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NR576 MIDTERM ADULT GERONTOLOGY
QUESTIONS AND ANSWERS 2025 UPDATED
GRADED 100% PASS
What is a differential diagnosis? - Solution Using clinical reasoning to distinguish between similar conditions. What is deductive clinical reasoning strategy? - Solution Analyzing and synthesizing clinical data related to patient's presentation. What is the first step in deductive clinical reasoning strategy? - Solution Starting with general information from chief complaint. What is the next step in deductive clinical reasoning strategy? - Solution Moving to more specific information collected through history of present illness. How can open-ended questions be used in deductive clinical reasoning strategy? - Solution To gain information utilizing OLDCARTS. What is evidence-based research? - Solution Research based on clinical trials or case studies. What is required for evidence-based research? - Solution Evidence of benefit to the patient. What are guidelines? - Solution Practice recommendations issued by professional organizations. How should guidelines be developed? - Solution Rigorously and trustworthy. What is the basic structure of the clinical reasoning process? - Solution Gathering initial patient information, organizing and interpreting information, generating hypotheses, testing hypotheses, planning diagnostic and treatment strategy.
What is the first step in the clinical reasoning process? - Solution Gathering initial patient information (health history and physical). What is the second step in the clinical reasoning process? - Solution Organizing and interpreting information to synthesize the problem. What is the third step in the clinical reasoning process? - Solution Generating hypotheses. What is the fourth step in the clinical reasoning process? - Solution Testing hypotheses until a working diagnosis is selected. What is the final step in the clinical reasoning process? - Solution Planning the diagnostic and treatment strategy. Sensitivity- is the proportion of patients with the disease that have a positive result - Solution it is the number of true positives divided by the total number of patients who have the disease. What does the OLD CARTS mnemonic stand for? - Solution Onset, Location, Duration, Character, Alleviating factors, Relieving factors, Timing, Severity Specificity: proportion of 'test negative' of total without the disease - Solution the number of true negatives over all negatives. What is pretest probability? - Solution Probability of the disease before the test is ordered. What factors are considered in pretest probability? - Solution Disease prevalence, patient's symptoms or clinical context. How is pretest probability evaluated? - Solution In terms of low, intermediate, or high. What is pretest probability based on? - Solution Probability of the suspected disease given the patient's symptoms or clinical context. What is Rubella? - Solution A viral infection that occurs in young children and non-immune young adults.
What is impetigo? - Solution A skin infection characterized by erythematous plaques with yellow crust. What are the symptoms of impetigo? - Solution Erythematous plaques with yellow crust, itchiness, and pain. How does impetigo spread? - Solution Impetigo is highly contagious and spreads easily. What is psoriasis? - Solution Chronic skin disorder with inflamed, itchy, rough patches. How is the specific type of psoriasis determined? - Solution By appearance and placement. What is plaque psoriasis? - Solution Most common type with silvery hard scales over inflamed rash. What factors can influence the course of psoriasis? - Solution Genetics, smoking, obesity, medications, and infection. What is contact dermatitis? - Solution Inflammation of the skin caused by direct contact with an allergen or irritant. What are the symptoms of contact dermatitis? - Solution Red rash, severe itching, bumps, swelling, burning, and tenderness. Is contact dermatitis contagious? - Solution No, it is not contagious. Is contact dermatitis life-threatening? - Solution No, it is not life- threatening. What causes irritant contact dermatitis? - Solution Direct contact with common irritants such as detergents, oils, and soaps. What causes allergic contact dermatitis? - Solution Direct contact with allergens such as latex, metals, poison ivy, and topical medication.
What is Atopic Dermatitis? - Solution A skin condition characterized by itchy, red, and scaly skin. What are the factors that contribute to Atopic Dermatitis? - Solution Genetics and overactive immune response. What are individuals with Atopic Dermatitis sensitive to? - Solution Environmental irritants. Where does Atopic Dermatitis commonly occur in adults? - Solution Flexural areas like inside of elbows or backs of knees. What is Hidradenitis Suppurativa (HS)? - Solution Chronic inflammatory skin condition with deep-seated nodules, abscesses, and fibrotic scars. Where do lesions of HS commonly occur? - Solution Intertriginous areas and areas rich in apocrine glands such as axillary, groin, perianal, perineal, and inframammary locations. What are the characteristics of nodules in HS? - Solution Deep nodules that can rupture and track subcutaneously. What are the other types of lesions seen in HS? - Solution Open comedones, often double or multi-headed, also known as 'tombstone' comedones. What is folliculitis? - Solution Superficial to deep skin infection of hair follicles. What are the characteristics of folliculitis lesions? - Solution Lesions can range from minute white topped pustules in newborns to large, yellow-white tender pustules in adults. How does folliculitis occur? - Solution Bacteria infects hair follicle at superficial level leading to erythematous papules and pustules. What are the main pathogens causing folliculitis? - Solution Gram-positive bacteria, occasional cases caused by fungus or gram-negative bacilli.
What are the symptoms of Herpes Zoster? - Solution Fever, headache, fatigue, sensitivity to light. What is dermatitis herpetiformis? - Solution A skin condition caused by gluten sensitivity. What are the symptoms of dermatitis herpetiformis? - Solution Itchy bumps, burning blisters, and rash similar to herpes. How does dermatitis herpetiformis affect teeth? - Solution Possible enamel pitting, discoloration, and canker sores. What is Candidiasis Albicans? - Solution Most common yeast isolate found in oropharynx and genitalia. What is tinea corporis? - Solution A circular red patch with a raised scaly edge. What is Erythema Multiforme? - Solution A skin condition characterized by symmetrical, red, raised skin areas. What can cause Erythema Multiforme? - Solution Drug reactions, among other factors. What is a common symptom of Erythema Multiforme? - Solution Rash or urticaria. How does Erythema Multiforme appear on the body? - Solution It can appear all over the body in symmetrical patterns. What is Actinic Keratosis? - Solution A precancerous lesion that occurs on sun-exposed areas. What are the characteristics of Actinic Keratosis? - Solution Multiple lesions with varied appearance and rough textured horn-like surface. How can Actinic Keratosis be managed? - Solution Through watchful waiting or removal with cryotherapy, topical immunotherapy, or laser therapy.
What is Basal Cell Carcinoma? - Solution A type of epidermal skin cancer. How does Basal Cell Carcinoma progress? - Solution Slowly and without pain. Where does Basal Cell Carcinoma typically occur? - Solution In sun- exposed areas, often on the face. What are some common symptoms of Basal Cell Carcinoma? - Solution Oozing, crusting, or bleeding. Who should be consulted for Basal Cell Carcinoma? - Solution A dermatologist. What is melanoma? - Solution A type of skin cancer. What is the ABCDE assessment for melanoma? - Solution A method to identify potential signs of melanoma. What does asymmetrical mean in the context of melanoma? - Solution One half of the mole does not match the other half. What does irregular border mean in the context of melanoma? - Solution The edges of the mole are not smooth or even. What does color refer to in the context of melanoma? - Solution The mole is dark or has uneven coloring. What does diameter >6 mm mean in the context of melanoma? - Solution The mole is larger than 6 millimeters in diameter. What does evolution mean in the context of melanoma? - Solution The mole has changed in shape, size, or color over time. What does ugly duckling mean in the context of melanoma? - Solution The mole does not resemble other moles or skin growths on the body. What should be done if melanoma is suspected? - Solution Refer to a dermatologist for further evaluation.
What is the recommended topical treatment for Onychomycosis? - Solution Ciclopirox nail lacquer twice daily for 6-18 months. What are the alternatives to ciclopirox for Onychomycosis treatment? - Solution Efinaconazole or tavaborole solution. When is ciclopirox recommended for Onychomycosis? - Solution For mild to moderate cases. What is Onychomycosis? - Solution Fungal infection of the nails. What is systemic treatment? - Solution Treatment that affects the whole body. What are the medications used for treating Onychomycosis? - Solution Itraconazole and terbinafine. What is a macule? - Solution Flat spot less than 1 cm in size. What is a patch? - Solution Flat spot larger than 1 cm in size. What is a papule? - Solution Raised spot less than 1 cm in size. What is a plaque? - Solution Raised spot larger than 1 cm in size. What is a vesicle? - Solution Fluid-filled lesion. What is a bulla? - Solution Large fluid-filled lesion. What is a pustule? - Solution Small collection of neutrophils or keratin that appears white. What is a furuncle? - Solution Inflamed hair follicle. What is a carbuncle? - Solution Multiple furuncles together. What is a nodule? - Solution Larger and deeper than a papule. What is a subcutaneous mass/cyst? - Solution Encapsulated collection of fluid or semisolid.
What is a wheal? - Solution Localized dermal edema that comes and goes within 1-2 days. What is a burrow? - Solution Small linear or serpiginous pathway in the epidermis created by the scabies mite. Presbycusis - Solution Age-related hearing loss affecting high-frequency sounds. Sensorineural hearing loss - Solution Hearing loss caused by damage to the inner ear or auditory nerve. What is conductive hearing loss? - Solution Impaired passage of sound waves through the ear. What causes conductive hearing loss? - Solution Factors that reduce sound wave flow through the ear. Is conductive hearing loss reversible? - Solution Yes, it is often reversible. What are some causes of conductive hearing loss? - Solution Cerumen impaction, perforated tympanic membrane, chronic ear infections, congenital abnormalities, otosclerosis or tympanosclerosis, temporal bone fractures or injuries. What is sensorineural hearing loss? - Solution Lesion in the organ of Corti or central neural pathways. What are some causes of sensorineural hearing loss? - Solution Presbycusis, Meniere's disease, tumors, medications, trauma, diseases. What is presbycusis? - Solution Age-related hearing loss. What are some medications that can cause sensorineural hearing loss? - Solution Aminoglycosides, aspirin, quinine. Schwabach Test - Solution Comparison of bone conduction between patient and examiner
What are the most common organisms responsible for AOM? - Solution Streptococcus pneumoniae (40-50% of cases), Haemophilus influenzae (10-30%), Moraxella catarrhalis. What is Acute Otitis Externa (AOE)? - Solution Inflammation of the auditory canal and outer ear. Why is AOE also called swimmer's ear? - Solution Due to its presentation and association with water exposure. What are the clinical presentations of Acute Otitis Media (AOM)? - Solution Severe ear pain, worse at night, worsened by pulling the pinna or applying pressure to the tragus. What is the classic sign of AOM? - Solution Tenderness on traction of the pinna and pain on applying pressure over the tragus. What is the most common organism responsible for AOE? - Solution Pseudomonas aeruginosa. What is another common organism responsible for AOE? - Solution Staphylococcus aureus. What is serous otitis media? - Solution Effusion in the middle ear resulting from incomplete resolution of acute otitis media or eustachian tube obstruction without infection. What are the symptoms of serous otitis media? - Solution Hearing loss and a sense of fullness or pressure in the ear. How is serous otitis media diagnosed? - Solution Based on appearance of the tympanic membrane and sometimes on tympanometry. How long does most cases of serous otitis media take to resolve? - Solution 2 to 3 weeks. What is the recommended treatment if there is no improvement in 1 to 3 months? - Solution Myringotomy with insertion of a tympanostomy tube.
What is Meniere's Disease? - Solution Peripheral sensory disorder of the inner ear. What are the symptoms of Meniere's Disease? - Solution Recurrent attacks of tinnitus, vertigo, and progressive hearing loss. What is the other name for Meniere's Disease? - Solution Meniere's Syndrome or Endolymphatic Hydrops. What causes the increased endolymphatic volume and inner ear pressure in Meniere's Disease? - Solution Unknown etiology. What are the two systems affected by Meniere's Disease? - Solution Labyrinth (semicircular canal system) and cochlea of the inner ear. What is Allergic Rhinitis? - Solution Immunoglobulin E mediated inflammation in the nose and upper respiratory tract. What are the ocular symptoms associated with Allergic Rhinitis? - Solution Tearing, redness, and itching of the eyes. What are the common symptoms of Allergic Rhinitis? - Solution Sneezing, runny nose, itchy eyes, nose, and palate, postnasal drip, cough, fatigue. When do the symptoms of Allergic Rhinitis typically occur? - Solution Seasonally, but can also occur with indoor allergens. What are some indoor allergens that can trigger Allergic Rhinitis? - Solution Animal dander, mold, dust mites, and cockroaches. What is the appearance of the nasal mucosa in Allergic Rhinitis? - Solution Pallor, pale bluish hues, and turbinate edema. What is the characteristic drainage seen in Allergic Rhinitis? - Solution Clear rhinorrhea and postnasal drip. What is the cobblestone appearance seen in Allergic Rhinitis? - Solution Hyperplastic lymphoid tissue from drainage.
What are the common symptoms of AVRS? - Solution Malaise, headache, sore throat, and occasionally fever. What does the mucosa typically look like in AVRS? - Solution Erythematous (red and inflamed) mucosa. What should patients know about treating AVRS? - Solution The majority of cases are viral and do not require antibiotics. What is pharyngitis? - Solution Discomfort or pain in the throat, especially when swallowing. What is strep pharyngitis? - Solution A type of pharyngitis caused by streptococcus bacteria. How is pharyngitis treated? - Solution Symptomatic care, antibiotics are not needed. What is strep pharyngitis? - Solution Pharyngitis caused by strep bacteria. What is the rapid streptococcal antigen test used for? - Solution To detect group A strep antigens and diagnose infection. Why is antibiotic treatment necessary for strep pharyngitis? - Solution To prevent significant sequelae in both the short and long terms. What organisms are associated with a sore throat? - Solution Group A Beta hemolytic streptococcus, Streptococcus pneumoniae, Epstein-Barr Virus. What are the diagnostic tests for strep pharyngitis? - Solution Rapid Strep, Throat Cultures, Mono Spot. What is the first-line treatment for strep pharyngitis in adults? - Solution 10-day course of penicillin B potassium or benzathine penicillin. What antibiotic is recommended for patients allergic to penicillin? - Solution Azithromycin for 5 days.
What should be done if a patient fails to respond to antibiotic therapy for strep pharyngitis? - Solution Test for infectious mononucleosis and streptococcal antibiotic sensitivity. What antibiotics are effective for penicillin-resistant beta-lactamase producing organisms? - Solution Amoxicillin/clavulanate, erythromycin ethyl succinate, erythromycin stearate. What antibiotics should be avoided for penicillin-resistant beta-lactamase producing organisms? - Solution Tetracycline and trimethoprim- sulfamethoxazole preparations. What is conjunctivitis? - Solution Inflammation of the front of the eye. What are the symptoms of allergic conjunctivitis? - Solution Bilateral itching, watery discharge, swollen and reddened conjunctiva and lids. When is allergic conjunctivitis most commonly seen? - Solution Fall and spring. What are the symptoms of bacterial conjunctivitis? - Solution Itching, tearing, yellow-green discharge, conjunctival hyperemia. Is there focal pain or visual disturbances in bacterial conjunctivitis? - Solution Typically no. What are the symptoms of viral conjunctivitis? - Solution Itching, burning, increased tearing, brilliant red conjunctiva. What are the signs of viral conjunctivitis? - Solution Watery mucoid discharge, conjunctival edema, follicles on palpebral conjunctiva, eyelid edema. What are the usual accompanying signs of viral conjunctivitis? - Solution Signs of upper respiratory infection or recent history of URI. What causes chemical conjunctivitis? - Solution Chemicals. What is a chalazion? - Solution A painless swelling on the eyelid caused by a granulomatous infection of a meibomian gland.
