NMS Q&A Family Medicine

316 NMS Q&A Family Medicineas the 70s while the subject may continue to function andgrow intellectually. That said, all reversible causes ofdementia must be ruled out. In addition to those conditionsdiscussed in Question 4, these conditions includechronic anemia, hypothyroidism, vitamin deficiencies,electrolyte imbalance, disease related to acquired immunodeficiencysyndrome and human immunodeficiencyvirus, congestive heart failure, and seizure disorders.11. The answer is D. Terazosin (Hytrin), when used tocombat benign prostatic hyperplasia or as an antihypertensive,may cause urinary incontinence, especially inwomen. Each of the other choices has anticholinergicactivity as a significant part of their pharmacologic effectivenessor as a significant side effect. Thus, urinary retentionis a logical sequela. Each of the choices has legitimateapplications in the aged population but must be utilizedprudently. Other drugs with anticholinergic side effectsinclude vincristine (anticancer drug); all the other calciumchannel blockers; all antihistamines; thioridazine(antipsychotic drug) and many other antipsychoticagents; and opiates, including hydrocodone, benztropine,and many others.ReferencesDickman R . Care of the elderly . In: Rakel RE , ed. Textbook ofFamily Practice . 6th ed . Philadelphia : WB Saunders ; 2002 :88 –130 .Family Medicine Review . Kansas City , Missouri ; May 3–10;2009.Johnston B , Harper GM , Landefeld S . Geriatric medicine . In:Tierney LM , McPhee SJ , Papadakis MA , eds. Current MedicalDiagnosis and Treatment . 45th ed . New York : McGraw-Hill/Appleton & Lange ; 2006 : 49 – 66 .Lyon C , Clark DC . Diagnosis of acute abdominal pain in olderpatients . Am Fam Physician . 2006 ; 74 : 1537 – 1544 .The Guide to Preventive Services 2009. Recommendations ofthe U.S. Preventive Services Task Force. Agency for HealthcareResearch and Quality .