Geriatric cases

An 85-year-old man was admitted to hospital with anorexia, nausea and vomiting.
He was known to have atrial fibrillation, congestive cardiac failure and chronic
renal impairment. He was on digoxin 250 micro gram once daily and furosemide
80 mg twice daily.
His serum biochemistry revealed the following (normal range in parentheses):

Question:
What are the likely causes of medical problems in this patient and how should
the drug therapy be altered?
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A 75-year-old lady who suffered from osteoarthritis of hip and knee joints
presented with a history of passing black stools. Her drug therapy included
diclofenac 50 mg three times daily and paracetamol 1 g as required.

Question
What is the likely cause of this patient's symptoms?
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A 75-year-old woman reports urinary urgency, frequency, and loss of urine when
she cannot get to the bathroom in time. She also wears a pad at night that she
changes two or three times because of incontinence. Her medical history is
significant for Mild Cognitive Impairment (MMSE score 25/30), OA, and
hypothyroidism. A urinalysis is negative. Physical examination is normal, and her
post void residual( PVR) is normal (less than 100 mL).
Q1. Which type of UI does the patient have?

Q2. Which therapy would be best to initiate for this patient at this time?
A. Mirabegron.
B. Darifenacin.
C. Pelvic floor exercises and solifenacin.
D. Pelvic floor exercises

A 50 year old patient suffering from anxiety , which of the following

benzodiazepines is appropriate and why ?

A – diazepam

B – lorazepam

C – a&b

D – oxazepam and diazepam

Mrs X came to the hospital and reported that her problem started 5 months
earlier, following the birth of her third child. She stated that she wet herself if she
sneezed or coughed and had reduced her fluid intake in an effort to prevent this
from occurring. She also urinated more frequently to ensure her bladder is empty.
The patient had no relevant bowel problems and was menstruating normally.

1- What is the most appropriate diagnosis of this case ?

2- Available treatment for this case ?

Illustrate pharmacokinetic changes in metabolism in geriatric patient .