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Prostate cancer screening — MCCQE Part 1 MCQ

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HardPreventive MedicineProstate cancer screeningMCCQE Part 1

A 78-year-old woman living independently reports two falls in the past six months and feels unsteady when turning. She takes six medications, wears bifocals, and has loose rugs on the stairs. Neurologic examination shows no acute focal deficit. Which intervention is most appropriate to reduce future falls?

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Correct answer: C — Arrange a multifactorial review plus progressive balance and strength exercise

Two recent falls and self-reported unsteadiness justify a multifactorial assessment and targeted prevention plan. This should examine gait and balance, orthostatic blood pressure, medications that cause dizziness or sedation, vision, footwear, cognition, cardiovascular and neurologic contributors, and home hazards. Progressive exercise that challenges balance and builds lower-limb strength is a core intervention; loose rugs and stair hazards should also be corrected. Bed rest worsens strength and balance and can increase risk. Sedatives are themselves important fall-risk medications. Routine neuroimaging is not a prevention strategy without a relevant acute presentation or focal finding. No vitamin supplement alone addresses her multiple modifiable risks. The plan should be individualized, feasible, and followed to confirm adherence and improvement.

Reference: Public Health Agency of Canada, Preventing Falls and Injuries for Older Adults: https://www.canada.ca/en/public-health/services/health-promotion/aging-seniors/preventing-falls-injuries-older-adults.html