1. Mr. Lee is an 87 year old right-handed gentleman who lives at home alone. He presents to your ED after a fall, and you have determined he has a Colles fracture of his left wrist. He has a history of hypertension, hypothyroidism, and hypercholesterolemia. He is on Ramipril, Hydrochlorothiazide, Levothyroxine and Atorvastatin. On a brief functional review, you determine he has been to the ED once in the last 6 months for a viral URTI but has not been admitted. His vision and memory are “decent” according to him, and he is otherwise quite independent. From what you know now, what is Mr. Lee’s Identifying Seniors At Risk (ISAR) score?
2. Your next patient is Mrs. Lebowski, a 74 year old woman who lives with her two cats. She comes in to your ED with productive cough and fever for the past 24 hours, and you diagnose a pneumonia on chest x-ray. She does not meet SIRS criteria, and her CURB65 score is 1 after a thorough work-up. She has a caregiver who visits her daily for one hour, and was the one who sent her in. On discussing her case with the caregiver over the phone, you determine that she is nearly blind without her glasses, has significant memory problems, and is on 5 different medications. She was also admitted 3 months ago for sepsis secondary to a urinary tract infection. What would you do now and why?
3. Which of the following statements is FALSE about how older patients are different to younger adults in the ED?
4. One of the Activities of Daily Living is the most complicated, and often lost first in the elderly with functional impairment. A simple screen is often to ask about this complex ADL and if the patient is still capable of performing it they are often capable of performing the rest of their ADLs. Which Activity of Daily Living is it?
5. Which of the following statements contribute to the definition of “frailty” in the older patient population? Select all that apply