Geriatrics Practice Questions

Q: Which of the following physiological parameters does NOT change significantly in old age?

Hematocrit. **Explanation:** In geriatric physiology, it is crucial to distinguish between normal age-related declines and pathological states. **Why Hematocrit is the correct answer:** Under normal physiological conditions, **Hematocrit (and hemoglobin levels) does not change significantly with age.** While the bone marrow becomes more fatty and the hematopoietic reserve decreases, the baseline production of red blood cells remains sufficient to maintain normal levels. If an elderly patient presents with a significant drop in hematocrit or anemia, it should be investigated as a **pathological process** (e.g., iron deficiency, chronic disease, or occult GI bleed) rather than being dismissed as "normal aging." **Why the other options are incorrect:** * **Glomerular Filtration Rate (GFR):** GFR decreases by approximately **1 mL/min/1.73m² per year** after the age of 40 due to nephrosclerosis and a reduction in the number of functional nephrons [1]. * **Glucose Tolerance:** Glucose tolerance decreases with age [1]. This is due to increased peripheral insulin resistance and a decline in pancreatic beta-cell sensitivity, leading to higher postprandial glucose levels. * **Blood Pressure:** Systolic blood pressure typically **increases** with age due to decreased arterial compliance and increased stiffness of the large arteries (arteriosclerosis) [1]. **High-Yield Clinical Pearls for NEET-PG:** * **Creatinine vs. GFR:** In the elderly, serum creatinine may remain within the "normal range" despite a significantly reduced GFR because of decreased muscle mass (sarcopenia). * **Vital Capacity:** While Total Lung Capacity remains constant, **Residual Volume increases** and **Vital Capacity decreases** with age [1]. * **Liver Function:** Liver enzymes (ALT/AST) and bilirubin levels generally remain stable, though hepatic blood flow and liver mass decrease. [1]

Q: In clinical assessment of an elderly patient, 'the get up and go test' is used to evaluate which of the following?

Gait and balance. Gait and balance - The **Timed Up and Go (TUG) test** is a widely used clinical tool designed to assess a person's **mobility**, **balance**, and **fall risk**. [2] - It measures the time taken for an individual to rise from a chair, walk 3 meters, turn, walk back, and sit down again. *Cognition* - While physical and cognitive functions are related, the TUG test does not directly assess **cognitive abilities** like memory, executive function, or language. - Cognitive assessment typically involves tools such as the **Mini-Mental State Examination (MMSE)** or **Montreal Cognitive Assessment (MoCA)**. [1] *Urinary incontinence* - The TUG test does not evaluate **urinary function** or the presence of incontinence. - Assessment of urinary incontinence involves patient history, bladder diaries, and physical examination. *Driving ability* - Although mobility and balance are important for driving, the TUG test alone is not a direct measure of **driving ability**. - Driving assessments are more comprehensive, often involving on-road tests and specialized cognitive and visual evaluations.

Question 1

Reversible dementia is a feature of which of the following conditions?

Accepted Answer

Hypothyroidism

Answer

Alzheimer's disease

Answer

Pick's disease

Answer

Multi-infarct dementia

Question 2

A 73-year-old woman presents to the clinic complaining of fatigue and feeling unwell. She notes the symptoms are worse on exertion but denies any chest pain or shortness of breath. Her past medical history is significant for hypertension and type 2 diabetes, both well-controlled on her current medications. On physical examination, vital signs are - blood pressure 135/80 mm Hg, pulse 72/min, and respiratory rate 10/min. The lungs are clear on auscultation, and heart sounds are normal. A CBC reveals a hemoglobin value of 9.5 g/dL and an MCV of 105 mm
3. Which of the following typically causes a macrocytic anemia?

Accepted Answer

Vitamin B12 deficiency due to vegan diet

Answer

Iron deficiency

Answer

Thalassemia

Answer

Anemia of chronic inflammation

Question 3

Which of the following physiological parameters does NOT change significantly in old age?

Accepted Answer

Hematocrit

Answer

Glomerular Filtration Rate (GFR)

Answer

Glucose tolerance

Answer

Blood pressure

Question 4

In clinical assessment of an elderly patient, 'the get up and go test' is used to evaluate which of the following?

Accepted Answer

Gait and balance

Answer

Cognition

Answer

Urinary incontinence

Answer

Driving ability

Geriatrics — MCQs

Geriatrics — MCQs

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