Discussion on muscle and sarcopenia questions

Discussion on muscle and sarcopenia questions
Question 148
An 86-year-old widow presented as
an outpatient, with her son. She had
experienced three falls in the previous
year, none with any associated palpations or chest pain. She had a past history of osteoarthritis which limited
her mobility, hypertension, ischaemic
heart disease, urinary incontinence
and anxiety. She lived alone and was
afraid to go out very much. She was
taking aspirin, ramipril, bendroflumethiazide, verapamil, escitalopram
and oxybutynin. She was also taking
pseudoephedrine as a cough medicine
which she had bought over the counter.
What is the next most appropriate step
in the assessment of her falls?
A. gait and balance assessment
B. 24-hour electrocardiogram monitoring
C. medication review
D. serum electrolyte measurement
E. tilt-table test
Question 149
A 70-year-old woman presents to
the falls clinic, complaining of a sudden and transient loss of consciousness, which subsided spontaneously and
without a localising neurological deficit.
She had been to the GP recently with a
three-month history of ‘dizziness’. She
described several episodes of the room
spinning around her. These typically
lasted between two hours and a whole
day. She felt tired after these attacks. She
has noticed progressive hearing loss. No
diagnosis had been made. She had a past
history of glaucoma and hypertension.
What is the next most appropriate step to
help with diagnosis?
Falls and Poor Mobility 95
A. audiology review
B. ENT review
C. Epley manoeuvre
D. restriction of salt, caffeine or alcohol
E. vestibular rehabilitation
Question 150
Which of the following statements
concerning muscle and sarcopenia is
A. IL-10, an anti-inflammatory cytokine,
declines in the human circulation
with age
B. it is generally accepted that low physical performance is defined as any gait
speed of less than 1.6 m/sec
C. the function of ‘satellite cells’ in sarcopenia is normal
D. the relationship between loss of muscle mass and loss of muscle strength is
best described as linear
E. there is little evidence from human
studies of sarcopenia to suggest that
loss of muscle mass is primarily
driven by a blunted synthetic response
to both feeding and exercise
Question 151
Which of the following states concerning postural or orthostatic hypotension is
A. antigravity suits are commonly useful
in management
B. cardiac pacemakers are a first-line
treatment for postural hypotension
due to chronic neurogenic failure
C. drugs are needed when non-pharmacological approaches are unsuccessful
D. postural (orthostatic) hypotension is
defined as a fall in blood pressure of
over 10 mmHg systolic (or 5 mmHg
diastolic), on standing or during headup tilt to at least 60°
E. the generalised use of home blood
pressure monitoring should be
Question 152
Prolonged standing, change in posture
and hot environments are common precipitating factors for vasovagal syncope
(VVS). Which of the following statements about VVS is also true?
A. older people are significantly more
likely to report prolonged standing,
change in posture and hot environments as precipitating factors for VVS
compared to younger people
B. patients should be advised to ensure
adequate hydration and to avoid possible precipitants
C. the classic prodrome always accompanies VVS
D. there is no reliable diagnostic test to
support a diagnosis of VVS
E. VVS is relatively uncommon as a
diagnosis in older people

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