A 78-year-old woman presents for evaluation with a severe unilateral headache, jaw pain, and scalp tenderness. The patient states the headache is of a piercing quality; her jaw hurts only when she chews and feels better a few minutes after she stops chewing. Tenderness is present over the temporal artery on the same side as her headache, and prednisone is prescribed until the patient can see a specialist. Which of the following reasons is the major justification for beginning treatment with corticosteroids in a patient with this condition?
A 68-year-old woman presents with malaise, severe unilateral…
A 68-year-old woman presents with malaise, severe unilateral headache, a decreased appetite, jaw pain and fatigue with chewing, and recent weight loss of approximately 10 pounds. The patient reports one transient episode of right eye visual loss lasting less than 5 minutes earlier that day. She currently has an oral temperature of 100.5°F, and there is tenderness on palpation of the right temporal area. The erythrocyte sedimentation rate is 104 mm/hr (normal ESR female: 0 to 20 mm/hr). Arrangements are made to obtain a temporal artery biopsy the following day. Which of the following interventions is the most appropriate next step in the management of this patient?
When assessing a 76-year-old male patient during a Geriatric…
When assessing a 76-year-old male patient during a Geriatric Clinic follow up visit, you determine that his score on the FRAIL scale is 2. Which of the following statements best describes the correct interpretation of this FRAIL scale score?
An 82-year-old male presents to your office for follow-up of…
An 82-year-old male presents to your office for follow-up of his multiple medical problems, including a history of cerebrovascular accident and dementia. The patient is bedridden and is cared for at home by his family. Examination of his sacrum reveals an area of intact skin with erythema that does not blanch with palpation. What stage decubitus ulcer is this lesion?
You are asked to evaluate a 76-year-old male patient who pre…
You are asked to evaluate a 76-year-old male patient who presents complaining of urinary incontinence. The patient states that he is experiencing urinary frequency, nocturia, decreased force of the urinary stream, and urinary dribbling after voiding. A post-void residual (PVR) determination reveals that approximately 240cc of urine remains in the bladder after voiding. Based on this information, which of the following conditions is the most likely underlying cause for this patient’s symptoms?
A 78-year-old male patient is diagnosed with delirium during…
A 78-year-old male patient is diagnosed with delirium during his hospitalization. He is frequently confused, and becomes agitated at times. Which of the following interventions would be helpful in the management of this patient?
While working on a short-term rehabilitation unit, you are a…
While working on a short-term rehabilitation unit, you are asked to evaluate an 82-year-old female who was recently hospitalized for pneumonia. PMH is significant for HTN, Type II DM, coronary artery disease, and heart failure. The patient is admitted to the rehabilitation unit with evidence of functional decline, weight loss, difficulty swallowing, and depression. Recent mini nutritional assessment (MNA) score is consistent with malnourishment. Which of the following antidepressant medications has proven effective in treating geriatric depression accompanied by weight loss and would be reasonable to initiate in this patient?
A 76-year-old female present for evaluation of excessive fat…
A 76-year-old female present for evaluation of excessive fatigue during the day, and the need for frequent afternoon naps. She has a long history of insomnia symptoms and admits to taking “sleeping medicine” for fifty years. Her daytime fatigue is a new symptom. An age-related increase in which of the following parameters may account for a prolongation in the metabolism of the sleep medication prescribed for this patient?
A 68-year-old female with liver cancer, presents for evaluat…
A 68-year-old female with liver cancer, presents for evaluation of pain in her right knee. She also has a PMH significant for osteoarthritis and recent GI bleed, and reports the knee pain has been increasing recently. During an office visit two weeks ago, she was instructed to take Tylenol 500 mg po QID for pain relief. Currently, she reports being in moderate constant pain, which is worsened with physical activities and interferes with her activities of daily living. Which of the following medications is most appropriate for the management of the patient’s pain?
A 78-year-old woman presents for evaluation with a severe un…
A 78-year-old woman presents for evaluation with a severe unilateral headache, jaw pain, and scalp tenderness. The patient states the headache is of a piercing quality; her jaw hurts only when she chews and feels better a few minutes after she stops chewing. Tenderness is present over the temporal artery on the same side as her headache, and prednisone is prescribed until the patient can see a specialist. Which of the following reasons is the major justification for beginning treatment with corticosteroids in a patient with this condition?