NMS Q&A Family Medicine

chapter 54GeriatricsExamination questions: Unless instructed otherwise, choosethe ONE lettered answer or completion that is BEST ineach case.1 Which of the following is the most effective regimen,besides pre-procedure generous hydration, to protectagainst acute renal failure before injection of radiographiccontrast medium?(A) IV mannitol(B) IV furosemide(C) IV prednisone(D) N-acetylcysteine(E) IV diphenhydramine2 Which of the following most simply differentiates thepain of pedal fat pad atrophy (FPA) from plantar fasciitis(PF)?(A) Time of day when pain is the worst(B) Location of the pain(C) Drugs to which the pain responds(D) Response specifically to glucocorticoids(E) Response to footwear3 A 67-year-old woman with abdominal pain entersthe office of a family physician. Which of the followingstatements regarding the diagnosis of the pain inthis patient is true?(A) A surgical cause is ruled out by lack of fever andleukocytosis.(B) Acute cholecystitis is likely to present withradiating flank and back pain.(C) The patient’s chances of having ascendingcholangitis are greater than those for a youngerperson.(D) One can expect appendicitis to be accompaniedby a temperature of 100 F (37.7 C).(E) Elevated alkaline phosphatase levels will not behelpful in diagnosing ascending cholangitis.4 Which of the following is the most significant differencebetween “old–old” patients (75 years) andyounger patients in the diagnosis of perforated pepticulcer?(A) The 75 group has devastating pain heraldingperforation.(B) Patients older than 75 years are more likely todemonstrate free air under the diaphragm.(C) Serum amylase is less helpful in the diagnosis ofperforation of these patients than it is inpatients younger than 75 years.(D) Symptoms and signs of perforated viscus aremore likely to occur without prior symptoms inpatients older than 75 years.(E) Leukocytosis is more likely to be present in theolder patient than in the younger one.5 A 70-year-old man complains of abdominal pain thatis steady and building. Abdominal examinationreveals a widened abdominal aortic palpable pulsation;otherwise, it is remarkable only for vague deeptenderness (i.e., showing no rebound tenderness).Abdominal ultrasound discloses an aneurysm 5 cm indiameter below the origin of the renal arteries. Whichof the following is nearly certainly true regarding atheroscleroticrisk factors present in this patient?(A) Dyslipidemia(B) Smoking(C) Hypertension(D) Psychological stress(E) Diabetes type 26 An 80-year-old previously well and self-sufficientgreat-grandfather who lives alone is brought to thefamily doctor because of newly occurring falls, urinaryincontinence, and confusion over the past 4days. His temperature and blood pressure are normalfor him. Which of the following is the least likelycause of this change?(A) Acute pneumonia(B) Urinary tract infection(C) Acute myocardial infarction(D) Stroke(E) Alzheimer disease (AD)313