Older LTC Cancer Eol1. A 81-year-old man who fell in the kitchen asks whether hip-protector pants are enough. What does NICE-aligned falls prevention emphasise in primary care? Select TWO correct statements.Select all that apply.A. Most appropriate: A multifactorial intervention (medicines, vision, strength/balance, home hazards), not hip protectors aloneB. The following is not the most appropriate next step: Hip protectors as the sole evidence-based intervention for all fallers for this presentation in this NHS general-practice settingC. Most appropriate: Prolonged bed rest to prevent the next fall in this NHS general-practice settingD. Most appropriate: Stopping all antihypertensive drugs indefinitely without review in this NHS general-practice settingCheck
Older LTC Cancer Eol2. A district nurse asks why you will not chase HbA1c of 48 mmol/mol in a woman with severe frailty and limited life expectancy. What is the key harm of tight control here? Select TWO correct statements.Select all that apply.A. Most appropriate: Hypoglycaemia, falls, and reduced quality of life with little long-term microvascular gainB. The following is not the most appropriate next step: Guaranteed progression to dialysis within a month if HbA1c is above 48 for this presentationC. Most appropriate: Immediate blindness if HbA1c is not 42D. Most appropriate: Mandatory conversion to a ketogenic dietCheck
Older LTC Cancer Eol3. A son wants 'Alzheimer's tablets started today' because his father failed a clock-draw while febrile with pneumonia. What is the most appropriate response?A. Start donepezil in the surgery this afternoonB. Do not diagnose dementia during delirium; reassess cognition after recoveryC. Certify young-onset Alzheimer's because the clock-draw was abnormal for this presentationD. Section under the Mental Health Act solely for a failed clock-drawCheck
Older LTC Cancer Eol4. A 74-year-old has 8 months of progressive memory loss and is not delirious. Before specialist referral, which NG97-aligned blood screen should general practice arrange for reversible causes?A. Only a random cortisol, omitting thyroid and B12B. Weekly tumour-marker panels as first-line dementia testsC. FBC, U&E, calcium, glucose, TFTs, B12 and folateD. No blood tests are ever required if the family 'already knows'Check
Older LTC Cancer Eol5. You consider a DNACPR recommendation for an 88-year-old with capacity who understands CPR outcomes. What does GMC guidance require?A. Complete the form in secret so as not to distress herB. Ask the receptionist to sign on her behalfC. Apply DNACPR to all residents on the street without conversation for this presentationD. Discuss the recommendation with her and explain why CPR would or would not be offeredCheck
Older LTC Cancer Eol6. A patient on a syringe driver receiving 30 mg subcutaneous morphine/24 h needs a PRN breakthrough opioid. What is the usual UK starting proportion of the regular 24-hour dose? Select TWO correct statements.Select all that apply.A. Most appropriate: About one-sixth of the 24-hour regular opioid doseB. The following is not the most appropriate next step: The entire 24-hour dose as a single extra bolus each timeC. Most appropriate: One-hundredth of the 24-hour dose onlyD. Most appropriate: A fentanyl patch 100 micrograms/hour added without calculationCheck
Older LTC Cancer Eol7. Family ask whether every dying patient at home must have a subcutaneous fluid drip. What is NG31-aligned advice?A. Insert a nasogastric tube in every dying patient in general practice for this presentation in this NHS general-practice settingB. Withhold all sips of fluid even if the patient wants themC. Give 3 litres of IV fluid daily in the sitting room as defaultD. Offer frequent mouth care and consider clinically assisted hydration individually; it is not mandatory for allCheck
Older LTC Cancer Eol8. A 69-year-old ex-smoker has a persistent cough. Platelets are 580 × 10⁹/L. NG12 lists thrombocytosis as a clue to which suspected cancer pathway action in this context? The most appropriate action is: Consider an urgent chest X-ray (and further suspected-cancer assessment) for possible lung cancerTRUE. TrueFALSE. FalseCheck
Older LTC Cancer Eol9. A 72-year-old still shops with a stick but needs help with heavy housework and bathes more slowly. Which CFS description fits mild frailty (CFS 5) rather than a dementia diagnosis?A. CFS 5 is synonymous with advanced Alzheimer's disease for this presentation in this NHS general-practice setting in this NHS general-practice settingB. CFS 5 means the person is dying within daysC. More evident slowing and need for help with higher-order ADLs, with relatively preserved independence in basic self-careD. CFS 5 can only be scored by a radiologistCheck
Older LTC Cancer Eol10. After a first mechanical trip over a rug, a 76-year-old is well with a normal examination. Which plan matches NICE multifactorial thinking rather than over-investigation?A. Urgent CT head for every trip even with no injury or neurological signs for this presentation in this NHS general-practice settingB. Lifelong high-dose codeine to 'stiffen' the legsC. Compulsory overnight hospital admission after every tripD. Medication review, vision/home-hazard check and strength-and-balance offer; not routine CT head in all well fallersCheck