1. Which patient could be expected to have the highest systolic blood pres-
sure?
A 21-year-old male
A 50-year-old perimenopausal female
A 35-year-old patient with Type 2 diabetes
A 75-year-old male: D.
Nearly 25
...
1. Which patient could be expected to have the highest systolic blood pres-
sure?
A 21-year-old male
A 50-year-old perimenopausal female
A 35-year-old patient with Type 2 diabetes
A 75-year-old male: D.
Nearly 25% of the US population has hypertension. The greatest incidence is in
older adults because of changes in the intima of vessels as aging and calcium
deposition occur. Males of any age are more likely to be hypertensive than females
of the same age. African American adults have the highest incidence in the
general population. Among adolescents, African Americans and Hispanics have
the highest rates. Hypertension occurs in 5-10% of pregnancies.
2. Mrs. Brandy is having contrast dye next week for a heart catheterization.
What drug does NOT need to be stopped prior to her catheterization?
Naproxen
Furosemide
Metformin
Losartan: D.
Naproxen and furosemide should be stopped for 24 hours prior to the catheter-
ization. Metformin should be stopped 48 hours prior to the catheterization.
Furosemide is stopped because it contributes to volume depletion. NSAIDs like
naproxen are withheld because of the impact on renal prostaglandin production.
Metformin has been implicated in lactic acidosis when combined with contrast dye
in an impaired kidney.
3. In older adults, the three most common ailments are:
hearing loss, vision loss, hypertension.
hearing loss, hypertension, arthritis.
depression, vision loss, hypertension.
arthritis, hearing loss, depression.: B.
Hypertension and arthritis are the two most common ailments in older adults.
Hearing loss occurs in half to almost 2/3 of older adults. The most common form
is known as presbycusis. There is no consensus for the frequency of screening
for hearing loss in older patients, but minimally, it should be grossly evaluated at
each visit and screened more thoroughly if deficits are observed. Blood pressure
should be screened annually, but it is usually screened at each visit. Arthritis is not
routinely screened.
4. Mr. Holbrook, a 75-year-old male, is a former smoker with a 30-pack-year
history. He has come in today for an annual exam. He walks daily for 25
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