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1. A 77-year-old woman is brought to the physician by her son for a routine health maintenance examination. She says that she feels well. Her son reports that 1 month ago, she got lost while driving home from the local supermarket. Two weeks ago, she forgot to turn off the stove after cooking dinner. She has been wearing bilateral hearing aids since audiometry 2 years ago showed bilateral high-frequency hearing loss. Her visual acuity corrected with glasses is 20/25 in both eyes. Neurologic examination shows mild fine tremors of the hands when the arms are outstretched; the tremor is not present at rest. Muscle strength is 5/5 in all extremities. Deep tendon reflexes are decreased at the ankles and 2+ elsewhere. Her gait is normal. Sensation to vibration is mildly decreased over
vibration is mildly decreased over the toes. On mental status examination, she is awake, alert, and conversant. Her language function is normal. She is oriented to person, place, and time and recalls one out of three objects after 10 minutes. Which of the following findings in this patient warrants further evaluation?
A) Decreased deep tendon reflexes at the ankles
B) Decreased sensation to vibration over the toes
C) High-frequency hearing loss
D) Memory loss
E) Tremor of the outstretched hands
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B) Decreased sensation to vibration over the toes
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and this one from NBME 3..a similar questions...
14. An 80-year-old man has had poor balance for 6 months. He has a history of hypertension treated with hydrochlorothiazide. His blood pressure is 136/86 mm Hg. Neurologic examination shows mild tremor of the hands when his arms are outstretched and decreased vibratory sensation at the knees. Deep tendon reflexes of the quadriceps and gastrocnemius-soleus muscles are hyperactive. Babinski's sign is present bilaterally. He is unable to stand with his eyes closed. Which of the following is most consistent with normal age-related changes?
O A) Babinski's sign
O B) Hyperactive deep tendon reflexes of the gastrocnemius-soleus muscles
O C) Inability to stand with the eyes closed
O D) Reduced vibratory sensation at the knees
0 E) Tremor of the outstretched hands
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buddy...I remember seeing some reference for it...could you plz..provide in some reference...I recall some online ref... mentioned these changes and stuff... ( i'm unable to find it now)
thanx in advance
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* Eyesight - loss of peripheral vision and decreased ability to judge depth. Decreased clarity of colors (for example, pastels and blues).
* Hearing - loss of hearing acuity, especially sounds at the higher end of the spectrum. Also, decreasing ability to distinguish sounds when there is background noise.
* Taste - decreased taste buds and saliva.
* Touch and Smell - decreased sensitivity to touch and ability to smell.
* Arteries - stiffen with age. Additionally, fatty deposits build up in your blood vessels over time, eventually causing arteriosclerosis (hardening of the arteries).
* Bladder - increased frequency in urination.
* Body Fat - increases until middle age, stabilizes until later in life, then decreases. Distribution of fat shifts - moving from just beneath the skin to surround deeper organs.
* Bones - somewhere around age 35, bones lose minerals faster than they are replaced.
* Brain - loses some of the structures that connect nerve cells, and the function of the cells themselves is diminished. "Senior moments" increase.
* Heart - is a muscle that thickens with age. Maximum pumping rate and the body's ability to extract oxygen from the blood both diminish with age.
* Kidneys - shrink and become less efficient.
* Lungs - somewhere around age 20, lung tissue begins to lose its elasticity, and rib cage muscles shrink progressively. Maximum breathing capacity diminishes with each decade of life.
* Metabolism - medicines and alcohol are not processed as quickly. Prescription medication requires adjustment. Reflexes are also slowed while driving, therefore an individual might want to lengthen the distance between him and the car in front and drive more cautiously.
* Muscles - muscle mass decline, especially with lack of exercise.
* Skin - nails grow more slowly. Skin is more dry and wrinkled. It also heals more slowly.
* Sexual Health - Women go through menopause, vaginal lubrication decreases and sexual tissues atrophy. In men, sperm production decreases and the prostate enlarges. Hormone levels decrease.
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shudnt the ans 2 Q.1 be D.memory loss as she cant find her way home n forgets 2 switch off the stove?
