Order Parkinson’s disease assignment

Order Parkinson’s disease assignment
You are reviewing a man with
Parkinson’s disease in the outpatient
clinic. You are discussing starting him
on a dopamine agonist to improve his
symptom control. He has heard reports
in the media of people developing problems, including compulsive gambling, on
this type of treatment. He asks you to tell
him more about this potential adverse
effect. Which of the following statements
regarding impulse control disorders is
most likely to be accurate?
A. all dopaminergic medication must be
withheld initially
B. cognitive behaviour therapy is the
most effective treatment
C. increased risk in current smokers
D. only occurs with dopamine agonist
E. suggests the onset of Parkinson’s disease dementia
Question 65
An 81-year-old man is reviewed in the
outpatient clinic. He has been admitted
three times in the last year for exacerbations of COPD and has had another two
recent episodes of pneumonia. His comorbidities include ischaemic heart disease,
hypertension and a non-disabling stroke.
He currently uses a long-acting muscarinic dry powder inhaler and a short-acting beta-agonist as required to manage
his COPD. He still smokes around ten
cigarettes per day and does not want
to stop. He has no childhood history of
asthma. He scores well on cognitive testing and reports good adherence to his
medications. Osteoarthritis changes are
noted in his hands. No kyphosis, clubbing or cyanosis are present. He has mild
lung hyper-expansion both on examination and on his chest X-ray. Blood tests
showed his eosinophil count to be in the
normal range. What change to his therapy would be most appropriate to reduce
the risk of further COPD exacerbations?
A. add a long-acting beta-2 agonist dry
powder inhaler
B. add an inhaled corticosteroid dry
powder inhaler
C. start antibiotic prophylaxis with
D. switch to a long-acting beta-2 agonist
dry powder inhaler
E. switch to a long-acting muscarinic agonist metered dose inhaler via a spacer
Question 66
An 83-year-old woman has attended the
falls clinic due to having three falls in her
own home during the last three months.
Her past medical history includes type 2
diabetes, chronic renal impairment and
vascular dementia. She has previously
had problems managing her medications.
She lives alone. For diabetic control, she
receives a once daily subcutaneous insulin
injection that is administered by a district
nurse. What would be a suitable target
range for her HbA1c?
A. 48 to 53 mmol/mol (6.5% to 7.0%)
B. 53 to 59 mmol/mol (7.0% to 7.5%)
C. 59 to 64 mmol/mol (7.5% to 8.0%)
D. 64 to 75 mmol/mol (8.0% to 9.0%)
E. 75 to 86 mmol/mol (9.0% to 10.0%)
Question 67
A 72-year-old woman has attended
the outpatient clinic complaining of low
mood and constipation. Her only significant past history is a diagnosis of rheumatoid arthritis, for which she is taking
oral methotrexate. As part of her assessment, some blood tests were taken to
assess her thyroid function, the results of
which are shown below:

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