CCP Geriatric Patient Assessment 2 — Questions and Answers
Question 1: Which validated tool is specifically designed to assess nutritional status in elderly patients and includes BMI, weight loss, mobility, and appetite questions?
- Mini Nutritional Assessment (MNA) (Correct answer)
- Malnutrition Universal Screening Tool (MUST)
- Subjective Global Assessment (SGA)
- Nutritional Risk Screening 2002 (NRS-2002)
Correct answer: Mini Nutritional Assessment (MNA)
The Mini Nutritional Assessment (MNA) is a validated 18-item tool designed specifically for geriatric nutritional screening and assessment.
Question 2: A 78-year-old patient scores 22/30 on the MMSE. Which category does this score fall into?
- Normal cognition
- Mild cognitive impairment (Correct answer)
- Moderate dementia
- Severe dementia
Correct answer: Mild cognitive impairment
MMSE scores of 18–23 indicate mild cognitive impairment, while 24–30 is considered normal and below 18 indicates moderate to severe dementia.
Question 3: The STOPP/START criteria are used in geriatric pharmacotherapy to identify which of the following?
- Potentially inappropriate medications and prescribing omissions (Correct answer)
- Drug-drug interactions only
- Renal dosing adjustments
- Medication adherence barriers
Correct answer: Potentially inappropriate medications and prescribing omissions
STOPP (Screening Tool of Older Persons' Prescriptions) identifies potentially inappropriate medications, while START (Screening Tool to Alert to Right Treatment) identifies prescribing omissions.
Question 4: Which of the following is the most appropriate method to estimate renal function for drug dosing in a frail elderly patient with low muscle mass?
- Cockcroft-Gault using actual body weight (Correct answer)
- CKD-EPI creatinine equation
- 24-hour urine creatinine clearance
- Serum creatinine alone
Correct answer: Cockcroft-Gault using actual body weight
Cockcroft-Gault using actual body weight is recommended for drug dosing in elderly patients, though some guidelines suggest using ideal or adjusted body weight in obese patients.
Question 5: Which geriatric syndrome is characterized by unintentional weight loss >10 lbs in the past year, exhaustion, slow walking speed, weak grip strength, and low physical activity?
- Frailty (Correct answer)
- Sarcopenia
- Cachexia
- Deconditioning
Correct answer: Frailty
These five criteria constitute the Fried Frailty Phenotype; meeting 3 or more criteria defines frailty in older adults.
Question 6: An 82-year-old patient on warfarin presents with an INR of 5.8 and minor bleeding. Which is the most appropriate immediate intervention?
- Hold warfarin and administer oral vitamin K (Correct answer)
- Administer IV vitamin K and fresh frozen plasma
- Continue warfarin and recheck INR in 48 hours
- Switch to a direct oral anticoagulant immediately
Correct answer: Hold warfarin and administer oral vitamin K
For supratherapeutic INR (4.5–10) with minor bleeding, holding warfarin and administering oral vitamin K 1–2.5 mg is recommended per ACCP guidelines.
Question 7: Which outcome measure is most appropriate for evaluating functional status changes over time in a nursing home resident?
- Barthel Index (Correct answer)
- Glasgow Coma Scale
- APACHE II score
- Charlson Comorbidity Index
Correct answer: Barthel Index
The Barthel Index assesses independence in 10 activities of daily living and is widely validated for monitoring functional status in long-term care settings.
CCP Geriatric Patient Assessment 2
Which validated tool is specifically designed to assess nutritional status in elderly patients and includes BMI, weight loss, mobility, and appetite questions?