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Questions and Answers
Mr. Davidson, an 82-year-old man, presents to your clinic with a history of three falls in the past two months. He reports feeling light-headed and dizzy when he stands up from sitting. On examination, his blood pressure is 140/80 mmHg when seated and drops to 110/65 mmHg on standing. Which of the following medications is the likely culprit?
Mr. Davidson, an 82-year-old man, presents to your clinic with a history of three falls in the past two months. He reports feeling light-headed and dizzy when he stands up from sitting. On examination, his blood pressure is 140/80 mmHg when seated and drops to 110/65 mmHg on standing. Which of the following medications is the likely culprit?
80 years old with Parkinson has experienced several falls during past month. He does not report any dizziness or vertigo. His Parkinson is managed with levodopa and carbidopa. What is the most likely cause of his fall?
80 years old with Parkinson has experienced several falls during past month. He does not report any dizziness or vertigo. His Parkinson is managed with levodopa and carbidopa. What is the most likely cause of his fall?
A 75-years-old male with history of recurrent falls. Choice next step in his long-term management?
A 75-years-old male with history of recurrent falls. Choice next step in his long-term management?
A 75-year-old man with diabetes and osteoarthritis is evaluated in your clinic for recurring falls. Which of the following is most predictive of future dependence in his activities of daily living?
A 75-year-old man with diabetes and osteoarthritis is evaluated in your clinic for recurring falls. Which of the following is most predictive of future dependence in his activities of daily living?
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A 85 years old male came to the ED complaining of recurrent falls in the bathroom. He has multiple illnesses and on multiple drugs. Which drug increases the risk of falls?
A 85 years old male came to the ED complaining of recurrent falls in the bathroom. He has multiple illnesses and on multiple drugs. Which drug increases the risk of falls?
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Which of these factors increases the risk of fall?
Which of these factors increases the risk of fall?
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A 77-year-old male with a 6-month history of recurrent falls. He is on furosemide for hypertension and insulin for diabetes. Which of the following reduces the risk of recurrent falls?
A 77-year-old male with a 6-month history of recurrent falls. He is on furosemide for hypertension and insulin for diabetes. Which of the following reduces the risk of recurrent falls?
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Which of the following multifactorial interventions for falls has the strongest evidence (evidence A)?
Which of the following multifactorial interventions for falls has the strongest evidence (evidence A)?
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An 87-year-old woman fell three days ago in her home while walking out of her bathroom. She has a past medical history of T2DM, peripheral neuropathy, hypertension, and osteoarthritis. She takes glipizide for her DM, lisinopril for her HTN, amitriptyline 100 mg for neuropathy, and acetaminophen, as needed for joint pain. On examination, her postural vital signs are unremarkable. Which of these would you do first to decrease the risk repeat falls?
An 87-year-old woman fell three days ago in her home while walking out of her bathroom. She has a past medical history of T2DM, peripheral neuropathy, hypertension, and osteoarthritis. She takes glipizide for her DM, lisinopril for her HTN, amitriptyline 100 mg for neuropathy, and acetaminophen, as needed for joint pain. On examination, her postural vital signs are unremarkable. Which of these would you do first to decrease the risk repeat falls?
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A 70-year-old-male with diabetes, hypertension, dementia and benign prostatic hypertrophy with urinary incontinence. The patient was started on clonazepam and tolterodine (antimuscarinic) for his incontinence. Two weeks later, he comes to the ER with a hip fracture due to a fall. Choose the next step in management?
A 70-year-old-male with diabetes, hypertension, dementia and benign prostatic hypertrophy with urinary incontinence. The patient was started on clonazepam and tolterodine (antimuscarinic) for his incontinence. Two weeks later, he comes to the ER with a hip fracture due to a fall. Choose the next step in management?
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A 74-years-old woman with recurrent falls is seen in your clinic with her daughter. She has a history of mild dementia, congestive heart failure, coronary artery disease, and hypertension. She takes furosemide, lisinopril, aspirin, metoprolol, olanzapine, and simvastatin currently. She lives by herself in an apartment she has lived in for 40 years and is assisted with housekeeping once a week. Her physical strength is unremarkable for decreased proximal muscle strength. Which of the following is an intervention for decreasing her risk of falling?
A 74-years-old woman with recurrent falls is seen in your clinic with her daughter. She has a history of mild dementia, congestive heart failure, coronary artery disease, and hypertension. She takes furosemide, lisinopril, aspirin, metoprolol, olanzapine, and simvastatin currently. She lives by herself in an apartment she has lived in for 40 years and is assisted with housekeeping once a week. Her physical strength is unremarkable for decreased proximal muscle strength. Which of the following is an intervention for decreasing her risk of falling?
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77 year old brought to ER by his son in law due to altered LOC. He is bedridden, has ecchymosis on both arms, and has sacral ulcers. His daughter and son in law reported that the patient is paranoid about being poisoned, what is most likely the cause of his findings?
77 year old brought to ER by his son in law due to altered LOC. He is bedridden, has ecchymosis on both arms, and has sacral ulcers. His daughter and son in law reported that the patient is paranoid about being poisoned, what is most likely the cause of his findings?
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Which medication increases the risk of falls?
Which medication increases the risk of falls?
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A 70-year-old male with a long history of poorly controlled type 2 diabetes is brought to the hospital with altered mental status, polyuria, and severe dehydration. His blood glucose is 600 mg/dL, but ketones are absent in the urine. His serum osmolality is calculated to be 333 mOsm/kg. What is the most likely diagnosis?
A 70-year-old male with a long history of poorly controlled type 2 diabetes is brought to the hospital with altered mental status, polyuria, and severe dehydration. His blood glucose is 600 mg/dL, but ketones are absent in the urine. His serum osmolality is calculated to be 333 mOsm/kg. What is the most likely diagnosis?
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A 40-ycar-old male with type 1 diabetes and recent poor glycemic control is experiencing frequent episodes of hypoglycemia, particularly late at night and early morning. His current regiment includes basal-bolus insulin therapy with insulin glargine and insulin aspart. Which of the following adjustments in his management is most appropriate?
A 40-ycar-old male with type 1 diabetes and recent poor glycemic control is experiencing frequent episodes of hypoglycemia, particularly late at night and early morning. His current regiment includes basal-bolus insulin therapy with insulin glargine and insulin aspart. Which of the following adjustments in his management is most appropriate?
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What is the most common neuropathic complication in DM?
What is the most common neuropathic complication in DM?
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A 54-year-old diabetic patient presented to the clinic with BP of 200/100 Hg mm, the rest of the question was forgotten……… What is the diagnosis?
A 54-year-old diabetic patient presented to the clinic with BP of 200/100 Hg mm, the rest of the question was forgotten……… What is the diagnosis?
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Diabetics have increased risk of heart diseases if they are also exposed to which of the following factors?
Diabetics have increased risk of heart diseases if they are also exposed to which of the following factors?
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A 65 year old man with diabetes and hypertension presented to the ED with bp 140/90 and high creatinine. What medication will protect his kidneys?
A 65 year old man with diabetes and hypertension presented to the ED with bp 140/90 and high creatinine. What medication will protect his kidneys?
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In fasting glucose level, what is the threshold to diagnose diabetes?
In fasting glucose level, what is the threshold to diagnose diabetes?
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Which of the following is NOT used to screen for diabetes?
Which of the following is NOT used to screen for diabetes?
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Which of the following is the MOST evidence - based strategy to prevent or delay the onset of Type 2 diabetes?
Which of the following is the MOST evidence - based strategy to prevent or delay the onset of Type 2 diabetes?
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Which of the following diabetes drugs acts by decreasing the amount of glucose produced by the liver?
Which of the following diabetes drugs acts by decreasing the amount of glucose produced by the liver?
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Which of the following is the most sensitive test to diagnose diabetic nephropathy?
Which of the following is the most sensitive test to diagnose diabetic nephropathy?
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A 49 - years - old male non - smoker diabetic patient has been on Rosuvastatin 20 mgs daily for primary prevention. His target serum LDL - C should be at least:
A 49 - years - old male non - smoker diabetic patient has been on Rosuvastatin 20 mgs daily for primary prevention. His target serum LDL - C should be at least:
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For a 60 - year - old woman with uncomplicated T2DM for 10 years which of following is the most appropriate screening test for diabetic nephropathy?
For a 60 - year - old woman with uncomplicated T2DM for 10 years which of following is the most appropriate screening test for diabetic nephropathy?
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Which medication is the most appropriate first line therapy for an obese patient with type 2 diabetes?
Which medication is the most appropriate first line therapy for an obese patient with type 2 diabetes?
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A diabetic patient is controlled on insulin. He also takes aspirin, and statin for hyperlipidemia, which is also controlled. He has proteinuria and elevated BP148/90. All labs are normal except for a slight increase in creatinine. What is the next step in management?
A diabetic patient is controlled on insulin. He also takes aspirin, and statin for hyperlipidemia, which is also controlled. He has proteinuria and elevated BP148/90. All labs are normal except for a slight increase in creatinine. What is the next step in management?
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A 32 y/o man with T2DM on metformin and sitagliptin. His renal, liver, functions are normal, what’s his glycemic target?
A 32 y/o man with T2DM on metformin and sitagliptin. His renal, liver, functions are normal, what’s his glycemic target?
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A 47 year old patient with hypertension and DM for 5 years. His average blood pressure for 3 readings was 140/90. All other investigations were normal except his albumin which was 30 (normal albumin <5). What is the best recommended treatment?
A 47 year old patient with hypertension and DM for 5 years. His average blood pressure for 3 readings was 140/90. All other investigations were normal except his albumin which was 30 (normal albumin <5). What is the best recommended treatment?
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A 42 year - old female with body mass index 32, fasting plasma glucose 8.2 mmol, her renal electrolyte hepatic labs were all normal , what is appropriate management?
A 42 year - old female with body mass index 32, fasting plasma glucose 8.2 mmol, her renal electrolyte hepatic labs were all normal , what is appropriate management?
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Study Notes
Medicine I - KSAU-HS
- Course materials include questions from batches 6-10 and previous batches, as well as a correction file.
Exam Contents
- Lectures: Recurrent Falls, Diabetes for Supervision, Choice of Imaging, Pulmonary Embolism, Asthma/COPD, Acute Monoarthritis, IBD, Thyroid Swelling, Hypertension, Systemic Vasculitis, Heart Failure, Abnormal Electrolyte, High Cholesterol for Treatment, Jaundice, Renal Failure, Viral Hepatitis, Unrelated Question, Case Discussion
- PBLs: COPD, Murky Waters, What Does This Mean?, An Uphill Battle, Amenorrhea, A dragging pain, Aching Joints, Burning up
Recurrent Falls
- Case 1: 82-year-old male with history of 3 falls, blood pressure drops on standing. Likely culprit medication: Amlodipine
- Case 2: 80-year-old with Parkinson's disease, falls without dizziness. Likely cause: Postural instability due to Parkinson
- Case 3: 75-year-old male with recurrent falls. Next step: correct management of postural hypotension.
- Case 4: 75-year-old with diabetes and osteoarthritis. Predictive of future dependence: T score on bone density test (-2.7), >20 difference in sitting/standing blood pressure, 10 seconds in Get Up and Go test, Mini mental status (28/30).
- Case 5: 85-year-old male with multiple illnesses and multiple drugs. Medication increasing risk of falls: Indapamide
- Case 6: Risk factors for falls: Age > 70, Black ethnicity, Arthritits.
- Case 7: 77-year-old with hypertension and diabetes. To reduce risk of falls: Change medication (furosemide).
- Case 8: Strongest multifactorial interventions for falls: Exercise and gait training.
- Case 9: 87 year-old woman fell. First step in decreasing risk of falls: Change amitriptyline to another drug for neuropathy, recommend hip protectors.
- Case 10: 74 year-old male with multiple health problems and incontinence. Treatment: Stop tolterodine
- Case 11: 74-year-old woman with recurrent falls. Intervention: Balance and gait training exercises, discontinue olanzapine
- Case 12: 77-year-old man with altered LOC. Cause: Elderly abuse
- Case 13: Medication increasing risk of falls: Enalapril
Diabetes for Supervision
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Case 1: 70-year-old with altered mental status, polyuria, and severe dehydration. Glucose: 600 mg/dL. Diagnosis: Hyperglycemic hyperosmolar state
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Case 2: 40-year-old with recurrent hypoglycemia, especially at night. Management: Decrease insulin aspart with evening meals, Switch insulin glargine to insulin degludec.
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Case 3: Most common neuropathic complication in DM: Distal symmetrical polyneuropathy
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Case 4: Diagnosis: Diabetic Nephropathy
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Case 5 & 6: Risk factors for heart disease in diabetes include smoking, high HDL cholesterol
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Case 7: Fasting glucose threshold for diabetes diagnosis: 7 mmol/L
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Case 8: Glucose tolerance tests: 50 g glucose, 75g glucose, fasting blood glucose, and random glucose. Which is NOT used to screen for diabetes: 50 g glucose tolerance test.
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Case 9: Evidence-based strategy to prevent type 2 diabetes: Weight reduction and daily exercise followed by daily exercise and a low glycemic index diet
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Case 10: Medication decreasing liver glucose production: Biguanides
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Case 11: Most sensitive test for diagnosing diabetic nephropathy: Urine microalbuminuria measurement
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Case 12: Target serum LDL-C for a 49-year-old diabetic on Rosuvastatin 20mg daily: <2.6 mmol/L
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Case 13: Diabetic nephropathy screening test: Early morning urine for albumin/creatinine ratio
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Case 14: First-line therapy for obese type 2 diabetes patient: Metformin
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Case 15: Management of a diabetic patient with slight increased creatinine and proteinuria, elevated BP: Start Lisinopril.
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Case 16: Glycemic target for a 32-year-old male with T2DM: HbA1c 6.5–6.5%
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Case 17: Treatment for a 47-year-old with hypertension and DM, albumin 30: Start ACE inhibitors
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Case 18: Management in a 42-year-old female with BMI 32, fasting plasma glucose 8.2mmol/L: Start Metformin
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Case 19: Management in a 63-yr-old with uncontrolled diabetes, renal failure & hypoglycemia: HbA1c target between 6.5–7.
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Case 20: Intervention for a decreased proximal muscle strength in a 74-year-old with multiple comorbidities: Balance and gait training.
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Case 21: Most likely cause of findings in 77-year-old man: Dementia
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Case 22: Treatment for 70-year-old male with incontinence, on clonazepam and tolterodine: Choose the next step in management
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Case 23: Medication increasing risk of falls: A- Metformin B- Atorvastatin C- Enalapril D- Montelukast
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Case 24: Appropriate first-line therapy in a 70-year-old man with diabetes & hypertension, proteinuria and >1 elevation in creatinine: Start Lisinopril
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Case 25: What is the medication implicated in 32yo male with raised creatinine and BP of 180/110, decreased LOC and SOB: Consider ACE inhibitors.
Choice of Imaging
- Case 1: 25-year-old male with lower back pain, positive straight leg raise test: MRI lumbar spine
- Case 2: Drowsy patient with hyper density in CT head: Intracranial hemorrhage.
- Case 3: Definition of Half-life: Time needed for half amount to decay.
- Case 4 Patient injected with Tc99m-MAG3: Obstructed kidney.
- Case 5: Pneumothorax case: Chest X-ray
- Case 6: 28-year-old male with painless left testicular mass: Testicular US
- Case 7: 40-year-old female with abdominal pain, positive fluid thrill: Abdominal paracentesis
- Case 8: 60-year-old female with acute pleuritic chest pain, dyspnea: Chest CT-angiogram
- Case 9: 45-year-old male with renal failure: Ultrasound study for kidney
- Case 10: 40-year-old male with headache, nausea and vomiting: Brain CT scan
- Case 11: 28-year-old male with pain after air travel: Chest X-ray
- Case 12: 28 year-old male with painless left testicle mass: Testicular US
- Case 13: 60-year-old female with chronic cough and weight loss: CT chest
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Description
Test your knowledge on critical medical topics covered in the Medicine I course at KSAU-HS. This quiz includes cases related to recurrent falls, pulmonary embolism, diabetes management, and more, providing a comprehensive review of your preparation for exams. Dive into patient scenarios and clinical considerations to enhance your understanding.
