There is a decreased absorption of acidic alkaline( acidic, alkaline ) drugs such as phenytoin, aspirin and penicillins in elderly patients due to an increasingly alkaline acidic( alkaline, acidic ) gastric pH
Elderly people have a higher lower( higher, lower ) volume of distribution of lipophilic drugs than the general population.
Grapefruit Juice, in theory, causes myalgia in patients who take which of the following medication types?
Statins
Antimuscarinics
Calcium Channel Blockers
Beta Blockers
ACE Inhibitors
Cranberry juice is known to lower a patient's INR, thus making thromboembolism more likely.
The end of a human chromosome, which progressively shortens within each cell replication, is called the
In humans, a telomere consists of multiple repeats of which single motif:
TTAGGG
AATCCC
CCGTTT
GCCAAA
Relating to telomeres, the limit is the number of times a normal human cell population will divide before cell division stops
Sepsis in elderly patients usually presents with a decreased an increased( a decreased, an increased ) temperature
Delirium typically has a fluctuating progressive( fluctuating, progressive ) course
Hypoactive hyperactive( Hypoactive, hyperactive ) delirium has twice the mortality rate of hyperactive hypoactive( hyperactive, hypoactive ) delirium
In terms of the 4AT score: In terms of Alertness, a patient who has mild sleepiness for <10s after waking then is normal receives which score?
0
1
2
3
4
In terms of the 4AT score: A patient whose alertness is judged to be 'clearly abnormal' would receive a score of ...
In terms of the 4AT score: After Alertness, the second part of the 4AT score assesses AMT4, which involves the patient stating their age, DOB, where they are and the current year. No mistakes warrants a score of 0 1 2( 0, 1, 2 ) 1 mistake warrants a score of 1 2 3( 1, 2, 3 ) 2 or more mistakes warrants a score of 2 1 3 4( 2, 1, 3, 4 )
In terms of the 4AT score: After assessing 4AT, the patient has their attention span assessed. In order to do this, the patient is asked to name the months of the year backwards from December. Achieves 7 months or more correctly = 0 1 2( 0, 1, 2 ) Starts but scores <7 months/refuses to start = 1 0 2 3( 1, 0, 2, 3 ) Untestable (too unwell, too drowsy, etc) = 2 4 3( 2, 4, 3 )
In terms of the 4AT score: After testing attention, the last parameter which is tested is the presence of an acute or fluctuating course (i.e. evidence of significant change or fluctuation in alertness, cognition, etc) A fluctuating course warrants a score of 4 1 2 3( 4, 1, 2, 3 )
The maximum score a patient can get for the 4AT is
12
8
10
6
16
In delirious patients, which medication is first line for sedation if it is needed (e.g. if patient is psychotic or refusing to stay in bed)?
For sedation of delirious patients, Haloperidol should be given intramuscularly.
Delirium is a risk factor for developing dementia
Age related loss of muscle mass and function is called
Muscle mass starts to decline as of age 30 25 35 40( 30, 25, 35, 40 )
The suggested target for physical activity in the elderly population (65+) is the same as it is for the adult population (18-64)
Weekly Physical Activity Guidelines for Adults (18-64) and Elderly (65+): minutes of moderate intensity activity OR minutes of vigorous intensity activity Strength and balance work should also be included at least times per week
Which of the following has been shown to increase muscle function associated with sarcopenia in elderly patients?
Dopamine Agonists
Levothyroxine
When stepping up a patient from codeine to morphine for analgesia, the following must be considered: 10mg of Codeine is equivalent to mg of morphine.
In order to convert the dosage of MST Morphine to the equivalent dosage of Oramorph, you divide the former by 6 5 4( 6, 5, 4 ).
For example, a patient on 60mg of MST would take 10 12 15( 10, 12, 15 )mg of Oramorph to have the same effect.
Smoothest delivery of medicines in palliative care patients is via a continuous subcutaneous infusion using a driver
In terms of using Syringe Drivers to administer medications in the elderly, how many different medicines can be mixed together in one syringe?
Only 1
Morphine is two times three times half( two times, three times, half ) as potent when given subcutaneously (as opposed to oral administration)
Arrange the steps of pharmacokinetics in order starting with the point the drug enters the body. ❌ ❌ ❌ ❌
Elderly people typically have a decreased increased( decreased, increased ) small bowel surface area
Protein binding of drugs: ❌ binds to Acidic Drugs ❌ binds to Alkaline Drugs
Elderly patients typically have decreased increased( decreased, increased ) albumin levels and increased decreased( increased, decreased ) alpha-1 acid glycoprotein levels
Elderly patients typically have a decreased increased( decreased, increased ) body water level.
Very importantly, the Volume of Distribution of Hydrophilic drugs (lithium, digoxin, etc) in elderly patients is decreased increased( decreased, increased ).
It is generally accepted that higher doses of medications are needed to achieve the same effects in the elderly population.
Which of the following minerals interferes with levothyroxine
Calcium
Potassium
Sodium
Verapamil (CCB) should never been given with which drug type, for fear of causing symptomatic heart block?
Beta Blocker
Anticonvulsants
Thiazide Diuretics
