An 82-year-old patient has decreased glomerular filtration rate (GFR) despite a serum creatinine of 0.9 mg/dL. Which physiologic aging change explains this finding?
Physiologic Aging
Question · Medium
Which age-related cardiovascular change increases risk of postural hypotension in older adults?
Which respiratory change is a hallmark of normal aging?
Question · Easy
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Which finding distinguishes delirium from dementia in an 85-year-old hospitalized patient?
Geriatric Syndromes
Which is the most common precipitant of delirium in a hospitalized older adult?
Which assessment tool is the gold standard for cognitive screening in primary care for older adults?
Cognitive Disorders
A 78-year-old has had two falls in the past year. Which is the most important assessment?
Which intervention has the strongest evidence for preventing falls in community-dwelling older adults?
A 72-year-old has slow gait speed, weak grip strength, low activity, exhaustion, and weight loss. Which syndrome is most consistent with these findings?
Which is the first-line treatment for stress urinary incontinence in an older woman?
Which is the most appropriate medication for an 80-year-old with urge urinary incontinence and no contraindications?
Polypharmacy
Which is the recommended target blood pressure for adults aged 65+ with hypertension per the 2017 ACC/AHA guidelines and updates?
Chronic Conditions
An 84-year-old with type 2 diabetes and frailty has an A1c of 7.5%. What is the appropriate target?
Which diabetes medication is preferred for an 80-year-old with frailty, eGFR 45, and risk of hypoglycemia?
Which medication class should be avoided in older adults with heart failure with preserved ejection fraction (HFpEF) per the 2022 AHA/ACC/HFSA guidelines?
Question · Hard
An 86-year-old with mild Alzheimer disease, MMSE 22/30, has clinical deterioration. Which medication is appropriate as first-line?
Which feature distinguishes Lewy body dementia from Alzheimer disease?
Which is the most appropriate first step in managing behavioral and psychological symptoms of dementia (BPSD) in a long-term care resident?
Which is the MOST important first step in deprescribing for an elderly patient on 12 medications?
Which of the following medications is on the AGS Beers Criteria "avoid" list for older adults?
Which is the most appropriate first-line analgesic for chronic non-cancer pain in an older adult?
Which is the appropriate management of a 75-year-old with mild dehydration and a serum sodium of 124 mEq/L?
Which screening test is recommended by USPSTF for osteoporosis in women?
Which medication is first-line for postmenopausal osteoporosis (T-score <= -2.5)?
Which is the recommended workup for unintentional weight loss of >5% in 6 months in an older adult?
Functional Assessment
Which is the most appropriate first-line treatment for major depressive disorder in an older adult with no contraindications?
Which is the most common cause of acute confusion in a long-term care resident?
An older patient is found to have asymptomatic bacteriuria. What is the recommended management?
An 85-year-old presents with progressive dyspnea, fatigue, and inability to climb stairs. Echocardiogram shows EF 40% and severe aortic stenosis (mean gradient 50 mmHg, AVA 0.7 cm²). What is the most appropriate management?
Which is the recommended pneumococcal vaccination schedule for an 80-year-old who has never been vaccinated?
Which vaccine is recommended for adults 50+ for shingles prevention?
Which is the most appropriate management of an 82-year-old with mild cognitive impairment and atrial fibrillation (CHA2DS2-VASc score = 4)?
Which is most appropriate for an 88-year-old patient with stage 4 metastatic cancer who is hospitalized for refractory dyspnea and pain, with limited life expectancy?
End Of Life
What is the Medicare hospice benefit eligibility criterion?
Which is the recommended initial opioid for moderate-to-severe pain in an opioid-naive older adult with normal renal function?
Which test best assesses functional status of an older adult in the office?
Which finding most strongly suggests elder abuse in an older adult presenting with multiple bruises?
Ethics Legal
An 85-year-old with mild dementia (MMSE 22) wants to refuse a recommended cataract surgery. Which is the most appropriate assessment of decision-making capacity?
Which is the most appropriate use of an advance directive (POLST/MOLST)?
Which finding is most specific for normal-pressure hydrocephalus (NPH)?
Which is the most appropriate intervention for an older adult with fecal incontinence due to overflow secondary to fecal impaction?
Which factor most predicts successful rehabilitation after hip fracture in an older adult?
Which is the most appropriate approach to transitions of care from hospital to home for an older adult?
Which is the most appropriate management of mild cognitive impairment (MCI) in an older adult?
Which laboratory finding is most consistent with malnutrition in an older adult?
Which physiologic change explains why older adults have decreased thermoregulation and are at risk for hypothermia and heat illness?
An older adult presents with new constipation. What is the most important step?
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