Geriatric syndromes, falls, polypharmacy, and cognitive decline as tested on USMLE Step 2 CK.
38 cards · basic cards · AI-written, checked twice. Edit anything.
- What is a geriatric syndrome?
- A multifactorial health condition in older adults resulting from the cumulative effect of impairments in multiple systems, not from a single disease
- What are the core components of Fried frailty phenotype?
- Unintentional weight loss, exhaustion, weakness (grip strength), slow gait speed, and low physical activity
- What single bedside test best screens for fall risk by timing a patient standing, walking 3 meters, turning, and sitting back down?
- Timed Up and Go (TUG) test
- A TUG test time of more than how many seconds suggests increased fall risk?
- 12 seconds
- What is the diagnostic criterion for orthostatic hypotension?
- A drop in systolic BP of at least 20 mmHg or diastolic BP of at least 10 mmHg within 3 minutes of standing
- What is the purpose of the Beers Criteria?
- A list identifying medications that are potentially inappropriate for use in older adults due to higher risk of adverse effects
- In the STOPP/START tool, what does STOPP identify?
- Potentially inappropriate medications that should be stopped in older adults
- In the STOPP/START tool, what does START identify?
- Medications that are appropriate and should be started if not already prescribed
- Why are benzodiazepines generally avoided in elderly patients?
- They increase the risk of falls, fractures, sedation, and cognitive impairment
- Why are anticholinergic medications particularly risky in elderly patients?
- They can worsen cognition, cause confusion or delirium, and contribute to falls and urinary retention
- What is polypharmacy commonly defined as?
- Regular use of five or more medications by a single patient
- What is the key clinical feature that distinguishes delirium from dementia?
- Delirium has an acute onset with a fluctuating course, while dementia has a gradual, progressive onset
- Which feature of consciousness is typically impaired in delirium but preserved in dementia?
- Attention and level of consciousness
- What tool is most commonly used at the bedside to diagnose delirium?
- Confusion Assessment Method (CAM)
- According to the CAM, delirium requires acute onset with fluctuating course, inattention, plus which one of the following two features: disorganized thinking or altered level of consciousness?
- Either disorganized thinking or altered level of consciousness (at least one is required)