Geriatric

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Across
  1. 4. Cardioselective beta-1 blocker; used in HFrEF and hypertension
  2. 7. Elevated intraocular pressure; optic nerve damage; gradual visual field loss; eye drops
  3. 8. Overnight sleep study; gold standard for diagnosing sleep apnea and REM disorders
  4. 9. Breast cancer imaging screening; decisions individualized in elderly based on life expectancy
  5. 12. Dopamine precursor; primary treatment for motor symptoms of Parkinsons disease
  6. 13. Hormone required for type 1 DM and advanced type 2; hypoglycemia risk in elderly
  7. 16. Mini-Mental State Examination; score less than 24 suggests dementia
  8. 20. T-score of negative 2.5 or less on DEXA; each SD below peak bone mass doubles fracture risk
  9. 21. Aldosterone antagonist; used in HFrEF alongside ACE inhibitor and beta-blocker
  10. 23. Geriatric syndrome of diminished physiological reserve; defined by Frieds 5-criterion phenotype
  11. 26. Mood stabilizer; narrow therapeutic index; renal clearance decreases with age; toxicity risk
  12. 28. Anticonvulsant used for neuropathic pain; dose-reduce in renal impairment
  13. 30. Tremor bradykinesia rigidity; can be drug-induced by antipsychotics and metoclopramide
  14. 31. Montreal Cognitive Assessment; more sensitive than MMSE for MCI detection
  15. 33. Dual-Energy X-ray Absorptiometry; gold standard bone mineral density scan
  16. 34. Mild Cognitive Impairment; cognitive decline without ADL impairment; precursor to dementia
  17. 35. Loop diuretic; first-line for acute decompensated heart failure and volume overload
  18. 36. Pulmonary function test; FEV1 over FVC less than 0.70 confirms COPD diagnosis
  19. 39. Most common sustained arrhythmia requiring anticoagulation; fibrillation
  20. 41. Antimuscarinic for overactive bladder; high anticholinergic burden; Beers Criteria PIM
  21. 47. First-line analgesic in elderly; safer than NSAIDs; max 2-3g per day in elderly
  22. 48. Short-acting benzodiazepine; Beers Criteria PIM; high fall and delirium risk in elderly
  23. 49. Acute confusion; CAM criteria: acute onset inattention disorganized thinking or altered consciousness
  24. 53. Weekly oral bisphosphonate; first-line treatment for osteoporosis
  25. 55. Monosodium urate crystal arthritis; acute attacks in great toe; treated with colchicine
  26. 56. Annual IV bisphosphonate for osteoporosis; convenient for adherence
  27. 57. HMG-CoA reductase inhibitors; first-line for hyperlipidemia; myopathy risk in elderly
  28. 58. Magnetic Resonance Imaging; best modality for early osteomyelitis and soft tissue detail
  29. 61. NMDA receptor antagonist; indicated for moderate-to-severe Alzheimers disease
  30. 63. Impaired coordination and balance; cerebellar sign; seen in NPH and drug toxicity
  31. 64. Muscle breakdown with myoglobinuria; statin complication; elevated CK; renal failure risk
  32. 66. Gold standard colorectal cancer screening; every 10 years from age 50; needs bowel prep
Down
  1. 1. Bladder function testing; measures detrusor pressure and flow; diagnoses incontinence type
  2. 2. First-line oral antidiabetic; reduces hepatic glucose production; hold if eGFR less than 30
  3. 3. Long-acting benzodiazepine; Beers Criteria PIM; accumulates in elderly due to high Vd
  4. 5. Proton pump inhibitor; reduces GI risk with NSAIDs; long-term use reduces B12 and magnesium
  5. 6. Dihydropyridine calcium channel blocker; first-line for isolated systolic hypertension in elderly
  6. 10. ADP receptor antagonist antiplatelet; used post-MI and post-stroke; pairs with aspirin
  7. 11. NPH triad: gait disturbance cognitive decline urinary incontinence; LP-responsive
  8. 14. Atypical antipsychotic; black box warning for dementia-related psychosis; BPSD
  9. 15. Protein misfolding disorder; AL or AA type; causes restrictive cardiomyopathy and neuropathy
  10. 17. Vitamin K antagonist anticoagulant; requires INR monitoring; high fall risk in elderly
  11. 18. Continuous 24-48hr ECG monitor; used to detect arrhythmias causing syncope
  12. 19. Ultrasound of the heart; evaluates ejection fraction; key in heart failure workup
  13. 22. Most common arthritis; cartilage degeneration; Heberden nodes at DIP joints; no DMARDs
  14. 23. WHO fracture risk tool; calculates 10-year probability of major osteoporotic fracture
  15. 24. Serum protein; reduced in malnutrition; increases free drug concentrations in elderly
  16. 25. Table test used to reproduce and diagnose vasovagal syncope
  17. 27. Opioid contraindicated in elderly; normeperidine metabolite causes seizures
  18. 29. Bone mineral measurement technique used in DEXA scanning
  19. 32. SSRI antidepressant; first-line for late-life depression; QTc prolongation risk
  20. 37. Timed Up and Go test; greater than 12 seconds indicates high fall risk in elderly
  21. 38. Proximal muscle pain and stiffness; ESR elevated; responds to steroids; rheumatica
  22. 40. Low thyroid hormone; treated with levothyroxine; start at low dose 25-50 mcg in elderly
  23. 42. Brain Natriuretic Peptide; elevated in heart failure; guides diagnosis and management
  24. 43. Peripheral nerve damage; common diabetic complication; burning and numbness in hands and feet
  25. 44. ACE inhibitor; first-line for HFrEF diabetic nephropathy and post-MI
  26. 45. Cholinesterase inhibitor; first-line drug for mild-to-moderate Alzheimers disease
  27. 46. Alpha-1 blocker for BPH; reduces urinary obstruction; causes orthostatic hypotension
  28. 50. International Normalized Ratio; monitors warfarin therapy; target 2-3 for AF
  29. 51. Prostate-Specific Antigen; screening test for prostate cancer; individualize in elderly
  30. 52. Progressive cognitive decline impairing daily function; Alzheimers most common type
  31. 54. Cardiac glycoside; used for rate control in AF; narrow therapeutic index; toxic in renal impairment
  32. 59. Excessive bone remodeling disease; elevated alkaline phosphatase
  33. 60. Thyroid Stimulating Hormone; most sensitive test for thyroid dysfunction
  34. 62. Electrocardiogram; first test in syncope workup; detects arrhythmia and ischemia
  35. 65. Non-invasive vascular imaging ultrasound for DVT and carotid artery stenosis