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Biology of Aging Quiz
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Questions in this quiz (27)
1Which of the following mechanisms is primarily responsible for the increased risk of orthostatic hypotension in elderly patients treated with terazosin?
- Adecreased sensitivity and response to the baroreceptor reflex
- Bcalcification of the left and right bundle branches
- Cpersistent elevation of catecholamines
2A physician wants to prescribe an as needed, low dose benzodiazepine for occasional acute anxiety attacks for an 82 year old female nursing facility resident.
Which of the following is the most appropriate agent to use?- AAlprazolam
- BClonazepam
- CDiazepam
3Which of the following physiologic changes contributes to increased activity of warfarin in geriatric patients?
- Areduced hepatic metabolism
- Bhigher albumin levels
- Cslower gastrointestinal transit time
4Changes in body composition with aging typically result in an increased volume of distribution of
- Aprotein-bound drugs
- Bwater-soluble drugs
- Clipid-soluble drugs
5Which of the following pharmacokinetic effects is TRUE with aging?
- Ano change in Phase II drug metabolism
- Bno change in Phase I drug metabolism
- Cno change in first pass metabolism
6Which of the following physiologic changes is associated with normal aging?
- Aneurofibrillary tangles
- Bincreased body water composition
- Cdecreased arterial compliance
7Which of the following is the BEST description of frailty?
- AA geriatric syndrome characterized by diminished muscle mass and body weight
- BA diminished ability to recover homeostasis following a stressor event
- CA chronic pattern of laboratory values that includes diminished serum albumin and increased inflammatory markers
8Which of the following drugs is MOST likely to have similar pharmacokinetic characteristics in older and younger patients?
- Adiazepam
- Blorazepam
- Cclonazepam
9W.G. is a 75 year old AA man with CAD, HTN, Type 2 DM, chronic low back pain caused by OA of the spine, BPH, and peripheral neuropathy. W.G. weighs 72 kg and is 71" tall, and his SCr is 1.4 mg/dL. W. G's medications include: metoprolol extended release 50 mg/day, lisinopril 20 mg/day, metformin 1000 mg two times /day, gabapentin 900 mg three times/day, glipizide extended release 10 mg/day, citalopram 20 mg/day, APAP 1000 mg three times/day, Tylenol PM as needed at night and hydrocodone-APAP 5 mg/500 mg 1 tablet as needed for pain every 4 to 6 hours.
Considering age-associated pharmacokinetic changes, a dose reduction in which medication may be most indicated for W.G.?- AMetoprolol
- BMetformin
- CGlipizide
- DGabapentin
10An 85 year old woman is taking ferrous sulfate to treat an iron deficiency anemia. Changes in which age-associated pharmacokinetic property can most affect this agent?
- AAbsorption
- BDistribution
- CMetabolism
- DRenal Elimination
11NH is an 85 year old woman who resides in a nursing home. She weighs 65 kg. Her medical history is significant for Type 2 DM, HTN, and moderate dementia, likely attributable to vascular changes. Two years ago she had a cerebrovascular accident and 1 year ago she sustained a right hip fracture after a fall. Her regularly scheduled medications include glyburide 10 mg/day, lisinopril 10 mg/day, metformin 500 mg two times/day, donepezil 10 mg/day, ASA 81 mg/day, and a multivitamin daily. Her as needed medications include zolpidem 5 mg/day as needed for sleep, meclizine 25 mg 1/2 tablet three times/day as needed for dizziness and the house bowel regimen.
Your evaluation of NH reveals that she has not used any of her as needed medications in 2 months. In addition her laboratory results reveal the following: Fasting plasma glucose 90 mg/dL, sodium 138 mEq/L, potassium 4.5 mEq/L, chloride 102 mEq/L, CO2 25 mEq/L, BUN 30 mg/dL, SCr 1.8 mg/dL, and TSH mU/L. Which pharmacokinetic parameter is most likely altered in NH?- AOral Absorption
- BDistribution
- CMetabolism
- DRenal Excretion
12On the basis of your assessment of age-and disease- related changes in NH, which is best to address first?
- ADiabetes treatment
- BAlzheimer disease treatment
- CHypertension treatment
- DStroke prevention
13Which of the following regarding normal physiological changes in the elderly is false?
- AReduction in % lean muscle mass
- BDeclining kidney function
- CReduction in % total body fat
- DReduction in GI motility speed
14A reduced creatinine clearance accompanied by a normal serum creatinine in elderly persons in MOST likely due to:
- ALoss of muscle mass
- BPrerenal azotemia
- CDecreased nephrons
15Age-related changes in which of the following organ systems MOST significantly impacts drug elimination in the elderly?
- AHepatic
- BPulmonary
- CRenal
16Which of the following changes is associated with the aging process?
- AReduction of Phase I hepatic drug metabolism
- BIncreased amount of total body water
- CDecreased percent of body fat
17A 79 year-old man with type 2 diabetes has had several falls attributed to dizziness. He reports that his dizziness and weakness is usually relieved by a snack or meal. His current medications include: hydrochlorothiazide, metformin, glyburide, lisinopril, liraglutide. Which of the following is MOST likely the cause of his falls?
- ALiraglutide
- BGlyburide
- CLisinopril
18Which of the following is a common symptom of frailty?
- AInsomnia
- BAnorexia
- CWeight gain
19BA is a 76 year old female with a history of HTN and DM. Today her SCr is 0.9 and CrCl is 69 ml/min. Over the past year her UA has shown a persistent elevation in protein (2-3 + on 4 separate occasions ). Which of the following is characteristic of an abnormal disease process?
- Alow SCr
- Blow CrCl
- CPersistent proteinuria
20Which of the following agents half-life is prolonged in healthy older adults (Assume 70 kg older adult)
- AWarfarin
- BDigoxin
- CTheophylline
21
1 week ago, Mr. Paul was admitted to the hospital for a CHF exacerbation after attending a crab feast to support the local fire department. Upon admission he was complaining of feeling sluggish, having shortness of breath and leg swelling.
Which of the following explain's Mr. Paul's change in health status?- AInability to adapt to stressor
- BAge-related CV changes
- CAge-related GU changes
22June, the pharmacist visits Mr. Paul today to review his home medication regimen before discharge. She notices that his kidney function has declines while in the hospital and his blood pressure and pulse are low.
Vitals
BP: 110/68 (sitting), Pulse: 70
Height: 68 inches, Weight: 74kg
Creatinine Clearance= 35ml/min
Medications:
Ramapril 5mg daily
Aspirin 81 mg daily
Atenolol 100 mg twice daily
Atorvastatin 10mg daily
Furosemide 40mg daily
OTC Naproxen 220mg TID
Which of Mr. Paul's medications is potentially inappropriate?- ARamapril
- BAspirin
- CNaproxen
23Age related pharmacokinetics affect therapeutic levels of which of the following medications?
- AVerapamil
- BLevofloxacin
- CHCTZ
- DRanitidine
24Which of the following changes is associated with the aging process?
- AReduction of Phase I hepatic drug metabolism
- BIncreased amount of total body water
- CDecreased percent of body fat
257. Which of the following is false regarding the cardiovascular system in association with aging?
- AIncreasing stiffness of large arteries can lead to isolated diastolic hypertension
- BCardiovascular disease is the leading cause of death in the elderly
- CIncreasing number of medications in the elderly can lead to increased risk of QTc prolongation
- DIn patients who are falling frequently, orthostatic blood pressure monitoring is recommended
26Which of the following regarding normal physiological changes in the elderly is false?
- AReduction in % lean muscle mass
- BDeclining kidney function
- CReduction in % total body fat
- DReduction in GI motility speed
27Which of the following would be false regarding creatinine and kidney function?
- AA. Creatinine will stay normal or be slightly reduced due to a reduction in muscle mass despite the
fact that kidney function declines over time - BB. Some medications can prevent creatinine from being excreted in the urine leading to false
assumptions about worsening kidney function - CC. As creatinine increases, it is a potential indication of worsening kidney function
- DD. A rise in creatinine from a baseline of 1.0 to 2.0 would be proportionally less concerning than a
rise in creatinine from a baseline of 4.0 to 5.0.
- AA. Creatinine will stay normal or be slightly reduced due to a reduction in muscle mass despite the
Information
- Description
- frailty, pharmacokinetics, pharmacodynamics, normal/abnormal physiologic changes
- Author
- Jessica Isaac
- Language
- English
- Views
- 31
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