poor nutrition, what further evaluation is MANDATORY to identify the underlying cause?
In an older adult diagnosed with iron deficiency anemia, even in the presence of poor nutrition, what further evaluation is MANDATORY to identify the underlying cause?
A 70-year-old female presents with fatigue and lymphadenopathy. Her CBC shows a WBC count of 98,000 with 90% lymphocytes. Peripheral blood smear shows mature lymphocytes. CT scan reveals widespread lymphadenopathy. Serum protein electrophoresis shows mild hypogammaglobulinemia. What is the MOST likely diagnosis?
A 70-year-old female presents with fatigue and lymphadenopathy. Her CBC shows a WBC count of 98,000 with 90% lymphocytes. Peripheral blood smear shows mature lymphocytes. CT scan reveals widespread lymphadenopathy. Serum protein electrophoresis shows mild hypogammaglobulinemia. What is the MOST likely diagnosis?
A 60-year-old patient presents with fatigue and easy bruising. Lab results show Hgb 10.1 g/dL, platelets 89,000/uL, WBC 31,300/uL with mature lymphocytes on peripheral smear. What is the MOST likely diagnosis?
A 60-year-old patient presents with fatigue and easy bruising. Lab results show Hgb 10.1 g/dL, platelets 89,000/uL, WBC 31,300/uL with mature lymphocytes on peripheral smear. What is the MOST likely diagnosis?
A 55-year-old man presents with bone pain and fatigue. Labs show normocytic anemia and increased serum globulin. Peripheral blood smear shows rouleaux formation. Radiographs reveal osteolytic lesions. Bone scan is normal. What is the MOST likely diagnosis?
A 55-year-old man presents with bone pain and fatigue. Labs show normocytic anemia and increased serum globulin. Peripheral blood smear shows rouleaux formation. Radiographs reveal osteolytic lesions. Bone scan is normal. What is the MOST likely diagnosis?
Which of the following statements regarding fecal occult blood testing (FOBT) for colorectal cancer screening is CORRECT?
Which of the following statements regarding fecal occult blood testing (FOBT) for colorectal cancer screening is CORRECT?
Screening for prostate cancer with Prostate-Specific Antigen (PSA) is controversial for several reasons. Which of the following is a PRIMARY reason for this controversy?
Screening for prostate cancer with Prostate-Specific Antigen (PSA) is controversial for several reasons. Which of the following is a PRIMARY reason for this controversy?
Which of the following statements concerning catheter-associated urinary tract infections (CAUTIs) is CORRECT?
Which of the following statements concerning catheter-associated urinary tract infections (CAUTIs) is CORRECT?
A 69-year-old female develops abdominal pain, fever, and bloody diarrhea four days after completing a 10-day course of ampicillin for a UTI. Sigmoidoscopy shows pseudomembranous plaques. What is the MOST likely diagnosis?
A 69-year-old female develops abdominal pain, fever, and bloody diarrhea four days after completing a 10-day course of ampicillin for a UTI. Sigmoidoscopy shows pseudomembranous plaques. What is the MOST likely diagnosis?
A 75-year-old woman presents with fatigue, weight loss, and painful purple hands on cold exposure. Labs show anemia, macrocytosis, and a positive direct Coombs test at 4°C but negative at 37°C. Which underlying condition is MOST likely?
A 75-year-old woman presents with fatigue, weight loss, and painful purple hands on cold exposure. Labs show anemia, macrocytosis, and a positive direct Coombs test at 4°C but negative at 37°C. Which underlying condition is MOST likely?
A 72-year-old man presents with fatigue, headache, pruritus after warm baths, plethora, and splenomegaly. Hematocrit is 63%, with leukocytosis and thrombocytosis. Peripheral blood smear is normal. What is the MOST likely diagnosis?
A 72-year-old man presents with fatigue, headache, pruritus after warm baths, plethora, and splenomegaly. Hematocrit is 63%, with leukocytosis and thrombocytosis. Peripheral blood smear is normal. What is the MOST likely diagnosis?
A 78-year-old man from a long-term care facility presents with confusion, absent fever, and mild tachypnea. Chest radiography initially appears normal. Which infection should be strongly suspected based on this atypical presentation?
A 78-year-old man from a long-term care facility presents with confusion, absent fever, and mild tachypnea. Chest radiography initially appears normal. Which infection should be strongly suspected based on this atypical presentation?
A 75-year-old woman has bacteriuria detected incidentally on a routine urinalysis during her annual physical. She has no urinary symptoms. What is the most appropriate management for this patient?
A 75-year-old woman has bacteriuria detected incidentally on a routine urinalysis during her annual physical. She has no urinary symptoms. What is the most appropriate management for this patient?
An 85-year-old man develops painful vesicular lesions along one side of his chest wall. He presents within 24 hours of symptom onset. Which of the following is the most appropriate initial treatment?
An 85-year-old man develops painful vesicular lesions along one side of his chest wall. He presents within 24 hours of symptom onset. Which of the following is the most appropriate initial treatment?
Which of the following vaccines is recommended annually for all individuals over the age of 65?
Which of the following vaccines is recommended annually for all individuals over the age of 65?
A 70-year-old female nursing home resident is evaluated for suspected pneumonia. Which of the following diagnostic steps is most appropriate to perform initially?
A 70-year-old female nursing home resident is evaluated for suspected pneumonia. Which of the following diagnostic steps is most appropriate to perform initially?
An 80-year-old patient with anemia presents with hypochromic red blood cells, elevated serum iron, and ringed sideroblasts on bone marrow biopsy. Which of the following treatments is most appropriate?
An 80-year-old patient with anemia presents with hypochromic red blood cells, elevated serum iron, and ringed sideroblasts on bone marrow biopsy. Which of the following treatments is most appropriate?
A 68-year-old man presents with progressive fatigue and lymphadenopathy. CBC reveals lymphocyte count of 90,000 cells/mm³. Peripheral smear shows mature lymphocytes. The malignant cells test positive for CD5. Which diagnosis is most likely?
A 68-year-old man presents with progressive fatigue and lymphadenopathy. CBC reveals lymphocyte count of 90,000 cells/mm³. Peripheral smear shows mature lymphocytes. The malignant cells test positive for CD5. Which diagnosis is most likely?
An 80-year-old patient presents with chronic lower back pain, normocytic anemia, and elevated serum globulins. Imaging shows multiple lytic bone lesions. What condition is most consistent with these findings?
An 80-year-old patient presents with chronic lower back pain, normocytic anemia, and elevated serum globulins. Imaging shows multiple lytic bone lesions. What condition is most consistent with these findings?
Which hematologic disorder is characterized by JAK2 mutation, elevated hematocrit, risk of thrombosis, and generalized proliferation of all blood cell lines, especially red blood cells?
Which hematologic disorder is characterized by JAK2 mutation, elevated hematocrit, risk of thrombosis, and generalized proliferation of all blood cell lines, especially red blood cells?
An elderly patient with anemia is evaluated and found to have low serum iron, low transferrin saturation, and elevated ferritin. Which of the following conditions is most likely?
An elderly patient with anemia is evaluated and found to have low serum iron, low transferrin saturation, and elevated ferritin. Which of the following conditions is most likely?
An 82-year-old man in a long-term care facility develops acute confusion, functional decline, and new urinary incontinence without fever or significant leukocytosis. Which of the following should be considered first?
An 82-year-old man in a long-term care facility develops acute confusion, functional decline, and new urinary incontinence without fever or significant leukocytosis. Which of the following should be considered first?
An 85-year-old patient recovering from hip surgery develops fever, abdominal cramps, and watery diarrhea after recent antibiotic therapy. Colonoscopy reveals hyperemic mucosa. Which is the most likely causative organism?
An 85-year-old patient recovering from hip surgery develops fever, abdominal cramps, and watery diarrhea after recent antibiotic therapy. Colonoscopy reveals hyperemic mucosa. Which is the most likely causative organism?
A 75-year-old patient presents with fatigue, numbness of lower extremities, and anemia. Labs reveal elevated methylmalonic acid and homocysteine levels. What vitamin deficiency is most likely?
A 75-year-old patient presents with fatigue, numbness of lower extremities, and anemia. Labs reveal elevated methylmalonic acid and homocysteine levels. What vitamin deficiency is most likely?
An 88-year-old woman presents with fatigue, weight loss, and Raynaud's phenomenon. Lab evaluation shows mild anemia, thrombocytopenia, and elevated lymphocyte count. Direct Coombs test is positive. What is the most likely underlying diagnosis?
An 88-year-old woman presents with fatigue, weight loss, and Raynaud's phenomenon. Lab evaluation shows mild anemia, thrombocytopenia, and elevated lymphocyte count. Direct Coombs test is positive. What is the most likely underlying diagnosis?
A 70-year-old man complains of headaches, dizziness, pruritus after bathing, and blurred vision. Physical exam reveals splenomegaly and plethoric appearance. Labs show elevated hematocrit and low EPO levels. What diagnosis is most likely?
A 70-year-old man complains of headaches, dizziness, pruritus after bathing, and blurred vision. Physical exam reveals splenomegaly and plethoric appearance. Labs show elevated hematocrit and low EPO levels. What diagnosis is most likely?
Which of the following vaccination recommendations is correct for older adults regarding pneumococcal disease prevention?
Which of the following vaccination recommendations is correct for older adults regarding pneumococcal disease prevention?
A 73-year-old male nursing home resident develops increased confusion, a respiratory rate of 28 breaths per minute, and reduced food intake. Which initial diagnostic step is appropriate?
A 73-year-old male nursing home resident develops increased confusion, a respiratory rate of 28 breaths per minute, and reduced food intake. Which initial diagnostic step is appropriate?
Which of the following findings distinguishes anemia of chronic disease (ACD) from iron deficiency anemia (IDA)?
Which of the following findings distinguishes anemia of chronic disease (ACD) from iron deficiency anemia (IDA)?
A 67-year-old woman presents with fatigue, angular cheilitis, and glossitis. Lab evaluation reveals anemia and low serum ferritin. What is the next most appropriate step in managing this patient?
A 67-year-old woman presents with fatigue, angular cheilitis, and glossitis. Lab evaluation reveals anemia and low serum ferritin. What is the next most appropriate step in managing this patient?
A 77-year-old nursing home resident has acute mental status changes, fever, shaking chills, and hypotension. The patient has an indwelling urinary catheter. Which is the most appropriate initial evaluation?
A 77-year-old nursing home resident has acute mental status changes, fever, shaking chills, and hypotension. The patient has an indwelling urinary catheter. Which is the most appropriate initial evaluation?
A 77-year-old woman presents with macrocytic anemia and neurological symptoms including paresthesias. Serum methylmalonic acid and homocysteine levels are elevated. Which is the correct treatment for this patient?
A 77-year-old woman presents with macrocytic anemia and neurological symptoms including paresthesias. Serum methylmalonic acid and homocysteine levels are elevated. Which is the correct treatment for this patient?
A 68-year-old man is diagnosed with polycythemia vera. Which medication would specifically help prevent complications associated with hyperuricemia?
A 68-year-old man is diagnosed with polycythemia vera. Which medication would specifically help prevent complications associated with hyperuricemia?
An 80-year-old man complains of fatigue, recurrent infections, and diffuse bone pain. Laboratory findings reveal anemia, hypercalcemia, and a monoclonal spike in serum protein electrophoresis. Which of the following additional findings would support this diagnosis?
An 80-year-old man complains of fatigue, recurrent infections, and diffuse bone pain. Laboratory findings reveal anemia, hypercalcemia, and a monoclonal spike in serum protein electrophoresis. Which of the following additional findings would support this diagnosis?
Which of the following statements regarding herpes zoster vaccination in elderly patients is correct?
Which of the following statements regarding herpes zoster vaccination in elderly patients is correct?
A 79-year-old woman has had increasing fatigue, pale conjunctiva, exertional dyspnea, and syncope. CBC reveals Hgb of 9.5 g/dL, low serum iron, and elevated total iron binding capacity. What is the most likely diagnosis?
A 79-year-old woman has had increasing fatigue, pale conjunctiva, exertional dyspnea, and syncope. CBC reveals Hgb of 9.5 g/dL, low serum iron, and elevated total iron binding capacity. What is the most likely diagnosis?
A nursing home resident has acute confusion, decreased functional ability, and fever of 101°F following recent antibiotic therapy. You suspect Clostridium difficile infection. Which initial diagnostic test should you order?
A nursing home resident has acute confusion, decreased functional ability, and fever of 101°F following recent antibiotic therapy. You suspect Clostridium difficile infection. Which initial diagnostic test should you order?
According to USPSTF guidelines, how often should mammography screening be performed in women aged 50 to 74 years?
According to USPSTF guidelines, how often should mammography screening be performed in women aged 50 to 74 years?
Which colorectal cancer screening recommendation is correct for an otherwise healthy 65-year-old patient, according to USPSTF guidelines?
Which colorectal cancer screening recommendation is correct for an otherwise healthy 65-year-old patient, according to USPSTF guidelines?
A 70-year-old woman with a 35 pack-year smoking history, who quit smoking 10 years ago, presents for a routine physical exam. According to USPSTF guidelines, which screening test should be recommended?
A 70-year-old woman with a 35 pack-year smoking history, who quit smoking 10 years ago, presents for a routine physical exam. According to USPSTF guidelines, which screening test should be recommended?
A 69-year-old woman has had consistently normal Pap smears. According to current guidelines, when should cervical cancer screening be discontinued?
A 69-year-old woman has had consistently normal Pap smears. According to current guidelines, when should cervical cancer screening be discontinued?
A 70-year-old female patient without risk factors asks about ovarian cancer screening. What recommendation aligns with current guidelines?
A 70-year-old female patient without risk factors asks about ovarian cancer screening. What recommendation aligns with current guidelines?
What is the USPSTF recommendation regarding routine clinical skin cancer screening exams in older adults?
What is the USPSTF recommendation regarding routine clinical skin cancer screening exams in older adults?
A 76-year-old patient with no prior history of colorectal abnormalities asks about continuing colorectal cancer screening. According to USPSTF guidelines, which of the following is most appropriate?
A 76-year-old patient with no prior history of colorectal abnormalities asks about continuing colorectal cancer screening. According to USPSTF guidelines, which of the following is most appropriate?
According to USPSTF guidelines, how frequently should adults aged 65 and older receive influenza vaccinations?
According to USPSTF guidelines, how frequently should adults aged 65 and older receive influenza vaccinations?
Flashcards
Atypical Fever in Elderly Patients?
Atypical Fever in Elderly Patients?
Older adults often have reduced fever response and atypical infection symptoms.
Infection Risk Factors in Older Adults?
Infection Risk Factors in Older Adults?
More frequent hospital stays, physiological changes, chronic diseases and DM all increase infection risk.
Atypical Pneumonia Presentation in Elderly?
Atypical Pneumonia Presentation in Elderly?
Pneumonia presents atypically, often with confusion and minimal respiratory symptoms.
Healthcare-Associated Pneumonia in Elderly?
Healthcare-Associated Pneumonia in Elderly?
Signup and view all the flashcards
UTI diagnosis in elderly
UTI diagnosis in elderly
Signup and view all the flashcards
Treating Asymptomatic Bacteriuria in Elderly?
Treating Asymptomatic Bacteriuria in Elderly?
Signup and view all the flashcards
Herpes Zoster (HZ) in Elderly?
Herpes Zoster (HZ) in Elderly?
Signup and view all the flashcards
Herpes Zoster Vaccine Effectiveness?
Herpes Zoster Vaccine Effectiveness?
Signup and view all the flashcards
Influenza Vaccine Recommendation for Elderly?
Influenza Vaccine Recommendation for Elderly?
Signup and view all the flashcards
Pneumococcal Vaccine Schedule
Pneumococcal Vaccine Schedule
Signup and view all the flashcards
Infective Endocarditis in Elderly?
Infective Endocarditis in Elderly?
Signup and view all the flashcards
Septic Arthritis in Elderly?
Septic Arthritis in Elderly?
Signup and view all the flashcards
Infection in LTCF residents
Infection in LTCF residents
Signup and view all the flashcards
Anemia in Elderly?
Anemia in Elderly?
Signup and view all the flashcards
Iron Deficiency Anemia Evaluation?
Iron Deficiency Anemia Evaluation?
Signup and view all the flashcards
Differentiating Anemia of Chronic Disease?
Differentiating Anemia of Chronic Disease?
Signup and view all the flashcards
Sideroblastic Anemia
Sideroblastic Anemia
Signup and view all the flashcards
Vitamin B12 and Folate Deficiency
Vitamin B12 and Folate Deficiency
Signup and view all the flashcards
Chronic Lymphocytic Leukemia (CLL)?
Chronic Lymphocytic Leukemia (CLL)?
Signup and view all the flashcards
Multiple Myeloma in Elderly?
Multiple Myeloma in Elderly?
Signup and view all the flashcards
Polycythemia Vera
Polycythemia Vera
Signup and view all the flashcards
Cancer in the Elderly?
Cancer in the Elderly?
Signup and view all the flashcards
Cancer Screening
Cancer Screening
Signup and view all the flashcards
USPSTF Screening Age?
USPSTF Screening Age?
Signup and view all the flashcards
Lung Cancer Screening in Elderly?
Lung Cancer Screening in Elderly?
Signup and view all the flashcards
Prostate Cancer Screening?
Prostate Cancer Screening?
Signup and view all the flashcards
Atypical Pneumonia in Geriatrics
Atypical Pneumonia in Geriatrics
Signup and view all the flashcards
Urinary Tract Infection (UTI) in Elderly
Urinary Tract Infection (UTI) in Elderly
Signup and view all the flashcards
Pneumonia Diagnosis in Elderly
Pneumonia Diagnosis in Elderly
Signup and view all the flashcards
Anemia of Chronic Disease (ACD)
Anemia of Chronic Disease (ACD)
Signup and view all the flashcards
Vitamin B12 Deficiency Symptoms
Vitamin B12 Deficiency Symptoms
Signup and view all the flashcards
Non-Hodgkin Lymphoma
Non-Hodgkin Lymphoma
Signup and view all the flashcards
Clostridium difficile Colitis
Clostridium difficile Colitis
Signup and view all the flashcards
Skin Cancer Screening Unnecessary
Skin Cancer Screening Unnecessary
Signup and view all the flashcards
Iron Deficiency Anemia Treatment
Iron Deficiency Anemia Treatment
Signup and view all the flashcards
Catheter-Associated UTIs
Catheter-Associated UTIs
Signup and view all the flashcards
Vitamin B12 Deficiency Treatment
Vitamin B12 Deficiency Treatment
Signup and view all the flashcards
B12 Deficiency Diagnostic Marker
B12 Deficiency Diagnostic Marker
Signup and view all the flashcards
Allopurinol Use in Polycythemia Vera
Allopurinol Use in Polycythemia Vera
Signup and view all the flashcards
Rouleaux Formation in Myeloma
Rouleaux Formation in Myeloma
Signup and view all the flashcards
Annual Influenza Vaccination in Elderly
Annual Influenza Vaccination in Elderly
Signup and view all the flashcards
Lung Cancer Screening Criteria
Lung Cancer Screening Criteria
Signup and view all the flashcards
Study Notes
- Iron deficiency anemia presents with low ferritin; initial treatment is oral iron and further evaluation to determine underlying cause (GI blood loss).
- Catheter-associated UTIs in elderly with indwelling catheters require immediate urinalysis with culture for symptoms such as fever, chills, or delirium.
- Vitamin B12 deficiency presents with neurological symptoms and elevated methylmalonic acid levels; lifelong monthly IM injections required, especially in pernicious anemia.
- Allopurinol indicated in polycythemia vera to prevent hyperuricemia associated with increased cell turnover.
- Multiple myeloma is characterized by rouleaux formation of RBCs, monoclonal spike, bone pain, anemia, hypercalcemia, and recurrent infections.
- Septic arthritis in elderly frequently caused by Staphylococcus aureus or gram-negative bacilli, unlike younger adults where gonococcal arthritis is common.
- Herpes zoster vaccine reduces incidence of shingles by ~50% and postherpetic neuralgia by 66%.
- Iron deficiency anemia presents with fatigue, pallor, syncope, exertional dyspnea, low ferritin, high TIBC, and low serum iron.
- Antibiotic-associated diarrhea and colitis with fever, abdominal pain in elderly indicates C. difficile infection; stool assay confirms diagnosis.
- USPSTF recommends mammography screening every 2 years for women ages 50-74.
- USPSTF recommends against PSA screening in men ≥75 years due to low benefit and potential harm.
- Colonoscopy every 10 years recommended by USPSTF from ages 50–75 for colorectal cancer screening.
- USPSTF recommends annual low-dose chest CT screening for adults aged 50-80 with ≥30 pack-year smoking history, including those who quit within the past 15 years.
- Cervical cancer screening (Pap smears) stops at age 65 if prior screenings normal.
- USPSTF advises against routine ovarian cancer screening in asymptomatic women without genetic risk.
- USPSTF does not recommend routine skin cancer screening due to insufficient evidence for reducing mortality.
- USPSTF recommends discontinuation of routine colorectal cancer screening after age 75 if prior screens are normal.
- Annual influenza vaccine strongly recommended for all adults aged 65 and older to reduce morbidity and mortality.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
