[GERIA] Quiz 1
1. Fundamentally, Geriatric Medicine
encompasses three essential “bodies
of knowledge”. These are, except,
a. Gerontology
b. Disease-specific
c. Complexity
d. Frailty
Three essential bodies of knowledge:
Gerontology, Disease specific and
Complexity. Brocklehurst’s Textbook of
Geriatrics Med & Gerontology p. 1
2. Frailty is characterised by the
following except;
a. Weakness
b. Slow walking speed
c. Low physical activity
d. Anorexia
weakness as measured by low grip strength,
slowness by slowed walking speed, low level
of physical activity, low energy or
self-reported exhaustion, and unintentional
weight loss
3. Which of these statements about
AGEISM are TRUE, except?
a. Ageism is not found among
health care professionals
and older people themselves.
b. Ageism can take many
forms, including prejudicial
attitudes, discriminatory
practices or institutional
policies and practices that
perpetuate stereotypical
beliefs.
c. Ageism can be a major
barrier to developing good
policies because it steers
policy options in limited
directions.
d. Ageism may seriously impact
the quality of health and
social care that older people
receive.
Ageism is found in all walks of life and the
older people themselves. Disease in older
people is typically multifactorial with a
strong component related to the
underlying aging process. Aging in
humans is associated with an exponential
risk of mortality with time. This plateaus in
extreme old age because of healthy
survivor bias. Trans (3) ixtlilton
4. The following are true of aging,
except;
a. Non genetic factors, such as
nutrition and exercise, can
have important effects in
modulating the rate of
buildup of damage within the
body.
b. Aging is caused by sudden
accumulation of cell and
tissue damage.
c. Much of the damage arises
as a side effect of an
essential biochemical
process Such as the use of
oxygen to generate chemical
energy through oxidative
phosphorylation.
d. Accumulation of damage
begins early and continues
progressively throughout life,
resulting after several
decades in the overt frailty,
disability and disease
associated with ageing.
5. The following are true about the
biology of ageing except;
a. Damage to the DNA
sufficient to block one of its
critical functions (replication,
transcription, repair, or
recombination) may lead to
cell death and need to
replace that cell from the
relevant progenitor cell pool.
b. Excessive cell death can
ultimately lead to exhaustion
of the relevant progenitor
cell pools responsible for
maintaining tissue
homeostasis in the presence
of stress.
[GERIA] Quiz 1

c. Increasing the activity of the d. The mitochondrial role in

insulin signalling pathway of response to caloric
many steps, in a variety of restriction is coming to light.
animal models, (fruit flies,
nematodes, mice) shifts the
focus of the organism, from
growth and reproduction to
stress response and survival
thereby increasing its
longevity.

d. Elucidating the biological

causes of ageing is
inherently important because
ageing is a major risk factor
for development of most
age-related pathology.
7.
6. The following are true about
genetics of ageing, except;
a. Longer telomeres
accompany human ageing
and premature ageing
syndromes.
b. The environment does not
affect epigenetic processes
that can influence the
progression of ageing and
age-related diseases.
c. Important links between ROS
production and mtDNA
mutations and ageing, while
strong, require further
research.
Hutchinson-Gilford Progeria
syndrome (HGPS) is characterized
with the following, except;
a. It is caused by a change in
the LMNA gene that codes
for the lamin A protein.
b. Generalised atherosclerosis,
cardiovascular disease and
stroke, hip dislocation and
unusual prominent veins of
the scalp, loss of the layer of
fat beneath the skin
(subcutaneous adipose
tissues), defects of the nails,
joint stiffness, skeletal
defects, and or other
abnormality.
c. Children with progeria die of
heart disease at an average
age of 50 years old.
d. They can experience high
blood pressure, strokes,
angina enlarge heart and
heart failure, all conditions
associated with aging.
[GERIA] Quiz 1
8. Which of the following contributes to
the improvement of life expectancy
in low to middle income countries?
a. Declining fertility rate.
b. Declining mortality in the
elderly.
c. Reduction in maternal and
child mortality.
d. Declining poverty rate.
9. Physiologic deterioration occurs
during the adult life of most, if not all
mammalian species. The following
are true and can be expected
except;
a. The ability to cope with
stressors diminished with
advancing adult age.
b. The capacity to carry out
activities. (The aerobic
exercise capacity) declines
with advancing adult age.
c. Homeostasis regulation
deteriorates with advancing
adult age.
d. The rate of age associated
physiologic deterioration and
its character does not vary
among species and among
individuals within species.
10. Causes of age-associated
physiologic deterioration except;
a. Damage resulting from
environmental factors.
b. Damage resulting from
intrinsic living processes.
c. Damage caused by extrinsic
factors.
d. Damage resulting from
age-associated diseases.
Rationale refer to above picture
11. A physiologic deficit seen in aging
can be summarized with:
a. A reduced functional
capacity
b. A decreased ability to cope
with challenges
c. An altered homeostasis
d. None of the above is an
exemption
[GERIA] Quiz 1

12. Age associated physiological in

vasculature, increase intimal
thickness, increase collagen, increase
vascular stiffness and endothelial
dysfunction could lead to
a. Systolic dysfunction
b. Promote Atherosclerosis
c. Increase risk of Vascular
disease
15. Polypharmacy includes what kinds
d. All of the above
of medication except.
a. Prescription.
b. Over the counter.
c. Complementary and
alternative medicine.
d. None of the above is an
example

13. The following are associated with

16. Drugs whose hepatic metabolism is
diastolic dysfunction in aging, except
impaired with advancing age,
a. Decreased left ventricular
except;.
preload
a. Amlodipine
b. Increased afterload
b. Diazepam
c. Decreased afterload
c. Enalapril
d. Prolonged calcium exposure
d. Atenolol

17. Drugs whose renal elimination is

impaired with advancing age, except;
a. Furosemide
b. Metformin
14. The following are the neurologic c. Omeprazole
age-related changes, except: d. Vancomycin
a. Psychomotor function
remains the same
b. Decreased visual acuity
c. Decreased hearing function
d. Mild swaying on Romberg
test
[GERIA] Quiz 1

18. What type of drugs should be

avoided in older adults due to its
poor benefit risk profile among the
geriatric population?
a. SSRIs
b. SNRIs
c. Benzodiazepines
d. Tricyclic antidepressants
19. Common drugs to herbal interaction
effects, except;
a. Clopidogrel + Gingko=
↑bleeding time
b. Thiazides + Gingko=↓drug 21. Which elderly patients should be
effect given supplements?
c. Chlorpropamide + a. With hemoglobin level that is
Garlic=↑glucose less that normal
concentrations b. Unable to eat regularly and
d. Warfarin + Ginseng=↓INR sufficiently
c. With chronic diseases
d. Underweight

22. Nonspecific symptoms, such as

altered mental status, can be the
presenting symptom for these
diseases, except:
a. Pneumonia
b. Dehydration
c. Hypothyroidism
d. None of the above

20. Drug disease interaction to avoid in

the elderly, except; 23. Fatigue can be nonspecific clinical
a. Alpha agonist decongestant presenting symptom of the following
plus hypertension. diseases, except;
b. Alpha blockers plus stress a. Urosepsis
incontinence. b. Hypoglycemia
c. Anticholinergic c. Cellulitis
antihistamines + Benign d. None of the above is an
prostatic hypertrophy, exemption
cognitive impairment. Ratio refers to the picture above
d. NOTA
[GERIA] Quiz 1

24. Myocardial Infarction presents b. Magnetic Resonance

atypically among older persons as, Imaging (MRI)
except: c. Olfactory test
a. Substernal chest pain to left d. Mini Mental Status Exam
arm or jaw (Typical) (MMSE)
b. Dyspnea
c. Vertigo
d. Weakness

25. What is the most common cause of

anemia in the elderly?
a. Medications and ethanol use
b. Nutritional anemia
c. Anemia of renal insufficiency
d. Myelodysplastic syndrome
Iron deficiency is the most common cause,
with other nutritional anemias (e.g., B12
deficiency)
29. 29. Which is a protective factor for
dementia?
a. Extensive social network
b. History of depression
c. Sleep disturbances
d. Dyslipidemia

26. What type of urinary incontinence

when the leakage of urine occurs
with increase in abdominal pressure
as with coughing, sneezing, laughing,
lifting heavy objects or during
exercise?
a. Urgency incontinence
30. Which of the following is a risk factor
b. Stress incontinence
for depression in older adults?
c. Overflow incontinence
a. Neurotic personality trait
d. Mixed incontinence
b. Sleep disturbances
c. Male sex (female)
27. Which of the following factors that
d. Marriage
contribute to dementia is
(separation/divorce)
non-modifiable?
a. Genetic
31. As a healthcare provider, what are
b. Physical inactivity
the clues to suspect elder abuse or
c. Social isolation
negligence except?
d. Obesity
a. Older persons seeking
Non-modifiable risk factors in
medical care long after an
dementia:
injury; lacerations and
Age - Most people develop dementia
fractures that have healed
when they are over the age of 65
without appropriate medical
Genes - Having certain genes might
slightly increase the risk of treatment.
developing dementia b. When caregivers insist on
providing the older person’s
28. Which of the following tools cannot medical history rather than
be used to diagnose dementia? allowing the older person to
a. Montreal Cognitive speak for himself.
Assessment (MoCA)
[GERIA] Quiz 1
c. If the older person seems
isolated, withdrawn,
depressed, fearful, or
demoralized.
d. If the older person is
accompanied by their
families or caregivers to their
medical appointment or
checkup.
Ratio: HELLO! COMMON SENSE … okay po
sorry na
32. Which of the following statements
about prevention of CAP in the
elderly is true?
a. Individuals aged 50 and
older must receive
pneumococcal vaccines.
b. proper hand washing is not
part of the
recommendations to prevent
CAP.
c. Individuals aged 60 and
older must receive an annual
flu vaccine.
d. Prophylactic antibiotics are
advised.
33. Which of the following statement/s
about the pneumococcal vaccine
is/are true?
a. pneumococcal vaccine naive
persons or those with
unknown vaccine status
should be administered with
PCV13, followed by PPSV23
at least 8 weeks later.
b. if PPSV23 was already given
without prior PCV13
administration, PCV13 must
be administered at least 1
year after the last dose of
PPSV23 was received. no
additional doses of PPSV23
are needed.
c. If both vaccines were
administered before the age
of 65, PPSV23 must be
readministered after the age
of 65. No additional doses of
PCV13 are needed.
d. AOTA
34. Before initiating an exercise
prescription for an elderly individual,
screening should be done to identify,
except.
a. Any decreased flexibility,
muscular rigidity, weakness
b. Any cardiac disease
c. Hypoglycemia
d. NOTA
35. The following are true about cancer
screening among elderly, except;
a. Should be discouraged or
very carefully considered in
patients with <10 years of
estimated life expectancy.
b. do not recommend
screening for breast, or
colorectal cancer or prostate
cancer without considering
life expectancy and the risks
of testing, overdiagnosis and
overtreatment.
c. Screen all elderly individuals
yearly for any presence of
malignancy.
d. Only A and B are correct
See trans 10 p.3
36. T.G, is an 83-year-old woman with
Alzheimer's Disease. She lives at
home with her daughter. She is
independent of basic activities of
daily living while fully dependent on
her instrumental activities of daily
[GERIA] Quiz 1
living. She has developed paranoid
delusions and has stopped eating as
she is convinced that her daughter is
poisoning her. She has been losing
weight and feels weak. She also
complains of shortness of breath on
exertion. The remainder of her
physical examination is normal.
What is the differential diagnosis for
her paranoid delusions?
a. Late-onset Schizophrenia
b. Depression with Psychotic
Symptoms
c. Delirium
d. Progressing dementia
In contrast to dementia, delirium has
an acute onset, is characterized bY
fluctuating consciousness and
inattention. Delirium may occur in
patient with dementia, patients with
dementia are more vulnerable to
delirium. Harrison’s IM page 57
37. The evaluation of the above patient
would include.
a. Thorough review of
prescription and OTC
medications.
b. Exclude infection and other
medical causes.
c. Utilizing Confusion
Assessment Method (CAM).
d. None of the above is an
exemption.
38. Management will include.
a. Haloperidol controls
symptoms and may reduce
duration and severity of
delirium.
b. Quetiapine is the drug of
choice for patient with
Lewy-Body dementia,
Parkinson’s disease,
AIDS-associated dementia
and EPS
c. Donepezil 5 Mg/tablet once
a day as an adjunct
treatment.
d. Thiamine 100 mg/day (PO,
IM, or IV)
39. On taking a clinical history of an
82-vear-old patient, his wife tells you
that he has had trouble
remembering to take his
medications. Last week he got lost
while driving alone and had to be
escorted home by strangers. What
would be the next appropriate step?
a. Refer the patient to a
memory clinic.
b. Conduct simple cognitive
screening using the MMSE,
Mini-cog or CDT.
c. Request for a neuroimaging
study to detect any cortical
infarct.
d. Assure the patient that her
symptoms are normal part
of the aging process.
[GERIA] Quiz 1

d. The patient’s Parkinson’s

Disease, Cataract, and recent
hospitalization all place her
at higher risk for fall.

42. An 86-year-old who has had two

recent falls in her home. She incurred
a fracture of her humerus 3 months
ago and presents today with some
bruising on her right cheek from a
fall yesterday. She has a history of
hypertension and osteoporosis.
Which of the following should be the
40. M. J., a 67-year-old man arrives at
first step in evaluating the falls?
your clinic complaining of difficulty
a. Carotid Sinus Massage
walking. He reports no pain in the
b. History, medication review,
hip. He also did not fall in the past
gait evaluation
year. A useful and
c. ECG
easy-to-administer test of functional
d. CT Scan of the head
mobility is the Timed-Up-and-Go
(TUG) test. You administer the test
43. Your patient, Mr.BBM, is 88 years old.
on him. A TUG that may be
He consults you regularly every
predictive of a fall is;
three months for monitoring of
a. More than 13 seconds
Hypertension and for
b. 12 seconds
Hypercholesterolemia. He calls you
c. 10-11 seconds
because he feels too tired to move
d. Less than 10 seconds
and he prefers that you see him
Rationale: An older adult who takes ≥12
directly at his home. You visit him
seconds to complete the TUG is at risk for
eight days later. He opens the door
falling. (Trans 06B. Caring for Older Persons
and leads you slowly to the dining
with Geriatric Syndrome p.4)
room where you meet his wife who
lives with him. Upon examination, his
41. An 83-year-old female patient with a
blood pressure was 150/80 mmHg,
history of Parkinson’s Diseases and
and he says his cholesterol has not
Cataract was brought to your clinic
been checked over the last 3 years.
after a fall. She was discharged from
He points out that he pays attention
the hospital 2 days ago with a
to his diet to avoid high fat foods. His
diagnosis of pneumonia. Which of
health seems to be as usual, and his
the following statements is true
physical examination is normal. For
regarding her risk for fall?
no particular reasons, he seems to
a. She no longer has any risk
have lost weight and his wife
for fall.
indicates that he never leaves the
b. She has a risk for fall until
house. The following are true of
the Pneumonia completely
Frailty, except
resolves.
a. The presence of 25 or more
c. The recent fall proves that
functional deficits, conditions,
this patient should not have
symptoms, and/or
been discharged from the
laboratory values, scored as
hospital.
[GERIA] Quiz 1

the proportion of total

indicators present in the
patient. Basic activities 6/6
b. Frailty indicators can be of daily living
measured clinically through
direct observation or Instrumental 4/8
self-report. activities of
c. Presence of weight loss, daily living
fatigue, low activity,
Vision 40/20
weakness, and slow gait
speed.
Hearing Unimpaired to
d. None of the above is an
whisper test
exception
Rationale: Frailty is an increased Mini-nutritional 16/30
vulnerability to adverse outcomes (e.g., falls, assessment
disability, delirium, failure to return to
functional baseline) after exposure to MMSE
stressful event Source: Trans 5B. Assessment
and Approach to the Older Patient II page 5 Geriatric 7/15
Depression
44. Mrs LR’s physical examination should scale
be narrowly focused on information
Timed Up and Not done
about identifying malnutrition
Go Test
obtained in the medical history and
must assess her;
a. Current weight and BMI 46. Based on the results, the following
b. Oral cavity, especially Geriatric Syndromes were identified.
dentition She is at risk of malnutrition
c. Ability to swallow a. True
d. All of the above b. False

45. Malnutrition may be a presenting 47. She has vision impairment that can
symptom of depression in the contribute to increased risk for fall
elderly. Further evaluation of this a. True
mental problem that afflicts as much b. False
as 38% of elderly patients include
a. Comprehensive Geriatric 48. She has possible cognitive
Assessment impairment such as dementia
b. Geriatric Depression Scale a. True
c. Determination of TSH, Ca, b. False
Liver and kidney function
test, electrolytes, CBC, and 49. She has moderated depression
UA a. True
d. All of the above b. False

50. The timed-up and go test was not

done, Mrs LR expressed that she was
Parameters Results
already tired and needs to rest.
[GERIA] Quiz 1

Without the screening test for

assessment of fall risk, does she
have any intrinsic factor for incurring
a fall in the future without
intervention
a. True
b. False